The opinion
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 24-0421V
DANIEL BRUNELL, Chief Special Master Corcoran
Petitioner,
v. Filed: February 23, 2026
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jonathan Joseph Svitak, Shannon Law Group, P.C., Woodridge, IL, for Petitioner.
Lynn Christina Schlie, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On March 19, 2024, Daniel Brunell filed a Petition seeking compensation under
the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”); see Section 11(c)(1)(D)(i). Petitioner alleges a right-sided shoulder injury
related to vaccine administration (“SIRVA”) following his receipt of a seasonal influenza
(“flu”) vaccine on October 17, 2022. Petition at Preamble, ¶ 7; 42 C.F.R. §§ 100.3(a),
(c)(10)(iii). The claim was assigned to the Special Processing Unit (“SPU”) of the Office
of Special Masters in August 2024.
1 Because this opinion contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the opinion 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).
For the reasons set forth below, I find that the vaccine at issue was more likely
than not administered in Petitioner’s right shoulder/arm, as alleged. In the absence of any
other objections from Respondent, and based on an independent review of the evidence,
I conclude that Petitioner has established entitlement to compensation for a Table SIRVA.
I. Procedural History
After the claim’s assignment to SPU, Respondent formally opposed compensation
for a right-sided SIRVA, because the vaccine administration form (“VAR”) indicated a “left
arm” situs. Rule 4(c) Report filed Dec. 9, 2024, ECF No. 15, at 6. I ordered Petitioner to
show cause why his claim should not be dismissed for that reason. Show Cause Order
filed May 20, 2025, ECF No. 17. Petitioner did not file any other evidence bearing on situs
or entitlement.3 The parties completed briefing, rendering the case ripe for adjudication.
See Petitioner’s Response to Order to Show Cause filed Aug. 7, 2025, ECF No. 21
(hereinafter “Brief”); Respondent’s Response filed Sept. 22, 2025, ECF No. 22,
Petitioner’s Reply filed Oct. 7, 2025, ECF No. 23; Joint Status Report filed Jan. 28, 2026,
ECF No. 25.
On February 20, 2026, I held an expedited entitlement hearing on the disputed
situs issue. After some discussion and questioning, I issued an oral ruling constituting my
findings of fact and conclusions of law, pursuant to Section 12(d)(3)(A). An official
recording of the proceeding was taken by a court reporter, although a transcript has not
yet been filed in this matter. I hereby fully adopt and incorporate that oral ruling as officially
recorded.
II. Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
Section 11(c)(1). In addition to requirements concerning the vaccination received, the
duration and severity of petitioner’s injury, and the lack of other award or settlement, 4 a
petitioner must establish that he suffered an injury meeting the Table criteria, in which
case causation is presumed, or an injury shown to be caused-in-fact by the vaccination
she received. Section 11(c)(1)(C).
3 Petitioner filed additional medical records as Ex. 11 on August 6, 2025, ECF No. 19. Those records pertain
to unrelated medical conditions and they are “not relevant to Petitioner’s SIRVA claim” according to
Respondent. Response filed Sept. 22, 2025, ECF No. 22.
4 In summary, a petitioner must establish that he or she received a vaccine covered by the Program,
administered either in the United States and its territories or in another geographical area but qualifying for
a limited exception; suffered an injury or its residual effects for more than six months, died from the injury,
or underwent a surgical intervention during an inpatient hospitalization; and has not filed a civil suit or
collected an award or settlement for the injury. See § 11(c)(1)(A)(B)(D)(E).
2
Section 11(c)(1) also contains requirements concerning the type of vaccination
received and where it was administered, the duration or significance of the injury, and the
lack of any other award or settlement. See Section 11(c)(1)(A), (B), (D), and (E). With
regard to duration, a petitioner must establish that he suffered the residual effects or
complications of such illness, disability, injury, or condition for more than six months after
the administration of the vaccine. Section 11(c)(1)(D).
The most recent version of the Table, which can be found at 42 C.F.R. § 100.3,
identifies the vaccines covered under the Program, the corresponding injuries, and the
time period in which the particular injuries must occur after vaccination. Section 14(a).
Pursuant to the Vaccine Injury Table, a SIRVA is compensable if it manifests within 48
hours of the administration of an influenza vaccine. 42 C.F.R. § 100.3(a)(XIV)(B). A
vaccine recipient shall be considered to have suffered SIRVA if such recipient manifests
all of the following:
(i) No history of pain, inflammation or dysfunction of the affected shoulder
prior to intramuscular vaccine administration that would explain the alleged
signs, symptoms, examination findings, and/or diagnostic studies occurring
after vaccine injection;
(ii) Pain occurs within the specified time frame;
(iii) Pain and reduced range of motion are limited to the shoulder in which
the intramuscular vaccine was administered; and
(iv) No other condition or abnormality is present that would explain the
patient’s symptoms (e.g. NCS/EMG or clinical evidence of radiculopathy,
brachial neuritis, mononeuropathies, or any other neuropathy).
