Do fines even matter? NYC councilor drafting bill to change restaurant inspection fine structure

A colleague at the vet college shared a story with me about restaurant grades a couple of months ago. He and his son went into a local sushi place and it was dead – they had no problem getting a seat during the usually busy lunch rush. He asked the manager what was up and she said that business had been down since they had been given a low score during a routine inspection.

That made him pause a bit, they ordered lunch and ate, but hadn’t been back. I guess some folks do make choices based on posted restaurant grades.

In New York, inspections and grade postings have been a hot topic for the past few months – and as Doug wrote a few weeks ago, the requisite whining from both sides is a bit tiring.

In attempt to take the clean doesn’t mean safe statement to a more pragmatic level, NYC councilor Christine Quinn is (I think) trying to make the health department to refocus their fine structure away from clean infractions and focus on safety (but it’s billed by the New York Daily News as “shrinking penalties for citations that don’t involve food”).

In my ideal regulatory environment fines would be based on risk to public health – and so would disclosure grades.

“They are definitely working on the bill,” said Robert Bookman, counsel to the New York City Hospitality Alliance, an influential new restaurant group. “There’s a universal feeling among the City Council that something must be done to rein in the Health Department.”

The likely legislative changes include shrinking penalties for citations that don’t involve food — problems like broken tiles and dented food cans, sources said. The legislation is also expected to waive fines for eateries that score an A after appealing a lower grade.

If, as expected, the bill clears the Council, it would need a thumbs up from Mayor Bloomberg, who hasn’t shown much of an appetite for overhauling the controversial system.

City Hall expects to bank a record $48 million in restaurant fines this fiscal year — a 50% increase from the $32 million collected in 2009, budget records show.

While the fine rhetoric is captivating, the biggest penalty to a restaurant might be a poor risk-based inspection grade.

Unsolved Mysteries: Three Botulism cases linked to korma sauce in 2011 outbreak

In the world of food safety risks botulism ranks high – while the probability of illness is low, the consequences are pretty dire. Paralysis (often leading to a ventilator) and potentially months of recovery.

Or death.

In November 2011, three kids from the same Scottish family became ill with botulism after eating from a jar of commercially-produced korma sauce. Health Protection Scotland released their report on the outbreak with no concrete answers as to what led to the illnesses: in-home contamination was unlikely, no other illnesses were linked to the product and the processing facility/supply chain controls checked out.

Executive summary of the report is below:

An outbreak of food-borne botulism in Scotland, November 2011

Health Protection Scotland

 

On Tuesday 8 November 2011, a 5 year old boy was admitted to Forth Valley Royal Hospital (FVRH), NHS Forth Valley (FV) with a history of transient double vision commencing on Monday 7 November, followed by a sore mouth and lower limb weakness.

On Wednesday 9 November, after a deterioration in his condition he was ventilated and transferred to the Royal  Hospital for Sick Children (RHSC) Yorkhill.  At the time of his transfer the most likely diagnosis was thought to be Guillain-Barré syndrome.

Also on Wednesday 9 November, the boy’s 7 year old sister was admitted to FVRH with similar symptoms and the same date of onset.  Botulism was now considered a possible though unlikely diagnosis.  Later that evening the 7 year old sister was also transferred to RHSC, and ventilated.  By late evening the suspicion of the diagnosis of botulism was sufficiently strong to warrant the obtaining of trivalent botulinum antitoxin which was administered to both children, after which their condition stabilized.

At around 11pm, RHSC informed the Health Protection Agency (HPA) as well as NHS Greater Glasgow  and Clyde (GG&C) Consultant in Public Health Medicine (CPHM) who undertook an interview with the parents of the affected children.  HPA informed Health  Protection Scotland (HPS) who again informed NHS GG&C and NHS FV HPTs.

On the morning of Thursday 10  November, NHS FV HPT convened a Problem Assessment Group (PAG).   On the afternoon of Thursday 10 November, NHS FV HPT and Stirling Council (SC) Environmental Health Officers (EHOs) undertook an in-depth interview with the father of the children and collected food related specimens.

On Friday 11 November the HPA alerted the competent public health authorities throughout the European Union (EU) via the Early Warning and Response System (EWRS).

On Sunday 13 November, following  epidemiological,  environmental, microbiological and toxicological investigations, a jar of commercially produced korma sauce was identified as the vehicle of intoxication and the UK Food Standards Agency (FSA) took immediate action to withdraw the potentially affected batch from the  supply chain and retail market and informed the European Commission (EC) via the Rapid Alert System for Food and Feed (RASFF).  The FSA also alerted  the public to the potential risks from consumption of sauce from jars of korma sauce from the same batch.

HPS alerted clinicians in Scotland to the incident, reminding them of the early signs and symptoms of botulism.

Five days later, on Monday 14 November 2011, a third (female) sibling aged 3.5 years became unwell and  deteriorated over the course of the following day, choking whilst trying to swallow liquids.  This child was admitted to RHSC on Wednesday 16 November with a diagnosis of suspected botulism.

SC EHOs’ detailed inspection and history-taking identified no evidence that the jar of korma sauce had been contaminated in the family’s home.  Despite the FSA’s intensive investigations at the production facility and the product’s supply chain, no faults were identified  to explain the contamination.  No evidence suggested that any jar, other than the one purchased by the affected family, had been contaminated.

The incident was closed at an Incident Management Team (IMT) meeting on Tuesday 6 December 2011.  All three children have recovered.

Click here for the report.

Maybe it was the Arctic Enema? UK Tough Mudder race linked to at least three E. coli O157 cases

In preparation for a legendary Raleigh event, the Krispy Kreme Challenge, I started running last fall. The challenge is to run 2.5 miles, eat a dozen donuts, and then run an another 2.5 miles. All under an hour. I finished in 1hr 6min (and I didn’t barf). I ran with a few guys from my hockey team – and now a couple of them are moving on to another endurance event, The Tough Mudder in South Carolina.

From the organizer’s website, “Tough Mudder events are hardcore 10-12 mile obstacle courses designed by British Special Forces to test your all around strength, stamina, mental grit, and camaraderie.

Triathlons, marathons, and other lame-ass mud runs are more stressful than fun. Not Tough Mudder. As hardcore as our courses are, we meet you at the finish line with a beer, a laugh, and a rockin’ live band.”

The site lists a set of obstacles with names like Arctic Enema, Dirty Ballerina and Kiss of Mud.

According to BBC, a Tough Mudder event last month in Scotland was linked to at least three cases of E. coli O157.

The trio developed symptoms in the days following the Tough Mudder event, which attracted almost 6,000 competitors to Drumlanrig Castle on 14 and 15 July.

Many of the assault course-style obstacles on the 12-mile run involved immersion in, or contact with, mud.

Health Protection Scotland (HPS) said that, even more than three weeks after the event, further cases could not be ruled out.

HPS added: “If local authorities are made aware that such events are being planned, they would normally advise the organisers on any potential risks, which might for instance include the risk of mud being contaminated with animal faeces or slurry.

“This underlines the importance of event organisers liaising with local authorities during the planning stage, not least to consider what information participants need in order to enjoy ‘extreme’ activities as safely as possible.”