VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00430
Package ID: USCOURTS-cofc-1_20-vv-00430
Petitioner: Jacalyn Broze
Filed: 2021-11-15
Decided: 2022-03-21
Vaccine: influenza
Vaccination date: 2017-10-23
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 102266

AI-assisted case summary:
Jacalyn Broze filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) from an influenza vaccine received on October 23, 2017. She stated her injury effects lasted more than six months. Respondent filed a Rule 4(c) report conceding entitlement, noting that Ms. Broze had no prior shoulder pain history, her pain began within 48 hours and was limited to the vaccinated shoulder, and she had no other condition explaining the pain. Respondent agreed that she met the Table requirements for SIRVA and that she met the other program requirements. Based on this concession, the Chief Special Master issued a ruling on entitlement. Subsequently, the parties filed a proffer on award of compensation. Respondent proffered an award of $102,266.93, which included $90,000.00 for pain and suffering, $5,158.84 for lost wages, and $7,108.09 for unreimbursed medical expenses. Ms. Broze, an adult, agreed with this proffered award. The Chief Special Master accepted the proffer and awarded Ms. Broze the lump sum of $102,266.93.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00430-0
Date issued/filed: 2021-12-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/15/2021) regarding 37 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00430-UNJ Document 40 Filed 12/15/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0430V
UNPUBLISHED
JACALYN BROZE, Chief Special Master Corcoran
Petitioner, Filed: November 15, 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)
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
Mark Kim Hellie, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On April 14, 2020, Jacalyn Broze 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 due to an influenza vaccine she received on October 23, 2017. Petition at
¶¶2. Petitioner further alleges that the effects of her injury continued for more than six
months and that she has not received any award or settlement related to her injury.
Petition at ¶¶ 21-22. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
On November 12, 2021, Respondent filed his Rule 4(c) report in which he states
that he does not contest that Petitioner is entitled to compensation in this case.
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 section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:20-vv-00430-UNJ Document 40 Filed 12/15/21 Page 2 of 2
Respondent’s Rule 4(c) Report at 1. Specifically, Respondent states that “Petitioner did
not have a history of shoulder pain. Petitioner’s right shoulder pain began within 48 hours
and was limited to the vaccinated shoulder. Petitioner did not have any other condition or
abnormality that would explain her right shoulder pain. Therefore, Petitioner has satisfied
the requirements contained in the Table for SIRVA.” Id. at 5. Respondent further agrees
that Petitioner received the vaccine in the United States, suffered the residual effects of
the injury for more than six months, and has not filed a civil action or received an award
or settlement for her vaccine injury. 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_20-vv-00430-1
Date issued/filed: 2022-03-21
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 02/18/2022) regarding 44 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00430-UNJ Document 48 Filed 03/21/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0430V
UNPUBLISHED
JACALYN BROZE, Chief Special Master Corcoran
Petitioner, Filed: February 18, 2022
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)
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
Mark Kim Hellie, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On April 14, 2020, Jacalyn Broze 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”) as a result of an influenza (“flu”) vaccination she received on
October 23, 2017. Petition at 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On November 15, 2021, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for her Table SIRVA. On February 18, 2022, Respondent filed
a proffer on award of compensation (“Proffer”) indicating Petitioner should be awarded
$102,266.93, representing $90,000.00 in pain and suffering, $5,158.84 in lost wages, and
$7,108.09 in unreimbursed out-of-pocket expenses. Proffer at 1. In the Proffer,
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-00430-UNJ Document 48 Filed 03/21/22 Page 2 of 5
Respondent represented that Petitioner agrees with the proffered award. Id. at 2. 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 $102,266.93 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 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-00430-UNJ Document 48 Filed 03/21/22 Page 3 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
JACALYN BROZE,
Petitioner,
Case No. 20-430V (ECF)
v. CHIEF SPECIAL MASTER
CORCORAN
SECRETARY OF HEALTH
AND HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Procedural History
On November 12, 2021, respondent filed a Vaccine Rule 4(c) report concluding
that Jacalyn Broze (“petitioner”) suffered an injury that is compensable under the
National Childhood Vaccine Injury Act of 1986, as amended, 42 U.S.C. §§ 300aa-10 to -
34 (“the Act”). Accordingly, on November 15, 2021, the Chief Special Master issued a
Ruling on Entitlement, finding that petitioner was entitled to compensation under the Act.
II. Items of Compensation and Form of the Award
Based upon the evidence of record, respondent proffers that petitioner should be
awarded $102,266.93. The award is comprised of the following: $90,000.00 for pain and
suffering, $5,158.84 in lost wages, and $7,108.09 for unreimbursed, out-of-pocket
medical expenses. This amount represents all elements of compensation to which

Case 1:20-vv-00430-UNJ Document 48 Filed 03/21/22 Page 4 of 5
petitioner would be entitled under 42 U.S.C. § 300aa-15(a) regarding her October 23,
2017, influenza vaccination. Petitioner agrees.1
III. Form of the Award
The parties recommend that compensation provided to petitioner should be made
through a lump sum payment of $102,266.93, in the form of a check payable to
petitioner. Petitioner agrees.
Petitioner is a competent adult. Evidence of guardianship is not required in this
case.
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy 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
1 Should petitioner die prior to entry of judgment, the parties reserve the right to move
the Court for appropriate relief. In particular, respondent would oppose any award for
future medical expenses, future lost earnings, and future pain and suffering.
2

Case 1:20-vv-00430-UNJ Document 48 Filed 03/21/22 Page 5 of 5
s/ Mark K. Hellie
MARK K. HELLIE
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Benjamin Franklin Station
Washington, D.C. 20044-0146
T: (202) 616-4208
E: mark.hellie@usdoj.gov
DATED: February 18, 2022
3