VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00662 Package ID: USCOURTS-cofc-1_19-vv-00662 Petitioner: Shannon McTernan Filed: 2019-05-03 Decided: 2020-07-14 Vaccine: influenza Vaccination date: 2017-11-09 Condition: shoulder injury related to vaccine administration (SIRVA) Outcome: compensated Award amount USD: 51405 AI-assisted case summary: Shannon McTernan filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) caused by the influenza vaccine she received in her right arm on November 9, 2017. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report conceding that Ms. McTernan's claim met the Table criteria for SIRVA and that she was entitled to compensation. Subsequently, the parties submitted a proffer on the award of compensation. The respondent recommended an award of $51,405.73, comprising $50,000.00 for pain and suffering and $1,405.73 for unreimbursable expenses. Ms. McTernan agreed with this proffered award. The Chief Special Master issued a decision awarding Ms. McTernan a lump sum payment of $51,405.73, representing compensation for all damages available under the Vaccine Act. Theory of causation field: Table Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_19-vv-00662-0 Date issued/filed: 2020-04-29 Pages: 2 Docket text: PUBLIC ORDER/RULING (Originally filed: 03/27/2020) regarding 28 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:19-vv-00662-UNJ Document 33 Filed 04/29/20 Page 1 of 2 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 19-0662V UNPUBLISHED SHANNON MCTERNAN, Chief Special Master Corcoran Petitioner, Filed: March 27, 2020 v. Special Processing Unit (SPU); SECRETARY OF HEALTH AND Ruling on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) Bruce William Slane, Law Office of Bruce W. Slane, P.C., White Plains, NY, for petitioner. Catherine Elizabeth Stolar, U.S. Department of Justice, Washington, DC, for respondent. RULING ON ENTITLEMENT1 On May 3, 2019, Shannon McTernan 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”) caused in fact by the influenza vaccine she received in her right arm on November 9, 2017. Petition at 1, ¶¶ 2, 27. Petitioner further alleged that she received the vaccination in the United States, suffered the residual effects of her SIRVA for more than six months, and that neither she nor any other party has filed a civil action or received compensation for her SIRVA, alleged as vaccine caused. Id. at 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-00662-UNJ Document 33 Filed 04/29/20 Page 2 of 2 ¶¶ 2, 29-31. The case was assigned to the Special Processing Unit of the Office of Special Masters. On March 27, 2020, Respondent filed his Rule 4(c) report in which he concedes that Petitioner is entitled to compensation in this case. Respondent’s Rule 4(c) Report at 1. Specifically, Respondent has “concluded that petitioner’s claim meets the Table criteria for SIRVA.” 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 2: USCOURTS-cofc-1_19-vv-00662-1 Date issued/filed: 2020-05-29 Pages: 3 Docket text: PUBLIC ORDER/RULING (Originally filed: 04/27/2020) regarding 32 Findings of Fact & Conclusions of Law, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:19-vv-00662-UNJ Document 35 Filed 05/29/20 Page 1 of 3 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 19-0662V UNPUBLISHED SHANNON MCTERNAN, Chief Special Master Corcoran Petitioner, Filed: April 27, 2020 v. Special Processing Unit (SPU); SECRETARY OF HEALTH AND Compensation Under the Vaccine HUMAN SERVICES, Program; Offset; Section 15(g); Claim of Subrogation by Private Respondent. Health Care Insurance; Section 15(h) Bruce William Slane, Law Office of Bruce W. Slane, P.C., White Plains, NY, for petitioner. Catherine Elizabeth Stolar, U.S. Department of Justice, Washington, DC, for respondent. RULING ON INABILITY TO CLAIM PRIVATE HEALTH CARE INSURANCE OFFSET IN VACCINE PROGRAM 1 On April 24, 2020, an attorney at Petitioner’s counsel’s law firm emailed the court requesting a ruling concerning how Sections 15(g) and (h) of the National Childhood Vaccine Injury Compensation Program (the “Vaccine Act” or “Program”)2 pertains to the present case. See Informal Remark, dated Apr. 24, 2020. Petitioner has been contacted by her health care insurer regarding recoupment of benefits under a right of subrogation set forth in the insurance policy. She has filed letters dated May 8 and 22, 2019 from Conduent Payment Integrity Solutions, the