Jenney v. Secretary of Health and Human Services

In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 14-338V Filed: April 13, 2015 Not for Publication ************************************* SAMANTHA JENNEY, * * Petitioner, * * Damages decision based on proffer; v. * tetanus-diphtheria-acellular * pertussis (Tdap) vaccine; shoulder SECRETARY OF HEALTH * injury related to vaccine AND HUMAN SERVICES, * administration (SIRVA) * Respondent. * * ************************************* Ronald C. Homer, Boston, MA, for petitioner. Claudia B. Gangi, Washington, DC, for respondent. MILLMAN, Special Master DECISION AWARDING DAMAGES1 On April 23, 2014, petitioner filed a petition under the National Childhood Vaccine Injury Act, 42 U.S.C. §§ 300aa-10–34 (2006), alleging that she suffered a shoulder injury as a result of the tetanus-diphtheria-acellular pertussis (“Tdap”) vaccination she received on July 21, 2011. On July 18, 2014, respondent filed her Rule 4(c) Report, conceding that petitioner suffered from a shoulder injury related to vaccine administration (“SIRVA”) and recommending compensation. 1 Because this decision contains a reasoned explanation for the special master's action in this case, the special master intends to post this decision on the United States Court of Federal Claims's website, in accordance with the E-Government Act of 2002, Pub. L. No. 107-347, 116 Stat. 2899, 2913 (Dec. 17, 2002). Vaccine Rule 18(b) states that all decisions of the special masters will be made available to the public unless they contain trade secrets or commercial or financial information that is privileged and confidential, or medical or similar information whose disclosure would constitute a clearly unwarranted invasion of privacy. When such a decision is filed, petitioner has 14 days to identify and move to redact such information prior to the document=s disclosure. If the special master, upon review, agrees that the identified material fits within the banned categories listed above, the special master shall redact such material from public access. 1 On April 10, 2015, respondent filed Respondent’s Proffer on Award of Compensation. The undersigned finds the terms of the proffer to be reasonable. Based on the record as a whole, the undersigned finds that petitioner is entitled to the award as stated in the proffer. Pursuant to the terms stated in the attached proffer, the court awards: a. a lump sum payment of $155,963.04, representing life care expenses for Year 1 ($15,299.00), past unreimbursable expenses ($664.04), and pain and suffering ($140,000.00). The award shall be in the form of a check for $155,963.04 payable to petitioner; b. a lump sum payment of $1,076.77, representing compensation for satisfaction of the Boston Medical Center HealthNet Plan lien. The award shall be in the form of a check for $1,076.77 payable jointly to petitioner and Boston Medical Center HealthNet Plan Two Copley Place, Suite 600 Boston, MA 02116 ATTN: Kelvin Britto, OPL/TPL Specialist Petitioner agrees to endorse this payment to the Boston Medical Center HealthNet Plan; c. a lump sum payment of $8,516.49, representing compensation for satisfaction of the Neighborhood Health Plan lien. The award shall be in the form of a check for $8,516.49 payable jointly to petitioner and Neighborhood Health Plan 253 Summer Street Boston, MA 02210 ATTN: Angela Layne Petitioner agrees to endorse this payment to Neighborhood Health Plan; and d. an amount sufficient to purchase the annuity contract described in paragraph II.D of the attached proffer. The award shall be in the form of a check payable to the life insurance company from which the annuity will be purchased. In the absence of a motion for review filed pursuant to RCFC Appendix B, the clerk of the court is directed to enter judgment herewith.2 2 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party, either separately or jointly, filing a notice renouncing the right to seek review. 