VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01136
Package ID: USCOURTS-cofc-1_20-vv-01136
Petitioner: Kelly Seim
Filed: 2020-09-03
Decided: 2023-07-11
Vaccine: Tdap
Vaccination date: 2017-09-11
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 60059

AI-assisted case summary:
Kelly Seim 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 a tetanus-diphtheria-acellular pertussis (Tdap) vaccine administered on September 11, 2017. The respondent, the Secretary of Health and Human Services, filed a report conceding that Seim is entitled to compensation. The respondent agreed that Seim satisfied the criteria for SIRVA as set forth in the Vaccine Injury Table and the Qualifications and Aids to Interpretation. The court issued a ruling on entitlement finding Seim entitled to compensation. Subsequently, the respondent filed a proffer on award of compensation, indicating that Seim should be awarded $60,059.75, which included $60,000.00 for pain and suffering and $59.75 for past unreimbursable expenses. Seim agreed with this proffered award. The court issued a decision awarding Seim the lump sum payment of $60,059.75.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01136-0
Date issued/filed: 2023-06-09
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/09/2023) regarding 41 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:20-vv-01136-UNJ Document 45 Filed 06/09/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1136V
UNPUBLISHED
KELLY SEIM, Chief Special Master Corcoran
Petitioner, Filed: May 9, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Tetanus Diphtheria
acellular Pertussis (Tdap) Vaccine;
Respondent. Shoulder Injury Related to Vaccine
Administration (SIRVA)
Jonathan Joseph Svitak, Shannon Law Group, P.C., Woodridge, IL, for Petitioner.
Madelyn Weeks, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On September 3, 2020, Kelly Seim 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 a tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccine administered on September 11, 2017. Petition at 1. The case was assigned to
the Special Processing Unit of the Office of Special Masters.
1 Because this Ruling contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (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-01136-UNJ Document 45 Filed 06/09/23 Page 2 of 2
On May 9, 2023, 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 “[P]etitioner has satisfied the criteria set forth in the
Vaccine Injury Table (“Table”) and the Qualifications and Aids to Interpretation (“QAI”) for
SIRVA.” Id. at 4. Respondent further agrees that Petitioner has satisfied all statutory and
jurisdictional requirements. 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-01136-1
Date issued/filed: 2023-07-11
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 06/08/2023) regarding 44 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:20-vv-01136-UNJ Document 51 Filed 07/11/23 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1136V
UNPUBLISHED
KELLY SEIM, Chief Special Master Corcoran
Petitioner, Filed: June 8, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Tetanus Diphtheria acellular
Pertussis (Tdap) Vaccine; Shoulder
Respondent. Injury Related to Vaccine
Administration (SIRVA)
Jonathan Joseph Svitak, Shannon Law Group, P.C., Woodridge, IL, for Petitioner.
Madelyn Weeks, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On September 3, 2020, Kelly Seim 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 a tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccine administered on September 11, 2017. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On May 9, 2023, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On June 7, 2023, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $60,059.75. Proffer at
2. In the Proffer, Respondent represented that Petitioner agrees with the proffered award.
1 Because this unpublished contains a reasoned explanation for the action taken in this case, it must be
made publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (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 (2018).

Case 1:20-vv-01136-UNJ Document 51 Filed 07/11/23 Page 2 of 5
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 $60,059.75 (comprised of $60,000.00 in pain and suffering and
$59.75 in 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 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-01136-UNJ Document 51 Filed 07/11/23 Page 3 of 5
THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
KELLY SEIM,
Petitioner,
v. No. 20-1136V
Chief Special Master Brian H. Corcoran
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On September 3, 2020, Kelly Seim (“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 a tetanus-
diphtheria-acellular pertussis (“Tdap”) vaccine she received on September 11, 2017. Petition at
1. On May 9, 2023, the Secretary of Health and Human Services (“respondent”) filed a Rule
4(c) Report indicating that this case is appropriate for compensation under the terms of the Act
for a SIRVA Table injury, and that same day, the Chief Special Master issued a Ruling on
Entitlement finding petitioner entitled to compensation. ECF No. 40; ECF No. 41.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $60,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:20-vv-01136-UNJ Document 51 Filed 07/11/23 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $59.75. See 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
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 $60,059.75, in the form of a
check payable to petitioner.
III. Summary of Recommended Payment Following Judgment
Lump sum payable to petitioner, Kelly Seim: $60,059.75
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
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-01136-UNJ Document 51 Filed 07/11/23 Page 5 of 5
TRACI R. PATTON
Assistant Director
Torts Branch, Civil Division
s/ MADELYN E. WEEKS
MADELYN E. WEEKS
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 305-3262
madelyn.e.weeks@usdoj.gov
Dated: June 7, 2023
3