VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00798
Package ID: USCOURTS-cofc-1_21-vv-00798
Petitioner: Rocelyn Nepomuceno
Filed: 2021-01-25
Decided: 2024-01-22
Vaccine: Tdap
Vaccination date: 2020-02-13
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 40000

AI-assisted case summary:
Rocelyn Nepomuceno filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) following a tetanus-diphtheria-acellular-pertussis (Tdap) vaccination on February 13, 2020. The respondent, the Secretary of Health and Human Services, denied that Ms. Nepomuceno sustained a Table SIRVA within the Table timeframe or met the six-month severity requirement, and also denied that the Tdap vaccine caused her alleged shoulder pain or any other injury. Despite these denials, the parties filed a joint stipulation agreeing to settle the case and award compensation. The court adopted the stipulation as its decision. Ms. Nepomuceno was awarded a lump sum of $40,000.00, which represents compensation for all items of damages available under the Vaccine Act. This case proceeded as a Table claim, as SIRVA is listed on the Vaccine Injury Table. The stipulation noted that the award reflects a compromise of the parties' respective positions on liability and damages, and it does not constitute an admission by the government that the vaccine caused the injury.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00798-0
Date issued/filed: 2024-01-22
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 12/14/2023) regarding 38 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:21-vv-00798-UNJ Document 42 Filed 01/22/24 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0798V
ROCELYN NEPOMUCENO, Chief Special Master Corcoran
Petitioner, Filed: December 14, 2023
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
Mark Kim Hellie, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On January 25, 2021, Rocelyn Nepomuceno 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”) following a tetanus-diphtheria-acellular-pertussis
(“Tdap”) vaccination she received on February 13, 2020. Petition at 1; Stipulation, filed at
December 13, 2023, ¶¶ 2, 4. “Respondent denies “that Petitioner sustained the onset of
a Table SIRVA within the Table timeframe of that she satisfies the six-month severity
requirement. Respondent further denies that the Tdap vaccine caused Petitioner’s
alleged shoulder pain, any other injury, or her current condition.” Stipulation at ¶ 6.
Nevertheless, on December 13, 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.
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-00798-UNJ Document 42 Filed 01/22/24 Page 2 of 7
Pursuant to the terms stated in the attached Stipulation, I award the following
compensation:
A lump sum of $40,000.00 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-00798-UNJ Document 42 Filed 01/22/24 Page 3 of 7
]n tbe Wniteb $tates (:ourt of jfe beral (:lat ms
OFFICE OF SPECIAL MASTERS
ROCELY N NEPOMUCENO,
Petitioner,
Case No. 21-798V (ECF)
V. CHIEF SPECIAL MASTER
CORCORAN
SECRETARY OF HEALTH
AND HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Rocelyn Nepomuceno, 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 a vaccine contained
in the Vaccine Injury Table (the "Table"), 42 C.F.R. § 100.3(a).
2. Petitioner received the vaccine on February 13, 2020.
3. The vaccination was administered within the United States.
4. Petitioner alleges that she suffered from a left shoulder injury related to vaccine
administration ("SIRVA") within the Table time period after receiving the Tdap vaccine. She
also alleges that she experienced the residual effects of these injuries 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 alleged injuries.

Case 1:21-vv-00798-UNJ Document 42 Filed 01/22/24 Page 4 of 7
6. Respondent denies that petitioner sustained the onset of a Table SIRVA within the
Table timeframe or that she satisfies the six-month severity requirement. Respondent further
denies that the Tdap vaccine caused petitioner's alleged shoulder pain, 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 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 of $40,000.00 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-l 5(a).
9. As soon as practicable after the entry ofj udgment 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.
l 0. 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-l 5(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
2

Case 1:21-vv-00798-UNJ Document 42 Filed 01/22/24 Page 5 of 7
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.
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-l 5(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-l 5(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 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, 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-I0 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 February 13, 2020,
as alleged by petitioner in a petition for vaccine compensation filed on or about
January 25, 2021, in the United States Court of Federal Claims as petition No. 21-798V.
3

Case 1:21-vv-00798-UNJ Document 42 Filed 01/22/24 Page 6 of 7
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.
15. If the 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 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 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
SIRVA or that it caused any shoulder injury or 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
4

Case 1:21-vv-00798-UNJ Document 42 Filed 01/22/24 Page 7 of 7
Respectfully submitted,
PETITIONER:
ROCEL~~
ATTORNEY OF RECORD FOR AUTBORJED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
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NATHANIEL C. ENOS Deputy Di rector
Counsel for Petitioner Torts Branch, Civil Division
Conway Homer, P.C. U.S. Department of Justice
16 ShawmutStreet P.O. Box 146
Boston, MA 02116 Benjamin Franklin Station
nenos@ccandh.com Washington, DC 20044-0146
(617) 695-0880
AUTHORIZED REPRESENTATIVE ATTONEYOFRECORDFOR
OFTHESECRETARYOFHEALTH RESPONDENT:
AND HUMAN SERVICES:
George R. Grimes -
Dlgltillt,slgned by George R
Grimes-S14
514
Date: 2023.12.07 12:26:22-05'00'
CDR GEORGE REED GRIMES, MD, MPH MARK K. HELLIE
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch, Civil Division
Health Systems Bureau U.S. Department of Justice
Heal th Resources and P.O. Box 146
Services Administration Benjamin Franklin Station
U.S. Department of Health and Washington, DC 20044-0146
Human Services mark.hellie@usdoj.gov
5600 Fishers Lane, 08W-25A (202) 616-4208
Rockville, MD 20857
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Dated: /7... • Z.f
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