VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00277
Package ID: USCOURTS-cofc-1_22-vv-00277
Petitioner: John Piermatteo
Filed: 2022-03-10
Decided: 2025-04-28
Vaccine: influenza
Vaccination date: 2019-12-11
Condition: Guillain-Barre Syndrome (GBS)
Outcome: compensated
Award amount USD: 224917

AI-assisted case summary:
On March 10, 2022, John Piermatteo filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that he suffered Guillain-Barre Syndrome (GBS) as a result of an influenza vaccine he received on December 11, 2019. Mr. Piermatteo, who was 50 years old at the time of vaccination, stated that he received the vaccine as a requirement for a new job. Twelve days after vaccination, on December 23, 2019, he presented to the emergency department with bilateral leg weakness, leading to falls. He was admitted to the ICU, where a neurologist noted decreased motor strength, absent reflexes in his lower extremities, and decreased sensation. A lumbar puncture revealed slightly elevated protein. Following the procedure, he experienced a cerebrospinal fluid leak with a migraine, which was treated with a blood patch. He received a five-day course of IVIG and gabapentin. By December 25, 2019, his condition had improved, and he was moved out of the ICU. On January 3, 2020, he was transferred to an inpatient rehabilitation facility. However, his GBS symptoms worsened on January 7, 2020, and he was readmitted to the hospital. He underwent a second five-day course of IVIG. Following this, he returned to inpatient rehabilitation in mid-January 2020, where he continued to experience numbness, tingling, and burning sensations, though improved. He was discharged from rehabilitation on January 23, 2020, needing a cane and precautions to avoid falls, and was not cleared to drive. He followed up with his primary care physician on January 29, 2020, complaining of weakness, numbness, and proprioception issues, and began outpatient physical therapy. He attended two PT sessions in February 2020 but was discharged from PT due to missed appointments. On March 30, 2020, his primary care physician noted that from a GBS standpoint, he was "back to normal." Approximately one year later, on March 11, 2021, he saw a podiatrist for foot pain and difficulty walking, reporting dyesthesia, hyperesthesia, and paresthesia. Two years after that, on April 3, 2023, he saw a neurologist for persistent toe numbness, which he attributed to his GBS. An EMG performed in June 2023 suggested a mild peripheral neuropathy. The respondent initially opposed compensation but later conceded entitlement, agreeing that Mr. Piermatteo met the criteria for a Table injury for GBS following a flu vaccine. The case proceeded to a damages hearing on March 28, 2025, before Chief Special Master Brian H. Corcoran. Petitioner's counsel was Leah VaSahnja Durant, and respondent's counsel was Mallori Browne Openchowski. Mr. Piermatteo requested $185,000.00 for past pain and suffering, citing his prolonged hospitalization, two rounds of IVIG, and ongoing symptoms. The respondent proposed $120,000.00, arguing his GBS course was less severe than cited comparables and that his primary care physician noted he was "back to normal" by March 2020. Chief Special Master Corcoran awarded Mr. Piermatteo $170,000.00 for actual pain and suffering and $54,917.29 to satisfy a Medicaid lien, totaling $224,917.29. The decision was issued on April 28, 2025.

Theory of causation field:
Petitioner John Piermatteo, age 50, received an influenza vaccine on December 11, 2019. He alleged Guillain-Barre Syndrome (GBS) as a vaccine-related injury. The respondent conceded entitlement, agreeing that Petitioner met the criteria set forth in the Vaccine Injury Table and Qualifications and Aids to Interpretation for GBS, which affords a presumption of vaccine causation when onset occurs between three and forty-two days after a seasonal flu vaccination, with no more likely alternative diagnosis and no apparent alternative cause. Petitioner's GBS onset occurred twelve days after vaccination. The Special Master determined Petitioner was entitled to compensation and awarded $170,000.00 for actual pain and suffering and $54,917.29 to satisfy a Medicaid lien, totaling $224,917.29. The decision was issued by Chief Special Master Brian H. Corcoran on April 28, 2025. Petitioner was represented by Leah VaSahnja Durant, and Respondent was represented by Mallori Browne Openchowski.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00277-0
Date issued/filed: 2023-12-08
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/06/2023) regarding 27 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:22-vv-00277-UNJ Document 30 Filed 12/08/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0277V
JOHN PIERMATTEO, Chief Special Master Corcoran
Petitioner, Filed: November 6, 2023
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Mallori Browne Openchowski, U.S. Department of Justice, Washington, DC, for
Respondent.
RULING ON ENTITLEMENT1
On March 10, 2022, John Piermatteo 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 he suffered Guillain-Barre Syndrome (“GBS”)
resulting from an influenza (“flu”) vaccine received on December 11, 2019. Petition at 1.
Petitioner further alleges that the vaccine was administered in the United States, his injury
has lasted for longer than six months, and neither Petitioner, nor any other party, has ever
received compensation in the form of an award or settlement for his vaccine-related injury.
