VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_24-vv-00563
Package ID: USCOURTS-cofc-1_24-vv-00563
Petitioner: Latronda Coble
Filed: 2024-04-11
Decided: 2026-03-03
Vaccine: influenza
Vaccination date: 2022-10-26
Condition: right shoulder injury related to vaccine administration (SIRVA)
Outcome: pending
Award amount USD: 

AI-assisted case summary:
On April 11, 2024, Latronda Coble filed a petition alleging a right shoulder injury related to vaccine administration after an influenza vaccine administered in her right shoulder at work on October 26, 2022. She worked as a labor and delivery nurse at a local hospital.

The parties attempted settlement but could not resolve the case. Respondent argued that the medical records did not prove onset within 48 hours of vaccination. Ms. Coble did not report right shoulder pain at a November 30, 2022 primary-care visit, where she discussed sore finger joints, shortness of breath, and palpitations. But on December 22, 2022, she contacted her PCP reporting continued right arm and shoulder pain since the flu vaccine, radiating to the elbow. A shoulder x-ray was normal.

On January 30, 2023, an orthopedist recorded right shoulder pain and night pain after the October 26 flu vaccine, reduced range of motion, and symptoms consistent with acute impingement; a steroid injection and physical therapy were ordered. At the February 6, 2023 PT evaluation, Ms. Coble reported right shoulder pain and stiffness after the flu shot and said the aching never improved as it normally would after an injection. She attended six PT sessions and reported no pain by February 22. In April her shoulder was doing better and almost gone, but she later returned with neck and shoulder complaints. MRI findings included mild subacromial bursitis and mild acromioclavicular arthritis. By July 2023 she reported doing much better and being able to do more activities.

In her affidavit, Ms. Coble recalled immediate unusual pain with the injection and continuing pain two days later. Chief Special Master Brian H. Corcoran found on March 3, 2026 that onset more likely than not occurred within 48 hours of vaccination. The ruling decided onset only; entitlement and damages were not yet final.

Theory of causation field:
Influenza vaccine in right shoulder on October 26, 2022, allegedly causing right SIRVA; FACT RULING/PENDING, no damages yet. Evidence: workplace vaccination; Dec 22 2022 PCP contact for continued right arm/shoulder pain since flu vaccine; Jan 30 2023 orthopedist found reduced ROM/acute impingement and gave steroid injection; PT Feb 6-22 for pain/stiffness after flu shot; MRI mild subacromial bursitis and mild AC arthritis; affidavit described immediate unusual injection pain and pain two days later. Chief SM Brian H. Corcoran found onset within 48 hours on March 3, 2026. Attorney: Bridget Candace McCullough, Muller Brazil, Dresher PA.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_24-vv-00563-0
Date issued/filed: 2026-04-03
Pages: 8
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/03/2026) regarding 22 Findings of Fact & Conclusions of Law. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:24-vv-00563-UNJ Document 24 Filed 04/03/26 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 24-563V
LATRONDA COBLE, Chief Special Master Corcoran
Petitioner,
v. Filed: March 3, 2026
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Nathaniel Trager, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING ON ONSET1
On April 11, 2024, Latronda Coble 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 right shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered to her on
October 26, 2022. 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-00563-UNJ Document 24 Filed 04/03/26 Page 2 of 8
I. Relevant Procedural History
Though the parties made a tentative effort to settle this claim, they were ultimately
unsuccessful. ECF Nos. 14, 18-20. Respondent filed his Rule 4(c) Report on July 29,
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 5-
6 (internal citations omitted). Petitioner has not filed any documents in response. The
issue of onset is thus 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-00563-UNJ Document 24 Filed 04/03/26 Page 3 of 8
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
• Petitioner received the subject flu vaccine in her right shoulder on October
26, 2022, at her place of employment (i.e., a local hospital where she
worked as a labor and delivery nurse). Ex 1 at 3.
• On November 30, 2022 (thus 35 days post vaccination), Petitioner had a
visit with a primary care physician (“PCP”) to establish a treatment
relationship. Ex. 5 at 7. Petitioner complained of “sore joints in her fingers,”
which began “a couple of months” prior. Id. She also reported shortness of
breath and palpitations. Id. Petitioner made no report of pain in her right
shoulder. See id. at 7-9. The physical examination did not reveal
musculoskeletal edema or other issues. Id. at 8.
• On December 22, 2022, Petitioner contacted her PCP’s office reporting
“having continued pain in her [right] arm/shoulder since getting the flu
vaccine in Sept. [sic].” Ex. 5 at 11. Petitioner also stated that “the pain
radiates down to her elbow.” Id. The PCP gave Petitioner an order for an x-
ray of her shoulder, which was normal. See id.; see also Ex. 4 at 9.
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-00563-UNJ Document 24 Filed 04/03/26 Page 4 of 8
• Petitioner saw an orthopedist on January 30, 2023. Ex. 2 at 21. The visit
notes contain a “reviewed problems” list, including pain of the right shoulder
joint “[o]nset: 01/30/2023” and impingement syndrome of the right shoulder
region “[o]nset: 01/30/2023.” Id. Despite these notations, the
“assessment/plan” for this visit states that Petitioner had “some right
shoulder pain and night pain after a flu vaccine injection on October 26.” Id.
at 22. Petitioner exhibited reduced range of motion (“ROM”) and symptoms
consistent with acute impingement syndrome upon examination. Id. The
orthopedist administered a steroid injection to Petitioner and referred her to
physical therapy (“PT”). Id.
• On February 6, 2023, Petitioner had an initial PT evaluation. Ex. 8 at 21.
The date of onset was listed as “10/26/22.” Id. Petitioner reported “onset of
R shoulder pain and stiffness follow[ing] a flu shot at work on 10/26/2022.”
Id. She also stated that “her achy pain following her injection never
improved as it normally does.” Id. She described the localization of her pain
and noted that it is in the “L [sic] upper arm deltoid with intermittent pain that
radiates to her elbow.” Id. Petitioner attended six PT sessions between
February 6–22, 2023. Id. at 21-36.
• At the final PT session on February 22, 2023, Petitioner stated she had “no
pain. Hasn’t had pain in a while.” Ex. 8 at 27. Petitioner thereafter cancelled
her remaining PT sessions due to “financial reasons.” Id. at 26.
• On April 13, 2023, Petitioner had a follow-up visit with her orthopedist. Ex.
2 at 19. At this visit, she reported her pain was “doing better” and was “pretty
much gone.” Id. at 20. The orthopedist noted that Petitioner’s right shoulder
ROM was “much improved” upon examination and “the tenderness is
basically gone.” Id. Petitioner was instructed to continue with home
exercises and to follow up if needed. Id.
• Approximately six months post-vaccination, on May 4, 2023, Petitioner
returned to her orthopedist with complaints of neck and ongoing right
shoulder pain. Ex. 2 at 17. A physical examination showed positive
impingement and Spurling signs on the right side. Id. at 18. The orthopedist
ordered an MRI of the right shoulder and cervical spine to rule out a cervical
radiculopathy issue. Id.
• Petitioner saw another treater at her orthopedist’s office on May 25, 2023,
to review her recent MRI results. Ex. 2 at 14. The orthopedist noted
4

