Food Poison Journal - Food poisoning outbreaks and litigation: surveillance and analysis

Tomorrow morning, we will file a lawsuit on behalf of Kelly and Matthew Cobb.  Kelly was one of at least ten people infected with E. coli O157:H7 in May 2008 after eating contaminated lettuce.  Kelly ultimately developed hemolytic uremic syndrome as a result of her infection, and she had to be hospitalized for two weeks.  Of course, a big part of Kelly's story is that her husband, Matt, was fighting with the marines in Iraq at the time she became ill, leaving Kelly home alone to care for their two children. 

The lawsuit tomorrow will be filed against multiple entities, all of whom played a role in manufacturing the lettuce that made Kelly sick.  The companies, all from California, are as follows:  Church Brothers, LLC; Premium Fresh Farms, LLC; True Leaf Farms, LLC; Andrew Smith Company; and Paul's Pak, Inc.

By Maureen O'Hagan - Seattle Times staff reporter - "Food-safety lawyer's wish: Put me out of business"

If there's an outbreak of food-borne illness anywhere in the country, chances are William Marler will be filing lawsuits. Marler says he and his law firm have pried $500 million in settlements out of companies that have sickened customers.

You might say that E. coli has been very, very good to William Marler.

Ditto for salmonella, listeria, hepatitis and the like. If there's an outbreak of food-borne illness anywhere in the country — spinach, cookie dough, hamburgers, you name it — chances are Marler will be filing lawsuits.

"I love my job," he said from his Seattle law office. "I represent poisoned little children against giant corporations."

Talk about a winning formula. Marler, 52, says he and his firm, Marler Clark, have pried $500 million in settlements out of companies that have sickened customers. Depending on your point of view, making millions off sick people may be a good thing or it may be a bad thing. But right now, food safety is unequivocally a big thing.

In March, President Obama said the nation's lax food-safety policies have created a "hazard to public health." He appointed a high-level policy group to "upgrade our food-safety laws for the 21st century." Then a major report warned it would be way too easy for terrorists to poison the food supply.

In the midst of all of this, 80 people were infected with the bacteria E. coli after eating Nestle cookie dough.

This year, food-safety legislation was introduced in Congress — legislation that, for the first time in years, seems to have a chance of passing.

Now, Marler's not only trying to wring money out of food companies, he's trying to change the way our food is safeguarded in the first place. He's been lobbying his political buddies, arranging for clients to testify in Congress, and even sending them to reporters at The Washington Post and The New York Times, both of which put his clients' E. coli ordeals on the front pages.

"I'm impatient," he said. "For God sakes, get the bill out of the Senate."

And then, in early fall, he hit upon an idea: T-shirts.

"Pass meaningful food safety legislation before Thanksgiving," the drab gray shirts, sent to every U.S. senator, say.

"Put a trial lawyer out of business."

His smiling face, with a line through it, is emblazoned on the front.

It's funny. And it's serious.

1993 was start

Brianne Kiner was Marler's introduction. In 1993, when the 9-year-old Redmond girl was hospitalized with E. coli infection, her kidneys failed. Her pancreas crashed. Her liver stopped working. She suffered seizures and was in a coma for 40 days.

When she came to, she had to relearn to walk. To chew. To use the bathroom. Her health problems — and expenses — are lifelong.

All this from eating an undercooked hamburger from Jack in the Box. Three kids died in that outbreak, and another 500 Washington residents were sickened.

Brianne's family hired Marler, who then was with the Keller Rohrback firm, to file suit. He had been out of law school for just five years.

"Being extremely overconfident, I sort of volunteered to do everything and pushed myself to the top," he recalled. "Everything" includes not only legal filings but also lots of news conferences.

Some call him a publicity hound. Marler calls it fighting fire with fire. Jack in the Box had a media strategy, and so did he. He figured, the more public the outbreak was, the more likely Jack in the Box would cave. With the family's blessing, he helped put Brianne's plight on the national news.

The firm was hired by 200 other families to file claims against Jack in the Box, too.

Bingo.

Marler got Brianne a $15.6 million settlement. Settlements for his other Jack clients ran into the millions. (Generally, clients get 65 percent to 75 percent after costs, and the firm gets the rest.)

After Jack in the Box, he went back to being a general-practice plaintiff's lawyer. Then, in 1996, came Odwalla. The all-natural juice company sickened 66 people with its unpasteurized juice. Considering the hubbub around Jack in the Box, victims knew where to turn.

By this point, Marler knew the system to protect us from food-borne illness is full of holes. Regulations are a hodgepodge; oversight authority is scattered between the U.S. Department of Agriculture (USDA), which covers meat and poultry, and the Food and Drug Administration (FDA), which covers everything else.

