In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 19-1011V

UNPUBLISHED

SANDRA BOTTA,

 Petitioner,

v.

SECRETARY OF HEALTH AND 

HUMAN SERVICES,

 Respondent.

Chief Special Master Corcoran 

Filed: November 16, 2021

Special Processing Unit (SPU); Joint 

Stipulation on Damages; Influenza 

(Flu) Vaccine; Shoulder Injury 

Related to Vaccine Administration 

(SIRVA)

Andrew Donald Downing, Van Cott & Talamante, PLLC, Phoenix, AZ , for Petitioner.

Ronalda Elnetta Kosh, U.S. Department of Justice, Washington, DC, for Respondent.

DECISION ON JOINT STIPULATION1

On July 15, 2019, Sandra Botta 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 an adverse reaction in her left shoulder after 

receiving an influenza vaccine on September 26, 2018. Petition at 1, ¶¶ 1, 3; Stipulation, 

filed at Nov. 15, 2021, ¶¶ 1-2, 4. Petitioner further alleges that she received the vaccine 

in the United States, that she suffered the residual effects of her injury for more than six 

months, and that neither she nor any other party has filed a civil action or received 

compensation for her injury. Petition at ¶¶ 1, 3, 11, 13; Stipulation at ¶¶ 3-5. “Respondent 

denies that [P]etitioner sustained a SIRVA Table injury; denies that the flu vaccine caused 

[P]etitioner’s alleged shoulder injury, or any other injury; and denies that her current 

condition is a sequelae of a vaccine-related injury.” Stipulation at ¶ 6. 

1 Because this unpublished Decision contains a reasoned explanation for the action in this case, I am 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).
2

Nevertheless, on November 15, 2021, 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 $50,000.00 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 Section 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 STA TES COURT OF FEDERAL CLAIMS 

OFFICE OF SPECIAL MASTERS 

SANDRA BOTTA, 

Petitioner, 

v. 

SECRETARY OF HEALTH AND 

HUMAN SERVICES, 

Respondent. 

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No.19-lOllV 

Chief Special Master Corcoran 

ECF 

STIPULATION 

The parties hereby stipulate to the following matters: 

1. Sandra Botta ("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 an injury allegedly related to petitioner's receipt 

of the influema ("Flu") vaccine, which is contained in the Vaccine Injury Table (the "Table"), 42 

C.F.R. § 100.3(a). 

2. Petitioner received the flu vaccine on September 26, 2018. 

3. The vaccine was administered in the United States. 

4. Petitioner alleges that as a result of receiving the flu vaccine, she suffered a Shoulder 

Injury Related to Vaccine Administration ("SIRVA") within the Table timeframe. She further 

alleges that she suffered the residual effects of her alleged injury for more than six months. 

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

for damages as a result of her alleged condition. 

6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the flu 

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

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)(I ), the Secretary of Health and Human Services will issue 

the following vaccine compensation payment: 

A lump sum of $50,000.00, in the form of a check payable to petitioner, which 

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-21(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 her 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-l5(g), including State compensation programs, insurance policies, Federal or State 

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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. 

11. Payment made pursuant to paragraph 8 of this Stipulation, and any amount awarded 

pursuant to paragraph 9, 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-15(g) and (h). 

13. In return for the payments described in paragraph 8, and any amount awarded 

pursuant to paragraph 9, petitioner, in her individua I capacity, and on behalf of her 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-l0 et seq., on account of, or 

in any way growing out of, any and all known or unknown, suspected or unsuspected personal 

injuries to or death of petitioner resulting from, or alleged to have resulted from the flu vaccine 

administered on September 26, 2018, as alleged in a Petition filed on July 15, 2019, in the 

United States Court of Federal Claims as petition No. 19-101 lV. 

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14. If petitioner should die prior to entry of judgment, this agreement shall be voidable 

upon proper notice of the Court on behalf of either or both of the parties. 

15. If the special master fails to issue a decision in complete conformity with the terms 

of this Stipulation or if the United States Court of Federal Claims fails to enter judgment in 

conformity 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 under 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 do any act or thing other than is herein expressly stated 

and clearly agreed to. The parties further agree and understand 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 nature 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 

lllJUfY, or any other injury. 

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

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

END OF STIPULATION 

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Respectfully submitted, 

PETIJIONER: 

_I /. 

SA 

ATTORNEY OF RECORD FOR 

PETITIONER: 

Van Cott & Talamante, P 

3030 N. Third Street, Suite 790 

Phoenix, AZ 85012 

Phone: (602) 257-9160 

Email: adowning@vancotttalamante.com 

AUTHORIZED REPRESENTATIVE 

OF THE SECRETARY OF HEAL TH 

AND HUMAN SERVICES: 

z:>cdtL ~I z:>&$c.-, A/>M, ~1, 

TAMARA OVERBY, M.D. (,) 

Acting Director, Division of Injury 

Compensation Programs 

Health Systems Bureau 

Heahh Resources and Services 

Administration 

U.S. Department of Heahh 

and Human Services 

5600 Fishers Lane, 08N I 46B 

Rockville, MD 20857 

Dated: II II S } Z()2, I 

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AUTHORIZED REPRESENTATIVE 

OF THE ATTORNEY GENERAL: 

~c.b.V\:v.,A\i Pe~ 

HEATHER L. PEARLMAN 

Deputy Director 

T011s Branch 

Civil Division 

U.S. Department of Justice 

P.O. Box 146 

Benjamin Franklin Station 

Washington, DC 20044-0146 

ATTORNEY OF RECORD FOR 

RESPONDENT: 

~~d~~~() 

RONALDA E. KOSH 

Ly~ 

Trial Attorney 

Torts Branch 

Civil Division 

U.S. Department of Justice 

P.O. Box 146 

Benjamin Franklin Station 

Washington, DC 20044-0146 

ronalda. kosh@usdoj.gov 

(202) 616-4476