VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00341
Package ID: USCOURTS-cofc-1_17-vv-00341
Petitioner: Alicia Debusca
Filed: 2017-03-13
Decided: 2018-09-05
Vaccine: influenza
Vaccination date: 2014-10-23
Condition: severe right shoulder pain
Outcome: compensated
Award amount USD: 55000

AI-assisted case summary:
Alicia Debusca filed a petition on March 13, 2017, seeking compensation under the National Vaccine Injury Compensation Program. She alleged that she received an influenza ("flu") vaccination on or about October 23, 2014, and subsequently suffered severe right shoulder pain, with residual effects lasting more than six months. The respondent denied that the flu vaccine caused the alleged injury or any other injury. The parties, however, filed a joint stipulation on May 29, 2018, agreeing to settle the case. The stipulation noted that the influenza vaccine is contained in the Vaccine Injury Table. Chief Special Master Nora Beth Dorsey adopted the stipulation as the decision of the Court. Pursuant to the stipulation, Alicia Debusca was awarded a lump sum of $55,000.00, payable to her, as compensation for all items of damages available under the Vaccine Act. This award represents a compromise of the parties' respective positions on liability and damages. Petitioner was represented by Randall G. Knutson of Knutson & Casey Law Firm. Respondent was represented by Glenn Alexander MacLeod of the U.S. Department of Justice.

Theory of causation field:
Petitioner Alicia Debusca alleged that a flu vaccine received on or about October 23, 2014, caused severe right shoulder pain and residual effects lasting more than six months. The respondent denied causation. The parties filed a joint stipulation agreeing to settle the case, acknowledging that the influenza vaccine is on the Vaccine Injury Table. The case was resolved via stipulation, with Chief Special Master Nora Beth Dorsey awarding $55,000.00 as a lump sum. The public decision does not describe the specific mechanism of injury, expert testimony, or detailed clinical findings. Petitioner was represented by Randall G. Knutson, and respondent by Glenn Alexander MacLeod. The award represents a compromise of liability and damages.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00341-0
Date issued/filed: 2018-09-05
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 05/29/2018) regarding 41 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-00341-UNJ Document 50 Filed 09/05/18 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-341V
Filed: May 29, 2018
UNPUBLISHED
ALICIA DEBUSCA,
Special Processing Unit (SPU); Joint
Stipulation on Damages; Influenza
Petitioner,
(Flu) Vaccine; Shoulder Injury
v.
Related to Vaccine Administration
(SIRVA)
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Randall G. Knutson, Knutson & Casey Law Firm, Mankato, MN, for petitioner.
Glenn Alexander MacLeod, U.S. Department of Justice, Washington, DC, for
respondent.
DECISION ON JOINT STIPULATION1
Dorsey, Chief Special Master:
On March 13, 2017, petitioner filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.,2 (the
“Vaccine Act”). Petitioner alleges that she suffered severe right shoulder pain as a
consequence of the influenza (“flu”) vaccination she received on or about October 23,
2014. Petition at 1; Stipulation, filed May 29, 2018, at ¶ 4. Petitioner further alleges that
she suffered the residual effects of this injury for more than six months.. Petition at 2;
Stipulation at ¶ 4. “Respondent denies that the flu vaccine caused petitioner's alleged
right shoulder pain, or any other injury, and further denies that her current disabilities
are a sequel a of a vaccine related injury. ” Stipulation at ¶ 6.
Nevertheless, on May 29, 2018, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. The undersigned
1 Because this unpublished decision contains a reasoned explanation for the action in this case, the
undersigned intends to post it on the United States Court of Federal Claims' website, in accordance with
the E-Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of
Electronic Government Services). In accordance with Vaccine Rule 18(b), petitioner has 14 days to
identify and move to redact medical or other information, the disclosure of which would constitute an
unwarranted invasion of privacy. If, upon review, the undersigned agrees that the identified material fits
within this definition, the undersigned will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for
ease of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:17-vv-00341-UNJ Document 50 Filed 09/05/18 Page 2 of 7
finds the stipulation reasonable and adopts it as the decision of the Court in awarding
damages, on the terms set forth therein.
Pursuant to the terms stated in the attached Stipulation, the undersigned
awards the following compensation:
A lump sum of $55,000.00 in the form of a check payable to petitioner.
Stipulation at ¶ 8. This amount represents compensation for all items of
damages that would be available under 42 U.S.C. § 300aa-15(a). Id.
The undersigned approves the requested amount for petitioner’s compensation.
In the absence of a motion for review filed pursuant to RCFC Appendix B, the clerk of
the court is directed to enter judgment in accordance with this decision.3
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice
renouncing the right to seek review.
2

