VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-01255
Package ID: USCOURTS-cofc-1_21-vv-01255
Petitioner: Janet M. Engels
Filed: 2021-04-20
Decided: 2025-06-09
Vaccine: pneumococcal
Vaccination date: 2020-11-03
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: entitlement_granted_pending_damages
Award amount USD: 

AI-assisted case summary:
Janet M. Engels filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a left shoulder injury related to vaccine administration (SIRVA) following a pneumococcal vaccine received on November 3, 2020. The parties agreed that Ms. Engels had no prior history of left shoulder pain. She reported immediate pain upon vaccination and experienced persistent pain and decreased range of motion thereafter. Medical records documented tendinopathy and impingement syndrome. Respondent initially opposed entitlement, arguing that Ms. Engels did not meet the statutory six-month severity requirement for her injury. However, the court found that her symptoms, including pain and decreased range of motion, continued through her last physical therapy session on April 26, 2021, just seven days shy of the six-month mark. Ms. Engels provided a credible explanation for the gap in treatment, citing her role as a caregiver. The court determined that her symptoms persisted beyond the six-month period and that she otherwise satisfied the criteria for a Table SIRVA claim. Consequently, Ms. Engels was found entitled to compensation, with a separate damages order to be issued.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-01255-0
Date issued/filed: 2025-06-09
Pages: 7
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/08/2025) regarding 127 Ruling on Entitlement, Order on Motion for Ruling on the Record Signed by Chief Special Master Brian H. Corcoran. (ppa) Service on parties made.
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Case 1:21-vv-01255-UNJ Document 131 Filed 06/09/25 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-1255V
JANET M. ENGELS, Chief Special Master Corcoran
Petitioner, Filed: May 8, 2025
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Robert Joel Krakow, Law Office of Robert J. Krakow, P.C. New York, NY, for Petitioner.
Alec Saxe, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On April 20, 2021, Janet M. Engels 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 left shoulder injury related to vaccine
administration (“SIRVA”) following a pneumococcal vaccine received on November 3,
2020. Petition at 1. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
For the reasons discussed below, I find that Petitioner more likely than not suffered
the residual effects of her alleged vaccine-related injury for more than six months, and
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-01255-UNJ Document 131 Filed 06/09/25 Page 2 of 7
that she has satisfied all of the other requirements for a Table SIRVA claim. Therefore,
Petitioner is entitled to compensation under the Vaccine Act.
I. Relevant Procedural History
On September 5, 2023, Respondent filed his Rule 4(c) Report opposing
entitlement. See ECF No. 27. Respondent argues that “the evidence does not establish
that Petitioner suffered the residual effects of her alleged injury for more than six months
after the administration of the vaccine to satisfy the severity requirement under the Act.”
Rule 4(c) Report at 5. Petitioner subsequently filed a Motion for Ruling on the Record
(“Mot.”) on October 23, 2023. ECF No. 79. Respondent filed a response (“Resp.”) on
January 4, 2024 and Petitioner filed a reply (“Repl.”) on February 12, 2024. ECF No. 93,
104. Petitioner filed a Supplemental Brief (“Supp. Br.”) on May 10, 2024 and Respondent
filed a response (“Supp. Resp.”) on June 27, 2024. ECF No. 110, 113. Respondent
“continues to maintain” that Petitioner has not satisfied the statutory severity requirement.
Supp. Resp. at 1.
The matter is now ripe for adjudication.
II. Factual History
The parties agree that Petitioner had no history of left shoulder pain or dysfunction
prior to vaccination. See Mot. at 9-12; Resp. at 2; Rule 4(c) Report at 2. Petitioner
received a Prevnar 13 vaccine in her left arm at on November 3, 2020, at a pharmacy in
New York. Ex. 5 at 2. Petitioner recalled that she “yelled in pain” and told the administrator
to “get the needle out of [her] arm because something was wrong.” Ex. 23 at ¶4. When
her pain did not subside, Petitioner returned to the pharmacy and was encouraged to see
her doctor. Id. at ¶6.
