National Steak and Poultry

It is Sunday, February 7, 2010; fifteen full days since Daniele Inc announced a recall of its salami products; and almost as long since the companies and investigating health authorities involved have either suspected or known that the ultimate source of illness in this large, and possibly growing outbreak, is black pepper.  But we, the food consuming public, continue to know nothing about the whereabouts of the contaminated pepper.  Why the silence?

To recap:  The CDC now counts 213 confirmed cases of Salmonella montevideo illnesses stretching from July 2009 to the present.  The cases are scattered across the country; 42 states in total; and California, Washington, Illinois, and Massachussets are the hardest hit states, with 30, 15, 13, and 12 cases respectively. Daniele Inc has recalled 1.28 million pounds of potentially contaminated product.  The Rhode Island health department announced on February 3 that it had detected the outbreak strain of Salmonella montevideo in pepper samples from two of Daniele Inc’s pepper suppliers, Overseas Spice Company and Wholesome Spice.  Neither company, nor any government agency involved in the investigation (including FSIS, CDC, and USDA) has announced whether other food companies have received any of the contaminated pepper, or even whether the contaminated pepper is sitting on store shelves.  Nor has there been a recall of the contaminated pepper. 

From a public health standpoint, the proper flow of information would dictate that the public be made aware of where the contaminated pepper is; alternatively, if the companies involved and the governmental agencies investigating the outbreak have information to suggest that there really is no ongoing risk to the public, we should know that too. 

Most of the ire about the slow flow of information in this outbreak exists because of the potential that the outbreak is broader than simply contaminated salami.  We know that it wasn’t the meat that was contaminated; it was contaminated pepper that ultimately caused the meat to become contaminated.  The pepper came from two companies who obviously had the same supplier of pepper.  Those pepper companies, Wholesome and Overseas, likely have more than one customer, thus creating the risk that more than Daniele is in possession of, or has used, the contaminated pepper.  And critically, there has been the suggestion, at least, that some people who are counted as outbreak cases (i.e. confirmed with the outbreak strain of Salmonella montevideo) did not even have any reported consumption of Daniele Inc salami in the days prior to their illnesses.  If true, this means that there must be more products that are making people sick, and may still be on store shelves. 

Some of the ire, though, exists because this is not an isolated instance of the slow flow of information in food outbreaks.  Recall that the E. coli O157:H7 outbreak linked to beef products from National Steak and Poultry was announced on Christmas Eve–probably the worst time possible to announce an outbreak and recall because most consumers simply aren’t paying attention to recalls at that point in time.  Another example is the West Missouri Beef recall of 14,000 pounds of potentially contaminated boneless beef products.  Apparently, the meat was distributed to Chicago-area wholesalers, yet neither FSIS nor the company itself has disclosed the retail locations that received the potentially contaminated products. 

So the silence of the peppers continues.  If there is an ongoing risk to the public, we should have the benefit of knowing that so that we can make an informed choice about what products to buy.  If there is no ongoing risk to the public, we should have the benefit of knowing that information too. 

The unfortunate trend for E. coli and beef in late 2009 and 2010 continues.  This evening, West MissourI Beef, LLC, a Rockville, Missouri beef company, recalled 14,000 pounds of boneless beef products due to potential E. coli O157:H7 contamination.  Today’s recall brings the tally for recalled beef due to E. coli contamination to 1,636,000 pounds of beef products in the last three months. 

On January 18, 2010, the USDA’s food inspection branch (FSIS) announced the recall of 846,000 pounds of ground beef products produced by a California company called Huntington Meat Packing, Inc., due to potential contamination by E. coli O157:H7.

On January 11, 2010, Adams Farm Slaughterhouse, LLC., an Athol, Mass., stablishment, recalled approximately 2,574 pounds of beef products due to potential E. coli O157:H7 contamination. The recall occurred in the wake of an epidemiological investigation into the E. coli illness of at least one Massachusetts resident.

In November 2009, ground beef from a New York ground beef company called Fairbank Farms was recalled due to E. coli O157:H7 contamination. That outbreak caused resulted in 26 E. coli O157:H7 illnesses, nineteen hospitalizations, and five who developed hemolytic uremic syndrome (HUS).

And on Christmas Eve 2009, National Steak and Poultry recalled at least 124 tons of mechanically tenderized beef products. The National Steak and Poultry outbreak caused at least 21 E. coli O157:H7 illness in 16 states, including nine hospitalizations and one case of HUS.

