VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00030
Package ID: USCOURTS-cofc-1_22-vv-00030
Petitioner: Jacqueline Nyarko
Filed: 2022-01-10
Decided: 2024-03-01
Vaccine: influenza
Vaccination date: 2020-11-07
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 10000

AI-assisted case summary:
Jacqueline Nyarko filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) or, alternatively, that her shoulder injury was caused by an influenza vaccine she received on November 7, 2020. She stated the vaccination occurred in the United States and that she experienced residual effects for more than six months. Respondent denied that Ms. Nyarko sustained a SIRVA Table injury or that the vaccine caused her alleged shoulder injury. Despite these differing positions, the parties filed a joint stipulation agreeing that a decision should be entered awarding compensation. The court adopted the stipulation as its decision, awarding Ms. Nyarko a lump sum of $10,000.00. This amount represents compensation for all items of damages available under the Vaccine Act. The case was brought as a Table claim for SIRVA. The decision was issued on March 1, 2024, following the petition filed on January 10, 2022.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00030-0
Date issued/filed: 2024-03-01
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 01/30/2024) regarding 47 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:22-vv-00030-UNJ Document 51 Filed 03/01/24 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0030V
JACQUELINE NYARKO, Chief Special Master Corcoran
Petitioner, Filed: January 30, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
William E. Cochran, Jr., Black McLaren et al., Memphis, TN, for Petitioner.
Naseem Kourosh, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On January 10, 2022, Jacqueline Nyarko 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 Table shoulder injury related to
vaccine administration (“SIRVA”) or, in the alternative, that her alleged shoulder injury
was a result of an influenza (“flu”) vaccine administered on November 7, 2020. Petition at
1; Stipulation, filed on January 29, 2024, at ¶¶ 2, 4. Petitioner further alleges that she
received the vaccine in the United States, that she experienced the residual effects of her
injury for more than six months, and there has been no prior award or settlement of a civil
action as a result of her condition. Petition at ¶¶ 1, 3-4; Stipulation at ¶¶ 3-5. “Respondent
denies that [P]etitioner sustained a SIRVA Table injury; denies that the vaccine caused
[P]etitioner’s alleged shoulder injury, or any other injury; and denies that [P]etitioner’s
current condition is a sequela 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 1:22-vv-00030-UNJ Document 51 Filed 03/01/24 Page 2 of 7
Nevertheless, on January 29, 2024, 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 $10,000.00 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.
2

Case 1:22-vv-00030-UNJ Document 51 Filed 03/01/24 Page 3 of 7
IN THE UNITED TATE COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MA TERS
JACQUELINE NY ARKO,
Petitioner,
No. 22-30V ( C )
V. Chief Special Master Corcoran
ECRETARY OF HEALT H
AND HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate ro the following matters:
I. Jacqueline Nyarko, petitioner, filed a petition for vaccine compensation under the
National Vaccine rn jury Compensation Program 42 U.S.C. §§ 300aa-10 et seq. (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of the influenza vaccine, which vaccine is contained in tbe Vaccine Injury Table (lhe "Table"),
42 C.F.R. § 100.3(a).
2. Petitioner received an influenza vaccine on November 7, 2020 in the lefl arm.
3. The vaccination was administered within the United States.
4. Pc1itio11cr alleges tlwt petitioner sustained .1 sl1 uldcr inju,y related to vaccine
administration(" lRVA") as set forth in the able. or, in the alternative, that her alleged
shoulder injury was caused by the vaccine. Petitioner further nllegcs that petitioner experienced
the residual effects of Ibis condition for morn than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on petitioner's behalf as a result of petitioner's condition.

Case 1:22-vv-00030-UNJ Document 51 Filed 03/01/24 Page 4 of 7
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies that
pctitioner;s current condition is a sequela of a vaccine-related inju1y.
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 Stiplllation.
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-21(a)(I), the Secretaiy of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of$10,000.00 in the form of a check payable to petitioner. This
amount represents compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
9. As soon as practicable after the ent1y of judgment 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)(l), and an application, the parties will submit to further proceedings before
tile special master lo award reasonable attorneys' fees and costs incurred in proceeding upon this
petition.
I 0. Petitioner and petitioner's 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 under42 U.S.C. § 300aa-15(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 Seciu·ity Act
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Case 1:22-vv-00030-UNJ Document 51 Filed 03/01/24 Page 5 of 7
(42 U.S.C. § 1396 et seq.)), of by entities that provide health services on a pre-paid basis.
l l. 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-
l 5(i), subject to the availability of sufficient statutory fonds.
12. The parties and their attorneys further agree and stipulale that, except for a11y award
for attorneys' fees and litigation costs, a11d past umeimbursable expenses, the mot1ey provided
pursuant to this Stipulation will be used solely for petitioner's benefit as contemplated by a strict
constrnction of 42 U.S.C. §§ 300aa-15(a) and (d), and subject LO the conditions of 42 U.S.C.
§§ 300au-15(g) and (h).
J 3. rn return for the payments described in paragraphs 8 and 9, petitioner, in petitioner's
individual capacity, and on behalf of petitioner's heirs, executors, administrators, successors or
assigns, does forever irrevocably and unconditional.ly release, acquit and discharge the United
States and the Secretary of Health and Human Services from any and all actions or causes of
action (including agreements, judgments, claims, damages, loss of services, expenses and all
demands ofw hatever kind or nature) that have been brought, could have been brought, or could
he timely brought in the Court of Federal Claims, under the Vaccine Program, 42 U.S.C.
§ 300aa-l O et seq., on account of, or in a11y way growing oul oC any and all known or w1k.nown,
suspected or unsuspected personal injuries to or death of petitioner resulting from, or alleged to
have resulted from, the influenza vaccination administered on November 7, 2020, as alleged by
petitioner in a petition for vaccine compensation filed on or about January 10, 2022, in the
United States Court of Federal Claims as petition No. 22-30V.
14. If petitioner should die prior to entry ofj udgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
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Case 1:22-vv-00030-UNJ Document 51 Filed 03/01/24 Page 6 of 7
15. If the special master fails lo issue a decision in complete conformity with the terms
of this Stipulation or if the Cotut of Federal Claims fails to enter judgment in conformity with a
decision that is in complete conformity with the terms of this Sti.pulation, 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 othe1wise 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 tbat the award described in this
Stipulation may reflect a compromise of the patties' 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 Stales or the
Secretary of Health and Human Service that the influenza vaccine caused petitioner's alleged
injury or :1ny other injury or petitioner's current disabilities, or that petitioner suffered un 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 1:22-vv-00030-UNJ Document 51 Filed 03/01/24 Page 7 of 7
Respectfully submitted,
PETITIONER:
ATTORNEY OF RECORD AUTHORIZED REPRESENTATIVE
FOR PETITIONER: OF THE ATTORNEY GENERAL:
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Black McLaren Jones Ryland Griffee Deputy Director
530 Oak Court Drive, Suite 360 Torts Branch
Memphis, TN 3 8117 Civil Division
Telephone: (901) 762-0535 U.S. Department of Justice
Email: wcochran@blackmclaw.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESF,NT ATTVE ATTORNEY OF RE ORD FOR
OF THE SECRET ARY OF HEAL TH RESPONDENT:
AND HUMAN SERVICES:
George R. Grimes
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CDR GEORGE REED GRIMES, MD, MPH N~
Director, Division oflnju.ry Tria.l Attorney
Compensation Programs Torts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. epa1tme11t 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 08W-25A Telephone: (202) 305-1 J 59
Rockville, MD 20857 Email: Naseem.Kourosh@usdoj.gov
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