authorized subrogation/reimbursement agent for Petitioner’s health insurance plan from Cigna, which purports to be a self-funded 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 The National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755, codified as amended, 42 U.S.C. §§ 300aa-10 et seq. Hereafter, individual section references will be to 42 U.S.C. § 300aa of the Act. Case 1:19-vv-00662-UNJ Document 35 Filed 05/29/20 Page 2 of 3 ERISA plan. Exhibit 12, ECF Nos. 30-31. Thus, Petitioner seeks to clarify whether her health care insurer is entitled to reimbursement of benefits that it has paid if Petitioner recovers monies in her Vaccine case. Under the Vaccine Program, a petitioner may recover actual and projected unreimbursable expenses, lost wages, and pain and suffering, and an award of $250,000 if the injury resulted in death. Section 15(a); see also Helman v. Sec’y of Health & Human Servs., No. 10-813V, 2014 WL 3589564, at *1 (Fed. Cl. Spec. Mstr. June 24, 2014) (citing Bruesewitz v. Wyeth, LLC, 131 S.Ct. 1068, 1074 (2011)). But such compensation elements are limited by subsequent sections of the Act. Thus, punitive and exemplary damages are prohibited, and for unreimbursable expenses and pain and suffering, compensation may be provided only for the “health, education, or welfare of the person who suffered the vaccine-related injury.” Section 15(d). Additionally, total recoverable compensation for an established vaccine injury is offset by amounts paid or expected to be paid under an insurance policy and certain State or Federal programs. Section 15(g).3 Thus, the Vaccine Act always and by its own terms functions as a secondary payer to a petitioner’s health care insurance.4 Any entitlement award paid to a petitioner cannot include amounts paid or expected to be paid under his or her existing health care insurance policy. The Act also prohibits any health insurance policy from “mak[ing] payment of benefits under the policy secondary to the payment of compensation under the Program.” Section 15(h). In light of the above, it is readily evident that the plain language of the Vaccine Act does not authorize reimbursement for benefits already paid under Petitioner’s health care insurance policy. This means that if Petitioner is successful in establishing entitlement to a Vaccine Act award, her insurer cannot be reimbursed by the Vaccine Program for its payments for Petitioner’s treatment in connection with the injury, sickness, accident, or condition which has been alleged. Petitioner shall so inform any entity that indicates the intent to act in controversion of the Act’s requirements. 3 As Section 15(g) specifically states: Payment of compensation under the Program shall not be made for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service (1) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program (other than under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)), or (2) by an entity which provides health services on a prepaid basis. 4 I and other special masters have issued similar rulings in other cases. See Gram v. Sec’y of Health & Human Servs., No. 15-0305V, 2018WL 2015 WL 7166097 (Fed. Cl. Spec. Mstr. Sept. 29, 2015); Dashty v. Sec’y of Health & Human Servs., No. 15-0966V, 2018 WL 2411049 (Fed. Cl. Spec. Mstr. Mar. 5, 2018); Kuhl v. Sec’y of Health & Human Servs., No. 16-1716V, 2018 WL 4391002 (Fed. Cl. Spec. Master May 24, 2018); Fennig v. Sec’y of Health & Human Servs., No. 17-2019V, 2018 WL 7247224 (Fed. Cl. Spec. Mstr. Dec. 17, 2018). Like this case, Fennig involved a self-funded ERISA insurance plan. 2018 WL 7247224, at *1. 2 Case 1:19-vv-00662-UNJ Document 35 Filed 05/29/20 Page 3 of 3 Any questions about this order or about this case generally may be directed to OSM staff attorney Stacy Sims at (202) 357-6349 or Stacy_Sims@cfc.uscourts.gov. IT IS SO ORDERED. s/Brian H. Corcoran Brian H. Corcoran Chief Special Master 3 ================================================================================ DOCUMENT 3: USCOURTS-cofc-1_19-vv-00662-2 Date issued/filed: 2020-07-14 Pages: 5 Docket text: PUBLIC DECISION (Originally filed: 06/11/2020) regarding 38 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:19-vv-00662-UNJ Document 42 Filed 07/14/20 Page 1 of 5 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 19-0662V UNPUBLISHED SHANNON MCTERNAN, Chief Special Master Corcoran Petitioner, Filed: June 11, 