VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00997
Package ID: USCOURTS-cofc-1_20-vv-00997
Petitioner: Ammar Halloum
Filed: 2023-01-19
Decided: 2023-02-21
Vaccine: Tdap
Vaccination date: 2019-06-09
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 89711

AI-assisted case summary:
Ammar Halloum filed a petition on January 19, 2023, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) after receiving a Tdap vaccine in his left deltoid on June 9, 2019. He claimed the injury met the Table definition for SIRVA and that he received the vaccine in the United States, experienced residual effects for over six months, and had not filed other actions or received compensation for the injury. Respondent denied that the vaccine caused the alleged shoulder injury or that the current condition was a sequela of a vaccine-related injury. Despite the denial, the parties filed a joint stipulation for compensation. The court adopted the stipulation, awarding Ammar Halloum $89,711.62. This amount included a lump sum of $80,000.00 payable to the petitioner and $9,711.62 to reimburse a Medicaid lien. The award was intended to compensate for all items of damages available under Section 15(a) of the Vaccine Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00997-0
Date issued/filed: 2023-02-21
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 01/19/2023) regarding 58 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:20-vv-00997-UNJ Document 62 Filed 02/21/23 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0997V
UNPUBLISHED
AMMAR HALLOUM, Chief Special Master Corcoran
Petitioner, Filed: January 19, 2023
v.
Special Processing Unit (SPU); Joint
SECRETARY OF HEALTH AND Stipulation on Damages; Tetanus
HUMAN SERVICES, Diphtheria acellular Pertussis (Tdap)
Vaccine; Shoulder Injury Related to
Respondent. Vaccine Administration (SIRVA)
Jessi Carin Huff, Maglio Christopher & Toale (WA), Seattle, WA, for Petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On August 10, 2020, Ammar Halloum 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 shoulder injury related to vaccine
administration (“SIRVA”), which meets the Table definition, after receiving the tetanus,
diphtheria, acellular pertussis (“Tdap”) vaccine in his left deltoid3 on June 9, 2019. Petition
at ¶¶ 2, 16-17; Stipulation, filed at Jan. 18, 2023, ¶¶ 1-2, 4. Petitioner further alleges that
he received the Tdap vaccine within the United States, that he suffered the residual
effects of his SIRVA injury for more than six months, and that neither he nor any other
individual has filed a civil action or received compensation for his SIRVA injury. Petition
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).
3 Petitioner acknowledged that he also received a Shingles vaccine in his left deltoid. Petition at ¶ 2. And
it appears Petitioner received a Pneumovax 23 vaccine, presumedly in his right deltoid. Exhibit 1 at 8
(vaccine record).

Case 1:20-vv-00997-UNJ Document 62 Filed 02/21/23 Page 2 of 8
at ¶¶ 2, 18, 20-21; Stipulation at ¶¶ 3-5. “Respondent denies that [P]etitioner sustained
a SIRVA Table injury; denies that the vaccine caused [P]etitioner’s alleged shoulder
injury, or any other injury; and denies that his current condition is a sequela of a vaccine-
related injury.” Stipulation at ¶ 6.
Nevertheless, on January 18, 2023, 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 $89,711.62 as
follows:
1. A lump sum payment of $80,000.00 in the form of a check payable to
Petitioner; and
2. A lump sum payment of $9,711.62, representing reimbursement of a
Medicaid lien for services rendered to Petitioner by the State of
Arizona/Mercy Care Plan, in the form of a check payable jointly to Petitioner
and the Equian, and mailed to:
Equian
PO Box 182643
Columbus, OH 43218
Event # 54968452.
Stipulation at ¶ 8. Petitioner agrees to endorse the check to the Equian for satisfaction of
the Medicaid lien. These amounts represent 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.4
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
4 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

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