VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01598
Package ID: USCOURTS-cofc-1_20-vv-01598
Petitioner: Keith Pickett
Filed: 2020-11-16
Decided: 2022-05-20
Vaccine: influenza
Vaccination date: 2017-11-27
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 84092

AI-assisted case summary:
Keith Pickett filed a petition for vaccine compensation on November 16, 2020, alleging that he suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of an influenza vaccination on November 27, 2017. He claimed the injury was a Table injury and that he experienced residual effects for more than six months. The respondent, the Secretary of Health and Human Services, denied that Mr. Pickett sustained a SIRVA Table injury, denied that the flu vaccine caused his alleged shoulder injury or any other injury, and denied that his current condition was a sequelae of a vaccine-related injury. Despite these differing positions, the parties filed a joint stipulation on April 5, 2022, agreeing to settle the case and award compensation. The court adopted the stipulation as its decision. Mr. Pickett was awarded a lump sum of $80,000.00 payable to him and a lump sum of $4,092.01 to reimburse a Medicaid lien for services rendered by the State of Arkansas. This total award of $84,092.01 represents compensation for all damages available under the Vaccine Act. The decision was issued on May 20, 2022.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01598-0
Date issued/filed: 2022-05-20
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 04/05/2022) regarding 31 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-01598-UNJ Document 35 Filed 05/20/22 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1598V
UNPUBLISHED
KEITH PICKETT, Chief Special Master Corcoran
Petitioner, Filed: April 5, 2022
v.
Special Processing Unit (SPU); Joint
SECRETARY OF HEALTH AND Stipulation on Damages; Influenza
HUMAN SERVICES, (Flu) Vaccine; Shoulder Injury
Related to Vaccine Administration
Respondent. (SIRVA)
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Lara Ann Englund, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On November 16, 2020, Keith Pickett 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 Table injury – a Shoulder Injury
Related to Vaccine Administration (“SIRVA”) – as a result of an influenza (“flu”)
vaccination on November 27, 2017. Petition at 1; Stipulation, filed April 4, 2022, ¶¶ 1-2,
4. Petitioner further alleges the vaccine was administered within the United States, that
he suffered the residual effects of his injury for more than six months, and that there has
been no prior award or settlement of a civil action on his behalf as a result of his injury.
Stipulation at ¶¶ 3-5; see Petition at ¶¶ 6, 24, 26-27. Respondent denies that [P]etitioner
sustained a SIRVA Table injury; denies that the flu vaccine caused [P]etitioner’s alleged
shoulder injury; or any other injury; and denies that his current condition is a sequelae of
a vaccine-related injury.” Stipulation at ¶ 6.
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-01598-UNJ Document 35 Filed 05/20/22 Page 2 of 8
Nevertheless, on April 5, 2022, 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 the following
compensation:
A. A lump sum of $80,000.00 in the form of a check payable to Petitioner;
and
B. A lump sum of $4,092.01 representing reimbursement of a Medicaid
lien for services rendered to Petitioner by the State of Arkansas, in the
form of a check payable jointly to Petitioner and the Arkansas
Department of Human Services:
Arkansas Department of Human Services Division of Medical Services
Third Party Liability Unit
Case Number: 202101330
700 Main Street, Slot S-296
Little Rock, AR 72201
Petitioner agrees to endorse this check to the Arkansas Department of
Human Services.
Stipulation at ¶ 8. This amount represents 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.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-01598-UNJ Document 35 Filed 05/20/22 Page 3 of 8
IN THE UNITED ST ATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
KEITH PICKETT, )
)
Petitioner, )
)
v. ) No. 20-1598V
) Chief Special Master Brian Corcoran
SECRETARY OF )
HEALTH AND HUMAN SERVICES, )
)
Respondent. )
STIPULATION
The parties hereby stipulate to the following matters:
I. Petitioner Keith Pickett ("petitioner'') filed a petition for vaccine compensation under
the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to 34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of the influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § 100.3 (a).
2. Petitioner received a flu vaccine on or about November 27, 2017.
3. The vaccine was administered within the United States.
4. Petitioner alleges that he sustained a shoulder injury related to vaccine administration
("SIRVA") within the time period set forth in the Table following administration of the vaccine.
He further alleges that he experienced the residual effects of this condition for more than six
months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages as a result of his condition.

