VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-01015
Package ID: USCOURTS-cofc-1_21-vv-01015
Petitioner: Ariana Drivdahl
Filed: 2021-02-24
Decided: 2023-05-19
Vaccine: influenza
Vaccination date: 2020-11-11
Condition: left-sided shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 75000

AI-assisted case summary:
Ariana Drivdahl filed a petition on February 24, 2021, alleging she received an influenza vaccine on November 11, 2020, and subsequently developed a left-sided shoulder injury related to vaccine administration (SIRVA). She claimed the injury persisted for more than six months. The respondent conceded that Ms. Drivdahl was entitled to compensation, agreeing that her condition met the criteria for SIRVA as outlined in the Vaccine Injury Table and Qualifications and Aids to Interpretation. Specifically, the respondent noted her lack of prior shoulder issues, the onset of pain within 48 hours of vaccination, the localization of pain and reduced range of motion to the injected shoulder, and the absence of other explanatory conditions. The respondent also agreed that she met the statutory severity requirement of suffering residual effects for over six months and had not received prior compensation for this injury. Based on the respondent's concession and the evidence, entitlement was granted. Subsequently, on May 19, 2023, a decision awarding damages was issued. The respondent proffered an award of $75,000.00 for all damages, which the petitioner accepted. The court awarded Ms. Drivdahl a lump sum payment of $75,000.00.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-01015-0
Date issued/filed: 2023-05-15
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/13/2023) regarding 28 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-01015-UNJ Document 35 Filed 05/15/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-1015V
UNPUBLISHED
ARIANA DRIVDAHL, Chief Special Master Corcoran
Petitioner, Filed: April 13, 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)
Alan Kenneth Nicolette, Nordstrom, Steele, et al., Tustin, CA, for Petitioner.
Nancy Tinch, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On February 24, 2021, Ariana Drivdahl 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 received an influenza (“flu”) vaccine on
November 11, 2020, and thereafter suffered from a left-sided shoulder injury related to
vaccine administration (“SIRVA”). Petition at 1-2. Petitioner further alleges that she
suffered her injury for more than six months. Petition at 3. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
On April 12, 2023, Respondent filed a combined Rule 4(c) report and Proffer (“Rule
4/Proffer”) in which he concedes that Petitioner is entitled to compensation in this case.
Rule 4/Proffer at 1. Specifically, Respondent states that “petitioner has satisfied the
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-01015-UNJ Document 35 Filed 05/15/23 Page 2 of 2
criteria for SIRVA set forth in the Vaccine Injury Table (‘Table’) and the Qualifications and
Aids to Interpretation (‘QAI’). Specifically, petitioner had no apparent history of pain,
inflammation or dysfunction of the affected shoulder prior to intramuscular vaccine
administration that would explain the alleged signs, symptoms, examination findings,
and/or diagnostic studies occurring after vaccine injection; she more likely than not
suffered the onset of pain within forty-eight hours of vaccine administration; her pain and
reduced range of motion were limited to the shoulder in which the intramuscular vaccine
was administered; and there is no other condition or abnormality present that would
explain petitioner’s symptoms.” Id. at 6. Respondent further agrees that “petitioner
satisfies the statutory severity requirement by suffering the residual effects or
complications of her injury for more than six months after vaccine administration” and she
has not “received compensation in the form of an award of settlement for [her] vaccine-
related injury.” Id. at 6-7.
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-01015-1
Date issued/filed: 2023-05-19
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 04/13/2023) regarding 29 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:21-vv-01015-UNJ Document 36 Filed 05/19/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-1015V
UNPUBLISHED
ARIANA DRIVDAHL, Chief Special Master Corcoran
Petitioner, Filed: April 13, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
Respondent. Administration (SIRVA)
Alan Kenneth Nicolette, Nordstrom, Steele, et al., Tustin, CA, for Petitioner.
Nancy Tinch, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On February 24, 2021, Ariana Drivdahl 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 received an influenza (“flu”) vaccine on
November 11, 2020, and thereafter suffered from a left-sided shoulder injury related to
vaccine administration (“SIRVA”). Petition at 1-2. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On April 13, 2023, a ruling on entitlement was issued, finding Petitioner entitled to
compensation. On April 13, 2023, Respondent filed a combined Rule 4(c) report and
Proffer on award of compensation (“Rule 4/Proffer”) indicating Petitioner should be
awarded a total of $75,000.00 for all damages. Rule 4/Proffer at 1. In the Rule 4/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-01015-UNJ Document 36 Filed 05/19/23 Page 2 of 2
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 Rule 4/Proffer, I award Petitioner a lump sum
payment of $75,000.00, 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