VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01681
Package ID: USCOURTS-cofc-1_20-vv-01681
Petitioner: Theresa Jackson
Filed: 2020-11-24
Decided: 2022-12-06
Vaccine: Tdap
Vaccination date: 2019-08-29
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 45494

AI-assisted case summary:
Theresa Jackson filed a petition for compensation under the National Vaccine Injury Compensation Program on November 24, 2020, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving a Tdap vaccine in her right deltoid on August 29, 2019. The respondent, the Secretary of Health and Human Services, filed a combined Rule 4(c) Report and Proffer on November 1, 2022, conceding that Petitioner was entitled to compensation. The respondent agreed that Petitioner's injury was consistent with SIRVA as defined by the Vaccine Injury Table and that she suffered residual effects or complications for more than six months after vaccination. Based on the respondent's concession and the evidence of record, Chief Special Master Brian H. Corcoran found Petitioner entitled to compensation. A decision awarding damages was issued on December 6, 2022. The award comprised a lump sum of $45,494.48, consisting of $45,000.00 for pain and suffering and $494.48 for unreimbursed expenses, payable to Petitioner. Petitioner was represented by Ronald Craig Homer of Conway, Homer, P.C., and the respondent was represented by Dorian Hurley of the U.S. Department of Justice. The public decision does not describe the specific onset of symptoms, medical tests performed, or treatments received.

Theory of causation field:
Petitioner Theresa Jackson received a Tdap vaccine on August 29, 2019, and alleged a shoulder injury related to vaccine administration (SIRVA). The respondent conceded that the injury was consistent with SIRVA as defined by the Vaccine Injury Table (42 C.F.R. §§ 100.3(a)(I)(C), (c)(10)) and that Petitioner suffered residual effects for more than six months, satisfying the requirements of 42 U.S.C. § 300aa-13(a)(1)(B) and § 300aa-11(c)(1)(D)(i). The case proceeded based on this concession, and no specific medical experts or detailed causation mechanisms beyond the Table definition were described in the public text. Chief Special Master Brian H. Corcoran issued a Ruling on Entitlement on November 1, 2022, and a Decision Awarding Damages on December 6, 2022. The award was $45,494.48, comprising $45,000.00 for pain and suffering and $494.48 for unreimbursed expenses. Petitioner was represented by Ronald Craig Homer, and Respondent was represented by Dorian Hurley.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01681-0
Date issued/filed: 2022-12-05
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/01/2022) regarding 41 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:20-vv-01681-UNJ Document 46 Filed 12/05/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1681V
UNPUBLISHED
THERESA JACKSON, Chief Special Master Corcoran
Petitioner,
v. Filed: November 1, 2022
SECRETARY OF HEALTH AND Special Processing Unit (SPU);
HUMAN SERVICES, Ruling on Entitlement; Concession;
Table Injury; Tetanus-Diphtheria-
Respondent. Acellular Pertussis (Tdap); Shoulder
Injury Related to Vaccine
Administration (SIRVA).
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
Dorian Hurley, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On November 24, 2020, Theresa Jackson (“Petitioner”) 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 shoulder
injury related to vaccine administration (“SIRVA”) as a result of a tetanus-diphtheria-
acellular pertussis (“Tdap”) vaccine she received in her right deltoid on August 29, 2019.
Petition at 1. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On November 1, 2022, Respondent filed a combined Rule 4(c) Report and Proffer
in which he concedes that Petitioner is entitled to compensation in this case.
Respondent’s Rule 4(c) Report and Proffer at 1. Specifically, Respondent states that
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-01681-UNJ Document 46 Filed 12/05/22 Page 2 of 2
Petitioner’s injury is consistent with SIRVA as defined by the Vaccine Injury Table. Id. at
5-6 (citing 42 C.F.R. §§ 100.3(a)(I)(C), (c)(10)). Respondent further agrees that Petitioner
suffered the residual effects or complications of her injury for more than six months after
vaccine administration. Id. (citing Section 13(a)(1)(B); Section 11(c)(1)(D)(i)).
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-01681-1
Date issued/filed: 2022-12-06
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 11/01/2022 ) regarding 42 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:20-vv-01681-UNJ Document 47 Filed 12/06/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1681V
UNPUBLISHED
THERESA JACKSON, Chief Special Master Corcoran
Petitioner,
v. Filed: November 1, 2022
SECRETARY OF HEALTH AND Special Processing Unit (SPU);
HUMAN SERVICES, Damages Decision Based on Proffer;
Tetanus-Diphtheria-Acellular
Respondent. Pertussis (Tdap); Shoulder Injury
Related to Vaccine Administration
(SIRVA).
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
Dorian Hurley, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On November 24, 2020, Theresa Jackson (“Petitioner”) 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 shoulder
injury related to vaccine administration (“SIRVA”) as a result of a tetanus-diphtheria-
acellular pertussis (“Tdap”) vaccine she received in her right deltoid on August 29, 2019.
Petition at 1. 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-01681-UNJ Document 47 Filed 12/06/22 Page 2 of 2
On November 1, 2022, Respondent filed a combined Rule 4(c) Report and Proffer
in which he conceded that Petitioner was entitled to compensation for a Table SIRVA.
Respondent’s Rule 4(c) Report and Proffer at 1, 5-6. That same day, I issued a Ruling on
Entitlement.
Respondent represents that Petitioner agrees to his proffer on an award of
compensation. Rule 4(c) Report and Proffer at 6. 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 combined Rule 4(c) Report and Proffer,3 I award
the following compensation:
A lump sum of $45,494.48 (representing $45,000.00 for pain and suffering,
and $494.48 for unreimbursed expenses) in the form of a check payable to
Petitioner. Respondent’s Rule 4(c) Report and Proffer at 6. This amount represents
compensation for all damages that would be available under Section 15(a). Id.
The Clerk of Court is directed to enter judgment in accordance with this decision.4
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Because the combined Rule 4(c) Report and Proffer contains information regarding Petitioner’s personal
medical history, which is not generally included in a Proffer when separately filed, it is not attached hereto.
4 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