VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01294
Package ID: USCOURTS-cofc-1_18-vv-01294
Petitioner: Donald Wells
Filed: 2018-08-27
Decided: 2019-12-26
Vaccine: influenza
Vaccination date: 2017-10-04
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 111081

AI-assisted case summary:
Donald Wells filed a petition for compensation under the National Vaccine Injury Compensation Program on August 27, 2018, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on October 4, 2017. The case was assigned to the Special Processing Unit. On October 7, 2019, the respondent conceded that Mr. Wells was entitled to compensation, agreeing that his medical course was consistent with a SIRVA and that he met all legal prerequisites. A ruling on entitlement was issued that day. Subsequently, on November 6, 2019, the respondent filed a proffer on award of compensation, stating that Mr. Wells should be awarded $111,081.55, comprised of $110,000.00 for pain and suffering and $1,081.55 for past unreimbursed medical expenses. The proffer indicated that Mr. Wells agreed with this award. On December 26, 2019, the Chief Special Master issued a decision awarding Mr. Wells the stipulated lump sum of $111,081.55.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01294-0
Date issued/filed: 2019-12-05
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 10/07/2019) regarding 30 Ruling on Entitlement Signed by Special Master Nora Beth Dorsey. (sw) Service on parties made.
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Case 1:18-vv-01294-UNJ Document 37 Filed 12/05/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1294V
Filed: October 7, 2019
UNPUBLISHED
DONALD WELLS,
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.
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for petitioner.
Adriana Ruth Teitel, 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 he suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered on
October 4, 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-01294-UNJ Document 37 Filed 12/05/19 Page 2 of 2
On October 4, 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 medical course is
consistent with a SIRVA as defined by the Vaccine Injury Table. Id. at 5. Respondent
further agrees that petitioner has satisfied all legal prerequisites for compensation under
the Vaccine 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
2

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DOCUMENT 2: USCOURTS-cofc-1_18-vv-01294-1
Date issued/filed: 2019-12-26
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 11/06/2019) regarding 33 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (ypb) Service on parties made.
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Case 1:18-vv-01294-UNJ Document 39 Filed 12/26/19 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1294V
Filed: November 6, 2019
UNPUBLISHED
DONALD WELLS,
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.
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for petitioner.
Adriana Ruth Teitel, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Corcoran, 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 he suffered a shoulder injury related to vaccine
administration (“SIRVA”) following an influenza (“flu”) vaccine administered on October
4, 2017. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On October 7, 2019, a ruling on entitlement was issued, finding petitioner entitled
to compensation for a SIRVA. On November 6, 2019, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $111,081.55
comprised of $110,000.00 for pain and suffering, and $1,081.55 for past unreimbursed
1 I intend 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, I agree that the identified
material fits within this definition, I will redact such material from public access. Because this unpublished
decision 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).
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-01294-UNJ Document 39 Filed 12/26/19 Page 2 of 4
medical expenses. Proffer at 1. 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 $111,081.55 (comprised of $110,000.00 for pain and suffering,
and $1,081.55 for past unreimbursed medical expenses) in the form of a check
payable to petitioner, Donald Wells. 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-01294-UNJ Document 39 Filed 12/26/19 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DONALD WELLS,
Petitioner,
v. No. 18-1294V
Chief Special Master Corcoran (SPU)
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On October 4, 2019, respondent filed a Rule 4(c) Report conceding that petitioner is
entitled to vaccine compensation for his Shoulder Injury Related to Vaccine Administration
(“SIRVA”) injury suffered following receipt of an influenza vaccination on October 4, 2017.
On October 7, 2019, a Ruling on Entitlement, adopting respondent’s recommendation,
was issued.
Based upon the evidence of record, respondent proffers that petitioner1 should be
awarded $111,081.55. This is comprised of pain and suffering ($110,000.00) and past
unreimbursable medical expenses ($1,081.55), and represents all elements of compensation to
which petitioner would be entitled under 42 U.S.C. § 300aa-15(a).2 Petitioner agrees.
1 Petitioner is a competent adult, therefore evidence of guardianship is not required in this case.
2 Should Petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief.

Case 1:18-vv-01294-UNJ Document 39 Filed 12/26/19 Page 4 of 4
II. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through:
a lump sum of $111,081.55 in the form of a check payable to petitioner. This
amount represents compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
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/ Adriana Teitel
ADRIANA TEITEL
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Benjamin Franklin Station
Washington, DC 20044-0146
Tel: (202) 616-3677
Dated: November 6, 2019