VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00538
Package ID: USCOURTS-cofc-1_20-vv-00538
Petitioner: David Dubriske
Filed: 2022-01-27
Decided: 2022-03-03
Vaccine: influenza
Vaccination date: 2018-09-12
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 45000

AI-assisted case summary:
David Dubriske filed a petition for compensation under the National Vaccine Injury Compensation Program on April 30, 2020, alleging that he suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of an influenza vaccine he received on September 12, 2018. Petitioner alleged that the vaccine was administered in the United States and that he suffered residual effects of the injury for more than six months, with no prior award or settlement for this condition. Respondent denied that the SIRVA onset occurred within the Table timeframe, denied that the flu vaccine caused the alleged shoulder injury or any other injury, and denied that the current disabilities were a sequela of a vaccine-related injury. Despite these disagreements, the parties filed a joint stipulation on January 25, 2022, agreeing to settle the case and award compensation. Chief Special Master Brian H. Corcoran adopted the stipulation as his decision. The stipulation awarded David Dubriske a lump sum of $45,000.00, payable to Petitioner, representing compensation for all items of damages available under Section 15(a) of the Vaccine Act. This award was a compromise of the parties' respective positions on liability and damages. Petitioner was represented by Jeffrey S. Pop of Jeffrey S. Pop & Associates, and Respondent was represented by Mallori Browne Openchowski of the U.S. Department of Justice. The decision was issued on March 3, 2022.

Theory of causation field:
Petitioner David Dubriske alleged a Shoulder Injury Related to Vaccine Administration (SIRVA) following an influenza (flu) vaccine administered on September 12, 2018. Respondent denied that the SIRVA onset occurred within the Table timeframe and denied that the flu vaccine caused the alleged shoulder injury or any other injury. The parties reached a joint stipulation to settle the case. Chief Special Master Brian H. Corcoran adopted the stipulation, awarding Petitioner a lump sum of $45,000.00 for all items of damages. The public decision does not describe the specific medical experts, clinical details of the injury onset, symptoms, diagnostic tests, or treatments. The theory of causation is based on the Vaccine Injury Table for SIRVA. Petitioner was represented by Jeffrey S. Pop, and Respondent was represented by Mallori Browne Openchowski. The decision date was March 3, 2022.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00538-0
Date issued/filed: 2022-03-03
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 01/27/2022) regarding 34 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00538-UNJ Document 43 Filed 03/03/22 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0538V
UNPUBLISHED
DAVID DUBRISKE, Chief Special Master Corcoran
Petitioner, Filed: January 27, 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.
Mallori Browne Openchowski, U.S. Department of Justice, Washington, DC, for
Respondent.
DECISION ON JOINT STIPULATION1
On April 30, 2020, David Dubriske 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 he suffered a Table injury – a Shoulder Injury
Related to Vaccine Administration (“SIRVA”) – as a result of an influenza (“flu”)
vaccination on September 12, 2018. Petition at 1; Stipulation, filed at January 25, 2022,
¶¶ 1-2, 4. Petitioner further alleges the vaccine was administered within the United States,
that he suffered the residual effects of his injury for more than six months, and that there
has been no prior award or settlement of a civil action on his behalf as a result of his
injury. Stipulation at ¶¶ 3-5; see Petition at ¶¶ 30, 33. “Respondent denies that [P]etitioner
suffered the onset of his alleged SIRVA within the Table timeframe; denies that the flu
vaccine caused [P]etitioner’s alleged shoulder injury or any other injury and further denies
that his current disabilities are a sequelae 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-00538-UNJ Document 43 Filed 03/03/22 Page 2 of 7
Nevertheless, on January 25, 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 $45,000.00 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-00538-UNJ Document 43 Filed 03/03/22 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DA YID DUBRISKE,
Petitioner, No. 20-538V
Chief Special Master Corcoran
v. SPU
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Res ondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Petitioner, David Dubriske, filed a petition forvaccine compensation underthe National
Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to 34 (the "Vaccine Program"). The
petition seeks compensation for injuries allegedly related to petitioner's receipt of the influenza
("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the "Table"), 42 C.F.R. §
100.3 (a).
2. Petitioner received a flu vaccine on or about September 12,201 8.
3. The vaccine was administered within the United States.
4. Petitioner alleges that he suffered a Shoulder Injury Related to Vaccine Administration
("SJRV A") as a consequence oft he flu immunization he received on or about September 12, 2018,
and further alleges that he suffered the residual effects of this injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on his behalf as a result of his condition.
Page 1 of 5

