VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00114
Package ID: USCOURTS-cofc-1_20-vv-00114
Petitioner: Teresa Washington-Jenkins
Filed: 2020-01-31
Decided: 2022-10-28
Vaccine: influenza
Vaccination date: 2017-09-18
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 40711

AI-assisted case summary:
Teresa Washington-Jenkins filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a left shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on September 18, 2017. She also alleged, in the alternative, that the vaccine caused her shoulder injury. Respondent denied that Ms. Washington-Jenkins sustained a SIRVA Table injury or that the vaccine caused her alleged shoulder injury. Despite these denials, the parties filed a joint stipulation agreeing that a decision should be entered awarding compensation. The court adopted the stipulation as its decision, awarding a total of $40,711.30. This amount included $40,000.00 as a lump sum payment to Petitioner and $711.30 to reimburse a Medicaid lien for services rendered by the State of Pennsylvania. The award represents compensation for all damages available under the Vaccine Act. The case proceeded as a Table claim, and the parties agreed to settle the issues of liability and damages.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00114-0
Date issued/filed: 2022-01-10
Pages: 7
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/07/2021) regarding 23 Findings of Fact & Conclusions of Law,, Scheduling Order, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00114-UNJ Document 25 Filed 01/10/22 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0114V
UNPUBLISHED
TERESA WASHIINGTON-JENKINS, Chief Special Master Corcoran
Petitioner, Filed: December 7, 2021
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Findings of Fact; Statutory Six Month
HUMAN SERVICES, Requirement Influenza (Flu)
Vaccine; Shoulder Injury Related to
Respondent. Vaccine Administration (SIRVA)
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Naseem Kourosh, U.S. Department of Justice, Washington, DC, for Respondent.
FINDINGS OF FACT1
On January 31, 2020, Teresa Washington-Jenkins 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 alleged that she suffered a left shoulder injury related to
vaccine administration (“SIRVA”), a defined Table Injury, after receiving the influenza
(“flu”) vaccine on September 18, 2017. Petition at 1, ¶ 5. In the alternative, Petitioner
alleged that her left shoulder injury was caused-in-fact by the flu vaccine she received.
Id. at 1. The case was assigned to the Special Processing Unit of the Office of Special
Masters (the “SPU”).
1 Because this unpublished Fact 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 Fact 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 Section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:20-vv-00114-UNJ Document 25 Filed 01/10/22 Page 2 of 7
For the reasons discussed below, I find Petitioner suffered the residual effects of
her alleged SIRVA for more than six months.
I. Relevant Procedural History
Within a month of initiating the case, Petitioner filed the medical records required
under the Vaccine Act. Exhibits 1-8, filed Feb. 13, 2020, ECF No. 6; see Section 11(c).
On April 26, 2021, Respondent indicated that he intended to oppose compensation in this
case. ECF No. 18. Two months later, he filed his Rule 4(c) Report setting out his
objections to compensation. ECF No. 20. In it, he specifically maintained the six-month
severity requirement could not be met. Rule 4(c) Report at 6, filed June 28, 2021. Citing
a five-month gap in treatment - from late December 2017 until mid-June 2018 - and
arguing that the left shoulder pain Petitioner experienced in June 2018 was due to a new
injury, Respondent maintained that “the evidence in this case establishes that
[P]etitioner’s alleged injury lasted for less than four months.” Id. at 6-7.
Petitioner maintains she can establish severity. Petitioner’s Brief Regarding the
Vaccine Ac’s Severity Requirement (“Pet. Brief”), filed Sept. 14, 2021, at 20, ECF No. 22.
Specifically, she stresses that she continued to attribute the onset of her left shoulder pain
to the flu vaccine she received during appointments more than six months post-
vaccination. She also maintains the medical record does not establish that she recovered
from her SIRVA, only to reinjure her shoulder in a different manner. Id. Along with her
brief, Petitioner filed a supplemental affidavit, affidavits from her son, two daughters, and
friend, and a copy of an October 9, 2017 text message she sent to one of her daughters
regarding her left shoulder pain. Exhibits 10-15, filed Sept. 14, 2021, ECF No. 21.
The matter is now ripe for adjudication.
II. Issue
At issue is whether Petitioner continued to suffer the residual effects of the alleged
SIRVA for more than six months. Section 11(c)(1)(D)(i) (statutory six-month requirement).
III. Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Section 11(c)(1).
A special master must consider, but is not bound by, any diagnosis, conclusion, judgment,
test result, report, or summary concerning the nature, causation, and aggravation of
2