Generally, the government deems it the food companies' responsibility to make a safe product. For example, the FDA does not require food processors to test for pathogens; the company can decide whether to do it, according to The Pew Charitable Trusts, which is pushing for tougher regulations.

For meats, the USDA can inspect, but it has limited power to close plants or order change. And while it's illegal, for example, to sell hamburger that tests positive for E. coli 0157, a particularly virulent strain, food processors aren't required to test for it in their finished products.

This untested meat nonetheless gets stamped with a USDA label and sold to consumers. "I think our government is as complicit in the process as the companies are," Marler said.

The scariest part? Just a few cells of E. coli in your food could put you through what Brianne went through.

Today, the Centers for Disease Control and Prevention estimates that 300,000 Americans are hospitalized and 5,000 die from food-borne illnesses each year. Some 76 million are sickened.

Back during the Odwalla outbreak, however, there wasn't as much awareness of the issue. But after that, Marler had a hunch. In 1998, he recruited his former Jack in the Box legal adversaries, Denis Stearns and Bruce Clark, and started a law firm that specialized in food-borne illnesses — a radical idea at the time.

Today, they have clients all over the country. Media coverage helps, but the lawyers also were early in recognizing the power of the Internet. They not only set up a Web site for the firm, they also created sites with comprehensive medical information on every conceivable food-borne illness — and included links back to Marler Clark.

After all, sitting at the bedside of an ailing loved one tends to focus the mind. What is this illness? And how can I possibly afford the medical care? If you Google E. coli — or listeria, or salmonella or even food-borne illness — you'll find a Marler Clark site in the top 10 hits.

They do not accept every case. The firm first has to pinpoint the cause of the illness — a particular lot of ground beef, an ingredient in a restaurant meal. That process can take months, and like most plaintiff's firms, it bears the costs upfront. If the firm can't make a positive match, it declines the case.

Some say Marler's no trial lawyer. In fact, he's tried just one E. coli case through to a jury verdict. It went in his favor. The vast majority of the firm's cases settle.

"We have a lot of big cases, $7 (million) to $10 million cases," Marler said. "People don't just give you that kind of money unless you have your foot on their throat."

Of course, the law of "strict liability" is on his side. If a customer gets sick, whoever made the tainted food is financially liable, whether or not they were negligent.

This, of course, strikes the food industry as unfair.

"There's plenty of people in the meat industry who, if they looked in the rearview mirror and saw they accidentally ran over Bill Marler, they'd put the car in reverse and make sure," said David Theno, a food-safety expert hired to revamp Jack in the Box after the outbreak.

Theno, it should be noted, considers Marler a friend.

Supporters, detractors

He's been called an "ambulance chaser." A vulture who "thrives on misery."

"Have a bad day, you parasite," someone once wrote to him.

Marler loves it. Recently, a reporter asked him for names of supporters and detractors. As to the former, he joked, "Do you want my mom's phone number?"

And the latter? He eagerly provided a long list of names.

"This guy will really tee off on me," he said of one food-industry insider. And another.

He likes to tell a story about a speech he gave before members of the National Meat Association. "They introduced me," he wrote in a blog post, "and nobody clapped."

"I walked up and stood there for a while without saying anything. And then I said, 'You may now clap.'"

He thinks it's hysterical.

The task of finding real-live Marler haters, however, proved difficult. Some likely candidates, like people in the spinach industry, who he's sued, declined to comment; others, like Rosemary Mucklow, director emeritus of the National Meat Association, have nice things to say, despite all the lawsuits (and the rank-and-file's failure to clap).

Which brings us back to his oft-repeated plea: Put me out of business. What he really means is he's tired of seeing so many people get horribly sick. He believes a lot of illness could be prevented with stricter food-safety laws, the sort Congress is considering.

Some time ago, he decided that just suing food companies wasn't enough. He travels across the country, and even the world, to speak about food safety to those who are in a position to do something about it — the farmers, processors and officials in charge of it all.

He tells them about his clients: the children on ventilators; the once-vibrant men on dialysis; the moms who've lost their intestines to the ravages of food-borne pathogens. And he lets them know how a jury might view things.

Marler calls it the "You shouldn't poison people" speech. He's made it before several industry groups, including the spinach growers, whom he sued after an E. coli outbreak in 2006. (He does not get paid for these kinds of talks.)

Even though the tainted greens were traced to just four fields in California, spinach sales plummeted.

"They were looking for scapegoats," recalled Brad Sullivan, an attorney who represents the industry.

