VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00560
Package ID: USCOURTS-cofc-1_21-vv-00560
Petitioner: Roxanne Rae Burkhardt
Filed: 2021-01-11
Decided: 2023-04-11
Vaccine: Tdap
Vaccination date: 2020-07-28
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 120000

AI-assisted case summary:
Roxanne Rae Burkhardt filed a petition for compensation under the National Vaccine Injury Compensation Program on January 11, 2021. She alleged that she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA), a condition listed in the Vaccine Injury Table, as a result of receiving a Tetanus Diphtheria acellular Pertussis (Tdap) vaccine on July 28, 2020. Ms. Burkhardt stated that the vaccine was administered in the United States, that she experienced residual effects of the injury for more than six months, and that she had not received a prior award or settlement for this condition. The respondent, the Secretary of Health and Human Services, denied that Ms. Burkhardt sustained a SIRVA Table Injury, denied that the Tdap vaccine caused her alleged shoulder injury, and denied that the vaccine caused any other injury or her current condition. Despite these denials, the parties filed a joint stipulation on March 6, 2023, agreeing to settle the case. Chief Special Master Brian H. Corcoran reviewed the stipulation and found it reasonable, adopting it as his decision. Pursuant to the stipulation, Ms. Burkhardt was awarded a lump sum of $120,000.00, payable by check, as compensation for all damages available under the Vaccine Act. This decision was issued on April 11, 2023. Petitioner was represented by Rhonda Lorenz-Pignato of Shannon Law Group, P.C. Respondent was represented by Benjamin Patrick Warder of the U.S. Department of Justice.

Theory of causation field:
Petitioner Roxanne Rae Burkhardt alleged a Shoulder Injury Related to Vaccine Administration (SIRVA) following a Tdap vaccination on July 28, 2020. The respondent denied that the injury was a SIRVA Table Injury or that the vaccine caused the injury. The parties reached a joint stipulation to settle the case. Chief Special Master Brian H. Corcoran adopted the stipulation, awarding a lump sum of $120,000.00. The stipulation does not detail the specific medical mechanism of injury or name any experts. The decision was issued on April 11, 2023. Petitioner's counsel was Rhonda Lorenz-Pignato, and respondent's counsel was Benjamin Patrick Warder.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00560-0
Date issued/filed: 2023-04-11
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 03/07/2023) regarding 41 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:21-vv-00560-UNJ Document 49 Filed 04/11/23 Page 1 of 7
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In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-560V
UNPUBLISHED
ROXANNE RAE BURKHARDT, Chief Special Master Corcoran
Petitioner, Filed: March 7, 2023
v.
Special Processing Unit (SPU); Joint
SECRETARY OF HEALTH AND Stipulation on Damages; Tetanus
HUMAN SERVICES, Diphtheria acellular Pertussis (Tdap)
Vaccine; Shoulder Injury Related to
Respondent. Vaccine Administration (SIRVA)
Rhonda Lorenz-Pignato, Shannon Law Group, Woodridge, IL, for Petitioner.
Benjamin Patrick Warder, U.S. Department of Justice, Washington, DC, for
Respondent.
DECISION ON JOINT STIPULATION1
On January 11, 2021, Roxanne Rae Burkhardt 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 Table injury – Shoulder Injury
Related to Vaccine Administration (“SIRVA”) – as a result of her July 28, 2020 Tetanus
Diphtheria acellular Pertussis (Tdap) vaccine. Petition at 1; Stipulation, filed at March 6,
2023, ¶¶ 1-2, 4. Petitioner further alleges the vaccine was administered within the United
States, that she suffered the residual effects of her injury for more than six months, and
that there has been no prior award or settlement of a civil action on her behalf as a result
of her injury. See Petition, ¶¶ 2, 25, 28-29; Stipulation, ¶¶ 3-5. Respondent “denies that
petitioner sustained a SIRVA Table Injury, denies that petitioner’s alleged shoulder injury
was caused-in-fact by the Tdap vaccine, and denies that the Tdap vaccine caused
petitioner any other injury or her current condition.” Stipulation at ¶ 6.
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.
2National 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-00560-UNJ Document 49 Filed 04/11/23 Page 2 of 7
Nevertheless, on March 6, 2023, 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 $120,000.00 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