Case 1:20-vv-00114-UNJ Document 25 Filed 01/10/22 Page 3 of 7
petitioner’s injury or illness that is contained in a medical record. Section 13(b)(1).
“Medical records, in general, warrant consideration as trustworthy evidence. The records
contain information supplied to or by health professionals to facilitate diagnosis and
treatment of medical conditions. With proper treatment hanging in the balance, accuracy
has an extra premium. These records are also generally contemporaneous to the medical
events.” Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525, 1528 (Fed. Cir.
1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Human Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, at *19. And the Federal Circuit recently “reject[ed] as
incorrect the presumption that medical records are accurate and complete as to all the
patient’s physical conditions.” Kirby v. Sec’y of Health & Human Servs., 997 F.3d 1378,
1383 (Fed. Cir. 2021).
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Human Servs., 42 Fed.
Cl. 381, 391 (1998). The Court later outlined four possible explanations for
inconsistencies between contemporaneously created medical records and later
testimony: (1) a person’s failure to recount to the medical professional everything that
happened during the relevant time period; (2) the medical professional’s failure to
document everything reported to her or him; (3) a person’s faulty recollection of the events
when presenting testimony; or (4) a person’s purposeful recounting of symptoms that did
not exist. La Londe v. Sec’y of Health & Human Servs., 110 Fed. Cl. 184, 203-04 (2013),
aff’d, 746 F.3d 1335 (Fed. Cir. 2014).
Medical records may be outweighed by testimony that is given later in time that is
“consistent, clear, cogent, and compelling.” Camery, 42 Fed. Cl. at 391 (citing Blutstein
v. Sec’y of Health & Human Servs., No. 90-2808, 1998 WL 408611, at *5 (Fed. Cl. Spec.
Mstr. June 30, 1998). The credibility of the individual offering such testimony must also
be determined. Andreu v. Sec’y of Health & Human Servs., 569 F.3d 1367, 1379 (Fed.
Cir. 2009); Bradley v. Sec’y of Health & Human Servs., 991 F.2d 1570, 1575 (Fed. Cir.
1993).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
3

Case 1:20-vv-00114-UNJ Document 25 Filed 01/10/22 Page 4 of 7
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La
Londe, 110 Fed. Cl. at 204 (citing Section 12(d)(3); Vaccine Rule 8); see also Burns v.
Sec’y of Health & Human Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within
the special master’s discretion to determine whether to afford greater weight to medical
records or to other evidence, such as oral testimony surrounding the events in question
that was given at a later date, provided that such determination is rational).
IV. Finding of Fact
I make this fact finding after a complete review of the record, including all medical
records, affidavits, testimony, expert reports, Respondent’s Rule 4 Report, and additional
evidence filed. Specifically, I determine the following:
• On September 18, 2017, Petitioner was seen by her primary care provider
(“PCP”) for lower back and left leg pain, specifically she reported
experiencing pain in the back of her left thigh which travel down her calf into
her foot. Exhibit 3 at 100, 104. Petitioner received the influenza vaccine
alleged as causal in her left deltoid during this visit. Id. at 100; see also
Exhibit 2.
• To treat her lower back and leg pain, Petitioner attended five physical
therapy (“PT”) sessions during late September through early November
2017. Exhibit 4 at 60-101. At her second PT session on October 11, 2017,
Petitioner reported “left shoulder pain since getting the flu shot a couple of
weeks ago.” Id. at 63. She added that she was going to the doctor for this
pain. Id.
• In the records from initial PT sessions on September 28 and October 11,
2017, it was noted that Petitioner’s blood pressure was measured at her left
wrist, presumably to avoid exacerbating her left shoulder pain. Exhibit 4 at
63, 67, 70, 74. This notation was not included in the records from PT
sessions beginning on October 19 and 24, 2017. Id. at 80, 82, 87.
• The same day she mentioned her left shoulder pain to her physical
therapist, Petitioner was seen by a physician’s assistant at her PCP clinic.
4

