VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-00496
Package ID: USCOURTS-cofc-1_23-vv-00496
Petitioner: Yvonne McClay
Filed: 2023-04-11
Decided: 2025-06-18
Vaccine: influenza
Vaccination date: 2020-12-02
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 25000

AI-assisted case summary:
Yvonne McClay filed a petition for compensation under the National Vaccine Injury Compensation Program on April 11, 2023, alleging injury from an influenza vaccine received on December 2, 2020. She claimed to have sustained a shoulder injury related to vaccine administration (SIRVA), which is a condition listed on the Vaccine Injury Table, and that she experienced residual effects for more than six months. The respondent, the Secretary of Health and Human Services, denied that Petitioner sustained a SIRVA Table injury or that the flu vaccine caused her alleged condition. Despite these denials, the parties reached a joint stipulation to settle the case. Pursuant to the stipulation, Chief Special Master Corcoran awarded Yvonne McClay a lump sum of $25,000.00 as compensation for all damages available under the program. This award represents a compromise of the parties' positions on liability and damages. The decision was entered on June 18, 2025, following the parties' agreement on May 12, 2025.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_23-vv-00496-0
Date issued/filed: 2024-04-09
Pages: 7
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/05/2024 ) regarding 19 Findings of Fact & Conclusions of Law,, Scheduling Order, Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:23-vv-00496-UNJ Document 22 Filed 04/09/24 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-0496V
YVONNE MCCLAY, Chief Special Master Corcoran
Petitioner,
v. Filed: March 5, 2024
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Camille Webster, U.S. Department of Justice, Washington, DC, for Respondent.
FINDINGS OF FACT AND CONCLUSIONS OF LAW1
On April 11, 2023, Yvonne McClay 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 left-sided shoulder injury related to
vaccine administration (“SIRVA”), a defined Table injury, after receiving an influenza
(“flu”) vaccine on December 2, 2020. The case was assigned to the Special Processing
Unit (“SPU”) of the Office of Special Masters.
For the reasons discussed below, I find that the flu vaccine was most likely
administered in Petitioner’s left arm, as alleged.
1 Because this ruling contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the ruling will be available to anyone with access to the internet. In accordance
with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,
the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:23-vv-00496-UNJ Document 22 Filed 04/09/24 Page 2 of 7
I. Relevant Procedural History
The Petition was accompanied by the statutorily-required supporting medical
documentation and Petitioner’s own declaration. Exhibits (“Exs.”) 1 – 11. In July 2023, the
case was assigned to the SPU. ECF No. 9. In November 2023, I adopted the parties’
proposed schedule for further proceedings. ECF No. 12. Petitioner subsequently filed
Exs. 12 – 16, ECF No. 14, followed by a Brief setting forth her position regarding the
factual issue of the implicated flu vaccine’s administration site on January 16, 2024. ECF
No. 16.3 Respondent filed a Response on February 26, 2024. ECF No. 17. I have
determined that a factual finding on this issue is required and will assist in the case’s
ultimate disposition.
II. Applicable Legal Standards
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). 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, this rule
does not always apply. “Written records which are, themselves, inconsistent, should be
accorded less deference than those which are internally consistent.” Murphy v. Sec’y of
Health & Hum. Servs., No. 90-882V, 1991 WL 74931, *4 (Fed. Cl. Spec. Mstr. April 25,
1991), quoted with approval in decision denying review, 23 Cl. Ct. 726, 733 (1991), aff'd
per curiam, 968 F.2d 1226 (Fed.Cir.1992)). And the Federal Circuit recently “reject[ed] as
incorrect the presumption that medical records are accurate and complete as to all the
patient’s physical conditions.” Kirby v. Sec’y of Health & Hum. Servs., 997 F.3d 1378,
1383 (Fed. Cir. 2021).
3 Petitioner and the additional witnesses’ statements, see Exs. 1, 12, 14 – 16, are sworn under penalty of
perjury. See 28 U.S.C.A. § 1746 (providing that such a declaration may be afforded “like force and effect”
as an affidavit).
2