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-00277-UNJ Document 30 Filed 12/08/23 Page 2 of 2
Petition at ¶¶ 1, 10, 11; Ex. 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On November 6, 2023, Respondent filed an amended Rule 4(c) report in which he
concedes that Petitioner is entitled to compensation in this case. Respondent’s Rule 4(c)
Report at 1-2. Specifically, Respondent agrees that “petitioner has satisfied the criteria
set forth in the Table and the Qualifications and Aids to Interpretation for GBS, which
afford him a presumption of vaccine causation if the onset occurs between three and
forty-two days after a seasonal flu vaccination and there is no more likely alternative
diagnosis and no apparent alternative cause.” Id. at 6-7. Respondent further agrees that
the record shows that the case was timely filed, the vaccine was received in the United
States, and Petitioner satisfies the statutory severity requirement by suffering the residual
effects of his injury for more than six months. Id. at 7. Respondent adds that Petitioner
has averred that no civil action or proceedings have been pursued in connection with the
vaccine-related injury. 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-00277-1
Date issued/filed: 2025-04-28
Pages: 13
Docket text: PUBLIC DECISION (Originally filed: 03/28/2025) regarding 46 DECISION of Special Master. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:22-vv-00277-UNJ Document 52 Filed 04/28/25 Page 1 of 13
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0277V
JOHN PIERMATTEO, Chief Special Master Corcoran
Petitioner, Filed: March 28, 2025
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Mallori Browne Openchowski, U.S. Department of Justice, Washington, DC, for
Respondent.
DECISION AWARDING DAMAGES1
On March 10, 2022, John Piermatteo 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 he suffered Guillain-Barré syndrome (“GBS”)
resulting from an influenza (“flu”) vaccine received on December 11, 2019. Petition at 1.
I determined Petitioner was entitled to compensation,3 but the parties were unable to
resolve damages, and instead briefed the matter (ECF Nos. 37, 38, 39). A “Motions Day”
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).
3 On February 21, 2023, Respondent filed a Rule 4(c) Report opposing compensation (ECF No. 21).
Thereafter, Petitioner filed additional evidence (ECF No. 23), and Respondent filed an amended Report
conceding that Petitioner is entitled to compensation (ECF No. 26).

Case 1:22-vv-00277-UNJ Document 52 Filed 04/28/25 Page 2 of 13
damages hearing was held on March 28, 2025, and this written decision memorializes
my oral ruling issued at the conclusion of the hearing.4
For the reasons described below, I find that Petitioner is entitled to an award of
damages in the amount of $170,000.00 for actual pain and suffering, in addition to
$54,917.295 to satisfy a Medicaid lien.
I. Legal Standard
Compensation awarded pursuant to the Vaccine Act shall include “[f]or actual and
projected pain and suffering and emotional distress from the vaccine-related injury, an
award not to exceed $250,000.” Section 15(a)(4). Additionally, a petitioner may recover
“actual unreimbursable expenses incurred before the date of judgment award such
expenses which (i) resulted from the vaccine-related injury for which petitioner seeks
compensation, (ii) were incurred by or on behalf of the person who suffered such injury,
and (iii) were for diagnosis, medical or other remedial care, rehabilitation . . . determined
to be reasonably necessary.” Section 15(a)(1)(B). The petitioner bears the burden of proof
with respect to each element of compensation requested. Brewer v. Sec’y of Health &
Human Servs., No. 93-0092V, 1996 WL 147722, at *22-23 (Fed. Cl. Spec. Mstr. Mar. 18,
1996).
There is no mathematic formula for assigning a monetary value to a person’s pain
and suffering and emotional distress. I.D. v. Sec’y of Health & Human Servs., No. 04-
1593V, 2013 WL 2448125, at *9 (Fed. Cl. Spec. Mstr. May 14, 2013) (“[a]wards for
emotional distress are inherently subjective and cannot be determined by using a
mathematical formula”); Stansfield v. Sec’y of Health & Human Servs., No. 93-0172V,
1996 WL 300594, at *3 (Fed. Cl. Spec. Mstr. May 22, 1996) (“the assessment of pain and
suffering is inherently a subjective evaluation”). Factors to be considered when
determining an award for pain and suffering include: 1) awareness of the injury; 2) severity
of the injury; and 3) duration of the suffering. I.D., 2013 WL 2448125, at *9 (quoting
McAllister v. Sec’y of Health & Human Servs., No 91-1037V, 1993 WL 777030, at *3 (Fed.
Cl. Spec. Mstr. Mar. 26, 1993), vacated and remanded on other grounds, 70 F.3d 1240
(Fed. Cir. 1995)).
4 At the March 28th hearing, Richard Amada argued for Petitioner, and Mary Holmes argued for
Respondent.
My oral ruling issued during the hearing will be set forth in the transcript from the hearing, which has not
yet been filed but is fully incorporated into this Decision.
5 During the March 28th hearing, there was discussion about whether the Medicaid lien amount required
updating. Following the hearing, Petitioner’s counsel and Respondent’s counsel confirmed in informal email
communications to each other and an OSM staff attorney that $54,917.29 is the correct amount for the lien.
