VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_24-vv-01283
Package ID: USCOURTS-cofc-1_24-vv-01283
Petitioner: MICHELLE HAGEN
Filed: 2024-08-20
Decided: 2026-05-26
Vaccine: tetanus-diphtheria
Vaccination date: 2023-12-19
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 24726

AI-assisted case summary:
Michelle Hagen filed a petition for compensation under the National Vaccine Injury Compensation Program on August 20, 2024, alleging injury from a tetanus-diphtheria (Td) vaccine received on December 19, 2023. She claimed a Shoulder Injury Related to Vaccine Administration (SIRVA) within the Table timeframe, with residual effects lasting over six months. Respondent denied that Petitioner sustained a SIRVA Table injury or that the vaccine caused her condition. Nevertheless, the parties filed a joint stipulation agreeing to a settlement. Chief Special Master Corcoran adopted the stipulation, awarding Petitioner $24,726.25 as compensation for all damages. The decision was filed on May 26, 2026.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_24-vv-01283-0
Date issued/filed: 2026-06-29
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 05/26/2026) regarding 37 DECISION Stipulation/Proffer, ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:24-vv-01283-UNJ Document 44 Filed 06/29/26 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 24-1283V
MICHELLE HAGEN, Chief Special Master Corcoran
Petitioner,
v. Filed: May 26, 2026
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Alison Haskins, Siri & Glimstad, LLP, Aventura, FL, for Petitioner.
Adam Nemeth Muffett, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On August 20, 2024, Michelle Hagen 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 tetanus-diphtheria (“Td”) vaccine, which vaccine is listed in the
Vaccine Injury Table (the “Table”), 42 C.F.R. § 100.3(a). Petitioner received the Td
vaccination in her left shoulder on December 19, 2023. Petitioner alleges that she
suffered a shoulder injury related to vaccine administration (“SIRVA”) within the time
period set forth in the Table following administration of the vaccine. Petitioner further
alleges that she experienced the residual effects of this injury 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-01283-UNJ Document 44 Filed 06/29/26 Page 2 of 8
Respondent denies that Petitioner sustained a SIRVA Table injury; denies that
Petitioner’s alleged shoulder injury was caused-in-fact by the Td vaccine; and denies that
the Td vaccine caused Petitioner any other injury or her current condition.
Nevertheless, on May 22, 2026, the parties filed the attached joint stipulation3
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 $24,726.25 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 In attaching the parties’ joint stipulation, I have omitted the last page – a DropBox Sign form that includes
personal information regarding Petitioner.
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 1:24-vv-01283-UNJ Document 44 Filed 06/29/26 Page 3 of 8
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
MICHELLE HAGEN. )
)
Petitioner, )
) No. 24-1283V (ECF)
V. ) Chief Special Master Corcoran
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
__________________
)
STIPULATION
The parties hereby stipulate to the following matters:
1. Michelle Hagen, petitioner, filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program. 42 U.S.C. § 300aa-l Oto -34 ("Vaccine
Program""). The petition seeks compensation for injuries allegedly related to petitioner·s receipt
of the tetanus-diphtheria ("Td"") vaccine, which is a vaccine contained in the Vaccine Injury
Table ("Table'"), 42 C.F.R. § I 00.3(a).
2. Petitioner received the Td vaccination in her left shoulder on December 19, 2023.
>
The vaccine was administered within the United States.
4. Petitioner alleges that she suffered a Shoulder Injury Related to Vaccine
Administration ("SIRVA"") within the time period set forth in the Table following administration
of the vaccine. Petitioner alleges that she experienced the 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 a:~ a result of her alleged injury.
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Case 1:24-vv-01283-UNJ Document 44 Filed 06/29/26 Page 4 of 8
6. Respondent denies that petitioner sustained a SIRVA Table Injury, denies that
petitioner·s alleged shoulder injury was caused-in-fact by the Td vaccine, and denies that the Td
vaccine caused petitioner any other injury or her current condition.
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 ofjudgment 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-2 I (a)( I). the Secretary of Health and Human Services will issue
the following vaccine compensation payment for all damages that would be available under 42
U.S.C. § 300aa-l 5(a).:
A lump sum payment of $24,726.25 to be paid through an ACH deposit to
petitioner·s counsel's IOL TA account for prompt disbursement to petitioner.
Michelle Hagen.
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 ·10 receive compensation pursuant to 42
U.S.C. § 300aa-2 I (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.
10. 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-I 5(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
2
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Case 1:24-vv-01283-UNJ Document 44 Filed 06/29/26 Page 5 of 8
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.
I I. Payment made pursuant to paragraph 8 of this Stipulation, 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, 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-l 5(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 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
the Secretary of Health and Human Services from any and all actions, 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 Td vaccine administered on or about December 19, 2023, as
alleged by petitioner in a petition for vaccine compensation tiled on August 20, 2024, in the
United States Court of Federal Claims as petition No. 24-l 283V.
3
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Case 1:24-vv-01283-UNJ Document 44 Filed 06/29/26 Page 6 of 8
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 Chief 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.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the Td vaccine caused petitioner's alleged shoulder
injury or any other injury.
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 1:24-vv-01283-UNJ Document 44 Filed 06/29/26 Page 7 of 8
Respectfully submitted,
PETITIONER:
MICHELLE HAGEN
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
PETITIONER: OF THE ATTORNEY GENERAL:
ON HASKINS HEATHER L. PEARLMAN
I & GLIM ST AD, LLP Deputy Director
20200 West Dixie Highway, Suite 902 To11s Branch
Aventura, FL 3 3180 Civil Division
(786) 244-5660 U.S. Department of Justice
ahaskins@sirillp.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
George R. Digitally signed by George
R. Grimes -516
Grimes -S16 Date: 2026.05.13 12:38:11 Ad±::c;J:i
M~
-04'00'
CAPT GEORGE REED GRIMES, MD, MPH
Director, Division of Injury Trial Attorney
Compensation Programs To11s Branch
Health Systems Bureau Civil Division
Health Resources and Services U.S. Department of Justice
Administration P.O. Box 146
U.S. Depai1ment of Health Benjamin Franklin Station
and Human Services Washington, DC 20044-0146
5600 Fishers Lane, 14 W-18 (202) 616-2895
Rockville, MD 20857 adam.muffett@usdoj.gov
Dated:
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Case 1:24-vv-01283-UNJ Document 44 Filed 06/29/26 Page 8 of 8
CERTIFICATE OF SERVICE
I certify that today, May 22, 2026, a copy of the foregoing pleading will be served by
electronic mail to Alison Haskins as ahaskins@sirillp.com.
/s/ Adam N. Muffett