Time To Revisit COOL Or Is It Too Hot?

First adopted on the Senate floor in late 2001, mandatory Country of Origin labeling (COOL) was to be in place on September 30, 2004, but language in the FY2004 consolidated appropriations act (P.L. 108-199) delayed implementation for meats, produce and peanuts, but not seafood, for two years, until September 30, 2006. Debate over COOL carried into the 109th Congress, which (in USDA’s FY2006 appropriation, P.L. 109-97) postponed implementation for an additional two years — until September 30, 2008 (a provision in H.R. 2744). Other measures in the 109th Congress would have made COOL voluntary for meats (including H.R. 2068, S.1300, and S. 1333). Still others (e.g., S. 135, S. 1331) would have expanded COOL requirements and/or accelerated its current implementation date.

The contrasting intents of these bills reflected the continuing divergence of opinion among lawmakers over whether a federally-mandated labeling program is needed. Some contend that mandatory COOL will provide U.S. products with a competitive advantage over foreign products because U.S. consumers, if offered a clear choice, prefer fresh foods of domestic origin, thereby strengthening demand and prices for them. Moreover, proponents argue that U.S. consumers have a right to know the origin of their food, particularly at a time when U.S. food imports are increasing, and whenever particular health and safety problems arise. Supporters of the COOL law argue that it is unfair to exempt meats and produce from the longstanding country labeling already required of almost all other imported consumer products, from automobiles to most other foods. They also note that many foreign countries already impose their own country-of-origin labeling.

Opponents of mandatory COOL counter that studies do not provide evidence that consumers want such labeling. They believe COOL is a thinly disguised trade barrier intended to increase importers’ costs and to foster the unfounded perception that imports may be inherently less safe (or of lower quality) than U.S. products. Food safety problems can as likely originate in domestic supplies as in imports, as evidenced by the more than 30 recalls of U.S. meat and poultry products announced by USDA in 2006 alone, these opponents point out. Opponents argue that all food imports already must meet equivalent U.S. safety standards, which are enforced by U.S. officials at the border and overseas; scientific principles, not geography, must be the arbiter of safety. Industry implementation and record-keeping costs, estimated by USDA to be as high as $3.9 billion in the first year and $458 million per year after that, would far outweigh any economic benefits, critics add. (COOL proponents assert that these cost estimates were grossly exaggerated while some in industry claim they were too low).

In the all becoming too common current food illness crises, one should ask where are these tomatoes coming from? Why does it take so long for the FDA to figure out where they are coming from? Are there funds available? Wouldn't a quicker response to the origin of the crop save lives? Clearly, a label would help this process. In the meantime, farmers with good, clean crops suffer irreparable financial damage. Congress is now on year seven of this debate. I suspect BLT is off the menu at the congressional cafeteria.

More Tomato Info

The Food and Drug Administration is alerting consumers nationwide that a salmonellosis outbreak appears to be linked to consumption of certain types of raw red tomatoes and products containing raw red tomatoes. The bacteria causing the illnesses are Salmonella serotype Saintpaul, an uncommon type of Salmonella.

The specific type and source of tomatoes are under investigation. However, preliminary data suggest that raw red plum, raw red Roma, or raw round red tomatoes are the cause. At this time, consumers should limit their tomato consumption to tomatoes that have not been implicated in the outbreak. These include cherry tomatoes, grape tomatoes, tomatoes sold with the vine still attached, and tomatoes grown at home.

Update on the Outbreak

June 10, 2008: The Food and Drug Administration has expanded its warning to consumers nationwide that a salmonellosis outbreak has been linked to consumption of certain raw, red tomatoes.

At this time, FDA is advising consumers to limit their consumption of tomatoes to the following types of tomatoes. The following types of tomatoes listed below are NOT likely to be the source of this outbreak.

* cherry tomatoes
* grape tomatoes
* tomatoes sold with the vine still attached
* tomatoes grown at home

Also, FDA recommends consuming raw red plum, raw red Roma, or raw red round tomatoes only if grown and harvested from the following areas that HAVE NOT BEEN ASSOCIATED WITH THE OUTBREAK:

Alabama
Arkansas
California
Georgia
Hawaii
Louisiana
Maine
Maryland
Minnesota
Mississippi
New York
Nebraska
North Carolina
Ohio
Pennsylvania
South Carolina
Tennessee
Texas
West Virginia

Belgium
Canada
Dominican Republic
Guatemala
Israel
Netherlands
Puerto Rico

Consumers who are unsure of where the tomatoes are from that they have in their home are encouraged to contact the store or place of purchase for that information.

Consumers should also be aware that raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo, are part of fillings for tortillas, and are used in other dishes.

Restaurants, grocery stores, and food service operators have been advised by the FDA not to offer for sale or service raw red plum, Roma, or red tomatoes and products made from these types of tomatoes unless they are from one of the areas listed above.

Since mid April, there have been 167 reported cases of salmonellosis nationwide caused by Salmonella Saintpaul, an uncommon form of Salmonella. At least 23 hospitalizations have been reported.

Tomatoes in Utah Eyed In Salmonella Outbreak

An outbreak of salmonella food poisoning first linked to uncooked tomatoes has now been reported in nine states, including Utah, U.S. health officials said Tuesday.

Lab tests have confirmed 40 illnesses in Texas and New Mexico as the same type of salmonella, right down to the genetic fingerprint. An investigation by Texas and New Mexico health authorities and the Indian Health Service tied those cases to uncooked, raw, large tomatoes.

Authorities have not yet determined a specific type of tomato for the outbreak, nor have they linked the outbreak to any specific farm, distributor or grocery chain.

At least 17 people in Texas and New Mexico have been hospitalized. None have died, according to the U.S. Centers for Disease Control and Prevention.

Another 30 people have become sick with the same Salmonella Saintpaul infection in Arizona, Utah, Colorado, Kansas, Idaho, Illinois and Indiana. CDC investigators are looking into whether tomatoes were culprits there, too.

In Texas and New Mexico, raw large tomatoes — including Roma and red round tomatoes — were found to be a common factor in the 40 illnesses. But no farm, distributor or grocery chain has been identified as the main source, said Casey Barton Behravesh, a CDC epidemiologist working on the investigation.

"The specific type and source of tomatoes is under investigation," she said.

Salmonella is a bacterial infection that lives in the intestinal tracts of humans and other animals. The bacteria are usually transmitted to humans by eating foods contaminated with animal feces.

Most infected people suffer fever, diarrhea and abdominal cramps starting 12 to 72 hours after infection. The illness tends to last four to seven days.

Many people recover without treatment. However, severe infection and even death is possible. Infants, the elderly and people with weakened immune systems are at greatest risk for severe infections.

In Texas and New Mexico, the patients ranged in age from ages 3 to 82. Of the 40, 38 were interviewed. Most said they ate raw tomatoes from either stores or restaurants before becoming ill between April 23 and May 27.

Another 17 cases are under investigation in New Mexico, CDC officials said.

USDA OFFERS FOOD SAFETY TIPS FOR A SUCCESSFUL SUMMER GRILLING SEASON

The days are getting longer, the weather is getting warmer and Memorial Day is fast approaching – all signs that the summer grilling season is nearly upon us. As you make plans to kick off the summer grilling season at your Memorial Day barbecue this year, USDA reminds you that safe food handling skills are the key to making your cookout a big hit with your guests.

“When you’re enjoying a cookout with friends and family, the last thing you want to do is make them sick,” said Under Secretary for Food Safety Dr. Richard Raymond. “Before you even fire up the grill, you need to be aware of safe grilling and food preparation practices that will make sure your guests enjoy a tasty and safe meal.”

Whether you’re hosting a neighborhood barbecue or cooking for a few friends and family members, the USDA’s Meat and Poultry Hotline offers four easy steps to help you Be Food Safe and reduce the threat of foodborne illness:
Clean: First things first – make sure you start with clean surfaces and clean hands. Be sure that you and your guests wash your hands before preparing or handling food. Hands should be washed with soap and warm water for 20 seconds before and after handling food. Equally important are the surfaces that come in contact with raw and cooked foods – make sure they are clean before you start and are washed frequently.

Separate: Raw meats and poultry should be prepared separately from veggies and cooked foods. When you chop meats and veggies, be sure to use separate cutting boards. Juices from raw meats can contain harmful bacteria that could cross-contaminate raw veggies and already cooked foods.

Cook: Masters of the grill are no match for foodborne illness, so it’s important to have all the right tools. Your food thermometer is the most important tool that will tell you if your food is thoroughly cooked, as color is not a reliable indicator of doneness.

Meat and poultry cooked on a grill often brown quickly and may appear done on the outside, but still may not have reached a safe minimum internal temperature to kill any harmful bacteria. Steaks, roasts and chops should be cooked to 145 °F. Hamburgers should reach 160 °F. All poultry should reach a minimum of 165 °F. Fish should be cooked to 145 °F. Fully cooked meats like hot dogs should be grilled to 165 °F or until steaming hot.

