VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01422
Package ID: USCOURTS-cofc-1_17-vv-01422
Petitioner: Wanda Evin
Filed: 2017-10-03
Decided: 2019-08-14
Vaccine: influenza
Vaccination date: 2014-10-07
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 116199

AI-assisted case summary:
Wanda Evin filed a petition for compensation under the National Vaccine Injury Compensation Program on October 3, 2017, alleging she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of her influenza vaccination on October 7, 2014. The respondent conceded entitlement to compensation, agreeing that her injury was consistent with SIRVA as defined on the Vaccine Injury Table. Specifically, she had no prior history of shoulder pain, her pain and reduced range of motion occurred within 48 hours of vaccination, her symptoms were limited to the vaccinated shoulder, and no other condition explained her symptoms. A ruling on entitlement was issued on September 7, 2018, finding her entitled to compensation. On May 26, 2019, the respondent filed a proffer on award of compensation, proposing an award of $116,199.60, which included $110,000.00 for pain and suffering and $6,199.60 for past lost wages. The petitioner agreed with this award. The court awarded the lump sum payment of $116,199.60 to Wanda Evin.

Theory of causation field:
Table

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_17-vv-01422-0
Date issued/filed: 2018-10-24
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 09/07/2018) regarding 24 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
--------------------------------------------------------------------------------
Case 1:17-vv-01422-UNJ Document 28 Filed 10/24/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1422V
Filed: September 7, 2018
UNPUBLISHED
WANDA EVIN,
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.
Kate Gerayne Westad, Larkin Hoffman, et al., Ltd, for petitioner.
Traci R. Patton, 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 suffers a Shoulder Injury Related to Vaccine
Administration (“SIRVA”) as a result of her October 7, 2014 influenza (“flu”) vaccination.
Petition at 1. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On September 5, 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 indicates that
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-01422-UNJ Document 28 Filed 10/24/18 Page 2 of 2
DICP has reviewed the petition and medical records filed in this case and
has concluded that compensation is appropriate in this case. DICP has
concluded that petitioner’s alleged injury is consistent with SIRVA, as
defined on the Vaccine Injury Table. Specifically, petitioner had no history
of pain, inflammation or dysfunction in her left shoulder; her pain and
reduced range of motion occurred within 48 hours of receipt of an
intramuscular vaccination; her symptoms were limited to the shoulder in
which the vaccine was administered; and no other condition or
abnormality was identified to explain her symptoms. 42 C.F.R. § 100.3(a),
(c)(10)
Id. at 3-4 (footnotes omitted).
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 2: USCOURTS-cofc-1_17-vv-01422-1
Date issued/filed: 2019-08-14
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 05/28/2019) regarding 41 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
--------------------------------------------------------------------------------
Case 1:17-vv-01422-UNJ Document 45 Filed 08/14/19 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1422V
Filed: May 28, 2019
UNPUBLISHED
WANDA E. EVIN,
Petitioner,
Special Processing Unit (SPU);
v.
Damages Decision Based on Proffer;
Influenza (Flu) Vaccine; Shoulder
SECRETARY OF HEALTH AND
Injury Related to Vaccine
HUMAN SERVICES,
Administration (SIRVA)
Respondent.
Kate Gerayne Westad, SiebenCarey, Minneapolis, MN, for petitioner.
Traci R. Patton, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
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”) as a result of her October 7, 2014 influenza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On September 7, 2018, a ruling on entitlement was issued, finding petitioner
entitled to compensation for SIRVA. On May 26, 2019, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $116,199.60.
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-01422-UNJ Document 45 Filed 08/14/19 Page 2 of 4
The award is comprised of the following: $110,000.00 for pain and suffering; and
$6,199.60 for past lost wages. Proffer at 1. 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
petitioner a lump sum payment of $116,199.60 (comprised of the following:
$110,000.00 for pain and suffering and $6,199.60 for past lost wages) in the form
of a check payable to petitioner, Wanda E. Evin. 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.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-01422-UNJ Document 45 Filed 08/14/19 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
WANDA EVIN,
)
)
Petitioner,
) No. 17-1422V
v.
) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND HUMAN
)
SERVICES,
)
)
Respondent.
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Items of Compensation
On September 5, 2018, respondent conceded that entitlement to compensation was
appropriate under the terms of the Vaccine Act. Chief Special Master Dorsey issued a Ruling on
Entitlement on September 7, 2018, finding that petitioner was entitled to vaccine compensation
for her left-sided shoulder injury related to vaccination administration (“SIRVA”). Based upon
the evidence of record, respondent proffers that petitioner should be awarded $116,199.60. The
award is comprised of the following: $110,000.00 for pain and suffering; and $6,199.60 for past
lost wages. This amount represents all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.1
1 As soon as practicable after the entry of judgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to 42
U.S.C. § 300aa-21(a)(1) and an application, the parties will submit to further proceedings before
the special master to award reasonable attorneys’ fees and costs incurred in proceeding upon this
petition.

Case 1:17-vv-01422-UNJ Document 45 Filed 08/14/19 Page 4 of 4
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
a lump sum payment of $116,199.60, in the form of a check payable to petitioner.2 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
s/ Traci R. Patton
TRACI R. PATTON
Senior Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Telephone: (202) 353-1589
Dated: May 22, 2019
2 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 pain and
suffering.
2