Hepatitis A Lawyer & Attorney : Marler Clark : Hepatitis A Blog

Quad Cities residents are not going to soon forget the Hepatitis A outbreak at the Milan McDonald’s.

An Alpha, IL couple, Nichole and John Shannon, became the latest to sue McDonald’s and Milan, IL franchise owner Kevin Murphy in Rock Island County Circuit Court late last week. Mrs. Shannon was hospitalized from July 11-17, tested positive for the Hepatitis A virus, and suffered from liver damage, according the lawsuit.

The Milan McDonald’s was closed July15-17 on orders from the Rock Island County Health Department. The department took the action when a second McDonald’s employee was diagnosed with Hepatitis A on July 15.

At least 32 people testing positive for Hepatitis A are now associated in the Milan McDonald’s outbreak.   Counties in both western Illinois and eastern Iowa have contributed to the count. Eighteen of those cases are from Rock Island County where the fast food burger joint is located.

In addition to the injured, 5,324 people who made the mistake of dining at the establishment took advantage of the health department’s offer for free vaccines, which can prevent sickness from occurring after exposure. 

Those exposed to the virus and got shots are part of a class action lawsuit that has also been filed.

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 Another lawsuit on behalf of a customer sickened in the Milan McDonald’s outbreak was filed today in the Circuit Court of the Fourteenth Judicial Circuit of Rock Island County. The lawsuit was filed against McDonald’s Inc., and Kevin Murphy, the owner of the McDonald’s restaurant at 400 West First Street in Milan, IL, by Marler Clark, the Seattle-based foodborne illness law firm, and Craig Mielke of the Illinois firm of Foote, Meyers, Mielke & Flowers LLC. This is the second illness lawsuit; a class action lawsuit was also filed on behalf of restaurant patrons who had to get a shot to avoid illness.

The lawsuit is being brought by Karie Fiegel and her 14-year-old daughter, both of whom ate at the Milan McDonald’s in early June, 2009. Hepatitis A Virus (HAV) has an incubation period of 15-50 days, and it was not until early July that Ms. Fiegel fell ill with nausea, vomiting, fever, and jaundice. She sought medical care, but her symptoms only intensified, and she was admitted to the hospital where she remained for three days. In the hospital, tests revealed that she had been infected with HAV. Hepatitis infects the liver, and Ms. Fiegel’s liver enzymes were found to be elevated during her hospitalization. Although she has been released, her liver enzymes remain elevated.

Meanwhile, her daughter also began experiencing symptoms of HAV infection. The teenager was tested and also diagnosed with Hepatitis A.

“There are 30 confirmed cases of HAV,” said William Marler, the family’s attorney. “Given the incubation period of hepatitis A, it’s possible that the outbreak is not over, and we may see additional illnesses. It is very important for anyone who ate at the Milan McDonalds in June to monitor their health—and their family’s heath—very carefully.”

A food worker at the Milan McDonald’s had Hepatitis A, and a series of mistakes exposed as many as 10,000 restaurant patrons to the virus before the restaurant was closed and cleaned (it has since re-opened). A separate class action lawsuit was filed July 21 on behalf of those who had to get Immune Globulin (IG) shots after exposure to HAV at the Milan McDonald’s restaurant. Almost five thousand people have already received shots in mass clinics coordinated by the Rock Island County Health Department. Eligible individuals are still joining the class action suit.

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The Milan McDonald’s in Rock County, IL is doing normal business again, while health officials continue to clean up the Hepatitis A problem.

Another confirmed case of Hepatitis A brings the count for the outbreak to 26. Free inoculation clinics in Rock County handed out 5,366 does of either the Hepatitis A vaccine or immune globulin. 

Two restaurant employees may have exposed an estimated 10,000 customers of the Milan McDonald’s to Hepatitis A. Located just off I-284, many Milan McDonald’s customers were probably travelers just passing through the Quad Cities.

The latest victim in the outbreak lives in Henry County, IL, just one county east of the bi-state Quad Cities area.

There 15 confirmed cases in Rock Island County, five in Mercer County, two in Henry County, and one each in Warren and Woodford counties, all in Illinois, as well as two cases in Scott County, Iowa. All the cases are part of the outbreak connected to the Milan McDonald’s.

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If confession is good for the soul, Trinity Medical Center’s Vice President for Hospital Operations Kathy Cunningham must be feeling better tonight.

On behalf of hospital, she stepped forward today to admit Trinity dropped the ball in not reporting a June Hepatitis A case to the Rock Island County Health Department within 24 hours as required by Illinois state law.

Timely reporting of that case might have prevented the Hepatitis A outbreak now surrounding the Milan, IL McDonald’s, which potentially exposed 10,000 people to the virus.   To date, there have been 23 confirmed cases of Hepatitis A in the two-state Quad Cities metro area where Milan is located.

