VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01194
Package ID: USCOURTS-cofc-1_19-vv-01194
Petitioner: Stacey Maslyn
Filed: 2019-08-14
Decided: 2022-03-21
Vaccine: influenza
Vaccination date: 2018-10-08
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 40000

AI-assisted case summary:
Stacey Maslyn filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine administered on October 8, 2018. She stated that the vaccine was given in the United States, that she experienced residual effects for more than six months, and that there had been no prior award or settlement for this condition. Respondent denied that Ms. Maslyn sustained a SIRVA Table injury, denied that the flu vaccine caused her injury, and denied that her current condition was a sequelae of a vaccine-related injury. Despite these denials, the parties filed a joint stipulation agreeing that a decision should be entered awarding compensation. The court adopted the stipulation as its decision, awarding Ms. Maslyn a lump sum of $40,000.00 as compensation for all items of damages available under Section 15(a). This award represents a settlement of liability and damages claimed under the Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-01194-0
Date issued/filed: 2022-03-21
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 02/17/2022) regarding 34 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-01194-UNJ Document 38 Filed 03/21/22 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1194V
UNPUBLISHED
STACEY MASLYN, Chief Special Master Corcoran
Petitioner, Filed: February 17, 2022
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.
Ronalda Elnetta Kosh, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On August 14, 2019, Stacey Maslyn 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 an influenza (“flu”) vaccine administered to her on
October 8, 2018. Petition at 1; Stipulation, filed February 15, 2022, at ¶¶ 1, 4. Petitioner
further alleges that she received in the United States, that she has experienced the
residual effects of her injury for more than six months, and there has been no prior award
or settlement of a civil action for damages as a result of her alleged condition”. Petition at
3; Stipulation at ¶¶ 3-5. “Respondent denies that petitioner sustained a SIRVA Table
injury; denies that the flu vaccine caused petitioner’s alleged shoulder injury, or any other
injury; and denies that her current condition is a sequelae 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-01194-UNJ Document 38 Filed 03/21/22 Page 2 of 7
Nevertheless, on February 15, 2022, 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 $40,000.00 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 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-01194-UNJ Document 38 Filed 03/21/22 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
STACEY MASLYN, )
)
)
Pe titio ne r, )
) No.19-1194V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
STIPULATION
The parties hereby stipulate to the following matters:
1. Stacey Maslyn ("petitioner") filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to 34 (the "Vaccine
Program"). The petition seeks compensation for an injury allegedly related to petitioner's receipt
of the influenza ("Flu") vaccine, which is contained in the Vaccine Injury Table (the "Table"), 42
C.F.R. § 100.3(a).
2. Petitioner received the flu vaccine on October 8, 2018.
3. The vaccine was administered in the United States.
4. Petitioner alleges that as a result of receiving the flu vaccine, she suffered a Shoulder
Injury Related to Vaccine Administration ("SIRVA") within the Table timeframe. She further
alleges that she suffered the residual effects of her alleged injury for more than six months.
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Case 1:19-vv-01194-UNJ Document 38 Filed 03/21/22 Page 4 of 7
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages as a result of her alleged condition.
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the flu
vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies that her
current condition is a sequelae 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-2l(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $40,000.00, in the form of a check payable to petitioner, which
represents compensation for all damages that would be available under 42 U.S.C. §
300aa-I 5(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-2l(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 they have identified to respondent all known
sources of payment for items or services for which the Program is not primarily liable under 42
U.S.C. § 300aa-15(g), including State compensation programs, insurance policies, Federal or State
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Case 1:19-vv-01194-UNJ Document 38 Filed 03/21/22 Page 5 of 7
health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C. § 1396 et
seq.)), or entities that provide health services on a pre-paid basis.
11. Payment made pursuant to paragraph 8 of this Stipulation, and any amount awarded
pursuant to paragraph 9, will be made in accordance with 42 U .S.C. § 300aa-l 5(D, subject to the
availability of sufficient statutory funds.
12. The parties and their attorneys further agree and stipulate that, except for any award
for attorneys' fees and litigation costs, and past unreimbursable expenses, the money provided
pursuant to this Stipulation will be used solely for the benefrt of petitioner as contemplated by a
strict construction of 42 U.S.C. § 300aa-15(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 paragraph 8, and any amount awarded
pursuant to paragraph 9, petitioner, in her individua I 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 vaccine
administered on October 8, 2018, as alleged in a Petition filed on August 14, 2019, in the United
States Court of Federal Claims as petition No. 19-1194V.
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Case 1:19-vv-01194-UNJ Document 38 Filed 03/21/22 Page 6 of 7
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice of 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 terms
of this Stipulation or if the United States 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 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 shoulder
injury, or any other injury.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:19-vv-01194-UNJ Document 38 Filed 03/21/22 Page 7 of 7
Respec_tfully submitted,
~ATTORNE,Y OFN RxECO:RD FOR AUTHORIZED REPRESENTATIVE
OF THE ATTORNEY GENERAL:
PETITIONER: ~
~
MJ~/\~~evvl-lV'--
l
HEATHER L. PEARLMAN
Law Offices of Leah V. Durant, PLLC Deputy Director
1717 K Street NW, Suite 900 Torts Branch
Washington, DC 20006 Civil Division
Telephone: 202-775-9200 U.S. Department of Justice
Fax:202-652-1178 P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALm RESPONDENT:
AND HUMAN SERVICES:
v& vdSc-, A/Jtf!AJ, /4'1-
~1
cDR GEORGE REED GRJMES, M.D1/,MPH RONALDA E. KOSH
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Department of Justice
Administration P.O.Box 146
U.S. Department of Health Benjamin Franklin Station
and Hwnan Services Washington, DC 20044-0146
5600 Fishers Lane, 08N 146B ronalda.kosh@usdoj.gov
Rockville, MD 20857 (202) 616-4476
liouz
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Dated: 1&
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