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Foodborne Illnesses Have Turned Food Shopping and Eating Out Into a Risky Game of Chance

Jun 1, 2009

Foodborne Illnesses Have Turned Food Shopping and Eating Out Into a Risky Game of Chance

Last month, we presented a detailed discussion of the most common foodborne illnesses and how you can protect yourself from them at home. The story does not end there, however, since your ability to avoid exposure to many of these pathogens becomes more of a game of "Russian roulette" once you place your trust in food from any store, farmers' market, restaurant, street vendor, sporting event, concert, or even a charity cookout.

Once food is cooked, stored, packaged, processed, refrigerated, or handled by other people or where any type of equipment is used in food preparation, you must take an active role in protecting yourself and your family from the serious, and sometimes fatal, consequences of foodborne illnesses.

Today, more than ever before, outbreaks of foodborne illnesses are becoming a common occurrence. Careless food handling in restaurants or processing facilities, unsanitary equipment, inaccurate or defective heating or refrigeration units, and sub-standard inspection practices, put members of the public at risk on a daily basis. Moreover, once an outbreak occurs, the search for its origin is like looking for the proverbial "needle in a haystack."

With the increased popularity of fast-food restaurants and the need for giant wholesale food processors to distribute their products quickly through a nationwide supply chain, foodborne illnesses not only appear suddenly but also spread rapidly throughout the country. The day of a few people getting sick from the food at a local restaurant has long since passed. Today, localized food-related problems are of little consequence when compared to 30,000,000 pounds of tainted meat distributed throughout 35 or 40 states.       

Cleanliness in restaurants, cafeterias, sports arenas, hospitals, passenger jets, schools, and other places that sell or dispense prepared foods can be literally a matter of life and death. Every locality, from major cities to small towns, is regularly exposed to significant dangers from foodborne illnesses emanating from sick workers, restaurant chains, and food manufacturing and distribution plants.

Most people rely on little more than their own judgment or restaurant reviews to form an opinion as to how clean, a restaurant is. Unfortunately, without knowing more about what is actually going on behind the scenes, customers are often jolted back to reality by a cockroach walking across their table, a mouse turning up in their fried chicken, or a trip to the emergency room (or worse). Today, such occurrences are on the rise, and the consequences are becoming more and more serious. In fact, litigation based upon foodborne illnesses has dramatically increased in the past few years.

Is "Dirty Dining" On Today's Menu?

In order to help maintain appropriate sanitary conditions in restaurants, the Food and Drug Administration (FDA) drafted the Food Code, a set of rules which is updated every two years. The Food Code includes recommended temperatures for cooking, cooling, refrigeration, reheating, and holding food in food-service establishments.

Finding a foreign object or substance in your food can be an unsettling and nauseating experience. Sometimes, the kinds of things found in food simply defy the imagination. Insects (whole or parts), rodent droppings, live worms, maggots, mice, condom wrappers, used band-aids, flies, sharp metallic objects, broken glass, garbage, other food that is rotten or spoiled, and blood are some of the things customers or health inspectors have found in food that is being served to the public. In one case, an employee of a fast food restaurant was actually observed bleeding from a hand wound onto a customer's order. Thus, the first lesson to be learned is that, when eating out, you should always pay close attention to what you are eating as well as to your surroundings.

While you will not be able to see microscopic bacteria that have made their way through the food preparation process, you certainly can observe many of the open and obvious conditions that strongly suggest an eating establishment or food store is unsanitary and potentially dangerous. If you ignore such warning signs, you may have only yourself to blame for the consequences. 

Garnishes and Samples May Be Hazardous to Your Health

Sometimes innocent additions to food can be a breeding ground for all sorts of germs. Lemon wedges or any type of vegetable or fruit additions that are pinned on to a meal for decoration can be full of foodborne bacteria. Chefs may accidentally use dirty knives or waiters or bartenders may handle the garnish with unwashed hands. Often, cherries, and slices of lemons, limes, and oranges remain for hours (or days) in open containers in kitchens and at bars where they are prime candidates for bacterial contamination. These seemingly trivial bad habits can lead to exposure to such bacteria as E. coli.


