VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00544
Package ID: USCOURTS-cofc-1_17-vv-00544
Petitioner: Natasha Itchkavich
Filed: 2017-04-18
Decided: 2018-08-29
Vaccine: influenza
Vaccination date: 2015-10-07
Condition: right shoulder injury
Outcome: compensated
Award amount USD: 85991

AI-assisted case summary:
Natasha Itchkavich filed a petition for compensation on April 18, 2017, alleging she suffered a right shoulder injury as a result of receiving an influenza vaccine on October 7, 2015. The respondent filed a Rule 4(c) report conceding that the petitioner's claim met the Table criteria for Shoulder Injury Related to Vaccine Administration (SIRVA). The respondent noted that the petitioner had no prior history of shoulder issues, experienced pain within 48 hours of vaccination, and the pain was limited to the injected shoulder, with no other condition explaining the symptoms. The ruling on entitlement was issued on November 28, 2017, by Chief Special Master Nora Beth Dorsey, finding the petitioner entitled to compensation. Subsequently, on May 1, 2018, the respondent filed a proffer recommending an award of $85,991.00, which the petitioner agreed to. On August 29, 2018, Chief Special Master Nora Beth Dorsey awarded Natasha Itchkavich a lump sum payment of $85,991.00. Petitioner was represented by John Caldwell and Joseph Alexander Vuckovich of Maglio Christopher & Toale, PA. Respondent was represented by Justine Elizabeth Walters of the U.S. Department of Justice.

Theory of causation field:
Petitioner Natasha Itchkavich filed a petition alleging a right shoulder injury after receiving an influenza vaccine on October 7, 2015. The respondent conceded that the claim met the Table criteria for SIRVA, noting the absence of prior shoulder issues, onset of pain within 48 hours of vaccination, pain limited to the injected shoulder, and no other explanatory condition. The ruling on entitlement was issued on November 28, 2017, by Chief Special Master Nora Beth Dorsey. A subsequent proffer on award of compensation, filed on May 1, 2018, recommended $85,991.00, which the petitioner agreed to. On August 29, 2018, Chief Special Master Dorsey awarded petitioner Natasha Itchkavich a lump sum payment of $85,991.00. Petitioner counsel was John Caldwell and Joseph Alexander Vuckovich; respondent counsel was Justine Elizabeth Walters.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00544-0
Date issued/filed: 2018-03-01
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 11/28/2017) regarding 20 Ruling on Entitlement. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:17-vv-00544-UNJ Document 32 Filed 03/01/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-544V
Filed: November 28, 2017
UNPUBLISHED
NATASHA ITCHKAVICH,
Special Processing Unit (SPU);
Petitioner, Ruling on Entitlement; Concession;
v. Table Injury; Influenza (Flu) Vaccine;
Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH AND Administration (SIRVA)
HUMAN SERVICES,
Respondent.
John Caldwell, Maglio Christopher & Toale, PA, Sarasota, FL, for petitioner.
Justine Elizabeth Walters, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On April 18, 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 right shoulder injury as a result of receiving
an influenza (“flu”) vaccine on October 7, 2015. Petition at 1. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On November 28, 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 “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
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-00544-UNJ Document 32 Filed 03/01/18 Page 2 of 2
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.” Id. at 4-5. Respondent
further agrees that petitioner suffered the residual effects of her injury for more than six
months, that the case was timely filed, and that the vaccine was received in the United
States. Id. at 5. Respondent further notes that petitioner has averred that no civil action
or proceeding was pursued in connection with the vaccine-related injury. Id.
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-00544-1
Date issued/filed: 2018-08-29
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 05/01/2018) regarding 38 DECISION Stipulation/Proffer, ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-00544-UNJ Document 47 Filed 08/29/18 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-544V
Filed: May 1, 2018
UNPUBLISHED
NATASHA ITCHKAVICH,
Special Processing Unit (SPU);
Damages Decision Based on Proffer;
Petitioner,
Influenza (Flu) Vaccine; Shoulder
v.
Injury Related to Vaccine
Administration (SIRVA)
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Joseph Alexander Vuckovich, Maglio Christopher & Toale, PA, Washington, DC, for
petitioner.
Justine Elizabeth Walters, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On April 18, 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 as a result of receiving an
influenza (“flu”) vaccination on October 7, 2015. Petition at 1. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On November 28, 2017, a ruling on entitlement was issued, finding petitioner
entitled to compensation for a shoulder injury related to vaccine administration
(“SIRVA”). On May 1, 2018, respondent filed a proffer on award of compensation
(“Proffer”) indicating petitioner should be awarded $85,991.00. Proffer at 1. In the
Proffer, respondent represented that petitioner agrees with the proffered award. Based
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-00544-UNJ Document 47 Filed 08/29/18 Page 2 of 4
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 $85,991.00 in the form of a check payable to
petitioner, Natasha Itchkavich. 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-00544-UNJ Document 47 Filed 08/29/18 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
NATASHA ITCHKAVICH, )
)
Petitioner, )
)
v. ) No. 17-544V
) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND ) SPU
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On April 18, 2017, petitioner, Natasha Itchkavich, filed a petition for compensation under
the National Childhood Vaccine Injury Act, 42 U.S.C. §§ 300aa-1 to -34 (“Vaccine Act”),
alleging that she developed a shoulder injury as a result of receiving an influenza vaccination on
October 7, 2015. On November 28, 2017, respondent filed a Rule 4(c) Report indicating that
petitioner is entitled to compensation for a shoulder injury related to vaccine administration
(“SIRVA”) as a result of her October 7, 2015, influenza vaccination. On November 28, 2017,
Chief Special Master Dorsey issued a Ruling on Entitlement finding that petitioner is entitled to
compensation for her SIRVA.
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
$85,991.00, which represents all elements of compensation to which petitioner is 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-00544-UNJ Document 47 Filed 08/29/18 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 $85,991.00 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
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
s/ Justine Walters__________
JUSTINE WALTERS
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) 307-6393
DATE: May 1, 2018
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