VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-02077
Package ID: USCOURTS-cofc-1_21-vv-02077
Petitioner: Randall S. Blank
Filed: 2021-10-26
Decided: 2026-03-23
Vaccine: influenza
Vaccination date: 2020-09-23
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: entitlement_granted_pending_damages
Award amount USD: 

AI-assisted case summary:
On October 26, 2021, Randall S. Blank, M.D., Ph.D., filed a petition alleging that an influenza vaccination administered in his left shoulder on September 23, 2020 caused a left shoulder injury related to vaccine administration. He was a 61-year-old anesthesiologist with no history of left shoulder pain or dysfunction at the time of vaccination.

Respondent did not contest most Table SIRVA elements, but argued that Dr. Blank failed to prove residual effects for more than six months because there was a long treatment gap after March 2021. The medical record showed that he was seen at employee health on October 12, 2020 for shoulder pain that began within hours of vaccination and worsened over two weeks. He continued to report pain with raising his arm, saw orthopedics in December 2020, received a steroid injection, and returned in March 2021 reporting that his pain had come back worse than before. A second steroid injection did not help.

MRI findings included full-thickness tearing of the posterior supraspinatus and anterior infraspinatus, diffuse labral degeneration and tearing, severe glenohumeral synovitis, biceps tendinosis with tenosynovitis, and a probable small Hill-Sachs deformity. The orthopedist described advanced glenohumeral osteoarthrosis with a superimposed inflammatory reaction to the flu vaccine and discussed arthroscopy, but Dr. Blank chose physical therapy. At physical therapy he reported severe shoulder pain after a shot placed too close to the joint and difficulty weightlifting, swimming, and running.

Chief Special Master Brian H. Corcoran found that the March 2021 MRI, examination findings, planned therapy, and declarations from Dr. Blank and his wife supported residual effects beyond six months despite the gap in shoulder-specific care. Entitlement was granted on March 23, 2026, but damages were left for later proceedings.

