VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_24-vv-00299
Package ID: USCOURTS-cofc-1_24-vv-00299
Petitioner: Ann Kaiser
Filed: 2024-02-26
Decided: 2026-02-02
Vaccine: influenza
Vaccination date: 2021-10-05
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: entitlement_granted_pending_damages
Award amount USD: 

AI-assisted case summary:
Ann Kaiser filed a petition on February 26, 2024, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine administered on October 5, 2021. The respondent argued that the medical records did not establish that the injury began within 48 hours of vaccination, as required for a Table SIRVA claim. The court reviewed medical records and a declaration from Ms. Kaiser. While Ms. Kaiser had two intervening medical visits without reporting shoulder pain, she did report arm pain approximately four weeks after vaccination, and subsequent records consistently linked her shoulder pain to the flu shot. The court found that the evidence preponderantly supported that the onset of her shoulder pain occurred within 48 hours of vaccination, satisfying the Table criteria. The parties were encouraged to attempt informal resolution regarding settlement or damages, with the court noting the injury appeared mild and likely to result in a modest award. The respondent was ordered to file a status report on how to proceed.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_24-vv-00299-0
Date issued/filed: 2026-02-02
Pages: 7
Docket text: PUBLIC ORDER/RULING (Originally filed: 01/02/2026) regarding 26 Findings of Fact & Conclusions of Law. ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:24-vv-00299-UNJ Document 28 Filed 02/02/26 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 24-299V
ANN KAISER, Chief Special Master Corcoran
Petitioner,
v. Filed: January 2, 2026
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Renee J. Gentry, Vaccine Injury Clinic, George Washington University Law School,
Washington, D.C., for Petitioner.
Alyssa M. Petroff, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING ON ONSET1
On February 26, 2024, Ann Kaiser filed a Petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”), alleging that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered to her on
October 5, 2021. See Pet. at 1, ECF No. 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
For the reasons discussed below, I find it more likely than not that the onset of
Petitioner’s shoulder pain occurred within 48 hours of vaccination, 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 (2018).

Case 1:24-vv-00299-UNJ Document 28 Filed 02/02/26 Page 2 of 7
I. Relevant Procedural History
Though the parties made a tentative effort to settle this claim, they were ultimately
unsuccessful. ECF Nos. 17-18, 20-24. Respondent filed his Rule 4(c) Report on June 9,
2025, arguing that the medical records do not preponderantly establish the alleged injury
began within 48 hours of the subject vaccination, as required for a Table SIRVA. Id. at 6
(internal citations omitted). Petitioner has not filed any documents in response. The issue
of onset is ripe for resolution.
II. Authority
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). “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. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, 2005 WL 6117475, at *19.
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Hum. Servs., 42 Fed. Cl.
381, 391 (1998). The Court later 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, 42
Fed. Cl. at 391 (citing Blutstein v. Sec’y of Health & Hum. Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
2

Case 1:24-vv-00299-UNJ Document 28 Filed 02/02/26 Page 3 of 7
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 § 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. Relevant Factual Evidence
I make this finding of fact after a complete review of the record, including all
medical records, declarations, and additional evidence filed, and in particular the
following:3
(cid:120) Petitioner received the subject flu vaccine in her right deltoid on October 5,
2021, at a local hospital while at a visit with her son. Ex. 1 at 3.
(cid:120) On October 25, 2021 (20 days post vaccination), Petitioner saw her primary
care provider (“PCP”) for an injury to her nose. Ex. 2 at 15. She reported
that her son had “hit her in the nose[;]” she thus had some soreness and
swelling. Id. Petitioner did not report shoulder pain at this visit.
(cid:120) The next day (October 26, 2021), Petitioner went to an ear nose and throat
specialist for consultation regarding a possible nasal fracture. Ex. 8 at 3.
She likewise did not report shoulder complaints at this visit.
(cid:120) Approximately 27 days post vaccination, on November 1, 2021, Petitioner
had a visit with her PCP for a complaint of “pain in the arm.” Ex. 2 at 12.
Petitioner reported she had “a flu shot 4 weeks ago” and the nurse told her
that she ‘“thinks she hit something.’” Id. at 14. Petitioner stated she “has
3 While I have reviewed all the evidence filed to-date in this case, only evidence related to onset will be
discussed herein, though other facts may be provided as necessary.
3

