On the evening of Friday, September 19, 2014 Diane Norman bought pizzas at Domino’s Pizza located at 2800 Milton Way in Milton, Washington.  She took the pizzas home for her family to consume. Michael Norman chose two slices of Canadian bacon and pineapple pizza and took a bite of one slice.  He swallowed and immediately felt something sharp in his throat.  He started to choke and dashed to the sink to drink water to help clear his throat. At this point he felt a sharp tearing at his throat and drank a glass of cranberry juice. His throat felt scratched and to relieve his pain he ate a slice of bread.  Although this action eliminated the feeling that food was lodged in his throat, Michael felt a dull pain in his stomach. Since he was no longer felt hungry, he did not eat any more pizza. Diane Norman froze the remaining leftover pizza. Sometime later she examined the frozen pizza slices and found a wire in a piece of the pizza she had saved.

Over the next few days Michael continued to feel a dull pain in his abdomen.  His doctor ordered x-rays which showed two metallic objects inside his abdomen.  A CT scan revealed that one of the metal objects had punctured his small intestines. After a failed attempt to remove the metal objects via endoscopy, Michael was rushed into surgery on September 27. It was then that surgeons removed two wires from Michael Norman’s intestines.

On September 30 Michael Norman filed a complaint with the Tacoma Pierce County Health Department.  In response to his complaint, TPCHD environmental health specialist, Christina Sherman, conducted an on-site investigation at the Domino’s in Milton.  Ms. Sherman reviewed the pizza making process with Domino’s employee, James Tyler. She noted that a wire brush was used to clean a wire rack inside the oven at the end of each day. Ms. Sherman also observed wear on some of the brush bristles. This wear was evident in photos of the brush taken by Ms. Sherman.

On October 8 Michael Johnson at TPCHD conducted a second on-site visit to Domino’s.  Mr. Johnson wrote in the inspection report:

“Observed a wire brush with food debris between the wires. Wires on the brush were bent and pointing in different directions and did not maintain its original design. Employee stated they had another brush that was used to clean the oven but was discarded last week. Person in charge stated the outside of the oven is cleaned every night and the inside of the oven is cleaned once a month using the brush.”

Ms. Johnson advised, “[E]quipment and utensils must be designed and construction to be durable and to retain their characteristic qualities under normal use conditions.”

The wire brush was discarded.

Of note is that other food safety violations were noted at Domino’s including inadequate handwashing facilities, improper cold holding and use of stem thermometers instead of digital thermometers.[1]

The facts of this case clearly link injuries experienced by Michael Norman to Domino’s pizza he consumed on September 19. Immediately after taking a bite of pizza he felt a sharp pain in his throat and started choking.  After experiencing several days of stomach pain x-rays were taken of his abdomen and revealed two metal wires in his intestines. Doctors performed emergency surgery and removed the wires.  Diane Norman found a metal wire in pizza leftover from the September 19 meal. Domino’s Pizza staff described how metal wire brushes were used to clean the pizza oven and public health investigators observed that wires on the brush at the Domino’s Pizza in Milton were bent.  A Tacoma Pierce County Health Department investigator took photos of the wire brush. These photos show obvious wear and tear of the brush.

Internal injuries from ingestion of wire grill-cleaning bristles are well documented. In a single hospital system 12 patients with injuries due to ingestion of wire bristles were reported between July 2009 and June 2012. The severity of injury ranged from puncture of the soft tissues of the neck, causing severe pain on swallowing, to perforation of the gastrointestinal tract requiring emergency surgery. (REF: Grand DJ, Egglin TK, Mayo-Smith WW. et al. Injuries from ingesting wire bristles dislodged from grill-cleaning brushes – Providence, Rhode Island, 2009-2012. J. Safety Res. 2012 Dec. 43(5-6):413-5.)  The Centers for Disease Control and Prevention (CDC) recommends actions to prevent these injuries by increasing awareness among consumers, manufacturers, retailers, and medical professionals to promote prevention, timely diagnosis and appropriate treatment. In an editorial published in the Morbidity and Mortality Weekly Report (MMWR), the agency suggests that awareness by manufacturers and retailers of the risk of ingesting wire bristles might encourage alteration of current products or development of safer ones. The CDC recommends those in the food services industry to “examine whether their patrons are at risk for this injury” and advises the “use of alternative grill-cleaning methods or products.”  (REF: Centers for Disease Control and Prevention, Injuries from ingestion of wire bristles from grill-cleaning brushes – Providence, Rhode Island, March 2011-June 2012. MMWR Morb Mortal Wkly Rep 2012 Jul 6;61(26):490-492.)