Case 1:17-vv-00341-UNJ Document 50 Filed 09/05/18 Page 3 of 7
IN THE UNITED STATRS COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
'
ALICI1\ DEBUSCA, '
'
'
Petitioner,
v. * No. 17-341Y (ECF)
' CHIEF SPECIAL MASTER
' NORA BETH DORSEY
'
SECRETARY OF HEALTH
AND HUMAN SERVICES, '
'
'
Respondent.
* * * * * * * * * * * * * '* * * * * * * * * * * * * * * *
STIPULATION
l'he pa1ties hereby stipulate to the fol\oiving n1atters:
1. Petitioner filed a petition tOr vaccine compensation under the National Vaccine Injury
Compensation llrogram, 42 U.S.C. § JOOaa-10 to 34 (the "Vaccine Program"). The petition
seeks compens_ation for injuries allegedly related to petitioner's receipt of trivalent influenza
("flu") vaccine, \Vhich vai.:cinc is contained in the Vaccine Injury Table (the '·Table"). 42 C.F.R.
§I
00.J(a).
2. Petitioner received the flu vaccine on or about October 23, 2014.
3. 'fhe vaccine v,ias administered within the United States.
4. Petitioner alleges that she suffered severe right shoulder pain as a consequence of the
flu imn1unization she received on or about October 23, 2014, and further alleges that she suffered
the residual effects of this injury for more than 'Six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for da1nages on her behalf as a result of her condition.
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Case 1:17-vv-00341-UNJ Document 50 Filed 09/05/18 Page 4 of 7
6. Respondent denies that the tlu vaccine caused petitioner's alleged right shoulder pain,
or any other injury, and further denies that her current disabilities are a sequel a of a vaccine-
related injury.
7. Maintaining their above-stated positions, the pa11ies nevertheless now agree that the
issues betw-cen them shall be settled and that a decision should be entered a\varding the
ccimpensation described in paragraph 8 of this Stipulation.
8 A.s soon as practicable after an entry of judgment reflecting a decision consistent \.Vith
. .
the terms of this Stipulation. and after petitioner has filed an election to receive coinpensation
pursuant to 42 TJ.S.C. § 300aa-21 (a)(l), the Secretary of I'Iealth and f·luman Services will issue
the fol!o,ving vaccine compensation pay1nent:
A lump sum ofSSS,000.00, which a1nount represents compensation for all
eletnents of damages available to petitioner under 42 U.S.C. § 300aa-15(a). in the
tOrm of a check payable to petitioner.
9. As soon as practicable after the entry of judgment on entitlement in this case, and a�er
petitioner has filed both a proper and timely election to receive con1pensation pursuant to 42
C.S.C. § 300aa-2 I (a)(I ), and an application, the parties \Vill submit to further proceedings before
the special master to award reasonable attorneys' fees and costs incurred in proceeding upon this
petition.
I 0, Petitioner and her attorney represent that they have identified to respondt:nt all
known sources of payment tor items Or services for \Vhich the Program is not primarlly liable
under42 lJ.S.C. § 300aa-15(g), including State co1npensation programs, insurance policies,
Federal or State health benefits programs (other than Title XIX of the Social Security Act (42
lJ.S.C. § 1396 et seq.)), or entities that provide health services on a prepaid basis.
Page 2 of5

