VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00265
Package ID: USCOURTS-cofc-1_22-vv-00265
Petitioner: Deborah Defosses
Filed: 2022-03-09
Decided: 2025-05-16
Vaccine: Tdap
Vaccination date: 2019-03-12
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 61268

AI-assisted case summary:
On March 9, 2022, Deborah Defosses filed a petition under the National Vaccine Injury Compensation Program, alleging a left shoulder injury related to vaccine administration (SIRVA) following a Tdap vaccine received on March 12, 2019. Ms. Defosses, who was 55 years old at the time, stated that the vaccine was initially attempted in her left arm but was aborted due to resistance, and the full dose was subsequently administered in her right arm. Thirteen days later, she reported severe pain in her left arm that disrupted her sleep. Her primary care physician noted the history of the aborted left-sided injection and the subsequent right-sided administration, with the right arm remaining asymptomatic. Initial examinations showed pain in the left shoulder but normal range of motion, with later appointments noting pain and mild decreases in range of motion. Diagnostic tests, including an X-ray and an MRI, revealed mild AC joint arthropathy, supraspinatus tendinosis, and a suspected SLAP tear. Ms. Defosses also saw an orthopedist who assessed impingement syndrome. The respondent initially argued that the claim was not compensable because the vaccine was not fully administered in the left arm. However, Chief Special Master Brian H. Corcoran, in a ruling on entitlement dated January 28, 2025, found that the initial attempt at vaccination in the left arm, which involved needle penetration and likely some antigen introduction, constituted a covered event under the Vaccine Act. He determined that Ms. Defosses had established entitlement to compensation for a Table SIRVA claim, as the injury met the criteria for SIRVA and causation was presumed. The case then proceeded to the damages phase. On April 16, 2025, Chief Special Master Corcoran issued a decision on damages based on a stipulation between the parties. Ms. Defosses was awarded a total of $61,268.94. This included a lump sum of $60,000.00 for pain and suffering, paid via ACH deposit to her counsel's IOLTA account, and a lump sum payment of $1,268.94 to satisfy a Rhode Island Medicaid lien, issued as a check payable jointly to Ms. Defosses and Optum. Petitioner was represented by David John Carney of Green & Schafle LLC, and Respondent was represented by James Vincent Lopez of the U.S. Department of Justice.

Theory of causation field:
Petitioner Deborah Defosses, age 55, received a Tdap vaccine on March 12, 2019. The vaccination was attempted in the left arm, but the needle encountered resistance, and the vaccine was completed in the right arm. Thirteen days later, Petitioner developed left shoulder pain, diagnosed as SIRVA. The public decision does not detail the specific mechanism of injury beyond the general SIRVA definition, nor does it name specific medical experts. The respondent initially argued that a "failed attempt" to vaccinate did not constitute "receiving a vaccine." However, Chief Special Master Brian H. Corcoran ruled on January 28, 2025, that the initial needle penetration and likely antigen introduction in the left arm constituted a covered event, establishing entitlement to compensation for a Table SIRVA claim. Causation was presumed under the Table. On April 16, 2025, a stipulation resulted in an award of $60,000.00 for pain and suffering and $1,268.94 for a Medicaid lien, totaling $61,268.94. Petitioner was represented by David John Carney (Green & Schafle LLC) and Respondent by James Vincent Lopez (U.S. Department of Justice).

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00265-0
Date issued/filed: 2025-03-07
Pages: 9
Docket text: PUBLIC ORDER/RULING (Originally filed: 01/28/2025) regarding 40 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 1 of 9
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-265V
DEBORAH DEFOSSES, Chief Special Master Corcoran
Petitioner,
v. Filed: January 28, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
David John Carney, Green & Schafle LLC, Philadelphia, PA, for Petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On March 9, 2022, Deborah Defosses filed a Petition under the National Vaccine
Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the “Vaccine Act”); see
Section 11(c)(1)(D)(i). Petitioner alleges that she suffered a left shoulder injury related to
vaccine administration (“SIRVA”) following her receipt of a tetanus-diphtheria-acellular
pertussis (“Tdap”) vaccine on March 12, 2019. Petition (ECF No. 1); see also Amended
Petition filed June 9, 2022 (ECF No. 6) (adding citations to the evidence). The case was
assigned to the Special Processing Unit (“SPU”) 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 (2012).

