VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00665
Package ID: USCOURTS-cofc-1_21-vv-00665
Petitioner: Marie Tyler
Filed: 2021-01-12
Decided: 2025-06-25
Vaccine: influenza
Vaccination date: 2018-10-01
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 30000

AI-assisted case summary:
Marie Tyler filed a petition for vaccine compensation on January 12, 2021, alleging injury from an influenza vaccine she received on October 1, 2018. She claimed to have sustained a shoulder injury related to vaccine administration (SIRVA), which is a condition listed on the Vaccine Injury Table. Tyler alleged that the flu vaccine caused her SIRVA and that she suffered residual effects for more than six months. The respondent, the Secretary of Health and Human Services, denied that Tyler sustained a SIRVA Table injury, denied that the vaccine caused her alleged injury, and denied that her current condition was a sequela of a vaccine-related injury. Despite these denials, the parties filed a joint stipulation agreeing to settle the case and award compensation. Chief Special Master Corcoran adopted the stipulation, awarding Marie Tyler a lump sum of $30,000.00 for all damages available under the Vaccine Act. This award represents a settlement of liability and damages, and the United States does not admit that the flu vaccine caused Tyler's alleged SIRVA or any other injury.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00665-0
Date issued/filed: 2024-10-22
Pages: 13
Docket text: PUBLIC DECISION (Originally filed: 09/20/2024) regarding 42 Findings of Fact & Conclusions of Law,, ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:21-vv-00665-UNJ Document 43 Filed 10/22/24 Page 1 of 13
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-665V
MARIE TYLER, Chief Special Master Corcoran
Petitioner,
v. Filed: September 20, 2024
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jessi Carin Huff, Maglio Christopher & Toale, Seattle, WA, for Petitioner.
Camille Jordan Webster, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING DISMISSING TABLE CLAIM1
On January 12, 2021, Marie Tyler filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”), alleging that she suffered a left-sided shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered to her on
October 1, 2018. Pet. at 1, ECF No. 1. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
For the reasons discussed below, I find it more likely than not that Petitioner’s injury
and its residual effects lasted for more than six months. But because the onset of
Petitioner’s shoulder pain did not likely occur within 48 hours of vaccination, her Table
1 Because this Ruling 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 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-00665-UNJ Document 43 Filed 10/22/24 Page 2 of 13
SIRVA claim must be dismissed (although this matter may remain viable as an off-Table
causation-in-fact claim).
I. Relevant Procedural History
After initiating her claim, Petitioner filed her vaccination record, medical records,
an affidavit, and a statement of completion on February 26, 2021. ECF Nos. 7-11. On
October 26, 2021, and May 26, 2022, Petitioner filed additional medical records. ECF
Nos. 25, 27. Approximately two months later, on July 20, 2022, Respondent filed a status
report indicating this case was not appropriate for compensation and requesting to file a
Rule 4(c) Report. ECF No. 29.
In that report (filed on October 20, 2022 (ECF No. 32)), Respondent argued that
Petitioner’s medical records do not show that the onset of her pain occurred within 48
hours of vaccination. Rule 4(c) Report at 6-7 (citing Ex. 7 at 15; Ex. 11 at 8). Respondent
further argued that Petitioner had failed to establish the statutory requirement that her
injury lasted for more than six months, and that any statements to the contrary in the
medical records were likely made in contemplation of litigation. Id. at 9 (citing 42 U.S.C.
§ 300aa-11(c)(1)(D)(i); Ex. 6 at 5).
Petitioner subsequently filed a motion for a ruling on the record (“Motion”) and
additional witness statements, including a letter from her treating physician, on March 27,
2023. ECF Nos. 34-35. Petitioner contends that she has met her burden of proof for a
Table SIRVA claim based on the record.3 ECF No. 35. Specifically, she argues that she
complained of pain attributable to her vaccination at her first post-vaccination visit and
consistently thereafter. Id. at 9 (citing Ex. 19; Ex. 14 at 9; Ex. 8 at 4, 7, 10, 18; Ex. 6 at 3,
5; Ex. 2 at 9). She also argues that she can satisfy the six-month severity requirement
because her medical records corroborate her ongoing shoulder pain linked to the flu
vaccine following her return to treatment (albeit after an approximate eleven-month gap).
Id. at 11-13.
