VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00007
Package ID: USCOURTS-cofc-1_19-vv-00007
Petitioner: Paul Christensen
Filed: 2019-01-02
Decided: 2022-09-19
Vaccine: influenza
Vaccination date: 2017-10-14
Condition: right shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 76226

AI-assisted case summary:
Paul Christensen filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging a right shoulder injury related to vaccine administration (SIRVA) resulting from an influenza vaccine he received on October 14, 2017. The case was assigned to the Special Processing Unit. Initially, the Respondent contested entitlement. However, following a ruling on entitlement in favor of Petitioner, the Respondent filed an amended report agreeing that Petitioner met the criteria for a SIRVA Table injury, as his condition had no prior history of shoulder issues, the onset of pain occurred within 48 hours of vaccination, and the pain was localized to the vaccinated shoulder. The Respondent also agreed that the residual effects lasted more than six months. Based on this agreement and the evidence, the Chief Special Master found Petitioner entitled to compensation. Subsequently, the parties submitted a proffer for damages. The Chief Special Master awarded Paul Christensen a total of $76,226.41, consisting of $75,000.00 for pain and suffering and $1,226.41 for past unreimbursable expenses, to be paid as a lump sum.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-00007-0
Date issued/filed: 2022-04-05
Pages: 11
Docket text: PUBLIC ORDER/RULING (Originally filed: 02/28/2022) regarding 29 Findings of Fact & Conclusions of Law,, Scheduling Order,, Order on Motion for Ruling on the Record, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00007-UNJ Document 31 Filed 04/05/22 Page 1 of 11
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-0007V
UNPUBLISHED
PAUL CHRISTENSEN, Chief Special Master Corcoran
Petitioner, Filed: February 28, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Findings of Fact; Site of Vaccination;
HUMAN SERVICES, Onset; Influenza (Flu) Vaccine;
Shoulder Injury Related to Vaccine
Respondent. Administration (SIRVA)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Adriana Ruth Teitel, U.S. Department of Justice, Washington, DC, for Respondent.
FINDINGS OF FACT1
On January 2, 2019, Paul Christensen 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 alleged that he suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered to his right
shoulder on October 19, 2017. Petition at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
1 Because this unpublished fact ruling 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 fact 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, 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 section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:19-vv-00007-UNJ Document 31 Filed 04/05/22 Page 2 of 11
After review of the record and other filings, and for the reasons discussed below, I
find that: (1) Petitioner received the vaccine in his right shoulder, and (2) Petitioner’s
SIRVA likely began within the 48-hour timeframe for the Table claim.
I. Relevant Procedural History
Mr. Christensen filed his petition for compensation along with medical record
exhibits on January 2, 2019. (ECF No. 1). After reviewing the records, Respondent filed
a status report stating that he would continue to defend the case. (ECF No. 19).
Respondent also noted that this case is a companion case to Christensen v. Sec’y of
Health & Human Servs., No. 18-1477, in which Respondent was filing a Rule 4(c) Report.
Id.
On January 27, 2020, Respondent filed his Rule 4(c) Report maintaining that the
case was not appropriate for compensation under the terms of the Vaccine Act.
Respondent’s Report at 1 (ECF No. 20). Respondent referenced Petitioner’s companion
case, in which he had alleged that he suffered a left shoulder injury as a result of a
vaccination. That claim was ultimately dismissed, however, for two reasons. Christensen
v. Sec'y of Health & Hum. Servs., No. 18-1477V, 2021 WL 2419720, at *7 (Fed. Cl. Spec.
Mstr. May 12, 2021). First, I found that Petitioner had not provide preponderant evidence
that his shoulder injury began within 48 hours of vaccination. Instead, the medical record
evidence demonstrated that Petitioner complained of left shoulder pain months prior to
his vaccination while on a two-week road trip. Second, I found that even if Petitioner
wanted to proceed with an off-Table shoulder injury claim, his claim would be barred by
the Vaccine Act’s 36-month statute of limitations. The case was initiated almost five years
from even the latest likely onset, and thus, facially untimely.
