# In the United States Court of Federal Claims

OFFICE OF SPECIAL MASTERS

No. 20

- 1473 V

UNPUBLISHED

JULIE ROUBIK, personal
representative of ESTATE OF

THOMAS ROUBIK

,

Petitioner,

v.

SECRETARY OF HEALTH AND

HUMAN SERVICES,

Respondent. Chief Special Master Corcoran

Filed: May 21, 2021

Special Processing Unit (SPU);
Damages Decision Based on Proffer;
Influenza (Flu) Vaccine; Guillain

Barre Syndrome (GBS)

Nancy Routh Meyers, Turning Point Litigation, Greensboro, NC , for P etitioner.

Lauren Kells , U.S. Department of Justice, Washington, DC, for R espondent.

.

DECISION AWARDING DAMAGES 1

On October 27, 2020

, Julie Roubik filed a petition for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa

- 10, et seq

. 2 (the “Vaccine Act”) , as personal representative of the estate of Thomas Roubik

. Petitioner allege d that “[a]s a direct and proximate result of the reaction to the influenza va ccination
administered to Thomas Roubik on November 8, 2019, he suffered from the effects of

Guillain

- Barré Syndrome (GBS) which ultimately lead to his untimely death

. ” Petit ion at ¶

16

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

Masters.

On April 16, 2021

, a ruling on entitlement was issued , finding P etitioner entitled to
compensation for Thomas Roubik ’ s injury . On May 21, 2021

, R espondent filed a p roffer

1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am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

Government 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 pert inent subpara graph of 42 U.S.C. § 300aa
(2012 ).2

on a ward of compensation (“Proffer”) indicating P etitioner should be awarded
$ 328,212.87, representing compensation in the amounts of $250,000.00 for the death

benefit, $77,500.00 for pain and suffering, and $712.87 for unreimbursed expenses

. Proffer at 1

- 2

. In the Proffer, R espondent represented that P etitioner agrees with the
proffered award. Id. at 2. Based on the record as a whole, I find that P etitioner is entitled

to an award as stated in the Proffer.

Pursuant to the terms stated in the attached Proffer, I award P etitioner a lump
sum payment of $ 328,212.87 , representing compensation in the amounts of $250,000.00 for the death benefit, $ 77,500.00 for pain and suffering, and $712.87 for

unreimbursed expenses in the form of a check payable to P etitioner , as the legal
representative of T h omas Roubik ’ s estate

. 3 This amount represents compensation for
all damages that w ould be available under Section 15 (a)

.

The clerk of the 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 The Proffer indicates that Petitioner will p rovide documentation showing her appointment as the legal
representative of Thomas Roubik ’s estate before any payment is ma de. Proffer at 2 n.1. Addition ally, if
another individual is appoint ed as the legal repre sentative , payment will be made to that individual. Id.

4 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint fil ing of notice
renouncing the right to seek review.IN THE UNITED STATES COURT OF FEDERAL CLAIMS

OFFICE OF SPECIAL MASTERS

____________________________________ )

JULIE ROUBIK, PERSONAL )

REPRESENTATIVE OF THE )

ESTATE OF THOMAS ROUBIK, )

)

Petitioner, )

) No. 20

- 1473 V

v. ) Chief Special Master Corcoran

) ECF

SECRETARY OF HEALTH AND )

HUMAN SERVICES, )

)

Respondent. )

____________________________________)

RESPONDENT’S PROFFER ON AWARD OF COMPENSATION

On October 27, 2020

, Julie Roubik (“petitioner”) , personal representative of the estate of

Thomas Roubik (“decedent”)

, filed a petition for compensation under the National Childhood

Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa

- 1 to

- 34 (“Vaccine Act” or “Act”) , alleging that

the decedent suffered Guillain

- Barré syndrome (“GBS”)

, as defined in the Vaccine Injury Table,

following administration of an influenza va cci ne he received on November 8, 2019; petitioner

further alleged that the decedent passed away due to complications of GBS on January 11, 2020

.

See generally Petition

. On April 16 , 2021 , the Secretary of Health and Human Services

(“respondent”) filed a Rule 4(c) Report indicating that this case is appropriate for compensation

under the terms of the Act for a GBS Table injury , and the same day

, the Chief Special Master

issued a Ruling on Entitlement finding petitioner entit led to compensation. ECF No s . 1 5

, 16

.

I. Items of Compensation

Based upon the evidence, respondent proffers that petitioner should be awarded a lump

sum of $328,212.87 ($250,000.00 for the death benefit; $ 77,500.00 for pain and suffering; and2 $712.87 for unreimbursed expenses). This amoun t represents all elements of compensation to

which petitioner would be entitled under 42 U.S.C. § 300aa

- 15(a). Petitioner agrees.

II. Form of the Award

Respondent recommends that compensation be awarded to petitioner in the amount of

$328,212.87 , in the form of a check payable to petitioner, as the legal representative of the

decedent’s estate. 1 Petitioner agrees.

Respectfully submitted,

BRIAN M. BOYNTON
Acting Assistant Attorney General

C. SALVATORE D’ALESSIO
Acting Director

Torts Branch, Civil Division

HEATHER L. PEARLMAN
Acting Deputy Director

Torts Branch, Civil Division

ALEXIS B. BABCOCK

Assistant Director

Torts Branch, Civil Division

/s/ Lauren Kells

LAUREN KELLS
Trial Attorney

Torts Branch, Civil Division
U.S. Department of Jus tice

P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044

- 0146
Tel.: (202) 616

- 4187
Email: Lauren.Kells@usdoj.gov

1 Before payment on a judgment can be made in this case, respondent will require petitioner to
provide documentation establishing her appointment as legal representatives of the decedent’s

estate. If petitioner is not authorized by a court of competent jur isdiction to serve as the legal
representative of the decedent’s estate, then such payment on any judgment shall be made to the
party or parties appointed by a court of competent jurisdiction to serve as legal representative of

the decedent’s estate.3 DATED: May 21 , 2021