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 2 of 9
Based on review of the evidence and briefing, I hereby conclude that Petitioner
likely received a covered vaccine in her injured left arm - prior to the administrator
switching to, and successfully completing the vaccination, in Petitioner’s opposing arm).
Petitioner has preponderantly established all other requirements for a Table SIRVA claim
– making her entitled to compensation.
I. Procedural History
The case was assigned to the SPU in August 2022. In September 2023,
Respondent completed his medical review and reported his openness to settlement
discussions. ECF No. 25. But after those discussions hit an impasse, the parties briefed
the issue of whether Petitioner’s Motion for a Ruling on the Record filed Jan. 16, 2024
(ECF No. 31); Respondent’s Combined Rule 4(c) Report and Response filed Feb. 29,
2024 (ECF No. 32); Petitioner’s Reply filed Mar. 14, 2024 (ECF No. 34) (referencing her
newly filed Ex. 8 (ECF No. 33), containing uncertified patient portal messages); Ex. 9 –
11 filed Oct. 28, 2024 (ECF No. 37); Respondent’s Supplemental Response filed Dec.
11, 2024). The matter is ripe for adjudication.
II. Authority
Before compensation can be awarded under the Vaccine Act, a petitioner must
demonstrate, by a preponderance of evidence, all matters required under Section
11(c)(1), including the factual circumstances surrounding his claim. Section 13(a)(1)(A).
In making this determination, the special master or court should consider the record as a
whole. Section 13(a)(1). Petitioner’s allegations must be supported by medical records or
by medical opinion. Id.
To resolve factual issues, the special master must weigh the evidence presented,
which may include contemporaneous medical records and testimony. See Burns v. Sec'y
of Health & Hum. Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (explaining that a special
master must decide what weight to give evidence including oral testimony and
contemporaneous medical records). Contemporaneous medical records are presumed to
be accurate. See Cucuras v. Sec’y of Health & Hum. Servs., 993 F.2d 1525, 1528 (Fed.
Cir. 1993). To overcome the presumptive accuracy of medical records testimony, a
petitioner may present testimony which is “consistent, clear, cogent, and compelling.”
Sanchez v. Sec'y of Health & Hum. Servs., No. 11–685V, 2013 WL 1880825, at *3 (Fed.
Cl. Spec. Mstr. Apr. 10, 2013) (citing Blutstein v. Sec'y of Health & Hum. Servs., No. 90–
2808V, 1998 WL 408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
2

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 3 of 9
In addition to requirements concerning the vaccination received, the duration and
severity of petitioner’s injury, and the lack of other award or settlement,3 a petitioner must
establish that she suffered an injury meeting the Table criteria, in which case causation
is presumed, or an injury shown to be caused-in-fact by the vaccination she received.
Section 11(c)(1)(C).
The most recent version of the Table, which can be found at 42 C.F.R. § 100.3,
identifies the vaccines covered under the Program, the corresponding injuries, and the
time period in which the particular injuries must occur after vaccination. Section 14(a).
Pursuant to the Vaccine Injury Table, a SIRVA is compensable if it manifests within 48
hours of the administration of a flu vaccine. 42 C.F. R. § 100.3(a)(XIV)(B). The criteria
establishing a SIRVA under the accompanying QAI are as follows:
Shoulder injury related to vaccine administration (SIRVA). SIRVA manifests
as shoulder pain and limited range of motion occurring after the
administration of a vaccine intended for intramuscular administration in the
upper arm. These symptoms are thought to occur as a result of unintended
injection of vaccine antigen or trauma from the needle into and around the
underlying bursa of the shoulder resulting in an inflammatory reaction.
SIRVA is caused by an injury to the musculoskeletal structures of the
shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is not a neurological
injury and abnormalities on neurological examination or nerve conduction
studies (NCS) and/or electromyographic (EMG) studies would not support
SIRVA as a diagnosis (even if the condition causing the neurological
abnormality is not known). A vaccine recipient shall be considered to have
suffered SIRVA if such recipient manifests all of the following:
(i) No history of pain, inflammation or dysfunction of the affected shoulder
prior to intramuscular vaccine administration that would explain the alleged
signs, symptoms, examination findings, and/or diagnostic studies occurring
after vaccine injection;
(ii) Pain occurs within the specified time frame;
3 In summary, a petitioner must establish that he received a vaccine covered by the Program, administered
either in the United States and its territories or in another geographical area but qualifying for a limited
exception; suffered the residual effects of his injury for more than six months, died from his injury, or
underwent a surgical intervention during an inpatient hospitalization; and has not filed a civil suit or collected
an award or settlement for her injury. See Section 11(c)(1)(A)(B)(D)(E).
3

