Excel (Cargill) Beef Kills A Three Year-Old Girl in
Milwaukee--Restaurant Patrons Beware

Modern Meat: Buyer Beware
An Outbreak Waiting to Happen
<http://www.washingtonpost.com/wp-dyn/articles/A56616-2001Apr8.html>
Beef-Inspection Failures Let In a Deadly Microbe

By Joby Warrick
Washington Post Staff Writer
Monday, April 9, 2001; Page A01

MILWAUKEE -- "Did your daughter eat meat that was pink or red?"

The nurse's question puzzled Connie Kriefall. In an intensive care ward a
few steps from where the young mother stood, doctors were struggling
to save her only daughter, a 3-year-old with sapphire eyes and a mysterious
disease.

In six days, tiny Brianna Kriefall had gone from a healthy preschooler with
a tummy ache to a deathly sick child with advanced organ failure. Her kidneys
had quit. Her heart was faltering. And now a nurse was asking: Could this
be E. coli?

Kriefall's mind raced back to dinner at a Sizzler restaurant the previous
week. Brianna had chosen the children's buffet, she remembered.
Watermelon, cantaloupe, cheese. Nothing likely to carry E. coli.
"That just couldn't be possible," she said.

But the outbreak that killed Brianna and sickened more than 500 others here
in July was not only possible, it was foreseeable. A series of systemic failures
by government and industry all but guaranteed that potentially deadly microbes
would make their way into a kitchen somewhere in America. It was simply a
question of when.

For decades, the familiar purple "USDA-inspected" stamp has given
Americans confidence that their meat supply is safe. But for the Kriefalls,
like thousands of other families stricken by meat-borne pathogens each
year, this veneer of safety proved dangerously deceptive.

Wisconsin health investigators later concluded Brianna Kriefall died from
eating watermelon that Sizzler workers had inadvertently splattered with
juices from tainted sirloin tips. The meat came from a Colorado slaughter-
house where beef repeatedly had been contaminated with feces, E. coli's
favorite breeding ground. Federal inspectors had known of the problems
at the plant and had documented them dozens of times. But ultimately
they were unable to fix them.

Nearly a century after Upton Sinclair exposed the scandal of America's
slaughterhouses in his novel "The Jungle," some of the nation's largest
meatpacking plants still fail to meet federal inspection guidelines to
produce meat free of disease-carrying filth, an investigation by The
Washington Post and Dateline NBC has found.

U.S. Department of Agriculture inspectors who patrol the nation's 6,000
meatpacking plants today are armed with more modern tools and tougher
standards than ever. But the government's watchdog agency often has
lacked the legal muscle and political will to address serious safety threats.
It cannot impose civil fines or recall meat even when its inspectors see
problems that could lead to outbreaks.

In the Milwaukee case, one of the nation's largest, most modern meatpacking
plants Excel Corp.'s Fort Morgan, Colo., facility was cited 26 times over a
10-month period before Brianna Kriefall's death for letting feces contaminate
meat, documents show. Despite new government controls on bacteria launched
three years ago, the plant shipped out beef tainted with E. coli on at least four
occasions. The last shipment delivered the pathogens that ended up in the
children's buffet at the suburban Milwaukee Sizzler.

"It was like making Fords without brakes," said Michael Schwochert, a
veterinarian and retired federal inspector who worked at the Excel plant.
"We used to sit around the office and say, 'They're going to have to kill
someone before anything gets done.',"

Excel officials said they were unable to talk about the Milwaukee outbreak,
citing litigation. In a statement, Excel said it uses cutting-edge technology to
prevent contamination, but food must be properly cooked and handled to
ensure safety. "Excel is committed to providing safe food for people," the
company said.

A lawyer for the Sizzler franchise in suburban Milwaukee said the restaurant
owners still did not know how the outbreak occurred, but had reached
settlements with numerous sickened customers. "The owners have been
devastated by this outbreak," attorney Ron Pezze Jr. said.

Criticism of the USDA's enforcement record comes as domestic E. coli
outbreaks and epidemics of mad-cow and foot-and-mouth disease in
Europe heighten concerns about America's meat supply. Contamination
similar to that found at Excel was documented at several other plants
around the country in an internal agency report a month before the
Milwaukee outbreak.

The USDA's inspector general, in a sharply critical review of the agency's
inspection system, said the government's safety net for consumers was
being compromised by confusing policies, blurred lines of authority
and a lack of options for enforcement. At some plants, regulators
frequently were finding tainted beef but doing nothing because they
simply "were unaware of any actions to take," the report said.

