VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01778
Package ID: USCOURTS-cofc-1_18-vv-01778
Petitioner: Christine McGee
Filed: 2018-11-16
Decided: 2022-04-20
Vaccine: influenza
Vaccination date: 2017-10-24
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: entitlement_granted_pending_damages
Award amount USD: 

AI-assisted case summary:
Christine McGee filed a petition for compensation under the National Vaccine Injury Compensation Program on November 16, 2018, alleging she sustained a left shoulder injury related to vaccine administration (SIRVA) from an influenza vaccination received on October 24, 2017. Petitioner was represented by Andrew D. Downing of Van Cott & Talamante, PLLC. Respondent, the Secretary of Health and Human Services, was represented by Jennifer L. Reynaud of the United States Department of Justice. Initially, Respondent recommended denial of the petition. However, following a fact ruling on November 30, 2021, by Special Master Herbrina Sanders, which found that Petitioner established by preponderant evidence that she experienced the onset of her left shoulder pain within 48 hours of her flu vaccination, Respondent filed an amended report on April 1, 2022. In this amended report, Respondent stated they would not defend the case on other grounds and conceded that Petitioner had otherwise satisfied the criteria set forth in the Vaccine Injury Table and the Qualifications and Aids to Interpretation for SIRVA. Respondent noted that Petitioner had no recent history of left shoulder pain, inflammation, or dysfunction; the onset of pain occurred within 48 hours of the intramuscular vaccine; the pain was limited to the vaccinated shoulder; and no other condition explained the pain. Respondent also acknowledged that Petitioner suffered residual effects for more than six months. Therefore, Respondent did not dispute that Petitioner satisfied all legal prerequisites for compensation. Special Master Sanders, reviewing the record and in light of Respondent's concession, ruled that Christine McGee is entitled to compensation. The matter was then set to proceed to the damages phase. The ruling was signed by Special Master Herbrina Sanders on April 5, 2022, and filed on April 20, 2022.

Theory of causation field:
Petitioner Christine McGee received an influenza vaccine on October 24, 2017, and alleged a left shoulder injury related to vaccine administration (SIRVA). The Special Master's ruling indicates that the case proceeded based on the Vaccine Injury Table criteria for SIRVA. Petitioner established the onset of left shoulder pain within 48 hours of vaccination, and the condition persisted for more than six months. Respondent conceded that Petitioner met the criteria for SIRVA as a Table injury, including no recent history of shoulder issues, onset within 48 hours of an intramuscular vaccine, pain localized to the vaccinated shoulder, and no other identified cause for the pain. The public text does not describe specific medical experts, the mechanism of injury, or the specific dollar amount awarded, as the case was proceeding to the damages phase. The ruling on entitlement was issued by Special Master Herbrina Sanders on April 5, 2022, and filed on April 20, 2022. Petitioner was represented by Andrew D. Downing, and Respondent by Jennifer L. Reynaud.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01778-0
Date issued/filed: 2021-12-17
Pages: 11
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/30/2021) regarding 39 Findings of Fact & Conclusions of Law. Signed by Special Master Herbrina Sanders. (arm) Service on parties made.
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Case 1:18-vv-01778-UNJ Document 41 Filed 12/17/21 Page 1 of 11
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
Filed: November 30, 2021
* * * * * * * * * * * * * * *
CHRISTINE MCGEE, * No. 18-1778V
*
Petitioner, * Special Master Sanders
*
v. *
*
SECRETARY OF HEALTH * Fact Finding; Onset of Injury;
AND HUMAN SERVICES, * Influenza (“Flu”) Vaccine;
* Shoulder Injury Related to Vaccine
Respondent. * Administration (“SIRVA”)
* * * * * * * * * * * * * * *
Andrew Downing, Van Cott & Talamante, PLLC, Phoenix, AZ, for Petitioner.
Jennifer Reynaud, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING1
On November 16, 2018, Christine McGee (“Petitioner”) filed a petition pursuant to the
National Vaccine Injury Compensation Program.2 Pet. at 1, ECF No. 1. Petitioner “request[ed]
compensation on her behalf, under [the Program] after suffering a left shoulder injury as a result
of the incorrect administration of an influenza vaccination she received on October 24, 2017.” Id.
In her petition, Petitioner noted that she “expected to experience some discomfort over the
following few days after the shot, but[] almost immediately after receiving it, felt pain that was
more severe and unusual.” Id. at 2. Petitioner continued that despite her attempts to self-medicate,
she eventually had to seek treatment from an occupational medical specialist on April 4, 2018. Id.
Petitioner makes a claim for a Table injury, asserting that her injury satisfies the definition of
shoulder injury related to vaccine administration (“SIRVA”) codified at 42 U.S.C. § 300aa-14. Id.
at 1. Alternatively, Petitioner claims her injuries were caused-in-fact by her vaccination. Id.
Respondent filed his Rule 4(c) report on January 17, 2020, and concluded that “this case is not
appropriate for compensation under the terms of the Vaccine Act.” Resp’t’s Report at 1, ECF No.
25. Respondent argued that Petitioner has a chronic pre-vaccination injury that “would explain
1This fact ruling shall be posted 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). In accordance with Vaccine Rule 18(b), a party has 14 days to identify
and move to delete medical or other information that satisfies the criteria in § 300aa-12(d)(4)(B). Further,
consistent with the rule requirement, a motion for redaction must include a proposed redacted fact ruling.
If, upon review, I agree that the identified material fits within the requirements of that provision, such
material will be deleted from public access.
2 The Program comprises Part 2 of the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-
10 et seq. (hereinafter “Vaccine Act,” “the Act,” or “the Program”). Hereafter, individual section references
will be to 42 U.S.C. § 300aa of the Act.

Case 1:18-vv-01778-UNJ Document 41 Filed 12/17/21 Page 2 of 11
Petitioner’s symptoms.” Id. at 4. Respondent also noted that Petitioner cannot establish pain onset
within 48 hours of vaccination because she did not seek medical care for 162 days following receipt
of her flu vaccine. Id. at 6. This delay, Respondent wrote, “plac[es] in doubt any recollection by
[P]etitioner that her pain began soon after the vaccine.” Id. Pursuant to my June 23, 2020
scheduling order, Petitioner filed a brief regarding onset, in which she “respectfully requests a
determination that her shoulder complaints began on October 24, 2017.” Pet’r’s Br. at 19, ECF
No. 34. For the reasons discussed herein, I find that Petitioner has provided preponderant evidence
that her shoulder pain began within 48 hours of her vaccination.