42 C.F.R. § 100.3(c)(10).
A special master must consider, but is not bound by, any diagnosis, conclusion,
judgment, test result, report, or summary concerning the nature, causation, and
aggravation of petitioner’s injury or illness that is contained in a medical record. Section
13(b)(1). “Medical records, in general, warrant consideration as trustworthy evidence.
The records contain information supplied to or by health professionals to facilitate
diagnosis and treatment of medical conditions. With proper treatment hanging in the
balance, accuracy has an extra premium. These records are also generally
contemporaneous to the medical events.” Cucuras v. Sec’y of Health & Hum. Servs., 993
F.2d 1525, 1528 (Fed. Cir. 1993).
3
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Hum. Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, the
Federal Circuit has recently “reject[ed] as incorrect the presumption that medical records
are always accurate and complete as to all of the patient’s physical conditions.” Kirby v.
Sec'y of Health & Hum. Servs., 997 F.3d 1378, 1383 (Fed. Cir. 2021). Medical
professionals may not “accurately record everything” that they observe or may “record
only a fraction of all that occurs.” Id.
Medical records may be outweighed by testimony that is given later in time that is
“consistent, clear, cogent, and compelling.” Camery v. Sec’y of Health & Hum. Servs., 42
Fed. Cl. 381 at 391 (1998) (citing Blutstein v. Sec’y of Health & Hum. Servs., No. 90-
2808, 1998 WL 408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998). The credibility of the
individual offering such testimony must also be determined. Andreu v. Sec’y of Health &
Hum. Servs., 569 F.3d 1367, 1379 (Fed. Cir. 2009); Bradley v. Sec’y of Health & Hum.
Servs., 991 F.2d 1570, 1575 (Fed. Cir. 1993).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La Londe
Sec’y of Health & Hum. Servs., 110 Fed. Cl. 184 at 204 (2013) (citing § 12(d)(3); Vaccine
Rule 8); see also Burns v. Sec’y of Health & Hum. Servs., 3 F.3d 415, 417 (Fed. Cir.
1993) (holding that it is within the special master’s discretion to determine whether to
afford greater weight to medical records or to other evidence, such as oral testimony
surrounding the events in question that was given at a later date, provided that such
determination is rational).
I am resolving the fact dispute in question on the filed record. The Vaccine Act and
Rules not only contemplate but encourage special masters to decide many matters on
the papers where, in the exercise of their discretion, they conclude that doing so will
properly and fairly resolve the issue. See 42 U.S.C. § 12(d)(2)(D); Vaccine Rule 8(d).
Indeed, the decision to rule on the record in lieu of a hearing has been affirmed on appeal.
Kreizenbeck v. Sec’y of Health & Hum. Servs., 945 F.3d 1362, 1366 (Fed. Cir. 2020);
4
Hooker v. Sec’y of Health & Hum. Servs., No. 02-472V, 2016 WL 3456435, at *21 n.19
(Fed. Cl. Spec. Mstr. May 19, 2016) (citing numerous cases where special masters
decided cases on the papers in lieu of hearing and those decisions were upheld).
III. Finding of Fact
The record preponderantly supports a finding that the October 17, 2022
vaccination was administered in Petitioner’s right arm. I make these findings after a
complete review of the record to include all medical records, testimonial evidence,
Respondent’s Rule 4(c) Report, and both parties’ briefing and argument at the February
20, 2026 expedited hearing. Specifically, I base my findings on the following evidence:
• Petitioner was born in 1968. He had no history of right shoulder pain or dysfunction.
See generally Exs. 3-8; Ex. 1 at ¶¶ 11-13.
• Petitioner received the at-issue flu vaccine at a Roe Family HealthMart Pharmacy
in Utah on October 17, 2022. Ex. 2 at 1. A printed vaccine consent and
administration form (hereinafter the “VAR”) reflects Petitioner’s handwritten patient
information and signature, then the following information:
Ex. 2 at 1.
• Eight days post-vaccination, on October 25, 2022, Petitioner called the
Intermountain Health Family Medicine Clinic requesting an urgent appointment for
“Shoulder pain since receiving flu vaccine on 10/17/22.” Ex. 3 at 1461
(emphasis added).
