VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00115
Package ID: USCOURTS-cofc-1_22-vv-00115
Petitioner: Maria Sims
Filed: 2022-02-03
Decided: 2024-02-07
Vaccine: influenza
Vaccination date: 2020-10-13
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 114171

AI-assisted case summary:
Maria Sims filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of her October 13, 2020 influenza vaccination. The respondent conceded that her injury was consistent with SIRVA, noting that she had no prior shoulder issues, the pain occurred within 48 hours of vaccination, was limited to the injection site, and no other condition explained the pain. The respondent also agreed that Ms. Sims suffered residual effects for more than six months and met all other legal prerequisites for compensation. A ruling on entitlement was issued on July 7, 2023, finding her entitled to compensation. Subsequently, on January 4, 2024, the respondent proffered an award of $114,171.13, which included $92,500.00 for pain and suffering, $15,549.00 for lost wages, and $6,122.13 for medical expenses paid by Medicaid. Ms. Sims, an adult, agreed with this proffered award. The Chief Special Master issued a decision awarding the total compensation amount on February 7, 2024, directing payment through two lump sums: one to Ms. Sims and another jointly to Ms. Sims and the Commonwealth of Pennsylvania to satisfy the Medicaid lien.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00115-0
Date issued/filed: 2023-08-18
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 07/07/2023) regarding 25 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:22-vv-00115-UNJ Document 29 Filed 08/18/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-115V
MARIA SIMS, Chief Special Master Corcoran
Petitioner, Filed: July 7, 2023
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
David John Carney, Green & Schafle LLC, Philadelphia, PA, for Petitioner.
Amanda Pasciuto, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On February 3, 2022, Maria Sims 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 Injury – Shoulder Injury
Related to Vaccine Administration (“SIRVA”) – as a result of her October 13, 2020
influenza (“flu”) vaccination. Petition at 1. Petitioner further alleges the vaccine was
administered within the United States, that she suffered the residual effects of her injury
for more than six months, and that there has been no prior award or settlement of a civil
action on her behalf as a result of her injury. See Petition at ¶¶ 3, 23, 26. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
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 1:22-vv-00115-UNJ Document 29 Filed 08/18/23 Page 2 of 2
On July 6, 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
has concluded that petitioner’s alleged injury is consistent with SIRVA as
defined by the Vaccine Injury Table. Specifically, petitioner had no history
of pain, inflammation, or dysfunction of her left shoulder prior to vaccination;
pain occurred within 48 hours after receipt of an intramuscular vaccination;
pain was limited to the shoulder in which the vaccine was administered; and
no other condition or abnormality has been identified to explain petitioner’s
shoulder pain.
Id. at 9-10 (citing 42 C.F.R. §§ 100.3(a), (c)(10))(internal footnote omitted). Respondent
further agrees that “based on the medical records . . . [P]etitioner suffered the residual
effects of her condition for more than six months” and otherwise established all legal
prerequisites for compensation under the Vaccine Act. Id. at 10.
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-00115-1
Date issued/filed: 2024-02-07
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 01/05/2024) regarding 34 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (ppa) Service on parties made.
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Case 1:22-vv-00115-UNJ Document 39 Filed 02/07/24 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-115V
MARIA SIMS, Chief Special Master Corcoran
Petitioner, Filed: January 5, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
David John Carney, Green & Schafle LLC, Philadelphia, PA, for Petitioner.
Mark Kim Hellie, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On February 3, 2022, Maria Sims 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 she suffered a Table Injury – Shoulder Injury Related to
Vaccine Administration (“SIRVA”) – as a result of her October 13, 2020 influenza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On July 7, 2023, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On January 4, 2024, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $114,171.13. The
award is comprised of the following: $92,500.00 for pain and suffering, $15,549.00 for lost
wages, and $6,122.13 for medical expenses paid by Medicaid. Proffer at 1-2. In the
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-00115-UNJ Document 39 Filed 02/07/24 Page 2 of 5
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.
Pursuant to the terms stated in the attached Proffer, I award the following
compensation:
1. A lump sum payment of $108,049.00 (comprised of $92,500.00 for pain and
suffering and $15,549.00 for lost wages) in the form of a check payable to
Petitioner; and
2. A lump sum payment of $6,122.13, representing compensation for
satisfaction of the Commonwealth of Pennsylvania’s Medicaid lien, payable
jointly to Petitioner and to:
Commonwealth of Pennsylvania
Bureau of Program Integrity
Division of Third Party Liability Recovery Section
P.O. Box 8486
Harrisburg, PA 17105-8486
ID#: 110 161 351
Petitioner agrees to endorse this payment to the Commonwealth of
Pennsylvania.
This amount represents 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-00115-UNJ Document 39 Filed 02/07/24 Page 3 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
MARIA SIMS,
Petitioner,
Case No. 22-115V (ECF)
v. CHIEF SPECIAL MASTER
CORCORAN
SECRETARY OF HEALTH
AND HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Procedural History
On July 6, 2023, respondent filed a Vaccine Rule 4(c) report concluding that
Maria Sims (“petitioner”) suffered an injury that is compensable under the National
Childhood Vaccine Injury Act of 1986, as amended, 42 U.S.C. §§ 300aa-10 to -34 (“the
Act”). ECF Doc. No. 24 at 1. Accordingly, on July 7, 2023, the Chief Special Master
issued a Ruling on Entitlement, finding that petitioner was entitled to compensation under
the Act. ECF Doc. No. 25 at 2.
II. Items of Compensation and Form of the Award
Based upon the evidence of record, respondent proffers that petitioner should be
awarded $114,171.13. The award is comprised of the following: $92,500.00 for pain and
suffering, $15,549.00 for lost wages, and $6,122.13 for medical expenses paid by

Case 1:22-vv-00115-UNJ Document 39 Filed 02/07/24 Page 4 of 5
Medicaid.1 This amount represents all elements of compensation to which petitioner
would be entitled under 42 U.S.C. § 300aa-15(a) regarding her October 13, 2020
influenza vaccination. Petitioner agrees.2
III. Form of the Award
Respondent recommends that the compensation provided to petitioner be made
through two lump sum payments as described below:
(1) The parties recommend that compensation provided to petitioner
should be made through a lump sum payment of $108,049.00, in the
form of a check payable to petitioner. Petitioner agrees.
(2) A lump sum payment of $6,122.13, representing compensation for
satisfaction of the Commonwealth of Pennsylvania’s Medicaid lien,
payable jointly to petitioner and to:
Commonwealth of Pennsylvania
Bureau of Program Integrity
Division of Third Party Liability Recovery Section
P.O. Box 8486
Harrisburg, PA 17105-8486
ID#: 110 161 351
Petitioner agrees to endorse this payment to the Commonwealth of
Pennsylvania.
1 The $6,122.13 lump sum payment represents full satisfaction of any right of
subrogation, assignment, claim, lien, or cause of action the Commonwealth of
Pennsylvania may have against any individual as a result of any Medicaid payments the
Commonwealth of Pennsylvania 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 October 13, 2020, under Title XIX of the
Social Security Act.
2 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 medical expenses, future lost earnings, and future pain and suffering.
2

Case 1:22-vv-00115-UNJ Document 39 Filed 02/07/24 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
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
s/ Mark K. Hellie
MARK K. HELLIE
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Benjamin Franklin Station
Washington, D.C. 20044-0146
T: (202) 616-4208
E: mark.hellie@usdoj.gov
DATED: January 4, 2024
3