VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00895
Package ID: USCOURTS-cofc-1_17-vv-00895
Petitioner: Derek Molina
Filed: 2017-06-30
Decided: 2018-10-23
Vaccine: influenza
Vaccination date: 2016-10-04
Condition: left shoulder injury
Outcome: compensated
Award amount USD: 93409

AI-assisted case summary:
Derek Molina filed a petition for compensation under the National Vaccine Injury Compensation Program on June 30, 2017. He alleged that he suffered a left shoulder injury as a result of an influenza vaccine administered on October 4, 2016. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report on March 5, 2018, conceding that Mr. Molina was entitled to compensation. The respondent agreed that the alleged injury was consistent with Shoulder Injury Related to Vaccine Administration (SIRVA), a condition listed on the Vaccine Injury Table. The respondent noted that Mr. Molina had no prior history of left shoulder pain, inflammation, or dysfunction, that medical records documented pain occurring within 48 hours after the intramuscular vaccination, that the pain was limited to the shoulder where the vaccine was administered, and that no other condition explained the shoulder pain. The respondent also agreed that Mr. Molina suffered residual effects for more than six months and that all legal prerequisites for compensation were met. Based on the respondent's concession and the evidence, Chief Special Master Nora Beth Dorsey issued a Ruling on Entitlement on March 23, 2018, finding Mr. Molina entitled to compensation. Subsequently, on August 23, 2018, the parties filed a stipulation regarding damages. The respondent submitted a proffer recommending an award of $93,409.05, which Mr. Molina agreed to. On October 23, 2018, Chief Special Master Dorsey issued a Decision Awarding Damages, awarding Derek Molina a lump sum payment of $93,409.05, payable by check to him, as compensation for all damages. Petitioner counsel was John Robert Howie of Howie Law, PC, and respondent counsel was Mallori Browne Openchowski of the U.S. Department of Justice.

Theory of causation field:
Petitioner Derek Molina received an influenza vaccine on October 4, 2016, and subsequently developed a left shoulder injury, diagnosed as Shoulder Injury Related to Vaccine Administration (SIRVA). The respondent conceded entitlement, agreeing that the injury was consistent with SIRVA, a condition listed on the Vaccine Injury Table. The respondent's concession was based on the absence of prior shoulder issues, onset of pain within 48 hours post-vaccination, localized pain to the vaccination site, and lack of alternative explanations. Petitioner suffered residual effects for over six months, satisfying the Table requirements. The case proceeded as a Table claim. Chief Special Master Nora Beth Dorsey issued a Ruling on Entitlement on March 23, 2018. Damages were stipulated, and on October 23, 2018, Chief Special Master Dorsey awarded Derek Molina $93,409.05 as a lump sum. Petitioner counsel was John Robert Howie, and respondent counsel was Mallori Browne Openchowski.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00895-0
Date issued/filed: 2018-06-12
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 3/23/2018) regarding 24 Ruling on Entitlement. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:17-vv-00895-UNJ Document 30 Filed 06/12/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-895V
Filed: March 23, 2018
UNPUBLISHED
DEREK MOLINA,
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 Robert Howie, Howie Law, PC, Dallas, TX, for petitioner.
Mallori Browne Openchowski, U.S. Department of Justice, Washington, DC, for
respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On June 30, 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 he suffered a left shoulder injury as a result of an influenza
(“flu”) vaccine administered on October 4, 2016. Petition at 1. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On March 5, 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 alleged injury is consistent with
a shoulder injury related to vaccine administration (“SIRVA”), as defined on the Vaccine
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-00895-UNJ Document 30 Filed 06/12/18 Page 2 of 2
Injury Table. Specifically, petitioner had no history of pain, inflammation, or dysfunction
of his left shoulder; medical records document that pain occurred within 48 hours after
receipt of an intramuscular vaccination; pain was limited to the shoulder in which the
vaccine was administered; and no other condition or abnormality has been identified to
explain petitioner’s shoulder pain.” Id. at 4. Respondent further agrees that petitioner
suffered residual effects of his condition for more than six months and that all legal
prerequisites for compensation under the Vaccine Act have been satisfied. 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-00895-1
Date issued/filed: 2018-10-23
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 08/23/2018) 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-00895-UNJ Document 46 Filed 10/23/18 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0895V
Filed: August 23, 2018
UNPUBLISHED
DEREK MOLINA,
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.
John Robert Howie, Howie Law, PC, Dallas, TX, for petitioner.
Mallori Browne Openchowski, U.S. Department of Justice, Washington, DC, for
respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On June 30, 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 he suffered a left shoulder injury as a result of an influenza
(“flu”) vaccine administered on October 4, 2016. Petition at 1. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On March 23, 2018, a ruling on entitlement was issued, finding petitioner entitled
to compensation for SIRVA. On August 23, 2018, respondent filed a proffer on award of
compensation (“Proffer”) indicating petitioner should be awarded $93,409.05. Proffer at
1. In the Proffer, respondent represented that petitioner agrees with the proffered
award. Id. Based on the
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-00895-UNJ Document 46 Filed 10/23/18 Page 2 of 4
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 $93,409.05 in the form of a check payable to
petitioner, Derek Molina. This amount represents compensation for all damages that
would be available.
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-00895-UNJ Document 46 Filed 10/23/18 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
DEREK MOLINA, )
)
Petitioner, )
) No. 17-895V
v. ) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND HUMAN )
SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On March 5, 2018, respondent concededed that entitlement to compensation was
appropriate under the terms of the Vaccine Act. Thereafter, on March 23, 2018, Chief Special
Master Dorsey issued a Ruling on Entitlement finding that petitioner was entitled to vaccine
compensation for his Shoulder Injury Related to Vaccine Administration (“SIRVA”). Based on
the evidence of record, respondent proffers that petitioner should be awarded $93,409.05. This
amount represents all elements of compensation to which petitioner would be entitled under 42
U.S.C. § 300aa-15(a).1 Petitioner agrees.
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
a lump sum payment of $93,409.05, in the form of a check payable to petitioner. Petitioner
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 lost earnings
and future pain and suffering.

Case 1:17-vv-00895-UNJ Document 46 Filed 10/23/18 Page 4 of 4
agrees.
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
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
s/ Mallori B. Openchowski
MALLORI B. OPENCHOWSKI
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Ben Franklin Station
Washington, DC 20044-0146
Tel.: (202) 305-0660
DATED: August 23, 2018