Case 1:23-vv-00496-UNJ Document 22 Filed 04/09/24 Page 3 of 7
The United States Court of Federal Claims has outlined four possible explanations
for inconsistencies between contemporaneously created medical records and later
testimony: (1) a person’s failure to recount to the medical professional everything that
happened during the relevant time period; (2) the medical professional’s failure to
document everything reported to her or him; (3) a person’s faulty recollection of the events
when presenting testimony; or (4) a person’s purposeful recounting of symptoms that did
not exist. La Londe v. Sec’y of Health & Hum. Servs., 110 Fed. Cl. 184, 203-04 (2013),
aff’d, 746 F.3d 1335 (Fed. Cir. 2014).
The Court has also said that 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, 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 fact 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.
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, 110 Fed. Cl. at 204 (citing Section 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).
III. Finding of Fact
I have reviewed the record to include all medical records, affidavits,
documentation, briefing, and additional evidence filed. Summarized below is the evidence
most pertinent to my factual finding regarding the site of vaccination.
3

Case 1:23-vv-00496-UNJ Document 22 Filed 04/09/24 Page 4 of 7
• Petitioner received a seasonal flu vaccine nearly every year from 2013-20, with the
site typically recorded as her left deltoid. See generally Ex. 3 at 2 – 6. In 2013 and
again in 2016, she is recorded as having received a flu vaccine in her left deltoid,
plus an additional vaccine in her right deltoid. Id. at 3 – 4, 6.
• On December 2, 2020, a registered nurse at the same primary care practice
administered a flu vaccine and a recombinant zoster vaccine (“RZV,” colloquially
referred to as shingles)4 to Petitioner.5 Ex. 4 at 2. While the nursing note does not
address situs, a computerized immunization history provides that both vaccines
were administered in Petitioner’s right deltoid. Ex. 3 at 3.
• Thirteen (13) days later, on December 15, 2020, Petitioner and her established
primary care physician had a telehealth6 encounter regarding various chronic
conditions. The encounter does not address her recent vaccinations or the
condition of her left shoulder. Ex. 5 at 168 – 69.
• Petitioner and the same physician scheduled another “phone visit” for January 19,
2021. Ex. 9 at 1. There are no medical records confirming that this encounter took
place, however. See generally Exs. 4, 5.7
• During the next telehealth encounter on February 2, 2021, Petitioner reported left
shoulder pain. Ex. 4 at 5. She was concerned “about when got flu and shingles
shots. Wonders if L arm soreness related… Believes L flu and R RZV.” Ex. 4
at 5 (emphasis added). The primary care physician’s objective assessment was
that Petitioner “provide[d] extensively detailed history.” Id. However, he informed
Petitioner that both vaccines were “documented as R deltoid.” Id. Based on the
limited information available (in the telehealth context, lacking any physical exam),
he suspected that Petitioner was suffering from left shoulder impingement, for
which he prescribed oxycodone-acetaminophen and provided instruction on home
exercises. Id.; Ex. 10 at 1. At subsequent appointments, the primary care physician
4 Shingles/ RZV is not listed on the Vaccine Injury Table. See, e.g., Fowler v. Sec’y of Health & Hum. Servs.,
No. 21-1611V, 2023 WL 5952034, at *1 (Fed. Cl. Spec. Mstr. Aug. 17, 2023) (internal citations omitted).
5 Petitioner was 64 years old with no history of left upper extremity pain or dysfunction, or other relevant
medical history according to the parties. Ex. 1 at ¶ 6; Response at 2; see also Ex. 5 at 145 – 167 (pre-
vaccination primary care records). She is noted to be right-handed. See, e.g., Ex. 4 at 69.
6 The primary care practice had imposed a “COVID-19 restriction on number of providers working onsite
simultaneously.” See, e.g., Ex. 5 at 168.
7 But see Ex. 1 at ¶ 10 (Petitioner’s recollection of this being the first date that she informed Dr. Pehling of
“pain and soreness in my left arm that never healed itself after having the flu shot in my left arm”).
4

