VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00722
Package ID: USCOURTS-cofc-1_19-vv-00722
Petitioner: Victoria Gauvin
Filed: 2019-05-16
Decided: 2021-10-08
Vaccine: influenza
Vaccination date: 2017-10-05
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 110000

AI-assisted case summary:
Victoria Gauvin filed a petition for compensation on May 16, 2019, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine she received on October 5, 2017. She stated that the vaccine was administered in the United States, that she experienced residual effects for more than six months, and that she had not received a prior award or settlement for this injury. Respondent denied that Ms. Gauvin sustained a SIRVA Table injury or that the vaccine caused her alleged shoulder injury. Despite these differing positions, the parties filed a joint stipulation agreeing that a decision should be entered awarding compensation. The court adopted the stipulation, awarding Ms. Gauvin a lump sum of $110,000.00. This amount represents compensation for all items of damages available under the Vaccine Act. The case proceeded as a Table claim, and the parties stipulated to the damages amount.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-00722-0
Date issued/filed: 2021-10-08
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 09/07/2021) regarding 36 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00722-UNJ Document 40 Filed 10/08/21 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-0722V
UNPUBLISHED
VICTORIA GAUVIN, Chief Special Master Corcoran
Petitioner, Filed: September 7, 2021
v.
Special Processing Unit (SPU); Joint
SECRETARY OF HEALTH AND Stipulation on Damages; Influenza
HUMAN SERVICES, (Flu) Vaccine; Shoulder Injury
Related to Vaccine Administration
Respondent. (SIRVA)
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Ida Nassar, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On May 16, 2019, Victoria Gauvin 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 right shoulder injuries related to
vaccine administration (“SIRVA”) as a result of an influenza vaccine she received on
October 5, 2017. Petition at 1; Stipulation, filed September 7, 2021, at ¶¶ 2-4. Petitioner
further alleges the vaccine was administered in the United States, she experienced the
residual effects of her condition for more than six months, and there has been no prior
award or settlement of a civil action for damages on her behalf as a result of her alleged
injury. Petition at ¶¶ 1, 7-8; Stipulation at ¶¶ 3-5. “Respondent denies that petitioner
sustained a SIRVA Table injury; denies that the vaccine caused petitioner’s alleged
shoulder injury, or any other injury; and denies that her current condition is a sequela of
a vaccine-related injury.” Stipulation at ¶ 6.
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-00722-UNJ Document 40 Filed 10/08/21 Page 2 of 7
Nevertheless, on September 7, 2021, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. I find the stipulation
reasonable and adopt it as my decision awarding damages, on the terms set forth therein.
Pursuant to the terms stated in the attached Stipulation, I award the following
compensation:
A lump sum of $110,000.00 in the form of a check payable to Petitioner.
Stipulation at ¶ 8. This amount represents compensation for all items of damages
that would be available under Section 15(a). Id.
I approve the requested amount for Petitioner’s compensation. In the absence of
a motion for review filed pursuant to RCFC Appendix B, 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-00722-UNJ Document 40 Filed 10/08/21 Page 3 of 7
IN THE UNITED ST ATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
VICTORIA GAUVIN, )
)
Petitioner, )
) No. I 9-722V
V. ) Chief Special Master Corcoran
)
SECRETARY OF HEALTH AND HUMAN )
SERVICES, )
)
______Re_spo_nde_nt._ ______)
)
STIPULATION
The parties hereby stipulate to the following matters:
I. Victoria Gauvin, petitioner, filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §§ 300aa-l0 to -34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of an influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § 100.3(a).
2. Petitioner received the flu vaccine on October 5, 2017.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she sustained a shoulder injury related to vaccine administration
("SIRVA") within the time period set forth in the Table, or in the alternative, that her alleged
shoulder injury was caused by the flu vaccine. She further alleges that she experienced the
residual effects of this condition for more than six months.

