VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00056
Package ID: USCOURTS-cofc-1_19-vv-00056
Petitioner: D.L.
Filed: 2019-01-11
Decided: 2023-09-20
Vaccine: Hepatitis A and Influenza Quadrivalent
Vaccination date: 2016-09-23
Condition: Guillain-Barré syndrome (“GBS”)
Outcome: compensated
Award amount USD: 156950

AI-assisted case summary:
On January 11, 2019, Ryan Larsen and Samantha Glover, as natural parents, filed a petition on behalf of their minor child, D.L. They alleged that Hepatitis A and Influenza Quadrivalent vaccinations administered on September 23, 2016, caused D.L. to develop Guillain-Barré syndrome (GBS), with symptoms persisting for over six months. The respondent, the Secretary of Health and Human Services, denied that the vaccines caused D.L.'s GBS. The parties subsequently reached a joint stipulation for compensation, which Special Master Christian J. Moran adopted as the decision of the Court. The stipulation awarded a total of $156,950.15. This amount included $8,788.37 for reimbursement of a lien from the Indiana Health Coverage Programs and $38,161.78 for reimbursement of a lien from Anthem Insurance Companies Inc. Additionally, $110,000.00 was allocated to purchase an annuity contract. This compensation was intended to cover all damages available under the program. The public decision does not describe the onset of symptoms, specific clinical details, or any expert testimony. The attorneys involved were Kathy Ann Lee of Christie Farrell Lee & Bell, P.C. for the petitioners and Madelyn Weeks of the United States Department of Justice for the respondent.

Theory of causation field:
Petitioners alleged that Hepatitis A and Influenza Quadrivalent vaccinations received on September 23, 2016, caused D.L. to suffer from Guillain-Barré syndrome (GBS) with symptoms persisting for over six months. The respondent denied causation. The parties reached a joint stipulation for compensation, which was adopted by Special Master Christian J. Moran. The stipulation awarded $156,950.15, comprising $8,788.37 for Indiana Health Coverage Programs lien reimbursement, $38,161.78 for Anthem Insurance Companies Inc. lien reimbursement, and $110,000.00 for an annuity contract. The public decision does not detail the specific theory of causation, medical experts, or the mechanism by which the vaccines allegedly caused GBS.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-00056-0
Date issued/filed: 2023-09-20
Pages: 10
Docket text: PUBLIC DECISION (Originally filed: 8/29/2023) regarding 136 DECISION Fees Stipulation/Proffer, Signed by Special Master Christian J. Moran. (dksc) Service on parties made.
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Case 1:19-vv-00056-UNJ Document 138 Filed 09/20/23 Page 1 of 10
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
* * * * * * * * * * * * * * * * * * * * * * * * *
RYAN LARSEN, Natural Father, and *
SAMANTHA GLOVER, Natural Mother, *
on behalf of D.L., a Minor, *
* No. 19-56V
Petitioners, * Special Master Christian J. Moran
*
v. *
* Filed: August 29, 2023
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
* * * * * * * * * * * * * * * * * * * * * * * * *
Kathy Ann Lee, Christie Farrell Lee & Bell, P.C., Indianapolis, IN, for Petitioner;
Madelyn Weeks, United States Dep’t of Justice, Washington, DC, for Respondent.
UNPUBLISHED DECISION1
On August 29, 2023, the parties filed a joint stipulation concerning the petition for
compensation filed by Ryan Larsen and Samantha Glover, on behalf of D.L., on January 11,
2019. Petitioners allege that the Hepatitis A and Influenza Quadrivalent vaccinations D.L.
received on September 23, 2016 caused D.L. to suffer from Guillain-Barré syndrome (“GBS”).
Petitioners further allege that D.L.’s symptoms persisted for more than six months. Petitioners
represent that there has been no prior award or settlement of a civil action for damages on D.L.’s
behalf as a result of D.L.’s alleged injury.
Respondent denies that the vaccines caused D.L. to suffer from GBS.
1 Because this decision contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government Act of
2002. 44 U.S.C. § 3501 note (2018) (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),
the parties have 14 days to identify and move to redact medical or other information, the disclosure of which would
constitute an unwarranted invasion of privacy. Any changes will appear in the document posted on the website.

Case 1:19-vv-00056-UNJ Document 138 Filed 09/20/23 Page 2 of 10
Nevertheless, the parties agree to the joint stipulation, attached hereto. The undersigned
finds said stipulation reasonable and adopts it as the decision of the Court in awarding damages,
on the terms set forth therein.
Damages awarded in that stipulation include:
a. A lump sum of $8,788.37, representing reimbursement of a lien for services rendered
by the Indiana Health Coverage Programs to D.L., in the form of a check payable
jointly to petitioners and Indiana Health Coverage Programs for $8,788.37:
Indiana Medicaid – TPL
P.O. Box 7262
Indianapolis, IN 46207-7262
Member ID: 106236084599
Petitioners agree to endorse this check to Indiana Medicaid.
b. A lump sum of $38,161.78, representing reimbursement of a lien for services
rendered by Anthem Insurance Companies Inc., to D.L., in the form of a check
payable jointly to petitioners and Carelon for $38,161.78:
Carelon
P.O. Box 659940
San Antonio, TX 78265-9939
Client No: G2001SSINZZ -186110
Petitioners agree to endorse this check to Carelon.
c. An amount of $110,000.00 to purchase the annuity contract described in paragraph 10
of the stipulation, paid to the life insurance company from which the annuity will be
purchased (the “Life Insurance Company”)
These amounts represent compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
In the absence of a motion for review filed pursuant to RCFC, Appendix B, the clerk is
directed to enter judgment according to this decision and the attached stipulation.2
IT IS SO ORDERED.
2 Pursuant to Vaccine Rule 11(a), the parties can expedite entry of judgment by each
party filing a notice renouncing the right to seek review by a United States Court of Federal
Claims judge.
2

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s/Christian J. Moran
Christian J. Moran
Special Master
3

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