VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01622
Package ID: USCOURTS-cofc-1_19-vv-01622
Petitioner: Donna R. Rands
Filed: 2019-10-17
Decided: 2021-07-28
Vaccine: influenza
Vaccination date: 2018-09-24
Condition: right shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 55000

AI-assisted case summary:
Donna R. Rands filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a right shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine administered on September 24, 2018. The respondent conceded that Ms. Rands satisfied the criteria for a Table injury, noting she had no prior shoulder issues, her pain and reduced range of motion occurred within 48 hours of the vaccination, and her symptoms were limited to the injection site. Based on the respondent's concession and the evidence, the court issued a ruling on entitlement, finding Ms. Rands entitled to compensation. Subsequently, the parties reached a proffer agreement for damages. The court awarded Ms. Rands a lump sum payment of $55,000.00 for actual pain and suffering. The petition was filed on October 17, 2019, and the final decision awarding damages was issued on July 28, 2021.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-01622-0
Date issued/filed: 2021-04-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/16/2021) regarding 25 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-01622-UNJ Document 27 Filed 04/15/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1622V
UNPUBLISHED
DONNA R. RANDS, Chief Special Master Corcoran
Petitioner, Filed: March 16, 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)
Kelly Danielle Burdette, Burdette Law, PLLC, North Bend, WA, for petitioner.
Kimberly Shubert Davey, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On October 17, 2019, Donna R. Rands 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 right shoulder injury related to
vaccine administration (“SIRVA”) as a result of an influenza vaccine administered on
September 24, 2018. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On March 12, 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. Specifically, Respondent agrees that “petitioner has satisfied the criteria set forth in the
Vaccine Injury Table (Table) and the Qualifications and Aids to Interpretation (QAI):
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-01622-UNJ Document 27 Filed 04/15/21 Page 2 of 2
petitioner has no history of pain, inflammation or dysfunction in her left shoulder; her pain
and reduced range of motion occurred within 48 hours of receipt of an intramuscular
vaccination; her symptoms 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 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-01622-1
Date issued/filed: 2021-07-28
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 06/25/2021) regarding 29 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-01622-UNJ Document 33 Filed 07/28/21 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1622V
UNPUBLISHED
DONNA R. RANDS, Chief Special Master Corcoran
Petitioner, Filed: June 25, 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)
Kelly Danielle Burdette, Burdette Law, PLLC, North Bend, WA, for Petitioner.
Kimberly Shubert Davey, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On October 17, 2019, Donna R. Rands 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 right shoulder injury related to
vaccine administration (“SIRVA”) as a result of an influenza vaccine administered on
September 24, 2018. Petition at 1. Petitioner further alleges that she suffered the residual
effects of her injury for more than six months. Petition at 3. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
On March 16, 2021, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On June 24, 2021, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $55,000.00 in actual
pain and suffering. Proffer at 1. In the Proffer, Respondent represented that Petitioner
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-01622-UNJ Document 33 Filed 07/28/21 Page 2 of 4
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 $55,000.00 (in actual pain and suffering), 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-01622-UNJ Document 33 Filed 07/28/21 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
DONNA R. RANDS, )
)
Petitioner, )
) No. 19-1622V (ECF)
v. ) Chief Special Master Corcoran
)
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On October 17, 2019, Donna R. Rands (petitioner) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986, as amended (“the Vaccine Act” or
“the Act”), 42 U.S.C. §§ 300aa-1 to -34. Petitioner alleged that she suffered a Shoulder Injury
Related to Vaccine Administration (“SIRVA”) as a result of an influenza (“flu”) vaccine
administered to her on September 24, 2018. Petition at 1. On March 12, 2021, the Secretary of
Health and Human Services (“respondent”) filed a Rule 4(c) Report recommending that
compensation be awarded, and the Chief Special Master issued a Ruling on Entitlement finding
petitioner entitled to compensation on March 16, 2021. ECF No. 23; ECF No. 25.
Items of Compensation
Pain and Suffering
Respondent proffers that petitioner should be awarded $55,000.00 in actual pain and
suffering. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:19-vv-01622-UNJ Document 33 Filed 07/28/21 Page 4 of 4
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 following: a lump sum payment of $55,000.00, representing
compensation for actual pain and suffering, in the form of a check payable to petitioner, Donna
R. Rands. Petitioner agrees.
Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Donna R. Rands: $ 55,000.00
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
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
/s/ Kimberly S. Davey
KIMBERLY S. DAVEY
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) 307-1815
Kimberly.Davey@usdoj.gov
DATED: June 24, 2021
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