Larry Wolford v. HHS - Influenza, right shoulder injury related to vaccine administration (SIRVA) (2022)
Case summary [AI summaries can sometimes make mistakes]
On March 29, 2017, Larry Wolford filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that an influenza vaccine administered on November 11, 2015, caused a right shoulder injury related to vaccine administration (SIRVA). Mr.
Wolford, who was 53 years old at the time of vaccination, reported experiencing aching and stiffness the evening of the vaccination, with pain disturbing his sleep and worsening over the next day or two. He testified that the administering nurse felt the needle "tighten up" and "jerk" during administration.
His wife corroborated that the nurse commented on the "jerk" and warned of soreness. Mr.
Wolford began using a compression sock as a sling and found relief with Tylenol, ibuprofen, and Icy Hot. He was unable to comb his hair due to restricted arm movement.
Due to Dr. Patel's unavailability, Mr.
Wolford did not see another medical provider until February 16, 2016, approximately 97 days after vaccination, when he presented to chiropractor Dr. Jarrod Thacker with severe shoulder and arm pain.
Dr. Thacker diagnosed impingement syndrome and bursitis, providing exercises and stretches.
Mr. Wolford continued treatment with Dr.
Thacker through November 2016. An MRI of his right shoulder on March 1, 2016, showed changes consistent with impingement syndrome or bursitis.
Orthopedist Dr. Jamie Varney, whom Mr.
Wolford saw on April 18, 2016, diagnosed impingement syndrome and bursitis, noting that while MRIs showed chronic tendinopathy and bursitis, it was unlikely the flu shot caused the damage, suggesting pre-existing conditions and a downward sloping acromion. Dr.
Varney administered a cortisone injection. Petitioner's experts, Dr.
Jeffrey Boyd and Dr. Tony Korman, opined that the flu vaccine caused Mr.
Wolford's SIRVA through an immune-mediated inflammatory reaction due to unintentional injection into synovial tissues. They noted that pre-existing conditions could be aggravated by vaccination.
Respondent's expert, Dr. Paul Cagle, opined that the flu vaccination did not cause Mr.
Wolford's symptoms, attributing them to pre-existing conditions and occupational history, and questioning whether a standard needle could over-penetrate the deltoid muscle. Special Master Nora Beth Dorsey issued a Ruling on Entitlement on July 9, 2021, finding that Mr.
Wolford proved by a preponderance of the evidence that the flu vaccine caused his right shoulder injury, satisfying all three prongs of the Althen test. A separate damages decision was issued on August 5, 2022.
The Special Master awarded Mr. Wolford $70,000.00 for pain and suffering and $1,971.85 for out-of-pocket medical expenses, totaling $71,971.85.
Theory of causation
Larry Wolford, age 53, received an influenza vaccine on November 11, 2015. He alleged and proved by a preponderance of the evidence that the vaccine caused a right shoulder injury related to vaccine administration (SIRVA), specifically impingement syndrome and bursitis. Petitioner's experts, Dr. Jeffrey Boyd and Dr. Tony Korman, proposed a mechanism involving unintentional injection of antigenic material into synovial tissues, leading to an immune-mediated inflammatory reaction and subsequent bursitis and impingement syndrome, consistent with the "Off-Table" theory for SIRVA. They argued that pre-existing conditions, while present, were asymptomatic prior to vaccination and were aggravated by the vaccine. Respondent's expert, Dr. Paul Cagle, disagreed, attributing the symptoms to pre-existing conditions and occupational history, and questioning the likelihood of needle over-penetration. Special Master Nora Beth Dorsey found that Mr. Wolford satisfied the three prongs of the Althen test: a sound medical theory (supported by Atanasoff et al. and respondent's own recognition of SIRVA as a vaccine-related injury), a logical sequence of cause and effect (onset of symptoms within 48 hours of vaccination, with a clear progression of shoulder pain and limitations despite pre-existing conditions), and a proximate temporal relationship (symptoms beginning the evening of vaccination). The Special Master awarded $70,000.00 for pain and suffering and $1,971.85 for out-of-pocket medical expenses, totaling $71,971.85. Petitioner was represented by Isaiah Richard Kalinowski and Kyle Edward Pozza. Respondent was represented by Kyle Edward Pozza. Special Master Nora Beth Dorsey issued the entitlement ruling on July 9, 2021, and the damages decision on August 5, 2022.