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.

So You Want Your Child to be a Rocket Scientist? Take Music Lessons

Research done at the University of California-Irvine indicates that young children taking music lessons have a greater ability to grasp concepts that are also essential to math and science. Coordination and concentration are also improved when, for instance, children take piano lessons and learn to play a different line of music with each hand. For that matter, take drum lessons and use all four limbs independently.

The world is full of music. It is one of the truly universal ties that binds us all. Introduce your kids to all types of music. Rock, jazz, classical, brazillian, african, middle eastern, etc. and all the variants. Also realize that good music can be found in all different types of music. You can find quality anywhere if you are open to it. Check out Radiohead's new album Rainbow for instance. You don't have to be 20 something to appreciate it. And if you like Radio Head's new album, check out a couple other groups that may be lesser known to you like: Blue Nile or My Morning Jacket.

When my kids were young, I would play classical music in the car at times and ask them what the music was about. Sometimes it was about storms, monsters, the rising sun, or flying. Sometimes it was happy or sometimes it was sad. Sometimes it had the sound of water or the rush of wind. Listen to Vivaldi or Prokofiev. Can you hear the french troops getting closer in Tchaikovsky as the children play?

If your child decides to take music lessons, look for a teacher who has a good rapport with your child. By all means, if you have a school that has cut out music instruction, bring the importance of music to the attention of the school board!

It's never too late to be what you wanted to be. If you want to learn to play an instrument yourself, take some lessons! Be the example.

Get to Know E. coli

This is a post from an informative article found at The Centers for Disease Control and Prevention or CDC on E. coli O157:H7. It is printed in its entirety.

Escherichia coli O157:H7 is a leading cause of foodborne illness. Based on a 1999 estimate, 73,000 cases of infection and 61 deaths occur in the United States each year. In the ten CDC Foodborne Diseases Active Surveillance Network (FoodNet) sites (which represent 15% of the US population), there was a 29% decline in E. coli O157:H7 infection since 1996-98 (see FoodNet Reports).

Infection with E. coli often leads to bloody diarrhea, and occasionally to kidney failure. People can become infected with E.coli O157:H7 in a variety of ways. Though most illness has been associated with eating undercooked, contaminated ground beef, people have also become ill from eating contaminated bean sprouts or fresh leafy vegetables such as lettuce and spinach. Person-to-person contact in families and child care centers is also a known mode of transmission. In addition, infection can occur after drinking raw milk and after swimming in or drinking sewage-contaminated water.

Consumers can prevent E. coli O157:H7 infection by thoroughly cooking ground beef, avoiding unpasteurized milk, and by washing hands carefully before preparing or eating food. Fruits and vegetables should be washed well, but washing may not remove all contamination. Public service announcements on television, radio, or in the newspapers will advise you which foods to avoid in the event of an outbreak.

Because the organism lives in the intestines of healthy cattle, preventive measures on cattle farms, during meat processing, and during the growth, harvest and processing of produce are being investigated.

What is Escherichia coli O157:H7?

E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Although most strains are harmless, this strain produces a powerful toxin that can cause severe illness. E. coli O157:H7 has been found in the intestines of healthy cattle, deer, goats, and sheep.

E. coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of severe bloody diarrhea; the outbreak was traced to contaminated hamburgers. Since then, more infections in the United States have been caused by eating undercooked ground beef than by any other food.

The combination of letters and numbers in the name of the bacterium refers to the specific markers found on its surface and distinguishes it from other types of E. coli.

How is E. coli O157:H7 spread?

The organism can be found on most cattle farms, and it is commonly found in petting zoos and can live in the intestines of healthy cattle, deer, goats, and sheep. Meat can become contaminated during slaughter, and organisms can be accidentally mixed into meat when it is ground. Bacteria present on the cow's udders or on equipment may get into raw milk. In a petting zoo, E.coli O157:H7 can contaminate the ground, railings, feed bins, and fur of the animals.

Eating meat, especially ground beef, that has not been cooked sufficiently to kill E. coli O157:H7 can cause infection. Contaminated meat looks and smells normal. The number of organisms required to cause disease is very small.

Among other known sources of infection are consumption of sprouts, lettuce, spinach, salami, unpasteurized milk and juice, and by swimming in or drinking sewage-contaminated water.

Bacteria in loose stool of infected persons can be passed from one person to another if hygiene or hand washing habits are inadequate. This is particularly likely among toddlers who are not toilet trained. Family members and playmates of these children are at high risk of becoming infected.

Young children typically shed the organism in their feces for a week or two after their illness resolves. Older children and adults rarely carry the organism without symptoms.

What illness does E. coli O157:H7 cause?

People generally become ill from E. coli O157:H7 two to eight days (average of 3-4) after being exposed to the bacteria. Escherichia coli O157:H7 infection often causes severe bloody diarrhea and abdominal cramps. Sometimes the infection causes non-bloody diarrhea or no symptoms. Usually little or no fever is present, and the illness resolves in 5 to 10 days.