In the present matter, Respondent argues, Petitioner’s claim also fails to meet the
criteria for a Table SIRVA claim, for three reasons. First, Respondent maintains the
alleged right shoulder situs has not been preponderantly established. Respondent’s
Report at 4. Second, Respondent argues that the contemporaneous medical records
“suggest that [P]etitioner’s right shoulder pain did not begin within 48 hours of his October
2017 vaccination.” Id. Mr. Christensen did not report his shoulder pain until one month
post-vaccination, despite his awareness of the Vaccine Program and the SIRVA claim
specifically.
Third, Mr. Christensen’s November 2017 MRI revealed another condition or
abnormality that would explain his symptoms. Respondent argues that the MRI of
Petitioner’s right shoulder did not reveal evidence of an inflammatory reaction in the
bursa, but rather revealed mild supraspinatus tendinopathy without focal tear.
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Case 1:19-vv-00007-UNJ Document 31 Filed 04/05/22 Page 3 of 11
Respondent’s Report at 5. But no treating physician associated these MRI findings with
vaccination. Id.
The parties agreed to brief the factual issues in dispute. I advised the parties that
they could present additional evidence on the third issue in dispute, i.e., the November
2017 MRI, but noted that I might be able to rule on this issue with the evidence presented
in the record as it currently stands. Petitioner filed his Motion for a Factual Ruling (“Br.”)
to resolve the factual issues regarding arm of administration and onset. (ECF No. 26).
Respondent filed his response (“Opp.”) on August 3, 2020. (ECF No. 27). Petitioner filed
a reply (“Reply”) on August 17, 2020. (ECF. No. 28). The matter is now ripe for
adjudication.
II. Issues
The two issues presented for resolution are:
(1) Whether Petitioner received the vaccination alleged as causal in his right arm.
42 C.F.R. § 100.3(a) XIV.B. (2017) (influenza vaccination), and
(2) Whether the onset of Petitioner’s right shoulder pain occurred within 48 hours
after vaccination, as required by the Vaccine Injury Table. 42 C.F.R. §§
100.3(a) XIV.B. (2017) (influenza vaccination) and 100.3(c)(10).
III. Authority
Pursuant to Vaccine Act § 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
§ 11(c)(1). A special master must consider, 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). “Medical records, in general, warrant consideration as trustworthy evidence.
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.” Cucuras v. Sec’y of Health & Human Servs.,
993 F.2d 1525, 1528 (Fed. Cir. 1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Human Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
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Case 1:19-vv-00007-UNJ Document 31 Filed 04/05/22 Page 4 of 11
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, at *19.
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Human Servs., 42 Fed.
Cl. 381, 391 (1998). The Court later outlined four possible explanations for
inconsistencies between contemporaneously created medical records and later
testimony: (1) a person’s failure to recount to the medical professional everything that
happened during the relevant time period; (2) the medical professional’s failure to
document everything reported to her or him; (3) a person’s faulty recollection of the events
when presenting testimony; or (4) a person’s purposeful recounting of symptoms that did
not exist. La Londe v. Sec’y of Health & Human Servs., 110 Fed. Cl. 184, 203-04 (2013),
aff’d, 746 F.3d 1335 (Fed. Cir. 2014).
The Court has also said that medical records may be outweighed by testimony that
is given later in time that is “consistent, clear, cogent, and compelling.” Camery, 42 Fed.
