VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01095 Package ID: USCOURTS-cofc-1_18-vv-01095 Petitioner: David Choi Filed: 2018-07-26 Decided: 2020-01-17 Vaccine: influenza Vaccination date: 2016-10-05 Condition: left shoulder injury related to vaccine administration (SIRVA) Outcome: compensated Award amount USD: 62065 AI-assisted case summary: David Choi filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that he suffered a left shoulder injury related to vaccine administration (SIRVA) caused by an influenza vaccine he received on October 5, 2016. The respondent, the Secretary of Health and Human Services, did not contest entitlement to compensation. The respondent filed a Rule 4(c) report stating that they would not contest that Mr. Choi suffered SIRVA, a Table injury, and agreed that he satisfied the legal prerequisites for compensation. Based on the respondent's position and the evidence of record, the Chief Special Master found that Mr. Choi was entitled to compensation. Subsequently, the parties filed a proffer on award of compensation. The respondent proffered that Mr. Choi should be awarded $62,065.00, consisting of $60,000.00 for past and future pain and suffering and $2,065.00 for unreimbursable expenses. Mr. Choi agreed with this proffered award. The decision awarded Mr. Choi a lump sum payment of $62,065.00. Theory of causation field: Table Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_18-vv-01095-0 Date issued/filed: 2019-11-08 Pages: 4 Docket text: PUBLIC ORDER/RULING (Originally filed: 8/16/2019) regarding 23 Findings of Fact & Conclusions of Law,, Scheduling Order, Signed by Special Master Nora Beth Dorsey. (ypb) Service on parties made. -------------------------------------------------------------------------------- Case 1:18-vv-01095-UNJ Document 28 Filed 11/08/19 Page 1 of 4 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 18-1095V Filed: August 16, 2019 UNPUBLISHED DAVID CHOI, Petitioner, Special Processing Unit (SPU); v. Findings of Fact; Onset; Influenza (Flu) Vaccine; Shoulder Injury SECRETARY OF HEALTH AND Related to Vaccine Administration HUMAN SERVICES, (SIRVA) Respondent. Matthew B. Vianello, Jacobson Press & Fields, Clayton, MO, for petitioner. Lisa Ann Watts, U.S. Department of Justice, Washington, DC, for respondent. FINDINGS OF FACT1 Dorsey, Chief Special Master: On July 26, 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, which was caused by an influenza (“flu”) vaccine he received on October 5, 2016. Am. Petition at ¶¶ 1-17.3 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). 3 Petitioner’s original petition and affidavit (Ex. 7), refer to the vaccination date as October 9, 2016. Petitioner filed an amended petition and supplemental affidavit noting that this date was provided in error having misread the vaccination record. Ex. 8 (Pet’s Supp’l Aff.). The undersigned notes that the date as Case 1:18-vv-01095-UNJ Document 28 Filed 11/08/19 Page 2 of 4 For the reasons discussed below, the undersigned finds the onset of petitioner’s shoulder injury related to vaccine administration (“SIRVA”) occurred within 48 hours of vaccination. Specifically, petitioner suffered pain within 48 hours of vaccination. I. Relevant Procedural History In support of his claim, petitioner filed medical records (Exs. 2, 4-6, 11-13), his own affidavits (Exs. 7, 8), and witness affidavits (Ex. 3, Aff. of Linh Hoang; Ex. 14, Aff. of Lan Ho; Ex. 15, Aff. of John Do; Ex. 16, Aff. of Eric Hamblett). Deadlines for respondent to report his position in the case were set following the September 24, 2018 initial status conference. Orders, ECF Nos. 8; see also Docket Entries dated Feb. 1, 2019, and Mar. 15, 2019. On May 15, 2019, respondent filed a status report proposing a Rule 4(c) report deadline and stating that he was not interested in exploring settlement. ECF No. 19. Respondent filed a Rule 4(c) report on June 19, 2019. Resp.’s Rep., ECF No. 20. In his report, respondent argued that petitioner had not met his burden of establishing that the onset of his alleged shoulder injury occurred within 48 hours of his October 5, 2016 flu vaccination. Id. at 3-4. Thereafter, the undersigned reviewed the evidence and determined that fact hearing or briefing would not be necessary. Order, ECF No. 21. A deadline was set for closing the record on the matter of onset. Id. In response, petitioner filed additional records and witness affidavits. ECF No. 22, Exs. 12-13 (additional pre-vaccination records), 14-16 (affidavits). The matter is now ripe for adjudication. II. Issue At issue is whether petitioner’s first symptom or manifestation of onset after vaccine administration was within 48 hours as set forth in the Vaccine Injury Table. 