• Fourteen days post-vaccination, on October 31, 2022, Petitioner attended the first
in-person medical appointment for this complaint. The appointment was apparently
brief – with the record (made by an intermountain registered nurse) reading, in full:
“Pt reports pain in R shoulder area post-flu immunization injection 2 weeks
prior, resulting in limited ROM d/t pain. No external s/sx of injury or damage
noted. [Primary care physician (“PCP”)] briefly evaluated pt RUE movement and
advised to take anti-inflammatory meds round the clock for a couple of days along
5
with ROM exercises and return to clinic in 2 weeks. RN scheduled pt for return visit
with [PCP].” Ex. 3 at 2431 (emphasis added).
• At the November 15, 2022 follow-up appointment with the PCP, Petitioner reported
that the October 17th vaccine had been given “right into the tendon… after that
he had a burning pain in his shoulder with movement, this has persisted off
and on since that time…” Ex. 3 at 2354 (emphasis added). Petitioner denied
having “any fall trauma or other injury” (although he acknowledged “using his
shoulder a lot” while remodeling his home and working as a long-haul truck driver).
Id. The PCP assessed “right anterior shoulder pain” potentially representing
arthritis, but he recommended further evaluation by an orthopedics specialist. Id.
• At a December 14, 2022 orthopedics initial evaluation for right shoulder pain,5
Petitioner reported that he had “received his flu shot at Walgreens [sic] 8
weeks ago. The technician injected him very high on the upper arm. The
following day, pain was so severe he could not lift or use his arm…” Ex. 5 at
4 (emphasis added). The orthopedist recorded that on physical examination of the
right shoulder: “Skin is intact. There is no erythema or induration about his needle
site. There is tenderness there and a little tenderness over the biceps tendon. He
is strong to global shoulder and Whipple exam.” The orthopedist assessed
Petitioner’s right shoulder injury as a “case of SIRVA which is 7 or 8 weeks in
duration.” Petitioner was prescribed oral steroids and told to return to the
orthopedics office as needed. Id.
• After a treatment gap of approximately four months, on May 15, 2023, Petitioner
underwent an MRI of his right shoulder, in light of his reported “pain and limited
range of motion.” Ex. 6 at 4-5; see also id. at 2 (reflecting that Petitioner paid out
of pocket for the MRI).
• At a May 15, 2023 “imaging follow-up” appointment, an orthopedics nurse
assessed that the MRI showed a “right shoulder massive rotator cuff tear with
subacromial impingement and biceps tendinosis” and “significant synovitis,” which
findings “could be related to SIRVA.” Ex. 5 at 8. The nurse recommended, and
Petitioner agreed to, future arthroscopic surgery. Id.
• The aforementioned orthopedist performed Petitioner’s right shoulder surgery on
June 20, 2023. Ex. 5 at 12-14. Afterwards, Petitioner attended 20 sessions of post-
operative physical therapy between August 3 – November 20, 2023. Ex. 7 at 95-
134. His shoulder was also reevaluated and assessed to be recovering at
orthopedics appointments through January 31, 2024. Ex. 7 at 137-38.
5 Petitioner had been seen at the orthopedics practice for previous unrelated medical concerns. See e.g.,
Ex. 5 at 50-123.
6
• In a June 2024 witness statement,6 Petitioner recalled that on October 17, 2022,
the pharmacy employee “indicated my dominant right arm and just asked me if this
arm was okay, [to] which I responded affirmatively because I was not especially
worried at that time.” Ex. 1 at ¶ 14. Petitioner recalls suffering immediate pain at
the time of vaccination, which persisted over time. Id. at ¶¶ 14-21. Petitioner states
that on or about March 1, 2024, he obtained a copy of the vaccine consent form
and discovered the notation of a “left arm” situs. Id. at ¶ 54. Petitioner contends
that this information is “erroneous,” and he immediately notified the pharmacy of
his concern, but he provided the form as it was originally created to his attorney.
Id.
Respondent’s sole objection to the Table SIRVA claim is that the VAR indicates
administration in Petitioner’s non-injured left arm. Rule 4(c) Report at 6 and Response at
3-6 (providing that 42 C.F.R. § 100.3(c)(10)(iii) requires Petitioner to demonstrate that his
symptoms were limited to the shoulder in which he received the flu vaccine). Respondent
correctly notes that this “left arm” situs notation was not computerized but handwritten –
and such notations are typically afforded greater comparative weight, because they
logically involve more specific action by the administrator, and because they may be more
contemporaneous to the actual fact of administration than a computer-generated record.
Response at 4-5 (internal citations omitted). Respondent also argues that that while the
VAR photocopy’s quality is not ideal, Petitioner has not identified any obvious lack of “due
care” or other obvious inaccuracies within the record that would render the “left arm”
notation less likely to be reliable. Id. at 5. Finally, there is not sufficient evidence that an
orthopedics appointment roughly two months post-vaccination observed or documented
any lingering evidence of a right-sided vaccination. Id. at 5-6.