Cl. at 391 (citing Blutstein v. Sec’y of Health & Human Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998). However, the Federal Circuit recently
“reject[ed] as incorrect the presumption that medical records are accurate and complete
as to all the patient’s physical conditions.” Kirby v. Sec’y of Health & Hum. Servs., 997
F.3d 1378, 1383 (Fed. Cir. 2021). The credibility of the individual offering such testimony
must also be determined. Andreu v. Sec’y of Health & Human Servs., 569 F.3d 1367,
1379 (Fed. Cir. 2009); Bradley v. Sec’y of Health & Human Servs., 991 F.2d 1570, 1575
(Fed. Cir. 1993).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” § 13(b)(2). “Such a finding may be
made only upon demonstration by a preponderance of the evidence that the onset [of the
injury] . . . did in fact occur within the time period described in the Vaccine Injury Table.”
Id.
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La
Londe, 110 Fed. Cl. at 204 (citing § 12(d)(3); Vaccine Rule 8); see also Burns v. Sec’y of
Health & Human Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within the
special master’s discretion to determine whether to afford greater weight to medical
records or to other evidence, such as oral testimony surrounding the events in question
that was given at a later date, provided that such determination is rational).
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Case 1:19-vv-00007-UNJ Document 31 Filed 04/05/22 Page 5 of 11
IV. Parties’ Positions
a. Petitioner’s Arguments
Petitioner asserts that he received the flu vaccine to his right shoulder and that his
right shoulder pain started within 48 hours of vaccination. Br. at 1, 7-9. The vaccination
record he submitted with his petition did not contain a specification as to which arm
received the vaccine. Ex. 1 at 1. Petitioner argues, however, that in the later-filed
vaccination record from Costco Pharmacy (Ex. 10), (which indicates that Petitioner
received the vaccine to his left shoulder), the arm of administration was not
contemporaneously recorded, and thus the vaccination records are internally
inconsistent. Br. at 7. Furthermore, Petitioner argues that because he underwent left
shoulder surgery several years prior, he specifically requested that the flu vaccine be
administered to his right shoulder. Petitioner also notes that all of his medical records
document an injury and treatment to his right shoulder only. Br. at 7-8. And the medical
records are supported by his sworn testimony and the testimony of his fact witness. Id. at
8.
Regarding the onset issue, Petitioner notes that he reported shoulder pain less
than one month after vaccination. But he maintains he felt right shoulder pain immediately
after vaccination, which worsened over time. The worsening later motivated him to make
an appointment directly with his orthopedist. Br. at 8.
b. Respondent’s Arguments
Regarding the situs dispute, Respondent notes that Petitioner submitted two
versions of his Immunization Consent form. Opp. at 2. The first version (Ex. 1) does not
memorialize an anatomical site of administration, while the second (Ex. 10) indicates the
flu vaccine was administrated in Petitioner’s left arm. Respondent argues that Petitioner
and his wife have “inferred” that the administration site must have been added to the
second version of the form at a later time, and both asserted the record should thus be
considered “unreliable.” Opp. at 2. But Respondent maintains that the two exhibits are
not copies of the same underlying document, but are actually copies of two different
documents. Id. at 3. Respondent also notes that the second vaccination record (Ex. 10)
contains a certification of records signed by an employee of Costco. Id. As such,
Respondent argues that “it is more likely that (1) the first version submitted was the copy
given directly to [P]etitioner at the time he received the vaccination and the second version
the Administrative copy kept by Costco and (2) that the vaccine administrator circled the
site of administration on her copy and neglected to circle it on the patient copy of the form
at the time of vaccination.” Thus, the second version stands as the truly
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“contemporaneous” item of evidence, and more reliably establishes situs than another
silent document. Id. at 4.
Turning to onset, Respondent argues that Petitioner’s contentions of immediate
pain are supported only by his own statement but are uncorroborated by any objective
evidence. Opp. at 4. Respondent also argues that because Petitioner had a prior pending
SIRVA claim, he would reasonably have been expected to seek care sooner, given his
awareness of the Program and SIRVA claims. Id. at 5. Therefore, Petitioner’s SIRVA
claim should be denied.
