VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01412
Package ID: USCOURTS-cofc-1_19-vv-01412
Petitioner: Kathie Smith
Filed: 2019-09-13
Decided: 2022-04-18
Vaccine: influenza
Vaccination date: 2016-10-06
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 41280

AI-assisted case summary:
Kathie Smith filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a left shoulder injury related to vaccine administration (SIRVA) caused by the influenza vaccine she received on October 6, 2016. She stated that the vaccine was administered in the United States and that she continued to suffer residual effects of the SIRVA for more than six months post-vaccination. Respondent denied that the injury was caused by the vaccine and denied it was a Table injury. Despite these positions, the parties filed a joint stipulation agreeing to a settlement. The court adopted the stipulation as its decision, awarding Kathie Smith $41,280.02 in compensation. This amount included $284.99 for past unreimbursed medical expenses payable to Active Physical Therapy, $885.81 for past unreimbursed medical expenses payable to iMotion Physical Therapy, $109.22 for past unreimbursed medical expenses payable to Summit Orthopedics, and $40,000.00 for all remaining compensation. The case was resolved via stipulation, with the court directing entry of judgment in accordance with the decision.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-01412-0
Date issued/filed: 2022-04-18
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 03/15/2022) regarding 43 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-01412-UNJ Document 47 Filed 04/18/22 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1412V
UNPUBLISHED
KATHIE SMITH, Chief Special Master Corcoran
Petitioner, Filed: March 15, 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)
Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Camille Michelle Collett, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On September 13, 2019, Kathie Smith 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 left shoulder injury related to vaccine
administration (“SIRVA”) caused-in-fact by the influenza (“flu”) vaccine she received on
October 6, 2016. Petition at 1, ¶ 2, 47; Stipulation, filed Mar. 15, 2022, at ¶¶ 1-2, 4.
Petitioner further alleges she received the vaccine in the United States, that she continues
to suffer the residual effects of her SIRVA more than six months post-vaccination, and
that neither she nor any other person has filed a civil action or received compensation for
her SIRVA. Petition at ¶¶ 2, 17-18; Stipulation at ¶¶ 3-5. “Respondent denies that
[P]etitioner’s alleged left shoulder injury or any other injury or condition was caused by
her receipt of the flu vaccine, and further denies that [P]etitioner sustained a SIRVA Table
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-01412-UNJ Document 47 Filed 04/18/22 Page 2 of 8
Nevertheless, on March 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 $41,280.02 as
follows:
1. A lump sum of $284.99 for past unreimbursed medical expenses in the
form of a check payable jointly to Petitioner and Active Physical
Therapy;3
2. A lump sum of $885.81 for past unreimbursed medical expenses in the
form of a check payable jointly to Petitioner and iMotion Physical
Therapy;4
3. A lump sum of $109.22 for past unreimbursed medical expenses in the
form of a check payable jointly to Petitioner and Summit Orthopedics;5
and
4. A lump sum of $40,000.00 for all remaining compensation which would
be available under Section 15(a) in a check payable to Petitioner.
Stipulation at ¶ 8.
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.6
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Petitioner agrees to endorse this payment to Active Physical Therapy. Stipulation at ¶ 8.
4 Petitioner agrees to endorse this payment to iMotion Physical Therapy. Id.
5 Petitioner agrees to endorse this payment to Summit Orthopedics. Id.
6 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-01412-UNJ Document 47 Filed 04/18/22 Page 3 of 8
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
KA THIE SMITH, )
)
Petitioner, )
) No. 19-1412V
V. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND HUMAN )
SERVICES, )
)
______Res_po_nde_nt. _______)
.)
STIPULATION
The parties hereby stipulate to the following matters:
1. Kathie Smith, 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 injuries allegedly related to petitioner's receipt of the
influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the ''Table"),
42 C.F.R. § 100.3(a).
2. Petitioner received the flu vaccination in her left arm on October 6, 2016.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she suffered a left Shoulder Injury Related to Vaccine
Administration ("SIRVA") within the Table time frame, and that she experienced residual effects
of this injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on her behalf as a result of her condition.

Case 1:19-vv-01412-UNJ Document 47 Filed 04/18/22 Page 4 of 8
6. Respondent denies that petitioner's alleged left shoulder injury or any other injury or
condition was caused by her receipt of the flu vaccine, and further denies that petitioner
sustained a SIRVA Table 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 ofj udgment 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-21(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payments:
a. a lump sum of$284.99, representing petitioner's past unreimbursed medical
expenses, in the form of a check payable jointly to petitioner and Active
Physical Therapy.
Petitioner agrees to endorse this payment to Active Physical Therapy.
b. a lump sum of $885.81, representing petitioner's past unreimbursed medical
expenses, in the form of a check payable jointly to petitioner and iMotion
Physical Therapy.
Petitioner agrees to endorse this payment to iMotion Physical Therapy.
c. a lump sum of$ I 09.22, representing petitioner's past unreimbursed medical
expenses, in the form of a check payable jointly to petitioner and Summit
Orthopedics.
Petitioner agrees to endorse this payment to Summit Orthopedics.
d. A lump sum of $40,000.00 in the form of a check payable to petitioner. This
amount represents compensation for all remaining damages that would be
available under 42 U.S.C. § 300aa-15(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
2

Case 1:19-vv-01412-UNJ Document 47 Filed 04/18/22 Page 5 of 8
U.S.C. § 300aa-21(a)(l), 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.
10. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U .S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C.
§ 1396 et seq.)), or by entities that provide health services on a pre-paid basis.
11. Payment made pursuant to paragraph 8 of this Stipulation, and any amounts awarded
pursuant to paragraph 9 of this Stipulation, will be made in accordance with 42 U.S.C. § 300aa-
15(i), 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 benefit 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 paragraphs 8 and 9, petitioner, in her
individual 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, 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
3

Case 1:19-vv-01412-UNJ Document 47 Filed 04/18/22 Page 6 of 8
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 or about October 6, 2016, as
alleged by petitioner in a petition for vaccine compensation filed on September 3, 2019, in the
United States Court of Federal Claims as petition No. 19-1412V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to 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 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 to 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 to suffer a
4

Case 1:19-vv-01412-UNJ Document 47 Filed 04/18/22 Page 7 of 8
shoulder injury or her current disabilities, or any other injury or condition, or that petitioner
sustained an injury contained in the Vaccine Injury Table.
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-01412-UNJ Document 47 Filed 04/18/22 Page 8 of 8
Respectfully submitted,
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
- e~
HEA TifER L. PEARLMAN
Deputy Director
Torts Branch
Civil Division
U.S.DepartmentofJustice
P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OFTHESECRETARYOFBEALTH RESPONDENT:
AND HUMAN SERVICES:
George R. Olgltally signed by George R.
Grtmes-S14 (p.~H-~
Grimes-S14 Date: 2022.02.17 14:59:41 ~ ~ L ( ) ~
-05'00'
CDR GEORGE REED GRIMES, MD, MPH CAMILLE M. COLLETT
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch, Civil Division
Health Systems Bureau U.S. Department of Justice
Health Resources and Services P.O. Box 146
Administration Benjamin Franklin Station
U.S. Department of Health Washington, DC 20044-0146
and Human Services Tel: (202) 616-4098
5600 Fishers Lane, 08Nl46B Email: Camille.M.Collett@usdoj.gov
Rockville, MD 208S7
Dated: oa { 1 s ]"Z,6'l/L
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