Case 1:20-vv-00114-UNJ Document 25 Filed 01/10/22 Page 5 of 7
Exhibit 3 at 108-15. She reported left arm pain after receiving the flu vaccine
in September 2017, which caused her difficulty when lifting her arm. Id. at
112. The physician assistant opined Petitioner’s pain was related to her
cervical radiculopathy and instructed Petitioner to apply heat, stretch, and
ensure her posture was correct. Petitioner declined pain medication,
steroids, and muscle relaxers. Id. at 114.
• When seen for a check of her diabetes on December 28, 2017, Petitioner
again complained of left shoulder pain since receiving the flu vaccine in
September 2017, noting that it hurt to move her arm. Exhibit 3 at 116, 121.
Observing non-specific discomfort upon palpitation, mildly decreased range
of motion (“ROM”), and normal strength, Petitioner’s PCP prescribed home
exercises for her left shoulder pain. Id. at 122-23.
• In early 2018, Petitioner sought medical treatment on February 15, 2018,
from an urgent care clinic for pink eye and on March 29, 2018, from her
PCP for a rash on her hands. Exhibit 6 at 28; Exhibit 3 at 126 (respectively).
There is no mention of left shoulder pain in the records from these two visits.
Exhibit 6 at 24-31; Exhibit 3 at 126-34.
• In her affidavit, Petitioner admitted that she did not mention her left shoulder
pain during the February 2018 appointment at the urgent care clinic, but
maintains that she reported continued left shoulder pain when seen by her
PCP in late March 2018. Exhibit 10 at ¶¶ 6-7. She posited that this was not
included in the medical record from that visit because her PCP did not
address the complaint, adding that she felt her complaint was not being
taken seriously. Id. at ¶ 7.
• On June 18, 2018, more than nine months post-vaccination, Petitioner
visited her PCP for a diabetes check and left shoulder pain and decreased
ROM - present since receiving the flu shot but recently worsening after
pulling a suitcase while traveling. Exhibit 3 at 135. Although she previously
refused PT - opting instead for a home exercise program which she
indicated had helped, Petitioner stated that she now was willing to attend
PT. Id. at 135, 140. Petitioner reported that she started taking Fosamax
along with a calcium supplement, and had increased her vitamin D
supplement after experiencing left arm pain since her flu shot. She added
that she had been “lifting a lot” prior to the appointment. Id. at 141. Her PCP
diagnosed Petitioner with rotator cuff strain which had been unresponsive
to home exercises and prescribed PT. Id. at 143.
5

Case 1:20-vv-00114-UNJ Document 25 Filed 01/10/22 Page 6 of 7
• Petitioner insists that her “left shoulder pain never went away [and that she]
never reinjured [her] shoulder.” Exhibit 10 at ¶ 12. Petitioner’s children
echoed this assertion in their affidavits. Exhibit 11 at ¶ 12; Exhibit 13 at ¶
12; Exhibit 14 at ¶ 9.
• From late August through mid-October 2018, Petitioner attended twelve PT
sessions. Exhibit 4 at 105-75. At her initial evaluation, she reported constant
upper left arm pain since her flu vaccine with intermittent flare-ups. She
estimated the level of her pain as three out of ten. Id. at 106. The physical
therapist observed pain with palpitation over the left deltoid, weakness, and
decreased ROM. Id. at 106-07. Her DASH score was noted to be 48. Id, at
107. At her last PT session on October 15, 2018, Petitioner was noted to be
progressing well - exhibiting improved ROM and increased strength. Noted
as meeting all PT goals, Petitioner was discharge with instructions to
continue her HEP. Id. at 173.
• The medical records show Petitioner sought medical treatment from her
PCP on two occasions during January and February 2019. They do not
contain any complaints of left shoulder pain. Exhibit 7 at 9-16; Exhibit 5 at
50-61 (respectively).
The above medical entries show that Petitioner experienced relatively mild left
shoulder pain and limitations in ROM after receiving the flu vaccine on September 18,
2017. Although she experienced intermittent flare-ups and appears to have aggravated
her injury during travel and exercise in early 2018, the evidence supports Petitioner’s
assertion that she experienced this low level of pain since vaccination.
Throughout the medical records, Petitioner consistently attributed her left shoulder
pain to the flu vaccine she received. And when she reported pain after pulling a suitcase
and lifting at the gym, she clearly characterized the effects of these activities as a
worsening of already-existing pain.
Petitioner’s failure to report her left shoulder pain when seen for pink eye at an
urgent care clinic in February 2018 is understandable, given that the appointment was for
an acute condition and did not occur with her normal provider. The lack of any mention of
left shoulder pain in the record from her March 2018 visit to her PCP is a more significant
omission, but not sufficient to counter the numerous other entries supporting Petitioner’s
claims of ongoing, albeit mild, pain.
6

