VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00825
Package ID: USCOURTS-cofc-1_18-vv-00825
Petitioner: Jerome Debeltz
Filed: 2019-06-21
Decided: 2019-07-29
Vaccine: influenza
Vaccination date: 2016-10-07
Condition: Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP)
Outcome: compensated
Award amount USD: 85568

AI-assisted case summary:
On June 12, 2018, Jerome Debeltz filed a petition seeking compensation under the National Vaccine Injury Compensation Program. He alleged that he developed Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) as a result of receiving an influenza vaccine on October 7, 2016. The respondent filed a Rule 4(c) Report on April 19, 2018, conceding that Mr. Debeltz was entitled to compensation. The respondent stated that the medical evidence demonstrated that Mr. Debeltz satisfied the criteria set forth in the Vaccine Injury Table and the Qualifications and Aids to Interpretation, concluding that he was entitled to an award of damages limited to his GBS and its related sequelae. Special Master Katherine E. Oler issued a Ruling on Entitlement on April 24, 2019, finding Mr. Debeltz entitled to compensation for his Table GBS injury. Subsequently, the parties reached a stipulation for damages. On June 21, 2019, the respondent filed a proffer agreeing to issue payments. Special Master Oler adopted the proffer and awarded Mr. Debeltz a lump sum payment of $85,567.78, comprising $85,000.00 for pain and suffering and $567.78 for out-of-pocket medical expenses, paid in the form of a check to Mr. Debeltz. The petition was filed on June 21, 2019, and the decision awarding damages was issued on July 29, 2019. Petitioner was represented by Amy A. Senerth of Muller Brazil, LLP, and respondent was represented by Jeffrey T. Sprague of the U.S. Department of Justice.

Theory of causation field:
Petitioner Jerome Debeltz received an influenza vaccine on October 7, 2016. He alleged that this vaccination caused Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). The respondent conceded that Mr. Debeltz's condition satisfied the criteria set forth in the Vaccine Injury Table. A Ruling on Entitlement was issued on April 24, 2019, finding Mr. Debeltz entitled to compensation for GBS. A subsequent proffer on June 21, 2019, agreed to a lump sum payment of $85,567.78, consisting of $85,000.00 for pain and suffering and $567.78 for out-of-pocket medical expenses. The decision awarding damages was issued on July 29, 2019, by Special Master Katherine E. Oler. Petitioner was represented by Amy A. Senerth and respondent by Jeffrey T. Sprague. The theory of causation relied on the Vaccine Injury Table, as the respondent conceded entitlement.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-00825-0
Date issued/filed: 2019-07-29
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 6/21/2019) regarding 19 DECISION Stipulation/Proffer. Signed by Special Master Katherine E. Oler. (dd) Service on parties made.
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Case 1:18-vv-00825-UNJ Document 24 Filed 07/29/19 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-0825V
(Not to be Published)
* * * * * * * * * * * * * * * * * * * * * * * * *
JEROME DEBELTZ, *
*
Petitioner, * Filed: June 21, 2019
*
v. *
* Entitlement; Decision by Proffer; Damages;
SECRETARY OF HEALTH AND * Influenza (“Flu”) Vaccine; Guillain-Barré
HUMAN SERVICES, * syndrome (“GBS”).
*
Respondent. *
* * * * * * * * * * * * * * * * * * * * * * * * *
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Jeffrey T. Sprague, U.S. Dep’t of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On June 12, 2018, Petitioner Jerome Debeltz filed a petition seeking compensation under
the National Vaccine Injury Compensation Program.2 Petitioner alleges that he developed
Guillain-Barré syndrome (“GBS”) and chronic inflammatory demyelinating polyneuropathy
(“CIDP”) as a result of receiving an influenza (“flu”) vaccine on October 7, 2016. Petition, ECF
No. 1.
1 Because this decision contains a reasoned explanation for my actions in this case, I will 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 (2012). This means the ruling will be available to anyone with access to the internet.
As provided by 42 U.S.C. § 300aa-12(d)(4)(B), however, the parties may object to the decision’s inclusion
of certain kinds of confidential information. Specifically, under Vaccine Rule 18(b), each party has fourteen
days within which to request redaction “of any information furnished by that party: (1) that is a trade secret
or commercial or financial in substance and is privileged or confidential; or (2) that includes medical files
or similar files, the disclosure of which would constitute a clearly unwarranted invasion of privacy.”
Vaccine Rule 18(b). Otherwise, the whole decision will be available to the public. Id.
2 The Vaccine Program comprises Part 2 of the National Childhood Vaccine Injury Act of 1986, Pub. L.
No. 99-660, 100 Stat. 3758, codified as amended at 42 U.S.C. §§ 300aa-10 through 34 (2012) (“Vaccine
Act” or “the Act”). Individual section references hereafter will be to § 300aa of the Act (but will omit that
statutory prefix).

