Age: 0.5
Sex: M
Vaccine: DTAP, HIBV, OPV
Symptoms: Drug toxicity, Echolalia, Gait disturbance, Gaze palsy, Hypokinesia
Clinical narrative: This case was reported by a lawyer and described the occurrence of neurological injury in a male subject who was vaccinated with hepatitis B vaccine Engerix B and or unidentified hepatitis B vaccine for prophylaxis. On an unspecified date the subject received unspecified dose of Hepatitis B vaccine. According to the legal complaint, at an unspecified time after vaccination with hepatitis B vaccine, the subject experienced serious and permanent neurological injuries which were attributed to toxic mercury exposure. The following information was received via medical records, the subject was vaccinated with hepatitis B vaccine Engerix B on 1/14/1998. The subject was vaccianted with DTP (manufacturer unknown) on 11/4/1991, 1/6/1992 and 3/11/1992. The subject was also vaccinated with hepatitis Vaccine Recombivax on 7/10/1997 and 9/4/1997, Haemophilus influenzae type B vaccine, live attenuated oral poliomyelitis vaccine, and MMR for prophylaxis. A physician or other health care professional has not verified this report. The subject was the product of a breech birth, and was notable following delivery for congenital torticollis and hypertonia. In March 1993 the subjects mother reported that he was occasionally toe walking, which seemed to be by choice. Additional concerns included tantrums. Upon examination on 9/14/1992m the subject was described as echoing words and using single words. By Sept 1995 the subject continued to repeat everything that was said to him, but did not engage in conversation and we not toilet trained. A developmental examination was recommended, but the mother elected not to proceed with testing. On 1/13/1996, the subject was reevaluated after exhibiting decreased eye contact, outbursts of hyperactivity, repetitive behavior and poor social interactions. He was diagnosed with pervasive developmental delay with autistic features. According to a letter written by the subjects physician dated 1/31/1996, the subject was extremely active, tantrum easily, and engaged in almost exclusively solitary play. In Feb 1996, the subject was diagnosed with a significant developmental delay. According to a progress note dated 9/18/96, autism and attention deficit hyperactivity disorder had been ruled out. The subject was physically normal in appearance but engaged in repetitive behaviors including twisting his head and streams of speech. By Jan 1997, the subject was experiencing trouble in school, displaying outbursts and pushing other children. Assessment included Aspergers syndrome. A neurological exam was normal, and the examiner believed the subject would certainly be labeled autistic. According to a progress note dated 9/2/1998, the subject had a history of autism and hyperactivity. In approx Oct 1998, the subject was suspended from school for increasingly uncontrollable and violent behavior problems, including an attempt to stab a teacher with scissors.  Testing conducted on 4/23/1998 reveals a severe to moderate receptive and expressive language delay, it was noted that during his speech therapy sessions, the subject displayed aggressive language delay, it was noted that during his speech therapy sessions, the subject displayed aggressive and very inappropriate behaviors including knocking things over, spitting, striking peers, and running from the building. On 7/7/1995 occupational therapy examination showed fine motor skills similar to a child 5.3 years of age (Chronological age six years nine months. On examination on 11/2/1998, assessment included behavior problems secondary to severe attention deficit disorder versus pervasive developmental delay versus other disorder. IN early 1999, the subject was diagnosed with autistic disorder and mental retardation. Testing in April 1999 showed mild cognitive deficit overall, variable adaptive skills, immature social skills, substantial language deficits in all domains, and daily living skills that were somewhat higher than would be expected. Eighteen months later, In Oct 2000, the subject continued to experience hyperactivity, impulsivity and distractibility. A two week trial of Ritalin was initiated, but was no help, and was replaced with Adderall which was also stopped after two weeks. In 2003 behavioral problems persisted. This case was assessed to be medically significant by manufacturer (OMIC).