VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01554
Package ID: USCOURTS-cofc-1_19-vv-01554
Petitioner: Zahra Leisi Zarnagh
Filed: 2019-10-04
Decided: 2022-01-20
Vaccine: influenza
Vaccination date: 2017-12-13
Condition: shoulder injury related to vaccine administration (SIRVA), which included brachial plexopathy
Outcome: compensated
Award amount USD: 35320

AI-assisted case summary:
Zahra Leisi Zarnagh filed a petition for vaccine compensation on October 4, 2019, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA), including brachial plexopathy, causally related to the influenza vaccine she received on December 13, 2017. On the same date, she also received pneumococcal and Zoster vaccines. Respondent denied that the vaccines caused her alleged injuries. Despite these denials, the parties filed a joint stipulation for compensation. The Chief Special Master adopted the stipulation, awarding Zahra Leisi Zarnagh $35,320.68. This amount includes $35,000.00 for pain and suffering and $320.68 to reimburse a Medicaid lien. The award represents compensation for all damages available under the Vaccine Act. The parties agreed that this stipulation constitutes a full and complete settlement of liability and damages, except for potential future awards for attorneys' fees and costs.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-01554-0
Date issued/filed: 2022-01-20
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 12/21/2021) 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-01554-UNJ Document 43 Filed 01/20/22 Page 1 of 8
CORRECTED
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1554V
UNPUBLISHED
ZAHRA LEISI ZARNAGH, Chief Special Master Corcoran
Petitioner, Filed: December 21, 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)
Jessica Olins, Maglio Christopher & Toale, PA, Washington, DC, for Petitioner.
Colleen Clemons Hartley, U.S. Department of Justice, Washington, DC, for
Respondent.
DECISION ON JOINT STIPULATION1
On October 4, 2019, Zahra Leisi Zarnagh 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”), which included brachial plexopathy, which was causally related
to the influenza (“flu”) vaccine she received on December 13, 2017, in her left deltoid.3
Petition at 1, ¶¶ 1, 14; Stipulation, filed at Dec. 21, 2021, ¶¶ 1-2, 4. Petitioner further
alleges that she received the flu vaccine within the United States, that she suffered the
residual effects of her SIRVA for more than six months, and that neither she nor any other
party has filed a civil action or received compensation for her SIRVA. Petition at ¶¶ 1, 15,
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).
3 Also, on December 13, 2017, Petitioner received pneumococcal and Zoster vaccines in her right deltoid.
Petition at ¶ 1; see Exhibit 1 at 3 (vaccine record).

Case 1:19-vv-01554-UNJ Document 43 Filed 01/20/22 Page 2 of 8
17-18; Stipulation at ¶¶ 3-5. “Respondent denies that [P]etitioner sustained a SIRVA
Table injury; denies that the vaccines caused [P]etitioner’s alleged shoulder injuries,
including brachial plexopathy, or any other injury; and denies that her current condition is
a sequelae of a vaccine-related injury.” Stipulation at ¶ 6.
Nevertheless, on December 21, 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 $35,320.68 as
follows:
1. A lump sum payment of $35,000.00 in the form of a check payable to
Petitioner; and
2. A lump sum payment of $320.68, representing reimbursement of a Medicaid
lien for services rendered to Petitioner by the State of Michigan, in the form
of a check payable jointly to Petitioner and the State of Michigan, and mailed
to:
Michigan Department of Health and Human Services
Member: Zahra Leisi Zarnagh
File No.: 1089967261
Third Party Liability Division
P.O. Box 30053
Lansing, MI 48909.
Stipulation at ¶ 8. Petitioner agrees to endorse the check to the State of Michigan for
satisfaction of the Medicaid lien. 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.4
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
4 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-01554-UNJ Document 43 Filed 01/20/22 Page 3 of 8
DocuSign Envelope ID: C41 FF825-A242-4CDE-81 F1-7A2F97D3EC59
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
ZAHRA LEIS! ZARNAGH,
)
)
Petitioner,
) No. 19-1554V
V.
) Chief Special Master Corcoran
ECF
SECRETARY OF HEALTH AND HUMAN ))
SERVICES, )
______Res_pon_de_nt. ______ )
)
STIPULATION
The parties hereby stipulate to the following matters:
I. Zahra Leisi Zamagh, petitioner, filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10 et seq. (the "Vaccine
Program"). The petition seeks compensation for injuries related to petitioner's receipt of the
influenz.a ("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 on December 13, 2017. 1
3. The vaccine was administered within the United States.
4. Petitioner alleges that she sustained a Shoulder Injury Related to Vaccine
Administration ("SIRVA") within the time period set forth in the Table, or in the alternative, that
her shoulder injury was caused by the vaccine. She further alleges that she experienced the residua 1
effects of this condition for more than six months.
1 The flu vaccination was administered in the left deltoid. On the same date, petitioner also
received a pneumococcal (Prevnar-13) in the right deltoid and a zoster vaccination in the right
arm, subcutaneous. The zoster vaccination is not contained in the Table.

