In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 17-1529V

Filed: August 13, 2019

UNPUBLISHED

RYAN THOMPSON,

 Petitioner,

v.

SECRETARY OF HEALTH AND 

HUMAN SERVICES,

 Respondent.

Special Processing Unit (SPU);

Findings of Fact; Onset; Influenza 

(Flu) Vaccine; Shoulder Injury 

Related to Vaccine Administration 

(SIRVA)

Jessica Olins, Maglio Christopher & Toale, PA, Washington, DC, for petitioner.

Camille Michelle Collett, U.S. Department of Justice, Washington, DC, for respondent.

FINDINGS OF FACT1

Dorsey, Chief Special Master:

On October 16, 2017, petitioner 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 he suffered a shoulder injury related to vaccine 

administration (“SIRVA”) in his left shoulder from an influenza (“flu”) vaccine 

administered on October 16, 2016. Petition at 1, 3. The case was assigned to the 

Special Processing Unit of the Office of Special Masters.

 

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

means the ruling 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 Because this unpublished ruling contains a reasoned explanation for the action in this 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

For the reasons discussed below, the undersigned finds the onset of petitioner’s 

shoulder injury related to vaccine administration (“SIRVA”) occurred within 48 hours of 

vaccination. Specifically, petitioner suffered pain within 48 hours of vaccination.

I. Relevant Procedural History

In support of his claim, petitioner filed medical records (Exs. 1-6, 8-10, 13-15), his 

own affidavit (Exs. 7), and witness affidavits (Ex. 16, Aff. of Angela Thompson (wife); 

Ex. 17, Aff. of Brenda Thompson (mother); Ex. 18, Aff. of Ashley Wendler (sister)). 

Deadlines for respondent to report his position in the case were set following the 

December 15, 2017 initial status conference. Orders, ECF Nos. 9, 18, 21. 

On June 18, 2018, respondent reported that he was interested in exploring an 

informal resolution of the case. ECF No. 23. The parties spent nearly a year discussing 

settlement. See generally ECF Nos. 25-40. On June 7, 2019, petitioner reported a 

“belief” that “respondent has a fact issue in this case with regards to onset of 

symptoms.” Pet.’s Status Report, ECF No. 42. A status conference was held on June 

13, 2019, to discuss petitioner’s status report. Order, ECF No. 43. During the 

conference, petitioner requested that the undersigned issue a fact ruling on onset. Id. 

Thereafter, the undersigned reviewed the evidence and determined that fact 

hearing or briefing would not be necessary. Order, ECF No. 43. A deadline was set for 

closing the record on the matter of onset. Id. In response, petitioner filed witness

affidavits. Exs. 16-18. Respondent filed a status report indicating that he did not intend 

to file anything in regards to onset. ECF No. 45. The matter is now ripe for 

adjudication. 

II. Issue

At issue is whether petitioner’s first symptom or manifestation of onset after 

vaccine administration was within 48 hours as set forth in the Vaccine Injury Table. 42 

C.F.R. § 100.3(a) XIV.B. (2017) (influenza vaccination). Additionally, the Qualifications 

and aids to interpretation (“QAI”) for a Table SIRVA require that a petitioner’s pain occur 

within this same time frame, 48 hours. 42 C.F.R. § 100.3(c)(10).

III. Authority

Pursuant to Vaccine Act § 13(a)(1)(A), a petitioner must prove, by a 

preponderance of the evidence, the matters required in the petition by Vaccine Act 

§ 11(c)(1). A special master may find that the first symptom or manifestation of onset of 

an injury occurred “within the time period described in the Vaccine Injury Table even 
3

though the occurrence of such symptom or manifestation was not recorded or was 

incorrectly recorded as having occurred outside such period.” Vaccine Act § 13(b)(2). 

“Such a finding may be made only upon demonstration by a preponderance of the 

evidence that the onset [of the injury] . . . did in fact occur within the time period 

described in the Vaccine Injury Table.” Id. 

A special master must consider, but is not bound by, any diagnosis, conclusion, 

judgment, test result, report, or summary concerning the nature, causation, and 

aggravation of petitioner’s injury or illness that is contained in a medical record. 

Vaccine Act § 13(b)(1). “Medical records, in general, warrant consideration as 

trustworthy evidence. The records contain information supplied to or by health 

professionals to facilitate diagnosis and treatment of medical conditions. With proper 

treatment hanging in the balance, accuracy has an extra premium. These records are 

also generally contemporaneous to the medical events.” Curcuras v. Sec’y of Health & 

Human Servs., 993 F.2d 1525, 1528 (Fed. Cir. 1993). 

