VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00001
Package ID: USCOURTS-cofc-1_21-vv-00001
Petitioner: Sheri Esters
Filed: 2021-01-04
Decided: 2024-01-17
Vaccine: influenza
Vaccination date: 2019-09-19
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 38158

AI-assisted case summary:
Sheri Esters filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine administered on September 19, 2019. The Chief Special Master found that Petitioner's injury and its residual effects lasted for more than six months, that her shoulder injury would not be explained by her prior medical history, that the onset of her shoulder pain occurred within 48 hours of vaccination, that her pain and reduced range of motion were limited to her right shoulder, and that no other condition or abnormality explained her symptoms. The court determined that SIRVA is a Table injury and that Petitioner met all the criteria for a Table SIRVA claim, including the severity requirement. The ruling on entitlement was issued on September 28, 2023. Subsequently, on January 17, 2024, a decision awarding damages was issued. The parties stipulated to an award of $37,500.00 for pain and suffering and $403.04 for past unreimbursable expenses, totaling $37,903.04. Additionally, $255.06 was awarded to satisfy the State of Idaho Medicaid lien. The total award was $38,158.00.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00001-0
Date issued/filed: 2023-11-17
Pages: 15
Docket text: PUBLIC ORDER/RULING (Originally filed: 09/28/2023) regarding 36 Ruling on Entitlement, Order on Motion for Ruling on the Record. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-00001-UNJ Document 40 Filed 11/17/23 Page 1 of 15
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0001V
UNPUBLISHED
SHERI ESTERS, Chief Special Master Corcoran
Petitioner,
v. Filed: September 28, 2023
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for Petitioner.
Julia Marter Collison, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 4, 2021, Sheri Esters filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”) alleging that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered on
September 19, 2019. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
1 Because this unpublished opinion contains a reasoned explanation for the action in this case, it must be
made publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the opinion 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 1:21-vv-00001-UNJ Document 40 Filed 11/17/23 Page 2 of 15
For the reasons discussed below, I find the evidence preponderates in the
conclusions that Petitioner’s injury and its residual effects lasted for more than six months;
that Petitioner’s shoulder injury would not be explained by her prior medical history; that
the onset of Petitioner’s shoulder pain occurred within 48 hours of vaccination; that
Petitioner’s pain and reduced range of motion were limited to her right shoulder; and that
no other condition or abnormality is present that would explain Petitioner’s symptoms.
Petitioner is entitled to compensation under the Vaccine Act.
I. Relevant Procedural History
As noted above, the case was initiated in January 2021. More than a year later, on
April 26, 2022, Respondent filed a status report stating that he was willing to entertain
settlement discussions, and although they entered into discussions, no terms could be
agreed upon. ECF No. 24.
Accordingly, on October 3, 2022, Respondent filed a Rule 4(c) Report disputing
Petitioner’s entitlement to a Vaccine Program award. ECF No. 29. Respondent argued
that Petitioner did not establish that she suffered the residual effects of her injury for
greater than six months (the “severity requirement”). Id. at 8-9. Respondent also argued
that Petitioner’s Table claim would fail because her symptoms did not begin within 48
hours of vaccination and her shoulder pain was not limited to her vaccinated shoulder. Id.
at 10-11.
On January 16, 2023, Petitioner filed a Motion for a Ruling on the Record (“Motion”)
arguing that she has met her burden of proof for both a Table SIRVA and off-Table claim.
ECF No. 32. Respondent filed his brief in reaction to Petitioner’s Motion on February 27,
2023 (“Response”). ECF No. 33. He maintains that “Petitioner has demonstrated neither
a Table claim nor an off-Table claim, and accordingly this case should be dismissed.” Id.
at 14. Petitioner filed her Reply on March 15, 2023. ECF No. 35.
II. Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
Section 11(c)(1). A Petitioner may prevail on his or her claim if he has “sustained, or
endured the significant aggravation of any illness, disability, injury, or condition” set forth
in the Vaccine Injury Table (the “Table”). Section 11(c)(1)(C)(i). The most recent version
of the Table, which can be found at 42 C.F.R. § 100.3, identifies the vaccines covered
under the Program, the corresponding injuries, and the time period in which the particular
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injuries must occur after vaccination. Section 14(a). If a claimant establishes that he has
suffered a “Table Injury,” causation is presumed.
Section 11(c)(1) also contains requirements concerning the type of vaccination
received and where it was administered, the duration or significance of the injury, and the
lack of any other award or settlement. See Section 11(c)(1)(A), (B), (D), and (E). With
regard to duration, a petitioner must establish that she suffered the residual effects or
complications of such illness, disability, injury, or condition for more than six months after
the administration of the vaccine. Section 11(c)(1)(D).
