VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-00531
Package ID: USCOURTS-cofc-1_23-vv-00531
Petitioner: Roxanne S. Cross
Filed: 2023-04-18
Decided: 2025-11-14
Vaccine: tetanus-diphtheria (Td)
Vaccination date: 2020-09-16
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 10000

AI-assisted case summary:
On April 18, 2023, Roxanne S. Cross filed a petition alleging that a tetanus-diphtheria vaccine administered on September 16, 2020 caused a shoulder injury related to vaccine administration. She alleged a Table SIRVA, or alternatively a shoulder injury caused in fact or significantly aggravated by the Td vaccine, with residual effects lasting more than six months.

Respondent denied that Ms. Cross sustained SIRVA, denied that the Td vaccine caused or significantly aggravated her alleged shoulder injury or any other injury, and denied that her current condition was a sequela of a vaccine-related injury. The public stipulation does not describe the first symptom, onset interval, treatment, imaging, injections, therapy, or functional limitations.

On November 13, 2025, the parties filed a joint stipulation. Chief Special Master Brian H. Corcoran adopted it on November 14, 2025 and awarded Ms. Cross $10,000.00 as a lump sum through counsel's IOLTA account for all damages available under the Vaccine Act. Ms. Cross was represented by Ramon Rodriguez, III of Siri & Glimstad, LLP.

Theory of causation field:
Adult petitioner; Td vaccine September 16, 2020; alleged Table SIRVA/off-Table shoulder injury/significant aggravation. COMPENSATED by stipulation. Respondent denied SIRVA and causation; public text lacks clinical chronology. SM Corcoran November 14, 2025. Award $10,000.00 lump sum. Petition filed April 18, 2023. Attorney: Ramon Rodriguez III.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_23-vv-00531-0
Date issued/filed: 2025-12-15
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 11/14/2025) regarding 55 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:23-vv-00531-UNJ Document 59 Filed 12/15/25 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-0531V
ROXANNE S. CROSS, Chief Special Master Corcoran
Petitioner, Filed: November 14, 2025
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Ramon Rodriguez, III, Siri & Glimstad, LLP, Richmond, VA, for Petitioner.
Katherine Edwards, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On April 18, 2023, Roxanne S. Cross 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”) resulting from a tetanus and diphtheria (“Td”) vaccine received
on September 16, 2020. Petition at 1; Stipulation, filed November 13, 2025, at ¶¶ 2-4.
Petitioner further alleges that the vaccine was administered in the United States, she
experienced 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 her behalf as a result
of her alleged injury. Petition at ¶¶ 4, 18; Stipulation at ¶¶ 3-5. “Respondent denies that
petitioner sustained a SIRVA; denies that the Td vaccine caused or significantly
aggravated petitioner’s alleged shoulder injury, or any other injury; and denies that
petitioner’s current condition is a sequelae of a vaccine-related injury.” Stipulation at ¶ 6.
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-00531-UNJ Document 59 Filed 12/15/25 Page 2 of 7
Nevertheless, on November 13, 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 $10,000.00, 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-00531-UNJ Document 59 Filed 12/15/25 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OUPECIAL MASTERS
r
ROXANNE S. CROSS,
Petitioner, No. 23-531V
Chief Special Master Brian H. Corcoran
v. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES.
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Roxanne S. Cross ("petitioner'') filed a petition for vaccine compensation under the
National Vaccine lnjury Compensation Program, 42 U.S.C. § 300aa-10 to 34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of a tetanus and diphtheria (''Tdj vaccine, which vaccine is contained in the Vaccine Injury
Table (the ''Table"), 42 C.F.R. § 100.3(a)
2. Petitioner received a Td vaccine on September 16, 2020.
3. The vaccine was administered within the United States.
4. Pedtioner alleges that petitioner sustained a shoulder injury related to vaccine
administration (SIRVA) within the time period set forth in the Table following administration of
the vaccine, or in the alternative that her alleged injury was caused-in-fact or significantly
aggravated by the Td vaccine. Petitioner further alleges that petitioner experienced the residual
effects of this condition for more than six months.

Case 1:23-vv-00531-UNJ Document 59 Filed 12/15/25 Page 4 of 7
5. Petitioner represents that there bas been no prior award or settlement of a civil action
for damages on petitioner's behalf as a result of the alleged injury.
6. Respondent denies that petitioner sustained a SIRVA; denies that the Td vaccine
caused or significantly aggravated petitioner's alleged shoulder injury, or any other injury; and
denies that petitioner's current condition is a sequelae 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
compensatjon described in paragraph 8 oft his Stipulation.
8. As soon as practicable after an entry ofj udgment reflecting a decision consistent with
the terms of this Stipulation. and after petitioner bas filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-2I(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of$10,000.00 to be paid through an ACH deposit to petitioner's
counsel's IOLTA account for prompt disbursement to petitioner.
9. As soon as practicable after the entry ofj udgment 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-2I(a)(l), and an application, the parties wi11 submit to further proceedings before
the special master to award reasonable attorneys' fees and costs incurred in proceeding upon this
petition.
10. 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-l 5(g), to the ex.tent that payment has been made or can
reasonably be expected to be made under any St.ate compensation programs, insurance policies,
2

Case 1:23-vv-00531-UNJ Document 59 Filed 12/15/25 Page 5 of 7
Federal or State heaJth 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-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 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-15(a) and (d), and subject to the conditions of4 2 U.S.C.
§ 300aa-l 5(g) and (b).
13. 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 Td vaccination administered on
September 16, 2020, as alleged in a petition for vaccine compensation filed on or about April l 8,
2023, in the United States Court of Federal Claims as petition No. 23-531 V.
3

Case 1:23-vv-00531-UNJ Document 59 Filed 12/15/25 Page 6 of 7
14. Ifp etitioner should die prior to entry ofj udgment, this agreement shall be voidable
upon proper notice to the Court on behalf ofe ither or both of the parties.
15. Ift he special master fails to issue a decision in complete conformity with the tenns
of this Stipulation or ift he 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 ofd amages, 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 Td vaccine 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-00531-UNJ Document 59 Filed 12/15/25 Page 7 of 7
Respectfully submit1cd,
PETITIONER
ROXANNG S. CROSS
AU THORJZED REPRESENT ATJVE
A TIORNEY OF RECORD 1:oR
OF THE ATTORNEY GENERAL:
PETITIONE._· --
~~~ fl-~
HEATHER L. PEARLMAN
RAMO R lJ
Siri & Glimstad, LLP Deputy Director
l l South 12th Street Torts Branch
Richmond, VA 23219 Civil Division
U.S. Department of Justice
804-420·9989
rrodriguez@sirillp.com P.O. Box J46
Benjamin Franklin Station
Washington, DC 20044..0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
Jeffrey 5.
~t~~gnectbyJeffrey
-S
~ ~
Beach Oate:2025.11.0314:13:52 ,
;-0sw ,or
CAPT GEORGE REED GRIMES. MD, MPH THERINEEOwARDS
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, J4 W -J 8 202-742-6374
Rockville, MD 20857 Katherine.Edwards2@usdoj.gov
Dated:' ~ /j ii@ f
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