In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 19-147V

UNPUBLISHED

LISA M. GILBERTSON,

 Petitioner,

v.

SECRETARY OF HEALTH AND 

HUMAN SERVICES,

 Respondent.

Chief Special Master Corcoran 

Filed: May 6, 2020

Special Processing Unit (SPU); 

Damages Decision Based on Proffer; 

Tetanus Diphtheria acellular 

Pertussis (Tdap) Vaccine; Shoulder 

Injury Related to Vaccine 

Administration (SIRVA)

Kate Gerayne Westad, SiebenCarey, Minneapolis, MN, for petitioner.

Adriana Ruth Teitel, U.S. Department of Justice, Washington, DC, for respondent.

DECISION AWARDING DAMAGES1

On January 29, 2019, Lisa Gilbertson 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 administered on February 4, 2016. Petition at 1. The case was 

assigned to the Special Processing Unit of the Office of Special Masters.

On April 13, 2020, a ruling on entitlement was issued, finding Petitioner entitled 

to compensation for her SIRVA. On May 5, 2020, Respondent filed a proffer on award 

of compensation (“Proffer”) indicating Petitioner should be awarded $165,850.07.

Proffer at 1. In the Proffer, Respondent represented that Petitioner agrees with the 

 

1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am 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 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 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 pertinent subparagraph of 42 U.S.C. § 

300aa (2012).
2

proffered award. Id. Based on the record as a whole, I find that Petitioner is entitled to 

an award as stated in the Proffer.

Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump 

sum payment of $165,850.07 (representing compensation in the amount of 

$162,500.00 for pain and suffering, $1,514.05 for past lost wages, and $1,836.02 

for past unreimbursed expenses) in the form of a check payable to Petitioner. 

This amount represents compensation for all damages that would be available under § 

15(a). 

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

 

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.
1

IN THE UNITED STATES COURT OF FEDERAL CLAIMS

OFFICE OF SPECIAL MASTERS

LISA M. GILBERTSON,

Petitioner, 

 v. 

SECRETARY OF HEALTH AND

HUMAN SERVICES, 

Respondent.

 No. 19-147V

 Chief Special Master Corcoran (SPU)

 ECF

RRESPONDENT’S PROFFER ON AWARD OF COMPENSATION

I. Compensation for Vaccine Injury-Related Items

On April 10, 2020, respondent filed a Rule 4(c) Report conceding that petitioner is 

entitled to vaccine compensation for her Shoulder Injury Related to Vaccine Administration 

(“SIRVA”) injury suffered following receipt of a Tdap vaccination on February 4, 2016. A

Ruling on Entitlement was issued on April 13, 2020. 

Based upon the evidence of record, respondent proffers that petitioner should be awarded 

$165,850.07.

1

 This award is comprised of pain and suffering ($162,500.00), past lost wages 

($1,514.05), and past unreimbursed expenses ($1,836.02), and represents all elements of 

compensation to which petitioner would be entitled under 42 U.S.C. § 300aa-15(a).2

 Petitioner 

agrees. 

 1 This proffer does not include any award for attorneys’ fees and costs that may be awarded 

pursuant to 42 U.S.C. § 300aa-15(e).

2 Should Petitioner die prior to entry of judgment, the parties reserve the right to move the Court 

for appropriate relief. 
2

II. Form of the Award 

Respondent recommends that the compensation provided to petitioner should be made 

through a lump sum payment of $165,850.07 in the form of a check payable to petitioner.3

 

Petitioner agrees.

Respectfully submitted, 

JOSEPH H. HUNT

Assistant Attorney General

C. SALVATORE D’ALESSIO

Acting Director 

Torts Branch, Civil Division 

CATHARINE E. REEVES

Deputy Director 

Torts Branch, Civil Division

HEATHER L. PEARLMAN

Assistant Director

Torts Branch, Civil Division

/s/ Adriana Teitel

ADRIANA TEITEL

Trial Attorney

Torts Branch, Civil Division

U.S. Department of Justice

P.O. Box 146, Benjamin Franklin Station

Washington, DC 20044-0146

Tel: (202) 616-3677

Dated: May 5, 2020

 3 Petitioner is a competent adult, therefore evidence of guardianship is not required in this case.