Effective for petitions filed beginning on March 21, 2017, SIRVA is an injury listed
on the Vaccine Injury Table. See Vaccine Injury Table: Qualifications and aids to
interpretation (“QAI”). 42 C.F.R. § 100.3(c)(10). The criteria are as follows:
A vaccine recipient shall be considered to have suffered SIRVA if such
recipient manifests all of the following: (i) No history of pain, inflammation
or dysfunction of the affected shoulder prior to intramuscular vaccine
administration that would explain the alleged signs, symptoms, examination
findings, and/or diagnostic studies occurring after vaccine injection; (ii) Pain
occurs within the specified time-frame; (iii) Pain and reduced range of
motion are limited to the shoulder in which the intramuscular vaccine was
administered; and (iv) No other condition or abnormality is present that
would explain the patient’s symptoms (e.g. NCS/EMG or clinical evidence
of radiculopathy, brachial neuritis, mononeuropathies, or any other
neuropathy).
Id.
III. Relevant Factual Evidence
I have fully reviewed the evidence, including all medical records, affidavits, and the
parties’ briefing. The below is a summary of the most relevant facts:
• Petitioner had a pre-vaccination medical history that includes Type 2 diabetes,
obesity, cervical cancer, migraines and chronic pain in her neck, hips, back and
knees. Ex. 5 at 5-28. Petitioner was prescribed hydrocodone and methocarbamol
to manage her chronic pain. Id.; See also Ex. 8.
• Petitioner was administered a flu vaccine on September 19, 2019, at Kootenai
Health. Ex. 2. It was injected into her right deltoid. Id.
3

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• In her affidavit, signed on January 1, 2021, Petitioner avers that she “felt pain in
and around the injection site in the afternoon after receiving the vaccination.” Ex.
3 at 1.
• Petitioner further avers that hydrocodone and methocarbamol, prescribed for
chronic lower back and knee pain, helped “to take the edge off” of the shoulder
pain she experienced following receipt of the flu vaccine. Ex. 3 at 2.
• On October 16, 2019 (nearly a month post-vaccination), Petitioner presented to
Idaho Pain Clinic for a monthly medication management appointment. Ex. 8 at 147-
149. There is no indication that Petitioner mentioned right shoulder pain during this
visit. However, in her supplemental affidavit, signed on January 16, 2023,
Petitioner states that she did not mention her right shoulder pain during this
appointment “because it was just a medication check-up for lower back pain and I
did not find it necessary or relevant to report unrelated right shoulder pain.” Ex. 23
at 1.
• On November 13, 2019, Petitioner sent an email to her attorney requesting a return
call “regarding a flu shot in September 2019.” Ex. 22 at 1.
• The next day - November 14, 2019 (now 56 days post-vaccination) - Petitioner
presented to Idaho Pain Clinic for a medication management appointment. Ex. 8
at 150. The record documenting this visit reflects Petitioner’s report of “trouble with
right arm after her flu shot . . . since September.” Id. at 151.
• Also on that same day, Petitioner presented to her primary care physician’s office
at Kootenai Clinic with complaints of “intermittent shooting pain down her right arm
from her right shoulder down to her lower arm . . . She isn’t exactly sure if the pain
shoots up or down . . . She says pain radiates to her wrist.” Ex. 5 at 39. Petitioner
reported that the onset of her condition was “2mo ago after the flu shot.” Id.
Petitioner was referred to physical therapy and prescribed a Medrol dosepak. Id.
at 43.
• A December 20, 2019 MRI of Petitioner’s right arm revealed no abnormalities. Ex.
5 at 58.
• Petitioner presented for medication management appointments at Idaho Pain
Clinic on January 9, February 5, and March 2, 2020. Ex. 8 at 156-164. The
assessment portion of the medical notes all include the following language:
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[Petitioner] is here for a medication management, refill, and monitoring
follow up. She experiences migraines, right upper extremity, pain in the
low back region with bilateral radicular symptoms down the lower
extremities and both knees. She is currently taking hydrocodone 10-
325mg up to three to four times daily #100 and methocarbamol 750mg to
help manage her pain. She denies any new injuries or symptoms since
her last visit.
Id. at 157, 160, 163 (emphasis added).
• The concluding sentences of Petitioner’s January 9, 2020 assessment indicate that
Petitioner “states that she also had a bone density scan done recently and that she
was placed on a new medication due to this.” Ex. 8 at 157.
• The concluding sentences of Petitioner’s February 5, 2020 assessment indicate
that Petitioner “has high blood pressure ans [sic] states she feels light headed. She
has an appointment tomorrow with her primary care. She has a new primary who
is Dr. Tracy Schwartzman.” Ex. 8. at 160.
• The concluding sentences of Petitioner’s March 2, 2020 assessment indicate that
Petitioner “is stable on her current regimen and is requesting a refill at this time.”
