VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01239
Package ID: USCOURTS-cofc-1_20-vv-01239
Petitioner: Wilson V. Rivera
Filed: 2020-09-21
Decided: 2023-01-03
Vaccine: pneumococcal conjugate
Vaccination date: 2017-12-27
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 15000

AI-assisted case summary:
Wilson V. Rivera filed a petition on September 21, 2020, seeking compensation under the National Vaccine Injury Compensation Program. Petitioner alleged a Table injury of shoulder injury related to vaccine administration (SIRVA) resulting from a pneumococcal conjugate vaccination received on December 27, 2017. The respondent denied that the petitioner sustained a SIRVA Table injury, that the vaccine caused the alleged shoulder injury, or that the current condition was a sequela of a vaccine-related injury. Despite maintaining these positions, both parties agreed to settle the case through a joint stipulation filed on November 30, 2022. Special Master Katherine E. Oler reviewed the stipulation and found it to be reasonable, adopting it as the decision. The stipulation awarded Petitioner a lump sum of $15,000.00, payable by check, as compensation for all damages. Petitioner's counsel was Matthew F. Belanger of Faraci Lange LLP, and respondent's counsel was Madelyn Weeks of the U.S. Department of Justice. Judgment was to be entered accordingly.

Theory of causation field:
Petitioner alleged a Table injury of shoulder injury related to vaccine administration (SIRVA) following a pneumococcal conjugate vaccination on December 27, 2017. Respondent denied the alleged injury and causation. The parties reached a settlement via joint stipulation, agreeing to an award of $15,000.00. Special Master Katherine E. Oler adopted the stipulation as her decision. The public decision does not detail the specific mechanism of injury, expert testimony, or clinical findings beyond the allegation of SIRVA.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01239-0
Date issued/filed: 2023-01-03
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 11/30/2022) regarding 36 DECISION of Special Master - Stipulation. Signed by Special Master Katherine E. Oler. (emh) Service on parties made.
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Case 1:20-vv-01239-UNJ Document 40 Filed 01/03/23 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1239V
(not to be published)
* * * * * * * * * * * * * * * * * * * * * * * * * *
*
*
WILSON V. RIVERA,
*
* Filed: November 30, 2022
Petitioner, *
*
*
v. * Decision by Stipulation; Damages;
* Pneumococcal Conjugate Vaccine;
SECRETARY OF HEALTH AND * SIRVA.
HUMAN SERVICES, *
*
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * *
Matthew F. Belanger, Faraci Lange LLP, Rochester, NY, for Petitioner
Madelyn Weeks, U.S. Department of Justice, Washington, DC, for Respondent
DECISION ON JOINT STIPULATION1
On September 21, 2020, Wilson V. Rivera (“Petitioner”) filed a petition, seeking
compensation under the National Vaccine Injury Compensation Program (“the Vaccine
Program”).2 Pet., ECF No. 1. Petitioner alleges he suffered from a Table injury of shoulder injury
related to vaccine administration (“SIRVA”) as a result of the pneumococcal conjugate vaccination
he received on December 27, 2017. See Stipulation ¶ 2, 4, dated November 30, 2022 (ECF No.
35); see also Petition.
1 Although this Decision has been formally designated “not to be published,” it will nevertheless be posted
on the Court of Federal Claims’ website in accordance with the E-Government Act of 2002, 44 U.S.C. §
3501 (2012). This means the Decision will be available to anyone with access to the internet. As
provided by 42 U.S.C. § 300aa-12(d)(4)(B), however, the parties may object to the Decision’s inclusion of
certain kinds of confidential information. Specifically, under Vaccine Rule 18(b), each party has fourteen
days within which to request redaction “of any information furnished by that party: (1) that is a trade secret
or commercial or financial in substance and is privileged or confidential; or (2) that includes medical files
or similar files, the disclosure of which would constitute a clearly unwarranted invasion of privacy.”
Vaccine Rule 18(b). Otherwise, the Decision in its present form will be available. Id.
2 The Vaccine Program comprises Part 2 of the National Childhood Vaccine Injury Act of 1986, Pub. L.
No. 99-660, 100 Stat. 3755 (codified as amended at 42 U.S.C. §§ 300aa-10–34 (2012)) (hereinafter
“Vaccine Act” or “the Act”). All subsequent references to sections of the Vaccine Act shall be to the
pertinent subparagraph of 42 U.S.C. § 300aa.

Case 1:20-vv-01239-UNJ Document 40 Filed 01/03/23 Page 2 of 7
Respondent “denies that petitioner sustained a SIRVA Table injury; denies that the vaccine
caused petitioner’s alleged shoulder injury, or any other injury; and denies that his current
condition is a sequela of a vaccine-related injury.” See Stipulation ¶ 6. Nonetheless, both parties,
while maintaining their above-stated positions, agreed in a stipulation filed November 30, 2022
that the issues before them can be settled and that a decision should be entered awarding Petitioner
compensation.
I have reviewed the file, and based upon that review, I conclude that the parties’ stipulation
is reasonable. I therefore adopt it as my decision in awarding damages on the terms set forth
therein.
The stipulation awards:
A lump sum of $15,000.00 in the form of a check payable to petitioner.
Stipulation ¶ 8. This award represents compensation for all damages that would be available under
42 U.S.C. § 300aa-15(a).
I approve a Vaccine Program award in the requested amount set forth above to be made to
Petitioner. In the absence of a motion for review filed pursuant to RCFC Appendix B, the Clerk of
the Court is directed to enter judgment herewith.3
IT IS SO ORDERED.
s/ Katherine E. Oler
Katherine E. Oler
Special Master
3 Pursuant to Vaccine Rule 11(a), the parties may expedite entry of judgment by jointly filing notice
renouncing their right to seek review.

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