As of June 24, 2013, 120 people have been confirmed to have become ill from Hepatitis A after eating ‘Townsend Farms Organic Anti-oxidant Blend’ in 8 states: Arizona (16), California (62), Colorado (24), Hawaii (5), New Mexico (5), Nevada (5), Utah (2), and Wisconsin (1). [Note: The one case reported from Wisconsin resulted from exposure to the product in California.]

70 (58%) ill people are women

Ages range from 2 – 84 years;

73 (61%) of those ill were between 40 – 64 years of age.

Currently, 5 children under age 18 have been infected as part of this outbreak; of these, none were hospitalized, and none were previously vaccinated.

Illness onset dates range from 3/31/2013 – 6/14/2013

54 (45%) ill people have been hospitalized, and no deaths have been reported

Investigation by state and local health departments, FDA, and CDC is ongoing. Costco notified its members who purchased this product since late February 2013, and has removed the “Townsend Farms Organic Antioxidant Blend” frozen berry and pomegranate mix from its shelves. The product was distributed in 12 states (AZ, AK, CA, CO, HI, ID, MT, NV, NM, OR, UT, and WA); however, no cases from Alaska, Idaho, Montana, Oregon, or Washington have been linked to the outbreak at this time. One case was reported from Wisconsin, however, the product was not distributed in the state and the person was exposed in California.

Sarah Schacht has the dubious distinction of being a client of mine – twice – 20 years apart.  However, Sarah has turned her double bad luck into a positive – advocating for the public’s ability of seeing restaurant inspections more readily.

Thanks Sarah.  Over at Food Safety News we are doing our best to provide links to all restaurant inspections.  See http://www.foodsafetynews.com/restaurant-inspections-in-your-area/#.UZauY4KhN9E

We filed a lawsuit today against Sunland, Inc. and Trader Joe’s, the manufacturer and retailer who sold Salmonella-contaminated peanut butter products that state and federal public health officials identified as the source of a multi-state Salmonella Bredeney outbreak in September. The lawsuit was filed in Worcester County Superior Court on behalf of the Henson family and their 4-year-old son of Worcester County, Massachusetts.

The complaint alleges that Ms. Henson purchased Valencia peanut butter on multiple occasions between May and July. Her child, who regularly ate peanut butter on sandwiches and other items, became ill with nausea, cramps, and diarrhea—all symptoms of Salmonella infection—on July 31, 2012. According to the complaint, he required 2 visits to the pediatrician. A stool sample submitted during one of the visits later tested positive for Salmonella Bredeney, the strain of Salmonella public health officials have shown is associated with the consumption of peanut butter made by Sunland, including Trader Joe’s Valencia peanut butter.

A lawsuit will be filed Thursday against Sunland, Inc. and Trader Joe’s, the manufacturer and retailer who sold Salmonella-contaminated peanut butter products that state and federal public health officials identified as the source of a multi-state Salmonella Bredeney outbreak in September. The lawsuit was filed in Worcester County Superior Court on behalf of the Henson family and their 4-year-old son of Worcester County, Massachusetts.

The complaint alleges that Ms. Henson purchased Valencia peanut butter on multiple occasions between May and July. Her child, who regularly ate peanut butter on sandwiches and other items, became ill with nausea, cramps, and diarrhea—all symptoms of Salmonella infection—on July 31, 2012. According to the complaint, he required 2 visits to the pediatrician. A stool sample submitted during one of the visits later tested positive for Salmonella Bredeney, the strain of Salmonella public health officials have shown is associated with the consumption of peanut butter made by Sunland, including Trader Joe’s Valencia peanut butter.

Here is a link to an ABC interview of our North Carolina client.

Korean War veteran Clifford Tousignant served the United States of America for 22 years, earning three purple hearts along the way. In 2009, he died from eating Salmonella contaminated peanut butter.

Mr. Tousignant was one of nine people who died and 714 who were sickened in a 2008/2009 Salmonella outbreak linked to Peanut Corporation of America (PCA). The outbreak affected almost every state in the nation and cost the peanut industry over one billion dollars.

PCA Peanut Butter Salmonella Outbreak Victim: Cliff Tousignant from Marlerclark on Vimeo.

Mr. Tousignant is still dead and Stewart Parnell, president of PCA, is still not in jail.

Last years Listeria Cantaloupe Outbreak is still claiming lives.  December 2011 official CDC report counted a total of 146 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes from 28 states.  However, the CDC still only counts thirty deaths as being reported in addition to one woman pregnant at the time of illness who had a miscarriage.  I believe the death toll is now at least 36, including Mike Hauser: