The Trouble with Chicken

>> NARRATOR: Tonight on Frontline... >> Salmonella sickens and kills more of us than any other foodborne pathogen.

>> NARRATOR: About one in four pieces of raw chicken carries salmonella.

>> The strains of salmonella that are showing up on these chickens are tougher, stronger, and many of them are antibiotic-resistant.

>> Is there enough on this plate to make one person sick?

>> There's enough to make thousands of people sick.

>> So these are all Salmonella Heidelberg cases.

>> NARRATOR: Correspondent David Hoffman investigates the largest salmonella outbreak from poultry in history.

>> We wondered, where does this stop?

>> NARRATOR: Examining the failure to keep the meat supply safe.

>> Has the inspection process kept pace with the times?

>> No, it hasn't.

>> NARRATOR: And raising questions about why more isn't being done to protect consumers.

>> So is the problem here just that Foster Farms wouldn't recall?

>> We didn't ask them to recall.

>> If they would have instituted a recall, my son would have never gotten sick.

>> NARRATOR: Tonight, Frontline investigates "The Trouble With Chicken."

♪ ♪ >> Yeah, are you gonna crawl for Mama?

(laughs) Noah was kind of a little bit of a surprise.

Look at you scooting around!

We had him in 2012.

He was the happiest baby that you would have ever seen.

He just would warm up to anybody the second he would meet them and smile and play with them.

>> Hello?

Hello?

>> NARRATOR: It was October 2013.

Amanda and James Craten were raising their three children in the western suburbs of Phoenix, when suddenly, 18-month-old Noah got sick.

>> We were all sitting down to dinner, and I spoon-fed him a bite of, you know, what we were eating.

And I turned my head, and he is just throwing up.

And my husband hopped up and took his temperature, and it was 103.5.

>> NARRATOR: The fever persisted for weeks, but doctors couldn't figure out what was causing it.

>> He gradually started being less friendly, and he gradually started being more lethargic.

You know, this is not my son, and there's something really wrong.

>> NARRATOR: They thought it might be related to salmonella poisoning his grandmother had gotten one week earlier.

>> I had asked, "Could this be salmonella?"

And they said, "Absolutely not.

"He would have bloody diarrhea if he had salmonella.

"He would have diarrhea.

He would be vomiting."

>> NARRATOR: They took Noah to the local hospital for more extensive testing.

>> We put the baby through so many tests, blood tests, catheter, and it's frustrating putting a very young child through that and still not having answers.

>> They had to take him in for this MRI.

This new surgeon takes a look at the MRI and he said, "This is an abscess, and it's growing.

We'll have to do a craniotomy," where they cut his scalp from one ear almost all the way over to the other, and they take a piece of his skull out.

It was surreal.

Just completely out of control.

>> NARRATOR: The surgery lasted nearly four hours.

>> When Noah first came back to the room, you know, it was scary.

I mean, he was in a coma.

>> NARRATOR: Days later, doctors finally explained the mystery behind his brain infection.

>> They said, "This is Salmonella Heidelberg."

And he said that, you know, it doesn't usually happen that they get brain abscesses from Salmonella Heidelberg, but salmonella is a very virulent bacteria, and when you have a young child with, you know, his immune system is not as developed as somebody else's, it will seed in his brain, and he said that it's because of how strong the bacteria is.

>> NARRATOR: Correspondent David Hoffman came across Noah Craten's story while investigating dangerous new bacterial threats.

Over the last three years, we've reported on deadly infections at the nation's most prestigious hospitals.

>> Could you give me just a tube fixator?

>> NARRATOR: The rise of antibiotic resistance... >> Resistant, resistant, resistant, resistant... >> NARRATOR: Both in humans and in animals.

And now, a common bacteria that has become dangerous in new ways: salmonella.

>> Is there enough on this plate to make one person sick?

>> There's enough to make thousands of people sick.

>> NARRATOR: Many kinds of salmonella are harmless, but some, like the one that sickened Noah Craten, are becoming more severe and difficult to treat.

Salmonella causes more hospitalizations and deaths than any other foodborne illness.

It's found on a wide variety of food and sickens more than a million Americans every year, about 200,000 from contaminated poultry.

>> Poultry products carry salmonella more than most other products.

And the strains of salmonella that are showing up on these chickens aren't the ones our grandmother knew about.

They are tougher, stronger, and many of them are antibiotic resistant.

>> NARRATOR: The story of how Noah Craten got so sick from salmonella actually starts more than a decade ago here in Portland, Oregon, 1,000 miles from where Noah lives.

>> It's part of the outbreak investigation.

>> NARRATOR: It was the summer of 2004 when Oregon health officials noticed that patients were showing up in hospitals with a particularly virulent strain of salmonella.

>> How many cases we have had... >> NARRATOR: It was a strain they didn't know much about.

>> We started looking at cases of Salmonella Heidelberg, and there was a particular pattern that we were very interested in.