Case 1:20-vv-00114-UNJ Document 25 Filed 01/10/22 Page 7 of 7
Accordingly, I find there is preponderant evidence to establish Petitioner suffered
the residual effects of her injury for more than six months.
V. Scheduling Order
Given the mild nature of Petitioner’s injury, which appears to have resolved by mid-
October 2018, and the impact of the non-vaccine related activities which may have
exacerbated her condition, I do not expect a high level of compensation in this case.
Petitioner previously submitted a demand, which included an amount to satisfy the
Medicaid lien in this case, on January 20, 2021. The parties should discuss the amount
Petitioner seeks and determine their preferred next step(s) in this case.
The parties shall file a status report updating me their efforts to informally
resolve this SPU case and informing me of their preferred next step(s) by no later
than Friday, January 07, 2022.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
7

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DOCUMENT 2: USCOURTS-cofc-1_20-vv-00114-1
Date issued/filed: 2022-10-28
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 09/21/2022) regarding 38 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0114V
UNPUBLISHED
TERESA WASHINGTON-JENKINS, Chief Special Master Corcoran
Petitioner, Filed: September 21, 2022
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)
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Naseem Kourosh, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On January 31, 2020, Teresa Washington-Jenkins 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 alleged that she suffered a left shoulder injury related to
vaccine administration (“SIRVA”), a defined Table Injury, after receiving the influenza
(“flu”) vaccine on September 18, 2017. Petition at 1, ¶¶ 5, 16; Stipulation, filed Sept. 21,
2022, ¶¶ 1-2, 4. In the alternative, Petitioner alleged that her shoulder injury was caused-
in-fact by the flu vaccine. Id. “Respondent denies that [P]etitioner sustained a SIRVA
Table injury; denies that the vaccine caused [P]etitioner’s alleged shoulder injury, or any
other injury; and denies that [P]etitioner’s current condition is a sequela of a vaccine-
related 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 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 2 of 8
Nevertheless, on September 21, 2022, 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 $40,711.30 as
follows:
1. A lump sum payment of $40,000.00 in the form of a check payable to
Petitioner; and
2. A lump sum payment of $711.30, representing reimbursement of a Medicaid
lien for services rendered to Petitioner by the State of Pennsylvania
Department of Human Services, in the form of a check payable jointly to
Petitioner and the Pennsylvania Department of Human Services, and mailed
to:
Pennsylvania Department of Human Services
Bureau of Program Integrity
Attention: Elvetta E. Knox, TPL Progrma Investigator
Re: Teresa Washington
CIS#: 220315911
Incident Date: 09/18/2017
P.O. Box. 8486
Harrisburg, PA 17105.
Stipulation at ¶ 8. Petitioner agrees to endorse the check to the Pennsylvania Department
of Human Services 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 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 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 3 of 8
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
TERESA WASHINGTON-JENKINS,
Petitioner,
No. 20-114V (ECF)
V. Chief Special Master Corcoran
SECRETARY OF HEALTH
AND HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Teresa Washington-Jenkins, 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 allegedly related to
petitioner's receipt of the influenza vaccine, which vaccine is contained in the Vaccine Injury
Table (the "Table"), 42 C.F.R. § 100.3(a).
2. Petitioner received an influenza vaccine on September 18, 2017.
3. The vaccination was administered within the United States.
4. Petitioner alleges that petitioner sustained a shoulder injury related to vaccine
administration ("SIRVA") as set forth in the Table, or, in the alternative, that petitioner's alleged
shoulder injury was caused in fact by the vaccine. Petitioner further alleges that petitioner
experienced the residual effects of this condition for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on petitioner's behalf as a result of petitioner's condition.

