VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00164
Package ID: USCOURTS-cofc-1_21-vv-00164
Petitioner: Tabitha Smith
Filed: 2021-01-06
Decided: 2024-08-26
Vaccine: Tdap
Vaccination date: 2020-08-05
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 20000

AI-assisted case summary:
Tabitha Smith filed a petition for compensation under the National Vaccine Injury Compensation Program on January 6, 2021, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving a Tdap vaccination on or about August 5, 2020. She claimed to have experienced residual effects of this injury for more than six months. The respondent, the Secretary of Health and Human Services, denied that the Tdap vaccine caused Ms. Smith's left shoulder injury or any other condition. Despite this denial, the parties reached a joint stipulation to settle the case. The stipulation stated that the Tdap vaccine is contained in the Vaccine Injury Table, and Ms. Smith alleged her injury had residual effects for over six months. The parties agreed that a decision should be entered awarding compensation. Chief Special Master Corcoran adopted the stipulation as the decision awarding damages. Ms. Smith was awarded a lump sum of $20,000.00 as compensation for all items of damages available under the Vaccine Act. This award represents a settlement of liability and damages, and the United States does not admit that the Tdap vaccine caused Ms. Smith's injury.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00164-0
Date issued/filed: 2024-08-26
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 07/15/2024) regarding 40 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (ppa) Service on parties made.
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Case 1:21-vv-00164-UNJ Document 44 Filed 08/26/24 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-164V
TABITHA SMITH, Chief Special Master Corcoran
Petitioner, Filed: July 15, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Bridget C. McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Austin J. Egan, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On January 6, 2021, Tabitha Smith 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”) after receiving a tetanus, diphtheria, and acellular pertussis
(“Tdap”) vaccination on or about August 5, 2020. Petition at 1; Stipulation, filed at July 12,
2024, ¶¶ 2-4. Petitioner further alleges that she experienced the residual effects of this
injury for more than six months and that there has been no prior award or settlement of a
civil action for damages as a result of her alleged condition. Stipulation at ¶¶ 4-5.
“Respondent denies that petitioner suffered from left shoulder injury as a result of the
Tdap vaccine, and denies that the Tdap vaccine caused her any other injury or her current
condition ” Stipulation at ¶ 6.
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-00164-UNJ Document 44 Filed 08/26/24 Page 2 of 7
Nevertheless, on July 12, 2024, 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 $20,000.00 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

C ase 1:21-vv-00164-UNJ Document 44 Filed 08/26/24 Page 3 of 7
IN THE UNITED STA TES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
TABITHA SMITH, )
)
Petitioner, )
) No. 21-164V
V. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND HUMAN
SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Tabitha Smith ("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
oft he tetanus, diphtheria, and acellular pertussis ("Tdap") vaccine, which is contained in the
Vaccine Injury Table (the "Table"), 42 C.F.R. § 100.3(a).
2. Petitioner received the Tdap vaccine on or about August 5, 2020.
3. The vaccine was administered in the United States.
4. Petitioner alleges that she suffered a left shoulder injury related to vaccine
administration ("Sffi.V A") as a result of receiving the Tdap vaccine. Petitioner further alleges
that she experienced the residual effects of this injury 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 alleged condition.

C ase 1:21-vv-00164-UNJ Document 44 Filed 08/26/24 Page 4 of 7
6. Respondent denies that petitioner suffered from left shoulder injury as a result of the
Tdap vaccine, and denies that the Tdap vaccine caused her any other injury 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 ofj udgment 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-2l(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $20,000.00 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 ofj udgment 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-2l(a)(l), 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 they have identified to respondent all known
sources of payment for items or services for which the Program is not primarily liable under 42
U.S.C. § 300aa-15(g), including State compensation programs, insurance policies, Federal or
State health benefits programs (o ther than Title XIX of the Social Security Act (4 2 U.S.C.
§ 1396 et seq.)), or entities that provide health services on a prepaid basis.
2

C ase 1:21-vv-00164-UNJ Document 44 Filed 08/26/24 Page 5 of 7
11. Payment made pursuant to paragraph 8 of this Stipulation and any amounts awarded
pursuant to paragraph 9 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 ofp etitioner 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-l S(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, and assi s,
gn
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 United States Court of Federal Claims, under the National Vaccine Injury
Compensation Program, 42 U.S.C. § 300aa-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 Tdap vaccination administered on
or about August 5, 2020, as alleged by petitioner in a petition for vaccine compensation filed on
or about January 6, 2021 , in the United States Court of Federal Claims as petition No. 21-164V.
14. Ifp etitioner should die prior to entry ofj udgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
3

C ase 1:21-vv-00164-UNJ Document 44 Filed 08/26/24 Page 6 of 7
15. Ift he special master fails to issue a decision in complete confonnity with the terms of
this Stipulation or ift he United States Court of Federal Claims fails to enter judgment in
conformity with a decision that is in complete conformity with the tenns 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 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 shaJJ not be construed as an admission by the United States or the
Secretary of Health and Human Services that the Tdap vaccine caused petitioner's left shoulder
injury, any other injury, or her current condition.
18. All rights and obligations ofp etitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
4

C ase 1:21-vv-00164-UNJ Document 44 Filed 08/26/24 Page 7 of 7
Respectfully submitted,
PETITIONER:
TABITHA SMITII
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE AT IORNEY GENERAL:
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\__Moc R ... Deputy Director
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715 Twinmg Road, Suite 2 8 Torts Branch
Dresher, PA 19025 Civil Division
Tel: (215) 885• 1655 U.S. Department of Justice
Email: bridget@mullerbrazil.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OFTHESECRETARYOFHEALTH RESPONDENT:
AND HUMANs SERVICES:
Jeffrey Digitally signed by
• Jeffrey S. Beach -5
Beach S Date:2024.06.25
---- - 08:55:04 -04'00'
for
CDR GEORGE REED GRJMES, MD, MPH A
Director, Division ofinjury Trial Attome
Compensation Programs Torts Branch, iv1 1v1s1on
Health Systems Bureau U.S. Department of Justice
Health Resources and Services P.O. Box 146
Administration Ben Franklin Station
U.S. Department of Health Washington, DC 20044-0146
and Human Services Tel: (202) 451-7479
5600 Fishers Lane, 08W-25A Email: Austin.J.Egan@usdoj.gov
Rockville, MD 20857
,Ji, /.2, ,,/W
Dated:
5