There is also the common practice of stores, restaurants, and bars giving away samples of new products, appetizers, or even peanuts and pretzels from open serving containers. Imagine a bar patron, with a communicable disease, eating peanuts from an open bowl for two or three hours, while dozens of other patrons do the same. Likewise, how many times have you seen samples of a new type of cracker, chips, or bread in an open bowl in a supermarket? Think about who might be reaching into that bowl ahead of you or your child.


Dateline's Investigation

In November of 2003, Dateline NBC presented a report on the fast food industry called "Dirty Dining." Using hidden cameras, the network's goal was to heighten the public's awareness of the extent to which tens of millions of people are exposed to unsanitary and unhealthy conditions every day at America's top 10 fast food chains. One hundred restaurants from each fast food chain, a total of 1000 in 38 states, were examined.

The investigators were looking for "critical violations," which are situations that may result in food becoming contaminated. Such violations include things like employees handling ready-to-eat food with bare or unwashed hands, undercooked meat, improper food-holding temperatures, sick employees preparing food, the presence of insects or rodents, or anything else which poses a direct health risk to the customer.

The various restaurant chains inspected were ranked from best to worst. The rankings included the number and nature of the "critical violations" found. (The numbers in parentheses represent the total number of critical violations)

  • Taco Bell (91): Including dirty food preparation, unclean counters, and rodent droppings;
  • McDonald's (136): In addition, some locations did not have a certified food handler on the premises which is required by law in most states. The food handler is responsible for guaranteeing that meat is prepared properly and in accordance with health regulations;
  • KFC (157): Including salmonella poisoning;
  • Subway (160): The most prevalent being a recurring problem of improper food holding temperatures which promotes accelerated bacterial growth;
  • Jack in the Box (164): Mostly related to food borne illness;
  • Dairy Queen (184): Including grime, debris, and an inaccurate thermometer;
  • Hardees (206): Due to the presence of insects and rodents. One restaurant was even cited for not having soap in the employee sink, while employees were found handling ready-to-eat food with their bare hands;
  • Wendy's (206): Including improper food holding temperatures, mice droppings on shelves, bare hand food contact, and one food borne illness complaint;
  • Arby's (210): Including improper hand-washing and employees handling ready-to-eat food with their bare hands;
  • Burger King (241): One Burger King in Virginia had 14 separate critical violations including employees not washing their hands, uncovered food in the refrigerator, grime and debris on the ice chute and drink machine at the drive-thru window.

More than 60% of all the fast food restaurants that were examined had at least one critical violation within 18 months of the survey. Out of the 1,000 restaurants included in the investigation there were a total of 1,755 critical violations and 613 restaurants were cited at least once.

Although all of these critical violations were cited by health inspectors, government agencies should not have to be relied on to find such problems since such a procedure is, at best, a hit or miss proposition. Restaurants should have their own internal standards and all owners and managers should be responsible for conducting daily inspections. Steve Grover, a representative of the National Restaurant Association argues that "99.9 percent is not good enough when it comes to food safety." Most customers would certainly agree with this statement since they are placing their trust in restaurants to provide the highest sanitary conditions possible to their customers.

After this expose was aired, each of the restaurant chains profiled responded to the NBC report. Some were more critical of themselves than others, some were apologetic, and some were defensive. On the whole, however, all expressed concern and each promised to do whatever was necessary to ensure that the problems were taken care of and avoided in the future. The actual letters can be found on the web at

Employee Negligence or Misconduct Can Take a Toll on Your Health

In the past several years, there have been numerous cases involving food contamination that has been traced to either negligent or intentional conduct on the part of employees at various restaurants or fast food outlets.