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 4 of 9
(iii) Pain and reduced range of motion are limited to the shoulder in which
the intramuscular vaccine was administered; and
(iv) No other condition or abnormality is present that would explain the
patient’s symptoms (e.g., NCS/EMG or clinical evidence of radiculopathy,
brachial neuritis, mononeuropathies, or any other neuropathy).
42 C.F.R. § 100.3(c)(10).
III. Evidence
I have reviewed all submitted evidence including all medical records and affidavits,
as well as the Petition, the Rule 4(c) Report, and both parties’ briefing. I highlight the
following:
At the time of the March 12, 2019 vaccination, Petitioner was fifty-five (55) years
old, with no history of shoulder pain or dysfunction. Rule 4(c) Report at 2 citing Ex. 1 at 1
– 2, 17 – 18, 94. She is right-hand dominant. Ex. 1 at 193.
The key events in question occurred while Petitioner was seeing her established
primary care physician (“PCP”) for a complete physical examination, smoking cessation
counseling, and evaluation of a sore throat. Ex. 1 at 93 – 99. A registered nurse actually
administered the Tdap vaccine, and completed a computerized vaccine administration
record’s fields including a site of “Right Arm.” Id. at 102.
Thirteen days later (on March 25, 2019), Petitioner messaged the PCP’s office –
writing: “I am getting concerned. When I was in the office a couple of weeks ago I had 2
tetanus shots. Something happened to the left side so she had to go get another needle
to do the right arm. Ever since then I have horrible pain in my left side. I don’t know if it’s
because she put the needle up so high that maybe it affected muscle. I just know this still
hurts so bad. The pain is so terrible. Is anything that can be done?” Ex. 11 at 14. The
nurse left Petitioner a voicemail, and then sent a follow-up message, writing: “I am so
sorry that you are still having pain in that arm. Can you describe the pain that you are
having? Is it a bruised feeling in the upper arm or nerve pain down the arm? Do you still
have full range of motion in that arm?” Id.
On April 8, 2019, Petitioner responded that her pain had persisted and disrupted
her sleep despite taking ibuprofen and applying heat, and her PCP scheduled an
evaluation. Ex. 11 at 16. At that appointment three days later, on April 11, 2019, the PCP
recorded a history of: “Left arm pain, at site of Tdap injection, given March 12, 2019,
4

