VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00065
Package ID: USCOURTS-cofc-1_22-vv-00065
Petitioner: Fay M. Haas
Filed: 2022-01-21
Decided: 2023-11-17
Vaccine: Tdap
Vaccination date: 2020-03-09
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 70148

AI-assisted case summary:
Fay M. Haas filed a petition for compensation under the National Vaccine Injury Compensation Program on January 21, 2022. She alleged that she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of a tetanus, diphtheria, and acellular pertussis (Tdap) vaccine received on March 9, 2020. The case was assigned to the Special Processing Unit of the Office of Special Masters. On September 18, 2023, the respondent filed a Rule 4(c) report conceding that Petitioner is entitled to compensation and that her alleged injury is consistent with SIRVA as defined by the Vaccine Injury Table. On September 19, 2023, Chief Special Master Brian H. Corcoran issued a ruling on entitlement, finding Petitioner entitled to compensation. On October 12, 2023, the respondent filed a proffer on award of compensation, which Petitioner agreed with. On November 17, 2023, Chief Special Master Corcoran issued a decision on damages. Fay Haas was awarded a lump sum payment of $64,500.00 for pain and suffering and $5,648.82 to satisfy a State of Ohio Medicaid lien, for a total award of $70,148.82. Petitioner was represented by Bobbie L. Flynt of Crandall & Pera Law, LLC, and the respondent was represented by Alexa Roggenkamp of the U.S. Department of Justice.

Theory of causation field:
Petitioner Fay M. Haas alleged a Table shoulder injury related to vaccine administration (SIRVA) following a tetanus, diphtheria, and acellular pertussis (Tdap) vaccination on March 9, 2020. The respondent conceded that Petitioner is entitled to compensation and that the alleged injury is consistent with SIRVA. The public decision does not describe the specific mechanism of injury, onset, symptoms, diagnostic tests, or treatments. No experts were named in the public decision. The respondent filed a proffer on award of compensation on October 12, 2023, which Petitioner agreed with. Chief Special Master Brian H. Corcoran issued a ruling on entitlement on September 19, 2023, and a decision on damages on November 17, 2023. The award included a lump sum of $64,500.00 for pain and suffering and $5,648.82 to satisfy a State of Ohio Medicaid lien, totaling $70,148.82. Petitioner was represented by Bobbie L. Flynt and respondent by Alexa Roggenkamp.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00065-0
Date issued/filed: 2023-10-20
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 09/19/2023) regarding 35 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:22-vv-00065-UNJ Document 39 Filed 10/20/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0065V
FAY M. HAAS, Chief Special Master Corcoran
Petitioner,
v. Filed: September 19, 2023
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Bobbie L. Flynt, Crandall & Pera Law, LLC, Chagrin Falls, OH, for Petitioner.
Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 21, 2022, Fay M. Haas 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”) as the result of a tetanus, diphtheria, and acellular
pertussis (“Tdap”) vaccine received on March 9, 2020. Petition at 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On September 18, 2023, Respondent filed his Rule 4(c) report in which he
concedes that Petitioner is entitled to compensation in this case. Respondent’s Rule 4(c)
Report at 1. Specifically, Respondent agrees that Petitioner’s alleged injury is consistent
with SIRVA as defined by the Vaccine Injury Table. Id. at 8 (citing 42 C.F.R. §§ 100.3(a),
1 Because this unpublished 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 1:22-vv-00065-UNJ Document 39 Filed 10/20/23 Page 2 of 2
100.3(c)(10)). Respondent further agrees that Petitioner has satisfied all legal requisites
for compensation under the Vaccine Act. Id.
In view of Respondent’s position and the evidence of record, I find that
Petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
2