In 2005, a family from Sidney Nebraska received $40,000 after they filed a lawsuit against Taco Bell for tainted food. Two children of the family, 4 and 7, fell ill after eating food that was contaminated with urine and saliva by employees. One child suffered from dehydration and gastrointestinitis and had to be hospitalized. Although some believe this was an attack directed toward the father of the children (since he was a police officer), this proves that anyone can fall victim to unsanitary conditions. The lawsuit also alleged that managers knew of the employee's actions but failed to inform the family.


In a highly publicized incident in 2008, one Burger King employee recorded a co-worker taking a bath in a large sink at the restaurant where they both worked. Several employees as well as a manager were fired after the video made its way to the internet. The sink was sterilized before an official inspection could be conducted.  


Dominos also suffered a blow to its reputation as a result of two employees who recorded themselves contaminating a sandwich. That video also ended up online. Both employees were fired and face criminal charges.


Smaller Does Not Mean Safer

Fast food restaurant chains are not alone when it comes to critical health violations. Individually owned restaurants, even exclusive ones, are prone to the very same problems when food preparation and handling fall below acceptable standards.


For example: In California, investigative reporters, Will Harper and Kelly Luker, compiled a list of restaurants which they deemed "The Dirty Dozen." The restaurants were chosen by reviewing establishments with the lowest inspection scores (from 0-65 out of a possible 100) and the most severe, consumer complaints. They first reviewed approximately 16 months of data and then visited each restaurant for a visual inspection and to assess food preparation and taste.

Although some of the restaurants had been closed several times for repeated critical violations, they continued to reopen. According to Harper and Luker, "[d]epartment officials are loath to punish violators. Between Jan. 1st 1999 and April 30th 2000, records indicate that the county shut down only 21 restaurants-usually for less than a day." 


One Chinese restaurant was shut down three times due to housekeeping problems, preparing raw food near vegetables, stinky garbage, inappropriate hygiene by employees, and serving foods at room temperature, which can promote bacterial growth. The restaurant continued to reopen, however, without permanently correcting the problems. Most of the Asian restaurants in this study were found to have repeated violations such as food being stored at improper temperatures, vermin, and unsanitary kitchen facilities. This investigative report can be found at

An investigation by ABC Action News in Tampa, Florida targeted a different aspect of the food distribution chain, namely the State's inspection system, after a woman suffered salmonella poisoning as a result of eating at a barbeque restaurant in the Bay area. The victim has permanent health problems which have left her crippled. In all, 33 people got sick from eating at the same restaurant, with most of them suffering salmonella poisoning.

ABC concluded that the problem was not simply one bad restaurant but, rather, the result of a poorly run health inspection program. Too few inspectors with too many restaurants to inspect caused the overburdened inspectors either to rush inspections or even fabricate results in order to "make quota." Remarkably, one inspector, who falsified reports, was promoted to supervisor.


With all of these potential problems lurking in any given restaurant, it is important to know how to avoid getting sick from bad food or unsanitary conditions. Phil Lempert, who wrote an article entitled "Dirty Dining Out," offers many helpful suggestions for safer dining. Here is his checklist of what to look for and what to avoid:

  • Check out the restaurant in the newspaper or on the internet. Some cities have mandatory cleanliness postings available.
  • Inspect the restaurant upon walking in. Chefs and health inspectors agree that a clean bathroom is a good indicator of the level of cleanliness in the entire restaurant.
  • If you cannot look at the kitchen or the chef, observe the wait staff's personal hygiene. After all, these are the people who will be handling your food.
  • If the restaurant has refrigerated display cases for desserts or other foods, touch the outside to make they are cool and look through the glass to make sure the cases are clean and the foods appear fresh.
  • Make sure that your table is cleaned with clean paper towels and disinfectant before you are seated. Cloth towels and sponges are breeding grounds for bacteria if they are repeatedly used, not laundered or disinfected properly, or not regularly replaced.
  • Condiments should be in one way serving containers like a squeeze bottle. Ask for fresh oils and butters if it looks like the ones at your table have already been used. (We might add that open bowls of pickles that remain on the table from sitting to sitting should be avoided. Likewise, any condiment dispenser that appears to be dirty or encrusted with dried condiment should not be used).
  • Inspect your food carefully before you start eating.
  • Be sure to order your foods cooked properly and avoid raw or undercooked foods like steak tartare, or raw shellfish. Avoid meats that are blood red or rare, chicken that is pink or bloody on the inside, runny eggs, shellfish that does not have the shell open and fish that does not flake to the fork.
  • Plates, glasses, and silverware should be spotless, un-cracked, and un-chipped.
  • If your food is not prepared properly SPEAK UP! Send it back to the kitchen and be sure that when they bring it to you again, the other foods on the plate are new as well. Cross-contamination caused by tainted or undercooked foods is a serious problem.
  • When "doggie bags" are necessary, make sure all the foods are packaged separately and refrigerated within an hour of leaving the restaurant.


