VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01469 Package ID: USCOURTS-cofc-1_19-vv-01469 Petitioner: William Forney Filed: 2019-09-25 Decided: 2021-11-16 Vaccine: influenza Vaccination date: 2017-11-03 Condition: left shoulder injuries related to vaccine administration (SIRVA) Outcome: compensated Award amount USD: 85000 AI-assisted case summary: William Forney filed a petition on September 25, 2019, seeking compensation under the National Vaccine Injury Compensation Program. He alleged that he suffered left shoulder injuries related to vaccine administration, commonly known as SIRVA, as a result of an influenza (flu) vaccination he received on November 3, 2017. Mr. Forney stated that the vaccination was administered in the United States, his symptoms persisted for more than six months, and he had not received any prior award or settlement for this condition. The respondent, the Secretary of Health and Human Services, denied that the flu vaccine caused Mr. Forney's injury or that it constituted a SIRVA Table injury. Despite the respondent's denial, the parties filed a joint stipulation on November 15, 2021, agreeing to an award of compensation. Chief Special Master Brian H. Corcoran reviewed the stipulation, found it reasonable, and adopted it as his decision. He awarded William Forney a lump sum of $85,000.00, payable by check to the petitioner, as compensation for all items of damages. The decision was issued on November 16, 2021. The public decision does not describe the specific onset of symptoms, clinical details of the injury, diagnostic tests performed, or treatments received. The names of petitioner's counsel were Paul R. Brazil of Muller Brazil, LLP, and respondent's counsel was Mollie Danielle Gorney of the U.S. Department of Justice. Theory of causation field: Petitioner William Forney alleged a left shoulder injury related to vaccine administration (SIRVA) following an influenza vaccination on November 3, 2017. The respondent denied causation and that the injury was a SIRVA Table injury. The parties filed a joint stipulation agreeing to compensation. Chief Special Master Brian H. Corcoran adopted the stipulation, awarding $85,000.00. The public decision does not detail the specific mechanism of injury, expert testimony, or the evidence considered beyond the stipulation. The theory of causation is based on the "Table" category of injuries under the Vaccine Act, as indicated by the SIRVA classification. Petitioner was represented by Paul R. Brazil, and Respondent was represented by Mollie Danielle Gorney. The decision was issued on November 16, 2021. Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_19-vv-01469-0 Date issued/filed: 2021-12-17 Pages: 7 Docket text: PUBLIC DECISION (Originally filed: 11/16/2021) regarding 26 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:19-vv-01469-UNJ Document 31 Filed 12/17/21 Page 1 of 7 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 19-1469V UNPUBLISHED WILLIAM FORNEY, Chief Special Master Corcoran Petitioner, Filed: November 16, 2021 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) Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for Petitioner. Mollie Danielle Gorney, U.S. Department of Justice, Washington, DC, for Respondent. DECISION ON JOINT STIPULATION1 On September 25, 2019, William Forney 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 left shoulder injuries related to vaccine administration (SIRVA) resulting from the influenza (flu) vaccination, received on November 3, 2017. Petition at 1; Stipulation, filed at November 15, 2021, ¶¶ 1-2. Petitioner further alleges that the vaccination was administered within the United States, Petitioner’s symptoms lasted for more than six months, and there has been no prior award or settlement of a civil action for damages on his behalf as a result of his condition. Petition at 1, 4; Stipulation at ¶¶ 3-5. “Respondent denies that the flu vaccine caused [P]etitioner to suffer a left shoulder injury, or any other injury, and 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-01469-UNJ Document 31 Filed 12/17/21 Page 2 of 7 Nevertheless, on November 15, 2021, 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 $85,000.00 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 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-01469-UNJ Document 31 Filed 12/17/21 Page 3 of 7 Case 1:19-vv-01469-UNJ Document 31 Filed 12/17/21 Page 4 of 7 Case 1:19-vv-01469-UNJ Document 31 Filed 12/17/21 Page 5 of 7 Case 1:19-vv-01469-UNJ Document 31 Filed 12/17/21 Page 6 of 7 Case 1:19-vv-01469-UNJ Document 31 Filed 12/17/21 Page 7 of 7