Robert Moss was a true representative of The Greatest Generation.  A child of modest means, Robert gave up a college scholarship to fight in the Navy in World War II, where he suffered a severe gunshot wound in combat.  After the war, Robert returned to Louisiana, where he married a woman named Mary Jane, produced

At 6:41 AM, on January 20, 2009, Minnie Borden was pronounced dead.  It was a stunning end to an illness that came about all because of an invisible collection of bacteria contained in a package of peanut butter crackers.

Minnie Borden was born in 1926, in the town of Lanett, Alabama.  Although she stopped attending school after the fifth grade, her education certainly did not cease to carry on.  In the words of her only daughter, Earlene Carter, “She was educated through her life experiences.”

Starting around age 16, she began perfecting her notorious work ethic, one that carried her through life until her retirement at the age of 70.  For many of those years she worked tirelessly as a housekeeper for local families, eventually segueing into the food service industry.  She continued in this field, ultimately working at the Sinclair Community College as a cook until she decided the time had arrived to retire.  The year was 1996.

Refuting the notion that retirees ease into an idle existence, Minnie continued to be a spitfire of independence.  She suffered from rheumatoid arthritis, a condition she was diagnosed with in the 1960s.  But despite the sometimes debilitating pain pulsating in her fingers, knees, and hips, she continued to be mobile, doing her own shopping and upkeep around the house without assistance.  By 2002, she was still as active as ever, but with a trusty cane planted firmly at her side.  Living by herself in Dayton, Ohio, Minnie stuck faithfully to her daily morning routine, rising from her bed, then making her way to the bathroom to clean up before heading to the kitchen for some breakfast.  Her days were peppered with a few favorite TV shows, some light chores, and chats with family and neighbors.

In late 2007, Earlene noticed that her mom’s joint pain had became very severe, making it more difficult for her to remain mobile.  Earlene purchased a wheelchair for her to use in the house.  She took to her new wheeled companion well, and continued living independently and generally caring for herself along with some assistance from Earlene, who lived a quick five miles down the road.

By fall of 2008, other than arthritis and poor hearing, her health was excellent.  It was quite unusual then, when in November, Minnie mentioned to Earlene that her appetite was lacking and her stomach hurt.  There was nothing unusual about her diet at that time.  In fact, she continued to enjoy one of her favorite snacks on a regular basis, Little Debbie’s Peanut Butter Cheese sandwich crackers.  Speaking daily and seeing each other nearly as often, Earlene took note of her mother’s new discomfort, but other than mentioning the abdominal pains, Minnie did her best to keep the escalating situation to herself.

On November 24, Earlene picked up Minnie for an appointment with an arthritis specialist, Dr. Mujeeb A. Ranginwala.  Again, she mentioned the stomach pain, but was not overly vocal about her discomfort.  He had a blood sample collected and sent to the lab for testing, but nothing unusual was uncovered.  They left the appointment and Earlene took Minnie back to the comfort of her home.

As the days continued, and November turned into December, Minnie’s gastrointestinal issues worsened and she became undeniably weaker.  Earlene started going over to her mother’s house early each morning, motivating her out of bed and providing some assistance for her to make it to the bathroom.  Earlene washed her up and even helped her dress, though Minnie increasingly stated that she would rather remain in her robe.

By December 10, Minnie was no longer able to keep quiet about her intensifying stomach cramps and distress.  That morning started off typical—Earlene came over and helped Minnie up, then took care of some cleaning chores around the house.  After she was done, Earlene returned home.  About an hour after she arrived home, the phone rang.  It was Minnie, with notable distress in her voice, stating that the stomach pain was worsening and was now in her chest too—she needed to go to the hospital.