>> NARRATOR: Emilio DeBess investigates foodborne outbreaks for the Oregon Health Department.

He and his small team keep a close eye on reports from local hospitals, tracking trends in food poisonings, trying to identify the food source that made people sick.

>> Is it hard to track these things down?

>> It's difficult to try to figure out how outbreaks happen.

>> NARRATOR: Many leads go nowhere.

Most investigations are never solved.

But as cases of Salmonella Heidelberg began to build in 2004, one of the victims gave DeBess an important lead.

>> And she kind of walked me through her day, and she says, you know, "At about 10:00 on Thursday mornings, I usually go to a store and buy chicken."

So I talked to my research assistant.

I said, "Let's go to the store."

And she goes, "Why?"

And I said, "Let's just go to the store."

>> NARRATOR: DeBess wanted to see if the same salmonella strain that had sickened the victim was on chicken in the store.

>> So we drove out to the store and I remember looking at all the chicken and thinking, "Boy, if I find Salmonella Heidelberg in this chicken, it's going to be huge."

And then I thought, "Well, what's the likelihood?

It's been three weeks."

So I just said, "Well, I'm just going to pick one here and pick one there and pick another one there."

It's finding a needle in a haystack, right?

It's just nearly impossible.

Three days later, we got a phone call from the lab saying, "Your chicken is positive."

>> And not only positive, but positive for the exact same strain of salmonella that was in the patient, you know?

I said, "Wow, was that a coincidence?

What's the likelihood of that?"

>> Hi, my name is Dr. DeBess.

I work for the State of Oregon Department of Health.

>> NARRATOR: Interviews with other victims revealed that many had eaten the same brand of chicken that DeBess had brought back from the store.

For him, it confirmed that the Salmonella Heidelberg was coming from one company.

(clucking to "Africa" by Toto) >> NARRATOR: Foster Farms, the largest poultry producer on the West Coast.

And it wasn't just Oregon.

Health officials in Washington State were also seeing a significant jump in cases of Salmonella Heidelberg that they traced back to Foster Farms.

>> After a while, we started calling this molecular pattern, this DNA fingerprint, if you will, the Foster Farms pattern because it was so tightly associated with people who were eating chicken from Foster Farms.

>> NARRATOR: The illnesses were more serious than just the usual food poisoning.

People were being hospitalized.

>> Salmonella Heidelberg is more commonly found in blood than many of the other salmonella serotypes, so it probably has more propensity to invade through the intestine and get into the body and do more damage.

>> NARRATOR: That summer, a man in his 60s was stricken by Heidelberg and died.

>> I think we knew that it was serious-- one, because a person had died of the disease, and then Washington was seeing so many cases.

It became... you know, it quickly fast-tracked into something really huge.

>> NARRATOR: With the outbreak growing, DeBess called Foster Farms officials to a meeting in January 2005.

>> It was somewhat of a tense meeting.

We actually had proof that the chicken had actually come from a Foster Farms plant in Kelso, Washington.

And so our expectation was for them to obviously argue about it but come to a consensus and correct whatever needed to be corrected.

And they wouldn't agree to that.

In their minds, nothing was wrong with it.

>> NARRATOR: Despite repeated requests, Foster Farms would not speak to us.

But DeBess says that at the time, the company told him it had done its own testing using its own methods and had gotten different results.

>> We were using the CDC method of DNA fingerprint testing.

>> And this is a very standard method used all around the world, and certainly around the United States.

>> Yes, and the person that Foster Farms had actually hired was using a different method, so they did not believe their chicken was the cause of an outbreak.

>> NARRATOR: DeBess turned to federal meat inspectors to intervene, and they agreed with him that Foster Farms was responsible for the outbreak that sickened 46 and killed one.

Under pressure, the company agreed to reduce the levels of salmonella at their Kelso plant.

And for a while, it worked.

By the spring of 2005, DeBess and his team were seeing fewer illnesses from Salmonella Heidelberg.

>> The outbreak was over.

>> The outbreak was almost over.

>> What the...?!

>> Foster Farms chicken gets to the store in 48 hours or less!

>> NARRATOR: Foster Farms has built its reputation on healthy, wholesome chicken, with an ad campaign that emphasizes freshness.

>> You know if this flight is less than 48 hours?

>> California-grown and delivered fresh within 48 hours.

Foster Farms: always natural, always fresh.

>> NARRATOR: What started as a backyard turkey farm in 1939 has become a $2 billion industrial operation where the company controls virtually all aspects of the business, from the hatcheries to the chicken in the package.

This kind of growth and consolidation has been common throughout the poultry industry.

>> One of the things that's happened in the United States around food and food production is that it has gotten a lot bigger and more industrial.

So whereas 50 years ago we might have seen outbreaks that happen, they would be relatively local.

Now when we see outbreaks, we often see cases that are in many, many different states.

