VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01253
Package ID: USCOURTS-cofc-1_19-vv-01253
Petitioner: Kim Bankowski
Filed: 2019-08-22
Decided: 2021-11-29
Vaccine: influenza
Vaccination date: 2017-11-02
Condition: left shoulder injuries related to vaccine administration (“SIRVA”)
Outcome: compensated
Award amount USD: 95707

AI-assisted case summary:
Kim Bankowski filed a petition for compensation under the National Vaccine Injury Compensation Program on August 22, 2019. She alleged that she suffered a left shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine she received on November 2, 2017. The case was assigned to the Special Processing Unit. On February 1, 2021, the Respondent filed a Rule 4(c) report conceding that Ms. Bankowski met the criteria for a presumed SIRVA injury as defined by the Vaccine Injury Table. The Respondent agreed that Ms. Bankowski had no prior history of pain, inflammation, or dysfunction in her left shoulder, that her pain occurred within 48 hours of the vaccination, that her pain and reduced range of motion were limited to the shoulder where the vaccine was administered, and that no other condition explained her symptoms. The Respondent also agreed that the statutory six-month sequela requirement was satisfied, meaning Ms. Bankowski had met all legal prerequisites for compensation. Based on the Respondent's concession and the evidence of record, Chief Special Master Brian H. Corcoran issued a ruling on entitlement on February 2, 2021, finding Ms. Bankowski entitled to compensation. Subsequently, on October 20, 2021, the Respondent filed a proffer on the award of compensation. The Respondent recommended an award of $95,707.08, consisting of $92,500.00 for pain and suffering and $3,207.08 for past unreimbursed medical expenses. The Petitioner agreed with this proffered award. On November 29, 2021, Chief Special Master Corcoran issued a decision awarding Ms. Bankowski a lump sum payment of $95,707.08, payable by check to her. The decision noted that Ms. Bankowski is a competent adult and that evidence of guardianship was not required. The award represented compensation for all damages available under Section 15(a) of the Vaccine Act. Petitioner counsel was Paul R. Brazil of Muller Brazil, LLP, and respondent counsel was Debra A. Filteau Begley of the U.S. Department of Justice.

Theory of causation field:
Petitioner Kim Bankowski received an influenza vaccine on November 2, 2017, and subsequently developed left shoulder injuries related to vaccine administration (SIRVA). The Respondent conceded that the claim met the criteria for a presumed SIRVA injury on the Vaccine Injury Table, satisfying the requirements of no prior shoulder issues, onset of pain within 48 hours of vaccination, localized symptoms to the vaccinated shoulder, and no other identified cause. The six-month sequela requirement was also met. A ruling on entitlement was issued on February 2, 2021, finding Petitioner entitled to compensation. On October 20, 2021, Respondent proffered an award of $95,707.08, comprising $92,500.00 for pain and suffering and $3,207.08 for past unreimbursed medical expenses, which Petitioner accepted. Chief Special Master Brian H. Corcoran issued a decision awarding this amount on November 29, 2021. Petitioner was represented by Paul R. Brazil, and Respondent was represented by Debra A. Filteau Begley.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-01253-0
Date issued/filed: 2021-03-04
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 02/02/2021) 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-01253-UNJ Document 31 Filed 03/04/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1253V
UNPUBLISHED
KIM BANKOWSKI, Chief Special Master Corcoran
Petitioner, Filed: February 2, 2021
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)
Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On August 22, 2019, Kim Bankowski 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 left shoulder injuries related to vaccine
administration (“SIRVA”) as a result of an influenza vaccine received on November 2,
2017. Petition at 1. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
On February 1, 2021, 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. Respondent agrees that “petitioner meets the criteria for a presumed SIRVA, as
defined by the Vaccine Injury Table. Specifically, petitioner had no history of pain,
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-01253-UNJ Document 31 Filed 03/04/21 Page 2 of 2
inflammation or dysfunction in her left shoulder; her pain occurred within 48 hours of
receipt of an intramuscular vaccination; her pain and reduced range of motion were
limited to the shoulder in which the vaccine was administered; and no other condition or
abnormality was identified to explain her symptoms.” Id. at 4. Respondent further agrees
that the statutory six month sequela requirement has been satisfied and thus Petitioner
has satisfied all legal prerequisites for compensation. Id. at 4-5.
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-01253-1
Date issued/filed: 2021-11-29
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 10/21/2021) 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-01253-UNJ Document 43 Filed 11/29/21 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1253V
UNPUBLISHED
KIM BANKOWSKI, Chief Special Master Corcoran
Petitioner, Filed: October 21, 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)
Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On August 22, 2019, Kim Bankowski 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”) following an influenza (“flu”) vaccine on November 2, 2017.
Petition at ¶1. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On February 2, 2021, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for a Table SIRVA. On October 20, 2021, Respondent filed a proffer on
award of compensation (“Proffer”) indicating Petitioner should be awarded $95,707.08,
representing $92,500.00 as compensation for pain and suffering and $3,207.08 as
compensation for actual past unreimbursed expenses. Proffer at 1-2. In the Proffer,
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-01253-UNJ Document 43 Filed 11/29/21 Page 2 of 4
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 $95,707.08 in the form of a check payable to Petitioner. 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-01253-UNJ Document 43 Filed 11/29/21 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
*************************************
KIM BANKOWSKI, *
*
Petitioner, * No. 19-1253V
* Chief Special Master Corcoran
v. *
*
SECRETARY OF HEALTH AND *
HUMAN SERVICES, *
*
Respondent. *
*************************************
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On February 1, 2021, respondent filed a Rule 4(c) Report, conceding that petitioner’s
claim meets the Table criteria for a SIRVA injury. On February 2, 2021, the Court issued a
Ruling on Entitlement finding petitioner entitled to compensation under the Vaccine Act.
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
the following, and requests that the Chief Special Master’s decision and the Court’s judgment
award:
a. a lump sum payment of $92,500.00, which represents compensation for pain and
suffering, see 42 U.S.C. § 300aa-15(a)(4), and
b. a lump sum payment of $3,207.08, which represents compensation for past
unreimbursed medical expenses, see 42 U.S.C. § 300aa-15(a)(1).
These amounts represent all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees.
1 Should petitioner die prior to the entry of judgment, the parties reserve the right to move the
Court for appropriate relief. In particular, respondent would oppose any award for future pain
and suffering.

Case 1:19-vv-01253-UNJ Document 43 Filed 11/29/21 Page 4 of 4
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that petitioner be awarded a lump sum payment of $95,707.08, in the
form of a check payable to petitioner. Petitioner agrees.
Respectfully submitted,
BRIAN M. BOYNTON
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
LARA A. ENGLUND
Assistant Director
Torts Branch, Civil Division
s/ DEBRA A. FILTEAU BEGLEY
DEBRA A. FILTEAU BEGLEY
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) 616-4181
Dated: October 20, 2021 Debra.Begley@usdoj.gov
2