I. Procedural History
Petitioner filed her petition on November 16, 2018. Pet. at 1. On November 28, 2018,
Petitioner filed a personal statement, medical records, her employee immunization record, and
workers’ compensation claim documents. Pet’r’s Exs. 1–12, ECF Nos. 6-1–6-10, 7-1–7-2.
Petitioner also filed a statement of completion on November 28, 2018. ECF No. 8. Petitioner
submitted a VAERS report on December 4, 2018. Pet’r’s Ex. 13, ECF No. 10-1. On April 3, 2019,
Petitioner filed the witness statement of Matthew Brady, R.N. Pet’r’s Ex. 15, ECF No. 15-1.
Petitioner filed an additional witness statement of Kaitlyn Ekema, on August 1, 2019. Pet’r’s Ex.
16, ECF No. 20.
On January 17, 2020, Respondent filed his Rule 4(c) report recommending compensation
be denied. Resp’t’s Report at 1. Petitioner filed her complete vaccination record on January 30,
2020. Pet’r’s Ex. 17, ECF No. 26-1. Following the parties’ participation in a status conference, the
chief special master informed the parties that he “examined the evidence in this case regarding
onset, including the affidavits and other corroborating evidence submitted by Petitioner, and would
likely find that the record sufficiently demonstrates that the onset of Petitioner’s symptoms
occurred within 48 hours of her receiving the influenza vaccine.” Order, ECF No. 27. The chief
special master ordered Respondent to file a status report indicating how he would like to proceed.
Id. In a status report filed on May 18, 2020, Respondent stated his intention to litigate this case.
ECF No. 28. Consequently, the case was transferred out of the special processing unit and
reassigned to me on May 26, 2020. ECF No. 30. On June 23, 2020, I ordered Petitioner to “file an
opening brief and any supporting documentation regarding the onset of her shoulder pain.” Order,
ECF No. 32. Petitioner filed her memorandum regarding onset on July 30, 2020. Pet’r’s Br., ECF
No. 34. Respondent filed a response on October 8, 2020. Resp’t’s Resp., ECF No. 37. Petitioner
filed her reply on October 21, 2020. Pet’r’s Reply, ECF No. 38. This matter is now ripe for review.
II. Summary of Relevant Evidence
a. Medical Records
Prior to October 24, 2017, Petitioner had a medical history that was significant for neck
pain and left arm numbness. Pet’r’s Ex. 7 at 40, ECF No. 6-7. On March 3, 2014, Petitioner was
seen by Shannon Sealey, N.P., with ACP-Arizona Internal Medicine Specialists. Id. A cervical3
MRI revealed mild C3/4 neural foraminal narrowing due to a disc bulge; C5/6 shallow posterior-
3 Cervical “pertain[s] to the neck.” Dorland’s Illustrated Medical Dictionary 1, 333 (32nd ed. 2012)
[hereinafter “Dorland’s”].
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Case 1:18-vv-01778-UNJ Document 41 Filed 12/17/21 Page 3 of 11
central disc protrusion with minimal cord compression, but not central stenosis; and a moderate
bilateral C5/6 neural foraminal stenosis attributed to a disc bulge. Id. at 32–33. N.P. Sealey’s
recommendations were “differential diagnosis of numbness of [Petitioner’s] left arm with patient
to include cervical radiculopathy,4 carpal tunnel syndrome,5 [and] impingement6 of the radial or
ulnar nerve.” Id.
Petitioner received treatment through 2015 for neck pain “symptoms [that] tend to wax and
wane and has flares every couple months.” Id. at 10. Petitioner described the pain as “dull, aching
sharp in nature,” and said it “is localized to the neck and radiates into the suprascapular region.”
Id. She rated the pain at its worse as a ten out of ten. Id. Petitioner initially denied any radiating
arm symptoms but complained of radiation to the shoulders on February 5, 2015. Id. at 10, 75.
Petitioner’s medical record notes treatment for her chronic neck pain with complaints of left arm
paresthesia in July 2016. Id. at 57.
On October 24, 2017, Petitioner received a flu shot in her left arm. Pet’r’s Ex. 17 at 1.
Petitioner’s first medical record created post vaccination is from an April 4, 2018 visit with Dennis
L. Thrasher, M.D., an occupational medicine specialist. Pet’r’s Ex. 9 at 32, ECF No. 6-9. Petitioner
presented with complaints of “a dull and constant pain” in her left shoulder that she associated
with her flu vaccination. Id. Petitioner reported to Dr. Thrasher that she self-treated with ibuprofen
every other day. Id. Petitioner reported that the pain had gotten worse over the prior two weeks.
Id. Petitioner denied any weakness, neck pain, or numbness in her arm. Id. The examination of
Petitioner’s left shoulder showed “some fullness” and tenderness in her mid-deltoid region, full
range of motion (“ROM”), and no signs of impingement. Id. at 33. Dr. Thrasher assessed Petitioner
with left shoulder pain associated with vaccine administration, and the treatment plan included X-
rays and physical therapy (“PT”). Id. The X-rays of Petitioner’s left shoulder revealed “[n]o
significant abnormality.” Pet’r’s Ex. 5 at 114, ECF No. 6-5.
Petitioner returned to Dr. Thrasher on April 18, 2018, for “follow up for left shoulder pain
chronologically related to a vaccine administration in the left deltoid region.” Pet’r’s Ex. 12 at 5,
ECF No. 7-2. She indicated that her pain was “slightly improved[.]” Id. Dr. Thrasher’s examination
of her shoulder showed “some tenderness and a soft tissue swelling over the lateral deltoid region.”
Id. Petitioner also exhibited limited ROM. Id.
An MRI was performed on Petitioner’s left shoulder on May 8, 2018. Pet’r’s Ex. 5 at 114.
The impression section of the record revealed mild superior subscapularis tendinosis,7 minor acute
4 Cervical radiculopathy is “radiculopathy of cervical nerve roots, often with neck or shoulder pain;
compression of nerve roots is a common cause in this area.” Dorland’s at 1571.
