In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 19-101V

UNPUBLISHED

BRIAN VAN VICKLE,

 Petitioner,

v.

SECRETARY OF HEALTH AND 

HUMAN SERVICES,

 Respondent.

Chief Special Master Corcoran 

Filed: May 6, 2020

Special Processing Unit (SPU); Joint 

Stipulation on Damages; Influenza 

(Flu) Vaccine; Shoulder Injury 

Related to Vaccine Administration 

(SIRVA)

Bruce William Slane, Law Office of Bruce W. Slane, P.C., White Plains, NY, for 

petitioner.

Lara Ann Englund, U.S. Department of Justice, Washington, DC, for respondent.

DECISION ON JOINT STIPULATION1

On January 18, 2019, Brian Van Vickle 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 he suffered a shoulder injury related to vaccine 

administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered on 

October 17, 2016. Petition at 1; Stipulation, filed May 5, 2020, at ¶¶ 1-2, 4. Petitioner 

further alleges that the vaccine was administered in the United States; that he suffered 

the residual effects of his injury for more than six months; and that there has been no 

prior award or settlement of a civil action for damages on his behalf as a result of his

condition. Petition at 1, 6; Stipulation at ¶¶ 3-5. “Respondent denies that petitioner 

sustained a SIRVA Table injury; denies that the vaccine caused petitioner’s alleged 

 

1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am 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).
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shoulder injury, or any other injury; and denies that his current condition is a sequelae of 

a vaccine-related injury.” Stipulation at ¶ 6. 

Nevertheless, on May 5, 2020, the parties filed the attached joint stipulation, 

stating that a decision should be entered awarding compensation. I find the stipulation 

reasonable and adopt it as my decision awarding damages, on the terms set forth 

therein.

Pursuant to the terms stated in the attached Stipulation, I award the following 

compensation:

A lump sum of $43,720.00 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. 

I approve 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/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.
IN THE UNITED STATES COURT OF FEDERAL CLAIMS 

OFFICE OF SPECIAL MASTERS 

BRIAN VAN VICKLE, 

Petitioner, 

V. 

SECRETARY OF 

HEALTH AND HUMAN SERVICES, 

Respondent. 

) 

) 

) 

) 

) No. 19-101 V 

) Chief Special Master Brian Corcoran 

) 

) 

) 

) 

STIPULATION 

The parties hereby stipulate to the following matters: 

l. Petitioner Brian Van Vick.le ("petitioner") filed a petition for vaccine compensation 

under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to 34 (the 

"Vaccine Program"). The petition seeks compensation for injuries allegedly related to 

petitioner'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 a flu vaccine on or about October 17, 2016. 

3. The vaccine was administered within the United States. 

4. Petitioner alleges that he sustained a shoulder injury related to vaccine administration 

("SIRVA") within the time period set forth in the Table. He further alleges that he experienced 

the residual effects of this condition for more than six months. 

5. Petitioner represents that there has been no prior award or settlement of a civil acti.on 

for damages as a result of bis condition. 
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the 

vaccine caused petitioner's alleged shoulder injwy, or any other injury; and denies that his 

current condition is a sequelae of a vaccine-related injury. 

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-21(a)(l), the Secretary ofHealth and Hwnan Services will issue 

the following vaccine compensation payment: 

A lump sum of $43,720.00, 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-15(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-2I(a)(l), 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 his attorney represent that they have identified to respondent all 

known sources of payment for items or services for which the Program is not primarily liable 

under 42 U.S.C. § 300aa-15(g), including 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 entities that provide health services on a pre-paid basis. 

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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-15(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 and past unreimbursable expenses, 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-l 5(g) and (h). 

l3. In return for the payments described in paragraphs 8 and 9, petitioner, in his 

individual capacity, and on behalf of his 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 aU 

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 or about October 17, 

2016, as alleged by petitioner in a petition for vaccine compensation filed on or about January 

18. 2019. in the United States Court of Federal Claims as petition No. 19-lOIV. 

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. 

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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 conformity 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 wider 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 W1derstand 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 natw-e 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 the flu vaccine caused petitioner's alleged shoulder 

injucy or any other injury or his current condition. 

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

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

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END OF STIPULATION 

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Respectfully submitted, 

PETITIONER: 

ATTORNEY OF RECORD FOR 

PETITIONER: 

.Lw~ 

BRUCE W. SLANE 

THE LAW OFFICE OF BRUCE W. SLANE, P.C. 

188 East Post Road, Suite 205 

White Plains, NY 10601 

(914) 269-2010 

AUTHORIZED REPRESENTATIVE 

OF THE SECRETARY OF HEALTH 

AND HUMAN SERVICES: 

TAMARA OVERBY 

Acting Director, Division of 

Injury Compensation Programs 

Healthcare Systems Bureau 

U.S. Department of Health 

and Human Services 

5600 Fishers Lane 

Parklawn Building, Mail Stop 08N146B 

Rockville, MD 20857 

Dated: S ]'5/ 7-0 

5 

AUTHORIZED REPRESENTATIVE 

OF THE ATTORNEY GENERAL: 

e::ffiVE~c___ 

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: 

~A~~ 

~ ~ "LL---~ ..... LARA A. ENGLUND 

Senior Trial Attorney 

Torts Branch 

Civil Division 

U.S. Department of Justice 

P.O. Box 146 

Benjamin Franklin Station 

Washingto~ DC 20044-0146 

(202) 307-3013