The New York City Department of Health and Mental Hygiene conducts unannounced inspections of all food-service establishments in the City so that a restaurant will not have time to cover up unsafe practices. Other cities have similar inspection procedures, yet there is no guarantee that every restaurant is operating safely at all times. You remain your last line of defense each time you dine out. The importance of being vigilant cannot be overstated.

While some problems may be minor and easily corrected, some are quite serious and may even be life threatening. In either case, however, the public is at risk and should neither be exposed to a minor bout of indigestion nor a serious, or even, fatal illness. Since there are many sources available to check the inspection history of a restaurant in most cities, you should always take advantage of them. The following websites contain information about restaurant inspections and other food-related topics:


You may also seek specific information on foodborne illnesses and outbreaks at 


The following is a list of noteworthy incidences of foodborne illnesses leading to food recalls and/or illnesses:



In 2002, a Listeria outbreak in Vancouver, British Columbia, caused two pregnant women to have miscarriages. The outbreak was a result of bad cheese served at a hotel.

In 2006, Listeria monocytogenes were found in 7-ounce bags of imitation crab dip. The contamination was discovered in time and customers who purchased the product were given a refund.


In 2000, many families filed lawsuits against Senor Felix Gourmet Mexican Foods in California as a result of contaminated dip. More than 335 people in Washington, California, Oregon, Idaho, New Mexico, Arizona and Alaska were affected by Shigella with symptoms such as severe diarrhea, nausea, fever and stomach cramps.

Hepatitis A

In 2008, over twenty customers who ate at a Chipotles restaurant in California contracted Hepatitis A. The outbreak may have been started by an infected worker.  

Customers at a Houlihans restaurant in Chicago needed to be inoculated, as a precaution, after being exposed to a worker at the restaurant who had Hepatitis A.

Large fast food chains such as Taco Bell, Subway and Quinzno's, have had problems with Hepatitis A exposure. 


One outbreak in a Washington State penitentiary was traced to a contaminated stainless steel food preparation table; 38 inmates and 4 staff members fell ill. After the outbreak, the penitentiary changed food preparation practices to include stressing hand-washing among inmates, requiring food handlers to wear gloves during preparation and serving, and thoroughly sanitizing food preparation surfaces.

E. Coli

In 2007, an outbreak of E. Coli led to a recall of 300,000 pounds of ground beef patties processed by Topps Meat Company in New York after 6 people fell ill. Health authorities found a box of the patties, which contained the E. coli O157:H7 strain, in one of the victim's freezer. The bacteria contaminated a few of Topps' products and cases of E. coli were reported in Connecticut, Florida, Indiana, Maine, New Jersey, Ohio and Pennsylvania.


In the past year, there have been an alarming number of recalls involving peanut butter products emanating from Peanut Corporation of America. Since January 2009, thousands of human products, as well as animal products, have been recalled due to traces of salmonella from a contaminated processing plant in Georgia.

Although Peanut Corporation is the source of the problem, there is still confusion as to which products are tainted since the company not only makes their own products but also supplies peanut butter-based products such as creams and pastes to other companies, which use them as ingredients in cereal bars, crackers, and baked goods.

Thus, even extremely reputable companies such as Kellogg's and Keebler had to recall some of their products that contained peanut butter processed by Peanut Butter Corporation. 