Ex. 8. at 163.
• On February 6, 2020, Petitioner presented to Advanced Practice Nurse
Practitioner (“NP”) Tracy Schwartzman at Rockwood Clinic Family Medicine for
multiple complaints, including dizziness and hypertension. Ex. 7 at 12-18. The
medical record does not reflect any reports of shoulder pain.
• In her January 2023 supplemental affidavit, Petitioner states that although she
reported right shoulder pain to NP Schwartzman on February 6, 2020, “she did not
examine my shoulder or provide any treatment. I feel she did not know how to treat
my shoulder condition and was a [sic] somewhat dismissive of my injury.” Ex. 23
at 2.
• Petitioner presented to her medication management appointments virtually on
March 30 and April 27, 2020 “due to COVID 19 restrictions.” Ex. 8 at 165-170. The
note documenting both appointments indicate that Petitioner “experiences
migraines, right upper extremity, pain in the low back region with bilateral radicular
symptoms down the lower extremities and both knees.” Id. at 166, 169 (emphasis
added).
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• In her supplemental affidavit, Petitioner avers that she was unable to obtain
treatment for her shoulder pain from February 2020 through August 2020 because
of the COVID-19 pandemic. Ex. 23 at 2. “All medical offices were closed . . . and
even after they opened, I did not seek medical treatment right away because I was
afraid of getting COVID-19.” Id.
• Petitioner also avers that personnel at “Rockwood Valley Orthopedics . . . told me
I need surgery for my shoulder, and I got the impression that anything other than
surgery will not be very helpful. I did not receive treatment for my shoulder from
April 2020 through May 2021 because I knew I need surgery, and I was not able
to proceed with surgery at that time.” Ex. 23 at 2.3
• Petitioner attended in-person medication management appointments at Idaho Pain
Clinic in May, June, July and August 2020. Ex. 8 at 171-179; 184-186. The
assessment portion of the medical notes all include the following language:
[Petitioner] is here today for a medication management, refill, and
monitoring follow up. She experiences migraines, right upper extremity,
pain in the low back region with bilateral radicular symptoms down the lower
extremities and both knees. She is currently taking hydrocodone 10-325mg
up to three to four times daily #100 and methocarbamol 750mg to help
manage her pain.
Id. at 172, 175, 178, 185 (emphasis added).
• The concluding sentences of Petitioner’s May 21, 2020 assessment indicate that
“[Petitioner] denies any new injuries or symptoms since her last visit. [Petitioner] is
stable on her current regimen and is requesting a refill at this time. She is
requesting a refill of pain medication at this time.” Id. at 172.
• The concluding sentences of Petitioner’s June 18, 2020 assessment indicate that
“she took a fall on Monday, and currently has back, bilateral leg, and neck pain.
[Petitioner] is stable on her current regimen and is requesting a refill at this time.
She is requesting a refill of pain medication at this time.” Ex. 8 at 175.
3 Petitioner’s first appointment at Rockwood Valley Orthopedics (“Rockwood”) did not take place until
December 9, 2020. Ex. 9 at 6-17. There is no indication that right shoulder surgery was discussed at
Rockwood until May 2022. See Ex. 17 at 14 (noting that “possible treatments including continued injection
therapy, PT vs surgery” were discussed).
6

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• The concluding sentences of Petitioner’s July 16, 2020 assessment indicate that
Petitioner “took a fall on Monday and currently has back, bilateral leg, and neck
pain. [Petitioner] states she pulled some muscles in her low back. She went to the
urgent care and they prescribed her a muscle relaxer. She is requesting Magda
take over the Rx. She is requesting a refill of pain medication at this time. Id. at
178-179.
• The concluding sentences of Petitioner’s August 17, 2020 assessment indicate
that Petitioner “is stable and doing well on her current regimen. She was called in
for a pill count on 8/3/20 and the count was more than expected to be remaining.”
Id. at 185.
• Petitioner presented for a virtual appointment with NP Schwartzman on May 4,
2020. Ex. 7 at 36-39. Petitioner’s blood pressure and mental health diagnosis were
discussed, and it was noted that she “ha[d] no other complaints.” Id. at 37. There
is no indication that Petitioner’s right shoulder was discussed.
• On August 20, 2020, Petitioner returned to NP Schwartzman for an annual
wellness visit. Ex. 7 at 45-57. There is no indication that Petitioner’s right shoulder
was discussed.
• The note documenting Petitioner’s September 14, 2020 medication management
appointment at Idaho Pain Clinic reflects Petitioner’s report of “pain in her upper
right arm for the past year.” Ex. 14 at 13. Petitioner further reported that the pain
started after receipt of a flu vaccine. Id.
