Texas Department of State Health Services (TX DSHS) announced on October 20, 2010 that the agency had identified food produced by SanGar Fresh Cut Produce (SanGar) as the source of listeriosis infections diagnoses in at least ten Texas residents over an 8-month period. The following day Texas authorities ordered SanGar to suspend business and recall all products shipped since January 2010. State law allows TX DSHS to issue such orders when conditions exist that pose an immediate and serious threat to human life or death. The recalled products – primarily cut fresh produce in sealed packages – were distributed to restaurants and institutional entities, such as hospitals and schools.
Public health investigators initiated an outbreak investigation after reports of listeriosis had surfaced earlier in 2010. Investigators ultimately identified 10 case patients, including five deaths. Illnesses occurred in residents of Bexar, Travis, Guadelupe, and Hidalgo counties. Seven of the 10 patients had consumed chopped celery produced at the SanGar plant in San Antonio. Listeria monocytogenes (LM) was isolated from samples of chopped celery produced by SanGar in early October 2010. Pulsed field gel electrophoresis (PFGE) analysis showed that isolates obtained from specimens obtained from case patients were genetically indistinguishable to isolates cultured from celery samples and from environmental surfaces in the SanGar plant.
TX DSHS inspectors found sanitation problems at the SanGar plant and believed LM found in celery might have contaminated other food produced at the plant. Inspectors found condensation about a food product area, soil on a preparation table and hand-washing lapses. State findings prompted inspections by federal investigators at the FDA who summarized their findings in Form 483. Numerous critical violations were noted during inspections conducted between October 14 and October 26. These included:
Observation 1: Failure to protect against contamination of food and food contact surfaces with microorganisms.
Observation 2: Failure to conduct cleaning and sanitizing operations for utensils and equipment in a manner that protects against contamination of food, food-contact surfaces, and food-packaging materials.
Observation 3: Employees did not wash hands thoroughly in an adequate hand-washing facility at any time their hands may have become soiled or contaminated.
Observation 4: Personnel with adverse health conditions are not instructed to report to their supervisors.
Observation 5: Failure to clean food-contact surfaces and utensils as frequently as necessary and to protect against contamination of food.
Observation 6: Failure to take apart equipment as necessary for thorough cleaning.
Observation 7: Failure to take effective measures to protect finished food from contamination by raw materials and refuse.
Observation 8: Failure to store raw materials in a manner that protects against contamination.
Observation 9: The design, construction, and use of equipment and utensils fail to preclude the adulteration of food with contaminants.
Observation 10: Failure to maintain equipment, containers, and utensils used to store food in a manner that protects against contamination.
Observation 11: Lack of adequate drainage of areas that may contribute to contamination of food by seepage, food-borne filth, and providing a breeding place for pests.
Observation 12: Failure to hold foods that can support the rapid growth of undesirable microorganisms at a temperature that prevents the food from becoming adulterated.
Observation 13: The plant is not constructed in such a manner as to allow floors and walls to be adequately cleaned and kept clean and kept in good repair.
Observation 14: Plumbing constitutes a source of contamination to food, water supplies, equipment, and utensils.
Observation 15: Failure to maintain in sanitary condition buildings, fixtures, or other physical facilities.
Observation 16: Failure to provide a sanitary towel service or suitable hand drying devices.
Observation 17: Hand-washing facilities lack running water of a suitable temperature.
Observation 18: Failure to adequately screen or provide other protection against pests.
Observation 19: Appropriate training in food handling techniques and food protection principles has not been provided to food handlers
The SanGar facility has remained closed since October 20. The company cannot reopen until the company assures regulators that the facility is clean and free of Listeria.