So I think not only the scale of production, but the scale of distribution has meant that if some product is contaminated, it has the potential for affecting a much broader number of people in a much broader geographic area.

>> NARRATOR: The dangers of widespread meat contamination were first brought home to consumers and regulators in 1993.

>> This is King 5 News.

>> Live at 6:30.

>> Good evening again, another child has died of E. coli poisoning.

>> A major medical catastrophe, this E. coli outbreak... >> NARRATOR: A bacteria called E. coli O157 had sickened more than 700 people across the West.

>> Most of the victims ate undercooked, contaminated hamburgers from Jack in the Box restaurants.

>> Four are in critical condition.

>> Ten are hooked up to kidney dialysis machines.

>> Today, a small child fights to live.

>> It really was a war zone here, and I think Jack in the Box was that crisis moment for the public realizing that this quintessential American meal, the hamburger, could kill kids.

>> The legal battles have just begun.

>> NARRATOR: Bill Marler became the lead attorney in the case against Jack in the Box.

>> Four children died.

>> A small white casket carried the 17-month-old child.

>> And they died really...

This is not, like, an easy death.

I mean, when these children die, they usually die of... their bowel perforates, they die of strokes, they die of heart attacks.

>> NARRATOR: It was a watershed moment.

The crisis had exposed gaping holes in the meat safety system.

The U.S. Department of Agriculture, which oversees meat safety, had failed to keep deadly strains of bacteria, like E. coli O157, from reaching consumers.

>> That was a seminal event for the agency.

We realized that the most important food safety issue was not what we could see with our eyes, but what existed invisibly to the naked eye, and that is bacteria.

>> NARRATOR: The disaster spawned a major overhaul of the meat safety system, and USDA banned E. coli O157 from raw ground beef by declaring it an "adulterant."

>> It means that from here on out, there's zero tolerance for E. coli O157:H7 in hamburger.

If it sickens somebody, you have to recall the product.

>> That was something that the agency had never done before, because bacteria were considered to be a natural occurring part of any animal that came in to be slaughtered.

>> NARRATOR: Despite opposition from meat companies who said the change would be too costly and couldn't be done, over the next two decades, illnesses from E. coli O157 dropped dramatically.

But E. coli O157 wasn't the only deadly bacteria found in meat.

>> Salmonella sickens and kills more of us than any other foodborne pathogen.

And over the last 20 years, I've represented dozens and dozens of families who have lost loved ones from salmonella contamination.

>> NARRATOR: After Jack in the Box, the USDA began testing for salmonella in slaughterhouses and set new limits on how much would be allowed.

But unlike E. coli O157, USDA didn't declare salmonella an adulterant and ban it.

They believed that question had been settled in court in 1974.

>> And in that decision, the American Public Health Association wanted salmonella to be considered an adulterant, and the USDA and the beef industry together said no.

And this is actually from the court decision: that housewives will take care of it, they know what they're doing by cooking it properly and handling it properly.

It's the consumer's problem.

>> NARRATOR: But that assumption would prove perilous.

Salmonella can easily spread and get people sick when raw poultry is being handled.

Over the past 15 years, salmonella outbreaks linked to poultry have become an increasing public health concern.

Between 1998 and 2012, chicken and turkey have been associated with 278 salmonella outbreaks in at least 41 states.

One of the biggest started in Arkansas in 2011 at Cargill.

>> Hi, David, I'm Shane Acosta with Cargill.

Welcome to the Springdale complex.

>> Now does that need to be adjusted?

>> Feels good.

>> NARRATOR: Cargill was the only poultry company that would allow us to visit parts of their production facilities.

>> So we can stop here in the middle and get an overall view of the area.

>> NARRATOR: Here at its Springdale plant, the company processes 48,000 turkeys a day.

>> Here's our marinated tender production.

>> NARRATOR: Like other meat companies, Cargill has had a history of foodborne outbreaks, but nothing like the crisis it faced in 2011.

>> This meat packaging plant in Springdale, Arkansas, could be responsible for a nationwide outbreak of salmonella that's killed one person and sickened 77 others.

>> Cargill foods has launched one of the largest meat recalls in U.S. history.

It covers 36 million pounds of ground turkey.

>> NARRATOR: The decision to recall the ground turkey was recommended by Cargill vice president Mike Robach.

>> Is it painful for a company to do that?

>> It's very painful for a company to do that.

It's not a decision taken lightly.

It was clear to us that there was an association with a number of those illnesses with our product.

>> NARRATOR: Cargill had known for months that it was having problems with salmonella.

>> When we saw increases in levels of salmonella in our product, we kind of looked and said, "Oh, you know, that's kind of a seasonal thing."

And it came up and it went down.

And I think at the end of the day, we weren't taking appropriate action.

>> NARRATOR: The failure to act allowed millions of pounds of ground turkey to leave the Springdale plant, and much of it was known to carry high levels of salmonella.

As a result, 136 people were sickened and one died.

