VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00220
Package ID: USCOURTS-cofc-1_22-vv-00220
Petitioner: Sarah Davis Buechner
Filed: 2025-02-26
Decided: 2025-04-01
Vaccine: influenza
Vaccination date: 2020-03-03
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: entitlement_granted_pending_damages
Award amount USD: 

AI-assisted case summary:
Sarah Davis Buechner filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on March 3, 2020. She stated her arm was sore and painful on the day of vaccination, and the pain intensified over the following week. Due to the COVID-19 pandemic, she delayed seeking formal medical treatment, attempting self-care in the interim. She eventually reported persistent pain, a "frozen shoulder," radiating pain, and some numbness in her fingertips to her primary care physician on June 18, 2020, and saw a sports medicine specialist on June 24, 2020, who diagnosed adhesive capsulitis. The respondent argued that the petitioner failed to establish Table onset within 48 hours and that her symptoms were not limited to the vaccinated shoulder. The court found that the petitioner's explanation for the delay in seeking treatment, particularly in light of the pandemic, was reasonable and credible. Multiple medical records consistently related her pain to the vaccination, and her affidavit provided further detail about immediate onset. While there was an initial report of radiating pain and numbness, subsequent examinations and treatments focused solely on the left shoulder, and the petitioner denied cervical or radiating symptoms during physical therapy. The court concluded that the petitioner provided preponderant evidence that her pain began within 48 hours of vaccination and was limited to her vaccinated shoulder, satisfying the requirements for a Table SIRVA claim. Therefore, Sarah Davis Buechner is entitled to compensation, and a separate damages order will be issued.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00220-0
Date issued/filed: 2025-04-01
Pages: 8
Docket text: PUBLIC ORDER/RULING (Originally filed: 02/26/2025) 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-00220-UNJ Document 38 Filed 04/01/25 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0220V
SARA DAVIS BUECHNER,
Chief Special Master Corcoran
Petitioner,
v.
SECRETARY OF HEALTH AND Filed: February 26, 2025
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.
FINDINGS OF FACT AND RULING ON ENTITLEMENT1
On February 25, 2022, Sarah Davis Buechner 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 alleged that she suffered a shoulder injury related to
vaccine administration (“SIRVA”) following an influenza vaccine she received on March
3, 2020. Petition at 1. The case was assigned to the Special Processing Unit (“SPU”) of
the Office of Special Masters.
For the reasons discussed below, I find that Petitioner has provided preponderant
evidence that her pain likely began within 48 hours of her vaccination, that her symptoms
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-00220-UNJ Document 38 Filed 04/01/25 Page 2 of 8
were limited to her vaccinated shoulder, and that she has satisfied all of the requirements
of a Table SIRVA claim. Therefore, Petitioner is entitled to compensation under the
Vaccine Act.
I. Relevant Procedural History
On August 17, 2023, after approximately two months of negotiations, the parties
reached an impasse in their settlement discussions. See ECF No. 28. Respondent filed
his Rule 4(c) Report opposing entitlement on October 5, 2023, in which he argued that
Petitioner failed to establish that her shoulder pain began within 48 hours of her
vaccination. Rule 4(c) Report at 6-7. Thereafter, Petitioner filed a Motion for Ruling on the
Record and Brief in Support of Damages (“Mot.”) on December 20, 2023. ECF No. 31.
Respondent filed a response (“Resp.”) on February 20, 2024, in which he again argues
that Petitioner has not proven Table onset, but also adds an argument that she suffered
symptoms outside of the vaccinated shoulder. Resp. at 7-8. Petitioner filed a reply
(“Repl.”) on March 5, 2024. ECF No. 34. The matter is now ripe for adjudication.
II. Relevant Facts
On March 3, 2020, Petitioner received a flu vaccine in her left shoulder at a CVS
Minute Clinic in Philadelphia, PA. Ex. 7 at 4. Petitioner states that her arm felt “sore and
painful” the day of her vaccination and “intensified . . . unlike anything [she] had ever
experienced from a vaccine.” Ex. 2 at ¶10. On March 23, 2020 (20 days after vaccination),
Petitioner had a telemedicine appointment with her primary care physician (“PCP”). Ex 3
at 6. The visit focused on two conditions for which Petitioner took regular medications
without any examination. Id. at 6-8. The record notes that lab tests were recommended,
but had to be delayed due to the Covid-19 pandemic. Id. at 8. There is no mention of
shoulder pain.
Petitioner states that she was generally unable to seek care for her shoulder pain
due to the Pandemic (which began and was ongoing in the spring and early summer of
2020). Ex. 2 at ¶11. During this period, she tried to stretch her shoulder and used weights,
“even though the pain was excruciating.” Id.
On June 18, 2020, Petitioner reported “persistent pain” in her left shoulder since
her “flu vaccine in early March 2020” during a telemedicine appointment with her PCP.
Ex. 3 at 10. Petitioner described a “full blown frozen shoulder” with significant “pain
radiating down arm,” “some numbness in the tips of her fingers”, and limited range of
motion. Id. The record notes that the doctor was unable to see Petitioner during the visit
due to “technology failure.” Id. at 11. Petitioner was referred to a sports medicine specialist
and physical therapy. Id. Petitioner recalled being advised to have an in-person
2