5 Carpal tunnel syndrome is “an entrapment neuropathy characterized by pain and burning or tingling
paresthesias in the fingers and hand, sometimes extending to the elbow. Symptoms result from compression
of the median nerve in the carpal tunnel.” Dorland’s at 1824.
6 Impingement is “advancement of one thing out of its expected place to where it may collide with something
else[.]” Dorland’s at 923.
7 Tendinosis is also referred to as tendinopathy or tendinitis. It is defined as “inflammation of tendons and
of tendon-muscle attachments[.]” Dorland’s at 1881. The suprascapular region is “above or on the upper
part of the scapula.” Id. at 1806.
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or chronic acromioclavicular joint osteoarthritis,8 and mild subacromial-subdeltoid bursitis.9 Id. at
116; Pet’r’s Ex. 9 at 41; Pet’r’s Ex. 12 at 7–8.
On May 16, 2018, Petitioner began treatment with PT. Pet’r’s Ex. 6 at 1, ECF No. 6-6.
Petitioner’s PT intake records note that “[Petitioner] had a flu shot in October and had pain but it
lingered.” Id. at 27. The record further notes that it “is decided that it was likely SERVA [sic].” Id.
Petitioner reported that the “[p]ain has worsened due to working in the PICU with doing a lot of
work with fusions and needing to move a lot of children.” Id. She indicated that she had been able
to continue to work on a light duty schedule. Id. Petitioner’s initial examination revealed weakness
and limited ROM in her left shoulder. Id.
Petitioner returned to Dr. Thrasher on May 17, 2018, complaining of aggravation of her
left shoulder pain due to “doing her regular duties and the lifting involving her patient care
activities as a registered nurse.” Pet’r’s Ex. 12 at 9. Petitioner had full ROM, but Dr. Thrasher’s
assessment of Petitioner noted “[s]houlder injury related to vaccine administration.” Id. A medical
record dated May 22, 2018, for care unrelated to her shoulder pain also noted Petitioner was
“[w]orking NICU while on light duty due to bursitis in shoulder from the flu vaccine.” Pet’r’s Ex.
4 at 55, ECF No. 6-4. Petitioner saw Dr. Thrasher for a follow-up on June 20, 2018, and she
consistently related her shoulder pain and injury to her vaccination. Pet’r’s Ex. 12 at 11.
On June 27, 2018, Petitioner was seen by Andrew Mahoney, M.D., an orthopedist, with
complaints of a left shoulder injury following the receipt of a flu vaccine on October 24, 2017.
Pet’r’s Ex. 7 at 28–29. Petitioner noted that her shoulder hurt initially, then it “got a little bit better
[before worsening again] when she lifted a patient at work.” Id. Petitioner was assessed with left
shoulder rotator cuff tendinitis. Id. On August 18, 2018, Petitioner filled out a VAERS form that
described “pain at injection site immediately following vaccination and continued through
8/18/18[, and p]ain with [activities of daily living (“ADL’s”), including] sleeping on [her] left side
and all the time to some degree.” Pet’r’s Ex. 13 at 2. Petitioner noted that “[p]hysical therapy has
reduced [her] pain level.” Id.
Petitioner continued to receive treatment from Dr. Mahoney for her shoulder pain through
September 2018. Pet’r’s Ex. 7 at 77–81. On September 10, 2018, Petitioner returned to Dr.
Mahoney where she reported “full [left shoulder ROM] and strength without pain.” Id. at 77. Dr.
Mahoney’s examination showed Petitioner had normal ROM and strength with negative
impingement signs. Id. Petitioner was assessed with recovered left shoulder function, and Dr.
Mahoney instructed Petitioner to return to full duty at work. Id.
Petitioner attended a total of eighteen PT sessions that concluded on September 20, 2018.
Id. at 1–2. At the time of discharge, Petitioner was able to push and pull fifty pounds without
symptoms and to reach overhead without restriction. Id. The recommendation at that time was
consistent with Dr. Mahoney’s plan for Petitioner to return to full duty at work. Id.
8 Acromioclavicular joint osteoarthritis is “inflammation in the acromioclavicular joint.” Dorland’s at 150.
The acromioclavicular joint is “the synovial joint between the acromion of the scapula and the acromial
extremity of the clavicle[.]” Id. at 971.
9 Bursitis is “inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying
tendon; the most common site is the subdeltoid bursa.” Dorland’s at 264.
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b. Affidavits
i. Petitioner
Petitioner filed two personal affidavits in this case, on November 16, 2018, and March 22,
2019. Pet’r’s Aff., ECF No. 1-2; Pet’r’s Ex. 14, ECF No. 13-1. In her first affidavit, Petitioner
explained that she is a pediatric ICU nurse at Tucson Medical Center (“TMC”), and she receives
flu vaccinations every year as a job requirement. Pet’r’s Aff. at 1. Petitioner wrote that on October
24, 2017, she received her annual flu vaccine. Id. She stated that she had never “experienced any
problems with [her] left shoulder prior to October 24, 2017.” Id. Petitioner further stated that after
this vaccination, she experienced “a painful and constant ache” that was different than past
vaccines. Id. Because of her professional training, Petitioner’s “immediate reaction was that the
pain would soon wane and, in the interim, [she] could treat it with over-the-counter medication
and alternating ice/heat treatment.” Id.
Shortly after vaccination, on November 8, 2017, Petitioner began a temporary position as
a traveling nurse with Kaiser Permanente-Oakland Medical Center (“Kaiser”). Id. Unlike TMC,
“Kaiser had a great patient transfer and lifting system in place, so [she] was not doing a lot of
lifting and [her] shoulder pain was manageable with self-treatment.” Id. at 2. Once Petitioner
returned to her position with TMC in February 2018, she was “having problems using [her] left
arm and shoulder while lifting and transferring patients[.]” Id. Petitioner wrote that she “tried to
ignore [her] pain and work through it, but early in April [of] 2018, [she] determined that it was
time to seek help since nothing had changed with [her] shoulder.” Id.
