Age: 0.84
Sex: M
Vaccine: HEP
Symptoms: Speech disorder
Clinical narrative: Information has been received regarding a case in litigation concerning a child who was exposed to high levels of mercury from thimerosal through exposure to unspecified products. The alleged result was that the pt experienced serious and permanent neurological injuries and damages which included past and future mental, intellectual, development and neurological incapacity and associated learning disabilities, disorders and impairments. It was also alleged that the pt experienced cumulative mercury toxicity. Additional information has been received through medical records concerning this 16 month old male child, the product of a normal pregnancy, with no known drug food allergies, and a history of sinus infections who was vaccinated with first, second and third dose of hepatitis B virus vaccine rHBsAg yeast (manufacturer unspecified) on 5/20/1995, 6/20/1995 and 3/22/1996 respectively. After 16 months of age (approximately Sept 1996), the pt had regression after initial normal development. On 12/4/1998 the pt had a neuro psychology evaluation regarding the pts delays in speech and language development, and his parents concerns with respect to their difficulty in managing his behavior. It was reported by the pts parents that he had been diagnosed with ADHD and possibly depression, he was started on Ritalin which was discontinued after one day because the pts behaviors were exacerbated on it. The pts parents also reported that he had difficulty with the demands of a structured preschool setting, and difficulty in understanding how to play with other children, the pt achieved developmental milestones which were generally within normal limits, with the exception of his language milestones, and he has no set and regular schedule for sleep. The pts family history is significant for learning difficulties on his mothers side and depression and alcohol abuse in his paternal family. The pts half brother from his maternal side is reported to have ADHD. It was observed during the evaluation that the pts attention was greatly diminished with tasks beyond his level of understanding, though he was very pleased with success, smiling and clapping when able to complete tasks. it was noted that the pts cooperation was better when sitting closer to his father. It was observed that the pt had a low frustration tolerance and difficulty calming himself once he became frustrated, he communicated this in non verbal and simple verbal ways. It was reported that due to the pts low frustration tolerance and variable attention, a screening was performed rather than a complete evaluation. It was noted that the pt was able to understand spoken simple one step commands and that he did demonstrate some separation anxiety. It was noted that the pts overall development is delayed and that he is functioning in the mental retarded range with his best reasoning abilities being at a 16-18 month developmental level. The pt was observed to use single words and gestures to make his needs and wants known. It was determined in this evaluation that there was no evidence to support the earlier suggestion of ADHD or depression, it is more likely that his behavioral difficulties are a result of his cognitive delays, low frustration tolerance and expectation beyond his level of understanding. On 9/1/00 the pt had a gastroenterology evaluation, Information provided in this evaluation indicated that the pt had been diagnosed with Autism and that he had regression after 16 months of age. It was also reported that the pt has frequent, unexplained daytime irritability, crying and aggressive behavior. It was noted in this evaluation that the pt was developmentally delayed and non verbal. Information was received on 9/12/06 which pertained to events that occurred following vaccination with hepatitis B virus. This information contained the following adverse experienced functional constipation, and gaseousness. Upon internal review, the pts autism, mercury toxicity, and mental retardation were determined to be other important medical events (OMIC). Additional information is not available. All available medical records will be provided upon request.