Respondent filed his response to Petitioner’s motion (“Response”) on June 20,
2023. ECF No. 38. He argued that the letter provided by Petitioner’s treater and the
affidavits drafted by her friends and family (made for the purpose of litigation) are a “stark
contrast” to the medical record evidence as to onset and should accordingly be given little
weight. Id. at 2-3. He also maintained that Petitioner cannot satisfy the six-month severity
requirement because she did not provide an explanation for her eleven-month gap in
3 Petitioner also requested that if her Table SIRVA claim is unsuccessful, she alternatively be allowed to
plead an off-Table causation-in-fact SIRVA claim. Motion at 13.
2

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treatment. Id. at 3 (citing Ex. 9 at 12). Additionally, any of Petitioner’s later complaints of
shoulder pain attributable to the subject flu vaccination were “likely made for the purpose
of impending litigation, given the reporting of six months with specificity in accord with the
severity requirement.” Id. (citing Ex. 6 at 5).
On June 30, 2023, Petitioner filed her reply (“Reply”) and reiterated that she has
met her burden for a Table SIRVA claim and has satisfied the six-month severity
requirement. ECF No. 39. She asserts that estimations regarding onset in the medical
records are “wrong,” and that she has provided a reasonable explanation for her gap in
treatment. Id. at 4-6. This matter is now ripe for consideration.
II. Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
Section 11(c)(1). A petitioner may prevail on his claim if he has “sustained, or endured
the significant aggravation of any illness, disability, injury, or condition” set forth in the
Vaccine Injury Table (the “Table”). Section 11(c)(1)(C)(i). The most recent version of the
Table, which can be found at 42 C.F.R. § 100.3, identifies the vaccines covered under
the Program, the corresponding injuries, and the time period in which the particular
injuries must occur after vaccination. Section 14(a). If a claimant establishes that he has
suffered a “Table Injury,” causation is presumed.
Section 11(c)(1) also contains requirements concerning the type of vaccination
received and where it was administered, the duration or significance of the injury, and the
lack of any other award or settlement. See Section 11(c)(1)(A), (B), (D), and (E). With
regard to duration, a petitioner must establish that he suffered the residual effects or
complications of such illness, disability, injury, or condition for more than six months after
the administration of the vaccine. Section 11(c)(1)(D).
In Cucuras, the Federal Circuit explained that “greater weight should be accorded”
to information contained within the medical records than statements made which are in
direct conflict with the contemporaneous documentary evidence. Cucuras v. Sec’y of
Health & Hum. Servs., 993 F.2d 1525, 1528 (Fed. Cir. 1993). Indeed, “[m]edical records,
in general, warrant consideration as trustworthy evidence. The records contain
information supplied to or by health professionals to facilitate diagnosis and treatment of
medical conditions. With proper treatment hanging in the balance, accuracy has an extra
premium. These records are also generally contemporaneous to the medical events.” 993
F.2d at 1528.
3

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Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Hum. Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, 2005 WL 6117475, at *19.
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Hum. Servs., 42 Fed. Cl.
381, 391 (1998). The Court later outlined four possible explanations for inconsistencies
between contemporaneously created medical records and later testimony: (1) a person’s
failure to recount to the medical professional everything that happened during the relevant
time period; (2) the medical professional’s failure to document everything reported to her
or him; (3) a person’s faulty recollection of the events when presenting testimony; or (4)
a person’s purposeful recounting of symptoms that did not exist. LaLonde v. Sec’y of
Health & Hum. Servs., 110 Fed. Cl. 184, 203-04 (2013), aff’d, 746 F.3d 1335 (Fed. Cir.
2014). The Court has also said that medical records may be outweighed by testimony
that is given later in time that is “consistent, clear, cogent, and compelling.” Camery, 42
Fed. Cl. at 391 (citing Blutstein v. Sec’y of Health & Hum. Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” LaLonde,
110 Fed. Cl. at 204 (citing § 12(d)(3); Vaccine Rule 8); see also Burns v. Sec’y of Health
& Hum. Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within the special
master’s discretion to determine whether to afford greater weight to medical records or to
other evidence, such as oral testimony surrounding the events in question that was given
at a later date, provided that such determination is rational).