Earlene hustled over to Minnie’s house, helped her to the car using the wheelchair, and together they headed off to the Miami Valley Hospital Emergency Room (ER).  As soon as the nurses and doctors were told that Minnie was having pain in her chest, their immediate concern was a potential heart attack.  An EKG machine was connected to Minnie’s frail body to monitor her heart functions, and a blood sample was obtained and sent to the lab for testing.  After preliminary results indicated she was not suffering from a heart attack, the treating physicians decided it was prudent to admit her for further observation and testing.  It took a number of hours before a room was ready and she was transferred from the ER.  Over the next two days, she was carefully observed and her blood test results were monitored.  A heart attack was ultimately ruled out and the causes of her abdominal and chest pains were left unanswered.

Earlene was at the hospital with her mother at the time of discharge.  The treating physician discussed the recommendations for physical/occupational therapy—preferably in a skilled nursing facility—to help with Minnie’s weakened state.  Moving Minnie to a nursing home was out of the question for Earlene.  The strengthening therapy she needed could be provided with in-home treatment visits, and if needed, Earlene agreed to have Minnie move in with her.  “I have been by her side and she has been by mine.  We walked that walk together for many years.  Whatever she needed, I could do and did, and whatever I needed that she could do, she did.  We cared for each other deeply.”

After being discharged, Minnie was driven home.  Earlene again used the wheelchair to move her from the car to the house, making it to the bedroom where she could rest.  Once home, however, Minnie’s gastrointestinal complaints only worsened.  By now, Minnie’s failing strength made it necessary for Earlene to help her mother out of bed to use the bedside toilet during the night, several times a night.  Earlene also had to help Minnie dress and groom herself every day, something she had not previously had to do.

Earlene also noticed that Minnie’s stools had turned loose and black.  When pressed, Minnie stated that she passed similar black stools recently.  Earlene continued to provide her with as much water as she could consume, aware of the importance of staying hydrated.  The downhill decline only continued.  As Earlene recalls, “I treated her like she was a little baby that I took care of, cleaning her up, powdering her down, and sanitizing her bottom.”

When her black, loose stools failed to resolve, Earlene became worried and decided a visit to the doctor was necessary—an appointment was set for December 18.  Earlene drove Minnie to the appointment and went into the examination room with her, bringing a sample of the stool along in an adult diaper that she had begun putting on Minnie.  Dr. Chitanya Kadakia, her primary care physician, took one look at the sample and said “there’s blood in that stool.”  The tone and words of Dr. Kadakia sent chills up Earlene’s spine as he explained that she must go immediately to the ER.  He agreed to call the hospital in advance to notify them that Minnie was on her way.  A short time later, they arrived at the Good Samaritan Hospital ER.

She was examined and noted to be very weak and pale, with bright red blood discharging from her rectum and black tarry stools.  Her abdomen was tender to the touch, with pain described as achy.

Minnie’s stay at Good Samaritan Hospital lasted from December 18 until her discharge on December 29.  While in the hospital, Minnie endured repeated procedures while the doctors attempted to diagnose her illness.

On Friday, December 19, Minnie was given a transfusion with packed red blood cells (PRBCs).  She continued to have frequent watery diarrhea and was in constant pain.  The next day, an esophagogastroduodenoscopy was performed, which revealed a benign gastric ulcer without any active bleeding.  The doctors remained stumped.

By Monday, December 22, her stools were described alternately as “greenish liquid” and “reddish brown,” indicating continued infection and bleeding.  A peripherally inserted central catheter (PICC) line was placed in her right arm, with Minnie wincing and struggling to maintain her composure throughout the procedure.  Later that evening, she passed another large green liquid stool.

Finally, on Wednesday, December 24, Christmas Eve, a sample of Minnie’s bloody liquid stool was obtained and sent to the lab to be cultured for pathogens.  Why this was not done sooner remains a mystery.  The results were alarming, and provided an explanation for her continued suffering—she was infected with Salmonella Group B.  The Ohio Department of Health was notified, and conducted further testing on the sample, revealing that she was infected with Salmonella Typhimurium, the same strain later identified as part of the nationwide PCA Salmonella outbreak.Continue Reading Another Salmonella Death Linked to Peanut Corporation of America

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