• On September 23, 2020, Petitioner sent an email to NP Schwartzman stating “I
wanted to send a message regarding my right shoulder pain, can we schedule a
MRI to see why I’m have [sic] so much pain?” Ex. 7 at 86.
• Petitioner presented to medication management appointments at the Idaho Pain
Clinic on October 12 and November 9, 2020. Ex. 14 at 15-20. These records
indicate that Petitioner “experiences migraines, right upper extremity, pain in the
low back region with bilateral radicular symptoms down the lower extremities and
both knees.” Id. at 16, 19 (emphasis added). There is no indication that Petitioner’s
right shoulder was discussed during these appointments.
• Petitioner underwent an MRI of her right shoulder on November 16, 2020. Ex. 7 at
118-119. The MRI revealed moderate supraspinatus tendinopathy, moderate
infraspinatus tendinopathy, mild subscapularis tendinopathy, mild biceps
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tendinopathy, degenerative fraying and tearing of the labrum, mild subacromial
subdeltoid bursitis, moderate acromioclavicular degenerative changes, and signs
of impingement syndrome. Id. at 119.
• On December 9, 2020, Petitioner presented to Certified Physician’s Assistant
(“PA”) Michael Prentice at Rockwood Valley Orthopedics for an evaluation of her
right shoulder. Ex. 9 at 6-17. The medical note reflects Petitioner’s report of right
shoulder pain that began “about one year ago.” Id. at 8. Petitioner was assessed
with a nontraumatic incomplete tear of the right rotator cuff and impingement
syndrome of her right shoulder. Id. at 12.
• Petitioner presented to medication management appointments at the Idaho Pain
Clinic on December 7, 2020 as well as on January 4 and February 1, 2021. Ex. 14
at 21-29. The notes documenting these visits indicate that Petitioner “experiences
migraines and pain in the right upper extremity, pain in the low back region with
bilateral radicular symptoms down the lower extremities and both knees.” Id. at 22,
25, 28 (emphasis added).
• The concluding sentences of Petitioner’s December 7, 2020 and February 1, 2021
assessment indicate that Petitioner “denies any new injuries or symptoms since
her last visit. She is requesting a refill of pain medication at this time.” Id. at 22, 28.
• The concluding sentences of Petitioner’s January 4, 2021 assessment indicate that
Petitioner “states her hydrocodone seems to be wearing off fairly quickly. She
denies any new symptoms or inquiries since her last visit. She is requesting a
medication refill at this time.” Id. at 25.
• During Petitioner’s February 15, 2021 presentation to PA Prentice, she underwent
an ultrasound-guided steroid injection in her right shoulder. Ex. 13 at 41-47.
Petitioner was diagnosed with “right shoulder pain with rotator cuff tear and
bursitis.” Id. at 43.
• On March 8, 2021, Petitioner presented to PA Prentice for right knee pain. Ex. 13
at 51. There is no indication that her right shoulder was discussed during this visit.
• Petitioner presented to the Idaho Pain Clinic on March 25, 2021 for a medication
management appointment. Ex. 14 at 33-35. This record reflects that Petitioner
“experiences migraines and pain in the right upper extremity, pain in the low back
region with radicular symptoms down the lower extremities and both knees.” Id. at
34-35 (emphasis added).
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• Petitioner presented to PA Prentice on April 15, 2021 concerning her right shoulder
and knee. Ex. 13 at 66-70. The medical note documenting this visit reflects
Petitioner’s report of “right shoulder issues.” Id. at 66.
• The note documenting Petitioner’s April 22, 2021 medication management
appointment at Idaho Pain Clinic indicates that Petitioner “needs a right shoulder
surgery.” Ex. 14 at 39. There is no further mention of Petitioner’s right shoulder.
• Petitioner returned to the Idaho Pain Clinic on July 15, 2021 for a medication
management appointment. Ex. 14 at 46-48. Petitioner reported doing “a lot of
weeding and [that] her shoulders are been [sic] bothering her.” Id. at 48.
• The note documenting Petitioner’s December 2021 medication management
appointment at Idaho Pain Clinic reflects that Petitioner reported “chronic pain from
her shoulder and needs shoulder surgery but does not want to go forward with the
surgery yet.” Ex. 16 at 11.
• Petitioner presented to the Idaho Pain Clinic on January 27, February 23, and
March 23, 2022 for medication management appointments. Ex. 16 at 13-23. There
is no indication that her right shoulder was discussed during these visits.
• On May 4, 2022, Petitioner returned to PA Prentice regarding right shoulder pain.
Ex. 17 at 8-15. The note documenting this appointment indicates that possible
treatments included “injected therapy, PT vs surgery.” Id. at 14. Petitioner
underwent her second steroid injection and was referred to physical therapy. Id. at
14.
