VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00634
Package ID: USCOURTS-cofc-1_21-vv-00634
Petitioner: Dolores Fernandes
Filed: 2021-01-12
Decided: 2022-12-07
Vaccine: pneumococcal conjugate vaccine
Vaccination date: 2018-10-11
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 105010

AI-assisted case summary:
Dolores Fernandes filed a petition on January 12, 2021, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving a pneumococcal conjugate vaccine on October 11, 2018. The respondent conceded entitlement, stating that Ms. Fernandes had no prior history of shoulder issues, her pain began within 48 hours of vaccination, and the symptoms were localized to the vaccinated shoulder. The respondent also agreed that the injury lasted more than six months, satisfying the Table injury requirement. A ruling on entitlement was issued on July 15, 2022, finding Ms. Fernandes entitled to compensation. Subsequently, on November 4, 2022, the respondent filed a proffer proposing an award of $105,010.00, which included $105,000.00 for pain and suffering and $10.00 for past unreimbursable expenses. Ms. Fernandes agreed with this proposed award. On December 7, 2022, the court issued a decision awarding Dolores Fernandes a lump sum payment of $105,010.00.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00634-0
Date issued/filed: 2022-08-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 07/15/2022) regarding 29 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (ke) Service on parties made.
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Case 1:21-vv-00634-UNJ Document 35 Filed 08/15/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0634V
UNPUBLISHED
DOLORES FERNANDES, Chief Special Master Corcoran
Petitioner, Filed: July 15, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Pneumococcal
Conjugate Vaccine; Shoulder Injury
Respondent. Related to Vaccine Administration
(SIRVA)
Jessi Carin Huff, Maglio, Christopher & Toale, Seattle, WA, for Petitioner.
Sarah Black Rifkin, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 12, 2021, Dolores Fernandes 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 from a shoulder injury related to
vaccine administration (“SIRVA”) as a result of a pneumococcal conjugate vaccine she
received on October 11, 2018. Petition at 1. Petitioner further alleges that her vaccine-
related injury lasted more than six months. Petition at ¶21. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
On July 14, 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.
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-00634-UNJ Document 35 Filed 08/15/22 Page 2 of 2
Specifically, Respondent states that “Petitioner had no history of pain, inflammation or
dysfunction in her right shoulder; her pain occurred within forty-eight hours of receipt of
an intramuscular vaccination; her pain and reduced range of motion were limited to the
shoulder in which the vaccine was administered; and no other condition or abnormality
was identified to explain her symptoms.” Id. at 7. Respondent further agrees that “the
statutory six month sequela requirement has been satisfied.” 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-00634-1
Date issued/filed: 2022-12-07
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 11/04/2022) regarding 39 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-00634-UNJ Document 43 Filed 12/07/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0634V
UNPUBLISHED
DOLORES FERNANDES, Chief Special Master Corcoran
Petitioner, Filed: November 4, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Pneumococcal Conjugate Vaccine;
Shoulder Injury Related to Vaccine
Respondent. Administration (SIRVA)
Jessi Carin Huff, Maglio Christopher & Toale, Seattle, WA, for Petitioner.
Sarah Black Rifkin, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 12, 2021, Dolores Fernandes 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”) as a result of a pneumococcal conjugate vaccine she received
on October 11, 2018. Petition at ¶¶ 3; 25. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On July 15, 2022, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for her SIRVA. ECF No. 29. On November 4, 2022, Respondent filed a
proffer on award of compensation (“Proffer”) indicating Petitioner should be awarded
$105,010.00, comprised on $105,000.00 in pain and suffering, plus $10.00 in past
unreimbursable expenses. Proffer at 1-2. In the Proffer, Respondent represented that
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-00634-UNJ Document 43 Filed 12/07/22 Page 2 of 5
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 $105,010.00, representing $105,000.00 in pain and suffering and
$10.00 in past unreimbursable 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

Case 1:21-vv-00634-UNJ Document 43 Filed 12/07/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DOLORES FERNANDES,
Petitioner, No. 21-634 (ECF)
Chief Special Master Corcoran
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On January 12, 2021, Dolores Fernandes (“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”), as amended., alleging that she suffered a Shoulder Injury Related to
Vaccine Administration (“SIRVA”), as defined in the Vaccine Injury Table, following
administration of pneumococcal conjugate vaccine on October 11, 2018. ECF No. 1. On July
14, 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 July 15, 2022, the Chief Special Master issued a Ruling on Entitlement
finding petitioner entitled to compensation. ECF No. 26; ECF No. 27.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $105,000.00 in pain and suffering
damages. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:21-vv-00634-UNJ Document 43 Filed 12/07/22 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $10.00. See 42 U.S.C. § 300aa-
15(a)(1)(B). 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 $105,010.00, in the form of
a check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Dolores Fernandes: $105,010.00
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 lost earnings
and future pain and suffering.
2

Case 1:21-vv-00634-UNJ Document 43 Filed 12/07/22 Page 5 of 5
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
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
s/Sarah B. Rifkin
SARAH B. RIFKIN
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) 305-5997
Sarah.Rifkin@usdoj.gov
Dated: November 4, 2022
3