VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00506
Package ID: USCOURTS-cofc-1_18-vv-00506
Petitioner: Bich Ngoc To
Filed: 2018-04-06
Decided: 2020-10-28
Vaccine: Tdap
Vaccination date: 2017-04-28
Condition: right shoulder injury
Outcome: compensated
Award amount USD: 147815

AI-assisted case summary:
Bich Ngoc To filed a petition for compensation under the National Vaccine Injury Compensation Program on April 6, 2018, alleging a right shoulder injury resulting from a Tdap vaccine administered on April 28, 2017. The case was assigned to the Special Processing Unit. On March 30, 2020, the Respondent conceded that Petitioner was entitled to compensation, agreeing that her claim met the Table criteria for Shoulder Injury Related to Vaccine Administration (SIRVA). The Respondent also confirmed the case was timely filed, the vaccine was received in the United States, and Petitioner satisfied the statutory severity requirement. A ruling on entitlement was issued on April 3, 2020, finding Petitioner entitled to compensation. On September 25, 2020, the Respondent filed a proffer on award of compensation, proposing an award of $147,815.81, which Petitioner agreed to. This amount included $140,604.50 for pain and suffering and future medical expenses, and $7,211.31 to satisfy a Medi-Cal lien. The decision dated October 28, 2020, awarded Petitioner the stipulated amount.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-00506-0
Date issued/filed: 2020-05-04
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/03/2020) regarding 45 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-00506-UNJ Document 47 Filed 05/04/20 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-506V
UNPUBLISHED
NGOC BICH TO, Chief Special Master Corcoran
Petitioner, Filed: April 3, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Tetanus Diphtheria
acellular Pertussis (Tdap) Vaccine;
Respondent. Shoulder Injury Related to Vaccine
Administration (SIRVA)
Hoa Xuan Manh, Charles H. Manh, P.C., Westminster, CA, for petitioner.
Camille Michelle Collett, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On April 6, 2018, Ngoc Bich To 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 right shoulder injury as a result of
a tetanus-diphtheria-acellular pertussis (“Tdap”) vaccine administered on April 28, 2017.
Petition at 2, 5. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On March 30, 2020, 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
1 Because this unpublished ruling 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 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, 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 1:18-vv-00506-UNJ Document 47 Filed 05/04/20 Page 2 of 2
at 1. Specifically, Respondent concludes that “petitioner’s claim meets the Table criteria
for SIRVA.” Id. at 3. Respondent further agrees “that the case was timely filed, that the
vaccine was received in the United States, and that petitioner satisfies the statutory
severity requirement by suffering the residual effects or complications of her injury for
more than six months after vaccine administration.” Id. at 4
In view of Respondent’s position and the evidence of record, I find that
Petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
2

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DOCUMENT 2: USCOURTS-cofc-1_18-vv-00506-1
Date issued/filed: 2020-10-28
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 09/28/2020) regarding 55 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-00506-UNJ Document 58 Filed 10/28/20 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-506V
UNPUBLISHED
BICH NGOC TO, Chief Special Master Corcoran
Petitioner, Filed: September 28, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Tetanus Diphtheria acellular
Pertussis (Tdap) Vaccine; Shoulder
Respondent. Injury Related to Vaccine
Administration (SIRVA)
Hoa Xuan Manh, Charles H. Manh, P.C., Westminster, CA, for petitioner.
Camille Michelle Collett, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
On April 6, 2018, Bich Ngoc To 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 right shoulder injury as a result of a tetanus-
diphtheria-acellular pertussis (“Tdap”) vaccine administered on April 28, 2017. Petition at
2, 5. The case was assigned to the Special Processing Unit of the Office of Special
Masters.
On April 3, 2020, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for a shoulder injury related to vaccine administration. On September 25,
2020, Respondent filed a proffer on award of compensation (“Proffer”) indicating
Petitioner should be awarded $147,815.81. Proffer at 1-2. In the Proffer, Respondent
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 1:18-vv-00506-UNJ Document 58 Filed 10/28/20 Page 2 of 5
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 the
following:
• A lump sum payment of $140,604.50 (representing compensation in the
amount of $115,000.00 in pain and suffering, and $25,604.50 in future
unreimbursable medical expenses, reduced to net present value) in the form
of a check payable to Petitioner. This amount represents compensation for all
damages that would be available under § 15(a).
• A lump sum payment of $7,211.31, representing compensation for
satisfaction of the State of California Medi-Cal lien, payable jointly to
Petitioner and to:
State of California—Health and Human Services
Department of Health Care Services
Recovery Branch – MS 4720
PO Box 997421
Sacramento, CA 95899-7421
DHCS account number: C95607513D-VAC03
Petitioner agrees to endorse this payment to the Medi-Cal program.
The clerk of the court is directed to enter judgment in accordance with this
decision.3
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
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-00506-UNJ Document 58 Filed 10/28/20 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
BICH NGOC TO, )
)
Petitioner, ) No. 18-506V
) Chief Special Master
v. ) Brian Corcoran
) ECF
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items:
On March 30, 2020, respondent conceded that entitlement to compensation for a shoulder
injury related to vaccine administration (“SIRVA”) was appropriate under the terms of the
Vaccine Act. ECF No. 44. On April 3, 2020, Chief Special Master Corcoran issued a Ruling on
Entitlement, finding that petitioner was entitled to vaccine compensation for SIRVA as a result
of a tetanus-diphtheria-acellular pertussis vaccination. ECF No. 45. Respondent proffers that
based on the evidence of record, petitioner, Bich Ngoc To, should be awarded $140,604.50
(including $115,000.00 in pain and suffering, and $25,604.50 in future unreimburseable medical
expenses, reduced to net present value). This amount represents all elements of compensation to
which petitioner would be entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
Respondent further proffers that petitioner, Bich Ngoc To, should be awarded funds to
satisfy, in full, the State of California Medi-Cal lien in the amount of $7,211.31, which represents
satisfaction of any right of subrogation, assignment, claim, lien, or cause of action the State of
California may have against any individual as a result of any Medi-Cal payments the State of

Case 1:18-vv-00506-UNJ Document 58 Filed 10/28/20 Page 4 of 5
California has made to or on behalf of Bich Ngoc To from the date of her eligibility for benefits
through the date of judgment in this case as a result of her vaccine-related injury, under Title XIX
of the Social Security Act.
II. Form of the Award:
The parties recommend that the compensation provided to Bich Ngoc To should be made
through two lump sum payments as described below, and request that the special master’s
decision and the Court’s judgment award the following:1
(1) A lump sum payment of $140,604.50, in the form of a check payable to petitioner,
Bich Ngoc To. This amount accounts for all elements of compensation under 42
U.S.C. § 300aa-15(a) to which petitioner would be entitled; and
(2) A lump sum payment of $7,211.31, representing compensation for satisfaction of the
State of California Medi-Cal lien, payable jointly to petitioner and to:
State of California—Health and Human Services
Department of Health Care Services
Recovery Branch – MS 4720
PO Box 997421
Sacramento, CA 95899-7421
DHCS account number: C95607513D-VAC03
Petitioner agrees to endorse this payment to the Medi-Cal program.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
JEFFREY BOSSERT CLARK
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
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 out-of-pocket
medical expenses.

Case 1:18-vv-00506-UNJ Document 58 Filed 10/28/20 Page 5 of 5
CATHARINE E. REEVES
Deputy Director
Torts Branch, Civil Division
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
s/Camille M. Collett
CAMILLE M. COLLETT
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) 616-4098
Dated: September 25, 2020