Age: 0.01
Sex: M
Vaccine: HEP, HIBV, MMR
Symptoms: Mental retardation severity unspecified, Nervous system disorder, Neurodevelopmental disorder, Ocular hyperaemia, 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 though 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 plants 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 include past and future mental, intellectual, developmental and neurological incapacity and associated learning disabilities, disorders and impairments. Upon internal review, serious and permanent neurological damage/injuries which include past and future mental, intellectual, developmental and neurological incapacity and associated learning disabilities, disorders and impairments and cumulative mercury toxicity were considered to be other important medical events (OMIC). Follow up information received from medical records revealed the following ON 2/21/1995, the infant who was born at 40 6/7 weeks via vaginal delivery, and whose Apgar were 9 and 8, and weight at time of birth was 9lb 2 oz (4155 grams) was vaccinated with the first dose of hepatitis B virus vaccine rHBsAg yeast. There was no neonatal complications. the infant was breast fed. The child had no known allergies. There were no concomitant therapies. Family history included tics (brother and father) and Parkinson disease (paternal grandfather). The child walked at 15 months and had long standing difficulty with both gross motor and fine motor skills affection the use of utensils, dressing and writing, He was late at learning to pump his legs on a swing and was clumsy with catching. He had difficulty learning to ride a bicycle with training wheels. He also was sensitive to sounds and certain clothing. His first words were at 12 months. At the age of 3 his pediatrician expressed concerns due to limited vocabulary and a lack of expressing full sentences. He exhibited low frustration tolerance, fascination with weapons and police, often talked about violence, demonstrated oppositional behaviors and anxiety at school and was very competitive. He had difficulty staying on task, was easily distracted, and socially showed interest in other children but hesitated to initiate interaction. He presented with an articulation disorder and pragmatic language disorder. Weakness was noted in following multi step directions and language formulation. He had subtle language formulation difficulties and was quite frustrated with some language tasks. Based on the test results of the Autism diagnostic observation schedule, he exhibited characteristics consistent with an Autism spectrum disorder. It was recommended that he received speech language therapy and group speech therapy. It was also recommended that the child receive intensive phonologically based reading instruction. In the spring of 2003, the child began having difficulties with aggressive behavior. His aggressive behavior decreased after a change in classroom placement and behavior program were made. The child at this time had significant difficulty with reading and writing and had poor fine motor skills. He also had difficulty remembering math facts. The child also still had difficulty with poor frustration tolerance and became easily upset with transitions and changes in routine, and was easily distracted. He often preferred to play on his own and had very little imaginative play on his own, He had motor sterotypies and repetitive use of objects. He also had difficulty with rapid sequential movement, had significant difficulties with motor planning, had mild difficulty with stressed gait maneuvers, and demonstrated significant motor im persistence. The child was diagnosed with Aspergers syndrome, (due to the presentation of encephalopathy characterized by developmental difficulties rather than autism, attention deficit hyperactivity disorder, and oppositional defiant disorder. An MRI of the brain was recommended to rule out structural lesions, and genetic work up with a serum karatype and multi telomere FISH Study were recommended in addition to the possible use of medications. upon internal review, the event of Aspergers syndrome and encephalopathy were felt to be other important medical events (OMIC). Other adverse events reported on 9/12/06 included jaundice 2/28/1995, red eyes, eye discharge 12/29/1995, cold symptoms and fever 1/23/1996, diaper rash and thrush 7/15/1996, bronchial infection 1/6/1997, hospitalization for pneumonia 1997, sleep disorder and nocturnal enuresis 2001. No further information is available.