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DOCUMENT 2: USCOURTS-cofc-1_22-vv-00065-1
Date issued/filed: 2023-11-17
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 10/13/2023) regarding 37 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:22-vv-00065-UNJ Document 45 Filed 11/17/23 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0065V
FAY M. HAAS, Chief Special Master Corcoran
Petitioner,
v. Filed: October 13, 2023
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Bobbie L. Flynt, Crandall & Pera Law, LLC, Chagrin Falls, OH, for Petitioner.
Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON DAMAGES1
On January 21, 2022, Fay M. Haas 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”) as the result of a tetanus, diphtheria, and acellular
pertussis (“Tdap”) vaccine received on March 9, 2020. Petition at 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On September 19, 2023, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On October 12, 2023, Respondent filed a proffer on
award of compensation (“Proffer”). Respondent represented that Petitioner agrees with
the proffered award. Id. at 2. Based on the record as a whole, I find that Petitioner is
entitled to an award as stated in the Proffer.
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-00065-UNJ Document 45 Filed 11/17/23 Page 2 of 5
Pursuant to the terms stated in the attached Proffer, I award the following:
A. A lump sum payment of $64,500.00 (representing actual pain and
suffering) in the form of a check payable to Petitioner.
B. A lump sum payment of $5,648.82, representing compensation for
satisfaction of the State of Ohio Medicaid lien, in the form of a check
payable jointly to Petitioner and:
Treasurer, State of Ohio
Ohio Tort Recovery Unit
5475 Rings Road Suite 125
Dublin, OH 43017
Petitioner agrees to endorse this payment to Treasurer, State of Ohio for
satisfaction of the Medicaid lien.
These amounts represent compensation for all damages that would be available
under Section 15(a).
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-00065-UNJ Document 45 Filed 11/17/23 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
FAY HAAS,
Petitioner,
No. 22-0065V
v.
Chief Special Master Corcoran
ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On January 21, 2022, Fay Haas (“petitioner”) filed a petition for compensation under the
National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34 (“Vaccine Act” or
“Act”), alleging that she suffered a Table shoulder injury related to vaccine administration
(“SIRVA”), as the result of a tetanus, diphtheria, and acellular pertussis (“Tdap”) vaccination
received on March 9, 2020. Petition at 1. On September 18, 2023, the Secretary of Health and
Human Services (“respondent”) filed a Rule 4(c) Report indicating that this case is appropriate
for compensation under the terms of the Act, and on September 19, 2023, the Chief Special
Master issued a Ruling on Entitlement finding petitioner entitled to compensation. ECF No. 34;
ECF No. 35.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that Fay Haas should be awarded $64,500.00 in actual pain and
suffering. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:22-vv-00065-UNJ Document 45 Filed 11/17/23 Page 4 of 5
B. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy a State of Ohio
Medicaid lien in the amount of $5,648.82, which represents full satisfaction of any right of
subrogation, assignment, claim, lien, or cause of action the State of Ohio may have against any
individual as a result of any Medicaid payments the State of Ohio has made to or on behalf of
petitioner from the date of her eligibility for benefits through the date of judgment in this case as
a result of her alleged vaccine-related injury suffered on or about March 9, 2020, under Title
XIX of the Social Security Act.
The above amounts represent all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that the compensation provided to petitioner be made through two
lump sum payments as described below:
1) A lump sum payment of $64,500.00 in the form of a check payable to petitioner.1
2) A lump sum payment of $5,648.82, representing compensation for satisfaction of
the State of Ohio Medicaid lien, payable jointly to petitioner and to:
Treasurer, State of Ohio
Ohio Tort Recovery Unit
5475 Rings Road Suite 125
Dublin, OH 43017
Petitioner agrees to endorse this payment to Treasurer, State of Ohio for satisfaction of
the Medicaid lien.
1 Should petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief. In particular, respondent would oppose any award for future lost earnings
and future pain and suffering.
2

Case 1:22-vv-00065-UNJ Document 45 Filed 11/17/23 Page 5 of 5
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
JULIA M. COLLISON
Assistant Director
Torts Branch, Civil Division
/s/ Alexa Roggenkamp
ALEXA ROGGENKAMP
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
(202) 616-4179
alexa.roggenkamp@usdoj.gov
DATED: October 12, 2023
3