Cunningham told the media today the Rock Island County Health Department called Trinity on Monday, July 13^th, about the June case but the hospital was not able to locate any information about it. 

What they could not find was the record of the June 16^th positive test result for McDonald’s employee Cheryl Scram. In the current outbreak, she is “Patient Zero.”

The Trinity investigation found the hospital failed to timely report both the June case and three others in July. “It is with genuine regret we share the information that our process of reporting was not within the required time frame because patient safety is a number one priority for us,” Cunningham said.

Hepatitis A cases must be reported “as soon as possible, within 24 hours.” Anyone with Hepatitis A “shall not work as food handlers or in sensitive occupations during the period when infection control precautions apply.”

The Illinois National Electronic Disease Surveillance System (I-NEDSS), a web-based system, for reporting, and other electronic means can also be used. However, it appears Trinity mailed the June report to the Rock Island Health Department where it went un-opened. 

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The Hepatitis A outbreak associated with the McDonald’s in Milan, IL today is up to 23 confirmed cases, including two employees of the fast-food restaurant. 

Two new cases from Scott County, IA, which like Rock County, IL is part of the two-state Quad Cities region. All others known to be stricken with Hepatitis A are from the Illinois side of the Mississippi River.

The Rock Island Health Department later today is expected to provide more information on the dates the various Hepatitis A cases were reported to health officials.

There have been numerous questions surrounding those dates because in the final analysis, the Milan McDonald’s Hepatitis A outbreak is not simply about who is lying or who is inept in this single instance.   It is about whether the public health system for reporting and managing communicable diseases really works.

Like other states, Illinois requires all health care providers to notify local health authorities whenever they come across certain “reportable diseases”

In Illinois, the overall reporting requirements are found in Section 690.200 of the Public Health Code. Specific provisions for Hepatitis A are found in Section 690.450.

Interestingly, Hepatitis A cases must be reported “as soon as possible, within 24 hours.” Anyone with Hepatitis A “shall not work as food handlers or in sensitive occupations during the period when infection control precautions apply.”

In addition to a long list of health care providers who must report, under the Illinois code “any other person having knowledge of a known or suspected case or carrier of a reportable communicable disease or communicable disease death” is also legally obliged to report it.

How might these legal requirements apply to the facts on some key dates that are now critical to the Milan McDonald’s Hepatitis A outbreak?

June 16, 2009 – McDonald’s Employee Cheryl Schram learns from Trinity Medical Center in Rock Island, IL that she has tested positive for Hepatitis A.

June 25, 2009 – Cheryl Schram visits Milan McDonald’s and informs a manager known only as “Michelle” of her Hepatitis A status.   This is confirmed by at least one witness.

July 10, 2009 – Multiple cases of Hepatitis A reported to both county and state health officials.

July 13, 2009 – McDonald’s franchise owner Kevin Murphy says he first learns of the Hepatitis A outbreak from the Rock Island County Health Department.   The Illinois Department of Public Health first learns about the Cheryl Schram case, but does not know she was a food handler for McDonald’s until the next day.

July 15, 2009 – A second McDonald’s employee tests positive for Hepatitis A.

July 16, 2009 – There are 19 confirmed and two suspected cases of Hepatitis A, all involving people who ate at the Milan McDonald’s.

July 18, 2009 – The Rock Island Health Department announces free Hepatitis A vaccination and immune globulin clinics for the following Monday and Tuesday for all those who dined at the Milan McDonalds from July 6-10 and July 13-14, 2009.

July 20-21, 2009 – Of the estimated 10,000 who might have been exposed, about 4,000 take advantage of the vaccinations. The Milan McDonald’s is located just a couple blocks off the Interstate 280 beltway that goes around the Iowa-Illinois Quad Cities.   Thousands who were exposed to Hepatitis A are far down the road by now.

There are obvious questions from all this that do not have answers at this point. Did Trinity Medical Center report within 24 hours on June 16th or 17th that Cheryl Schram had testing positive for Hepatitis A?

If Trinity did so, it probably used the Illinois National Electronic Disease Surveillance System (I-NEDSS), a web-based system.

When, if so, did the Rock Island County Health Department read the report?    It would have included information on the Hep A patient and the attending physician. Finding out more would have required some investigation by the county health department.

Illinois law gives local health departments a lot of power to get investigations done. It requires businesses to cooperate and gives health officials emergency access to records. Finding out fast if someone with Hepatitis A is a food handler is clearly a major goal in the code.

How about the Milan McDonald’s manager who learned on June 25 that one of her employees, who she knew was recently released from the hospital, and now learns of the Hepatitis A diagnosis?

Illinois law obligates “any other person having knowledge of a known or suspected case… to contact local health officials that license restaurants to operate. The number is usually on the license on the wall by the phone. 