2 IT IS SO ORDERED. Dated: April 13, 2015 /s/ Laura D. Millman Laura D. Millman Special Master 3 IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS _________________________________________ ) SAMANTHA JENNEY, ) ) Petitioner, ) ) No. 14-338V v. ) Special Master Millman ) ECF SECRETARY OF HEALTH AND ) HUMAN SERVICES, ) ) Respondent. ) ) RESPONDENT'S PROFFER ON DAMAGES Respondent submits the following recommendations regarding items of compensation to be awarded to petitioner under the Vaccine Act. I. Items of Compensation A. Life Care Items Respondent engaged life care planner Linda Curtis, RN, MS, CCM, CNLCP, and petitioner engaged Maureen Clancy, RN, BSN, CLCP, to provide an estimation of Samantha Jenney’s future vaccine-injury related needs. All items identified in the agreed life care plan dated March 16, 2013, are supported by the evidence and are illustrated by the chart entitled Tab A: Summary of Life Care Items. 1 Respondent proffers Samantha Jenney (“petitioner”) should be awarded all items of compensation that are set forth in the agreed life care plan and illustrated by the chart attached as Tab A. Petitioner agrees. Respondent further proffers that the 1 The chart at Tab A illustrates the annual benefits as contained in the life care plan. The annual benefit years run from the date of judgment up to the first anniversary of the date of judgment and every year thereafter up to the anniversary of the date of judgment. 1 appropriate growth rate for life care items of compensation should be four percent (4.0%) for non-medical items and six percent (6.0%) for medical items, compounded annually from the date of judgment, as set forth in Tab B: Annuity Funding Portfolio. Petitioner agrees. B. Lost Earnings The parties agree that based upon the evidence of record, Samantha Jenney will be able to engage in gainful employment. Therefore, respondent proffers that Samantha Jenney is not entitled to receive future lost earnings compensation provided for under the Vaccine Act, 42 U.S.C. §300aa-15(a)(3)(A). Petitioner agrees. C. Pain and Suffering Respondent proffers that petitioner should be awarded $140,000.00 in actual and projected pain and suffering. This amount reflects that the award for projected pain and suffering has been reduced to net present value. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees. D. Past Unreimbursed Expenses Evidence supplied by petitioner documents her expenditure of past un-reimbursable expenses related to her vaccine-related injury. Respondent proffers that the petitioner is entitled to past un-reimbursed expenses in the amount of $664.04. Petitioner agrees. E. Medicaid Lien Respondent proffers that Samantha Jenney should be awarded funds to satisfy the Boston Medical Center HealthNet Plan lien in the amount of $1,076.77, and the Neighborhood Health Plan lien in the amount of $8,516.49, which represents full satisfaction of any right of subrogation, assignment, claim, lien, or cause of action the Boston Medical Center HealthNet 2 Plan and/or the Neighborhood Health Plan may have against any individual as a result of any Medicaid payments the Boston Medical Center HealthNet Plan and/or the Neighborhood Health Plan has made to or on behalf of Samantha Jenney from the date of her eligibility for benefits through the date of judgment in this case as a result of her vaccine-related injury suffered on or about July 21, 2011, under Title XIX of the Social Security Act. F. Attorney’s Fees and Costs This proffer does not address final attorneys’ fees and costs. Petitioner is entitled to reasonable attorneys’ fees and costs, to be determined at a later date upon petitioner filing substantiating documentation. II. Form of the Award The parties recommend that the compensation provided to petitioner for her future medical care needs should be made through a combination of a one-time cash payment and future annuity payments as described below, and request that the special master’s decision and the Court’s judgment reflect the following items of compensation. 