Case 1:19-vv-01554-UNJ Document 43 Filed 01/20/22 Page 4 of 8
DocuSign Envelope ID: C41 FF825-A242-4CDE-81 F1-7A2F97D3EC59
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.
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
vaccines caused petitioner's alleged shoulder injuries, including brachia! plexopathy, 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-21(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payments:
a. A lump sum of$35,000.00, which amount represents compensation for pain
and suffering, in the form of a check payable to petitioner; and
b. A lump sum of $320.68 representing reimbursement of the State of
Michigan Medicaid lien, in the form of a check payable jointly to petitioner and
Michigan Department of Health and Human Services
Member: Zahra Leisi Zamagh
File No.: 1089967261
Third Party Liability Division
P.O. Box 30053
Lansing, Ml 48909
This lump sum represents full satisfaction of any right of subrogation, assignment, claim,
lien, or cause of action the state of Michigan may have against any individual as a result of any
Medicaid payments the state of Michigan has made to or on behalf of petitioner from the date of
her eligibility for benefits through the date of judgment in this case as a result of her alleged
2

Case 1:19-vv-01554-UNJ Document 43 Filed 01/20/22 Page 5 of 8
DocuSign Envelope ID: C41FF825-A242-4CDE-81F1-7A2F97D3EC59
vaccine-related injury suffered on or about December 13, 2017, under Title XIX of the Social
Security Act. Petitioner agrees to endorse this check to the state of Michigan.
These amounts represent compensation for all 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 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 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 unreimbursed 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).
3

Case 1:19-vv-01554-UNJ Document 43 Filed 01/20/22 Page 6 of 8
DocuSign Envelope ID: C41 FF825-A242-4CDE-81 F1-7A2F97D3EC59
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her individua 1
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 vaccination or any other vaccination on or around December 13, 2017, as alleged by
petitioner in a petition for vaccine compensation filed on or about October 4, 2019, in the United
States Court of Federal Claims as petition No. 19-1554V.
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
4

Case 1:19-vv-01554-UNJ Document 43 Filed 01/20/22 Page 7 of 8
DocuSign Envelope ID: C41 FF825-A242-4CDE-81 F1-7A2F97D3EC59
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 constmed as an admission by the United States or the
Secretary of Health and Human Services that a vaccine caused petitioner's alleged left shoulder
injury, or any other injury or condition.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
5

Case 1:19-vv-01554-UNJ Document 43 Filed 01/20/22 Page 8 of 8
DocuSign Envelope ID: C41FF825-A242-4CDE-81F1-7A2F9703EC59
Respectfully submitted,
PETITIONER:
DocuSlgned by: J
I/.-'
,))Al--4-A,~-------
ZAHRA LEISI ZARNAGH
ATTORNEY OF RECORD FOR AUTHORIZED REPRSENTATIVE
OF THE ATTORNEY GENERAL:
PE/~
/ ~
~~\ti)~
L!J:Ss
A A. OLINS HEATHER L. PEARLMAN
Ma o Christopher & Toale, PA Deputy Director
17 5 Pennsylvania Avenue, NW Torts Branch
S ite 225 Civil Division
Washington, D.C. 20006 U.S. Department of Justice
Tel: (888) 952-5242 P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
[;)~ ~ I Pr1/S~I Al'M, ~ ~
TAMARA OVERBY COLLEEN C. HARTLEY
Acting Director, Division of Injury Trial Attorney
Compensation Programs Tmts 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 Human Services Washington, DC 20044-0146
5600 Fishers Lane, 08Nl46B Tel: 202-616-3644
Rockville, MD 20857 Email: colleen.hartley@usdoj.gov
)z.o-z.
Dated: Iv 2-1 J
6