VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01176
Package ID: USCOURTS-cofc-1_17-vv-01176
Petitioner: Jennifer Claypool
Filed: 2018-06-22
Decided: 2019-05-29
Vaccine: Tdap
Vaccination date: 2016-06-22
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 73329

AI-assisted case summary:
Jennifer Claypool filed a petition for compensation under the National Vaccine Injury Compensation Program on June 22, 2018. She alleged that she received a Tetanus diphtheria acellular pertussis (Tdap) vaccination on June 22, 2016, and subsequently developed a left shoulder injury related to vaccine administration (SIRVA). The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report conceding that petitioner's injury was caused-in-fact by the Tdap vaccine and that she met all legal prerequisites for compensation. On June 26, 2018, Chief Special Master Nora Beth Dorsey issued a ruling on entitlement, finding petitioner entitled to compensation. Subsequently, on March 29, 2019, the parties submitted a proffer on the award of compensation. The respondent proposed an award of $73,329.86, which included $72,621.73 for unreimbursed past expenses and past and future pain and suffering, and $708.13 to satisfy a State of Nevada Medicaid lien. Petitioner agreed with this proffered award. Chief Special Master Dorsey issued a decision on May 29, 2019, awarding Jennifer Claypool the total sum of $73,329.86. This amount was to be paid as a lump sum of $72,621.73 to petitioner, Jennifer Claypool, and a lump sum of $708.13 to satisfy the State of Nevada Medicaid lien. Petitioner is a competent adult and did not require guardianship. Joseph Alexander Vuckovich of Maglio Christopher & Toale, PA, represented the petitioner, and Daniel Anthony Principato of the U.S. Department of Justice represented the respondent. The public decision does not describe the specific onset of symptoms, medical tests performed, or treatments received.