In some persons, particularly children under 5 years of age and the elderly, the infection can also cause a complication called hemolytic uremic syndrome (HUS), in which the red blood cells are destroyed and the kidneys fail. About 8% of persons whose diarrheal illness is severe enough that they seek medical care develop this complication. In the United States, HUS is the principal cause of acute kidney failure in children, and most cases of HUS are caused by E. coli O157:H7.


How is E. coli O157:H7 infection diagnosed?

Infection with E. coli O157:H7 is diagnosed by detecting the bacterium in the stool. About one-third of laboratories that culture stool still do not test for E. coli O157:H7, so it is important to request that the stool specimen be tested on sorbitol-MacConkey (SMAC) agar for this organism. All persons who suddenly have diarrhea with blood should get their stool tested for E. coli O157:H7.

How is the illness treated?

Most people recover without antibiotics or other specific treatment within 5 to 10 days. Antibiotics should not be used to treat this infection. There is no evidence that antibiotics improve the course of disease, and it is thought that treatment with some antibiotics could lead to kidney complications. Antidiarrheal agents, such as loperamide (Imodium®), should also be avoided.

In some people, E. coli O157:H7 infection can cause a complication called hemolytic uremic syndrome (HUS), a life-threatening condition that is usually treated in an intensive care unit. Blood transfusions and kidney dialysis are often required. With intensive care, the death rate for hemolytic uremic syndrome is 3%-5%.

What are the long-term consequences of infection?

Persons who only have diarrhea usually recover completely.

A small proportion of persons with hemolytic uremic syndrome (HUS) have immediate complications with lifelong implications, such as blindness, paralysis, persistent kidney failure, and the effects of having part of their bowel removed. Many persons with hemolytic uremic syndrome have mild abnormalities in kidney function many years later.

What can be done to prevent the infection?

Cattle are the principal source of E. coli O157 infection; they carry E. coli O157 in their intestines. Changes in the preparation of animals for slaughter and in slaughter and processing methods could decrease the contamination of carcasses with E. coli O157 and the subsequent contamination of meat. Testing ground beef for E. coli O157 and withholding it from the market until the test is negative, as many meat producers began doing in 2002, is probably partly responsible for the subsequent decrease in illnesses.

Cattle manure is an important source of E. coli O157. Manure can contaminate the environment, including streams that flow through produce fields and are used for irrigation, pesticide application, or washing. Collaborative efforts are needed to decrease environmental contamination and improve the safety of produce.

What can you do to prevent E. coli O157:H7 infection?

Cook all ground beef and hamburger thoroughly. Because ground beef can turn brown before disease-causing bacteria are killed, use a digital instant-read meat thermometer to ensure thorough cooking. Ground beef should be cooked until a thermometer inserted into several parts of the patty, including the thickest part, reads at least 160º F. Persons who cook ground beef without using a thermometer can decrease their risk of illness by not eating ground beef patties that are still pink in the middle.

If you are served an undercooked hamburger or other ground beef product in a restaurant, send it back for further cooking. You may want to ask for a new bun and a clean plate, too.

Avoid spreading harmful bacteria in your kitchen. Keep raw meat separate from ready-to-eat foods. Wash hands, counters, and utensils with hot soapy water after they touch raw meat. Never place cooked hamburgers or ground beef on the unwashed plate that held raw patties. Wash meat thermometers in between tests of patties that require further cooking.

Drink only pasteurized milk, juice, or cider. Commercial juice with an extended shelf-life that is sold at room temperature (e.g. juice in cardboard boxes, vacuum sealed juice in glass containers) has been pasteurized, although this is generally not indicated on the label. Juice concentrates are also heated sufficiently to kill pathogens.

Wash fruits and vegetables under running water, especially those that will not be cooked. Be aware that bacteria are sticky, so even thorough washing may not remove all contamination. Remove the outer leaves of leafy vegetables. Children under 5 years of age, immunocompromised persons, and the elderly should avoid eating alfalfa sprouts until their safety can be assured. Persons at high risk of complications from foodborne illness may choose to consume cooked vegetables and peeled fruits.

Drink municipal water that has been treated with chlorine or another effective disinfectant.

Avoid swallowing lake or pool water while swimming. (For more information, see the CDC Healthy Swimming website.)

Make sure that persons with diarrhea, especially children, wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection, and that persons wash hands after changing soiled diapers. Anyone with a diarrheal illness should avoid swimming in public pools or lakes, sharing baths with others, and preparing food for others.

Omission is Commission

This is an open letter to the public-at-large. I hope this may help families particularly in Utah and other Western States like Idaho, Wyoming, Colorado, Nevada, Arizona and New Mexico, where E. coli has been prevalent recently and has injured and even caused death.

E. coli has dramatic effects and unfortunately, it appears to be again on the rise after a downward trend. I have been involved with E.coli cases involving Dole, Wendy's, and other companies serving hamburger, spinach and lettuce. It's impact is devastating. Some may read this and believe that I'm just an attorney out to make a buck. While it is true this is what I do for a living and I do make money suing companies that harm my client's, making money for myself and my client's is not why I do it. I do it to help stop the spread of this leading cause of foodborne illness. Companies will change when their pocketbooks are hurt and they start to see the faces and families that they hurt. Their insurers will do likewise.