V. Finding of Fact
I make the following findings after a complete review of the record to include all
medical records, affidavits, Respondent’s Rule 4(c) report, the parties’ briefing, and any
additional evidence filed. Specifically, I observe as follows:
 Mr. Christensen (a 47 year-old software engineer) received a flu vaccine on
October 14, 2017, at Costco Pharmacy. Ex. 1 at 1-3. The initial record of
vaccination (Ex. 1) does not specify the situs of administration.3 The vaccination
record also contains a handwritten note in response to the question “Have you
ever had a serious reaction after receiving an immunization?” This question is
marked “Yes” with a handwritten note directly above the question stating: “Too
high in shoulder → rotator cuff”. Ex. 1, p. 1.
 Another copy of the vaccination record was filed as Exhibit 10. On this version of
the document, the Site of Injection section has “LA” circled for “left arm.” Ex. 10
at 2.4
 Mr. Christensen’s medical history reveals that he had a prior left shoulder injury
dating back to 2013, and that he underwent left shoulder surgery on February 19,
2014. Ex. 6 at 3. The medical records include an April 17, 2014 note drafted by
Dr. David Badger, Petitioner’s orthopedist, which states that Mr. Christensen
“was eventually diagnosed with a rotator cuff tear due to anatomic impingement
of down-turn acromion and had beginning of frozen shoulder. Had laparoscopic
surgery to repair things. Since then, things are much better. He has been doing
PT.” Ex. 3 at 21-23.
3 The petition alleges that Petitioner received the vaccination on October 19, 2017. However, in his Motion
for a Factual Ruling (ECF No. 20), Petitioner appears to agree and confirm that he received the flu
vaccine on October 14, 2017, as set forth in the record of vaccination. Br. at 1.
4 Exhibit 10 contains a certification of records by the Records Custodian of Costco.
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 On November 9, 2017 (less than one month post-vaccination), Petitioner
presented to Dr. Badger at Ortho Washington for complaints of right shoulder
pain. Ex. 2 at 12. The record from this visit states “Patient states he got a flu shot
3 weeks ago and has had pain ever since. He has a constant soreness and
sharp pain with reaching and lift[ing] weight.” Id. Mr. Christensen rated his pain at
a 3 on a scale from 0 to 10. Id. Upon examination, he exhibited tenderness in
the subacromial region and limited range of motion due to pain. The Hawkin’s
and Neer’s impingement tests were both positive. Id. at 10. The diagnosis is
listed as “Impingement syndrome of right shoulder.” Id.
 On November 10, 2017, Petitioner underwent an MRI of his right shoulder to
assess for right shoulder impingement. Ex. 2 at 16. The impression was “[m]ild
supraspinatus tendinopathy without a focal tear… [o]therwise normal MR
examination of the right shoulder. No labral tear.” Id. at 17.
 On November 17, 2017, Mr. Christensen returned to Ortho Washington to review
the results of his MRI. Ex. 2 at 11. He received a steroid injection to the right
shoulder and was instructed to reduce his activities for the day, but that he could
resume activities the following day. Id. He was told to follow up to discuss the
possibility of shoulder surgery if his shoulder pain continued. Id.
 On March 27, 2019, Petitioner returned to Dr. Badger complaining of worsening
shoulder pain. Ex. 2 at 8. Mr. Christensen reported that the “cortisone steroid
injection … worked for only 3-4 weeks and now worse.” Id. He was instructed to
continue with ice treatment and to elevate his right shoulder when at rest. Mr.
Christensen agreed to move forward with shoulder surgery. Id.
 Petitioner underwent a pre-operative examination on March 29, 2018, Ex. 2 at 5-
6, and underwent right shoulder surgery on April 11, 2018, Ex. 2 at 14-15. The
operative note from the surgery states that “[t]he subacromial space was noted to
a have a market subacromial bursitis and a thorough bursectomy was performed.
This included an acromioplasty and release of coracoacromial ligament.” Id. at
15.