As you take the cooked meats off the grill, be sure to place them on a clean plate or platter, NOT on the unwashed dish that held them when they were raw. The juices left on the plate from the raw meats can cross-contaminate cooked foods.

If you prefer to prepare meats using a smoker, the temperature in the smoker should be maintained between
225 °F and 300 °F for safety. Be sure to use your food thermometer to be certain the food has reached a safe minimum internal temperature.

Chill: Keeping food at a safe temperature is always a major concern at picnics and cookouts. Too often, food is prepared and left to sit out while guests munch over the course of several hours. However, bacteria can start to grow on perishable food that has been sitting out too long.

It’s important to keep hot food hot and cold food cold. Hot food can be kept safe at 140 °F or above in chafing dishes, slow cookers or warming trays, and cold food can be kept chilled at 40 °F or below with ice packs or ice sources underneath.

Perishable food should never sit out for more than two hours. And if the temperature is above 90 °F – which can be common at summer picnics – perishable foods shouldn't sit out more than one hour. Refrigerate or freeze leftovers promptly and discard any food that has sat out too long.

One of the best resources available before you plan a summer cookout is USDA’s virtual representative, “Ask Karen,” a feature that allows you to ask food safety-related questions 24 hours a day. Visit “Ask Karen” at AskKaren.gov. Food safety coaches are available by phone at the USDA’s Meat and Poultry Hotline at 1-888-MPHotline (1-888-674-6854). Recorded messages are available 24 hours a day and the Hotline is staffed with food safety experts, Monday through Friday from 10 a.m. to 4 p.m. Eastern Time.

Wendy's Needs to Jump

Writing occurs when it's ready. I went rather spontaneously to Zion National Park in Southern Utah last weekend to get away from the mundane. Zion Park is magical as is the small town at its entrance, Springdale. With a bit of hiking and effort you find yourself in the middle of beautiful nowhere. Sure, you will pass the varied Europeans along the way (first French, then German, then English) but eventually you will find yourself with just the elements, wind, water and earth. Standing within the great expanse and vista you find inner peace, balance and perspective. Every step takes you closer to the openness you are searching for. People, places, senses, become more acute and take on a more magical meaning.

Fast forward two days to May 6, 2008. We sued Wendys--again--in Federal Court in Salt Lake City. We have in good faith attempted the last several months to resolve two tragic cases of E.coli poisoning without litigation. We've been to mediation twice with no resolution on these two cases.

As you might recall, from my earlier blog and outside news reports, in the summer of 2006, public health officials in Weber County, Utah, became aware of several people who attended a teachers’ conference luncheon that had contracted E. coli O121:H19. The case for all purposes is a slam dunk. So why would Wendys choose to drag this out you may ask? They have the money to settle. They have individuals within it's organization that mean well. They have insurance. They have suppliers who have insurance. So why so long? In the long run, whether everyone involved pays x or x plus three won't amount to anything as far as they are concerned. They can sell more, make more, choose more, have more, create more, more, more, more, more. It's an institution with deep roots that spread. Unfortunately, institutions don't make decisions, people do. One person. Once that person makes up his mind, it will be over. Literally. Maybe not immediately, but it will be the domino that starts the process. Here's the formula, it's rather simple: Have the thought, say it, take the action and don't look back. Jump into the flow of the river that is carving a beautiful landscape. It's easier, smoother and you might just enjoy the ride of what you are creating. Our clients would appreciate it as well.

It's Spring in Salt Lake City

It's amazing that 14 year old girls innately know when it's Spring.

Washington Never Went to Yellowstone

Grey wolves were re-introduced in the greater Yellowstone area in a controversial but very successful program in 1995. They were apparently absent there for almost 70 years, although I've talked to a few old-timers in the area that claim that they were never really all gone. I'm not sure I believe them, but it made for a good story especially around the campfire late at night. The animals that were placed in Yellowstone came from Canada and have done remarkably well, reproducing at a rapid rate. I have now seen a wolf pack in Yellowstone as it has stalked its prey. I watched from just outside my car. The prey appeared to be an elk. At least that's how I remember it. I mean it's not like there was sniper fire in the area or something that made me so damned nervous that I can't remember that there were a few wolves in the area that were taking down an elk. Oh, and I don't think I was wearing a flack jacket either. Nor did I run to my vehicle due to possible incoming. I remember my kids were waiting for me in the car as I snapped off a few photos. I can't remember if they were reading poetry or not.

After reading American Creation and Founding Brothers by Joseph J. Ellis, I find it interesting that our Founding Fathers never campaigned for the presidency. They were asked by a few close associates and then voted on by the electoral college. They usually told their friends no a few times before they warmed up to the idea. Washington, Jefferson, and even Lincoln to a great degree, never sought to become President. They would have viewed that as a character flaw. They served the people for a season and then expected to retire to a private life.

Washington actually had a great reluctance to come again into public life after the war. In a letter to the Marquis de la Fayette, regarding the desire for many that he, Washington, become President, Washington observed:

"Your sentiments indeed coincide much more nearly with those of my other friends, that with my own feelings. In truth, my difficulties increase and magnify as I draw towards the period, when, according to the common belief, it will be necessary for me to give a definitive answer in one way or other. Should circumstances render it in a manner inevitably necessary to be in the affirmative, be assured, my dear sir, I shall assume the task with the most unfeigned reluctance, and with a real diffidence, for which I shall probably receive no credit from the world. If I know my own heart, nothing short of a conviction of duty, will induce me again to take an active part in public affairs. And in that case, if I can form a plan for my own conduct, my endeavours shall be unremittingly exerted, (even at the hazard of former fame or present popularity,) to extricate my country from the embarrassments in which it is entangled through want of credit, and to establish a general system of policy, which, if pursued, will ensure permanent felicity to the commonwealth. I think I see a path as clear and as direct as a ray of light, which leads to the attainment of that object. Nothing but harmony, honesty, industry, and frugality, are necessary to make us a great and a happy people. Happily the present posture of affairs and the prevailing disposition of my countrymen, promise to co-operate in establishing those four great and essential pillars of public felicity."

What is it today that someone would actually want to be President so bad that they would embellish their past or have to campaign for two years before they take office? Washington saw his men starve to death at Valley Forge. He saw the blood stained snow as they marched to the Delaware River during Christmas to cross during a blizzard. He road his horse over snake-like trenches and saw the blown-off body parts of his young soldiers as they literally dug their way towards freedom in the trenches at Yorktown-- much to his aides dismay as they took incoming. He turned the tide of retreat several times and rallied his nearly naked men toward the battle. He was prepared for the presidency. He didn't have to beg for it or talk about it. His reputation and honor didn't need embellishment.

If you ever walk deep into the wilderness and have the opportunity to hear the wolves cry, stop and listen. I hope for a moment you feel your heart beat faster. I also hope that no one is around to film it so it doesn't show up a few months later on Youtube.

Salmonella Risk with Cantaloupes

The FDA has just sent out a warning about a Salmonella Outbreak in the U.S. involving cantaloupes grown in Honduras. The States involved include Utah. Although we have our own set of problems with our food supply in our own country, we need to question whether our food grown outside of the United States meets the standards we expect and what controls are in place to protect our food supply. Here is the body of the FDA warning:

FOR IMMEDIATE RELEASE
March 22, 2008

FDA Warns of Salmonella Risk with Cantaloupes from Agropecuaria Montelibano
The agency detains products from the Honduran manufacturer

The U.S. Food and Drug Administration has issued an import alert regarding entry of cantaloupe from Agropecuaria Montelibano, a Honduran grower and packer, because, based on current information, fruit from this company appears to be associated with a Salmonella Litchfield outbreak in the United States and Canada. The import alert advises FDA field offices that all cantaloupes shipped to the United States by this company are to be detained.

In addition, the FDA has contacted importers about this action and is advising U.S. grocers, food service operators, and produce processors to remove from their stock any cantaloupes from this company. The FDA also advises consumers who have recently bought cantaloupes to check with the place of purchase to determine if the fruit came from this specific grower and packer. If so, consumers should throw away the cantaloupes.

To date, the FDA has received reports of 50 illnesses in 16 states and nine illnesses in Canada linked to the consumption of cantaloupes. No deaths have been reported; however, 14 people have been hospitalized. The states are Arizona, California, Colorado, Georgia, Illinois, Missouri, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Tennessee, Utah, Washington, and Wisconsin.

The FDA is taking this preventive measure while the agency continues to investigate this outbreak in cooperation with the Centers for Disease Control and Prevention and state partners. Such intervention is a key component of FDA’s Food Protection Plan.

Symptoms of foodborne Salmonella infection include nausea, vomiting, fever, diarrhea, and abdominal cramps. In persons with poor health or weakened immune systems, Salmonella can invade the bloodstream and cause life-threatening infections. Individuals who have recently eaten cantaloupe and experienced any of these symptoms should contact their health care professional.