And it all happened under the watch of USDA's inspection arm, the Food Safety and Inspection Service, FSIS, which has inspectors in every slaughterhouse in the country.

>> Has the inspection process kept pace with the times?

>> No, it hasn't.

I mean, you know, we have inspectors that are doing the same thing they've been doing for years and years and years, before Jack in the Box, looking for abscesses... >> Bruises or bones.

>> Bruises, bones, some quality issues.

>> Something you can see.

>> Something that you can see.

So it's kind of like they sniff, they smell, and they look.

That is not the modern way for us to be applying what we know from a scientific standpoint to providing good oversight.

>> NARRATOR: Most inspectors aren't looking for bacterial threats like salmonella.

That's because USDA's inspection practices were set by law over 100 years ago.

>> You go back to the days of The Jungle, and Upton Sinclair and Teddy Roosevelt creating USDA's oversight responsibility for meat and poultry inspection.

The focus was then really getting diseased animals out of slaughterhouses.

We don't have that problem today.

We didn't have that problem when this occurred.

>> We'll walk all the way down to the end where you'll actually see product entering the chiller.

>> NARRATOR: Companies like Cargill do take steps to reduce salmonella during processing.

>> These cold water baths also contain our intervention, a dilute solution of peracetic acid, the same acetic acid that you find in vinegar.

>> NARRATOR: After the baths, FSIS inspectors occasionally test for salmonella.

They have limits, or standards, on the number of birds that can be found with it.

But some salmonella still gets into the marketplace.

>> When I first started in the poultry industry, sometimes 70% of the carcasses would be positive for salmonella.

We've driven that number down to where now we're less than ten percent, so you look at a huge decrease in the prevalence of salmonella in poultry without a corresponding decrease in human salmonellosis.

>> Salmonella levels are going down, human illness is not.

And it doesn't take a genius to understand that if this is going down and this is not, this must be the wrong standard.

>> NARRATOR: The problem with the standards is that USDA's testing is sporadic and unreliable.

Inspectors test less than one bird a day, even in plants that process hundreds of thousands daily.

What's more, the testing doesn't measure the amount of salmonella found or differentiate between innocuous and dangerous types, like Heidelberg.

>> A company can meet the salmonella performance standards and their product can still be responsible for causing an outbreak of foodborne illness.

>> NARRATOR: That's exactly what Cargill realized during the 2011 outbreak.

>> The whole time, we were in compliance with the USDA performance standards.

So we were meeting the USDA requirements.

>> You were meeting it.

>> We were meeting it.

>> So what does that tell you about the performance standards?

>> That it has been ineffective and it's time to change it.

>> Is it broken?

>> It never worked.

>> NARRATOR: But the inspection process wasn't the only weakness in the system.

Once the salmonella-tainted poultry had left the plant and started making people sick, the USDA had very little authority to get the meat off the market.

>> The fact that Cargill did recall the product, um...

They didn't have to.

>> Mm.

>> They didn't have to.

Since salmonella is not an adulterant, there was no authority for the USDA to pull that product.

>> NARRATOR: Unable to order a recall, the government had to rely on the goodwill of Cargill to pull their tainted ground turkey.

>> For us, it was the right thing to do.

Make people aware, let's get it off the market, let's get the problem fixed, and let's move on.

>> NARRATOR: Cargill overhauled its salmonella controls, and within four months, the government declared the outbreak over.

But the threat of Salmonella Heidelberg wasn't gone.

By 2012, back in Oregon, state health officials were seeing a familiar pattern.

>> Our attitude was one of "here it comes again."

>> NARRATOR: The Salmonella Heidelberg was back.

>> Historically, it would be two to three years, and then again, and in two to three years, it would begin again.

So were we expecting it?

In the back of our minds, we were.

>> NARRATOR: The contamination was traced to two Foster Farms plants, including the one in Kelso, Washington, that was linked to the 2004 outbreak.

But this time, it was worse.

>> The case counts went way up, higher than anything we'd seen in 2004 or 2009.

>> NARRATOR: By August, 35 cases of salmonella poisoning had been officially reported.

>> And if you know anything about disease reporting, you know that most people with salmonella don't go to the doctor.

So you can typically multiply any salmonella number that we get by something like 30 to get the true number of cases out there.

>> NARRATOR: And there was a new, alarming development: some of the Heidelberg was resistant to crucial antibiotics.

>> And that makes it much more difficult to treat.

And then the virulence of the strain, if people get sick with it, they're more likely to get severe illness, and that severe illness is going to be less susceptible to antibiotics to be treated.

That's sort of a double whammy, if you will, that makes it doubly dangerous.

>> That to me was probably that switch, you know, in which I said, "There's a bunch of blood infections here.

"You know, this is not our usual salmonella and a little bit of, "you know, vomiting and diarrhea.

"This is more severe.

"These people are getting hospitalized.

Something needs to happen here."

>> NARRATOR: By September, the case count hit 65.

