VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00907
Package ID: USCOURTS-cofc-1_21-vv-00907
Petitioner: Sandra Williams
Filed: 2021-02-10
Decided: 2022-04-27
Vaccine: influenza
Vaccination date: 2020-10-27
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: dismissed
Award amount USD: 

AI-assisted case summary:
Sandra Williams filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) from an influenza vaccine received on October 27, 2020. She initially alleged a Table SIRVA injury but later filed a motion to dismiss the petition. Ms. Williams' counsel stated that they could no longer establish a presumptive Table SIRVA injury and were awaiting authorization to withdraw the claim. Subsequently, Ms. Williams filed a motion for a decision dismissing the petition, conceding that she would be unable to demonstrate the required six months of sequelae for her injury. To receive compensation, a petitioner must prove either a Table injury or that the vaccine actually caused the injury, and must also establish the severity requirement of more than six months of sequelae or hospitalization/surgery. As Ms. Williams failed to establish entitlement due to insufficient proof, her case was dismissed. The decision was issued by Chief Special Master Brian H. Corcoran on April 27, 2022.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00907-0
Date issued/filed: 2022-05-24
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 4/27/2022) regarding 16 DECISION of Special Master. Signed by Chief Special Master Brian H. Corcoran. (abs) Service on parties made.
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Case 1:21-vv-00907-UNJ Document 20 Filed 05/24/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-907V
UNPUBLISHED
SANDRA WILLIAMS,
Chief Special Master Corcoran
Petitioner,
v. Filed: April 27, 2022
SECRETARY OF HEALTH AND Motion for decision; Dismissal;
HUMAN SERVICES, Influenza Vaccine; Shoulder Injury
Related to Vaccine Administration
Respondent. (SIRVA)
Leigh Finfer, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Heather L. Pearlman, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION1
On February 10, 2021, Sandra Williams filed a petition for compensation under
the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa—10 through
34,2 (the “Vaccine Act”). Ms. Williams alleged that she suffered a shoulder injury related
to vaccine administration (“SIRVA”) from an influenza vaccine she received on October
27, 2020. ECF no. 1.
On April 26, 2022, Ms. Williams filed a motion for a decision dismissing the
petition. For the reasons set forth below, Ms. Williams’ motion is GRANTED, and this
case is DISMISSED.
In the petition, Ms. Williams alleged that she suffered a shoulder injury from an
influenza vaccination but did not provide any medical history for treatment of the injury.
ECF No. 1. Ms. Williams did not submit any medical records with the petition.
1 Although I have not formally designated this Decision for publication, I am required to post it on the United
States Court of Federal Claims' website because it contains a reasoned explanation for the action in this
case, 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 “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2012).

Case 1:21-vv-00907-UNJ Document 20 Filed 05/24/22 Page 2 of 2
The February 11, 2021 PAR Initial Order required Ms. Williams to file all the
statutorily required documents, including medical records supporting the vaccination,
pre-vaccination treatment, and post-vaccination treatment. ECF No. 5.
On March 22, 2022, Ms. Williams filed a status report stating that “Petitioner’s
counsel no longer feels as though Petitioner can establish a presumptive Table SIRVA
injury. Counsel is awaiting return of written authorization to take the necessary steps to
withdraw Petitioner’s claim.”
On April 26, 2022, Ms. Williams filed some medical records and a motion for a
decision dismissing the petition stating that “[a]fter a review of relevant medical records,
Petitioner is unable to demonstrate six (6) months of sequelae.” ECF No. 15.
To receive compensation under the National Vaccine Injury Compensation
Program, a petitioner must prove either 1) that the vaccinee suffered a “Table Injury” –
i.e., an injury falling within the Vaccine Injury Table – corresponding to one of the
vaccinations, or 2) that the vaccinee suffered an injury that was actually caused by a
vaccine. See §§ 300aa—13(a)(1)(A) and 11(c)(1). Ms. Williams alleged that she
sustained a SIRVA Table Injury.
Under the Vaccine Act, a petitioner may not receive compensation based solely
on the petitioner’s claims alone. Rather, the petition must be supported by either
medical records or by the opinion of a competent physician. § 300aa—13(a)(1). Among
other requirements, Ms. Williams must establish the severity requirement, that her injury
persisted for more than six months or resulted in inpatient hospitalization and surgical
intervention. 42 U.S.C. § 300aa—11(c)(1)(D)(i). In her motion for decision, Ms. Williams
conceded that she would not be able to establish the severity requirement.
Thus, Petitioner has failed to establish entitlement to compensation in the
Vaccine Program. This case is dismissed for insufficient proof. The clerk shall
enter judgment accordingly.3
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 If Petitioner wishes to bring a civil action, she must file a notice of election rejecting the judgment
pursuant to § 21(a) “not later than 90 days after the date of the court’s final judgment.”
2