The FDA recommends that consumers take the following steps to reduce the risk of contracting Salmonella or other foodborne illnesses from cantaloupes:

* Purchase cantaloupes that are not bruised or damaged. If buying fresh-cut cantaloupe, be sure it is refrigerated or surrounded by ice.

* After purchase, refrigerate cantaloupes promptly.

* Wash hands with hot, soapy water before and after handling fresh cantaloupes.

* Scrub whole cantaloupes by using a clean produce brush and cool tap water immediately before eating. Don't use soap or detergents.

* Use clean cutting surfaces and utensils when cutting cantaloupes. Wash cutting boards, countertops, dishes, and utensils with hot water and soap between the preparation of raw meat, poultry, or seafood and the preparation of cantaloupe.

* If there happens to be a bruised or damaged area on a cantaloupe, cut away those parts before eating it.

* Leftover cut cantaloupe should be discarded if left at room temperature for more than two hours.

* Use a cooler with ice or use ice gel packs when transporting or storing cantaloupes outdoors.

Ongoing Conversation on Top of the Rug

I've been out of the office the last few days mostly involved in E. coli cases in state and federal court. While I was out, U.S. Presidential Candidate, Barack Obama, held a press conference that was precipitated by some of the controversial comments his former minister had said regarding race in the United States. This controversy is not new. It's been around since recorded time began.

In the United States, when the founding fathers created a constitution of limited government, arguably the two greatest failures of those founding fathers was the fact they failed to do anything about slavery and the native peoples. It wasn't that it wasn't discussed, it's just that some of the founders thought both topics too hot to do anything about less they fail to form a union over the ongoing controversy. Those topics were left to be debated another day. Along the way, there were other opportunities. Washington (Henry Knox, tried wonderfully but unsuccessfully under Washington to help the Native peoples), Jefferson and presidents till Lincoln all had chances to act, but in one way or another, left the debate to be settled in the future. We eventually erased most of native peoples by the sheer growth of a westward moving population and confronted the slavery issue with a bloody civil war. The effects of slavery did not end with the emancipation proclamation. They continued well into the civil rights movement of the latter half of the 20th century. That discussion is still ongoing. Whether people wish to recognize and join that conversation is another issue.

Today we have a candidate that is half black and half white. He embodies the ongoing argument of race. He may be the Lincoln of our time. History will tell us later if he is elected. Opportunities for change don't always present themselves neatly. It is often quoted that the right answer at the wrong time is still the wrong answer. But it is equally possible that ongoing dialogue about difficult subjects may be the best pressure valve to effect change in a positive direction so that issues of race, crime, poverty, health care, global climate change, war, peace, and pursuit of happiness don't erupt into a wider more entrenched conflict. Let the conversation continue.

Mediation and Walden Pond

I spent Thursday and Friday mediating E. coli cases involving Wendys and its supplier. About 35 attorneys, company representatives and 6 layers of insurance showed up in a confined area in Federal Court for the District of Utah. We settled three of the cases and still have two remaining. For our clients that are irreparably injured, it is by far the worst thing they have ever endured. For the insurance companies, producers and retailers of the tainted product, it seems to be more of a business decision. However, I did see in the face of one senior executive real concern for our clients. He appears to have what I call humanity.

Henry David Thoreau was a 27-year-old former schoolteacher when he went to live at Walden Pond in the summer of 1845. His friend Ralph Waldo Emerson, who had recently purchased 14 wooded acres of on the northwestern shore of Walden Pond, agreed to let the young writer conduct his "experiment in simplicity" there. Henry built a small cabin next to the large pond and spent a couple of years thinking about what was important. He sought balance. I suspect he took many deep breaths and listened to the silence.

Being in a place where there are over 35 lawyers trying to make a good decision is not a Walden experience. It is however, a necessary step to help seriously injured people. I suspect Thoreau spent a few stormy nights in his small one-room cabin. It allowed him to appreciate the open expanse of thought and the promise of renewal. Although I am disappointed not all of our cases settled, I am hopeful that as the main decision makers have now had time to step outside the small spaces that they occupied last week, they now have an opportunity to find perspective and return with a new expanse of thought to settle the storm that has occurred in the lives of our clients.

Aunt Jemina?

Limited Number of Aunt Jemima Pancake & Waffle Mix Products Recalled for Possible Health Risk. These products are sold in Utah.

FOR IMMEDIATE RELEASE -- March 4, 2008 – The Quaker Oats Co. announced the products in the recall are a small quantity of Aunt Jemima Pancake & Waffle Mix: Original, Original Complete and Buttermilk Complete, which may have potential salmonella contamination. No other Aunt Jemima, frozen Aunt Jemima or Quaker products are affected.

The products, sold in 2 pound and 5 pound boxes with Best Before dates of FEB 08 09 H through FEB 16 09 H stamped on the top, contain the following UPC codes:

30000 43272: Aunt Jemima Buttermilk Complete, 5 lb.
30000 05040: Aunt Jemima Original, 2 lb.
30000 05070: Aunt Jemima Original Complete, 2 lb.
30000 05300: Aunt Jemima Buttermilk Complete, 2 lb.
Salmonella is a food borne illness that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with salmonella often experience fever, diarrhea, nausea, vomiting and abdominal pain.

No illnesses have been reported in connection with this issue to date. There is very low risk of illness when preparation directions on box are followed and product is not consumed raw or undercooked. Salmonella bacteria is killed at a temperature of 160° F.

If consumers have this product with the indicated UPC codes and Best Before dates, they should return it to the place of purchase for a full refund. Consumers with questions may contact the company by calling the toll-free hotline at 1-800-407-2247 or by logging onto www.auntjemima.com.

Quaker is in the process of recovering the product involved. Quaker knows specifically to which customer warehouses the product was shipped. Approximately 98% of the product is within Quaker's control. The 2% of product which is outside of Quaker's control was shipped to a limited number of retail and mass merchandiser stores (no direct distribution to West Coast). Of that small quantity, the vast majority likely has not been placed on store shelves. Product was shipped to 17 states including Texas, Georgia, Alabama, South Carolina, North Carolina, Illinois, Florida, Missouri, Minnesota, Colorado, Wisconsin, Ohio, New York, New Mexico, Kansas and Utah.

What Stays in Vegas May Not Stay in Vegas-More on the Hepatitis C Outbreak

Now there is a report that the hepatitis C outbreak in Las Vegas may just be the proverbial "tip of the iceberg." So the question remains. What were they thinking? Trying to save a buck at the expense of public safety? Here's the latest from AP:

Clinic Hepatitis Case May Not Be Unique
By ERICA WERNER,
AP
Posted: 2008-03-04 12:04:44

WASHINGTON (March 3) - An outbreak of hepatitis C at a clinic in the Western state of Nevada might represent "the tip of an iceberg" of safety problems at clinics around the country, says the head of the Centers for Disease Control and Prevention.
The city of Las Vegas shut down the Endoscopy Center of Southern Nevada last Friday after state health officials determined that six patients had contracted hepatitis C because of unsafe practices including clinic staff reusing syringes and vials. Nevada health officials are trying to contact about 40,000 patients who received anesthesia by injection at the clinic between March 2004 and Jan. 11 to urge them to be tested for hepatitis C, hepatitis B and HIV.

In Washington, Senate Majority Leader Harry Reid, met Monday with CDC director Dr. Julie Gerberding, and the Democratic leader shared a media conference call with her after their meeting. Both strongly condemned practices at the clinic.

Health care accreditors "would consider this a patient safety error that falls into the category of a `never event,' meaning this should never happen in contemporary health care organizations," said Gerberding.

"This is the largest number of patients that have ever been contacted for a blood exposure in a health care setting. But unfortunately we have seen other large-scale situations where similar practices have led to patient exposures," Gerberding said.

"Our concern is that this could represent the tip of an iceberg, and we need to be much more aggressive about alerting clinicians about how improper this practice is," she said. At the same time, she said, inspectors also should continue "to invest in our ability to detect these needles in a haystack at the state level, so we recognize when there has been a bad practice and patients can be alerted and tested."

Reid said he would work with Gerberding to try to get the CDC more resources in an emergency spending bill Congress is to take up in April.

State health officials said they were unsure how many of the 40,000 patients they had been able to contact since making the risk public last Wednesday. At least initially they did not have correct addresses for 1,400, officials said.

The clinic's head, Dr. Dipak Desai, bought space in the newspaper the Las Vegas Review-Journal on Sunday in which he expressed "my deepest sympathy to all our patients and their families for the fear and uncertainty that naturally arises from this situation."

Desai offered no apology but said a foundation was being set up to cover testing costs. He also defended practices at his clinic, which performs colonoscopies.

"The evidence does not support that syringes or needles were ever reused from patient to patient at the center," Desai wrote.

A spokeswoman, Nancy Katz, declined Monday to comment further.