2

Case 1:22-vv-00277-UNJ Document 52 Filed 04/28/25 Page 3 of 13
I may also consider prior pain and suffering awards to aid my resolution of the
appropriate amount of compensation for pain and suffering in this case. See, e.g., Doe
34 v. Sec’y of Health & Human Servs., 87 Fed. Cl. 758, 768 (2009) (finding that “there is
nothing improper in the chief special master’s decision to refer to damages for pain and
suffering awarded in other cases as an aid in determining the proper amount of damages
in this case.”). And, of course, I may rely on my own experience (along with my
predecessor Chief Special Masters) adjudicating similar claims. Hodges v. Sec’y of
Health & Human Servs., 9 F.3d 958, 961 (Fed. Cir. 1993) (noting that Congress
contemplated the special masters would use their accumulated expertise in the field of
vaccine injuries to judge the merits of individual claims).
Although pain and suffering in the past was often determined based on a
continuum, as Respondent argues, that practice was cast into doubt by a Court of Federal
Claims decision several years ago. Graves v. Sec’y of Health & Human Servs., 109 Fed.
Cl. 579 (Fed. Cl. 2013). Graves maintained that to do so resulted in “the forcing of all
suffering awards into a global comparative scale in which the individual petitioner’s
suffering is compared to the most extreme cases and reduced accordingly.” Id. at 590.
Instead, Graves assessed pain and suffering by looking to the record evidence, prior pain
and suffering awards within the Vaccine Program, and a survey of similar injury claims
outside of the Vaccine Program. Id. at 595. Under this approach, the statutory cap merely
cuts off higher pain and suffering awards – it does not shrink the magnitude of all possible
awards as falling within a spectrum that ends at the cap. Although Graves is not
controlling of the outcome in this case, it provides reasoned guidance in calculating pain
and suffering awards – and properly emphasizes the importance in each case of basing
damages on the specific injured party’s circumstances.
II. Prior SPU Compensation of GBS Pain and Suffering6
A. Data Regarding Compensation in SPU Flu/ GBS Cases
Flu/GBS cases have an extensive history of informal resolution within the SPU. As
of January 1, 2025, since SPU’s inception ten years ago, 897 GBS cases have been
resolved. Compensation has been awarded in the vast majority of cases (852), with the
remaining 45 cases dismissed.
The data for all categories of theses damages decisions reflect the expected
differences in outcome, summarized as follows:
6 From July 2014 until September 2015, the SPU was overseen by former Chief Special Master Vowell. For
the next four years, until September 30, 2019, all SPU cases, including the majority of GBS claims, were
assigned to former Chief Special Master Dorsey, now Special Master Dorsey. In early October 2019, the
majority of SPU cases were reassigned to me as the current Chief Special Master.
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Case 1:22-vv-00277-UNJ Document 52 Filed 04/28/25 Page 4 of 13
Damages Proffered Stipulated Stipulated7
Decisions by Damages Damages Agreement
Special Master
Total Cases 56 412 20 364
Lowest $96,008.66 $9,050.40 $20,000.00 $3,098.64
1st Quartile $156,760.64 $125,000.00 $128,700.00 $100,000.00
Median $171,082.15 $162,940.13 $224,397.27 $150,000.00
3rd Quartile $186,457.51 $244,193.98 $380,028.33 $221,250.00
Largest $244,390.18 $2,282,465.84 $985,000.00 $1,200,000.00
B. Adjudication Specifically of GBS Pain and Suffering
Only a small minority of cases have involved a special master’s adjudication of
damages issues. The written decisions setting forth such determinations provide the most
reliable guidance in deciding what similarly-situated claimants should also receive.8
As of January 1, 2025, in nearly every occasion that SPU has had to resolve the
appropriate award for GBS pain and suffering, over $100,000.00 has been awarded (with
a lower sum, lower sum, $92,500.00, only awarded once). The remaining fifty-five (55)
awards far exceeded $100,000.00. The first-quartile value is $153,750.00. The median is
$167,500.00. The third-quartile value is $178,500.00. The largest award was
$197,500.00.
These decisions are informed by what is known about GBS, including its
description as set forth in the Vaccine Injury Table (“Table”). Pursuant to the Table,
vaccine causation is presumed for GBS with an onset 3 – 42 days (not less than 3 days,
and not more than 42 days) after receipt of a seasonal flu vaccine. 42 C.F.R. §
100.3(a)(XIV)(D). The Qualifications and Aids to Interpretation (“QAI”) explain:
GBS is an acute monophasic peripheral neuropathy that encompasses a
spectrum of four clinicopathological subtypes… The interval between the
first appearance of symptoms and the nadir of weakness is between 12
7 One award was for an annuity only, the exact amount which was not determined at the time of judgment.
8 Of course, even though all independently-settled damages issues (whether by stipulation/settlement or
proffer) must still be approved by a special master, such determinations do not provide the same judicial
guidance or insight obtained from a reasoned decision. But given the aggregate number of such cases,
these determinations nevertheless “provide some evidence of the kinds of awards received overall in
comparable cases.” Sakovits v. Sec’y of Health & Human Servs., No. 17-1028V, 2020 WL 3729420, at *4
(Fed. Cl. Spec. Mstr. June 4, 2020) (discussing the difference between cases in which damages are agreed
upon by the parties and cases in which damages are determined by a special master).