Case 1:20-vv-01598-UNJ Document 35 Filed 05/20/22 Page 4 of 8
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the flu
vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies that his
current condition is a sequelae of a vaccine-related injury.
7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry ofj udgment reflecting a decision consistent with
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21(a)(I), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A. A lump sum of$80,000.00 in the form of a check payable to petitioner; and
B. A lump sum of$4,092.0l I representing reimbursement of a Medicaid lien for
services rendered to petitioner by the State of Arkansas, in the form of a check
payable jointly to petitioner and the Arkansas Department of Human Services:
Arkansas Department of Human Services
Division of Medical Services
Third Party Liability Unit
Case Number: 202101330
700 Main Street, Slot S-296
Little Rock, AR 72201
Petitioner agrees to endorse this check to the Arkansas Department of Human
Services.
1 This amount represents full satisfaction of any right of subrogation, assignment, claim, lien, or
cause of action the State of Arkansas may have against any individual as a result of any
Medicaid payments the State of Arkansas has made to or on behalf of petitioner as a result of
petitioner's alleged injury relating to a vaccine administered on November 27, 2017, under Title
XIX of the Social Security Act, see 42 U. S.C. § 300aa-l 5(g), (h).
2

Case 1:20-vv-01598-UNJ Document 35 Filed 05/20/22 Page 5 of 8
These amounts represents compensation for all damages that would be available under 42 U.S.C.
§ 300aa-15(a).
9. As soon as practicable after the entry ofj udgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to 42
U.S.C. § 300aa-2l(a)(I), and an application, the parties will submit to further proceedings before
the special master to award reasonable attorneys' fees and costs incurred in proceeding upon this
petition.
I 0. Petitioner and his attorney represent that they have identified to respondent all
known sources of payment for items or services for which the Program is not primarily liable
under 42 U. S.C. § 300aa-15(g), including State compensation programs, insurance policies,
Federal or State health benefits programs (other than Title XIX of the Social Security Act (42
U.S.C. § 1396 et seq.)), or entities that provide health services on a pre-paid basis.
I I. Payment made pursuant to paragraph 8 and any amounts awarded pursuant to
paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-l5(i), subject
to the availability of sufficient statutory funds.
12. The parties and their attorneys further agree and stipulate that, except for any award
for attorneys' fees and litigation costs and past unreimbursable expenses, the money provided
pursuant to this Stipulation will be used solely for the benefit of petitioner as contemplated by a
strict construction of 42 U.S.C. § 300aa-l 5(a) and (d), and subject to the conditions of 42 U.S.C.
§ 300aa-I 5(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in his
individual capacity, and on behalf of his heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
3

Case 1:20-vv-01598-UNJ Document 35 Filed 05/20/22 Page 6 of 8
the Secretary of Health and Human Services from any and all actions or causes of action
(including agreements, judgments, claims, damages, loss of services, expenses and all demands
of whatever kind or nature) that have been brought, could have been brought, or could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. § 300aa-10 et seq., on account of, or in any way growing out of, any and all
known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from, or alleged to have resulted from, the flu vaccination administered on or about November
27, 2017, as alleged by petitioner in a petition for vaccine compensation filed on or about
November 16, 2020, in the United States Court of Federal Claims as petition No. 20-1598V.
14. If petitioner should die prior to entry ofj udgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
15. If the special master fails to issue a decision in complete confonnity with the terms
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a
decision that is in complete conformity with the terms of this Stipulation, then the parties'
settlement and this Stipulation shall be voidable at the sole discretion of either party.
16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the award described in this
Stipulation may reflect a compromise of the parties' respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
4

Case 1:20-vv-01598-UNJ Document 35 Filed 05/20/22 Page 7 of 8
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that flu vaccine caused petitioner's alleged shoulder
injury or any other injury or his current condition, or that petitioner suffered an injury contained
in the Vaccine Injury Table.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
5

Case 1:20-vv-01598-UNJ Document 35 Filed 05/20/22 Page 8 of 8
Respectfully submitted,
PETITIONER:
AT IORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE AT IORNEY GENERAL:
~~~~
HEATHER L. PEARLMAN
JEFFREYS. POP & ASSOCIATES Deputy Director
9150 Wilshire Blvd. Suite 241 Torts Branch
Beverly Hills, CA 90212 Civil Division
(310) 273-5462 U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
George R. Digitally signed by George R. t9° f-N\~v'J.
Grimes-S14 l--GA'4
Grimes -514 Date: 2022.03.28 11 :50:11 ~ Dk~ L .P~a..11
-04'00' V\--.--..
CDR GEORGE REED GRIMES, MD, MPl-l LARA A. ENGLUND
Director, Division of Assistant Director
Injury Compensation Programs Torts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Department of Justice
Administration P.O. Box 146
U.S. Depat1ment of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 Fishers Lane, 08N 146B (202) 307-3013
Rockville, MD 20857 lara.a.cngl und@usdoj.gov
DY Jos/11222.
Dated:
6