VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01365
Package ID: USCOURTS-cofc-1_20-vv-01365
Petitioner: Rachel Kellogg
Filed: 2020-10-13
Decided: 2022-02-17
Vaccine: influenza
Vaccination date: 2019-11-23
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 61799

AI-assisted case summary:
Rachel Kellogg filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a left shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on November 23, 2019. The respondent, the Secretary of Health and Human Services, conceded that Ms. Kellogg is entitled to compensation, agreeing that she suffered a SIRVA, which is a defined Table Injury. A ruling on entitlement was issued on December 20, 2021, finding her eligible. Subsequently, on January 14, 2022, the respondent filed a proffer on award of compensation. The parties agreed to an award of $57,500.00 for pain and suffering and $4,299.79 to satisfy a New York State Medicaid lien. Chief Special Master Corcoran issued a decision awarding a total of $61,799.79 on February 17, 2022. The award was structured as a lump sum payment to Ms. Kellogg for pain and suffering and a separate payment for the Medicaid lien, payable jointly to Ms. Kellogg and the New York Department of Health.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01365-0
Date issued/filed: 2022-01-19
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/20/2021) regarding 26 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-01365-UNJ Document 30 Filed 01/19/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1365V
UNPUBLISHED
RACHEL KELLOGG, Chief Special Master Corcoran
Petitioner, Filed: December 20, 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)
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On October 13, 2020, Rachel Kellogg 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”), a defined Table Injury, after receiving the influenza (“flu”)
vaccine on November 23, 2019. Petition at 1, ¶ 1. Petitioner further alleges she received
the vaccine in the United States, that she continues to suffer the residual effects of her
SIRVA more than six months post-vaccination, and that neither she nor any other person
has filed a civil action or received compensation for her SIRVA. Petition at ¶¶ 1, 7-8. 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-01365-UNJ Document 30 Filed 01/19/22 Page 2 of 2
On December 17, 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 has “concluded that [P]etitioner suffered a SIRVA,
as defined by the Vaccine Injury Table.” Id. at 4. Respondent further agrees that “based
on the current record, [P]etitioner has satisfied all legal prerequisites for compensation
under the Act.” 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
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DOCUMENT 2: USCOURTS-cofc-1_20-vv-01365-1
Date issued/filed: 2022-02-17
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 01/18/2022) regarding 29 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-01365-UNJ Document 34 Filed 02/17/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1365V
UNPUBLISHED
RACHEL KELLOGG, Chief Special Master Corcoran
Petitioner, Filed: January 18, 2022
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)
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On October 13, 2020, Rachel Kellogg 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”), a defined Table Injury, after receiving the influenza (“flu”)
vaccine on November 23, 2019. Petition at 1, ¶ 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On December 20, 2021, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for her SIRVA. On January 14, 2022, Respondent filed a proffer
on award of compensation (“Proffer”) indicating Petitioner should be awarded $57,500.00
for her pain and suffering and $4,299.79 for satisfaction of the State of New York Medicaid
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-01365-UNJ Document 34 Filed 02/17/22 Page 2 of 5
lien. Proffer at 1-2. 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 Stipulation, I award $61,799.79 as
follows:
1. A lump sum payment of $57,500.00 in the form of a check payable to
Petitioner; and
2. A lump sum payment of $4,299.79, representing reimbursement of a
Medicaid lien for services rendered to Petitioner by the State of New York,
in the form of a check payable jointly to Petitioner and New York Department
of Health, and mailed to:
New York Department of Health
P.O. Box 415874
Boston, MA 02241-5874
Stipulation at ¶ 8. Petitioner agrees to endorse the check to New York State Department
of Health for satisfaction of the Medicaid lien. This amount represents compensation for
all items of damages that would be available under Section 15(a). Id.
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-01365-UNJ Document 34 Filed 02/17/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
RACHEL KELLOGG,
Petitioner, No. 20-1365V
Chief Special Master Corcoran
v. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On October 13, 2020, Rachel Kellogg (“petitioner”), filed a Petition for compensation
under the National Childhood Vaccine Injury Act of 1986, as amended (“the Vaccine Act” or
“the Act”), 42 U.S.C. §§ 300aa-1 to -34. Petitioner alleges that she suffered a shoulder injury
related to vaccine administration (“SIRVA”) in her left shoulder as a result of an influenza
(“flu”) vaccine administered on November 23, 2019. Petition at 1. On December 17, 2021, 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, and on December 20, 2021,
the Chief Special Master issued a Ruling on Entitlement finding petitioner entitled to
compensation. ECF No. 24; ECF No. 26.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $57,500.00 in actual pain and
suffering. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
B. Medicaid Lien

Case 1:20-vv-01365-UNJ Document 34 Filed 02/17/22 Page 4 of 5
Respondent proffers that petitioner should be awarded funds to satisfy the State of New
York Medicaid lien in the amount of $4,299.79, which represents full satisfaction of any right of
subrogation, assignment, claim, lien, or cause of action the State of New York may have against
any individual as a result of any Medicaid payments the State of New York has made to or on
behalf of petitioner from the date of her eligibility for benefits through the date of judgment in
this case as a result of her alleged vaccine-related injury suffered on or about November 23,
2019, under Title XIX of the Social Security Act.
The above amounts represent all elements of compensation to which petitioner would be
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 be made through a lump
sum payment as described below:
A. A lump sum payment of $57,500.00, in the form of a check payable to
petitioner, Rachel Kellogg; and
B. A lump sum payment of $4,299.79, representing compensation for satisfaction of
the State of New York Medicaid lien, in the form of a check payable jointly to
petitioner and:
New York State Department of Health
P.O. Box 415874
Boston, MA 02241-5874
Petitioner agrees to endorse the check to New York State Department of Health for
satisfaction of the Medicaid lien.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
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Case 1:20-vv-01365-UNJ Document 34 Filed 02/17/22 Page 5 of 5
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
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
/s/ Alexa Roggenkamp
ALEXA ROGGENKAMP
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
(202) 616-4179
alexa.roggenkamp@usdoj.gov
DATED: January 14, 2022
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