VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00797
Package ID: USCOURTS-cofc-1_18-vv-00797
Petitioner: Molly Anderson
Filed: 2018-06-06
Decided: 2019-11-08
Vaccine: influenza
Vaccination date: 2017-09-26
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 55210

AI-assisted case summary:
Molly Anderson filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of her September 26, 2017, influenza vaccination. The respondent, the Secretary of Health and Human Services, reviewed the petition and medical records and conceded that petitioner was entitled to compensation. The respondent determined that petitioner's injury was consistent with SIRVA as defined on the Vaccine Injury Table, noting she had no prior history of shoulder issues, the pain occurred within 48 hours of the vaccination, was limited to the injection site, and no other condition explained the pain. The respondent also agreed that petitioner suffered residual effects for more than six months, satisfying all legal prerequisites for compensation. Subsequently, a ruling on entitlement was issued on April 17, 2019, finding petitioner entitled to compensation. On August 14, 2019, the respondent filed a proffer on award of compensation, recommending a lump sum payment of $55,210.00. This amount represented $55,000.00 for pain and suffering and $210.00 for past unreimbursable expenses. Petitioner agreed with the proffered award. The Chief Special Master issued a decision awarding damages on November 8, 2019, granting Molly Anderson a lump sum payment of $55,210.00.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-00797-0
Date issued/filed: 2019-06-27
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/17/2019) regarding 20 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:18-vv-00797-UNJ Document 24 Filed 06/27/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-797V
Filed: April 17, 2019
UNPUBLISHED
MOLLY ANDERSON,,
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.
Sarah Christina Duncan, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On June 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 she suffered a Shoulder Injury Related to Vaccine
Administration (SIRVA) as a result of her September 26, 2017 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.

Case 1:18-vv-00797-UNJ Document 24 Filed 06/27/19 Page 2 of 2
On April 16, 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 indicates that he
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 of her left shoulder; pain occurred
within 48 hours after receipt of an intramuscular vaccination; pain was
limited to the shoulder in which the vaccine was administered; and no
other condition or abnormality has been identified to explain petitioner’s
shoulder pain. 42 C.F.R. §§ 100.3(a), (c)(10).
Id. at 5. Respondent further agrees that
based on the medical records . . . petitioner suffered the residual effects of
her condition for more than six months. Therefore, based on the record as
it now stands, petitioner has satisfied all legal prerequisites for
compensation under the Act. See 42 U.S.C. § 300aa-13(a)(1)(B); 42
U.S.C. § 300aa-11(c)(1)(D)(i).
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-00797-1
Date issued/filed: 2019-11-08
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 8/15/2019) regarding 28 DECISION Stipulation/Proffer Signed by Special Master Nora Beth Dorsey. (ypb) Service on parties made.
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Case 1:18-vv-00797-UNJ Document 31 Filed 11/08/19 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-797V
Filed: August 15, 2019
UNPUBLISHED
MOLLY ANDERSON,
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.
Sarah Christina Duncan, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On June 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 she suffered Shoulder Injury Related to Vaccine
Administration (“SIRVA”) as a result of her September 26, 2017 influneza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On April 17, 2019, a ruling on entitlement was issued, finding petitioner entitled to
compensation for SIRVA. On August 14, 2019, respondent filed a proffer on award of
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-00797-UNJ Document 31 Filed 11/08/19 Page 2 of 5
compensation (“Proffer”) indicating petitioner should be awarded a lump sum payment
of $55,210.00, representing compensation for actual and projected pain and suffering
($55,000.00) and past unreimbursable expenses ($210.00). Proffer at 1-2. 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 $55,210.00, representing compensation for
actual and projected pain and suffering ($55,000.00) and past unreimbursable
expenses ($210.00) in the form of a check payable to petitioner, Molly Anderson.
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-00797-UNJ Document 31 Filed 11/08/19 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
MOLLY ANDERSON, )
)
Petitioner, )
) No. 18-797V
v. ) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND HUMAN )
SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On June 6, 2018, Molly Anderson (“petitioner”) filed a petition for compensation under
the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34 (“Vaccine Act”
or “Act”), alleging that she suffered a “Shoulder Injury Related to Vaccine Administration
(‘SIRVA’), resulting from adverse effects of an influenza (‘flu’) vaccine she received on
September 26, 2017.” Petition at 1. On April 16, 2019, the Secretary of Health and Human
Services (“respondent”) filed a Rule 4(c) Report indicating that this case is appropriate for
compensation under the terms of the Act, and on April 17, 2019, the Chief Special Master issued
a Ruling on Entitlement finding petitioner entitled to compensation. ECF No. 19; ECF No. 20.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that Molly Anderson should be awarded $55,000.00 in actual and
projected pain and suffering. This amount reflects that the award for projected pain and
suffering has been reduced to net present value. See 42 U.S.C. § 300aa-15(a)(4). Petitioner
agrees.

Case 1:18-vv-00797-UNJ Document 31 Filed 11/08/19 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents Molly Anderson’s expenditure of past
unreimbursable expenses related to her vaccine-related injury. Respondent proffers that
petitioner should be awarded past unreimbursable expenses in the amount of $210.00, as
provided under the Vaccine Act, 42 U.S.C. § 300aa-15(a)(1)(B). Petitioner agrees.
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that the compensation provided to Molly Anderson should be made
through a lump sum payment as described below and requests that the Chief Special Master’s
decision and the Court’s judgment award the following1: a lump sum payment of $55,210.00,
representing compensation for pain and suffering ($55,000.00), and past unreimbursable
expenses ($210.00), in the form of a check payable to petitioner, Molly Anderson.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Molly Anderson: $55,210.00
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
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 lost earnings
and future pain and suffering.
2

Case 1:18-vv-00797-UNJ Document 31 Filed 11/08/19 Page 5 of 5
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
s/ Sarah C. Duncan
Sarah C. Duncan
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 514-9729
Fax: (202) 616-4310
DATED: August 14, 2019
3