VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01795
Package ID: USCOURTS-cofc-1_17-vv-01795
Petitioner: Steven Widner
Filed: 2017-11-15
Decided: 2019-08-14
Vaccine: influenza
Vaccination date: 2016-10-11
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 113681

AI-assisted case summary:
Steven Widner filed a petition for compensation under the National Vaccine Injury Compensation Program on November 15, 2017, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on October 11, 2016. The respondent reviewed the petition and medical records and conceded that the claim met the Table criteria for SIRVA, agreeing that no other cause for the injury was identified and that the petitioner suffered sequelae for more than six months. On December 3, 2018, the court issued a ruling on entitlement, finding Mr. Widner entitled to compensation. Subsequently, on May 28, 2019, the respondent filed a proffer on award of compensation, stating that Mr. Widner should be awarded $110,000.00 for pain and suffering and $3,681.82 for past out-of-pocket medical expenses, totaling $113,681.82. Mr. Widner, a competent adult, agreed with this proffered award. On August 14, 2019, the court issued a decision awarding Mr. Widner the stipulated amount of $113,681.82.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-01795-0
Date issued/filed: 2019-01-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/03/2018) regarding 25 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-01795-UNJ Document 28 Filed 01/15/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1795V
Filed: December 3, 2018
UNPUBLISHED
STEVEN WIDNER,
Petitioner, Special Processing Unit (SPU);
v. Ruling on Entitlement; Concession;
Table Injury; Influenza (Flu) Vaccine;
SECRETARY OF HEALTH AND Shoulder Injury Related to Vaccine
HUMAN SERVICES, Administration (SIRVA)
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On November 15, 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 he suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of receiving an influenza (“flu”) vaccine on October
11, 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 ruling on the United States Court of Federal Claims' website. This
means the ruling 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 ruling 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-01795-UNJ Document 28 Filed 01/15/19 Page 2 of 2
On November 30, 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 “reviewed the petition and medical records
filed in this case and concluded that petitioner’s claim meets the Table criteria for
SIRVA.” Id. at 3. Respondent further agrees that no other cause for petitioner’s injury
was identified, that he suffered sequela of his injury for more than six months, and that
he has met the statutory requirements for entitlement to 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-01795-1
Date issued/filed: 2019-08-14
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 05/29/2019) regarding 36 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-01795-UNJ Document 40 Filed 08/14/19 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1795V
Filed: May 29, 2019
UNPUBLISHED
STEVEN WIDNER,
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.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On November 15, 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 he suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of receiving an influenza (“flu”) vaccine on October
11, 2016. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On December 3, 2018, a ruling on entitlement was issued, finding petitioner
entitled to compensation for SIRVA. On May 28, 2019, respondent filed a proffer on
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-01795-UNJ Document 40 Filed 08/14/19 Page 2 of 4
award of compensation (“Proffer”) indicating petitioner should be awarded $110,000.00
in compensation for pain and suffering and $3,681.82 in compensation for past-out-of-
pocket medical expenses. 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 $113,681.82, representing $110,000.00 in
compensation for petitioner’s pain and suffering and $3,681.82 in compensation
for petitioner’s past out-of-pocket expenses, in the form of a check payable to
petitioner, Steven Widner. 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-01795-UNJ Document 40 Filed 08/14/19 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
*************************************
STEVEN WIDNER, *
*
Petitioner, * No. 17-1795V
* CHIEF SPECIAL MASTER
v. * NORA BETH DORSEY
*
SECRETARY OF HEALTH AND *
HUMAN SERVICES, *
*
Respondent. *
*************************************
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On November 30, 2018, respondent filed a Rule 4(c) Report, conceding that petitioner’s
claim meets the Table criteria for a SIRVA injury. On December 3, 2018, the Court issued a
Ruling on Entitlement finding petitioner entitled to compensation under the Vaccine Act.
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
the following, and requests that the Chief Special Master’s decision and the Court’s judgment
award:
1. A lump sum payment of $110,000.00, which represents compensation for pain and
suffering, see 42 U.S.C. § 300aa-15(a)(4); and
2. A payment of $3,681.82, which represents compensation for past out-of-pocket
medical expenses, see 42 U.S.C. § 300aa-15(a)(1).
These amounts represent all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees.
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 pain
and suffering.

Case 1:17-vv-01795-UNJ Document 40 Filed 08/14/19 Page 4 of 4
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that petitioner be awarded a lump sum payment of $113,681.82, in the
form of a check payable to petitioner. Petitioner agrees.
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/ DEBRA A. FILTEAU BEGLEY
DEBRA A. FILTEAU BEGLEY
Senior 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) 616-4181
Dated: May 28, 2019
2