Sex: M
Vaccine: HEP
Symptoms: Insomnia, Mental impairment, Mental retardation severity unspecified, Mood swings, Nervous system disorder
Clinical narrative: Information has been received regarding a case in litigation concerning a minor male patient who was exposed to high levels of mercury from thimerosal through exposure to unspecified products. In addition the patient was exposed to mercury from continually inhaling and ingesting mercury emissions from fossil fuel driven power plants. The mercury included in thimerosal laden products and power plant emissions together caused the patient to suffer from serious and permanent neurological injuries. The patient 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 patient 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 patient, minor male was caused to suffer serious and permanent neurological damage which included past and future mental, intellectual, developmental and neurological incapacity and associated learning disabilities. Additional information has been received from medical records concerning a 20 day old white male whose mother has a history of selective reduction of twin pregnancy. Terbutaline was used in the second trimester. The patient was 9 pounds at birth and was delivered by a caesarian section due to failure to progress, his family history includes a sister with ADHA and a mood disorder. On 08-SEP-1995, he was vaccinated with a dose of hepatitis B virus vaccine rHBsAg (yeast) (manufacturer unknown). Secondary suspect vaccinations included Hib conj vaccine (OMPC) (MSD) given on -8-NOV-1000 (lot #"0828B") in the right leg, 18-JAN 1996 (lot # 616982/1194B) in the left leg and 21-AUG-1996 (lot #619845/0639D) in the right leg. Subsequently, on 05-AUG-1000 at 3 years and 11 months of age the patient was seen for a psychiatric evaluation due to concerns of "frequent temper tantrums, mood instability, initial insomnia for his age, some possible articulation speech deficit, periods of high energy, talkativeness, loudness, aggressive at times, tendency to get focused on a particular subject in an obsessive fashion and difficulties in interpersonal boundaries. At that time he was diagnosed with a Multicomplex Developmental Disorder or Pervasive Developmental Disorder. The patient was started on methylphenidate hydrochloride (Ritalin) 2.5mg BID, sometime in September 1999. It was noted in another psychiatric evaluation that the patient engaged in spinning his body, jumping up and down and "windmill arm action" and requires a set routine. He also uses repetitive phrases, over and over. Conclusions from evaluations included an Axis I diagnosis of Anxiety Disorder. On an unspecified date the patient began taking paraoxetine hydrochloride (Paxil) for anxiety. On -5-FEB-2002, the boy underwent further testing in order to determine whether the student was educationally disabled and eligible for special education services. Several problems were identified that put him at risk for academic failure, these included: inattentiveness, over-activity and resistance to adult authority. Following the evaluation he was coded Autistic and began receiving 9.5 hours of resource support and indirect speech and language services per week. He was also referred for Occupational Therapy for the remainder of the school year. The patient's vaccination history included: a dose of poliovirus vaccine live oral (Orimune) given orally on 08-Nov-1995 (lot #394-9922), 18-Jan-1996 (lot #394-9922), 25-Feb-1997 (lot #440-068) and 13-Sep-1999 (lot#464-252); diphtheria toxoid (+) pertussis acellular 4 component vaccine (+) tetanus toxoid (ACEL-IMUNE) given on 08-Nov-1995 (lot#428-062). 18-Jan-1996 (lot #428-062), 14-Mar-1996 (lot#425-621) and 25-Feb-1997 (lot #431-912); a dose of diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid (manufacturer unspecified ) given on 13-Sept-1999; measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn ) (+) rubella virus vaccine live (Wistar RA 27/3) (MSD) given on 25-Feb-1997 (lot #616453/0876D) given in the right leg and 25-Oct-1999 (Lot # 631049/0548J) given in the right arm; hepatitis B virus vaccine rHBsAg (yeast) (Engerix-B) given in the right leg on 03-Oct-1995 (lot #1816AZ) and 14-Mar-1996 (Lot #1966AZ); and varicella virus vaccine live (Oka/Merck) (MSD) given in the left leg on 25-Feb-1007 (lot #618139/0780D). Information received on 12-Sep-2006 contained the following adverse experiences: colic (27-Sep-1995), thrush (03-Oct-1995), fall resulting in a fractured left radium (12-Jul-1006), cold (21-Aug-1996), diarrhea (20-Aug-1996), cough (26-Aug-1996), fever (02-Jan-1997), erythema (28-Jul-1997), cyanotic lips (28-Jul-1997), abdominal pain (05-Jan-1998), incontinent of urine (05?-Jan-1998), frequent urination (11-Aug-1998), allergies (06-May-1999), strep throat (04-Apr-2000), eye lid inflamed (26-Apr-2000), eye lid pruritus (26-Apr-2000), upper respiratory infection (27-Nov-2000), vomiting (23?-Jan-2001), infected finger secondary to Ferret bit (30?-May-20001), clostridium difficile colitis (11-Jun-2001), right ear pain (18-Jul-2001), breathing difficulty (27?-Aug-2001), and pneumonia (13-Mar-2002, recovered on 03-Apr-2002). Upon internal review, autism, ADHA, multi-complex pervasive developmental disorder and cumulative mercury toxicity were considered to be other important events. No further information is available. All available medical records will be available upon request.