VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00802
Package ID: USCOURTS-cofc-1_22-vv-00802
Petitioner: Tammy Zollman
Filed: 2022-07-25
Decided: 2024-09-27
Vaccine: influenza
Vaccination date: 2021-09-20
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 45000

AI-assisted case summary:
Tammy Zollman filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) resulting from an influenza vaccine received on September 20, 2021. She claimed the injury was a Table injury, that it occurred within the United States, that she experienced residual effects for more than six months, and that there had been no prior award or settlement. The respondent, the Secretary of Health and Human Services, denied that Ms. Zollman sustained a SIRVA Table injury, denied that the vaccine caused her injury, and denied that her condition was a sequela of a vaccine-related injury. Despite these differing positions, the parties filed a joint stipulation agreeing to settle the case and award compensation. Chief Special Master Corcoran adopted the stipulation as her decision, awarding Ms. Zollman a lump sum of $45,000.00 for all items of damages. This award represents a negotiated settlement of liability and damages claimed under the Vaccine Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00802-0
Date issued/filed: 2024-09-27
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 08/27/2024) regarding 37 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:22-vv-00802-UNJ Document 43 Filed 09/27/24 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-802V
TAMMY ZOLLMAN, Chief Special Master Corcoran
Petitioner, Filed: August 27, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Andrew Donald Downing, Downing, Allison & Jorgenson, Phoenix, AZ , for Petitioner.
Zoe Wade, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On July 25, 2022, Tammy Zollman filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related to vaccine
administration (“SIRVA”), a Table injury, resulting from an influenza (“flu”) vaccine she
received on September 20, 2021. Pet., ECF No. 1. Petitioner further alleges that the
vaccine was administered in the United States, she experienced the residual effects of
her condition for more than six months, and there has been no prior award or settlement
of a civil action for damages on Petitioner’s behalf as a result of her condition. Id.
Respondent denies “that [P]etitioner sustained a SIRVA Table injury; denies that the
vaccine caused [P]etitioner’s alleged shoulder injury, or any other injury; and denies that
her current condition is a sequela of a vaccine-related injury.” Stipulation at 2, ECF No.
36.
1 Because this Decision contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the Decision will be available to anyone with access to the internet. In
accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other
information, the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I
agree that the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2018).

Case 1:22-vv-00802-UNJ Document 43 Filed 09/27/24 Page 2 of 7
Nevertheless, on August 27, 2024, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. I find the stipulation
reasonable and adopt it as my decision awarding damages, on the terms set forth therein.
Pursuant to the terms stated in the attached stipulation, I award the following
compensation:
A lump sum of $45,000.00 in the form of a check payable to Petitioner.
Stipulation at 2. This amount represents compensation for all items of damages
that would be available under Section 15(a). Id.
I approve the requested amount for Petitioner’s compensation. In the absence of
a motion for review filed pursuant to RCFC Appendix B, 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-00802-UNJ Document 43 Filed 09/27/24 Page 3 of 7
Docusign Envelope ID: EF66F288·3334-4E98-BBBC-7039C05341CD
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
TAMMY ZOLLMA ,
Petitioner, No. 22-802V
Chief Special Master Corcoran
V. ECF
SECRETARY OF HEALT H A D
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
I. Tammy Zollman ("petitioner") filed a petition for vaccine compensation under the
ational Vaccine Inju1y Compensation Program, 42 U.S.C. § 300aa-IO to 34 (the "Vaccine
Program"}. The petition seeks compensation for injuries allegedly related to petitioner's receipt
of the influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § 100.3(a)
2. Petitioner received a flu vaccine on September 20, 2021.
3. The flu vaccine was administered within the United States.
4. Petitioner alleges that she sustained a shoulder injury related to vaccine administration
("SIRVA") following receipt of the flu vaccine within the time period set forth in the Table. She
further alleges that she experienced the residual effects of this condition for more than six
months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on her behalf as a result of her alleged inju1y.