By January 2013, it was over 120.

And cases were showing up in other states, like California.

State health officials began pressing FSIS to make Foster Farms clean up the contamination.

But it wasn't so simple.

>> FSIS is telling us that "We have people in the facility and the company is meeting the targets that we set for them," and that's why, you know, they couldn't take any action.

And our response of course is, "Well, I don't know why a product "that's meeting your requirements is able to cause so many cases of illness, but these are the facts."

>> Did you ever urge them to take actions, such as pushing for a recall?

>> We suggested recalls to them and weren't successful.

>> A six-month long outbreak of about 100 cases of salmonella has prompted health officials in Oregon and Washington to warn people about improperly cooked chicken.

>> The state department of health says that a "great majority of this strain of salmonella came from Foster."

Everyone is being cautious, but there is no recall in place.

>> What you're seeing now is an example of a system that is not working well.

And when people don't want to do what we think is a responsible thing, the question is, "What are the authorities to compel people to do the right thing?"

And that's where the breakdown is.

>> NARRATOR: By fall of 2013, new strains of Salmonella Heidelberg were hospitalizing scores of victims and spreading from California to more than a dozen other states, like Arizona, where it would eventually sicken Noah Craten.

>> I had a nurse tell me, you know, when we first realized that he had an abscess, she said, "I cannot believe that he's still alive."

>> There are a lot of papers here.

>> NARRATOR: As Noah was recovering from surgery, his parents got the DNA test results showing where the salmonella had come from.

>> "The S. Heidelberg outbreak associated to Foster Farms chicken."

>> NARRATOR: Once again, it was Foster Farms.

Though Noah is getting better, the Cratens claim that his nightmare could have been avoided, and they're pursuing legal action against the company.

>> Foster Farms were well aware of this chicken potentially making people sick long before October, so if they would have instituted a recall in the beginning when people started getting sick early in the year, then my son would have never gotten sick.

>> Still, Foster Farms has not recalled any chicken.

The poultry company says its products are safe to eat if properly handled and fully cooked.

>> NARRATOR: With no recall in place and people continuing to get sick, officials at the CDC in Atlanta were on full alert.

>> Currently at this point, ORPB is following 25 different illness clusters: one E. coli, one listeria, one campylobacter, and 22 salmonella.

So that's sort of our snapshot for the last week.

>> NARRATOR: They track foodborne illnesses nationally and see outbreaks every week.

>> That brings us to our first investigation of the day.

>> NARRATOR: But this one was far more troubling.

>> This outbreak put a lot of people in the hospital with severe illness.

Nearly 40% were hospitalized, which is almost twice what we expect in the usual salmonella outbreak.

>> So these are all Salmonella Heidelberg cases?

>> Each little line is a Salmonella Heidelberg that has been sent in from state health departments.

>> NARRATOR: What had started as a trickle of cases cascaded into a stream of illnesses.

>> We wondered, "Where does this stop?

How many are there going to be?"

This was really taking us into new territory.

>> NARRATOR: They turned to investigators at FSIS.

>> We'll have to analyze those trends.

>> NARRATOR: Dr. David Goldman is the point person for FSIS on foodborne outbreaks.

>> The interviews of the patients told us repeatedly, it's Foster Farms predominantly.

Not in every case, but most of them mentioned Foster Farms.

I think about 80% said that.

>> NARRATOR: What was confounding was that Foster Farms had been meeting the salmonella standards in four plants that were suspected of causing the outbreak.

>> I think Foster Farms had passed all of their sets in terms of the performance standards we had for whole chickens.

>> So in plain language, Foster Farms had... >> Had been performing according to our expectations.

>> NARRATOR: The agency's own internal data show that government inspectors failed to find any sign of salmonella inside these four Foster Farms production plants between 2010 and early 2013.

More than 500 samples had been taken.

Not one was positive for salmonella, and yet people were still being sickened.

>> At the time, outbreaks are happening.

There was an outbreak in 2012 in Oregon and Washington.

A big outbreak starts in 2013.

>> Right.

>> Do you think that there was really no salmonella for three years before that?

>> I think what we learned in this particular outbreak is that it's not detectable perhaps at the time we test or, you know, given the concerns about or the questions about techniques.

>> NARRATOR: There was another reason FSIS hadn't found salmonella: they had been looking in the wrong place.

>> When we were talking to sick people, we were asking them, "What kind of chicken did you eat?

"Where did you buy it?

"And what was it?

"Was it a whole carcass?

Was it thighs or breasts?"

>> Why is that important?

>> Most of the regulatory attention and most of the industry attention has been focused on reducing contamination in the whole chicken carcasses.

But there's been little attention focused on chicken parts.

>> NARRATOR: And that was a huge problem, because 80% of the chicken sold today has been cut into parts, a process that can release salmonella buried in the skin.

Yet FSIS had never set limits for salmonella on chicken parts.

