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Home My WebLink AboutCASE-3-11-2553.TIF 2011- Mar -07 11 50 AM i4CK: IN THE 2G:: 85.85 12574 1;4 Jack in the Box Inc. Regulatory Affairs 9330 Balboa Avenue San Diego, CA 92123 In the box Fax: 858 -571 -2116 Number of pages including cover: 4 Date: March 7, 2011 To: Julia English Fax: (828) 465-8276 From: Dee Williams, Regulatory Affairs Manager 1 858 -571 -2550 dee.williants@jackinthebox.com Re: Allegation of Foodborne Illness — FYI It is our practice to notify you of any issues brought to our attention that may require your assistance or we feel may be of interest to you. If you determine that further investigation is warranted based on the attached information, please feel free to visit the restaurant concerned or call the sender of this fax at the number indicated. Also, please call if there are any findings that we need to be aware of or if you have any questions. If contact with your Public Health Nurse /Communicable Disease Specialist is necessary, please provide that individual with the number of our Epidemiologist, Paula Tanner (858) 571 -2461. Thank you. 2011 - Mar -07 1150 411 JACK: IN THE BO:: 8585712574 2/a • • ( .. g t ,... e ` Jack In The Box Guest Report 0 o' Report 6: EV2011533086 Assigned to: Suzanne Devlin Time Reported: 4:57 PM Cato Roported: 3/4/2011 Guest Information Perot Name: Carrie Last Name: Matthews Additional Info: caller Nancy (Mother) Address: Address 2: City: State: Zip Coda: Home Phone: Business Phone: Cell Phone: (828) 994 -0169 Call Source: Guest Direct Visit Date: 3/2/2011 Time: 1:00 PM Clouod Date: Action: Area Coach Notified; Reg. Affairs - Notified; Restaurant Manager Notified; PMT Notified Issue: GR069 illness, Alleged Restaurant lnformatlon JIB: 006834 - Jack In The Box Region Name: Charlotte Roglon: 54 Address: 510 10th St Nay City: Conover State: NC Phone: (828) 695 - 1638 Restaurant Manager: MAI LEE Are Coach: MC CHARLES DC: Danville Distribution Product Information Line #: QA Mgr: PMID: 9999 - UNKNOWN /OTHER Dollvory Dato: Supplier: Occurred Data: 3/2/2011 Codes: • Product Sample (if applicable) Requested: Received: Sent to Vendor: Vendor Response: Evaluation Comments: Period: 8 Pogo 1 Monday, March 07, 2011 8:20:02 AM 2011 - Mr -07 1150 AM IGr,( IN THE 2o „ 8585 3/4 Comments 3/4/2011 04:57:56 PM (EAH) OSt states that her daughter was diagnosed w/ having E -coli sickness after having tests done &; being sick, both her &; her boyfriend Qst states that they checked her daughter &; drew blood &; Dr came back saying that she had E -coli bacteria in her system Qst &; her boyfriend both only had eaten at JIB together &; this was the only thing that she had &; by Sam gets daughter was in the bathroom sick Gst does not know if her daughters boyfriend had been checked yet Transferred to senior 3/4/2011 05:08:05 PM (SCD) Qst Nancy is calling on behalf of her daughter Carrie (24 y /o). - Verified information provided. - Daughter and boyfriend had a hamburger meal. Daughter did not have cheese on her meal. Gst Nancy was not sure what exactly the Gst had ordered. - Daughter works at a Sports Bar. - Daughter did not eat anything after MB. - Boyfriend became ill at 3 ant with symptoms of nausea, vomiting (multiple times), diarrhea (multiple times), headache. -Gst does not know how the boyfriend is doing now. -Gst became ill at 5 am with nausea, vomiting (multiple times), diarrhea (multiple times), headache - Daughter took IB Profen. -3/3: Daughter went to Urgent Care (Boeings Printery Urgent Care). Her blood was drawn. Gst was given a shot of "finlean” for nausea. The doctor came back and