Case 1:18-vv-00825-UNJ Document 24 Filed 07/29/19 Page 2 of 4
On April 19, 2018, Respondent filed a Rule 4(c) Report (“Respondent’s Report”) in which
he conceded that Petitioner is entitled to compensation for his claims. Respondent’s Report, ECF
No. 14. Specifically, Respondent stated that the medical evidence demonstrates Petitioner has
“satisfied the criteria set forth in the Vaccine Injury Table (“Table”) and the Qualifications and
Aids to Interpretation (“QAI”).” Id. at 5. Accordingly, Respondent concluded that Petitioner is
entitled to an award of damages, the scope of which is limited to Petitioner’s GBS and its related
sequelae. Id.
In light of Respondent’s concession, I issued a Ruling on Entitlement on April 24, 2019.
ECF No. 16. I subsequently ordered the parties to inform the Court on their progress towards
resolving damages. See Damages Order, ECF No. 17.
Respondent filed a proffer on June 21, 2019 (ECF No. 18), agreeing to issue the following
payments:
a. a lump sum payment of $85,567.78, for all damages, with $85,000.00 being for
pain and suffering and $567.78 for out-of-pocket medical expenses, paid in the
form of a check to Petitioner.
These amounts represent all elements of compensation for all damages that would be
available under § 300aa-15(a).
I adopt the parties’ proffer attached hereto, and award compensation in the amount and on
the terms set forth therein. I, therefore, award compensation in the amount of a lump sum
payment of $85,567.78, in the form of a check payable to Petitioner, Jerome Debeltz. The clerk
of court is directed to enter judgment in accordance with this decision.3
IT IS SO ORDERED.
s/ Katherine E. Oler
Katherine E. Oler
Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party filing a notice
renouncing the right to seek review.
2

Case 1:18-vv-00825-UNJ Document 24 Filed 07/29/19 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
JEROME DEBELTZ, )
)
Petitioner, ) No. 18-825V ECF
)
v. ) Special Master Oler
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
___________________________________ )
PROFFER ON AWARD OF COMPENSATION1
I. Procedural History
On June 12, 2018, Jerome DeBeltz (“petitioner”) filed a petition for compensation
(“petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -
34, as amended. He alleges that, as a result of receiving the influenza vaccine on October 7,
2016, he suffered Guillain-Barre Syndrome (GBS) and chronic inflammatory demyelinating
polyneuropathy (CIDP). Petition. On April 19, 2019, respondent filed his Vaccine Rule 4(c)
report, conceding GBS as a Table injury. On April 24, 2019, the Special Master issued a ruling
on entitlement, finding that petitioner was entitled to compensation for GBS.
II. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
a lump sum of $85,567.78, for all damages, with $85,000.00 being for pain and suffering, and
$567.78 for out-of-pocket medical expenses, paid in the form of a check to petitioner. This
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to
address after the Damages Decision is issued.

