Earline Mages always says when you talk to her – “This is Earline Mages from Farmer’s Branch Texas.”

“She will never be that person she was before September 7, 2011” Frank Mages

Ms. Earline Mages is a 76-year-old woman who has been healthy and active throughout her life.  Her medical history is significant only for hypothyroidism, hypertension, and elevated cholesterol.  Ms. Mages had never suffered a major illness until she became acutely ill after consuming food products contaminated with Listeria monocytogenes in the fall of 2011.  The causal link between Earline Mages’ Listeria infection and contaminated cantaloupe grown at the Jensen Farms facility is clear.  In August 2011, Ms. Mages consumed Jensen Farms/Frontera cantaloupe purchased on several occasions at Kroger located on Valwood Parkway in Dallas, Texas.

A.             Onset of Ms. Mages’ Listeriosis

Ms. Mages was enjoying her usual state of good health until she developed a severe headache with nausea and vomiting on September 7, 2011.  Her symptoms were severe enough to alarm her family, and so they took her to the ER at Baylor Regional Medical Center at Plano, Texas.  A head CT showed no intracranial abnormality.  Since she also had a mild cough, a chest x-ray was done, but this showed no evidence of pulmonary disease.  Between about 9 AM and 2 PM, she was observed and treated with IV fluids and medications for her symptoms.  She was released to the care of her family and sent home with instructions to return if she did not continue to feel improved.

B.             Hospitalization

Unfortunately, Ms. Mages did not feel better, and in fact her symptoms worsened over the course of the next few hours at home.  After doing poorly overnight and then spiking a fever, her family called 911 around noon on September 8, 2011.  The Farmers Branch Fire Department arrived at her home to find her sitting in a chair and complaining of dizziness, nausea, and continued headache.  Their first impression was that she had suffered a stroke, however because of a temperature of 104.6ºF, a urinary tract infection was suspected.  Ms. Mages’ vital signs were otherwise stable, with a blood pressure of 114/80.  Her oxygen saturation, however, was only 86% on room air, but it came up to 96% with supplemental oxygen.  Her blood glucose was elevated at 193.

After arrival at the ER, family members reported that Ms. Mages had been weak and not feeling well ever since she came back from the hospital the day before.  She had now developed confusion and was delayed on responding to questions on her own.  She reported that she had pain in her belly around the umbilicus, with some shortness of breath but no chest pain.  The EMT placed a cold pack on her neck and she was moved to a stretcher for transport.  Their initial impression of stroke ruled out, they notified Baylor Medical Center that they were en route to the emergency department with Ms. Mages, where they arrived at 1:40 PM.

Upon arrival at the ER, a right PICC line was placed in the superior vena cava, and a chest x-ray was done to confirm placement and check Ms. Mages’ lungs.  The x-ray revealed a change in her lungs from the imaging the day before, with diffuse increased interstitial markings consistent with interstitial edema versus interstitial infection.  There were patchy bibasilar opacities suspicious for atelectasis, early pneumonia, or early air space edema.

Dr. Sayantani Lahiri was the attending physician, and he admitted Ms. Mages to the hospital with a diagnosis of pneumonia, hypoxia, and possible early sepsis.  He reviewed the progression of symptoms that Ms. Mages had experienced since she was seen the day before in the ER.  This involved worsening coughing, continued vomiting, and spiking a fever and chills.  Her negative medical history was noted, with notable exceptions of hypertension, thyroid disease, and high cholesterol.  Dr. Lahiri noted that she had always been a nonsmoker and non-drinker and was independent of all activities of daily living in her own home.

Ms. Mages’ fever came down to 102.5ºF in the ER, and her vital signs remained stable.  Her lungs sounded coarse to auscultation, her abdomen was nontender without rebound, and there were audible bowel tones.  Her white count had been 6.7 the day before, and it was now 16.  Dr. Lahiri thought that Ms. Mages probably had severe community-acquired pneumonia.  After consulting with Pulmonary Medicine, he decided to treat her with aggressive IV fluids and continue her home medications.  For DVT prophylaxis, he started Lovenox.  He ordered lab studies for urine and serum osmolality, in order to rule out SIADH of acute disease versus dehydration.  Levaquin and Rocephin were started while in the ER, but Pulmonary Medicine soon changed the Rocephin over to Meropenem to cover anaerobes, because Ms. Mages suspected she might have aspirated while at home the day before.

