VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01109
Package ID: USCOURTS-cofc-1_18-vv-01109
Petitioner: John Veselovsky
Filed: 2020-01-17
Decided: 2020-02-19
Vaccine: influenza
Vaccination date: 2016-11-29
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 35000

AI-assisted case summary:
John Veselovsky filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) from an influenza vaccine he received on November 29, 2016. He stated the vaccination occurred in the United States and that he experienced residual effects for more than six months, with no prior award or settlement for his condition. Respondent denied that Mr. Veselovsky suffered a SIRVA Table injury or that the flu vaccine caused his injury. Despite these differing positions, the parties filed a joint stipulation agreeing to settle the case and award compensation. Chief Special Master Corcoran adopted the stipulation as his decision, awarding Mr. Veselovsky a lump sum of $35,000.00. This amount is intended to compensate for all damages available under the Vaccine Act. The decision directs the clerk of the court to enter judgment accordingly, pending any motion for review.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01109-0
Date issued/filed: 2020-02-19
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 01/17/2020) regarding 27 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01109-UNJ Document 31 Filed 02/19/20 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1109V
UNPUBLISHED
JOHN VESELOVSKY, Chief Special Master Corcoran
Petitioner, Filed: January 17, 2020
v.
SECRETARY OF HEALTH AND Special Processing Unit (SPU); Joint
HUMAN SERVICES, Stipulation on Damages; Influenza
(Flu) Vaccine; Shoulder Injury
Respondent. Related to Vaccine Administration
(SIRVA)
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for petitioner.
Christine Mary Becer, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
On July 30, 2018, John Veselovsky 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”) vaccine administered on
November 29, 2016. Petition at 1-2; Stipulation, filed January 16, 2020, at ¶¶ 2, 4.
Petitioner further alleges that he received the vaccine in the United States, that he
suffered the residual effects of this injury for more than six months, and that there has
been no prior award or settlement of a civil action for damages on his behalf as a result
of his condition. Petition at 2-3; Stipulation at ¶¶ 3-5. “Respondent denies that
[P]etitioner suffered a SIRVA Table injury, and denies that the flu vaccine caused
[P]etitioner to suffer from a right shoulder injury or any other injury or his current
condition. ” Stipulation at ¶ 6.
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-01109-UNJ Document 31 Filed 02/19/20 Page 2 of 7
Nevertheless, on January 16, 2020, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. I find the stipulation
reasonable and adopt it as my decision awarding damages, on the terms set forth
therein.
Pursuant to the terms stated in the attached Stipulation, I award the following
compensation:
A lump sum of $35,000.00 in the form of a check payable to Petitioner.
Stipulation at ¶ 8. This amount represents compensation for all items of
damages that would be available under § 15(a). Id.
I approve the requested amount for Petitioner’s compensation. In the absence of
a motion for review filed pursuant to RCFC Appendix B, 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.
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Case 1:18-vv-01109-UNJ Document 31 Filed 02/19/20 Page 3 of 7
IN THE UNITED ST ATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
JOHN VESELOVSKY, )
)
Petitioner, )
) No. 18-1109V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
STIPULATION
The parties hereby stipulate to the following matters:
1. John Veselovsky, petitioner, filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §§ 300aa-l0 to -34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of an influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § 100.3 (a).
2. Petitioner received the flu vaccine on November 29, 2016.
3. The vaccination was administered within the United States.
4. Petitioner alleges that he sustained a SIRVA within the time period set forth in the
Table, or in the alternative, that his alleged shoulder injuries were caused by the vaccine. He
further alleges that he experienced the residual effects of his alleged injuries for more than six
months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on his behalf as a result of his condition.

Case 1:18-vv-01109-UNJ Document 31 Filed 02/19/20 Page 4 of 7
6. Respondent denies that petitioner suffered a SIRVA Table injury, and denies that the
flu vaccine caused petitioner to suffer from a right shoulder injury or any other injury or his
current condition.
