VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00990 Package ID: USCOURTS-cofc-1_17-vv-00990 Petitioner: Barbara Stoliker Filed: 2017-07-21 Decided: 2020-09-14 Vaccine: influenza Vaccination date: 2014-09-30 Condition: Shoulder Injury Related to Vaccine Administration (SIRVA) Outcome: compensated Award amount USD: 121119 AI-assisted case summary: Barbara Stoliker filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a right Shoulder Injury Related to Vaccine Administration (SIRVA) after receiving an influenza vaccination on September 30, 2014. Initially, the respondent opposed compensation, but later conceded that the petitioner met the criteria for SIRVA, a Table injury. A ruling on entitlement was issued on December 11, 2018. The case proceeded to determine damages. The petitioner sought $170,000.00 for pain and suffering, while the respondent proposed $110,000.00. The parties agreed on $1,119.77 for past unreimbursable expenses. The court considered the severity and duration of the petitioner's injury, including a significant treatment gap and surgical intervention. Ultimately, the court awarded Barbara Stoliker $120,000.00 for pain and suffering and $1,119.77 for past unreimbursable expenses, for a total award of $121,119.77. Theory of causation field: Table Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_17-vv-00990-0 Date issued/filed: 2018-12-19 Pages: 9 Docket text: PUBLIC DECISION (Originally filed: 11/09/2018) regarding 52 Findings of Fact & Conclusions of Law ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made. -------------------------------------------------------------------------------- Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 1 of 9 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 17-990V Filed: November 9, 2018 PUBLISHED BARBARA STOLIKER, Petitioner, Special Processing Unit (SPU); v. Ruling on Entitlement; Finding of Fact; Administration Site; Evidence SECRETARY OF HEALTH AND of Vaccination; Table Injury; Influenza HUMAN SERVICES, (Flu) Vaccine; Shoulder Injury Related to Vaccine Administration Respondent. (SIRVA) Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for petitioner. Alexis B. Babcock, U.S. Department of Justice, Washington, DC, for respondent. FINDINGS OF FACT – SPECIAL PROCESSING UNIT1 Dorsey, Chief Special Master: On July 27, 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”) resulting from her September 30, 2014 influenza (“flu”) vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the Office of Special Masters. The undersigned now resolves factual disputes regarding the site of administration of petitioner’s alleged injury-causing vaccination and the onset of 1 The undersigned intends to post this ruling on the United States Court of Federal Claims' website. This means the ruling will be available to anyone with access to the internet. 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. Because this unpublished ruling contains a reasoned explanation for the action in this case, undersigned is required 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). 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-00990-UNJ Document 58 Filed 12/19/18 Page 2 of 9 petitioner’s shoulder pain. For the reasons described below, the undersigned finds that petitioner’s September 30, 2014 influenza vaccination was administered in her right deltoid and that the onset of the shoulder pain allegedly resulting from that vaccination occurred within 48 hours of vaccine administration. I. Procedural History On July 28, 2017, petitioner filed medical records marked as Exhibit 1 through 4 along with a statement of completion. (ECF Nos. 7-8.) On August 12, 2017, petitioner filed transcribed records from one of her medical providers (Dr. Sands) as Exhibit 5 and an affidavit as Exhibit 6. (ECF No. 9.) Thereafter, an initial status conference was held with the staff attorney managing this case on September 7, 2017. (ECF No. 10.) Respondent was allowed 60 days to file a status report indicating how he intends to proceed. (Id.) However, citing high case volume, budget constraints, and hiring restrictions, respondent asked for additional time to determine his position on multiple occasions. (ECF Nos. 11, 15, 17.) After six months, respondent advised on March 9, 2018, that he was willing to consider a reasonable settlement demand. (ECF No. 19.) Petitioner had previously presented respondent a demand for damages. (ECF No. 13.) However, settlement discussions did not commence. On June 19, 2018, the parties filed competing status reports explaining that respondent would not be responding to the demand because respondent had determined that the medical records in the case include two vaccination records which differ on the site of injection. (ECF Nos. 29, 30.) Subsequently, on June 27, 2018, petitioner filed additional evidence. (ECF No. 34.) Specifically, petitioner filed a supplement affidavit (Exhibit 8) and a handwritten note from a CVS pharmacy manager, Sam Bright, Pharm.D. (Exhibit 7). (Id.) Respondent filed a motion for discovery seeking authorization to depose Dr. Bright along with Raed Ahmed, a CVS employee identified in Dr. Bright’s note as the individual whose handwritten initials appear on one of the two vaccination records filed in the case. (ECF No. 33.) The undersigned held a status conference on July 11, 2018. (ECF No. 37.) The undersigned addressed both respondent’s motion for discovery and petitioner’s concern that the case had been unreasonably delayed. (Id.) The undersigned granted respondent’s motion for discovery, but time-limited the request due to respondent’s delay in presenting the issue. (Id.) During the call, the parties agreed that Flores Orlando, listed as the administering immunizer on petitioner’s vaccination record, would also be deposed. (Id.) The undersigned also ordered respondent to file his Rule 4 report. (Id.) Subsequently, respondent filed transcripts of the depositions of Raed Ahmed and Samuel Bright as respondent’s Exhibits A and B respectively. (ECF No. 46.) Respondent confirmed that he was unable to effectuate service of process upon Flores Orlando and he was not deposed. (ECF No. 49, p. 3, n. 2.) 