VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-01917
Package ID: USCOURTS-cofc-1_22-vv-01917
Petitioner: Chelsea Hughes
Filed: 2022-12-29
Decided: 2025-08-25
Vaccine: influenza
Vaccination date: 2020-01-22
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: dismissed
Award amount USD: 

AI-assisted case summary:
Chelsea Hughes filed a petition alleging a shoulder injury related to vaccine administration (SIRVA) from an influenza vaccine received on January 22, 2020. The case was initially processed as a Table claim. However, the Special Master found that the petitioner's pain and symptoms were not limited to the vaccinated shoulder, citing evidence of numbness, tingling, and pain in her hands, arms, face, and neck, as well as a tremor and stuttering tongue. Because the injury did not meet the Table criteria for SIRVA, which requires symptoms to be limited to the affected shoulder, the Table claim was dismissed. The case was transferred out of the Special Processing Unit to allow the petitioner to pursue an off-Table claim for an alternative injury, such as neuropathy or aggravation of existing sickle cell disease, with expert support. The petitioner's Table SIRVA claim was dismissed, but her non-Table claim may proceed.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-01917-0
Date issued/filed: 2026-03-16
Pages: 10
Docket text: arties made.PUBLIC ORDER/RULING (Originally filed: 08/25/2025) regarding 28 Findings of Fact & Conclusions of Law, Order Reassigning Case Special Master. ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on p
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Case 1:22-vv-01917-UNJ Document 33 Filed 03/16/26 Page 1 of 10
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-1917V
CHELSEA HUGHES, Chief Special Master Corcoran
Petitioner,
v. Filed: August 25, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Kirk Tripp William Otto, III, Rawls Law Group, Richmond, VA, for Petitioner.
Katherine Edwards, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING DISMISSING TABLE CLAIM AND TRANSFER ORDER1
On December 29, 2022, Chelsea Hughes filed a petition for compensation under
the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”), alleging that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) – a Table injury – as a result of an influenza (“flu”) vaccine
administered to her on January 22, 2020.3 Pet. at 1, ECF No. 1. The case was assigned
to the Special Processing Unit of the Office of Special Masters (the “SPU”).
For the reasons discussed below, I find it more likely than not that Petitioner’s injury
was not limited to the shoulder in which the vaccine was administered. Petitioner’s Table
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).
3 Petitioner alternatively alleges that her subject flu vaccination was the cause-in-fact of her injury.

Case 1:22-vv-01917-UNJ Document 33 Filed 03/16/26 Page 2 of 10
claim is therefore DISMISSED, and the matter transferred out of SPU for resolution of a
non-Table claim.
I. Relevant Procedural History
Respondent filed his Rule 4(c) Report defending this case on April 15, 2024. ECF
No. 23. In it, he made a number of arguments4 against Petitioner’s ability to establish a
Table SIRVA claim, including that her pain and diminished range of motion (“ROM”) was
not limited to the shoulder in which the subject vaccination was administered. Id. at 10
(internal citations omitted).
After a review of the record and Respondent’s arguments, I issued an Order to
Show Cause, outlining the critical issues related to Petitioner’s ability to satisfy a Table
SIRVA claim (specifically the third QAI criterion for a Table SIRVA) and affording her an
opportunity to submit any additional evidence to remedy these main deficiencies in the
record. ECF No. 24. But I warned Petitioner that my ultimate analysis would start with the
medical record documentation, supplemented by declarations or affidavits. Id. at 5.
In response, Petitioner submitted a status report stating that she “does not have
additional evidence to support her claim that she suffered a Table SIRVA.” ECF No. 26.
As a result, Petitioner requested this matter be removed from SPU so she may determine
(with expert support) whether her subject vaccination caused “an off-Table SIRVA, the
alternative injury of some form of neuropathy manifested by her [p]aresthesia, or
significantly aggravated her existing neuropathy manifested by her [p]aresthesia and/or
Sickle Cell Disease, which had previously led to an instance of [p]aresthesia.” See id.
Respondent requested Petitioner’s SIRVA Table claim be dismissed and the new
causation-in-fact claim be placed on a litigation track. ECF No. 27. The Table claim is
thus now ripe for consideration.
