VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-01957
Package ID: USCOURTS-cofc-1_21-vv-01957
Petitioner: Daniel Wolfe
Filed: 2021-10-04
Decided: 2025-06-04
Vaccine: tetanus toxoid-containing vaccine
Vaccination date: 2018-10-04
Condition: brachial neuritis
Outcome: dismissed
Award amount USD: 

AI-assisted case summary:
Daniel Wolfe filed a petition alleging brachial neuritis following a tetanus toxoid-containing vaccine administered on October 4, 2018. He was 48 years old at the time. The medical records indicate he received both a tetanus and an influenza vaccine on that date. Mr. Wolfe reported experiencing pain in his left arm and shoulder on the evening of the vaccination, which he described as muscle spasms and burning pain radiating to his neck and armpit. He sought emergency care two days later for severe pain and spasms, and was diagnosed with suspected brachial neuritis. The respondent argued that the onset of symptoms occurred within hours of vaccination, which would not meet the Table's timeframe of 2-28 days for brachial neuritis. The court reviewed the medical records, which showed varying descriptions of onset, but ultimately found that Mr. Wolfe experienced new pain within approximately twelve hours of vaccination. Because this onset was inconsistent with the Table's requirements for brachial neuritis, the court dismissed the Table claim. The court noted that an off-Table claim might still be feasible, but that it would face other challenges. The parties were instructed to explore informal resolution of the remaining claim.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-01957-0
Date issued/filed: 2025-06-04
Pages: 13
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/01/2025) regarding 35 Findings of Fact & Conclusions of Law, Scheduling Order. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:21-vv-01957-UNJ Document 36 Filed 06/04/25 Page 1 of 13
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-1957V
DANIEL WOLFE, Chief Special Master Corcoran
Petitioner,
v. Filed: May 1, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Jamica Marie Littles, U.S. Department of Justice, Washington, DC, for Respondent.
FINDINGS OF FACT AND CONCLUSIONS OF LAW DISMISSING TABLE CLAIM1
On October 4, 2021, Daniel Wolfe filed a Petition under the National Vaccine Injury
Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the “Vaccine Act”); see Section
11(c)(1)(D)(i). Petitioner alleges that he suffered brachial neuritis3 following his receipt of
1 Because this opinion 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 opinion 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).
3 Brachial neuritis has several synonyms including Parsonage-Turner syndrome, brachial plexus
neuropathy, neuralgic amyotrophy, idiopathic brachial plexus neuropathy, brachial plexitis, and brachial
plexopathy. See, e.g., Madan v. Sec’y of Health & Hum. Servs., No. 19-537V, 2023 WL 3946834, at *2
(Fed. Cl. Spec. Mstr. May 16, 2023). Several of these alternate terms appear in Mr. Wolfe’s medical records.
This opinion consistently utilizes the term brachial neuritis, consistent with the Table definition.

Case 1:21-vv-01957-UNJ Document 36 Filed 06/04/25 Page 2 of 13
a tetanus toxoid-containing vaccine on October 4, 2018. The case was assigned to the
Special Processing Unit (“SPU”) of the Office of Special Masters.
After review of the record and the parties’ arguments, I conclude (under the Act’s
more likely than not standard) that Petitioner developed new pain in the affected arm and
shoulder within twelve (12) hours after his tetanus vaccination, mandating dismissal of
his Table claim (although an off-Table claim might be feasible).
I. Procedural History
In March 2022, the claim was assigned to the SPU (OSM’s forum for claims that
have typically not required extensive litigation). ECF No. 9. The next month during an
initial status conference, Petitioner’s prior counsel4 was offered an introduction to the
Vaccine Program. ECF No. 12. Petitioner was also ordered to file certified and unredacted
copies of his medical records, which were entered on May 4, 2022. ECF No. 13.5
On September 12, 2022, Respondent filed his Rule 4(c) Report formally opposing
compensation – particularly contending that “Petitioner’s records, including his own
reports, document the onset of left shoulder pain and symptoms within hours of his
October 2018 receipt of the Td vaccination,” and hence too soon to meet the Table’s
timeframe for such a claim. Rule 4(c) Report, ECF No. 12 at 12. Petitioner then retained
current counsel. ECF No. 19.
