After salmonella nearly killed their toddler, Glendale parents sue Foster Farms – and win

Kaila White | The Republic | azcentral.com

Show Caption Hide Caption Arizona parents talk about son sickened by salmonella from Foster Farms chicken Glendale parents Amanda and James Craten discuss how their 17-month-old son became ill with salmonella in 2013 and why Foster Farms was responsible.

Noah Craten was just 17 months old when he got sick from salmonella.

After a monthlong fever and countless visits to the pediatrician, a CT scan revealed that an infection caused by salmonella had caused an abscess in his skull. The growth pressed on his young brain, damaging it.

The salmonella that infected him traced back to Foster Farms chicken.

Noah was one of hundreds of people across the country who were confirmed to have been sickened by a salmonella outbreak linked to Foster Farms chicken in 2013 and 2014. The outbreak, which drew national attention at the time, likely sickened thousands more who never reported their illness.

He was one of the youngest victims of the outbreak. And it's rare for a salmonella infection to cause such severe damage.

Unlike other victims who settle their claims out of court, his parents, Amanda and James Craten, sued Foster Farms and took the case all the way to trial.

And in a landmark ruling, they won.

"We've been trying to get Foster Farms to have some accountability," Amanda said. "They need to bear that burden because there's no way we, as consumers, can be educated enough to protect our children."

Baby Noah, a surprise in every way

Amanda and James are high-school sweethearts. They met through friends as teens living in Glendale and Peoria.

"We got married too young," he said, laughing in the living room of their Glendale home. He was 18 and she was 19 on their wedding day. Soon after, they planned and had their first child, Adam.

The first half-decade of parenthood was kind of a breeze. Adam and the Cratens' second child, Anna, were both reserved, sweet babies. They are now both quiet, thoughtful children and straight-A students.

Then came Noah, who has been a surprise in every way — starting with his conception.

Adam, now 11, remembers the day Noah was born.

"It was April 27, 2012," he said. "Everyone was really excited 'cause he was the surprise."

Even as a baby, Noah's personality was big.

"Our other kids were really shy – when they were little, when the doorbell would ring, they would run away and peek at who it was. Noah was always smiling and crawling over to people," Amanda said. "He was very happy and very playful."

A mysterious illness, and then heartbreak

The story of Noah's illness starts with Noah's grandmother, James's mother, Monica Craten.

In the fall of 2013, Monica had cancer. The family was gathering at her house two or three times a week to make dinner and spend time together.

The day before Monica was scheduled to have her first chemotherapy treatment, she became so sick from a salmonella infection that doctors delayed her chemo by two weeks, Amanda said.

Monica had a strain of salmonella Heidelberg, one of the most common types of salmonella to infect humans. The CDC found seven different strains of salmonella Heidelberg bacteria in the Foster Farms chicken outbreak during this time.

Noah's cousin Ethan, who was 9 months old at the time, became sick with a different strain of salmonella Heidelberg. Soon after, 17-month-old Noah developed a fever, chills, mild diarrhea and nasal congestion.

Amanda took him to a pediatrician Oct. 3, 2013, and again three other times. She always brought up that other family members had recently been sick from salmonella, but said doctors told her Noah wasn't having severe enough gastrointestinal issues for that to be the problem.

After three weeks with a fever, doctors hospitalized Noah for testing. Within a day, one side of his face began to droop. A CT scan showed a pool of fluid in his brain.

He had to be transferred to another hospital for surgery, a moment Amanda describes as one of the most difficult of her life.

"I lost it. I was hyperventilating and hysterical," she said. "I wanted someone to fix him and bring him back to me. I couldn't see him like that."

A brain abscess is an enclosed glob of pus in the brain tissue resulting from an infection. It disrupts the brain's supply of oxygen and blood, and can be fatal, especially if it bursts.

Noah had brain surgery on Oct. 26 to remove the abscess, which had flattened the front of his brain, shifted it and put pressure on the rest. The fluid in the abscess tested positive for one of the rare strains of salmonella Heidelberg linked to the Foster Farms outbreak.

"When we found out the abscess was from salmonella I instantly lost my composure and cried my eyes out," Amanda said. Her suspicions had been right.

The Cratens still don't know exactly how Noah got sick.