Case 1:21-vv-00560-UNJ Document 49 Filed 04/11/23 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
ROXANNE RAE BURKHARDT,
)
)
Petitioner,
) No. 2 l-560V (ECF)
) Chief Special Master Corcoran
V.
)
)
SECRETARY OF HEALTH
)
AND HUMAN SER VICES,
)
)
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
l. Roxanne Rae Burkhardt ("petitioner") filed a petition for vaccine compensation under
the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-l0 to -34 ("Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of the tetanus, diphtheria, and pertussis ("Tdap") vaccine, which vaccine is contained in the
Vaccine Injury Table ("Table"), 42 C.F.R. § 100.3(a).
2. Petitioner received the Tdap vaccination in her left shoulder on July 28, 2020.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she suffered a Shoulder Injury Related to Vaccine
Administration ("SIRVA") within the time period set forth in the Table, and that she experienced
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 on her behalf as a result of her condition.

Case 1:21-vv-00560-UNJ Document 49 Filed 04/11/23 Page 4 of 7
6. Respondent denies that petitioner sustained a SIRVA Table Injury, denies that
petitioner's alleged shoulder injury was caused-in-fact by the Tdap vaccine, and denies that the
Tdap vaccine caused petitioner 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 of judgment reflecting a decision consistent with
the tenns 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 $120,000.00 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 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 attorney fees and costs incurred in proceeding upon this
petition.
10. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), to the extent that payment bas been made or can reasonably be
expected to be made under any 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 by entities that provide health services on a pre-paid basis.
2

Case 1:21-vv-00560-UNJ Document 49 Filed 04/11/23 Page 5 of 7
11. Payment made pursuant to paragraph 8 of this Stipulation, and any amounts awarded
pursuant to paragraph 9 of this Stipulation, 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 attorney fees and litigation costs, and past unreimbursable 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-15(g) and (h).
13. In rerurn for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity and on behalf of her heirs, executors, administrators, successors or 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, 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 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 vaccine administered on or about July 28, 2020, as
alleged by petitioner in a petition for vaccine compensation filed on January 11, 2021, in the
United States Court of Federal Claims as petition No. 21-560V.
14. If petitioner 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

Case 1:21-vv-00560-UNJ Document 49 Filed 04/11/23 Page 6 of 7
15. lfthe Chief Special Master fails to issue a decision in complete conformity with the
terms of this Stipulation, or if the Court of Federal Claims fails to enter judgment in confonnity
with a decision that is in complete conformity with the terms 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 to 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 alleged
shoulder injury or any other injury.
18. AIJ 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-00560-UNJ Document 49 Filed 04/11/23 Page 7 of 7
Respectfu11y submitted,
PETITIONER:
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
cMJ d-J-LA~ ~~
RHONDA LORENZ-PI ATO HEATHER L. PEARLMAN
SHANNON LAW GROUP, P.C. Deputy Director
3550 Hobson Road, Suite 403 Torts Branch
Woodridge, IL 60517 Civil Division
(312) 578-950 I U.S. Department of Justice
r1orenzpignato@shannonlawgroup.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
George R. Digitally signed by
George R. Grimes -S14
Grimes-S14 Date: 2023.02.27 21:05:28
~ -??~
-05'00'
CDR GEORGE REED GRIMES, MD, MPH ~ WARDER
Director, Division oflnjury Trial Attorney
Compensation Programs Torts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Department of Justice
Administration P.O. Box 146
U.S. Department of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 Fishers Lane, 08Nl46B (202) 532-5464
RockviJle, MD 20857 Benjamin.P .W arder@usdoj.gov
o~/oe:,/zoz.s
Dated:
5