VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01106
Package ID: USCOURTS-cofc-1_18-vv-01106
Petitioner: Sarah L. Ickes
Filed: 2018-07-30
Decided: 2019-11-06
Vaccine: influenza
Vaccination date: 2017-09-05
Condition: shoulder tendonitis, Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 42500

AI-assisted case summary:
Sarah L. Ickes filed a petition for compensation under the National Vaccine Injury Compensation Program on July 30, 2018, alleging she suffered shoulder tendonitis resulting from an influenza vaccination received on September 5, 2017. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report on August 12, 2019, conceding that Ms. Ickes is entitled to compensation. The respondent specifically indicated that Ms. Ickes suffered Shoulder Injury Related to Vaccine Administration (SIRVA) as defined by the Vaccine Injury Table and satisfied all legal prerequisites for compensation. Based on the respondent's concession and the evidence of record, the Chief Special Master found Ms. Ickes entitled to compensation. Subsequently, on November 6, 2019, a decision awarding damages was issued. The respondent proffered an award of $42,500.00 for Ms. Ickes' actual and projected pain and suffering, which Ms. Ickes agreed to. The court awarded Ms. Ickes a lump sum payment of $42,500.00 for pain and suffering.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01106-0
Date issued/filed: 2019-10-29
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/12/2019) regarding 20 Ruling on Entitlement Signed by Special Master Nora Beth Dorsey. (ypb) Service on parties made.
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Case 1:18-vv-01106-UNJ Document 31 Filed 10/29/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1106V
Filed: August 12, 2019
UNPUBLISHED
SARAH L. ICKES,
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.
Nancy Routh Meyers, Ward Black Law, Greensboro, NC, for petitioner.
Robert Paul Coleman, III, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On July 30, 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 “injuries, including shoulder tendonitis,
resulting from the influenza vaccination she received on September 5, 2017.” Petition
at 1. Petitioner further alleges that she received the vaccination in the United States,
that she suffered the residual effects of her injury for more than six months, and that
neither she nor any other party has filed a civil action or received compensation for her
injury, alleged as vaccine caused. Id. at ¶¶ 2-3, 9, 14-15. 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-01106-UNJ Document 31 Filed 10/29/19 Page 2 of 2
On August 12, 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
and Proffer at 1. Specifically, respondent indicates that he “has concluded that
petitioner suffered SIRVA as defined by the Vaccine Injury Table.” Id. at 2. Respondent
further indicates “based on the case record as it now stands, petitioner has satisfied all
legal prerequisites for compensation under the Act.” Id. at 3.
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-01106-1
Date issued/filed: 2019-11-06
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 08/12/2019) regarding 21 DECISION Stipulation/Proffer Signed by Special Master Nora Beth Dorsey. (sw) Service on parties made.
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Case 1:18-vv-01106-UNJ Document 32 Filed 11/06/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1106V
Filed: August 12, 2019
UNPUBLISHED
SARAH L. ICKES,
Special Processing Unit (SPU);
Petitioner,
Damages Decision Based on Proffer;
v.
Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
SECRETARY OF HEALTH AND
Administration (SIRVA)
HUMAN SERVICES,
Respondent.
Nancy Routh Meyers, Ward Black Law, Greensboro, NC, for petitioner.
Robert Paul Coleman, III, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On July 30, 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 “injuries, including shoulder tendonitis,
resulting from the influenza vaccination she received on September 5, 2017.” Petition
at 1. The case was assigned to the Special Processing Unit of the Office of Special
Masters.
On August 12, 2019, respondent filed a combined Rule 4 report and proffer on
award of compensation. Respondent’s Rule 4(c) Report and Proffer (“Rule 4 Report
and Proffer”) (ECF No. 19). The same day, a ruling on entitlement was issued, finding
petitioner entitled to compensation for his SIRVA. (ECF No. 20). In the Rule 4 Report
and Proffer, respondent represents that $42,500.00 for petitioner’s actual and projected
pain and suffering is an appropriate award in this case and that petitioner agrees with
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.

Case 1:18-vv-01106-UNJ Document 32 Filed 11/06/19 Page 2 of 2
the proffered award. Rule 4 Report and Proffer at 3.3 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 Proffer, the undersigned awards petitioner
a lump sum payment of $42,500.00, representing compensation for petitioner’s
actual and projected pain and suffering, in the form of a check payable to
petitioner, Sarah L. Ickes. 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.4
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 The combined Rule 4 report and proffer contains information regarding petitioner’s personal medical
history which is not generally included in a proffer, when separately filed. Thus, the undersigned will not
attach the proffer to the decision in this case.
4 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