Case 1:19-vv-00722-UNJ Document 40 Filed 10/08/21 Page 4 of 7
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on her behalf as a result of her alleged injury.
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies that her
current condition is a sequela of a vaccine-related injury.
7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry of judgment reflecting a decision consistent with
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-2 l(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of$110,000.00 in the form of a check payable to petitioner. This amount
represents compensation for all damages that would be available under 42 U.S.C.
§ 300aa-15(a).
9. As soon as practicable after the entry of judgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to 42
U .S.C. § 300aa-2 l (a)( 1) , and an application, the parties will submit to further proceedings before
the special master to award reasonable attorneys' fees and costs incurred in proceeding upon this
petition.
I 0. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-l 5(g), to the extent that payment has been made or can reasonably be
2

Case 1:19-vv-00722-UNJ Document 40 Filed 10/08/21 Page 5 of 7
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C.
§ 1396 et seq.}), or by entities that provide health services on a pre-paid basis.
11. Payment made pursuant to paragraph 8 and any amounts awarded pursuant to
paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-15(i), subject
to the availability of sufficient statutory funds.
12. The parties and their attorneys further agree and stipulate that, except for any award
for attorney's fees and litigation costs, the money provided pursuant to this Stipulation will be
used solely for the benefit of petitioner as contemplated by a strict construction of 42 U. S.C. §
300aa-l 5( a) and ( d), and subject to the conditions of 42 U. S.C. § 300aa-15(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity, and on behalf of her heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
the Secretary of Health and Human Services from any and all actions or causes of action
(including agreements, judgments, claims, damages, loss of services, expenses and all demands
of whatever kind or nature) that have been brought, could have been brought, or could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. § 300aa-10 et seq., on account of, or in any way growing out of, any and all
known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from, or alleged to have resulted from, the flu vaccination administered on October 5, 2017, as
alleged in a petition for vaccine compensation filed on or about May 16, 20 I 9, in the United
States Court of Federal Claims as petition No. 19-722V.
3

Case 1:19-vv-00722-UNJ Document 40 Filed 10/08/21 Page 6 of 7
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
15. If the special master fails to issue a decision in complete conformity with the tenns
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a
decision that is in complete conformity with the terms of this Stipulation, then the parties'
settlement and this Stipulation shall be voidable at the sole discretion of either party.
16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the award described in this
Stipulation may reflect a compromise of the parties' respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the flu vaccine caused petitioner's alleged injury or
any other injury or her current disabilities, or that petitioner suffered an injury contained in the
Vaccine Injury Table.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
4

Case 1:19-vv-00722-UNJ Document 40 Filed 10/08/21 Page 7 of 7
Respectfully submitted.
PETITIONER:
\ l .ivL ~ .]¼l_-~,
VICTORIA GOIN
ATTORNEY OF RF.CORD AUTHORIZED REPRESENTATIVE
FOR PETITIONER: OF THE ATTORNEY GENERAL:
LEAH VA HEATHER L. PEARLMAN
Law Offices of Leah V. Durant, PLLC Deputy Director
1717 K Street, NW Torts Branch
Suite 900 Civil Division
Washington. DC 20006 U.S. Depanmcnt of Justice
r.o. Box 1..io
Benjamin Franklin Station
Washington. DC 20044-0146
AUTHORIZED REPRESE:"'IT ATl\'E ATTOR:\EY ot· RECORD f'OR
OF THE SECRETA RV OF HEAi.TH RESPONDENT:
AND HUMAN SERVICES:
1el-A N0-44cv, 0
z::;a/4 ~ / ;?#Sc-/~~ ~~~LI(~
TAMARA OVFRBY IDA NASSAR
Acting Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch
Healthcare System Bureau Civil Division
Health Resources and Services U.S. Departmenl of Justice
Administration P.O. Box 146
U.S. Department of Health Benjamin Franklin Station
and Human Services Washington. DC 20044-0146
5600 Fishers Lane. 08N I 46B Tel: 202-616-4186
Ro<:kville. MD 20857 Email: lda.Nassar(aiusdoj.gov
lo11wzrt
Dated: 04
5