In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS 

No. 19-1779V 

UNPUBLISHED 

KATHERINE BELTZ, 

 Petitioner, 

v. 

SECRETARY OF HEALTH AND 

HUMAN SERVICES, 

 Respondent. 

Chief Special Master Corcoran 

Filed: April 8, 2021 

Special Processing Unit (SPU); 

Damages Decision Based on Proffer; 

Tetanus Diphtheria acellular 

Pertussis (Tdap) Vaccine; Shoulder 

Injury Related to Vaccine 

Administration (SIRVA) 

 

John Robert Howie, Howie Law, PC, Dallas, TX, for Petitioner. 

Amanda Pasciuto, U.S. Department of Justice, Washington, DC, for Respondent. 

DECISION AWARDING DAMAGES1

 On November 11, 2019, Katherine Beltz filed a petition for compensation under 

the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the 

“Vaccine Act”). Petitioner alleges that she received a tetanus/diphtheria/acellular 

pertussis (“Tdap”) vaccine on December 21, 2016, and that she subsequently suffered a 

left shoulder injury related to the vaccine administration (“SIRVA”), a Table injury. Petition 

at 1. The case was assigned to the Special Processing Unit of the Office of Special 

Masters. 

On April 8, 2021, a ruling on entitlement was issued, finding Petitioner entitled to 

compensation for SIRVA. On April 5, 2021, Respondent filed a combined Rule 4(c) report 

and proffer on award of compensation (“Rule 4/Proffer”) stating that Petitioner is entitled 

to compensation and should be awarded $47,500.00. Rule 4/Proffer at 7. In the Rule 

1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am 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 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 “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa 

(2012). 
2

4/Proffer, Respondent represented that Petitioner agrees with the proffered award. Id.

Based on the record as a whole, I find that Petitioner is entitled to an award as stated in 

the Rule 4/Proffer. 

 Pursuant to the terms stated in the Rule 4/Proffer, I award Petitioner a lump sum 

payment of $47,500.00, in the form of a check payable to Petitioner. This amount 

represents compensation for all damages that would be available under § 15(a). 

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.