VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00741
Package ID: USCOURTS-cofc-1_19-vv-00741
Petitioner: Tina Coppersmith
Filed: 2019-05-17
Decided: 2020-09-30
Vaccine: influenza
Vaccination date: 2018-03-30
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 55533

AI-assisted case summary:
Tina Coppersmith filed a petition for compensation under the National Vaccine Injury Compensation Program on May 17, 2019, alleging she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of her influenza vaccination on March 30, 2018. The respondent conceded that Ms. Coppersmith is entitled to compensation, agreeing that her injury met the criteria for SIRVA as defined by the Vaccine Injury Table. Specifically, the respondent noted that she had no recent history of shoulder issues, the pain onset was within 48 hours of vaccination, the pain was limited to the vaccinated shoulder, and no other condition explained the pain. The respondent also agreed that she suffered residual effects for more than six months. Based on this concession and the evidence, entitlement was granted. Subsequently, on September 30, 2020, a decision awarding damages was issued. The respondent proffered an award of $55,533.04, comprising $55,000.00 for pain and suffering and $533.04 for past unreimbursed medical expenses, which Ms. Coppersmith agreed to. The court awarded this amount as compensation for all damages.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-00741-0
Date issued/filed: 2020-09-24
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/24/2020) regarding 22 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00741-UNJ Document 33 Filed 09/24/20 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-741V
UNPUBLISHED
TINA COPPERSMITH, Chief Special Master Corcoran
Petitioner, Filed: August 24, 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)
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On May 17, 2019, Tina Coppersmith 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 that she suffered a Shoulder Injury Related to
Vaccine Administration (SIRVA) as a result of her March 30, 2018 influneza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On August 24, 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 indicates that
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-00741-UNJ Document 33 Filed 09/24/20 Page 2 of 2
[i]t is Respondent’s position that Petitioner suffered SIRVA as defined by
the Vaccine Injury Table. Specifically, Petitioner had no recent history of
pain, inflammation, or dysfunction of her left shoulder that would explain the
alleged signs, symptoms, examination findings and/or diagnostic studies
occurring after vaccine injection; the onset of pain occurred within forty-eight
hours after receipt of an intramuscular vaccination; the pain was limited to
the shoulder in which the vaccine was administered; and, no other condition
or abnormality has been identified to explain Petitioner’s left shoulder pain.
Id. at 4-5 (citing 42 C.F.R. §§ 100.3(a), (c)(10).) Respondent further agrees that
“Petitioner suffered the residual effects of her condition for more than six months.” Id. at
5 (citing 11(c)(1)(D)(i)).
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

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DOCUMENT 2: USCOURTS-cofc-1_19-vv-00741-1
Date issued/filed: 2020-09-30
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 08/28/2020) regarding 27 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00741-UNJ Document 34 Filed 09/30/20 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-741V
UNPUBLISHED
TINA WILKEN, Chief Special Master Corcoran
Petitioner, Filed: August 28, 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)
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
On May 17, 2019, Tina Wilken 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 her March 30, 2018 influneza (“flu”) vaccination.
Petition at 1. Petitioner further alleges that the vaccine was administered within the United
States, that she suffered the residual effects of her injury for more than six months, and
that there has been no prior award or settlement of a civil action on her behalf as a result
of her injury. See Petition at ¶¶2, 11-13. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
On August 24, 2020, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On August 26, 2020, Respondent filed a proffer on award of
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-00741-UNJ Document 34 Filed 09/30/20 Page 2 of 4
compensation (“Proffer”) indicating Petitioner should be awarded $55,533.04. This is
comprised of pain and suffering ($55,000.00) and past unreimbursed out-of-pocket
medical expenses ($533.04). Proffer at 1. 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 $55,533.04 (comprised of pain and suffering ($55,000.00) and past
unreimbursed out-of-pocket medical expenses ($533.04)) 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-00741-UNJ Document 34 Filed 09/30/20 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
TINA WILKEN, )
)
Petitioner, )
) No. 19-741V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On August 24, 2020, respondent filed a Rule 4(c) Report conceding that petitioner is
entitled to vaccine compensation for her Shoulder Injury Related to Vaccine Administration
(“SIRVA”) injury suffered following receipt of an influenza (“flu”) vaccination on March 30,
2018. On August 24, 2020, a Ruling on Entitlement, adopting respondent’s recommendation,
was issued.
Based upon the evidence of record, respondent proffers that petitioner1 should be
awarded $55,533.04. This is comprised of pain and suffering ($55,000) and past unreimbursed
out-of-pocket medical expenses ($533.04), and represents all elements of compensation to which
petitioner would be entitled under 42 U.S.C. § 300aa-15(a).2 Petitioner agrees.
1 Petitioner is a competent adult, therefore evidence of guardianship is not required in this case.
2 Should Petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief.

Case 1:19-vv-00741-UNJ Document 34 Filed 09/30/20 Page 4 of 4
II. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through:
a lump sum of $55,533.04 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).
Petitioner agrees.
Respectfully submitted,
ETHAN P. DAVIS
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Deputy Director
Torts Branch, Civil Division
GABRIELLE M. FIELDING
Assistant Director
Torts Branch, Civil Division
s/ JAMES V. LOPEZ
James V. Lopez
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Ben Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-3655
Fax: (202) 616-4310
Email: james.lopez@usdoj.gov
Dated: August 26, 2020