7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry of judgment reflecting a decision consistent with
the tenns of this Stipulation, and after petitioner has filed an election to receive compensation
pmsuant to 42 U.S.C. § 300aa-2l{a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $35,000.00 in the fom1 of a check payable to petitioner. This
amount represents compensation for all damages that would be available under 42
U.S.C. § 300aa-l 5(a).
9. As soon as practicable after the entry of judgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to
42 U.S.C. § 300aa-21(a)(l ), and an application, the parties will submit to further proceedings
before the special master to award reasonable attorneys' fees and costs incurred in proceeding
upon this petition.
10. Petitioner and his attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U. S.C. § 300a~-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C.
§ 1396 et seq.)), or by entities that provide health services on a pre-paid basis.
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Case 1:18-vv-01109-UNJ Document 31 Filed 02/19/20 Page 5 of 7
11. Payment made pursuant to paragraph 8 of this Stipulation and any amounts awarded
pursuant to paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-
15(i), subject to the availability of sufficient stah1tory funds.
12. The parties and their attorneys further agree and stipulate that, except for any award
for attorneys' fees and litigation costs, and past unreimbursed expenses, the money provided
pursuant to this Stipulation will be used solely for the benefit of petitioner as contemplated by a
strict constmction of 42 U.S.C. § 300aa-l 5(a) and (d), and subject to the conditions of 42 U.S.C.
§ 300aa-15(g) and (h).
13. In return for the payments desciibed in paragraphs 8 and 9, petitioner, in his
individual capacity, and on behalf of his heirs, executors, administrators, successors or assigns,
does forever in-evocably and unconditionally release, acquit and discharge the United States and
the Secretary of Health and Human Services from any and all actions or causes of action
(including agreements, judgments, claims, damages, loss of services, expenses and all demands
of whatever kind or nature) that have been brought, could have been brought, or could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. § 300aa-l 0 et seq., on account of, or in any way growing out of, any and all
known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from, or alleged to have resulted from, the flu vaccination administered on November 29, 2016,
as alleged by petitioner in a petition for vaccine compensation filed on or about July 30, 2018, in
the United States Comt of Federal Claims as petition No. 18-1109V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
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Case 1:18-vv-01109-UNJ Document 31 Filed 02/19/20 Page 6 of 7
15. If the special master fails to issue a decision in complete confonnity with the tenns
of this Stipulation or if the Court of Federal Claims fails to enter judgment in confom1ity with a
decision that is in complete confonnity with the terms of this Stipulation, then the patties'
settlement and this Stipulation shall be voidable at the sole discretion of either party.
16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Actof 1986, as amended, except·
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
patties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties ftuther agree and understand that the award described· in this
Stipulation may reflect a compromise of the parties' respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the flu yaccine caused petitioner to have a right
shoulder injury or any other injury or his current condition.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:18-vv-01109-UNJ Document 31 Filed 02/19/20 Page 7 of 7
Respectfully submitted,
PETJl'lONER:
~ - - -
ATTORNEY OF RECORD FOR
AUTHORIZED REPRESENTATIVE
PETITIONER:
OF THE AT l'ORNEY GENERAL:
./-Ju
~~~~~:_-==-=====-..-...- , .
J~ . INE E. REEVES ·
Jeffrey S. Pop & Associates ·Depu Director
9150 Wilshire Blvd., Suite 241 Torts Branch, Civil Division
Beverly Hills, CA 90212 U.$ .. Depattment ofJwitice
P.O.Box 146
Benjamin Franklin Station
'Washington, DC 20044-0146
AUrn'.OlUZED REPRESENTA TlVE ATTORNEY OF RECORD FOR
OFTHESECRETARYOFUEALTH RESPONDENT:
AND HUMAN SER.VICES:
~ -
TAMARA OVERBY, M.'iY. CBRlST™E M. BECER
Acting Director, Division of Injury Trial Attorney
Compensation Programs Torts Bra.nch,.'Civit Division.
Healthcare Systems Bureau • U.S. Department of Justice
U.S. Department of Health P.O. Box. 146
and Human Services Benjamin Franklin Station
S600 Fishers Lane Washington, DC20044--0l46
Parklawn Building, Mail Stop 08Nl46B Tel: (202) 616-3665
Rockville, MO 20857
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