• Petitioner underwent an initial physical therapy exam for right shoulder pain on
June 2, 2022. Ex. 18 at 14-22. The record indicates that Petitioner’s symptoms
“started a couple years ago after a flu shot and symptoms have slowly gotten
worse.” Id. at 14. It’s further noted that Petitioner “initially had some numbness . .
. [she] doesn’t have this anymore.” Id.
• Petitioner participated in physical therapy on June 7, 2022. Ex. 18 at 25-29. The
note documenting this session indicates that Petitioner “woke up . . . with
neck/shoulder hurting and potentially slept awkwardly.” Id. at 25.
• Petitioner completed her physical therapy on June 30, 2022 after attending four
sessions. Ex. 18 at 24-36; Ex. 20 at 33-34.
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• Petitioner presented to Dr. Byron Humble, an orthopedic surgeon on August 23,
2022. Ex. 19 at 22-39. The medical record documenting this visit reflects
Petitioner’s report of “shoulder pain since having a flu shot about [three] years
ago.” Id. at 23. Dr. Humble noted that Petitioner had “components of rotator cuff
syndrome with impingement with impingement possible rotator cuff tear.” Id. at 27.
• Petitioner presented to her primary care provider on January 17, May 25 and
October 6, 2022. Ex. 21 at 428-453; 507-517; 574-587. There is no indication that
Petitioner’s right shoulder was discussed during these visits.
IV. Findings of Fact
A. Severity
The first issue to be resolved is whether Petitioner has demonstrated that she
suffered “residual effects or complications of [the injury alleged] for more than six months
after the administration of the vaccine,” as required for eligibility under the Vaccine
Program. Section 11(c)(1)(D)(i).
There appears to be no dispute that Petitioner received the flu vaccine on
September 19, 2019, and she therefore must demonstrate by preponderant evidence that
her residual symptoms continued at least through March 19, 2020. See, e.g., Herren v.
Sec'y of Health & Human Servs., No. 13-100V, 2014 WL 3889070, at *2 (Fed. Cl. Spec.
Mstr. July 18, 2014); see also Hinnefeld v. Sec'y of Health & Human Servs., No. 11-328V,
2012 WL 1608839, at *4-5 (Fed. Cl. Spec. Mstr. Mar. 30, 2012) (dismissing case where
medical history revealed that petitioner's Guillain-Barré syndrome resolved less than two
months after onset).
The record establishes that Petitioner initially sought treatment for her shoulder
injury on November 14, 2019 – almost two months post-vaccination. However,
Respondent argues that because Petitioner did not specifically mention her shoulder pain
again until September 2020 (more than one year later) despite attending monthly
medication management appointments, she is unable to meet the severity requirement.
Response at 9. Respondent also argues that Petitioner has not established that any
subsequent findings “are more likely related to her alleged vaccine-related shoulder injury
than to any other conditions,” and that the timing of Petitioner’s return to treatment
“suggests a primary motivation to support the litigation of her vaccine injury claim.” Id.
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Although Petitioner acknowledges not receiving “extensive” treatment for her
shoulder injury prior to September 2020 (which she attributes both to the challenges
presented by the COVID-19 pandemic and the ameliorative effects of hydrocodone –
which had been prescribed for back pain), she disputes Respondent’s contention that she
did not ever report shoulder pain to her providers. In addition to noting that her complaints
of “right upper extremity pain” were noted at each medication management appointment,
she also asserts that she discussed her right shoulder pain with her primary care provider,
NP Schwartzman, on at least three separate occasions. Reply at 2. Specifically, Petitioner
claims that “[d]espite [her] consistent complaints of right shoulder pain, NP Schwartzman
failed to document those complaints or examine her right shoulder at any of those visits.”
Id. Petitioner points to record evidence of NP Schwartzman’s willingness to refer her for
a right shoulder MRI as evidence of their previous discussions of her shoulder symptoms.
Id.
Although I have previously determined that the intervention of the COVID-19
pandemic (“Pandemic”) can reasonably be understood to have caused individuals to put
off treatment, especially in the spring of 2020, the treatment gap in this case cannot be
completely explained by this event. Petitioner did not attend any appointments concerning
shoulder pain in December 2019 or in January and February of 2020 – before the
Pandemic was declared. And although Petitioner attended her March and April 2020
medication management appointments virtually, she resumed her in-person monthly
visits in May 2020 – indicating that she was willing to schedule and attend her most
pressing healthcare appointments.
However, I do find it likely that Petitioner’s continued use of hydrocodone
contributed to her ability to withstand her shoulder pain without meaningful intervention.
And I also acknowledge that Petitioner’s “right upper extremity” pain was consistently
noted during her monthly medication management appointments from January through
August 2020. See Ex. 8 at 156-179; 184-186. Although Respondent asserts that these
notations were included “in the auto-generated portion of the ‘Assessment’ field of the
records,” a close examination of the entries reveal that the concluding notes within this
section were updated on a regular basis. Compare Ex. 8 at 157 with id. at 160, 163; Ex.