On June 23, 2023, Petitioner confirmed that he was maintaining a Table claim, and
the parties agreed to brief the disputed onset issue for my resolution. ECF No. 22. Over
subsequent months, Petitioner fell out of communication with the Durant firm and
considered switching legal representation again, and he was ordered to show cause why
his claim should not be dismissed for failure to prosecute. See generally ECF Nos. 23 –
29. On March 11, 2024, Petitioner confirmed that he was maintaining representation by
the Durant firm, and the parties proposed a schedule for briefing onset, which was
accepted. ECF No. 30; see also Brief filed May 10, 2024, ECF No. 31); Response filed
4 Petitioner was represented by Kimberly Johnson until December 2022. ECF No. 19. This case’s docket
indicates that Ms. Johnson moved from a private law firm to the Vermont Attorney General’s Office.
5 Petitioner did not file the requested motion to strike the previous versions of his medical records, which
remain on the docket. This opinion utilizes Petitioner’s refiled medical records at Exhibits 2 – 4, and 6 – 7
(ECF No. 13) as well as his originally-filed affidavit at Ex. 5 (ECF No. 7-1).
It is further noted that Petitioner incorrectly labeled Exhibit 7 (ECF No. 13-5) as Exhibit 6. This opinion
utilizes the correct exhibit number. (In contrast, Respondent refers to the filing as “Ex. 6 (SVMC),” see Rule
4(c) Report at n. 1.)
2

Case 1:21-vv-01957-UNJ Document 36 Filed 06/04/25 Page 3 of 13
July 9, 2024, ECF No. 32; Reply filed Sept. 3, 2024, ECF No. 34. The matter is ripe for
adjudication.
II. Authority
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). 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 & Hum. 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 & Hum. Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. “Written records which are, themselves, inconsistent, should be
accorded less deference than those which are internally consistent.” Murphy v. Sec’y of
Health & Hum. Servs., No. 90-882V, 1991 WL 74931, *4 (Fed. Cl. Spec. Mstr. April 25,
1991), quoted with approval in decision denying review, 23 Cl. Ct. 726, 733 (1991), aff'd
per curiam, 968 F.2d 1226 (Fed.Cir.1992)). 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 & Hum. Servs., 997 F.3d 1378,
1383 (Fed. Cir. 2021).
The United States Court of Federal Claims has 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 & Hum. Servs., 110 Fed. Cl. 184, 203-04 (2013),
aff’d, 746 F.3d 1335 (Fed. Cir. 2014).
3

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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 v. Sec’y
of Health & Hum. Servs., 42 Fed. Cl. 381, 391 (1998) (citing Blutstein v. Sec’y of Health
& Hum. Servs., No. 90-2808, 1998 WL 408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998).
The credibility of the individual offering such fact testimony must also be determined.
Andreu v. Sec’y of Health & Hum. Servs., 569 F.3d 1367, 1379 (Fed. Cir. 2009); Bradley
v. Sec’y of Health & Hum. Servs., 991 F.2d 1570, 1575 (Fed. Cir. 1993).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
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 & Hum. 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).
In addition to requirements concerning the vaccination received, the duration and
severity of petitioner’s injury, and the lack of other award or settlement,6 a petitioner must
establish that she suffered an injury meeting the Table criteria, in which case causation
is presumed, or an injury shown to be caused-in-fact by the vaccination she received.
Section 11(c)(1)(C).