2 Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 3 of 9 Respondent filed his Rule 4 report on August 27, 2018. (ECF No. 47.) In his report, respondent indicated that petitioner has not met her burden to establish a table injury of SIRVA because there is not preponderant evidence that she received her vaccination in her right arm or that onset of her shoulder injury was within 48 hours of vaccination. (ECF No. 47, p. 5.) Additionally, on August 31, 2018, respondent filed a motion for a limited factual ruling. (ECF Nos. 47, 49.) In his motion, respondent indicated that “[a] determination as to the arm in which petitioner received her September 30, 2014 flu vaccination is a necessary factual predicate that will inform further proceedings on this petition.” (ECF No. 49, p. 6.) Accordingly, respondent requested that “based on the totality of the evidence, the Chief Special Master make a finding as to the site of petitioner’s September 30, 2014 flu vaccination.” (Id.) Petitioner filed a response to the motion on October 1, 2018. (ECF No. 50.) Petitioner requested that the undersigned issue a ruling finding that petitioner received her September 30, 2014 flu vaccine in her right arm and further finding that the onset of her shoulder injury occurred within 48 hours of vaccination. (Id. at 2.) Respondent filed no reply. Thus, this case is ripe for the undersigned’s finding of fact. II. Factual History On September 30, 2014, petitioner received an influenza vaccination at a CVS pharmacy. (Ex. 1; Ex. 2, pp. 2-3; Ex. 6, p. 1.) Petitioner averred that she received the vaccination in her right arm and that it was “uncomfortable.” (Ex. 6, p. 1.) She further indicated that by mid-day the following day her pain had increased to the point that she could not lift her arm. (Id.) Approximately two weeks later on October 15, 2014, petitioner was seen by her primary care physician, Dr. Sands, at which time she complained of right shoulder pain “since receiving the flu shot at pharmacy on 9/30/2014.” (Ex. 2, p. 12; Ex. 5, p. 8.) Dr. Sands attributed petitioner’s shoulder pain to her vaccination. (Id.) Petitioner subsequently returned to Dr. Sands on October 20, 2014, and December 15, 2014, continuing to complain of pain in the right shoulder “s/p” – status post – injection. (Ex. 2, pp. 10-11.) In subsequent medical records, petitioner’s right shoulder condition continued to be consistently attributed to her vaccination. (See, e.g. Ex. 2, pp. 8, 9, 37; Ex. 3, p. 2.) Nonetheless, two conflicting copies of petitioner’s vaccination record have been filed. (Ex. 1; Ex. 2, pp. 2-3.) Petitioner’s medical records from Dr. Sands include a copy of petitioner’s Vaccine Consent and Administration Record. (Ex. 2, pp. 2-3.) Contrary to the above, it indicates petitioner received her vaccination in her left deltoid. (Id. at 3.) Additionally, petitioner separately filed as Exhibit 1 a copy of her vaccination record that she obtained herself. (Ex. 1; Ex. 8, p. 1.) That record indicates that petitioner’s vaccination was administered in her right arm. (Ex. 1.) Petitioner averred that she obtained the record at Exhibit 1 directly from the CVS pharmacy on June 7, 2017. (Ex. 8, p. 1.) Upon reviewing the record, petitioner determined that the record incorrectly indicated that petitioner had received her vaccination in her left arm rather than her right arm. (Id.) She indicated that she returned to the pharmacy “a few days later” and that Raed Ahmed, the pharmacy 3 Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 4 of 9 manager, amended her record to correct the site of administration. (Id.) The vaccination record at Exhibit 1 includes a handwritten notation striking out “left” deltoid as the site of administration and writing in “right.” (Ex. 1.) This alteration is initialed “R.A.” (Id.) Petitioner further averred that she again returned to the CVS pharmacy on June 22, 2018, after respondent raised an issue regarding her evidence of vaccination in this case. (Ex. 8, p. 1.) At that time, she was informed by Samuel Bright that Mr. Ahmed no longer worked at that CVS location. (Id.) However, Dr. Bright provided a handwritten note authenticating Mr. Ahmed’s initials on petitioner’s vaccination form. (Ex. 8, pp. 1-2; Ex. 7.) In deposition testimony, Mr. Ahmed confirmed that he was the manager at the CVS location where petitioner received her vaccination at the time she received her vaccination. (Ex. A, pp. 10-11.) Mr. Ahmed explained that at CVS documentation of the vaccinations administered, including the Vaccine Consent and Administration Record, are generated at the beginning of the technician’s encounter with the patient. (Id. at 14- 15.) He indicated that these forms include a printed description of the site of administration (left versus right deltoid). (Id. at 15-16.) Mr. Ahmed further explained that, once collected, the electronic information cannot be changed or deleted at the pharmacy level. (Ex. A, p. 17.) However, it is the normal practice at CVS to determine the site of administration for a vaccination only after these forms have been generated. (Id. at 22-23.) As a result, Mr. Ahmed testified that it is common for CVS vaccination records to be altered by hand as to the site of administration. (Id. at 22-23, 27-28, 39- 40.) He indicated that it happens “quite often.” (Id. at 28.) Mr. Ahmed did not recall petitioner or ever talking with her. (Ex. A, p. 16-18. 28- 29.) However, he indicated that the signature on her vaccination record is his own.3 (Id. at 21.) He also authenticated his handwritten initials on the vaccination record and confirmed that based on the record with his notation, he would have administered petitioner’s vaccination in her right deltoid. (Id. at 23.) Mr. Ahmed testified that this notation would have been made at the time of the vaccination and not subsequently. (Ex. A, pp. 23-24, 32-33.) He testified that he would not have changed the record after- the-fact even if asked. (Id. at 25, 32-34.) Mr. Ahmed testified that the consent forms are not retained electronically, but that a physical copy is stored on site at the pharmacy. (Ex. A, pp. 30-31, 42.) He indicated that the pharmacy sometimes gets requests for records. (Id. at 35-36.) Record requests from physicians’ offices are handled by the CVS Privacy Office and not directly by the pharmacy. (Id.) Mr. Ahmed testified he is not familiar with that process. (Id. at 36.) However, with regard to the additional, unaltered copy of petitioner’s vaccination record contained in Dr. Sands’ records, Mr. Ahmed indicated that he is not surprised that it exists. (Id. at 37-38.) He explained that at the beginning of the encounter two copies of the document are produced, one for pharmacy records and one for the vacinee to keep. (Id.) He reasoned, but could not confirm, that the additional 3 Despite the fact that Mr. Ahmed authenticated his own signature on the document, the vaccination lists Orlando Flores as the administering immunizer. Mr. Ahmed indicated that the fact of his signature on the document indicates that he certified that he had reviewed the form with petitioner and confirmed the lack of any contraindication, but that he could not tell from the signature whether he or Mr. Flores administered the vaccination. (Ex. A, pp. 21-22.) 