VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00183
Package ID: USCOURTS-cofc-1_18-vv-00183
Petitioner: Zach Kellen
Filed: 2018-02-06
Decided: 2019-11-14
Vaccine: influenza
Vaccination date: 2016-11-29
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 52500

AI-assisted case summary:
Zach Kellen filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered a left shoulder injury related to vaccine administration (SIRVA) as a result of his November 29, 2016 influenza vaccination. The case was assigned to the Special Processing Unit. Respondent filed a Rule 4(c) report conceding entitlement, stating that petitioner's alleged injury was consistent with SIRVA as defined on the Vaccine Injury Table. Respondent further agreed that no other condition or abnormality was identified to explain his condition, that petitioner suffered residual effects for more than six months, and that all legal prerequisites for compensation were satisfied. A ruling on entitlement was issued on March 5, 2019, finding petitioner entitled to compensation. Subsequently, on September 10, 2019, respondent filed a proffer on award of compensation, recommending an award of $52,500.00 for pain and suffering, which petitioner agreed to. The Chief Special Master issued a decision awarding petitioner a lump sum payment of $52,500.00 for pain and suffering, representing all elements of compensation under the Vaccine Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-00183-0
Date issued/filed: 2019-04-24
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/05/2019) regarding 22 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:18-vv-00183-UNJ Document 26 Filed 04/24/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-183V
Filed: March 5, 2019
UNPUBLISHED
ZACH KELLEN,
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.
Shealene Priscilla Mancuso, Muller Brazil, LLP, Dresher, PA, for petitioner.
Linda Sara Renzi, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On February 6, 2018, 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 left shoulder injury related to
vaccine administration (“SIRVA”) as a result of his November 29, 2016 influenza (“flu”)
vaccination. 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 1:18-vv-00183-UNJ Document 26 Filed 04/24/19 Page 2 of 2
On March 4, 2019, 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 concluded that petitioner’s alleged injury is
consistent with SIRVA, as defined on the Vaccine Injury Table. Id. at 5. Respondent
further agrees that no other condition or abnormality was identified to explain his
condition, that petitioner suffered residual effects of his injury 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_18-vv-00183-1
Date issued/filed: 2019-11-14
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 09/13/2019) regarding 35 DECISION Stipulation/Proffer Signed by Special Master Nora Beth Dorsey. (sw) Service on parties made.
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Case 1:18-vv-00183-UNJ Document 41 Filed 11/14/19 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-183V
Filed: September 13, 2019
UNPUBLISHED
ZACH KELLEN,
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.
Shealene Priscilla Mancuso, Muller Brazil, LLP, Dresher, PA, for petitioner.
Linda Sara Renzi, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On February 6, 2018, 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 left shoulder injury related to
vaccine administration (“SIRVA”) as a result of his November 29, 2016 influenza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On March 5, 2019, a ruling on entitlement was issued, finding petitioner entitled
to compensation for SIRVA. On September 10, 2019, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $52,500.00,
for pain and suffering. Proffer at 1. In the Proffer, respondent represented that
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 1:18-vv-00183-UNJ Document 41 Filed 11/14/19 Page 2 of 4
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 $52,500.00, for pain and suffering, in the form
of a check payable to petitioner, Zach Kellen. 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 1:18-vv-00183-UNJ Document 41 Filed 11/14/19 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
ZACH KELLEN, )
)
Petitioner, ) No. 18-183V
) Chief Special Master
v. ) Nora Beth Dorsey
) ECF
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On March 4, 2019, respondent filed a Rule 4 (c) Report conceding entitlement in
this case. On March 5, 2019, the Chief Special Master issued a Ruling on Entitlement
finding that petitioner was entitled to vaccine compensation for his Shoulder Injury Related
to Vaccine Administration (“SIRVA”). Respondent proffers that based on the evidence of
record, petitioner should be awarded $52,500.00, for pain and suffering. This amount
represents all elements of compensation to which petitioner is entitled under 42 U.S.C. §
300aa-15(a)(1); 15(a)(3)(A); and 15(a)(4). Petitioner agrees.
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be
made through a lump sum payment as described below, and request that the Chief Special
Master’s decision and the Court’s judgment award the following:1
1 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 medical expenses, future lost earnings, and future pain and suffering.

Case 1:18-vv-00183-UNJ Document 41 Filed 11/14/19 Page 4 of 4
A lump sum payment of $52,500.00, in the form of a check payable to
petitioner, Zach Kellen. This amount accounts for all elements of
compensation under 42 U.S.C. § 300aa-15(a) to which petitioner is
entitled.
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/ Linda S. Renzi
LINDA S. RENZI
Senior Trial Counsel
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel.: (202) 616-4133
Dated: September 10, 2019