Petitioner described her first appointment post vaccination with Dr. Thrasher on April 4,
2018. Id. She noted that she told him her pain began shortly after her flu vaccination and had
recently increased, despite her self-treatment with over-the-counter medications. Id. Petitioner
recounted her medical treatment, including an MRI and PT, from that initial visit in April through
September 2018. Id. at 2–3. Petitioner wrote that during her September 5, 2018 PT session, she
reported that her “left shoulder pain had resolved.” Id. at 3. She noted that she met with Dr.
Mahoney on September 10, 2018, and he released her back “to full duty [at work] without
restrictions.” Id. Petitioner stated that she is “back on regular duty, although [she] continue[s] to
occasionally suffer some pain in [her] left shoulder.” Id.
Petitioner’s second affidavit provided more background information about her work as a
pediatric nurse in the ICU. Pet’r’s Ex. 14 at 6. Petitioner wrote that her “long term goal has always
been to become a traveling nurse,” because her “favorite hobby is landscape photography and
exploring new places.” Id. She noted that she “had a wonderful experience with [her] first travel
assignment [from] November 2017 through February 2018 in the [B]ay area.” Id. Petitioner wrote
that she “was looking forward to booking another travel job after coming home to Tucson for a
couple of months” but she “was not able to [] since [she] ha[d] been on light duty at work and
doing PT [] since May 2018[,] due to SIRVA.” Id.
She further described the vaccination as “painful as most flu shots are in [her] opinion but
did not seem any different than any other flu shots [she had] had every winter at the time.” Id. She
noted, “[t]his injection site continued to be painful though days after the shot.” Id. Petitioner wrote
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that she “expressed [how painful her shot was] to a couple of fellow nurses while at work curious
if anyone had ever had long lasting shoulder pain from the flu shot.” Id. She continued, that she
“had never had any problems prior and it seemed odd.” Id. Petitioner wrote that she “thought
perhaps it was just taking a little longer to heal and went about [her] life as usual.” Id.
Ultimately, Petitioner wrote that she decided to go to employee health after “days, weeks
and months passed [and] the pain in [her] shoulder where [she] received the flu shot persisted.” Id.
She had “never had any pain in [her] left shoulder before.” Id. Petitioner noted that she filed a
workers’ compensation claim and presented statements from her co-workers “attesting to [her]
complaints of persistent shoulder pain post the flu shot.” Id. Petitioner reiterated that she “did not
seek medical care for 5 months since the flu shot but as a nurse [they] tend to grin and bear it when
something hurts.” Id. She wrote that as a result of her injury, Petitioner’s employer reassigned her
to a different unit and placed her on light duty. Id. Petitioner noted that with her accommodations,
she was able to continue her work as a pediatric and neonatal nurse. Id. However, Petitioner
reiterated that she has “not been able to take another travel RN job.” Id.
ii. Kaitlyn Ekema
Ms. Ekema is Petitioner’s co-worker. Pet’r’s Ex. 14 at 7. Ms. Ekema provided the same
statement for Petitioner on two different occasions. Id.; Pet’r’s Ex. 16 at 1, ECF No. 20-1. The first
copy was submitted as a part of Petitioner’s workers’ compensation claim in April 2018. Pet’r’s
Ex. 14 at 7. The second copy was filed as a statement in this case on August 1, 2019. Pet’r’s Ex.
16 at 1. The statement is signed by Ms. Ekema, but it is undated. The complete text is as follows:
To Whom it may concern:
In early November of 2016, I worked in the Pediatric Intensive Care Unit with
[Petitioner]. On that day she told me that she received her flu shot two weeks ago,
but that her arm still hurt a lot. She proceeded to rotate her arm and was unable to
fully rotate it upwards due to pain. I do not remember the exact date this was, but I
do specifically remember her saying that it had been two weeks since her flu shot,
and that her arm had continuously hurt since.
Thank you,
Kaitlyn Ekema, PCT, TMC Pediatrics/PICU.
Pet’r’s Ex. 14 at 7; Pet’r’s Ex. 16 at 1.
iii. Matthew Brady
Mr. Brady is also a registered nurse and Petitioner’s co-worker. Pet’r’s Ex. 15 at 1. Mr.
Brady’s first statement was an email submitted as a part of Petitioner’s workers’ compensation
claim. Pet’r’s Ex. 14 at 8. The email, dated April 19, 2018, read:
On October 26th, 2017 [Petitioner] told me her arm hurt from the flu shot she
received on October 24th, 2017. [S]he also said she could not lift her arm all the
way up without it hurting.
Thank you[,]
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Matt Brady.
Id.
Mr. Brady’s second statement was signed and dated April 26, 2019. Pet’r’s Ex. 15 at 2.
Mr. Brady wrote that he and Petitioner received the flu shot on October 24, 2017. Id. at 1. “Two
days later on October 26, 2017,” Mr. Brady wrote that his soreness had gone away, but Petitioner
“was complaining that her shoulder and arm were still in extreme pain.” Id. Mr. Brady noted that
he “could tell by looking at her face that she was in pain.” Id. Mr. Brady wrote that Petitioner told
him that “it felt different from previous vaccinations and it was much more painful.” Id. Mr. Brady
described how Petitioner “would have difficulty at work,” specifically he “saw that she was having
trouble lifting anything because of her arm.” Id. at 1–2. He wrote there is “no question that I
personally saw and discussed with [Petitioner] the complaints she was having with her shoulder
two days after vaccination.” Id. at 2. Mr. Brady asserted that it was “clear that her complaints
started immediately after the vaccination, and they were certainly present within 48 hours of her
shot.” Id.