Case 1:23-vv-00496-UNJ Document 22 Filed 04/09/24 Page 5 of 7
continued to record Petitioner’s complaints of a left shoulder injury caused by a
left-sided flu vaccine administration. See, e.g., Ex. 4 at 11 – 12, 24 – 25, 49 –
50.
• On March 16, 2021, an occupational therapist recorded Petitioner’s history of
“decreased left shoulder ROM due to shingles shot received in Dec. 2020.” Ex. 4
at 14. However, the context was an initial evaluation for treating Petitioner’s chronic
bilateral carpal tunnel syndrome. Id. at 7, 14 - 17.
• At a January 14, 2022, initial evaluation, an orthopedist recorded Petitioner’s
history of left shoulder pain for the past year, “associated with the flu shot
that she received [in her] left shoulder prior to symptomatology. It is the only
thing that she can connect to current symptoms… No known trauma or injury.” Ex.
4 at 55 (emphasis added).
• On March 2, 2022, upon starting physical therapy (“PT”) for her left shoulder,
Petitioner reported that it had been “normal” until her “last flu shot [on…]
12/2/2020.” Ex. 4 at 69, 75 (emphasis added).
• Petitioner declined further flu vaccinations. See, e.g., Ex. 4 at 57.8 She also
declined steroid injections to treat her left shoulder. See, e.g., Ex. 5 at 203,
215, 221, 242; Ex. 7 at 38.
• In April 2023, Petitioner recalled that on December 5, 2020, she had specifically
asked the nurse to administer only one vaccine in each arm. Ex. 1 at ¶ 7. Petitioner
recalled that she received the shingles vaccine in her right arm, first and without
incident. Id. The nurse then administered the flu vaccine in her left arm, which was
followed immediately by “excruciating” pain, which she reported to the nurse. Id.
Petitioner also recalled informing her primary care physician that the medical
record indicating that both vaccines were given in her right shoulder was incorrect,
while seeking treatment for her left shoulder injury. Id. at ¶ 10. She maintains that
she would never “let anyone give me two vaccines in the same arm,” after studying
the subject as part of her college major in medical administration. Id.
• A daughter, two neighbors, and her employer also recall Petitioner’s complaints,
beginning in December 2020, that a left-sided administration of a flu vaccine had
injured her left shoulder. These individuals did not personally observe the
8 Petitioner did receive three vaccine doses to protect against COVID-19 on March 31, April 28, and October
27, 2021 – but their administration site is not recorded. Ex. 4 at 21, 26; Ex. 6 at 12.
5

Case 1:23-vv-00496-UNJ Document 22 Filed 04/09/24 Page 6 of 7
vaccination, but they all observed her left shoulder injury within approximately the
first month thereafter. See generally Exs. 12 – 16.
Respondent correctly observes that the primary care practice’s computerized
immunization history represents that the at-issue flu vaccine was administered in
Petitioner’s non-injured right arm. Respondent further contends that Petitioner “has not
persuasively demonstrated that [this] record is more likely than not an error” - and that to
do so, Petitioner would need a supporting statement from the vaccine administrator, as
seen in the Mezzacapo case. Response at 8, citing Mezzacapo v. Sec’y of Health Servs.,
No. 18-1977, 2021 WL 1940435, at *2 (Fed. Cl. Spec. Mstr. Apr. 19, 2021).
The Act, however, contains no such evidentiary requirement, nor does it otherwise
set forth in black and white the precise evidence required to corroborate a situs of
administration contention. Rather, resolving such issues depends on the mix of evidence
before the special master. In addition (based particularly upon my experience resolving
SPU cases - over 2,000 since my appointment as Chief Special Master), it is not unusual
for the information regarding site of vaccination as set forth in computerized systems to
be incorrect. Many of these systems use a ‘dropdown’ menu which may not be updated
each time a separate vaccine is administered to a different individual. See, e.g.,
Mezzacapo, 2021 WL 1940435, at *6; Desai v. Sec’y of Health & Human Servs., No 14-
0811V, 2020 WL 4919777, at *14 (Fed. Cl. Spec. Mstr. July 30, 2020); Rodgers v. Sec’y
of Health & Human Servs., No. 18-0559V, 2020 WL 1870268, at *5 (Fed. Cl. Spec. Mstr.
Mar. 11, 2020); Stoliker v. Sec’y of Health & Human Servs., No. 17-0990V, 2018 WL
6718629, at *4 (Fed. Cl. Spec. Mstr. Nov. 9, 2018). Thus, although such records are
unquestionably the first-generated documents bearing on issues pertaining to situs, they
are not per se reliable simply because they come first – and in fact the nature of their
creation provides some basis for not accepting them at face value.
This case involves such a computerized record, as well as the administration of
two vaccines on the same day. In previous cases, the practice of vaccine administrators
has been to administer one vaccine in each arm. See, e.g., Rodgers, 2020 WL 1870268,
at *5. Here, Petitioner recalls that she asked to receive one vaccine in each arm on
December 2, 2020 – a credible assertion, especially because it is supported by the
records from her prior vaccination encounters (which Respondent has not challenged).
Also worthy of consideration are the medical records reflecting Petitioner’s
consistently-reported history of a left-sided administration of the flu vaccine, which in her
view, caused her left shoulder injury. While that history was first obtained two months
6