Together, the recalls and outbreaks linked to beef from Adams Farm, National Steak and Poultry, Fairbank Farms, and now West Missouri Beef have caused at least 48 illnesses nationally. At least 1,636,000 pounds of beef have been recalled in total in the five recalls. .
 

Counting Friday’s sausage recall by Daniele International, Inc., food companies have recalled at least 2,880,000 pounds of meat products since November 2009 due to contamination by E. coli or Salmonella. 

Friday’s recall:  (from FSIS press release)

Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., is recalling approximately 1,240,000 pounds of ready-to-eat (RTE) varieties of Italian sausage products, including salami/salame, in commerce and potentially available to customers in retail locations because they may be contaminated with Salmonella, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The Daniele Inc. sausage outbreak, due to contamination by Salmonella Montevideo, has caused at least 184 illnesses in residents of 38 states. 

On January 18, 2010, the USDA’s food inspection branch (FSIS) announced the recall of 846,000 pounds of ground beef products produced by a California company called Huntington Meat Packing, Inc., due to potential contamination by E. coli O157:H7.

On January 11, 2010, Adams Farm Slaughterhouse, LLC., an Athol, Mass., establishment, recalled approximately 2,574 pounds of beef products that was potentially contaminated with E. coli O157:H7.  The beef was the cause of infection in at least one Massachusetts resident. 

On December 24, 2009 (The Christmas Eve sneak), an Oklahoma company called National Steak and Poultry recalled 248,000 pounds of tenderized beef products due to contamination by E. coli O157:H7.  The outbreak is known to have sickened at least 21 people in 16 states.  Last week, Marler Clark filed the first lawsuit arising from the outbreak on behalf of a Utah resident.

And in November 2009, A New York company called Fairbank Farms recalled 545,699 pounds of ground beef due to E. coli O157:H7 contamination. The outbreak caused resulted in 26 E. coli O157:H7 illnesses, nineteen hospitalizations, and five who developed hemolytic uremic syndrome (HUS). 

 

 

 Today’s announcement by USDA-FSIS of another beef recall due to E. coli O157:H7 contamination bodes poorly for this new year.  Adams Farm Slaughterhouse, LLC., an Athol, Mass., establishment, is recalling approximately 2,574 pounds of beef products that may be contaminated with E. coli O157:H7.  The recall occurs in the wake of an epidemiological investigation into the E. coli illness of at least one Massachusetts resident.  The recall also marks the third beef recall in the last three months due to E. coli O157:H7 contamination.

In November 2009, ground beef from a New York ground beef company called Fairbank Farms was recalled due to E. coli O157:H7 contamination. That outbreak caused resulted in 26 E. coli O157:H7 illnesses, nineteen hospitalizations, and five who developed hemolytic uremic syndrome (HUS).   

And on Christmas Eve 2009, National Steak and Poultry recalled at least 124 tons of mechanically tenderized beef products.  The National Steak and Poultry outbreak caused at least 21 E. coli O157:H7 illness in 16 states, including nine hospitalizations and one case of HUS.   

Together, the recalls and outbreaks linked to beef from Adams Farm, National Steak and Poultry, and Fairbank Farms, has caused at least 48 illnesses in nationally.  At least 776,000 pounds of beef have been recalled in total in the three outbreaks.  

The Meat Trade News Daily misses only a couple major food safety issues (i.e. outbreaks) in yesterdays summary of ten major food stories in 2009.  In the blog post, titled "USA – Food Safety a Bloody Disgrace," MTND includes: 

1.  Stephanie Smith’s E. coli O157:H7 and HUS illness from eating a contaminated Cargill ground beef patty.  Stephanie has sued Cargill for $100,000,000.

2.  Linda Rivera’s E. coli O157:H7 and HUS illness from eating contaminated Nestle cookie dough.

3.  Peanut Corporation of America’s Salmonella Typhimurium outbreak, remarkable for a lot of things, not least of which the depth of its seemingly utter disdain for the wellbeing of consumers.

4.  The Salmonella Newport (an antibiotic resistant strain) outbreak linked to Cargill ground beef.

5.  President Obama’s failure to nominate somebody, despite having served for almost a year–a year marked by, well, see above and below–for the position of Undersecretary of Food Safety at the USDA.

6.  The Milan, Illinois McDonald’s Hepatitis A outbreak, lacking only an ounce of intent in its comarability to the actions of PCA and Stewart Parnell.

7.  The Organic Pastures E. coli O157:H7 outbreak linked to raw milk.

8.  The E. coli O157:H7 outbreak linked to JBS beef.

9.  A Chinese court’s acceptance of the first lawsuit to arise from the 2008 melamine scandal linked to tainted milk, which killed 6 babies and sickened about 300,000.