III. Parties’ Arguments
a. Petitioner
Petitioner’s memorandum regarding onset is largely a recitation of her medical record. See
Pet’r’s Br. Petitioner notes that “Respondent objects to the length of time between vaccination and
the first medical record reflecting [Petitioner’s] shoulder injury,” and “also highlighted concerns
of pre-existing neck pain.” Id. at 16–17. Petitioner responds by arguing that her attestation of an
immediate onset of pain is corroborated by her witnesses. Id. at 17. Petitioner also argues that
beginning with her first medical visit post vaccination, she consistently and unequivocally
identifies her pain onset as immediately following her vaccination. Id. Petitioner acknowledges
that “she waited to seek medical treatment,” but reiterates her belief that “she could treat this issue
on her own” until it was apparent that she could not. Id. Lastly, she acknowledges that “she had
long-standing neck complaints,” but argues that her neck injury is different from her SIRVA in
how it was assessed and treated. Id.
b. Respondent
Respondent argues that Petitioner has failed to present evidence that her pain began within
48 hours of her flu vaccine. Resp’t’s Resp. at 5. He notes that “there are no contemporaneous
records, medical, employment, or otherwise, until she first reports her symptoms about five-and-
a-half months later, placing in doubt any recollection by [P]etitioner or her witness that her pain
began soon after the vaccine.” Id. (citing Pet’r’s Ex. 9 at 32–33). Respondent also contends
Petitioner’s witness statements are not credible due to vagueness, and/or “the passage of time”
between the preparation of the statements and the conversations described therein that took place
eighteen months earlier. Resp’t’s Resp. at 6. Respondent argues that Mr. Brady’s recollection that
Petitioner’s ROM was ‘“severely limited, and she could not life her arm up without it hurting’ is
not easily reconciled with her failure to seek medical treatment for many months.” Id. (citing
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Pet’r’s Ex. 15 at 2). Respondent argues this is more consistent with Petitioner’s pain beginning six
months post vaccination. Resp’t’s Resp. at 6 (citing Pet’r’s Ex. 9 at 32–33).
IV. Applicable Legal Standard
To receive compensation under the Vaccine Act, Petitioner must demonstrate either that:
(1) she suffered a “Table injury” by receiving a covered vaccine and subsequently developing a
listed injury within the time frame prescribed by the Vaccine Injury Table set forth at 42 U.S.C. §
300aa-14, as amended by 42 C.F.R. § 100.3; or (2) that she suffered an “off-Table injury,” one not
listed on the Table as a result of her receipt of a covered vaccine. See 42 U.S.C. §§ 300aa-
11(c)(1)(C); Moberly v. Sec’y of Health & Hum. Servs., 592 F.3d 1315, 1321 (Fed. Cir. 2010);
Capizzano v. Sec’y of Health & Hum. Servs., 440 F.3d 1317, 1319–20 (Fed. Cir. 2006).
The Vaccine Injury Table considers a SIRVA a presumptive injury for the flu vaccine if
the first symptom or manifestation of onset of the illness occurs within forty-eight hours of an
intramuscular vaccine administration. See 42 C.F.R. § 100.3(a)(XIV).
The process for making determinations in Vaccine Program cases regarding factual issues
begins with consideration of the medical records. § 11(c)(2). The special master is required to
consider “all [] relevant medical and scientific evidence contained in the record,” including “any
diagnosis, conclusion, medical judgment, or autopsy or coroner's report which is contained in the
record regarding the nature, causation, and aggravation of the petitioner's illness, disability, injury,
condition, or death,” as well as “the results of any diagnostic or evaluative test which are contained
in the record and the summaries and conclusions.” § 13(b)(1)(A). The special master is then
required to weigh the evidence presented, including contemporaneous medical records and
testimony. See Burns v. Sec'y of Health & Hum. Servs., 3 F.3d 415, 417 (Fed. Cir. 1993). Pursuant
to Vaccine Act § 13(a)(1)(A), a petitioner must prove their claim by a preponderance of the
evidence. A special master must consider the record as a whole, but is not bound by any diagnosis,
conclusion, judgment, test result, report, or summary concerning the nature, causation, and
aggravation of petitioner’s injury or illness that is contained in a medical record. § 13(b)(1).
In Program cases, contemporaneous medical records and the opinions of treating
physicians are favored. Capizzano, 440 F.3d at 1326 (citing Althen v. Sec’y of the Dept. of Health
& Hum. Servs., 418 F.3d 1274, 1278–79 (Fed. Cir. 2005)). This is because “treating physicians
are likely to be in the best position to determine whether ‘a logical sequence of cause and effect
show[s] that the vaccination was the reason for the injury.’” See id. In addition, “[m]edical records,
in general, warrant consideration as trustworthy evidence.” Cucuras v. Sec’y of Health & Hum.
Servs., 933 F.2d 1525, 1528 (Fed. Cir. 1993). Indeed, contemporaneous medical records are
ordinarily to be given significant weight due to the fact that “the records contain information
supplied to or by health professionals to facilitate diagnosis and treatment of medical conditions.
With proper treatment hanging in the balance, accuracy has an extra premium. These records are
also generally contemporaneous to the medical events.” Id. However, there is no “presumption
that medical records are accurate and complete as to all of the patient’s physical conditions.” Kirby
v. Sec’y of Health & Hum. Servs., 997 F.3d 1378, 1383 (Fed. Cir. 2021) (finding that a special
master must consider the context of a medical encounter before concluding that it constitutes
evidence regarding the absence of a condition.). While a special master must consider these
8

Case 1:18-vv-01778-UNJ Document 41 Filed 12/17/21 Page 9 of 11
opinions and records, they are not “binding on the special master or court.” 42 U.S.C. § 300aa-
13(b)(1). Rather, when “evaluating the weight to be afforded to any such . . . [evidence], the special
master . . . shall consider the entire record . . . .” Id.
For cases alleging a condition found in the Vaccine Injury Table, special masters may find
when a first symptom appeared, despite the lack of a notation in a contemporaneous medical
record. 42 U.S.C. § 300aa-13(b)(2). By extension, special masters may engage in similar fact-
finding for cases alleging an off-Table injury. In such cases, special masters are expected to
consider whether medical records are accurate and complete.
