SIRVA Success: Court Confirms Improperly Administered Vaccination Caused Plaintiff Permanent Injury

In Bradley v. Wang, 2025 ONSC 2267, the plaintiff Bonnie Bradley, a registered nurse, was given a tetanus vaccination by a first-year family medicine resident, the defendant Dr. Richard Wang. After receiving the injection, Bradley felt immediate pain, which she described as “white-hot lightening” at the injection site. Upon feeling this, she looked at where the needle had been injected and noted that it was given too high and too anterior (as a nurse, Bradley had given numerous intramuscular injections over the course of her 15-yearcareer). Bradley had never experienced this with previous injections nor had any prior adverse reactions to vaccinations. Unfortunately, the pain persisted and Bradley developed frozen shoulder, physical limitations and chronic pain, which subsequently resulted in her being unable to return to work. The injury she suffered from is known by the acronym SIRVA — shoulder injury related to vaccine administration.

With respect to standard of care, credibility of the parties and reliability of their evidence were critical factors. The only evidence from the parties themselves regarding standard of care was Bradley’s account of the needle placement and the defendant’s evidence regarding his usual practice and landmarking technique (having no recollection of the injection administered to Bradley). In addition, both parties called experts in family medicine to comment on the standard of care. Both experts agreed on the applicable standard: the landmarking technique that was described by the defendant.

Given the above evidence, the judge had to determine whether the defendant followed the applicable standard of care on the day of the injection. This involved an in-depth analysis of Bradley’s post-injection conduct and whether it was consistent with the pain that she said she experienced following the injection. Ultimately, the judge found that Bradley’s account was the best evidence regarding the incident and accepted what she said regarding the needle placement on the day of the injection. Consequently, the judge found the defendant breached the standard of care by failing to landmark properly and by administering the vaccination in the wrong location.

With respect to causation, the plaintiff’s expert explained that as a result of the improperly administered vaccination, it went into Bradley’s rotator cuff (rather than the deltoid muscle), which consequently caused a significant inflammatory response in the biceps tendon and supraspinatus tendon. The expert reached his opinion based on Bradley’s description of where the injection occurred, the onset of symptoms immediately afterward, and where the pain was located. Thereafter, her rotator cuff and joint became inflamed, she developed adhesive capsulitis (frozen shoulder), and secondary pain problems (including neck) because of the significantly impaired movement and function of her left shoulder.

The defence expert accepted that Bradley’s difficulties were a direct result of the vaccine administration but argued that this type of reaction could occur with a properly administered vaccination. While the plaintiff’s expert accepted that in theory that was possible, that was not what happened in this case. He explained that Bradley’s presentation was much more consistent with an immediate/acute injury to some musculoskeletal structure in the left shoulder joint area caused by improper administration of a vaccine and a direct traumatic injury related to the needle and improper injection of a foreign material/irritant into a musculoskeletal structure that should not be injected with a vaccine.

The plaintiff’s expert further explained that the immediate, severe and uninterrupted pain that Bradley experienced in the hours, days and weeks following the vaccination was not consistent with the milder muscular discomfort commonly associated with proper administration of a vaccine into the deltoid muscle (and the possible development of an abnormal immune response that would cause a delayed inflammatory reaction that would take much longer to develop).

Ultimately, the court agreed with the plaintiff’s expert and found causation was established. The plaintiff was awarded over $1 million in damages. The defendant appealed the judge’s decision on standard of care, causation and damages. The appeal was dismissed on all issues (Bradley v. Wang, 2026 ONCA 570).

Although SIRVA cases remain relatively uncommon in Canada, they are frequently litigated in the United States. The central difficulty in these claims is usually the absence of direct evidence about where the injection was actually administered, and how that bears on the standard of care. Most plaintiffs are not nurses and have no training in intramuscular injection technique. They simply receive the vaccine, experience a reaction that is more painful and prolonged than past vaccinations, and grow concerned only after the fact, long after the moment of administration has passed.

These evidentiary challenges, however, are not insurmountable. A vaccine properly administered into the deltoid muscle does not typically produce the severe and lasting injuries characteristic of SIRVA. Rather, it is the misplaced injection into the shoulder joint itself that triggers the inflammatory response and the persistent symptoms that follow.

Karen Vigmond, who is a partner at personal injury law firm Oatley Vigmond, joined the firm in 2013 as an associate lawyer. She holds a BA from Queen’s University and her juris doctor from Bond University in Australia.

The opinions expressed are those of the author and do not reflect the views of the author’s firm, its clients, Law360 Canada, LexisNexis Canada or any of its or their respective affiliates. This article is for general information purposes and is not intended to be and should not be taken as legal advice.