Effective for petitions filed beginning on March 21, 2017, SIRVA is an injury listed
on the Vaccine Injury Table. See Vaccine Injury Table: Qualifications and Aids to
Interpretation. 42 C.F.R. § 100.3(c)(10). The criteria are as follows:
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A vaccine recipient shall be considered to have suffered SIRVA if such
recipient manifests all of the following: (i) No history of pain, inflammation
or dysfunction of the affected shoulder prior to intramuscular vaccine
administration that would explain the alleged signs, symptoms, examination
findings, and/or diagnostic studies occurring after vaccine injection; (ii) Pain
occurs within the specified time-frame; (iii) Pain and reduced range of
motion are limited to the shoulder in which the intramuscular vaccine was
administered; and (iv) No other condition or abnormality is present that
would explain the patient’s symptoms (e.g. NCS/EMG or clinical evidence
of radiculopathy, brachial neuritis, mononeuropathies, or any other
neuropathy).
Id.
III. Relevant Factual Evidence
A. Medical Evidence
Petitioner’s prior medical history was non-contributory. At age 48, Petitioner
received the subject flu vaccine in her left shoulder on October 1, 2018. Ex. 1 at 1.
On October 23, 2018 (22 days post vaccination), Petitioner visited her primary care
provider (“PCP”), complaining of “[l]eft shoulder discomfort x2 weeks, [and that it] hurts to
do things overhead.” Ex. 7 at 15. Petitioner did not report a “fall or known injury.” Id. She
exhibited tenderness of the left scapular bursae and left posterior shoulder bursae. Id. at
16. The PCP assessed Petitioner with shoulder bursitis. Id.
Approximately a month and a half post-vaccination, on November 16, 2018,
Petitioner returned to her PCP complaining that her “[left] shoulder [was] persistent[ly]
sore, aching, [and it] hurts to [abduct] overhead, no fall or trauma x3 wks.” Ex. 11 at 8. A
physical examination showed tenderness of the left shoulder bursa and that Petitioner
was using her trapezius muscles for lifting. Id. at 9. The PCP’s assessment of bursitis
remained unchanged, and Petitioner received a steroid injection in her left shoulder. Id.
The records then reveal an approximate eleven-month gap in Petitioner’s
treatment for left shoulder pain. On October 9, 2019, Petitioner returned to care and
visited an orthopedist complaining of “L shoulder pain since flu shot fall 2018.” Ex. 9 at
12. Petitioner stated she “[n]ever had a shot that hurt that bad – then developed soreness
lasting several weeks.” Id. She described her prior treatment course and noted that the
cortisone shot “helped for 4-6 months” but her shoulder was “[g]radually hurting again.”
Id. Petitioner “report[ed] that symptoms began 1 yr [sic] ago.” Id. A physical examination
5

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showed diminished range of motion (“ROM”) and positive impingement signs. Id. at 13.
Petitioner was assessed with left shoulder adhesive capsulitis; she received a repeat
steroid injection and was referred to physical therapy (“PT”). Id.
On October 22, 2019, Petitioner attended her initial PT evaluation. Ex. 4 at 18.
Petitioner reported the date of onset as “09/22/2018[.] No new aggravation/injury.” Id.
Three weeks of PT was recommended. Id. The records for this visit do not contain more
detail.
Petitioner followed up with her orthopedist on November 11, 2019. Ex. 9 at 9. The
visit notes reflect the same description of left shoulder pain beginning after the flu shot in
2018 as her prior visit in October. Id. The orthopedist assessed Petitioner with adhesive
capsulitis and a possible rotator cuff tear. Id. at 10. He also noted Petitioner was
performing an at-home exercise program “but [it] seems to be irritating – so now only
stretching.” Id. at 11. Petitioner was referred for an MRI, which showed moderate
tendinosis, mild arthrosis, and “synovial thickening subacromial/subdeltoid bursa,
compatible with mild bursitis.” Id. at 11, 18.
Following her MRI, Petitioner had an orthopedic follow up on November 25, 2019.
Ex. 9 at 6. She reported that her October steroid injection “worked for a few weeks.” Id.
Based on her MRI findings and clinical examination, Petitioner received a repeat steroid
injection and was given another referral to PT. Id. at 8.
Petitioner attended three additional PT sessions and was discharged on December
27, 2019. Ex. 2 at 9, 14, 16. The discharge summary states that the “initial onset [of
Petitioner’s injury] was mid sept [sic] when she got a flu shot, she started having pin [sic]
right after.” Id. at 9. Petitioner reported that she was “basically pain free” and the therapist
noted that Petitioner was “now fully functional with very minor pain.” Id. She also reported
that she was “back to were [sic] [she] was before[.]” Id. The therapist noted that Petitioner
had met all of her goals and she “completed [the] current program.” Id. at 10.