Theory of causation field:
Influenza vaccine on September 23, 2020, causing Table left SIRVA; ENTITLEMENT GRANTED, damages pending. Age 61. Respondent disputed six-month severity due treatment gap after March 2021. Evidence: pain within hours, worsening over two weeks, employee health/orthopedics, two steroid injections, MRI showing rotator cuff tears/labral degeneration/severe synovitis/biceps tendinosis, orthopedist noted inflammatory reaction to vaccine, PT documented severe pain and activity limits. Chief SM Corcoran found residual effects past six months despite gap. Petition filed October 26, 2021; entitlement March 23, 2026. Attorney: Kirk Tripp Otto, Siri & Glimstad.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-02077-0
Date issued/filed: 2026-04-23
Pages: 7
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/23/2026) regarding 55 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-02077-UNJ Document 57 Filed 04/23/26 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-2077
RANDALL S. BLANK, M.D., Ph.D., Chief Special Master Corcoran
Petitioner, Filed: March 23, 2026
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Kirk Tripp Otto, Siri & Glimstad, LLP, Richmond, VA, for Petitioner.
Jamica Marie Littles, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On October 26, 2021, Randal S. Blank, M.D., Ph.D., (“Petitioner”) 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 left shoulder
injury related to vaccine administration (“SIRVA”) following an influenza (“flu”) vaccine
received on September 23, 2020. Petition at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
For the reasons set forth below, I find that Petitioner more likely than not suffered
the residual effects of his vaccine-related injury for more than six months, and that he has
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-02077-UNJ Document 57 Filed 04/23/26 Page 2 of 7
satisfied all of the requirements for a Table SIRVA claim. Therefore, Petitioner is entitled
to compensation under the Vaccine Act.
I. Relevant Procedural History
The parties engaged in settlement discussions from June 2023 through September
2024, when they reached an impasse. Respondent filed his Rule 4(c) Report on
November 12, 2024 contending that Petitioner has failed to satisfy the statutory severity
requirement. Rule 4(c) Report at 6-10. Petitioner subsequently filed a Motion for Ruling
on the Record (“Mot.”) on January 13, 2025. ECF No. 48-49. Respondent filed a response
(“Resp.”) on March 25, 2025. ECF No. 52.
II. Relevant Facts
A. Medical Records
Petitioner was a 61-year-old anesthesiologist when he received a flu vaccine in his
left shoulder on September 23, 2020. Ex. 6 at 2; Ex. 1 at 1. He had no history of pain or
dysfunction of his left shoulder at the time. Mot. at 2; Resp. at 2.
On October 12, 2020, Petitioner was seen at employee health for shoulder pain
that began within a few hours of his vaccination, but then worsened over the following two
weeks. Ex. 3 at 296. On exam, he had full range of motion with pain during “extreme
abduction,” and tenderness to deep palpation of the deltoid. Id. at 297. Petitioner was
advised to use ice and ibuprofen and to avoid aggravating activities. Id. Petitioner called
into employee health again on December 2, 2020, to reporting continued shoulder pain,
now with “raising arm above shoulder height and with external rotation.” Id. at 277. He
was referred to an orthopedist. Id.
Petitioner saw an orthopedist on December 8, 2020. Ex. 3 at 238. He reported left
shoulder pain “that developed after flu shot in September 2020.” Id. at 239. On exam, he
had nearly full range of motion, with a “catch” at 90 degrees of forward elevation, internal
rotation only to his lumbar vertebrae, and pain with external rotation. Id. at 241. X-rays
revealed moderate osteoarthritis in the AC and GH joints. Id. at 235. He was diagnosed
with caustic bursitis [post] incorrectly administered flu shot and moderate glenohumeral
arthritis. Id. at 242. Petitioner received a steroid injection and was instructed to follow-up
if his “pain fail[ed] to improve.” Id. at 242.
Petitioner returned to the orthopedist and saw a physician assistant on March 1,
2021. Ex. 3 at 166. He reported good relief from the steroid injection, but that his pain had
“returned and [was] even worse than before.” Id. Petitioner received a second steroid
injection. Id. at 168.
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Petitioner returned to his orthopedist a week later to follow up. Ex. 3 at 117. He
reported “no relief” from the second steroid injection, and that he continued to have
“significant pain” with overhead activities. Id. He was diagnosed with left shoulder bursitis
and moderate osteoarthritis. Id. at 118. Petitioner was sent for an MRI, which revealed a
“[f]ull-thickness tear of the posterior supraspinatus and anterior infraspinatus with
differential tendon retraction…Diffuse labral degeneration and degenerative
tearing…Severe glenohumeral synovitis[,] Intra-articular biceps tendinosis with
tenosynovitis, and a probable small Hill-Sachs deformity.” Id. at 82-83.
On March 16, 2021, Petitioner returned to the orthopedist to review his MRI results.
Ex. 3 at 55. The doctor’s review of the MRI was that Petitioner had “advanced
glenohumeral osteoarthrosis with [a] superimposed inflammatory reaction to previous [flu]
vaccine administration.” Id. at 57. He noted that the “MRI [was] quite impressive,” with
notable synovial reaction with debris and fluid in subacromial space.” Id. Although an
arthroscopy was discussed, Petitioner elected to treat with physical therapy. Id.
On March 18, 2021 (now five months and 25 days after vaccination), Petitioner
had an initial physical therapy evaluation. Ex. 3 at 46. He reported receiving a vaccination
“too close to the joint and quickly develop[ing] severe shoulder pain.” Id. He stated that
he was unable to perform his everyday activities such as weightlifting, swimming, and
running. Id. at 47. His range of motion was reduced, with “extreme pain with abduction
and external rotation. Id. Treatment was planned for once or twice a week for 12 weeks.
Id. at 49. He was also given a home exercise program. Id. at 48.
Between March and October 2021, Petitioner sought care for unrelated issues
including a dental appointment, two vision appointments, an endoscopy, and a visit with
an internist. Ex. 3 at 26, 6-8; Ex. 7 at 577, 523, 469. But he did not in this timeframe seek
shoulder-specific treatment.
On October 15, 2021 (now seven months since his last shoulder focused