II. Relevant Medical Evidence
I have reviewed all of the medical records and evidence filed to date. Only such
information related to whether Petitioner’s pain was limited to the arm in which the subject
4 While not addressed in this Ruling, Respondent relatedly argued that Petitioner suffered from another
condition or abnormality that could explain her post vaccination shoulder symptoms better than the subject
vaccination. ECF No. 23 at 11 (internal citations omitted). Respondent also argued Petitioner cannot
demonstrate that the onset of her symptoms occurred within 48-hours of her receipt of the subject
vaccination or that she suffered from reduced range of motion consistent with a Table SIRVA. Id. at 8, 10.
More so, he contended that Petitioner has not provided evidence to establish causation-in-fact and/or
significant aggravation claims. See id. at 12-14. Finally, he asserted that Petitioner cannot establish the
Act’s six-month severity requirement. Id. at 15-17. Although this is a threshold requirement, Respondent
inexplicably addressed it last in his Rule 4(c) Report. See id.
2

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vaccination was administered will be discussed herein, though other facts may be
included as necessary.
Petitioner received the subject vaccination in her left deltoid on January 22, 2020,
while at a visit at her primary care provider (“PCP”)’s office. Ex. 3 at 76.
On March 9, 2020, Petitioner saw her PCP with a chief complaint of “[l]eft
arm/finger numbness.” Ex. 3 at 68. During a physical examination, Petitioner reported
specifically “[n]umbness/tingling [in the] (hands bilat[erally], and left arm),” plus “[l]eft face
paresthesias” which “began after [a] flu shot.” Id. at 68-69. And she did not mention left
shoulder complaints during that visit (instead merely reporting left arm pain).
Petitioner had a telehealth appointment with her PCP on May 15, 2020. Ex. 3 at
59. Petitioner reported “left shoulder pain after flu shot 1/22/20” and “[p]aresthesias left
left [sic] 1, 2 fingers.” Id. at 60. Under the “physical examination” section (though
performed via video), the PCP noted tenderness of the left rotator cuff and “paresthesias
left 1, 2 finger [sic].” Id. The PCP assessed Petitioner with pain in the left shoulder, pain
in the left shoulder joint, and left hand paresthesias – for which an orthopedic consult and
carpal tunnel splint were recommended. Id. at 60-61.
Similarly, during Petitioner’s PCP follow-up visit on June 15, 2020, she reported
“[l]eft shoulder pain [and] paresthesias since 2/20,” specifically in the bilateral upper
extremities and left hand. Ex. 3 at 56. She also endorsed “[n]umbness [and] tingling [in
the] hand[,]” pain with raising the left shoulder, and “[p]aresthesias [that] extend[ed] to
[her] neck.” Id. at 57. A physical examination showed tenderness to the “paracervical
area, left” neck. Id. The PCP’s diagnoses included pain in the left arm, left arm
paresthesias, and neck pain. Id. at 57-58. Based on these symptoms, Petitioner’s PCP
recommended consultations for “[carpal tunnel syndrome] vs. cervical radiculopathy
(failed carpal tunnel splint).” Id. at 58.
Six months later, when Petitioner followed up with her PCP on December 21, 2020,
during a “review of systems” Petitioner complained of “persistent pain since flu shot right
shoulder.” Ex. 3 at 53-54 (emphasis added). Despite this entry, a physical examination
revealed tenderness of the left deltoid. Id. at 54 (emphasis added). The visit diagnoses
included “left arm paresthesias.” Id. Petitioner underwent x-rays of the left shoulder and
left humerus; both were unremarkable. Id. at 55, 126-27.
During a February 22, 2021 PCP follow-up visit, Petitioner reported “[p]ersistent
left shoulder pain /13 months [status post] flu shot.” Ex. 3 at 45. She also noted the pain
3

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“[r]adiates to [the] left hand[,]” she had a “tremor,” and “neck pain.” Id. Petitioner’s PCP
recommended treatment with both a neurologist and an orthopedist. Id. at 46.
