VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01890
Package ID: USCOURTS-cofc-1_20-vv-01890
Petitioner: Donna M. Winters
Filed: 2020-12-17
Decided: 2023-01-25
Vaccine: influenza
Vaccination date: 2019-11-17
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 67000

AI-assisted case summary:
Donna M. Winters filed a petition for compensation on December 17, 2020, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on November 17, 2019. The petition stated the vaccine was administered in the United States, the injury's residual effects lasted more than six months, and no civil action had been filed or award received for this injury. The respondent denied that the flu vaccine caused her SIRVA or any other injury. The parties subsequently filed a joint stipulation agreeing that a decision should be entered awarding compensation. Chief Special Master Brian H. Corcoran adopted the stipulation as the decision, awarding Donna M. Winters a lump sum of $67,000.00 for all items of damages available under the Vaccine Act. The decision was entered on January 25, 2023. Petitioner counsel was Richard H. Moeller, and respondent counsel was Mary Eileen Holmes.

Theory of causation field:
Petitioner Donna M. Winters alleged a shoulder injury related to vaccine administration (SIRVA) following an influenza vaccine on November 17, 2019. The injury is listed in the Vaccine Injury Table. Respondent denied the vaccine caused the alleged SIRVA or any other injury. The parties filed a joint stipulation agreeing to a settlement. Chief Special Master Brian H. Corcoran adopted the stipulation, awarding $67,000.00 as a lump sum. The stipulation was filed on December 22, 2022, and the decision was entered on January 25, 2023. Petitioner counsel was Richard H. Moeller, and respondent counsel was Mary Eileen Holmes.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01890-0
Date issued/filed: 2023-01-25
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 12/23/2022) regarding 45 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:20-vv-01890-UNJ Document 53 Filed 01/25/23 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1890V
UNPUBLISHED
DONNA M. WINTERS, Chief Special Master Corcoran
Petitioner, Filed: December 23, 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)
Richard H. Moeller, Moore, Heffernan, et al., Sioux City, IA, for Petitioner.
Mary Eileen Holmes, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On December 17, 2020, Donna M. Winters 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”), a defined Table injury, after receiving an influenza (“flu”)
vaccine on November 17, 2019. Petition at 1, ¶ 4; Stipulation, filed at December 22, 2022,
¶¶ 1-2, 4. In the alternative, Petitioner alleges that she suffered a shoulder injury which
was caused by the flu vaccine she received. Petition at 1-2. Petitioner further alleges that
she received the vaccine within the United States, that she suffered the residual effects
of her injury for more than six months, and that neither she nor any other party has filed
a civil action or received an award for her alleged SIRVA injury. Id. at 1, ¶¶ 4, 32-34;
Stipulation at ¶¶ 3-5. “Respondent denies that flu vaccine caused [P]etitioner to develop
a SIRVA, or any other injury, or her current condition.” 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-01890-UNJ Document 53 Filed 01/25/23 Page 2 of 7
Nevertheless, on December 22, 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 lump sum of $67,000.00 in the form of a check payable to Petitioner.
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-01890-UNJ Document 53 Filed 01/25/23 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DONNA M. WINTERS,
Petitioner, No. 20-1890V
Chief Special Master Corcoran
v. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. On December 17, 2020, Donna M. Winters (“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 the flu vaccine on November 17, 2019.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she suffered from a shoulder injury related to vaccine
administration (“SIRVA”) as a result of receiving the flu vaccine. Petitioner alleges that she
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 her condition.
1

Case 1:20-vv-01890-UNJ Document 53 Filed 01/25/23 Page 4 of 7
6. Respondent denies that the flu vaccine caused petitioner to develop a SIRVA, any
other injury, and/or her current condition.
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 of judgment 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)(1), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $67,000.00 in the form of a check payable to petitioner. This
amount 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 of judgment 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-21(a)(1), 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.
10. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any 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 by entities that provide health services on a pre-paid basis.
2

Case 1:20-vv-01890-UNJ Document 53 Filed 01/25/23 Page 5 of 7
11. 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-15(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 unreimbursed 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-15(a) and (d), and subject to the conditions of 42 U.S.C.
§300aa-15(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity, and on behalf of her heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
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. § 300 aa-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 November 17, 2019,
as alleged by petitioner in a petition for vaccine compensation filed on or about December 17,
2020, in the United States Court of Federal Claims as petition No. 20-1890V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
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Case 1:20-vv-01890-UNJ Document 53 Filed 01/25/23 Page 6 of 7
15. If the special master fails to issue a decision in complete conformity 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.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the flu vaccine caused petitioner to suffer from a
SIRVA or any other injury or condition.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner’s
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:20-vv-01890-UNJ Document 53 Filed 01/25/23 Page 7 of 7