Roughly four-and-a-half months later, on May 6, 2020, Petitioner returned to her
orthopedist. Ex. 8 at 18. The same description and history of Petitioner’s injury appears
in the visit notes for this encounter. See id. The orthopedist maintained his assessment
of arthropathy, adhesive capsulitis, and impingement; Petitioner received a repeat steroid
injection. Id. at 20.
After another five-month gap in treatment, on October 7, 2020, Petitioner had a
telehealth visit with a spine and sports medicine specialist. Ex. 6 at 3. Petitioner stated
she had a “two-year history of left shoulder pain, was acute onset immediately after
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receiving her flu vaccine on 10/1/18.” Id. She reported that the pain continued and “has
remained present throughout that time.” Id. Petitioner also noted her first steroid injection
“lasted around six months” but the relief she experienced with her repeat injections did
not last as long. Id. Upon examination, Petitioner exhibited “near full active [ROM] . . . but
. . . pain on the left with anything overhead” and across her body. Id. Petitioner was
assessed with a “[p]robable shoulder injury related to vaccine administration (SIRVA).”
Id. at 4.
Petitioner had an in-person follow-up visit with the sports medicine office on
November 3, 2020. Ex. 6 at 5. Petitioner reported that she had a left shoulder flu injection
“in 2018[;]” she experienced “persistent pain and saw her [PCP] two weeks later.” Id. The
steroid injection she received provided six months of relief, according to Petitioner. Id.
The treater noted that “[s]ymptoms were present at six months.” Id. Petitioner was
assessed with vaccination-related shoulder dysfunction and mild impingement of the left
shoulder. Id. The treater noted that Petitioner’s recent MRI showed a bony cyst near the
infraspinatus tendon. Id. Petitioner received a repeat steroid injection. Id. at 6.
On April 22, 2021 (now approximately five-and-a-half months since Petitioner’s last
visit for left shoulder pain), Petitioner returned to the office of the sports medicine
specialist and received another steroid injection for her ongoing pain. Ex. 14 at 8. The
next day, Petitioner underwent a debridement procedure of the tendon and bony cyst
present on MRI. Id. at 7.
One month later, on May 11, 2021, Petitioner reported to the sports medicine
specialist that her “postsurgical pain appears to have resolved.” Ex. 14 at 6. However,
she still had pain when she raises her arm “overhead in front or behind her.” Id. By the
following month, on June 1, 2021, Petitioner complained that “the left shoulder ha[d] not
improved since [her] procedure five weeks ago.” Id. at 4. Specifically, “[n]either the pain
nor the function ha[d] improved.” Id. A physical examination revealed diminished ROM
and Petitioner received a repeat steroid injection. Id. at 5. Petitioner received additional
steroid injections for ongoing left shoulder symptomology in September 2021 and May
2022. Ex. 16 at 3; Ex. 18 at 5-6. No additional medical records have been filed.
B. Affidavit Evidence
In her witness declaration, signed on January 12, 2021, Petitioner attests that upon
receiving the subject vaccination on October 1, 2018, she “immediately felt a strong,
burning sensation unlike anything [she has] ever experienced after getting a vaccine.” Ex.
10 ¶ 3. Petitioner assumed the pain “would last for a few days.” Id. ¶ 4. However, “a week
went by” and she was still experiencing pain, prompting her to seek medical care. Id. ¶ 5.
She described her initial visits and noted that her first cortisone shot “actually helped.” Id.
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¶¶ 6-7. She stated that “in approximately May of 2019, the cortisone shot started to wear
off and the pain slowly began to return.” Id. ¶ 8. By the end of August 2019, Petitioner
sought a referral to an orthopedist for her ongoing left shoulder symptoms; she was
unable to get an appointment before October 2019. Id. ¶ 10. Petitioner explained that she
did not seek continued care before August 2019 despite ongoing pain because she was
“incredibly busy” preparing her children to leave home. Ex. 24 ¶¶ 7-10. Instead, she used
over-the-counter pain killers, ice, and heat to manage the pain during this time. Id. ¶ 11.
Petitioner’s husband recalls that on October 1, 2018, he “came home from work
and found [his] wife in discomfort[,]” she told him that she was experiencing “extreme
pain” from her flu vaccination she received “earlier that day.” Ex. 20 ¶¶ 2-3. “That night,”
he witnessed Petitioner being “protective of her shoulder, holding it at times and struggling
to find a position that was comfortable.” Id. ¶ 6.
