In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 17-1575V

Filed: March 7, 2019

UNPUBLISHED

KATHLEEN SMITH,

 Petitioner,

v.

SECRETARY OF HEALTH AND 

HUMAN SERVICES,

 Respondent.

Special Processing Unit (SPU); Joint 

Stipulation on Damages; Influenza 

(Flu) Vaccine; Shoulder Injury 

Related to Vaccine Administration 

(SIRVA)

Alison H. Haskins, Maglio Christopher & Toale, PA, Sarasota, FL, for petitioner.

Voris Edward Johnson, U.S. Department of Justice, Washington, DC, for respondent.

DECISION ON JOINT STIPULATION1

Dorsey, Chief Special Master:

On October 20, 2017, petitioner 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”) after an influenza (“flu”) vaccination administered on October 

5, 2016. Petition at 1, 3; Stipulation, filed March 7, 2019, at ¶¶ 2, 4. Petitioner further 

alleges that she received the vaccine in 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 for damages as a result of her condition. Petition at 

1, 3-4; Stipulation at ¶¶ 3-5. “Respondent denies that the flu vaccine caused petitioner’s 

alleged SIRVA and residual effects, or any other injury. ” Stipulation at ¶ 6. 

 

1 The undersigned intends to post this decision on the United States Court of Federal Claims' website. 

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, the 

undersigned agrees that the identified material fits within this definition, the undersigned will redact such 

material from public access. Because this unpublished decision contains a reasoned explanation for the 

action in this case, undersigned is required to post it on the United States Court of Federal Claims' 

website in accordance with the E-Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal 

Management and Promotion of Electronic Government Services).

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

Nevertheless, on March 7, 2019, the parties filed the attached joint stipulation, 

stating that a decision should be entered awarding compensation. The undersigned 

finds the stipulation reasonable and adopts it as the decision of the Court in awarding 

damages, on the terms set forth therein.

Pursuant to the terms stated in the attached Stipulation, the undersigned

awards the following compensation:

A lump sum of $85,000.00 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. 

The undersigned approves 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/Nora Beth Dorsey

Nora Beth Dorsey

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

__________________________________________

)

KATHLEEN SMITH, )

)

Petitioner, )

) No. 17-1575V (ECF)

v. ) Chief Special Master Dorsey

)

SECRETARY OF HEALTH )

AND HUMAN SERVICES, )

)

Respondent. )

__________________________________________)

STIPULATION

The parties hereby stipulate to the following matters:

1. Kathleen Smith (“petitioner”) 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 sustained following 

petitioner’s receipt of an influenza (“flu”) vaccine, which vaccine is contained in the Vaccine 

Injury Table (the “Table”), 42 C.F.R. §100.3(a). 

2. Petitioner received a flu vaccine on October 5, 2016.

3. The vaccine was administered within the United States.

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

Vaccine Administration (“SIRVA”), which petitioner alleges was caused by her receipt of the flu

vaccine. Petitioner further alleges that she experienced the residual effects of her injury for more 

than six months.

5. Petitioner represents that there has been no prior award or settlement of a civil 

action for damages as a result of her condition.
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6. Respondent denies that the flu vaccine caused petitioner’s alleged SIRVA and 

residual effects, or any other 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)(1), the Secretary of Health and Human 

Services will issue the following vaccine compensation payment:

A lump sum of $85,000.00 in the form of a check payable to petitioner, which

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)(1), 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.

11. Payment made pursuant to paragraph 8 and any amounts awarded pursuant to 
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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 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 Secretary of 

Health and Human Services and the United States of America 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-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 

October 5, 2016, as alleged by petitioner in a petition for vaccine compensation filed on or about 

October 20, 2017, in the United States Court of Federal Claims as petition No. 17-1575V.

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 decision that is in complete conformity with the terms of this Stipulation, then the parties’ 
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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 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 of 

America or the Secretary of Health and Human Services that petitioner’s alleged SIRVA and 

residual effects, or any other injury, were caused-in-fact by the flu vaccine.

18. All rights and obligations of petitioner hereunder shall apply equally to 

petitioner’s heirs, successors and/or assigns.

END OF STIPULATION

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