Now, this makes for an interesting factual causation case. We often talk about the chain of causation, but this case involves a 9-foot tapeworm of causation. Anthony Franz blames Shaw’s Crab House in 2006 and had salmon salad. He later became violently ill and “passed” the giant tapeworm.
A pathologist determined came from undercooked fish, such as salmon, and Franz immediately fingered Shaw’s.
He is seeking $100,000 from Shaw’s and its parent company, Lettuce Entertain You Enterprises, but the company insists that it is not responsible.
The problem remains the possibility of alternative sources and the lack of evidence in such cases. Attorneys for the company are likely to “grill” Franz on the other possible sources in his diet. He likely has a record of his order at the restaurant, but a nine-foot tapeworm takes time to mature. If the jury decides that the restaurant is the likely source, res ipsa loquitur will take it from there. This is not the type of thing that occurs but for negligence on the part of the restaurant.
For the full story, click here.
Hi,
I myself was just diagnosed with a tapeworm. Parasitolgist believes it was/is Diphyllobothrium latum considering my history of eating Sushi three times in spring of 2007. Started to lose a lot of weight in July/August. Have had a lot of symptoms including fatigue, abdominal pain, nausea, loss of appetite, sense of fullness. Still dealing with the problem right now and just had another x-ray done to take a look at calcifications (larvae cysts?) in abdomen. Also, a lesion was found on my liver (larvae cyst?). Parasitologist did tell me that D. latum can cause abdominal cysts to occur. Did have some of the tapeworm pass out of me after surgery this last summer 2008 to repair rectocele (herniation) and cystocele (bladder herniation) which I and my family believe was caused by the severe colonic constipation (almost a blockage) that occurred from this parasite. Anyway, this is nothing to laugh about. I’ve gone through Hell to get a diagnosis. I will never eat Sushi again. Two of the places that I ate Sushi at were brand new upscale restaurants. I will never know which place I got it at. By the way, D. latum tapeworm is huge. Still could have parts of it in me. Will be seeing a team of of doctors at UNC Hospital pretty soon I guess. At least my gasterologist is trying to get me in to see them. He does not want me to take the tapeworm medication yet for some reason. Hopefully, he will call me tomorrow with his reasoning. Scared to death right now.
CMN: He didn’t consume a tapeworm that size nor did one grow to be
9 feet in length, in a matter of a couple of weeks. Neither scenario is plausible and the restaurant cannot be found at fault – based on this, ‘August’ 2006, exposure. Continue reading!
Unless I miss my guess, he was carrying this thing around in his gut for 2-3 years and had recently changed his diet ‘to eating healthy’, because he was already not feeling well…
From ‘Market Watch’:
http://www.gourmet.com/foodpolitics/2008/08/raw-salmon-tapeworm
“Salmon tartare—eye-catching, fun, hip and tasty—has become a popular menu item in many top restaurants. Celebrity chefs prepare it on television. Mainstream magazines, newspapers, and cookbooks feature recipes. Raw salmon dishes—tartare, crudo, sushi, marinated and cured salmon—are growing in popularity. But unless that fish has been frozen first, it would be wise to pass.
Related links
* Gourmet’s guide to buying sustainable seafood
* Plus: Politics of the Plate
That’s because a tiny tapeworm larva may lurk in the raw salmon flesh, just waiting for you to eat it so that it can take up residence in your digestive tract. Diphyllobothrium latum, carried by freshwater fish (including anadromous wild salmon, which spend their early lives in fresh water), is the largest human tapeworm. After the larva is ingested by a fish-eating mammal, it hooks onto the small intestine, where it grows to maturity, freeloading on its host for nutrients (it has a special affinity for Vitamin B12). Cooking fish or freezing it at minus 31 degrees Fahrenheit or colder for 15 hours will kill Diphyllobothrium larvae. Marinating will not. Freezing fish at slightly higher temperatures for longer periods will also kill the larvae but will likely diminish the quality of the fish.
Just this week, a Chicago man sued a well-known local restaurant for $100,000, claiming that he had acquired a nine-foot tapeworm from an undercooked salmon salad in 2006. (The restaurant’s parent company, LEYE, says the restaurant was cleared in the incident by a 2006 Chicago Health Department investigation.) It’s the first case of tapeworm infection to make the news in a while, and that lack of media coverage—combined with the growing popularity of sushi over the past few decades—may help explain the prevalence of raw fish dishes in recent years. (Ironically, Japanese chefs, at least those who have passed the exam that is required for opening a restaurant in Japan, never serve fresh salmon raw or lightly seared—“has to be frozen for sushi,” stresses sushi master Shiro Kashiba, of Shiro’s Sushi Restaurant in Seattle.)