 At his first post-operative visit on April 13, 2018, Mr. Christensen was noted to be
healing well, with no inflammation and no signs of infection. Ex. 2 at 3. He was
instructed to continue with activity modification (no lifting, pulling, pushing) and to
keep his right shoulder in a sling with continued ice treatment. Id. at 4. Physical
therapy was prescribed after his second post-operative exam. Id. at 2.
 Mr. Christensen began physical therapy on April 23, 2018. See Ex. 3 generally.
He underwent 25 sessions over an eight (8) week period and was discharged to
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a home exercise program on August 20, 2018. Id. At the time of discharge, Mr.
Christensen was noted to have “made good progress with respect to his strength,
ROM, posture, endurance. He has resumed all his typical activities without
increase [symptoms] and he is well educated about continued exercises for
home.” Id. at 70.
 Mr. Christensen filed an affidavit stating that he specifically recalled telling the
pharmacist who administered the vaccine to him on October 14, 2017, that he
“had a prior left shoulder injury caused by the influenza vaccine in 2013 which
required surgery. Therefore, on that day I explained to the vaccine administrator
and specifically requested the vaccination in my right arm.” Ex. 14 at 1, ¶4. His
wife’s affidavit corroborates this statement. Ex. 15 at 1, ¶3.
A. Arm of Administration
The record as summarized above preponderantly supports the conclusion that Mr.
Christensen received the October 14, 2017 flu vaccine to his right shoulder, despite some
inconsistencies in the relevant records.
There are two competing situs records to reconcile. The first one does not specify
the right shoulder – but it does provide a very credible reason for why Petitioner wanted
a right-arm vaccination. It is undisputed that Mr. Christensen had a prior left shoulder
injury that necessitated surgery, just three years prior. Thus, on the vaccination record
itself, Mr. Christensen wrote that he had a prior serious reaction to a flu vaccination, which
corroborates his affidavit, and his wife’s affidavit, where he explains that he told the
pharmacist to inject his right shoulder because of his previous injury. This explanation is
reasonable, and supports the conclusion that Petitioner did likely ask that the vaccine be
administered in his right arm, despite the silence of this record.
In the second version, the left arm “LA” has been circled to indicate the vaccination
was administered to the patient’s left arm. To explain why this document differs from the
other, Respondent contends that “the vaccine administrator circled the site of
administration on her copy and neglected to circle it on the patient copy of the form at the
time of administration.” Opp. at 3-4. As such, Respondent argues that I should view this
second document as the strongest proof of a contemporaneous record.
I agree that some credence should be given to this second document, especially
since it has been certified by the pharmacy as a complete record. However, Respondent’s
explanation for why the two documents differ is somewhat speculative, since there is no
evidence in the record to suggest that this is what actually occurred. It could equally be
inferred that the vaccine administrator assumed that the vaccine was administered to
Petitioner’s left shoulder since most individuals are right-handed, and request that a
vaccination be administered to the non-dominant arm, and therefore circled left
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automatically. Under the circumstances, Petitioner’s personal reason for wanting to avoid
a left shoulder vaccination is more compelling and better corroborated by the record.
Also favoring Petitioner on the situs question is the fact that all of Mr. Christensen’s
medical records filed in this case associated with his post-vaccination treatment
document an injury to his right shoulder. Indeed, in his very first medical appointment
after vaccination less than a month later, the medical provider, Dr. Badger, notes in his
report, “Patient states he got a flu shot 3 weeks ago and has had pain ever since.” Ex. 2
at 12. And all subsequent reports of pain and injury following vaccination are consistent
with an injury to the right shoulder. “[W]ritten records which are, themselves, inconsistent,
should be accorded less deference than those which are internally consistent.” Lowrie, at
*19. Thus, I find that Petitioner has provided preponderant evidence to support his claim
that he received the October 14, 2017 flu vaccine to his right shoulder.