The most recent version of the Table, which can be found at 42 C.F.R. § 100.3,
identifies the vaccines covered under the Program, the corresponding injuries, and the
time period in which the particular injuries must occur after vaccination. Section 14(a). At
issue here is the listing for brachial neuritis with an onset between 2 – 28 days, i.e., not
less than 2 days and not more than 28 days, after receipt of a tetanus toxoid vaccine. 42
6 In summary, a petitioner must establish that he received a vaccine covered by the Program, administered
either in the United States and its territories or in another geographical area but qualifying for a limited
exception; suffered the residual effects of his injury for more than six months, died from his injury, or
underwent a surgical intervention during an inpatient hospitalization; and has not filed a civil suit or collected
an award or settlement for her injury. See Section 11(c)(1)(A)(B)(D)(E).
4

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C.F.R. § 100.3(a)(I)(B). The corresponding Qualifications and Aids to Interpretation
(“QAI”) for a Table brachial neuritis injury are as follows:
Brachial neuritis… is defined as dysfunction limited to the upper extremity
nerve plexus (i.e., its trunks, divisions, or cords). A deep, steady, often
severe aching pain in the shoulder and upper arm usually heralds onset of
the condition. The pain is typically followed in days or weeks by weakness
in the affected upper extremity muscle groups. Sensory loss may
accompany the motor deficits, but is generally a less notable clinical feature.
Atrophy of the affected muscles may occur. The neuritis, or plexopathy, may
be present on the same side or on the side opposite the injection. It is
sometimes bilateral, affecting both upper extremities. A vaccine recipient
shall be considered to have suffered brachial neuritis if such recipient
manifests all of the following:
(i) Pain in the affected arm and shoulder is a presenting symptom and
occurs within the specified time-frame;
(ii) Weakness;
(A) Clinical diagnosis in the absence of nerve conduction and
electromyographic studies requires weakness in muscles
supplied by more than one peripheral nerve;
(B) Nerve conduction studies (NCS) and electromyographic (EMG)
studies localizing the injury to the brachial plexus are required
before the diagnosis can be made if weakness is limited to
muscles supplied by a single peripheral nerve.
(iii) Motor, sensory, and reflex findings on physical examination and the
results of NCS and EMG studies, if performed, must be consistent in
confirming that dysfunction is attributable to the brachial plexus; and
(iv) No other condition or abnormality is present that would explain the
vaccine recipient’s symptoms.
42 C.F.R. § 100.3(c)(6).7
7 I am resolving Petitioner's claim on the filed record. The Vaccine Act and Rules not only contemplate but
encourage special masters to decide petitions on the papers where (in the exercise of their discretion) they
conclude that doing so will properly and fairly resolve the case. Section 12(d)(2)(D); Vaccine Rule 8(d). The
5

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III. Evidence
I have reviewed all of the filings submitted by both parties to date. The below
summary focuses on the disputed onset issue.
Medical Records. Petitioner was 48 years old when he received the tetanus
vaccine in his left arm on October 4, 2018. His medical history included anxiety,
depression, low back pain, and a suspected peripheral neuropathy in his hands and feet.
He was taking Valium and gabapentin, and was unemployed and on Medicaid. See
generally Ex. 7 at 102 – 63.
Petitioner also had a history of shoulder pain and dysfunction, particularly on the
right side. See Ex. 7 at 109 (listing a right rotator cuff strain in 1995); id. at 4 – 8 (July
2015 urgent care encounter for right shoulder pain with no known cause); id. at 29 – 34
(July 2016 urgent care encounter for right shoulder arm/neck/pain following a motor
vehicle accident); id. at 41 – 55 (December 2016 urgent care encounters for chest pain
radiating into his arms). But in the year prior to the at-issue vaccination, his primary care
records suggest left shoulder pain – with no corresponding examination or assessment.
Id. at 102 – 06, 131 – 33, 142 – 45.
On Thursday, October 4, 2018 in the late morning,8 Petitioner attended a primary
care annual evaluation. He reported: “Lots of aches and pains. Same aches that he has
had previously. Knees, back left shoulder.” Ex. 7 at 164. However, there is no
corresponding exam or assessment, and the problem list included the right shoulder. Ex.