4 Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 5 of 9 copy is the patient copy and that he neglected to correct both copies of the form when petitioner was vaccinated. (Id.) Dr. Bright testified in deposition that he took over management of the CVS location where petitioner was vaccinated in February or March of 2018. (Ex. B, p. 9.) He indicated that he was Mr. Ahmed’s direct successor in the position. (Id.) He offered testimony regarding storage of the vaccine consent forms consistent with the description offered by Mr. Ahmed.4 (Ex. B, pp. 14-15.) Dr. Bright also testified that the process for amending vaccine records to change the site of vaccination as described by Mr. Ahmed is consistent with CVS policy. (Id. at 16-17.) He agreed that it is “not uncommon,” estimating that it happens about ten percent of the time. (Id. at 21, 36.) Dr. Bright recalled meeting petitioner on one occasion. (Ex. B, p. 17.) He explained that petitioner came to the pharmacy and asked him to authenticate Mr. Ahmed’s initials on her vaccine record. (Id. at 17-18.) He authenticated the handwritten note filed at Exhibit 7. (Id. at 26.) He further testified that in his one meeting with petitioner he had agreed that, to the best of his knowledge, the initials on the document filed as Exhibit 1 were Mr. Ahmed’s. (Id. at 18, 26-27.) Dr. Bright indicated that his authentication was based on his knowledge of Mr. Ahmed’s handwriting and that he does not know when the notation was written. (Id. at 20, 22, 35.) He never spoke to Mr. Ahmed about the record. (Id. at 26.) Dr. Bright disclaimed any knowledge of whether the record was correct. (Id. at 26-29.) With regard to the additional, unaltered vaccination record within Exhibit 2, Dr. Bright did not know how that would have come into Dr. Sands’ possession. He indicated that the patient copy of the form would not be an exact duplicate in that it would be blank, unlikely to have the immunizer’s signature or the checkboxes completed. (Id. at 38-41.) III. Party Contentions In his motion for a finding of fact, respondent stresses the fact that petitioner’s and Mr. Ahmed’s accounts regarding the alteration of the vaccine record are in conflict. (ECF No. 49, p. 3.) While petitioner indicates the record was amended in June of 2017 (Ex. 8, p. 1), Mr. Ahmed testified that he only would have made the correction at the time of the vaccination. (ECF No. 49, p. 3 (citing Ex. A, pp. 21-22).) Respondent also cites Dr. Bright’s testimony that he believes the record within Exhibit 2 would have been the original. (ECF No. 49, pp. 3-4.) Respondent stresses that both pharmacists testified that they would not change a vaccination record after the fact because they would not be able to recall the details. (Id.) Respondent argues that “[a]side from the changed record, petitioner’s only support for her allegation that the shot was administered in her right arm is her own affidavit. Because the [Vaccine] Act prohibits a special master from finding in favor of entitlement ‘based on the claims of petitioner alone, unsubstantiated by medical records or by medical opinion,’ 42 U.S.C. § 300aa-13(a)(1), petitioner must provide 4 Dr. Bright indicated, however, that he would fax a copy of a vaccine record directly to a physician’s office. (Ex. B, p. 16.) 5 Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 6 of 9 corroborating evidence to be entitled to compensation.”5 (ECF No. 49, p. 5.) In light of the conflicting vaccination records, respondent contends there is not adequate proof regarding the location of the vaccination. (Id. at 5.) In his Rule 4 Report, respondent recommends against compensation in this case. (ECF No. 47, p. 6.) Respondent identifies the same injection site issue discussed in his motion as detrimental to petitioner’s case, suggesting that “the records do not establish by preponderant evidence that the flu vaccination at issue was given in petitioner’s right arm.” (Id. at 5.) Additionally, respondent argues that “petitioner’s medical records do not establish that she suffered the onset of her alleged vaccine-induced injury within 48 hours of her vaccination.” (ECF No. 47, p. 5.) Respondent notes that “[a]t her first medical visit after receiving the flu vaccine, petitioner reported that her shoulder pain began “since receiving the flu shot at pharmacy 9/30/14.” (Id. (citing Ex. 2, p. 12).) Respondent characterizes such notations as offering “a relative time frame for the onset of shoulder pain,” but argues that they “do not clearly demonstrate that petitioner’s shoulder pain began within 48 hours of vaccine administration.” (ECF No. 47, p. 5.) In response, petitioner argues that she explained the differing vaccine records in her supplemental affidavit. (ECF No. 50, p. 5.) She further notes that, but for the timing of the correction, her explanation is corroborated by Mr. Ahmed’s testimony authenticating his notations on the vaccine record. (Id. at 6.) Petitioner further stresses that her allegation that the vaccine was administered in her right shoulder is also corroborated by her other medical records. (Id. at 7.) Petitioner disputes respondent’s interpretation of the medical records as insufficient to place onset of petitioner’s condition within 48 hours of her vaccination. (Id. at 8-9.) Petitioner contends that the medical records are clear in indicating that petitioner’s pain began the day of her vaccination and further stresses that based on petitioner’s report of pain since vaccination, her physician attributed her condition to her vaccination. (Id.) IV. Findings of Fact Petitioner has the burden of demonstrating the facts necessary for entitlement to an award by a “preponderance of the evidence.” § 300aa-12(a)(1)(A). Under that standard, the existence of a fact must be shown to be “more probable than its nonexistence.” In re Winship, 397 U.S. 358, 371 (1970) (Harlan, J., concurring). 