10.  The "food fight" sparked by the Center for Science in the Public Interest’s report on the ten riskiest foods regulated by the FDA.

A good list.  I would add many more if there was room in a list of ten, but two are certainly worthy of emphasis:

1.  The E. coli O157:H7 outbreak, announced in a Christmas Eve press release, linked to tenderized beef products produced by National Steak and Poultry.

2.  The large Salmonella Saintpaul outbreak from January through April linked to contaminated sprouts.  Ultimately, at least 228 people were sickened in the outbreak from 13 states.

In 1999, the USDA-FSIS asked the National Advisory Comittee for Microbiological for Foods whether tenderized beef presented increased risks of contamination by E. coli O157:H7.  The answer, of course, was that it does, and that risks to consumer health increased correspondingly.  See Recommendations

This is not surprising, of course, nor is it particularly newsworthy in and of itself given the recent outbreak linked to tenderized beef from National Steak and Poultry.  In other words, we already knew that.  What i am interested in at this point is what questions we need to ask of National Steak and Poultry in upcoming litigation over the outbreak.  Essentially, what did National Steak and Poultry, and the industry at large, know about the risks of tenderized beef, and what did they do in order to reduce these risks and make a safer product. 

FSIS recommended several such steps, which certainly do not exhaust the list of things that manufacturers of tenderized beef need to do, but are good first steps at least:

First, the FSIS asked each plant operater that mechanically tenderizes beef to specifically consider in their annual reassessment of their HACCP (hazard analysis and critical control points) plan the significance of E. coli outbreaks linked to tenderized beef as a hazard that is reasonably likely to occur. 

Second, FSIS asked that each of these processors implement purchase specifications requiring the incoming product to be treated to reduce or eliminate E. coli to an undetectable level or apply an approved antimicrobial treatment to the meat.  See yesterday’s post on this subject.

Third, though not really a recommendaiton, FSIS was "considering" a requirement that raw, mechanically tenderized beef be labeled to show that it had undergone mechanical tenderization.  (A brilliant idea, and one that all state legislatures should consider independently of any FSIS commandment on the subject; consumers should, at the very least, know whether the meat they are about to consume has undergone a tenderization process that may require a different cooking approach to make the product safe to eat)

Further, in light of the FSIS research and recommendations, the Dairy and Food Protection Branch (Division of Environmental Health, Department of Environmental and Natural Resources) issued the following additional recommendations:

1.  All beef not labeled as intact and without buyer specifications to show that it is intact must be assumed to be a non-intact beef product based on the standard meat processing industry practices of pinning, tenderizing or injecting these products. This also includes comminuted beef steak (chopped, flaked, ground, minced, restructured or reformulated).

2. Cook non-intact beef products to a temperature of 155°F as measured by a properly calibrated food thermometer as required by the FDA Food Code.

3. If you currently tenderize beef steaks or other beef products in your restaurant kitchen, please stop this practice.

4. Educate your staff about the identified risks of mechanically tenderized (non-intact) beef products.

5. When possible, notify consumers about the risk of getting E. coli from mechanically tenderized (nonintact) beef steaks and roasts

I wholeheartedly agree, particularly with any recommendation aimed at achieving elimination of bacterial contamination by the slaughterhouses, as well as with any recommendation that aims to educate the consumer about the risks he or she faces by consuming tenderized beef.  National Steak and Poultry, which of these steps were you actively taking at the time of the outbreak?

Injury issues aside (see John Mcdonalds HUS story), the problem with tenderized beef is that it internalizes bacteria from the surface of intact cuts of beef, thereby reducing the likelihood that cooking will serve as an effective kill step.  The recent (ongoing???) outbreak of E. coli O157:H7 linked to National Steak and Poultry products occurred because the cuts of beef were mechanically tenderized.  In fact, somewhat frighteningly, a majority of the steaks and roasts destined for consumption at hotels, restaurants, and other institutional settings are mechanically tenderized.  Clearly, unless consumers stop eating tenderized beef or a reliable pre-cooking kill step is established and actually used, the onus for the task of manufacturing safe beef products remains squarely on the manufacturers’ shoulders.

"Manufacturer" is a broad term, and I intend to confine it to no one entity in the process of manufacturing beef products.  It includes slaughterhouses and retail meat producers alike (e.g. National Steak and Poultry).  Because our inboxes and voicemail systems are already filling up with inquiries about the outbreak, we will have the opportunity to discover everything that National Steak and Poultry, and the entities who sold it the contaminated products, knew about the risks associated with tenderized beef.  And more importantly, we will have the opportunity to discover what those entities did to minimize or eliminate the risk that consumers of their products would become infected by E. coli O157:H7.