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Case 1:22-vv-00277-UNJ Document 52 Filed 04/28/25 Page 5 of 13
hours and 28 days. This is followed in all subtypes by a clinical plateau with
stabilization at the nadir of symptoms, or subsequent improvement without
significant relapse. Death may occur without a clinical plateau. Treatment-
related fluctuations in all subtypes of GBS can occur within 9 weeks of GBS
symptom onset, and recurrence of symptoms after this timeframe would not
be consistent with GBS.
42 C.F.R. § 100.3(c)(15)(I) (2017). The three most common subtypes are acute
inflammatory demyelinating polyneuropathy (“AIDP”); acute motor axonal neuropathy
(“AMAN”); and acute motor and sensory neuropathy (“AMSAN”). Id. The onset of each is
marked by “bilateral flaccid limb weakness and decreased or absent deep tendon reflexes
in weak limbs.” Id. at (c)(15)(II). The fourth subtype – Fisher syndrome or Miller-Fisher
syndrome – has a different onset of “bilateral ophthalmoparesis; bilateral reduced or
absent tendon reflexes; [and] ataxia.” Id. at (c)(15)(III).9
A consistent starting consideration is that “GBS pain and suffering awards
generally should be higher than those awarded to petitioners who have suffered a less
frightening and physically alarming injury, such as SIRVA.”10 Gross v. Sec’y of Health &
Human Servs., No. 19-0835V, 2021 WL 2666685, at *5 (Fed. Cl. Spec. Mstr. March 11,
2021); see also, e.g., Castellanos v. Sec’y of Health & Human Servs., No. 19-1710V,
2022 WL 1482497, at *10 (Fed. Cl. Spec. Mstr. Mar. 30, 2022) (emphasizing recognition
of “the seriousness of GBS as a general matter,” in awarding a six-figure sum); Voeller v.
Sec’y of Health & Human Servs., No. 20-1526V, 2023 WL 5019830, at *10 (Fed. Cl. Spec.
Mstr. July 6, 2023) (noting GBS’s “frightening” nature).
But of course, not every GBS case is equally severe. Further details of the initial
medical course are considered – including any mistake or delay in diagnosing GBS; any
in-patient hospitalization and/or in-patient rehabilitation (and the duration of any such
stays); diagnostic procedures (e.g., bloodwork, lumbar punctures, electrodiagnostic
studies, imaging); the severity of symptoms at their nadir (e.g., involving incontinence or
respiratory failure); the extent and effectiveness of treatment (e.g., IVIg, plasmapheresis,
pain medications); other interventions (e.g., feeding tubes, breathing tubes,
catheterization); and any complications (e.g., sepsis during hospitalization).
Also relevant is the long-term course – as evidenced by out-patient therapies,
neurology evaluations, and other medical appointments concerning GBS; the results of
9 See also National Vaccine Injury Compensation Program: Revisions to the Vaccine Injury Table – Notice
of Proposed Rulemaking, 80 Fed. Reg. 45132, at 45144 – 45 (July 29, 2015) (proposing addition of Table
flu/GBS claims – explaining GBS is “an acute paralysis caused by dysfunction in the peripheral nervous
system [that…] may manifest with weakness, abnormal sensations, and/or abnormality in the autonomic
(involuntary) nervous system,” and that death, when it occurs, is most often related to respiratory failure).
10 Shoulder injury related to vaccine administration (“SIRVA”) is another Table injury. 42 C.F.R. §§ 100.3(a),
(c)(10).
5

Case 1:22-vv-00277-UNJ Document 52 Filed 04/28/25 Page 6 of 13
repeat electrodiagnostic studies and other relevant tests; medical providers’ assessments
of the degree of recovery achieved; ongoing reliance on assistive devices and
medications; and relevant treatment gaps. Previous opinions have recognized that “a
substantial recovery does not mean that [an individual] has fully recovered from his GBS
and has no ongoing sequelae. It is common for petitioners to experience ongoing
symptoms of GBS, such as numbness and fatigue, even with a good recovery.” Elenteny
v. Sec’y of Health & Human Servs., No. 19-1972V, 2023 WL 2447498, at *5 (Fed. Cl.
Spec. Mstr. Mar. 10, 2023). But symptoms of that nature are typically folded into a “typical”
past pain and suffering award, and will not justify a future component. See, e.g., id.; Miller
v. Sec’y of Health & Human Servs., No. 21-1559V, 2023 WL 2474322, at *8 (Fed. Cl.
Spec. Mstr. Feb. 10, 2023).
“The mere fact that a claimant had pre-vaccination comorbidities does not per se
diminish the impact of [the vaccine injury] on his life – especially one as alarming and
potentially life-altering as GBS – and therefore is not alone reason for a lower award.”