Chefs who offer raw salmon today are no doubt unaware of the 1980s press—like these articles by Mimi Sheraton in The New York Times—about outbreaks of Diphyllobothrium latum infection (known as diphyllobothriasis) and the risks associated with eating raw or undercooked salmon. In the fall of 1980 there were 36 known cases of diphyllobothriasis on the East Coast attributed to raw salmon. In the same year, the CDC issued an advisory after four medical doctors in Los Angeles acquired tapeworms from salmon sushi. In 1984, 17 people in the aptly named village of King Salmon, Alaska acquired tapeworms from eating salmon ceviche prepared from a recipe supplied by a visitor from California.”
Left Photograph by Romulo Yanes
Why You Should Avoid Raw Salmon
continued (page 2 of 2)
“It’s unclear how many cases of diphyllobothriasis there are today: The Centers for Disease Control and Prevention in Atlanta are aware that such infections happen, but according to the CDC’s Susan Montgomery, “there is no systematic reporting of cases in the U.S.”
While diphyllobothriasis is not life threatening, the tapeworm can grow up to 30 feet long and live for decades, sometimes causing anemia from B12 depletion. Most diphyllobothriasis cases are initially asymptomatic, so they often go undetected; people can live with a tapeworm for years without knowing they have one. Some make the unhappy discovery after passing a segment in their stool. Others learn of their cohort after seeking treatment for symptoms such as diarrhea, abdominal cramping, fatigue, and nausea. (Such was the case with Jeff Smith, aka The Frugal Gourmet, one of the first celebrity TV chefs, who confided to writer Alicia Arter during an interview in 1992 that he was being treated for an “enormous tapeworm” he said he got from eating salmon sushi made from salmon that had not been frozen.) If a physician relates these symptoms to the possibility of tapeworm infection, a diagnosis is made and the infection is treated with a prescription medication.
But if a physician has not had a tapeworm patient before, the diagnosis can be challenging. In 2006, a doctor described in The New York Times how his medical partner couldn’t figure out what was causing his normally energetic wife’s fatigue and, as blood tests showed, anemia. There were no gastrointestinal symptoms. The correct diagnosis came when a colleague, after learning that the patient tasted her fresh gefilte fish as she seasoned it before cooking, suggested she might have a tapeworm. (Diphyllobothriasis is sometimes referred to as “Jewish housewives’ disease” for that reason.) Bingo! Diphyllobothrium latum. After treatment, the patient discharged the parasite—a three-foot-long specimen.
How likely is it that the salmon you’re eating contains a tapeworm? According to Tammy Burton, a fish pathologist for the Alaska Department of Fish and Game, the levels of infestation fluctuate seasonally and from year to year, but in general Diphyllobothrium latum is “fairly common” in Alaska salmon. In its Bad Bug Book, the FDA warns that farmed salmon, if they spend time in fresh water, can also acquire the larvae. Farmed salmon from Chile, where juvenile salmon are grown in cages in freshwater lakes, have been implicated in diphyllobothriasis outbreaks in Brazil and elsewhere.
So a better question is: How likely is it that you will get a tapeworm if you eat raw, unfrozen salmon that contains a tapeworm larva? According to Phillip Klesius, a research leader at the USDA Aquatic Animal Health Research Laboratory in Auburn, Alabama, “The consumption of one live larva can result in tapeworm infection.” So until you find out if that salmon has been frozen first, it would be best to hold your fork.”
Sorry, but this story sounds… “fishy” to me.
How exactly did this fellow ingest this tapeworm without realizing he was doing so?
How exactly do you eat a Salmon Salad without noticing the 9 foot tapeworm sitting on your plate?
And how exactly did he consume it without chewing it up? They seem to be indicating he supposedly passed it whole. What’d he do, suck it up like a big fat peice of spagetti?
Somethings wrong with this picture.
PattyC,
I take my hat off to you. I don’t think I could have worked for an insurance company. I saw too many instances of the insurance company taking advantage of people who needed help.
You’re right, Rafflaw, as manager, I WAS the insurance company within my generous authority and it’s a judgment call every time.
I hand-picked a great team who did great investigative work and who always kept in touch with me by phone and followed up with timely, detailed, written reports plus graphic photos etc.
My desk was often worse than the 6 o’clock News because our clients were considered high-risk in the industry – all day, every day, 24/7
– for years. And I did this work until I ‘burned out’…
Literally, until I realized, I was the only one like me in my field.
My basic philosophy was, ‘not a penny less AND not a penny more…’
I think insurance should pay under the terms of the contracts.
I also strongly supported Underwriters and Insureds toward Risk-Management.
I went way beyond my job description in terms of dedication, lack of compensation for time spent ‘beyond the call’, and plenty of sleepless nights trying to measure the projected differences in realistic prospects between the deaths and even more so in the continued disabled lives of either a poor kid from the Projects
or an affluent kid from the ‘burbs!
