In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 18-603V

UNPUBLISHED

PAULINE ANITA GUNNARSON,

 Petitioner,

v.

SECRETARY OF HEALTH AND 

HUMAN SERVICES,

 Respondent.

Chief Special Master Corcoran 

Filed: November 13, 2019

Special Processing Unit (SPU); Joint 

Stipulation on Damages; Influenza 

(Flu) Vaccine; Shoulder Injury 

Related to Vaccine Administration 

(SIRVA)

Douglas Lee Burdette, Burdette Law, PLLC, North Bend, WA, for petitioner.

Alexis B. Babcock, U.S. Department of Justice, Washington, DC, for respondent.

DECISION ON JOINT STIPULATION1

On April 26, 2018, Pauline Anita Gunnarson filed a petition for compensation 

under the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et 

seq.,

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(the “Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related 

to vaccine administration (“SIRVA”) as a result of an influenza (“flu”) vaccine 

administered on October 16, 2017. Petition at 1; Stipulation, filed November 13, 2019,

at ¶¶ 2, 4. Petitioner further alleges the flu vaccine was administered within the United 

States, that she experienced 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 her alleged injury. Petition at 1-2; Stipulation at ¶¶ 3-5. “Respondent denies

that petitioner sustained a SIRVA Table injury, and denies that the flu vaccine is the 

cause of petitioner’s alleged SIRVA, or any other injury or condition. ” Stipulation at ¶ 6. 

 

1 Because this unpublished ruling contains a reasoned explanation for the action in this case, I am 

required to post it on the United States Court of Federal Claims' website in accordance with the EGovernment Act of 2002. 44 U.S.C. § 3501 note (2012) (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 “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 

300aa (2012).
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Nevertheless, on November 13, 2019, 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 $25,000.00 in the form of a check payable to Petitioner. 

Stipulation at ¶ 8. This amount represents compensation for all items of 

damages that would be available under § 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 the 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.
IN THE UNITED STATES COURT OF FEDERAL CLAIMS 

OFFICE OF SPECIAL MASTERS 

PAULINE ANITA GUNNARSON, 

Petitioner, 

V. 

SECRET ARY OF HEAL TH AND HUMAN 

SERVICES, 

Respondent. 

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No. 18-603V 

Chief Special Master Corcoran 

ECF 

__________________ ) 

STIPULATION 

The parties hereby stipulate to the following matters: 

1. Petitioner, Paulette Gunnarson, 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 the influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the 

"Table"), 42 C.F.R. § 100.3(a). 

2. Petitioner received the flu vaccine on October 16, 2017. 

3. The flu vaccine was administered within the United States. 

4. Petitioner alleges that she suffered a Shoulder Injury Related to Vaccination 

("SIRVA") as the result of the flu vaccine and 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 her behalf as a result of her alleged injuries. 
6. Respondent denies that petitioner sustained a SIRVA Table injury, and denies that the 

flu vaccine is the cause of petitioner's alleged SIRVA, or any other injury or 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 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-2l(a)(l), the Secretary of Health and Human Services will issue 

the following vaccine compensation payment: 

A lump sum of $25,000.00, in the form of a check payable 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-2l(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 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-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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11. 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. § 300aa15(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, 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 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-10 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 flu vaccine administered on or about October 16, 2017, as 

alleged by petitioner in a petition for vaccine compensation filed on April 26, 2018, in the United 

States Court of Federal Claims as petition No. 18-603V. 

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 conformity with the terms 

of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a 

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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 SIRVA, 

or any other injury or her current condition. 

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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Respectfully submitted, 

PETITIONER: 

flL~ou.. ~ G~ 

PAULINE ANITA GUNNARSON 

ATTORNEY OF RECORD FOR 

PETITIONER: 

rdJb,/de 1⁄2t !Jl Et)Jdic D. LEE BURDEWE -=---=-

BURDETTE LAW, PLLC 

249 Main Ave., S., Ste 107 #333 

North Bend, WA 98045 

Tel: (206) 441-5544 

AUTHORIZED REPRESENTATIVE 

OF THE SECRETARY OF HEAL TH 

AND HUMAN SERVICES: 

TAMARA OVERBY 

Acting Director, Division of Injury 

Compensation Programs {DICP) 

Healthcare Systems Bureau 

Health Resources and Services Administration 

U.S. Department of Health and Human Services 

5600 Fishers Lane 

Parklawn Building, Mail Stop 08Nl 468 

Rockville, MD 20857 

Dated: \ \ l l ~ I l 1 

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AUTHORIZED REPRSENTATIVE 

OF THE ATTORNEY GENERAL: 

~ -~L 

ARINE E. REEVES 

Deputy Director 

Torts Branch 

Civil Division 

U.S. Department of Justice 

P.O. Box 146 

Benjamin Franklin Station 

Washington, DC 20044-0146 

ATTORNEY OF RECORD FOR 

RESPONDENT: 

a.u~Ba~a:Jz. 

ALEXIS B. BABCOCK 

Assistant Director 

Torts Branch 

Civil Division 

U.S. Department of Justice 

P.O. Box 146 

Benjamin Franklin Station 

Washington, DC 20044-0146 

Tel: (202) 616-7678 

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