VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01475
Package ID: USCOURTS-cofc-1_19-vv-01475
Petitioner: Daniel Van Doren
Filed: 2021-02-12
Decided: 2021-04-06
Vaccine: influenza
Vaccination date: 2018-01-30
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 72352

AI-assisted case summary:
Daniel Van Doren filed a petition for compensation under the National Vaccine Injury Compensation Program alleging that he suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of his January 30, 2018 influenza vaccination. The case was assigned to the Special Processing Unit of the Office of Special Masters. Respondent filed a Rule 4(c) report conceding that Petitioner is entitled to compensation, stating that DICP concluded his alleged injury meets the requirements of a Table injury claim for a left SIRVA. Respondent agreed that Petitioner had satisfied all legal prerequisites for compensation. On February 12, 2021, a ruling on entitlement was issued, finding Petitioner entitled to compensation. Subsequently, on March 1, 2021, Respondent filed a proffer on award of compensation, indicating Petitioner should be awarded $72,352.00, representing $72,000.00 in pain and suffering and $352.00 for past unreimbursable expenses. Petitioner agreed with the proffered award. Based on the record, the Chief Special Master awarded Petitioner a lump sum payment of $72,352.00.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-01475-0
Date issued/filed: 2021-03-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 02/12/2021) 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-01475-UNJ Document 36 Filed 03/15/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1475V
UNPUBLISHED
DANIEL VAN DOREN, Chief Special Master Corcoran
Petitioner, Filed: February 12, 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.
Terrence Kevin Mangan, Jr., U.S. Department of Justice, Washington, DC, for
respondent.
RULING ON ENTITLEMENT1
On September 25, 2019, Daniel Van Doren 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 a Table Injury – Shoulder Injury Related
to Vaccine Administration (“SIRVA”) – as a result of his January 30, 2018 influneza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On February 11, 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 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-01475-UNJ Document 36 Filed 03/15/21 Page 2 of 2
1. Specifically, Respondent indicates that
DICP [Division of Injury Compensation Programs, Department of Health
and Human Services] has concluded that petitioner’s alleged injury meets
the requirements of a Table injury claim for a left SIRVA stemming from the
flu vaccination on January 30, 2018. DICP did not identify any other causes
for petitioner’s left arm injury, and records show that he suffered the sequela
of this injury for more than six months. Based on the medical records
outlined above, petitioner has met the statutory requirements for entitlement
to compensation. See 42 U.S.C. § 300aa-13(a)(1)(B); 42 U.S.C. § 300aa-
11(c)(1)(D).
Id. at 5. Respondent further agrees that “based on the record as it now stands, petitioner
has satisfied all legal prerequisites for compensation under the Act.” 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

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DOCUMENT 2: USCOURTS-cofc-1_19-vv-01475-1
Date issued/filed: 2021-04-06
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 03/03/2021) regarding 32 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-01475-UNJ Document 37 Filed 04/06/21 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1475V
UNPUBLISHED
DANIEL VAN DOREN, Chief Special Master Corcoran
Petitioner, Filed: March 3, 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.
Terrence Kevin Mangan, Jr., U.S. Department of Justice, Washington, DC, for
respondent
DECISION AWARDING DAMAGES1
On September 25, 2019, Daniel Van Doren 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 a Table Injury – Shoulder Injury Related
to Vaccine Administration (“SIRVA”) – as a result of his January 30, 2018 influneza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On February 12, 2021, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On March 1, 2021, Respondent filed a proffer on
award of compensation (“Proffer”) indicating Petitioner should be awarded $72,352.00,
representing compensation in the amount of $72,000.00 in pain and suffering and
$352.00 for past unreimbursable expenses. Proffer at 1-2. In the Proffer, Respondent
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 “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2012).

Case 1:19-vv-01475-UNJ Document 37 Filed 04/06/21 Page 2 of 5
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 $72,352.00 in the form of a check payable to Petitioner. This amount
represents compensation for all damages that would be available under § 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-01475-UNJ Document 37 Filed 04/06/21 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DANIEL VAN DOREN,
Petitioner,
v.
No. 19-1475V
Chief Special Master Corcoran
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On September 25, 2019, Daniel Van Doren (“petitioner”) filed a petition for
compensation under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1
to -34 (“Vaccine Act” or “Act”), alleging that he suffered a Shoulder Injury Related to Vaccine
Administration (“SIRVA”), as defined in the Vaccine Injury Table, following administration of
an influenza vaccine he received on January 30, 2018. Petition at 1. On February 11, 2021, the
Secretary of Health and Human Services (“respondent”) filed a Rule 4(c) Report indicating that
this case is appropriate for compensation under the terms of the Act for a SIRVA Table injury,
and on February 12, 2021, the Chief Special Master issued a Ruling on Entitlement finding
petitioner entitled to compensation. ECF No. 27; ECF No. 29.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $72,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:19-vv-01475-UNJ Document 37 Filed 04/06/21 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that he incurred past unreimbursable expenses
related to his vaccine-related injury. Respondent proffers that petitioner should be awarded past
unreimbursable expenses in the amount of $352. See 42 U.S.C. § 300aa-15(a)(1)(B). Petitioner
agrees.
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that the compensation provided to petitioner should be made through a
lump sum payment as described below and requests that the Chief Special Master’s decision and
the Court’s judgment award the following1: a lump sum payment of $72,352.00, in the form of a
check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Daniel Van Doren: $72,352.00
Respectfully submitted,
BRIAN M. BOYNTON
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Acting Deputy Director
Torts Branch, Civil Division
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 lost earnings
and future pain and suffering.
2

Case 1:19-vv-01475-UNJ Document 37 Filed 04/06/21 Page 5 of 5
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
/s/ Terrence K. Mangan, Jr.
TERRENCE K. MANGAN, JR.
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Phone: (202) 514-8988
Email: terrence.mangan@usdoj.gov
Dated: March 1, 2021
3