For starters, we will be interested to know what studies these entities participated in to research both the prevelance of E. coli and other bacteria on the surface and in the interior of tenderized beef; what the results of those studies were; and how these entities used or acted upon the results of their work.  If the answer is, as it very well may be, "No, we did not fund or participate in any such studies," i’m not sure that’s going to mean much in front of a jury who is going to hear that such studies have, in fact, been done. 

One such study by The Center for Red Meat Safety at Colorado State University, which sought to determine the efficacy of anti-microbial treatments at various stages of the manufacturing process, found that the obvious was true:  bacteria is very hard to effectively remove or kill once it has been introduced into the interior of the beef; but that surface interventions can effectively reduce the contamination load on the surface of the product.  See the whole study here.   The timing of the chosen treatment (in the study, researchers used both water and lactic acid) is also important, as the study quite logically found that the treatments were more effective when done prior to tenderization. 

The main point of this study, or at least the point that i think we should all take from this and other similar studies, is that there is no failsafe method, in use presently, of eliminating bacteria from the surface or interior of beef products once those products become contaminated.  Thus, manufacturers must attack the problem of bacterial contamination on meat products where interventions can be more effectively applied:  during the slaughtering process.  If we prevent meat from becoming contaminated in the first place, the need to eliminate contamination from the surface or interior of the meat will cease to exist.  

Every time an E. coli O157:H7 outbreak occurs, we get yet another reminder how devastating the bacteria can be, particularly when it causes hemolytic uremic syndrome (HUS).  See www.about-hus.com..  And every time we represent a young child with HUS, I am reminded of the story of Regan Erickson, who was sickened in the spinach E. coli outbreak in September 2006 (We represented over 100 victims, including nearly 30 who suffered kidney failure and hemolytic uremic syndrome). 

Tiffany and Russ Erickson were just like most Americans until September 2006. Their four-year-old son Regan (pronounced "Ree-gun") was one of many young kids whose future was unalterably and forever changed by spinach. What appears below is Regan’s story. It is a little long, but that must be forgiven. Regan’s illness very nearly cost him his life.

ONSET OF ILLNESS:

Regan’s mother, Tiffany, and his sister, Emma, were both sickened during the Spinach outbreak as well. Tiffany actually fell ill first, on August 28. It felt like cruel timing, given that it was only three days before Emma’s birthday and little more than a week since discovering that she was pregnant with her third child, Maggie, but Tiffany took everything in stride. She had no reason to suspect that she was dealing with anything more than a run-of-the-mill flu, and her primary concern was with the health of her unborn child.

After twenty-four hours or so, however, thoughts began to change about the nature of Tiffany’s illness. Her bouts of diarrhea had grown more frequent and severe, and her abdomen was beset by cramps more severe than labor pains. Then, the evening of August 29, after a particularly painful bout of diarrhea, Tiffany noticed that the toilet bowl was streaked with blood. Up until this point, Tiffany had endured everything with resolute confidence, but this symptom suggested something that she had never before reckoned with.

Tiffany soon underwent a diagnostic procedure called an endoscopy to shed light on what was wrong. Of his wife’s illness, before his thoughts turned to Regan alone, Russ recalls:

We left the urgent care facility and gave the drugs some time to work, but the pain continued to be unbearable. As my concern shifted from the baby to Tiffany I couldn’t stand seeing her in that much pain, tired from lack of sleep, and not able to get comfortable.

Meanwhile, Regan had begun to develop symptoms, and Emma soon would. “We didn’t realize that the illnesses could be related,” Russ recalls, “since Regan couldn’t express his pain as well as Tiffany. He just knew his ‘tummy’ hurt and he began having diarrhea.” Emma’s symptoms began the very next day, September 1.

Russ recalls:

Everyone in the family was sick, tired, and the children being so young, not knowing how to tell or deal with the symptoms like diarrhea, I was continually cleaning, comforting, and helping where I could, all without Tiffany’s help who is usually the stalwart caregiver. We knew that we had some kind of ‘bug’ but not how severe yet. It presented a lot like flu symptoms, but we began to know it was more serious as the kids, just as Tiffany, began to have blood in their stool, and then blood instead of stool. That is a scary, unnerving experience to see blood when your 3 and 4 year olds are using the bathroom.

