bill marler: dissecting the science behind food poisoning legal claims
TRANSCRIPT
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Dissecting the Science Behind Salmonella, Listeria and E. coli Claims
An Examination of How the Science Links to Causation and Opens the Door to Liability
William D. Marler, Esq.
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To Put Things in Perspective
• According to the CDC, pathogens in food cause an estimated 48 million cases of human illness annually in the United States
• 125,000 hospitalized
• Cause up to 3,000 deaths
• Illnesses from food poisoning pose a $75 to $125 billion economic burden in the United States annually
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Estimates Differ From Actual Counts
• Annual E. coli O157:H7
Estimates:
– 62,000 illnesses
– 1,800 hospitalizations
– 52 deaths
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Bottom Line: Most Victims Never Linked
E. coli O157:H7Patterns Submitted 5,376Clusters Identified 67Multi-state Clusters 36Epi Investigation 19Vehicle Implicated 4Regulatory Activity 4
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Ill person
Specimen collection
The Long Pathway of a Foodborne Illness Investigation
Health Care Provider
Organism identified
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Ill person
Organism identified
Specimen collection
The Pathway Continued
Health Care Provider
Epidemiologic investigation
Public Health Laboratory
If there are more ill persons than expected, an
OUTBREAK might be underway
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Ill person
Organism identified
Specimen collection
Pathway of a Foodborne Illness Investigation
Health Care Provider
Epidemiologic investigation
Public Health Laboratory
Environmental investigation
Product Trace BackPRODUCT RECALL
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Proving a Case Using Lab Tests
• All states require reporting of tests for a number of pathogens, including;
– E. coli O157:H7
– Salmonella
– Shigella
– Listeria
– Hepatitis A
– Campylobacter
• The process of obtaining the DNA fingerprint is called Pulse Field Gel Electrophoresis (PFGE).
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Proving a Case with PulseNet
• PulsetNet is an early-warning system for outbreaks of foodborne disease.
• Using this system scientists at labs throughout the country can rapidly compare the PFGE patterns of bacteria from ill persons to help determine where the outbreak occurred.
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Proving a Case Using PFGE
• The PFGE pattern of bacteria isolated from contaminated food can be compared and matched to the PFGE pattern of the strain isolated from the stool of infected persons.
• When paired, PFGE and epidemiological evidence are extremely potent in supporting causation.
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Causation - Science
• “Causation is an essential concept in epidemiology, yet there is no single, clearly articulated definition ….” J Epidemiol Community Health 2001Dec;55(12):905-12; Parascandola M, Weed DL.
• Confidence Interval (CI) – Range within which 95% of times the true value of the estimated association lies (95% CI)
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Causation – The Law
• “A proximate cause of an injury is a cause which, in natural and continuous sequence, produces the injury, and without which the injury would not have [likely] occurred. The concept of proximate causation has given courts and commentators consummate difficulty and has in truth defied precise definition.” Prosser, Torts, pp. 311-313
• However, “It really is what is more likely than not. It is 50% and an extra grain of sand.” Marler on the law
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Resources
• Food Safety News
• Foodborne Illness Outbreak Database
• Marler Blog
• Occupy Food Safety
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Questions?