Most would assume he ate undercooked chicken, but maybe it was cross-contamination, like another food touched the chicken package in the fridge or he touched a contaminated shopping cart. Maybe it spread person-to-person, like if Monica hadn't washed her hands well enough and then touched him. They can't know.

Noah was sedated and on a ventilator for three days. Doctors also inserted an IV line to his heart to administer antibiotics in hopes of shrinking the rest of the abscess that couldn't be removed during surgery.

After seven weeks of twice-daily antibiotic infusions and doctors' visits, they removed the IV and Noah's health improved.

For a moment, the Cratens thought they were out of the woods. They thought life was back to normal, even joking that now he would be "Noah 2.0."

What you need to know about salmonella

Salmonella bacteria usually live in human and animal intestines and spread through feces. Food contaminated with salmonella most often was in contact with feces or water that has been contaminated by feces, such as during butchering.

Poultry that is kosher, free-range, organic or "natural" is not less likely to have salmonella, according to the U.S. Department of Agriculture.

The Centers for Disease Control and Prevention estimates salmonella causes about 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths in the U.S. every year. The vast majority are caused by tainted food.

Children are the most susceptible. Kids under the age of five have higher rates of salmonella infection than any other age group, according to the CDC.

Although salmonella in raw poultry can severely sicken and even kill people, up to a certain level is legally allowed to be in food. The U.S. government does not consider it an adulterant, or something that makes a product unsafe and illegal.

In 1994, an E. coli outbreak linked to contaminated beef patties at Jack in the Box restaurants sickened 732 people and killed four children. The outbreak led to widespread changes in the beef industry, including the USDA officially designating that strain of E. coli to be an adulterant. It added six more strains in 2012.

Despite multiple salmonella outbreaks linked to chicken, none have swayed the industry to do the same for poultry. Instead, there are limits to how much salmonella can be present.

But even if that limit is exceeded, food-safety lawyers and activists said, the USDA doesn't have the power to shut down a meat plant or even order a mandatory recall of a tainted product.

Instead, much of the burden lies with the consumer.

The CDC lists 11 steps consumers should take when handling poultry, such as:

Wash your hands and all surfaces with hot, soapy water after each food item you're preparing. Bleach surfaces.

Always use a food thermometer to cook chicken to 165 degrees. Refrigerate food within two hours, or one hour if it's above 90 degrees.

Despite longstanding advice from famous chefs such as Julia Child, do not wash poultry, as that can spread salmonella elsewhere. Still, in a 2016 FDA food-safety survey, nearly 70 percent of respondents said they always wash raw chicken before cooking.

It can feel like an impossible battle.

"Consumers shouldn't have to do that," James said. "They shouldn't have to treat a product like a biohazard."

The change of a lifetime

About seven months after Noah's brain surgery, the left side of his mouth began to droop again.

Then he began speaking with a stutter. He developed facial tics. Doctors realized the abscess had affected Noah's brain development.

"We were devastated," Amanda said. "It's been slowly, like every six months, we have a new problem."

As his brain grows and changes, new issues emerge.

Now, at age 5, Noah is not properly developing executive function, which are the set of mental skills associated with the frontal lobe of the brain where Noah's abscess had been.

Executive function includes memory, self-control, paying attention, organizing and planning, and understanding different points of view. Noah struggles to control his emotions.

He has issues with language, sometimes forgetting the word for his favorite food, tomato. The left side of his body is weak, so he runs with a hobble.

Most recently, the family learned that Noah also has sensory-processing issues. He gets overwhelmed in noisy rooms, and can't track movement with his eyes.

He has some of the symptoms of autism and ADHD, but has not been diagnosed with either.

"Anybody who meets him or sees him, they're going to see his attention problems and be like, 'Wow, that kid has ADHD big time,' " Amanda said. "But you can't just throw medication at him and fix him because it's not just that."

Noah is getting old enough to know he's different. Once, when Amanda was driving him to therapy, she asked him to pause their conversation so she could focus on the traffic.

"He's like, 'Mommy, I'm not going to be able to drive when I'm older' and I said, 'Why not?' and he's like, 'Because I can't pay attention,' " Amanda said. "He hears that so much from school and everybody else that he realizes that."

Even after recovery, the outbreak raged on

Researchers now know the salmonella outbreak that sickened Noah started three months earlier. It poisoned people for 16 months before Foster Farms issued a recall of the tainted chicken.

