VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00886
Package ID: USCOURTS-cofc-1_21-vv-00886
Petitioner: Emilia Ostrowska
Filed: 2021-02-08
Decided: 2023-05-15
Vaccine: human papillomavirus (HPV)
Vaccination date: 2020-09-16
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 45000

AI-assisted case summary:
Emilia Ostrowska filed a petition for compensation on February 8, 2021, on behalf of herself, alleging a shoulder injury related to vaccine administration (SIRVA) following a human papillomavirus (HPV) vaccine administered on September 16, 2020. Ms. Ostrowska stated that the vaccination occurred in the United States, the residual effects of her injury lasted more than six months, and she had not received prior compensation or filed a civil action. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report conceding entitlement. The respondent determined that Ms. Ostrowska met the criteria for SIRVA as a Table injury, timely filed her case, received the vaccination in the United States, and satisfied the statutory severity requirement. Chief Special Master Brian H. Corcoran issued a ruling on entitlement on April 11, 2023, finding Ms. Ostrowska entitled to compensation. Subsequently, on May 15, 2023, Chief Special Master Corcoran issued a decision awarding damages based on a proffer agreed to by both parties. Ms. Ostrowska was awarded a lump sum of $45,000.00, payable by check, representing compensation for all damages available under Section 15(a) of the Vaccine Act. Petitioner was represented by Brynna Gang of Kraus Law Group, LLC, and Respondent was represented by Parisa Tabassian of the U.S. Department of Justice. The public decision does not describe the specific onset of symptoms, medical tests, treatments, or the mechanism of injury.

Theory of causation field:
Petitioner Emilia Ostrowska alleged a shoulder injury related to vaccine administration (SIRVA) following a human papillomavirus (HPV) vaccine administered on September 16, 2020. The respondent conceded entitlement, determining that Petitioner met the criteria for SIRVA as a Table injury. The public text does not detail the specific mechanism of injury, expert testimony, or competing medical theories. Petitioner was represented by Brynna Gang (Kraus Law Group, LLC) and Respondent by Parisa Tabassian (U.S. Department of Justice). Chief Special Master Brian H. Corcoran issued a ruling on entitlement on April 11, 2023, and a decision awarding damages on May 15, 2023. The award was a lump sum of $45,000.00.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00886-0
Date issued/filed: 2023-05-12
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/11/2023) regarding 29 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-00886-UNJ Document 34 Filed 05/12/23 Page 1 of 2
CORRECTED
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-886V
UNPUBLISHED
EMILIA OSTROWSKA, Chief Special Master Corcoran
Petitioner, Filed: April 11, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Human Papillomavirus
(HPV) Vaccine; Shoulder Injury
Respondent. Related to Vaccine Administration
(SIRVA)
Brynna Gang, Kraus Law Group, LLC, Chicago, IL, for Petitioner.
Parisa Tabassian, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On February 8, 2021, Emilia Ostrowska 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 suffered a shoulder injury related to vaccine
administration (SIRVA) following human papillomavirus (HPV) vaccine administered to
her on September 16, 2020. Petition at 1. Petitioner further alleges that the vaccination
was administered within the United States, she suffered the residual effects of her injury
for more than six months, and that she has not received compensation in the form of an
award or settlement, nor has she filed a civil action for her vaccine-related injuries prior
to filing her petition. Petition at 1-3. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
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-00886-UNJ Document 34 Filed 05/12/23 Page 2 of 2
On April 11, 2023, 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.
Specifically, Respondent determined that Petitioner satisfied the criteria set forth in the
Vaccine Injury Table (Table) and the Qualifications and Aids to Interpretation (QAI) for
SIRVA. Id. at 4. Respondent further agrees that Petitioner timely filed her case, that she
received the vaccination within the United States, and that she satisfies the statutory
severity requirement by suffering the residual effects or complications of her injury for
more than six months after vaccine administration. 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-00886-1
Date issued/filed: 2023-05-15
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 04/11/2023) regarding 30 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-00886-UNJ Document 35 Filed 05/15/23 Page 1 of 2
CORRECTED
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-886V
UNPUBLISHED
EMILIA OSTROWSKA, Chief Special Master Corcoran
Petitioner, Filed: April 11, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Human Papillomavirus (HPV)
Vaccine; Shoulder Injury Related to
Respondent. Vaccine Administration (SIRVA)
Brynna Gang, Kraus Law Group, LLC, Chicago, IL, for Petitioner.
Parisa Tabassian, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On February 8, 2021, Emilia Ostrowska 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 suffered a shoulder injury related to vaccine
administration (SIRVA) following human papillomavirus (HPV) vaccine administered to
her on September 16, 2020. Petition at 1.
On April 11, 2023, Respondent filed a combined Rule 4(c) report and proffer on
award of compensation (“Proffer”). On April 11, 2023, a ruling on entitlement was issued,
finding Petitioner entitled to compensation for SIRVA. In the Proffer, Respondent
indicated that Petitioner should be awarded $45,000.00. Proffer at 5. Also in the Proffer,
Respondent represented that 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.
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-00886-UNJ Document 35 Filed 05/15/23 Page 2 of 2
Pursuant to the terms stated in the Proffer, I award Petitioner a lump sum
payment of $45,000.00 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