VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01030
Package ID: USCOURTS-cofc-1_19-vv-01030
Petitioner: Javier Jimenez Rosas
Filed: 2020-06-11
Decided: 2023-01-03
Vaccine: influenza
Vaccination date: 2017-10-10
Condition: Guillain-Barre Syndrome (GBS)
Outcome: compensated
Award amount USD: 768184

AI-assisted case summary:
Javier Jimenez Rosas filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered Guillain-Barre Syndrome (GBS) as a result of an influenza vaccine administered on October 10, 2017. The respondent conceded that Mr. Rosas's GBS satisfied the criteria of the Vaccine Injury Table, and therefore conceded his entitlement to compensation. A ruling on entitlement was issued on June 11, 2020, finding him entitled to compensation. Subsequently, on November 22, 2022, the parties filed a proffer on the award of damages. The respondent proffered that Mr. Rosas should be awarded $205,000.00 for actual and projected pain and suffering, and $563,184.43 to satisfy a State of California Medicaid lien. Mr. Rosas, who is a competent adult, agreed with the proffered award. The Chief Special Master issued a decision awarding compensation totaling $768,184.43 on January 3, 2023.

Theory of causation field:
Table

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_19-vv-01030-0
Date issued/filed: 2020-07-14
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/11/2020) regarding 23 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
--------------------------------------------------------------------------------
Case 1:19-vv-01030-UNJ Document 26 Filed 07/14/20 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1030V
UNPUBLISHED
JAVIER JIMENEZ ROSAS, Chief Special Master Corcoran
Petitioner, Filed: June 11, 2020
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Influenza (Flu) Vaccine;
Guillain-Barre Syndrome (GBS)
Respondent.
Theodore J. Hong, Maglio Christopher & Toale, PA, Seattle, WA, for Petitioner.
Jennifer Leigh Reynaud, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On July 17, 2019, Javier Jimenez Rosas 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 Guillain-Barre Syndrome (GBS) .
Petition at 1, 6. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On June 9, 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 states that it his “position that [P]etitioner has satisfied
the criteria set forth in the Vaccine Injury Table (“Table”) and the Qualifications and Aids
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-01030-UNJ Document 26 Filed 07/14/20 Page 2 of 2
to Interpretation (“QAI”).” Id. at 5. Respondent further agrees that “[t]he scope of
damages to be awarded is limited to [P]etitioner’s GBS and its related sequalae only.”
Id.
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-01030-1
Date issued/filed: 2023-01-03
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 11/28/2022) regarding 60 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
--------------------------------------------------------------------------------
Case 1:19-vv-01030-UNJ Document 64 Filed 01/03/23 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1030V
UNPUBLISHED
JAVIER JIMENEZ ROSAS, Chief Special Master Corcoran
Petitioner, Filed: November 28, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu) Vaccine; Guillain-
Barre Syndrome (GBS)
Respondent.
Jessi Carin Huff, Maglio Christopher & Toale (WA) Seattle, WA, for Petitioner.
Jennifer Leigh Reynaud, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On July 17, 2019, Javier Jimenez Rosas 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 Guillain-Barre Syndrome (GBS) .
Petition at 1, 6. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On June 11, 2020, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On November 22, 2022, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $205,000.00 for
actual and projected pain and suffering and $563,184.43 to satisfy the State of California
Medicaid lien. Proffer at 1-2. In the Proffer, Respondent represented that Petitioner
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-01030-UNJ Document 64 Filed 01/03/23 Page 2 of 5
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 the
following compensation:
1. A lump sum payment of $205,000.00 for actual and projected pain and
suffering in the form of a check payable to Petitioner, Javier Jimenez
Rosas.
2. A lump sum payment of $563,184.43, representing compensation for
satisfaction of a State of California Medicaid lien, payable jointly to
Petitioner and Department of Health Care Services, and mailed to:
Department of Health Care Services
Recovery Branch - MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
DHCS Account No: C98455695D-VAC03
This amount represents compensation for all damages that would be available
under Section 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-01030-UNJ Document 64 Filed 01/03/23 Page 3 of 5
THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
JAVIER JIMENEZ ROSAS,
Petitioner, No. 19-1030V
Chief Special Master Corcoran
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
PROFFER ON AWARD OF DAMAGES
On July 17, 2019, Javier Jimenez Rosas (“petitioner”) filed a petition for compensation
(“Petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -
34 (“Vaccine Act” or “Act”), as amended. Petitioner alleges that he suffered Guillain-Barré
syndrome (“GBS”) as a result of an influenza vaccine administered on October 10, 2017.
Petition at 1. Respondent concluded that petitioner’s alleged injury of GBS satisfied the criteria
of the Vaccine Injury Table, and therefore conceded petitioner’s entitlement to compensation in
his Rule 4(c) Report filed on June 9, 2020. ECF No. 22. Based on Respondent’s Rule 4(c)
Report the Court found petitioner entitled to compensation on June 11, 2020. ECF No. 23.
I. Items of Compensation
A. Pain and Suffering
Based upon the evidence of record, respondent proffers that petitioner should be awarded
a lump sum of $205,000.00 for actual and projected pain and suffering, in the form of a check
payable to petitioner. This amount reflects that any award for projected pain and suffering has
been reduced to net present value. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
1

Case 1:19-vv-01030-UNJ Document 64 Filed 01/03/23 Page 4 of 5
B. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy the State of
California Medicaid lien in the amount of $563,184.43. This amount represents full satisfaction
of any right of subrogation, assignment, claim, lien, or cause of action the State of California
may have against any individual as a result of any Medicaid payments the State of California has
made to or on behalf of petitioner from the date of his eligibility for benefits through the date of
judgment in this case as a result of his alleged vaccine-related injury of GBS suffered on or about
November 9, 2017, under Title XIX of the Social Security Act. Petitioner agrees.
The above amounts represent all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
two lump sum payments described below, and request that the Chief Special Master’s decision
and the Court’s judgment award the following: 1
A. A lump sum payment of $205,000.00 in the form of a check payable to petitioner;
and
B. A lump sum payment of $563,184.43, representing compensation for satisfaction of
the State of California Medicaid lien, in the form of a check payable jointly to
petitioner and:
Department of Health Care Services
Recovery Branch - MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
DHCS Account No: C98455695D-VAC03
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 medical
expenses, future pain and suffering, and future lost wages.
2

Case 1:19-vv-01030-UNJ Document 64 Filed 01/03/23 Page 5 of 5
Petitioner agrees to receive, endorse, and forward the check to the Department of Health
Care Services for satisfaction of the Medicaid lien.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C.SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
s/Jennifer L. Reynaud
JENNIFER L. REYNAUD
Senior 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) 305-1586
Jennifer.L.Reynaud@usdoj.gov
DATED: November 22, 2022
3