On December 1, 2020 (28 days after her vaccination), Petitioner called her primary
care provider (“PCP”) requesting an x-ray to determine whether the needle had broken or
otherwise caused damage to her arm. Ex. 2 at 11. Due to Petitioner’s report of severe
pain, she was encouraged to seek urgent or emergency care. Id. at 10. Petitioner went to
urgent care on December 9, 2020. Ex. 4 at 1-3. She reported pain and “trouble moving
her arm” following her vaccination five weeks prior. Id. at 1. An x-ray of Petitioner’s left
humerus was normal. Ex. 8 at 12. She was prescribed naproxen for pain. Id. Ex. 4 at 3.
Petitioner called her PCP again on January 6, 2021, stating that she was “still in a
lot of pain and she hasn’t slept at all since she got the vaccine.” Ex. 2 at 9. Her provider
was out of the office, but Petitioner declined a telehealth appointment with another doctor
that same day, noting that she would attempt to self-treat and would follow up in a week.
Id. at 8. Petitioner also stated that it was difficult for her to come in for an appointment as
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she was “the primary caregiver for her mother and can’t leave her at this time.” Id.
Petitioner then attempted to seek care at an orthopedic clinic, but was unsuccessful. Id.
at 6.
On January 19, 2021, Petitioner’s left shoulder was evaluated by her PCP. Ex. 2
at 2. She reported that her vaccination had been “was really painful,” and that her pain
and decreased range of motion had persisted thereafter. Id. On exam, Petitioner’s “range
of motion was impaired,” with “only about 30 degrees of abduction.” Id. at 3. She was
assessed with impingement syndrome and an MRI was ordered. Id. The MRI revealed
mild AC joint osteoarthritis, mild bursitis, and distal supraspinatus tendinopathy. Ex. 3 at
2.
On February 23, 2021, Petitioner was evaluated by an orthopedist. Ex. 13 at 10.
She reported left shoulder pain that “started after getting a pneumonia shot back on
November 3, 2020.” Id. On exam, Petitioner had full range of motion with pain, mild
tenderness over the deltoid, and positive impingement testing. Id. She was diagnosed
with tendinopathy of the left rotator cuff. Id. at 11. She was encouraged to use anti-
inflammatory medications and referred to physical therapy. Id.
On April 19, 2021, Petitioner started physical therapy. Ex. 19 at 6. Petitioner
reported “pain immediately upon entry” of the needle that had “not changed since then.”
Id. The evaluation revealed poor range of motion and strength, and poor functional use.
Id. at 7. Treatment was planned for six weeks. Id. Petitioner returned for one additional
physical therapy treatment on April 26, 2021. Id. at 8. At that session, she reported an
increase in pain due to catching her mother during a fall. Id. During the session, Petitioner
exhibited pain with extension and abduction exercises. Id. She stated that she did not
continue with physical therapy because her shoulder felt worse after each session and
she “couldn’t afford to have worse shoulder pain because [her] main purpose at that time
was to help [her] mother.” Ex. 38 at ¶12.
Approximately nine months later, on February 15, 2022, Petitioner mentioned her
left shoulder pain during a visit with her PCP. Ex. 32 at 28. She reported that her pain
“continued” from when it had started at the time of her vaccination. Id. She stated that
was “managing” and could raise her arm, but that the movement “causes discomfort.” Id.
She had decreased abduction on exam. Id. at 29. No diagnosis was made and no
treatment was recommended. Id. at 29-30.
During the intervening period, Petitioner sought treatment for other medical issues,
including: diverticulitis, which was treated with antibiotics (Ex. 42 at 53); “wavy vision” (Ex.
42 at 47); a refill of insomnia medication (Ex. 42 at 45); cardiac testing (Ex. 42 at 30-31);
flu, Covid-19, and pneumococcal vaccinations (Ex. 35 at 15-16); and a colonoscopy (Ex.
45 at 23-24). None of the records of those medical contacts mention Petitioner’s left
shoulder pain.
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Petitioner again sought treatment for left shoulder pain on March 20, 2024, and
April 11, 2024. Ex. 50 at 8-9; Ex. 51 at 7. During the latter visit, she reported that the pain
had been “present for 3 years and 6 months” and started after a pneumonia shot.” Ex. 51
at 7. Petitioner was diagnosed with bursitis and prescribed Celebrex. Id. at 8.