Bircheat v. Sec’y of Health & Human Servs., No. 19-1088V, 2021 WL 3026880, at *4
(Fed. Cl. Spec. Mstr. June 16, 2021). However, a special master is statutorily required to
consider to what extent a petitioner’s pain and suffering is truly “from the vaccine-related
injury,” Section 15(a)(4) (emphasis added), and not from any unrelated preexisting or
subsequently-developed medical issues. See, e.g., Bircheat, 2021 WL 3026880, at *4;
Gross, 2021 WL 2666685, at *5.
Also worthy of consideration are the injury’s impact on a petitioner’s personal
circumstances including his or her family and other personal obligations, and professional
life (whether or not lost wages are directly claimed).
All of these facts are primarily gleaned from the medical records – although sworn
statements and/or other evidence may also be considered, especially if they supplement,
and do not contradict, the facts reflected in the medical records.
III. Relevant Medical History
Petitioner was 50 years old when he received the flu vaccine on December 11,
2019 at WellSpan Health. Ex. 1 at 1. Twelve days later (December 23rd), he went to the
emergency department (“ED”) for bilateral leg weakness that had resulted in him falling
twice. Ex. 2 at 58. On examination, he had diminished patellar reflexes. Id. at 62. Dr.
Chiemeke Nwabueze noted concern for GBS, and Petitioner was admitted to the
intensive care unit (“ICU”). Id. at 58.
The same day, Petitioner was evaluated by neurologist Dr. Anthony Torres. Ex. 2
at 31. Petitioner exhibited decreased motor strength bilaterally in his lower and upper
extremities, an absence of reflexes bilaterally in his lower extremities, decreased reflexes
in his upper extremities, and decreased sensation. Id. at 35. He underwent a lumbar
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puncture which showed a slightly elevated protein level. Id. at 69, 183. Following the
lumbar puncture, he had a cerebrospinal fluid leak with migraine headache, which was
treated with a blood patch. Ex. 4 at 17. Dr. Torres ordered a five day course of IVIG and
prescribed gabapentin. Ex. 2 at 31.
By December 25, 2019, Petitioner was no longer in the ICU. Ex. 2 at 88. He had
improved muscle strength in upper and lower extremities, and his pain had improved
significantly with one dose of Toradol. Id. On January 3, 2020, Petitioner was transferred
to an inpatient rehabilitation facility for physical therapy, occupational therapy,
rehabilitative nursing, psychology, and case management support, with a diagnosis of
GBS. Ex. 4 at 754. He was expected to stay there for seven days. Id.
Four days later, however (January 7, 2020), Petitioner’s GBS symptoms
worsened, and he was taken by ambulance back to the hospital. Ex. 4 at 752-53; Ex, 5
at 57. On January 8, 2020, he saw neurologist Dr Robert Sterling, who noted that the
recurrence of symptoms was unexpected for “standard” GBS, and ordered additional lab
work. Ex. 5 at 78. Petitioner reported a pain level of seven out of ten, which was treated
with prescription medications. Id. at 147-48. An EMG performed that day “suggest[ed] the
presence of a sensorimotor peripheral neuropathy, with some suggestion of
demyelinating features.” Id. at 183. Dr. Sterling viewed the EMG as inconclusive, and
recommended a second five-day course of IVIG. Id. at 133.
Following completion of IVIG, Petitioner was transferred back to inpatient
rehabilitation in mid-January 2020. Ex. 5 at 59, 240. He continued to have numbness,
tingling, and burning sensations in his arms and legs, though it had improved since his
second course of IVIG. Ex. 4 at 21. He now exhibited normal strength except for 4 to 4+/5
distal lower extremity weakness. Id. at 25.
Petitioner remained in inpatient rehabilitation from January 15-23, 2020. Ex. 4 at
14. An occupational therapy assessment on January 16th revealed deficits in activities of
daily living, balance, fine motor control, functional mobility, range of motion, trunk control,
gross motor control, strength, and endurance. Id. at 42. At discharge, he could shower,
but needed a cane and precautions to avoid falls. Id. at 16, 19. He was not cleared to
drive. Id. at 19.
Petitioner followed up with his primary care physician, Dr. Diane Kepner, on
January 29, 2020 complaining of weakness, numbness, and issues with proprioception.
Ex. 3 at 11. On examination, he had normal motor strength in upper and lower extremities,
but still walked with a shuffling gait. Id. at 12. He was scheduled to begin outpatient
physical therapy (“PT”). Id. at 11-12.
On February 4, 2020, Petitioner underwent a PT evaluation for GBS, impaired
mobility and activities of daily living, ambulatory dysfunction, bilateral leg weakness, gait
disturbance, and physical deconditioning. Ex. 6 at 30. He was assessed with signs and
symptoms consistent with deconditioning and muscle weakness from GBS. Id. at 32. He
7

Case 1:22-vv-00277-UNJ Document 52 Filed 04/28/25 Page 8 of 13
was unable to work due to his symptoms, which included hand and foot numbness,
weakness, and decreased endurance. Id. He rated his pain three out of ten. Id. at 34. His
treatment plan was two sessions a week. Id. at 32.
