# In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 15-142V Filed: December 30, 2015 UNPUBLISHED * * * * * * * * * * * * * * * * * * * * * * * * * * * * PAULETTE CUMMINS, * * Petitioner, * Joint Stipulation on Damages; * Influenza (“Flu”) Vaccine; * Severe Shoulder Pain; Special SECRETARY OF HEALTH * Processing Unit (“SPU”) AND HUMAN SERVICES, * * Respondent. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Jeffrey S. Pop, Jeffrey S. Pop, Attorney at Law, Beverly Hills, CA, for petitioner. Adriana Ruth Teitel, U.S. Department of Justice, Washington, DC, for respondent. DECISION ON J OINT STIPULATION 1 

### Dorsey , Chief Special Master: On February 11, 2015, petitioner fil ed a petition for co mpensation under the National Vaccine Injury Compensat ion Program, 42 U.S.C. §300aa-10, et seq. , 2

### [the “Vaccine Act”]. Petitioner alleges that she suffered severe shoulder pain as a result of her September 18, 2012 influenza [“flu”] vaccine. Petition at 1; Stipulation, filed December 30, 2015, ¶¶ 2, 4. Petitioner fu rther alleges that she has suffered the residual effects of her injury for more than six months and has received no prior compensation, award, or settl ement of a civil action for damages as a result of her injury. Petition, ¶¶ 26-27; Stipulation, ¶¶ 4-5. “Respondent denies that the flu vaccine caused petitioner’s alleged shoulder pain. Respondent further denies that the flu vaccine caused petitioner any other injury or her current conditi on. ” Stipulation, ¶ 6. Nevertheless, on December 30, 2015, the parties filed the attached joint stipulation, stating that a decision should be entered awarding compensation. The
1 

### Because this unpublished decision contains a reasoned explanation for the action in this case, the undersigned intends to post it on the United States Court of Federal Claims' website, in accordance with the E-Government Act of 2002, Pub. L. No. 107-3 47, § 205, 116 Stat. 2899, 2913 (codified as amended at 44 U.S.C. § 3501 note (2006)). In accordance with Vaccine Rule 18(b), petitioner has 14 days to identify and move to redact medical or other inform ation, the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, t he undersigned agrees that the identified material fits within this definition, the undersigned 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 

### undersigned finds the stipulat ion reasonable and adopts it as the decision of the Court in awarding damages, on the terms set forth therein. The parties stipulated that petitioner s hall receive the following compensation: A lump sum of $95,000.00 in the form of a check payable to petitioner

. Stipulation, ¶ 8. This amount represents compensation for all items of damages that would be available under 42 U.S.C. § 300aa-15(a). Id
. The undersigned approves the requested amountfor petitioner’s compensation. In the absence of a motion for review filed pursuant to RCFC Append ix B, the clerk of the court is directed to enter judgm ent 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 c an be expedited by the parties’ joint filing of notice renouncing the right to seek review.

### IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFI CE OF SPECIAL MASTER S
P

AULETfE CUMM I NS. Petit i o ner.
v. 

### No. 15-l-1 2V SECRF.TA RY O F HEALTH A D H UMAN SE R V I CES. C h ie l' Special Ma ster**Dnrse~** 

### 1 -:CF
Rc sro ndcnt.


### STIP ULATIO N Th e partie s hereb y sti pulate to the follo\\'i ng matter s: I
. P e t i t io n er 

### lilcd n petition for vacci n e compcnsmio n undcr the N at i o n al**V~11:e 111.:**  Injur y Co m pensatio n Pro gram. 

### 42 l l .S.C.**~** 

### 300aa-10 to 

### 3-1 ( the "Vaccin e Program"). The rc1iti o11 seeks compen satio n for injuries alleged l y related 10 pctitin n er· s receipt ol' an inllucn1.a ("llu" ) vaccine. w hi c h va ccine i s co ntained in th e Vacci n e Inj ury T able (the ·Table"). -1 2 C.F.R.**~** 

### 100.3 (a ).

.., Petit inner recei\'ccl her llu i mmuni n lli nn o n Se ptem be r 

### 18. 20 12. 

### 3
. Th e v accine \\n s admini ste red wit hin the U nited State s. 4. P e t i ti o n er allege s that s he dc vdop cd sev ere sho uld er pain as a conse qu e n ce n l't h e llu immuni.-::ation s h e re ce i ved. and l'urth e r alle ges that sh<.: c.\pe r icnccd the r es i dual effect s ol'this injury 

### fi)I' mo r e than s i x mon th s. 5. Petitioner r epre sent s that t here ha s been n o pr i or a\\ard or se ttlcment o l'a civ il ac t ion f<> r damages as a r es ult of her co nditi o n . 

