VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01143
Package ID: USCOURTS-cofc-1_18-vv-01143
Petitioner: Iris J. Jackson
Filed: 2018-08-06
Decided: 2020-02-05
Vaccine: influenza
Vaccination date: 2017-09-25
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 124348

AI-assisted case summary:
Iris J. Jackson filed a petition for compensation under the National Vaccine Injury Compensation Program on August 6, 2018, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine she received on September 25, 2017. The respondent conceded that the petitioner's claim met the Table criteria for SIRVA, noting that she had no prior history of shoulder issues, experienced pain within 48 hours of vaccination, and the pain was limited to the injected shoulder. The respondent also confirmed the case was timely filed, the vaccine was administered in the United States, and the petitioner met the statutory severity requirement. A ruling on entitlement was issued on July 25, 2019, finding Iris J. Jackson entitled to compensation. Subsequently, on January 3, 2020, the respondent filed a proffer on award of compensation, recommending a total award of $124,348.79, which included $120,000.00 for pain and suffering and $4,348.79 for past unreimbursable expenses. The petitioner agreed with this proffered award. On February 5, 2020, the court issued a decision awarding Iris J. Jackson a lump sum payment of $124,348.79.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01143-0
Date issued/filed: 2019-10-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 07/25/2019) regarding 24 Ruling on Entitlement Signed by Special Master Nora Beth Dorsey. (ypb) Service on parties made.
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Case 1:18-vv-01143-UNJ Document 30 Filed 10/15/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1143V
Filed: July 25, 2019
UNPUBLISHED
IRIS J. JACKSON,
Petitioner, Special Processing Unit (SPU);
v. Ruling on Entitlement; Concession;
Table Injury; Influenza (Flu) Vaccine;
SECRETARY OF HEALTH Shoulder Injury Related to Vaccine
AND HUMAN SERVICES, Administration (SIRVA)
Respondent.
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for petitioner.
Ashley Monique Simpson, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On August 6, 2018, Iris J. Jackson (“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 an influenza (“flu”) vaccine she
received on September 25, 2017. 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. 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-01143-UNJ Document 30 Filed 10/15/19 Page 2 of 2
On July 24, 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 states that
[t]he Division of Injury Compensation Programs has reviewed the facts of this
case and concluded that petitioner’s claim meets the Table criteria for SIRVA.
Specifically, petitioner had no history of pain, inflammation or dysfunction of the
affected shoulder prior to intramuscular vaccine administration that would explain
the alleged signs, symptoms, examination findings, and/or diagnostic studies
occurring after vaccine injection; she suffered the onset of pain within forty eight
hours of vaccine administration; her pain and reduced range of motion were
limited to the shoulder in which the intramuscular vaccine was administered; and
there is no other condition or abnormality present that would explain petitioner’s
symptoms. Therefore, petitioner is entitled to compensation.
Id. at 4-5. Respondent further agrees that “the records show that the case was timely
filed, that the vaccine was received in the United States, and that petitioner satisfies the
statutory severity requirement by suffering the residual effects or complications of her
injury for more than six months after vaccine administration.” 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
2

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DOCUMENT 2: USCOURTS-cofc-1_18-vv-01143-1
Date issued/filed: 2020-02-05
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 01/06/2020) regarding 41 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01143-UNJ Document 44 Filed 02/05/20 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1143V
UNPUBLISHED
IRIS J. JACKSON, Chief Special Master Corcoran
Petitioner, Filed: January 6, 2020
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)
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for petitioner.
Catherine Elizabeth Stolar, U.S. Department of Justice, Washington, DC, for
respondent.
DECISION AWARDING DAMAGES1
On August 6, 2018, Iris J. Jackson 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 an influenza (“flu”) vaccine she received on
September 25, 2017. Petition at 1. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
On July 25, 2019, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On January 3, 2020, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded a total of $124,348.79,
representing compensation for Petitioner’s actual and projected pain and suffering
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-01143-UNJ Document 44 Filed 02/05/20 Page 2 of 5
($120,000.00) and past unreimbursable expenses ($4,348.79). Proffer at 2. In the
Proffer, Respondent 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 $124,348.79, (representing compensation for pain and suffering
($120,000.00) and past unreimbursable expenses ($4,348.79)) 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-01143-UNJ Document 44 Filed 02/05/20 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
IRIS J. JACKSON, )
)
Petitioner, )
) No. 18-1143V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On August 6, 2018, Iris J. Jackson (“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 right shoulder injury as a result of an influenza (“flu”)
vaccine administered on September 25, 2017. On July 25, 2019, the Chief Special Master issued
a Ruling on Entitlement finding petitioner entitled to compensation.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $120,000.00 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.
B. Unreimbursable Expenses
Evidence supplied by petitioner documents petitioner’s unreimbursable expenses as a
result of her vaccine injury. Respondent proffers that petitioner should be awarded

Case 1:18-vv-01143-UNJ Document 44 Filed 02/05/20 Page 4 of 5
unreimbursable expenses in the amount of $4,348.79, 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 petitioner 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 $124,348.79, representing
compensation for pain and suffering ($120,000.00), and past unreimbursable expenses
($4,348.79), in the form of a check payable to petitioner, Iris J. Jackson.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Iris J. Jackson: $124,348.79
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
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-01143-UNJ Document 44 Filed 02/05/20 Page 5 of 5
s/ Catherine E. Stolar
CATHERINE E. STOLAR
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) 353-3299
Fax: (202) 616-4310
Email: catherine.stolar@usdoj.gov
DATED: 1/3/2020
3