42 C.F.R. § 100.3(a) XIV.B. (2017) (influenza vaccination). Additionally, the Qualifications and aids to interpretation (“QAI”) for a Table SIRVA require that a petitioner’s pain occur within this same time frame, 48 hours. 42 C.F.R. § 100.3(c)(10). III. Authority Pursuant to Vaccine Act § 13(a)(1)(A), a petitioner must prove, by a preponderance of the evidence, the matters required in the petition by Vaccine Act written on vaccine recipient line of the vaccination administration record is indeed the number “5” that could be interpreted alternatively as the number “9.” Ex. 2 2 Case 1:18-vv-01095-UNJ Document 28 Filed 11/08/19 Page 3 of 4 § 11(c)(1). A special master may find that the first symptom or manifestation of onset of an injury occurred “within the time period described in the Vaccine Injury Table even though the occurrence of such symptom or manifestation was not recorded or was incorrectly recorded as having occurred outside such period.” Vaccine Act § 13(b)(2). “Such a finding may be made only upon demonstration by a preponderance of the evidence that the onset [of the injury] . . . did in fact occur within the time period described in the Vaccine Injury Table.” Id. A special master must consider, but is not bound by, any diagnosis, conclusion, judgment, test result, report, or summary concerning the nature, causation, and aggravation of petitioner’s injury or illness that is contained in a medical record. Vaccine Act § 13(b)(1). “Medical records, in general, warrant consideration as trustworthy evidence. The records contain information supplied to or by health professionals to facilitate diagnosis and treatment of medical conditions. With proper treatment hanging in the balance, accuracy has an extra premium. These records are also generally contemporaneous to the medical events.” Curcuras v. Sec’y of Health & Human Servs., 993 F.2d 1525, 1528 (Fed. Cir. 1993). IV. Finding of Fact The undersigned makes the finding after a complete review of the record to include all medical records, affidavits, testimony, expert reports, respondent’s Rule 4 report, and additional evidence filed. Specifically, the undersigned bases the finding on the following evidence: • Petitioner received the flu vaccine in his left deltoid on October 5, 2016 at Barnes-Jewish Hospital/Washington University in St. Louis, Missouri. Ex. 2 at 1. • On March 13, 2017, petitioner was seen by orthopedist Dr. Craig Ziegler at Barnes Jewish Hospital for left shoulder pain “starting in October 2016 after receiving a flu shot to the left shoulder.” Ex. 4 at 10. Petitioner reported “the pain was sore initially, and worsened over the following 2 days.” Id. An x-ray and ultrasound were performed and appeared normal. Id. Petitioner received a corticosteroid injection and was referred to physical therapy (“PT”). Id. at 10-11. • Petitioner began PT on March 21, 2017 at Excel Sports and Physical Therapy. Ex. 5 at 8. Petitioner reported that his injury onset was in October 2016, “after the flu shot.” Id. The Physical Therapist, Jhanal Mitra Chakraborty, noted that petitioner presented “with approx 5 month [history] of L shoulder pain that started with a flu shot in Oct 2016.” Ex. 5 at 23. • Petitioner returned to his orthopedist for a follow up on May 9, 2017. Ex. 4 at 4. The record from this appointment notes “[petitioner] was seen previously for persistent rotator cuff tendonitis following a improperly placed fluid injection.” Id. Orthopedist, Dr. Ljiljana Bogunovic ordered an MRI and directed petitioner to return following the results. Id. 3 Case 1:18-vv-01095-UNJ Document 28 Filed 11/08/19 Page 4 of 4 • Petitioner returned to Dr. Bogunovic on June 19, 2017. Ex. 4 at 2. Dr. Bogunovic reviewed petitioner’s MRI results and administered a lidocaine/Mercaine/Depo-Medrol injection. Id. Petitioner’s MRI showed