While the “left arm” notation is somewhat problematic for Petitioner, it is not
necessarily dispositive just based on its handwritten character or status as the “first-
created” record of the vaccination. A factual finding must be made on the totality of all
case evidence, which here tips in Petitioner’s favor. In particular, Petitioner had no history
of right shoulder pain or dysfunction (which might have represented an obvious reason
for avoiding a right-sided vaccination, and/or a potential alternative cause for the injury
alleged). Additionally, the medical record evidence starting just eight days post-
vaccination7 support the conclusion that Petitioner had suffered a right-sided shoulder
6 Exhibit 1 is improperly characterized as an “affidavit,” because it is not notarized. However, the statement
at Exhibit 1 is declared as true and correct pursuant to 28 U.. § 1746 (providing that such a statement may
be given like force and effect as an affidavit).
7
In this case, Petitioner’s very early reporting and evaluation of a vaccine shoulder injury is distinguishable
from other cases such as Daugherty v. Sec’y of Health & Hum. Servs., No. 19-1519V, 2024 WL 3416068
at *3-5 (Fed. Cl. Spec. Mstr. June 5, 2024) (in which a handwritten “left arm” notation outweighed reporting
of a right-sided vaccination, reported only four months later), cited in Response at 5.
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injury, which he believed was caused by misadministration of the vaccine on his right
side. The medical evaluations documented an objective injury which warranted treatment
including orthopedic surgery. In short, all of the medical record evidence other than the
VAR support the alleged right-sided vaccine administration. Reply at 15-16. I conclude
that the case-specific evidence and arguments preponderate in Petitioner’s favor, thereby
supporting a finding that the October 17, 2022 flu vaccine was administered in his right
arm/ shoulder.
IV. Remaining Table SIRVA QAI Criteria and Statutory Requirements
Petitioner’s success in meeting the remaining QAI requirements is not disputed,
and I also find that they have been preponderantly satisfied. The record does not reflect
any potentially explanatory prior history of alternative conditions that would better explain
Petitioner’s alleged right-sided SIRVA. More likely than not, his right shoulder pain began
within 48 hours after the vaccination; the right shoulder was later documented to have
range of motion deficits; and those symptoms were localized to the right shoulder.
The statutory requirements applicable to all claims are also preponderantly
established. Petitioner received a covered vaccine in the United States. Ex. 2 at 1. He
experienced residual effects of the right shoulder injury for more than six months. See,
e.g., Ex. 5 at 6-8; Ex. 1 at ¶¶ 26-28. And he states that he has not pursued or received
any other compensation for this injury. Ex. 1 at ¶¶ 57-58. Thus, Petitioner is entitled to
Vaccine Program compensation.
Conclusion and Damages Order
For the foregoing reasons, Petitioner is entitled to compensation for a right-sided
SIRVA. Thus, this case is now in the damages phase.
The parties are reminded that they should not retain a medical expert, life
care planner, or other expert without consulting with each other and the Chief
Special Master.8 If counsel retains an expert without so consulting in advance,
reimbursement of those costs may be affected.
8 If the parties feel that a life care plan is necessary, they are encouraged to consider the possibility of
engaging a joint life care planner. Selecting a joint life care planner can often cut months from the time
period between an entitlement determination and the award of damages. With a joint life care planner, the
damages process moves more quickly and with less contention. When a joint life care planner is not used,
the life care planners should work together to coordinate interviews and site visits in order to avoid delay
and duplication of effort.
8
As discussed during the February 20, 2026 proceeding, this case’s damages
appear to be limited in scope. Petitioner’s right shoulder was the subject of surgery, but
that intervention was apparently followed by limited post-operative treatment and a
substantial recovery, with the medical course ending within about 15 months post-
vaccination. During the argument, I estimated that an appropriate award for past pain and
suffering might be somewhere between $100,000.00 - $140,000.00 – although in
assessing damages, the parties should of course carefully review the facts of this case
against those from past cases that involved reasoned determinations of SIRVA pain and
suffering. Petitioner should also not delay in substantiating any claimed out-of-pocket
medical expenses or any existing lien. The case is unlikely to involve a claim for lost
earnings or ongoing medical treatment.
Within 60 days, by no later than Friday, April 24, 2026, Petitioner shall file a
Status Report updating me on the parties’ progress toward informally resolving the
issue of damages. The Status Report shall specifically state the date by which Petitioner
provided or intends to provide a demand for damages to Respondent. Additionally,
Petitioner shall confirm whether any Medicaid lien exists, and if so, state the date by which
Petitioner anticipates providing Respondent a letter from the appropriate state agency
verifying the amount of the lien. As always, Petitioner should continue to file any updated
medical records as they become available.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
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