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 5 of 9
actually injection was not given, nurse changed sides due to resistance… The right arm,
where injection had been given is not symptomatic.” Ex. 1 at 117 (emphasis added). On
examination, the left shoulder had pain, but normal range of motion (“ROM”). Id. at 120.
The PCP expressed uncertainty about what had happened, but prescribed pain
medication. Id. at 122.
At a May 21, 2019 follow-up, the PCP recorded a similar history, and exam findings
of pain, plus a mild decrease in glenohumeral internal rotation and pain. Ex. 1 at 131. The
PCP opined that Petitioner previously had injection site pain, plus unrelated “shoulder
joint pain.” Id. The PCP then ordered an x-ray of the left shoulder, which found mild AC
joint arthropathy. Id. at 143. Over the following week, the PCP then offered referrals to
physical therapy and an orthopedist, Ex. 11 at 17 – 19, but no such encounters occurred.
While Petitioner reported “residual” left shoulder pain, her PCP did not document
any positive exam findings, assessment, or treatment plan at appointments on September
12, 2019, Ex. 1 at 151 - 56, and August 18, 2020, id. at 178 – 84.
But at the next PCP appointment on February 18, 2021, Petitioner reported
“chronic left shoulder pain… in left shoulder laterally from head of humerus to midshaft,
still has the pain from attempted vaccination… approximately 2 years ago.” Ex. 1 at 197.
An exam found grossly symmetrical ROM, but the left shoulder had “a little decreased
abduction and full flexion,” and “a little weak[ness].” Id. at 200. The PCP discussed the
differential diagnosis including “labral tear, bursitis, SIRVA.” Id. at 203.
On her PCP’s referral, over the next month, Petitioner underwent an MRI of the
left shoulder which showed acromioclavicular joint arthrosis, supraspinatus tendinosis,
and a suspected superior labrum anterior to posterior (“SLAP”) tear, Ex. 1 at 206, 227 –
28, and she attended three occupational therapy (“OT”) sessions, Ex. 3 at 26 – 39.
Then on April 12, 2021, Petitioner established care with an orthopedist, who
recorded her same history of chronic left shoulder pain since a tetanus shot two years
earlier. Ex. 4 at 12. An exam found atrophy, weakness, tenderness, and difficulty with
active abduction and forward flexion – but possible active internal and external rotation,
and full passive ROM. Id. at 13. The orthopedist commented that the recent MRI did not
demonstrate any rotator cuff tearing but did demonstrate tendinopathy and inflammation.”
Id. He obtained an x-ray that was suggestive of calcific tendinitis, assessed impingement
syndrome, and recommended additional formal therapy (commenting that “3 sessions is
hardly enough for a condition that has been going on for 2 years”). Id.
5

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 6 of 9
Petitioner never resumed OT, reportedly due to “family issues” and “multiple
competing demands and life stressors,” and instead performed home exercises. Ex. 4 at
8. At a June 21, 2021, follow-up, the orthopedist documented an ongoing left shoulder
injury, and prescribed a prednisone taper. Id. at 8 – 9. Nearly two years later, the
orthopedist’s physician assistant (“PA”) documented a still ongoing left shoulder injury
and provided a Lidocaine topical patch. Ex. 7 at 4 – 11. It also appears that on the PA’s
referral, Petitioner began attending formal physical therapy (“PT”) in spring 2023, see id.
at 7, 11, but no corroborating records have been filed.
In a June 2022 affidavit, Petitioner recalls that on March 12, 2019: “As soon as the
vaccine needle was inserted into my left arm, I noticed that it was injected far up on the
arm. As soon as [the nurse] pressed to administer the contents of the vaccine, I
immediately felt a burning sensation. The nurse then informed me that she was unable to
get all the vaccine in my arm.” Ex. 1 at ¶ 9. Petitioner recalls that the nurse left the room,
got another needle, and then administered the rest of the vaccine in her right shoulder.
Id.
IV. Analysis
In seeking dismissal, Respondent contends that the Vaccine Act does not permit
“a claim for an injury arising from a failed attempt to administer a covered vaccine.”
Combined Rule 4(c) Report and Response at 7 (citing Section 11(c)(1)(a) (requiring a
petition to demonstrate that the injured person “received a vaccine” listed in the Vaccine
Injury Table)).
The key words – “received a vaccine” – are not defined by the Act or by any
precedential ruling. At best, special masters in other cases have evaluated whether a
vaccination-like event meets the Act’s requirements. See, e.g., Dean v. Sec’y of Health &
Hum. Servs., No. 16-1245V, 2018 WL 3104388 (Fed. Cl. Spec. Mstr. May 29, 2018)
(holding that a percutaneous allergy test did not involve the administration, receipt, or
purpose of a vaccine as defined by the Vaccine Act). But I have determined that even an
incomplete vaccination at a single situs can give rise to a Vaccine Act claim. Clark v.
Sec’y of Health & Hum. Servs., No. 21-421V, 2024 WL 4284924, at *10 (Fed. Cl. Spec.
Mstr. Aug. 21, 2024) (concluding that it was “sufficient that [a] vaccination effort resulted
in needle penetration and antigen introduction to be deemed to have been ‘received,’ and
the record [in Clark] suggests both occurred”).
Ms. Defosses’s case is strikingly similar to that of the Clark petitioner. Ms.
Defosses’s March 12, 2019 Tdap vaccine administration record lists a right-sided
administration, and that record’s reliability is not in dispute. But there is also preponderant
evidence that the nurse initially selected a left-sided site of administration, and that the
6