Case 1:24-vv-00563-UNJ Document 24 Filed 04/03/26 Page 5 of 8
Petitioner’s history in that she “started having symptoms several weeks ago
when she had a flu shot.” Id. The MRI was felt to be consistent with mild
subacromial bursitis and mild acromioclavicular joint arthritis. Id. at 15.
Petitioner’s physical examination showed “excellent” ROM and negative
impingement signs. Id. The orthopedist recommended Petitioner return to
her strengthening program and prescribed Meloxicam, as needed. Id.
• Less than nine months post vaccination, on July 10, 2023, Petitioner
attended her final follow-up visit with her orthopedist. Ex. 2 at 13. She
reported that her shoulder was “doing a lot better” and she was “able to do
more activities than she had been doing.” Id. A physical examination
showed improvement in ROM and “excellent rotator cuff strength.” Id. The
orthopedist recommended Petitioner continue with her strengthening
program and to return if needed. Id.
• In her affidavit (authored in June 2024), Petitioner attests that when she
received the subject vaccination, she “[i]mmediately” thought “this was the
first time [she] ever received a flu vaccine that was unusually uncomfortable
and painful.” Ex. 7 ¶ 5. Petitioner states that her “right shoulder was sore
after the intramuscular injection.” Id. ¶ 6. And, “instead of the pain subsiding,
the pain worsened from that point forward.” Id.
• Petitioner also recalls that “two days after the flu vaccine,” she “still felt pain
and discomfort on the surface and deep into [her] muscle at the injection
site,” plus an achy and throbbing sensation. Ex. 7 ¶ 7. She expected the
pain to resolve as she recalled with previous flu vaccines, but the “achy and
throbbing feeling never subsided.” Id. Thus, activities of daily living (“ADLs”)
became difficult within the week following vaccination; she therefore
scheduled an appointment but had to wait weeks to be seen, as a result of
being a new patient. Id. ¶¶ 9-10.
• No other medical record or affidavit 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). Respondent contends that Petitioner cannot
establish this criterion because her most contemporaneous medical records from 35 days
post-vaccination revealed a normal musculoskeletal physical examination. Rule 4(c)
5