7 at 164 – 65. The at-issue tetanus vaccine was at this time administered in Petitioner’s
left deltoid. Id. at 169.9
decision to rule on the record in lieu of hearing has been affirmed on appeal. Kreizenbeck v. Sec’y of Health
& Hum. Servs., 945 F.3d 1362, 1366 (Fed. Cir. 2020); see also Hooker v. Sec’y of Health & Hum. Servs.,
No. 02-0472V, 2016 WL 3456435, at *21 n. 19 (Fed. Cl. Spec. Mstr. May 19, 2016) (citing numerous cases
where special masters decided cases on the papers in lieu of hearing and that decision was upheld). I am
simply not required to hold a hearing in every matter, no matter the preferences of the parties. Hovey v.
Sec’y of Health & Hum. Servs., 38 Fed. Cl. 397, 402 – 03 (1997) (determining that special master acted
within his discretion in denying evidentiary hearing); Burns, 3 F.3d at 417; Murphy v. Sec’y of Health &
Hum. Servs., No. 90-0882V, 1991 WL 71500, at *2 (Fed. Cl. Spec. Mstr. Apr. 19, 1991).
8 A licensed practical nurse checked in Petitioner and reconciled his medications by 10:36 a.m. Ex. 7 at
166. A nurse practitioner signed the annual examination record at 12:43 p.m. Id. at 170.
9 Additionally on October 4, 2018, an influenza (“flu”) vaccine was administered in Petitioner’s right deltoid,
Ex. 7 at 169, but the Petition and medical records do not suggest any injury stemming from that second
vaccine.
6

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Two days later – October 6, 2018 – at 12:01 p.m., Petitioner was admitted to an
emergency room for an initial diagnosis of “severe left chest pain.” Ex. 3 at 20. At 12:04
p.m., registered nurse Kathleen Cloud recorded: “Patient got tetanus booster Thursday,
began that evening to left arm with muscle spasming radiating to left side of neck
and left armpit.” Id. at 21 (emphasis added). Petitioner rated his current pain at 10/10.
Id.
At 12:43 p.m., a second registered nurse, Aubrey Davis, recorded that Petitioner
was resting on a stretcher, in no acute distress. Ex. 3 at 22. Petitioner “state[d] he received
a tetanus injection on Thursday and later that evening, he began to have what he
describes [as] ‘muscle spasms.’… describes a constant burning sensation that travels
up into his left neck and down into his left chest wall… unable to lift arm due to brain and
spasms… pain causes him to lose his breath.” Id. (emphasis added).
Afterwards,10 the attending emergency medicine physician met with Petitioner and
recorded the following history:
This is a generally healthy 48-year-old man who presents to the emergency
department with post-vaccination pain involving the left side of his neck, his
entire left hemi-thorax and his left arm. He received influenza vaccination in
his right arm and tetanus vaccination in his left arm on Thursday at his
primary care office. By later that night, he was feeling tired and started
having pain in his left arm and left side of his neck. Since then he has
had persistent severe pain. He was not able to sleep last night. He tells
me that any movement of his arm or neck aggravates this pain. Coughing
or taking a deep breath aggravates it as well. He does have a history of
asthma and is also a smoker. He seems to have a chronic baseline
discomfort in that area described which is acutely worsened at times
randomly, but can be triggered by movement or coughing. When that
happens, the pain becomes a severe, searing, sharp discomfort that affects
the entire area. He describes this as a ‘spasm.’
Ex. 3 at 13 (emphasis added).
10 See Ex. 3 at 22 (reflecting that the registered nurse notified the emergency medicine physician at 12:45
p.m., and he entered Petitioner’s room by 12:47 p.m.).
