# In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 19-1993V UNPUBLISHED ALMA NELSON, Petitioner, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent. Chief Special Master Corcoran Filed: January 25, 2022 Special Processing Unit (SPU); Joint Stipulation on Damages; Tetanus Diphtheria acellular Pertussis (Tdap) Vaccine; Shoulder Injury Related to Vaccine Administration (SIRVA) Richard Gage, Richard Gage, P.C. (W Y), Cheyenne, WY, for Petitioner. Christine Mary Becer, U.S. Department of Justice, Washington, DC, for Respondent. DECISION ON JOINT STIPULATION 1 

### On December 30, 2019, Alma Nelson 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 suffered a shoulder injury related to vaccine administration (“SIRVA”) as a result of a Tetanus-diphtheria-acellular pertussis (“Tdap”) vaccine she received on August 23, 2017. Petition at1-2; Stipulation, filed at January 25, 2022, 2-4. Petitioner further alleges that she experienced residual effects of this injury for more than six months. Petition at2; Stipulation at ¶ 4. Respondent deniesthat “petitioner sustained a SIRVA, as defined in the Table;denies that the vaccine caused petitioner’s alleged shoulder injury, or any other injury; and denies that her current condition is a sequelae of a vaccine-related injury.” Stipulation at ¶ 6. Nevertheless, on January 25, 2022, 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.
1Because this unpublished Decision contains a reasoned explanation for the action in this case, I am required to post it on the United States Court of Federal Claims' website in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 with in this definition, I will redact such material from public access. 2National 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 (2012).2 

### Pursuant to the terms stated inthe attached Stipulation, I awardthe following compensation: A lump sum of $82,000.00, 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 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 Append ix 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

3Pursuant 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
ALMA NELSON, ) ) ) ) ) Petitioner, V. No. 19-1993V SECRETARY OF HEALTH AND HUMAN ) SERVICES,

## ~ Chief Special Master Corcoran ECF

R~~n~M. ) 

# ________________ ) 

### STIPULATION The parties hereby stipulate to the following matters: I. Alma Nelson, 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 related to petitioner's receipt ofthe Tetanus-diphtheria-acellular pertussis ("Tdap") vaccine, which vaccine is contained in the Vaccine Injury Table (the "Table"), 42 C.F.R. § 100.3(a). 2. Petitioner received the Tdap vaccination in her left arm on August 23, 2017. 3. The vaccine was administered within the United States. 4. Petitioner alleges that she suffered a Shoulder Injury Related to Vaccine Administration ("SIRVA") as a result ofreceiving the Tdap vaccine within the Table time frame, and that she experienced residual effects ofthis 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 as a result of her condition.6. Respondent denies that petitioner sustained a SIRVA, as defined in the Table; denies that the vaccine caused petitioner's alleged shoulder injury, or any other injury; and denies that her current condition is a sequelae 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 ofthis Stipulation. 8. As soon as practicable after an entry of judgment reflecting a decision consistent with the terms ofthis 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 a lump sum of $82,000.00 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-l 5(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- l 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 State health benefits programs (other than Title XIX ofthe Social Security Act (42 U.S.C. 

### § 1396 et seq.)), or by entities that provide health services on a pre-paid basis.



### 211. Payment made pursuant to paragraph 8 ofthis Stipulation, and any amounts awarded pursuant to paragraph 9 ofthis Stipulation, will be made in accordance with 42 U.S.C. 

### § 300aal 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 ofpetitioner, as contemplated by a strict construction of42 U.S.C. 

### § 300aa-l 5(a) and (d) , and subject to the conditions of42 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 ofwhatever 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 ofpetitioner resulting from, or alleged to have resulted from, the Tdap vaccine administered on or about August 23, 2017, as alleged by petitioner in a petition for vaccine compensation filed on December 30, 2019, in the United States Court of Federal Claims as petition No. I9-1993V. 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 ofthe parties.



### 3

### I5. 

### Ifthe special master fails to issue a decision in complete conformity with the terms ofthis Stipulation or ifthe Court of Federal Claims fails to enterjudgment in conformity with a decision that is in complete conformity with the terms ofthis Stipulation, then the parties' settlement and this Stipulation shall be voidable at the sole discretion ofeither party. 16. This Stipulation expresses a full and complete negotiated settlement of liability and damages claimed under the National Childhood Vaccine Injury Act of I986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part ofthe 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. I7. This Stipulation shall not be construed as an admission by the United States or the Secretary of Health and Human Services that the Tdap vaccine caused petitioner to suffer a shoulder injury or her current disabilities, or any other injury or condition, or that petitioner sustained an injury contained in the Vaccine Injury Table. 18. All rights and obligations ofpetitioner hereunder shall apply equally to petitioner's heirs, executors, administrators, successors, and/or assigns
.
I 

### I I I END OF STIPULATION



### 4

### Respectfully submitted,
PETITIONER:

ALMA NELSON
ATTORNEY OF RECORD FOR PETITIONER:

RlCHARD GAGE RICHARD GAGE, PC P.O
. Box 1223 1815 

### Pebrican Ave., Cheyenne, WY 82003

AUTHORIZED REPRESENTATIVE OF THE SECRETARY OF HEALTH AND HUMAN SERVICES:


### 0~ ~I 

## Pf'(Sc-, 

# AP~

# #1-- CDR GEORGE REED GRlMES. 

### MD, ivfisH Director, Division of Injury

Compensation Programs Health Systems Bureau Health Resources and Services

Administration 

### U.S. Department of Health



### and Human Services 5600 Fishers Lane, 08N l 46B Rockville, MD 20857 Dated:
________ _


### 5 AUTHORIZED REPRSENTATIVE OF THE ATTORNEY GENERAL:



### ~J. ~

# ~

# e -e.,u...Jv-- HEATHER 

### L. PEARLMAN Deputy Director Torts Branch Civil Division U.S. Department ofJustice P.O. Box 146 Benjamin Franklin Station Washington, DC 20044-0146
ATTORNEY OF RECORD FOR RESPONDENT:

## ~~ 

# \-1. ~(..L/'\

# ~~LP~ CHRISTINE M. BECER Trial Attorney Torts Branch, Civil Division U.S. Department of Justice P.O. Box 146 Benjamin Franklin Station Washington, DC 20044-0146 Tel: (202) 616-3665 christine.m.becer@ usdoj.gov