VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01626
Package ID: USCOURTS-cofc-1_20-vv-01626
Petitioner: Andrea C. Everhart
Filed: 2020-11-19
Decided: 2022-06-16
Vaccine: Tdap
Vaccination date: 2019-06-04
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 65683

AI-assisted case summary:
Andrea C. Everhart filed a petition on November 19, 2020, seeking compensation under the National Vaccine Injury Compensation Program. She alleged that she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA), a "Table injury," as a result of receiving a tetanus diphtheria acellular pertussis (Tdap) vaccine on June 4, 2019. Ms. Everhart stated that she received the vaccination in the United States, experienced residual effects of the injury for more than six months, and had no prior award or settlement for this injury. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report on March 4, 2022, conceding that Ms. Everhart was entitled to compensation. The respondent indicated that medical personnel reviewed the petition and records, and agreed that Ms. Everhart met the criteria for a SIRVA Table injury. Specifically, the respondent noted that she had no prior history of shoulder pain, inflammation, or dysfunction, her symptoms occurred within 48 hours of the intramuscular vaccination, her symptoms were limited to the vaccinated shoulder, and no other condition explained her symptoms. On March 10, 2022, Chief Special Master Brian H. Corcoran issued a ruling on entitlement, finding Ms. Everhart entitled to compensation. Subsequently, on May 3, 2022, the respondent filed a proffer on award of compensation. The proffer recommended an award of $65,683.90, comprising $65,000.00 for pain and suffering and $683.90 for past unreimbursable expenses. Ms. Everhart, who is a competent adult, agreed with this proffered award. On June 16, 2022, Chief Special Master Corcoran issued a decision awarding the stipulated amount of $65,683.90 as a lump sum payment to Ms. Everhart. Petitioner's counsel was Kimberly Wilson White of Wilson Law, P.A., and respondent's counsel was Lauren Kells of the U.S. Department of Justice.

Theory of causation field:
Petitioner Andrea C. Everhart alleged a Shoulder Injury Related to Vaccine Administration (SIRVA) following a tetanus diphtheria acellular pertussis (Tdap) vaccine received on June 4, 2019. The respondent conceded entitlement, agreeing that the injury met the criteria for a Table injury. The respondent's position, accepted by the Chief Special Master, was that petitioner had no prior shoulder issues, symptoms occurred within 48 hours of vaccination, symptoms were limited to the shoulder, and no other condition explained the symptoms. The public text does not detail the specific mechanism of injury or name any medical experts. The case resulted in a stipulated award of $65,683.90, consisting of $65,000.00 for pain and suffering and $683.90 for past unreimbursable expenses, paid as a lump sum to the petitioner. Chief Special Master Brian H. Corcoran issued the ruling on entitlement on March 10, 2022, and the final decision awarding damages on June 16, 2022. Petitioner was represented by Kimberly Wilson White, and respondent by Lauren Kells.

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_20-vv-01626-0
Date issued/filed: 2022-04-11
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/10/2022) regarding 28 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
--------------------------------------------------------------------------------
Case 1:20-vv-01626-UNJ Document 32 Filed 04/11/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1626V
UNPUBLISHED
ANDREA C. EVERHART, Chief Special Master Corcoran
Petitioner, Filed: March 10, 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)
Kimberly Wilson White, Wilson Law, P.A. Raleigh, NC, for Petitioner.
Lauren Kells, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On November 19, 2020, Andrea Everhart 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 Table injury – Shoulder Injury
Related to Vaccine Administration (“SIRVA”) – as a result of her June 4, 2019 tetanus
diphtheria acellular pertussis (Tdap) Vaccine. Amended Petition, filed April 7, 2021, at 1.
Petitioner further alleges that she received her vaccination in the United States, that she
suffered the residual effects of her injury for more than six months, and that there has
been no prior award or settlement of a civil action on her behalf as a result of her injury.
See Amended Petition at ¶¶ 2, 25-27. 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-01626-UNJ Document 32 Filed 04/11/22 Page 2 of 2
On March 4, 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 indicates that
[m]edical personnel at the Division of Injury Compensation Programs,
Department of Health and Human Services (DICP), have reviewed the
petition and medical records filed in the case. It is respondent’s position that
petitioner has satisfied the criteria set forth in the Vaccine Injury Table
(Table) and the Qualifications and Aids to Interpretation (QAI); petitioner
had no history of pain, inflammation or dysfunction in her left shoulder; her
pain and reduced range of motion occurred within 48 hours of receipt of an
intramuscular vaccination; her symptoms were limited to the shoulder in
which the vaccine was administered; and no other condition or abnormality
was identified to adequately explain her symptoms.
Id. at 5 (citing 42 C.F.R. § 100.3(a), (c)(10)).
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

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_20-vv-01626-1
Date issued/filed: 2022-06-16
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 05/04/2022) regarding 35 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
--------------------------------------------------------------------------------
Case 1:20-vv-01626-UNJ Document 39 Filed 06/16/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1626V
UNPUBLISHED
ANDREA C. EVERHART, Chief Special Master Corcoran
Petitioner, Filed: May 4, 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)
Kimberly Wilson White, Wilson Law, P.A., Raleigh, NC, for Petitioner.
Lauren Kells, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On November 19, 2020, Andrea Everhart 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 Table injury – Shoulder Injury
Related to Vaccine Administration (“SIRVA”) – as a result of her June 4, 2019 tetanus
diphtheria acellular pertussis (“Tdap”) Vaccine. Amended Petition, filed April 7, 2021, at
1. The case was assigned to the Special Processing Unit of the Office of Special Masters.
On March 10, 2022, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On May 3, 2022, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $65,683.90
(representing $65,000.00 for pain and suffering and $683.90 for past unreimbursable
expenses). Proffer at 2. In the Proffer, Respondent represented that Petitioner agrees
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-01626-UNJ Document 39 Filed 06/16/22 Page 2 of 5
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 Petitioner a lump
sum payment of $65,683.90 (representing $65,000.00 for pain and suffering and
$683.90 for 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-01626-UNJ Document 39 Filed 06/16/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
ANDREA C. EVERHART, )
)
Petitioner, )
) No. 20-1626V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On November 19, 2020, Andrea C. Everhart (“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”). ECF No. 1. On April 7, 2021, petitioner filed an amended
petition, 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, and acellular pertussis (“Tdap”) vaccine she received on June 4, 2019.1 See ECF No.
14 (“Amended Petition”) at 1. On March 4, 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 10, 2022, the Chief Special
Master issued a Ruling on Entitlement finding petitioner entitled to compensation. ECF No. 26;
ECF No. 28.
1 The Amended Petition corrected errors in the initial petition and clarified that petitioner was
alleging that a Tdap vaccination, not an influenza vaccination, caused her to suffer a SIRVA.

Case 1:20-vv-01626-UNJ Document 39 Filed 06/16/22 Page 4 of 5
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $65,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
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 $683.90. 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 following2: a lump sum payment of $65,683.90, in the form of a
check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Andrea C. Everhart: $65,683.90
2 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-01626-UNJ Document 39 Filed 06/16/22 Page 5 of 5
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
TRACI R. PATTON
Assistant Director
Torts Branch, Civil Division
/s/ Lauren Kells
LAUREN KELLS
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) 616-4187
Email: Lauren.Kells@usdoj.gov
DATED: May 3, 2022
3