Dr. Jason Clark came in for a Pulmonary Medicine Consultation on request of Dr. Lahiri at about 5 PM. for Ms. Mages’ diagnoses of pneumonia and hypoxemia and respiratory failure.  He continued oxygen by non-rebreather mask, which held her oxygen levels around 98%.  He noted that she had been confused that morning, but she was alert and oriented to his exam.  Her nausea and vomiting had resolved, but she continued to have some mild burning pain in the mid epigastric area, as well as pain in both shoulders.

On September 9, 2011, Dr. Lahiri continued to manage Ms. Mage’s hospital care.  She reported that she was feeling better that morning, and her temperature was down to 99ºF.  Her lungs continued to sound coarse, and Dr. Clark continued to follow her from a pulmonary standpoint.  She continued her on her current antibiotic regimen and IV fluid hydration.  Dr. Clark also restricted free water out of concern for hyponatremia and SIADH.

On September 10, 2011, Dr. Lahiri came in and noted that Ms. Mages was feeling so much better that she was ready to get up and out of bed.  Her exam was benign except for coarse lung sounds, and her vital signs were stable.  Dr. Lahiri continued her antibiotic regimen and Dr. Clark continued to follow her progress.  He planned to stop the Meropenem if the cultures remained negative and to change the Levaquin to oral delivery.  He was happy to see that her hypoxemia was resolving so well that he was able to wean her oxygen from the non-rebreather mask to oxygen by nasal cannula at 3 liters/min.

Dr. Lahiri came in on September 11, 2011, reporting an alarm value from the laboratory that one out of four of Ms. Mages’ blood cultures was coming up positive.  Repeat cultures were ordered with identification of the organism to follow.

On September 12, 2011, Dr. Lahiri came back in and reported that the blood culture positive result had been identified as Listeria monocytogenes.  He consulted with Infectious Disease specialist Dr. Lauren V. Hobratsch, who advised changing the antibiotic regimen to high dose ampicillin with synergistic gentamicin.  Dr. Hobratsch came in for a consultation and stated that the case was being reported to the Dallas County Health Department, with final identification of Listeria to be confirmed by their laboratory.Continue Reading Listeria Tainted Cantaloupe Cost this Proud Texan and Kroger Shopper $100,000

The causal link between Sharon Jones’ Listeria infection and contaminated cantaloupe grown at the Jensen Farms facility is clear.  In August and September 2011, while living at the Victorian House, Ms. Jones consumed Jensen Farms/Frontera cantaloupe purchased at King Soopers in the Castle Rock area of Colorado.

On the morning of September 15, Sharon was found unresponsive in her room and was transported to the Emergency Department at Parker Adventist Hospital.  A blood specimen collected on September 15 was culture positive for Listeria monocytogenes (LM).  The Colorado Department of Public Health and Environment (CDPHE) Public Health Laboratory confirmed this result (CDPHE Laboratory ID Number HUM-2011025518) and conducted Pulsed Field Gel Electrophoresis (PFGE) of the isolate cultured from her blood.  Test results showed that Sharon was infected with LM strain identified as CDPHE “11-D/11-E.”  CDPHE foodborne epidemiologist Alicia Cronquist has confirmed that CDPHE Strain “11-D/11-E” is equivalent to CDC PulseNet Pattern GX6A16.029/GX6A12.0069, which is one of the five outbreak associated strains.

Sharon Jones from Marlerclark on Vimeo.

Sharon Jones—Her pre-Listeria cancer struggle

Sharon Jones was a 62 year-old native of Colorado who was raised in Denver, along with her five siblings.  She graduated from Aurora Central High School in 1967 and married David A. Jones in 1969.  Sharon and David met in 1965 in study hall on the first day of school.  Early on they became friends.  David became close to Sharon’s family, even joining them on vacations.  In 1966 Sharon and David began dating and David asked Sharon to marry him that summer.  They were finally married November 8, 1969.  They were together for 46 years and married for 42.

They had one son (Dub).  Dub was named after David’s grandfather, Wesley Bacon Justice.  They moved their growing family to Castle Rock, Colorado in 1976, where Sharon worked at the Douglas County Treasurer’s Office for 35 years.  For 28 of those years she was the Chief Deputy Treasurer.  In 2002, Sharon was elected Douglas County Treasurer.  David acted as campaign manager.

Sharon was known by all for her friendly, gracious, and warm personality, earning her the unofficial title of County Hugger.  She was so good in this role that she enticed hugs from the most irascible personalities, a quality earning her hundreds of friends by the time she retired.  Her generous nature and conscientious leadership made her a favorite elected official among her employees, peers, fellow elected officials, state government, and treasurers’ offices across Colorado.  She retired after her second term, in 2011, and continued working part-time for the Sheriff’s Office.

