VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-01911
Package ID: USCOURTS-cofc-1_21-vv-01911
Petitioner: John Michael Smith, Jr.
Filed: 2021-09-27
Decided: 2023-10-23
Vaccine: influenza
Vaccination date: 2018-10-01
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 35500

AI-assisted case summary:
John Michael Smith, Jr. filed a petition for compensation under the National Vaccine Injury Compensation Program alleging he suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of an influenza vaccine administered on October 1, 2018. He asserted that the vaccine was administered in the United States, that his injury occurred within the time period set forth in the Vaccine Injury Table, that he experienced residual effects for more than six months, and that no prior civil action for damages had been filed. The respondent, the Secretary of Health and Human Services, denied that Mr. Smith sustained a SIRVA, denied that the vaccine caused his injury, and denied that his condition was a sequelae of a vaccine-related injury. Despite these differing positions, the parties filed a joint stipulation agreeing to settle the issues and award compensation. The Chief Special Master adopted the stipulation, awarding Mr. Smith a lump sum of $35,500.00. This amount represents compensation for all items of damages available under the Vaccine Act. The decision also noted that the parties would submit to further proceedings to award reasonable attorneys' fees and costs.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-01911-0
Date issued/filed: 2023-10-23
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 09/21/2023) regarding 34 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:21-vv-01911-UNJ Document 38 Filed 10/23/23 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-1911V
JOHN MICHAEL SMITH, JR., Chief Special Master Corcoran
Petitioner, Filed: September 21, 2023
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Robert P. Goodwin, Walsh Roberts & Grace, Buffalo, NY, for Petitioner.
Bridget Corridon, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On September 27, 2021, John Michael Smith, Jr., 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 he suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered on
October 1, 2018. Petition at 1; Stipulation, filed at September 19, 2023, ¶¶ 1, 2. Petitioner
further alleges that the vaccine was administered within the United States, that he
sustained an injury within the time period set forth in the Vaccine Injury Table, that he
experienced the residual effects of his condition for more than six months, and that there
has been no prior award or settlement of a civil action for damages on her behalf as a
result of her injury. Petition at 7; Stipulation at ¶¶ 3-6. Respondent denies that Petitioner
sustained a SIRVA, as defined in the Vaccine Injury Table; denies that the vaccine caused
Petitioner’s alleged shoulder injury, or any other injury; and denies that his current
condition is a sequelae of a vaccine-related injury. Stipulation at ¶ 6.
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-01911-UNJ Document 38 Filed 10/23/23 Page 2 of 7
Nevertheless, on September 19, 2021, the parties filed the attached joint
stipulation, stating that a decision should be entered awarding compensation. I find the
stipulation reasonable and adopt it as my decision awarding damages, on the terms set
forth therein.
Pursuant to the terms stated in the attached Stipulation, I award the following
compensation:
A lump sum of $35,500.00 in the form of a check payable to Petitioner.
Stipulation at ¶ 8. This amount represents compensation for all items of damages
that would be available under Section 15(a). Id.
I approve the requested amount for Petitioner’s compensation. In the absence of
a motion for review filed pursuant to RCFC Appendix B, 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.
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Case 1:21-vv-01911-UNJ Document 38 Filed 10/23/23 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
JOHN MICHAEL SMITH, JR.,
)
)
Petitioner,
) No. 21-191 IV
v.
) Chief Special Master Corcoran
ECF
SECRETARY OF HEALTH AND HUMAN )
SERVICES, ~
______R_esp_ond_en_t. ______ )
)
STIPULATION
The parties hereby stipulate to the following matters:
I. John Michael Smith, Jr., petitioner, filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to -34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of the influenza ("flu") vaccine, which vaccine is contained in the Vaccine [njury Table (the
"Table"), 42 C.F.R. § I0 0.3(a).
2. Petitioner received the flu vaccination in his left ann on October I, 2018.
3. The vaccine was administered within the United States.
4. Petitioner alleges that he suffered a Shoulder Injury Related to Vaccine
Administration ("SIRVA") as a result of receiving the flu vaccine within the Table time frame,
and that he experienced residual effects of this injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on his behalf as a result of his condition.

