VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01534
Package ID: USCOURTS-cofc-1_18-vv-01534
Petitioner: Jamie Blaylock
Filed: 2018-10-04
Decided: 2020-03-09
Vaccine: influenza
Vaccination date: 2016-10-04
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 91906

AI-assisted case summary:
Jamie Blaylock filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of an influenza vaccination received on October 4, 2016. The respondent conceded that the petitioner's injury was consistent with SIRVA, a Table injury, and that she suffered residual effects for more than six months. Based on this concession, a ruling on entitlement was issued on October 25, 2019, finding Jamie Blaylock entitled to compensation. Subsequently, on February 5, 2020, the respondent filed a proffer on award of compensation, recommending $91,906.04. The petitioner agreed with this amount, which represented compensation for pain and suffering and past unreimbursed medical expenses. A decision awarding damages was issued on March 9, 2020, granting the lump sum payment of $91,906.04.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01534-0
Date issued/filed: 2019-12-23
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 10/25/2019) regarding 28 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01534-UNJ Document 32 Filed 12/23/19 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1534V
Filed: October 25, 2019
UNPUBLISHED
JAMIE BLAYLOCK,
Petitioner, Special Processing Unit (SPU);
v. Ruling on Entitlement; Concession;
Table Injury; Influenza (Flu) Vaccine;
SECRETARY OF HEALTH AND Guillain-Barre Syndrome (GBS)
HUMAN SERVICES,
Respondent.
Brenton Aaron Elswick, Maglio Christopher & Toale, PA, Seattle, WA, for petitioner.
Christine Mary Becer, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Corcoran, Chief Special Master:
On December 3, 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 Guillain-Barré Syndrome (GBS) as a
result of receiving an influenza vaccination, on December 30, 2015. Petition at 1 ¶¶ 1,
6, 7, 14, 15. Petitioner further alleges that she received the vaccination in the United
States, that she suffered the residual effects of her GBS for more than six months, and
that neither she nor any other party has filed a civil action or received compensation for
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-01534-UNJ Document 32 Filed 12/23/19 Page 2 of 2
her GBS. Id. at ¶¶ 2, 28, 29. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On October 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 based on the medical records, “petitioner’s
alleged injury is consistent with a shoulder injury related to vaccine administration
(“SIRVA”), as defined on the Vaccine Injury Table . . . .” and “petitioner suffered the
residual effects of her condition for more than six months. Therefore, based on the
record as it now stands, petitioner has satisfied all legal prerequisites for compensation
under the Act.” Id. at 5, (citing 42 C.F.R. §§ 100.3(a), 100.3(c)(10); 42 U.S.C.
§§ 300aa-13(a)(1)(B), 300aa-11(c)(1)(D)(I).
In view of respondent’s position and the evidence of record, I find that
petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
2

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DOCUMENT 2: USCOURTS-cofc-1_18-vv-01534-1
Date issued/filed: 2020-03-09
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 02/06/2020) regarding 37 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01534-UNJ Document 41 Filed 03/09/20 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1534V
UNPUBLISHED
JAMIE BLAYLOCK, Chief Special Master Corcoran
Petitioner, Filed: February 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)
Lawrence D. Greenbaum, McAnany, Van Cleave & Phillips, P.A., Kansas, KS, for
Petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On October 4, 2018, Jamie Blaylock 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 injury
related to vaccine administration (SIRVA), resulting from the adverse effects of an
influenza vaccination received on October 4, 2016. Petition at 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On October 25, 2019, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On February 5, 2020, Respondent filed a proffer
on award of compensation (“Proffer”) indicating Petitioner should be awarded
$91,906.04. Proffer at 1. In the Proffer, Respondent represented that Petitioner agrees
1 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). 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.
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-01534-UNJ Document 41 Filed 03/09/20 Page 2 of 4
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 $91,906.04 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

CCaassee 11::1188--vvvv--0011553344--UUNNJJ DDooccuummeenntt 3461 FFiilleedd 0023//0059//2200 PPaaggee 13 ooff 24
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
JAMIE BLAYLOCK,
Petitioner,
No. 18-1534V
v.
Chief Special Master Corcoran (SPU)
ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On October 24, 2019, respondent filed a Rule 4(c) Report conceding that petitioner is
entitled to vaccine compensation for her Shoulder Injury Related to Vaccine Administration
(“SIRVA”) injury suffered following receipt of an influenza vaccination on October 4, 2016. On
October 25, 2019, a Ruling on Entitlement, adopting respondent’s recommendation, was issued.
Based upon the evidence of record, respondent proffers that petitioner1 should be
awarded $91,906.04. This is comprised of pain and suffering ($90,000) and past unreimbursed
out-of-pocket medical expenses ($1,906.04), 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.

CCaassee 11::1188--vvvv--0011553344--UUNNJJ DDooccuummeenntt 3461 FFiilleedd 0023//0059//2200 PPaaggee 24 ooff 24
II. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through:
a lump sum of $91,906.04 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/ JAMES V. LOPEZ
James V. Lopez
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Ben Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-3655
Fax: (202) 616-4310
Email: james.lopez@usdoj.gov
Dated: February 5, 2020