Ive been running into the same problem on my system and deleting the FALLOUT.ini didn't work, any other suggestions?
i had the same issue. i fixed it by installing the http://www.microsoft.com/downloads/en/details.aspx?familyid=a5c84275-3b97-4ab7-a40d-3802b2af5fc2&displaylang=en. i think the error happens when FO3 is installed; it overwrites some files related to C++/.NET with older files that are on the DVD.
see this thread:
http://forum.vuze.com/thread.jspa?messageID=183440
another thread mentioned .NET Framework 3.5. you can try that if the C++ redestributable doesn't work.
http://www.pchelpforum.com/pc-games/60044-fallout-3-trouble.html