Theory of causation field:
Petitioner Jennifer Claypool received a Tdap vaccine on June 22, 2016, and alleged a left shoulder injury related to vaccine administration (SIRVA). The respondent conceded causation-in-fact, agreeing that the Tdap vaccine caused petitioner's injury. The case proceeded to an award of compensation based on this concession. The theory of causation was determined to be off-Table. The parties stipulated to an award of $73,329.86, comprising $72,621.73 for unreimbursed past expenses and past and future pain and suffering, and $708.13 to satisfy a State of Nevada Medicaid lien. Chief Special Master Nora Beth Dorsey issued the ruling on entitlement on June 26, 2018, and the final decision awarding damages on May 29, 2019. Petitioner was represented by Joseph Alexander Vuckovich, and respondent by Daniel Anthony Principato. The public text does not detail specific medical experts, the mechanism of injury, or the specific onset and progression of symptoms.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-01176-0
Date issued/filed: 2018-09-26
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/26/2018) regarding 26 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-01176-UNJ Document 33 Filed 09/26/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1176V
Filed: June 26, 2018
UNPUBLISHED
JENNIFER CLAYPOOL,
Special Processing Unit (SPU);
Petitioner, Ruling on Entitlement; Concession;
v. Causation-In-Fact; Tetanus
Diphtheria acellular Pertussis (Tdap)
SECRETARY OF HEALTH AND Vaccine; Shoulder Injury Related to
HUMAN SERVICES, Vaccine Administration (SIRVA)
Respondent.
Joseph Alexander Vuckovich, Maglio Christopher & Toale, PA, Washington, DC, for
petitioner.
Daniel Anthony Principato, U.S. Department of Justice, Washington, DC, for
respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On June 22, 2018, 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 a Tetanus diphtheria acellular pertussis
(“Tdap”) vaccination on June 22, 2016, and thereafter suffered from a left 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.
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-01176-UNJ Document 33 Filed 09/26/18 Page 2 of 2
On June 22, 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 a preponderance of evidence
stablishes that petitioner’s injury was caused-in-fact by the administration of the Tdap
vaccine on June 22, 2016. Id. at 3. Respondent further agrees that petitioner has
satisfied all legal prerequisites for compensation under the Vaccine Act. Id. at 5.
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-01176-1
Date issued/filed: 2019-05-29
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 03/29/2019) regarding 47 DECISION Stipulation/Proffer (Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-01176-UNJ Document 50 Filed 05/29/19 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1176V
Filed: March 29, 2019
UNPUBLISHED
JENNIFER CLAYPOOL,
Petitioner,
Special Processing Unit (SPU);
v.
Damages Decision Based on Proffer;
Tetanus Diphtheria acellular
SECRETARY OF HEALTH AND
Pertussis (Tdap) Vaccine; Shoulder
HUMAN SERVICES,
Injury Related to Vaccine
Administration (SIRVA)
Respondent.
Joseph Alexander Vuckovich, 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 June 22, 2018, 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”) as a result of a Tetanus diphtheria acellular pertussis (“Tdap”)
vaccination she received on June 22, 2016. 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 decision on the United States Court of Federal Claims' website.
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, the
undersigned agrees that the identified material fits within this definition, the undersigned will redact such
material from public access. Because this unpublished decision 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-01176-UNJ Document 50 Filed 05/29/19 Page 2 of 5
On June 26, 2018, a ruling on entitlement was issued, finding petitioner entitled
to compensation for a SIRVA. On March 29, 2019, respondent filed a proffer on award
of compensation (“Proffer”) indicating petitioner should be awarded $72,621.73
(representing $121.73 for unreimbursed past expenses and $72,500.00 for past and
future pain and suffering) and $708.13 to satisfy a State of Nevada Medicaid lien.
Proffer at 2. In the Proffer, respondent represented that petitioner agrees 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
(1) Petitioner a lump sum payment of $72,621.73 (representing $121.73 for
unreimbursed past expenses and $72,500.00 for past and future pain and
suffering) in the form of a check payable to petitioner, Jennifer Claypool;
and
(2) A lump sum payment of $708.13, representing compensation for
satisfaction of the State of Nevada Medicaid lien3 and to:
State of Nevada Division of Health Care Financing and Policy
HMS NV Casualty Unit
PO Box 844648
Los Angeles, CA 90084
The clerk of the court is directed to enter judgment in accordance with this
decision.4
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 Petitioner agrees to endorse this payment to the State of Nevada.
4 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-01176-UNJ Document 50 Filed 05/29/19 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
JENNIFER CLAYPOOL, )
)
Petitioner, ) No. 17-1176V
) 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 June 22, 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 June 26, 2018, the Chief Special
Master issued a Ruling on Entitlement.
Respondent now proffers that, based on the evidence of record, petitioner should be
awarded $73,329.86. 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 payments 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-01176-UNJ Document 50 Filed 05/29/19 Page 4 of 5
A. Petitioner’s Damages
A lump sum payment of $72,621.73 (representing $121.73 for unreimbursed past
expenses and $72,500 for past and future pain and suffering) in the form of a check payable to
petitioner, Jennifer Claypool.
B. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy the State of
Nevada Medicaid lien in the amount of $708.13, which represents full satisfaction of any right of
subrogation, assignment, claim, lien, or cause of action the State of Nevada had made to or on
behalf of Jennifer Claypool from the date of her eligibility for benefits through the date of
judgment in this case as a result of her vaccine-related injury suffered on or about June 22, 2016,
under Title XIX of the Social Security Act. Reimbursement of the State of Nevada lien shall be
made through a lump sum payment of $708.13, representing compensation for satisfaction of the
State of Nevada lien, payable jointly to petitioner, and
State of Nevada Division of Health Care Financing and Policy
HMS NV Casualty Unit
PO Box 844648
Los Angeles, CA 90084
Petitioner agrees to endorse this payment to the State of Nevada.
C. Guardianship
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
III. Summary of Recommended Payments Following Judgment
A. Lump sum paid to petitioner $72,621.73
B. Reimbursement of Medicaid lien $708.13
2

Case 1:17-vv-01176-UNJ Document 50 Filed 05/29/19 Page 5 of 5
Respectfully submitted,
JOSEPH H. HUNT
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/ 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: March 29, 2019
3