Following another six-month gap in care, Petitioner had another telehealth visit
with her PCP on August 25, 2021. Ex. 3 at 40. Petitioner complained of left shoulder pain,
as well as “[l]eft side face, neck, shoulder, arm weakness[,]” a tremor in the left arm, and
a stuttering tongue, “[s]ince flu shot 1/20 left deltoid.” Id. at 40-41. She noted she was
“concerned about sirva [sic]” and also had “left facial numbness x 2 months.” Id. at 41. A
musculoskeletal examination showed tenderness to the left paracervical area (neck), a
left hand tremor, and left facial numbness. Id. at 42. The PCP ordered Petitioner to
undergo MRIs of the cervical spine; Petitioner did so as ordered. Id. at 43, 123.
On September 2, 2021, Petitioner had another telehealth visit with her PCP. Ex. 3
at 37. The reason for the visit was listed as “left shoulder pain, left neck pain, [and] left
facial pain.” Id. In addition, she also complained of “left arm pain.” Id. at 38. A
musculoskeletal examination was consistent with “[p]ain [in] left face, neck, shoulder.” Id.
The visit diagnoses included left shoulder pain, left arm pain, and neck pain; the PCP
again recommended consultations with neurology and orthopedics. Id. at 38-39.
A month later, on October 4, 2021, Petitioner returned to her PCP (via an audio-
only telehealth visit). Ex. 3 at 34. She again complained of left shoulder pain, left neck
pain, and left facial pain. Id. Petitioner also noted a tremor in both hands (left worse than
the right), as well as “[p]aresthesias left face, arm.” Id. at 35. A physical examination
(performed via audio) was consistent with left hand and arm weakness, diminished
forward flexion in the left shoulder, and a “tremor in the left greater than right hand.” Id.
An October 27, 2021 repeat MRI of the cervical spine was “[s]clerotic” and showed an
“indeterminate bone lesion in the C5 vertebral body[,]” which Petitioner’s PCP felt “most
likely represent[ed] a bone infarct and is related to [Petitioner’s pre-existing] sickle cell
disease.”5 Id. at 121-22.
During a March 23, 2022 PCP follow-up telehealth visit, Petitioner complained of
“[l]eft shoulder, left neck pain, left facial pain.” Ex. 3 at 28. She also reported left arm pain
and tremors. Id. at 29. A physical examination showed cervical/neck tenderness, left
shoulder tenderness, and paresthesias in the left hand. Id. at 29-30. The diagnoses for
this visit included left hand and arm paresthesias, atypical facial pain, and an unspecified
tremor. Id. at 30. The PCP again recommended Petitioner consult with neurology and
5 Petitioner’s relevant medical history indeed includes sickle cell disease. Ex. 6 at 4. For instance, in
December 2018 (pre vaccination), Petitioner experienced symptoms that were suspected to be related to
a sickle cell “crisis” including generalized paresthesias in all limbs, plus right hip pain. Ex. 5 at 204.
4

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orthopedics, undergo another cervical-spine MRI, and noted that “Sirva [sic] forms [were]
to be completed.” Id.
Petitioner’s repeat cervical-spine MRI (performed on April 8, 2022), was consistent
with the previous findings and showed no significant changes. Ex. 3 at 119. She thereafter
returned to her PCP on April 28, 2022, with ongoing complaints of “[n]eck pain, left
shoulder pain, paresthesias left.” Id. at 25. The PCP’s assessment of pain in the left arm
and shoulder, plus “left arm paresthesias” remained unchanged, and the treater reiterated
the proposal to seek care with specialists. Id. at 26-27.
On June 3, 2022, Petitioner saw her PCP and reported “[n]eck pain, left shoulder
pain, left arm paresthesisa [sic], left facial pain, tremor.” Ex. 3 at 22. She also endorsed
“[p]ersistent left neck, shoulder pain, left arm paresthesias.” Id. at 23. Upon physical
examination, Petitioner exhibited “minimal” left neck tenderness, diminished ROM,
paresthesias in the left arm and hand, and a slight left upper extremity tremor. Id. at 23-
24. The PCP’s assessment of Petitioner remained unchanged and included atypical facial
pain, left arm and hand paresthesias, neck pain, left shoulder pain, and an unspecified
tremor. Id. at 24. The treater noted that Petitioner “request[ed a] summary medical letter
and supporting documents to submit to siva [sic].” Id. No other medical records related to
Petitioner’s left shoulder symptoms have been filed.
