VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01412
Package ID: USCOURTS-cofc-1_17-vv-01412
Petitioner: Debra Sepulveda
Filed: 2017-09-24
Decided: 2020-06-29
Vaccine: influenza
Vaccination date: 2015-12-04
Condition: Shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 126537

AI-assisted case summary:
Debra Sepulveda filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) after receiving an influenza vaccine on December 4, 2015. The respondent conceded that her injury was consistent with SIRVA caused by the flu vaccination and that she met all legal prerequisites for compensation. The respondent also confirmed no other cause for the injury was identified and that she suffered residual effects for more than six months. An initial ruling on entitlement was issued on September 24, 2018, finding her entitled to compensation. Subsequently, on May 22, 2020, the parties filed a proffer on award of damages. The court awarded Debra Sepulveda a total of $126,537.56. This amount included $120,000.00 for pain and suffering and $6,537.56 for unreimbursable expenses. The award was made as a lump sum payment.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-01412-0
Date issued/filed: 2018-10-24
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 09/24/2018) regarding 28 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-01412-UNJ Document 32 Filed 10/24/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1412V
Filed: September 24, 2018
UNPUBLISHED
DEBRA SEPULVEDA,
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.
Isaiah Richard Kalinowski, Maglio Christopher & Toale, PA, Washington, DC, for
petitioner.
Jennifer Leigh Reynaud, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On October 3, 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 December 4, 2015 influenza (“flu”)
vaccination. Petition at 1, 4. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On September 17, 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 determined that petitioner’s alleged
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-01412-UNJ Document 32 Filed 10/24/18 Page 2 of 2
injury is consistent with SIRVA that was caused by the administration of petitioner’s flu
vaccination.” Id. at 4. Respondent further agrees that no other cause for petitioner’s
injury was identified, that petitioner suffered residual effects of her condition for more
than six months, and that petitioner has satisfied all legal prerequisites for
compensation under the Vaccine 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-01412-1
Date issued/filed: 2020-06-29
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 05/22/2020) regarding 70 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:17-vv-01412-UNJ Document 74 Filed 06/29/20 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1412V
UNPUBLISHED
DEBRA SEPULVEDA, Chief Special Master Corcoran
Petitioner, Filed: May 22, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
Respondent. Administration (SIRVA)
Isaiah Richard Kalinowski, Maglio Christopher & Toale, PA, Washington, DC, for
petitioner.
Jennifer Leigh Reynaud, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
On October 3, 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 December 4, 2015 influenza (“flu”)
vaccination. Petition at 1, 4. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On September 24, 2018, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for her SIRVA. On May 22, 2020, Respondent filed a proffer
on award of compensation (“Proffer”) indicating Petitioner should be awarded
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-01412-UNJ Document 74 Filed 06/29/20 Page 2 of 5
$126,537.56, representing $120,000.00 for her actual and projected3 pain and suffering
and $6,537.56 for her actual unreimburseable expenses. Proffer at 1-2. In the Proffer,
Respondent represented that Petitioner agrees with the proffered award. Id. Based on
the record as a whole, I find that Petitioner is entitled to an award as stated in the
Proffer.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $126,537.56, representing $120,000.00 for her actual and future
pain and suffering and $6,537.56 for her actual unreimburseable expenses 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.4
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 The Proffer indicates that any amounts for projected pain and suffering have been reduced to net
present value. Proffer at 1 (citing § 15 (a)(4)).
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-01412-UNJ Document 74 Filed 06/29/20 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DEBRA SEPULVEDA,
Petitioner, No. 17-1412V
v. Chief Special Master Corcoran
ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
PROFFER ON AWARD OF DAMAGES
On October 3, 2017, Debra Sepulveda (“petitioner”) filed a petition for compensation
(“Petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -
34 (“Vaccine Act” or “Act”), as amended. The Petition alleges that petitioner received an
influenza (“flu”) vaccine in her left shoulder on December 4, 2015, and that she subsequently
suffered a Shoulder Injury Related to Vaccine Administration (“SIRVA”). Petition at 1, 4.
Respondent concluded that petitioner’s alleged injury satisfies the criteria of the Vaccine Injury
Table, and therefore conceded petitioner’s entitlement to compensation in his Rule 4(c) Report
filed on September 17, 2018. Based on Respondent’s Rule 4(c) Report the Court found
petitioner entitled to compensation.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $120,000.00 in actual and
projected pain and suffering. This amount reflects that any award for projected pain and
suffering has been reduced to net present value. See 42 U.S.C. § 300aa-15(a)(4). Petitioner
agrees.
1

Case 1:17-vv-01412-UNJ Document 74 Filed 06/29/20 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents her expenditure of past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $6,537.56. Petitioner agrees.
II. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $126,537.56, in the form of a check made payable to petitioner.1
This lump sum payment represents all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
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
GABRIELLE M. FIELDING
Assistant Director
Torts Branch, Civil Division
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

Case 1:17-vv-01412-UNJ Document 74 Filed 06/29/20 Page 5 of 5
s/Jennifer L. Reynaud
JENNIFER L. REYNAUD
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 305-1586
Date: May 22, 2020
3