It’s heartbreaking work.
Patty C,
It might be fun for us to follow, but I am not sure the insurance company and the Restaurant would be too anxious to let this drag on too long. Jill, I would be afraid of taking that “sample” into the vet. He may charge me by the foot!
Having professionally managed lawyers and adjusters in the handling of CGL BI/PD claims regionally, for a living, in the not so distant past, I don’t see a settlement – unless it is nominal.
The duty to defend is not coextensive with the duty to indemnify.
Science aside, which took me no less than five minutes to find, the facts, as I understand them do not support a negative conclusion for the defense, and while I am not privy to ‘the specials’ I’d be monitoring this case, I’d set aside a reserve, and if it were up to me, I might be preparing for trial!
This case could be fun – while still keeping an eye on the bottom line!
Now that you’ve eaten there I have some advice, rafflaw. Next time you’re supposed to take the “sample” into the vets, well, you know what to do:)
I have eaten at this restaurant, but it was a few years ago. I am not much of a fish eater and stories like this convince me to stay away from fish. This restaurant is a big deal in the Chicago area and the Lettuce Entertain You chain is huge. There are some deep pockets there, but I agree with Mespo’s concerns. I would think it would be pretty tough to prove that the genesis of the tape worm was from Shaw’s food. The whole case sounds a bit fishy to me. (Sorry about that pun!) I smell a quick settlement.
9 feet? – this would be one for the record books if true, which I doubt, and may be further discounted even more readily on the basis of what variety salmon, in August, Pacific, Atlantic, or farm-raised is at issue.
Pathophysiology
Adult Diphyllobothrium worms range from 1-12 meters in length, have proglottids that are wider than their length, and discharge ovoid eggs that measure 60 µm X 40 µm. The life cycle of Diphyllobothrium species begins with an infected host discharging eggs into a freshwater environment that contains susceptible crustaceans and fish. After the eggs hatch, the embryonic flatworms are ingested by water fleas; in these crustaceans, the first larval stage develops. When a fish devours the infected crustacean, a second larval stage develops, and this larva is infective to the definitive hosts. The juvenile worm develops to maturity in the small intestine of the definitive host and, within 3-5 weeks, begins to produce eggs. Adult Diphyllobothrium worms may survive longer than 10 years.
Frequency
United States
In North America, Diphyllobothrium latum infections have been reported in fish from the Great Lakes; however, no recent reports have been received, and the worm may have ceased to reside in this area. Eskimos have also reported infections, and 6 Diphyllobothrium species are known to reside in Alaskan lakes and rivers. Diphyllobothrium infections are not species specific, and widespread reports describe infection in North American fish-eating birds and mammals. The incidence in the United States has been declining, but the growing popularity of Japanese sushi and sashimi may increase the incidence. Pike, perch, and salmon (80% in a recent case series) are among the fish most commonly infected.
Other than analyzing the growth rates of tapeworms, I think the real question here is how did Bill O’Reilly get into the salmon salad?
Mespo,
A bunch of lazy shulbs, I say! Still, was it Colonel Flounder in the Kitchen with the knife?
Also, to you and Vince Treacy, cryptozoology is an interesting subject. I just saw the movie Gorgo and I want to believe!
Jill:
You have inspired me to do some tapeworm research and I now know that most tapeworm infections come through ingestion of undercooked beef and pork, although fish can too present the issue. I hope our plaintiff here didn’t ingest steak or sausage in Chicago (a rarity there I’m sure) since his meal at Shaws and before his surgery.
The doggone defense bar has it so easy!
From the tapeworm digest…
The fish tapeworm, Diphyllobothrium latum, transmitted to humans from fish, especially pike, is common in Asia and in Canada and the northern lake regions of the United States. This tapeworm has a more elaborate life cycle, involving both a fish and a crustacean as intermediate hosts.
Well obviously it was Sir Lobster in the parlor with the pincers!
I think tainted food cases are the most difficult cases to prove. There are usually alternate sources of the illness, and the restaurant has the ready-made defense that the evidence was destroyed by the digestion process in most cases. The evidence may be preserved in this case but the tainted food was a salad with various components and was likely consumed well before the injury became known. Who knows how many fish were eaten in the interim between the dinner at Shaws and the discovery of the tapeworm. I think the restaurant may pay to avoid the hassle but the proof problems are considerable. Add to that the possibility that the restaurant merely served a prepared salad or that the salmon was cooked elsewhere, and the number of the defendants starts to look infinite. I also wonder if res ipsa will save him. But for negligence this doesn’t occur, but the question remains whose negligence? The exclusive control element of the doctrine will surely be tested.