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Petitioner submitted to a physical examination and tests including laboratory
studies, EKG, cardiac markers, and a CT angiogram of the neck. Ex. 3 at 18, 24 - 25. He
displayed a “very good response” to intravenous Toradol and Decadron, and oral Valium.
Id. at 18, 25 – 26.
The emergency medicine physician noted that Petitioner had “present[ed to the]
emergency department 2 days after receiving a tetanus vaccination. Since then, he has
had progressively worsening pain symptoms with a neuropathic character involving
the territory of the left brachial plexus and also including portions of the left chest wall.”
Ex. 3 at 18 (emphasis added). While the emergency evaluation found “no evidence of a
cardiac, respiratory, or central neurological cause of his symptoms,” the physician
considered that the “location of his symptoms and the proximity to his vaccination… would
be compatible with [brachial neuritis].” Id. The physician believed that Petitioner’s
symptoms were “related to an inflammatory condition that might be related to” his
vaccination. Id. Petitioner was discharged home with impressions of “severe post-
vaccination neuropathic pain” and “suspect[ed]” brachial neuritis, to be managed with
gabapentin (Neurontin) and over-the-counter non-steroidal anti-inflammatory medications
(“NSAIDs”). Id. at 18, 26 – 27.
On October 7, 2018, a hospital nurse called to follow up on Petitioner’s condition.
Ex. 3 at 24. He reported ongoing “spasming” and “tingling numbness.” Id. at 24. Later that
month, a primary care provider (“PCP”) recorded Petitioner’s history of: “Reaction to
tetanus shot. Thursday night following injection increased pain, swelling left arm,
pain spread down left arm, ribs sore, not using left arm at all, burning tingling pain.”
Ex. 3 at 69 (emphasis added). The “impression” contains similar details, except for
suggesting that the tetanus vaccination had been “the day before reaction.” Id. at 71.
Petitioner was instructed to manage his pain with heat, ice, and ibuprofen. Id.
At a November 5, 2018 primary care follow-up, Petitioner had decreased strength;
decreased range of motion; pain in his left shoulder radiating all the way down his arm;
burning and tingling upon making a fist; discomfort in his ribs; and soreness in his neck.
Ex. 3 at 73 – 74. Petitioner had been taking Valium and gabapentin, and he rated the
current pain at 8/10. Id. The PCP recommended a neurology evaluation of possible
brachial neuritis. Id. at 75.
Between December 2018 and June 2019, Petitioner followed up regularly with his
PCP for his alleged vaccine injury. The records do not shed further light on onset, but
they document an ongoing left shoulder injury suspected to represent brachial neuritis (or
complex regional pain syndrome, see Ex. 3 at 86) which warranted a neurology consult.
Petitioner also described difficulties with health insurance, transportation, family
8

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obligations, anxiety, depression, and an intervening pneumonia infection. See generally
Ex. 3 at 77 – 101 (PCP records); see also id. at 37 – 61 (December 2018 emergency visit
for pneumonia).
At the June 14, 2019 neurology initial evaluation, Petitioner reported that “his
problems began” with his October 2018 annual exam and tetanus vaccination. Ex. 4 at
56. “Later in the day, he had an uncomfortable feeling in his arm, but noted that he
was warned that this is to be expected. However, over the next two days, his pain
progressed. He initially noted discomfort underneath his left armpit, followed by
discomfort down his left arm, followed by tingling and numbness of his whole
arm… [B]ecause of the pain, discomfort, and cramping he sought evaluation in the
emergency department… [W]hile there, he was having contractions of his left upper
extremity that were extremely vigorous in nature… so bad that they would essentially train
[sic?] him and… he had no ability to do anything else.” Id. (emphasis added). A physical
exam and EMG of Petitioner’s left upper extremity were limited by his significant pain, but
suggestive of nerve dysfunction consistent with brachial neuritis mainly in the upper trunk.