IV. Finding of Fact

The undersigned makes the finding after a complete review of the record to 

include all medical records, affidavits, testimony, expert reports, respondent’s Rule 4 

report, and additional evidence filed. Specifically, the undersigned bases the finding on 

the following evidence:

• On October 6, 2016, petitioner received an influenza vaccination in his left 

deltoid, at Federal Occupational Health in Washington, DC. Petitioner’s 

Exhibit (“Ex.”) 1 at 1. 

• Petitioner recalls pain in his left shoulder immediately upon receiving the 

vaccination, and states that the following day his “left shoulder felt worse and 

throughout the day continued to get worse.” Ex. 7 at 1.

• On October 24, 2016, petitioner went to his primary care physician’s office 

(“PCP”) and was seen by Jessica Martin, N.P., at his with complaints of left 

deltoid pain following the influenza vaccination. Ex. 2 at 5. (“complained of 

left deltoid pain after taking flu shot last Oct 6”). Petitioner complained of 

popping sensations and weakness with raising his left arm. Id. Petitioner had 

been “dealing” with the pain, which was aching and weak. Id. Nurse 

Practitioner Martin diagnosed petitioner with left shoulder bursitis and ordered 

an MRI. Id.

• On November 1, 2016, petitioner was seen by board certified radiologist, Uma 

J. Thakur, M.D., for MRI imaging of his left shoulder. Ex. 2 at 10. Dr. Thakur 

noted petitioner’s history as “29-year-old man with left shoulder pain and loss 

of range of motion for one month following flu shot, pain with abduction in all 

directions.” Id. Petitioner’s MRI report states, “trace fluid at the 

myotendinous junction of the teres minor muscle extending to the attachment 

site on the humeral head where there are small subcortical cysts.” Id.
4

• On November 21, 2016, Christopher Koth, P.T., evaluated petitioner’s left 

shoulder pain. Ex. 5 at 2. Physical Therapist Koth noted petitioner’s history 

as “Pt got a flu shot on 10/6/16 and afterwards had left shoulder soreness

that then turned just to pain.” Id. 

• On December 19, 2016, petitioner returned to his PCP and again was 

evaluated by Nurse Practitioner Martin. Ex. 2 at 6. Nurse Practitioner Martin 

noted petitioner’s continued shoulder pain since receiving a flu shot and that 

petitioner had been attending physical therapy for 6-7 sessions without 

improvement and was experiencing a decreased range of motion. Id. Nurse 

Practitioner Martin referred Petitioner to an orthopedic physician. Id.

• On January 4, 2017, petitioner was seen by board certified orthopedic 

surgeon, Professor Robert J. Neviaser, M.D., of the George Washington 

University School of Medicine for evaluation of his left shoulder pain. Ex. 3 at 

2. Dr. Neviaser noted petitioner’s history as “[f]ollowing a [] on October 6,

2016, within a couple of days, he had severe pain in his left shoulder.” Id. 

Neviaser also noted that “other than the flu shot, he recalls nothing that might 

have caused this” when discussing petitioner’s shoulder pain. Id. Dr. 

Neviaser administered a subacromial injection. Id.

• On January 26, 2017, petitioner submitted a Vaccine Adverse Event Report 

indicating the onset of his left shoulder pain as October 6, 2016, the day he 

received the flu vaccination. Ex. 19 at 2. 

• Petitioner’s wife, mother, and sister all saw him on the day of his October 6, 

2016 flu vaccination and recall him mentioning having left shoulder pain. Exs. 

16-18. 

The above medical entries are consistent with petitioner’s affidavit testimony that 

his left shoulder pain began at the time he received the flu vaccine on October 6, 2016. 

The undersigned finds the sworn testimony of petitioner’s witnesses to be credible and 

in agreement with the contemporaneously created treatment records. As such, the 

undersigned finds preponderant evidence that the onset of petitioner’s left shoulder 

injury occurred within 48 hours of his October 6, 2016 flu vaccination. 

V. Scheduling Order

Respondent shall file a Rule 4(c) report by Wednesday, September 25, 2019.

IT IS SO ORDERED.

s/Nora Beth Dorsey

Nora Beth Dorsey

Chief Special Master