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 7 of 9
vaccine needle penetrated the skin and some underlying structures before that initial
vaccination effort was deemed “aborted.” See, e.g., Ex. 11 at 14 (Petitioner’s message
and the nurse’s response acknowledging the left-sided injury); Ex. 1 at 117 (PCP’s note
that the “nurse changed sides due to resistance”); accord Supplemental Response at 2
(conceding the fact of a left-sided “needle injectio[n]”). Thereafter, a second vaccination
attempt was made, and completed on Petitioner’s right arm (with no adverse symptoms
reported from this).
Respondent contends that even if record evidence supports the conclusion that a
failed initial effort at vaccination in Petitioner’s left shoulder is established, it has not been
shown that any Tdap vaccine antigen was injected during the left-sided failed attempt.
Supplemental Response at 7 - 8. Certainly the fact that vaccine administration on the left
side was not completed somewhat supports this conclusion. And it is fair for Respondent
to question whether this is an aspect of “vaccine administration” that must be proven –
especially in the context of injuries that are less about an antigenic reaction than some
other vaccine-related negligence (although such cases have resulted in compensation –
albeit where there was no question that the vaccine’s contents were “administered”). See,
e.g., Silver v. Sec’y of Health & Hum. Servs., No. 20-1V, 2024 WL 2799285, at *10 (Fed.
Cl. Spec. Mstr. Apr. 25, 2024) (Vaccine Program broadly permits “claims involving the
‘cleanliness’ of vaccine needles/ syringes, or even the circumstances of administration
more broadly, to be actionable ‘vaccine-related’ injuries”).
However, the record is ambiguous but ultimately close on this disputed point. See
generally Ex. 1 at 117. This particular record, created just two weeks post-vaccination,
contains Petitioner’s account that the nurse switched sides after encountering
“resistance” on the left. Ex. 1 at 117. While this note does not specify whether the
”resistance” was to the needle or to attempted injection of the vaccine antigen, the fact of
the effort is established, along with its incompletion – not that the introduction of vaccine
antigen did not occur at all. Compare Dean, 2018 WL 3104388 at *7 – 8 (concluding that
an individual did not “receive a vaccine” upon being “exposed to only a minute amount of
[influenza antigen] upon the outermost layer of her skin,” during an allergy test). And it is
reasonable to expect that the fast process of vaccination might include coterminous
piercing of a patient’s skin by the vaccine needle with introduction of antigen as well; it is
not the usual experience of vaccination for the needle to be first pushed down entirely.
The Program counsels special masters to resolve close questions in favor of
Petitioners. See, e.g., Prude v. Sec’y of Health & Hum. Servs., No. 19-1537V, 2021 WL
3913930, at *6 (Fed. Cl. Spec. Mstr. July 29, 2021) (“[t]he facts of this case present a very
close call… Program law does counsel to decide such matters in favor of the petitioner”);
Al-Uffi v. Sec’y of Health & Hum. Servs., No. 13-956V, 2017 WL 1713113, at *17, 19 (Fed.
7

