VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01639
Package ID: USCOURTS-cofc-1_19-vv-01639
Petitioner: Debra Rose
Filed: 2021-02-09
Decided: 2021-10-28
Vaccine: influenza
Vaccination date: 2018-11-11
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 162445

AI-assisted case summary:
Debra Rose filed a petition for compensation under the National Vaccine Injury Compensation Program alleging that an influenza vaccine administered on November 11, 2018, caused a left shoulder injury related to vaccine administration (SIRVA). The respondent conceded that the injury was consistent with SIRVA and met the requirements of a Table injury claim. The respondent also stated that no other causes for the injury were identified and that the sequelae lasted for more than six months, satisfying the legal prerequisites for compensation. Based on the respondent's concession and the evidence, entitlement to compensation was granted on February 9, 2021. Subsequently, on September 28, 2021, the parties submitted a proffer for an award of compensation. The respondent proposed, and the petitioner agreed, to a lump sum payment of $162,445.95. This amount was intended to cover past pain and suffering ($140,000.00), past loss of earnings ($11,072.40), and past unreimbursed expenses ($11,373.55). The Chief Special Master issued a decision awarding this amount on October 28, 2021, concluding the case.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_19-vv-01639-0
Date issued/filed: 2021-03-11
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 02/09/2021) regarding 26 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-01639-UNJ Document 28 Filed 03/11/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1639V
UNPUBLISHED
DEBRA ROSE, Chief Special Master Corcoran
Petitioner, Filed: February 9, 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)
Bobbie L. Flynt, Crandall & Pera Law, LLC, Chagrin Falls, OH, for petitioner.
Darryl R. Wishard, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On October 22, 2019, Debra Rose 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”) as a result of an influenza (“flu”) vaccine administered on
November 11, 2018. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On February 8, 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’s alleged injury is consistent with
SIRVA of the left arm and that it meets the requirements of a Table injury claim for SIRVA
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-01639-UNJ Document 28 Filed 03/11/21 Page 2 of 2
stemming from the flu vaccination on November 11, 2018.” Id. at 4. Respondent further
states that he “did not identify any other causes for petitioner’s left arm injury, and records
show that she suffered the sequela of this injury for more than six months . . . . Therefore,
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-01639-1
Date issued/filed: 2021-10-28
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 09/28/2021) regarding 35 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:19-vv-01639-UNJ Document 40 Filed 10/28/21 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 19-1639V
UNPUBLISHED
DEBRA ROSE, Chief Special Master Corcoran
Petitioner, Filed: September 28, 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)
Bobbie L. Flynt, Crandall & Pera Law, LLC, Chagrin Falls, OH, for Petitioner.
Darryl R. Wishard, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On October 22, 2019, Debra Rose 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”) as a result of an influenza vaccine administered on November
11, 2018. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On February 9, 2021, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On September 28, 2021, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $162,445.95. Proffer
at 1-2. In the Proffer, Respondent represented that Petitioner agrees with the proffered
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-01639-UNJ Document 40 Filed 10/28/21 Page 2 of 4
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 $162,445.95 (consisting of $140,000.00 for past pain and suffering,
$11,072.40 for past loss of earnings, and $11,373.55 for past unreimbursed
expenses) in the form of a check payable to Petitioner. This amount represents
compensation for all damages that would be available under Section 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-01639-UNJ Document 40 Filed 10/28/21 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
DEBRA ROSE, )
)
Petitioner, ) No. 19-1639V ECF
)
v. ) Chief Special Master Corcoran
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
___________________________________ )
PROFFER ON AWARD OF COMPENSATION1
I. Procedural History
On October 22, 2019, Debra Rose (“petitioner”) file a petition alleging that an influenza
(“flu”) vaccination that she received in her left arm on November 11, 2018, caused a shoulder
injury related to vaccine administration (“SIRVA”). See Petition. On February 8, 2021,
respondent filed his Vaccine Rule 4(c) report, conceding a Table injury for SIRVA. ECF No. 25.
On February 9, 2021, Chief Special Master Corcoran issued a ruling on entitlement, finding that
petitioner was entitled to compensation for SIRVA. ECF No. 26.
II. Items of Compensation
Based upon the evidence, respondent proffers that petitioner should be awarded a lump
sum of $162,445.95, consisting of $140,000.00 for past pain and suffering, $11,072.40 for past
loss of earnings, and $11,373.55 for past unreimbursed expenses. This amount represents all
elements of compensation to which petitioner is entitled under 42 U.S.C. § 300aa-15(a).
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to
address after the Damages Decision is issued.

Case 1:19-vv-01639-UNJ Document 40 Filed 10/28/21 Page 4 of 4
Petitioner agrees.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
III. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $162,445.95, in the form of a check payable to petitioner.2
Petitioner agrees.
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
LARA A. ENGLUND
Assistant Director
Torts Branch, Civil Division
/s/Darryl R. Wishard
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
U. S. Department of Justice
P.O. Box l46, Benjamin Franklin Station
Washington, D.C. 20044-0146
Direct dial: (202) 616-4357
Dated: September 28, 2021 Fax: (202) 616-4310
darryl.wishard@usdoj.gov
2 Should petitioner die prior to entry of judgment, respondent would oppose any award
for future medical expenses, future lost earnings, and future pain and suffering, and the parties
reserve the right to move the Court for appropriate relief.
2