The Clark County district attorney is investigating, as are various health agencies, including the Nevada State Board of Nursing. Several lawsuits already have been filed and a hearing is scheduled Thursday before a Nevada legislative committee.

It may never be known how many people contracted hepatitis C because of unsafe practices at the endoscopy center, state health officials said. Brian Labus, head epidemiologist of the Southern Nevada Health District, said that because 4 percent of the population has hepatitis C, he expects to get numerous positive results after the at-risk clinic patients are tested and it may be impossible to determine which of those were infected at the clinic.

Of the six cases that health officials traced to the clinic, five happened on the same day and genetic testing was used to make the connection, Labus said.

Hepatitis C can cause fatal liver disease as well jaundice and fatigue, but 80 percent of people infected show no symptoms. Hepatitis B is a more rare and serious disease that attacks the liver.

Costco Recall of Frozen Chicken Entrees in Utah, Alaska, Idaho, Montana, Oregon and Washington.

Costco today recalled frozen chicken entrées due to possible Listeria contamination
According to the USDA the health risk is high.
Costco is voluntarily recalling approximately 10,368 pounds of frozen chicken Entrées that may be contaminated with Listeria monocytogenes, the U.S. Department of Agriculture's Food Safety and Inspection Service announced today.

The following product is subject to recall:
* Four-pack of 12-ounce packages of "Discover Cuisine Red Curry Chicken & Jasmine Rice." Each package bears the Canadian establishment number "Est. 302" inside the Canadian Food Inspection Agency mark of inspection as well as a "Best By" date of "12 18 08." The item number "2880" also appears by the UPC code on the package.
The frozen chicken entrees were produced on Oct. 18, 2007, and were sent to retail establishments in Alaska, Idaho, Montana, Oregon, Utah and Washington.

The problem was discovered through food safety inspections by microbiological sampling. There are currently no reports of illnesses associated with consumption of this product.

Consumption of food contaminated with Listeria monocytogenes can cause listeriosis, an uncommon but potentially fatal disease. Healthy people rarely contract listeriosis. However, listeriosis can cause high fever, severe headache, neck stiffness and nausea. Listeriosis can also cause miscarriages and stillbirths, as well as serious and sometimes fatal infections in those with weakened immune systems, such as infants, the elderly and persons with HIV infection or undergoing chemotherapy.

Media with questions about the recall should contact Inovata Foods Chief Operating Officer Bob McColl, at (780) 454-8665. Consumers with questions about the recall should contact the Costco Call Center at (800) 774-2678.

Consumers with food safety questions can "Ask Karen," the FSIS virtual representative available 24 hours a day at AskKaren.gov. The toll-free USDA Meat and Poultry Hotline 1-888-MPHotline (1-888-674-6854) is available in English and Spanish and can be reached from l0 a.m. to 4 p.m. (Eastern Time) Monday through Friday. Recorded food safety messages are available 24 hours a day.


Recommendations For People At Risk For Listeriosis

Wash hands with warm, soapy water before and after handling raw meat and poultry for at least 20 seconds. Wash cutting boards, dishes and utensils with hot, soapy water. Immediately clean spills.

Keep raw meat, fish and poultry away from other food that will not be cooked. Use separate cutting boards for raw meat, poultry and egg products and cooked foods.

Do not eat hot dogs, luncheon meats, bologna or other deli meats unless reheated until steaming hot.

Do not eat refrigerated pâté, meat spreads from a meat counter or smoked seafood found in the refrigerated section of the store. Foods that don't need refrigeration, like canned tuna and canned salmon, are safe to eat. Refrigerate after opening.

Do not drink raw (unpasteurized) milk and do not eat foods that have unpasteurized milk in them.

Do not eat salads made in the store such as ham salad, chicken salad, egg salad, tuna salad or seafood salad.

Do not eat soft cheeses such as Feta, queso blanco, queso fresco, Brie, Camembert cheeses, blue-veined cheeses and Panela unless it is labeled as made with pasteurized milk.

Use precooked or ready-to-eat food as soon as you can. Listeria can grow in the refrigerator. The refrigerator should be 40 °F or lower and the freezer 0 °F or lower. Use an appliance thermometer to check the temperature of your refrigerator.

HEPATITIS C OUTBREAK IN VEGAS AFFECTING 40,000--OUT OF NEGLIGENT PRACTICES

So today we learn that there is a Hepatitis C outbreak that has been caused by the Endoscopy Center of Nevada, putting 40,000 at risk. If you have ever met someone with a severe case of hepatitis C, you know that what they are going through is literally a fight for their life. At times they are walking dead. Hepatitis C damages the liver. It is important to know that 80% of people with the disease do not have symptoms. In those who do, symptoms may not appear for 10-20 years, or even longer. Even then, the symptoms usually come and go and are mild and vague. Unfortunately, by the time symptoms appear, the damage may be very serious. What went wrong in Vegas will not stay in Vegas. Look for major legal fallout.


* A minority of people have symptoms during the early acute phase of the infection. These symptoms typically develop 5-12 weeks after exposure to HCV. Some people describe the symptoms as being flulike. The symptoms may last a few weeks or months.

o Nausea
o Vomiting
o Diarrhea
o Loss of appetite
o Fatigue
o Pain over the liver (on the right side of the abdomen, just under the rib cage)
o Jaundice - A condition in which the skin and the whites of the eyes turn yellow
o Dark-colored urine (may look like cola or tea)
o Stools become pale in color (grayish or clay colored)

* Prolonged nausea and vomiting can cause dehydration. If you have been vomiting repeatedly, you may notice the following symptoms:

o Fatigue or weakness
o Confusion or difficulty concentrating
o Headache
o Not urinating
o Irritability

* Chronic hepatitis C can lead to cirrhosis of the liver in many people, a condition traditionally associated with alcoholism. Cirrhosis is a condition in which healthy liver tissue is replaced by fibrous tissue, followed by scarlike hardening. As this happens, the liver gradually begins to fail, or lose its ability to carry out its normal functions. Eventually, symptoms develop. Symptoms of cirrhosis include the following:

o Fluid retention causing swelling of the belly (ascites), legs, or whole body
o Persistent jaundice
o Fatigue
o Disturbances in sleeping
o Itchy skin
o Loss of appetite, weight loss, wasting
o Vomiting with blood in the vomit
o Mental disturbances such as confusion, lethargy, extreme sleepiness, or hallucinations (hepatic encephalopathy)


THE LAS VEGAS SUN REPORTS THE STORY HERE:

Endoscopy Center of Southern Nevada doctors Sanjay Nayyar, left, and Clifford Carrol flank fellow doctor Eladio Carrera as he reads a statement during a news conference at the health district Wednesday, February 27, 2008. The Southern Nevada Health District is notifying about 40,000 former patients of the Endoscopy Center of Southern Nevada that they may have been exposed to hepatitis C.

Southern Nevada Health District officials announced today they have identified six cases of hepatitis C, five of which stemmed from procedures occurring on the same day that involved anesthesia at the Endoscopy Center of Nevada.

Following a joint investigation with the Nevada State Bureau of Licensure and Certification (BLC) and with consultation from the Centers for Disease Control and Prevention, the health district determined that unsafe injection practices related to the administration of anesthesia medication might have exposed patients to the blood of other patients.

The health district is recommending 40,000 patients who had procedures requiring injected anesthesia at the clinic between March 2004 and January 11, 2008, contact their primary care physicians or health care providers to get tested for hepatitis C as well as hepatitis B and HIV.

And here is the company’s response:

On behalf of the Endoscopy Center of Southern Nevada, we want to express our deep concern about this incident to the many patients who have put their trust in us over the years. As always, our patients remain our primary responsibility and we have already corrected the situation.

The recent events related to the Southern Nevada Health District study mark the first time anything like this has ever happened at our facility. We have already taken steps to ensure that it will never happen again.

The health district began its investigation in January, and we have been fully cooperating with them. We were officially notified by the health district on February 6, 2008 and submitted our detailed Plan of Correction on February 15, 2008. All concerns noted by the health department were addressed immediately. We continue to work closely with the Southern Nevada Health District and other health agencies during this ongoing review. We want to be sure that every patient who may have been exposed is informed and tested.

To help us with these issues, we have engaged the services of nationally renowned experts who have extensive epidemiological experience and that have worked closely with the Centers for Disease Control in the past. They include Dr. Janine Jason, CEO of Jason and Jarvis Associates. She is a Harvard Medical School-trained physician, epidemiologist, and immunologist who served as a medical scientist and senior epidemiologist at the Centers for Disease Control and Prevention and was on the Emory Medical School faculty for 23 years prior to becoming a private consultant. Dr. Jason has authored more than a hundred peer-reviewed medical and epidemiologic scientific articles.

In addition to our corrective actions, we are on a mission to maintain the trust our patients have had in us during our years of service to southern Nevada.

