VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-00697
Package ID: USCOURTS-cofc-1_23-vv-00697
Petitioner: Jennifer Marie Tate
Filed: 2023-05-10
Decided: 2024-08-14
Vaccine: Tdap
Vaccination date: 2022-08-24
Condition: left shoulder injury related to vaccine administration (SIRVA) and/or brachial neuritis
Outcome: compensated
Award amount USD: 26457

AI-assisted case summary:
Jennifer Marie Tate filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a left shoulder injury related to vaccine administration (SIRVA) and/or brachial neuritis resulting from a tetanus diphtheria acellular pertussis (Tdap) vaccine she received on August 24, 2022. The petition stated that the vaccine was administered in the United States, the residual effects of her injury have persisted for more than six months, and no prior action or compensation had been sought for this injury. Respondent denied that Ms. Tate sustained the alleged injuries or that the Tdap vaccine caused them. Despite these denials, the parties filed a joint stipulation agreeing that a decision should be entered awarding compensation. The Chief Special Master adopted the stipulation, awarding Ms. Tate a lump sum of $25,000.00 and $1,457.56 to reimburse a Medicaid lien for services rendered by the Commonwealth of Pennsylvania. This award represents compensation for all damages available under the Vaccine Act. The case proceeded as a Table claim, and the parties agreed to settle the issues of liability and damages.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_23-vv-00697-0
Date issued/filed: 2024-08-14
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 07/15/2024) regarding 28 DECISION Stipulation/Proffer ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:23-vv-00697-UNJ Document 34 Filed 08/14/24 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-0697V
JENNIFER MARIE TATE, Chief Special Master Corcoran
Petitioner, Filed: July 15, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jimmy A. Zgheib, Zgheib Sayad, P.C., White Plains, NY, for Petitioner.
Katherine Carr Esposito, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On May 10, 2023, Jennifer Marie Tate 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 shesuffered a left shoulder injury related to vaccine
administration (“SIRVA”) and/or brachial neuritis resulting from a tetanus diphtheria
acellular pertussis (“Tdap”) vaccine received on August 24, 2022. Petition at 1;
Stipulation, filed July 15, 2024, at ¶¶ 2-4. Petitioner further alleges that the Tdap vaccine
was administered in the United States, the residual effects of her injury have persisted for
more than six months, and neither Petitioner, nor any other party, has ever filed any
action, or received or accepted compensation in the form of an award or settlement, for
Petitioner’s vaccine-related injury. Petition at ¶¶ 4, 24-26; Stipulation at ¶¶ 3-5.
“Respondent denies that petitioner sustained injuries including SIRVA and/or brachial
neuritis; denies that the Tdap vaccine caused or significantly aggravated petitioner’s
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-00697-UNJ Document 34 Filed 08/14/24 Page 2 of 8
alleged left shoulder injury, or any other injury; and denies that her current condition is a
sequela of a vaccine-related injury.” Stipulation at ¶ 6.
Nevertheless, on July 15, 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) A lump sum of $25,000.00 in the form of a check payable to Petitioner;
and
b) A lump sum of $1,457.56, representing reimbursement of a Medicaid
lien for services rendered to Petitioner by the Commonwealth of
Pennsylvania Department of Human Services.
Petitioner agrees to endorse this check to the Commonwealth of Pennsylvania
Department of Human Services and send it to the following address:
Department of Human Services
Bureau of Program Integrity
Division of Third Party Liability
Recovery Section
Attn: Elyetta E. Knox
P.O. Box 8486
Harrisburg, PA 17105-8486
Stipulation at ¶ 8. These amounts represent 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-00697-UNJ Document 34 Filed 08/14/24 Page 3 of 8
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
JENNIFER MARIE TATE,
Petitioner,
No. 23-697V
Chief Special Master Corcoran
V,
ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
I. Petitioner, Jennifer Marie Tate, filed a petition for vaccine compensation under
the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-l Oto 34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of a tetanus-containing vaccine, which is contained in the Vaccine Injury Table (the "Table"), 42
C.F.R. § I 00.3 (a).
2. Petitioner received a tetanus-diphtheria-acellu lar pertussis ("Tdap") vaccine in her
left deltoid on or about August 24, 2022.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she subsequently developed a shoulder injury related to
vaccine administration ("SIRVA") and/or brachia! neuritis as a result of her vaccination. She
further alleges that she has experienced residual effects of this 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 her behalf as a result of her condition.