5 In fact, several prior decisions within this program have held that the fact of vaccination need not be supported by medical records or opinion pursuant to Section 13(a) of the Vaccine Act. See, e.g., Centmehaiey v. HHS, 32 Fed. Cl. 612 (1995), aff’d 73 F.3d 381 (Fed. Cir. 1995) (stating that “[t]he lack of contemporaneous, documentary proof of a vaccination, however, does not bar recovery.”); see also Wonish v. HHS, No. 90-667V, 1991 WL 83959 (May 6, 1991) (Fed. Cl.) (stating that “[v]accination is an event that in ordinary litigation could be established by lay testimony. Medical expertise is not typically required.”); Woodson v. HHS, No. 91-263V, 1992 WL 59707 (Mar. 5, 1992) (Fed. Cl.) (finding that “the petition should not be dismissed as a matter of law merely because there is no documentary evidence that the vaccination took place and [petitioner] is the only witness claiming personal knowledge of the vaccination. Her testimony on this point must be weighed in the context of the entire record.”). In any event, as described below the undersigned has found significant evidence corroborating petitioner’s allegation, including corroborating medical records. 6 Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 7 of 9 a. Finding of Fact Regarding Injection Site Upon review of the entire record and consideration of the parties’ briefing, the undersigned finds that there is preponderant evidence that petitioner’s September 30, 2014 influenza vaccination was administered in her right deltoid. Contrary to respondent’s argument, petitioner has filed substantial evidence that the vaccine was administered in her right shoulder. First, petitioner provided a vaccination record that so indicates. (Ex. 1.) Moreover, the notation of a right shoulder administration on that record has been authenticated by two individuals. (Ex A, p. 23; Ex. B, pp. 18, 26-27; Ex. 7.) And significantly, both pharmacists testified that notations such as those appearing on petitioner’s vaccination record are routine.6 (Ex. A, p.28; Ex. B, p. 21, 36.) Additionally, based on that record, Mr. Ahmed testified that he administered the vaccination in petitioner’s right shoulder. (Ex. A, p. 23.) To the extent an additional unaltered record has been filed reflecting the left shoulder, Mr. Ahmed explained that he likely amended only the pharmacy’s copy of the record (Ex. A, p. 37-38), potentially explaining the discrepant records. The undersigned does not find evidence in the record sufficient to explain how Dr. Sands obtained the unaltered copy of the vaccine record.7 Additionally, although Dr. Bright offered testimony opining on these questions, the undersigned does not find his testimony useful in resolving this issue because he testified that he had no personal knowledge of the accuracy of the records at issue in this case. (Ex. B, p. 26-29.) Most significantly, however, petitioner’s contemporaneous treatment records consistently attribute petitioner’s right shoulder injury to the vaccination she received on September 30, 2018. This provides strong corroborating evidence that petitioner received her vaccination in her right arm. See, e.g. Parker v. HHS, No. 15-1331V, 2016 WL 3443929 (Fed. Cl. Spec. Mstr. May 13, 2016)(finding that a vaccine record recording administration in the left arm was incorrect based primarily on petitioner’s consistent attribution of his right shoulder condition to his vaccination throughout his treatment). Upon the undersigned’s review, petitioner linked her right shoulder condition to her vaccination the very first time she sought treatment and the remainder of petitioner’s medical records consistently link petitioner’s right shoulder condition to 6 Specifically, Mr. Ahmed characterized the practice as occurring “quite often” while Dr. Bright indicated that it is “not uncommon.” (Ex. A, p. 28; Ex. B, pp. 21, 36.) Dr. Bright additionally estimated that it occurs about ten percent of the time. (Ex. B, p. 36.) 7 There were some questions during the depositions suggesting that a date stamp bannered across the top of the vaccine record at Exhibit 2, pages 2 and 3, may indicate that the record was faxed to Dr. Sands on March 8, 2017. Respondent again noted this potential transmittal date in his motion for a finding of fact. (ECF No. 50, p. 4, n. 3.) The undersigned notes, however, that this date stamp appears on all 51 pages of medical records from Dr. Sands’ office and is not unique to the vaccine record. Nor does the date stamp indicate whether the fax was incoming or outgoing or even necessarily confirm that it is a fax transmittal date. Thus, it does not appear that the date stamp reflects a time at which the vaccine record was provided by fax to Dr. Sands. It likely suggests that Dr. Sands had the record in his possession no later than March 8, 2017. 7 Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 8 of 9 the same vaccination. The undersigned found no notation in any of petitioner’s treatment records that is contrary or inconsistent on that point. Moreover, the first of these treatment records was generated only two weeks following the vaccination and long before petitioner reportedly returned to CVS to obtain a copy of her vaccination record. Specifically, on October 15, 2014, Dr. Sands wrote, not only that petitioner attributed her right shoulder condition to her vaccination, but also explicitly that “Pt. received flu shot 9/30/14 in R deltoid.” (Ex. 2, p. 12; Ex. 5, p. 8.) For this reason, the undersigned does not find the timing of the amendment to petitioner’s vaccine record to be a significant issue. Petitioner’s consistent and contemporaneous treatment records would provide preponderant evidence overcoming the contrary or incorrect vaccination record (at Ex. 2, pp. 2-3) even in the complete absence of an amended record by Mr. Ahmed (at Ex. 1). b. Finding of Fact Regarding Onset Upon review of the entire record and consideration of the parties’ briefing, the undersigned finds that there is preponderant evidence that petitioner’s right shoulder pain began within 48 hours of her vaccination. Respondent argues that petitioner’s records are insufficient to establish that onset of petitioner’s condition was within 48 hours of vaccination; however, the undersigned disagrees. As noted above, petitioner first sought treatment for her shoulder injury on October 15, 2014, just a little over two weeks