In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 19-1771V

UNPUBLISHED

CARIANA M. FORBUSH as 

administrator for ESTATE OF KRISTI 

A. BAKER,

 Petitioner,

v.

SECRETARY OF HEALTH AND 

HUMAN SERVICES,

 Respondent.

Chief Special Master Corcoran 

Filed: December 20, 2021

Special Processing Unit (SPU); 

Damages Decision Based on Proffer; 

Influenza (Flu) Vaccine; Shoulder 

Injury Related to Vaccine 

Administration (SIRVA)

Simina Vourlis, Law Offices of Simina Vourlis, Columbus, OH, for Petitioner.

Steven Santayana, U.S. Department of Justice, Washington, DC, for Respondent.

DECISION AWARDING DAMAGES1

On November 18, 2019, this petition for compensation was filed under the National 

Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2(the “Vaccine 

Act”). Petitioner alleges that Kristi A. Baker suffered right shoulder injuries related to 

vaccine administration (“SIRVA”) as a result of a November 23, 2017 influenza vaccine. 

Petition at 1-7. The case was assigned to the Special Processing Unit of the Office of 

Special Masters.

On April 12, 2021, a ruling on entitlement was issued, finding Petitioner entitled to 

compensation for SIRVA. On December 20, 2021, Respondent filed a proffer on award 

of compensation (“Proffer”) indicating Petitioner should be awarded $130,750.30. Proffer 

1 Because this unpublished Decision contains a reasoned explanation for the action in this case, I am 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 section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. 

§ 300aa (2012).
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at 3. In the Proffer, Respondent represented that Petitioner agrees with the 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 $130,750.30 (comprised of $107,500.00 for pain and suffering, 

$2,524.97 for past out-of-pocket expenses, $980.00 in estate costs, and $19,745.33 

in past lost wages) in the form of a check payable to Petitioner. This amount

represents compensation for all damages that would be available under Section 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

____________________________________ 

 ) 

CARIANA M. FORBUSH, as administrator ) 

of the estate of KRISTI A. BAKER, ) 

 ) 

 Petitioner, ) 

 ) No. 19-1771V 

v. ) Chief Special Master Corcoran

 ) ECF

SECRETARY OF HEALTH AND ) 

HUMAN SERVICES, ) 

 ) 

 Respondent. ) 

____________________________________)

RESPONDENT’S PROFFER ON AWARD OF COMPENSATION

On November 18, 2019, Kristi A. Baker (“original petitioner”) filed a petition for 

compensation under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 

to -34 (“Vaccine Act” or “Act”), alleging that she suffered a Shoulder Injury Related to Vaccine 

Administration (“SIRVA”), as defined in the Vaccine Injury Table, following administration of 

an influenza vaccine she received on November 23, 2017. Petition at 1. On April 8, 2021, the 

Secretary of Health and Human Services (“respondent”) filed a Rule 4(c) Report indicating that 

this case is appropriate for compensation under the terms of the Act for a SIRVA Table injury, 

and on April 12, 2021, the Chief Special Master issued a Ruling on Entitlement finding original 

petitioner entitled to compensation. ECF No. 35; ECF No. 36. On June 1, 2021, the Chief 

Special Master issued an order granting a motion for substitution of parties and to amend the 

caption to substitute the original petitioner with the administrator of the original petitioner’s 

estate. ECF No. 42; ECF No. 40. The motion explained that Cariana M. Forbush (“petitioner”), 
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was appointed administrator of the original petitioner’s estate following her death on October 19, 

2020. ECF No. 40 at 1. 

Items of Compensation

Pain and Suffering

Respondent proffers that petitioner should be awarded $107,500.00 in pain and suffering. 

See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Past Out-of-Pocket Expenses

Evidence supplied by petitioner documents that she incurred past out-of-pocket expenses 

related to the vaccine-related injury. Respondent proffers that petitioner should be awarded past 

out-of-pocket expenses in the amount of $2,524.97. See 42 U.S.C. § 300aa-15(a)(1)(B). 

Petitioner agrees.

Estate Costs 

Respondent proffers that petitioner should be awarded $980.00 in estate costs. See 42 

U.S.C. § 300aa-15(a)(1)(B). Petitioner agrees.

Lost Wages 

Respondent proffers that petitioner should be awarded $19,745.33 in past lost wages. See

42 U.S.C. § 300aa-15(a)(3)(A). Petitioner agrees.

These amounts represent all elements of compensation to which petitioner is entitled 

under 42 U.S.C. § 300aa-15(a). Petitioner agrees. 

Form of the Award

Petitioner is a competent adult. Evidence of guardianship is not required in this case. 

Respondent recommends that the compensation provided to petitioner should be made through a 

lump sum payment as described below and requests that the Chief Special Master’s decision and 
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the Court’s judgment award the following1: a lump sum payment of $130,750.30, in the form of 

a check payable to petitioner. 

Summary of Recommended Payments Following Judgment

Lump sum payable to petitioner, Cariana Forbush: $130,750.30

Respectfully submitted,

BRIAN M. BOYNTON

Acting Assistant Attorney General

C. SALVATORE D’ALESSIO

Acting Director

Torts Branch, Civil Division

HEATHER L. PEARLMAN

Deputy Director

Torts Branch, Civil Division

ALEXIS B. BABCOCK

Assistant Director

Torts Branch, Civil Division

 /s/ Steven C. Santayana

 STEVEN C. SANTAYANA

 Trial Attorney

 Torts Branch, Civil Division

U.S. Department of Justice

P.O. Box 146, Benjamin Franklin Station

Washington, D.C. 20044-0146

Tel: (202) 451-7675

Fax: (202) 616-4310

Email: steven.c.santayana@usdoj.gov 

Date: December 20, 2021 

 

1 Should petitioner die prior to entry of judgment, the parties reserve the right to move the Court 

for appropriate relief. In particular, respondent would oppose any award for future lost earnings 

and future pain and suffering.