### Case 1:15-vv-00142-UNJ Document 24 Filed 12/30/15 Page 1 of 5

### 6. Respo nd ent denie s that the llu vacc ine caused petitioner's alleged s h o u l der pa i n . Responcle nc fu rthe r denies t h at the nu \a cc ine caused petitioner**an~** 

### other injury o r h er cu r rent co nd ition. 7. Mai nta i nin g their abo\'e- s tated posi tion s. the pa nic s ncvcrlhtks s 110\\ 

### agree that the is su es between the m shall be se ttled and that a c lcl.:i sio n sho ul J be entered a"arding the compensat i o n de s cribed in paragraph 8 of thi s S tipulation. 8. As s oon a s pra cticabl e nf't e r an entr) ol'judgmen t r ellecting a decision consis tent" ith rhe t erms o f thi s St ip ulati on. and aller pet it i o ner ha s lilccl an ele ct i o n to recei v e co mpen sati o n pursuan t to**2** 

### LJ.S.C. 

# * 300an-2 I (a)( I). t he Set:retar) o l' I lea Ith and 1 lum an Ser v ices" i l l i ssue th e fol l owi n g vacei ne co mpcn s at ion pa) mcn t: A 

### lump sum o l'S95,000.00 in the form o ra check pa) able to pcti t ionL'r. Thi s amount rep resent s c o mpen s ati o n fo r all damage s that \\Otild be a\' ailablc u nder 

### 42 U.S.C
.**~** 

### 300aa- 1 5(a). 9. As 

### !ino n a-; prac t i <.: abl c n l'tcr th e e ntry o l' juJg1111.:nt on cn titlcmrnt in thi s L'asc. and a lier pcriti o n e r has filed bot h a rropc r and timely e l ection to recci\'c co mpen sation pursuant 

### to 

### .:\ 2 U.S.C.**~** 

### 300aa-2 I (a)( I )
. and an application. the parties" ill sub mit t o rurt her proc c c.:din gs before the special m aster to ;rna rd rea so na ble attornc.:)s· lt:cs and cos t s in c urred in p rnn:c clin g. up o n thi s pe tit ion. I 0. Peti tioner and her 

### alt orney rep rese nt that the : have idcntilied t o rc s po mknt all kn ow n so urces o r payment l or item s o r s e rv ice s 1\ ) r "hich th e Prngrnm i s no t primaril) liable und er 

### -1 2 U.S. C
. 

# *300aa - I 5(g)
. incl uding S t :llc com pen sat i c1 n**prngram ~.**  

### insuran ce po lii.:ics. Federal or S tat e hea l th benefits prog ram s ( oth e r than Title XIX o f th e S1.icial Sc1:urit: 1 \ ct (-12 Ll.S.C.**~** 

### 1 396 ct seq.) )
. o r entit i es that pro vi de hea lth se r v i ces on a pre-paid ba sis. 

### Case 1:15-vv-00142-UNJ Document 24 Filed 12/30/15 Page 2 of 511. Pa) nH !n l s made pursuant l o paragraph 8 and any amoun t s 11\\ardt.:cl pursuant to 

### paragraph 9 ofthis Stipulation will be ma ck in accordance ''ith -12 

### lJ.S.C.**~** 300aa-15(i). subj ect to the availability of sufficient st atutor) !imd s. 

### 12. The parties and th dr attornc)s rurther agree and s t ipulate that. e.\ccpl for**an~** a"<ml 

### for mtorney s· 

### tees and litigation costs and pa st urm:imhursa blc**c:-.pcnse~.** tht: 

### mo ney prcl\' idcd pursuant to this Stipulation\\ ill 

### be used so ld) for the benclit 

### o f peti t ioner as co ntemplated**b~** a stri ct construc t io n of 

### 42 U 

### .S.C.**~** 300aa- 

### I 5(a) and ( d ). and**sul~jet.:l** to the co nditi ons 

# or -12 lJ .S.C.**~** 300aa- 15 (g) and (h). 1 3. In rctllrn for the payment :, de scr i bed in pnragraph s 

### 8 and 

### 9. petitioner. i n her i ndividua l capacity. and o n bchall'ol'hcr ht:irs. cxo;:cutors. administrators.**uccess ~**  or as sign s. d ocs forever irrevocabl y and uncondilion all::. rcl e ast:
. acquit and discharge th!.! U nit ed State s and 

### the Secre t a r y 

### of Health and Human Servi ces 

### from an) and all actions or causes 

# or ac t i o n (i n c ludin g agn : c111e11t s . juugmcnts. c laim s. danwgcs. luss uf'Sl! J'\ ice::-. c:-.pcnses and all dc11 11 111d -; ol'wha 1cvc r kind or nature) that ha\e bel.!n brought. co uld have been brought. o r co uld be tim e!;. bro u ght in the Co urt 