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) Bruce William Slane, Law Office of Bruce W. Slane, P.C., White Plains, NY, for petitioner. Catherine Elizabeth Stolar, U.S. Department of Justice, Washington, DC, for respondent. DECISION AWARDING DAMAGES1 On May 3, 2019, Shannon McTernan 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 she suffered a shoulder injury related to vaccine administration (“SIRVA”) caused in fact by the influenza vaccine she received in her right arm on November 9, 2017. Petition at 1, ¶¶ 2, 27. Petitioner further alleged that she received the vaccination in the United States, suffered the residual effects of her SIRVA for more than six months, and that neither she nor any other party has filed a civil action or received compensation for her SIRVA, alleged as vaccine caused. Id. at ¶¶ 2, 29-31. The case was assigned to the Special Processing Unit of the Office of Special Masters. 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-00662-UNJ Document 42 Filed 07/14/20 Page 2 of 5 On March 27, 2020, a ruling on entitlement was issued, finding Petitioner entitled to compensation for SIRVA. On June 11, 2020, Respondent filed a proffer on award of compensation (“Proffer”) indicating Petitioner should be awarded $51,405.73, representing compensation in the amount of $50,000.00 for her actual pain and suffering and $1,405.73 for her unreimburseable expenses. Proffer at 1-2. In the Proffer, Respondent represented that Petitioner agrees with 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 $51,405.73, representing compensation in the amount of $50,000.00 for her actual pain and suffering and $1,405.73 for her unreimburseable expenses 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 Case 1:19-vv-00662-UNJ Document 42 Filed 07/14/20 Page 3 of 5 IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS ) SHANNON MCTERNAN, ) ) Petitioner, ) ) No. 19-662V v. ) Chief Special Master Corcoran ) ECF SECRETARY OF HEALTH AND ) HUMAN SERVICES, ) ) Respondent. ) ) RESPONDENT’S PROFFER ON AWARD OF COMPENSATION On May 3, 2019, Shannon McTernan (“petitioner”) filed a petition for compensation under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-10 to -34 (“Vaccine Act” or “Act”), alleging that she suffered a right shoulder injury as a result of an influenza (“flu”) vaccine administered on November 9, 2017. On March 27, 2020, respondent filed a Rule 4(c) Report concluding that petitioner sustained an injury that is compensable under the Act, that is, a shoulder injury related to vaccine administration (“SIRVA”), as defined in the Vaccine Injury Table. See 42 C.F.R. § 100.3. The same day, the Chief Special Master issued a Ruling on Entitlement finding petitioner entitled to compensation. I. Compensation for Vaccine Injury-Related Items A. Pain and Suffering Respondent proffers that petitioner should be awarded $50,000.00 in actual and projected pain and suffering, as provided under Section 300aa-15(a)(4) of the Vaccine Act. Petitioner agrees. Case 1:19-vv-00662-UNJ Document 42 Filed 07/14/20 Page 4 of 5 B. Unreimbursable Expenses Respondent proffers that petitioner should be awarded unreimbursable expenses in the amount of $1,405.73, as provided under Section 300aa-15(a)(1)(B) of the Vaccine Act. Petitioner agrees. These amounts represent all elements of compensation to which petitioner is entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees. II. 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 be made through a lump sum payment as described below and requests that the Chief Special Master’s decision and the Court’s judgment award the following1: a lump sum payment of $51,405.73, in the form of a check payable to petitioner, Shannon McTernan. III. Summary of Recommended Payments Following Judgment Lump sum payable to petitioner, Shannon McTernan: $51,405.73 Respectfully submitted, JOSEPH H. HUNT Assistant Attorney General C. SALVATORE D’ALESSIO Acting Director Torts Branch, Civil Division 1 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 lost earnings and future pain and suffering. 2 Case 1:19-vv-00662-UNJ Document 42 Filed 07/14/20 Page 5 of 5 CATHARINE E. REEVES Deputy Director Torts Branch, Civil Division GABRIELLE M. FIELDING Assistant Director Torts Branch, Civil Division s/ Catherine E. Stolar CATHERINE E. STOLAR 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) 353-3299 Fax: (202) 616-4310 Email: catherine.stolar@usdoj.gov DATED: 6/11/20 3