Additionally, Petitioner’s son attests that he received a flu vaccine along with
Petitioner, and that he witnessed Petitioner make “an immediate facial reaction of pain”
upon receiving the vaccination. Ex. 21 ¶ 6. He recalls that Petitioner had a difficult time
driving them home from the shot, as she kept “wincing and rubbing the area where the
shot was administered.” Id. ¶ 8. When they got home, he recalls getting Petitioner an ice
pack for her shoulder pain. Id. ¶ 9. He states that Petitioner’s pain has continued since
receiving the flu shot. Id. ¶¶ 10, 14.
Two of Petitioner’s friends also submitted witness declarations on her behalf. The
first attested that Petitioner received the subject vaccination “[a] little over four years ago,”
and that she experienced pain “immediately afterwards.” Ex. 22 ¶ 2. According to this
friend, Petitioner’s pain “continues to this day.” Id. ¶ 4. The second friend recalls that
“when [Petitioner] first received her flu vaccination[, s]he told [her] that it was an incredibly
painful injection[.]” Ex. 23 ¶ 3. Additionally, “over the days that followed[,]” Petitioner had
not experienced any relief. Id. ¶ 4. According to this friend, Petitioner’s pain is ongoing.
Id. ¶ 6.
Additionally, Petitioner’s PCP authored a letter on Petitioner’s behalf. Ex. 19 at 1.
Her PCP wrote that Petitioner “was seen . . . today [January 30, 2023,] for a medical
appointment.” Id. The PCP stated that “[a]lthough the filed record does not reflect this,
[the treater does] recall that during [Petitioner’s] 1st visit . . . in relation to her shoulder
pain on October 23, 2018, [Petitioner] reported that her pain immediately began after the
administration of the flu shot on October 1, 2018.” Id.
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IV. Findings of Fact
A. Factual Findings Regarding Onset
A petitioner alleging a SIRVA claim must show that she experienced the first
symptom or onset within 48 hours of vaccination (42 C.F.R. § 100.3(a)(XIV)(B)), and that
her pain began within that same 48-hour period (42 C.F.R. § 100.3(c)(10)(ii) (QAI
criteria)). Respondent argues that Petitioner is unable to meet this requirement because
the contemporaneous medical records at Petitioner’s first post-vaccination visit and
thereafter place onset outside the 48-hour window. Resp. at 2. Respondent discounts the
weight to be afforded to the letter from Petitioner’s treating physician and witness
declarations, arguing that they were drafted in support of litigation. Id.
I find Respondent’s arguments regarding onset to be persuasive and that the
totality of the record supports the conclusion that Petitioner’s shoulder pain most likely
did not begin within 48 hours of receiving her October 1, 2018 flu vaccination. What
proves most detrimental is the fact that when the medical records reference the onset of
her left shoulder pain, they place onset more than a week post-vaccination (at the
earliest), and they do not link the pain to the subject vaccination either.
For example, during Petitioner’s first post-vaccination visit on October 23, 2018,
Petitioner reported shoulder discomfort “for x2 weeks” – or since roughly October 9, 2018,
and she did not attribute her pain to a “fall or known injury.” Ex. 7 at 15. More so, at her
next visit on November 16, 2018, Petitioner reported that her pain had been present for
“x3 wks” [sic] (which places onset around October 26, 2018) and thus outside the 48-hour
window. Ex. 11 at 8. Petitioner again did not link her pain to a known injury or event. Id.
at 8-9. Both entries therefore do not provide support for 48-hour onset and, in fact, negate
such a finding.
Additionally, some of Petitioner’s medical records place onset as beginning as
early as in mid-September 2018 (pre-vaccination) and are thus inconsistent with any
vaccine injury at all. See, e.g., Ex. 4 at 18 (an October 22, 2019 PT note listing the date
of onset as “09/22/2018”); Ex. 2 at 9 (a December 27, 2019 PT discharge summary
describing onset as “mid sept [sic] when she got a flu shot”). But even if they are incorrect,
these notations in Petitioner’s contemporaneous medical records heavily detract from her
ability to establish the Table’s 48-hour onset requirement.