Petitioner attended a second PT session on February 11, 2020. Ex. 6 at 16. He
was noted to be highly motivated, but experienced shortness of breath and fatigue,
needing rest breaks. Id. He continued to report pain of three out of ten. Id. He did not
attend any further PT sessions, and following multiple cancellations, he was formally
discharged from PT. Id. at 12. On March 30, 2020, Petitioner returned to Dr. Kepner for
an annual physical examination. Ex. 3 at 4. Dr. Kepner noted that “from [a] gbs standpoint,
[Petitioner] is back to normal.” Id. He did not report dizziness, numbness, or difficulty
walking, or other neurological symptoms, and no neurological examination was
documented. Id. at 5.
Almost a year later, on March 11, 2021, Petitioner was seen by podiatrist David
Baskwill for bilateral foot pain and difficulty walking after sitting for periods of time. Ex. 7
at 5. On examination, he had dyesthesia, hyperesthesia, and paresthesia in his distal
extremities. Id. at 7. He was assessed with idiopathic peripheral neuropathy and casted
for orthotics. Id.
Two years after that (April 3, 2023), Petitioner saw neurologist Dr. Albert Heck
complaining of persistent numbness in his toes. Ex. 11 at 3. Petitioner explained that the
sensation in his toes “never came back” after his GBS. Id. During Petitioner’s 2019-20
hospitalization, Dr. Sterling had suggested that Mr. Piermatteo follow up for tertiary care,
but “apparently that did not happen.” Id. On examination, Petitioner had trace to absent
reflexes. Id. at 7. Dr. Heck noted that GBS is “[u]sually a monophasic illness, [but] there
are patients who have recurrent episodes . . . . It is not unusual for patients to sometimes
have residual sensory symptoms associated with recovery from Guillain-Barré.” Id. at 3.
A repeat EMG was ordered. Id. Petitioner’s June 21, 2023 EMG suggested the presence
of a mild peripheral neuropathy. Ex. 12 at 5. No further medical records have been filed.
IV. Declaration11
Petitioner explains that in order to start a new job with WellSpan, a healthcare
provider, he was required to receive a flu vaccine. Ex. 9 at ¶ 1. Twelve days after
vaccination, he went to the ED with numbness in his legs and arms. Id. He needed a
lumbar puncture before he could receive IVIG, and it “took several attempts before a
puncture was accurately made.” Id. When the GBS diagnosis was confirmed, he was
admitted to the ICU and IVIG was started. Id. For the next three days, he suffered a
migraine from the lumbar puncture, and thus spent those days in darkness. Id. He
11 Although Petitioner labeled Exhibit 9 as an affidavit, it is not notarized. Nonetheless, it is acceptable as a
declaration because it complies with the requirements of 28 U.S.C. §1746.
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received an epidural blood patch – which took two painful attempts – to relieve the pain
from the migraine. Id. He was given morphine because the nerve pain was “unbearable.”
Id.
After completing the first round of IVIG, Petitioner was transferred to an inpatient
rehabilitation hospital. Ex. 9 at ¶ 2. At the time, he still lacked strength in his legs and
arms. Id. After several days there, the numbness in his arms and legs returned and he
was sent back to the hospital for another round of IVIG. Id. Once he completed the second
round of IVIG, he returned to the inpatient rehabilitation facility. Id.
When Petitioner was discharged home from inpatient rehabilitation, he was still
taking morphine for nerve pain. Ex. 9 at ¶ 3. He could walk with a cane, and still did not
have sensation in his feet and legs, and his arms and hands were weak. Id. at ¶ 2. He
started outpatient rehabilitation, and once his arms and legs were strong enough he
stopped going to formal rehabilitation appointments and did his exercises on his own at
home. Id. at ¶ 3.
Petitioner states that he was unable to begin his new job and pay his bills due to
his GBS. Ex. 9 at ¶ 4. If not for the kindness of friends, he “would have lost [his] home.”
Id. He was “far too weak” to work, and fell at home a few times, though without serious
injury. Id. He accidentally burned his hands a few times because he could not feel how
hot dish water was. Id. After this, he weaned himself off of morphine. Id.
Petitioner was told that the feeling may or may not return in his feet and toes. Ex.
9 at ¶ 5. He experienced severe foot pain. Id. After suffering “for several months,” he went
to a podiatrist – who said there was nothing they could do, suggesting only leg, calf, and
foot stretches, which he did. Id.
As of April 2022, when he signed his declaration, Petitioner continued to “live with
terrible pain in [his] feet.” Ex. 9 at ¶ 6. His toes were numb, and his balance was “nowhere
near what it was before December, 2019.” Id. He had to be careful going down stairs
because he could not fully feel when his foot hit the step. Id. He could no longer play
volleyball and golf at the level he could before his GBS due to his balance deficits. Id.