Case 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 4 of 8
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies that
petitioner's current condition is a sequela 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-2 l (a)(I), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A. A lump sum of $40,000.00 in the form of a check payable to petitioner; and
B. A lump sum of $711.301 representing reimbursement of a Medicaid lien for
services rendered to petitioner by the State of Pennsylvania Department of Human
Services, in the form of a check payable jointly to petitioner and the Pennsylvania
Department of Human Services, to be sent to:
Pennsylvania Department of Human Services
Bureau of Program Integrity
Attention: Elvetta E. Knox, TPL Program Investigator
Re: Teresa Washington
CIS #: 220315911
Incident Date: 09/18/2017
PO Box 8486
Harrisburg, PA 171 05
Petitioner agrees to endorse this check to the Pennsylvania Department of Human
Services.
1 This amount represents full satisfaction of any right of subrogation, assignment, claim, lien, or
cause of action the State of Pennsylvania may have against any individual as a result of any
Medicaid payments the State of Pennsylvania has made to or on behalf of petitioner as a result of
petitioner's alleged injury relating to a vaccine administered on September 18, 2017, under Title
XIX of the Social Security Act, see 42 U.S.C. § 300aa-15(g), (h).
2

Case 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 5 of 8
This amount represents compensation for all damages that would be available under 42 U.S.C.
§ 300aa-l 5(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-2l(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 petitioner's 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-l 5(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
(4 2 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 of this Stipulation and any amounts awarded
pursuant to paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa
l 5(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 unreimbursable expenses, the money provided
pursuant to this Stipulation will be used solely for petitioner's benefit 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).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in petitioner's
individual capacity, and on behalf of petitioner's heirs, executors, administrators, successors or
3

Case 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 6 of 8
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 Vaccine Program, 42 U.S.C.
§ 300aa-l 0 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 influenza vaccination administered on September 18, 2017, as alleged by
petitioner in a petition for vaccine compensation filed on or about January 31, 2020, in the
United States Court of Federal Claims as petition No. 20-l 14V.
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
Stipulation may reflect a compromise of the parties' respective positions as to liability and/or
4

Case 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 7 of 8
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 construed as an admission by the United States or the
Secretary of Health and Human Service that the influenza vaccine caused petitioner's alleged
injury or any other injury or petitioner's current disabilities, or that petitioner suffered an injury
contained in the Vaccine Injury Table.
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 1:20-vv-00114-UNJ Document 42 Filed 10/28/22 Page 8 of 8
Respectfully submitted,
PETITIONER:
ATTORNEY OF RECORD AUTHOIUZED REPRESENTATIVE
FOR PETITIONER: OF THE A TTORi"i"'"EY GENER4.L:
, ,M~ ~
JEF~ HEA~ . -RL.?EARLM~ N
Jeffrey S. Pop & Associates Deputy Director
9150 WHshire Blvd., Suite 24.l Torts Branch
Beverly Hills\ CA 90212 .. 3429 Civil Division
Telephone: (888) 921-3995 U.S. Department of Justice
Eman~ jpo_p@poplawyer.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF TitE SECRETARY. OF HEAL tH RESPONDENT:
AND HUMA.t'< SERVICES:
George R. Grimes - ...
Ol9ltollyslgnedby(:gor1,J?A.
S1 4 ,, . , , 1 , • · • < c, ir ~ 1 ; r t( n l; ~ ~ ~ 0 •S ~ 1 1 ' 0 i 9, 12 t 6:23:30 -o-roo·
CDR GEORGE REED GRlMESt MD, MPH NA~
Director, Div-ision of Tnjury Trial Attorney
Compensation Programs Torts Branch
Health System[) Bureau Civil Di.vision
Health Resources and Services U,S. Department of Justice
Administration P.O. Box 146
U.S. Department of I-lea 1th Benjamin .Franklin Station
and Human Services Wesh1ngto.n, DC 20044•0146
5600 Fishers Lane, 08N 146B Telephone! (202) 305• 1159
RockviU~, MD 20857 Email: Naseem.Kaurosh@usdoj.gov