VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00902
Package ID: USCOURTS-cofc-1_19-vv-00902
Petitioner: K.B.
Filed: 2020-12-18
Decided: 2021-02-01
Vaccine: Tdap
Vaccination date: 2017-12-01
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 141603

AI-assisted case summary:
K.B. filed a petition for compensation under the National Vaccine Injury Compensation Program on December 18, 2020, alleging a Shoulder Injury Related to Vaccine Administration (SIRVA) resulting from a Tdap vaccine administered on December 1, 2017. The case was assigned to the Special Processing Unit. On October 16, 2020, a ruling on entitlement was issued, finding K.B. entitled to compensation. The respondent conceded that K.B. suffered SIRVA, meeting the criteria for a Table injury. Specifically, the respondent noted that K.B. 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 had been identified to explain K.B.'s left shoulder pain. The respondent further agreed that K.B. suffered the residual effects of her condition for more than six months. Based on the respondent's concession and the evidence of record, Chief Special Master Brian H. Corcoran found K.B. entitled to compensation. On November 19, 2020, the respondent filed a proffer of award, which K.B. accepted. Chief Special Master Corcoran awarded K.B. a total of $141,603.72, comprising $137,500.00 for pain and suffering and $4,103.72 for unreimbursable expenses. The decision was originally filed on December 18, 2020, and later reissued in redacted form on April 9, 2021, with K.B.'s name redacted to initials. Petitioner's counsel was Ronald Craig Homer, and respondent's counsel was James Vincent Lopez.

Theory of causation field:
Petitioner K.B. alleged a Shoulder Injury Related to Vaccine Administration (SIRVA) following a Tdap vaccination on December 1, 2017. The respondent conceded that Petitioner suffered SIRVA, meeting the criteria for a Table injury, including onset of pain within 48 hours of vaccination, pain limited to the vaccinated shoulder, and residual effects lasting more than six months. The public decision does not describe the specific mechanism of injury or name any medical experts. The case resulted in a compensated outcome. Chief Special Master Brian H. Corcoran issued the ruling on entitlement on October 16, 2020, and the decision awarding damages on February 1, 2021. The award totaled $141,603.72, consisting of $137,500.00 for pain and suffering and $4,103.72 for unreimbursable expenses. Petitioner was represented by Ronald Craig Homer, and Respondent was represented by James Vincent Lopez.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-00902-0
Date issued/filed: 2021-02-01
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 12/18/2020) regarding 40 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00902-UNJ Document 44 Filed 02/01/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-902V
UNPUBLISHED
K.B., Chief Special Master Corcoran
Petitioner, Filed: December 18, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Tetanus Diphtheria acellular
Pertussis (Tdap) Vaccine; Shoulder
Respondent. Injury Related to Vaccine
Administration (SIRVA)
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
On June 20, 2019, K.B. 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 as a result of the tetanus, diphtheria, and acellular pertussis vaccine
administered to her on December 1, 2017. Petition at 1. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
On October 16, 2020, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On November 19, 2020, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $141,603.72
(representing $137,500.00 in pain and suffering and $4,103.72 in unreimbursable
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-00902-UNJ Document 44 Filed 02/01/21 Page 2 of 2
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 Proffer, I award Petitioner a lump sum
payment of $141,603.72 (representing $137,500.00 in pain and suffering and
$4,103.72 in unreimbursable 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

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DOCUMENT 2: USCOURTS-cofc-1_19-vv-00902-3
Date issued/filed: 2021-04-09
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 10/16/2020) regarding 33 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00902-UNJ Document 53 Filed 04/09/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-902V
UNPUBLISHED
K.B., Chief Special Master Corcoran
Petitioner, Filed: October 16, 2020
v. Refiled in Redacted Form: April 9,
2021
SECRETARY OF HEALTH AND
HUMAN SERVICES, Special Processing Unit (SPU);
Ruling on Entitlement; Concession;
Respondent. Table Injury; Tetanus Diphtheria
acellular Pertussis (Tdap) Vaccine;
Shoulder Injury Related to Vaccine
Administration (SIRVA)
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On June 20, 2019, K.B. 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 alleges that she suffered a Shoulder Injury Related to
Vaccine Administration (“SIRVA”) as a result of the tetanus, diphtheria, and acellular
pertussis (“Tdap”) vaccine administered to her on December 1, 2017. Petition at 1. The
case was assigned to the Special Processing Unit of the Office of Special Masters.
1 When this ruling was originally filed I advised of my intent 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). In accordance with Vaccine Rule 18(b),
Petitioner filed a timely motion to redact certain information. This decision is being reissued with Petitioner’s
name redacted to initials. Except for those changes and this footnote, no other substantive changes have
been made. This decision will be posted on the court’s website with no further opportunity to move for
redaction.
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-00902-UNJ Document 53 Filed 04/09/21 Page 2 of 2
On October 15, 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
Medical personnel at the Division of Injury Compensation Programs,
Department of Health and Human Services (“DICP”), have reviewed the
petition and medical records filed in the case. It 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. 42
C.F.R. §§ 100.3(a), (c)(10).
Id. at 5. Respondent further agrees that “Petitioner suffered the residual effects of her
condition for more than six months. 42 U.S.C. § 300aa- 11(c)(1)(D)(i).” Id. at 5-6.
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