following her vaccination. (Ex. 2, p. 12; Ex. 5, p. 8.) At that time, she presented with a chief complaint of “pain in R shoulder since receiving flu shot at pharmacy 9/30/14.” (Id.) The undersigned disagrees with respondent’s characterization of this notation as indicating “a relative time frame for the onset of shoulder pain.” (ECF No. 47, p. 5.) To the contrary, the undersigned finds the notation to be an explicit statement that petitioner’s shoulder pain began on September 30, 2014, which is within 48 hours of petitioner’s vaccination. Moreover, even if the notation at issue did constitute only a “relative time frame,” the undersigned would still find preponderant evidence that the onset of petitioner’s pain was within 48 hours of vaccination. See, e.g. Cooper v. HHS, No. 16-1387V, 2018 WL 1835179, at *5, n. 13 (Fed. Cl. Spec. Mstr. Jan. 18, 2018)(noting with regard to petitioner’s medical records that “the undersigned recognizes that many of these records are imprecise regarding onset . . . It is sufficient that, petitioner’s vaccination having occurred on October 30, the reported timeframe of early November reflected by the record as a whole does encompass the 48 hour post-vaccination period.”). In this case, there is no suggestion that petitioner’s history of onset was recorded in her medical records verbatim; however, the history she provided was sufficient for her physician to attribute her condition to her vaccination, characterizing it as an “adverse effect flu shot.” (Ex. 2, p. 12; Ex. 5, p. 8.) Additionally, petitioner averred that her shoulder pain began within 48 hours of vaccination, indicating that she was uncomfortable the day of her vaccination and that her pain increased the next day. (Ex. 6, p. 1.) This is also further corroborated by petitioner’s subsequent treatment records. Respondent has not contended that any of 8 Case 1:17-vv-00990-UNJ Document 58 Filed 12/19/18 Page 9 of 9 petitioner’s medical records suggest that onset was not within 48 hours. Nor has the undersigned located any such record upon her own review. V. Conclusion In light of all of the above and in view of the record as a whole, the undersigned finds (1) that petitioner’s September 30, 2014 influenza vaccination was administered into her right deltoid and (2) that the onset of petitioner’s alleged shoulder pain resulting from her vaccination began within 48 hours of the administration of the September 30, 2014 influenza vaccination. IT IS SO ORDERED. s/Nora Beth Dorsey Nora Beth Dorsey Chief Special Master 9 ================================================================================ DOCUMENT 2: USCOURTS-cofc-1_17-vv-00990-1 Date issued/filed: 2019-01-17 Pages: 2 Docket text: PUBLIC ORDER/RULING (Originally filed: 12/11/2018) regarding 56 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made. -------------------------------------------------------------------------------- Case 1:17-vv-00990-UNJ Document 61 Filed 01/17/19 Page 1 of 2 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 17-990V Filed: December 11, 2018 UNPUBLISHED BARBARA STOLIKER, Petitioner, Special Processing Unit (SPU); v. Ruling on Entitlement; Table Injury; Influenza (Flu) Vaccine; Shoulder SECRETARY OF HEALTH AND Injury Related to Vaccine HUMAN SERVICES, Administration (SIRVA) Respondent. Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for petitioner. Alexis B. Babcock, U.S. Department of Justice, Washington, DC, for respondent. RULING ON ENTITLEMENT1 Dorsey, Chief Special Master: On July 21, 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 receipt of her September 30, 2014 influenza (“flu”) vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the Office of Special Masters. 1 The undersigned intends to post this ruling on the United States Court of Federal Claims' website. This means the ruling will be available to anyone with access to the internet. 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. Because this unpublished ruling contains a reasoned explanation for the action in this case, undersigned is required 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). 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-00990-UNJ Document 61 Filed 01/17/19 Page 2 of 2 Initially, respondent filed a Rule 4(c) report recommending against compensation. (ECF No. 47.) Subsequently, however, respondent moved for a fact ruling. (ECF No. 49.) The undersigned issued her findings of fact on November 9, 2018. (ECF No. 52.) Respondent filed an amended Rule 4(c) report on December 10, 2018. (ECF No. 54.) In his amended Rule 4(c) report, respondent indicated that: Medical personnel at the Division of Injury Compensation Programs (“DICP”), Department of Health and Human Services, have reviewed the evidence filed in this case, as well as the Findings of Fact and Conclusions of Law issued by the Chief Special Master. Recognizing that the Chief Special Master’s factual finding that petitioner received a flu vaccination in her right shoulder on September 30, 2014, is the law of the case, and further finding that onset of the symptoms took place within 48 hours, respondent advises that he will not defend the case on other grounds during further proceedings before the Office of Special Masters. While preserving his right to appeal the Chief Special Master’s November 9, 2018 Ruling on Facts, respondent submits that petitioner has otherwise satisfied the criteria set forth in the Vaccine Injury Table and the Qualifications and Aids to Interpretation (“QAI”) for Shoulder Injury Related to Vaccine Administration (“SIRVA”). (ECF No. 54, p. 2.) Respondent further indicated that “based on the record as it now stands and subject to his right to appeal the Ruling of Facts, respondent does not dispute that petitioner has satisfied all legal prerequisites for compensation under the Act. 42 U.S.C. § 300aa-13.” (Id. at 6.) 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 3: USCOURTS-cofc-1_17-vv-00990-2 Date issued/filed: 2020-09-14 Pages: 7 Docket text: PUBLIC DECISION (Originally filed: 08/07/2020) regarding 92 DECISION of Special Master Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:17-vv-00990-UNJ Document 98 Filed 09/14/20 Page 1 of 7 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 17-0990V UNPUBLISHED BARBARA STOLIKER, Chief Special Master Corcoran Petitioner, Filed: August 7, 2020 v. Special Processing Unit (SPU); SECRETARY OF HEALTH AND Decision Awarding Damages; Pain HUMAN SERVICES, and Suffering; Influenza (Flu) Vaccine; Shoulder Injury Related to Respondent. Vaccine Administration (SIRVA) Leah V. Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for petitioner. Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for respondent. DECISION AWARDING DAMAGES1 On July 21, 2017, Barbara Stoliker 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 Related to Vaccine Administration (SIRVA) as a result of an influenza (“flu”) vaccination administered on September 30, 2014. Petition at 1. The case was assigned to the Special Processing Unit of the Office of Special Masters. For the reasons described below, I find that Petitioner is entitled to an award of damages in the amount $121,119.77, representing compensation in the amount of $120,000.00 for actual pain and suffering and $1,119.77 for past unreimbursable expenses. 1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am required 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). This means the decision will be available to anyone with access to the internet. 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, I agree that the identified material fits within this definition, I 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-00990-UNJ Document 98 Filed 09/14/20 Page 2 of 7 I. Relevant Procedural History3 As noted, this case was initiated in 2017. On August 27, 2018, Respondent filed a Rule 4(c) report opposing compensation because there was not preponderant evidence that Petitioner received her vaccination in the right arm or that onset of her shoulder injury was within 48 hours of vaccination. ECF 47 at 5. Respondent also filed a motion for a limited factual ruling to determine the arm in which Petitioner received her flu vaccination. ECF 49. On November 9, 2018, former Chief Special Master Dorsey (to whom the case was assigned at the time)4 issued a fact ruling finding that Petitioner’s flu vaccination was administered in her right arm, and that onset of her condition occurred within 48 hours. ECF 52. Respondent subsequently filed an amended Rule 4(c) report stating that “based on the record as it now stands . . . [R]espondent does not dispute that [P]etitioner has satisfied all legal prerequisites for compensation under the Act.” ECF 54. A ruling finding Petitioner entitled to compensation was issued on December 11, 2018. ECF 56. Shortly thereafter, Petitioner filed a motion to stay proceedings due to upcoming shoulder surgery. ECF 63. After the stay was lifted, in June 2019, the parties attempted to informally resolve the issue of damages but subsequently reported an impasse on the amount of pain and suffering to be awarded (the sole disputed damages issue to be resolved). ECF 72. After giving the parties an opportunity to file written briefs on this issue, I scheduled this matter for an expedited hearing and ruling based upon all the evidence filed to date and the parties’ briefing. ECF 91. The hearing was held on July 31, 2020.5 In her brief, Petitioner requests that I award her $170,000.00 for past and future pain and suffering. ECF 83. Respondent proposes that I award the lesser amount of $110,000.00. ECF 86. The parties do not dispute that $1,119.77 in actual unreimbursable expenses should also be awarded. II. Legal Standard Compensation awarded pursuant to the Vaccine Act shall include “[f]or actual and projected pain and suffering and emotional distress from the vaccine-related injury, an award not to exceed $250,000.” Section 15(a)(4). Additionally, a petitioner may recover “actual unreimbursable expenses incurred before the date of judgment award such expenses which (i) resulted from the vaccine-related injury for which petitioner seeks compensation, (ii) were incurred by or on behalf of the person who suffered such injury, and (iii) were for diagnosis, medical or other remedial care, rehabilitation . . . determined to be reasonably necessary.” Section 15(a)(1)(B). The petitioner bears the burden of proof with respect to each element of compensation requested. Brewer v. Sec’y of Health & Human Servs., No. 93-0092V, 1996 WL 147722, at *22-23 (Fed. Cl. Spec. Mstr. Mar. 18, 1996). 3 I adopt the comprehensive procedural history set forth in ECF 52. 4 I was appointed Chief Special Master on October 1, 2019. This case was reassigned to me that same day. 5 The transcript from the hearing has yet to be filed, but it is incorporated by reference herein 2 Case 1:17-vv-00990-UNJ Document 98 Filed 09/14/20 Page 3 of 7 There is no mathematic formula for assigning a monetary value to a person’s pain and suffering and emotional distress. I.D. v. Sec’y of Health & Human Servs., No. 04- 1593V, 2013 WL 2448125, at *9 (Fed. Cl. Spec. Mstr. May 14, 2013) (“[a]wards for emotional distress are inherently subjective and cannot be determined by using a mathematical formula”); Stansfield v. Sec’y of Health & Human Servs., No. 93-0172V, 1996 WL 300594, at *3 (Fed. Cl. Spec. Mstr. May 22, 1996) (“the assessment of pain and suffering is inherently a subjective evaluation”). Factors to be considered when determining an award for pain and suffering include: 1) awareness of the injury; 2) severity of the injury; and 3) duration of the suffering. I.D., 2013 WL 2448125, at *9 (quoting McAllister v. Sec’y of Health & Human Servs., No 91-1037V, 1993 WL 777030, at *3 (Fed. Cl. Spec. Mstr. Mar. 26, 1993), vacated and remanded on other grounds, 70 F.3d 1240 (Fed. Cir. 1995)). Prior pain and suffering awards in comparable cases also bear on the resolution herein. See, e.g., Doe 34 v. Sec’y of Health & Human Servs., 87 Fed. Cl. 758, 768 (2009) (finding that “there is nothing improper in the chief special master’s decision to refer to damages for pain and suffering awarded in other cases as an aid in determining the proper amount of damages in this case.”). And, of course, I may rely on my own experience (along with my predecessor Chief Special Masters) adjudicating similar claims.6 Hodges v. Sec’y of Health & Human Servs., 9 F.3d 958, 961 (Fed. Cir. 1993) (noting that Congress contemplated the special masters would use their accumulated expertise in the field of vaccine injuries to judge the merits of individual claims). III. Appropriate Compensation in this SIRVA Case In this case, awareness of the injury is not disputed. The record reflects that at all times, Petitioner was a competent adult with no impairments that would impact her awareness of her injury. Therefore, I analyze principally the severity and duration of Petitioner’s injury. In so doing, I review the record as a whole to include the medical records and affidavits filed and all assertions made by the parties in written documents and at the expedited hearing held on July 31, 2020. I consider prior awards for pain and suffering in both SPU and non-SPU SIRVA cases and rely upon my experience in adjudicating those cases.7 However, I ultimately base my determination on the circumstances of this case. 6 From July 2014 until September 2015, the SPU was overseen by former Chief Special Master Vowell. For the next four years, until September 30, 2019, all SPU cases, including the majority of SIRVA claims, were assigned to former Chief Special Master Dorsey, now Special Master Dorsey. In early October 2019, the majority of SPU cases were reassigned to me as the current Chief Special Master. 