There have also been recalls in pistachio nuts and peppers in recent years due to salmonella contamination.

Recently the FDA has improved regulations regarding the safety of egg distribution in order to prevent future outbreaks of Salmonella. The new regulations require egg producers to keep up-to-date records of their products and report them to the FDA. This is an attempt to find the needle before it makes it to the haystack.


In 2007, four cases of Botulism occurred in Texas and Indiana as a result of poisoning from Castleberry Hot Dog Chili Sauce. Since Botulism is anaerobic, and can survive without oxygen, sealed containers present a prime breeding ground. The offending product in this case was canned chili sauce from a factory in Augusta that were inadequately heated before sealing.  

Norwalk Virus (Norovirus)

At the 2002 Academy of Motion Pictures Arts and Sciences, Scientific and Technical Awards, the virus affected several guests at the Regent Beverly Wilshire Hotel and was traced to food delivered to the hotel, with lobster bisque being the likely cause of the outbreak.

Outbreaks of Norwalk Virus in the U.S. have been linked to raw shellfish, especially oysters, and clams. Even steaming does not kill the virus or prevent its transmission. Contaminated water, ice, eggs, salad ingredients, and ready-to-eat foods have also been known to cause outbreaks of Norwalk Virus. In 2002 alone, there were 9 major Norwalk outbreaks in the United States.

Recently, an Olive Garden in Indianapolis, where some employees tested positive, was blamed for approximately 370 cases of the virus.  


Although not exclusively a foodborne bacteria, cryptosporidium can find its way into water. In the early 1990s, a massive outbreak of cryptosporidium occurred when a water treatment plant in Milwaukee failed to remove the bacteria from the water supply before distribution.


In May 1996 berries served at a catered wedding reception were suspected of infecting some 50 guests. Since Cyclospora resides in fecal matter, contaminated dirt in countries that do not have the resources to properly clean the soil where food crops are grown allows these bacteria to contaminate fruits and vegetables, which are then imported into the U.S.

Risky Practices and Greed Also Pose a Threat

Even when specific foodborne illnesses are not present or suspected, unscrupulous or negligent practices as well as greed place our food supply in danger of contamination. a prime example of this occurred in February 2008, when the Agriculture Department ordered the largest meat recall in history because the company implicated did not prevent ailing animals from entering the U.S. food supply.

Some 143 million pounds of beef, a California meatpacker's (Westland Meat) entire production for two years was involved. USDA officials believed the meat posed little or no hazard to consumers, and most of it was eaten long before the recall was issued. The recall came shortly after a videotape was released that showed serious violations of federal animal care regulations by employees of a Westland partner, Hallmark Meat Packing in Chino, California.

Hallmark failed to consistently bring in federal veterinarians to examine cattle headed for slaughter that were too sick or weak to stand on their own and, as a result, the affected cattle did not receive complete and proper inspection.

About 37 million pounds of the in various forms went to school lunch and other public nutrition programs where it was probably consumed before the recall. Some larger purchasers, however, sometimes keep meat for as long as a year.

In 2007, the USDA issued 20 meat recalls, including one of more than 20 million pounds, which prompted Sen. Tom Harkin of the Senate Agriculture Committee to call on the agency to toughen its inspection requirements stating, "How much longer will we continue to test our luck with weak enforcement of federal food safety regulations?" 

Even the National Cattlemen's Beef Association "support[ed] USDA's recall as a precautionary measure. At the same time, we can say with confidence that the beef supply is safe. . . . There are multiple safety hurdles before it arrives at our grocery stores or restaurants," said James O. Reagan, who chairs the organization's Beef Industry Food Safety Council.

Some 150 school districts and two fast-food chains, Jack in the Box and In-N-Out, announced they will no longer use ground beef from Westland. 

If you or a loved one has suffered a foodborne illness attributable to the negligence or misconduct of an eating establishment, food store, or food processor/distributor, contact Parker Waichman LLP at  for a free case assessment.

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