Case 1:24-vv-00299-UNJ Document 28 Filed 02/02/26 Page 4 of 7
had persistent pain,” plus pain with range of motion (“ROM”) and laying on
her side. Id.
(cid:120) Petitioner underwent an MRI of the right shoulder on December 4, 2021.
Ex. 2 at 33. She reported her history of “[l]ateral right shoulder pain since
getting a flu shot two months ago.” Id. The findings were “presumably
related to the recent vaccine administration [(SIRVA)].” Id.
(cid:120) On December 17, 2021, Petitioner had an appointment for right shoulder
and wrist pain with a sports medicine specialist. Ex. 4 at 37. Petitioner
reported the pain had been present “since early October.” Id. She did not
describe an injury, but added that “her pain did start shortly after [sic] . . . .”
Id. The treater’s impression was chronic right shoulder pain, and he referred
Petitioner for physical therapy (“PT”). Id. at 39.
(cid:120) Petitioner began PT on December 23, 2021. Ex. 4 at 62. Petitioner reported
a “2.5 month history of [right] shoulder pain and [dysfunction] following a
vaccine in early October.” Id. at 63. The “mechanism of injury” was listed as
“flu vaccine,” and the “duration” was noted to be “2.5 months.” Id. at 62.
Despite these entries, there is a separate notation listing the onset date as
“12/01/2021.” Id.
(cid:120) On August 19, 2022, Petitioner sought a second opinion with another
orthopedist regarding her shoulder pain. Ex. 5 at 14. Petitioner reported her
“shoulder pain began in October 2021 after she received a flu shot in the
arm.” Id. Petitioner denied previous right shoulder pain “prior to October
2021.” Id. The treater’s assessment included a notation that Petitioner’s
right shoulder pain “started in October 2021 after a flu shot.” Id. at 15.
(cid:120) Petitioner has filed a signed declaration in support of her claim. Petitioner
recalls her October 5, 2021 vaccination being “extremely painful.” Ex. 19 at
1. She states the nurse who administered the shot “may have given it too
high given how much it hurt” and she specifically remembers the nurse
saying, ‘“I think I hit something.”’ Id. In the past, she recalls it “usually takes
a day or two for [her] arm to feel normal.” Id. at 2. As a result, she “expected
[her] arm to improve” but instead it “got worse.” Id. Specifically, she
describes stabbing pain with movement and difficulties with activities of
daily living, including dressing, washing, holding her young son, and with
wearing a backpack while hiking. Id.
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Case 1:24-vv-00299-UNJ Document 28 Filed 02/02/26 Page 5 of 7
(cid:120) Additionally, Petitioner attests that on October 28, 2021, she had a follow-
up appointment for her son in the same doctor’s office where she received
the flu vaccine. Ex. 19 at 2. Petitioner contends that she mentioned her
shoulder pain during this visit, and the “office manager came out . . . and
did a brief examination.” Id. She asserts that the office manager asked the
name of Petitioner’s PCP and advised she would reach out for an
appointment on Petitioner’s behalf. Id. Despite Petitioner’s assertions, there
is no evidence of this encounter in the contemporaneous medical records.
(cid:120) No other medical record or declaration evidence regarding the onset of
Petitioner’s post-vaccination shoulder injury has been filed.
IV. Finding of Fact Regarding Onset
A petitioner alleging a SIRVA claim must show that she experienced the first
symptom or onset of pain within 48 hours of vaccination. 42 C.F.R. § 100.3(a)(XIV)(B);
42 C.F.R. § 100.3(c)(10)(ii) (QAI criteria). As noted, Respondent contends that Petitioner
cannot establish this criterion because she had two intervening medical encounters in the
month of October 2021, without mentioning shoulder pain, and did not complain of right
shoulder pain until nearly one month post-vaccination. Rule 4(c) Report at 6 (internal
citations omitted). And when she did report pain, she did not describe onset within 48
hours of vaccination. Id. Respondent also asserts that Petitioner’s alleged report of her
pain to a treater on October 28, 2021, is unsupported by the records. Id.
The totality of the evidence favors Petitioner’s onset contentions. The
aforementioned medical records establish that Petitioner consistently reported to treaters
onset close-in-time to vaccination, that she sought treatment within one month of the
vaccination, and that she indeed was experiencing symptoms.
The fact that Petitioner sought treatment within one month of the subject
vaccination (on November 1, 2021), actually helps Petitioner in establishing Table-
consistent onset. In other cases, even much greater delays have not undermined an
otherwise-preponderantly-established onset showing consistent with the Table. See, e.g.,
Tenneson v. Sec’y of Health & Hum. Servs., No. 16-1664V, 2018 WL 3083140, at *5 (Fed.
Cl. Spec. Mstr. Mar. 30, 2018), mot. for rev. denied, 142 Fed. Cl. 329 (2019) (finding a
48-hour onset of shoulder pain despite a nearly six-month delay in seeking treatment);
Williams v. Sec’y of Health & Hum. Servs., No. 17-830V, 2019 WL 1040410, at *9 (Fed.
Cl. Spec. Mstr. Jan. 31, 2019) (noting a delay in seeking treatment for five-and-a-half
months because a petitioner underestimated the severity of her shoulder injury). The
delay here is not nearly as long.
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Case 1:24-vv-00299-UNJ Document 28 Filed 02/02/26 Page 6 of 7
In fact, some delay in seeking treatment itself is never per se evidence of a non-
conforming onset. As I have previously noted, SIRVA petitioners often put off seeking
shoulder-related care based on the reasonable assumption that the pain is normal and
will resolve on its own over time, especially since patients are often told by medical
providers at the time of vaccination to expect some soreness and pain. This appears to
have been (at least partially) the case here, with Petitioner explaining that she “expected
[her] arm to improve” within a few days but instead the pain “got worse.” Ex. 19 at 2.
Likewise, the fact that Petitioner sought care on two occasions post-vaccination
without mentioning right shoulder pain does not fully detract from her arguments on onset.
For instance, Petitioner’s visits on October 25-26, 2021, were for an acute issue – a nasal
fracture – and/or were with a specialist for this issue. See, e.g., Ex. 2 at 15 (an October
25th PCP visit for nasal soreness and swelling after being hit in the face by her son); Ex.
8 at 3 (an October 26th visit with an ear, nose, and throat specialist for assessment of a
possible nasal fracture). It was reasonable that Petitioner did not bring up shoulder-
related complaints during those visits.4
In addition, Petitioner affirmatively and repeatedly linked her shoulder pain to the
subject flu vaccine – beginning with the November 1, 2021 treatment encounter, at which
time she reported pain in the right arm after she had “a flu shot 4 weeks ago,” and the
nurse told her that she ‘“thinks she hit something.’” Ex. 2 at 12. Although this entry does
not preponderantly support Table onset on its own, other subsequent medical records
consistently corroborate this entry with more detail and thus provide support for a two-
day onset showing. See, e.g., Ex. 2 at 33 (a December 4, 2021 history taken during an
MRI, stating “[l]ateral right shoulder pain since getting a flu shot two months ago.”); Ex. 4
at 62-63 (a December 23, 2021 PT visit reporting a “2.5 month history of [right] shoulder
pain and [dysfunction] following a vaccine in early October” with a listed mechanism of
“flu vaccine” and a “duration” of “2.5 months.”); Ex. 5 at 14 (an August 19, 2022 orthopedic
visit reporting “shoulder pain [that] began in October 2021 after she received a flu shot in
the arm.”).
Admittedly, at least one of Petitioner’s records suggest an onset beginning at some
unspecified time in “October 2021” without specifically mentioning the flu vaccine. See
Ex. 4 at 37 (a December 17, 2021 report of pain present “since early October” and that
the pain “start[ed] shortly after [sic] . . . .”). But I do not find this evidence alone negates
Petitioner’s earlier reports supportive of an onset around October 5, 2021, as it is
4 More so, I do not find the lack of record support for Petitioner’s contentions regarding her October 28th
examination and affiliated complaints to be dispositive on the issue of onset in light of the existing record.
Specifically, Petitioner still sought care for vaccine-related shoulder complaints approximately four days
later and within one month of vaccination – factors supportive of Table-consistent onset.
6