8 at 172 with id. at 175, 178-179, 185; Ex. 14 at 22, 28 with id. at 25. Therefore, I find it
likely that Petitioner’s shoulder issues were mentioned during these visits – even if just in
passing.
Moreover, Petitioner’s argument that NP Schwartzman failed to chart Petitioner’s
references to shoulder pain – especially given that two out of three of their appointments
concerned specific concerns (hypertension and a dizziness, in one instance, and
Petitioner’s mental health, in another) – is persuasive. See Ex. 7 at 12-18, 36-39. I also
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note NP Schwartzman’s willingness to refer Petitioner for an MRI without examination.
See Ex. 7 at 86. As the Court has recognized, physicians may enter information
incorrectly and “typically record only a fraction of all that occurs.” Shapiro v. Sec'y of
Health & Human Servs., 101 Fed. Cl. 532, 538 (2011) (citing Murphy v. Sec'y of Health &
Human Servs., 23 Cl. Ct. 726, 733 (1991)).
Thus, I find that the evidence preponderates – just barely – in Petitioner's favor on
this issue. Petitioner should take note, however, that the existing record (which features
long gaps in which treatment was not sought) speaks to a particularly mild SIRVA, and
therefore that any damages allowed in this case will be more modest than other claims.
B. Factual Findings Regarding QAI Criteria for Table SIRVA
1. Prior Condition
The first QAI requirement for a Table SIRVA is lack of a history revealing problems
associated with the affected shoulder which were experienced prior to vaccination and
would explain the symptoms experienced after vaccination. 42 C.F.R. § 100.3(c)(10)(i).
Respondent has not contested that Petitioner has met the first requirement under
the QAI for a Table SIRVA. Additionally, I do not find any evidence that Petitioner suffered
a pre-vaccination history of problems that would explain her post-vaccination shoulder
symptoms. Accordingly, I find that Petitioner has met the first criterion to establish a Table
SIRVA.
2. Onset
A petitioner alleging a SIRVA claim must also show that she experienced the first
symptom or onset within 48 hours of vaccination (42 C.F.R. § 100.3(a)(XIV)(B)), and that
her pain began within that same 48-hour period (42 C.F.R. § 100.3(c)(10)(ii) (QAI
criteria)). Respondent argues that Petitioner has not met this criterion because “[o]ne
month post-vaccination, [P]etitioner visited her pain specialist, but made no mention of
shoulder pain.” Report at 11. Respondent also argues that when Petitioner finally did
report her shoulder pain – first to her attorney, and then to “the same pain specialist to
whom she had not mentioned any shoulder pain the month prior,” she did not specify a
precise date of onset. Id.
Despite Respondent’s contentions, the totality of the record supports the
conclusion that Petitioner’s shoulder pain most likely began within 48 hours of
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vaccination. Respondent correctly notes that the medical records do not assign an exact
date to the start of Petitioner’s symptoms and that vague temporal references to onset in
the record (e.g., “trouble with right arm after her flu shot . . . since September” (emphasis
added)) allow for the possibility that onset could have occurred more than 48 hours from
vaccination. However, there is no counterevidence undercutting Petitioner’s contention
that her pain likely began close-in-time to vaccination, and she consistently attributed her
shoulder symptoms to the flu shot.
While there was an intervening medical appointment after vaccination and at which
time Petitioner could have mentioned her pain, I do not find that it undermines a favorable
onset determination. Petitioner has explained that she did not disclose her right shoulder
pain during her October 16, 2019 visit to the Idaho Pain Clinic “because it was just a
medication check-up . . . and I did not find it necessary or relevant to report unrelated
right shoulder pain.” Ex. 23 at 1. And not long thereafter, she informed this same provider
(on November 14, 2019) of her pain. Indeed, on the same date, Petitioner sought
treatment from her primary care provider for her shoulder (which substantiates her claim
that she did not believe this issue was relevant to the care she was receiving from the
Idaho Pain Clinic), relating her symptoms to her September 2019 flu shot.
Accordingly, I find that Petitioner has met the second criterion to establish a Table
SIRVA.
3. Scope of Pain
The third QAI requirement for a Table SIRVA requires a petitioner’s pain and
reduced range of motion to be “limited to the shoulder in which the intramuscular vaccine
was administered.” 42 C.F.R. § 100.3(c)(10)(iii). Respondent argues that Petitioner has
not satisfied this criterion because “[she] initially described her pain as ‘intermittent
shooting pain down her right arm from her right shoulder down to her lower arm’ and as
radiating to her wrist.” Response at 12. Respondent further argues that “in June 2022,
[P]etitioner alleged right-sided neck pain and numbness concurrent with shoulder pain.”
