VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00505
Package ID: USCOURTS-cofc-1_21-vv-00505
Petitioner: Jenna Wagner
Filed: 2021-01-11
Decided: 2024-02-05
Vaccine: Tdap
Vaccination date: 2020-08-22
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 23000

AI-assisted case summary:
Jenna Wagner filed a petition for vaccine compensation on January 11, 2021, alleging a left shoulder injury related to vaccine administration (SIRVA) caused by a Tetanus, Diphtheria, and Acellular Pertussis (Tdap) vaccination received on August 22, 2020. Ms. Wagner stated the vaccine was administered in the United States and that she suffered residual effects of the injury for more than six months. She also affirmed there had been no prior award or settlement for this condition. The respondent, the Secretary of Health and Human Services, denied that Ms. Wagner suffered a left shoulder injury as a result of the Tdap vaccine, and denied that the vaccine caused her injury or any other condition. Despite these opposing positions, the parties filed a joint stipulation on December 18, 2023, agreeing that the case should be settled and compensation awarded. Chief Special Master Brian H. Corcoran adopted the stipulation as the decision of the court. Pursuant to the stipulation, Ms. Wagner was awarded a lump sum of $23,000.00, payable by check to the petitioner, as compensation for all damages. This amount represents a negotiated settlement of liability and damages claimed under the National Childhood Vaccine Injury Act. The Tdap vaccine is listed on the Vaccine Injury Table, and the parties agreed to settle the case as a Table claim. Petitioner's counsel was Jonathan Joseph Svitak of Shannon Law Group, P.C. Respondent's counsel was Austin Joel Egan, an attorney with the U.S. Department of Justice. The decision was signed by Chief Special Master Brian H. Corcoran on February 5, 2024.

Theory of causation field:
Petitioner Jenna Wagner alleged a left shoulder injury related to vaccine administration (SIRVA) following a Tdap vaccination on August 22, 2020. The Tdap vaccine is listed on the Vaccine Injury Table. Respondent denied the alleged injury and causation. The parties reached a joint stipulation to settle the case as a Table claim. Chief Special Master Brian H. Corcoran adopted the stipulation, awarding Petitioner a lump sum of $23,000.00 for all damages. Petitioner's counsel was Jonathan Joseph Svitak; respondent's counsel was Austin Joel Egan. The decision date was February 5, 2024.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00505-0
Date issued/filed: 2024-02-05
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 01/03/2024) regarding 42 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:21-vv-00505-UNJ Document 47 Filed 02/05/24 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-505V
JENNA WAGNER, Chief Special Master Corcoran
Petitioner, Filed: January 3, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jonathan Joseph Svitak, Shannon Law Group, P.C., Woodridge, IL, for Petitioner.
Austin Joel Egan, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On January 11, 2021, Jenna Wagner 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”) caused by a Tetanus, Diphtheria, and Acellular Pertussis
(“Tdap”) vaccination on August 22, 2020. Petition at 1; Stipulation, filed at December 18,
2023, ¶¶ 1, 2. Petitioner further alleges the vaccine was administered within the United
States, that she suffered the effects of her 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
condition. Petition at 1-3; Stipulation at ¶¶ 3-5. Respondent denies that Petitioner suffered
from a left shoulder injury as a result of the Tdap vaccine, and denies that the Tdap
vaccine caused her injury or 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-00505-UNJ Document 47 Filed 02/05/24 Page 2 of 7
Nevertheless, on December 18, 2023, the parties filed the attached joint
stipulation, stating that a decision should be entered awarding compensation.3 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 $23,000.00 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.4
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 The Joint Stipulation has been modified to remove Petitioner’s personal information.
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

Case 1:21-vv-00505-UNJ Document 47 Filed 02/05/24 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
JENNA WAGNER, )
)
Petitioner, )
) No. 21-S0SV
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND HUMAN )
SERVICES, )
)
Respondent. )
________________
)
STIPULATION
The parties hereby stipulate to the following matters:
I. Jenna Wagner ("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
of the 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 22, 2020.
3. The vaccine was administered in the United States.
4. Petitioner alleges that she suffered a left shoulder injury related to vaccine
administration ("SIRVA") 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.
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Case 1:21-vv-00505-UNJ Document 47 Filed 02/05/24 Page 4 of 7
6. Respondent denies that petitioner suffered from a left shoulder injury as a result of the
Tdap vaccine, and denies that the Tdap vaccine caused her injury or 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 tenns of this Stipulation, and after petitioner bas filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $23,000.00 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-l5(a).
9. As soon as practicable after the entry of judgment 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-21(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 (other than Title XIX of the Social Security Act (42 U.S.C.
§ 1396 et seq.)), or entities that provide health services on a prepaid basis.
2
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Case 1:21-vv-00505-UNJ Document 47 Filed 02/05/24 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 of petitioner 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 5(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 assigns,
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 22, 2020, as alleged by petitioner in a petition for vaccine compensation filed on
or about January 11, 2021, in the United States Court of Federal Claims as petition No. 21-505V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
3
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Case 1:21-vv-00505-UNJ Document 47 Filed 02/05/24 Page 6 of 7
15. If the special master fails to issue a decision in complete confonnity with the terms of
this Stipulation or if the 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 shall 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 of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:21-vv-00505-UNJ Document 47 Filed 02/05/24 Page 7 of 7
Respectfully submitted,
PETITIONER:
JENNA WAGNER
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
~
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HEATHER L. PEARLMAN
Shannon Law Group, P.C. Deputy Director
3550 Hobson Road Torts Branch
Woodridge, Illinois 60517 Civil Division
Tel: (312) 578-9501 U.S. Department of Justice
Email: jsvitak@shannonlawgroup.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OFTHESECRETARYOFHEALffl RESPONDENT:
AND HUMAN SERVICES:
Ge orge R• Digitally signed by
GeorgeR.Grimes-S14
.Imes -S14
Gr Date:2023.12.11
20:43:48 -05'00'
CDR GEORGE REED GRIMES, MD, MPH AUSTIN J. EGAN
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch, Civil Division
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
h I
Dated: l 1 ,., 3 U> t -3
5
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