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 8 of 9
Cl. Spec. Mstr. Feb. 22, 2017) (resolving intertwined onset and causation questions in
favor of the petitioner) (citing Andreu v. Sec’y of Health & Hum. Servs., 569 F.3d 1367,
1378 (Fed. Cir. 2009).
Although another case might involve better evidence that no antigenic introduction
occurred,4 this one allows for the inference it did – and given the overall context, the
record permits the finding that the first vaccination effort here involved some antigenic
introduction, sufficient to constitute “vaccine administration.” There is, therefore,
preponderant evidence to conclude that Ms. Defosses received a covered Tdap vaccine
in her left upper arm or shoulder.
Conclusion and Scheduling Order
Respondent does not raise any other objections to entitlement, see generally
Combined Rule 4(c) Report and Response. He was obligated to have done so pursuant
to Vaccine Rule 4(c) (stating that the Rule 4(c) Report “must… contain Respondent’s
medical analysis of Petitioner’s claims and must present any legal arguments that
Respondent may have in opposition to the petition”) (emphasis added).
Based on my independent review, I find that Petitioner has preponderantly
established all requirements for a Table SIRVA claim. 42 C.F.R. §§ 100.3(a), (c)(10).
Accordingly, she need not prove causation-in-fact. Section 11(c)(1)(C). I also find that
Petitioner has satisfied all other requirements of Section 11(c) including a sufficiently
severe injury, and the lack of other award or settlement. Section 11(c)(A), (B), and (D).
For the foregoing reasons, I find that Petitioner has established entitlement
and is thus entitled to compensation for a SIRVA following a March 12, 2019, left-
sided receipt of a covered Tdap vaccine. Therefore, the case is now formally in the
damages phase.
4 My hypothetical from Silver illustrates such a circumstance. Silver, 2024 WL 2799285 at n. 11. If a vaccine
syringe filled with the vaccine was hurled, dart-like, at a person and the needle caused harm, but no antigen
was delivered, I would not find any vaccine has been administered, even if after this event the claimant
received a second vaccination to account for the failed first.
8

Case 1:22-vv-00265-UNJ Document 41 Filed 03/07/25 Page 9 of 9
By no later than Friday, March 14, 2025, Petitioner shall file a Status Report
updating on the parties’ efforts towards informally resolving damages.5
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
5 Previously in June 2023, Petitioner conveyed a demand, which included satisfaction of a Medicaid lien,
for Respondent’s consideration. See Status Report filed Oct. 13, 2023 (ECF No. 27). Petitioner’s
(unsolicited) damages briefing, at ECF No. 31, only discusses past pain and suffering, and does not address
the lien. I am deferring any substantive review of the appropriate award of damages in hopes that the parties
will reach an informal resolution on that topic. However, if the parties again hit an impasse, I expect to
promptly receive Respondent’s briefing on the appropriate award of damages, followed by any Reply from
Petitioner.
9

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DOCUMENT 2: USCOURTS-cofc-1_22-vv-00265-1
Date issued/filed: 2025-05-16
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 04/16/2025) regarding 46 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:22-vv-00265-UNJ Document 52 Filed 05/16/25 Page 1 of 5
(cid:36)(cid:48)(cid:51)(cid:51)(cid:38)(cid:36)(cid:53)(cid:38)(cid:37)
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-265V
DEBORAH DEFOSSES, Chief Special Master Corcoran
Petitioner,
v. Filed: April 16, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
David John Carney, Green & Schafle LLC, Philadelphia, PA, for Petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON DAMAGES1
On March 9, 2022, Deborah Defosses filed a Petition under the National Vaccine
Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the “Vaccine Act”); see
Section 11(c)(1)(D)(i). Petitioner alleged that she suffered a left shoulder injury related to
vaccine administration (“SIRVA”) following her receipt of a tetanus-diphtheria-acellular
pertussis (“Tdap”) vaccine on March 12, 2019. Petition (ECF No. 1); see also Amended
Petition filed June 9, 2022 (ECF No. 6) (adding citations to the evidence). The case was
assigned to the Special Processing Unit (“SPU”) of the Office of Special Masters.
1Because 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.
2National 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 (2012).