2 Respondent proffers and petitioner agrees that an award of compensation include the following elements: A. A lump sum payment of $155,963.04, representing life care expenses for Year 1 ($15,299.00), past un-reimbursed expenses ($664.04), and pain and suffering ($140,000.00), in the form of a check payable to petitioner. 2 Should petitioner die prior to entry of judgment, respondent would oppose any award for future medical expenses, future lost earnings, and future pain and suffering, and the parties reserve the right to move the Court for appropriate relief. 3 B. A lump sum payment of $1,076.77, representing compensation for satisfaction of the Boston Medical Center HealthNet Plan lien, payable jointly to petitioner and Boston Medical Center HealthNet Plan Two Copley Place, Suite 600 Boston, MA 02116 ATTN: Kelvin Britto, OPL/TPL Specialist Petitioner agrees to endorse this payment to the Boston Medical Center HealthNet Plan. C. A lump sum payment of $8,516.49, representing compensation for satisfaction of the Neighborhood Health Plan lien, payable jointly to petitioner and Neighborhood Health Plan 253 Summer Street Boston, MA 02210 ATTN: Angela Layne Petitioner agrees to endorse this payment to the Neighborhood Health Plan. D. An amount sufficient to purchase an annuity contract, 3 subject to the conditions described below, that will provide payments for the life care items contained in the life care plan, as illustrated by the chart at Tab A, attached hereto, and paid to the life insurance company 4 from 3 In respondent’s discretion, respondent may purchase one or more annuity contracts from one or more life insurance companies. 4 The Life Insurance Company must have a minimum of $250,000,000 capital and surplus, exclusive of any mandatory security valuation reserve. The Life Insurance Company must have one of the following ratings from two of the following rating organizations: a. A.M. Best Company: A++, A+, A+g, A+p, A+r, or A+s; b. Moody's Investor Service Claims Paying Rating: Aa3, Aa2, Aa1, or Aaa; c. Standard and Poor’s Corporation Insurer Claims-Paying Ability Rating: AA-, AA, AA+, or AAA; d. Fitch Credit Rating Company, Insurance Company Claims Paying Ability Rating: AA-, AA, AA+, or AAA. 4 which the annuity will be purchased. 5 Compensation for Year Two (beginning on the first anniversary of the date of judgment) and all subsequent payments shall be provided through respondent’s purchase of an annuity, which annuity will make payments directly to the petitioner only so long as she is alive at the time a particular payment is due. The “annual amounts” set forth in Tab B describe the total year sum to be paid and do not require that the payment be made in one single payment. The parties agree that petitioner is a competent adult and that no guardians/conservators of his estate will be required. 1. Growth Rates Respondent proffers that a four percent (4.0%) growth rate should be applied to all non- medical items, and a six percent (6.0%) growth rate should be applied to all medical items. Petitioner agrees. 2. Life-contingent Annuity Petitioner will continue to receive the annuity payments for future medical care from the Life Insurance Company only so long as she is alive at the time that a particular payment is due. Written notice to the Secretary of Health and Human Services and the Life Insurance Company shall be made within twenty (20) days of petitioner’s death. III. Summary of Recommended Payments Following Judgment A. Lump Sum paid to petitioner: $155,963.04 B. Lump Sum paid jointly to petitioner and Boston Medical Center HealthNet Plan: $1,076.77 5 Petitioner authorizes the disclosure of certain documents filed by the petitioner in this case consistent with the Privacy Act and the routine uses described in the National Vaccine Injury Compensation Program System of Records, No.09-15-0056. 