Sex: M
Vaccine: HEP, HIBV, MMR
Symptoms: Obsessive-compulsive disorder, Otitis media, Pain, Periorbital oedema, Pharyngitis
Clinical narrative: Information has been received regarding a case in litigation concerning a minor male pt who was exposed to high levels of mercury from thimerosal through exposure to unspecified products. In additional, the pt was exposed to mercury from continually inhaling and ingesting industry mercury emissions from fossil fuel driven power plants. The mercury included in thimerosal laden products and power plant emissions together caused the pt to suffer from serious and permanent neurological injuries. The pt was exposed to airborne mercury vapor and mercury through food chain. The exposure to airborne mercury in the environment through inhalation, the food chain, and other sources contributed to the cumulative mercury toxicity and was a substantial factor in causing his neurological damage. it was noted that the pt had a heightened vulnerability to suffer neurological injuries from industrial mercury as a direct result of thimerosal exposure. As a direct and proximate cause of the toxic mercury exposure to  the pt, minor male was caused to suffer serious and permanent neurological damage which included past and future mental, intellectual, development and neurological incapacity and associated learning disabilities, disorders and impairments. Additional information has been received through medical records concerning an approx 6 month old male with an umbilical hernia and no known drug allergies who on 12/5/1994, at birth, was vaccinated with a first dose of hepatitis B virus (manufacturer unk). The pts mother reported that the pt had a somewhat difficult infancy, he cried daily at 3pm, and never slept through the night. At about 6 months old, when the pt was happy or excited he would shake all over and emit a low level growl. The pt was seen for psychological evaluations on 11/24/00, 12/1/00, 12/7/00 at 6 years of age. The pt was referred for assessment due to having significant behavior problems at home and at school. He was described as being significantly hyperactive and impulsive in all places. He has frequent temper tantrums especially when he experienced frustration. Tantrums and inappropriate behavior were so problematic at school that his mother was required to sit beside him through out the day to manage his behavior. The pts mother reported that she had concerns about his serotyped mannerisms and compulsive trials. When the pt was happy or excited, he shakes all over and emits a low level growl. This began when he was about 6 months old. The ritual she described was that the pt often paces and when he reaches a wall, he stops short, stares, then breaks into a smile for a moment and abruptly changes directions and continues to pace. He also frequently eats things that are not food containing. An attention assessment was performed and his performance suggested that he has difficulty in tasks that require focusing, sustaining, encoding and executive functioning. His problems are exacerbated with approaching tasks that require perceptual organization, planning or fine motor skills. Emotionally he has significant problems with reading social cues. His ability to imitate and sustained appropriate social interactions with his peers was impaired and often results in him being teased and socially isolated. He exhibits stereotyped and repetitive motor mannerisms and displays persistent preoccupation with objects and or ideals. He also appears to have difficulty identifying and expressing his emotional which manifests itself in low frustration tolerance when faced with situations or tasks that are challenging for him. Although, he has significant attention difficulties, ADHD was not diagnosed. The pt was diagnosed with pervasive development disorder and allergies. On 6/8/2001 the pt was seen for cardiac evaluation. It was reported that the pt has ADHD and was under consideration for clonidine for sleep. He had an EKG on 5/30/01 which showed ST elevation, considerate early repolarization. He has not had any cardiac symptoms. The cardiologist did not find any cardiac abnormality and his EKG was normal, including corrected QT interval of 0.407. The pt may proceed with medications to help symptoms related to his ADHD. IT was reported that he will need periodic EKG follow up while on the medication. At his 7 year well check his assessment was well child, with Aspergers syndrome and Tic. On 4/25/02 the pt was seen in the ER with a questionable ear infection. It was reported that the pt has chronic cough for months and months which was thought to possibly be the onset of Tourettes. It was noted that the pt was complaining of left ear pain for 2 days. His past medical history included Autism, seasonal allergies and wheezing. His medications included Risperdal and Benadryl. The discharge diagnosis was eustacian tube dysfunction. On 9/1/04 the pt had an EEG performed for episodes of staring and body twitching to rule out seizures. It was reported that the pt was not taking any medications. The impressions was normal awake and asleep electroencephalogram with hyperventilation and photic stimulation. Upon internal review, Autism, Aspergers syndrome and pervasive developmental disorder were determined to be other important medical events (OMIC). Additional information received on 9/12/06 included the following adverse experiences URI and right otitis medic 3/18/1996, URI and bilateral otitis media 4/3/96, cough bronchitis URI and left otitis media 1997, URI fever and right otitis media 12/4/98, viral syndrome fever cough 2/2/99, strep throat, mild periorbital edema, fine papular rash 4/4/99, rapid weight gain 7/23/01, worsening umbilical hernia 9/25/01, pain at umbilical site and allergy rhinitis 01/10/2002, coughing and itchy throat 2/23/2002, eustacian tube dysfunction 4/25/02, pharyngitis 9/14/2003. NO further information is available. All available medical records are available upon request.