VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-01662 Package ID: USCOURTS-cofc-1_23-vv-01662 Petitioner: Brenda Smull Filed: 2023-09-27 Decided: 2025-08-15 Vaccine: influenza; COVID-19 (same day, non-Table) Vaccination date: 2021-12-28 Condition: shoulder injury related to vaccine administration (SIRVA) Outcome: compensated Award amount USD: 20000 AI-assisted case summary: On September 27, 2023, Brenda Smull filed a petition alleging that an influenza vaccine administered on December 28, 2021 caused a shoulder injury related to vaccine administration. The stipulation noted that she also received a COVID-19 vaccine that same day, which is not a Vaccine Injury Table vaccine. Respondent denied that Ms. Smull sustained a Table SIRVA, denied that the flu vaccine caused her alleged shoulder injury or any other injury, and denied vaccine-related sequelae. The public stipulation does not describe her first symptom, treatment visits, imaging, injections, therapy, or residual limitations. The parties settled the case by joint stipulation. On August 15, 2025, Chief Special Master Brian H. Corcoran adopted the stipulation and awarded Ms. Smull $20,000.00 as a lump sum. The settlement also released claims relating to the same-day COVID-19 vaccination in the Countermeasures Injury Compensation Program. Theory of causation field: Influenza vaccine December 28, 2021, with same-day COVID-19 vaccine noted as non-Table/CICP countermeasure, allegedly causing SIRVA; adult, exact age not stated. COMPENSATED by stipulation. Respondent denied Table SIRVA, causation, and sequelae; public stipulation lacks clinical chronology. Award $20,000 lump sum. Chief SM Brian H. Corcoran; petition September 27, 2023; decision August 15, 2025. Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_23-vv-01662-0 Date issued/filed: 2025-09-16 Pages: 8 Docket text: PUBLIC DECISION (Originally filed: 08/15/2025) regarding 42 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (nh) Service on parties made. -------------------------------------------------------------------------------- Case 1:23-vv-01662-UNJ Document 43 Filed 09/16/25 Page 1 of 8 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 23-1662V BRENDA SMULL, Chief Special Master Corcoran Petitioner, Filed: August 15, 2025 v. SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent. Christopher Williams, Siri & Glimstad, LLP, New York, NY, for Petitioner. Madylan Louise Yarc, U.S. Department of Justice, Washington, DC, for Respondent. DECISION ON JOINT STIPULATION1 On September 27, 2023, Brenda Smull 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 received on December 28, 2021. Petition at ¶¶ 3, 23; Stipulation ¶¶ 1-4. Petitioner further alleges that she received her vaccination in the United States, 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 his injury. Petition at ¶¶ 3, 19, 22-23; Stipulation at ¶¶ 3-5. “Respondent denies that [P]etitioner sustained a SIRVA Table injury; denies that the vaccine caused [P]etitioner’s alleged shoulder injury, or any other injury; and denies that [Petitioner’s] current condition is a sequela of a vaccine-related injury.” Stipulation at ¶ 6. Nevertheless, on August 14, 2025, the parties filed the attached joint stipulation, stating that a decision should be entered awarding compensation. I find the stipulation 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-01662-UNJ Document 43 Filed 09/16/25 Page 2 of 8 reasonable and adopt it as my decision awarding damages, on the terms set forth therein.3 Pursuant to the terms stated in the attached Stipulation, I award the following compensation: A lump sum of $20,000.00, 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.4 IT IS SO ORDERED. s/Brian H. Corcoran Brian H. Corcoran Chief Special Master 3 The final page of the parties’ stipulation, a Dropbox Sign verification, has been removed from the attached copy of the stipulation. 4 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-01662-UNJ Document 43 Filed 09/16/25 Page 3 of 8 IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS BRENDA SMULL, Petitioner, No. 23-1662V 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. On September 27, 2023, Brenda Smull ("petitioner") filed a petition for vaccine compensation under the National Vaccine Injury 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 an influenza ('flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the "Table"), 42 C.F.R. § 100.3(a) 2. Petitioner received a flu vaccine on December 28, 2021. 1 3. The vaccine was administered within the United States. 