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A class action lawsuit was filed today in the Circuit Court of the Fourteenth Judicial Circuit of Rock Island County against McDonald’s Inc., and Kevin Murphy, the owner of the McDonald’s restaurant at 400 West First Street in Milan, Illinois. Marler Clark, the Seattle-based foodborne illness law firm, and the Illinois firm of Foote, Meyers, Mielke & Flowers LLC, filed the lawsuit on behalf of the named plaintiff, Cody Patterson, and all others who were forced to receive Immune globulin (IG) shots after being exposed to the hepatitis A virus (HAV) at the Milan McDonald’s.

An estimated 10,000 people were exposed to Hepatitis A at the Milan McDonald’s. If a person exposed to HAV can get a shot of IG within 14 days of exposure, they can avoid getting sick.

“This lawsuit is on behalf of the thousands of people who have to get IG shots because of exposure to Hepatitis A at McDonald's,” said William Marler, attorney on behalf of the plaintiffs. “These consumers chose McDonald’s in part because of the convenience, and now they have to wait hours in line or pay for a shot, and very likely miss work in order to do either one. Filing a class action suit on their behalf is a way to compensate them for the time, wage loss, and expense.”

“Our experience in handling large Hepatitis A exposures has allowed us to develop a system for helping as many people as possible recover for injuries sustained without the process being too taxing on individuals or the legal system,” continued Marler. “We filed a class action on behalf of the exposed who are able to avoid infection, and then help individuals who fall ill on a case by case basis.”

In 2007, Marler Clark represented members of a class action arising out of a hepatitis A outbreak at a Houlihan’s in Southern Illinois, where 3000 people received IG shots. Marler Clark represented 9000 people who received shots after a 2003 outbreak at a Pennsylvania Chi-Chi’s along with nearly 100 who became ill with HAV. The case of one individual resolved for $6,250,000. The firm also represented the state of Pennsylvania in recovering the cost of the investigation of the outbreak.

Marler Clark represented customers of Boston-area Quizno’s and Friendly’s Restaurant, both of which had HAV outbreaks in 2004. Additional HAV class action suits handled by Marler Clark include over 1,500 people who received shots after an HAV outbreak at D’Angeleo’s Deli in Massachusetts (2001) and 1,400 people after exposure at a Carl’s Jr. in Spokane, Washington (2000). Marler Clark has represented many victims who were unable to avoid infection and fell ill with HAV including suits against McDonald's, Subway and Taco Bell. The most recent group of cases involved those sickened at a San Diego-area Chipotle Grill in 2008.

Hepatitis A is a viral infection of the liver. The hepatitis A virus is commonly spread through the fecal-oral route, and symptoms include nausea, abdominal cramping, fatigue, and fever. In young children these symptoms can appear flu-like, but in some cases do not appear at all. Symptoms most often begin two to six weeks after exposure and can last several weeks. Preventative treatment (the IG shot) is only effective when administered within 14 days of exposure to the virus, after 14 days there is no treatment.

ABOUT MARLER CLARK: William Marler has been a major force in food safety policy in the United States and abroad. His food safety blog, Marler Blog, is read by over 1,000,000 people around the world every year. He and his partners at Marler Clark have represented thousands of individuals in claims against food companies whose contaminated products have caused serious injury and death. His advocacy for better food regulation has led to invitations to address local, national, and international gatherings on food safety, including recent testimony to US Congress Committee on Energy and Commerce. In 1998, Mr. Marler formed the not for profit, Outbreak Inc. He spends much of the year speaking on how to prevent foodborne illnesses.

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The chairman of the Rock Island County Board is calling for Sheriff Michael T. Huff to investigate the Hepatitis A outbreak linked to the McDonald's in Milan, IL. Democrat

Jim Bohnsack, who chairs the 25-member County Board, told the local News 8 that public health and tax dollars at stake, he wants to know whether the outbreak could have been avoided and who's at fault.

State budget cuts, according to Bohnsack, forced Rock Island County to cut two health department positions last month. He said he does not think the staff cuts have impacted how the county health department has handled the current outbreak.

With thousands of people are lining up in Rock Island County to receive Immunoglobulin (IG or Immune Globulin or Gamma Globulin) shots, the call for the sheriff to investigate should not come as a surprise.

"If our investigation shows the way I think I it's gonna be, McDonalds has got to be on the hook for that kind of money for all that expense that we've got", said Bohnsack.

IG is pooled/plasma-containing antibodies against a number of diseases like measles, rubella, varicella, and Hepatitis A. For protection against Hepatitis A after exposure, it must be given within two weeks of exposure and should be given concurrently with Hepatitis A to develop active immunity. A second dose of Hepatitis A is required six months later.

As many as 20 people have now been infected with Hep A due to their apparent association with the Milan McDonald's. The fast food outlet was apparently told by an employee in early June that she had been hospitalized for Hep A and the Milan McDonald's performed poorly in county health inspections conducted in April and July.

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