VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-00163
Package ID: USCOURTS-cofc-1_23-vv-00163
Petitioner: Matthew J. Koehler
Filed: 2023-02-06
Decided: 2024-03-22
Vaccine: influenza
Vaccination date: 2020-09-22
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 102500

AI-assisted case summary:
Matthew J. Koehler filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) resulting from an influenza vaccine received on September 22, 2020. He claimed this was a Table injury and that he experienced residual effects for more than six months, with no prior award or settlement. Respondent denied that Mr. Koehler sustained a SIRVA Table injury, denied that the flu vaccine caused his alleged shoulder injury or any other injury, and denied that his current condition was a sequela of a vaccine-related injury. Despite these denials, the parties filed a joint stipulation agreeing that a decision should be entered awarding compensation. The court adopted the stipulation as its decision, awarding Mr. Koehler a lump sum of $102,500.00 as compensation for all items of damages available under the program. This amount represents a settlement of liability and damages claimed under the Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_23-vv-00163-0
Date issued/filed: 2024-03-22
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 02/21/2024) regarding 41 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (ppa) Service on parties made.
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Case 1:23-vv-00163-UNJ Document 47 Filed 03/22/24 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-163V
MATTHEW J. KOEHLER, Chief Special Master Corcoran
Petitioner, Filed: February 21, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Matthew F. Belanger, Faraci Lange LLP, Rochester, NY, for Petitioner.
Dorian Hurley, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On February 6, 2023, Matthew J. Koehler 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 a shoulder injury related to vaccine
administration (“SIRVA”), a Table injury, resulting from an influenza (“flu”) vaccine he
received on September 22, 2020. Pet. at 1, ECF No. 1. Petitioner further alleges that the
vaccine was administered in the United States, he experienced the residual effects of his
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 his condition. Id. at 2, 8.
Respondent denies “that [P]etitioner sustained a SIRVA Table injury; denies that the flu
vaccine caused [P]etitioner’s alleged shoulder injury, or any other injury; denies that
[P]etitioner suffered the residual effects of his injury for more than six months; and denies
that [P]etitioner’s current condition is a sequela of a vaccine-related injury.” Stipulation at
2, ECF No. 40.
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 1:23-vv-00163-UNJ Document 47 Filed 03/22/24 Page 2 of 7
Nevertheless, on February 21, 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 $102,500.00 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 1:23-vv-00163-UNJ Document 47 Filed 03/22/24 Page 3 of 7
IN THE UNITED STA TES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
MATTHEW J. KOEHLER,
Petitioner, No. 23-163V
Chief Special Master Corcoran
v. ECF
SECRETARY OF HEAL TH AND
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
l. Matthew J. Koehler ("petitioner") tiled a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-l0 to 34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of an influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § I00.3(a)
2. Petitioner received a flu vaccine on September 22, 2020.
3. The vaccine was administered within the United States.
4. Petitioner alleges that petitioner suffered a shoulder injury related to vaccine
administration ("SIRVA") within the time period set forth in the Table following administration
of the vaccine. Petitioner further claims that petitioner suffered the residual effects of the alleged
injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on petitioner's behalf as a result of the alleged injury.

Case 1:23-vv-00163-UNJ Document 47 Filed 03/22/24 Page 4 of 7
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the flu
vaccine caused petitioner's alleged shoulder injury, or any other injury; denies that petitioner
suffered the residual effects of his alleged injury for more than six months; and denies that
petitioner's current 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 ofj udgment 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-2l(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of$102,500.00 in the fonn 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 of judgment 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-2 l (a)( I), and an application, the parties will submit to further proceedings before
the special master to award reasonable attorneys' fees and costs incurred in proceeding upon this
petition.
I 0. Petitioner and petitioner's 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,
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Case 1:23-vv-00163-UNJ Document 47 Filed 03/22/24 Page 5 of 7
Federal or State health benefits programs (other than Title XIX of the Social Security Act (42
U.S.C. § 1396 et seq.)), or by entities that provide health services on a pre-paid basis.
11. Payment 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 attorney's fees and litigation costs, and past unreimbursed 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-l 5(a) and (d), and subject to the conditions of 42 U.S.C.
§ 300aa-15(g) and (h).
I 3. In return for the payments described in paragraphs 8 and 9, petitioner, in petitioner's
individual capacity, and on behalf of petitioner's 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-10 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 22, 2020, as alleged in a petition for vaccine compensation filed on or about February
6, 2023, in the United States Court of Federal Claims as petition No. 23-163V.
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Case 1:23-vv-00163-UNJ Document 47 Filed 03/22/24 Page 6 of 7
14. If 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.
I 5. If the special master fails to issue a decision in complete confonnity with the tenns
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity 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 parties further agree and understand that the award described in this
Stipulation may reflect a compromise of the parties' respective positions as to liabi Ii ty 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 the flu vaccine caused petitioner's alleged injury or
any other injury or petitioner's current condition, or that petitioner suffered an injury contained
in the Vaccine Injury Table.
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 1:23-vv-00163-UNJ Document 47 Filed 03/22/24 Page 7 of 7
Respectfully submitted,
PETITIONER:
MATTHEW.i:K
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
,i~ f
'-~ ~¼ -(? ~
MATTHEW F. BEL HEATHER L. PEARLMAN
FARACILANGE,LLP Deputy Director
1882 South Winton Road, Suite 1 Torts Branch
Rochester, New York 14618 Civil Division •
Tel.: (585) 399-6026 U.S. Department of Justice
Email: mbelanger@faraci.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORJZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
George R. Grimes
Digitally signed by George R.
Grimes-$14 ~!JuJ_w
-S 14
Date:2024.01.29 21:21:01-05'00'
~
CDR GEORGE REED GRIMES, MD, MPH DORIAN HURLEY
Director, Division of Injury Trial Attorney
Compensation Programs Torts 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 Tel.: (202) 353-7751
Rockville, MD 20857 Email: Dorian.Hurley@usdoj.gov
Dated: 2 /2 \ / 2 02~
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