V. Analysis of Shoulder Injury Onset
Although I am not bound by the chief special master’s conclusions prior to the
reassignment of this case to me, I ultimately agree with Chief Special Master Corcoran that
Petitioner has provided preponderant evidence that her shoulder pain began within 48 hours of
vaccination. This case is fairly straightforward, as Respondent’s main contentions are that
Petitioner has a pre-existing shoulder injury, and that she did not seek medical treatment for an
extended period of time. Contrary to Respondent’s assertions, these issues can be easily reconciled.
a. Pre-vaccination injury
Petitioner’s medical records prior to her vaccination document a localized chronic neck
injury with occasional complaints of left arm paresthesia. Petitioner described her neck pain as
sharp and rated it a ten out of ten at its worst. She said it waxed and waned with numbness radiating
into her arm. She received treatment from 2014 through July of 2016, to include prescription
medication and physical therapy. In April of 2018, Petitioner first complained of a vaccine-
related shoulder injury, but she did not complain of neck pain or arm numbness at that
time. Petitioner described her shoulder pain as a constant ache that was exacerbated with
lifting. She also noted that the pain was initially manageable, and she was able to self-treat with
over-the-counter medication for a period of several months. There is a clear distinction between
the location and nature of the pain that Petitioner experienced in her neck prior to her vaccination
and in her shoulder post vaccination. Petitioner has a pre-vaccination history that includes
symptoms affecting her shoulder. However, there is a period of time of over a year between the
last recorded medical visit for her neck injury and the first visit post vaccination, wherein she
complained of the shoulder injury. That period of time and the different nature of her
reported symptoms provide preponderant evidence that Petitioner’s injuries are distinct.
b. Delay in seeking medical treatment
It is true that Petitioner does not have medical records that document a complaint of shoulder
pain consistent with SIRVA to a medical provider for more than five-and-a-half months post
vaccination. However, when Petitioner did finally seek treatment for her shoulder pain on April 4,
2018, and thereafter, she consistently related it back to her vaccination. Petitioner credibly
explained that she did not seek treatment immediately, because she has received vaccines in the
past and expected some degree of soreness and pain. She also relied on her occupation as a nurse
to explain that she, too, “grins and bears it” when something hurts. She said she attempted to self-
9

Case 1:18-vv-01778-UNJ Document 41 Filed 12/17/21 Page 10 of 11
treat her pain with over-the-counter medication, which helped manage her pain initially. She also
described how during the months immediately post vaccination, she was able to function at work,
because her temporary contract with Kaiser as a traveling nurse was less physically demanding
than her permanent duties with TMC. Although contemporaneous medical records often contain
evidence that is contradictory to a petitioner’s claim, the lack of medical records or treatment is
not per se evidence that a petitioner was not suffering from an injury. See 42 U.S.C. § 300aa-
13(b)(2); see also Kirby, 997 F.3d at 1383. Indeed, it is not uncommon in the Program for
individuals not to seek treatment immediately for shoulder pain post vaccination. See, e.g., Lang
v. Sec'y of Health & Hum. Servs., No. 17-995V, 2020 WL 7873272, at *11 (Fed. Cl. Spec. Mstr.
Dec. 11, 2020) (citing Forman-Franco v. Sec’y of Health & Hum. Servs., No. 15-1479V, 2018 WL
1835203 (Fed. Cl. Spec. Mstr. Feb. 21, 2018); Tenneson v. Sec’y of Health & Hum. Servs., No.
16-1664V, 2018 WL 3083140 (Fed. Cl. Spec. Mstr. Mar. 30, 2018), mot. rev. denied 142 Fed. Cl.
329 (2019); Gurney v. Sec’y of Health & Hum. Servs., No. 17-481V, 2019 WL 2298790 (Fed. Cl.
Spec. Mstr. Mar. 19, 2019)). In fact, it is not at all unusual for people not to seek immediate
medical care for an injury consistent with SIRVA and special masters have determined that such
claims may succeed despite delayed treatment. See, e.g., Hanna v. Sec’y of Health & Hum. Servs.,
No. 18-1455V, 2021 WL 3486248 (Fed. Cl. Spec. Mstr. July 15, 2021) (citing Lang, 2020 WL
7873272, at *10 (noting that “[R]espondent’s expert has conceded that there is no such thing as an
‘appropriate’ time to seek treatment” for SIRVA); Smallwood v. Sec’y of Health & Hum. Servs.,
No. 18-291V, 2020 WL 2954958, at *10 (Fed. Cl. Spec. Mstr. Apr. 29, 2020) (finding that it is
“common for a SIRVA petitioner to delay treatment, thinking his/her injury will resolve on its
own.”)). Petitioner has therefore presented a logical explanation for her delay in seeking medical
treatment.
c. Evidence of onset
The statements provided by Mr. Brady and Ms. Ekema as direct evidence in this case were
filed in April of 2019. Respondent argues that these statements were drafted approximately
eighteen months post vaccination and should be discounted due to the passage of time. This
argument, however, is inapplicable to the statements that these witnesses submitted as a part of
Petitioner’s workers’ compensation claim in April of 2018.
Ms. Ekema’s statements are not dated. Furthermore, the two documents signed by Ms.
Ekema are copies of the same statement, and there is little substantive information within the
statement relating to the onset of Petitioner’s pain. Ms. Ekema references a conversation that she
had with Petitioner in November of 2016, but Petitioner received the vaccine at issue in October
of 2017. It is unclear if Ms. Ekema mixed up the dates, but ultimately, her statement is less
persuasive given the erroneous 2016 date she referenced and the statement’s overall vagueness.
Mr. Brady, however, provided support for Petitioner’s assertion that she complained of pain
immediately post vaccination. Mr. Brady provided two distinct statements for Petitioner’s
workers’ compensation claim and her vaccine injury claim. Mr. Brady’s email statement from
April 19, 2018, explained that Petitioner complained of arm pain from her flu shot on October 26,
2017, two days post vaccination. He also wrote that Petitioner told him, “she could not lift her arm
all the way up without it hurting.” Pet’r’s Ex. 14 at 8. He wrote that she experienced pain when
she did. The email is credible in its simplicity. There does not appear to be any effort to assist in
10

Case 1:18-vv-01778-UNJ Document 41 Filed 12/17/21 Page 11 of 11
Petitioner’s litigation. The email is a recounting of his conversation with Petitioner. Mr. Brady did
not reach conclusions with legal significance.
Mr. Brady is more explicit in his second statement regarding the onset of Petitioner’s
symptoms and the type of pain that she experienced. It is curious that he is able to remember so
much more detail in this later statement that is dated over a year after his initial email. However,
context is probative. His second statement does not appear exactly in line with Petitioner’s own
accounting that she was able to self-treat and ignore the pain in the days immediately post
vaccination, as Mr. Brady noted he could tell by looking at her face that Petitioner was in pain. It
is possible, however, that Petitioner believed that she was masking the pain, but was ultimately
unsuccessful. Mr. Brady’s recollection of Petitioner’s post-vaccination pain is further supported
by the fact that they received their flu shots on the same day, but while his soreness dissipated two
days post vaccination, Petitioner was still experiencing extreme pain. Pet’r’s Ex. 15 at 2. While
Mr. Brady does provide much more detail in his second account, prepared nearly eighteen months
post vaccination, his statements are consistent with all the other evidence that Petitioner
experienced arm pain immediately following the vaccination.