Case 1:21-vv-01911-UNJ Document 38 Filed 10/23/23 Page 4 of 7
6. Respondent denies that petitioner sustained a SIRVA, as defined in the Table; denies
that the vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies that
his current condition is a sequelae of a vaccine~related injury.
7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry ofj udgment reflecting a decision consistent with
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-2l(a)(I), the Secretary of Health and Human Services will issue
the following compensation payment:
A lump sum of$3S,S00.00 in the form ofa check payable to petitioner. This amount
represents compensation for all damages that would be available under 42 U.S.C.
§ 300aa-l 5(a).
9. As soon as practicable after the entry ofj udgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to 42
U.S.C. § 300aa-2l(a)(I), and an application, the parties will submit to further proceedings before
the special master to award reasonable attorneys' fees and costs incurred in proceeding upon this
petition.
I 0. Petitioner and his attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U. S.C. § 300aa-I 5(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C.
§ 1396 et seq.)), or by entities that provide health services on a pre-paid basis.
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Case 1:21-vv-01911-UNJ Document 38 Filed 10/23/23 Page 5 of 7
11. Payment made pursuant to paragraph 8 of this Stipulation, and any amounts awarded
pursuant to paragraph 9 of this Stipulation, will be made in accordance with 42 U.S.C. § 300aa-
15(i), subject to the availability of sufficient statutory funds.
12. The parties and their anomeys further agree and stipulate that, except for any award
for attorneys' fees and litigation costs, the money provided pursuant to this Stipulation will be
used solely for the benefit of petitioner, as contemplated by a strict construction of 42 U.S.C. §
300aa-15(a) and (d), and subject to the conditions of 42 U.S.C. §§ 300aa-15(g) and (h}.
13. In return for the payments described in paragraphs 8 and 9, petitioner, in his
individual capacity and on behalf of his heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
the Secretary of Health and Human Services from any and all actions, causes of action (including
agreements, judgments, claims, damages, loss of services, expenses and al I demands of whatever
kind or nature) that have been brought, could have been brought, or could be timely brought in
the Court of Federal Claims, under the National Vaccine Injury Compensation Program, 42
U.S.C. § 300aa 10 et seq., on account of, or in any way growing out of, any and all known or
unknown, suspected or unsuspected personal injuries to or death of petitioner resulting from, or
alleged to have resulted from, the flu vaccine administered on or about October I, 2018, as
alleged by petitioner in a petition for vaccine compensation filed on September 27, 2021, in the
United States Court of Federal Claims as petition No. 21-1911 V.
14. lf petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
15. If the special master fails to issue a decision in complete conformity with the terms
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a
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Case 1:21-vv-01911-UNJ Document 38 Filed 10/23/23 Page 6 of 7
: ,..,
decision that is in complete confonnity with the terms of this Stipulation, then the parties'
settlement and this Stipulation shall be voidable at the sole discretion of either party.
16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the award described in this
stipulation may reflect a compromise of the parties' respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the flu vaccine caused petitioner to suffer a
shoulder injury or his current disabilities, or any other injury or condition, or that petitioner
sustained an injury contained in the Vaccine Injury Table.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:21-vv-01911-UNJ Document 38 Filed 10/23/23 Page 7 of 7
A
Respectfully submitted,
AI TORNEY OF RECORD FOR AUTHORIZED REPRSENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
=
ROBERTP .GO{)ll'J
400 Rand Building Deputy Director
14 Lafayette Square Torts Branch
Buffalo, NY 14203-1904 Civil Division
(716) 856-1636 U.S. Department of Justice
E-mail: rgoodwin@walshrobertsgrace.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
H e n ry P• Digitally signed by
Henry P. Mcmillan -S3
·11an -S3 f!i/!f:'tl!N~
Mcml Date:2023.08.31
by
13:3s:3s 04•00·
CDR GEORGE REED GRIMES, MD, MPH
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Department of Justice
Administration P.O. Box 146
U.S. Department of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 Fishers Lane, 08N 146B Tel: (202) 305-4117
Rockville, MD 20857 E-mai I: Bridget.Corridon@usdoj.gov
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