5 C. Lump Sum paid jointly to petitioner and Neighborhood Health Plan: $8,516.49 D. An amount sufficient to purchase the annuity contract described above in section II. D. Respectfully submitted, BENJAMIN C. MIZER Acting Assistant Attorney General RUPA BHATTACHARYYA Director Torts Branch, Civil Division VINCENT J. MATANOSKI Deputy Director Torts Branch, Civil Division MICHAEL P. MILMOE Senior Trial Counsel Torts Branch, Civil Division /s/ Claudia B. Gangi CLAUDIA B. GANGI Senior 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) 616-4138 Dated: April 10, 2015 6 TAB A Pet. Samantha Jenney D.O.B. 05/24/1969 DATE: 03/20/15 TIME: 11:20 PM SUMMARY OF LIFE CARE ITEMS - AGREED LIFE CARE PLAN dated March 16, 2015 ITEM OF CARE Insurance Medical Ancillary Equipment Medications Home Transportation TOTALS TOTALS TOTALS OF Care Services Services of Items of Items 4.0 and 6.0% ITEMS with a 6.0% with a 4.0% & APPLYING Growth Rate Growth Rate THE GROWTH GROWTH RATE 6.0% 6.0% 6.0% 6.0% 6.0% 4.0% 4.0% RATES AGE YEAR 46 2015 7,113.08 523.40 785.00 768.08 540.00 4,007.49 480.87 9,730 4,488 14,981 47 2016 7,113.08 348.40 460.00 202.39 540.00 3,878.50 68.31 8,664 3,947 14,004 48 2017 7,113.08 348.40 460.00 202.39 540.00 3,878.50 68.31 8,664 3,947 14,758 49 2018 7,113.08 348.40 460.00 202.39 540.00 3,878.50 68.31 8,664 3,947 15,555 50 2019 10,463.08 0.00 390.00 199.25 0.00 3,878.50 76.33 11,052 3,955 19,602 51 2020 7,113.08 104.80 70.00 202.39 540.00 3,878.50 65.18 8,030 3,944 16,381 52 2021 7,113.08 104.80 70.00 202.39 540.00 3,878.50 65.18 8,030 3,944 17,264 53 2022 7,113.08 104.80 70.00 202.39 540.00 3,878.50 65.18 8,030 3,944 18,196 54 2023 7,113.08 104.80 70.00 202.39 540.00 3,878.50 65.18 8,030 3,944 19,180 55 2024 7,113.08 414.80 255.00 202.39 540.00 3,878.50 97.71 8,525 3,976 21,153 56 2025 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 9,880 57 2026 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 10,352 58 2027 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 10,847 59 2028 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 11,366 60 2029 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 11,911 61 2030 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 12,484 62 2031 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 13,085 63 2032 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 13,717 64 2033 0.00 428.30 434.80 214.98 928.56 3,878.50 65.18 2,007 3,944 14,380 PAGE 1 TAB A Pet. Samantha Jenney D.O.B. 05/24/1969 DATE: 03/20/15 TIME: 11:20 PM SUMMARY OF LIFE CARE ITEMS - AGREED LIFE CARE PLAN dated March 16, 2015 ITEM OF CARE Insurance Medical Ancillary Equipment Medications Home Transportation TOTALS TOTALS TOTALS OF Care Services Services of Items of Items 4.0 and 6.0% ITEMS with a 6.0% with a 4.0% & APPLYING Growth Rate Growth Rate THE GROWTH GROWTH RATE 6.0% 6.0% 6.0% 6.0% 6.0% 4.0% 4.0% RATES AGE YEAR 65 2034 920.16 85.66 290.00 307.01 0.00 3,761.50 49.09 1,603 3,811 13,490 66 2035 920.16 85.66 290.00 163.13 0.00 3,761.50 49.09 1,459 3,811 13,643 67 2036 920.16 85.66 290.00 163.13 0.00 3,761.50 49.09 1,459 3,811 14,288 68 2037 920.16 85.66 290.00 163.13 0.00 3,761.50 49.09 1,459 3,811 14,965 69 2038 920.16 85.66 290.00 163.13 0.00 3,761.50 49.09 1,459 3,811 15,675 70 2039 920.16 85.66 290.00 163.13 0.00 3,761.50 49.09 1,459 3,811 16,420 71 2040 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 16,613 72 2041 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 17,410 73 2042 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 18,247 74 2043 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 19,126 75 2044 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 20,049 76 2045 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 21,019 77 2046 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 22,037 78 2047 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 23,107 79 2048 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 24,231 80 2049 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 