VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00965
Package ID: USCOURTS-cofc-1_21-vv-00965
Petitioner: Andera Smith
Filed: 2021-02-19
Decided: 2024-03-01
Vaccine: Tdap
Vaccination date: 2020-12-28
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 152778

AI-assisted case summary:
Andera Smith filed a petition for compensation under the National Vaccine Injury Compensation Program on February 19, 2021. She alleged that a tetanus-diphtheria-acellular pertussis (Tdap) vaccination she received on December 28, 2020, caused a Table shoulder injury related to vaccine administration (SIRVA). The respondent conceded that the injury was consistent with SIRVA, noting that Ms. Smith had no prior shoulder issues, experienced pain within 48 hours of vaccination, the pain was limited to the shoulder of injection, and no other condition explained the pain. The respondent also agreed that she suffered residual effects for more than six months. A ruling on entitlement was issued on July 28, 2023, finding her entitled to compensation. On January 29, 2024, the respondent proffered an award of $152,778.61, comprising $150,000.00 for pain and suffering and $2,778.61 for past unreimbursable expenses. Ms. Smith, an adult, agreed with this award. A decision awarding damages was issued on March 1, 2024, granting the proffered award.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00965-0
Date issued/filed: 2023-08-29
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 07/28/2023) regarding 36 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-00965-UNJ Document 40 Filed 08/29/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-965V
ANDERA SMITH, Chief Special Master Corcoran
Petitioner, Filed: July 28, 2023
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Nina Ren, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On February 19, 2021, Andera Smith 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 Table shoulder injury related to
vaccine administration (“SIRVA”), as the result of a tetanus-diphtheria-acellular pertussis
(“Tdap”) vaccination she received on December 28, 2020. Petition at 1. Petitioner further
alleges the vaccine was administered within the United States, that she suffered the
residual effects of her injury for more than six months, and that there has been no prior
award or settlement of a civil action on her behalf as a result of her injury See Amended
Petition, filed August 31, 2021, at ¶¶ 6, 33-35. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
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 (2018).

Case 1:21-vv-00965-UNJ Document 40 Filed 08/29/23 Page 2 of 2
On July 26, 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 indicates that he
has reviewed the petition and medical records filed in this case and has
concluded that compensation is appropriate. DICP has concluded that
[P]etitioner’s alleged injury is consistent with SIRVA as defined by the
Vaccine Injury Table. Specifically, [P]etitioner had no history of pain,
inflammation, or dysfunction of her left shoulder prior to vaccination; 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 [P]etitioner’s
shoulder pain.
Id. at 8 (citing 42 C.F.R. §§ 100.3(a), (c)(10)). Respondent further agrees that “[P]etitioner
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-00965-1
Date issued/filed: 2024-03-01
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 01/30/2024) regarding 47 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-00965-UNJ Document 51 Filed 03/01/24 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0965V
ANDERA SMITH, Chief Special Master Corcoran
Petitioner, Filed: January 30, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Nina Ren, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On February 19, 2021, Andera Smith 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”) as a result of a tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccination she received on December 28, 2020. Petition at 1. The case was assigned to
the Special Processing Unit of the Office of Special Masters.
On July 28, 2023, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On January 29, 2024, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $152,778.61
(comprised of $150,000.00 in pain and suffering and $2,778.61 in past unreimbursable
expenses). Proffer at 1-2. In the Proffer, Respondent represented that Petitioner agrees
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-00965-UNJ Document 51 Filed 03/01/24 Page 2 of 5
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 $152,778.61 (comprised of $150,000.00 in pain and suffering and
$2,778.61 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-00965-UNJ Document 51 Filed 03/01/24 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
ANDERA SMITH,
Petitioner, No. 21-965V
Chief Special Master Corcoran
v. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On February 19, 2021, Andera Smith (“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” or “Act”), alleging that she suffered a Table shoulder injury related to vaccine
administration (“SIRVA”), as the result of the tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccination that she received on December 28, 2020. Petition at 1. On July 26, 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 Act for a SIRVA Table injury,
and on July 28, 2023, the Chief Special Master issued a Ruling on Entitlement finding petitioner
entitled to compensation. ECF No. 35; ECF No. 36.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $150,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:21-vv-00965-UNJ Document 51 Filed 03/01/24 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 $2,778.61. 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 $152,778.61, in the form of
a check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Andera Smith: $152,778.61
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-00965-UNJ Document 51 Filed 03/01/24 Page 5 of 5
JULIA M. COLLISON
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
Date: January 29, 2024
3