VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01503
Package ID: USCOURTS-cofc-1_20-vv-01503
Petitioner: Luis Rodriguez
Filed: 2020-10-30
Decided: 2022-06-21
Vaccine: Tdap
Vaccination date: 2018-05-16
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 63801

AI-assisted case summary:
Luis Rodriguez filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered a left shoulder injury related to vaccine administration (SIRVA) as a result of a Tetanus Diphtheria acellular Pertussis (Tdap) vaccine he received on May 16, 2018. The respondent conceded that Mr. Rodriguez is entitled to compensation, agreeing that his injury met the criteria for SIRVA as set forth in the Vaccine Injury Table. The respondent noted that Mr. Rodriguez had no prior history of shoulder issues, his pain occurred within 48 hours of the vaccination, and the pain and reduced range of motion were limited to the injection site. The respondent also confirmed that the statutory six-month sequela requirement was satisfied. Based on the concession and the evidence, the court found Mr. Rodriguez entitled to compensation. Subsequently, the parties reached a proffer on the award of compensation. The court awarded Mr. Rodriguez $62,500.00 for pain and suffering and an additional $1,300.85 to satisfy a Commonwealth of Massachusetts Medicaid lien, for a total award of $63,801.85.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01503-0
Date issued/filed: 2022-04-07
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/03/2022) 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-01503-UNJ Document 29 Filed 04/07/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1503V
UNPUBLISHED
LUIS RODRIGUEZ, Chief Special Master Corcoran
Petitioner, Filed: March 3, 2022
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)
Harrison Whitten Long, Rawls Law Group (Richmond), Richmond, VA, for Petitioner.
Ronalda Elnetta Kosh, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On October 30, 2020, Luis Rodriguez 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 left shoulder injury related to vaccine
administration (“SIRVA”) as a result of a Tetanus Diphtheria acellular Pertussis (“Tdap”)
vaccine received on May 16, 2018. Petition at 1. Petitioner further alleges that the vaccine
was received in the United States, he suffered residual effects or complications of his
injury for at least six months, and neither Petitioner nor any other party has filed an action,
or received compensation in the form of an award or settlement, for this vaccine-related
injury. Petition at 2-5, ¶¶ 2, 22-23. 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-01503-UNJ Document 29 Filed 04/07/22 Page 2 of 2
On March 1, 2022, 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 has satisfied the criteria for SIRVA set
forth in the Vaccine Injury Table and the Qualifications and Aids to Interpretation, which
afford petitioner the presumption of causation, because petitioner had no history of pain,
inflammation, or dysfunction in his left shoulder; his pain occurred within 48 hours of
receipt of an intramuscular vaccination; his pain and reduced range of motion were limited
to the shoulder in which the vaccine was administered; and no other condition or
abnormality was identified to explain his symptoms.” Id. at 5. Respondent further agrees
that the statutory six month sequela requirement has been satisfied. 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-01503-1
Date issued/filed: 2022-06-21
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 05/09/2022) regarding 32 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-01503-UNJ Document 37 Filed 06/21/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1503V
UNPUBLISHED
LUIS RODRIGUEZ, Chief Special Master Corcoran
Petitioner, Filed: May 9, 2022
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)
Harrison Whitten Long, Rawls Law Group (Richmond), Richmond, VA, for Petitioner.
Ronalda Elnetta Kosh, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On October 30, 2020, Luis Rodriguez 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 left shoulder injury related to vaccine
administration (“SIRVA”) as a result of a Tetanus Diphtheria acellular Pertussis (“Tdap”)
vaccine received on May 16, 2018. Petition at 1. Petitioner further alleges that the vaccine
was received in the United States, he suffered residual effects or complications of his
injury for at least six months, and neither Petitioner nor any other party has filed an action,
or received compensation in the form of an award or settlement, for this vaccine-related
injury. Petition at 2-5, ¶¶ 2, 22-23. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
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-01503-UNJ Document 37 Filed 06/21/22 Page 2 of 5
On March 3, 2022, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On May 9, 2022, Respondent filed a proffer on award of
compensation (“Proffer”) indicating that the court should award $62,500.00 in the form of
a check payable to Petitioner and $1,300.85 to satisfy the Commonwealth of
Massachusetts Medicaid lien. 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 the following:
A. A lump sum payment of $62,500.00 (in pain and suffering) in the form of a
check payable to Petitioner; and
B. A lump sum payment of $1,300.85, representing compensation for
satisfaction of the Commonwealth of Massachusetts Medicaid lien, in the
form of a check payable jointly to Petitioner and the “Commonwealth of
Massachusetts – CRU”; and mailed to:
Commonwealth of Massachusetts
Casualty Recovery
P.O. Box 417811
Boston, MA 02241-7811
Petitioner agrees to endorse this payment to the Commonwealth of
Massachusetts – CRU.
These amounts 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-01503-UNJ Document 37 Filed 06/21/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
LUIS RODRIGUEZ, )
)
)
Petitioner, )
) No. 20-1503V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On October 30, 2020, Luis Rodriguez (“petitioner”) filed a petition for compensation
(“Petition”) under the National Childhood Vaccine Injury Act of 1986, as amended (“Vaccine
Act” or “Act”). See 42 U.S.C. §§ 300aa-1 et seq. Petitioner alleged that he suffered a Shoulder
Injury Related to Vaccine Administration (“SIRVA”) as a result of a Tetanus-diphtheria-
acellular pertussis (“Tdap”) vaccine administered in his left shoulder on May 16, 2018. Petition
at 1. . On March 1, 2022, 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 on March 3, 2022, the Chief Special Master issued a Ruling
on Entitlement finding petitioner entitled to compensation. ECF No. 25; ECF No. 26.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $62,500.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:20-vv-01503-UNJ Document 37 Filed 06/21/22 Page 4 of 5
B. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy the
Commonwealth of Massachusetts Medicaid lien in the amount of $1,300.85, which represents
full satisfaction of any right of subrogation, assignment, claim, lien, or cause of action the
Commonwealth of Massachusetts may have against any individual as a result of any Medicaid
payment the Commonwealth of Massachusetts has made to or on behalf of petitioner from the
date of his eligibility for benefits through the date of judgment in this case as a result of his
alleged vaccine-related injury suffered on or about May 16, 2018, under Title XIX of the Social
Security Act.
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
two lump sum payments as described below and requests that the Chief Special Master’s
decision and the Court’s judgment award the following1:
A. A lump sum payment of $62,500.00, in the form of a check payable to petitioner;
and
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 pain and
suffering.
2

Case 1:20-vv-01503-UNJ Document 37 Filed 06/21/22 Page 5 of 5
B. A lump sum payment of $1,300.85, representing compensation for satisfaction of
the Commonwealth of Massachusetts Medicaid lien, in the form of a check
payable jointly to petitioner and the “Commonwealth of Massachusetts – CRU”,
and mailed to:
Commonwealth of Massachusetts
Casualty Recovery
P.O. BOX 417811
Boston, MA 02241-7811
Petitioner agrees to endorse this payment to the Commonwealth of Massachusetts – CRU.
III. Summary of Recommended Payments Following Judgment
A. Lump sum payable to petitioner, Luis Rodriguez: $62,500.00
B. Medicaid lien: $1,300.85
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy 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/ Ronalda E. Kosh
RONALDA E. KOSH
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) 616-4476
Email: ronalda.kosh@usdoj.gov
DATED: May 9, 2022
3