VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00690
Package ID: USCOURTS-cofc-1_17-vv-00690
Petitioner: Mona Ibrahim
Filed: 2018-01-05
Decided: 2018-09-05
Vaccine: influenza
Vaccination date: 2016-10-03
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 50467

AI-assisted case summary:
Mona Ibrahim filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she received an influenza vaccine on October 3, 2016, and subsequently suffered a shoulder injury related to vaccine administration (SIRVA). The respondent conceded that petitioner was entitled to compensation, agreeing that her medical course was consistent with a SIRVA as defined on the Vaccine Injury Table. A ruling on entitlement was issued on January 5, 2018, finding her eligible for compensation. Subsequently, on May 11, 2018, the respondent filed a proffer on award of compensation, recommending an award of $50,467.38. This amount included $467.38 for unreimbursed past expenses and $50,000.00 for past and future pain and suffering. Petitioner agreed with the proffered award. The Chief Special Master issued a decision awarding Mona Ibrahim a lump sum payment of $50,467.38 on September 5, 2018, representing compensation for all damages available under the Vaccine Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00690-0
Date issued/filed: 2018-04-18
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 1/5/2018) 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-00690-UNJ Document 31 Filed 04/18/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-690V
Filed: January 5, 2018
UNPUBLISHED
MONA IBRAHIM,
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.
Anne Carrion Toale, Maglio Christopher & Toale, PA, Sarasota, FL, for petitioner.
Daniel Anthony Principato, U.S. Department of Justice, Washington, DC, for
respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On May 24, 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 received an influenza (“flu”) vaccine on October 3,
2016, and thereafter suffered a shoulder injury related to vaccine administration
(“SIRVA”). Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On January 4, 2018, 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 believes that petitioner’s medical course is consistent with
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-00690-UNJ Document 31 Filed 04/18/18 Page 2 of 2
a SIRVA as defined on the Vaccine Injury Table Id. at 3. Respondent further agrees
that petitioner has satisfied all legal prerequisites for compensation under the Vaccine
Act. 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-00690-1
Date issued/filed: 2018-09-05
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 05/14/2018) regarding 36 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-00690-UNJ Document 40 Filed 09/05/18 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-690V
Filed: May 14, 2018
UNPUBLISHED
MONA IBRAHIM,
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.
Isaiah Richard Kalinowski, Maglio Christopher & Toale, PA, Washington, DC, for
petitioner.
Daniel Anthony Principato, U.S. Department of Justice, Washington, DC, for
respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On May 24, 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”) following the administration of an influenza (“flu”) vaccination
she received on October 3, 2016. Petition at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On January 5, 2018, a ruling on entitlement was issued, finding petitioner entitled
to compensation for a SIRVA. On May 11, 2018, respondent filed a proffer on award of
compensation (“Proffer”) indicating petitioner should be awarded $50,467.38
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-00690-UNJ Document 40 Filed 09/05/18 Page 2 of 4
representing $467.38 for unreimbursed past expenses and $50,000.00 for past and
future pain and suffering. Proffer at 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 $50,467.38 in the form of a check payable to
petitioner, Mona Ibrahim. 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-00690-UNJ Document 40 Filed 09/05/18 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
MONA IBRAHIM, )
)
Petitioner, ) No. 17-690V
) Chief Special Master Dorsey
v. ) ECF
)
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
)
PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On January 4, 2018, 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 January
5, 2018, the Chief Special Master issued a Ruling on Entitlement.
Respondent now proffers that, based on the evidence of record, petitioner should
be awarded $50,467.38. This amount represents all elements of compensation to which
petitioner would be entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Items of Compensation and Form of the Award
The parties recommend that the compensation provided to petitioner should be
made through lump sum payment described below, and request that the Chief Special
Master’s decision and the Court’s judgment award the following: 1
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 pain and suffering, and future lost wages.

Case 1:17-vv-00690-UNJ Document 40 Filed 09/05/18 Page 4 of 4
A. Petitioner’s Damages
A lump sum payment of $50,467.38 (representing $467.38 for unreimbursed past
expenses and $50,000.00 for past and future pain and suffering) in the form of a check
payable to petitioner, Mona Ibrahim.
B. Guardianship
Petitioner is a competent adult. Evidence of guardianship is not required in this
case.
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
GABRIELLE M. FIELDING
Assistant Director
Torts Branch, Civil Division
/s/ Daniel A. Principato
DANIEL A. PRINCIPATO
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Phone: (202) 616-3662
Fax: (202) 353-2988
Dated: May 11, 2018
2