Case 1:23-vv-00496-UNJ Document 22 Filed 04/09/24 Page 7 of 7
post-vaccination,9 it was provided for the purposes of obtaining medical care.10 There is
no evidence to suggest that Petitioner was not acting in good faith, and her primary care
physician’s “objective” assessment was that she was a good historian. And while the four
witnesses did not personally observe the vaccination, their statements somewhat “fill in
the gap” regarding Petitioner’s belief that the flu vaccine was administered on her left
side, contrary to what was initially recorded.
Overall, the evidence does not dictate a finding that on December 2, 2020, both
the shingle and flu vaccines were administered in Petitioner’s right arm. Rather, Petitioner
has presented preponderant evidence that the flu vaccine was instead most likely
administered in her left, subsequently injured arm.
Conclusion and Scheduling Order
Petitioner previously planned to file updated medical records and determine the
components of any potential demand (specifically whether a lien exists). Status Report
filed Dec. 22, 2023 (ECF No. 15). She should be sure to complete those tasks. And
although it is not clear whether Petitioner’s injury meets all criteria for a Table SIRVA,
given my above finding of fact and my preliminary review of the evidence, it would be
appropriate for Petitioner to promptly convey a demand and any necessary supporting
documentation for Respondent’s consideration. Petitioner shall file a status report
updating on her progress by no later than Friday, April 5, 2024.
Respondent previously reported that his medical review was complete, and he
requested to file his Rule 4(c) report within 60 days. Status Report filed Feb. 26, 2024
(ECF No. 18). Accordingly, Respondent shall file the Rule 4(c) Report – or
alternatively, a status report updating on his position and requesting suspension
of the deadline for the Rule 4(c) Report – by no later than Monday, April 29, 2024.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
9 Petitioner’s initial two-month delay in documenting her left shoulder injury and the intervening medical
encounter for unrelated concerns does not render her history of the site of vaccination unreliable. But those
circumstances do suggest that the injury could be self-managed and was less severe than some other
shoulder injuries I have adjudicated – factors relevant to whatever damages might be awarded.
10 The Federal Circuit has stated that “[m]edical records, in general, warrant consideration as trustworthy
evidence . . . [as they] contain information supplied to or by health professionals to facilitate diagnosis and
treatment of medical conditions.” Cucuras, 993 F.2d at 1528 (emphasis added).
7

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DOCUMENT 2: USCOURTS-cofc-1_23-vv-00496-1
Date issued/filed: 2025-06-18
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 05/12/2025) regarding 35 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made.
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Case 1:23-vv-00496-UNJ Document 39 Filed 06/18/25 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-0496V
YVONNE MCCLAY, Chief Special Master Corcoran
Petitioner,
v. Filed: May 12, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Camille Jordan Webster, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On April 11, 2023, Yvonne McClay filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). On December 2, 2020, Petitioner received an influenza (“flu”) vaccine,
which vaccine is listed in the Vaccine Injury Table (the “Table”), 42 C.F.R. § 100.3(a).
Petitioner alleges that she sustained a Table shoulder injury related to vaccine
administration (“SIRVA”) within the time period set forth in the Table following
administration of the vaccine. Petitioner further alleges that she experienced the residual
effects of this condition for more than six months.
1Because this Decision contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the Decision will be available to anyone with access to the internet. In
accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other
information, the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I
agree that the identified material fits within this definition, I will redact such material from public access.
2National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2018).