Id. at 59 – 60, 67. The neurologist recommended additional diagnostic lab work and MRIS
of his neck and plexus, and entered a referral to pain management. Id. at 60,
At the July 2, 2019, pain management initial evaluation, Petitioner reported: “In
October 2018 he had onset of pain in the left upper extremity following a tetanus
booster… over the 2 days following his visit, he had pain under the left arm in axilla,
pain shooting down the left arm, and tingling and numbness of his whole arm… He
was seen in the emergency department… for this issue as he has having severe spasms
and pain… this has been ongoing since October 2018.” Ex. 4 at 29 (emphasis added).
The record further states: “Sudden onset. Since onset pain is unchanged. Location: Left
neck, left arm and left hand. Duration: 9 months.” Id. The pain was currently 8/10, and
ranged from 7 – 10/10. Id. Based on the history, EMG findings, and her own physical
examination of Petitioner, he the pain management provider assessed that Petitioner “had
some components of” chronic regional pain syndrome (“CRPS”), his signs and symptoms
could “somewhat be explained by” brachial neuritis. Id. at 38. She suggested further
evaluation (including the previously suggested MRIs), following up in six weeks, and
taking Lyrica and naltrexone for the pain. Id.
Between October 2019 – September 2021, Petitioner followed up several times
with his PCP. These records suggest that Petitioner’s left upper extremity injury was
ongoing, but he received no further evaluation by any specialists (e.g., neurology, pain
management, MRIs) despite the PCP’s repeated urging. See generally Ex. 3 at 102 –
120.
9

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Petitioner’s Affidavit. In October 2021, Petitioner states that three years earlier:
“During the evening of October 4, 2018, I started to feel some fatigue and minor pain in
my left arm. On October 6, 2018, two days after my vaccine, I went to the [emergency
room] for a significant aggravation of my symptoms. I had severe pain in my left neck,
shoulder, chest, armpit, and arm. I had muscle spasms in my left upper arm, and I had
tingling and numbness down my entire left arm into my left hand.” Ex. 5 at ¶¶ 5 – 6.
Petitioner’s affidavit also suggests that his pre-vaccination history included a left
rotator cuff tear in 2016, and a further left-sided injury during a motor vehicle accident
later in 2016. Ex. 5 at ¶ 8. But in April 2022, the parties were informed that my preliminary
review did not identify any corresponding records. ECF No. 12 at 1. In June 2022,
Petitioner confirmed that “all pre-vaccination medical records, and any other evidence
pertaining to any potential left shoulder injury before the vaccination, ha[d] been filed” and
that the only rotator cuff tear and traumatic injuries were on his right side. ECF No. 15.
IV. Analysis
A Table brachial neuritis injury requires proof of new shoulder and arm pain and
dysfunction beginning not less than two days after receipt of a tetanus vaccine. 42 C.F.R.
§§ 100.3(a)(I)(B), (c)(6).
Respondent argues that in this case, “Petitioner’s records, including his own
reports, document the onset of left shoulder pain and symptoms within hours” after the
vaccination. Rule 4(c) Report at 12; accord Response at 11. Petitioner responds that his
medical records and affidavit establish two distinct and unrelated types of pain: 1) “initial
discomfort within hours of his tetanus vaccination (fatigue, minor left arm pain) consistent
with the common side effects of tetanus vaccine”11) and 2) “severe neuropathic pain
symptoms reach[ing] a crescendo at the two-day mark post-vaccination, which is
consistent with the Table timeframe for the onset of brachial neuritis.” Brief at 16; accord
Reply at 6 – 7 (internal citations omitted). Respondent opposes any “dissection of
[Petitioner’s] pain into different stages and/or types.” Response at 13.
Here, the record does not support Petitioner’s arguments distinguishing his initial
pain from what came later. For example, the emergency medicine physician described
“two kinds of pain,” in the following initial notation: “[L]ater that night, [Petitioner] was
feeling tired and started having pain in his left arm and left side of his neck. Since then
[Petitioner] has had persistent severe pain.” Brief at 15, citing Ex. 3 at 13. But that
11 In support of this proposition, Petitioner’s Brief at n. 2 cites to a Centers for Disease Control and
Prevention (“CDC”) webpage which I could not access.
