In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 17-1572V

Filed: June 19, 2019

UNPUBLISHED

DEANNE A. GRAF,

 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)

Peter M. Young, Habush, Habush & Rottier, S.C., Wausau, WI, for petitioner.

Traci R. Patton, 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 “Shoulder Injuries Related to

Vaccine Administration (“SIRVA”), including, tendinitis, tendinosis, frozen shoulder, and

adhesive capsulitis of the left shoulder, and irritation of the left radial nerve,” resulting 

from the influenza vaccination she received on October 27, 2014. Petition at 1; 

Stipulation, filed June 17, 2019, at ¶ 5. Petitioner further alleges she has experienced 

residual effects of this injury for more than six months. Petition at 13; Stipulation at ¶ 5. 

“Respondent denies that petitioner sustained a Table SIRVA, and denies that she

suffered any other injury or condition that was caused by or significantly aggravated by 

the flu vaccination.” 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 Because this unpublished decision contains a reasoned explanation for the 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 June 17, 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 

DEANNE A. GRAF, ) 

) 

) 

) 

) 

Petitioner, 

V. No. 17-1572V 

SECRETARY OF HEALTH AND HUMAN ) 

SERVICES, ~ 

Chief Special Master Dorsey 

ECF 

___________ Respondent. ___ ) ) 

STIPULATION 

The parties hereby stipulate to the following matters: 

1. Deanne A. Graf, petitioner, filed a petition for vaccine compensation under the 

National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-I0 et seq. (the "Vaccine 

Program"). The petition seeks compensation for injuries allegedly related to Ms. Graf 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 her flu immunization on October 27, 2014. 

3. The vaccine was administered within the United States. 

4. Pt:titioner alleges that she sustained "Shoulder Injuries Related to Vaccination 

Administration (' SrR VA'), including tendinitis, tendinosis, frozen shoulder, and adhesive 

capsulitis of the left shoulder, and irritation of the left radial nerve" within the time period set 

forth on the Table. Petitioner also alleges that the flu vaccine "caused in fact" petitioner's 

SIRVA. She further alleges that she has experienced residual effects of this 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 Table SIRVA, and denies that she 

suffered any other injury or condition that was caused by or significantly aggravated by the flu 

vaccination. 

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 $85,000.00 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-2 l (a)( I), 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 

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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 

paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-l 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, 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 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 vaccination administered on October 27, 2014, 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. 17-1572V. 

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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 confonnity with a 

decision that is in complete confonnity 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 petitioner sustained a Table SIRVA, or that she 

suffered any other injury or condition that was caused by or significantly aggravated by the flu 

vaccination. 

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

heirs, executors, administrators, successors, and/or assigns. 

END OF STIPULATION 

4 
Respectfully submitted, 

PETITIONER: 

DEANNE A. GRAF 

ATTORNEY OF RECORD FOR 

PETITIONER: 

P ~TER M. YOUNG 

H:hHabush & Rottier® 

3100 Eagle A venue 

Wausau, WI 54402 

Tel: (715) 842-4444 

AUTHORIZED REPRESENTATIVE 

OF THE SECRETARY OF HEALTH 

AND HUMAN SERVICES: 

NARAYAN NAIR, M.D. 

Director, Division oflnjury 

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 08N 146B 

Rockville, MD 20857 

Dated: crl,U\(,. l 7, }t; l 4 

5 

AUTHORIZED REPRSENTATIVE 

OF THE A 'ITORNEY GENERAL: 

{_ t~ f. yZ,uveJ,l 

N elf~ 'd-Pe~ 

CATHARINE 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: 

~ '{<1°~ 

TRACI R. PATTON 

Senior Trial Attorney 

Torts Branch 

Civil Division 

U.S. Department of Justice 

P.O. Box 146 

Benjamin Franklin Station 

Washington, DC 20044-0146 

Tel: (202) 353-1589