>> So what you're telling me is the government has not tried to reduce the amount of salmonella on chicken breasts and chicken legs, like the kind I buy?

>> The effort has been focused in the industry and in the government regulations on the whole chicken, the whole chicken carcasses.

>> NARRATOR: But FSIS had recently done research showing that about one in four chicken parts nationally were actually contaminated with salmonella.

So they quickly began testing the chicken parts from Foster Farms.

>> When we sampled the Foster Farms plants, in three of them, we found roughly 25% of chicken parts, maybe slightly higher, had salmonella.

>> So in the middle of the outbreak, it's building steam.

>> Yes.

>> And you do more sampling of chicken parts... >> That's right.

>> Under Foster Farms... >> Right.

>> And you find that one in four pieces of chicken are contaminated?

>> With salmonella, predominantly Salmonella Heidelberg, and more than that, most of them had the outbreak strains.

So we had very convincing evidence to us that this plant was, or these plants, three of the four were producing products that had Salmonella Heidelberg, and many of which, most of which contained the outbreak strain.

>> So you get this pretty convincing evidence.

Why not a recall?

>> Because at that point, none of those samples were linked directly to somebody getting sick.

>> NARRATOR: What they needed to find was a victim that still had an unopened package of chicken with the exact same strain of salmonella that had sickened them, nearly an impossible task.

>> We were missing that straight line, that direct line of evidence that would have made it possible for us to request a recall.

>> NARRATOR: Soon, they thought they'd found it in San Jose, California.

In September 2013, Rick Schiller came down with a bad case of food poisoning, and then, one night, woke up in real trouble.

>> We go to bed.

About 3:00 in the morning, I moved just a little bit, and it's such unbearable pain.

And I pull the covers back.

My right leg is about two to three times the normal size.

It's like a balloon about to pop.

And my fiancée freaked out.

And I'm literally just screaming out, and she says, "What do you want me to do?"

And I said, "Just get ready and get to the car."

It's the most excruciating pain I've ever had in my life.

>> NARRATOR: Doctors immediately tried to relieve pressure by removing fluid from his knee.

>> And when she pulled on the syringe just filled with, like, a meat-type substance, and she says, "Something's seriously not right here."

>> NARRATOR: While lying in his hospital bed, Schiller got a call.

>> And it happens to be my regular doctor, and he says, "Do you realize you have salmonella poisoning?"

>> NARRATOR: The salmonella had triggered a severe reaction in Schiller's knee, and DNA testing confirmed it was one of several strains of salmonella coming from Foster Farms.

In time, the company would reach a settlement with Schiller.

But it was after he went home and recovered that Schiller's case took on special significance.

A health official contacted him to find out where he buys his chicken.

His credit card showed that he'd been to the supermarket just before getting sick, where he'd purchased two packs of Foster Farms chicken.

>> She said, "Did you consume both?"

And I said, "I didn't consume both," and she said, "Well, what happened to the other pack?"

And I said, "It's in my freezer."

>> NARRATOR: It seemed to be the breakthrough FSIS had been hoping for.

If the pack in the freezer had the exact same strain of salmonella that sickened Schiller, it would be the direct evidence FSIS needed to request a recall.

But when they tested it... >> In this case, it didn't quite match.

Yes, it was produced from the plant and was associated with this outbreak, but it was a different strain.

So this is one where we thought we were close and it didn't pan out.

>> The unopened package in the possession of someone who's gotten sick is called the gold standard.

It's the undeniable proof that the contamination didn't happen in the consumer's home.

In this case, it's ridiculous.

You have people all over 26 states who are getting sick from the same product.

You... You didn't need that level of proof.

>> NARRATOR: Instead of requesting a recall, FSIS issued a public health alert about the trouble with Foster Farms chicken.

And with the crisis spreading, the agency demanded that the company devise a plan to reduce its salmonella levels, or it would pull its inspectors.

>> I just wonder at this time, here we are in the fall.

There are hundreds of people getting ill.

The hospitalization rate is nearly twice normal, but the stuff is still being sold.

People are buying it.

>> Right.

>> Is that the way it should be?

>> We believe we took the strongest action we can take.

They have to respond to our notice that we're gonna withdraw inspectors, you're gonna have to shut down your operations.

And they presented to us a plan, and the agency looked at it and said, "Looks like they can control salmonella if they implement all these things."

>> If I'm clear, you did not cause any withdrawal of product from the food chain, from commerce.

>> We did not, we did not.

>> Which is part of your charge, right, is to keep the stuff from getting out there.

>> That's right.

>> And you didn't because you were still pursuing that match.

>> That's right.

>> NARRATOR: But then an unexpected development.

>> For now, no operations at this Foster Farms plant, with the USDA shutting down the 250,000-square-foot facility in Livingston.

>> NARRATOR: Ten months after the outbreak in California had started, FSIS finally shut down a Foster Farms plant.

But not because of salmonella.