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appointment visit on June 22, 2020. Ex. 2 at ¶12. The record of that visit notes a nearly
identical history identical to that in the previous virtual visit. See id. at 10, 14. On exam,
Petitioner had good range of motion that was “slightly restricted by pain” and positive
special tests. Id. at 16. The doctor thought Petitioner’s numbness was possibly related to
a cervical problem, but noted that Petitioner had “no significant neck pain.” Id. at 16. She
prescribed tramadol and referred Petitioner to sports medicine and physical therapy. Id.
On June 24, 2020, Petitioner saw a sports medicine specialist. Ex. 5 at 4. She
reported “shoulder pain since 3/5/2020 after an influenza vaccination,” with dull pain that
worsened to “more severe.” Id. On exam, Petitioner’s shoulder range of motion was “off
by 15 degrees of forward flexion and 20 degrees of external rotation.” Id. at 8. She was
diagnosed with adhesive capsulitis, prescribed naproxen, and referred for physical
therapy and acupuncture. Id.
Petitioner had a physical therapy evaluation on July 2, 2020. Ex. 5 at 29. She
reported left shoulder pain that she attributed to her flu shot on 3/5/2020. Id. She denied
any cervical or radiating symptoms. Id. She exhibited reduced range of motion and
decreased strength of the left shoulder and positive impingement testing consistent with
her adhesive capsulitis diagnosis. Id. at 30-31. She returned for a second physical therapy
treatment on July 9, 2020, reporting worsening symptoms. Id. at 59.
Petitioner also received acupuncture treatment on July 2 and 9, 2020.3 Ex. 9 at 3-
5. At her first treatment, Petitioner reported that she had a flu shot in her left arm on March
3 which gradually got worse. Id. at 4. Petitioner also provided a letter from Dr. Yoshihiro
Yamaguchi regarding acupuncture treatment between July 29, 2020 and July 13, 2021,
which states that Petitioner came to him for treatment of her frozen shoulder. See Ex. 10
at 1-3. He states that he provided 11 acupuncture treatments and that Petitioner showed
improvement in her range of motion after treatment, although she continued to have
“some ongoing pain and symptoms.” Id. at 2. He stated that his office was not able to
provide records of those treatments. Id.
On November 9, 2020, Petitioner had an annual physical. Ex. 4 at 25. The record
contains no mention of Petitioner’s shoulder problems. Adhesive capsulitis is noted in the
record of Petitioner next visit on January 18, 2021 as a “reviewed problem” without
additional detail. Id. at 21-24. She received two doses of the Covid-19 vaccine in her right
(non-injured) arm on January 22, 2021 and February 19, 2021. Id at 15, 19.
3 The records of Philadelphia Acupuncture state that Petitioner also had appointments for July 16 and July
23, 2020, however no records of visits on those dates were provided. See Ex. 9 at 3.
3

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On August 19, 2021 and August 26, 2021, Petitioner received additional
acupuncture treatments. Ex. 6 at 5. Her handwritten intake form indicates that she sought
treatment for her “achy” shoulder and neck stiffness, however the records do not include
any significant description of the treatment provided. Id. at 3.
III. Applicable Law
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).
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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).
IV. Findings of Fact
A. Onset
Respondent maintains that Petitioner has not established Table onset because
“although Petitioner claims that the onset of her symptoms was immediate, these claims
are not corroborated by the contemporaneous medical records.” Resp. at 7. Specifically,
Respondent takes issue with one intervening appointment that Petitioner had 20 days
after her vaccination that does not mention shoulder pain, and the three-month delay
before Petitioner formally sought treatment for her shoulder pain. Id.
Petitioner saw her PCP on March 23, 2020, 20 days after her vaccination, and did
not seek treatment for shoulder pain at that time. See Ex. 3 at 6-8. However, that
appointment, which occurred at the beginning of the Covid-19 Pandemic, was conducted
via video and addressed two specific chronic conditions for which Petitioner took
medication. Id. Petitioner received refills of her medications without any examination. Id.
5

