VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01837
Package ID: USCOURTS-cofc-1_17-vv-01837
Petitioner: Praveen Mathada
Filed: 2017-11-27
Decided: 2019-04-30
Vaccine: Tdap
Vaccination date: 2016-08-15
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 50000

AI-assisted case summary:
On November 27, 2017, Praveen Mathada filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) after receiving a Tetanus Diphtheria acellular Pertussis (Tdap) vaccination on August 15, 2016. Mr. Mathada claimed residual effects of the condition lasting more than six months. The respondent, the Secretary of Health and Human Services, denied that the Tdap vaccine caused Mr. Mathada's SIRVA or any other injury. The parties, represented by Shealene Priscilla Mancuso of Muller Brazil, LLP for the petitioner and Ashley Monique Simpson of the U.S. Department of Justice for the respondent, filed a joint stipulation on April 30, 2019. In this stipulation, they agreed to an award of compensation. Chief Special Master Nora Beth Dorsey reviewed and adopted the stipulation as the decision of the Court. The decision awarded Mr. Mathada a lump sum of $50,000.00, payable by check to the petitioner, as compensation for all items of damages. The public decision does not describe the specific onset of symptoms, diagnostic tests, treatments, or expert witnesses involved in this case. The decision was originally filed on April 30, 2019, and the full decision document was filed on August 7, 2019.

Theory of causation field:
Petitioner Praveen Mathada alleged a shoulder injury related to vaccine administration (SIRVA) following a Tdap vaccination on August 15, 2016, with residual effects lasting over six months. Respondent denied causation. The parties filed a joint stipulation on April 30, 2019, agreeing to compensation. Chief Special Master Nora Beth Dorsey adopted the stipulation, awarding a lump sum of $50,000.00 for all damages. The theory of causation is based on the "Table" of the Vaccine Injury Table, which presumes SIRVA is vaccine-related if it meets certain criteria. The public decision does not detail specific medical experts, the mechanism of injury, or the evidence presented beyond the stipulation.

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_17-vv-01837-0
Date issued/filed: 2019-08-07
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 04/30/2019) regarding 36 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
--------------------------------------------------------------------------------
Case 1:17-vv-01837-UNJ Document 42 Filed 08/07/19 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-1837V
Filed: April 30, 2019
UNPUBLISHED
PRAVEEN MATHADA,
Petitioner,
Special Processing Unit (SPU); Joint
v.
Stipulation on Damages; Tetanus
Diphtheria acellular Pertussis (Tdap)
SECRETARY OF HEALTH AND
Vaccine; Shoulder Injury Related to
HUMAN SERVICES,
Vaccine Administration (SIRVA)
Respondent.
Shealene Priscilla Mancuso, Muller Brazil, LLP, Dresher, PA, for petitioner.
Ashley Monique Simpson, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
Dorsey, Chief Special Master:
On November 27, 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”) following receipt of his August 15, 2016 Tetanus Diphtheria
acellular Pertussis (“Tdap”) vaccination . Petition at 1; Stipulation, filed April 30, 2019,
at ¶¶ 4. Petitioner further alleges that he experienced residual effects of this condition
for more than six months and that there has been no prior award or settlement of a civil
action for damage on his behalf as a result of his condition. Petition at 3; Stipulation at
¶¶ 4-5. “Respondent denies that the Tdap vaccine is the cause of petitioner’s SIRVA or
any other injury or condition. ” Stipulation at ¶ 6.
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-01837-UNJ Document 42 Filed 08/07/19 Page 2 of 7
Nevertheless, on April 30, 2019, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. The undersigned
finds the stipulation reasonable and adopts it as the decision of the Court in awarding
damages, on the terms set forth therein.
Pursuant to the terms stated in the attached Stipulation, the undersigned
awards the following compensation:
A lump sum of $50,000.00 in the form of a check payable to petitioner.
Stipulation at ¶ 8. This amount represents compensation for all items of
damages that would be available under § 15(a). Id.
The undersigned approves the requested amount for petitioner’s compensation.
In the absence of a motion for review filed pursuant to RCFC Appendix B, 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-01837-UNJ Document 42 Filed 08/07/19 Page 3 of 7

Case 1:17-vv-01837-UNJ Document 42 Filed 08/07/19 Page 4 of 7

Case 1:17-vv-01837-UNJ Document 42 Filed 08/07/19 Page 5 of 7

Case 1:17-vv-01837-UNJ Document 42 Filed 08/07/19 Page 6 of 7

Case 1:17-vv-01837-UNJ Document 42 Filed 08/07/19 Page 7 of 7