1

In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS 

No. 18-0332V 

 Filed: February 27, 2019 

UNPUBLISHED 

DEREK CLARK, 

 Petitioner, 

v. 

SECRETARY OF HEALTH 

AND HUMAN SERVICES, 

 Respondent. 

Special Processing Unit (SPU); 

Ruling on Entitlement; Concession; 

Table Injury; Influenza (Flu) Vaccine; 

Shoulder Injury Related to Vaccine 

Administration (SIRVA) 

   

Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for petitioner. 

Meredith Burns Healy, U.S. Department of Justice, Washington, DC, for respondent. 

RULING ON ENTITLEMENT1

Dorsey, Chief Special Master 

 On March 5, 2018, Derek Clark (“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 right shoulder injury 

related to vaccine administration (“SIRVA”) as a result of an influenza (“flu”) vaccine 

administered to his right shoulder on November 15, 2016. Petition at 1. 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 Because this unpublished ruling contains a reasoned explanation for the action in this 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

On February 27, 2019, respondent filed his Rule 4(c) report in which he 

concedes that petitioner is entitled to compensation in this case. Respondent’s Rule 

4(c) Report at 1. Specifically, respondent states that “petitioner has satisfied the criteria 

for SIRVA set forth in the recently revised Vaccine Injury Table (‘Table’) and the 

Qualifications and Aids to Interpretation (‘QAI’), which afford petitioner a presumption of 

causation if petitioner had no recent history of pain, inflammation, or dysfunction of his 

right shoulder, pain occurred within 48 hours after receipt of an intramuscularlyadministered vaccination, pain was limited to the shoulder in which the vaccine was 

administered, and no other condition or abnormality, such as brachial neuritis, has been 

identified to explain petitioner’s shoulder pain.” Id. at 4. Respondent further agrees that 

“based on the medical records outlined above, petitioner suffered the residual effects of 

his condition for more than six months. Therefore, based on the record as it now stands, 

petitioner has satisfied all legal prerequisites for compensation under the Act.” Id. 

 In view of respondent’s position and the evidence of record, the 

undersigned finds that petitioner is entitled to compensation. 

IT IS SO ORDERED. 

 s/Nora Beth Dorsey 

 Nora Beth Dorsey 

 Chief Special Master