10

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physician also recorded that Petitioner’s pain was significant enough to disrupt his sleep
the night before his emergency room presentation. Id. And after further evaluation, the
same physician summarized that “since then [the vaccination,] [Petitioner] had suffered
“progressively worsening pain symptoms with a neuropathic character.” Id. at 18. The
physician’s only assessment was of a post-vaccination brachial neuritis, and he did not
endorse any distinguishable preceding pain.12
In addition, several other medical providers independently recorded that Petitioner
had experienced significant left shoulder/arm/neck pain and “spasming” beginning on the
night of the vaccination. Ex. 3 at 21 – 22 (hospital nurses); id. at 69 (PCP). Later records
indicate that his “pain progressed, “over the next two days” leading up to his emergency
room visit. Ex. 4 at 56, 29. These records support the conclusion that the providers viewed
the overall progression of symptoms as being consistent with brachial neuritis.
Within Mr. Wolfe’s medical records, certain wording (e.g., “since” vaccination) is
admittedly vague. But as I previously observed, even when claimants employ “imprecise
terminology in describing to treaters when symptoms began . . . terms like ‘since’ or
‘shortly after’ are reasonably understood by the special master to mean very close in
time.” Flowers v. Sec’y of Health & Hum. Servs., No. 20-285V, 2024 WL 2828211, at *11
(Fed. Cl. Spec. Mstr. May 8, 2024), mot. for rev. den’d, 173 Fed. Cl. 613 (2024). “[I]ndeed,
in the context of [SIRVA claims], a patient’s reports of pain conveyed with similarly non-
specific language are consistently interpreted to mean within 48 hours of vaccination.”
Id.13 A contrary interpretation is not warranted simply because a different Table injury
(brachial neuritis) that requires a more delayed onset is at issue.
12 The emergency medicine physician’s additional note of a “chronic baseline discomfort in that area,”
aggravated by movement, is ambiguous – potentially referring either to Petitioner’s pre-vaccination aches
and pains” apparently including in the left shoulder, or to the suspected brachial neuritis. Ex. 3 at 13.
13 Citing O’Leary v. Sec’y of Health & Hum. Servs., No. 18-584V, 2021 WL 3046617, at *10 (Fed. Cl. Spec.
Mstr. June 24, 2021); Williams v. Sec’y of Health & Hum. Servs., No. 17-1046V, 2020 WL 3579763, at *5
(Fed. Cl. Spec. Mstr. Apr. 1, 2020) (holding that “based on the record as a whole, I find the notations
characterizing onset as ‘since,’ ‘after receiving,’ ‘following,’ and ‘very soon after’ injection are best
understood as indicating onset was effectively immediate, or within 48 hours of vaccination”).
See also, e.g., Kallin v. Sec’y of Health & Hum. Servs., No. 20-0113V, 2024 WL 5135419, at *6 (Fed. Cl.
Spec. Mstr. Nov. 12, 2024) (accepting that the petitioner’s shoulder injury began immediately upon
vaccination, and progressed over time leading up to her first formal medical evaluation); Robuck v. Sec’y
of Health & Hum. Servs., No. 20-0465V, 2023 WL 6214986, at *5 – 6 (Fed. Cl. Spec. Mstr. Aug. 21, 2023)
(reports of shoulder pain “following the flu shot” and “since… flu shot a few weeks ago” supported a finding
of onset within 48 hours post-vaccination); Smith v. Sec’y of Health & Hum. Servs., No. 20-0300V, 2023
WL 6620362, at *4 (Fed. Cl. Spec. Mstr. Feb. 24, 2023) (“when [the petitioner] received [the at-issue
vaccine,]” “after receiving a tetanus injection”); Hunt v. Sec’y of Health & Hum. Servs., No. 19-1003V, 2022
WL 2826662, at *6 (Fed. Cl. Spec. Mstr. June 16, 2022) (shoulder pain “from” and “beg[inning] after she
received a flu shot”).
