VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00649
Package ID: USCOURTS-cofc-1_20-vv-00649
Petitioner: Lacey Cupp
Filed: 2020-05-27
Decided: 2022-01-06
Vaccine: influenza
Vaccination date: 2018-10-15
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 145847

AI-assisted case summary:
Lacey Cupp filed a petition for compensation under the National Vaccine Injury Compensation Program alleging that she suffered a left shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine administered on October 15, 2018. The respondent conceded that Petitioner is entitled to compensation, agreeing that she suffered a SIRVA of the left shoulder as defined by the Vaccine Injury Table and met the statutory requirements for the condition lasting more than six months. Based on the respondent's concession and the evidence of record, the Chief Special Master issued a ruling on entitlement finding Petitioner entitled to compensation. Subsequently, the respondent filed a proffer on award of compensation, indicating that Petitioner should be awarded $145,847.93, comprised of $140,000.00 for pain and suffering and $5,847.93 for past unreimbursable expenses. Petitioner agreed with the proffered award. The Chief Special Master issued a decision awarding damages in the amount of $145,847.93 as a lump sum payment to Petitioner, representing compensation for all damages available under the Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00649-0
Date issued/filed: 2021-09-30
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/30/2021) regarding 34 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00649-UNJ Document 36 Filed 09/30/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0649V
UNPUBLISHED
LACEY CUPP, Chief Special Master Corcoran
Petitioner, Filed: August 30, 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)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Laurie Wiesner, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On May 27, 2020, Lacey Cupp 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 that was administered
on October 15, 2018. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On August 30, 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 states that “petitioner suffered a SIRVA of the left shoulder
as defined by the Vaccine Injury Table.” Id. at 5. Respondent further agrees that Petitioner
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-00649-UNJ Document 36 Filed 09/30/21 Page 2 of 2
“meets the statutory requirements by suffering the condition for more than six months.”
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-00649-1
Date issued/filed: 2022-01-06
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 12/07/2021) regarding 43 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00649-UNJ Document 47 Filed 01/06/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0649V
UNPUBLISHED
LACEY CUPP, Chief Special Master Corcoran
Petitioner, Filed: December 7, 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)
Amy A. Senerth, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Wei Kit Tai, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On May 27, 2020, Lacey Cupp 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 that was administered
on October 15, 2018. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On August 30, 2021, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On December 6, 2021, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $145,847.93
(comprised of $140,000.00 in pain and suffering and $5,847.93 in past unreimbursable
expenses). Proffer at 1-2. In the Proffer, Respondent represented that Petitioner agrees
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-00649-UNJ Document 47 Filed 01/06/22 Page 2 of 5
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 $$145,847.93 (comprised of $140,000.00 in pain and suffering and
$5,847.93 in 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 1:20-vv-00649-UNJ Document 47 Filed 01/06/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
LACEY CUPP,
)
)
Petitioner,
) No. 20-649V
v.
) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND HUMAN
)
SERVICES,
)
)
Respondent.
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On May 27, 2020, Lacey Cupp (“petitioner”) filed a petition for compensation under the
National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34 (“Vaccine Act” or
“Act”), alleging that she suffered a shoulder injury related to vaccine administration (“SIRVA”),
as defined in the Vaccine Injury Table, following administration of flu vaccine on October 15,
2018. Petition at 1.
On August 30, 2021, the Secretary of Health and Human Services (“respondent”) filed a
Vaccine Rule 4(c) Report indicating that this case is appropriate for compensation under the
terms of the Act for a shoulder injury related to vaccine administration (“SIRVA”) Table injury.
ECF No. 33. Later that day, the Chief Special Master issued a Ruling on Entitlement finding
petitioner entitled to compensation. ECF No. 34.
I. Compensation for Vaccine Injury-Related Items
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $140,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4).

Case 1:20-vv-00649-UNJ Document 47 Filed 01/06/22 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to his vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $5,847.93. See 42 U.S.C. § 300aa-
15(a)(1)(B).
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that the compensation provided to petitioner should be made through a
lump sum payment as described below and requests that the Chief Special Master’s decision and
the Court’s judgment award the following1: a lump sum payment of $145,847.93, in the form of
a check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Andrea Carrier: $145,847.93
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
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 lost earnings
and future pain and suffering.
2

Case 1:20-vv-00649-UNJ Document 47 Filed 01/06/22 Page 5 of 5
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
s/ Wei Kit (Ricky) Tai
WEI KIT (RICKY) TAI
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Ben Franklin Station
Washington, D.C. 20044-0146
Direct dial: (202) 598-7705
Wei.Tai@usdoj.gov
Dated: December 6, 2021
3