VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00899
Package ID: USCOURTS-cofc-1_20-vv-00899
Petitioner: Jan Koonce
Filed: 2020-07-24
Decided: 2022-01-18
Vaccine: influenza
Vaccination date: 2018-01-18
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 110616

AI-assisted case summary:
Jan Koonce filed a petition for compensation under the National Vaccine Injury Compensation Program alleging she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine received on January 18, 2018. The petition stated that the vaccine was administered in the United States, she suffered residual effects for more than six months, and no lawsuits had been filed. Respondent filed a Rule 4(c) report conceding that Petitioner was entitled to compensation. Respondent agreed that Petitioner had no prior history of shoulder issues, her pain and reduced range of motion occurred within 48 hours of vaccination, her symptoms were limited to the injection site, and no other condition explained her symptoms. Respondent also confirmed the petition was timely filed, the vaccine was received in the U.S., and Petitioner met the statutory severity requirement. Based on the concession and evidence, entitlement to compensation was granted. Subsequently, a decision awarding damages was issued. Respondent filed a proffer indicating Petitioner should be awarded $110,616.28, which included $107,500.00 for pain and suffering and $3,116.28 for past unreimbursable expenses. Petitioner agreed with this proffered award. The court awarded Jan Koonce a lump sum payment of $110,616.28.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00899-0
Date issued/filed: 2021-12-13
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/10/2021) 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-00899-UNJ Document 38 Filed 12/13/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0899V
UNPUBLISHED
JAN KOONCE, Chief Special Master Corcoran
Petitioner, Filed: November 10, 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.
Lynn Christina Schlie, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On July 24, 2020, Jan Koonce 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 vaccine received on January 18,
2018. Petition at 1. 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 no
lawsuits have been filed or settlements or awards accepted by anyone, including
Petitioner, due to her vaccine-related injury. Petition at ¶¶ 28-30. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
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-00899-UNJ Document 38 Filed 12/13/21 Page 2 of 2
On November 9, 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 agrees that “petitioner had no relevant history of pain,
inflammation, or dysfunction in her left shoulder prior to vaccination; her pain and reduced
range of motion occurred within 48 hours of receipt of an intramuscular vaccination; her
symptoms were limited to the shoulder in which the vaccine was administered; and no
other condition or abnormality was identified to explain her symptoms.” Id. at 4.
Respondent further agrees that the petition was timely filed, the vaccine was received in
the United States, and Petitioner satisfies the statutory severity requirement by suffering
the residual effects or complications of her injury for more than six months after vaccine
administration. Id. at 4-5.
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-00899-1
Date issued/filed: 2022-01-18
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 12/15/2021) regarding 40 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00899-UNJ Document 44 Filed 01/18/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0899V
UNPUBLISHED
JAN KOONCE, Chief Special Master Corcoran
Petitioner, Filed: December 15, 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)
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
Wei Kit Tai, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On July 24, 2020, Jan Koonce 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 vaccine received on January 18,
2018. Petition at 1. 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 no
lawsuits have been filed or settlements or awards accepted by anyone, including
Petitioner, due to her vaccine-related injury. Petition at ¶¶ 28-30. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On November 10, 2021, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On December 14, 2021, Respondent filed a 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-00899-UNJ Document 44 Filed 01/18/22 Page 2 of 5
on award of compensation (“Proffer”) indicating Petitioner should be awarded
$110,616.28. Proffer at 2. In the Proffer, Respondent represented that Petitioner agrees
with the proffered award. Id. 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 $110,616.28 (comprised of $107,500.00 for pain and suffering and
$3,116.28 for past unreimbursable 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-00899-UNJ Document 44 Filed 01/18/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
JAN KOONCE,
)
)
Petitioner,
) No. 20-899V
v.
) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND HUMAN
)
SERVICES,
)
)
Respondent.
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On July 24, 2020, Jan Koonce (“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 January 18,
2018. Petition at 1.
On November 9, 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. On November 10, 2021, 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 $107,500.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4).

Case 1:20-vv-00899-UNJ Document 44 Filed 01/18/22 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 $3,116.28. 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 $110,616.28, in the form of
a check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Jan Koonce: $110,616.28
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-00899-UNJ Document 44 Filed 01/18/22 Page 5 of 5
LARA A. ENGLUND
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 14, 2021
3