told the mother that the Qst had food poisoning and that there were traces of E Coll bacteria in her system. Gst was not told her what strand she had. This was determined from the blood test. - Daughter was prescribed a heavy antibiotic (S85 ?) and nausea medication ( "Finican "). Gst was put on a special diet. Qst was asked if she was allergic to sulfur or sulfhte. •Qst Nancy returned to the JIB and spoke to EE (female, Nina) who apologized profusely. - Daughter is feeling better now, but she is very weak. -Asked Gat If a call back could be arranged for Monday. -Gst may call the health department. -Asked Qst if it would be possible to speak with the her daughter directly. Gat states that her daughter lost her cell phone. Qst will see if she can arrange for her daughter to speak with guest relations. -Gst is not available until after 5 or 5:30pnt. 3/4/2011 05:30:38 PM (SCD) Notified Regulatory Affairs- Alleged E.Coli 3/4/2011 05:34:20 PM (SCD) Notified PMT. 3/4/2011 05:35:26 PM (SCD) Left voicemail for General Manager and AC Charles McCall. 3/4/2011 05:35:42 PM (SCD) Emalled AC. 3/4/2011 05:44:31 PM (SCD) Notified CNG, KAN, and DPW. 3/4/2011 05:45:03 PM (SCD) Called over to hotline and spoke to DPW. 3/4/2011 05:50:08 PM (DPW) Called JIB and spoke with Mai, Restaurant Manager. Illness report was called in without guest contact information as EV201 1532411. - Advised manager all information wilt be moved to EV2011533086 as this the report contains guest contact Information. 3/4/2011 06:02:10 PM (DPW) Info copied from Heads Up report EV2011S33086: 3/3/2011 03:14:59 PM (DAC) Mylie, Mgr., Dolled reporting guest alleges her daughter (25 yrs old) became ill after eating the JIB food. -Guest was not sure what her daughter had eaten, but suspects It was a burger. - Guest's daughter and her daughter's boyfriend ate at the JIB at night before the daughter went to work at Wild Wings. -Guest informed her daughter Informed her that MB was all she had to eat. - Guest's daughter was fine at work, but then became ill at 2AM this morning. - Guest's daughter was kept until later this morning for observation, but was released then. - Guest's daughter was diagnosed with ecoli (unknown what type). -Guest Informed that a urine test was done on her daughter to determine Illness. -The JIB has not been contacted by any other guests alleging illness. -No EEs working while ill. -No problems with any of the fridges/freezers. - Verified that all appropriate handwashing procedures are being followed. -Mgr. provided UBS foi jumbo and regular patties. -Mgr. informs that the JIB EEs do cook everything properly according to procedure. • -Mgr. reports she already spoke with her A/C regarding this guest's allegations. -Guest requested the 800 number for GR which was provided for her, but guest would not leave personal contact information with the JIB. Period: 0 Page 2 Monday, March 07, 2011 8:20:02 AM 2011 - Mr -0T 11 50 AM lAC IN THE BOA;: 8585 4/4 Comments • Hotline follow up complete. 3/4/2011 06:03:40 PM (DPW) Transferred from heads up report: 3/3/2011 03:29:28 PM (DAC) Notified Reg. Affairs - Guest alleges oeoli. 3/4/2011 06:09:14 PM (DPW) Comments copied from Heads up report - EV2011532411: • 3/4/2011 02:03:48 PM (DW) Insufficient guest Information, no HD contact at this time. 3/7/2011 08:01:00 AM (PMT) The Incubation period for E -coli 0157:H7 is typically 3- 5 days. The presentation, reporting that a blood sample was positive, etc. are not compatible with an E -coli 0157:1-17. Regulatory affairs will forward alleged complaint to the local health dept,. Period: 6 Pugs 3 Monday, March 07, 2011 8:38:26 AM