Given Petitioner’s statement that immediately post vaccination her job did not require
manual patient transfer and lifting, it is reasonable that despite extreme pain with certain
movements, she would have initially attempted “to ignore her pain and work through it.” See
Pet’r’s Br. at 7. There is no dispute that once Petitioner did seek treatment, she never identified an
alternative cause for her shoulder pain and consistently attributed it to the flu vaccine. There is
also evidence in the medical records that once Petitioner did seek treatment, her medical providers
believed her injury to be vaccine-related. Respondent is correct that Ms. Ekema’s statement is
unreliable; however, the same cannot be said with respect to Mr. Brady’s statement. Therefore, I
find that Petitioner has established it more likely than not that she experienced shoulder pain within
48 hours of her flu vaccination.
VI. Conclusion
Based on the above reasoning, I find that Petitioner has provided evidence establishing it
more likely than not that she experienced left shoulder pain within 48 hours of her vaccination.
Petitioner and Respondent have fourteen (14) days from the filing of this ruling to file a joint status
report indicating how they wish to proceed.
IT IS SO ORDERED.
s/Herbrina D. Sanders
Herbrina D. Sanders
Special Master
11

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_18-vv-01778-1
Date issued/filed: 2022-04-20
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/05/2022) regarding 44 Ruling on Entitlement. Signed by Special Master Herbrina Sanders. (arm) Service on parties made.
--------------------------------------------------------------------------------
Case 1:18-vv-01778-UNJ Document 46 Filed 04/20/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
Filed: April 5, 2022
* * * * * * * * * * * * * * *
CHRISTINE MCGEE, * No. 18-1778V
*
Petitioner, * Special Master Sanders
*
v. *
*
SECRETARY OF HEALTH * Ruling on Entitlement; Influenza
AND HUMAN SERVICES, * (“Flu”) Vaccine; Shoulder Injury
* Related to Vaccine Administration
Respondent. * (“SIRVA”)
* * * * * * * * * * * * * * *
Andrew D. Downing, Van Cott & Talamante, PLLC, Phoenix, AZ, for Petitioner.
Jennifer L. Reynaud, United States Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On November 16, 2018, Christine McGee (“Petitioner”) filed a petition for compensation
under the National Vaccine Injury Compensation Program (“the Program”). Pet. at 1, ECF No. 1;
42 U.S.C. § 300aa-10 to -34 (2012). Petitioner alleges that she sustained a left shoulder injury
related to vaccine administration (“SIRVA”) as a result of an influenza (“flu”) vaccination she
received on October 24, 2017. Id. at 1.
On January 17, 2020, Respondent filed a report pursuant to Vaccine Rule 4(c),
recommending compensation be denied. Resp’t’s Report at 5–6, ECF No. 25. The parties then
filed briefs regarding the onset of Petitioner’s shoulder pain. ECF Nos. 34, 37–38. On November
30, 2021, I issued a fact ruling finding Petitioner established by preponderant evidence that she
experienced the onset of her left shoulder pain within 48 hours of her flu vaccination. Fact Ruling
at 11, ECF No. 39.
Respondent filed an amended Rule 4(c) report on April 1, 2022, advising that Respondent
“will not defend the case on other grounds” and noting that “[P]etitioner has otherwise satisfied
the criteria set forth in the Vaccine Injury Table and the Qualifications and Aids to Interpretation
1 This Ruling shall be posted 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), a party has 14 days to identify and move to delete medical
or other information that satisfies the criteria in § 300aa-12(d)(4)(B). Further, consistent with the rule
requirement, a motion for redaction must include a proposed redacted Ruling. If, upon review, I agree that
the identified material fits within the requirements of that provision, such material will be deleted from
public access.

Case 1:18-vv-01778-UNJ Document 46 Filed 04/20/22 Page 2 of 2
(“QAI”) for SIRVA.” Am. Resp’t’s Report at 2, ECF No. 43 (citing 42 C.F.R. §§ 100.3(a)(XIV),
(c)(10)). Specifically, Respondent noted that Petitioner had no recent history of pain,
inflammation, or dysfunction of her left shoulder; the onset of her pain occurred within 48 hours
after receipt of an intramuscular vaccine; her pain was limited to the shoulder in which the vaccine
was administered; and no other condition or abnormality, such as brachial neuritis, has been
identified to explain her left shoulder pain. Am. Resp’t’s Report at 5–6 (citing §§ 100.3(a), (c)(10)).
Respondent further noted Petitioner suffered the residual effects of her condition for more than six
months. Am. Resp’t’s Report at 6 (citing 42 U.S.C. § 300aa-11(c)(1)(D)(i)). Therefore,
Respondent “does not dispute that [P]etitioner has satisfied all legal prerequisites for compensation
under the [Vaccine] Act.” Am. Resp’t’s Report at 6.
A special master may determine whether a petitioner is entitled to compensation based
upon the record. A hearing is not required. § 300aa-13; Vaccine Rule 8(d). In light of Respondent's
concession and my review of the record, I find that Petitioner is entitled to compensation. This
matter shall now proceed to the damages phase.
IT IS SO ORDERED.
s/Herbrina D. Sanders
Herbrina D. Sanders
Special Master
2

================================================================================
DOCUMENT 3: USCOURTS-cofc-1_18-vv-01778-2
Date issued/filed: 2023-02-10
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 01/26/2023) regarding 55 DECISION - Proffer. Signed by Special Master Herbrina Sanders. (arm) Service on parties made.
--------------------------------------------------------------------------------
Case 1:18-vv-01778-UNJ Document 60 Filed 02/10/23 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
Filed: January 26, 2023
* * * * * * * * * * * * * *
CHRISTINE MCGEE, * No. 18-1778V
*
Petitioner, * Special Master Sanders
*
v. * Decision on Proffer; Damages;
* Influenza (“Flu”) Vaccine; Shoulder
SECRETARY OF HEALTH * Injury Related to Vaccine
AND HUMAN SERVICES, * Administration (“SIRVA”)
*
Respondent. *
* * * * * * * * * * * * * *
Andrew Downing, Downing, Allison & Jorgenson, Phoenix, AZ, for Petitioner.