We wish to emphasize that the actual risk of anyone being affected by this is extremely low, but as a precaution, anyone who has undergone procedures at the Endoscopy Center who required anesthesia should be tested.

As I’m sure you understand this situation brings with it a number of complex elements including patient privacy and regulatory guidelines. At this time, our counsel has asked that we limit our comments to this statement, and we are unable to take questions.

Thank you.

CORRECTION: Earlier this blog said “Health officials say that practitioners were routinely using the same syringe on more than one patient, which is widely known to pass on infection.” Actually, the same syringe was not being used on multiple patients. But single dose vials of medication, which had become infected through their initial use, were being used again. Health officials say this is widely known to pass infection.

More Lantern, Less Bus in the Ditch

History in the United States is short and still moving outward. It is still being written as it expands. I knew a couple of my Great Grandmothers growing up. They were born in the late 1800's. Their parents were alive when Lincoln was President. My Great, Great, Grandfather was alive during the War of 1812. His father saw the birth of our nation.

One of my favorite places to visit is Boston. Not only is it where my oldest daughter Laura lives and attends college, it is where you can walk into living spaces that played and still play out a roll in the founding of our country. Take Christ's Church, better known as the Old North Church, for instance. This is where a young twenty-three year-old Episcopal Sexton, named, Robert Newman, had been directed by Paul Revere and the Sons of Liberty, to climb the tall steeple where he briefly hung two burning lanterns, signaling the direction independence would take. It was by water. Newman climbed a narrow dark stairwell to reach the top. Liberty demands as such. Once the two lanterns were lit, his friends across the Charles River in Lexington and Concord, readied themselves as they knew the British regulars were coming by boat as opposed to marching by land.

It may be an over simplification, but as I understand it, an argument had arisen between the Crown and its colonial subjects over who would represent the voice of the people. Would it be a distant Parliament separated by an ocean or left to the various individual legislatures found in the colonies at that time? The Crown took a hard position because it was powerful and felt it was the best parent for a rebellious child. In fact, Great Britain was the most powerful country at that time. There would be no negotiation. Ben Franklin was sent to England over a period of several years to work a compromise on behalf of the various individual colonies to try to keep the Empire together. After hitting his head against a wall, even he, perhaps one of the greatest minds of the last 400 years, saw the futility of trying to work a solution with the deaf Crown.

What ultimately happened was a revolt. But not in the sense of what has been or would become a revolution as we have seen in other parts of the world. No, it was a revolution of a very slow burn--one, that some would argue, still continues today. Slow was its genius. It gave time for the people to awaken and be touched by the light of liberty that was burning. It gave time to lighten the darkness. This slow paced revolution continues in our founding document the Constitution. It has the component of Federalism, reserving certain rights to the states. The boundaries are meant to be discussed and constantly shift. It is not meant to be an absolute rigid measuring stick. It's soft and malleable to avoid breakage. Different people will interpret it differently. There is no black and white. There are checks and balances.

People are born with the potential to make a difference if they involve themselves in the flow of the revolution. It is not the end that matters. It is the progress of the process. Although the lanterns of the night only burned a short while so not to be given away to the enemy, that light is still expanding out into the dark night.

The Silly Season

Plagiarize : to steal and pass off (the ideas or words of another) as one's own (Merriam-Webster Dictionary).

I think I must have plagiarized sometime today. I don't keep track, but that's the point. I know I said something to my friend at lunch. I know I spoke to my office mate. Not too long ago, I read the book "Mayflower" by Nathaniel Philbrick. Being excited to tell someone about Bradford's wife, being so distraught, due to her young child being left behind in England (after being told to do so by her overbearing husband) that she jumped to her death into the icy waters below once it anchored of the Cape; and that it was clear to me that the Mayflower Compact was a forerunner to the U.S. Constitution and the Declaration of Independence in that it provided limited government, I think I forgot to give the author of "Mayflower" credit. But then again, were did he get that idea? Then again, where did Thomas Jefferson get his idea?

By Jefferson's own admission, the ideas contained in the Declaration of Independence were commonly expressed throughout the 17th and 18th centuries. I remember studying about Locke and Hobbes in College and seeing that much of what Jefferson said was lifted to some degree. John Adams claimed that Jefferson also borrowed from Samuel Adams. I'm surprised John Adams didn't claim he wrote it. Perhaps they were friends. I recently learned that the Scottish philosophers in the 17th and 18th century probably came up with just about everything. The Irish undoubtedly will be shocked to hear this since they saved civilization in a time when the Romans were failing and medieval Europe was on the rise. Ireland had monks that liked to copy down everything. Oh, and then you can't forget the Dutch and their Oath of Abjuration. It basically discusses the idea of a people's right to denounce and overthrow their leaders should they fail to respect the people's laws and traditions. I got that from Wikipedia. Thomas Paine's pamphlet, Common Sense had in it the line, "life, liberty, and the pursuit of property," as well as the line, "the pursuit of happiness."

So here's the deal: Sometime along time ago when language began, someone said something. It was overheard and someone else liked it. They repeated it. After a few mellenia I repeated it in some from. I apologize that I can't remember her name so as to give her credit. I think it was Ilene. Nonetheless, I didn't mean not to give her credit. Don't get me wrong, if someone is guilty of copyright infringement or if they pass off an idea or analysis as their own without giving proper credit they should be held accountable. Politics, inherently, is nothing but a form of plagiarism. We take something that has hopefully worked in the past and, with a few minor changes, appropriate it and call it our own. The Mayflower and it's passengers mattered. The People watching them from behind the forest cover mattered. Words matter. I think I just plagiarized again. I'm sorry.

Just Being There

Don't ask where this idea comes from. Sometimes I'm of the impression that we are not the source of an idea. The idea exists in and of itself. We are just the receptacles of that thought. If we are open to it, it will arrive. If it arrives, it's up to us to listen to it.

There seems to be the thought that being first at something is the preferred method. It is entrenched in our psyches from birth, whether it's little league sports, being the head of the class or making the most money. It is the pursuit to get ahead at all cost no matter what. You can find it at home, at work, on the ski slopes and on CNN as you watch certain candidates and their spouses this season.

In this Machiavellian model, to progress to an end result at any cost, to achieve more knowledge, more power, more this, more that, we ultimately lose. We lose ourselves. Sometimes taking a breath and doing nothing is the best thing to do. Sometimes getting in your car and taking a scenic drive while listening to Rachmaninov, Shostakovich, Chopin, Miles, or Bill Evans is the best thing you can do. But the reality is, is that the people that get this already do this. And most likely the ones that don't are at this very moment thinking of ways to get on top. Their egos, or lack thereof, don't allow just being there--being in the moment. In my experience, there is no top.

My son is just 16 years old. The fact is, is that he will be a better musician than I am. He has a better temperament than I do. He is gifted with balance. Being first is not that important to him. He's more interested in clarity and understanding. For him happiness will come more easily as he is a better container for bliss. He plays in a band that occasionally asks me to play back-up percussion. I add "color" or so they say. I've learned I don't mind being second fiddle. It gives you the opportunity to look around and observe what's going on around you. It gives you more time to step back and contemplate what your part is and how you can best contribute to the whole.

You need that down time, you need to have a place to go and think. If all you are doing is trying to catch up and ultimately win--whatever that is-- you will most likely miss the point of what the universe is trying to whisper to you. If you want to see a person and what they stand for you have to understand what it is they are doing when no one is watching them. Hard to do, but for yourself.

Perhaps that's why there is a Camp David. Perhaps that's why Lincoln had a cottage that he would ride to about 3 miles North of Washington, D.C. As he rode to that Victorian cottage to find refuge, he would have undoubtedly seen the scores of Union troops encamped for a cause he believed deeply in, a cause to which thousands were dying and would continue to die. Quietly, and by himself, and away from the confusion of the White House he drew up the plans of how to unite a divided country, mourn the death of his son Willie, and dream up the Emancipation Proclamation. He understood the necessity of space and just being there.

Nationwide Recall of Beef being Fed to Our Children

The USDA has ordered the Nation's Largest Beef Recall. Based on what I'm reading and hearing don't be surprised if the Fed's don't bring additional criminal charges against the company Westland/Hallmark. If they don't, they're not doing there job. People should be outraged. Is it not outrageous that food not fit for human consumption is being fed to our children at school? What group of money focused idiots thought this would be a good idea and would go unnoticed? It also clearly calls into question what our government is doing about inspection. Obviously the inspection program at the USDA is soundly asleep at the wheel while our kids are eating beef from sick "downer" cattle. Yet another reason to write your member of congress and tell them to stop hearings that are a waste of time (see blog on Clemens below) and do something for our nations food supply.

Here's the story:

AP Greg Risling
Posted: 2008-02-17 22:31:57

LOS ANGELES (Feb. 17) - The U.S. Department of Agriculture on Sunday ordered the recall of 143 million pounds of frozen beef from a California slaughterhouse, the subject of an animal-abuse investigation, that provided meat to school lunch programs.

