Holmstrom v. Secretary of Health and Human Services

$033&$5&%

In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 24-682V

VALERIE HOLMSTROM, Chief Special Master Corcoran Petitioner, Filed: September 3, 2025 v. SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent.

Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.

Katherine Edwards, U.S. Department of Justice, Washington, DC, for Respondent.

DECISION ON JOINT STIPULATION 1 On April 29, 2024, Valerie Holmstrom 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 shoulder injuries related to vaccine administration (“SIRVA”) as a result of a tetanus, diphtheria, and acellular pertussis (“Tdap”) vaccine administered on March 29, 2023. Petition at 1; Stipulation, filed at August 25, 2025, ¶¶ 1, 2. Petitioner further alleges that the vaccine was administered within the United States, that she sustained an injury within the time period set forth in the Vaccine Injury Table, that she experienced the residual effects of her condition for more than six months, and that there has been no award or settlement of a civil action for damages on her behalf as a result of her injury. Petition at 1, 4-5; Stipulation at ¶¶ 1-5. Respondent denies that Petitioner sustained a SIRVA Table injury; denies that the Tdap vaccine caused Petitioner’s alleged SIRVA, or any other injury; and denies that Petitioner’s current condition is a sequela of a vaccine-related injury. Stipulation at ¶ 6.

Nevertheless, on August 25, 2025, 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. A lump sum of $30,173.38, to be paid through an ACH deposit to Petitioner’s counsel’s IOLTA account for prompt disbursement to Petitioner; and B. A lump sum of $25.27, representing reimbursement of a Medicaid lien for services to Petitioner by the State of Wisconsin, in the form of a check payable jointly to Petitioner and Wisconsin Casualty Recovery 5615 High Point Drive, Suite 100 Irving, TX 75038-984 Case Number: 277393 Petitioner agrees to endorse this check to Wisconsin Casualty Recovery.

C. A lump sum of $801.35, representing reimbursement of a Medicaid lien for services to Petitioner by the State of Wisconsin, in the form of a check payable jointly to Petitioner and Security Health Plan: Security Health Plan 1515 N Saint Joseph Avenue, P.O. Box 8000 Marshfield WA 54449-8000 Case Number SUB362377 Petitioner agrees to endorse this check to Security Health Plan.

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 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

IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS

VALERIE HOLMSTROM, Petitioner, No. 24-682V Chief Special Master Brian H. Corcoran V. ECF SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent

STIPULATION The parties hereby stipulate to the fo1lowing matters: 1. Valerie Holmstrom ("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 aUegedly related to petitioner's receipt of a tetanus, diphtheria, and acellular pertussis ("Tdap") vaccine, which vaccine is contained in the Vaccine Injury Table (the ''Table"). 42 C.F.R. § l00.3{a) 2. Petitioner received a Tdap vaccine on March 29, 2023.

3. The vaccine was administered within the United States.

4. Petitioner al1eges that petitioner sustained a Shoulder Injury Related to Vaccine Administration ("SIRVA") within the time period set forth in the Table following administration of the vaccine. Petitioner further alleges that petitioner 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 action for damages on petitioner's behalf as a result of the alleged injury.

6. Respondent denies that petitioner sustained a SIRVA Tab)e injwy; denies that the Tdap vaccine caused petitioner's alJeged SIRVA, or any other injwy; and denies that petitioner's current condition is a sequelae of a vaccine-related injwy.

7. Maintaining their above-stated positions, the parties nevertheless now agree that the issues between them shaJI be settled and that a decision should be entered awarding the compensation descnl>ed in paragraph 8 of this Stipulation.

8. As soon as practicable after an entry ofjudgment 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-2l(a}(l), the Secretary of Health and Hwnan Services will issue the following vaccine compensation payments for all damages that would be available under 42 U.S.C. § 300aa-15(a): A lwnp sum of $30,173.38 to be paid through an ACH deposit to petitioner's counsel's IOLTA account for prompt disbursement to petitioner.