>> It's closed this morning because of a cockroach infestation.

A lot of customers are understandably worried, and so they have closed it down.

>> Why cockroaches and not salmonella?

Why close a plant over cockroaches?

>> Cockroaches, infestations of any pest can bring in pathogens, salmonella, or other things that could contaminate the environment, could contaminate products.

>> It just sort of shows how ineffectual they are.

Because, you know, salmonella kills people, salmonella sickens people, salmonella puts them in the hospital.

Cockroaches are kind of gross, but I've never seen a salmonella outbreak that's ever been definitively linked to cockroaches.

>> NARRATOR: Although Foster Farms would not speak to us, it issued a statement saying that it regrets any illness that may have been associated with its products.

It has invested $75 million in its facilities and says its salmonella levels are now significantly below those of other companies.

>> Foster Farms could say, "But we're following the law," which they are.

"We have our USDA inspectors in here, "and we are not selling any product that is not allowed in the United States," and they would be correct.

So the gap really is, in my mind, when we identify a product such as the Foster Farms chicken which has caused now multistate outbreak going over months on end... >> More than a year.

>> Right, with a large number of cases and hospitalization, that there hasn't been a more active response to this particular outbreak.

>> NARRATOR: We obtained FSIS enforcement records for Foster Farms over the past decade.

>> There were some documents that we found in our research that said that Foster Farms... >> NARRATOR: After the 2004 outbreak in Oregon, FSIS sent Foster Farms a warning letter, noting that the company had failed to effectively control salmonella and that its hazard control plan didn't even list salmonella as a health threat to worry about.

>> "Salmonella, a hazard not reasonably likely to occur," is what Foster Farms wrote in their plan.

How can that be?

>> It shouldn't be.

They should have accounted for it and they should have done something more than what they did.

>> NARRATOR: The records show that Foster Farms itself was aware of a "dramatic increase" in Salmonella Heidelberg back in 2004.

>> I guess the question comes up looking at all this, "Where was the agency?"

>> Well, I think again, I'm...

I'll try to answer this.

If they had an outbreak in 2004, we had that letter that you just read, and it says, "We expect you to make some changes."

And then you have another outbreak five years later, and so then we have to ask ourselves, we all have to ask ourselves, "Did they do enough?"

>> Did they do enough?

I'm asking you.

>> If they had another outbreak that's Salmonella Heidelberg, then I don't think they did enough.

>> And what are the consequences of that?

>> The consequences were probably more letters like that and more expectations on the part of the agency that they make some changes, which... >> But the 2013 letter uses the exact same language of deficiency as the 2004 letter.

>> So what that suggests to me is that we recommended that they look at salmonella and Salmonella Heidelberg in particular as a hazard reasonably likely to occur, account for that in their food safety system, and they did not.

>> And is there some punishment for that?

Is there some action?

>> Um...

There is no specific action that I'm aware of.

>> NARRATOR: Responsibility for overseeing meat safety ultimately rests with the secretary of agriculture, the former governor of Iowa, Tom Vilsack.

>> Mr. Secretary, I still don't understand what happened with Foster Farms.

This outbreak went on for a year, over 600 people.

And I just wondered, were you standing here in Washington and saying, "My goodness, what's going on?"

Why didn't you just say, "We have a problem.

We should shut it down"?

>> Shutting Foster Farms down wouldn't necessarily have prevented any of those hospitalizations or illnesses, because the product that caused those illnesses had already entered the stream of commerce.

But in terms of being able to recall the product, we certainly would have if we'd had definitive proof of the specific product that was causing the illness.

That definitive proof is necessary in order to meet the legal burdens that are required in order to make sure that a court doesn't overturn it.

>> NARRATOR: Vilsack says that trying to take stronger action would likely be blocked by the courts, and he points to a 2001 case where the agency was prevented from shutting down a meat plant with high levels of salmonella.

The reason: Salmonella is not considered an adulterant.

>> Thank you, Mr. Chairman.

>> NARRATOR: Last year, with more severe strains of salmonella emerging, Congresswoman Rosa DeLauro questioned Secretary Vilsack about the problem.

>> Why does USDA refuse to consider multiple resistant salmonella as an adulterant the same way we do as E. coli O157: H7?

>> We attempted to do what you're asking us to do relative to salmonella and adulterants, and we were basically told by the court that we did not have the authority or the jurisdiction to do that.

>> I asked Secretary Vilsack in a hearing, when he said they didn't have the authority in the hearing, I looked directly at him and I said, "Well, ask for the authority."

Ask us for the authority.

>> Well, we've attempted to exercise the authority and courts have basically told us, "Can't do it."

>> Ask us for the authority.

>> Well, um... >> I'm serious.

>> Well, I didn't realize... >> We have legislation here, we can deal with these issues.

Ask for the authority.

Thank you, Mr. Chairman.

Thank you, Mr. Secretary.

>> Did the Obama administration ask for more authority?

>> No.