Case 1:24-vv-00299-UNJ Document 28 Filed 02/02/26 Page 7 of 7
otherwise consistent with her other reports of pain beginning in October 2021 and
provides further support for onset within two days of vaccination.
Finally, while there is one record entry (from Petitioner’s December 23, 2021 PT
visit) containing a notation listing the onset date as “12/01/2021,” this entry is insufficient
to overcome the bulk of evidence that favors Petitioner on onset. In fact, the same record
includes two separate descriptions of her pain being present for “2.5 months,” following a
vaccination in early October. Ex. 4 at 62-63. The contemporaneous medical records thus
establish that the onset of Petitioner’s injury occurred within the timeframe required by
the Table.
Conclusion
Petitioner has provided preponderant evidence that the onset of her shoulder pain
occurred within 48 hours of vaccination.
I encourage the parties to make a final re-attempt at informal resolution (of
settlement or damages). Respondent shall file, by no later than Monday, February
02, 2026, a status report concerning how he intends to proceed, including, if appropriate,
whether he would like to file an amended Rule 4(c) Report or whether he is otherwise
willing to entertain a renewed settlement demand from Petitioner.
In the event Respondent is open to informal resolution of either settlement or
damages, and to aid in those discussions, the parties should keep in mind that the record
supports a mild injury overall, requiring fairly conservative treatment for a limited duration.
Petitioner participated in five PT sessions, received two injections, did not undergo
surgery; and by April 2022, she acknowledged using her rowing machine. See, e.g., Ex.
4 at 43-45, 50-62; Ex. 5 at 14. Petitioner should thus not expect more than a modest
award, even at full value of this case.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
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