Case 1:22-vv-00802-UNJ Document 43 Filed 09/27/24 Page 4 of 7
Docusign Envelope ID: EF66F288-3334-4E98-BBSC-7039C05341CD
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
vaccine caused petitioner's alleged shoulder injury, or any other inju1y; and denies that her
cun-ent condition is a sequela of a vaccine-related injury.
7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry of judgment reflecting a decision consistent with
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21 (a)( I), the Secreta1y of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $45,000.00 in the fo1m of a check payable to petitioner.
This amount represents compensation for all damages that would be available under 42
U.S.C. § 300aa-l 5(a).
9. As soon as practicable after the entry ofjudgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to 42
U.S.C. § 300aa-21 (a)( 1) , and an application, the parties will submit to further proceedings before
the special master to award reasonable attorneys' fees and costs incuned in proceeding upon this
petition.
I 0. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
2

Case 1:22-vv-00802-UNJ Document 43 Filed 09/27/24 Page 5 of 7
Oocusign Envelope 10: EF66F28B-3334-4E98-BB8C-7039C05341 CD
State health benefits programs (other than Title XJX of the Social Security Act (42 U.S.C.
§ I 396 et seq.)), or by entities that provide health services on a pre-paid basis.
11. Payments made pursuant to paragraph 8 and any amounts awarded pursuant to
paragraph 9 of this Stipulation will be made in accordance with 42 U .S.C. § 300aa-l 5(i), subject
to the availability of sufficient statutory funds.
12. The parties and their attorneys further agree and stipulate that, except for any award
for attomey's fees and litigation costs, and past unrcimburscd expenses, the money provided
pursuant to this Stipulation will be used solely for the benefit of petitioner as contemplated by a
strict construction of 42 U.S.C. § 300aa-I 5(a) and (d), and subject to the conditions of 42 U.S.C.
§ 300aa-l 5(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity, and on behalf of her heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
the Secretary of Health and Human Services from any and all actions or causes of action
(including agreements.judgments, claims, damages, loss of services, expenses and all demands
of whatever kind or nature) that have been brought, could have been brought, or could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. § 300aa-l 0 et seq., on account of, or in any way growing out of, any and all
known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from. or alleged to have resulted from, the flu vaccination administered on September 20, 2021,
as alleged in a petition for vaccine compensation filed on or about July 25, 2022, in the United
States Court of Federal Claims as petition No. 22-802V.
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Case 1:22-vv-00802-UNJ Document 43 Filed 09/27/24 Page 6 of 7
Docusign Envelope ID: EF66F28B-3334-4E98-BB8C-7039C05341CO
14. ff petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
15. 1f the special master fails to issue a decision in complete confo,mity with the terms
of this Stipulation or if the Court of Federal Claims fails to enter judgment in confonnity with a
decision that is in complete conformity with the terms of this Stipulation, then the parties'
settlement and this Stipulation shall be voidable at the sole discretion of either party.
16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The pa11ies funhcr agree and understand that the award described in this
Stipulation may reflect a compromise of the parties' respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that petitioner sustained a SIRVA Table injury; that the
flu vaccine caused any other injury; or that her current condition is a sequelae of a vaccine
related injury.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:22-vv-00802-UNJ Document 43 Filed 09/27/24 Page 7 of 7
Docusign Envelope 10: EF66F288-3334-4E98-8B8C-7039C05341 CD
Respectfully submitted,
PETITIONER:
Signed by:
~-✓
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
Downing Allison Jorgenson Deputy Director
3030 N. Central Avenue, 1ite 507 To1ts Branch
Phoenix, AZ 85012 Civil Division
(4 80) 701-0999 U.S. Department of Justice
Email: adowning@daj-law.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALT H RESPONDENT:
AND HUMAN SERVICES:
Jeffrey S. Digitally signed by Jeffrey
S.Beach-5
-5
Be aC h Date: 2024.08.20 11 :58:54
.04•00· for
CAPT GEORGE REED GRIMES, MD, MPH ZOE R. WADE
Director, Division of Inju,y Trial Attorney
Compensation Programs T0 1ts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Department of Justice
Administration P.O. Box 146
U.S. Department of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 Fishers Lane, 08W-25A (202) 616-4118
Rockville, MD 20857 Email: zoe.wade@usdoj.gov
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