VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_24-vv-01271
Package ID: USCOURTS-cofc-1_24-vv-01271
Petitioner: JUMAR BUSTO
Filed: 2024-08-19
Decided: 2026-03-09
Vaccine: pneumococcal
Vaccination date: 2023-06-19
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 17500

AI-assisted case summary:
Jumar Busto filed a petition for compensation on August 19, 2024, alleging injury from a Prevnar-20 vaccine received on June 19, 2023. Petitioner claimed a shoulder injury related to vaccine administration (SIRVA) within the Table timeframe and residual effects for over six months. Respondent denied that the vaccine caused a Table SIRVA injury or any other injury. Nevertheless, the parties filed a joint stipulation on March 9, 2026, agreeing to settle the case. Chief Special Master Corcoran adopted the stipulation, awarding Petitioner a lump sum of $17,500.00 for all items of damages. This amount is to be paid via ACH deposit to Petitioner's counsel for prompt disbursement.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_24-vv-01271-0
Date issued/filed: 2026-04-09
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 03/09/2026) regarding 26 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 24-1271V
JUMAR BUSTO, Chief Special Master Corcoran
Petitioner,
v. Filed: March 9, 2026
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Rachelle Bishop, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On August 19, 2024, Jumar Busto filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). The petition seeks compensation for injuries allegedly related to
Petitioner’s receipt of a pneumococcal (“Prevnar-20”) vaccine, which vaccine is listed in
the Vaccine Injury Table (the “Table”), 42 C.F.R. § 100.3(a), on or about June 19, 2023.
Petitioner alleges that he sustained a shoulder injury related to vaccine administration
(“SIRVA”) within the time period set forth in the Table. Petitioner further alleges that he
experienced the residual effects of this condition for more than six months.
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 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 2 of 8
Respondent denies that Petitioner sustained a Table SIRVA injury; denies that the
Prevnar-20 vaccine caused Petitioner’s alleged shoulder injury, or any other injury; and
denies that Petitioner’s current condition is a sequela of a vaccine-related injury.
Nevertheless, on March 9, 2026, 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 lump sum of $17,500.00 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.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 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 3 of 8
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
JUMAR BUSTO,
Petitioner, No. 24-1271V
Chief Special Master Corcoran
V. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Jumar Busto ("petitioner") filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §§ 300aa-l O et seq. (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of a pneumococcal ("Prevar-20") vaccine, which is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § 100.3(a).
2. Petitioner received a Prevnar-20 vaccine on June 19, 2023.
3. The vaccine was administered within the United States.
4. Petitioner alleges that he sustained a shoulder injury related to vaccine administration
("SIRVA") within the time period set fo11h in the Table. He fm1her alleges that he 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 his behalf as a result of his alleged injmy.

Case 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 4 of 8
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
Prevanr-20 vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies
that his 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-21(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum payment of$17,500.00 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.
10. Petitioner and his 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.
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Case 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 5 of 8
11. Payment 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 fu1iher agree and stipulate that, except for any award
for attorneys' fees and litigation costs, and past unreimbursable 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-15(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in his
individual capacity, and on behalf of his heirs, executors, administrators, successors or assigns,
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 could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. §§ 300aa-l 0 et seq., 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 petitioner resulting
from, or alleged to have resulted from, the Prevnar-20 vaccine administered on June 19, 2023, as
alleged in a petition for vaccine compensation filed on August 19, 2024, in the United States
Court of Federal Claims as petition No. 24-1271 V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Comi on behalf of either or both of the parties.
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Case 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 6 of 8
15. If the special master fails to issue a decision in complete conformity with the terms
of this Stipulation or if the Cowi 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
patiies hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The paiiies fmiher agree and understand that the award described in this
Stipulation may reflect a compromise of the pa1iies' 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 Prevnar-20 vaccine caused petitioner's alleged
injury or any other injury or his 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
4

Case 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 7 of 8
Respectfully submitted,
PETITIONER:
irilf!iiusTo
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
-&~ \i::Pe ~
HEATHER L. PEARLMAN
JEFFREYS. POP & ASSOCIATES Deputy Director
9150 Wilshire Blvd., Suite 24 l Torts Branch
Beverly Hills, CA 90212 Civil Division
Tel: (310) 273-5462 U.S. Department of Justice
Email: jpop@poplawyer.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OFTHESECRETARYOFHEALTH RESPONDENT:
AND HUMAN SERVICES:
(
Jeffrey S Dlgltally signed by Jeffrey
• }.. S. Beach -S
-5
Beach I _b~:2026.02.1211:47:34 f
// -os·oo· or
CAPT GEORGE REED GRIMES, MD, MPH
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch
Health Systems Bureau Civil Division
}Iealth Resources and Services U.s:--DepartmentofJustice
Administration P.O. Box 146
U.S. Department of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 Fishers Lane, 14 W-18 Tel: (202) 616-3662
Rockville, MD 20857 Email: Rachelle.P .B ishop@usdoj.gov
Dated: --------
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Case 1:24-vv-01271-UNJ Document 30 Filed 04/09/26 Page 8 of 8
CERTIFICATE OF SERVICE
I certify that today, March 9, 2026, a copy of the foregoing pleading was served by
electronic mail to petitioner’s counsel of record.
/s/ Rachelle P. Bishop
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