An adventurous soul, Sharon, David and Dub took numerous camping trips and road trips across the United States.  She developed a love for hot air balloons and determined that her second career would be as a hot air balloon chaser.  Sharon also became a “motorcycle mama,” graduating at the top of her ABATE riding class and then taking cross-country trips on a bigger bike than many men ride.  It was a source of great amusement for her son, Dub and daughter-in-law, Melody, to watch people’s reaction to seeing this short, round, matronly woman putting on her leather gear, hopping aboard a large motorcycle and roaring off.  Sharon’s zest for life and joy was near limitless.

In 2007, Sharon’s life took a marked turn when she was diagnosed with ductal cell carcinoma of the right breast.  Although she was devastated by the news, she refused to let the cancer take over her life.  She hit back hard, undergoing a lumpectomy, lymph node resection, radiation and chemotherapy.

Following her cancer diagnosis and treatment, Sharon continued to be followed by various doctors for several years.  Her internist and primary care provider, Stephanie Kraft, MD, noted that she was fairly stable overall.  She was also regularly treating with oncologist, Douglas Resnick, MD, and was on the drug, Arimidex, to suppress Estrogen-associated breast cancer recurrence.  She was working with Dr. Slamowich on her obstructive sleep apnea, using a CPAP machine to assist with her breathing at night.  Other than that, there were no medical events or significant changes in her medical history for several years.

Then, starting on July 6, 2010, routine lab tests showed a new finding—elevated liver function tests (LFT’s). Eventually Sharon was referred to Parker Imaging Center for studies of the spine, which indicated scoliosis with multilevel disc space narrowing and arthritis.

In June, 2011, an MRI of the lumbar spine was performed, the results of which were terrible news.  Sharon had diffuse metastatic cancer from the T10 to S3 and the iliac bones, with ventral epidural tumor extension at L5, causing severe central stenosis at L5.

The radiologist reported these findings to Dr. Kraft, who contacted Sharon and scheduled an appointment for the following day.  In the meantime, Dr. Kraft spoke with oncologist, Dr. Resnick, who advised treatment with the chemotherapy drug, Decadron.  She called the office of neurosurgeon, Chad Prusmack, MD, and discussed the findings with PA, David Whatmore.  Additional imaging studies were scheduled to definitively identify the stage of the recurrent metastatic breast cancer.

Dr. Kraft discussed the extent and seriousness of the current findings with Sharon and her husband, David.  To say the news was heartbreaking would be a profound understatement.  Dr. Kraft discussed the plan, and instructed Sharon to go to the Emergency Department if she developed increasing weakness, numbness, pain, bowel or bladder problems; signs and symptoms that signal advancing metastatic disease.

Sharon returned to the Parker Imaging Center on June 6 for an MRI of the cervical, thoracic and lumbosacral spine.  Widespread, multilevel metastatic cancer of the spine and pathologic fracture of ribs 6 and 9 were evident secondary to spread of the breast cancer.  A CT scan of the brain on June 11 demonstrated metastatic cancer of her skull but no involvement of the brain itself.  Neurosurgeon, Dr. Prusmack, reviewed the spine imaging studies and advised radiation for treatment, given the absence of neurological signs and symptoms at this time.

Based on the results of several studies, and the finding of metastatic cancer of the spine, Sharon’s cancer was determined to be a stage IV and she was referred to an oncologist, Dr. Resnick, for treatment recommendations in addition to radiation therapy.

Sharon began treatment with radiation in July 2011 and underwent insertion of a right subclavian vein PowerPort for administration of the chemotherapy.  Over the next month, Sharon had several hospitalizations for medical problems related to her cancer treatments and medications, including an alarming episode of medicine-induced psychosis.  These series of events weakened Sharon greatly, and she began having great difficulty tolerating the many side-effects of the intense radiation and chemotherapy regimen prescribed by Dr. Resnick.  After consultation with Sharon and Dub, Dr. Kenney decided to halt the intense radiation and chemo, instead switching to Faslodex (Fulvestrant).

Eventually, on August 15, Sharon was transferred to an assisted living facility, The Victorian House, to help with her mobility.  A home health nurse came to the residence to work with Sharon twice weekly with “great results,” as Dub recalls.  “Dr. Kenney was optimistic that she would experience a full and long-term remission.”

At Victorian House, Sharon was independent for most all her care, including brushing her teeth, general grooming, dressing, and skin care, although she did need some assistance with bathing.  Dub remembers, “through rehabilitation and hard work, she had just gotten to the point of being able to get in and out of bed on her own, in and out of a wheelchair, and had just started using a walker.”

