The family of one of the teens that contracted E. coli poisoning at a Washington camp last summer has sued Spokane Produce Inc. County health officials implicated the firm’s romaine lettuce as the possible source of infection. But Spokane Produce says the lawsuit hinges on a flawed investigation by local health officials and that the scientific evidence falls short of implicating the company’s product.

Last July, health officials investigated an E. coli O157:H7 outbreak at a summer dance camp after some 50 campers complained of nausea, vomiting and other gastrointestinal symptoms. Investigators with the Spokane Regional Health District conducted several inspections of the camp, tested water samples, interviewed food service staff, and polled campers on diet choices in search of the cause of the outbreak. By July 31, 33 cases of E. coli O157:H7 were confirmed by culture in Spokane County. The food surveys showed a strong association between a salad offered at the camp and a culture-confirmed gastroenteritis, said a report issued by the Spokane Regional Health District.

At the same time, reports of E. coli infection sprung up in other locations; some samples matched the campers’ stool samples, while others didn’t. Those patients whose infection matched the campers remembered eating a salad containing romaine lettuce at Walla Walla and Spokane restaurants, both of which were later traced to Spokane Produce, said the local health department’s report.

With data from the dance camp and the Walla Walla case, FDA moved quickly to implicate Spokane Produce’s romaine lettuce as the culprit and issued a nationwide alert advising the public to throw out the company’s bagged, prewashed, precut romaine lettuce. Sources say documents unearthed in preparation for the legal battle show Washington health officials were concerned that FDA moved too fast to issue the product withdrawal announcement.

Company says the investigation was mishandled.

FDA investigated the Spokane Produce plant, took hundreds of samples and found no evidence of E. coli O157:H7 at the company facility, nor has any E. coli O157 been found on any of the company’s lettuce, said Gregory Arpin, an attorney who represents Spokane Produce.

The company says the investigation was mishandled, because health investigators sent out an incomplete survey to campers and employees who were asked whether they ate a Caesar salad with romaine lettuce at a July 11 dinner. Investigators failed to mention in the first survey that a tossed salad, with lettuce supplied from another company, was also offered that night. To clarify the survey, investigators sent another survey out on July 31-Aug. 1, just after FDA had sent out its July 29 nationwide warning about romaine lettuce. The risk ratio of people who got sick after eating the Caesar salad dropped when results of the second survey were analyzed, Arpin said.

Concerning the Walla Walla incident, documents show lettuce from Spokane Produce was either already consumed or thrown out by the time that person could have been served the salad, the company will argue. The surveys, which are critical in outbreak investigations, could raise questions about the scientific evidence supporting the government’s charge that only romaine lettuce could have caused all the illnesses. The produce firm also suggests that other leads, such as whether the water supplied in the camp or whether at least one camper who showed up already sick at the Washington camp, weren’t followed up on.

I say not enough was done.

Spokane Produce washed and cleaned the lettuce, but it was not enough. Kids still got sick. My client, Angela Hadley, developed hemolytic uremic syndrome, a life-threatening condition, and may have long-term kidney problems as a result of exposure to E. coli O157:H7. The likelihood that another source caused the outbreak is slim, since health investigators found other people whose illness matched the campers’ fingerprint and who ate the lettuce.

The lawsuit is based largely on the county health department’s report on the outbreak and the government’s conclusion that the produce company should be held responsible for her illness. Even if FDA moved too quickly to issue the warning, it doesn’t mean they got it wrong. An investigation of the Eastern Washington University Dining Service, which administered the meals at the camp, didn’t identify any food handling practices that might have been a probable source of contamination of the salad.

The lesson for the industry is that produce companies need to learn as much as they can about their suppliers, make clear in contracts where the responsibility lies in the event of a mishap, and have sophisticated traceback systems in place. Some of the California farms that supplied the company’s romaine lettuce followed better sanitation procedures than other suppliers.

For now, both sides of the case are waiting on a missing piece in the puzzle: the state health department’s report on the outbreak. That report, which has been delayed due to internal personnel changes and competing public health priorities, is close to being completed and may be available in the next few weeks. It will include an analysis of the epidemiological evidence gathered in the case. FDA is not expected to issue a similar report.