The only support in the contemporaneous medical records for 48-hour onset is
from Petitioner’s October 7, 2020 visit, during which she reported a two-year history of
left shoulder pain “immediately after receiving her flu vaccine on 10/1/18.” Ex. 6 at 3. This
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is the first entry in the medical records that describes onset with such particularity, and I
find it relevant that it was made over two years post vaccination – and less than three
months before the filing of the instant claim. This singular entry does not outweigh the
bulk of evidence against 48-hour onset.
Furthermore, the witness declarations submitted by Petitioner and her
family/friends are inconsistent with the evidence contained in her contemporaneous
medical records – that her shoulder pain began immediately post vaccination – and they
accordingly are deserving of less weight. Exs. 10, 20-24. Likewise, there exist reasons to
doubt the credibility of the letter drafted by Petitioner’s treating physician. The letter was
authored on January 30, 2023 – over four years post vaccination and two years since this
claim’s initiation. See Ex. 19. More so, the treater’s letter acknowledges that the filed
record from Petitioner’s first visit with the treater on October 23, 2018, does not reflect
immediate onset of shoulder pain following Petitioner’s receipt of the subject flu vaccine;
only after the fact does the treater recall a report of immediate onset. Compare id. at 1,
with Ex. 7 at 15. It is thus strains credulity that a treater would – more than four years later
– recall a specific report of shoulder pain beginning “immediately” after administration of
an October 1, 2018 flu vaccination. Thus, the weight of the evidence regarding onset does
not favor Petitioner in this case.
B. Severity
Respondent also questions whether Petitioner has demonstrated that she suffered
“residual effects or complications of [the injury alleged] for more than six months after the
administration of the vaccine,” as required for eligibility under the Vaccine Program.
Section 11(c)(1)(D)(i).
There appears to be no dispute that Petitioner received the flu vaccine on October
1, 2018, and she therefore must demonstrate by preponderant evidence that her residual
symptoms continued for more than six months thereafter from the onset of her symptoms.
See, e.g., Herren v. Sec'y of Health & Hum. Servs., No. 13-100V, 2014 WL 3889070, at
*2 (Fed. Cl. Spec. Mstr. July 18, 2014); see also Hinnefeld v. Sec'y of Health & Hum.
Servs., No. 11-328V, 2012 WL 1608839, at *4–5 (Fed. Cl. Spec. Mstr. Mar. 30, 2012)
(dismissing case where medical history revealed that petitioner's Guillain-Barré syndrome
resolved less than two months after onset).
To satisfy the six-month requirement, “[a] potential petitioner must do something
more than merely submit a petition and an affidavit parroting the words of the statute.”
Faup v. Sec’y of Health & Hum. Servs., No. 12-87V, 2015 WL 443802, at *4 (Fed. Cl.
Spec. Mstr. Jan. 13, 2015). Rather, a petitioner is required to “submit supporting
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documentation which reasonably demonstrates that the alleged injury or its sequelae
lasted more than six months[.]” Id. Although a petitioner cannot establish the length or
ongoing nature of an injury merely through self-assertion, the fact that a petitioner has
been discharged from medical care before the expiration of the six-month period does not
necessarily indicate that there are no remaining or residual effects from his or her alleged
injury. See, e.g., Herren, 2014 WL 3889070, at *3 (finding that a petitioner suffered from
residual symptoms that due to their mild nature did not require medical care).
As discussed above, Petitioner’s treatment records suggest that the onset of her
symptoms did not begin within 48 hours of her October 1, 2018 flu vaccination. Without
resolving the approximate date of the onset of her symptoms, however, I will assume
arguendo (for purposes of resolving severity, only) that the onset of her symptoms
occurred at least by October 4, 2018, just beyond two days of vaccination. Therefore, she
logically must demonstrate that her left shoulder injury was extant as of April 4, 2019.
Petitioner initially sought treatment for her shoulder injury on October 23, 2018,
and continued for only one additional appointment on November 16, 2018 – less than one
month later. There is then an eleven-month gap in the medical records – to October 9,
2019. Respondent thus maintains that this fact suggests recovery before the April 2019
six-month “deadline.” Indeed, Respondent notes that Petitioner waited almost a year
before returning to treatment and her later complaints of left shoulder pain have not been
established to be “connected with the injury of which [she] first complained.” Resp. at 3.
Such undisputed facts indeed cast doubt on Petitioner’s ability to satisfy the Act’s severity
requirement.