Case 1:17-vv-00341-UNJ Document 50 Filed 09/05/18 Page 5 of 7
11. Payment made pursuant to paragraph 8 of this Stipulation and any amounts awarded
pursuant to paragraph 9 will be tnade in accordance with 42 U.S.C. § 300aaM15(i). subject to the
availability of sufficient statutory funds.
12. The parties and their attorneys further agree and stipulate that, except for any award
for attorney's fees and litigation costs, the 1noney provided pursuant to this Stipulatlon will be
used solely for the benefit of petitioner as conten1plated by a strict construction of 42 U.S.C,
§ 300aa�l5(a) and (d), and subject to the conditions of 42 U.S.C. § 300aa-15(g) and (h).
13. In return tbr the payments described in paragraphs 8 and 9. petitioner, in her
individual capacity, and on behalf of her heirs, executors, administrators, successors. and assigns.
does forever irrevocably and unconditionally release. acquit and discharge the United States and
the Secretary of f-Iea!th and I-luman Services fi-01n any and all actions or causes of action
(including agreements, judgments, claims, da1nages, loss of services, expenses and all demands
of \Vhatever kind or nature) that have been brought, could have been -brought, or could be timely
brought in the United States Court of Federal Clain1s, under the National Vaccine Injury
Compensation Progra1n, 42 lJ.S.C. § 300aaM10 et seq., on account of, or in any way gro\ving out
of, any and all kno\vn or unkno\vn, suspected or unsuspected personal injuries to or death of
petitioner resulting from, or alleged to have resulted fi·o1n, the t1u vaccination administered on or
about October 23, 2014, as alleged by petitioner in a petition for vaccine compensation filed on
or about r-...1arch 13, 2017. in the United States Court of Federal Claiins as petition No. 17M341V .
14. lf petitioner should die prior to entry ofjudgn1ent., this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
15. If the special master fails to issue a decision in complete confor1nlty with the terms
of this Stipulation or if the lJnited States Court of Federal Claims fails to enter judg1nent in
Page 3 of5

Case 1:17-vv-00341-UNJ Document 50 Filed 09/05/18 Page 6 of 7
confonnity with a decision that is in co1nplete conformity \Vith the terms of this Stipulation, then
the parties' settlen1ent and this Stipulation shall be voidable at the sole discretion of either parry.
16. 'l'his Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury· Act of 1986. as amended, except
as othef',.vise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the a\vard described in this
Stipulation n1ay reflect a compro1nise of the parties· respective positions as to liability and/or
amount of da1nagcs, and further, that a change in the nature of the injury or condition or in the
items of co1npensation sought, is not grounds to 1nodify or revise this agreement.
17. This Stipulation shall not be constnied as an admission by the United States or the
Secretary of tlealth and t-luman Services that the flu vaccine caused petitioner's alleged right
shoulder pain, or any other injury or any of her current disabilities.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
Page 4 of5

Case 1:17-vv-00341-UNJ Document 50 Filed 09/05/18 Page 7 of 7
Respectfully submitted,
PETITIONER:
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ALICIA DEBUSCA
AUTHORIZED REPRESENTATIVE
OF THE ATTORNEY GENERAL:
((A';Th(I/� f flu "'UJ
ht_, Pk� yt{ltL.J�W­
RANDALL . K UTSON, ESQ.,. cAT HARfNE E. REEVES
KNUTSON CASEY LAW FIRM Deputy Director
l 96 St. Andrews Drive, Suite I 00 Torts Branch
Mankato, MN 5600 l Civil Division
Tel: 507-344-8888 U. S. Department of Justice
P. 0. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
AUTHORIZED REPRESENTATIVE OF ATTORNEYOFRECORDFOR
THE SECRET ARY OF HEALT R AND RESPONDENT:
HUMAN SERVICES:
NARAYAN NAIR, M.iY
Director, Division oflnjury Senior Trial Counsel
Compensation Programs Torts Branch, Civil Division
Healthcare Systems Bureau U.S. Department of Justice
Health Resources and Services Administration P.O. Box 146
U.S. Department of Health Benjamin Franklin Station
and Human Services Washington, D.C. 20044-0146
5600 Fishers Lane Tel: (202) 616-4122
Parkl awn Building, Stop-08N l 46B
Rockville, MD 20857 _S"i..&1 .-- µ
_<{
__
Dated: _
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