A lwnp sum of $25.27 1representing reimbursement of a Medicaid lien for services rendered to petitioner by the State of Wisconsin, in the fonn of a check payable jointly to petitioner and Wisconsin Casualty Recovery: Wisconsin Casualty Recovery 5615 High Point Drive, Suite 100 Irving, TX 75038-9984 Case Number: 277393 Petitioner agree to endorse this check to Wisconsin Casualty Recovery.

This amount represents full satisfaction of any right of subrogation, assignment, claim, lien, or cause of action the State of Wisconsin may have against any individual as a result of any Medicaid payments the Wisconsin Program has made to or on behalf of Valerie Holmstrom as a result of her alleged vaccine-related injury suffered on or about March 29, 2023, under Title XIX of the Social Security Act,~ 42 U.S.C. § 300aa-15(g), (h).

A Jump sum of $801.352 representing reimbursement of a Medicaid lien for services rendered to petitioner by the State of Wisconsin, in the form of a check payable jointly to petitioner and Security Health Plan: Security Health Plan t 5 N Saint Joseph Avenue, P.O. Box 8000 Marshfield WA 54449-8000.

Case Number: SUB362377 Petitioner agrees to endorse this check to Security Health Plan.

This amount represents compensation for all damages that would be available under42 U.S.C. § 300aa-15(a).

9. As soon as practicable after the entry ofjudgment 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-2l(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 petitioner's attorney represent that compensation to be provided pursuant to this Stipulation is not for any items or services for which the Program is not primarily liable under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be expected to be made under any State compensation programs, insurance policies, Federal or State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C. § 13% et seq.)), or by entities that provide health services on a pre-paid basis.

This amount represents full satisfaction of any right of subrogation, assignment. claim, lien, or cause of action the State of Wisconsin may have against any individual as a result of any Medicaid payments the Wisconsin Program has made to or on behalf of Valerie Holmstrom as a result of her alleged vaccine-related injury suffered on or about March 29, 2023, under Title XIX of the Social Security Act, m 42 U.S.C. § 300aa-15(g), (h).

11. Payments 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-1S(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 unreimbursed 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- l5(g) and (h).

13. In return for the payments described in paragraphs 8 and 9, petitioner, in petitioner's individual capacity, and on behalf of petitioner's 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 al] 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 Tdap vaccination administered on March 29, 2023, as alleged in a petition for vaccine compensation filed on or about April 29, 2024, in the United States Court of Federal Claims as petition No. 24-682V.

14. If petitioner should die prior to entry ofjudgment, this agreement shall be voidable upon proper notice to 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 Court of Federal Claims fails to enter judgment in conformity with a decision that is in complete conformity with the tenns of this Stipulation, then the parties' settlement and this Stipulation shall be voidable at the sole discretion ofeither party.

16. This StipuJation 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 to 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 SIRVA or any other injury or petitioner's current condition, or that petitioner suffered an injury contained in the Vaccine Injury Table.

18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's heirs, executors, administrators, successors, and/or assigns.

END OF STIPULATION I

RespectfuJty submitted, PETITIONER:

VALERIE HOLMSTROM

ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE p OF THE ATTORNEY GENERAL:

'"44<»lL>'°!b,. p ~ HEATHER L. PEARLMAN Deputy Director d, Suite 208 Torts Branch Dresher, PA 19025 Civil Division 215-885-1655 U.S. Department of Justice [email protected] P.O. Box 146 Benjamin Franklin Station Washington, DC 20044-0146 AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR OF TIIE SECRETARY OF HEALTH RESPONDENT: AND HUMAN SERVICES: Jeffrey S. Dgbliyilgoedb1J,f!,oyS.IN<l\·S Beach -S o.,,.2ms.oe.,,,-44W CAPT GEORGE REED GRIMES, MD, MPH tor ~ ,:_,£~ RINEEDWARDS Director, Division of Injury Trial Attorney Compensation Programs Torts Branch Health Systems Bureau Civil Division Health Resources and Services U.S. Department of Justice Administration P.O. Box 146 U.S. Department of Health Benjamin Franklin Station and Human Services Washington, DC 20044-0146 5600 Fishers Lane, 08W-25A 202-742-6374 Rockville, MD 20857 [email protected]

Dated: ~ -.h4:/- Q(2, ,.Jo,JS