Case 1:24-vv-00563-UNJ Document 24 Filed 04/03/26 Page 6 of 8
Report at 5 (internal citations omitted). And, while she complained of joint pain in her
hands during that visit, she failed to mention right shoulder complaints. Id. Respondent
asserts it is “highly implausible” that a nurse would not have mentioned right shoulder
issues had she been experiencing them for over a month, as alleged in her affidavit. Id.
More so, Respondent asserts that when she did report pain, she did not describe onset
within 48 hours of vaccination. Id. at 6.
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 less than two months
of the vaccination, and that she indeed was experiencing symptoms in the relevant
timeframe.
The fact that Petitioner sought treatment within two months of the subject
vaccination (on December 22, 2022), 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.
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
the pain to resolve as she recalled with previous flu vaccines, but the “achy and throbbing
feeling never subsided.” Ex. 7 ¶ 7.
Likewise, the fact that Petitioner sought care on one occasion post-vaccination
without mentioning right shoulder pain does not fully detract from her arguments on onset.
For instance, Petitioner’s November 30, 2022 PCP visit was to establish care and to
discuss joint pain, as well as acute issues including shortness of breath and heart
palpitations. Ex. 5 at 7. While it would have been somewhat reasonable for Petitioner to
have mentioned right shoulder complaints to this type of general practitioner, especially
6

Case 1:24-vv-00563-UNJ Document 24 Filed 04/03/26 Page 7 of 8
if discussing joint pain in other areas, I do not find this omission to preclude a successful
two-day onset showing. Likewise, although Petitioner had an otherwise-normal
musculoskeletal examination during this visit, I do not find this to be wholly detrimental to
her onset contentions, as the evaluation appears to have looked for edema, rather than
evaluating the features of a SIRVA (i.e., ROM limitations and pain). See id. at 8.
In addition, Petitioner affirmatively and repeatedly linked her shoulder pain to the
subject flu vaccine – beginning with the December 22, 2022, treatment encounter, at
which time she reported “having continued pain in her [right] arm/shoulder since getting
the flu vaccine in Sept. [sic].” Ex. 5 at 11. This entry does not preponderantly support
Table onset on its own, as it contains reference to an incorrect month of vaccination (i.e.,
September versus October), but other subsequent medical records consistently
corroborate this entry with more detail and thus provide support for Table-compliant
onset. See, e.g., Ex. 8 at 21 (a February 6, 2023 PT visit listing onset as “10/26/22” and
describing “onset of R shoulder pain and stiffness follow[ing] a flu shot at work on
10/26/2022 . . . [that] never improved as it normally does.”).
Admittedly, while there is one record entry (from Petitioner’s January 30, 2023
orthopedist visit) containing a notation listing the onset date as the date of that
appointment, “01/30/2023,” it is insufficient to overcome the bulk of evidence that favors
Petitioner on onset. Ex. 2 at 21. In fact, the same record includes a summary that
Petitioner experienced “some right shoulder pain and night pain after a flu vaccine
injection on October 26.” Id. at 22. This record entry is therefore consistent with her other
reports of pain beginning on October 26, 2022, and thus on the same day as her receipt
of the subject vaccination.
At least one of Petitioner’s records suggest an onset beginning at some
unspecified time after a vaccination. See Ex. 2 at 14 (a May 25, 2023 visit with a second
orthopedist noting she “started having symptoms several weeks ago when she had a flu
shot.”). But I do not find this evidence alone negates Petitioner’s earlier reports supportive
of an onset on October 26th, as it is otherwise consistent with her other reports of pain
beginning after a flu vaccination and provides further support for a close-in-time onset.
The contemporaneous medical records thus establish that the onset of Petitioner’s injury
occurred within the two-day timeframe required by the Table.
Conclusion
Petitioner has provided preponderant evidence that the onset of her shoulder pain
occurred within 48 hours of vaccination.
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I encourage the parties to make a final re-attempt at informal resolution (of
settlement or damages). Respondent shall file, by no later than Thursday, April 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 and/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
that likely did not exceed nine months post vaccination. Petitioner participated in six PT
sessions, received one steroid injection (that provided some relief), and did not undergo
surgery. Moreover, by the winter into spring 2023, she reported her shoulder pain had
subsided, was “doing better,” and was “pretty much gone.” See, e.g., Ex. 2 at 19-22; Ex.
8 at 27. Petitioner should thus not expect more than a modest pain and suffering award
(likely not to exceed $50,000.00), 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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