7 Statistical data for all SIRVA cases resolved in SPU from inception through January 2020 as well as a brief description of any substantive decisions can be found in the following decisions: Vinocur v. Sec’y of Health & Human Servs., No. 17-0598V, 2020 WL 1161173 (Fed. Cl. Spec. Mstr. Jan. 31, 2020); Wilt v. Sec’y of Health & Human Servs., No. 18-0446V, 2020 WL 1490757 (Fed. Cl. Spec. Mstr. Feb. 24, 2020); Smallwood v. Sec’y of Health & Human Servs., No. 18-0291V, 2020 WL 2954958 (Fed. Cl. Spec. Mstr. Apr. 29, 2020). 3 Case 1:17-vv-00990-UNJ Document 98 Filed 09/14/20 Page 4 of 7 Petitioner’s SIRVA, plus her related treatment and recovery, was consistent with that experienced by many other petitioners who also required surgery after their injury. Approximately two weeks after receiving the flu vaccine on September 30, 2014, Petitioner presented to her primary care provider (PCP) with complaints of right shoulder pain “since receiving flu shot.” Ex 2 at 12. Physical examination (PE) revealed tenderness to palpation (TTP) in the posterior deltoid. Id. After three months, Petitioner’s pain had not resolved, and she was referred for physical therapy (PT), which she began in January 2015. Ex 2 at 37. During six PT sessions from January to March 2015, Petitioner displayed “moderate weakness,” “deficits” in her range of motion (ROM), and TTP. Ex 2 at 37, 39 and Ex 4 at 121-131. Petitioner was discharged from PT secondary to failure to schedule future appointments. Ex 4 at 132. Because Petitioner continued to complain of right shoulder pain, she underwent an MRI in June 2015, which showed findings of (1) thinning of the infraspinatus tendon and (2) a possible partial undersurface tear of the infraspinatus. Ex 2 at 26. Petitioner was subsequently referred to an orthopedist, Dr. Thomas Wu. At Petitioner’s initial appointment on November 30, 2015, PE revealed slightly decreased strength and positive impingement sign. Ex 3 at 2. She was diagnosed with a rotator cuff tear, but Dr. Wu reported that Petitioner did “not feel that her symptoms [we]re significant enough for [a cortisone injection or surgery].” Id. The record then reflects an almost three-year gap in treatment for Petitioner’s shoulder – and this gap bears on the magnitude of pain and suffering to be awarded in this case.8 On July 18, 2018, Petitioner reported right shoulder pain during an appointment with her PCP, and she was referred to another orthopedist, Dr. Craig Zeman. Ex 9 and Ex 10 at 4. Examination by Dr. Zeman on July 20, 2018 revealed decreased ROM, TTP, and positive impingement, and Petitioner was diagnosed with bursitis. Ex 9 at 11-13. These records do not explain the reason for this delay in treatment. Dr. Zeman subsequently performed a corticosteroid injection into the acromioclavicular (AC) joint and subacromial space in September 2018.9 Ex 9 at 6. Petitioner also underwent an MRI arthrogram of the right shoulder in February 2019, which showed mild to moderate tendinosis with a small articular surface tear of the distal infraspinatus.10 Ex 11 at 6. 8 Petitioner occasionally visited her PCP during this time but did not complain of shoulder pain at these appointments. See Ex 2, Ex 5, and Ex 10. 9 Petitioner alleges that she had a second corticosteroid injection in December 2018; however, a detailed review of the notes from the December appointment reflect that Dr. Zemen is referencing Petitioner’s history of receiving an injection in September 2018. There is no indication that Dr. Zemen performed a second injection at the December 2018 appointment. Ex 11 at 1-4. 10 The MRI also showed osteoarthritis of the AC joint. Neither Petitioner nor Petitioner’s physicians have attributed Petitioner’s arthritis to her SIRVA. See, e.g., Ex 11 at 40. 4 Case 1:17-vv-00990-UNJ Document 98 Filed 09/14/20 Page 5 of 7 One month later, Petitioner underwent shoulder surgery.11 Ex 11 at 19. Petitioner subsequently attended nine post-surgical PT sessions and was discharged in May 2019, when she reported she “[was] doing well.” Id at 41. At follow-up visits with Dr. Zemen in May and December 2019, PE did show TTP, slightly decreased strength, and positive impingement; however, she had resumed physical activities. Id. at 38 and Ex 13 at 1-2. She returned to Dr. Zemen in January 2020 after experiencing a flare of her symptoms while swimming. Ex 15 at 1. However, these symptoms subsided over the course of a week and Petitioner has received no further treatment since February 2020. Ex 15. In her affidavits, Petitioner alleges that she spent multiple years in pain and lives in fear that her pain will return. Ex 6, Ex 14, and Ex 16. Prior to surgery, she had difficulty getting dressed and using the computer, was unable to swim or otherwise exercise, and could not lift her infant grandson. Id. She also reports that she was only able to sleep on her left side for five years, which has changed the physical appearance of her face. Id. As I informed the parties during the expedited hearing,12 the question in this case is not whether Petitioner is entitled to any compensation for her pain and suffering, but rather what amount of compensation is justified, based upon the facts of the case and considered relevant input. This determination is not an exact science but more of an art. While it is tempting to “split the difference” and award an amount halfway between the amounts proposed by the parties (acknowledging that in this case, the parties’ respective positions reasonably “frame” high and low potential awards), each petitioner