1 On December 28, 2021, petitioner also received a COVID-19 vaccine. Vaccines against COVTD-19 are not contained in the Vaccine Injury Table. See 42 U.S.C. § 300aa-l 4 and 42 C.F.R. § 100.3(a). Pursuant to the declaration issued by the Secretary of Health and Human Services under the Public Readiness and Emergency Preparedness Act (42 U.S.C. §§ 247d-6d, 24 7 d-6e ), claims for alleged injuries from COVID-19 countermeasures, including vaccines, may be compensable under the Counte1measures Injury Compensation Program ("CICP"). See 85 Fed. Reg. 15198, 15202 (March 17, 2020). Doc1D:e08f77e14b8b95275c13eaa27bd5e8308d1941a6 Case 1:23-vv-01662-UNJ Document 43 Filed 09/16/25 Page 4 of 8 4. Petitioner alleges that she sustained a shoulder injury related to vaccine administration ("SIRVA") within the time period set forth in the Table. She further alleges that she experienced the residual effects of this condition 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. 6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the vaccine caused petitioner's alleged 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 neve1iheless 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 ft led an election to receive compensation pursuant to 42 U.S.C. § 300aa-2l(a)(l), the Secretaiy of Health and Human Services will issue the following vaccine compensation payment: A lump sum of $20,000.00 to be paid through an ACH deposit to petitioner's counsel's IOL TA account for prompt disbursement to petitioner. This amount represents compensation for all damages that would be available under 42 U.S.C. § 300aa-15(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. 2 Doc ID: e08f77e14b8b95275c13eaa27bd5e8308d1941a6 Case 1:23-vv-01662-UNJ Document 43 Filed 09/16/25 Page 5 of 8 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-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 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 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-15(a) and (d), and subject to the conditions of 42 U.S.C. § 300aa-l 5(g) and (h). 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, (a) 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 hereafter could be timely brought in the Court of Federal Claims, under the Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 et seq., (i) 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 3 Doc ID: e08f77e14b8b95275c13eaa27bd5e8308d1941a6 Case 1:23-vv-01662-UNJ Document 43 Filed 09/16/25 Page 6 of 8 petitioner resulting from, or that may be alleged to have resulted from, the vaccinations administered on December 28, 2021, and (ii) that petitioner has had, no,.v has, or hereafter may have with respect to the injury that gave rise to the petition for vaccine compensation filed on or about September 27, 2023, in the United States Court of Federal Claims as petition No. 23- 1662V: and (b) waives any and all rights to any compensation that may be available under the Countermeasures Injury Compensation Program (CICP), 42 U.S.C. ~ 247d-6e (or an action under 42 U.S.C. § 247d-6d(d)), for a claim alleging that a covered countermeasure, including the COVID-19 vaccination administered on December 28, 2021, on its own or in combination with the flu vaccination also administered on December 28, 2021, caused or seriously aggravated the injuries that were the subject of the petition for vaccine compensation filed on or about September 27, 2023, in the United States Court of Federal Claims as petition 23-1662V, including a SIRVA, for which petitioner will receive compensation pursuant to this Stipulation. ff petitioner has such a claim currently pending with the CTCP, petitioner hereby withdraws such claim for compensation in the CICP. 2 If no claim for compensation has been filed in the CICP as of the date this Stipulation is filed, petitioner waives the right to file a claim as described in this paragraph for compensation in the CICP. 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. 15. If the special master fails to issue a decision in complete confonnity with the terms of this Stipulation or if the Court of Federal Claims fails to enter judgment in confonnity with a 2 After entry of judgment reflecting a decision consistent with the terms of this Stipulation, petitioner agrees that respondent will send this Stipulation to the ClCP as evidence of petitioner's withdrawal of their CICP claim and waiver of any potential compensation under the CTCP. 4 Doc1D:e08f77e14b8b95275c13eaa27bd5e8308d1941a6 Case 1:23-vv-01662-UNJ Document 43 Filed 09/16/25 Page 7 of 8 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 caused petitioner's alleged injury or any other injury or petitioner's current disabilities. 