III. Applicable Legal Standards
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove by a
preponderance of the evidence the matters required in the petition by Vaccine Act Section
11(c)(1). The Vaccine Act also requires that a petitioner demonstrate that “residual effects
or complications” of a vaccine-related injury continued for more than six months. Vaccine
Act §11(c)(1)(D)(i). A petitioner cannot establish the length or ongoing nature of an injury
merely through self-assertion unsubstantiated by medical records or medical opinion.
§13(a)(1)(A). “[T]he fact that a petitioner has been discharged from medical care does not
necessarily indicate that there are no remaining or residual effects from her alleged
injury.” Morine v. Sec’y of Health & Human Servs., No. 17-1013V, 2019 WL 978825, at
*4 (Fed. Cl. Spec. Mstr. Jan. 23, 2019); see also Herren v. Sec’y of Health & Human
Servs., No. 13-1000V, 2014 WL 3889070, at *3 (Fed. Cl. Spec. Mstr. July 18, 2014).
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Section 11(c)(1).
A special master must consider, but is not bound by, any diagnosis, conclusion, judgment,
test result, report, or summary concerning the nature, causation, and aggravation of
petitioner’s injury or illness that is contained in a medical record. Section 13(b)(1).
“Medical records, in general, warrant consideration as trustworthy evidence. The records
contain information supplied to or by health professionals to facilitate diagnosis and
treatment of medical conditions. With proper treatment hanging in the balance, accuracy
has an extra premium. These records are also generally contemporaneous to the medical
events.” Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525, 1528 (Fed. Cir.
1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Human Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, at *19. And the Federal Circuit recently “reject[ed] as
incorrect the presumption that medical records are accurate and complete as to all the
patient’s physical conditions.” Kirby v. Sec’y of Health & Human Servs., 997 F.3d 1378,
1383 (Fed. Cir. 2021).
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The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Human Servs., 42 Fed.
Cl. 381, 391 (1998). The Court later outlined four possible explanations for
inconsistencies between contemporaneously created medical records and later
testimony: (1) a person’s failure to recount to the medical professional everything that
happened during the relevant time period; (2) the medical professional’s failure to
document everything reported to her or him; (3) a person’s faulty recollection of the events
when presenting testimony; or (4) a person’s purposeful recounting of symptoms that did
not exist. La Londe v. Sec’y of Health & Human Servs., 110 Fed. Cl. 184, 203-04 (2013),
aff’d, 746 F.3d 1335 (Fed. Cir. 2014).
The Court has also said that medical records may be outweighed by testimony that
is given later in time that is “consistent, clear, cogent, and compelling.” Camery, 42 Fed.
Cl. at 391 (citing Blutstein v. Sec’y of Health & Human Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998). The credibility of the individual offering
such testimony must also be determined. Andreu v. Sec’y of Health & Human Servs., 569
F.3d 1367, 1379 (Fed. Cir. 2009); Bradley v. Sec’y of Health & Human Servs., 991 F.2d
1570, 1575 (Fed. Cir. 1993).
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La
Londe, 110 Fed. Cl. at 204 (citing Section 12(d)(3); Vaccine Rule 8); see also Burns v.
Sec’y of Health & Human Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within
the special master's discretion to determine whether to afford greater weight to medical
records or to other evidence, such as oral testimony surrounding the events in question
that was given at a later date, provided that such determination is rational).
IV. Findings of Fact - Severity
To satisfy the statutory severity requirement, Petitioner must demonstrate that her
symptoms more likely than not continued until at least May 3, 2021 – six months after the
onset of her pain on November 3, 2020. The record establishes (and the parties agree)
that Petitioner continued treating her shoulder pain at least through her final physical
therapy treatment on April 26, 2021 – just seven days prior to the six-month mark.
Thereafter, Respondent contends, Petitioner “did not seek treatment for her left shoulder
for nearly nine months,” which “supports a finding that Petitioner’s symptoms resolved
prior to the six-month post-onset date.” Resp. at 8. Respondent also argues that Petitioner
had a history, both before and after her vaccination, of seeking regular medical care for
various medical problems, including during the gap in treatment for her left shoulder pain.
Id. at 9-12.