Case 1:18-vv-00825-UNJ Document 24 Filed 07/29/19 Page 4 of 4
amount represents all elements of compensation to which petitioner would be entitled under 42
U.S.C. § 300aa-15(a). Petitioner agrees.
III. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $85,567.78 in the form of a check payable to petitioner.2
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/Jeffrey T. Sprague
JEFFREY T. SPRAGUE
Trial Attorney
Torts Branch, Civil Division
U. S. Department of Justice
P.O. Box l46, Benjamin Franklin Station
Washington, D.C. 20044-0146
Direct dial: (202) 616-4179
Dated: June 21, 2019 Fax: (202) 616-4310
2 Should petitioner die prior to entry of judgment, respondent would oppose any award
for future medical expenses, future lost earnings, and future pain and suffering, and the parties
reserve the right to move the Court for appropriate relief.
2

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DOCUMENT 2: USCOURTS-cofc-1_18-vv-00825-1
Date issued/filed: 2019-10-24
Pages: 2
Docket text: PUBLIC RULING (Originally filed: 4/24/2019) regarding 16 Ruling on Entitlement. Signed by Special Master Katherine E. Oler. (dd) Service on parties made.
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Case 1:18-vv-00825-UNJ Document 27 Filed 10/24/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-0825V
(Unpublished)
* * * * * * * * * * * * * * * * * * * * * * * * *
JEROME DEBELTZ, *
* Filed: April 24, 2019
Petitioner, * Special Master Oler
*
v. * Entitlement; Influenza (“Flu”) Vaccine
* Guillain-Barré syndrome (“GBS”).
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
* * * * * * * * * * * * * * * * * * * * * * * * *
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Jeffrey T. Sprague, U.S. Dep’t of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On June 12, 2018, Jerome Debeltz (“Petitioner”) filed a petition seeking compensation
under the National Vaccine Injury Compensation Program.2 Petitioner alleges that he developed
Guillain-Barré syndrome (“GBS”) and chronic inflammatory demyelinating polyneuropathy
(“CIDP”) as a result of an influenza (“flu”) vaccine that he received on October 7, 2016. See
Petition at 1, ECF No. 1.
In his Rule 4(c) Report, filed on April 19, 2019, Respondent recommends that
compensation be awarded in this case. Rule 4(c) Report at 1, ECF No. 14. Respondent states
that the medical evidence demonstrates Petitioner has “satisfied the criteria set forth in the
recently revised Vaccine Injury Table (“Table”) and the Qualifications and Aids to Interpretation
1 Although this ruling is not formally designated for publication, it will be posted nonetheless on the United States
Court of Federal Claims website, in accordance with the E-Government Act of 2002, 44 U.S.C. § 3501 (2012). As
provided by 42 U.S.C. § 300aa-12(d)(4)(B), however, the parties may object to the ruling’s inclusion of certain
kinds of confidential information. Specifically, under Vaccine Rule 18(b), each party has fourteen days within
which to request redaction “of any information furnished by that party: (1) that is a trade secret or commercial or
financial in substance and is privileged or confidential; or (2) that includes medical files or similar files, the
disclosure of which would constitute a clearly unwarranted invasion of privacy.” Vaccine Rule 18(b). Otherwise,
the whole decision will be available to the public. Id.
2 The Vaccine Program comprises Part 2 of the National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660,
100 Stat. 3758, codified as amended at 42 U.S.C. §§ 300aa-10 through 34 (2012) (“Vaccine Act” or “the Act”).
Individual section references hereafter will be to § 300aa of the Act (but will omit that statutory prefix).

Case 1:18-vv-00825-UNJ Document 27 Filed 10/24/19 Page 2 of 2
(“QAI”).” Id. at 5. Accordingly, Respondent concludes that Petitioner is entitled to an award of
damages, the scope of which is limited to Petitioner’s GBS and its related sequelae. Id. While
the type and amount of damages is to be determined through further proceedings, Respondent
requests the following to facilitate a damages determination:
1. the type, level, and cost of care presently provided to petitioner for his GBS;
2. all insurance policies which may cover petitioner’s treatment;
3. any local, state, or Federal services or aid provided to petitioner (including,
but not limited to Medicaid coverage), and the amount of such services or aid;
and
4. any other information, entitlement, or fact that would aid the respondent and
the court in assessing petitioner’s damages and/or needs with respect to his
GBS.
ECF No. 15 at 1.
In light of Respondent’s concession, and based on my own review of the record (see
Section 13(a)(1)), I find that Petitioner is entitled to compensation for his Table GBS injury. A
separate damages order will issue accordingly.
IT IS SO ORDERED.
/s/ Katherine E. Oler
Katherine E. Oler
Special Master
2