18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's heirs, executors, administrators, successors, and/or assigns. END OF STIPULATION I I I 5 DoclD:e08f77e14b8b95275c13eaa27bd5e8308d1941a6 Case 1:23-vv-01662-UNJ Document 43 Filed 09/16/25 Page 8 of 8 Respectfully submitted, PETITIONER: BRENDA SMULL ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE PETITIONER: OF THE ATTORNEY GENERAL: CH~ c . ~ ~ 4M ~A,~~-<"'"'"- LA.J./l--_ HEATHER L. PEA LM~ ----- SIRI & GLIMST AD LLP Deputy Director 745 Fifth Avenue, Suite 500 Torts Branch New York, NY 10151 Civil Division (929) 58 1-0 I 87 U.S. Department of Justice cwilliams@sirillp.com P.O. Box 146 Benjamin Franklin Station Washington, DC 20044-0146 AUTHORJZED REPRESENT AT IVE ATTORNEY OF RECORD FOR OF THE SECRETARY OF HEALTH RESPONDENT: AND HUMAN SERVICES: George R. Grimes - Digitally signed byGeorgeR. /,AaA.fl~ Ltf<:u c.. Grimes-516 S1 6 i--,~~Lf~ Date: 2025.07.28 13:32:13 -04'00' CAPT GEORGE REED GRIMES. MD, MPH Madylan Yarc Director, Division oflnjury Trial Attorney Compensation Programs Torts Branch Health Systems Bureau Civil Division Health Resources and Se1vices 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 (202) 742-6376 Rockville, MD 20857 madylan.l.yarc@usdoj.gov 6 Doc1D:e08f77e14b8b95275c13eaa27bd5e8308d1941a6 ================================================================================ DOCUMENT 2: USCOURTS-cofc-1_23-vv-01662-cl-extra-11138963 Date issued/filed: 2025-09-16 Pages: 1 Docket text: Supplementary opinion from CourtListener cluster 10672376 -------------------------------------------------------------------------------- In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 23-1662V BRENDA SMULL, Chief Special Master Corcoran Petitioner, Filed: August 15, 2025 v. SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent. Christopher Williams, Siri & Glimstad, LLP, New York, NY, for Petitioner. Madylan Louise Yarc, U.S. Department of Justice, Washington, DC, for Respondent. DECISION ON JOINT STIPULATION1 On September 27, 2023, Brenda Smull 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 received on December 28, 2021. Petition at ¶¶ 3, 23; Stipulation ¶¶ 1-4. Petitioner further alleges that she received her vaccination in the United States, 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 his injury. Petition at ¶¶ 3, 19, 22-23; Stipulation at ¶¶ 3-5. “Respondent denies that [P]etitioner sustained a SIRVA Table injury; denies that the vaccine caused [P]etitioner’s alleged shoulder injury, or any other injury; and denies that [Petitioner’s] current condition is a sequela of a vaccine-related injury.” Stipulation at ¶ 6. Nevertheless, on August 14, 2025, the parties filed the attached joint stipulation, stating that a decision should be entered awarding compensation. I find the stipulation 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). reasonable and adopt it as my decision awarding damages, on the terms set forth therein.3 Pursuant to the terms stated in the attached Stipulation, I award the following compensation: A lump sum of $20,000.00, 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.4 IT IS SO ORDERED. s/Brian H. Corcoran Brian H. Corcoran Chief Special Master 3 The final page of the parties’ stipulation, a Dropbox Sign verification, has been removed from the attached copy of the stipulation. 4 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 IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS BRENDA SMULL, Petitioner, No. 23-1662V 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. On September 27, 2023, Brenda Smull ("petitioner") filed a petition for vaccine compensation under the National Vaccine Injury 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 an influenza ('flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the "Table"), 42 C.F.R. § 100.3(a) 2. Petitioner received a flu vaccine on December 28, 2021. 1 3. The vaccine was administered within the United States. 1 On December 28, 2021, petitioner also received a COVID-19 vaccine. Vaccines against COVTD-19 are not contained in the Vaccine Injury Table. See 42 U.S.C. § 300aa- l 4 and 42 C.F.R. § 100.3(a). Pursuant to the declaration issued by the Secretary of Health and Human Services under the Public Readiness and Emergency Preparedness Act (42 U.S.C. §§ 247d-6d, 24 7d-6e ), claims for alleged injuries from COVID-19 countermeasures, including vaccines, may be compensable under the Counte1measures Injury Compensation Program ("CICP"). See 85 Fed. Reg. 15198, 15202 (March 17, 2020). Doc1D:e08f77e14b8b95275c13eaa27bd5e8308d1941a6 4. Petitioner alleges that she sustained a shoulder injury related to vaccine administration ("SIRVA") within the time period set forth in the Table. She further alleges that she experienced the residual effects of this condition 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. 