B. Onset
To refute Mr. Christensen’s claim that his right shoulder pain began within 48-
hours, Respondent objects that Petitioner waited until November 9, 2017 (just 26 days
after vaccination) to report his shoulder pain. Because there are no objective findings for
the presence of shoulder pain in the days immediately following vaccination, Respondent
argues that I cannot find in favor of Petitioner. Respondent also argues that because Mr.
Christensen had asserted a prior SIRVA claim regarding his left shoulder, he had
knowledge of SIRVA claims in general and should have known to seek care on a more
“expedited basis.”
Neither argument is persuasive. The delay in seeking treatment herein is not
notably lengthy, and thus, not inconsistent with what other Program petitioners
experience, based on the assumption that their pain is likely transitory. Many SIRVA
cases feature medical record notations from physicians recommending that a patient wait
a period of time after vaccination to allow time for the shoulder pain to fade before seeking
treatment. Subsequent records corroborate the injury and onset, and the Vaccine Act
expressly does not obligate claimants to prove onset issues with evidence from within the
alleged timeframe in any event. Section 13(b)(2).
In addition, Respondent’s belief that Petitioner should have “known” of his claim
(and therefore should be penalized for not acting on his injury sooner) does not
substantiate a reason to question onset herein. Indeed, the opposite situation could have
also been used as a basis to refute Mr. Christensen’s claim. Had Petitioner sought
treatment immediately after vaccination, Respondent could have just as easily argued
that because of Petitioner’s knowledge of the Vaccine Program, he only rushed to seek
treatment in an effort to meet this Table element.
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Another factor that weighs on my finding of the 48-hour onset of right shoulder pain
is the absence of any statement or record that places the onset of Mr. Christensen’s right
shoulder pain outside the 48-hour window. While Respondent correctly notes that Dr.
Badger’s record memorialized a three-week history of arm pain - which if correct would
place the onset of right shoulder pain five days after vaccination (see Opp. at 4) - it is
clear from that record that Dr. Badger was generalizing the onset period rather than
precisely calculating it from a legal standpoint.5 Dr. Badger otherwise clearly sets the
onset of Petitioner’s right shoulder pain as starting on 10/14/2017, and taken as a whole,
this is the most reasonable interpretation of his entire statement.
Respondent further argues that Petitioner cannot overcome inconsistencies or
discrepancies in the medical records simply by filing affidavits that gainsay or modify what
the records set forth. But the Federal Circuit has expressly recognized that witness
testimony on issues pertaining to fact matters like symptoms onset can be proven through
this kind of evidence (even if they must be weighed against the records, which continue
to have evidentiary significance). Kirby, 997 F.3d at 1383. Respondent has not otherwise
identified any other inconsistencies or discrepancies in the medical records. All other
references to onset clearly relate Petitioner’s right shoulder pain as occurring immediately
after vaccination.
Weighing the evidence overall, I find that Petitioner has met his burden, and thus
that onset of Petitioner’s pain within 48 hours of vaccination.
C. Petitioner’s MRI
I will also address Respondent’s argument in the Rule 4(c) Report that Petitioner’s
November 2017 MRI did not reveal evidence of an inflammatory reaction in or around the
bursa, a key element of SIRVA as it is described in the Table’s Qualification and Aids to
Interpretation (Opp. at 1, fn. 1).6 I note that in Petitioner’s Exhibit 2, page 14-15, the
Operative Report from Mr. Christensen’s April 11, 2018 arthroscopic and debridement
shoulder surgery, the surgeon found that Petitioner’s “subacromial space was noted to
have marked subacromial bursitis and a thorough bursectomy was performed.” The term
“bursitis” is defined in Dorland’s Medical Dictionary Online as “inflammation of a bursa,
occasionally accompanied by a calcific deposit in the underlying tendon; the most
5 The entire statement by Dr. Badger states that Mr. Christensen “states he got a flu shot 3 weeks ago and
has had pain ever since.” Ex. 2 at 12.
