VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01542
Package ID: USCOURTS-cofc-1_18-vv-01542
Petitioner: Annie Brown
Filed: 2018-10-04
Decided: 2020-06-12
Vaccine: influenza
Vaccination date: 2017-10-27
Condition: right-sided shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 45539

AI-assisted case summary:
Annie Brown filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a right-sided shoulder injury related to vaccine administration (SIRVA) from an influenza vaccine received on or about October 27, 2017. She claimed the residual effects of this injury lasted for more than six months. Respondent denied that petitioner sustained a Table SIRVA within the specified timeframe and denied that the flu immunization caused or significantly aggravated her injury. Despite these denials, the parties reached a joint stipulation for settlement. The court found the stipulation reasonable and adopted it as its decision, awarding Annie Brown a lump sum of $45,539.73. This amount represents compensation for all items of damages available under the Vaccine Act. The decision was issued on June 12, 2020, following the petition filed on October 4, 2018. The case was treated as a Table claim, and the award was for SIRVA, a condition listed on the Vaccine Injury Table.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01542-0
Date issued/filed: 2020-06-12
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 05/12/2020) regarding 35 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01542-UNJ Document 40 Filed 06/12/20 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1542V
UNPUBLISHED
ANNIE BROWN, Chief Special Master Corcoran
Petitioner, Filed: May 12, 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)
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for Petitioner.
Ryan Daniel Pyles, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On October 4, 2018, Annie Brown 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 right-sided shoulder injury related
to vaccine administration (“SIRVA”) as a result of an influenza (“flu”) vaccine she
received on or about October 27, 2017, in her right shoulder. Petition at 1; Stipulation,
filed May 12, 2020, at ¶¶ 4, 6. Petitioner further alleges that she experienced the
residual effects of this injury for more than six months. Petition at 5; Stipulation at ¶ 4.
“Respondent denies that petitioner sustained a Table SIRVA within the timeframe set
forth in the Table; and denies that the flu immunization caused or significantly
aggravated petitioner’s shoulder injury and/or any other injury. ” Stipulation at ¶ 6.
Nevertheless, on May 12, 2020, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. I find the stipulation
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-01542-UNJ Document 40 Filed 06/12/20 Page 2 of 7
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 $45,539.73, 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-01542-UNJ Document 40 Filed 06/12/20 Page 3 of 7
I ;,,
THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
ANNIE BROWN,
Petitioner,
V. No. 18-1542V
Chief Special Master Brian H. Corcoran
SECRETARY OF HEAL TH AND ECF
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
I. Annie Brown ("'petitioner") filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 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 a flu vaccine on or about October 27, 2017, in her right deltoid.
3. The vaccine was administered within the United States.
4. Petitioner alleges that the flu vaccine caused her to develop a right-sided shoulder
injury related to vaccine administration ("'SIRVA.,) and that she experienced residual effects of
this injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages as a result of her condition.

Case 1:18-vv-01542-UNJ Document 40 Filed 06/12/20 Page 4 of 7
6. Respondent denies that petitioner sustained a Table SIRVA within the timeframe set
forth in the Table; and denies that the flu immunization caused or significantly aggravated
petitioner's alleged shoulder injury and/or any other injury.
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 terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant 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$45,539.73 in the form of a check payable to petitioner. This amount
represents all compensation for damages that vvould be available under 42 U.S.C.
~ 300aa-l 5(a) for injuries allegedly related ti) petitioner· s receipt of the flu vaccine.
9. As soon as practicable after the entry of judgment on entitlement in this case, and after
petitionl;!r 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 pm1ies 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 her attorney represent that they have identified to respondent all
known sources of payment for items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-l 5(g), including 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 entities that provide health services on a pre-paid basis.
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Case 1:18-vv-01542-UNJ Document 40 Filed 06/12/20 Page 5 of 7
1 1. Payment made pursuant to paragraph 8 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 statutory funds.
12. The parties and their attorneys fm1her agree and stipulate that except for any award
for attorneys' fees and litigation costs, and past unreimbursable expenses, the money provided
pursuant to this Stipulation will be used solely for the benefit of petitioner as contemplated by a
strict construction of 42 U.S.C. § 300aa-l 5(a) and (d). and subject to the conditions of 42 U.S.C.
§ 300aa-l 5(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity and on behalf of her heirs. executors, administrators, successors and/or
assigns. does forever irrevocably 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-10 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 or
about October 27, 2017, as alleged by petitioner in a petition for vaccine compensation filed on
or about October 4, 2018, in the United States Court of Federal Claims as petition No. l 8-l 542V.
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-01542-UNJ Document 40 Filed 06/12/20 Page 6 of 7
15. If the special master fails to issue a decision in complete conformity with the terms
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a
decision that is in complete conformity with the terms of this Stipulation, then the parties·
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 Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties fmther 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 vaccine caused petitioner's alleged shoulder
injury and/or any other injury.
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-01542-UNJ Document 40 Filed 06/12/20 Page 7 of 7
Respectfully submitte.d,
EBROWN
ATTORNEY OF RECORD FOR AUTHOIUZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
/ ~ LL_ _____
~ N"E E. REEVES
ZGHEIB SAVA , P.C. Deputy Director
75 South Broadway. 4th Floor Torts Branch
Whit~ Plains, New York 10601 Civil Division
(914) 729-11 10 U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORi~EYOFRECORDFOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
b~Jil=
TAMARA OVERBY
Acting Director, Division oflnjury Senior Trial Attorney
Compensation Programs Torts Branch
Healthcare Systems Bureau Civil Division
U.S. Department of Health U.S. Department of Justice
and Human Services P.O. Box 146
5600 Fishers Lane Benjamin Franklin Station
Parklawn Building, Mail Stop 08Nl46B Washington, DC 20044-0146
Rockville, MD 20857 (202) 616-9847
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