In what officials said was the largest beef recall in U.S. history, the Department of Agriculture on Sunday ordered the recall of 143 million pounds of frozen beef from a California slaughterhouse that provided meat to school lunch programs. The recall will affect beef products that came from the Westland/Hallmark Meat Co.
Officials said it was the largest beef recall in the United States, surpassing a 1999 ban of 35 million pounds of ready-to-eat meats. No illnesses have been linked to the newly recalled meat, and officials said the health threat was likely small.

The recall will affect beef products dating to Feb. 1, 2006, that came from Chino-based Westland/Hallmark Meat Co., the federal agency said.

Secretary of Agriculture Ed Schafer said his department has evidence that Westland did not routinely contact its veterinarian when cattle became non-ambulatory after passing inspection, violating health regulations.

"Because the cattle did not receive complete and proper inspection, Food Safety and Inspection Service has determined them to be unfit for human food and the company is conducting a recall," Schafer said in a statement.

A phone message left for Westland president Steve Mendell was not immediately returned.

Federal officials suspended operations at Westland/Hallmark after an undercover Humane Society video surfaced showing crippled and sick animals being shoved with forklifts.

Two former employees were charged Friday. Five felony counts of animal cruelty and three misdemeanors were filed against a pen manager. Three misdemeanor counts — illegal movement of a non-ambulatory animal — were filed against an employee who worked under that manager. Both were fired.

Authorities said the video showed workers kicking, shocking and otherwise abusing "downer" animals that were apparently too sick or injured to walk into the slaughterhouse. Some animals had water forced down their throats, San Bernardino County prosecutor Michael Ramos said.

No charges have been filed against Westland, but an investigation by federal authorities continues.

Officials estimate that about 37 million pounds of the recalled beef went to school programs, but they believe most of the meat probably has already been eaten.

"We don't know how much product is out there right now. We don't think there is a health hazard, but we do have to take this action," said Dr. Dick Raymond, USDA Undersecretary for Food Safety.

Most of the beef was sent to distribution centers in bulk packages. The USDA said it will work with distributors to determine how much meat remains.

Federal regulations call for keeping downed cattle out of the food supply because they may pose a higher risk of contamination from E. coli, salmonella or mad cow disease because they typically wallow in feces and their immune systems are often weak.

About 150 school districts around the nation have stopped using ground beef from Hallmark Meat Packing Co., which is associated with Westland. Two fast-food chains, Jack-In-the-Box and In-N-Out, said they would not use beef from Westland/Hallmark.

Jack in the Box, a San Diego-based company with restaurants in 18 states, told its meat suppliers not to use Hallmark until further notice, but it was unclear whether it had used any Hallmark meat. In-N-Out, an Irvine-based chain, also halted use of the Westland/Hallmark beef. Other chains such as McDonald's and Burger King said they do not buy beef from Westland.

Raymond countered a claim leveled by Humane Society President and CEO Wayne Pacelle, who said a USDA inspector was at the Westland plant for about two hours each day. USDA inspectors are there at slaughterhouses "continuously," Raymond said.

Federal lawmakers on Thursday had called for the Government Accountability Office to investigate the safety of meat in the National School Lunch Program.

Upon learning about the recall, some legislators criticized the USDA, saying the federal agency should conduct more thorough inspections to ensure tainted beef doesn't get to the public.

"Today marks the largest beef recall in U.S. history, and it involves the national school lunch program and other federal food and nutrition programs," said U.S. Sen. Tom Harkin, chairman of the Chairman of the Senate Committee on Agriculture, Nutrition and Forestry. "This begs the question: how much longer will we continue to test our luck with weak enforcement of federal food safety regulations?"

Advocacy groups also weighed in, noting the problems at Westland wouldn't have been revealed had it not been for animal right activists.

"On the one hand, I'm glad that the recall is taking place. On the other, it's somewhat disturbing, given that obviously much of this food has already been eaten," said Jean Halloran, director of food policy initiatives at Consumers Union. "It's really closing the barn door after the cows left."

Associated Press writer Jacob Adelman contributed to this report.

Sesame Seeds and Salmonella

The FDA just sent out the following press release regarding Nutri-Foods Organis Sesame Seeds due to possible salmonella contamination.

Recall -- Firm Press Release

FDA posts press releases and other notices of recalls and market withdrawals from the firms involved as a service to consumers, the media, and other interested parties. FDA does not endorse either the product or the company.
Nutri-Foods Recalls "Organic Sesame Seeds Natural - Unhulled" Because of Possible Health Risk

FOR IMMEDIATE RELEASE -- February 15, 2008 -- Nutri-Foods, Inc. ("Nutri-Foods") of Royal Oak, Michigan, is recalling its .50 pound packages of "Organic Sesame Seeds Natural - Unhulled" due to possible salmonella contamination, an organism, which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting, and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illness such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

The recalled "Organic Sesame Seeds Natural - Unhulled" were sold at Nutri-Foods.

The product comes in a .50 pound clear plastic package with a product SKU #170 at the top and a "packed on" date of December 28. This product was sold from circa December 15, 2007 through January 28, 2008.

No illnesses have been reported to date in connection with this problem.

Production of the product has been suspended while the FDA and manufacturer of the product continue their investigation.

Write Congress and Tell Them You Don't Care About Roger Clemens' Injections in His Backside!

How much did we as taxpayers pay today to watch Roger Clemens and his former physical therapist talk before a committee of Congress to discuss whether the PT injected him with steroids and human growth hormone? Based on my experience, it was well into the seven figures. Here's a thought: Why doesn't Congress focus on what "we the people" sent them to do? Enact legislation and pass bills that help the economy, build bridges, roads, dams, schools, healthcare, pollution, global warming, poverty, etc, etc, etc.

Here's something you can do: The FDA recently published a report on the need to partner with Congress to make the changes necessary to transform the safety of the nation's food supply. They call it the Food Safety Plan. The Plan recommends legislative changes to strengthen the FDA's ability to continue to protect Americans from foodborne illnesses. In part, the plan will:

Authorize FDA to Accredit Highly Qualified Third Parties for Voluntary Food Inspections.
Require New Reinspection Fee From Facilities That Fail to Meet current Good Manufacturing Practices (cGMPs)
Authorize FDA to Require Electronic Import Certificates for Shipments of Designated High-Risk Products
Require New Food and Animal Feed Export Certification Fee to Improve the Ability of U.S. Firms to Export Their Products
Provide Parity Between Domestic and Imported Foods if FDA Inspection Access is Delayed, Limited, or Denied
RESPOND Rapidly to Minimize Harm.
Empower FDA to Issue a Mandatory Recall of Food Products When Voluntary Recalls Are Not Effective
Give FDA Enhanced Access to Food Records During Emergencies

See the full Plan here: http://www.fda.gov/oc/initiatives/advance/food.html

Although this Plan is by no means perfect, it does put focus on a too common problem in the United States--food poisoning. The CDC estimates that 76 million foodborne illness, or food poisoning, cases occur in the United States every year, which means that one in four Americans contract a foodborne illness annually after eating foods contaminated with such pathogens as E. coli O157:H7, Salmonella, Hepatitis A, Campylobacter, Shigella, Norovirus, and Listeria. Approximately 325,000 people are hospitalized with a diagnosis of food poisoning, and 5,000 die. The estimated costs in terms of medical expenses and lost wages or productivity are between $6.5 and $34.9 billion (Buzby and Roberts, 1997; Mead, et al., 1999).

Now ask yourself, why do "we the people" care about Roger Clemens and his injections? Write your member of Congress and tell them how you feel about it and, why you're at it, tell them you want a few things to change or you will vote them out. Then they will have plenty of time for America's favorite past-time--just make sure the hot dog is cooked and hot when you get it.

Botulism in Asparagus, Beans and Blackeye Peas

A recent nationwide recall has been broadened by the U.S. Food and Drug Administration (FDA). Unfortunately, due to the sizes of the cans (institutionalized 6-7 pounders) much of what is being consumed might place consumers at greater risk. I suspect the majority of the cans are not being opened by consumers but more likely retail restaurants, and other larger institutions such as schools and hospitals. I hope they are paying attention.

The FDA is alerting consumers, food service operators, and food retailers that New Era Canning Company, New Era, Mich., is broadening its nationwide recall of canned vegetable products for a third time because of the potential for its foods to be contaminated with Clostridium botulinum (C. botulinum).

C. botulinum produces the toxin that causes botulism and can cause life-threatening illness or death. The affected New Era products are large institutional-sized cans, weighing between six and seven pounds, of various types of beans, blackeye peas, and asparagus.

To date, no illnesses have been reported to the FDA. However, consumers should not consume these products, even if they appear to be normal, because of the potential serious risk to health. Consumers who have the affected products, or who have used them in recipes, should immediately throw the cans and food away.

