VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00068
Package ID: USCOURTS-cofc-1_21-vv-00068
Petitioner: Mary Ross
Filed: 2021-01-05
Decided: 2022-12-15
Vaccine: influenza
Vaccination date: 2020-09-18
Condition: left shoulder vaccine related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 125657

AI-assisted case summary:
Mary Ross filed a petition for compensation under the National Vaccine Injury Compensation Program alleging that she suffered a left shoulder injury related to vaccine administration (SIRVA) resulting from an influenza vaccine she received on September 18, 2020. She stated that the vaccine was received in the United States, that her injury caused residual effects for more than six months, and that she had not received other compensation for her injuries. Respondent conceded entitlement to compensation, agreeing that Ms. Ross had no prior history of shoulder issues, that her pain and reduced range of motion were limited to the injection site, and that the onset of symptoms occurred within 48 hours of vaccination. The case proceeded as a Table claim. Following the ruling on entitlement, the parties submitted a proffer for damages. The Chief Special Master awarded Mary Ross a lump sum of $125,657.50, comprising $125,000.00 for pain and suffering and $657.50 for out-of-pocket medical expenses.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00068-0
Date issued/filed: 2022-12-13
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/09/2022) regarding 49 Ruling on Entitlement (Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:21-vv-00068-UNJ Document 56 Filed 12/13/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0068V
UNPUBLISHED
MARY ROSS, Chief Special Master Corcoran
Petitioner, Filed: November 9, 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)
Michael Adly Baseluos, Baseluos Law Firm, PLLC, San Antonio, TX, for Petitioner.
Steven Santayana, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 5, 2021, Mary Ross 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 left shoulder vaccine related to
vaccine administration (“SIRVA”) resulting from an influenza vaccine received on
September 18, 2020. Petition at 1. Petitioner further alleges that the vaccine was received
in the United States, she suffered the sequela of her injury for more than six months, and
she has not received compensation in the form of an award or settlement, or filed a civil
action, for her vaccine-related injuries. Petition at 1; Ex. 10 at 8, 10. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
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 1:21-vv-00068-UNJ Document 56 Filed 12/13/22 Page 2 of 2
On November 9, 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 had 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; she more likely than not suffered the onset of
pain within forty-eight hours of vaccine administration; her pain and reduced range of
motion were limited to the shoulder in which the intramuscular vaccine was administered;
and there is no other condition or abnormality present that would explain petitioner’s
symptoms.” Id. at 7. 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,” and Petitioner avers that
she has not received compensation for her vaccine-related injuries. 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_21-vv-00068-2
Date issued/filed: 2022-12-15
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 11/09/2022) regarding 50 DECISION Stipulation/Proffer ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:21-vv-00068-UNJ Document 58 Filed 12/15/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0068V
UNPUBLISHED
MARY ROSS, Chief Special Master Corcoran
Petitioner, Filed: November 9, 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)
Michael Adly Baseluos, Baseluos Law Firm, PLLC, San Antonio, TX, for Petitioner.
Steven Santayana, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 5, 2021, Mary Ross 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 left shoulder vaccine related to
vaccine administration (“SIRVA”) resulting from an influenza vaccine received on
September 18, 2020. Petition at 1. Petitioner further alleges that the vaccine was received
in the United States, she suffered the sequela of her injury for more than six months, and
she has not received compensation in the form of an award or settlement, or filed a civil
action, for her vaccine-related injuries. Petition at 1; Ex. 10 at 8, 10. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On November 9, 2022, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On November 9, 2022, Respondent filed a proffer on
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 1:21-vv-00068-UNJ Document 58 Filed 12/15/22 Page 2 of 2
award of compensation (“Proffer”) indicating Petitioner should be awarded $125,657.50.
Proffer at 7-8. 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 $125,657.50 (comprised of $125,000.00 for pain and suffering and
$657.50 for out of pocket medical 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.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