Case 1:23-vv-00496-UNJ Document 39 Filed 06/18/25 Page 2 of 8
Respondent denies that Petitioner sustained a SIRVA Table injury; denies that the
flu vaccine caused Petitioner’s alleged SIRVA, or any other injury; and denies that
Petitioner’s current condition is a sequela of a vaccine-related injury.
Nevertheless, on May 12, 2025, 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 $25,000.00, to be paid through an ACH deposit to Petitioner’s
counsel’s IOLTA account for prompt disbursement to Petitioner. Stipulation
at ¶ 8. 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-00496-UNJ Document 39 Filed 06/18/25 Page 3 of 8
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
YVONNE MCCLAY,
Petitioner,
v. No. 23-496V
Chief Special Master Corcoran
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Yvonne McClay ("petitioner") filed 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 the influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § J0 0.3(a).
2. Petitioner received a flu vaccination on December 2, 2020. 1
3. The tlu vaccine was administered within the United States.
4. Petitioner alleges that she sustained a Table shoulder injury related to vaccine
administration ("SIRVA") within the time period set forth in the Table following administration
of the vaccine. Petitioner further alleges that she experienced the residual effects of this
condition for more than six months.
1 On December 2, 2020, petitioner also received a shingles vaccine, which is not contained in
the Vaccine Injury Table. See 42 U.S.C. § 300aa-l4 and 42 C.F.R. § 100.3.

Case 1:23-vv-00496-UNJ Document 39 Filed 06/18/25 Page 4 of 8
5. Petitioner represents that there has been no prior award or settlement of a civil
action for damages on his behalf as a result of her condition.
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
flu vaccine caused petitioner's alleged SIRVA, or any other injury; 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 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)(l), the Secretary of Health and Human
Services will issue the following vaccine compensation payment:
A lump sum payment of$2S,000.00 be paid through an ACH deposit to
petitioner's counsel's IOLTA account for prompt disbursement to
petitioner. This amount represents compensation for all damages that
would be available under42 U.S.C. § 300aa-l5(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-21(a)(l), 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.
L0 . 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- l 5(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 1:23-vv-00496-UNJ Document 39 Filed 06/18/25 Page 5 of 8
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.
l l . 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-15(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 attorneys' fees, and litigation costs, and past unreimbursable 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-15(a) and (d), and subject to the
conditions of 42 U.S.C. § 300aa-15(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-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 vaccinations administered on December 2, 2020, as
alleged in a petition for vaccine compensation filed on or about April l I, 2023, in the United
States Court of Federal Claims as petition No. 23-496V.
3

Case 1:23-vv-00496-UNJ Document 39 Filed 06/18/25 Page 6 of 8
14. If petitioner should die prior to entry ofj udgment, this agreement shall be
voidable upon proper notice to the Court on behalf of either or both of the parties.
15. If the special master fails to issue a decision in complete conformity with the
terms 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 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 the flu vaccine or any other vaccination caused
petitioner's alleged SIRVA 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
4

Case 1:23-vv-00496-UNJ Document 39 Filed 06/18/25 Page 7 of 8
Respectfully submitted.
PETittONER:
NNBMCCLAY
ATTORNEY OF RECORD AUTDORIZED REl>RESENTATIVE
FOR PETITIONER: OF TUE ATTORNEY GENERAL:
, .4&i~al·NA~
PEA
HEATBER.L. ~
s.
Jeffrey Pop & Associates Deputy Director
9150 Wilshire Blvd., Suite 241 Torts Branch
Beverly Hills, CA 90212 Civil Division
(310) 273-5462 U.S. Department of Iustice
jpop@poplawyer.<:om P.O.Box 146
Benjainin Franklin Station
Washington, DC 20044--0146
AUTHORIZED REPRESENTATIVE A'ITORNEY OF RECORD FOR
OF TBE SECRETARY OF HEALTH RESPONDENT:
AND HOMAN SERVICES:
J e u u rey $ • . D!gitally aigned by
Jtrmty $.Buch-S
Beach S 1 ,._,Da{t:2025.04.29 for ~ :
-'-'--..;...;;._;----'--------•_. ot50:5i:0,·mt
CAPT GEORGE REED OR.I.MES. MD, MPH AMILLE J. WEBSTER
Director, Division. of I'njucy Trial Attomey
Componsation Programs Torts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S.Departmontofiusticc
Admillistration P.O. Box 146
U.S. Department ofH ealth Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
S600 Fis.hers Lane, 08W-2SA (202) 307-3241
Rockville, MD 20857 Camille.Webster@usdoJ.gov
5

Case 1:23-vv-00496-UNJ Document 39 Filed 06/18/25 Page 8 of 8
ir;-
Dated: 5 { J L{
6