VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00423
Package ID: USCOURTS-cofc-1_20-vv-00423
Petitioner: Dawn Mack
Filed: 2022-02-02
Decided: 2022-03-04
Vaccine: influenza
Vaccination date: 2018-10-15
Condition: right shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 23000

AI-assisted case summary:
Dawn Mack filed a petition for compensation under the National Vaccine Injury Compensation Program on April 13, 2020, alleging she suffered a right shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on October 15, 2018. Petitioner alleged the vaccine was administered in the United States, that she experienced residual effects of the injury for more than six months, and that there had been no prior award or settlement of a civil action for damages on her behalf. Respondent denied that Ms. Mack sustained a SIRVA Table injury, denied that the vaccine caused her alleged right shoulder injury or any other injury, and denied that her current condition was a sequela of a vaccine-related injury. Despite these differing positions, the parties reached a joint stipulation for settlement on February 1, 2022. Chief Special Master Brian H. Corcoran adopted the stipulation as his decision. Pursuant to the stipulation, Ms. Mack was awarded a lump sum of $23,000.00, payable to Petitioner, representing compensation for all items of damages available under Section 15(a) of the Vaccine Act. The decision was issued on March 4, 2022. Petitioner was represented by Leah VaSahnja Durant of the Law Offices of Leah V. Durant, PLLC. Respondent was represented by Alexa Roggenkamp, an attorney with the U.S. Department of Justice.

Theory of causation field:
Petitioner Dawn Mack alleged a right shoulder injury related to vaccine administration (SIRVA) following an influenza vaccine received on October 15, 2018. The injury was alleged to have occurred within the Table timeframe and resulted in residual effects lasting more than six months. Respondent denied a SIRVA Table injury and causation. The parties reached a joint stipulation for settlement, agreeing to an award of $23,000.00 for all damages under 42 U.S.C. § 300aa-15(a). The stipulation, adopted by Chief Special Master Brian H. Corcoran on March 4, 2022, does not detail the specific mechanism of injury or name any medical experts. The public text does not describe the onset, specific symptoms, diagnostic tests, or treatments for Ms. Mack's condition. The theory of causation is based on the "Table" category for SIRVA, though respondent denied this classification. Petitioner was represented by Leah VaSahnja Durant, and respondent by Alexa Roggenkamp.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00423-0
Date issued/filed: 2022-03-04
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 02/02/2022) regarding 30 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00423-UNJ Document 34 Filed 03/04/22 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0423V
UNPUBLISHED
DAWN MACK, Chief Special Master Corcoran
Petitioner, Filed: February 2, 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)
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On April 13, 2020, Dawn Mack 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 right shoulder injuries related to vaccine
administration (“SIRVA”) as a result of an influenza vaccine received on October 15,
2018. Petition at 1; Stipulation, filed February 1, 2022, at ¶¶ 2-4. Petitioner further alleges
the vaccine was administered in the United States, she suffered the residual effects of
her injury for more than six months, and there has been no prior award or settlement of a
civil action for damages on her behalf as a result of her condition. Petition at ¶¶ 1, 10-11;
Stipulation at ¶¶ 3-5. “Respondent denies that petitioner sustained a SIRVA Table injury;
denies that the vaccine caused petitioner’s alleged right shoulder injury, or any other
injury, and denies that her 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-00423-UNJ Document 34 Filed 03/04/22 Page 2 of 7
Nevertheless, on February 1, 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 the following
compensation:
A lump sum of $23,000.00 in the form of a check payable to Petitioner.
Stipulation at ¶ 8. 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-00423-UNJ Document 34 Filed 03/04/22 Page 3 of 7
IN THE UNITED ST ATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DAWN MACK,
Petitioner, No. 20-423V
Chief Special Master Corcoran
V. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
I. Dawn Mack, petitioner, filed a petition for vaccine compensation under the National
Vaccine Injury Compensation Program, 42 U.S.C. §§ 300aa-lO to -34 (the "Vaccine Program").
The petition seeks compensation for injuries allegedly related to petitioner's receipt of an
influenza ("flu") vaccine, which is a vaccine contained in the Vaccine Injury Table (the "Table"),
42 C.F.R. § 100.3 (a).
2. Petitioner received the influenza vaccine on October 15, 2018.
3. The vaccination was administered within the United States.
4. Petitioner alleges that she sustained a right shoulder injury related to vaccination
administration ("SIRVA") within the time period set forth in the Table following administration
of the flu vaccine, or in the alternative, that her alleged shoulder injury was caused by the
vaccine. She further alleges that she experienced the residual effects of this alleged injury for
more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action

Case 1:20-vv-00423-UNJ Document 34 Filed 03/04/22 Page 4 of 7
for damages on her behalf as a result of her condition.
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
vaccine caused petitioner's alleged right shoulder injury, or any other injury, and denies that her
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-21(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $23,000.00 in the form of a check payable to petitioner. This
amount represents compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
9. As soon as practicable after the entry ofj udgment 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 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-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 (42 U.S.C.
2

Case 1:20-vv-00423-UNJ Document 34 Filed 03/04/22 Page 5 of 7
§ 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 unreimbursed expenses, the money provided
pursuant to this Stipulation will be used solely for the benefit of petitioner as contemplated by a
strict construction of42 U.S.C. § 300aa-15(a) and (d), and subject to the conditions of 42 U.S.C.
§ 300aa-l 5(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual 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 administered on October I 5, 2018, as
alleged by petitioner in a petition for vaccine compensation filed on or about April 13, 2020, in
the United States Court of Federal Claims as petition No. 20-423V.
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.
3

Case 1:20-vv-00423-UNJ Document 34 Filed 03/04/22 Page 6 of 7
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
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 Services that the flu vaccine caused petitioner's alleged injury,
or any other injury or her current condition, or that petitioner suffered an injury contained in the
Vaccine Injury Table.
18. A II rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:20-vv-00423-UNJ Document 34 Filed 03/04/22 Page 7 of 7
Respectfully submitted,
PETITIONER:
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ATTORNEYOFRECORD AUTHORIZED REPRESENTATIVE
FOR PETITIONER: OF THE ATTORNEY GENERAL:
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L~ ~ESQ. HEATHER L. PEARLMAN
LAW OFFICES OF LEAH V. DURANT. Deputy Director
PLLC Torts Branch
1717 K Street NW. Suite 900 Civil Division
Washington. DC 20006 U.S. Department of Justice
202-775-9200 P.O.Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRET ARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
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CDR GEORGE REED GRIMES, MD, MPH ALEXA ROGGENK.AMP
Director. Divi5ion of Injury Trial Attorney
Compensation Programs Torts Branch
Healthcare System Bureau Civil Division
Health Resources and Services U.S. Department of Justice
A~tration P.O. Box 146
U.S. Department of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 F~hers Lane, 08N 146B 202-616-4179
Rockville, MD 20857 alexa.roggenkamp@usdoj.gov
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