VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01139
Package ID: USCOURTS-cofc-1_17-vv-01139
Petitioner: Raquel Fournier
Filed: 2017-08-23
Decided: 2018-09-26
Vaccine: influenza
Vaccination date: 2016-09-30
Condition: left shoulder injuries
Outcome: compensated
Award amount USD: 102196

AI-assisted case summary:
Raquel Fournier filed a petition for compensation under the National Vaccine Injury Compensation Program on August 23, 2017, alleging that she suffered left shoulder injuries due to an influenza vaccination received on September 30, 2016. The case was assigned to the Special Processing Unit. On June 11, 2018, the respondent filed a Rule 4(c) report conceding that petitioner's alleged injury was consistent with a shoulder injury related to vaccine administration (SIRVA) and that she met the statutory requirements for compensation. Based on the respondent's concession and the evidence of record, Chief Special Master Nora Beth Dorsey issued a ruling on entitlement, finding petitioner entitled to compensation. Subsequently, on June 22, 2018, the respondent filed a proffer on the award of compensation. The proffer recommended a lump sum payment of $95,169.66 to petitioner and $7,027.61 to satisfy a Medicaid lien, which petitioner agreed to. Chief Special Master Dorsey issued a decision awarding damages based on this proffer. The total award was $102,196.66, consisting of $95,169.66 payable to Raquel Fournier and $7,027.61 payable jointly to Raquel Fournier and the California Department of Health Care Services to satisfy the Medicaid lien. Petitioner agreed to endorse the latter check to the state of California. Petitioner was represented by Danielle Strait of Maglio Christopher & Toale, PA, and respondent was represented by Ilene Clair Albala of the U.S. Department of Justice.

Theory of causation field:
Petitioner Raquel Fournier alleged left shoulder injuries from an influenza vaccine administered on September 30, 2016. The respondent conceded that the injury was consistent with a shoulder injury related to vaccine administration (SIRVA), a condition listed in the Vaccine Injury Table. Petitioner met the statutory requirements for compensation. The case resulted in a compensated outcome. The award was a total of $102,196.66, comprising a lump sum of $95,169.66 to petitioner and $7,027.61 to satisfy a Medicaid lien. Chief Special Master Nora Beth Dorsey presided over the case. Petitioner was represented by Danielle Strait (Maglio Christopher & Toale, PA), and respondent was represented by Ilene Clair Albala (U.S. Department of Justice). The decision date was September 26, 2018.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-01139-0
Date issued/filed: 2018-09-19
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/11/2018) regarding 27 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-01139-UNJ Document 34 Filed 09/19/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1139V
Filed: June 11, 2018
UNPUBLISHED
RAQUEL FOURNIER,
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.
Danielle Strait, Maglio Christopher & Toale, PA, Seattle, WA, for petitioner.
Ilene Clair Albala, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On August 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 that she suffered left shoulder injuries due to an
influenza vaccination received on September 30, 2016. Petition at 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On June 11, 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 “petitioner’s alleged injury is consistent with a shoulder
injury related to vaccine administration (“SIRVA”). Id. at 3. Respondent further agrees
that “petitioner met the statutory requirements by suffering the condition for more than
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-01139-UNJ Document 34 Filed 09/19/18 Page 2 of 2
six months . . . [and] 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

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DOCUMENT 2: USCOURTS-cofc-1_17-vv-01139-1
Date issued/filed: 2018-09-26
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 06/22/2018) regarding 30 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-01139-UNJ Document 35 Filed 09/26/18 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1139V
Filed: June 22, 2018
UNPUBLISHED
RAQUEL FOURNIER,
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.
Danielle Strait, Maglio Christopher & Toale, PA, Seattle, WA, for petitioner.
Ilene Clair Albala, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On August 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 that she suffered left shoulder injuries due to an
influenza vaccination received on September 30, 2016. Petition at 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On June 11, 2018, a ruling on entitlement was issued, finding petitioner entitled
to compensation for her SIRVA. On June 22, 2018, respondent filed a proffer on award
of compensation (“Proffer”) indicating petitioner should be awarded a lump sum of
$95,169.66, as well as $7,027.61 to satisfy a Medicaid lien. Proffer at 1. 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.
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-01139-UNJ Document 35 Filed 09/26/18 Page 2 of 4
Pursuant to the terms stated in the attached Proffer, the undersigned awards
the following compensation, which represents compensation for all damages that
would be available under § 300aa-15(a):
1. A lump sum payment of $95,169.66 in the form of a check payable to
petitioner, Raquel Fournier; and
2. A lump sum payment of $7,027.61, representing compensation to the state of
California of a Medicaid lien, in the form of a check payable jointly to petitioner
and to:
Department of Health Care Services
Recovery Branch – MS4720
P.O. Box 997421
Sacramento, CA 95899-7421
Petitioner agrees to endorse this check to the state of California.
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-01139-UNJ Document 35 Filed 09/26/18 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
RAQUEL FOURNIER, )
)
Petitioner, )
) No. 17-1139V
v. ) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
PROFFER ON AWARD OF COMPENSATION
I. Items of Compensation
On June 11, 2018, Chief Special Master Dorsey issued a Ruling on Entitlement finding
that petitioner is entitled to vaccine compensation for her shoulder injury related to vaccine
administration (“SIRVA”). Based upon the evidence of record, respondent proffers that
petitioner should be awarded compensation consisting of a lump sum of $95,169.66, as well as
$7,027.61 to satisfy a Medicaid lien, which 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
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $95,169.66, in the form of a check payable to petitioner, as well
as a lump sum payment of $7,027.61, representing reimbursement to the state of California
Medicaid lien (“Medi-Cal”), in the form of a check payable jointly to petitioner and:

Case 1:17-vv-01139-UNJ Document 35 Filed 09/26/18 Page 4 of 4
Department of Health Care Services
Recovery Branch – MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
Petitioner agrees to endorse this check to the state of California.
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
HEATHER L. PEARLMAN
Assistant Director
Torts Branch, Civil Division
/s/ Ilene Albala
ILENE ALBALA
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Ben Franklin Station
Washington, D.C. 20044-0146
Direct dial: (202) 616-3655
Dated: June 22, 2018
1 Should petitioner die prior to the 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 lost earnings, and future pain and suffering.
2