VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00966
Package ID: USCOURTS-cofc-1_17-vv-00966
Petitioner: Rowena Adcox
Filed: 2017-07-18
Decided: 2018-05-16
Vaccine: influenza
Vaccination date: 2016-10-11
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 80000

AI-assisted case summary:
Rowena Adcox filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving the influenza vaccine in her left deltoid on October 11, 2016. The respondent, the Secretary of Health and Human Services, conceded that Ms. Adcox's injury was consistent with SIRVA and met the requirements of a Table injury claim. Based on this concession and the evidence of record, the Chief Special Master issued a ruling on entitlement, finding Ms. Adcox entitled to compensation. Subsequently, the parties reached a stipulation for damages. The respondent proffered an award of $80,000.00, representing all elements of compensation available under the Act, which Ms. Adcox agreed to. The Chief Special Master issued a decision awarding Ms. Adcox a lump sum payment of $80,000.00 for pain and suffering and other damages.

Theory of causation field:
Table

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_17-vv-00966-0
Date issued/filed: 2018-04-05
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 1/23/2018) regarding 15 Ruling on Entitlement. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
--------------------------------------------------------------------------------
Case 1:17-vv-00966-UNJ Document 25 Filed 04/05/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0966V
Filed: January 23, 2018
UNPUBLISHED
ROWENA ADCOX,
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.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
petitioner.
Darryl R. Wishard, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On July 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 injuries to include a shoulder injury related to
vaccine administration (“SIRVA”) after receiving the influenza vaccine in her left deltoid
on October 11, 2016. Petition at 1, ¶¶ 1, 5. Petitioner further alleges that she suffered
the residual effects of her injuries for more than six months, and neither she nor any
other party has received compensation for her injuries alleged as vaccine caused. Id. at
¶¶ 5-6. The case was assigned to the Special Processing Unit of the Office of Special
Masters.
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-00966-UNJ Document 25 Filed 04/05/18 Page 2 of 2
On January 23, 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 :has concluded that petitioner’s alleged injury is
consistent with SIRVA of the left arm, and that it meets the requirements of a Table
injury claim of SIRVA stemmming from the flu vaccination on October 11, 2016.” Id. at
4. Respondent further agrees that “based on the record as it now stands, petitioner
has satisfied all legal prerequisites for compensation under the 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

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_17-vv-00966-1
Date issued/filed: 2018-05-16
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 3/5/2018) regarding 21 DECISION Stipulation/Proffer. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
--------------------------------------------------------------------------------
Case 1:17-vv-00966-UNJ Document 26 Filed 05/16/18 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-966V
Filed: March 5, 2018
UNPUBLISHED
ROWENA ADCOX,
Special Processing Unit (SPU);
Petitioner,
Damages Decision Based on Proffer;
v.
Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
SECRETARY OF HEALTH AND
Administration (SIRVA)
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
petitioner.
Darryl R. Wishard, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On July 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 injuries to include a shoulder injury related to
vaccine administration (“SIRVA”) after receiving the influenza vaccine in her left deltoid
on October 11, 2016. Petition at 1, ¶¶ 1, 5. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On January 23, 2018, a ruling on entitlement was issued, finding petitioner
entitled to compensation for her SIRVA. On March 5, 2018, respondent filed a proffer
on award of compensation (“Proffer”) indicating petitioner should be awarded
$80,000.00. Proffer at 2. In the Proffer, respondent represented that petitioner agrees
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-00966-UNJ Document 26 Filed 05/16/18 Page 2 of 5
with the proffered award. Id. 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 $80,000.00 in the form of a check payable to
petitioner, Rowena Adcox. This amount represents compensation for all damages
that would be available under § 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-00966-UNJ Document 26 Filed 05/16/18 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
ROWENA ADCOX, )
)
Petitioner, ) No. 17-966V ECF
)
v. ) Chief Special Master Dorsey
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
___________________________________ )
PROFFER ON AWARD OF COMPENSATION1
I. Procedural History
On July 18, 2017, Rowena Adcox (“petitioner”) filed a petition for compensation
(“Petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -
34, as amended. She alleges that, as a result of receiving the influenza (“flu”) vaccine on
October 11, 2016, she suffered from a left shoulder injury related to vaccine administration
(“SIRVA”). Petition at 1-2. On January 23, 2018, respondent filed his Vaccine Rule 4(c) report,
conceding causation-in-fact for a SIRVA to petitioner’s left arm. On January 23, 2018, the Chief
Special Master issued a ruling on entitlement, finding that petitioner was entitled to
compensation for a SIRVA to petitioner’s left arm.
II. Items of Compensation
Petitioner has alleged entitlement to the following elements of compensation: past and
future pain and suffering; past unreimbursed expenses; and, projected unreimbursable expenses.
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to
address after the Damages Decision is issued.

Case 1:17-vv-00966-UNJ Document 26 Filed 05/16/18 Page 4 of 5
Based upon the evidence of record, respondent proffers that petitioner should be awarded
$80,000.00, which represents all elements of compensation to which petitioner would be entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
III. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $80,000.00, in the form of a check payable to petitioner.2
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
2 Should petitioner die prior to entry of judgment, respondent would oppose any award
for future medical expenses, future lost earnings, and future pain and suffering, and the parties
reserve the right to move the Court for appropriate relief.
2

Case 1:17-vv-00966-UNJ Document 26 Filed 05/16/18 Page 5 of 5
/s/Darryl R. Wishard
DARRYL R. WISHARD
Senior Trial Attorney
Torts Branch, Civil Division
U. S. Department of Justice
P.O. Box l46, Benjamin Franklin Station
Washington, D.C. 20044-0146
Direct dial: (202) 616-4357
Dated: March 5, 2018 Fax: (202) 616-4310
3