Patient had a legal complaint. An attorney reported that a male infant, a quadruplet, received Acel-Imune (diphtheria and tetanus toxoids and acellular pertussis vaccine absorbed) and Tetramune vaccine (diphtheria and tetanus toxoids and pertussis vaccine absorbed and haemophilus  B conjugate vaccine) from 1/13/99 to 3/10/00. It is alleged that as a result of the cumulative exposure to thimerosal in the vaccines the child experienced neurological damage in September 2000. He was also diagnosed with autism. The attorney alleges that all 4 quadruplets from this family experienced these events. See related cases HQ4142510SEP2002, HQ4142610SEP2002 and HQ4142710SEP2002. This case was considered serious since autism, thimerosal poisoning and neurological damage were considered medically important in this case. No additional information was available as of the date of this report. A 15-day follow up report received 01/12/2004 adds: Follow-up info was received on 12/29/2003 from an attorney which included the pt's medical records. An attorney reported that a male infant received a dose of Acel-Imune (diphtheria and tetanus toxoids and acellular pertussis) vaccine (manufacturer unknown) and Tetramune (diphtheria and tetenus toxoids and pertussis vaccine adsorbed) vaccine (manufacturer unknown) on an unspecified date sometime between the dates of 01/13/1999 and 03/10/2000. It is alleged that the child, now 5 years of age, subsequently developed thimerosal-induced mercury poisoning. The legal brief alleges that the child is afflicted with autism because he was exposed to toxic levels of mercury and suffered neurological damage in September 2000. Medical history: The child, one of a set of quadruplets, was born prematurely at 31.5 weeks. Due to the premature birth, the pt experienced apnea of prematurity, anemia of prematurity, jaundice, and respiratory distress (transient tachypnea). He also had a problem with slow feeding. At birth, Apgar scores were 8 at 1 minute and 9 at 5 minutes. Product details: Additional suspect vaccines administered during the alleged time period of 01/13/1999 and 03/10/2000 included poliovirus vaccine live oral trivalent vaccine (manufacturer unknown) Hib (Haemophilus b conjugate) vaccine (manufacturer unknown), Synagis (palivizumab) vaccine (MedImmune), Engerix-B (hepatitis B) vaccine (GSK), M-M-R II (measles, mumps and rubella) vaccine (Merck), IPOL (inactivated poliomyelitis) vaccine (Aventis), and hepatitis B vaccine (manufacturer unknown). Event details: According to the medical records, a psychological evaluation was performed on 02/01/2000. The psychologist's assessment indiated that the child's "unusual pattern of development in his communication skills, reciprocal social interactions, and behavioral patterns are characteristic of children with autism". On 09/29/2000, a speech/language pathologist assessed the pt as having moderate delays in receptive and expressive language skills. On 12/08/2000, a child neurologist evaluated the pt and indicated that the child may have pervasive developmental delay or autism. On 01/04/2001, a psychologist reported that the pt "meets criteria for a DSM-IV diagnosis of Autistic Disorder." This case was considered medically important. Medical records are on file. Related case(s): HQ4142510SEP2002, HQ4142710SEP2002, and HQ4142610SEP2002.