6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the vaccine caused petitioner's alleged 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 neve1iheless 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 ft led an election to receive compensation pursuant to 42 U.S.C. § 300aa-2l(a)(l), the Secretaiy of Health and Human Services will issue the following vaccine compensation payment: A lump sum of $20,000.00 to 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 under 42 U.S.C. § 300aa-15(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. 2 Doc ID: e08f77e14b8b95275c13eaa27bd5e8308d1941a6 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-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 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 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-15(a) and (d), and subject to the conditions of 42 U.S.C . § 300aa-l 5(g) and (h). 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, (a) 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 hereafter could be timely brought in the Court of Federal Claims, under the Vaccine Injury Compensation Program, 42 U.S .C. § 300aa-10 et seq., (i) 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 3 Doc ID: e08f77e14b8b95275c13eaa27bd5e8308d1941a6 petitioner resulting from, or that may be alleged to have resulted from, the vaccinations administered on December 28, 2021, and (ii) that petitioner has had, no,.v has, or hereafter may have with respect to the injury that gave rise to the petition for vaccine compensation filed on or about September 27, 2023, in the United States Court of Federal Claims as petition No . 23- 1662V: and (b) waives any and all rights to any compensation that may be available under the Countermeasures Injury Compensation Program (CICP), 42 U.S .C. ~ 247d-6e (or an action under 42 U.S .C. § 247d-6d(d)) , for a claim alleging that a covered countermeasure, including the COVID-19 vaccination administered on December 28, 2021, on its own or in combination with the flu vaccination also administered on December 28, 2021, caused or seriously aggravated the injuries that were the subject of the petition for vaccine compensation filed on or about September 27, 2023, in the United States Court of Federal Claims as petition 23-1662V, including a SIRVA, for which petitioner will receive compensation pursuant to this Stipulation. ff petitioner has such a claim currently pending with the CTCP, petitioner hereby withdraws such claim for compensation in the CICP. 2 If no claim for compensation has been filed in the CICP as of the date this Stipulation is filed, petitioner waives the right to file a claim as described in this paragraph for compensation in the CICP. 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. 15. If the special master fails to issue a decision in complete confonnity with the terms of this Stipulation or if the Court of Federal Claims fails to enter judgment in confonnity with a 2 After entry of judgment reflecting a decision consistent with the terms of this Stipulation, petitioner agrees that respondent will send this Stipulation to the ClCP as evidence of petitioner's withdrawal of their CICP claim and waiver of any potential compensation under the CTCP. 4 Doc1D:e08f77e14b8b95275c13eaa27bd5e8308d1941a6 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 caused petitioner's alleged injury or any other injury or petitioner's current disabilities. 18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's heirs, executors, administrators, successors, and/or assigns . END OF STIPULATION I I I 5 DoclD:e08f77e14b8b95275c13eaa27bd5e8308d1941a6 Respectfully submitted, PETITIONER: BRENDA SMULL ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE PETITIONER: OF THE ATTORNEY GENERAL: CH~ c.~~ 4M ~ A , ~~ -<"'"'"- LA.J./l--_ HEATHER L. PEALM~ ----- SIRI & GLIMST AD LLP Deputy Director 745 Fifth Avenue, Suite 500 Torts Branch New York, NY 10151 Civil Division (929) 58 1-0 I 87 U.S. Department of Justice cwilliams@sirillp.com P.O. Box 146 Benjamin Franklin Station Washington, DC 20044-0146 AUTHORJZED REPRESENT AT IVE ATTORNEY OF RECORD FOR OF THE SECRETARY OF HEALTH RESPONDENT: AND HUMAN SERVICES: George R. Grimes - Digitally signed byGeorge R. /,AaA.fl~ Ltf<:u c.. Grimes -516 S16 Date: 2025.07.28 13:32:13 -04'00' i--,~~Lf~ CAPT GEORGE REED GRIMES. MD, MPH Madylan Yarc Director, Division oflnjury Trial Attorney Compensation Programs Torts Branch Health Systems Bureau Civil Division Health Resources and Se1vices 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 (202) 742-6376 Rockville, MD 20857 madylan.l.yarc@usdoj.gov 6 Doc1D:e08f77e14b8b95275c13eaa27bd5e8308d1941a6