The record, however, reveals that Petitioner’s symptoms did continue. Significant
to my determination on severity is the fact that when Petitioner returned to care on
October 9, 2019, she consistently related her pain back to her flu shot she had received
the previous year. Ex. 9 at 12 (reporting “L shoulder pain since flu shot fall 2018” and that
her symptoms “began 1 yr [sic] ago”); Ex. 2 at 9 (a December 27, 2019 PT discharge
summary noting that the “initial onset was . . . when she got a flu shot, she started having
pin [sic] right after.”). I have no reason to doubt the accuracy of these records, and I find
Petitioner’s reports to her treaters worthy of appropriate weight. See Cucuras, 993 F.2d
at 1528 (finding medical records warrant consideration as trustworthy evidence as they
are “generally contemporaneous to the medical events,” and “accuracy has an extra
premium” because a patient’s “proper treatment is hanging in the balance.”). Otherwise,
the lack of evidence of continuous treatment does not prevent a finding that severity of
injury persisted beyond six months of onset. See, e.g., Herren, 2014 WL 3889070, at *3.
Such evidence suggests that Petitioner’s vaccine-related pain was ongoing during the
gap in treatment, through the April 2019 six-month “deadline.”
11

Case 1:21-vv-00665-UNJ Document 43 Filed 10/22/24 Page 12 of 13
Furthermore, Petitioner’s explanation for why she did not return for treatment
during the eleven-month period, despite the existence of pain, was persuasive and
supported by the record. Indeed, at Petitioner’s last visit before the significant gap in
treatment, on November 16, 2018, she received a steroid injection – thus reasonably
accounting for a break in continuous treatment. Ex. 11 at 9. More so, Petitioner’s later
medical records corroborate her affidavit – stating that she experienced approximately six
months of relief from said injection. Ex. 9 at 12 (an October 9, 2019 note stating the
cortisone injection “helped for 4-6 months” or through May 2019); Ex. 10 ¶¶ 7-8 (stating
in her affidavit that the cortisone injection helped and she did not experience “significant
pain . . . for about six months” but that pain “slowly began to return” in May 2019). This
evidence preponderantly establishes that Petitioner’s pain was ongoing through at least
May 2019 and thus through the April 2019 deadline.
I must note, however, that I do not rely on Petitioner’s 2020 reports to treaters in
making my determination regarding severity, for it is likely Petitioner had undertaken
efforts to initiate the instant claim by the time of the later reports. Indeed, the specificity
with which Petitioner explains her symptoms lasting through the six-month deadline (and
other newly recalled details regarding onset) raises suspicion regarding the credibility of
such records, and I thus find them to be less reliable. See, e.g., Ex. 6 at 5 (a November
3, 2020 note that Petitioner’s “[s]ymptoms were present at six months.”). Still, such a
finding is immaterial, as Petitioner has otherwise satisfied the Act’s severity requirement.
Thus, after consideration of the entire record, the evidence supports a finding that
severity has been met. (Certainly, however, the lengthy treatment gaps go to damages,
assuming Petitioner can substantiate some kind of vaccine injury).
Conclusion
Petitioner has not provided preponderant evidence that the onset of her shoulder
pain occurred within 48 hours of vaccination. Accordingly, Petitioner’s Table SIRVA claim
is DISMISSED. Nevertheless, a non-Table claim could be viable, and I therefore do not
opt to dismiss the case in its entirety at this time. Instead, I urge the parties to make one
final brief attempt at settlement, since the case will likely be transferred out of SPU shortly
so that Petitioner can attempt to establish a causation-in-fact claim.
Petitioner shall file a joint status report stating that she has provided Respondent
with a settlement demand for her off-Table claim (and one that takes into account litigative
risk in attempting to prove a non-Table SIRVA-like claim), and the parties’ efforts towards
informal resolution, by no later than Tuesday, November 19, 2024. If the parties do not
report progress in their efforts, the matter will likely be transferred out of SPU.
12

Case 1:21-vv-00665-UNJ Document 43 Filed 10/22/24 Page 13 of 13
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
13

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_21-vv-00665-1
Date issued/filed: 2025-06-25
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 05/13/2025) regarding 54 DECISION Stipulation/Proffer, ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
--------------------------------------------------------------------------------
Case 1:21-vv-00665-UNJ Document 57 Filed 06/25/25 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-665V
MARIE TYLER, Chief Special Master Corcoran
Petitioner,
v. Filed: May 13, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jessi Carin Huff, Maglio Christopher & Toale, PA, Seattle, WA, for Petitioner.
