Tracy Murray v. HHS - Influenza, shoulder injury related to vaccine administration (SIRVA) (2023)
Case summary [AI summaries can sometimes make mistakes]
On September 27, 2017, Tracy Murray, a 46-year-old adult, filed a petition alleging that an influenza vaccine administered on October 12, 2016, caused her to suffer a shoulder injury related to vaccine administration (SIRVA). Petitioner initially sought compensation under the Vaccine Injury Table for SIRVA.
However, the Special Master found that while petitioner experienced immediate pain and itching at the injection site and throat symptoms consistent with an allergic reaction the day after vaccination, the medical records did not conclusively demonstrate that her musculoskeletal shoulder pain began within the 48-hour timeframe required for a Table SIRVA injury. The Special Master noted that prednisone treatment may have masked the onset of her shoulder pain.
Consequently, the Table SIRVA claim was denied. Petitioner also pursued an "off-Table" claim, arguing the vaccine was the cause-in-fact of her shoulder injury.
The Special Master reviewed the evidence and expert opinions to determine if the vaccine was the actual cause. Petitioner's experts, orthopedic surgeons Clifford J.
Colwell, Jr., M.D., and Uma Srikuraman, M.D., opined that the flu vaccine could cause bursitis and shoulder inflammation through an immune-mediated inflammatory reaction. They argued that petitioner's symptoms, including shoulder pain, limited range of motion, and positive physical exam tests consistent with bursitis, were caused by the vaccine.
They also contended that while petitioner's MRI did not show bursal fluid, this did not rule out acute bursitis, and that her surgical intervention supported an acute process. They further argued that alternative explanations like AC joint arthritis or cervical radiculopathy were not fully supported by the evidence.
Respondent's expert, orthopedic surgeon Brian Feeley, M.D., argued that petitioner's immediate symptoms were due to an allergic reaction, not bursitis, and that her shoulder pain onset occurred about a week after vaccination, outside the typical timeframe for acute bursitis. He suggested AC joint arthritis or cervical radiculopathy as more likely causes.
The Special Master found Dr. Feeley's arguments less persuasive.
The Special Master concluded that petitioner had established a reputable medical theory connecting the vaccine to her injury, a logical sequence of cause and effect supported by her medical records and expert opinions, and a proximate temporal relationship, finding that her shoulder symptoms began within a medically acceptable timeframe, even if not precisely within 48 hours. The Special Master determined that respondent had not persuasively established that factors unrelated to the vaccine caused petitioner's condition.
Following the entitlement ruling, a damages decision was issued on February 23, 2023. Tracy Murray was awarded a total of $97,839.11.
This amount comprised a lump sum payment of $90,000.00 for pain and suffering and $7,839.11 to satisfy a State of Maine Medicaid lien. Petitioner was represented by Leah VaSahnja Durant of the Law Offices of Leah V.
Durant, PLLC, and respondent was represented by Austin Joel Egan of the U.S. Department of Justice.
Special Master Daniel T. Horner issued both the entitlement and damages decisions.
Theory of causation
Petitioner Tracy Murray, age 46, received an influenza vaccine on October 12, 2016. She alleged a shoulder injury related to vaccine administration (SIRVA). The claim was initially pursued as a Table Injury, but the Special Master found the evidence insufficient to establish onset of musculoskeletal shoulder pain within the 48-hour requirement. The case proceeded as an "off-Table" cause-in-fact claim. Petitioner's experts, Drs. Colwell and Srikuraman, proposed a medical theory that vaccine antigens injected into the shoulder can trigger an immune-mediated inflammatory reaction, leading to bursitis and shoulder dysfunction, supported by studies like Atanasoff et al. and Hesse et al. They argued that petitioner's symptoms, including pain, limited range of motion, and surgical findings, demonstrated an acute vaccine-caused bursitis, and that alternative diagnoses like AC joint arthritis or cervical radiculopathy were not fully supported. Respondent's expert, Dr. Feeley, contended that petitioner's symptoms were more consistent with an allergic reaction and AC joint arthritis or cervical radiculopathy, and that her presentation was inconsistent with acute bursitis. Special Master Daniel T. Horner found that petitioner established a reputable medical theory, a logical sequence of cause and effect, and a proximate temporal relationship, concluding that the flu vaccine was the cause-in-fact of her shoulder injury. The Special Master rejected respondent's alternative explanations. Petitioner was awarded $90,000.00 for pain and suffering and $7,839.11 for a Medicaid lien, totaling $97,839.11. Attorneys: Leah VaSahnja Durant (Petitioner), Austin Joel Egan (Respondent). Decision Date: October 27, 2022 (Entitlement), February 23, 2023 (Damages).