6 The Qualifications and Aids to Interpretation define “SIRVA” as an unintended injection of vaccine antigen
or trauma from the needle into and around the underlying bursa of the shoulder resulting in an inflammatory
reaction. See 42 C.F.R. § 100.3 (c)(10) (Updated March 21, 2017) (“QAI”).
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common site is the subdeltoid bursa.”7 Thus, although the November 2017 MRI scan may
not have detected inflammation in the bursa, it is clear that when Mr. Christensen
underwent surgery and his shoulder bursa was inspected, it was found to have “marked
bursitis.” Therefore, I am very likely to find preponderant evidence of inflammation in the
right shoulder bursa to satisfy the SIRVA Qualifications and Aids Interpretation.
VI. Scheduling Order
Given my findings of fact regarding the arm of administration and the onset of Mr.
Christensen’s right shoulder pain, Respondent should evaluate and provide his current
position regarding the merits of Petitioner’s case.
Accordingly, Respondent shall file, by no later than Friday, April 1, 2022, an
amended Rule 4(c) Report reflecting Respondent’s position in light of the above
fact-finding.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
7 (https://www.dorlandsonline.com/dorland/definition?id=7315).
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DOCUMENT 2: USCOURTS-cofc-1_19-vv-00007-1
Date issued/filed: 2022-05-20
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/07/2022) regarding 33 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00007-UNJ Document 38 Filed 05/20/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-0007V
UNPUBLISHED
PAUL CHRISTENSEN, Chief Special Master Corcoran
Petitioner, Filed: April 7, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Uncontested;
HUMAN SERVICES, Table Injury; Influenza (Flu) Vaccine;
Shoulder Injury Related to Vaccine
Respondent. Administration (SIRVA)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Adriana Ruth Teitel, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 2, 2019, Paul Christensen 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 suffers from a right shoulder injury related to
vaccine administration (“SIRVA”), resulting from an influenza vaccine administered on
October 19, 2017. Petition at 1. Petitioner further alleges that his injuries lasted for more
than six months. Petition at 3. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
1 Because this unpublished Ruling 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 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, 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 section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:19-vv-00007-UNJ Document 38 Filed 05/20/22 Page 2 of 2
On January 27, 2020, Respondent filed his report pursuant to Vaccine Rule 4(c) in
which he contested entitlement to compensation. Respondent’s Rule 4(c) Report at 1. On
February 28, 2022, I issued findings of fact to resolve the disputed factual issues in favor
of Petitioner.
On April 6, 2022, Respondent filed an Amended Rule 4(c) report in which he states
that he does not contest that Petitioner is entitled to compensation in this case.
Respondent’s Amended Rule 4(c) Report at 2. Specifically, Respondent states that “[i]n
light of the Chief Special Master’s fact ruling, and medical record evidence submitted in
this case, DICP has concluded that petitioner meets the criteria for a SIRVA as defined
by the Vaccine Injury Table. Specifically, petitioner had no recent history of pain,
inflammation, or dysfunction of his right shoulder. Additionally, the onset of pain occurred
within 48 hours after receipt of an intramuscular vaccination, and the pain was limited to
the shoulder in which the vaccine was administered. Also, no other condition or
abnormality, such as brachial neuritis, has been identified to explain petitioner’s right
shoulder pain.” Id. at 4-5. Respondent further agrees that “petitioner suffered the residual
effects of his condition for more than six months … Therefore, based on the record as it
now stands and subject to his right to appeal the Findings of Facts, respondent does not
dispute that petitioner has satisfied all legal prerequisites for compensation under the
Act.” Id. at 5.
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

================================================================================
DOCUMENT 3: USCOURTS-cofc-1_19-vv-00007-2
Date issued/filed: 2022-09-19
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 08/19/2022) regarding 43 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (ke) Service on parties made.
