VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00929
Package ID: USCOURTS-cofc-1_21-vv-00929
Petitioner: Amy Congilose
Filed: 2021-02-16
Decided: 2023-07-28
Vaccine: influenza
Vaccination date: 2020-10-21
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 83730

AI-assisted case summary:
Amy Congilose filed a petition for compensation under the National Vaccine Injury Compensation Program alleging she suffered a shoulder injury related to vaccine administration (SIRVA) resulting from an influenza vaccine received on October 21, 2020. The respondent conceded that Petitioner's injury was consistent with SIRVA as defined by the Vaccine Injury Table, noting she had no prior history of shoulder issues, the pain occurred within 48 hours after vaccination, was limited to the injection site, and no other condition explained the pain. The respondent also agreed that Petitioner experienced residual effects for more than six months. Based on the concession and the evidence, entitlement was granted. Subsequently, the respondent proffered an award of $83,730.89, comprised of $82,500.00 for pain and suffering and $1,230.89 for past unreimbursable expenses, which Petitioner agreed to. The court awarded this amount as a lump sum payment.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00929-0
Date issued/filed: 2023-06-29
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/26/2023) regarding 37 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:21-vv-00929-UNJ Document 42 Filed 06/29/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0929V
UNPUBLISHED
AMY CONGILOSE, Chief Special Master Corcoran
Petitioner, Filed: May 26, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Influenza (Flu) Vaccine;
Shoulder Injury Related to Vaccine
Respondent. Administration (SIRVA)
Nancy Routh Meyers, Turning Point Litigation, Greensboro, NC, for Petitioner.
Nina Ren, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On February 16, 2021, Amy Congilose 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 May 25, 2023, Petitioner filed an amended petition. Petitioner alleges
that she suffered a shoulder injury related to vaccine administration (“SIRVA”) resulting
from an influenza vaccine received in her left deltoid on October 21, 2020. Amended
Petition at 1-4. Petitioner further alleges that the vaccine was administered in the United
States, she experienced residual effects of her injury for more than six months, and
neither Petitioner, nor any other party, has ever filed an action or received compensation
1 Because this unpublished 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 (2018).

Case 1:21-vv-00929-UNJ Document 42 Filed 06/29/23 Page 2 of 2
in the form of an award for her vaccine-related injury. Petition at ¶¶ 16-19. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On May 17, 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 agrees that “petitioner’s alleged injury is consistent with SIRVA
as defined by the Vaccine Injury Table. Specifically, petitioner had no history of pain,
inflammation, or dysfunction of her left shoulder; pain occurred within 48 hours after
receipt of an intramuscular vaccination; pain was limited to the shoulder in which the
vaccine was administered; and no other condition or abnormality has been identified to
explain petitioner’s shoulder pain.” Id. at 4. Respondent further agrees that “based on the
medical records outlined [in the Rule 4(c) Report], petitioner suffered the residual effects
of her condition for more than six months.” 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-00929-1
Date issued/filed: 2023-07-28
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 06/26/2023) regarding 40 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:21-vv-00929-UNJ Document 45 Filed 07/28/23 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0929V
AMY CONGILOSE, Chief Special Master Corcoran
Petitioner, Filed: June 26, 2023
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Nancy Routh Meyers, Turning Point Litigation, Greensboro, NC, for Petitioner.
Nina Ren, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On February 16, 2021, Amy Congilose 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 May 25, 2023, Petitioner filed an amended petition. Petitioner alleges
that she suffered a shoulder injury related to vaccine administration (“SIRVA”) resulting
from an influenza vaccine received in her left deltoid on October 21, 2020. Amended
Petition at 1-4. Petitioner further alleges that the vaccine was administered in the United
States, she experienced residual effects of her injury for more than six months, and
neither Petitioner, nor any other party, has ever filed an action or received compensation
in the form of an award for her vaccine-related injury. Petition at ¶¶ 16-19. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
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-00929-UNJ Document 45 Filed 07/28/23 Page 2 of 5
On May 26, 2023, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On June 26, 2023, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $83,730.89. Proffer at
2. 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.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $83,730.89 (comprised of $82,500.00 in pain and suffering and
$1,230.89 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-00929-UNJ Document 45 Filed 07/28/23 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
AMY CONGILOSE,
Petitioner,
v. No. 21-929V
Chief Special Master Corcoran
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On February 16, 2021, Amy Congilose (“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”), alleging that she suffered a shoulder injury related to vaccine administration
(“SIRVA”) as a result of an influenza vaccine she received in her left deltoid on October 21,
2020. See generally Petition.
On May 17, 2023, 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 Vaccine
Act for a SIRVA Table injury, and on May 26, 2023, the Chief Special Master issued a Ruling on
Entitlement finding petitioner entitled to compensation. ECF No. 34; ECF No. 37.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $82,500.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
1

Case 1:21-vv-00929-UNJ Document 45 Filed 07/28/23 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 $1,230.89. 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 $83,730.89, in the form of a
check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Amy Congilose: $83,730.89
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
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-00929-UNJ Document 45 Filed 07/28/23 Page 5 of 5
LARA A. ENGLUND
Assistant Director
Torts Branch, Civil Division
/s/ NINA Y. REN
NINA Y. REN
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington D.C. 20044-0146
(202) 451-7499
Nina.Ren@usdoj.gov
DATED: June 26, 2023
3