Jennifer Reynaud, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On November 16, 2018, Christine McGee (“Petitioner”) filed a petition for compensation
under the National Vaccine Injury Compensation Program. Pet., ECF No. 1; 42 U.S.C. § 300aa-
10, et seq.2 (2012) (“Vaccine Act” or “Program”). Petitioner alleged that an influenza (“flu”)
vaccine administered on October 24, 2017, caused her to suffer from “a left shoulder injury as a
result of incorrect administration of” the vaccine. Pet. at 1.
On January 17, 2020, Respondent filed his report pursuant to Vaccine Rule 4(c). Resp’t’s
Report, ECF No. 25. Respondent argued that Petitioner has a chronic pre-vaccination injury that
“would explain Petitioner’s symptoms.” Id. at 4. Respondent also noted that Petitioner cannot
establish pain onset within 48 hours of vaccination because she did not seek medical care for 162
days following receipt of her flu vaccine. Id. at 6. This delay, Respondent wrote, “plac[es] in doubt
any recollection by [P]etitioner that her pain began soon after the vaccine.” Id. The parties then
filed briefs regarding the issue of onset. ECF Nos. 34, 37–38. On November 30, 2021, the
1 This Decision shall be posted 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), a party has 14 days to identify and move to delete medical
or other information that satisfies the criteria in § 300aa-12(d)(4)(B). Further, consistent with the rule
requirement, a motion for redaction must include a proposed redacted Decision. If, upon review, the
undersigned agrees that the identified material fits within the requirements of that provision, such material
will be deleted from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub L. No. 99-660, 100 Stat. 3755.
1

Case 1:18-vv-01778-UNJ Document 60 Filed 02/10/23 Page 2 of 5
undersigned issued a Fact Ruling and determined that Petitioner provided preponderant evidence
that her shoulder pain began within 48 hours of her vaccination. See ECF No. 39.
Respondent filed an amended Rule 4(c) report on April 1, 2022, advising that Respondent
“will not defend the case on other grounds” and noting that “[P]etitioner has otherwise satisfied
the criteria set forth in the Vaccine Injury Table and the Qualifications and Aids to Interpretation
(“QAI”) for [a shoulder injury related to vaccine administration (“SIRVA”)].” Am. Resp’t’s
Report at 2, ECF No. 43 (citing 42 C.F.R. §§ 100.3(a)(XIV), (c)(10)). On April 5, 2022, the
undersigned issued a Ruling on Entitlement, finding that Petitioner is entitled to compensation for
her SIRVA. Ruling on Entitlement, ECF No. 44.
Following negotiations, on January 20, 2023, Respondent filed a Proffer on Award of
Damages (“Proffer”). Proffer, ECF No. 54. Based on the record as a whole, the undersigned finds
that Petitioner is entitled to an award as stated in the Proffer.
Pursuant to the terms stated in the Proffer, attached as Appendix A, the undersigned awards
Petitioner:
[A] lump sum payment of $25,000.00, [representing actual and projected
pain and suffering,] in the form of a check payable to [P]etitioner. This
[amount] represents all elements of compensation to which [P]etitioner
would be entitled under 42 U.S.C. § 300aa-15(a).
Id. at 2.
In the absence of a motion for review filed pursuant to RCFC Appendix B, the clerk of
court SHALL ENTER JUDGMENT herewith.3
IT IS SO ORDERED.
s/Herbrina D. Sanders
Herbrina D. Sanders
Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment is expedited by the parties’ joint filing of a notice
renouncing the right to seek review.
2

Case 1:18-vv-01778-UNJ Document 60 Filed 02/10/23 Page 3 of 5
THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
CHRISTINE McGEE,
Petitioner, No. 18-1778V
Special Master Sanders
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
PROFFER ON AWARD OF DAMAGES
On November 16, 2018, Christine McGee (“petitioner”) filed a petition for compensation
(“Petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to
34 (“Vaccine Act” or “Act”), alleging that she sustained a left shoulder injury related to vaccine
administration (“SIRVA”), as defined in the Vaccine Injury Table, following an influenza (“flu”)
vaccine on October 24, 2017. Petition at 1. On April 1, 2022, the Secretary of Health and
Human Services (“respondent”) filed an Amended Rule 4(c) Report advising that, in light of
Special Master Sander’s Findings of Fact ruling that the onset of petitioner’s left shoulder pain
occurred within 48 hours of vaccination, and the medical evidence submitted in this case,
respondent did not dispute that petitioner had satisfied all legal prerequisites for compensation
under the Vaccine Act. Amended Rule 4(c) Report at 5-6 (ECF No. 43). On April 5, 2022,
Special Master Sanders issued a Ruling on Entitlement, finding that petitioner was entitled to
vaccine compensation for her SIRVA.1 See Ruling on Entitlement (ECF No. 44).
1 Respondent has no objection to the amount of the proffered award of damages set forth herein.
Assuming the Special Master issues a damages decision in conformity with this proffer,
respondent waives his right to seek review of such damages decision. However, respondent
1

Case 1:18-vv-01778-UNJ Document 60 Filed 02/10/23 Page 4 of 5
I. Item of Compensation
Respondent proffers that petitioner should be awarded $25,000.00 in actual and projected
pain and suffering. This amount reflects that any award for projected pain and suffering has
been reduced to net present value. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
II. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $25,000.00 in the form of a check made payable to petitioner.2
This lump sum payment represents all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
LARA ENGLUND
Assistant Director
Torts Branch, Civil Division
reserves his right, pursuant to 42 U.S.C. § 300aa-12(e), to seek review of the Special Master’s
April 5, 2022 entitlement decision.
2 Should petitioner die prior to the entry of judgment, the parties reserve the right to move the
Court for appropriate relief. In particular, respondent would oppose any award for future
medical expenses, future lost earnings, and future pain and suffering.
2

Case 1:18-vv-01778-UNJ Document 60 Filed 02/10/23 Page 5 of 5
s/Jennifer L. Reynaud
JENNIFER L. REYNAUD
Senior 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) 305-1586
Jennifer.L.Reynaud@usdoj.gov
DATED: January 20, 2023
3