# or Federa l Claims. under the r\ation : ll Vaccine Inju r y Compensatio n Prog r am. 42 U .S. C.**~** JOOaa- 1 0 ct seq .. o n an:ou111 nl: ti r in illl)**\\ll ~**  gro" ing l lUl or. any and all knm v n o r unkn ow n. su spect ed or 1111 sus pc c tcd pe rso nal injuries l o or death 

# o r pct i t inner rc su It ing frnm. or a ll eged to have re s ulted rr n m. the llu "accination admini st ered o n September 18
. 2012.
as alleged by petitioner in a petition for v a cc ine compe n s ation filed o n Februar: 11. 2015. in the Uni ted States Court orFcderal Claims as petition o. 15-l-12V. 1-1. I I' pe t itioner should die prio r to cntr) ofjudg mcnt. thi s ag reement shall be voidab le up on proper n ot ice 10 the Co urt o n behalf of ei ther or both ol'thc parti es.



## " Case 1:15-vv-00142-UNJ Document 24 Filed 12/30/15 Page 3 of 51 5. If' t he specia l ma ste r foi l s t o issue a d ecisio n in com plete con l im11 ity \\ · ith t he t er m s 

### of thi s St i pulation o r ir t he Court 

# or Federal Claims foils to en ter judgment in co nl or mi ty \\ ith a decision t hat i s in comple t e con l o r rn i ty ''ith the terms of't hi s Stipulmion. then the partie s· settlemen t and thi s St i pulat i o n shall be' oida bl c at th e so le di sc reti o n nl'cit hcr 

### pan:. 16. Thi s Stipu l ation expre sses 

### a l"ull and com ple t e neg ot ia t ed sc u lcmen t 

### or liabi li ty and damage s c l a i med under t he National Childhood Vaccine I njury /\c t o f" 

### 1986. as amended. c\ccpt
as ot herw i se noted i n 

### paragraph 9 above. There 

### is absolu te!; nn agrcc mL'nt o n the p art ol' th c partie s heret o t o nrn k e any pa ymen t o r to do an: act o r thing 01 he r tlrnn is here i n exp ress l y st at ed and clear l y agree d t o. The parti es r·urther ag ree and unt krstand that the a \\ard described in th is St i pulat i on 

### may refl ec t 

### a co m promise 

### of the partie s · rcs p ec ti\ ·c posit i ons as to

## liabilit~**·** amllor
amoun t 

### of dam ages. and further. th at 

### a change in t he nat ure ol'thc injur") or conditiun 

### or in t hc it e m s 

# o rco mpen sa ti o n so ught. is not grounds to

## modif~ or re v i se this agreemen t. 17. T h is Stirulntion s h all not be construed 

### a s an adm ission

### b~ the l l nitcd St ales t)r the Secretary 

# o r I I cal th and I luman Services th ai the 

### llu v; 1 c1: inat io 11 

### caused

## peti**ti ne** **r"~** shuulckr pain o r any o t her injury. 

### 18. All r i ghts 

### and obligat i o n s 

### o f peti1ioncr hcrcundcr 

### shall appl: cquall: to pctitiom:r
.. 

### s hci 

### r s. e:-;cc u to r s . administrators. successors. and /o r nssigns.

I I 

### / I I 

### I I 

### I I 

### I 

### E ND OF STIPI Jl. .1\TION 

### Case 1:15-vv-00142-UNJ Document 24 Filed 12/30/15 Page 4 of 5

### Respectfully submitted, l'E'I'mONER:

A'ITORNEY OF RECORD FOR PETITIONER:

# •m 9107 Wilshire Blvd, Sutte 700 Bem-ly Hills, CA 90210 (310) 273

- 5462

NTATlVt; FHEALTB

A. 

### MELISSA H USTON , M.D ., 

### M
.P
.H, FAAP Director, Division of Injury Compensation Programs 

### Healthcare Systems 

### Bureau V

•. S. 

### Department 

### ofHealth 

### and Huma!) Services 

### 5600 fishers Lano Parklawn Building, Mail Stop 08Nl46B 

### Rockville. MD 20857

oaicd : 

# D e

c 3 0 

# .' 20l5 }



### .s AUTHORIZED REPRESENTATIVE OF' 1liE ATTORNEY GENERAL:

# ~a~ VINCENT J. 

### M'ATANOSKI Deputy OiredDr 

### Tons Branch Civil Division 

### U.S.DepartinentofJusticc P.O. Box 

### 146 Benjamin f'rankiin Sratlon Washington, DC 20044-0146
A'ITORNEY OF RECORD FOR 

### RESPONDENT:



### ADRIANA TEITEL 

### Trial Attorney Torts Branch 

### C

i vil Divis ion 

### U

.S. Department ofJustice P
. O
. Bax 146 Benjamin Franklin Station 

### Washington , DC 20044--0146 (202) 616-3677 

### Case 1:15-vv-00142-UNJ Document 24 Filed 12/30/15 Page 5 of 5