VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00469
Package ID: USCOURTS-cofc-1_17-vv-00469
Petitioner: Barbara Jayne
Filed: 2017-12-20
Decided: 2018-09-05
Vaccine: pneumococcal conjugate
Vaccination date: 2016-01-20
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 77746

AI-assisted case summary:
Barbara Jayne filed a petition for compensation under the National Vaccine Injury Compensation Program on December 20, 2017, alleging she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of a pneumococcal vaccine she received on January 20, 2016. The respondent conceded that petitioner's claim met the Table criteria for SIRVA, noting that she had no prior history of shoulder pain, experienced onset of pain within 48 hours of vaccination, and her pain was limited to the injected shoulder. The respondent also confirmed that the case was timely filed, the vaccine was received in the United States, and the statutory severity requirement was met. On September 5, 2018, a decision awarding damages was issued, granting Barbara Jayne a lump sum payment of $77,746.25, which included $77,500.00 for pain and suffering and $246.25 for past unreimbursable expenses.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00469-0
Date issued/filed: 2018-03-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/20/2017) regarding 22 Ruling on Entitlement. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:17-vv-00469-UNJ Document 27 Filed 03/15/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-469V
Filed: December 20, 2017
UNPUBLISHED
BARBARA JAYNE,
Special Processing Unit (SPU);
Petitioner, Ruling on Entitlement; Concession;
v. Table Injury; Pneumococcal
Conjugate Vaccine; Shoulder Injury
SECRETARY OF HEALTH AND Related to Vaccine Administration
HUMAN SERVICES, (SIRVA)
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
petitioner.
Christine Mary Becer, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On March 31, 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 a Shoulder Injury Related to
Vaccine Administration (“SIRVA”) as a result of her pneumococcal vaccine received on
January 20, 2016. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On December 18, 2017, respondent filed his Rule 4(c) report in which he
concedes that petitioner is entitled to compensation in this case. Respondent’s Rule
4(c) Report at 1. Specifically, respondent indicates that
1 Because this unpublished ruling 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-00469-UNJ Document 27 Filed 03/15/18 Page 2 of 2
DICP has reviewed the facts of this case and concluded that petitioner’s
claim meets the Table criteria for SIRVA. Specifically, petitioner had no
history of pain, inflammation or dysfunction of the affected shoulder prior
to intramuscular vaccine administration that would explain the alleged
signs, symptoms, examination findings, and/or diagnostic studies
occurring after vaccine injection; she suffered the onset of pain within
forty-eight hours of vaccine administration; her pain and reduced range of
motion were limited to the shoulder in which the intramuscular vaccine
was administered; and there is no other condition or abnormality present
that would explain petitioner’s symptoms. Therefore, petitioner is entitled
to a presumption of vaccine causation.
Id. at 3-4. Respondent further agrees that
With respect to other statutory and jurisdictional issues, the records show
that the case was timely filed, that the vaccine was received in the United
States, and that petitioner satisfies the statutory severity requirement by
suffering the residual effects or complications of her injury for more than
six months after vaccine administration. See 42 U.S.C. §§ 300aa-
11(c)(1)(D)(i). Petitioner avers that no civil action or proceedings have
been pursued in connection with the vaccine-related injury. See 42 U.S.C.
§§ 300aa-11(a)(5) and -11(c)(1)(E); Pet. Ex. 9. Thus, in light of the
information contained in petitioner’s medical records and affidavit,
respondent concedes that entitlement to compensation is appropriate
under the terms of the Vaccine Act.
Id. at 4.
In view of respondent’s position and the evidence of record, the
undersigned finds that petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master

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DOCUMENT 2: USCOURTS-cofc-1_17-vv-00469-1
Date issued/filed: 2018-09-05
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 05/10/2018) regarding 32 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-00469-UNJ Document 35 Filed 09/05/18 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-469V
Filed: May 10, 2018
UNPUBLISHED
BARBARA JAYNE,
Special Processing Unit (SPU);
Damages Decision Based on Proffer;
Petitioner,
Pneumococcal Conjugate Vaccine;
v.
Shoulder Injury Related to Vaccine
Administration (SIRVA)
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
petitioner.
Christine Mary Becer, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On March 31, 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 a Shoulder Injury Related to
Vaccine Administration (“SIRVA”) as a result of her pneumococcal vaccination received
on January 20, 2016. Petition at 1. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
On December 20, 2017, a ruling on entitlement was issued, finding petitioner
entitled to compensation for SIRVA. On May 9, 2018, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $77,746.25
($77,500.00 for pain and suffering and $246.25 for past unreimbursable expenses).
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-00469-UNJ Document 35 Filed 09/05/18 Page 2 of 4
Proffer at 1-2. In the Proffer, respondent represented that petitioner agrees with the
proffered award.
Based on the record as a whole, the undersigned finds that petitioner is entitled
to an award as stated in the Proffer.
Pursuant to the terms stated in the attached Proffer, the undersigned awards
petitioner a lump sum payment of $77,746.25 ($77,500.00 for pain and suffering
and $246.25 for past unreimbursable expenses) in the form of a check payable to
petitioner, Barbara Jayne. This amount represents compensation for all damages that
would be available under § 300aa-15(a).
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-00469-UNJ Document 35 Filed 09/05/18 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
BARBARA JAYNE, )
)
Petitioner, )
) No. 17-469V
v. ) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On December 18, 2017, respondent filed a Vaccine Rule 4(c) report concluding that
petitioner suffered an injury that is compensable under the National Childhood Vaccine Injury
Act of 1986, as amended, 42 U.S.C. §§300aa-10 to -34. Accordingly, on December 20, 2017,
the Chief Special Master issued a Ruling on Entitlement.
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
$77,746.25 ($77,500.00 for pain and suffering and $246.25 for past unreimbursable expenses)
which represents all elements of compensation to which petitioner would be entitled under 42
U.S.C. § 300aa-15(a).1 Petitioner agrees.
1 Should petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief. In particular, respondent would oppose any award for future medical
expenses, future lost earnings, and future pain and suffering.

Case 1:17-vv-00469-UNJ Document 35 Filed 09/05/18 Page 4 of 4
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be made
through a lump sum payment of $77,746.25 in the form of a check payable to petitioner.
Petitioner agrees.
Respectfully submitted,
CHAD A. READLER
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Deputy Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Assistant Director
Torts Branch, Civil Division
s/Christine Mary Becer
CHRISTINE MARY BECER
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-3665
Date: May 9, 2018
2