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Case 1:21-vv-01255-UNJ Document 131 Filed 06/09/25 Page 6 of 7
Despite the above, the overall record preponderantly supports the conclusion that
Petitioner’s symptoms more likely than not continued for at least seven days after her
physical therapy appointment on April 26, 2021 – and therefore, that the statutory severity
requirement has been met. During that last treatment event, Petitioner reported a
worsening of her pain – up to 8-9/10 – after catching her elderly mother during a fall and
the physical therapist noted that Petitioner exhibited pain during the exercises. Ex. 18 at
8. Further, treatment was ongoing and was planned to continue for several additional
weeks. Id. And there is no evidence that petitioner had met any of her physical therapy
goals at that time. Id.
Although Petitioner did not complete the planned therapy, she has provided a
credible explanation for why she did not seek further treatment – that the sessions made
her shoulder feel worse, and hindered her ability as sole caregiver for her elderly mother.
Ex. 38 at ¶12. When Petitioner returned to treatment after a nine-month gap, she
expressed that her pain had “continued” from the date of her vaccination, and that she
continued to have decreased abduction on exam – which was present prior to the gap.
Ex. 32 at 28. In fact, Petitioner continued to relate her left shoulder pain back to her
vaccination as late as April 2024. See Ex. 51 at 7. Therefore, given that Petitioner
expressed severe pain, exhibited pain with movement seven days prior to the six months,
and consistently related her continuing pain thereafter to her vaccination, it is reasonable
to conclude that her symptoms had not resolved as of the six-month onset “anniversary.”
Further, the various medical visits cited by Respondent during the nine-month gap
were not necessarily occasions on which Petitioner would have been expected to
complain of her shoulder problem. During that time, for example, Petitioner saw her
ophthalmologist for “wavy vision,” her cardiologist for cardiac testing, and had a
colonoscopy. See Ex. 42 at 23-24, 30-31, 47. None of these specialists would reasonably
be expected to treat shoulder pain. Otherwise, Petitioner only had brief medical contacts
for one medication refill and three preventative vaccinations, and for an acute diverticulitis
that required antibiotics. Ex. 35 at 15-16; Ex. 42 at 53, 72.
Thus, after consideration of the entire record, I find that the evidence
preponderates in Petitioner’s favor on the issue of severity. Of course, the substantial
gaps in treatment, coupled with the mild nature of the treatments received, will bear on
any pain and suffering award – and Petitioner should keep this in mind when making any
demand.
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V. Ruling on Entitlement
A. Requirements for Table SIRVA
I have found that Petitioner has preponderantly established that her pain began
within 48 hours after her vaccination. 42 C.F.R. § 100.3(c)(10)(ii). Respondent concedes
that Petitioner otherwise “has satisfied the Table criteria for a left-sided SIRVA.” Resp. at
7; See 42 C.F.R. § 100.3(c)(10)(i), (iv). Therefore, I find that Petitioner has provided
preponderant evidence to establish that she suffered a Table SIRVA injury.
B. Additional Requirements for Entitlement
Because Petitioner has satisfied the requirements of a Table SIRVA, she need not
prove causation. Section 11(c)(1)(C). However, she must satisfy the other requirements
of Section 11(c) regarding the vaccination received, the duration and severity of injury,
and the lack of other award or settlement. Section 11(c)(A), (B), and (D).
The vaccine record shows that Petitioner received a Prevnar 13 vaccine in her left
arm on November 3, 2020 at a pharmacy in New York. Ex. 5 at 2; Section 11(c)(1)(A)
(requiring receipt of a covered vaccine); Section 11(c)(1)(B)(i) (requiring administration
within the United States or its territories). Additionally, Petitioner has stated that she has
not filed any civil action or received any compensation for her vaccine-related injury, and
there is no evidence to the contrary. Ex. 23 at ¶12; Section 11(c)(1)(E) (lack of prior civil
award). And as noted above, I have found that severity has been established. See Section
11(c)(1)(D)(i) (statutory six-month requirement). Therefore, Petitioner has satisfied all
requirements for entitlement under the Vaccine Act.
Conclusion
Based on the entire record in this case, I find that Petitioner has provided
preponderant evidence satisfying all requirements for a Table SIRVA. Petitioner is
entitled to compensation in this case. A separate damages order will be issued.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
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