V. The Parties’ Arguments
Petitioner requests an award of $185,000.00 in past pain and suffering. Petitioner’s
Damages Brief, filed July 1, 2024, at *6 (“Br.”). Petitioner asserts that he experienced a
severe and continuous injury that precipitated an extended course of treatment that has
never fully restored him to his pre-vaccination state of health. Br. at *8. He argues that
within two weeks of vaccination, he suffered two falls due to bilateral weakness in his
thighs. Id.
Petitioner was hospitalized (including inpatient rehabilitation) for 30 days beginning
just 12 days after vaccination, underwent two rounds of five-day IVIG treatments, a
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lumbar puncture, and intensive physical and occupational therapy. Br. at *8-9. He was
“shuttled back and forth repeatedly” between the hospital and inpatient rehabilitation
center. Id. at *9. Following his hospitalization, he continued to have bilateral leg
weakness, ambulatory dysfunction, gait disturbance, physical deconditioning, and deficits
in his ability to perform activities of daily living. Id. Petitioner asserts that he was “unable
to work for five months,” although the record cited to support this allegation is from
February 4, 2020 (Ex. 6 at 32), and thus does not appear to support an inability to work
much beyond about six weeks. Id. He continued to have foot pain long after his
hospitalization. Id. at *9-10.
Petitioner received the flu vaccine at issue in this case because it was required to
begin a new job. Br. at *10. Due to his illness, however, he was unable to do the work
needed for the job, resulting in “financial hardship, [inability] to pay his bills, and [the need]
to rely on the kindness of friends to prevent him from losing his home.” Id. Petitioner’s
2023 neurology follow up demonstrated continued sensory disturbances and diminished
reflexes. Id. Petitioner has not continued treatment for his GBS “only because his doctor
informed him that, at this stage, there is no further treatment that can be offered to him.”
Id. at *11.
Petitioner cites McCray, Johnson, and Fedewa – all with pain and suffering awards
of $180,000.00 – in support of his requested pain and suffering award.12 Br. at *11-13.
Petitioner asserts that his injury is similar to that of the McCray petitioner, in that both
suffered numbness, balance problems, and an unsteady gait, and both underwent
hospitalization and rehabilitation therapy. Id. at *11-12. However, Petitioner was
hospitalized longer than the McCray petitioner – suggesting a more serious injury, and
thus justifying a greater award. Id.
Similarly, Petitioner argues that the Johnson petitioner was hospitalized for five
days and underwent a five-day course of IVIG, while he was hospitalized for a total of 30
days (including inpatient rehabilitation) and underwent two five-day IVIG treatments. Br.
at *12. Both petitioners were unable to work for a period of time and suffered lasting
effects, although Mr. Piermatteo asserts that his injury has continued for longer. Id. And
the Fedewa petitioner was able to return to work after only three months, with lifting
restrictions, and reported no numbness or weakness after a year and a half. Id. at *13.
Respondent asserts that the medical records demonstrate a less severe course of
GBS, comparatively speaking. Respondent’s Damages Brief, filed Sept. 6, 2024, at *8
(ECF No. 38) (“Resp.”). While some GBS patients require extensive and lengthy
hospitalizations, Mr. Piermatteo was in the hospital for 15 non-consecutive days, and his
12 McCray v. Sec’y of Health & Human Servs., No. 19-0277V, 2021 WL 4618549 (Fed. Cl. Spec. Mstr. Aug.
31, 2021); Johnson v. Sec’y of Health & Human Servs., No. 16-1356V, 2018 WL 5024012 (Fed. Cl. Spec.
Mstr. July 20, 2018); Fedewa v. Sec’y of Health & Human Servs., No. 17-1808V, 2020 WL 1915138 (Fed.
Cl. Spec. Mstr. Mar. 26, 2020).
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inpatient rehabilitation also occurred over 15 non-consecutive days. Resp. at *8-9.
Petitioner underwent two five-day courses of IVIG, took prescription medications, and
attended only two outpatient PT sessions. Id. at *9. Most of his treatment occurred during
the immediate two months after his GBS diagnosis and hospitalization. Id. Importantly, in
March 2020, Petitioner’s primary care physician stated that “from [a] gbs standpoint,
[petitioner] [wa]s back to normal.” Id. at *9 (citing Ex. 3 at 4).
Petitioner then did not seek any medical care for a year, at which point he sought
care for “foot issues that seemed to predate his GBS.” Resp. at *9. Not until another two
years later – April 2023 – did Petitioner return to a neurologist to evaluate toe numbness
that he related to his GBS diagnosis. Id. His EMG showed a mild, but improved, peripheral
neuropathy, and he did not receive GBS-specific treatment. Id. at *9-10.
