VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00979
Package ID: USCOURTS-cofc-1_19-vv-00979
Petitioner: John J. Samluk
Filed: 2019-07-08
Decided: 2021-04-23
Vaccine: influenza
Vaccination date: 2018-02-06
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 77461

AI-assisted case summary:
John J. Samluk filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that he suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of his February 6, 2018 influenza vaccination. The respondent conceded that Mr. Samluk was entitled to compensation, agreeing that he met the criteria for a Table injury. Specifically, the respondent noted that Mr. Samluk had no prior history of shoulder issues, his pain and reduced range of motion occurred within 48 hours of the vaccination, his symptoms were limited to the vaccinated shoulder, and no other condition adequately explained his symptoms. Following the ruling on entitlement, the parties submitted a proffer on the award of compensation. The respondent recommended, and Mr. Samluk agreed, that he should be awarded $75,000.00 for pain and suffering and $2,461.01 for past unreimbursable expenses. The Chief Special Master issued a decision awarding Mr. Samluk a total lump sum payment of $77,461.01.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-00979-0
Date issued/filed: 2021-02-08
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/18/2020) regarding 29 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00979-UNJ Document 32 Filed 02/08/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-979V
UNPUBLISHED
JOHN J. SAMLUK, Chief Special Master Corcoran
Petitioner, Filed: December 18, 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)
Jennifer Sayad, Zgheib Sayad, P.C., White Plains, NY, for petitioner.
Lauren Kells, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On July 8, 2019, John J. Samluk 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 he suffered the Table injury of Shoulder Injury
Related to Vaccine Administration (SIRVA) as a result of his February 6, 2018 influneza
(“flu”) vaccination. Petition at 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On December 14, 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-00979-UNJ Document 32 Filed 02/08/21 Page 2 of 2
It is respondent’s position that petitioner has 8 satisfied the criteria set forth
in the Vaccine Injury Table (Table) and the Qualifications and Aids to
Interpretation (QAI); petitioner had no history of pain, inflammation, or
dysfunction in his left shoulder; his pain and reduced range of motion
occurred within 48 hours of receipt of an intramuscular vaccination; his
symptoms were limited to the shoulder in which the vaccine was
administered; and no other condition or abnormality was identified to
adequately explain his symptoms. See 42 C.F.R. § 100.3(a), (c)(10).
Id. at 7-8.
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-00979-1
Date issued/filed: 2021-04-23
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 03/24/2021) regarding 35 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-00979-UNJ Document 39 Filed 04/23/21 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-979V
UNPUBLISHED
JOHN J SAMLUK, Chief Special Master Corcoran
Petitioner, Filed: March 24, 2021
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)
Jennifer Sayad. Sayad, Zgheib Sayad, P.C., White Plains, NY, for petitioner.
Lauren Kells, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
On July 8, 2019, John J. Samluk 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 he suffered the Table injury of Shoulder Injury
Related to Vaccine Administration (SIRVA) as a result of his February 6, 2018 influneza
(“flu”) vaccination. Petition at 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On December 18, 2020, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On March 24, 2021, Respondent filed a proffer on
award of compensation (“Proffer”) indicating Petitioner should be awarded $75,000.00 in
pain and suffering, and past unreimbursable expenses in the amount of $2,461.01. Proffer
at 1-2. In the Proffer, Respondent represented that Petitioner agrees with the proffered
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-00979-UNJ Document 39 Filed 04/23/21 Page 2 of 5
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 $77,461.01 (representing$75,000.00 in pain and suffering, and
$2,461.01 in past 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

Case 1:19-vv-00979-UNJ Document 39 Filed 04/23/21 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
JOHN J. SAMLUK, )
)
Petitioner, )
) No. 19-979V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On July 8, 2019, John J. Samluk (“petitioner”) filed a petition for compensation under the
National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34 (“Vaccine Act” or
“Act”), alleging that he suffered a Shoulder Injury Related to Vaccine Administration
(“SIRVA”), as defined in the Vaccine Injury Table, following administration of an influenza
vaccine he received on February 6, 2018. Petition at 1. On December 14, 2020, the Secretary of
Health and Human Services (“respondent”) filed a Rule 4(c) Report indicating that this case is
appropriate for compensation under the terms of the Act for a SIRVA Table injury, and on
December 18, 2020, the Chief Special Master issued a Ruling on Entitlement finding petitioner
entitled to compensation. ECF No. 27; ECF No. 29.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $75,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:19-vv-00979-UNJ Document 39 Filed 04/23/21 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that he incurred past unreimbursable expenses
related to his vaccine-related injury. Respondent proffers that petitioner should be awarded past
unreimbursable expenses in the amount of $2,461.01. See 42 U.S.C. § 300aa-15(a)(1)(B).
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 should 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 $77,461.01, in the form of a
check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, John J. Samluk: $77,461.01
Respectfully submitted,
BRIAN M. BOYNTON
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Acting Deputy 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-00979-UNJ Document 39 Filed 04/23/21 Page 5 of 5
/s/ Lauren Kells
LAUREN KELLS
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) 616-4187
Email: Lauren.Kells@usdoj.gov
DATED: March 24, 2021
3