Id. 4
I nevertheless find that (for purposes of the Table SIRVA claim), a preponderance
of the evidence supports the conclusion that Petitioner’s injury was limited to her right
shoulder, even if symptoms elsewhere were documented. It Is true that Petitioner initially
described “intermittent shooting pain” that radiated to her wrist.” Ex. 5 at 39. However,
Petitioner’s records reveal that this was the only time she described radiating symptoms.
Further, Petitioner’s right shoulder was the focus of her complaints and the resulting
4 Petitioner’s complaint of numbness was limited to her “lateral right shoulder.” Ex. 20 at 12.
13

Case 1:21-vv-00001-UNJ Document 40 Filed 11/17/23 Page 14 of 15
diagnoses. See, e.g., Ex. 9 at 8 (December 9, 2020 orthopedic note documenting
Petitioner’s complaint of right shoulder pain); Ex. 13 at 43 (February 15, 2021 orthopedic
note reflecting the diagnosis of “[r]ight shoulder pain with rotator cuff tear and bursitis”
and charting Petitioner’s receipt of a steroid injection); Ex. 19 at 27 (August 23, 2022
orthopedic note indicating that Petitioner “does have components of rotator cuff syndrome
with impingement possible rotator cuff on exam.”).
I also do not find Petitioner’s lone report of “neck/shoulder” pain (due to sleeping
“awkwardly”) fatal to her claim. I have previously recognized that the third QAI criterion
does not prevent a petitioner with simultaneous areas of pain due to unrelated conditions
from also meeting the Table SIRVA definition. Rodgers v. Sec’y of Health & Hum. Servs.,
No. 18-0559, 2021 WL 4772097, at *8 and n.16 (Fed. Cl. Spec. Mstr. Sept. 9, 2021).
However, Petitioner must bear in mind that unrelated conditions must be separated out
from the damages attributable for a Table SIRVA. Rodgers, 2021 WL 47772097 at n. 16;
see also Knudsen v. Sec'y of Health & Hum. Servs., No. 18-1971V, 2021 WL 4448738,
at *5 (Fed. Cl. Spec. Mstr. Aug. 23, 2021) (“distinguishable injuries are not an additional
basis for recovery”). Rather, the focus of fact-finding for this criterion is whether pain is
consistently reported with respect to the relevant shoulder, even if concurrent reports of
pain elsewhere are also evident from the record. Here, the preponderance of evidence
suggests that Petitioner’s shoulder was her main concern – and any distinguishable injury
can be differentiated in the process of calculating damages.
4. Other Condition or Abnormality
The last QAI criteria for a Table SIRVA states that there must be no other condition
or abnormality which would explain a petitioner’s current symptoms. 42 C.F.R. §
100.3(c)(10)(iv). Respondent has not contested that Petitioner meets this criterion, and
there is no evidence in the record to the contrary. Thus, the record contains preponderant
evidence establishing that there is no other condition or abnormality which would explain
the symptoms of Petitioner’s right shoulder injury.
C. Other Table Requirements for Entitlement
Based on the above, I find that Petitioner has satisfied all requirements for a Table
SIRVA and is entitled to a presumption of causation. However, even if a petitioner has
satisfied the requirements of a Table injury or established causation-in-fact, he or she
must also provide preponderant evidence of the additional requirements of Section 11(c).
The overall record contains preponderant evidence to fulfill these additional requirements.
14

Case 1:21-vv-00001-UNJ Document 40 Filed 11/17/23 Page 15 of 15
The record shows that Petitioner received a flu vaccine intramuscularly in her right
shoulder on September 19, 2019 in Idaho. Ex. 2; Ex. 5 at 38; see Section 11(c)(1)(A)
(requiring receipt of a covered vaccine); Section 11(c)(1)(B)(i)(I) (requiring administration
within the United States or its territories). There is no evidence that Petitioner has
collected a civil award for her injury. Section 11(c)(1)(E) (lack of prior civil award).
Additionally, as stated above, I have found that Petitioner suffered the residual effects of
her shoulder injury for more than six months. See Section 11(c)(1)(D)(i)(statutory six-
month requirement).
Thus, based upon all of the above, Petitioner has established that she suffered a
Table SIRVA. Additionally, she has satisfied all other requirements for compensation.5 I
therefore find that Petitioner is entitled to compensation in this case.
Conclusion
Based on the entire record, I find that Petitioner has provided preponderant evidence
satisfying all requirements for a Table SIRVA and the Vaccine Act’s severity requirement
for both Table and non-Table claims. Petitioner is entitled to compensation in this case.
A subsequent order will set further proceedings towards resolving damages (and I
reiterate my earlier point that this case is not one in which a large pain and suffering award
is called for, and therefore Petitioner must factor in the overall mild nature of her injury in
seeking damages).