III. Declaration Evidence
In her signed declaration, Petitioner recalls that the day following her subject flu
vaccination, she called her PCP to tell him that her “arm was swollen, sore with sharp
pains and [she] could not sleep on [her] left side.” Ex. 1 at 1. She explains that by her first
post-vaccination visit, she “could no longer feel [her] thumb . . . or use [her] thumb to
properly pick up things or write, not being able to feel hot or cold water.” Id. She also
notes that her “fingers lock out when [she does] things like holding something, moving or
opening a door and making phone calls.” Id. Petitioner states that her arm “is still
swollen[,]” and her “fingers get numb and swollen, [her] fingers lock and arm stings, [her]
left arm is limp, sore and shakes.” Id. at 2. She notes that after her flu vaccination, she
“lean[s] to the left and [her] arm shakes with spasms.” Id.
Petitioner’s husband submitted a signed declaration on Petitioner’s behalf. Ex. 2.
Petitioner’s husband recalls that she experienced pain “in her whole arm.” Id. at 2.
According to her husband, Petitioner also had “muscle spasms along with a numbing
sensation in her arm.” Id. No other declaration evidence regarding Petitioner’s left
shoulder symptoms has been submitted.
5

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IV. Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
Section 11(c)(1). In addition to requirements concerning the vaccination received, the
duration and severity of petitioner’s injury, and the lack of other award or settlement,6 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).
Section 11(c)(1) also contains requirements concerning the type of vaccination
received and where it was administered, the duration or significance of the injury, and the
lack of any other award or settlement. See Section 11(c)(1)(A), (B), (D), and (E). With
regard to duration, a petitioner must establish that he suffered the residual effects or
complications of such illness, disability, injury, or condition for more than six months after
the administration of the vaccine. Section 11(c)(1)(D).
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 an influenza vaccine. 42 C.F.R. § 100.3(a)(XIV)(B). 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;
(iii) Pain and reduced range of motion are limited to the shoulder in which
the intramuscular vaccine was administered; and
6 In summary, a petitioner must establish that she 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 her injury for more than six months, died from her 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 § 11(c)(1)(A)(B)(D)(E).
6

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(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).
A special master must consider, but is not bound by, any diagnosis, conclusion,
judgment, test result, report, or summary concerning the nature, causation, and
aggravation of petitioner’s injury or illness that is contained in a medical record. Section
13(b)(1). “Medical records, in general, warrant consideration as trustworthy evidence.
The records contain information supplied to or by health professionals to facilitate
diagnosis and treatment of medical conditions. With proper treatment hanging in the
balance, accuracy has an extra premium. These records are also generally
contemporaneous to the medical events.” Cucuras v. Sec’y of Health & Hum. Servs., 993
F.2d 1525, 1528 (Fed. Cir. 1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Hum. Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, the
Federal Circuit has recently “reject[ed] as incorrect the presumption that medical records
are always accurate and complete as to all of the patient’s physical conditions.” Kirby v.
Sec'y of Health & Hum. Servs., 997 F.3d 1378, 1383 (Fed. Cir. 2021). Medical
professionals may not “accurately record everything” that they observe or may “record
only a fraction of all that occurs.” Id.
Medical records may be outweighed by testimony that is given later in time that is
“consistent, clear, cogent, and compelling.” Camery v. Sec’y of Health & Hum. Servs., 42
Fed. Cl. 381 at 391 (1998) (citing Blutstein v. Sec’y of Health & Hum. Servs., No. 90-
2808, 1998 WL 408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998). The credibility of the
individual offering such testimony must also be determined. Andreu v. Sec’y of Health &
Hum. Servs., 569 F.3d 1367, 1379 (Fed. Cir. 2009); Bradley v. Sec’y of Health & Hum.