>> Why not?

>> I still believe that this is a question of the industry.

It's a very powerful industry, and I believe they have a very strong lobbying effort that the USDA is not willing to buck.

>> NARRATOR: But the administration points the blame at Congress, which over the years has been unwilling to give USDA more authority.

>> If Congress wants to give us additional power and direction, fair enough, but at this point in time, I have to live with the rules that we have.

>> Have you asked for more authority?

>> Well, right now, our focus has been primarily on making sure that our regulatory systems are what they need to be.

>> NARRATOR: Recently, USDA began requiring companies to recognize salmonella as a likely hazard and proposed salmonella standards on chicken parts.

But that doesn't give USDA any more legal authority.

>> That means if a company is producing chicken with salmonella rates much higher than what's allowed under these performance standards, they can continue to operate and they can continue to sell that chicken.

>> NARRATOR: We wanted to speak to the National Chicken Council, the industry's main lobbying group, but they declined repeated requests for an interview.

The group, and many companies, have long opposed tighter regulations and efforts to ban any types of salmonella as adulterants.

>> Well, I don't believe that salmonella rises to the level of an adulterant.

I don't believe that the mere presence of salmonella, you know, causes a food safety hazard the way the presence of E. coli O157 does.

>> Even these more dangerous types of salmonella?

>> Even the ones that are more prevalently found in human illness, I don't believe that they rise to that level.

>> Let's make no mistake about what's going on here.

It is the failure of FSIS to think about themselves as a public health entity.

They choose not to go to Congress and ask for authority, for recall authority, and they choose not to do the basic scientific work that they need to justify calling salmonella an adulterant so they can withstand a court challenge from the industry.

That's the failure here.

>> NARRATOR: That leaves the burden on consumers to handle and prepare poultry as carefully as possible.

>> I use a meat thermometer when I cook my meat.

I use all of the food safety measures.

I use antibacterial wipes.

>> NARRATOR: Last May, as the Foster Farms salmonella outbreak entered its 15th month, Jennifer Robinson was cooking chicken for her family, the way she often does.

>> Say I have the raw chicken on my cutting board.

I'll put it into the frying pan, and then I will take everything, put it in the sink, wash it with antibacterial, take the antibacterial wipes, wipe down the countertop, wash my hands with antibacterial soap.

I'm extremely careful.

>> NARRATOR: But days later, despite all the precautions, her son AJ landed in the hospital with a bloodstream infection.

>> It's very scary when your child is sick and you don't know what's going to happen, and it's scary when a doctor says, "We don't know what kind of bacteria this is."

>> NARRATOR: Testing would show it was Salmonella Heidelberg and it matched the Foster Farms pattern.

AJ ultimately recovered, but his case would be the turning point in the investigation because in a freezer in the family's garage, Jennifer Robinson had what FSIS had been hunting for since the outbreak began: an unopened package of Foster Farms chicken with the exact strain of Salmonella Heidelberg that had sickened her son.

FSIS had finally found the direct evidence it needed.

>> California's Foster Farms is recalling 170 chicken products.

>> At that point, and immediately at that point, the recall was issued because then you had the specific proof that you needed to be able to say specifically this product needs to come back.

>> NARRATOR: A decade after health officials first found Salmonella Heidelberg problems at Foster Farms, USDA finally asked the company to recall some of the chicken it had sold.

The company agreed, but insisted that its responsibility for the outbreak was limited.

>> Foster Farms says only one illness was definitively traced to its chicken, but that it's voluntarily expanding the recall to all products packaged in that period in the fullest interest of food safety.

>> NARRATOR: In the end, the CDC says, the Foster Farms outbreak was the largest from chicken in history, spreading to 29 states and sickening 634 people.

And this was just one of a dozen salmonella outbreaks associated with poultry in 2013 alone.

>> Since this has happened, some things have come to my attention that are frightening for a mom.

So for example, it doesn't seem like our governmental regulators have much enforcement power over things like this.

If Foster Farms is able to say, "No, we don't want to recall because we don't have any hard evidence," then we don't have laws that are protecting us.

>> Even though chicken is causing people to become ill, government is allowing salmonella and Salmonella Heidelberg to be just part of the chicken equation.

And until they just come to grips with the fact there isn't an acceptable level of salmonella, it's going to remain this way for the foreseeable future.

>> Go to pbs.org/frontline for more on "The Trouble with Chicken."

>> The strains of Salmonella are tougher, stronger, and many of them are antibiotic-resistant.

>> And check out more on the Jack in the Box E. coli outbreak from our partners at Retro Report.

>> Jack in the Box was a wake-up call to many.

It changed consumers' perceptions and it absolutely changed the behaviors of the industry.

>> Then connect to the Frontline community.

Tell us what you think on Facebook and on Twitter, and sign up for our newsletter at pbs.org/frontline.

>> For more on this and other Frontline programs, visit our website at pbs.org/frontline.

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