25,412 81 2050 920.16 85.66 290.00 163.13 0.00 3,549.00 49.09 1,459 3,598 26,653 90,124 7,714 11,933 7,438 13,217 135,428 2,542 130,426 137,970 601,484 33.58% 2 87% 4.45% 2.77% 4.92% 50.46% 0.95% 100.00% This Report was generated using Sequoia Settlement Services, LLC Software (c) 1990 Jenney AGREED LCP 03 20 15 REV3 PAGE 2 TAB B ANNUITY FUNDING PORTFOLIO AGREED LIFE CARE PLAN dated March 16, 2015 4.0 and 6.0% GROWTH RATES DATE: 03/20/15 TIME: 11:20 PM Pet. Samantha Jenney D.O.B. 05/24/1969 Column 1 Column 2 Column 3 Column 4 Column 5 Column 6 Column 7 Column 8 Column 9 Column 10 Column 11 Settlement Item TOTAL ANNUAL CASH & ANNUITY ANNUITY ANNUITY ANNUITY ANNUITY ANNUITY ANNUALCUMULATIVE Starting Amount MEDICAL STRUCTURED ANNUITY 1,640 7,999 1,040 3,891 374 328 SAFETY SAFETY Inflation Factor CARE NEEDS SETTLEMENT LUMP 6.00% 6.00% 6.00% 4.00% 4.00% 4.00% MARGIN MARGIN Beginning Year 2015 BENEFITS SUMS 2016 2016 2025 2016 2016 2034 2015 2015 Ending Year 2050 LIFE 2023 2033 LIFE 2033 2039 2050 2050 TOTAL S/S Cash & Deferred Deferred Deferred Deferred Deferred Deferred Safety Cum.Safety AGE YEAR NEEDS TOTAL Lump Sums Annuity Annuity Annuity Annuity Annuity Annuity Margin Margin 46 2015 14,981 15,299 15,299 318 318 47 2016 14,004 13,904 1,640 7,999 3,891 374 -100 218 48 2017 14,758 14,653 1,738 8,479 4,047 389 -105 113 49 2018 15,555 15,443 1,843 8,988 4,209 405 -112 1 50 2019 19,602 19,601 3,323 1,953 9,527 4,377 421 -1 0 51 2020 16,381 17,158 2,070 10,099 4,552 438 777 777 52 2021 17,264 18,088 2,195 10,704 4,734 455 824 1,601 53 2022 18,196 19,070 2,326 11,347 4,923 473 873 2,474 54 2023 19,180 20,106 2,466 12,028 5,120 492 926 3,400 55 2024 21,153 17,757 9,306 2,614 5,325 512 -3,396 4 56 2025 9,880 9,881 2,771 1,040 5,538 532 1 5 57 2026 10,352 10,353 2,937 1,102 5,760 554 1 6 58 2027 10,847 10,848 3,113 1,169 5,990 576 1 7 59 2028 11,366 11,367 3,300 1,239 6,230 599 1 8 60 2029 11,911 11,913 3,498 1,313 6,479 623 1 9 61 2030 12,484 12,485 3,708 1,392 6,738 648 1 10 62 2031 13,085 13,087 3,930 1,475 7,007 674 1 11 63 2032 13,717 13,718 4,166 1,564 7,288 700 1 13 64 2033 14,380 14,382 4,416 1,658 7,579 729 2 14 PAGE 3 TAB B ANNUITY FUNDING PORTFOLIO AGREED LIFE CARE PLAN dated March 16, 2015 4.0 and 6.0% GROWTH RATES DATE: 03/20/15 TIME: 11:20 PM Pet. Samantha Jenney D.O.B. 05/24/1969 Column 1 Column 2 Column 3 Column 4 Column 5 Column 6 Column 7 Column 8 Column 9 Column 10 Column 11 Settlement Item TOTAL ANNUAL CASH & ANNUITY ANNUITY ANNUITY ANNUITY ANNUITY ANNUITY ANNUALCUMULATIVE Starting Amount MEDICAL STRUCTURED ANNUITY 1,640 7,999 1,040 3,891 374 328 SAFETY SAFETY Inflation Factor CARE NEEDS SETTLEMENT LUMP 6.00% 6.00% 6.00% 4.00% 4.00% 4.00% MARGIN MARGIN Beginning Year 2015 BENEFITS SUMS 2016 2016 2025 2016 2016 2034 2015 2015 Ending Year 2050 LIFE 2023 2033 LIFE 2033 2039 2050 2050 TOTAL S/S Cash & Deferred Deferred Deferred Deferred Deferred Deferred Safety Cum.Safety AGE YEAR NEEDS TOTAL Lump Sums Annuity Annuity Annuity Annuity Annuity Annuity Margin Margin 65 2034 13,490 14,251 1,359 4,681 7,882 328 761 775 66 2035 13,643 13,501 4,962 8,198 341 -142 633 67 2036 14,288 14,140 5,260 8,526 355 -148 485 68 2037 14,965 14,811 5,575 8,867 369 -154 331 69 2038 15,675 15,515 5,910 9,221 384 -160 171 70 2039 16,420 16,254 6,264 9,590 399 -166 4 71 2040 16,613 16,614 6,640 9,974 1 5 72 2041 17,410 17,411 7,039 10,373 1 7 73 2042 18,247 18,249 7,461 10,788 1 8 74 2043 19,126 19,128 7,909 11,219 2 10 75 2044 20,049 20,051 8,383 11,668 2 11 76 2045 21,019 21,021 8,886 12,135 2 13 77 2046 22,037 22,039 9,419 12,620 2 15 78 2047 23,107 23,109 9,984 13,125 2 17 79 2048 24,231 24,233 10,584 13,650 2 19 80 2049 25,412 25,414 11,219 14,196 2 22 81 2050 26,653 26,655 11,892 14,764 3 25 ITEMIZED TOTALS 601,484 601,509 29,287 182,753 79,170 11,951 286,581 9,591 2,176 25 25 This Report was generated using Sequoia Settlement Services, LLC Software (c) 1990 Jenney AGREED LCP 03 20 15 REV3 PAGE 4