Age: 0.34
Sex: F
Vaccine: DTAPH, HIBV, OPV, HIBV, MMR
Symptoms: Skin ulcer, Upper respiratory tract infection, Vaginal infection, Viral infection
Clinical narrative: Info has been regarding a case in litigation concerning a minor pt who was exposed to high levels of mercury from thimerosal through exposure to unspecified products. In addition, 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 direst result of thimerosal exposure. As a direct and proximate cause of the toxic mercury exposure to the pt, minor was caused to suffer serious had permanent neurological damage which include past and future mental, intellectual, developmental and neurological incapacity and associated learning disabilities, disorders and impairments. Follow-up info has been received from a lawyer concerning a 23 month old white female who on 6/24/91 was vaccinated with Hib conj vaccine, (8/26/91, 11/5/91, 8/10/92) (dose not reported). Concomitant therapy included MMR (lots 0561 and1310R) (8/10/92, 5/14/96), (dose not reported); DPT (Tetramune), 6/24/91, 8/26/91 and 11/5/91; DTAP (lots 320975 and 4E61148), (11/2/92 and 5/12/95) and poliovirus vaccine live oral (IPOL) (lots 0665H and 0718C) (11/2/92 and 5/12/95). On 3/29/93, the pt was dx'd with sensory integration disorder where the pt did not respond to sound and at this time no hearing test was performed. On an unspecified date (when the pt was approx. 2 years old), the pt was dx'd with autistic spectrum disorder. On 11/26/93 (also reported as 4/26/94), the pt was seen for a neurological evaluation and was dx'd with severe communication disorder where the pt spoke with scattered few words which was secondary to autistic spectrum disorder. On 3/22/94, a direct DNA analysis for fragile X was performed the results were negative for DNA changes associated with fragile X syndrome. On 10/3/94 and 10/13/94, the pt had a hearing screening performed results reported were negative middle ear pressure which was suggestive of meddle ear dysfunction. In 1997, the pt developed transcortical aphasia secondary to autism, the pt had trouble following directions, using the computer and reading, needed 1:1 instruction, attends school 3 hours/week. Treatment included vitamin therapy, exercise program, recommendation of play therapy with other children and to see a dentist. On 10/17/97, a neuro-biological autism evaluation was performed results reported were encephalopathy characterized by disorder of language, social interactive and symbolic play impairments and autism. On 11/3/97, an MRI of the brain was performed with the results being normal. On 1/7/99, the pt's autistic spectrum disorder was assessed and savant features were noted and the pt started treatment with secretin injections. On 4/28/99, treatment with secretin injections was changed to risperidone (Risperdal), 1.0mg/mL, 1 mL twice daily as there was no remarkable change in the pt's behavior following injections. Therapy with risperidone was started on 5/3/99. On 5/5/99, the pt's mother reported that the pt's mother reported that the pt's self stimulating behaviors decreased greatly and attention was better. The mother observed a glazed eye " drug appearance" and cut the dose to 0.5mL. On 12/11/00, an EEG was performed results reported were an abnormal EEG due to the lack of sleep but transients during sleep. This most likely was attributable to the anesthetic agents. In addition, a pre-existing encephalopathy can not be excluded. There were no definite epileptiform potentials. On 12/11/00, an MRI of the brain without contrast was performed results reported appear within normal limits. On 12/11/00, a single view portable chest x-ray was performed results reported judging for the hypoinflation, no acute abnormality. However, follow-up with superior inspiration was recommended. On 4/19/02 and 4/20/02, the pt had an EEG performed results reported were normal awake and drowsy EEG with episodes of eye fluttering which were not associated with electrographic abnormalities. On 8/13/02, the pt had a neurological evaluation performed due to the recent onset of behavioral regression as well as spells which certainly could be consistent with seizures. The physician recommended 23 hour video EEG, lab tests and to see a child psychiatrist. On 11/19/02, the pt had a necrotic tooth no. 19 extracted which was performed under general anesthesia via an orotracheal root. On 9/10/03, the physician assessed the pt as having possible bipolar disease. Follow-up info received from medical records on 9/12/06 contained the following adverse experiences: otitis, pharyngitis, conjunctivitis and laryngeal duct stenosis (all on 3/1/92) which were treated with cefaclor (Ceclor) and gentamicin sulfate (Garamycin); right otitis media persistent (3/12/92) which was treated with amoxicillin (+) clavulanate potassium (Augmentin); strep B throat (4/24/92); fell and pacifier jammed in her nose (11/2/92); conjunctivitis (1/30/93) which was treated with gentamicin sulfate (Garamycin);strep B throat, ear disorder and sensory integration disorder (3/29/93) which were treated with cefaclor; pharyngitis and maculopapular exanthema (6/4/93); left otitis media and croup (11/4/93) which was treated with amoxicillin; ear sensitive to touch (11/29/93) which was treated with co-trimoxazole (Bactrim); gastric disorder (4/13/94) which was treated with hydrochloride (Phenergan); strep B throat and rhinitis (10/4/94); mole sebaceous nevus (5/31/95); swallowed glass (1/11/96); conjunctivitis and otitis (3/7/96) which were treated with cefaclor and mupirocin (Bactroban); voiding few times a day (3/11/96) which was treated with acetaminophen (Tylenol) and diphenhydramine hydrochloride (Benadryl); upper respiratory tract infection (URI) (5/11/96); R calf wound with purulent drainage and cellulitis R calf (6/30/97) which was treated with warm compresses and amoxicillin (+) clavulanate potassium; erythema infection (7/24/97); acute pharyngitis (12/29/97); acute bronchitis (1/11/98) which was treated with azithromycin (Zithromax); lesions on fingers (10/8/98) was referred to a dermatologist; multiple periungual warts on all fingers (10/29/98) which was treated with hot water soaking regimen with sanding and topical duo-film liquid; insect stings (5/24/99); viral syndrome with rash (5/24/99); viral syndrome with rash (5/24/99); folliculitis (6/3/99) which was treated with cephalexin; viral respiratory infection (9/24/99); viral upper respiratory infection and cough (5/23/00; cough and chills (11/18/00; right otitis media and possible sinusitis (11/20/00) which was treated with amoxicillin (+) clavulanate potassium; benign folliculitis and vaginal strep candidal (1/15/01) which was treated with mupirocin, fluconazole (Diflucan) and amoxicillin; benign skin abrasion (1/23/01) which was cauterized with silver nitrate; vaginal strep and sinusitis (2/26/01) which was treated with amoxicillin (+) clavulanate potassium and miconazole nitrate (Monistat); viral upper respiratory infection and cough (12/27/01); bilateral otitis media and sinusitis (1/4/02) which was treated with amoxicillin; acute sinusitis and bilateral otitis media (2/4/02) which was treated with amoxicillin (+) clavulanate potassium; cough variant asthma (2/18/02) which was treated with prednisolone; obese and weight gain (11/27/02); impetigo (10/5/04) which was treated with amoxicillin (+) clavulanate potassium. Upon internal review, autistic spectrum disorder and cumulative mercury toxicity were considered to be other important medical events. No further info is available. All available medical records will be provided upon request.