VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00140
Package ID: USCOURTS-cofc-1_21-vv-00140
Petitioner: Kathy Blackmon
Filed: 2021-01-06
Decided: 2024-04-24
Vaccine: influenza
Vaccination date: 2019-10-09
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 172091

AI-assisted case summary:
Kathy Blackmon filed a petition for compensation under the National Vaccine Injury Compensation Program on January 6, 2021, alleging a shoulder injury related to vaccine administration (SIRVA) following an influenza vaccine received on October 9, 2019. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report on June 21, 2022, conceding that Ms. Blackmon's injury met the Vaccine Injury Table definition for SIRVA and that she was entitled to compensation. Chief Special Master Brian H. Corcoran issued a Ruling on Entitlement on June 22, 2022, finding Ms. Blackmon entitled to compensation. Subsequently, on March 22, 2024, the respondent filed a Proffer on Award of Compensation, which Ms. Blackmon agreed to. The Special Master's decision, issued on April 24, 2024, awarded Ms. Blackmon a lump sum payment of $172,091.00. This award included $145,000.00 for pain and suffering and $27,091.00 for past lost wages, representing compensation for all damages available under the Vaccine Act. Petitioner's counsel was Maximillian J. Muller of Muller Brazil, LLP, and respondent's counsel was Lynn Christina Schlie of the U.S. Department of Justice.

Theory of causation field:
Kathy Blackmon filed a petition alleging a shoulder injury related to vaccine administration (SIRVA) following an influenza vaccine received on October 9, 2019. The respondent conceded that the injury met the Vaccine Injury Table definition for SIRVA. A ruling on entitlement was issued on June 22, 2022, finding petitioner entitled to compensation. On March 22, 2024, the respondent filed a proffer on award of compensation, which petitioner agreed to. The Special Master awarded a lump sum of $172,091.00, comprising $145,000.00 for pain and suffering and $27,091.00 for past lost wages. The public decision does not detail the specific medical mechanism of injury or name any experts. The theory of causation is based on the Vaccine Injury Table definition of SIRVA. Petitioner's counsel was Maximillian J. Muller, and respondent's counsel was Lynn Christina Schlie. Chief Special Master Brian H. Corcoran presided over the case.

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_21-vv-00140-0
Date issued/filed: 2022-07-27
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/22/2022) regarding 29 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
--------------------------------------------------------------------------------
Case 1:21-vv-00140-UNJ Document 34 Filed 07/27/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0140V
UNPUBLISHED
KATHY BLACKMON, Chief Special Master Corcoran
Petitioner, Filed: June 22, 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)
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Lynn Christina Schlie, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 8, 2021, Kathy Blackmon 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”) which meets the Table definition for SIRVA related to the
influenza vaccine she received on October 9, 2019. Petition at 1, ¶ 1. She further alleged
that she received the vaccine in the United States, that she suffered the residual effects
of her SIRVA for more than six months, and that neither she nor any other party has filed
a civil action or received compensation for her SIRVA. Petition at ¶¶ 1, 6-8. 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-00140-UNJ Document 34 Filed 07/27/22 Page 2 of 2
On June 21, 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 has concluded “that [P]etitioner has satisfied the criteria set forth
in the Vaccine Injury Table (“Table”) and the Qualifications and Aids to Interpretation
(“QAI”).” Id. at 5.
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

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_21-vv-00140-1
Date issued/filed: 2024-04-24
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 03/22/2024) regarding 63 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
--------------------------------------------------------------------------------
Case 1:21-vv-00140-UNJ Document 69 Filed 04/24/24 Page 1 of 5
CORRECTED
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0140V
KATHY BLACKMON, Chief Special Master Corcoran
Petitioner, Filed: March 22, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Lynn Christina Schlie, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 6, 2021, Kathy Blackmon 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”) which meets the Table definition for SIRVA related to the
influenza vaccine she received on October 9, 2019. Petition at 1, ¶ 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On June 22, 2022, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for her SIRVA. On March 22, 2024, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $172,091.00,
representing compensation in the amounts of $145,000.00 for pain and suffering and
$27,091.00 for past lost wages. Proffer at 1-2. In the Proffer, Respondent represented
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-00140-UNJ Document 69 Filed 04/24/24 Page 2 of 5
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 attached Proffer, I award Petitioner a lump
sum payment of $172,091.00, representing compensation in the amounts of
$145,000.00 for pain and suffering and $27,091.00 for actual lost wages 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 1:21-vv-00140-UNJ Document 69 Filed 04/24/24 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
KATHY BLACKMON, )
)
Petitioner, )
) No. 21-140V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND HUMAN )
SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On January 6, 2021, Kathy Blackmon (“petitioner”) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34
(“Vaccine Act” or “Act”), alleging that she suffered a Shoulder Injury Related to Vaccine
Administration (“SIRVA”), as defined in the Vaccine Injury Table, following administration of
an influenza vaccine she received on October 9, 2019. Petition at 1. On June 21, 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 June 22, 2022, the Chief Special Master issued a Ruling on Entitlement finding petitioner
entitled to compensation. ECF No. 28; ECF No. 29.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $145,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:21-vv-00140-UNJ Document 69 Filed 04/24/24 Page 4 of 5
B. Lost Wages
Evidence supplied by petitioner documents that she incurred past lost wages related to
her vaccine-related injury. Respondent proffers that petitioner should be awarded past lost
wages in the amount of $27,091.00. See 42 U.S.C. § 300aa-15(a)(3)(A). Petitioner agrees.
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
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 $172,091.00, in the form of
a check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Kathy Blackmon: $172,091.00
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
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,
unreimbursed expenses, future lost earnings and future pain and suffering.
2

Case 1:21-vv-00140-UNJ Document 69 Filed 04/24/24 Page 5 of 5
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
/s/ Lynn C. Schlie
LYNN C. SCHLIE
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146 Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-3667
E-mail: lynn.schlie@usdoj.gov
Dated: March 22, 2024
3