"How long does it take for a 'bad' plant to be listed as bad? We can't tell
you," USDA Inspector General Roger Viadero said in an interview,
"because [the USDA] has not told the inspector what's bad."

USDA officials at the Excel plant were still searching for that line last
June 14 when they sent the last in a series of warnings to the plant's
management. Nine days later, records show, a package of
contaminated meat left the factory and ended up at the
Sizzler in Milwaukee.

"It was like a ticking time bomb by the time it got to the Sizzler
restaurant," said William Cannon, attorney for the Kriefall
family. "And unfortunately, this ticking time bomb killed Brianna Kriefall."
A Safer System?


The internal struggle over beef quality at the Excel plant would likely
have never attracted public attention were it not for two headline-
generating events.

The first came in August 1999 with the chance discovery in a USDA
random survey of E. coli in Excel beef at an Indiana grocery store.

The second was the Milwaukee E. coli outbreak last summer. In one
of the worst such incidents in state history, more than 500 people got
sick, 62 with confirmed E. coli infections.

What happened between the two incidents starkly illustrates how
problems at modern meat plants test the limits of the USDA's new
inspection and meat safety system.

Located on a dry plain 80 miles northeast of Denver, the Excel factory
is an imposing agglomeration of smokestacks and aircraft hangar-sized
buildings covering 2 million square feet. The only outward sign that the
plant produces beef is the line of trucks delivering cattle to the stockyard.
That, and the ubiquitous smell cow manure with a hint of decaying meat.

Inside, much of the butchering is done the old-fashioned way, by workers
using various sorts of knives. At the front of the line is the "knocker," who
uses a pistol-like device to drive a metal bolt into the steer's head the law
requires that animals be rendered insensible to pain before slaughtering.
Another worker slits the animal's throat to drain the blood. Others in turn
remove limbs, hide and organs.

At line speeds of more than 300 cattle per hour, things frequently go wrong.
Organs tear and spill their contents. Fecal matter is smeared and splattered.

The presence of fecal matter greatly increases the risk of pathogens, which
is why USDA inspectors enforce a "zero-tolerance" policy for fecal
contamination on meat carcasses. Meat smeared with fecal matter is
supposed to be pulled off the line and cleaned by trimming. But there is
no law that requires raw meat to be free of pathogens; the exception is
for ground beef. Thus, raw meat must carry a label that specifies it must
be properly cooked.

In 1993, the Jack in the Box food poisonings on the West Coast killed
four children and awakened Americans to E. coli 0157, a mutant bacterial
strain that lurked in undercooked ground beef. Three years later, the
Clinton administration officially scrapped a century-old system that relied
on the eyes and noses of federal inspectors called "poke and sniff" in favor
of a preventative system of controls developed by the industry with federal
supervision.

That system, supported by food safety experts and many consumer groups,
was called the Hazard Analysis and Critical Control Point system, or HACCP
(pronounced hass-ip). Under HACCP, companies create their own plans for
addressing safety threats a "hazard analysis" and their own methods of dealing
with threats "control points." The theory is that hazards arise at many points
in the production process, and steps can be taken to minimize risks from
pathogens. The measures can range from lowering room temperatures to
dousing meat with a chlorine rinse to kill germs.

In a nod to consumer groups, HACCP introduced mandatory testing for
microbes for the first time. Plants would be subjected to testing for salmonella
and a benign form of E. coli, but not the deadly E. coli 0157:H7.

Three years into HACCP implementation, the reviews are decidedly mixed.
The rate for deadly E. coli illness remains steady, with 73,000 people stricken
and 61 killed a year, according to the U.S. Centers for Disease Control and Prevention.

But a steady decline in disease rates for salmonella and several other
pathogens since 1996 has prompted UDSA officials and many consumer
groups to declare HACCP a major success.

"The nation's food supply is safer than ever," Thomas J. Billy, administrator
of the Food Safety Inspection Service, said in a statement in response
to questions about HACCP's performance. "Our data shows the level
of harmful bacteria has been markedly reduced."

But pathogens remain a major concern. The USDA estimates that salmonella
is present in 35 percent of turkeys, 11 percent of chickens and 6 percent of
ground beef. Each year, food-borne pathogens cause 76 million illnesses and
5,000 deaths, according to the CDC.

According to critics, gaps in HACCP still allow too many pathogens to slip
through.

The report by the USDA's inspector general last summer said meat companies
were manipulating the new system to limit interference from inspectors. For
example, by their placement of control points, plants can effectively dictate
which parts of the process inspectors can fully monitor.

Viadero said the agency was "uncertain of its authorities" and had "reduced
its oversight short of what is prudent and necessary for the protection
of the consumer."

"After what I've seen," Viadero said in an interview, "if my hamburgers
don't look like hockey pucks, I don't eat them."

Meat inspectors and consumer groups like HACCP's microbe-testing
requirements, but some argue the new system is an "industry-honor
system" that puts consumers at greater risk. Under the old system,
meat with fecal matter on it was trimmed to remove pathogens.
Now, inspectors say, chemical rinses can wash off visible traces
of fecal matter without removing all the pathogens.

"It's the biggest disaster I've seen," said Delmer Jones, president of
the National Joint Council of Food Inspection Locals, which represents
most of the government's 7,600 meat inspectors. "We're vulnerable
to more deaths and no one seems to care."

Last fall, two Washington watchdog groups, the Government
Accountability Project and Public Citizen, released results of an
unscientific poll of 451 inspectors. While a majority approved of
HACCP in concept, more than three-fourths said their ability
to enforce the law had declined.

One inspector scribbled these words:

"HACCP ties our hands and limits what we can do. If this is the best
the government has to offer, I will instruct my family and friends to
turn vegetarian."

Schwochert, formerly the night shift inspector-in-charge at Excel's Fort
Morgan Plant, worked 15 years in private business before joining the
USDA. He prided himself on his ability to work with industry, but he
felt that HACCP made his job even tougher.

"I've never seen anything so slow to respond," he said.

"Nothing in my professional training or life gave me the tools for dealing
with what was going on. It was a calamity of errors. If it weren't so
serious, it would be funny." Showdown at Excel


By the late summer and fall of 1999, Schwochert was accustomed to
tussling with Excel's managers over problems ranging from filthy, urine-
soaked employee washrooms to occasional findings of fecal matter on
carcasses. But the skirmishes intensified dramatically on Sept. 13, after
the USDA found E. coli 0157 in a package of Excel beef at the Indiana
grocery store.

The discovery, part of a routine survey of grocery stores and meatpacking
plants, triggered a series of reviews of the Excel plant's food-safety practices.

The measures began with two weeks of E. coli testing. Inspectors found E.
coli not once but twice, in the first three days of testing. The USDA
ordered the contaminated meat seized, but it was too late. Some of the
meat had been loaded onto a delivery truck.

"Not only were those samples positive, but that meat had left the plant,"
Schwochert said. Excel tracked down the truck and returned the meat
to the plant.

USDA documents show the combination of E. coli positives and the improper
shipment of the contaminated beef prompted the government to impose
its harshest sanction: A district supervisor "withheld inspection" from the plant,
forcing Excel to shut down for three days. On Sept. 28, the plant reopened
under the threat of another suspension if new violations occurred.

They did, but no suspension followed. By Sept. 29, inspectors were finding
so much fecal contamination on carcasses that Schwochert said he tried to
close the plant again, even though he felt he lacked the authority to do so.
At the last minute, the plant's top supervisor agreed to shutter the factory
voluntarily for the rest of the day, Schwochert said.

Excel promised to retrain its workers and fine-tune its carcass-dressing
system, although details of its plan are considered proprietary information.
But more contaminated carcasses turned up two days later, and regularly
after that, agency records show:

Oct. 1: "Fecal contamination observed . . . sample failed to meet
zero-tolerance requirements."

Oct. 2: "Identifiable fecal deficiencies on two carcasses (out of 11)."

Oct. 4: "Fecal contamination splotched in an area 1 inch by 4 inches .. . .
carcasses retained."

Oct. 9: "Deficiencies were observed on six carcasses (out of 11).

In company memos, Excel responded that the inspectors were focusing on
"unrelated" and "isolated" incidents. But USDA district supervisors took
a different view. One USDA letter called the company's explanations
"incredible, frivolous and capricious." Another specifically suggested
Excel was putting its customers at risk.

"In the light of recent E. coli positives, I would think that food safety
and preventive dressing procedures would be of utmost importance
on your corporate agenda," Dale Hansen, the FSIS's circuit
supervisor in Greeley, Colo., wrote on Nov. 29 to
Marsha Kreegar, Excel's regulatory affairs superintendent.

USDA's enforcement records contain no response to that letter. Excel has
declined to make officials at the Fort Morgan plant available for interviews.

