The Cost of Foodborne Illness

The Food Safety Bill is being debated on Capitol Hill as I write this post.  Hopefully the human cost of foodborne illness will weigh on our Representatives' minds as they vote.  The folks below have been involved.  They have visited Washington DC, met with members and have testified.

Lindsey Jennings (below, center) was a healthy 21-year-old starting medical school in the fall of 2008. After eating lettuce contaminated with E. coli O157:H7, she was hospitalized for 11 days. Her medical bills to date total $55,444.49.



In 2006, Ashley Armstrong (below), age 2, became infected with E. coli O157:H7 after eating Dole brand baby spinach. She was hospitalized for 43 days with hemolytic uremic syndrome (HUS). She suffered acute renal failure and pancreatitis and was on dialysis for nearly 4 months. She has a 95 to 100 percent chance of end stage renal disease, and is expected to require a kidney transplant within three to ten years. Ashley will require a combination of kidney dialysis and transplants throughout the rest of her life. Ashley’s medical bills during her acute illness exceeded $200,000, and the value of her projected future medical expenses and future economic losses total between $6 and $7.5 million.

Heather Whybrew (below, in cap and gown) is a 20-year-old college student pursuing a double major in biology and psychology. In 2008, she was hospitalized for 18 days after consuming romaine lettuce contaminated with E. coli O157:H7. Her medical bills to date are $113.959.04.

Mora Lou Marshall (below) was functionally independent before her Salmonella Tennessee illness, which she contracted as a result of eating Con Agra’s Peter Pan Peanut Butter. As a result of her illness, Mora was hospitalized for more than 30 days at Willis-Knighton Medical Center and Life-Care Hospital. Furthermore, to date, Mora has never able to return home to her family. Since her multiple hospitalizations and illness, Mora Lou Marshall has lived at the Garden Park Nursing Home in Shreveport, Louisiana. Her medical expenses currently total $352,960.

Clifford Tousignant (below, with granddaughter) was a highly decorated Korean War veteran. He received 3 purple hearts and faithfully served his country for over 22 years. Mr. Tousignant became sick with Salmonella Typhimurium in December of 2008, as a result of eating peanut butter products manufactured by King Nut and the Peanut Corporation of America. Mr. Tousignant was hospitalized because of his infection and illness for 6 days at St. Joseph’s Hospital in Brainerd, Minnesota. As a result of his illness, Mr. Tousignant died on January 12, 2009. His medical expenses totaled $42,853.

Posted on July 30, 2009 by Bill Marler
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Marler, Honored, Blessed, Hard Work or Just Damn Lucky?

Poor Bill Baldwin of Forbes – his Editorial “Needed: Tort Lawyers” in this week's Forbes – has been printed and reprinted on other lawyer blogs and websites to tout their bona fides as food lawyers. Funny thing, all of them missed this part of Mr. Baldwin’s editorial:

Meet William Marler, a 52-year-old Seattle attorney whose career was launched with a $15.6 million settlement against Jack in the Box. (This victim survived but lost her large intestine.) Sixteen years later he can brag that his firm, Marler Clark, has extracted just shy of half a billion dollars in settlements from food vendors. This suggests cumulative revenues of maybe $150 million for a small firm (seven lawyers, one full-time epidemiologist). But letting lawyers get rich has a nice side effect. The settlements get the attention of food producers. Bill Marler is not shy about using the Web, press releases and Capitol Hill testimony to publicize what he's doing.

The “newbie” lawyers into food litigation believe that if they put up a few Google ads and post a few blogs, the glitter of it all will attract people poisoned by the food they and their children have eaten to their firms. They then think they can cash in on the victims injuries.

