VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01710
Package ID: USCOURTS-cofc-1_20-vv-01710
Petitioner: Nancy Dubrow
Filed: 2020-11-30
Decided: 2022-10-24
Vaccine: influenza
Vaccination date: 2019-09-29
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 62500

AI-assisted case summary:
Nancy Dubrow filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on September 29, 2019. She stated that the vaccination occurred in the United States, her injuries lasted more than six months, and she had not filed any other civil action for her injuries. The respondent conceded that Ms. Dubrow was entitled to compensation, finding that her case met the criteria for SIRVA as a Table injury. Specifically, the respondent noted that she had no prior shoulder issues, her pain and reduced range of motion occurred within 48 hours of the vaccination, her symptoms were limited to the injection site, and no other condition explained her symptoms. A ruling on entitlement was issued on May 18, 2022, finding her entitled to compensation. Subsequently, on September 19, 2022, the respondent filed a proffer agreeing to an award of $62,500.00 for pain and suffering, which Ms. Dubrow accepted. The Chief Special Master issued a decision awarding Ms. Dubrow a lump sum payment of $62,500.00 on October 24, 2022.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01710-0
Date issued/filed: 2022-06-24
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/18/2022) regarding 22 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-01710-UNJ Document 27 Filed 06/24/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1710V
UNPUBLISHED
NANCY DUBROW, Chief Special Master Corcoran
Petitioner, Filed: May 18, 2022
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)
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Amanda Pasciuto, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On November 30, 2020, Nany Dubrow 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) after receiving an influenza (flu) vaccination on September 29,
2019. Petition at 1. Petitioner further alleges that the vaccination was administered within
the United States, her injuries have lasted more than six months, and she has never filed
a civil action for her vaccination-related injuries. Petition at 1, 5. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On April 25, 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.
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-01710-UNJ Document 27 Filed 06/24/22 Page 2 of 2
Respondent found that Petitioner “has satisfied the criteria set forth in the Vaccine Injury
Table (“Table”) and the Qualifications and Aids to Interpretation (“QAI”) for SIRVA.” Id. at
6. Specifically, Respondent determined that “[P]etitioner had no history of pain,
inflammation, or dysfunction in her left shoulder; her pain and reduced range of motion
occurred within forty-eight 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 explain her initial symptoms.” Id. Respondent further
agrees that the scope of damages to be awarded is limited to petitioner’s SIRVA and its
related sequelae only. Id. at 7.
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-01710-1
Date issued/filed: 2022-10-24
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 09/21/2022) regarding 31 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:20-vv-01710-UNJ Document 35 Filed 10/24/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1710V
UNPUBLISHED
NANCY DUBROW, Chief Special Master Corcoran
Petitioner, Filed: September 21, 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)
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Amanda Pasciuto, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On November 30, 2020, Nany Dubrow 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) after receiving an influenza (flu) vaccination on September 29,
2019. Petition at 1. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
On May 18, 2022, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On September 19, 2022, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $62,500.00 in pain
and suffering. Proffer at 1. 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-01710-UNJ Document 35 Filed 10/24/22 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 $62,500.00 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-01710-UNJ Document 35 Filed 10/24/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
NANCY DUBROW,
Petitioner, No. 20-1710V
Chief Special Master Brian H. Corcoran
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On November 30, 2020, Nancy Dubrow (“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 left Shoulder
Injury Related to Vaccine Administration (“SIRVA”) as a result of an influenza (“flu”) vaccine
administered to her on September 29, 2019. See generally Petition.
On April 25, 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 May 18, 2022, the Chief Special Master issued a Ruling
on Entitlement finding petitioner entitled to compensation. ECF No. 21; ECF No. 22.
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-01710-UNJ Document 35 Filed 10/24/22 Page 4 of 5
This amount 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 following1: a lump sum payment of $62,500.00, in the form of a
check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Nancy Dubrow: $62,500.00
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
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
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 lost earnings
and future pain and suffering.
2

Case 1:20-vv-01710-UNJ Document 35 Filed 10/24/22 Page 5 of 5
/s/ Amanda Pasciuto
AMANDA PASCIUTO
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
(202)616-4847
Amanda.Y.Pasciuto@usdoj.gov
Dated: September 19, 2022
3