Case 1:23-vv-00697-UNJ Document 34 Filed 08/14/24 Page 4 of 8
6. Respondent denies that petitioner sustained injuries including SIRVA and/or
brachial neuritis; denies that the Tdap vaccine caused or significantly aggravated petitioner's
alleged left shoulder injury, or any other injury; and denies that her 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-2l(a)(I), the Secretary of Health and I luman
Services will issue the following vaccine compensation payments:
(a) A lump sum of $25,000.00 in the form of a check payable to petitioner.
(b) A lump sum of $1,457.56, 1 representing reimbursement of a Medicaid Ii en for
services rendered to petitioner by the Commonwealth of Pennsylvania, in the form of a
check jointly payable to petitioner and the Commonwealth of Pennsylvania Department
of Human Services.
Petitioner agrees to endorse this check to the Commonwealth of Pennsylvania
Department of Human Services and send it to the following address:
Department of Human Services
Bureau of Program Integrity
Division of Third Party Liability
Recovery Section
Attn: Elyetta E. Knox
P.O. Box 8486
Harrisburg, PA 17105-8486.
1 This amount represents full satisfaction of any right of subrogation, assignment, claim, lien, or
cause of action the Commonwealth of Pennsylvania may have against any individual as a result
of any Medicaid payments made to or on behalf of petitioner as a result of her alleged vaccine
related injury suffered as a result of the vaccination administered on or about August 24, 2022,
under Title XIX of the Social Security Act, see 42 U.S.C. § 300aa-l 5(g), (h).
2

Case 1:23-vv-00697-UNJ Document 34 Filed 08/14/24 Page 5 of 8
These amounts represent compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
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-21( 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 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-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, 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. Payments rnade 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 attorneys' fees, and litigation costs, 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).
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
3

Case 1:23-vv-00697-UNJ Document 34 Filed 08/14/24 Page 6 of 8
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-IO et seq., on account of, or in any way growing out of, any and all
k11own or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from, or alleged to have resulted from a Tdap vaccine administered on or about August 24, 2022,
as alleged by petitioner in a petition for vaccine compensation filed on or about May 10, 2023, in
the United States Court of Federal Claims as petition No. 23-697V.
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.
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Case 1:23-vv-00697-UNJ Document 34 Filed 08/14/24 Page 7 of 8
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the Tdap vaccine caused petitioner's alleged injury
or any other injury or her current disabilities, 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-00697-UNJ Document 34 Filed 08/14/24 Page 8 of 8
Respectfully submitted,
PETITIONER:
Jen~~1 0, 2024 11:00 COT)
JENNIFER MARIE TATE
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
' l~
• ,4A .1 ~ Qe.u.lJAIV:::::::
HEIB
JI~ HEA TI-IER L. PEARLMAN
Counsel for Petitioner Deputy Director
Zgheib Sayad, P.C. Torts Branch
75 South Broadway, 4th Floor Civil Division
White Plains, NY I 0061 U.S. Department of Justice
Phone: (914) 729-1110 P.O. Box 146
Fax: (914) 729-1134 Benjamin Franklin Station
j im(@.vaccinclawycrs.com Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
Jeffrey S.
Digitally signed by C l.41X'M°O
Jeffrey S. Beach -S I< ~(A..l
-5
Beach Date: 2024.06.25 ~ J..Jt~ LP~~
______ 08·s8·22-04•00· for
CDR GEORGE REED GRIMES, MD, MPH KA THERINE C. ESPOSITO
Director, Division of Injury Trial Attorney
Compensation Programs To1ts Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Depa1tment 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) 305-3774
Rockville, MD 20857 Email: kathcrine.csposito@usdoj.gov
Dated: o:rltsfuz.,.,
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