But these “newbie” lawyers are mistaken it is not about the money – victims of foodborne illness today can tell the real from the fake, from the glittery website site and dazzling smile to 21 years of 24/7 365 day advocacy. Those clients, like Heather Wybrew, Carl Ours and Mari Tardiff profiled in the New York Times this Monday in “Health experts say food supply is safer today than a decade ago, but recalls raise new concerns,” understand the differences. They get it. As I said to the New Your Times:

The paradox is that even as food has grown safer, contamination scares and recalls keep coming to light. William Marler, a Seattle lawyer who specializes in representing victims of food-borne illness, said that every time his business appeared to slow from a drop-off in cases, some new type of contamination would crop up.

"It's like the Dutch boy putting his finger in the dike," Marler said. "When you put your finger in one hole, another emerges."

The clients understand that it is not about the money, the glitz or the glitter – it is about hard work, dedication and caring. Well, time to board the plane to London. I need to put another finger in the dike.

Posted on May 10, 2009 by Food Poisoning Attorney
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The Community Summary Report on Food-Borne Outbreaks in The European Union in 2007

I am heading to London Sunday for a series of lectures on food safety and just in time the EU put out its report on foodborne diseases for 2007.  Full report - Here.

In total, 5,609 food-borne outbreaks were reported by MSs in 2007 that is a slight decrease of 2.2% compared to 2006. Together 36.1% of the reported outbreaks were classified as verified. The verified outbreaks affected 39,727 people resulting in 3,291 hospitalizations and causing 19 deaths. In addition, the two non-MSs reported 93 food-borne outbreaks, of which 38.7% were verified and 1,475 people were affected, resulting in 55 hospitalizations and causing five deaths. France and Spain reported most (73.0%) of the verified outbreaks in the EU. There was a great variation between MSs in the numbers and proportions of verified outbreaks reported, which may reflect differences in the sensitivity and efficiency of the national systems for investigating and reporting outbreaks in place.

Salmonella was, as in previous years, the most commonly reported cause of food-borne outbreaks in the EU. Twenty-two MSs reported 2,201 Salmonella outbreaks of which 26.8% were verified. The 590 verified Salmonella outbreaks affected 8,922 people, resulted in 1,773 hospitalizations and caused ten deaths.

Food-borne viruses, mainly calicivirus (including norovirus), were reported as the second most common known cause of food-borne outbreaks, and 18 MSs reported a total of 668 outbreaks of which 16.6% were verified. The 111 verified virus outbreaks affected 3,784 people and resulted in 131 hospitalizations.

Campylobacter also remained a common cause of food-borne outbreaks in the EU and 17 MSs reported 461 outbreaks where only 6.5% were verified. The 29 (excluding the large waterborne outbreak) verified Campylobacter outbreaks affected 244 people and resulted in 19 hospitalizations.

Fourteen MSs reported 65 outbreaks caused by pathogenic E. coli, of which 44.6% were verified. The 29 verified E. coli outbreaks affected 541 people and resulted in 24 hospitalizations.
Bacterial toxins produced by Bacillus spp., Clostridium spp. or Staphylococcus spp. were reported by 18 MSs as the cause of 458 outbreaks, of which 93.2% were verified. The 427 verified outbreaks caused by bacterial toxins affected 6,277 people, resulted in 345 hospitalizations and caused four deaths.

Few outbreaks caused by other bacterial agents like Yersinia, Listeria, Shigella, Enterobacter and Citrobacter were reported. In addition, a number of outbreaks caused by parasites were recorded and most of them were Trichinella outbreaks related to consumption of uninspected pig and wild boar meat.

Posted on May 8, 2009 by Food Poisoning Lawyer
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Obama Eating A Burger - A "Teachable Moment" in Food Safety

So, what is the big deal? President Obama ordered a medium-well burger for himself and the VP, and ordered medium burgers for the press – in a restaurant with a spotty food safety record that does not use, or may not even have, a thermometer. Forgoing the phrase “teachable moment” for a bit, I would like to get right to the “meat” of the matter. What Obama did was foolish - in the view of many food safety experts - but it is something that many consumers do every day; they order a burger from their favorite restaurant or cook it themselves on the backyard grill.