Marler gave his talk, and withstood pointed questions. In the end, Sullivan recalls, farmers stood in line to shake his hand.

"Through the force of his personality, and being so knowledgeable ... he made a lot of people think," he said.

Legislation on the move

Periodically, in the wake of an outbreak, Congress considers food-safety legislation.

"They call me up and ask me if I have any victims who will testify," Marler said. "Little kids, dead people's families. It's theater.

"In 2006, it was spinach. (Lawmakers) shook a bag of spinach, belittled the corporate leaders but nothing happened."

Same thing with the peanut-butter outbreak in 2008.

But this year, things seem different. Obama is interested. And consumers are become increasingly aware of food-safety problems. The House passed one bill, and another bill was passed out of a Senate committee last week. Meanwhile, Marler is working on another angle. He wants to become the undersecretary of Agriculture for food safety, a job for which he's applied, and for which former Gov. Gary Locke, now Obama's commerce secretary, floated Marler's name.

"My wife has said, 'I don't think you have the patience for it,' " Marler said. "And maybe that's ultimately true. But when you know you're right ... ."

Parties, family dinners, and other gatherings where food is served are all part of the holiday cheer. But the merriment can change to misery if food makes you or others ill.

Typical symptoms of foodborne illness are vomiting, diarrhea, and flu-like symptoms, which can start anywhere from hours to days after contaminated food or drinks are consumed.

The symptoms usually are not long-lasting in healthy people—a few hours or a few days—and usually go away without medical treatment. But foodborne illness can be severe and even life-threatening to anyone, especially those most at risk:

* older adults
* infants and young children
* pregnant women
* people with HIV/AIDS, cancer, or any condition that weakens their immune systems
* people who take medicines that suppress the immune system; for example, some medicines for rheumatoid arthritis

Combating bacteria, viruses, parasites, and other contaminants in our food supply is a high priority for the Food and Drug Administration. But consumers have a role to play, too, especially when it comes to safe food handling practices in the home.

"The good news is that practicing four basic food safety measures can help prevent foodborne illness," says Marjorie Davidson, a consumer educator at FDA.

1. Clean:

The first rule of safe food preparation in the home is to keep everything clean.

* Wash hands with warm water and soap for 20 seconds before and after handling any food. "For children, this means the time it takes to sing 'Happy Birthday' twice," says Davidson.
* Wash food-contact surfaces (cutting boards, dishes, utensils, countertops) with hot, soapy water after preparing each food item and before going on to the next item.
* Rinse fruits and vegetables thoroughly under cool running water and use a produce brush to remove surface dirt.
* Do not rinse raw meat and poultry before cooking. "Washing these foods makes it more likely for bacteria to spread to areas around the sink and countertops," says Davidson.

2. Separate:

Don't give bacteria the opportunity to spread from one food to another (cross-contamination).

* Keep egg products, raw meat, poultry, seafood, and their juices away from foods that won't be cooked. Take this precaution while shopping in the store, when storing in the refrigerator at home, and while preparing meals.
* Consider using one cutting board only for foods that will be cooked (such as raw meat, poultry, and seafood) and another one for those that will not (such as raw fruits and vegetables).
* Keep fruits and vegetables that will be eaten raw separate from other foods such as raw meat, poultry or seafood—and from kitchen utensils used for those products.
* Do not put cooked meat or other food that is ready to eat on an unwashed plate that has held any egg products, or any raw meat, poultry, seafood, or their juices.

3. Cook:

Food is safely cooked when it reaches a high enough internal temperature to kill harmful bacteria.

* "Color is not a reliable indicator of doneness," says Davidson. Use a food thermometer to make sure meat, poultry, and fish are cooked to a safe internal temperature. To check a turkey for safety, insert a food thermometer into the innermost part of the thigh and wing and the thickest part of the breast. The turkey is safe when the temperature reaches 165ºF. If the turkey is stuffed, the temperature of the stuffing should be 165ºF. (Please read on for more pointers on stuffing.
* Bring sauces, soups, and gravies to a rolling boil when reheating.
* Cook eggs until the yolk and white are firm. When making your own eggnog or other recipe calling for raw eggs, use pasteurized shell eggs, liquid or frozen pasteurized egg products, or powdered egg whites.
* Don't eat uncooked cookie dough, which may contain raw eggs.

4. Chill:

Refrigerate foods quickly because harmful bacteria grow rapidly at room temperature.

* Refrigerate leftovers and takeout foods—and any type of food that should be refrigerated—within two hours. That includes pumpkin pie!
* Set your refrigerator at or below 40ºF and the freezer at 0ºF. Check both periodically with an appliance thermometer.
* Never defrost food at room temperature. Food can be defrosted safely in the refrigerator, under cold running water, or in the microwave. Food thawed in cold water or in the microwave should be cooked immediately.
* Allow the correct amount of time to properly thaw food. For example, a 20-pound turkey needs four to five days to thaw completely when thawed in the refrigerator.
* Don't taste food that looks or smells questionable. Davidson says, "A good rule to follow is, when in doubt, throw it out."
* Leftovers should be used within three to four days.

Also, use care with stuffing.

In its Holiday Food Safety Success Kit, the Partnership for Food Safety Education recommends:

* Whether it is cooked inside or outside the bird, all stuffing and dressing recipes must be cooked to a minimum temperature of 165ºF. For optimum safety, cooking your stuffing in a casserole dish is recommended.
* Stuffing should be prepared and stuffed into the turkey immediately before it's placed in the oven.
* Mix wet and dry ingredients for the stuffing separately and combine just before using.
* The turkey should be stuffed loosely, about 3/4 cup stuffing per pound of turkey.
* Any extra stuffing should be baked in a greased casserole dish.

People who purchased a meal at a fund raiser in Conway Nov. 13 are urged to dispose of any leftover food from the fund raiser as an investigation has begun into a possible foodborne outbreak involving the event, the S.C. Department of Health and Environmental Control announced today.

“The meals were prepared at a local hunting club and sold at the Cedar Grove Baptist Church in Conway to raise money to benefit the family of an ill child,” said Covia L. Stanley, M.D., director of DHEC’s Region 6 public health office, which serves Horry, Georgetown and Williamsburg counties. “So far, we have received reports of five people hospitalized with gastro-intestinal illness symptoms after purchasing and consuming food from the fund raiser.”

Dr. Stanley said meals sold at the fund raiser included barbeque pork, baked sweet potatoes, cole slaw and rolls.

“Members of the hunting club and the church are cooperating fully with DHEC staff as this investigation continues,” he said. “Anyone who ate the food from this fund raiser and becomes ill with symptoms including nausea, vomiting, diarrhea and abdominal cramping should take care to wash their hands thoroughly, avoid preparing food for others and contact their healthcare provider right away.”

Dr. Stanley said anyone with leftovers from that fund raiser should not eat or feed the leftovers to animals. Samples of the leftover food are being sent to the DHEC laboratories in Columbia for analysis.

Global Food Technologies ("GFT"), a California-based life science company specializing in food safety, today announced the commencement of deliveries of its iPura brand tilapia to Safeway. iPura, the world's first food safety brand, will be in the service counter of Safeway supermarkets by the end of the month.

"We are thrilled to have the opportunity to become a supply partner for Safeway because of their unrivaled reputation for leadership in food safety and environmental responsibility," stated Keith Meeks, President of GFT. "iPura was designed to provide greater control over the processing and distribution phases by implementing proprietary extraordinary precautions, thereby earning the trust of food distributors, retailers and consumers. This is especially important with seafood sourcing where over 80 percent of the seafood consumed in the US originates overseas. We provide the technology, hardware and manpower on-site to achieve what we refer to as The Highest Standard in Food Safety," Meeks added.

Aaron Ormond, VP of Food Safety for GFT, explained, "iPura contracts with premier aquaculture producers to assure we start with high quality products, which marks only the beginning of our commitment to provide the best quality seafood in the industry. With our unique 'boots on the ground every day' approach, the iPura on-site food safety and quality assurance team, including microbiologists, system operators, technicians, and quality assurance personnel, execute extraordinary science-based controls to mitigate and reduce the proliferation of pathogens and spoilage organisms on both the raw material and within the processing environment. iPura assures safety and quality at a level unmatched in the industry."

"Food safety and quality are the main concerns of food executives and iPura has taken food safety and quality to a new level with patented organic technologies and security controls throughout the supply chain. iPura is a fantastic solution to many of today's critical supplier issues," stated Tom DeMott, COO of Encore Associates, a sales and marketing advisory group.

iPura tilapia was launched in March at the International Boston Seafood Show. GFT has plans to introduce striped pangasius, steelhead, salmon and shrimp under the iPura label. "We have over a dozen regional distributors and I think we can expect to see iPura products in more stores and on many restaurant menus in the very near future," commented Robert Clark, Director of Marketing for GFT, who was also quick to point out, "iPura isn't just about health and sustainability; iPura also won the American Masters of Taste gold medal as the best tasting tilapia in the US."

For more information about iPura visit www.iPura.com