treatment), Petitioner attended a second physical therapy session. Ex. 7 at 415. The
recorded history of the problem was identical to his previous sessions. Id. at 416. Both
active and passive range of motion were decreased. Id. Again, therapy was planned for
once or twice a week, over a 12-week period. Id. at 418. Petitioner returned for a third
and final physical therapy session on November 11, 2021. Id. at 319. He reported “no
significant changes.” Id.
B. Witness Statements
Petitioner filed a signed declaration in support of his claim. See Ex. 1. He
described “severe pain, markedly exacerbated by movement,” within 24 hours after the
injection. Id. at 1. At the time of his declaration (September 14, 2021), Petitioner stated
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that he was continuing to seek treatment with his orthopedist, including possible surgery.
Id. at 2.
Petitioner’s wife, Janis Gretz, M.D., also provided a signed declaration. See Ex. 2.
Dr. Gretz stated that “[s]hortly after this injury, [Petitioner’s] pain was so debilitating that
it prevented him from sleeping and working.” Id. at 1. She stated that he continued to be
impacted at the time of her statement (September 2021), including being “frequently
awakened at night,” and being unable to engage in his previous recreational activities. Id.
at 1-2.
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 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).
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
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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).
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).
IV. Findings of Fact - Severity
To satisfy the statutory severity requirement in this case, Petitioner must
demonstrate that his symptoms more likely than not continued until at least March 23,
2021 – six months after the onset of his pain on September 23, 2020 (the day of
vaccination). The record establishes (and the parties agree) that Petitioner treated his
shoulder pain through his physical therapy evaluation on March 18, 2021 – five months
and 25 days after vaccination – but then did not seek additional care for approximately
seven months. See Mot. at 11; Resp. at 8. Respondent contends that “Petitioner’s
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medical treatment fell short of satisfying the statutory severity requirement on March 23,
2021, by at least one week.” Resp. at 8.
This argument, however, ignores the significant symptoms documented in
Petitioner’s medical records in the March 16-18th period. On March 16, 2021, Petitioner’s
orthopedist noted both advanced glenohumeral osteoarthritis and “notable synovial
reaction with debris and fluid in subacromial space.” Ex. 3 at 57. He provided a referral to
physical therapy to “evaluate and treat left shoulder pain, progress with ROM and
strengthening.” Id. at 64. On March 18, 2021, Petitioner’s physical therapist noted
“extreme pain” with abduction above 90 degrees and external rotation. Id. at 47.
Treatment for twelve weeks was planned. Id. at 49. Given the significant MRI findings,
the physical examination findings, and the lengthy planned treatment, it is unlikely that
Petitioner’s symptoms resolved within five days of the six-month cut-off, as suggested by
Respondent.
Respondent further argues that the seven-month gap in treatment “[broke] any
claimed nexus between his then shoulder symptoms and 2020 flu vaccination after
months with no care.” Resp. at 9. But the record from Petitioner’s return to physical
therapy on October 15, 2021, suggests that his injury still existed. See Ex. 7 at 415-416.
The history of injury in both records is identical. Id. at 415; See also Ex. 3 at 46. His exam
was also similar, with findings of pain with abduction above 90 degrees and with external
rotation. Ex. 7 at 416; See also Ex. 3 at 47. And there is no evidence of any intervening
source of unrelated shoulder pain.
Petitioner notably did receive medical care for unrelated conditions during the
treatment gap, and has not provided an explanation for why during this time he did not
complain of shoulder problems or maintain treatment for them. Resp. at 9-10. Petitioner
had a dental exam, two vision appointments, an endoscopy, and one visit for a sore throat
and hiccups during the treatment gap. Resp. at 10. But a claimant would not reasonably
be expected to report shoulder problems to other kinds of medical care specialists. And
he had already established care for his shoulder with an orthopedist and physical
therapist, suggesting he would be unlikely to seek an alternative provider. Further,
although Petitioner’s written statement could provide more specific details of his activities
and experience during the treatment gap, he alleged in his Petition that he had “continued
to work his home exercise program since March, had a follow up physical therapy
appointment in October, and will continue” with treatment “as prescribed.” Petition at ¶11.
And Petitioner credibly argues that as a physician himself, he “understood the benefits
and risks of surgery, he had a HEP PT program, and he decided to see if the injury would
heal on its own over time.” Mot. at 13.
Thus, after consideration of the entire record, I find that it is more likely than not
that Petitioner continued to suffer the residual effects of his vaccine-related injury
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thorough at least March 23, 2021 – satisfying the statutory severity requirement. But gaps
in treatment always inform any award for pain and suffering, which Petitioner should
consider when evaluating his demand for damages.
V. Ruling on Entitlement
A. Requirements for Table SIRVA
Respondent has not contested Petitioner’s proof on the elements of a Table
SIRVA. See ECF No. 46, 52; See also 42 C.F.R. § 100.3(c)(10)(i)-(iv). Therefore, I find
that Petitioner has provided preponderant evidence to establish that he suffered a Table
SIRVA injury.
B. Additional Requirements for Entitlement
Because Petitioner has satisfied the requirements of a Table SIRVA, he need not
prove causation. Section 11(c)(1)(C). However, he 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 flu vaccine in his left arm on
September 23, 2020. Ex. 6 at 2; Section 11(c)(1)(A) (requiring receipt of a covered
vaccine). Additionally, Petitioner has stated that he has not filed any civil action or
received any compensation for his vaccine-related injury, and there is no evidence to the
contrary. Ex. 4; 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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