Compared to four year-old Regan, the illnesses that Tiffany and Emma Erickson suffered were nothing more than a small current in a raging sea. Nevertheless, to hear Russ describe what his wife and daughter endured is to fully comprehend the aggressive nature of this virulent pathogen. Emma endured many days of an illness more acutely painful than anything her parents had ever seen. But as sick as she was, her older brother was fast-becoming critically ill, and her parents thoughts and attention soon went solely and exclusively to Regan.

 

Continue Reading Hemolytic uremic syndrome (HUS) and E. coli O157:H7

Certain circumstances surrounding the National Steak and Poultry E. coli O157:H7 outbreak have me worried.  The pathogen is incredibly dangerous; the vehicle (non-ground beef products) is often not cooked to a high enough temperature to kill E. coli; many of the beef products recalled are frozen, thus extending the shelf-life, putting more people at risk over a longer time frame, and frustrating public health detection efforts; and perhaps most concerning, the list of products is really long: 

4-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68408.”

6-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SP680608.”

8-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68808”

9-ounce “NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “SC68908.”

“NATIONAL STEAK AND POULTRY BONELESS BEEF TIPS,” with an identifying case code of “69108.”

“NATIONAL STEAK AND POULTRY BONELESS BEEF SIRLOIN STEAK” with an identifying case code of “XXSP68008.”

“NATIONAL STEAK AND POULTRY SAVORY SIRLOIN TIPS” with an identifying case code of “XX69008.”

5-ounce “NATIONAL STEAK AND POULTRY BACON WRAPPED BEEF FILLET,” with an identifying case code of “23508.”

“NATIONAL STEAK AND POULTRY USDA SELECT BEEF SHOULDER MARINATED TENDER MEDALLIONS” with an identifying case code of “23289.”

“NATIONAL STEAK AND POULTRY 75% BONELESS BEEF TRIMMINGS,” with an identifying case code of “33575.”

"NATIONAL STEAK AND POULTRY BEEF TRIMMINGS,” with an identifying case code of “36545.”

“NATIONAL STEAK AND POULTRY BEEF SIRLOIN PHILLY STEAK,” with an identifying case code of “88008.”

4-ounce “EGN BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680425.”

7-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “69725.”

9-ounce “EGN BONELESS BEEF SIRLOIN TRI TIP STEAK,” with an identifying case code of “680925.”

7-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680715.”

9-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680915.”

12-ounce “KRM BONELESS BEEF SIRLOIN STEAK,” with an identifying case code of “680215.”

8-ounce “CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK,” with an identifying case code of “130874.”

“CARINO’S BONELESS BEEF OUTSIDE SKIRT STEAK PIECES,” with an identifying case code of “13074.”

“MOE’S BEEF STEAK,” with an identifying case code of “78027.”

I suppose that only time, and the CDC, will tell how many people since September have been sickened, or died, in this outbreak.  We already know that there are victims in six states, including Washington, Michigan, South Dakota, Iowa, Colorado, and Kansas.  Maybe the final destructive tally will not be as large as the circumstances of this outbreak suggest that they could be.  But it certainly seems like a perfect storm, of sorts, to me.

E. coli O157:H7 strikes again, this time stealing some of Santa’s thunder and delivering a pile of bad news (for the meat industry, the consumer, everybody) on Christmas Eve.  The outbreak linked to National Steak and Poultry, an Oklahoma-based purveyor of pre-portioned beef products, has sickened people in Colorado, Iowa, Kansas, Michigan, South Dakota, and Washington.  I havent’ yet seen reference to how many are thought to have been sickened in the outbreak, but a listing of six states stretching from the eastern time zone all the way to the west coast portends some bad news on that front.

There is never "down time" at Marler Clark.  We are constantly busy, sometimes almost too busy, representing people who have been sickened in E. coli and other outbreaks.  But this outbreak adds more than a few "to dos" to our lists at Marler Clark.  The epidemiological evidence so far establishes that people were falling ill in this outbreak as far back as September 09; it also suggests that we’re dealing with a possibly frozen product–i.e. one that does not necessarily have a short shelf life (all the more reason for National Steak and Poultry to heed Bill Marler’s call to release its customer list so that people don’t continue to get sick). 

I can think of more than a few people who have called me since September who were ill themselves, or were distraught over the illness of a family member.  We investigate even the illnesses of those who are not part of a recognized outbreak, but even the lawyers at Marler Clark are sometimes limited by the known epidemiological evidence.  Now, however, after announcement of the National Steak and Poultry outbreak, we’ve got a heck of a lot more to go on.  I know what I’ll be doing this afternoon, tomorrow, and into next week:  sorting through the files of probably one hundred E. coli victims who have called since September, looking for possible exposures to national steak and poultry products.