Case 1:20-vv-00538-UNJ Document 43 Filed 03/03/22 Page 4 of 7
6. Respondent denies that petitioner suffered the onset of his alleged SIRVA within the
Table timeframe; denies that the flu vaccine caused petitioner's alleged shoulder injury or any
other injury and further denies that his current disabilities are a sequela of a vaccine-related injucy.
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 ofj udgment reflecting a decision consistent w.ilh
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-2l(a}(l}, the Secretary of Health and Human Services will issue the
following vaccine compensation payment:
A lump sum of $45,000.00, in the form of a check payable to petitioner,
representing 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 ofj udgment on entitlement in this case, and airer
petitioner has filed both a proper and timely election to receive compensation pursuant to 42 U. S.C.
§ 300aa-2 l (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.
I 0. Petitioner and his attorney represent that they have identified to respondent all known
sources of payment for items or services for which the Program is not primarily liable under 42
U.S.C. § 300aa-l 5(g), including State compensation programs, insurance policies, Federal or State
health benefitsprograms(otherthan Title XIX ofthe Social Security Act (42 U.S.C. § 1396et
seq.)), or entities that provide health services on a prepaid basis.
Page 2of5

Case 1:20-vv-00538-UNJ Document 43 Filed 03/03/22 Page 5 of 7
11. Payment made pursuant to paragraph 8 of this Stipulation and any amounts awarded
pursuant to paragraph 9 will be made in accordance with 42 U.S.C. § 300aa-15(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 attorney's fees and litigation costs, the money provided pursuanttothis Stipulation will be used
solely for the benefit of petitioner 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 his individual
capacity, and on behalfofhisheirs, executors, administrators, successors, and 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 United
States Court of Federal Claims, under the National Vaccine Injury Compensation Program, 42
U.S.C. § 300aa-l Oe t seq., on account of, or in any way growing out of, any and a11 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 or about September 12, 2018,
as alleged by petitioner in a petition for vaccine compensation filed on or about April 30, 2020 in
the United States Court of Federal Claims as petition No. 20-538V.
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 tenns of
this Stipulation or if the United States Court of Federal Claims fails to enter judgment in
Page 3 of 5

Case 1:20-vv-00538-UNJ Document 43 Filed 03/03/22 Page 6 of 7
conformity with a decision that is in complete confonnity 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 do any act or thing other than is herein expressly stated and
clearly agreed to. The pa11ies 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 shoulder
injury or any other injury or any of his current disabilities.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
Page 4 of 5

Case 1:20-vv-00538-UNJ Document 43 Filed 03/03/22 Page 7 of 7
Respectfully submitted,
PETITIONER:
DAVID DUBRISKE
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
~cY:NA\LQ~-
J~ HEA THER L. PEARLMAN
JEFFREY S. POP & ASSOCIATES Deputy Director
9150 Wilshire Blvd. Torts Branch
Suite 241 Civil Division
Beverly Hills, CA 90212 U.S. Department of Justice
(310) 273-5462 P. 0. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
AUTHORIZED REPRESENTATIVE OF ATTORNEY OF RECORD FOR
THE SECRETARY OF HEALTH AND RESPONDENT:
HUMAN SERVICES:
H.~ 8 ~~ ~
z:;~ z:;~Sc-, MS, A/JM,fa1,, ~ ~ ~~
~I
CDR GEORGE REED GRIMES, MD, MPif' MALLORI B. OPENCHOWSKI
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch, Civil Division
Health Systems Bureau U.S. Department of Justice
Health Resources and Services P.O. Box 146
Administration Benjamin Franklin Station
U.S. Department of Health Washington, D.C. 20044-0146
and Human Services Tel: (202) 305-0660
5600 Fishers Lane, 08N l 46B mallori.b.openchowski@usdoj.gov
Rockville, MD 20857
li.sf'lDLZ.
Dated: 01
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