Servs., 991 F.2d 1570, 1575 (Fed. Cir. 1993).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
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The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La Londe
Sec’y of Health & Hum. Servs., 110 Fed. Cl. 184, 204 (2013) (citing § 12(d)(3); Vaccine
Rule 8); see also Burns v. Sec’y of Health & Hum. Servs., 3 F.3d 415, 417 (Fed. Cir.
1993) (holding that it is within the special master’s discretion to determine whether to
afford greater weight to medical records or to other evidence, such as oral testimony
surrounding the events in question that was given at a later date, provided that such
determination is rational).
V. Respondent’s Objections and Findings of Fact
Petitioner’s SIRVA turns on the third QAI requirement – that a petitioner’s pain and
reduced range of motion be shown to be “limited to the shoulder in which the
intramuscular vaccine was administered.” 42 C.F.R. § 100.3(c)(10)(iii).
Respondent argues that Petitioner’s pain was not limited to her vaccinated
shoulder. ECF No. 23 at 10. And as I noted in my Order to Show Cause (ECF No. 24),
there is ample record evidence of pain outside of the vaccinated shoulder. For instance,
during a physical examination on March 9, 2020, Petitioner complained of “[l]eft arm/finger
numbness,” specifically “[n]umbness/tingling [in the] (hands bilat[erally], and left arm),”
plus “[l]eft face paresthesias” which “began after [a] flu shot.” Ex. 3 at 68-69. And she did
not mention left shoulder complaints during that visit (instead reporting left arm pain).
There is also a record of Petitioner’s first post-vaccination visit when left shoulder
pain was in fact reported (on May 15, 2020). But at this time, she also complained of
“[p]aresthesias [in the] left left [sic] 1, 2 fingers.” Ex. 3 at 60. The assessment included
pain in the left shoulder and left hand paresthesias – for which a carpel tunnel splint was
recommended. Id. at 61. Similarly, during her follow-up visit on June 15, 2020, she
reported “[l]eft shoulder pain [and] paresthesias[,]” specifically in the bilateral upper
extremities and left hand. Id. at 56. She also endorsed “[n]umbness [and] tingling [in the]
hand” and “[p]aresthesias [that] extended to [her] neck.” Id. at 57. Based on these
symptoms, Petitioner’s PCP recommended consultations for “[carpal tunnel syndrome]
vs. cervical radiculopathy (failed carpal tunnel splint).” Id. at 58.
Other entries in Petitioner’s medical records also describe symptoms outside of
her left shoulder area. See, e.g., Ex. 3 at 54 (a December 21, 2020 report of “persistent
pain since flu shot [in the] right shoulder”) (emphasis added); id. at 45 (a February 22,
2021 report of “[p]ersistent left shoulder pain . . . [that] radiates to [the] left hand” with a
tremor and neck pain); id. at 41 (an August 25, 2021 report of “[l]eft side face, neck,
shoulder, arm weakness, [t]remor left arm, [and a] [s]tuttering tongue”); id. at 37 (a
8

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September 2, 2021 report of “[l]eft shoulder pain, left neck pain, left facial pain”); id. at 34
(an October 4, 2021 follow up for left shoulder pain, left neck pain, and left facial pain,
plus a bilateral tremor worse in the left hand and paresthesias in the “left face, arm”); id.
at 30 (a March 23, 2022 note of “[p]ersistent left shoulder, arm, hand paresthesias, , [sic]
pain”); id. at 22-23 (a June 3, 2022 complaint of “neck pain, left shoulder pain, left arm
paresthesias, left facial pain, tremor” diagnosed as atypical facial pain, left arm and hand
paresthesias, neck pain, left shoulder pain, and an unspecified tremor). In fact, the entries
in her medical records are consistent with her declaration, wherein she complains of
symptoms including that her “fingers get numb and swollen, [her] fingers lock and [her]
arm stings, [her] left arm is limp, sore and shakes.” Ex. 1 at 2.