no signs of arthritis or rotator cuff tendon tear. Id. Dr. Bogunovic’s diagnosis was “subacromial bursitis status post flu shot injection into the subacromial space.” Id. • Petitioner recalls that he began experiencing pain in his left shoulder immediately following his October 5, 2016 flu vaccination. Ex. 8 at 2. • Lihn Hoang, the sister of petitioner’s girlfriend, recalls that when visiting with her in October 2016, petitioner mentioned his left shoulder pain which started after his flu vaccine. Ex. 3. Petitioner asked Ms. Hoang, who is a Nurse Practitioner, to take a look at his shoulder. Id. Ms. Hoang recalls petitioner having limited range of motion in his left shoulder for which she recommended he take over-the-counter anti-inflammatory medication. Id. • Lan Ho, petitioner’s girlfriend, was with petitioner on the day of his flu vaccination and recalls his complaints of shoulder pain that evening while at dinner with their friends. Ex. 14 at 2. • John Do, petitioner’s roommate, recalls petitioner being unable to participate in their usual basketball games starting in October 2016 due to his left shoulder pain. Ex. 15. • Eric Hamblett, accompanied petitioner to Barnes Jewish Hospital on October 5, 2016 so they could both get a flu shot. Ex. 16. Mr. Hamblett recalls that in the days following the flu shot petitioner complained of pain and referred to his left arm as his “dead arm.” Id. The above medical entries are consistent with petitioner’s affidavit testimony that his left shoulder pain began at the time he received the flu vaccine on October 5, 2016. The undersigned finds the sworn testimony of petitioner’s witnesses to be credible and in agreement with the contemporaneously created treatment records. As such, the undersigned finds preponderant evidence that the onset of petitioner’s left shoulder injury occurred within 48 hours of his October 5, 2016 flu vaccination. V. Scheduling Order Respondent shall file a status report by Thursday, September 19, 2019, indicating whether he is interested in exploring an informal resolution of petitioner’s claim. IT IS SO ORDERED. s/Nora Beth Dorsey Nora Beth Dorsey Chief Special Master 4 ================================================================================ DOCUMENT 2: USCOURTS-cofc-1_18-vv-01095-1 Date issued/filed: 2019-11-27 Pages: 2 Docket text: PUBLIC ORDER/RULING (Originally filed: 09/26/2019) regarding 25 Ruling on Entitlement Signed by Special Master Nora Beth Dorsey. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:18-vv-01095-UNJ Document 29 Filed 11/27/19 Page 1 of 2 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 18-1095V Filed: September 26, 2019 UNPUBLISHED DAVID CHOI, Petitioner, Special Processing Unit (SPU); v. Ruling on Entitlement; Uncontested; Table Injury; Influenza (Flu) Vaccine; SECRETARY OF HEALTH AND Shoulder Injury Related to Vaccine HUMAN SERVICES, Administration (SIRVA) Respondent. Matthew B. Vianello, Jacobson Press & Fields, Clayton, MO, for petitioner. Lisa Ann Watts, U.S. Department of Justice, Washington, DC, for respondent. RULING ON ENTITLEMENT1 Dorsey, Chief Special Master: On July 26, 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, which was caused by an influenza (“flu”) vaccine he received on October 5, 2016. Am. Petition at ¶¶ 1-17.3 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). 3 Petitioner’s original petition and affidavit (Ex. 7), refer to the vaccination date as October 9, 2016. Petitioner filed an amended petition and supplemental affidavit noting that this date was provided in error having misread the vaccination record. Ex. 8 (Pet’s Supp’l Aff.). The undersigned notes that the date as Case 1:18-vv-01095-UNJ Document 29 Filed 11/27/19 Page 2 of 2 On September 18, 2019, respondent filed his Rule 4(c) report in which he states that he does not contest that petitioner is entitled to compensation in this case. Respondent’s Rule 4(c) Report at 1. Specifically, respondent states that “[b]ased on the Chief Special Master’s fact ruling, and medical record evidence submitted in this case, DICP will not continue to contest that petitioner suffered SIRVA as defined by the Vaccine Injury Table.” Id. at 5. Respondent further agrees that “based on the record as it now stands and subject to his