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Petitioner correctly notes (Brief at 16) that the Federal Circuit has held that “sworn
testimony as to facts within [a] witness’s personal knowledge” can constitute objective
evidence. James-Cornelius v. Sec’y of Health & Hum. Servs., 984 F.3d 1374, 1380 (Fed.
Cir. 2021). Petitioner’s affidavit is thus entitled to some consideration – but its probative
value is somewhat limited because it was prepared three years after the events in
question. Additionally, Petitioner’s affidavit (describing only “minor” left arm pain the night
of the vaccination, followed by a “significant aggravation” and emergency evaluation
within two days post-vaccination) conflicts with the contemporaneous medical records
(evidencing more significant pain the night of the vaccination, which further progressed in
intensity, eventually prompting his emergency evaluation).14 I reasonably give the medical
records more weight.
Conclusion and Scheduling Order
For the foregoing reasons, Petitioner more likely than not experienced the onset
of new pain involving his left arm and shoulder on the evening of October 4, 2018 – within
roughly twelve (12) hours of receipt of the tetanus vaccine. That onset is inconsistent with
a Table brachial neuritis claim, which must be dismissed.
An off-Table claim based on these same facts, however, might be feasible –
although it will face other challenges. Having reviewed the file for purposes of this onset
determination, I recognize Respondent’s additional argument that there is “not evidence
confirming” the alleged brachial neuritis. Rule 4(c) Report at 12; accord Response at 15
– 16. But the available evidence contains repeated consideration of brachial neuritis as
being the best explanation for Petitioner’s post-vaccination injury, and numerous
explanations for Petitioner’s failure to seek further evaluation (e.g., his unemployment,
and healthcare access through Medicaid). It is also emphasized that Petitioner not only
bears the burden of establishing the alleged injury, but a showing of vaccine causation-
14 This case’s evidence is distinguishable from that in Davis, in which the special master found that an initial
lack of contemporaneous medical records, plus affidavits from the petitioner and ten other fact witnesses,
were sufficiently consistent, clear, cogent, and compelling to outweigh later medical records which
suggested an onset not fitting the Table brachial neuritis timeframe. Davis v. Sec’y of Health & Hum. Servs.,
No. 16-0276V, 2016 WL 6471911 (Fed. Cl. Spec. Mstr. Oct. 7, 2016), cited in Brief at 17.
Petitioner’s reliance on Jones is not particularly helpful because that litigation did not center on
understanding the onset of pain, but rather, a differential diagnosis including thoracic outlet syndrome.
Jones v. Sec’y of Health & Hum. Servs., No. 04-1147V, 2006 WL 2052379 (Fed. Cl. Spec. Mstr. July 5,
2006), cited in Brief at 18 – 19.
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in-fact based on the onset described herein. No experts have been authorized in the case
to date.15
The parties are instructed to promptly explore the potential for informal resolution
of Petitioner’s remaining claim, to include the previously-acknowledged Medicaid lien.16
If the parties cannot report a tentative settlement agreement within 60 days, the case will
be transferred out of SPU for further proceedings.
Accordingly within 60 days, by no later than Monday, June 30, 2025,
Petitioner shall file a Joint Status Report updating on the case, unless a 15-Week
Order has been requested by that deadline.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
15 See SPU Initial Order entered Mar. 18, 2022, ECF No. 10, at 1 (stating that no expert should be retained
in a case assigned to SPU without prior consultation with the opposing party and the Court, and that
engaging experts is not routine in SPU cases).
16 See Petitioner’s Status Report filed June 13, 2022, ECF No. 15 at 2.
13