VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00532
Package ID: USCOURTS-cofc-1_19-vv-00532
Petitioner: Shelley Peterson
Filed: 2019-04-10
Decided: 2021-02-01
Vaccine: influenza
Vaccination date: 2017-11-06
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 65000

AI-assisted case summary:
Shelley Peterson filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine she received on November 6, 2017. The respondent conceded that Ms. Peterson is entitled to compensation, as she met the criteria set forth in the Vaccine Injury Table, including having no relevant prior shoulder history, experiencing pain and reduced range of motion within 48 hours of vaccination, and having symptoms limited to the vaccinated shoulder. A ruling on entitlement was issued on November 25, 2020. Subsequently, on February 1, 2021, a decision awarding damages was issued. The respondent had previously proffered an award of $65,000.00 for pain and suffering, which Ms. Peterson agreed to. The court awarded Ms. Peterson a lump sum payment of $65,000.00 for pain and suffering.

Theory of causation field:
Table

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_19-vv-00532-0
Date issued/filed: 2020-12-28
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/25/2020) regarding 34 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
--------------------------------------------------------------------------------
Case 1:19-vv-00532-UNJ Document 49 Filed 12/28/20 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-0532V
UNPUBLISHED
SHELLEY PETERSON, Chief Special Master Corcoran
Petitioner, Filed: November 25, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Influenza (Flu) Vaccine;
Shoulder Injury Related to Vaccine
Respondent. Administration (SIRVA)
Mark Theodore Sadaka, Mark T. Sadaka, LLC, for Petitioner.
Kimberly Shubert Davey, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On April 10, 2019, Shelley Peterson filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine she received in her left
shoulder on November 6, 2017. Petition at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On November 23, 2020, Respondent filed a combined Rule 4(c) report and Proffer
(“Rule 4/Proffer) in which he concedes that Petitioner is entitled to compensation in this
case. Rule 4/Proffer at 1. Specifically, Respondent states that “petitioner has satisfied
the criteria set forth in the Vaccine Injury Table (‘Table’) and the Qualifications and Aids
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 “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2012).

Case 1:19-vv-00532-UNJ Document 49 Filed 12/28/20 Page 2 of 2
to Interpretation (‘QAI’). That is, petitioner had no relevant history of pain, inflammation,
or dysfunction in her right shoulder; her pain and reduced range of motion occurred within
48 hours of receipt of an intramuscular vaccination; her symptoms were limited to the
shoulder in which the vaccine was administered; and no other condition or abnormality
was identified to explain her symptoms … Therefore, based on the record as it now
stands, petitioner has satisfied all legal prerequisites for compensation under the Vaccine
Act.” Id. at 4.
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 2: USCOURTS-cofc-1_19-vv-00532-1
Date issued/filed: 2021-02-01
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 11/25/2020) regarding 35 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
--------------------------------------------------------------------------------
Case 1:19-vv-00532-UNJ Document 50 Filed 02/01/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-0532V
UNPUBLISHED
SHELLEY PETERSON, Chief Special Master Corcoran
Petitioner, Filed: November 25, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
Respondent. Administration (SIRVA)
Mark Theodore Sadaka, Mark T. Sadaka, LLC, for Petitioner.
Kimberly Shubert Davey, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On April 10, 2019, Shelley Peterson filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine she received in her left
shoulder on November 6, 2017. Petition at 1. Petitioner further alleges that she suffered
this injury for more than six months. Petition at 4. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On November 25, 2020, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On November 23, 2020, Respondent filed a
combined Rule 4(c) report and proffer on award of compensation (“Rule 4/Proffer”)
indicating Petitioner should be awarded $65,000.00 in pain and suffering. Rule 4/Proffer
at 4. In the Rule 4/Proffer, Respondent represented that Petitioner agrees with the
1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am
required to post it on the United States Court of Federal Claims' website in accordance with the E-
Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic
Government Services). This means the decision will be available to anyone with access to the
internet. In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact
medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy.
If, upon review, I agree that the identified material fits within this definition, I will redact such material from
public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2012).

Case 1:19-vv-00532-UNJ Document 50 Filed 02/01/21 Page 2 of 2
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 Rule 4/Proffer (ECF No. 33), I award Petitioner
a lump sum payment of $65,000.00 (for pain and suffering) in the form of a check
payable to Petitioner. This amount represents compensation for all damages that would
be available under § 15(a).
The clerk of the court is directed to enter judgment in accordance with this
decision.3
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice
renouncing the right to seek review.
2