For five months, the USDA chose not to impose new sanctions, despite
14 additional citations for fecal contamination and a host of other problems.
Government records also describe mice infestation, grease and rainwater
leaking onto meat; unsanitary knives; equipment sullied with day-old meat
and fat scraps; and carcasses being dragged across floors.

USDA inspectors asked their supervisors for guidance. How many
violations before the plant is suspended again? Three? Five?

"The question was asked by myself or in my presence at least 10 times,"
Schwochert said, "and we never got a clear answer."

On May 23, the USDA threatened another suspension. "Recent repetitive
fecal findings on product produced by your firm demonstrates that the
HACCP plan at your facility is not being effectively implemented to control
food safety hazards," USDA District Manager Ronald Jones wrote to Excel
General Manager Mike Chabot.

Excel was given three days to make changes then a three-day extension,
after Excel's initial proposals proved less than convincing.

Finally, on June 14, based on Excel's promise to improve its process,
USDA withdrew its threat with an additional warning. "Your firm will
be required to consistently demonstrate that your slaughter process is
under control, meeting food-safety standards," the agency wrote.

On June 23, a sealed package of sirloin tips contaminated with E. coli
was loaded into an Excel truck bound for Milwaukee.

A Family's Ordeal

The Sizzler restaurant on South Milwaukee's Layton Avenue was one
of Brianna's favorite places, even if she could never quite remember its
name. To her 3-year-old mind it was just the restaurant "up the hill."

"We used to pass it all the time, and she'd have a fit if we didn't go
there," her father, Doug Kriefall, recalled.

On the night of July 17, her parents were happy to oblige. It was the
end of a harried workday for a young family juggling two careers and
two kids, and the lure of a quick and inexpensive night out was
irresistible. As a bonus, Sizzler offered an adult menu as well as a special
salad bar stocked with kids' favorites: macaroni and cheese, fresh fruit,
dinosaur-shaped chicken nuggets.

Emotionally, the family was still in shock from the loss of a baby girl just
seven weeks earlier. The girl the family calls Haley was stillborn. The loss
reopened old wounds: Connie Kriefall had lost six fetuses in eight years
before finally giving birth to Brianna in May 1997.

"She was my miracle baby," the mother said. "It was the best Mother's Day
present any mom could ever get."

The couple's difficulty in having children made Connie Kriefall an
exceptionally careful mother. She knew improperly cooked
meat can carry E. coli, a microbe sometimes fatal to young children.
So at Sizzler, the Kriefalls' buffet choices reflected caution: watermelon,
cantaloupe, cheese, ham cubes, a meatball or two.

But on that night, the bacteria was hidden not in meat but in watermelon,
an investigation concluded. A state health task force would determine that
E. coli entered the restaurant in sealed packages of sirloin tips.

The USDA inspection stamp on the package read "XL Est. 86R" the code
assigned to the Fort Morgan plant. Unopened packages of Excel beef in
the restaurant's cooler would test positive for the same genetic strain of
E. coli 0157 found in the bodies of Brianna Kriefall and other restaurant
patrons.

Once loose in the restaurant's cramped kitchen, the task force found, the
bacteria easily made the jump from raw meat to raw fruit. Health officials
discovered that kitchen workers had violated the restaurant's rules by
preparing watermelon and meat on the same counter top. A meat grinder
used to convert steak trimmings into hamburger was located inches from
the same counter, close enough to splatter juices on other foods.

The recycling of salad bar items over several days eventually exposed
hundreds of people to the bacteria. The first symptoms surfaced on July
14, three days before the Kriefalls' dinner. By July 24, Milwaukee health
officials were tracking an epidemic. Twenty-three victims were hospitalized.
The intensive care unit at Milwaukee's Children's Hospital was already
jammed with sufferers before medical investigators confirmed the cause
of the illness and its source.

"I knew it was bad. I just didn't know how bad," recalled Judy Fortier, a
Milwaukee mother whose oldest daughter, Carly, was among the most
seriously ill. For days, Carly, 8, suffered painful bouts of bloody diarrhea
so severe her intravenous line was moved to the bathroom so she could
nap during the brief lulls between attacks. "She would lean against me,"
Fortier said, "and that's how she slept."

Like many other parents, Connie Kriefall assumed her children had picked
up a summer virus when both came down with stomachaches on a
Wednesday evening, two days after their meal at Sizzler.

By Friday, Chad had recovered, but Brianna's condition had taken a
frightful turn. Severely dehydrated from diarrhea, she was admitted to
the hospital the next morning.

