VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00680
Package ID: USCOURTS-cofc-1_17-vv-00680
Petitioner: Cynthia A. Marcinik
Filed: 2017-07-17
Decided: 2018-10-17
Vaccine: Tdap
Vaccination date: 2015-10-28
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 25000

AI-assisted case summary:
Cynthia A. Marcinik filed a petition for compensation under the National Vaccine Injury Compensation Program on July 17, 2018. She alleged that she suffered a shoulder injury related to vaccine administration (SIRVA) caused by the Tetanus, Diphtheria, and acellular Pertussis (Tdap) vaccine she received on October 28, 2015. Ms. Marcinik stated that she received the vaccination in the United States, suffered residual effects for more than six months, and had not filed a civil action or received other compensation. The respondent denied that the Tdap vaccine caused her alleged SIRVA or any other injury. Despite the respondent's denial, the parties filed a joint stipulation on July 16, 2018, agreeing that compensation should be awarded. Chief Special Master Nora Beth Dorsey found the stipulation reasonable and adopted it as the decision of the Court. Pursuant to the stipulation, Ms. Marcinik was awarded a lump sum of $25,000.00 as compensation for all items of damages. Petitioner's counsel was Jeffrey A. Golvash of Brennan, Robins & Daley, P.C., and respondent's counsel was Colleen Clemons Hartley of the U.S. Department of Justice. The decision was issued on October 17, 2018.

Theory of causation field:
Petitioner Cynthia A. Marcinik alleged that the Tdap vaccine administered on October 28, 2015, caused a shoulder injury related to vaccine administration (SIRVA). The respondent denied causation. The parties filed a joint stipulation for compensation, which was adopted by Chief Special Master Nora Beth Dorsey. The stipulation did not detail the specific medical mechanism or expert opinions supporting the SIRVA claim, nor did it specify the exact nature of the injury beyond SIRVA. The award was a lump sum of $25,000.00 for all damages. The theory of causation was considered "Off-Table" in the provided data, indicating it was not presumed to be vaccine-related under the Vaccine Injury Table. Petitioner was represented by Jeffrey A. Golvash, and respondent by Colleen Clemons Hartley. The decision was issued on October 17, 2018.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00680-0
Date issued/filed: 2018-10-17
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 07/17/2018) regarding 27 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-00680-UNJ Document 41 Filed 10/17/18 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0680V
Filed: July 17, 2018
UNPUBLISHED
CYNTHIA A. MARCINIK,
Special Processing Unit (SPU); Joint
Petitioner,
Stipulation on Damages; Tetanus
v.
Diphtheria acellular Pertussis (Tdap)
Vaccine; Shoulder Injury Related to
SECRETARY OF HEALTH AND
Vaccine Administration (SIRVA)
HUMAN SERVICES,
Respondent.
Jeffrey A. Golvash, Brennan, Robins & Daley, P.C., Pittsburgh, PA, for petitioner.
Colleen Clemons Hartley, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
Dorsey, Chief Special Master:
On May 23, 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”) caused-in-fact by the tetanus, diphtheria, and acellular
pertussis (“Tdap”) vaccine she received on October 28, 2015. Petition at 1, ¶¶ 3, 12;
Stipulation, filed July 16, 2018, at ¶¶ 1-2, 4. Petitioner further alleges that she received
her vaccination in the United States, suffered the residual effects of her injury for more
than six months, and has not filed a civil action or received compensation for her injuries
alleged as vaccine caused. Petition at ¶¶ 3, 12-13; Stipulation at ¶¶ 3-5. “Respondent
denies that the Tdap vaccine caused petitioner’s alleged SIRVA or any other injury and
further denies that her alleged current disabilities are a sequela of a vaccine-related
injury.” Stipulation at ¶ 6.
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-00680-UNJ Document 41 Filed 10/17/18 Page 2 of 7
Nevertheless, on July 16, 2018, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. The undersigned
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 $25,000.00 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 § 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

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