The potentially contaminated products are marketed under ten different brand names:

Classic Sysco
Code
Frosty Acres Restaurant’s Pride Preferred
GFS
Kitchen Essentials
Monarch Heritage
Necco
New Era
Nugget
Reliance Sysco

Processors other than New Era may be packing these brands. Only products packed by New Era are subject to the recall, so individuals must check the lot numbers on the bottom of the cans to determine if the product is affected by the recall. A complete list of specific brands, products, and lot codes subject to the New Era recalls can be found at http://www.fda.gov/oc/opacom/hottopics/newera.html.

Symptoms of botulism poisoning in humans can begin from six hours to two weeks after eating food that contains the toxin. Symptoms may include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, and muscle weakness that moves progressively down the body, affecting the shoulders first, then descending to the upper arms, lower arms, thighs, and calves. Botulism poisoning also can cause paralysis of the breathing muscles, which can result in death unless assistance with breathing (mechanical ventilation) is provided. Individuals who have these symptoms and who may have recently eaten the products under recall or other food products made with them should seek immediate medical attention.

Any food that may contain the affected products should be disposed of carefully. Even tiny amounts of the C. botulinum toxin can cause serious illness when ingested, inhaled, or absorbed through the eye or a break in the skin. Skin contact should be avoided as much as possible, and hands should be washed immediately after handling the food.

When disposing of these products, double-bag the cans in plastic bags. Make sure the bags are tightly closed, then place in a trash receptacle for non-recyclable trash outside of the home. Restaurants and institutions should ensure that such products are only placed in locked receptacles that are not accessible to the public. Additional instructions for safe disposal may be found at www.cdc.gov/ncidod/dbmd/diseaseinfo/botulism_g.htm . Anyone with questions may call the FDA at 1-888-SAFEFOOD.

This recall is the most recent to result from an ongoing investigation of New Era Canning’s processing plant by the FDA and the Michigan Department of Agriculture. The FDA initiated an inspection of New Era Canning, along with inspections of other low acid canned food manufacturers, following four cases of botulism in consumers who had consumed canned, hot dog chili sauce in the summer of 2007.

Conflict Resolved

I spent most of the my day yesterday in mediation. It was confidential so I can't discuss any of the specifics, but it was successful in its outcome. What I can say is that it was a case that had been litigated up until mediation for over two years. Both sides had risk. Both sides had strengths and weaknesses. In the end, both sides had to give a bit more than what they really wanted to. But also in the end, both sides had more say and control than what they would have if it had been given to a jury.

There are certain things you can do both as a client and an attorney to prepare for medition that will help in having a successful outcome. These ideas are by no means complete but are some thoughts from what has worked for me and my clients.

First things first, know your case. This doesn't mean your side only, it means try to understand your case from the other side as well. Obviously, there is a dispute or you wouldn't be here. Try to objectively discern if the otherside might have a valid point. Also, not all facts are critical at mediation. You may have lived with your case for a few years but trying to explain the details of the front door to your cabin that is 47 miles down a rutted dirt road may not be salient to this process. It's like the details of a book versus the same story in a two hour movie. I once took a screenwriting class that went over how to adapt a book to a movie. The instructor said the following: "Read the book carefully from cover to cover then put it down. Write out what you remember from it--the main points. If you can't remember all the details they were most likely not that important." So know which facts are critical and which are merely background.

I think it's also affective to research any comparable jury verdicts in your area to some degree. I feel this was probably more important to see what value is in your particular area a few years ago. Area distinctions are becoming less dramatic than they were fifteen years ago. The internet has made the world smaller. Just because I live in Utah or Oregon should I take less that a similar case that is in California or New York? So research cases from your area and beyond. See what's out there.

What are your alternatives to settlement? Will this be your last bite of the apple before litigation? Can you try again if it doesn't wotk out? Could another form of settlement be suggested such as arbitration? Timing is every thing. Some case take a while to become ripe. The right answer at the wrong time is still the wrong answer. Don't short circiut the process of getting to quick to mediation and don't short circuit the process once you are at the mediation or you will most likely take less than you would have otherwise. It is a dance that has several components. Patience still can be a virtue.

Another helpful process to go through with your clients is to explain to them how long and how expensive it will be to go to trial and what outcome is possible at trial. If they could settle today for $500,000, is it better or worse than going to trial a year down the road and spending and additional $50,000 with the amount on the table today at risk to potenetially get another $500,000? The answer may be yes or no but you need to honestly make an assessment.

When preparing both you and your client, make sure your are on the same page in most critical respects. You don't want an additional dispute to errupt during this most critical time of potential settlement at mediation. If you feel it coming on, politely ask the mediator to step outside and work through it until you reach an understanding with your client. Remember to listen to your client as they are the ones that have lived thrugh it.

It is also important ahead of time to explain the mechanics of the system (especially how a mediation session goes) so they are not surprised. Explain to them that the mediator is not the judge but someone that can hopefully facilitate a resolution. They are not there to tell you what to do. You and your cleint get to decide that together.

Like I said, this is by no means an exhaustive list. It is just a list of thoughts I have from spending my day in mediation that can hopefully better help in getting conflict resolved.

Get to Know Listeria

This is yet another article from the CDC on another bacteria that is an important health problem in the United States caused primarily from undercooked meats and vegetables.

What is listeriosis?

Listeriosis, a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes, has recently been recognized as an important public health problem in the United States. The disease affects primarily persons of advanced age, pregnant women, newborns, and adults with weakened immune systems. However, persons without these risk factors can also rarely be affected. The risk may be reduced by following a few simple recommendations.

What are the symptoms of listeriosis?

A person with listeriosis has fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea or diarrhea. If infection spreads to the nervous system, symptoms such as headache, stiff neck, confusion, loss of balance, or convulsions can occur.

Infected pregnant women may experience only a mild, flu-like illness; however, infections during pregnancy can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn.

How great is the risk for listeriosis?

In the United States, an estimated 2,500 persons become seriously ill with listeriosis each year. Of these, 500 die. At increased risk are:

* Pregnant women - They are about 20 times more likely than other healthy adults to get listeriosis. About one-third of listeriosis cases happen during pregnancy.
* Newborns - Newborns rather than the pregnant women themselves suffer the serious effects of infection in pregnancy.
* Persons with weakened immune systems
* Persons with cancer, diabetes, or kidney disease
* Persons with AIDS - They are almost 300 times more likely to get listeriosis than people with normal immune systems.
* Persons who take glucocorticosteroid medications
* The elderly

Healthy adults and children occasionally get infected with Listeria, but they rarely become seriously ill.

How does Listeria get into food?

Listeria monocytogenes is found in soil and water. Vegetables can become contaminated from the soil or from manure used as fertilizer. Animals can carry the bacterium without appearing ill and can contaminate foods of animal origin such as meats and dairy products. The bacterium has been found in a variety of raw foods, such as uncooked meats and vegetables, as well as in processed foods that become contaminated after processing, such as soft cheeses and cold cuts at the deli counter. Unpasteurized (raw) milk or foods made from unpasteurized milk may contain the bacterium.

Listeria is killed by pasteurization and cooking; however, in certain ready-to-eat foods such as hot dogs and deli meats, contamination may occur after cooking but before packaging.


How do you get listeriosis?

You get listeriosis by eating food contaminated with Listeria. Babies can be born with listeriosis if their mothers eat contaminated food during pregnancy. Although healthy persons may consume contaminated foods without becoming ill, those at increased risk for infection can probably get listeriosis after eating food contaminated with even a few bacteria. Persons at risk can prevent Listeria infection by avoiding certain high-risk foods and by handling food properly.


Can listeriosis be prevented?

The general guidelines recommended for the prevention of listeriosis are similar to those used to help prevent other foodborne illnesses, such as salmonellosis. In addition, there are specific recommendations for persons at high risk for listeriosis.


How can you reduce your risk for listeriosis?

General recommendations:

* Thoroughly cook raw food from animal sources, such as beef, pork, or poultry.
* Wash raw vegetables thoroughly before eating.
* Keep uncooked meats separate from vegetables and from cooked foods and ready-to-eat foods.
* Avoid unpasteurized (raw) milk or foods made from unpasteurized milk.
* Wash hands, knives, and cutting boards after handling uncooked foods.
* Consume perishable and ready-to-eat foods as soon as possible

Recommendations for persons at high risk, such as pregnant women and persons with weakened immune systems, in addition to the recommendations listed above:

* Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot.
* Avoid getting fluid from hot dog packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats.
* Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk.
* Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten.
* Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.

How do you know if you have listeriosis?

There is no routine screening test for listeriosis during pregnancy, as there is for rubella and some other congenital infections. If you have symptoms such as fever or stiff neck, consult your doctor. A blood or spinal fluid test (to cultivate the bacteria) will show if you have listeriosis. During pregnancy, a blood test is the most reliable way to find out if your symptoms are due to listeriosis.

What should you do if you've eaten a food recalled because of Listeria contamination?