She remained independent for most activities, but did need some assistance for dressing beginning the second week of her stay until September 15, 2011. Nonetheless, she was doing much better by early September.  As Dub’s wife, Melody, recalls of that time:

As her strength improved and she regained her independence, we enjoyed a fun-filled three day September weekend with out-of-town family.  She went shopping and enjoyed being back out in the “real world.”  She had met with her oncologist and was planning on resuming treatments, something she had been too weak to do up until that point.

Most importantly for Sharon and her family, she was strong enough to continue with the chemotherapy treatments she desperately needed.  According to Dub, “my mom’s oncologist felt that she could still have a good chance at extending her life, if not achieving full remission, if she began taking the chemotherapy treatments soon.  My mom and all of her family were hopeful and overjoyed at this news.”

Even more important than the treatments themselves, was the effect the renewed strength had on Sharon’s optimism:

I noticed a change in my mom’s outlook because she began to act and talk like she could and would survive; she started planning trips and vacations; she spoke of future events; she was overall happier and had a positive outlook.  This was an important change because the oncologist had told us both that a positive attitude is as effective as all of the other treatments.

Dub, Melody, and Sharon began working on the itinerary and logistics for their long-planned trip to Italy together.  Dub, after months of anxiousness surrounding his mom’s health, began to relax a bit.  Only a few short days later, however, all their plans were forever changed.

Her Acute Listeriosis InfectionContinue Reading King Sooper Cantaloupe Customer Killed by Cancer with a Push from Listeria

$100,000 in medical bills and a loving family could not save her.

Marie tried to eat healthy, and to stay on budget.  She purchased cantaloupe from Kroger in Garland, Texas in August 2011.  Over the next few days Marie consumed the cantaloupe in her home.

Despite her advanced age, Marie Jones entered September 2011 as a remarkably healthy, vivacious and active person.  She still dressed to the nines, often going out in high-heels.  Her daughter described her as a “firecracker.”  It is hard to find a photo of her where is not first of all, with other people, and most of all, smiling.  Her death was a crushing blow to her children and her sisters, and a loss for the whole community:

I was truly amazed by the outpouring of grief and sympathy from people that knew my mom from church, her old school friends, and even people she saw on a regular basis, from the girls at the Wal-Mart, and all of the friends she made everywhere she frequented.  It was such a shock and a sad loss for everyone.  I always knew she was an amazing and special woman and mother to me, but to hear it from total strangers, to me, really showed me just how special she really was and how much she will be missed.  Everything in our lives has changed from getting used to the fact that we can’t call her every night to talk about how everyone’s day went, or just to talk about life in general.  (Russell Jones)

This amazing woman was my mom, my best friend.   I don’t know how I can put sixty-one years in a few pages.  She was our ‘June Cleaver.’  We were always well fed and never wanted for anything.  She walked us to school every day regardless of the weather.  She warmed our clothes over the floor furnace so they wouldn’t be cold and warmed the dishtowel for our chests when we were sick.  (Terri Blackmon)

Marie Jones was born Marie Troy on June 2, 1922 in Dallas, Texas.  She had two sisters, Connie and Virginia, as well as a younger brother, James.  She married Bill Jones in 1945, and moved with him to Arizona.  The pull of family was too strong, though, and within a year, they were back in Texas.  Marie and Bill raised two children, daughter Terri and son Russell.  As Terri noted above, Marie was the consummate mother and homemaker.  Terri recalls this story of her mother’s love and commitment to her family:

She was great when my husband and I told her we were getting married in three days.  He was in the service in Vietnam, and was due to go back.  She and Daddy got busy and put together a church wedding for us that couldn’t compare to one that would have cost much more.  Little did they know that three months later they would be putting me on a plane to Japan.  Over the next two and a half years I would have a baby and major surgery.  It was nothing for them to have $600 phone bills.   When we finally came home to settle down, the grandkids were Mother and Daddy’s pride and joy.  They went to every event as long as they could.

Bill died in 1987, and from that time forward, Marie was “inseparable” from her two sisters.  Her life revolved around her children, grandchildren, and sisters.  At the time of the incident, she was in remarkably good health for an 89-year-old woman, living on her own at her home in Dallas, Texas.  Her primary doctor for twenty-one years, William D. Burnett, MD, states as follows:

Ms. Jones was a very compliant patient and took very good care of herself and was therefore in exceptionally good health for her age, both mentally and physically, prior to contracting Listeriosis.