I live in the conservative State of Utah. Many residents of the West are conservative, strong willed and independent, all great qualities. I commonly am confronted with the notion that suing is inherently evil or immoral. Some have even suggested that the loss of life or permanent damage caused by an illness like E. coli, is even God's will and that the best thing to do, is move on and not involve themselves in a lawsuit. I truly try to appreciate and respect all points of points of view and certainly being non-litigious is a valid point of view. I have even written about using litigation as a last resort. I feel for families confronted with such great loss and their willingness to forgive. But there is a difference between forgiving and forgetting. You don't have to hate a company to pressure it to change. On the other hand, just forgetting about it, in my opinion, is wrong.

Unfortunately, the real world is not fair. The star money players in agri-business don't even play in the same arena as you and I. They are surrounded with legal armor and quite frankly, don't want you to show up, they'd just rather focus on market share and making money. When something that can literally kill is allowed to continue because agri-business has not cleaned up it's act, it is not fair. But doing nothing and allowing it to happen becomes part of the problem. If you don't want to make money after you or a family member has gone through the suffering of E. coli and perhaps HUS, donate the money you will potentially receive to a hospital, to a charity that helps survivors, or create a scholarship fund for a deserving medical student. In other words, do something good! Doing nothing is not acceptable. What we have been waiting for is you. Be the difference. Confronting the producers and sellers of E. coli tainted food is the right thing to do, not only for you, but others that need your example of doing. That's why, I would argue in great measure, that we saw a downward trend in the 1990's. Clients and their attorneys such as the pioneering law firm Marler Clark were and still are taking it to the businesses that cause the problem. Agri-business started to clean up their act. They started to get the message. Rational inaction will not win this fight. We need you. If you were hurt by E. coli, don't let it continue to hurt by doing nothing.

Uncle Bill Is Too Busy

Unfortunately, the food undustry is still too busy trying to keep Bill Marler in business. Don't get me wrong, it's part of my business as well. Bill and I met one day about 8 years ago. I was knee deep in a Salmonella case involving a past divorce client of mine who unfortunately found himself on dialysis after eating at a buffet in a casino in Nevada. I'd never seen anyone so sick and so near death. My client had gone to the casino to place a bet, he just didn't know he'd be betting his life while eating eggs. After some initial research on the net where Marler's name came up about 10 times, I began thumbing through my then issue of National Geographic. Low and behold, there was an article on World food supply and illness. In the article was a photo of Bill Marler and a reference to Jack in the Box. I literally called Bill with the article still in my lap. We teamed up on my case. He and his very astute partner, Bruce Clark, flew down to meet me and my client(Oh, and we went fly fishing too on the Provo River). I learned a great deal by being around Bill and Bruce and still do to this day. The one thing that has stuck me is that Bill doesn't care about the money. If he could, he'd do it for free. What he cares about are his clients and that they are compensated for the injuries inflicted upon them by the careless people and entities that keep poisoning them. Please, put Bill Marler out of business. I hope one day Bill, Bruce and I can go fly fishing without worrying about the multiple cases of food poisoning we are now faced with--like a slow river without a worry in the world. See a recent AP article about Bill:
http://ap.google.com/article/ALeqM5gak52KP5ZmMn9wjYcwpKfrl8hC2wD8UJMEEG0

You're No Steve Gadd

I remember the line that Senator Lloyd Bentsen, the then Democratic vice-presidential nominee, shot at Dan Quayle (Potatoe) after he had made comparison of himself to the late President John Kennedy. "I knew John Kennedy. John Kennedy was a friend of mine, and Senator, you're no John F. Kennedy." Quayle's career never recovered nor did his spelling.

I can't say I know Steve Gadd. I've met and talked to him a couple of times, attended a few clinics, been to several concerts where he was the drummer, and listened to 90% of his discography (take a look--you know this guy, I guarantee it http://www.drstevegadd.com/discography.htm ). What I do know, is that he is an original. Is he the best drummer out there? No. There are guys out there, perhaps I should say German drummers out there, that are beyond human. You can watch what they do over and over and still have no idea what or how they do it. No, who Steve Gadd is, is the guy who broke the trail of innovation for everyone else to follow. We are all followers of Steve. A real drummer will never say differently. If you don't believe this, just ask. If they stare at you blankly they need to go back and start over, or at least take some lessons. What Steve brings, besides a tasty technique and bucket load of innovation, is emotion. He literally becomes the song, the rhythm, the beating heart. Watch him play in any live performance. Find him on Youtube or a DVD with Eric Clapton on the song, "Old Love." You'll see what I mean. http://www.youtube.com/watch?v=EklciRHZnUQ

When I first heard his solo on the title track to Steely Dan's album from the 70's Aja, I was mesmerized. I still am. It is a classic drum solo. It's now over 30 years old and I still find it fresh. Take a cleansing breath, take 8 minutes out of your busy day and listen to it. You can find the tune on the net. http://www.youtube.com/watch?v=KaNt5S9pibQ Better yet, go down into your basement and go get the 33 vinyl, dust off your old turntable and play one of the best engineered albums of all time. Trust me, it will be better than any presidential debate you have heard.