Food safety professionals inside and outside government will tell you that medium or medium-well means nothing in the food safety world – temperature is the key. Pink or brown color is not a good indicator of “doneness.” Temperature on the inside of the burger (at several places) of 155 to 160 degrees (rules vary a bit state to state) is the only way to assure that the burger is safe. Yet less that 2% of consumers use or own a thermometer. Restaurants are required to have thermometers, but not necessarily use them. So, why do consumers - including the President - ignore the advice of experts who are trying to protect them from the bacteria and viruses lurking in their cheeseburgers that can sicken or kill them or their children?

What consumers believe, including the President apparently, is what they hear every day from Government officials and the Beef Industry – “Our Food Supply Is The Safest In the World”. Compared to China? Great! Clearly, any food safety message is missed, because of lack of honesty (hamburger really may contain animal feces that can sicken or kill you!) and lack of education (why don’t we teach kids how to cook safely in addition to teaching them to wear seatbelts and shun smoking?)

So, what is a President to do - avoid hamburgers? Well, I do (and so does my family) ever since the Jack in the Box E. coli O157:H7 Outbreak of 1993 that sickened nearly 600, caused acute kidney failure in 50 and killed four children - but that is just me.

Full disclosure, I am a trial lawyer who represents victims of foodborne illness. I have seen too much misery, and yes, death, caused by failures in food production at every stage of the food supply. If you do not think our food supply is dangerous, then just open a newspaper, turn on the radio or TV or surf the Internet. Foodborne illness outbreaks linked to all types of food (including hamburger) are nearly a daily occurrence. However, the Government and Industry keep telling us its safe and we seem to believe it.

So, what is a President to do?

First call the head of Food Safety Inspection Services (actually, a spot yet to be filled) and ask him why there is cow feces in hamburger meat in the first place. Also, while you have him on the phone, ask about Salmonella, Listeria, MRSA and all the other bugs that may have been in the hamburger you ate the other day.

Next, be honest with the American Public. With 76,000,000 foodborne illnesses cases yearly, 325, 000 hospitalizations and 5,000 deaths, our food supply might be safer than China’s – but it is not safe enough.

Third, put food safety on the “front burner” and turn up the heat. It is time that we commit to the American Public to get animal feces out of our food. How to do it:

A. Revise food regulations to criminalize manufacturers who sell food that poisons consumers. I am not suggesting the “China Method,” but it is time to impose stiff fines, and jail sentences for businesses that kill kids;

B. Give tax credits and other incentives to businesses that invest in safe food methods and technology. Remind me, how many billions have we given the banks? Perhaps it is time to invest in those who will actually invest in us;

C. Increase the surveillance of foodborne diseases. Right now, for every one person counted in an outbreak, we miss another 20 to 40. This causes delays in determining what food product is sickening our neighbors allowing hundreds of others to become sick before we figure out what product to pull;

D. Fully fund Local, State and Federal Health and Food Inspectors and give them the legislative and financial tools to get the job done.

The “teachable moment” is simply that the hamburger that the President ordered on Monday should not put him at risk for getting sick on Thursday. That is true for all of us and all the food that we eat. The “teachable moment” has passed, the real question is, “did we learn anything?’

Posted on May 7, 2009 by Food Poisoning Attorney
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Foodborne Illness

The Centers for Disease Control and Prevention (CDC) estimates that each year 76 million - or one out of every four - Americans are sickened as a result of consuming contaminated foods or beverages. Some become seriously ill; 325,000 require hospitalization and 5,000 die. Older adults, young children, and those who have weakened immune systems are particularly vulnerable.

More than 250 different foodborne diseases have been identified. Most of these diseases are infections caused by a variety of bacteria, viruses, and parasites.

Foods that are contaminated with poisonous chemicals or harmful substances can also cause illness. Symptoms of foodborne illness vary by disease but the most common are nausea, vomiting, abdominal cramps, and diarrhea.

