It took years for Brian and Elizabeth Hall to have their first baby.
It will take years more for their infant daughter to get well.
Amy Hall turned 2 last month, battling a debilitating form of salmonella that, according to her parents, surfaces every two to three weeks and is expected to plague her for years to come.
She got it from her family’s dogs. The pets, Amy’s parents later learned, became infected in 2012 from eating contaminated dog food produced at a South Carolina plant.
Now, Amy is a salmonella carrier. Earlier this summer, her parents sued the pet food company they hold responsible.
Health officials have told the Halls their child is a health risk to anyone she is around. The couple sterilizes their Union County home regularly. They don’t believe it’s safe to put Amy in daycare, and have hired a specialized nanny to step in while they’re at work.
“I could not risk it,” Elizabeth Hall says. “I could not put another mother through this.”
Amy is among some 50 salmonella victims in at least 20 states and Canada who health investigators have linked to the Diamond Pet Foods plant in Gaston, S.C. In 2005, the facility produced contaminated food that killed or sickened dozens of dogs in more than 20 states.
Asked about the Hall’s lawsuit, Mark Schell, the company’s vice president, said Diamond had responded to the Salmonella outbreak by improving the health standards of its production plants. He said he had no comment about the Halls’ complaint.
The company’s legal response to the lawsuit is due any day, said Fred DeVore, the Halls’ attorney.
The salmonella outbreak two years ago infected seven people in the Carolinas. Nationally, 10 of the victims required hospitalization.
Amy was the youngest victim of all. Nine days after her homecoming from a Charlotte hospital, Brian and Elizabeth’s newborn daughter returned. This time, the infant was rushed to the emergency room.
First the dogs
The Halls, who married in 2006, had been trying for several years to have a baby when Elizabeth became pregnant in fall 2011.
In late February, four months before Amy’s birth, the couple needed food for their first “children,” Bailey, a Shetland sheepdog and Abby, a greyhound. They bought their standard brand, Apex, which is produced in Gaston, a small town in suburban Columbia where the Missouri-based Diamond has one of its production facilities.
Bailey and Abby became sick almost immediately and stayed that way through March, Elizabeth Hall says. So the couple did what many dog owners would do: They fed their pets blander food. Eventually, that seemed to work. The dogs got better, and their owners never took them to their vet.
Unknown to the couple, the family’s health situation had already been imperiled. Bailey and Abby had become carriers of Salmonella Infantis.
Soon, and almost four months before the Halls learned that their pets carried the bacteria, the tip of a serious health problem began to emerge.
In early April 2012, according to the Centers for Disease Control and Prevention, agricultural inspectors in Michigan found traces of salmonella bacteria during a routine test of a bag of Diamond sold at a store. Health investigators using molecular testing matched the strain in the bag with what had sickened several nearby residents.
Other states followed course. Their science led to the same result: Contaminated dog food from the Gaston plant had infected pets and made dozens of people sick, CDC records show.
The Food and Drug Administration inspected the South Carolina facility that April. According to the subsequent report, investigators found that Diamond didn’t properly clean and maintain its equipment, adequately test incoming animal fat used in its products, or provide enough hand-washing stations for its workers.
On April 26, the company recalled 30,000 tons of dog and cat food marketed under 17 labels, including what was sold by shopping giant Costco under its Kirkland brand. The FDA also issued a health warning.
The Halls, lost in the chaotic preparations of parents-to-be, say they did not hear about the recall.
On June 25, 2012, their healthy daughter was born.
When Brian brought his wife and baby home to Waxhaw, Bailey and Abby were waiting to greet them.
‘We could have lost her’
Salmonella is one of those diseases that confounds modern science.
While E. coli infections have been cut in half over the past 15 years, salmonella cases remain steady, even slightly increasing in recent years. According to the CDC, the disease hits 1.2 million people each year and accounts for more than $365 million in medical costs. Some 400 people die.
The bacteria can hide in everything from peanut butter to exotic animals. Pet food, however, remains a common source, even as Americans pay far more attention to what they feed their dogs and cats.
In the past 11 months, the FDA has ordered at least eight recalls of dog and cat food because of salmonella contamination. Most of them occurred after the federal agency proposed tougher safety rules for pet food production in October.
Amy started showing symptoms – fever, diarrhea, stomach cramps and a bloody stool – about a week after arriving home. On the night of July 7, 2012, mother and child slept together on the family couch.
Except, Elizabeth Hall didn’t sleep. She says she spent the night “skin to skin” with her daughter, monitoring her baby’s condition. Amy’s temperature spiked, then fell. “I just knew something wasn’t right,” Hall says.
The next morning after nursing, Amy threw up. Her mother had seen enough. On Sunday, July 8, Amy returned to the hospital.
The family’s pediatrician had taken stool samples a few days earlier, but Amy’s test results were not back in. At the ER, the first doctor held off on antibiotics, her mother says. But after a shift change, a second physician did not. The new doctor had once treated a baby who had come down with salmonella after drinking contaminated well water.
Amy went on antibiotics that night. Otherwise, the bacteria could have entered her blood stream before the doctors knew what they were fighting. “Without the antibiotics, we could have lost her,” Hall says.
She remained in the hospital 10 days. When her tests came back positive for salmonella, Hall says she and her husband were at a loss on how their daughter had become infected and blamed themselves.
A family friend who is a pediatrician in Virginia reached out on Facebook. She had seen stories of a salmonella outbreak tied to pet food.
“Check your dogs,” she wrote.
Diamond is one of the country’s more successful pet food producers. But twice in the past decade, its Gaston plant has been the source of a significant outbreak of disease.
In 2005, toxic food produced at Gaston killed 100 dogs and sickened dozens more along the East Coast. Three years later, Diamond admitted it had not followed its own testing protocols and agreed to pay $3.1 million to settle a class-action lawsuit covering pet owners in 23 states. Company lawyers said at the time that Diamond worked hard to save the victimized animals and had improved safety procedures at Gaston and other plants.
Seven years later, the salmonella outbreak again was tied to the brand.
Amy was hospitalized with a relapse over the Fourth of July this summer. Doctors have told her parents that she may be 5 or 6 before she outgrows the condition, her mother says. In all, Hall says, the illness has sent her daughter to hospitals or to pediatric specialists as far away as Duke University almost 20 times.
DeVore says his clients have spent more than $70,000 on Amy’s treatment. Between them, he says, the Halls have lost about 750 hours at their health care jobs. Their suit, which asks for a jury trial, accuses Diamond of negligence and willful and wanton conduct, among other counts.
“When you are producing a product for consumers, which potentially exposes consumers to danger, you have to be particularly careful,” DeVore said.
The Halls decided to sue in part because after they reported Amy’s sickness to Diamond, they never heard back, Elizabeth Hall says. Every time Amy gets sick, Hall says she gets angry again.
“None of us asked for this,” she says. “My ultimate goal is Amy needs to be taken care of.”