In the Program, special masters have found that claims involving musculoskeletal
pain primarily occurring in the shoulder are valid under the Table even if there are
additional allegations of pain extending to adjacent parts of the body. K.P. v. Sec’y of
Health & Hum. Servs., No. 19-65V, 2022 WL 3226776, at *8 (Fed. Cl. Spec. Mstr. May
25, 2022) (holding that “claims involving musculoskeletal pain primarily occurring in the
shoulder are valid under the Table even if there are additional allegations of pain
extending to adjacent parts of the body”). But the gravamen of the third QAI criterion is
intended to “guard against compensating claims involving patterns of pain or reduced
[ROM] indicative of a contributing etiology beyond the confines of a musculoskeletal injury
to the affected shoulder.” Grossmann v. Sec’y of Health & Hum. Servs., No. 18-0013V,
2022 WL 779666, at *15 (Fed. Cl. Spec. Mstr. Feb. 15, 2022).
Thus, special masters balance complaints about shoulder pain, and associated
treatment, against evidence that the overall presentation is more systemic. See, e.g.,
Cross v. Sec’y of Health & Hum. Servs., No. 19-1958V, 2023 WL 120783, at *7 (Fed. Cl.
Spec. Mstr. Jan. 6, 2023) (finding that “despite the notations of pain extending beyond
the shoulder, Petitioner’s injury is consistent with the definition of SIRVA and there is not
preponderant evidence of another etiology”); Werning v. Sec’y of Health & Hum. Servs.,
No. 18-0267V, 2020 WL 5051154, at *10 (Fed. Cl. Spec. Mstr. July 27, 2020) (finding that
a petitioner satisfied the third SIRVA QAI criterion where there was a complaint of
radiating pain, but the petitioner was “diagnosed and treated solely for pain and limited
range of motion to her right shoulder”).
This record is not reflective of circumstances in which a claimant’s treatment
evidence contains only “stray notations” of pain extending beyond the shoulder. See K.P.,
2022 WL 3226776, at *8. Rather, there is evidence that Petitioner initially complained of
(and treatment was proposed for) paresthesias and tremors not specific to or focused on
the left shoulder nor specifically radiating from the shoulder. Overall, the existing medical
record does not consistently reflect a new injury localized to the left shoulder as the
9

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primary complaint, that can be isolated from other incidental complaints of pain,
paresthesias, and/or tremors elsewhere. As a result, Respondent’s localization objections
thus wholly undermine Petitioner’s Table SIRVA claim.
Conclusion
At bottom, it is the overall mix of evidence herein that causes me to find Petitioner’s
Table claim cannot be preponderantly established. Petitioner has not provided
preponderant evidence that her pain and limited ROM were limited to the shoulder in
which subject vaccination was administered. Nevertheless, a non-Table claim for an
alternate injury could be viable, and I therefore do not dismiss the case in its entirety at
this time.7 Rather, the claim is transferred out of SPU for resolution of that form of claim.
Accordingly, Petitioner’s Table SIRVA claim is DISMISSED. Petitioner’s non-Table
claim, however, may proceed. Because of the factual and medical issues to be decided
(requiring amplification via experts), the claim is unlikely to be expeditiously resolved in
SPU; and the time for settlement in SPU has also passed. For this reason, transfer is
appropriate. Pursuant to Vaccine Rule 3(d), the above-captioned case is hereby
transferred out of SPU and reassigned randomly to a Special Master by the Clerk’s
Office. Further proceedings will be determined by the assigned Special Master.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
7 Respondent has also argued that Petitioner cannot establish the Act’s threshold statutory severity
requirement, as her medical records contain two separate six-month gaps in care (one of which being only
four months post vaccination). ECF No. 23 at 15-17. And, despite her PCP’s insistence on seeking
treatment with specialists during those gaps, Petitioner did not, and she has otherwise provided no
explanation for the gaps in care. See id. (internal citations omitted). While not a Finding of Fact per se, my
preliminary view of Respondent’s severity objections is that they will likely prove unsuccessful if further
contested. For instance, the record does not at any time show that Petitioner’s left shoulder pain had
resolved, and, more importantly, upon her return to care on each occasion (post-gap), she related her
ongoing shoulder pain to the subject flu vaccination. See, e.g., Ex. 3 at 40-41, 53-54, 56-58.
10