VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-02075
Package ID: USCOURTS-cofc-1_20-vv-02075
Petitioner: May Tom
Filed: 2020-12-30
Decided: 2022-12-13
Vaccine: influenza
Vaccination date: 2019-10-27
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 73722

AI-assisted case summary:
May Tom filed a petition for compensation under the National Vaccine Injury Compensation Program on December 30, 2020, alleging a left shoulder injury related to vaccine administration (SIRVA) resulting from an influenza vaccine received on October 27, 2019. She stated that the vaccine was received in the United States, the adverse effects lasted longer than six months, and she had not received other compensation or filed a civil action. The Respondent filed a Rule 4(c) report conceding that Petitioner is entitled to compensation, agreeing that she suffered a SIRVA Table injury and is presumed to have vaccine causation. The Respondent also confirmed the timely filing, receipt of the vaccine in the U.S., and satisfaction of the statutory severity requirement. A ruling on entitlement was issued on November 10, 2022, finding Petitioner entitled to compensation. Subsequently, on November 10, 2022, the Respondent filed a proffer proposing an award of $73,722.00, which Petitioner accepted. The court awarded Petitioner a lump sum payment of $73,722.00, comprising $72,500.00 for pain and suffering and $1,222.00 for unreimbursed expenses.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-02075-0
Date issued/filed: 2022-12-13
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/10/2022) regarding 30 Ruling on Entitlement ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:20-vv-02075-UNJ Document 35 Filed 12/13/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-2075V
UNPUBLISHED
MAY TOM, Chief Special Master Corcoran
Petitioner, Filed: November 10, 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.
Parisa Tabassian, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On December 30, 2020,2 May Tom filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.3 (the
“Vaccine Act”). In her April 27, 2021 amended petition, Petitioner alleges that she suffered
a left shoulder injury related to vaccine administration (“SIRVA”) resulting from an
influenza vaccine received on October 27, 2019. Amended Petition at 1. Petitioner further
alleges that she received the vaccine in the United States, the adverse effects of her
vaccine-related injuries have lasted for longer than six months, and Petitioner has not
received compensation in the form of an award or civil settlement, or filed a civil action,
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 Petitioner filed an amended petition on April 27, 2021.
3 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-02075-UNJ Document 35 Filed 12/13/22 Page 2 of 2
for her vaccine-related injuries. Amended Petition at ¶¶ 6, 23-25. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On November 10, 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 agrees that “Petitioner has provided preponderant
or reliable evidence that she suffered a SIRVA Table injury, and therefore is entitled to a
presumption of vaccine causation for SIRVA.” Id. at 4. Respondent further agrees that
“the records show that the case was timely filed, that the vaccine was received in the
United States, and that petitioner satisfies the statutory severity requirement by suffering
the residual effects or complications of her injury for more than six months after vaccine
administration.” Id. at 5. Respondent also notes that Petitioner has averred that she has
not filed any other action or received any compensation in the form of an award or
settlement for her vaccine-related injury. Id.
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-02075-1
Date issued/filed: 2022-12-14
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 11/10/2022) regarding 31 DECISION Stipulation/Proffer ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:20-vv-02075-UNJ Document 36 Filed 12/14/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-2075V
UNPUBLISHED
MAY TOM, Chief Special Master Corcoran
Petitioner, Filed: November 10, 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.
Parisa Tabassian, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On December 30, 2020,2 May Tom filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.3 (the
“Vaccine Act”). In her April 27, 2021 amended petition, Petitioner alleges that she suffered
a left shoulder injury related to vaccine administration (“SIRVA”) resulting from an
influenza vaccine received on October 27, 2019. Amended Petition at 1. Petitioner further
alleges that she received the vaccine in the United States, the adverse effects of her
vaccine-related injuries have lasted for longer than six months, and Petitioner has not
received compensation in the form of an award or civil settlement, or filed a civil action,
for her vaccine-related injuries. Amended Petition at ¶¶ 6, 23-25. 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 Petitioner filed an amended petition on April 27, 2021.
3 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-02075-UNJ Document 36 Filed 12/14/22 Page 2 of 2
On November 10, 2022, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On November 10, 2022, Respondent filed a proffer
on award of compensation (“Proffer”) indicating Petitioner should be awarded $73,722.00.
Proffer at 5. In the Proffer, Respondent represented that Petitioner agrees 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 Proffer, I award Petitioner a lump sum
payment of $73,722.00 (of which $72,500.00 represents an award for pain and
suffering, and $1,222.00 represents an award for unreimbursed 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.4
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
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