VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01293
Package ID: USCOURTS-cofc-1_18-vv-01293
Petitioner: Terri L. Vanderjack
Filed: 2018-08-27
Decided: 2019-11-06
Vaccine: influenza
Vaccination date: 2015-09-17
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 110000

AI-assisted case summary:
Terri L. Vanderjack filed a petition for compensation under the National Vaccine Injury Compensation Program on August 27, 2018. She alleged that she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on September 17, 2015. The case was assigned to the Special Processing Unit. On August 8, 2019, the respondent filed a Rule 4(c) report conceding that the petitioner's claim met the Table criteria for SIRVA and that she was entitled to a presumption of vaccine causation. A ruling on entitlement was issued by Chief Special Master Nora Beth Dorsey on August 12, 2019, finding Ms. Vanderjack entitled to compensation. Subsequently, on November 6, 2019, a decision awarding damages was issued. Based on a joint Rule 4 report and proffer, the respondent recommended an award of $110,000, to which the petitioner agreed. Chief Special Master Dorsey awarded Terri L. Vanderjack a lump sum of $110,000, payable by check to the petitioner, for all damages available under § 15(a). Mark Stephen Bishop represented the petitioner, and Ryan Daniel Pyles represented the respondent.

Theory of causation field:
Petitioner Terri L. Vanderjack alleged a shoulder injury related to vaccine administration (SIRVA) following an influenza vaccine on September 17, 2015. The respondent conceded that the claim met the Table criteria for SIRVA and agreed to a presumption of vaccine causation. The public decision does not describe the specific mechanism of injury, onset, symptoms, diagnostic tests, or treatments. No specific medical experts were named in the public text. Chief Special Master Nora Beth Dorsey issued a ruling on entitlement on August 12, 2019, finding petitioner entitled to compensation. On November 6, 2019, Chief Special Master Dorsey issued a decision awarding damages based on a joint Rule 4 report and proffer, granting a lump sum of $110,000 to petitioner Terri L. Vanderjack. Petitioner was represented by Mark Stephen Bishop, and respondent was represented by Ryan Daniel Pyles.

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_18-vv-01293-0
Date issued/filed: 2019-10-29
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/12/2019) regarding 34 Ruling on Entitlement Signed by Special Master Nora Beth Dorsey. (ypb) Service on parties made.
--------------------------------------------------------------------------------
Case 1:18-vv-01293-UNJ Document 39 Filed 10/29/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1293V
Filed: August 12, 2019
UNPUBLISHED
TERRI L. VANDERJACK,
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.
Mark Stephen Bishop, Law Offices of Mark S. Bishop, LLC, Naperville, IL, for petitioner.
Ryan Daniel Pyles, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On August 27, 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 a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccination administered on
September 17, 2015. 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-01293-UNJ Document 39 Filed 10/29/19 Page 2 of 2
On August 8, 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 has concluded that petitioner’s claim meets the Table
criteria for SIRVA. Id. at 2-3. Respondent further agrees that petitioner is entitled to a
presumption of vaccine causation. 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

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_18-vv-01293-1
Date issued/filed: 2019-11-06
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 08/12/2019) regarding 35 DECISION Stipulation/Proffer Signed by Special Master Nora Beth Dorsey. (sw) Service on parties made.
--------------------------------------------------------------------------------
Case 1:18-vv-01293-UNJ Document 40 Filed 11/06/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1293V
Filed: August 12, 2019
UNPUBLISHED
TERRI L. VANDERJACK,
Petitioner,
Special Processing Unit (SPU);
v.
Damages Decision Based on Proffer;
Influenza (Flu) Vaccine; Shoulder
SECRETARY OF HEALTH AND
Injury Related to Vaccine
HUMAN SERVICES,
Administration (SIRVA)
Respondent.
Mark Stephen Bishop, Law Offices of Mark S. Bishop, LLC, Naperville, IL, for petitioner.
Ryan Daniel Pyles, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On August 27, 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 a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccination administered on
September 17, 2015. Petition at 1. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
On August 12, 2019, a ruling on entitlement was issued, finding petitioner entitled
to compensation for SIRVA. On August 8, 2019, respondent filed a combined Rule 4
report/proffer on award of compensation (“Rule 4/Proffer”) indicating petitioner should
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. 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-01293-UNJ Document 40 Filed 11/06/19 Page 2 of 2
be awarded $110,000. Rule 4/Proffer at 3. In the Rule 4/Proffer, respondent
represented that petitioner agrees with the proffered award. Id. Based on the record as
a whole, the undersigned finds that petitioner is entitled to an award as stated in the
Rule 4/Proffer.
Pursuant to the terms stated in the Rule 4/Proffer, the undersigned awards
petitioner a lump sum payment of $110,000 in the form of a check payable to
petitioner, Terri L. Vanderjack. 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/Nora Beth Dorsey
Nora Beth Dorsey
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