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The record specifically notes that lab tests were recommended but had to be delayed due
to the pandemic. Id. at 8. Given the circumstances of the time, including that Petitioner
knew of the limitations on in-person examinations and testing, it is understandable that
Petitioner may not have mentioned her shoulder pain during that visit.
Further, although Petitioner waited over three months to seek medical treatment
for her shoulder pain, such delay does not preclude a Table onset finding. Petitioner’s
delay was not substantial when compared to other SIRVA petitioners, and particularly in
light of the Pandemic, which hindered access to non-emergency medical care. See e.g.
Winkle v. Sec’y of Health & Human Servs., No. 20-0485V, 2021 WL 2808993 (Fed. Cl.
Spec. Mstr. 2021) (finding onset after a nearly five-month delay); Welch v. Sec’y of Health
& Human Servs. No. 18-0660V, 2020 WL 7483129 (Fed. Cl. Spec. Mstr. 2020) (finding
onset after more than three- and one-half-month delay). Petitioner has also explained that
due to the limitations imposed by the Pandemic, she attempted to self-treat her shoulder
symptoms with stretching and weights. Ex. 2 at ¶11. She was later able to have a video
appointment with her PCP on June 18, 2020, approximately 3.5 months after her
vaccination, and was instructed to have an in-person appointment only four days later.
Ex. 3 at 9-16. Petitioner has thus provided an explanation for her delay that is both
reasonable and credible. Petitioner’s affidavit testimony is not inconsistent with the
medical records and adds to the totality of evidence supporting onset.
Finally, once Petitioner started treatment, there are multiple records that not only
consistently relate Petitioner’s pain to her vaccination but place the onset close in time to
her vaccination. For example, on June 18, 2020, Petitioner reported “persistent pain” in
her left shoulder since her “flu vaccine in early March 2020” during a telemedicine
appointment with her PCP. Ex. 3 at 10. Then, at her first visit with a sports medicine
specialist, on June 24, 2020, Petitioner reported “shoulder pain since 3/5/2020 after an
influenza vaccination.” Ex. 5 at 4. She continued to relate her shoulder pain to her flu shot
during physical therapy and acupuncture treatments. See e.g., Ex. 5 at 29; Ex. 9 at 4.
While these records do not provide perfect evidence of onset, Petitioner provided
additional detail in her affidavit, stating that her arm felt “sore and painful” the day of her
vaccination and worsened the next day and over the following week. Ex. 2 at ¶10. In the
end, Petitioner need only preponderantly establish that her pain “more likely than not”
began within 48 hours of her vaccination – and here such a showing is made.
B. Injury Localized to Vaccinated Arm
Respondent further argues that “Petitioner’s pain was not limited to her left
shoulder.” Resp. at 8. He bases this argument on the record of Petitioner’s first visit with
6

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her PCP, when she “claimed her shoulder pain radiated down her arm and that she
experienced numbness in the tips of her fingers.” Id.
The records of Petitioner’s visits with her PCP June 18, 2020 (virtual) and June 22,
2020 (in-person) do mention pain radiating from her shoulder and “some numbness in the
tips of her fingers.” Ex. 3 at 10, 14. However, upon examination there were no medical
findings outside of Petitioner’s shoulder. Id. at 16. Petitioner’s doctor noted the possibility
of a neck problem, but she also noted that Petitioner had not reported any neck pain. Id.
In addition, Petitioner subsequently only had treatment focused on her left shoulder pain.
See Ex. 5 at 4-8 (Petitioner was diagnosed with adhesive capsulitis with no mention of
neck, arm, or hand symptoms.); Ex. 5 at 29 (Petitioner specifically denied “cervicalgia and
radiating” symptoms during her physical therapy evaluation.).
Beyond the one notation cited by Respondent, there is no other evidence in the
record that Petitioner complained of or received treatment for pain or injury outside of her
left shoulder. While I acknowledge the one report of radiating pain, it is outweighed by the
remainder of the evidence in Petitioner’s medical and treatment records establishing that
her pain and decreased range of motion was limited to her left shoulder. Despite
Respondent’s argument, Petitioner’s medical records need not be devoid of all reference
to pain or other symptoms outside the affected shoulder. I note again: a petitioner need
only present preponderant, not certain, evidence to prevail. See Moberly ex. rel. Moberly
v. Sec’y of Health & Human Servs, 592 F.3d 1315, 1322 (Fed. Cir. 2010) (holding that the
applicable level of proof is not certainty, but the traditional tort standard of “preponderant
evidence”). Thus, this objection also is defeated by preponderant record evidence.
V. Ruling on Entitlement
A. Requirements for Table SIRVA
I have found that Petitioner has preponderantly established that her pain began
within 48 hours after her vaccination and that her symptoms were limited to her vaccinated
shoulder. 42 C.F.R. § 100.3(c)(10)(ii-iii). Respondent has not contested Petitioner’s proof
on the remaining elements of a Table SIRVA. See 42 C.F.R. § 100.3(c)(10)(i), (iv).
Therefore, I find that Petitioner has provided preponderant evidence to establish that she
suffered a Table SIRVA injury.
B. Additional Requirements for Entitlement
Because Petitioner has satisfied the requirements of a Table SIRVA, she need not
prove causation. Section 11(c)(1)(C). However, she must satisfy the other requirements
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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 her left deltoid
on March 3, 2020 at a pharmacy in Pennsylvania. Ex. 7 at 4; Section 11(c)(1)(A) (requiring
receipt of a covered vaccine); Section 11(c)(1)(B)(i) (requiring administration within the
United States or its territories). Additionally, Petitioner has stated that she has not filed
any civil action or received any compensation for his vaccine-related injury, and there is
no evidence to the contrary. Ex. 2 at ¶8; Section 11(c)(1)(E) (lack of prior civil award).
Finally, the records indicate that Petitioner has suffered the residual effects of her
vaccine-related injury for more than six months and Respondent has not argued
otherwise. See Ex. 6 at 5; Ex. 10 at 3; 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
8