# In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS

No. 18-990V UNPUBLISHED
KILEY LIZAMA , Petitioner, v. SECRETARY OF HEALTH AND HUMAN SERVICES,

Respondent. Chief Special Master Corcoran Filed: April 24, 2020 Special Processing Unit (SPU); Joint Stipulation on Damages; Tetanus Diphtheria acellular Pertussis (Tdap) Vaccine; Shoulder Injury Related to Vaccine Administration (SIRVA) Amy A. Senerth, Muller Brazil, LLP, Dresher, PA , for Petitioner. Camille Michelle Collett , U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION 1 On January 15, 2019 , Kiley Lizama 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 a SIRVA resulting from adverse effects of her October 13, 2017 vaccination . Petition at 1 ; Stipulation , filed April 21, 2020 , at ¶ 1

. Petitioner further alleges that the vaccine was administered in the United States, she experienced the residual effects of this alleged injury for more than six months, and there has been no prior award or settlement of a civil action for damages as a result of her condition . Petit ion at 1, 4 ; Stipulation at ¶¶ 1
-5

. “ Respondent denies that petitioner sustained a SIRVA Table injury, or and further denies that the vaccine caused her alleged shoulder injury or any other injury or condition. ” 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1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am required to post it on the United States Court of Federal Claims' website in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 E
- Government 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 pe rtinent subparagraph of 42 U.S.C. § 300aa (2012 ). 

### CORRECTED2

Nevertheless, o n April 21, 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 term s stated in the attached Stipulation , I award the following compensation: A lump sum of $30,000.00 in the form of a check payable to Petitioner

. Stipulation at ¶ 8. This amount represents compensation for all items of damages that wo uld be available under § 15 (a). Id

. I approve the requested amount for P etitioner’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** 
**KILEY LIZAMA,**  **Petitioner,**
**V. No.**  **18-990V SECRETARY**  **OF HEALTH**  **AND HUMAN**  **SERVICES, Chief**  **Special Master**  **Brian Corcoran**  **ECF Respondent.** 

**STIPULATION**
**The parties**  **hereby stipulate**  **to the**  **following matters:**  **1. 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 Tetanus**  **diphtheria-acellular pertussis**  **( ..** **Tdap") vaccine,**  **which vaccine**  **is contained**  **in the**  **Vaccine Injury**  **Table (the**  **"Table"), 42**  **C.F.R. §**  **100.3(a). 2.**  **Petitioner received**  **the Tdap**  **vaccination on or about**  **April 23,**  **2016. 3.**  **The vaccine**  **was administered**  **within the**  **United States.**  **4. Petitioner**  **alleges that**  **the Tdap**  **vaccine caused**  **her to**  **develop a**  **right shoulder injury**  **related to**  **vaccine administration ("SIRVA"),**  **as defined**  **in the**  **Table, and**  **further alleges**  **that she**  **experienced the**  **residual effects**  **of this**  **alleged injury**  **for more**  **than six**  **months. 5.**  **Petitioner represents that**  **there has**  **been no**  **prior award**  **or settlement**  **of a**  **civil action**  **for damages**  **as a**  **result of**  **her condition.** **6. Respondent**  **denies that**  **petitioner sustained a**  **SIRVA Table**  **injury, or**  **and further** 

**denies that**  **the vaccine caused her**  **alleged shoulder**  **injury or**  **any other**  **injury or**  **condition. 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 tenns**  **of this**  **Stipulation, and**  **after petitioner**  **has filed**  **an election**  **to receive**  **compensation pursuant**  **to 42**  **U.S.C. §**  **300aa-2l(a)(l), the**  **Secretary of**  **Health and Human**  **Services will**  **issue the**  **following vaccine**  **compensation payment:**  **A lump**  **sum of$30,000.00**  **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-I 5(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. l**  **0. 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-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.** 

**2 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**  **attorney's 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-**  **l 5(a)**  **and (d),**  **and subject**  **to the**  **conditions of 42**  **U.S.C. §**  **300aa-15(g) and**  **(h). 13.**  **In return**  **for the**  **payment described**  **in paragraph**  **8, and**  **any amount**  **awarded pursuant**  **to paragraph**  **9, petitioner,**  **in her individual**  **capacity, and**  **on behalf**  **of her heirs,**  **executors, administrators,**  **successors and/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-l 0**  **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 Tdap**  **vaccine administered**  **on or**  **about April**  **23, 2016,**  **as alleged**  **by petitioner**  **in a**  **petition for**  **vaccine compensation**  **filed on**  **or about**  **July 11,**  **20 l**  **8, in**  **the United**  **States Court**  **of Federal**  **Claims as**  **petition No.**  **18-990V. 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.**

**3 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**  **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**  **Tdap vaccine**  **caused petitioner's**  **alleged shoulder**  **injury or**  **any other**  **injury or**  **condition. 18.**  **All rights**  **and obligations**  **of petitioner**  **hereunder shall**  **apply equally**  **to petitioner's**  **heirs, executors,**  **administrators, successors,**  **and/or assigns.** 

**I I**  **I I**  **I I**  **I I**  **I I**  **END OF**  **STIPULATION**

**4**Respectfully submitted,

PETITIONER:

AMYSENERTH MULLER BRAZll.., LLP 715 Twining Road , Suite 208 Dresher, PA 19025 (215 ) 885-1655

AUTHORIZED REPRESENTATIVE OF THE SECRETARY OF HEALffl AND HUMAN SERVICES:

TAMARA OVERBY Acting Director, Division of Injury Compensation Programs (DICP) Healthcare Sys tems Bureau Health Resources and Services Administration 5600 Fishers Lane Parklawn Building, Mail Stop 08N 146B Rockville, MD 20857

5 AUTHORIZED REPRSENTATIVE OF HE ATTORNEY GENERAL:

C ~~~EE. REEVES 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: 

# (_**~** 

# m lclla:x:r

~~ - G-___ Trial Attorney Torts Branch Civil Division U.S. Department of Justice P.O. Box 146 Benjamin Franklin Station Washington, DC 20044-0146 Tel: (202) 616-4098