I have some of the symptoms described. Do I have a foodborne illness?

Possibly. For example, scientists estimate that 35% of diarrheal illness is caused by a foodborne pathogen. Diarrhea that is caused by food poisoning usually lasts one week or less. Symptoms that appear suddenly are a sign of foodborne illness, although the last food consumed is not necessarily the cause of illness. Different microbes have different incubation periods. The incubation period refers to the time between ingestion and onset of symptoms.

Incubation Periods of Common Foodborne Pathogens

PATHOGEN INCUBATION PERIOD
Staphylococcus aureus1 to 8 hours, typically 2 to 4 hours.
Campylobacter 2 to 7 days, typically 3 to 5 days.
E. coli O157:H7 1 to 10 days, typically 2 to 5 days.
Salmonella 6 to 72 hours, typically 18-36 hours.
Shigella 12 hours to 7 days, typically 1-3 days.
Hepatitis A 15 to 50 days, typically 25-30 days.
Listeria 3 to 20 days, typically 14 days
Norovirus 24 to 72 hours, typically 36 hours.

How can I find out if I am sick because of something I ate or drank?

Foodborne infections are usually diagnosed by laboratory tests that identify the organism. Bacteria such as E. coli O157:H7, Salmonella, Shigella, and Campylobacter are found by microbiologic testing of the ill person's stool. Parasites can be identified by examining stool specimens under the microscope. Laboratory testing to detect viruses requires stool specimens or serum derived from blood samples. Many foodborne infections are not detected through routine laboratory procedures and health care providers must order appropriate testing before the cause can be identified.

Should I see a doctor if I think I have a foodborne illness?

A person with symptoms of a foodborne illness should seek prompt medical attention if there is blood in the stools, if they are experiencing prolonged vomiting or show signs of dehydration, if diarrhea last 3 days or more or if diarrhea lasts more than 3 days. Anyone at risk for serious consequences - the very young, the very old, or those with immune impairment - should consult a health care provider if symptoms do not improve after 24 hours.

What else should I do?

If you think you have a foodborne illness contact your local health department. They will ask you questions about your symptoms, when they started, and what you have eaten for several days prior to symptom onset. Because some of the organisms that cause illness can be spread by ways other than food, they will ask you about other potential sources such as contact with others with similar symptoms or exposure to animals. This distinction is important so that public health authorities can if necessary, take steps to stop others from becoming ill.

If you know others who have similar symptoms, urge them to contact the health department. Oftentimes, information compiled from a group of individuals provides clues to the source of illness that can be missed when only one person reports to the health department.

If you suspect that your illness is food related, keep any left over food for possible testing. If laboratory tests show the food was contaminated, you will have powerful evidence that the food is the likely cause of your illness. The health department will advise you about any laboratory tests that should be conducted and how long food should be kept. Similarly, keep retail or restaurant receipts showing that you purchased the suspected food. Receipts often contain valuable pieces of information about a food product that the consumer does not know or cannot recall.

Common myths of foodborne illness

As you attempt to determine if you have a foodborne illness and what the potential source could be, avoid these common misconceptions.

The last thing I ate is what made me sick.

Not necessarily. Refer to the table that shows how long it takes for certain microbes to grow inside your body and cause illness. Write down what you ate, where you ate, and when you ate in as much detail as possible. Health department investigators will ask you for this information and accurate recall is critical.

If other people ate what I ate and did not become ill, that particular meal could not be the source of my illness.

Not necessarily. It is well documented that microbes that cause foodborne illness are not always uniformly distributed in a food item. Also, people have different immune systems. One person may consume hamburger prepared from a package of ground beef and become seriously ill with E. coli O157:H7 or Salmonella while his dining companion consumes ground beef from the same package and remains healthy.
Posted on July 6, 2005 by Marler Lawyer
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