Camille Jordan Webster, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On January 12, 2021, Marie Tyler filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). On October 1, 2018, Petitioner received an influenza (“flu”) vaccine, a
vaccine contained in the Vaccine Injury Table (the “Table”), 42 C.F.R. § 100.3(a).
Petitioner alleges that she sustained a shoulder injury related to vaccine administration
(“SIRVA”) as defined in the Table; she further alleges that the flu vaccine caused her
alleged shoulder injury, and that she suffered the residual effects of her alleged injury for
more than six months.
Respondent denies that Petitioner sustained a SIRVA Table injury; denies that the
vaccine caused Petitioner’s alleged shoulder injury, or any other injury; and denies that
her current condition is a sequela of a vaccine-related injury.
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-00665-UNJ Document 57 Filed 06/25/25 Page 2 of 7
Nevertheless, on May 13, 2025, 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 $30,000.00 to be paid through an ACH deposit to Petitioner’s
counsel’s IOLTA account for prompt disbursement to Petitioner. Stipulation
¶ 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-00665-UNJ Document 57 Filed 06/25/25 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
MARIE TYLER,
Petitioner,
V. No. 21-665V
Chief Special Master Corcoran
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Marie Tyler ("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 influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § 100.3(a).
2. Petitioner received a flu vaccination on October 1, 2018.
3. The flu vaccine was administered within the United States.
4. Petitioner alleges that she sustained a Table shoulder injury related to vaccine
administration ("SIRVA") within the time period set forth in the Table following administration
of the vaccine. Petitioner further alleges that she experienced the residual effects of this
condition for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil
action for damages on his behalf as a result of her condition.

Case 1:21-vv-00665-UNJ Document 57 Filed 06/25/25 Page 4 of 7
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
flu vaccine caused petitioner's alleged SIRVA, or any other injury; and denies that petitioner's
cmTent condition is a sequela of a vaccine-related injury.
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 terms of this Stipulation, and after petitioner has 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 payment of $30,000.00 be paid through an ACH deposit to
petitioner's counsel's IOLTA account for prompt disbursement 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 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-2 l(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 compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under42 U.S.C. § 300aa-15(g), to the extent that payment has 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.
§ 13 96 et seq.)), or by entities that provide health services on a pre -paid basis.
2

Case 1:21-vv-00665-UNJ Document 57 Filed 06/25/25 Page 5 of 7
11. Payment made pursuant to paragraph 8 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 attorneys' 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 return 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 or causes of action
(including agreements, judgn1ents, claims, damages, loss of services, expenses and all demands
of whatever kind or natme) 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 flu vaccination or any other vaccination administered
on October 1, 2018, as alleged in a petition for vaccine compensation filed on or about January
12, 2021, in the United States Court of Federal Claims as petition No. 21-665V.
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

Case 1:21-vv-00665-UNJ Document 57 Filed 06/25/25 Page 6 of 7
15. If the special master fails to issue a decision in complete conformity with the
terms of this Stipulation or if the Couii of Federal Claims fails to enter judgment in conformity
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 paiiy.
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 paiiies 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 flu vaccine or any other vaccination caused
petitioner's alleged SIRVA or any other injury or petitioner's current condition, or that petitioner
suffered an injury contained in the Vaccine Injury Table.
18. All rights and obligations of petitioner hereunder shall apply equally to
petitioner's heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
4

Case 1:21-vv-00665-UNJ Document 57 Filed 06/25/25 Page 7 of 7
Respectfully submitted,
PETITIONER:
MARIE TYLER
ATTORNEY OF RECORD AUTHORIZED REPRESENTATIVE
FOR PETITIONER: OF THE ATTORNEY GENERAL:
f~
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Jt5s""i ~~Jc~~-
JESSI C. HUFF
mctlaw Deputy Director
1325 4th Ave. Suite 1730 Torts Branch
Seattle, WA 98101 Civil Division
(888) 952- 5242 U.S Department of Justice
jhuff@mctlaw.com P 0. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
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fi~~:~I~ ~~gned by Jeffrey
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Beach Date: 2025.04.0814:32:05
-04'00' for
CAPT GEORGE REED GRIMES, MD, MPH ~ wEBsTER
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Department of Justice
Administration P 0. Box 146
US Department of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 Fishers Lane, 08W-25A (202) 307-3241
Rockville, MD 20857 Camille.Webster@usdoj.gov
5/
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3/)..)
Dated
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5