deserves an examination of the specific facts in his or her case. Thus, while amounts ultimately awarded may end up falling somewhere in the range between the awards proposed by both parties, this result flows from a specific analysis of Ms. Stoliker’s personal circumstances. Overall, I find that the proper pain and suffering award for this case should fall somewhere above the median amount typically awarded in SIRVA cases that result in surgery. Ms. Stoliker’s pain and suffering were overall more significant than most, but not so egregious as to justify an award at the level proposed by Petitioner. Petitioner argues that her case is comparable to Reed, where the petitioner was awarded $160,000.00 in pain and suffering.13 However, while the facts in Reed are analogous to Petitioner’s case (mainly in that both petitioners experienced improvement 11 Specifically, arthroscopy with excision of the distal end of the clavicle, excision of the os acromiale, debridement of the glenohumeral joint, subacromial decompression, and partial acromioplasty. Ex 11 at 19. 12 An official recording of the proceeding was taken by court reporter, and a link to instructions on the court’s website detailing how to order a certified transcript or audio recording of the proceeding can be found in the minute entries for this proceeding. Minute Entry, dated July 31, 2020; see also www.uscfc.uscourts.gov/trans (last visited July 9, 2020). 13 Reed v. Sec’y of Health & Human Servs., No. 16-1670V, 2019 WL 1222925 (Fed. Cl. Spec. Mstr. Feb. 1, 2019). 5 Case 1:17-vv-00990-UNJ Document 98 Filed 09/14/20 Page 6 of 7 after surgery), Ms. Reed rated her pain as 6-9/10 for six months, whereas Petitioner’s symptoms were consistently described as mild to moderate. Furthermore, Ms. Reed displayed severely limited ROM and attended more than 30 sessions of PT over 12 months, while Petitioner attended only 15 sessions over five months. Ms. Reed also continued to see a pain management physician two-and-a-half years after her surgery. Petitioner, by contrast, was only taking non-steroidal anti-inflammatory medications as needed within six months of her surgery. Petitioner also alleges that her case is similar to Reed because both petitioners found their ability to perform childcare limited by their injury – but the cases are not truly comparable on this issue. As previously noted, Petitioner was unable to lift and carry her infant grandson, while Ms. Reed was a single mother to an eight-year-old. Another factor suggesting that the pain and suffering award herein should be less than demanded by Petitioner is the significant, 3.5-year gap in her treatment, since it suggests an injury mild enough to tolerate for a long period of time. Treatment gaps are “a relevant consideration in determining the degree of Petitioner’s pain and suffering.” Dirksen v. Sec’y of Health & Human Servs., No. 16-1461V, 2018 WL 6293201, at *9-10 (Fed. Cl. Spec. Mstr. Oct. 18, 2018). Petitioner did not complain of shoulder pain from December 2015 to mid-July 2018, despite opportunities to do so at various visits to her PCP. She also declined cortisone injections and surgery when offered by Dr. Wu in November 2015. Petitioner boldly asserts the contrary, arguing that the treatment gap actually supports a higher award than in Reed, because she lived with the pain far longer (given that the petitioner in Reed underwent surgery within six months of injury). However, this argument is facially unpersuasive. The fact that Petitioner’s injury did not merit more invasive treatment on a shorter timeframe undercuts her allegations of its severity, and therefore supports a lesser pain and suffering award than Petitioner requests. Respondent, by contrast, references Knudson14 in his brief to support a lower award, but it too presents inapposite facts. The petitioner’s pain in that case had virtually resolved after only seven months. Even discounting Petitioner’s gap in treatment, she received active treatment for approximately two years total, and her pain and suffering award should account for that time, even if treatment was voluntarily delayed. In actuality, the factual circumstances in Petitioner’s case are more similar to those in Wallace.15 As with Petitioner, the Wallace petitioner received active treatment for variable symptoms over the course of approximately two years. He had two cortisone injections and attended multiple courses of physical therapy, and he also experienced significant improvement after surgery. Additionally, while the petitioner in Cooper16 did 14 Knudson v. Sec’y of Health & Human Servs., No. 17-1004V, 2018 WL 6293381 (Fed. Cl. Spec. Mstr. Nov 7, 2018) (awarding $110,000.00 for pain and suffering). 15 Wallace v. Sec’y of Health & Human Servs., No. 16-1472V, 2019 WL 4458393 (Fed. Cl. Spec. Mstr. June 27, 2019) (awarding $125,000.00 in pain and suffering). 16 Cooper v. Sec’y of Health & Human Servs., No. 16-1387V, 2018 WL 6288181, at *13 (Fed. Cl. Spec. Mstr. Nov. 7, 2018) (awarding $110,000.00 in pain and suffering). 6 Case 1:17-vv-00990-UNJ Document 98 Filed 09/14/20 Page 7 of 7 not undergo surgery, the court found that Ms. Cooper’s opting for conservative treatment (as Petitioner did in 2015) and treatment gaps justified reducing her award for pain and suffering. The same approach is justified under the facts of Ms. Stoliker’s case. Accordingly, I find an award of $120,000.00 is appropriate for Petitioner’s pain and suffering. IV. Conclusion For all of the reasons discussed above and based on consideration of the record as a whole, I find that $120,000.00 represents a fair and appropriate amount of compensation for Petitioner’s actual pain and suffering.17 I also find that Petitioner is entitled to $1,119.77 in actual unreimbursable expenses. Accordingly, I award Petitioner a lump sum payment of $121,119.77 in the form of a check payable to Petitioner. 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.18 IT IS SO ORDERED. s/Brian H. Corcoran Brian H. Corcoran Chief Special Master 17 Since this amount is being awarded for actual, rather than projected, pain and suffering, no reduction to net present value is required. See § 15(f)(4)(A); Childers v. Sec’y of Health & Human Servs., No. 96-0194V, 1999 WL 159844, at *1 (Fed. Cl. Spec. Mstr. Mar. 5, 1999) (citing Youngblood v. Sec’y of Health & Human Servs., 32 F.3d 552 (Fed. Cir. 1994)). 18 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. 7