Case 1:22-vv-00265-UNJ Document 52 Filed 05/16/25 Page 2 of 5
On January 28, 2025, a Ruling on Entitlement was issued, finding Petitioner
entitled to compensation for a SIRVA. On April 9, 2025, 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.
Pursuant to the terms stated in the attached proffer, I award the following
compensation:
A. A lump sum of $60,000.00 (for pain and suffering) to be paid through an
ACH deposit to Petitioner’s counsel’s IOLTA account for prompt
disbursement to Petitioner.
B. A lump sum payment of $1,268.94, representing compensation for
satisfaction of the State of Rhode Island Medicaid lien, in the form of a
check payable to Petitioner and:
Optum
P.O. Box 182643
Columbus, OH 43218-2643
Petitioner agrees to endorse the check to Optum for satisfaction of the
Medicaid lien.
Proffer at 2 – 3. These amounts represent compensation for all damages that would be
available under Section 15(a). Id.
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-00265-UNJ Document 52 Filed 05/16/25 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
DEBORAH DEFOSSES, )
)
Petitioner, )
) No. 22-265V
v. ) Chief Special Master Brian H. Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER OF DAMAGES
On June 9, 2022, Deborah DeFosses (“petitioner”) filed an Amended Petition for
compensation under the National Childhood Vaccine Injury Act of 1986, as amended (“the
Vaccine Act” or “the Act”), 42 U.S.C. §§ 300aa -1 to - 34, alleging that she suffered a Shoulder
Injury Related to Vaccine Administration as a result of a tetanus, diphtheria, and acellular
pertussis (“Tdap”) vaccine she received on March 12, 2019. Amended Petition at 1. In the
alternative, petitioner alleged a causation-in-fact left shoulder injury from the Tdap vaccine. Id.
at 9.
On February 29, 2024, respondent filed his Vaccine Rule 4(c) report setting forth his
position that this case was not appropriate for compensation. ECF No. 32. On January 28,
2025, the Chief Special Master issued a Ruling on Entitlement, finding that petitioner was
entitled to vaccine compensation. ECF No. 40.1
1 The parties have no objection to the amount of the proffered award of damages. However,
respondent reserves his right, pursuant to 42 U.S.C. § 300aa-12(f), to seek review of the Special
Master’s January 28, 2025 Ruling on Entitlement, finding petitioner entitled to an award under
the Vaccine Act. This right accrues following the issuance of the damages decision.

Case 1:22-vv-00265-UNJ Document 52 Filed 05/16/25 Page 4 of 5
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $60,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
B. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy the State of Rhode
Island Medicaid lien in the amount of $1,268.94, which represents full satisfaction of any right of
subrogation, assignment, claim, lien, or cause of action the State of Rhode Island may have
against any individual as a result of any Medicaid payments the State of Rhode Island 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
12, 2019 under Title XIX of the Social Security Act.
These amounts represent all elements of compensation to which petitioner is 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.
The parties recommend that compensation provided to petitioner should be made through two
lump sum payments described below, and request that the Chief Special Master’s decision and
the Court’s judgment award the following: 2
A. A lump sum payment of $60,000.00, to be paid through an ACH deposit to
petitioner’s counsel’s IOLTA account for prompt disbursement to petitioner; and
B. A lump sum payment of $1,268.94, representing compensation for satisfaction of
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 pain and suffering, and future lost wages.
2

Case 1:22-vv-00265-UNJ Document 52 Filed 05/16/25 Page 5 of 5
the State of Rhode Island Medicaid lien, in the form of a check payable jointly to
petitioner and:
Optum
P.O. Box 182643
Columbus, OH 43218-2643
Petitioner agrees to endorse the check to Optum for satisfaction of the Medicaid lien.
Respectfully submitted,
YAAKOV M. ROTH
Acting 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/ James V. Lopez
James V. Lopez
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Ben Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-3655
Fax: (202) 616-4310
Email: james.lopez@usdoj.gov
Date: April 9, 2025
3