--------------------------------------------------------------------------------
Case 1:19-vv-00007-UNJ Document 47 Filed 09/19/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-0007V
UNPUBLISHED
PAUL CHRISTENSEN, Chief Special Master Corcoran
Petitioner, Filed: August 19, 2022
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)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Tyler King, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 2, 2019, Paul Christensen 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 from a right shoulder injury related to
vaccine administration (“SIRVA”), resulting from an influenza vaccine administered on
October 19, 2017. Petition at 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On April 7, 2022, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On August 19, 2022, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded a total of $76,226.41
consisting of $75,000 in pain and suffering and $1,226.41 for past unreimbursable
expenses. Proffer at 2. In the Proffer, Respondent represented that Petitioner agrees with
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 section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:19-vv-00007-UNJ Document 47 Filed 09/19/22 Page 2 of 5
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 $76,226.41 (consisting of $75,000.00 in pain and suffering and
$1,226.41 in past unreimbursable expenses), in the form of a check payable to
Petitioner. This amount represents compensation for all damages that would be available
under Section 15(a).
The Clerk of 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 1:19-vv-00007-UNJ Document 47 Filed 09/19/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
PAUL CHRISTENSON,
Petitioner,
v. No. 19-0007V
Chief Special Master Corcoran
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION1
I. Procedural History
On January 2, 2019, Paul Christenson (“petitioner”) filed a petition for compensation
(“petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to
-34, as amended. He alleges that he sustained a Shoulder Injury Related to Vaccine
Administration (“SIRVA”), as defined in the Vaccine Injury Table, within the Table time
period following administration of an influenza vaccine he received on October 19, 2017.2 See
Petition. On January 27, 2020, the Secretary of Health and Human Services (“respondent”)
filed a Rule 4(c) Report recommending compensation be denied. ECF No. 20. On February
28, 2022, Chief Special Master Corcoran issued a Findings of Fact, holding that petitioner had
received the flu vaccine in his right shoulder and petitioner’s SIRVA likely began within the
48-hour timeframe for the Table claim. ECF No. 29. On April 6, 2022, respondent filed his
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to address
after the Damages Decision is issued.
2 The petition alleged the flu vaccine was administered on October 19, 2017, but the filed
vaccination records document administration on October 14, 2017. The court’s Findings of
Fact found that petitioner received the vaccination on October 14, 2017. ECF No. 29 at 6.

Case 1:19-vv-00007-UNJ Document 47 Filed 09/19/22 Page 4 of 5
amended Rule 4(c) report, indicating that based on the Chief Special Master’s findings of fact,
this case is appropriate for compensation under the terms of the Act for a SIRVA Table injury.
ECF No. 32. On April 7, 2022, the Chief Special Master issued a ruling on entitlement, finding
that petitioner was entitled to compensation for a SIRVA Table injury.3 ECF No. 33.
II. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $75,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $1,226.41. See 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
III. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that the compensation provided to petitioner should be made through
a lump sum payment as described below and requests that the Chief Special Master’s decision
3 Respondent has no objection to the amount of the proffered award of damages set forth
herein. Assuming the Chief Special Master issues a damages decision in conformity with this
proffer, respondent waives his right to seek review of such damages decision. However,
respondent reserves his right, pursuant to 42 U.S.C. § 300aa-12(e), to seek review of the Chief
Special Master’s April 7, 2022, entitlement decision.

Case 1:19-vv-00007-UNJ Document 47 Filed 09/19/22 Page 5 of 5
and the Court’s judgment award the following:4 a lump sum payment of $76,226.41, in the
form of a check payable to petitioner.
IV. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Paul Christensen: $76,226.41
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
TRACI R. PATTON
Assistant Director
Torts Branch, Civil Division
s/ Tyler C. King
TYLER C. KING
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) 305-0730
Tyler.King@usdoj.gov
Dated: August 19, 2022
4 Should petitioner die prior to entry of judgment, the parties reserve the right to move the
Court for appropriate relief. In particular, respondent would oppose any award for future pain
and suffering.