Although it officially sickened 634 people in 29 states and Puerto Rico, likely more than 15,000 others also got sick and never reported it.

The salmonella Heidelberg strains in this outbreak were strong, hospitalizing and causing blood infections in a higher percentage of victims than usual. Many of the strains were also antibiotic-resistant, making infections more difficult to treat.

"His illness and many, many of the others could have been prevented with a recall," Amanda said of Noah.

The month Noah got sick, the USDA threatened to shut down Foster Farms processing plants in California and said investigators found "fecal material on carcasses." One California Costco location recalled thousands of rotisserie chickens that may have been contaminated with salmonella Heidelberg.

Still, the outbreak continued for another nine months before Foster Farms recalled more than 40,000 pounds of chicken products and instituted new measures to reduce future contamination.

A family takes on Foster Farms

It is common for people who become sickened by food to settle with the food producer out of court for large sums of money.

The practice has increased since the Jack in the Box E. coli outbreak, when acclaimed lawyer William Marler represented a 9-year-old girl who experienced kidney failure and a 42-day coma due to sickness, and won her $15.6 million.

Amanda said they tried to settle with Foster Farms but the company rescinded its offer without explanation. So the family sued.

After years of preparation and a three-week trial, a jury in March ruled in favor of Noah and said the damages associated with his illness were valued at $6.5 million. The jury deemed Foster Farms 30 percent responsible, meaning the net verdict for the family was $1.95 million.

Eric Hageman, a lawyer who worked on the Cratens' case, told The Arizona Republic that the ruling "sets an important precedent for food safety."

"At trial, the case really boiled down to this: responsible food manufacturers don’t expose the public to dangerous bacteria. And after hearing all the evidence over the course of the trial, that is exactly what the jury concluded," Hageman said.

Jaydee Hanson, a senior policy analyst for the Center for Food Safety in Washington, D.C., did not work on the Cratens case but said he had followed it because of its uniqueness.

"It’s not the first time a company has paid out to people harmed by a poultry product. It’s just the first time it’s gone all the way to trial," he said.

"A company like Foster Farms should not have had this in the first place and should have been able to stop it very quickly. That’s the sad thing, and that a court has found them guilty? Not a huge surprise."

Hanson said this case will likely lead to food producers settling out of court more often. In his words, it's easier to negotiate with one lawyer than 12 jurors.

Foster Farms said in a statement to The Republic that its food-safety practices are among the best in the industry. In a statement, it noted that the jury determined 70 percent of the fault lay with the Cratens.

"Family shopping records presented at the trial, covering the six-month period prior to the onset of illness, failed to demonstrate the purchase of Foster Farms chicken. Regardless of the source of illness, Foster Farms is pleased that Noah Craten has recovered. "It is in the interest of all poultry producers to ensure that the safest possible product reaches the marketplace. Since 2013, Foster Farms has instituted a multi-hurdle Salmonella control program and committed to a company-wide Salmonella prevalence level of 5 percent in whole body chickens and parts. This compares to the USDA permissible level of 9.8 percent for whole body chickens and 15.4 percent for parts. Foster Farms’ current food safety performance record is recognized as being among the best in the U.S. poultry industry, and the company is committed to advancing food safety for the benefit of consumers, customers and the poultry industry."

An optimistic future

The settlement money is only for Noah. Amanda and James did not include themselves or their other children in the lawsuit.

And although he needs the money now to cover various therapies, Amanda and James do not expect to see it for years.

They're waiting to see if Foster Farms will appeal. Even if they don't, Amanda said Noah will end up receiving less than $1 million after attorneys' fees. And the judge still hasn't issued a final verdict – he could decide to toss the whole case.

"It's not about the money. It's about accountability and making sure that Noah can have his best chance," Amanda said.

Now that 4.5 years of never-ending doctors' appointments and lawyers' calls are over, James said, it's time for the family to "re-create normal."

Noah is set up to spend part of his school day in a resource classroom, a move that Amanda said should help him in first grade.

The couple said the difficult experience has made them better, more tolerant parents, and has helped their children learn empathy.

"One time Noah was having a really hard time, freaking out fully to a 10, and Adam stopped him, put his hand on his chest, and said, 'How big is the problem?' It was the same tools we use," James said.

"We've never instructed him to be that for Noah. He just saw us doing it and repeated it to help his little brother," James said. "There's a lot of good that's coming to us."

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