For her parents, the next seven days unfolded with deepening horror.
On Sunday, the family learned Brianna had developed a life-threatening
complication. By Tuesday, doctors had begun dialysis to prop up the
girl's failing kidneys. The normally bright, playful child had become nearly
unresponsive, uttering only a single, mournful phrase for hours at a time.

"It was just 'Ow-wee, Mama, Ow-wee, Mama,' " Connie Kriefall recalled.
"And those eyes. I'll never forget how she looked at me."

The crying would end abruptly. On Wednesday morning, Brianna was
placed on a respirator after her heart briefly stopped beating. Finally, on
Thursday, she suffered a catastrophic stroke and lapsed into a coma.

With all medical options exhausted, the Kriefalls decided to allow the
doctors to disconnect Brianna's life support.

"Thursday night we both stayed up with her, and took turns crawling in
bed with her, telling her how much we loved her and reading her stories,"
her mother said. "I couldn't hold her, and I wanted to hold her so bad.
And her heart was racing all night her heart rate was so high."

On Friday, just before 7 a.m., Brianna's heart stopped. Afterward

The months since the Sizzler outbreak inevitably brought investigations
and lawsuits, as both victims and governments tried to parcel out blame.
An early casualty was the Sizzler restaurant on Layton Avenue, which
was permanently closed.

Excel lawyers have maintained in court documents that the corporation was
not at fault, since it had no control over Sizzler's food-handling practices.

"Excel is continuously seeking ways to eliminate or reduce food hazards,"
the statement said. "For the benefits of those efforts to reach the consumer,
it is essential for food preparers to follow safe handling practices."

Pezze, the lawyer for the Sizzler franchise, said he had seen the USDA
documents from the Excel plant and found the reports of fecal contamination
surprising. "Obviously, if suppliers and producers could nip this problem in
the bud, we wouldn't need to rely purely on preparers."

Industry trade groups and the USDA also argue that it is impossible to
make meat germ-free, so consumers bear responsibility for using proper
preparation techniques and fully cooking their food.

It's an argument that William Cannon, the Kriefalls' attorney, finds
especially galling. The Kriefalls have joined other victims in a
lawsuit that names Sizzler and Excel.

"They have blamed other people for not catching their mistakes, but the
blame starts with them," Cannon said of Excel. "They knew or should
have known they were sending out meat that contained this bacteria.
And that there was a substantial risk that somebody, somewhere, in
America would end up eating this meat."

But others find more disturbing the government's ineffectiveness in
responding to chronic lapses at plants such as Excel's. It's a
problem nearly as old as meat inspection itself, said Carol Tucker Foreman,
the assistant secretary for food and consumer services in the Carter administration.

"There is almost no notion of shutting down a plant for failing to meet
standards," said Foreman, now a distinguished senior fellow at the
Washington-based Food Policy Institute. "The regulations help
ensure that plants stay just above the level that requires sanctions."

USDA officials are promising change. After devoting three years to
implementing HACCP, the agency is beginning an extensive review
to determine how the system can be improved.

Congressional supporters of stronger food safety protections say they
will press again this year for a law giving meat inspectors more effective
enforcement tools, including the power to impose civil fines and order
mandatory meat recalls. But after similar legislation failed in the last three
sessions, backers acknowledge their prospects are far from certain.

"The American people would be shocked," said Sen. Tom Harkin, an Iowa
Democrat and sponsor of several previous bills, "to learn that the USDA
does not have the fundamental authority to protect public health."

Anger and Grief


The memorial card for Brianna Kriefall is a collage of things the little
girl liked best: Barney and Barbies, dancing and Dr. Seuss, the little
watering can that was Brianna's delight on summer days when the
flowers were in bloom. The card's verse is written in a child's words.

"Mom and Dad, don't cry that I didn't stay," it begins. "I know you'll be
lonesome for me for a while, but time heals all wounds and again you will smile."

For now, though, the promise of healing seems a hollow one. At the
Kriefalls' neatly kept home in middle-class South Milwaukee, every
day brings searing reminders. Pictures of Brianna adorn almost every
wall. The little girl's room and toys remain just as she left them. Their
son Chad, now 2½, asks about his sister and sometimes loses patience
with his parents' explanations. ",'Nana come home now!'," he wails.

For Connie Kriefall, just knowing that Brianna's ordeal might have been
prevented fires emotions too intense for words. Like her son's, the
mother's grief is tinged with an anger she suspects is beyond healing.

"They need to be aware that this has completely destroyed our lives," she
says in a whisper. "Our daughter was a miracle child we waited eight
years for. And now she's gone, and we'll never get her back."
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See also:
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