right to appeal the Findings of Fact, respondent does not dispute that petitioner has satisfied all legal prerequisites for compensation under the 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 written on vaccine recipient line of the vaccination administration record is indeed the number “5” that could be interpreted alternatively as the number “9.” Ex. 2 2 ================================================================================ DOCUMENT 3: USCOURTS-cofc-1_18-vv-01095-2 Date issued/filed: 2020-01-17 Pages: 4 Docket text: PUBLIC DECISION (Originally filed: 12/12/2019) regarding 32 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:18-vv-01095-UNJ Document 40 Filed 01/17/20 Page 1 of 4 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 18-1095V UNPUBLISHED DAVID CHOI, Chief Special Master Corcoran Petitioner, Filed: December 12, 2019 v. Special Processing Unit (SPU); SECRETARY OF HEALTH AND Damages Decision Based on Proffer; HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder Injury Related to Vaccine Respondent. Administration (SIRVA) Matthew B. Vianello, Jacobsen Press & Fields, Clayton, MO, for petitioner. Lisa Ann Watts, U.S. Department of Justice, Washington, DC, for respondent. DECISION AWARDING DAMAGES1 On July 26, 2018, David Choi 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”) as a result of an influenza (“flu”) vaccination administered on October 5, 2016. Petition at 1. The case was assigned to the Special Processing Unit of the Office of Special Masters. On September 26, 2019, a ruling on entitlement was issued, finding Petitioner entitled to compensation for SIRVA. On December 12, 2019, Respondent filed a proffer on award of compensation (“Proffer”) indicating Petitioner should be awarded $62,065.00 (consisting of $60,000.00 for past and future pain and suffering, and $2,065.00 for unreimbursable expenses). Proffer at 1. In the Proffer, Respondent 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-01095-UNJ Document 40 Filed 01/17/20 Page 2 of 4 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 a lump sum payment of $62,065.00 (consisting of 60,000.00 for past and future pain and suffering, and $2,065.00 for past unreimbursable expenses) in the form of a check payable to Petitioner. 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/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-01095-UNJ Document 40 Filed 01/17/20 Page 3 of 4 IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS _________________________________________ DAVID CHOI, ) ) ECF-SPU Petitioner, ) ) v. ) No. 18-1095V ) Chief Special Master SECRETARY OF HEALTH AND HUMAN ) Brian H. Corcoran SERVICES, ) ) Respondent. ) ) RESPONDENT’S PROFFER ON AWARD OF COMPENSATION On September 26, 2019, the Court issued a Ruling on Entitlement finding that David Choi (“petitioner”) suffered a left shoulder injury related to vaccine administration (“SIRVA”), a Table injury, following receipt of an influenza (“flu”) vaccination administered to him on October 5, 2016. Respondent now Proffers the following regarding the amount of compensation to be awarded.1 I. Items of Compensation Based upon the evidence of record, respondent proffers that petitioner should be awarded a total of $62,065.00, consisting of $60,000.00 for his past and future pain and suffering and $2,065.00 for past unreimbursable expenses. This represents all elements of compensation to which petitioner would be entitled under 42 U.S.C. § 300aa-15(a).2 Petitioner agrees. 1 The parties have no objection to the proffered award of damages. However, respondent reserves his right to seek review of the Chief Special Master’s decision pursuant to 42 U.S.C. § 300aa-12(e)(1). 2 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 damages. 1 Case 1:18-vv-01095-UNJ Document 40 Filed 01/17/20 Page 4 of 4 II. Form of the Award The parties recommend that the compensation provided to petitioner should be made through a lump sum payment of $62,065.00 in the form of a check payable to petitioner.3 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/Lisa A. Watts LISA A. WATTS Senior 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) 616-4099 DATED: December 12, 2019 3 Petitioner is a competent adult. Proof of guardianship is not required in this case. 2