The risk of an individual person developing Listeria infection after consumption of a contaminated product is very small. If you have eaten a contaminated product and do not have any symptoms, we do not recommend that you have any tests or treatment, even if you are in a high-risk group. However, if you are in a high-risk group, have eaten the contaminated product, and within 2 months become ill with fever or signs of serious illness, you should contact your physician and inform him or her about this exposure.

Can listeriosis be treated?

When infection occurs during pregnancy, antibiotics given promptly to the pregnant woman can often prevent infection of the fetus or newborn.

Babies with listeriosis receive the same antibiotics as adults, although a combination of antibiotics is often used until physicians are certain of the diagnosis. Even with prompt treatment, some infections result in death. This is particularly likely in the elderly and in persons with other serious medical problems.

What is the government doing about listeriosis?

Government agencies and the food industry have taken steps to reduce contamination of food by the Listeria bacterium. The Food and Drug Administration and the U. S. Department of Agriculture monitor food regularly. When a processed food is found to be contaminated, food monitoring and plant inspection are intensified, and if necessary, the implicated food is recalled.

The Coordinating Center for Infectious Diseases (CCID) is studying listeriosis in several states to help measure the impact of prevention activities and recognize trends in disease occurrence. CCID also assists local health departments in investigating outbreaks. Early detection and reporting of outbreaks of listeriosis to local and state health departments can help identify sources of infection and prevent more cases of the disease.

Get to Know Salmonella

This is another article posted with the hope of educating the public about another serious health risk from a bacteria known as Salmonella. I have seen first hand the potentially deadly affects of the bacteria. I have had clients that have come done with this bug due to improper food handling of eggs and peanut butter. What follows is an article from the CDC.

What is salmonellosis?

Salmonellosis is an infection with a bacteria called Salmonella. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. However, in some persons the diarrhea may be so severe that the patient needs to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness.

What sort of germ is Salmonella?

The Salmonella germ is actually a group of bacteria that can cause diarrheal illness in humans. They are microscopic living creatures that pass from the feces of people or animals, to other people or other animals. There are many different kinds of Salmonella bacteria. Salmonella serotype Typhimurium and Salmonella serotype Enteritidis are the most common in the United States. Salmonella has been known to cause illness for over 100 years. They were discovered by a American scientist named Salmon, for whom they are named.

How can Salmonella infections be diagnosed?

Many different kinds of illnesses can cause diarrhea, fever, or abdominal cramps. Determining that Salmonella is the cause of the illness depends on laboratory tests that identify Salmonella in the stools of an infected person. These tests are sometimes not performed unless the laboratory is instructed specifically to look for the organism. Once Salmonella has been identified, further testing can determine its specific type, and which antibiotics could be used to treat it.

How can Salmonella infections be treated?

Salmonella infections usually resolve in 5-7 days and often do not require treatment unless the patient becomes severely dehydrated or the infection spreads from the intestines. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Antibiotics are not usually necessary unless the infection spreads from the intestines, then it can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Unfortunately, some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.

Are there long term consequences to a Salmonella infection?

Persons with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal. A small number of persons who are infected with Salmonella, will go on to develop pains in their joints, irritation of the eyes, and painful urination. This is called Reiter's syndrome. It can last for months or years, and can lead to chronic arthritis which is difficult to treat. Antibiotic treatment does not make a difference in whether or not the person later develops arthritis.

How do people catch Salmonella?

Salmonella live in the intestinal tracts of humans and other animals, including birds. Salmonella are usually transmitted to humans by eating foods contaminated with animal feces. Contaminated foods usually look and smell normal. Contaminated foods are often of animal origin, such as beef, poultry, milk, or eggs, but all foods, including vegetables may become contaminated. Many raw foods of animal origin are frequently contaminated, but fortunately, thorough cooking kills Salmonella. Food may also become contaminated by the unwashed hands of an infected food handler, who forgot to wash his or her hands with soap after using the bathroom.

Salmonella may also be found in the feces of some pets, especially those with diarrhea, and people can become infected if they do not wash their hands after contact with these feces. Reptiles are particularly likely to harbor Salmonella and people should always wash their hands immediately after handling a reptile, even if the reptile is healthy. Adults should also be careful that children wash their hands after handling a reptile.

What can a person do to prevent this illness?

There is no vaccine to prevent salmonellosis. Since foods of animal origin may be contaminated with Salmonella, people should not eat raw or undercooked eggs, poultry, or meat. Raw eggs may be unrecognized in some foods such as homemade hollandaise sauce, caesar and other homemade salad dressings, tiramisu, homemade ice cream, homemade mayonnaise, cookie dough, and frostings. Poultry and meat, including hamburgers, should be well-cooked, not pink in the middle. Persons also should not consume raw or unpasteurized milk or other dairy products. Produce should be thoroughly washed before consuming.

Cross-contamination of foods should be avoided. Uncooked meats should be keep separate from produce, cooked foods, and ready-to-eat foods. Hands, cutting boards, counters, knives, and other utensils should be washed thoroughly after handling uncooked foods. Hand should be washed before handling any food, and between handling different food items.

People who have salmonellosis should not prepare food or pour water for others until they have been shown to no longer be carrying the Salmonella bacterium.

People should wash their hands after contact with animal feces. Since reptiles are particularly likely to have Salmonella, everyone should immediately wash their hands after handling reptiles. Reptiles (including turtles) are not appropriate pets for small children and should not be in the same house as an infant.

How common is salmonellosis?

Every year, approximately 40,000 cases of salmonellosis are reported in the United States. Because many milder cases are not diagnosed or reported, the actual number of infections may be thity or more times greater. Salmonellosis is more common in the summer than winter. Children are the most likely to get salmonellosis. Young children, the elderly, and the immunocompromised are the most likely to have severe infections. It is estimated that approximately 600 persons die each year with acute salmonellosis.

What else can be done to prevent salmonellosis?

It is important for the public health department to know about cases of salmonellosis. It is important for clinical laboratories to send isolates of Salmonella to the City, County, or State Public Health Laboratories so the specific type can be determined and compared with other Salmonella in the community. If many cases occur at the same time, it may mean that a restaurant, food or water supply has a problem which needs correction by the public health department.

Some prevention steps occur everyday without you thinking about it. Pasteurization of milk and treating municipal water supplies are highly effective prevention measures that have been in place for many years. In the 1970s, small pet turtles were a common source of salmonellosis in the United States, and in 1975, the sale of small turtles was halted in this country. Improvements in farm animal hygiene, in slaughter plant practices, and in vegetable and fruit harvesting and packing operations may help prevent salmonellosis caused by contaminated foods. Better education of food industry workers in basic food safety and restaurant inspection procedures, may prevent cross-contamination and other food handling errors that can lead to outbreaks. Wider use of pasteurized egg in restaurants, hospitals, and nursing homes is an important prevention measure. In the future, irradiation or other treatments may greatly reduce contamination of raw meat.

What is the government doing about salmonellosis?

The Centers for Disease Control and Prevention (CDC) monitors the frequency of Salmonella infections in the country and assists the local and State Health Departments to investigate outbreaks and devise control measures. CDC also conducts research to better identify specific types of Salmonella. The Food and Drug Administration inspects imported foods, milk pasteurization plants, promotes better food preparation techniques in restaurants and food processing plants, and regulates the sale of turtles. The FDA also regulates the use of specific antibiotics as growth promotants in food animals. The US Department of Agriculture monitors the health of food animals, inspects egg pasteurization plants, and is responsible for the quality of slaughtered and processed meat. The US Environmental Protection Agency regulates and monitors the safety of our drinking water supplies.

How can I learn more about this and other public health problems?

You can discuss any medical concerns you may have with your doctor or other heath care provider. Your local City or County Health Department can provide more information about this and other public health problems that are occurring in your area. General information about the public health of the nation is published every week in the "Morbidity and Mortality Weekly Report", by the CDC in Atlanta, GA. Epidemiologists in your local and State Health Departments are tracking a number of important public health problems, investigating special problems that arise, and helping to prevent them from occurring in the first place, or from spreading if they do occur.

What can I do to prevent salmonellosis?

Cook poultry, ground beef, and eggs thoroughly before eating. Do not eat or drink foods containing raw eggs, or raw unpasteurized milk. If you are served undercooked meat, poultry or eggs in a restaurant, don't hesitate to send it back to the kitchen for further cooking. Wash hands, kitchen work surfaces, and utensils with soap and water immediately after they have been in contact with raw meat or poultry.

Be particularly careful with foods prepared for infants, the elderly, and the immunocompromised. Wash hands with soap after handling reptiles or birds, or after contact with pet feces. Avoid direct or even indirect contact between reptiles (turtles, iguanas, other lizards, snakes) and infants or immunocompromised persons. Don't work with raw poultry or meat, and an infant (e.g., feed, change diaper) at the same time. Mother's milk is the safest food for young infants. Breast-feeding prevents salmonellosis and many other health problems.