It seems to always begin this way. 

The U.S. Department of Agriculture’s Food Safety & Inspection Service (FSIS) announces the recall of 845,000 pounds of ground beef from the nation’s largest privately held company, Cargill Inc.

Thumbnail image for hamburger1.jpgThe day was Oct. 6, 2007.

It was already too late for five-year old John McDonald, who had been admitted to East Tennessee Children’s Hospital two days earlier on Oct. 4, 2007.

The recalled ground beef was contaminated with deadly bacteria known as E. coli O157:H7.  Cargill’s Butler, WI beef processing plant produced the poisoned product between Aug. 9 and 17, 2007.

John and his younger sister, Michaela, shared a hamburger made from the ground beef at their home in Tennessee in the late summer of 2007.

They did not know that Cargill, with annual sales of $120 billion, had failed to provide them with beef that was safe to eat.   No one would know until people started getting sick and the Minnesota Departments of Health and Agriculture linked the illnesses to Cargill’s Butler beef processing facility.

John and Michaela were among those who fell ill.  Both would suffer from Hemolytic Uremic Syndrome (HUS).  “John’s illness was about as bad as an illness can get without causing death,” recalled attorney Drew Falkenstein of the Seattle law firm Marler Clark.

John McDonald was a patient in Knoxville at East Tennessee Children’s Hospital from Oct. 4-12, and was then transferred to the nearby University of Tennessee Medical Center, where he remained until Oct. 29, 2007.

During those 25 days, young John’s kidneys failed, requiring extensive dialysis to cleanse his blood.  He became badly anemic, requiring numerous blood transfusions.  These are conditions that are potentially lethal in and of themselves, but they were just the beginnings of John’s suffering.

Injury to John’s gastrointestinal tract would separate his HUS from most other cases.  Jim McDonald, the boy’s father, was there in the early morning hours of Oct. 11, 2007 when it became apparent how severe John’s illness truly was.

“As usual, I got up to help as much as possible when the nurses came in and woke us up,” Jim remembers from that pre-dawn morning two years ago.  “When we opened his diaper, I got excited since it looked like he had had dark brown diarrhea, which told me that his digestive system was finally starting to kick in again. Realizing how liquidy the diaper was, we turned on an extra light to help us while changing him.

“I will never forget what I saw. To my dismay, the diaper was not full of a bowel movement like I had desperately hoped. It was full of blood. An entire bowel movement of blood. Maybe an entire cup of blood. I got light-headed and almost passed out. I immediately sat down and grasped my head, apologizing to the nurses and telling them that I could no longer help them treat my son. This was the first of five grossly bloody stools that day.”

Bloody diarrhea is typical of E. coli O157:H7 illnesses.  Young John, however, was losing blood directly from his gastrointestinal tract in a manner that was not much different than bleeding from an open artery.  He’d require transfusions of packed red blood cells to offset this rapid blood loss.

His worsening condition meant he had to be transferred to UT, where it became apparent John was suffering from an infection somewhere in his little body.  His bleeding heavily from the rectum and the abdominal pain he kept telling his doctors about caused them to suspect abdominal infection.

Heavy-duty antibiotics were administered, but over the next several days John continued to show signs of severe infection.

In the afternoon of Oct. 16, 2007, doctors began to suspect that John had suffered a perforation or puncture somewhere along the gastrointestinal tract.  John’s continued intense pain and the fear that shiga toxin-producing E. coli O157:H7 bacteria could escape via the perforation and deliver a potentially lethal infection elsewhere in his body greatly concerned the worried physicians.

Around 8 p.m., John was rushed into the Operating Room at the UT Medical Center for an emergency exploratory laparoscopy.   The operation involves making an incision through the abdominal wall to gain access to the abdominal cavity.

Inside, the surgical team found a mess of fecal material and grossly swollen bowel loops.  Part of John’s rectum was found to be necrotic (diseased and dead), and about five inches of his colon and rectum were removed.

After days of sedation and uncomfortable mechanical ventilation, John was hardly able to walk when discharged.  On that day, Oct. 29, 2007, his father wrote: “John got to come home today.  He came home to a new house.  He still couldn’t walk, but was trying to very hard.  It was difficult for him (like Michaela) to rebuild his strength in his atrophied and skinny legs.  We carried him when he couldn’t crawl.  Nonetheless, everybody, including John, was thrilled that he was home.  There were many tears of joy shed by all.”

Since leaving the UT Medical Center over two years ago, John McDonald is doing well in his ongoing recovery.