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
5 Because I have found that Petitioner has demonstrated a Table injury, there is no need to address
Petitioner’s “causation-in-fact” allegation.
15

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_21-vv-00001-1
Date issued/filed: 2024-01-17
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 12/13/2023) regarding 43 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
--------------------------------------------------------------------------------
Case 1:21-vv-00001-UNJ Document 49 Filed 01/17/24 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0001V
SHERI ESTERS, Chief Special Master Corcoran
Petitioner, Filed: December 13, 2023
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for Petitioner.
Julia Marter Collison, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 4, 2021, Sheri Esters 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 an influenza (“flu”) vaccine administered on
September 19, 2019. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On September 28, 2023, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On December 11, 2023, Respondent filed a proffer
on award of compensation (“Proffer”) indicating Petitioner should be awarded (a) a lump
sum payment of $37,903.04 (comprised of $37,500.00 for pain and suffering and $403.04
for past unreimbursable expenses); and (b) a lump sum payment of $255.06, representing
1 Because this Decision contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (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 (2018).

Case 1:21-vv-00001-UNJ Document 49 Filed 01/17/24 Page 2 of 5
compensation for satisfaction of the State of Idaho Medicaid lien. Proffer at 2-3. In the
Proffer, Respondent represented that Petitioner agrees with the proffered award. Id. at 2.
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. a lump sum payment of $37,903.04 (comprised of $37,500.00 for pain and
suffering and $403.04 for past unreimbursable expenses) in the form of a
check payable to Petitioner; and
B. A lump sum of $255.06, representing compensation for satisfaction of the
State of Idaho Medicaid lien, in the form of a check payable jointly to
petitioner and
HMS Idaho Recovery Unit
Case Number: 115902
P.O. Box 84551
Seattle, WA 98124-5851
Petitioner agrees to endorse the check to the HMS Idaho Recovery Unit
for satisfaction of the Medicaid lien.
These amounts represent 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 1:21-vv-00001-UNJ Document 49 Filed 01/17/24 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
SHERI ESTERS,
Petitioner, No. 21-0001V (ECF)
Chief Special Master Corcoran
v. SPU
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On January 16, 2023, petitioner filed a Motion for a Ruling on the Record (“Motion”)
arguing that she has established entitlement to compensation for a shoulder injury related to
vaccine administration. ECF No. 32. Respondent filed his Response to Petitioner’s Motion on
February 27, 2023, recommending that entitlement to compensation be denied. ECF No. 33. On
September 28, 2023, the Chief Special Master issued a Ruling on Entitlement finding petitioner
entitled to compensation.1 ECF No. 36.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $37,500.00 in pain and suffering
damages. See 42 U.S.C. § 300aa-15(a). Petitioner agrees.
1 Respondent has no objection to the amount of the proffered award of damages set forth
herein. Assuming the Chief Special Master issues a damages decision in conformity with this
proffer, respondent waives his right to seek review of such damages decision. However,
respondent reserves his right, pursuant to 42 U.S.C. § 300aa-12(e), to seek review of the Chief
Special Master’s September 28, 2023, entitlement decision.

Case 1:21-vv-00001-UNJ Document 49 Filed 01/17/24 Page 4 of 5
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 $403.04. See 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
C. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy the State of Idaho
Medicaid lien in the amount of $255.06, which represents full satisfaction of any right of
subrogation, assignment, claim, lien, or cause of action the State of Idaho may have against any
individual as a result of any Medicaid payments the State of Idaho has made to or on behalf of
petitioner from the date of her eligibility for benefits through the date of judgment in this case as
a result of her alleged vaccine-related injury suffered on or about September 19, 2019 under Title
XIX of the Social Security Act.
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
The parties recommend that compensation provided to petitioner should be made through
two lump sum payments described below, and request that the Chief Special Master’s decision
and the Court’s judgment award the following:2
A. A lump sum payment of $37,903.04 in the form of a check payable to petitioner; and
B. A lump sum payment of $255.06, representing compensation for satisfaction of the
State of Idaho Medicaid lien, in the form of a check payable jointly to petitioner and:
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
medical expenses, future pain and suffering, and future lost wages.
2

Case 1:21-vv-00001-UNJ Document 49 Filed 01/17/24 Page 5 of 5
HMS Idaho Recovery Unit
Case Number: 115902
P.O. Box 84551
Seattle, WA 98124-5851
Petitioner agrees to endorse the check to the HMS Idaho Recovery Unit for satisfaction of
the Medicaid lien.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
/s/ Julia M. Collison
JULIA M. COLLISON
Assistant Director
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Ben Franklin Station
Washington, DC 20044-0146
Tel: (202) 305-0102
Julia.collison@usdoj.gov
Dated: December 11, 2023
3