Marie Jones from Marlerclark on Vimeo.Continue Reading Another Texas Kroger Shopper Felled By Listeria Cantaloupe

The causal link between Hazel “Abby” Jacobs’ Listeria infection and cantaloupe grown at the Jensen Farms facility is clear.  In the summer of 2011, Abby’s good friend, Sharon Goodall, regularly did her grocery shopping, shopping at City Market located at 508 East Main Street Cortez, Colorado.  During August and September, 2011, Sharon purchased one or more cantaloupes from this City Market location, which Abby then consumed.

Abby was born on April 7, 1938 in Yellow Jacket, Colorado to Edward and Edith (Chamblee) Watson.  Hazel was raised on their Yellow Jacket farm with her three brothers: Cecil, Bill and Tom Watson.  After losing her mother at a young age, her father Ed married Sadie Chandler, which made her “sis” to eight more brothers. Later, Hazel married Chuck Englehart of Lewis, Colorado.  She had often said that some of her fondest memories were of their first years when they traveled from state to state. She loved the adventure of living in a small RV hooked to the back of the old truck as Chuck worked in different mines.

After a few years of mining, Chuck, Hazel, and their first child, Rob, returned to Lewis, Colorado and purchased farmland. After their second child, Rhonda, was born they were still living in a single room home, which was later, referred to as “the little red house.” It was evident they were going to need more space so they built their first new home.  After they moved in, Neal and Lisa were born.

There was never a dull or lazy moment as Hazel guided her four children through all the adventures a farm could offer.  Working on the farm and raising their family was Hazel’s first priority but she was also known for her involvement in the community. She attended the Arriola church, helped lead projects in 4-H, Girl Scouts, and White Elephant fundraisers.  Her kitchen was the most used room in the house. There was always cooking, baking, canning and then cleaning up to get it ready for the beauty shop, which included cut, color, perm and style at no charge.  When she was not busy in the kitchen she was the local “Avon” lady and worked the winters at the County Clerk’s office.  On many occasions the family hosted ice cream and croquet gatherings in the summer, then followed that up with poker and chili parties in the winter.  Hazel was a dedicated sister to her brothers and their wives. She dearly loved each and every one of her nieces and nephews.  Hazel’s friends were like the sisters she never had.  Her daughter, Rhonda, recalls her mom:

Hazel was a wife, an amazing mom to four children and our rock. Whether the situation was good or bad, she remained the solid foundation of our family.  Along with her children, mom also took care of the dogs, chickens, cows, and horses.  Mom was also extremely close with our neighbors.  Although she had such a busy life, I never recall mom missing any of our sports games, our showings at 4H, or every time we participated in rodeos.  Every Sunday, mom partook in church; something that she looked forward to all week.

The years flew by as their family grew and the farm was sold. They moved to Cortez which is where Hazel became deeply involved with the church and her growing Faith.  Over time, Hazel and Chuck grew apart and eventually separated.  In the years that followed, Hazel had many new pathways, the first being two years of school to become an Ordained Minister.

Through her church and ministry she met and married Elvin Jacobs.  During their marriage, and due to their shared love of the Word, Hazel became known as Abigail, or Abby.  Sadly, after only one blessed year of marriage, Elvin passed away.  After the loss of Elvin, Abby began work with the ministry she is most known and loved for. Through her favorite ministry, she counseled and supported numerous people in their time of need.  She spent countless hours and resources with this program and the people she helped will never forget her for the work she did.

Abby Jacobs from Marlerclark on Vimeo.

Abby Jacobs was a 73-year-old single woman living in Cortez, Colorado when she was stricken with listeriosis.  Although she had struggled with serious rheumatoid arthritis since her 40’s, her health was otherwise good.  She did have to take steroids and Methotrexate for her arthritis, which made her vulnerable to the bacteria, which would claim her life.

To her three children, Rhonda Crosby, Lisa Gasper and Robert Englehart, and her eleven grandchildren, she was known as a vivacious and joyful mother and grandmother. That changed quickly in September of 2011.  Abby’s oldest son, Rob, recalls his mother’s inherent strength and determination to cope with anything:

Mom was a strong woman raised in a pioneer family of Southwest Colorado. She grew up with three brothers on a dirt poor farm so she knew how to survive. As children she raised all of us to stand up and be counted. The strength and pride she instilled in us has carried each of us through life very well.

Mom battled rheumatoid arthritis the last 35 years of her life. Trust me, if you don’t know what that does to a body both physically and spiritually, then you have no idea of how strong she was. If anyone could handle pain she could. Mom carried herself through these years with dignity and grace never once allowing herself any pity from those around her. I absolutely admired her for that.Continue Reading After Listeria Cantaloupe, A City Market Customer No Longer