VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-00685
Package ID: USCOURTS-cofc-1_23-vv-00685
Petitioner: Dawn Coppersmith
Filed: 2023-05-09
Decided: 2024-11-06
Vaccine: influenza
Vaccination date: 2021-10-30
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 140128

AI-assisted case summary:
Dawn Coppersmith filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on October 30, 2021. She claimed the injury was a Table injury and that its residual effects lasted for more than six months. The respondent, the Secretary of Health and Human Services, reviewed the petition and medical records and conceded that compensation was appropriate. The respondent confirmed that the injury was consistent with SIRVA as defined by the Vaccine Injury Table, noting no prior history of shoulder issues, pain occurring within 48 hours post-vaccination, pain limited to the injection site, and no other identified cause. A ruling on entitlement was issued on April 29, 2024, finding Ms. Coppersmith entitled to compensation. Subsequently, on October 2, 2024, the respondent filed a proffer on award of compensation, proposing $135,000.00 for pain and suffering, $1,241.79 for past unreimbursable expenses, and $3,886.75 for past lost wages. Ms. Coppersmith agreed with these amounts. The Chief Special Master issued a decision awarding a total lump sum of $140,128.54 to Ms. Coppersmith.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_23-vv-00685-0
Date issued/filed: 2024-06-05
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/29/2024) regarding 17 Ruling on Entitlement ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:23-vv-00685-UNJ Document 19 Filed 06/05/24 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-685V
DAWN COPPERSMITH, Chief Special Master Corcoran
Petitioner, Filed: April 29, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Michael Joseph Lang, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On May 9, 2023, Dawn Coppersmith 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”) as a result of an influenza (“flu”) vaccine she received
on October 30, 2021 (a “Table injury”). Petition at 1. Petitioner further alleges that she
suffered the residual effects of her injury for more than six months, and that there has
been no prior award or settlement of a civil action on her behalf as a result of her injury.
See Petition at ¶¶ 13-15. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
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 (2018).

Case 1:23-vv-00685-UNJ Document 19 Filed 06/05/24 Page 2 of 2
On April 26, 2024, Respondent filed his Rule 4(c) report in which he concedes that
Petitioner is entitled to compensation in this case. Respondent’s Rule 4(c) Report at 1.
Specifically, Respondent states that
DICP [Division of Injury Compensation Programs, Department of Health
and Human Services] has reviewed the petition and medical records filed in
this case and has concluded that compensation is appropriate. DICP has
concluded that petitioner’s alleged injury is consistent with SIRVA as
defined by the Vaccine Injury Table. Specifically, petitioner had no history
of pain, inflammation, or dysfunction of her left shoulder prior to vaccination;
pain occurred within 48 hours after receipt of an intramuscular vaccination;
pain was limited to the shoulder in which the vaccine was administered; and
no other condition or abnormality has been identified to explain petitioner’s
shoulder pain.
Id. at 7 (citing 42 C.F.R. § 100.3(a), (c)(10)). Respondent further agrees that “[P]etitioner
suffered the residual effects of her condition for more than six months.” Id.
In view of Respondent’s position and the evidence of record, I find that
Petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
2

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DOCUMENT 2: USCOURTS-cofc-1_23-vv-00685-1
Date issued/filed: 2024-11-06
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 10/02/2024) regarding 25 DECISION Stipulation/Proffer, ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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CaCsaes e1 :12:32-3v-vv-v0-00608658-5U-NUJN J DDooccuummeenntt 3215 F Filieledd 1 101/0/026/2/244 P aPgaeg e1 1o fo 2f 5
Corrected
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-685V
DAWN COPPERSMITH, Chief Special Master Corcoran
Petitioner, Filed: October 2, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Michael Joseph Lang, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On May 9, 2023, Dawn Coppersmith 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”) as a result of an influenza (“flu”) vaccine she received
on October 30, 2021 (a “Table injury”). Petition at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On April 29, 2024, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On October 2, 2024, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $135,000.00 in pain and
suffering, $1,241.79 in past unreimbursable expenses, and $3,886.75 in past lost wages.
Proffer at 1-2. In the Proffer, Respondent represented that Petitioner agrees with the
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).

CaCsaes e1 :12:32-3v-vv-v0-00608658-5U-NUJN J DDooccuummeenntt 3215 F Filieledd 1 101/0/026/2/244 P aPgaeg e2 2o fo 2f 5
proffered award. Id. Based on the record as a whole, I find that Petitioner is entitled to an
award as stated in the Proffer.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $140,128.54 (representing $135,000.00 in pain and suffering,
$1,241.79 in past unreimbursable expenses, and $3,886.75 in past lost wages) in
the form of a check payable to Petitioner. This amount represents compensation for
all damages that would be available under Section 15(a).
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-00685-UNJ Document 31 Filed 11/06/24 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
DAWN COPPERSMITH, )
)
Petitioner, ) No. 23-685V
) Chief Special Master Brian H. Corcoran
v. ) ECF
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
___________________________________ )
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On May 9, 2023, Dawn Coppersmith (“petitioner”) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34
(“Vaccine Act” or “Act”), alleging that she suffered a Shoulder Injury Related to Vaccine
Administration (“SIRVA”), as defined in the Vaccine Injury Table, following administration of
an influenza vaccine she received on October 30, 2021. Petition at 1. On April 26, 2024, the
Secretary of Health and Human Services (“respondent”) filed a Rule 4(c) Report indicating that
this case is appropriate for compensation under the terms of the Act for a SIRVA Table injury,
and on April 29, 2024, the Chief Special Master issued a Ruling on Entitlement finding
petitioner entitled to compensation. ECF No. 16; ECF No. 17.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $135,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:23-vv-00685-UNJ Document 31 Filed 11/06/24 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $1,241.79. See 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
C. Lost Wages
Evidence supplied by petitioner documents that she incurred past lost wages related to
her vaccine-related injury. Respondent proffers that petitioner should be awarded past lost
wages in the amount of $3,886.75. See 42 U.S.C. § 300aa-15(a)(3)(A). Petitioner agrees.
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that the compensation provided to petitioner should be made through a
lump sum payment as described below and requests that the Chief Special Master’s decision and
the Court’s judgment award the following1: a lump sum payment of $140,128.54, in the form of
a check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Dawn Coppersmith: $140,128.54
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
1 Should petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief. In particular, respondent would oppose any award for future,
unreimbursed expenses, future lost earnings and future pain and suffering.
2

Case 1:23-vv-00685-UNJ Document 31 Filed 11/06/24 Page 5 of 5
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
JULIA M. COLLISON
Assistant Director
Torts Branch, Civil Division
s/ Michael J. Lang
MICHAEL J. LANG
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 880-0239
Email: Michael.Lang3@usdoj.gov
Dated: October 2, 2024
3