Respondent argues that Petitioner’s case was less severe than any of the cases
he cites. Resp. at *10. For example, the McCray petitioner suffered more lasting sequela,
such as new onset asthma and pain still treated with medication years after her diagnosis,
was unable to return to her part-time job, and walked with a cane. Id. Although Petitioner
alleged temporary inability to work, he has not substantiated this claim. Id. The Johnson
petitioner was unable to drive or work “for a considerable length of time,” and experienced
ongoing numbness/tingling, decreased sensation, fatigue, and urinary issues. Resp. at
*10. And the Fedewa petitioner had complications relating to his lumbar puncture and his
diagnosis “interfered with his ability to work for months.” Id. at *10-11. Due to these
differences, Respondent proposes a pain and suffering award of $120,000.00 – although
he does not cite any reasoned decisions in support of this sum. Id. at *11.
Petitioner takes issue with Respondent’s characterization of his hospitalization as
“relatively short,” asserting that 30 days – a full month – is “anything but an
inconsequential period of time to be hospitalized, especially when compared to other
Vaccine Program GBS cases.” Petitioner’s Reply, filed Sept. 20, 2024, at *2 (ECF No. 39)
(“Reply”). He notes that he spent “a large portion of that time” in the ICU. Reply at *2.
After 11 days of in the hospital, he was transferred to inpatient rehabilitation. Id. However,
after only four days there, his condition worsened and he was returned to the hospital by
ambulance. Id.
Petitioner asserts that he “suffered grievously for several days in hospital,” followed
by ongoing sequela and recurrent symptoms. Reply at *2. Petitioner acknowledges that
the Fedewa petitioner underwent two lumbar punctures – but asserts that Mr. Fedewa
was only hospitalized for 14 days. Id. at *4. Petitioner acknowledges that no two cases
are exactly the same, but in his view the cases he cites “are truly comparable cases.” Id.
at *3-4.
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VI. Appropriate Compensation for Petitioner’s Pain and Suffering
In this case, awareness of the injury is not disputed. The record reflects that at all
times Petitioner was a competent adult with no impairments that would impact his
awareness of his injury. Therefore, I analyze principally the severity and duration of
Petitioner’s injury.
In performing this analysis, I have reviewed the record as a whole, including the
medical records, declaration, and all assertions made by the parties in written documents
and at the hearing. I considered prior awards for pain and suffering in both SPU and non-
SPU GBS cases and rely upon my experience adjudicating these cases. However, I
ultimately base my determination on the circumstances of this case.
As I said during the hearing, Respondent has not adequately defended his
proposed award with comparable cases. As a result, I rely on Petitioner’s comparables –
which I consider to be fairly good guideposts herein – as a starting point.
In this case, Petitioner underwent intense treatment during the acute phase,
including time spent in the ICU. Although I acknowledge that inpatient rehabilitation
treatment is not the same as hospitalization, it is meaningful that Petitioner had two
rehabilitation stays totaling 11 days in addition to 19 days of hospitalization. However, his
overall course of treatment was not particularly long, and he had few lingering effects by
the six month mark. Although he had some later treatment, it was not significant.
Petitioner had a somewhat unusual course of illness, in that he improved enough
to go to a rehabilitation facility, then worsened and was sent back to the hospital for a
second round of IVIG before returning to rehabilitation. He suffered a complication of his
lumbar puncture that caused migraine, exacerbating his suffering. However, his assertion
that he was unable to work for five months is not well substantiated.
I agree with Petitioner that McCray is particularly similar. Mr. Piermatteo and the
McCray petitioner were hospitalized for similar amounts of time, and underwent
comparable treatment while hospitalized. However, the McCray petitioner had greater
impairments and required more treatment in the months after being discharged, needing
a walker and home-based therapies, and suffered anxiety and panic attacks. In light of
the McCray petitioner’s more significant residual effects, I find Mr. Piermatteo’s award
should be somewhat lower.
Conclusion
For all of the reasons discussed above and based on consideration of the record
as a whole, I find that $170,000.00 represents a fair and appropriate amount of
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compensation for Petitioner’s actual pain and suffering.13 I also find that Petitioner
is entitled to $54,917.29 to satisfy a Medicaid lien.
Based on the record as a whole and arguments of the parties, I award Petitioner
the following:
• A lump sum payment of $170,000.00 to be paid through an ACH deposit to
Petitioner’s counsel’s IOLTA account for prompt disbursement to Petitioner;
and
• A lump sum payment of $54,917.29, representing compensation for satisfaction
of a Pennsylvania Medicaid lien, in the form of a check payable jointly to
Petitioner and:
Department of Human Services – CIS (Reference)#: 464225037
Bureau of Program Integrity/Division of Third Party Liability – Recovery Section
P.O. Box 8486
Harrisburg, PA 17105-8486
Petitioner agrees to endorse the check to the above payee 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.14
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
13 Since this amount is being awarded for actual, rather than projected, pain and suffering, no reduction to
net present value is required. See Section 15(f)(4)(A); Childers v. Sec’y of Health & Human Servs., No. 96-
0194V, 1999 WL 159844, at *1 (Fed. Cl. Spec. Mstr. Mar. 5, 1999) (citing Youngblood v. Sec’y of Health &
Human Servs., 32 F.3d 552 (Fed. Cir. 1994)).
14 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.
13