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Widow sues restaurant

Rarely fatal bacteria contributed to diner's death

Just after noon on April 7, Ron Bonds and his wife sat down to lunch at the El Azteca restaurant on Ponce de Leon Avenue. They both ordered and ate meals that contained ground beef. An hour later, they paid their bill and left.

At 9 p.m., a wave of nausea hit Bonds. Then the vomiting and diarrhea set in. Six hours later, his condition alarmed him enough to ask his wife, who had become slightly ill, to call an ambulance. Shortly after it pulled up to their Morningside home, Bonds collapsed on the bathroom floor.

For years, Bonds had suffered both gastritis, a swelling of the stomach, and diverticulosis, a tiny pouch-like scarring of the colon and intestinal walls. Those pouches, when irritated by a foreign substance such as food-borne bacteria, can swell and cause painful inflammation and bleeding.

When Bonds arrived at Grady Memorial Hospital, tubes were inserted into his nose and mouth, reaching into his intestines and lungs. But doctors could do little to stop the internal swelling or to rouse him from unconsciousness.

At 5:30 a.m. April 8, Bonds died. He was 48.

Nancy Kratzer didn't believe the doctors when they told her her husband was dead. According to her attorney Mark Harper, she kept repeating, No, that can't be; it was only food poisoning.

A Fulton County medical examiner performed an autopsy April 9. According to the death certificate, severe swelling of the stomach and the intestines killed Bonds. The swelling was triggered by bacteria called Clostridium perfringens, the certificate states. It describes the injury as "ingested contaminated food" and lists the place of injury as "restaurant ... 939 Ponce de Leon Ave."

On the day following the autopsy, the medical examiner notified the county health department that a large amount of Clostridium perfringens had been found in Bonds' stool. The day after, county health inspectors visited El Azteca. Four days had passed since Bonds ate there. The inspectors took samples of beef from a steam table and delivered them that afternoon to a state lab, according to the health department's investigative report. State epidemiologists found 6 million cells of the bacteria per gram of beef.

Fulton health department officials said those numbers warrant attention, since as few as 10,000 cells per gram can cause illness. But the numbers don't indicate how harmful the beef could be, because different people have different reactions to the bacteria, officials told CL.

Clostridium perfringens multiplies in cooked food that is cooled too slowly, according to Michael Doyle, a professor at the University of Georgia's Center for Food Safety. Even if cooked ground beef is refrigerated immediately, a big vat can take hours or even a day to cool, Doyle says. To kill the bacteria, food must be reheated to a specific degree.

Doyle says ingesting too much of the bacteria typically entails a day or two of diarrhea and, sometimes, vomiting. "But on rare occasion, especially when somebody has underlying illnesses, it can be worse," he says.

The Centers for Disease Control and Prevention reported in a 1999 study that a fatal reaction to Clostridium perfringens food poisoning occurs in .0005 percent of cases.

A week after health inspectors took El Azteca meat samples, the health department obtained credit card receipts from all of the customers who ate at the restaurant the day Bonds and his wife did, according to the department's report.

From 217 names, the inspectors tracked down 118 potential customers. Seven said they'd had diarrhea anywhere from 12 to 81 hours after eating at El Azteca. Five said they had suffered cramps in that time period. Three said they had vomited.

Although none of those people was able to submit a stool sample, the department report states that one suffered "a probable case of Clostridium perfringens infection," judging from the length of incubation time and the characteristics of the symptoms.

After identifying the other possible illness, the department put the restaurant on probation, testing samples of El Azteca beef weekly until two consecutive weeks passed without notable amounts of the bacteria. Because the next two tests proved relatively bacteria free, the department ceased testing after two weeks and concluded its investigation.

In order to suspend or revoke a restaurant's permit following a food-borne illness outbreak, the health director must determine that the outbreak is a "substantial or imminent health hazard to the public," according to department rules. Fulton Health Director Adewale Troutman did not reach that finding.

Although inspectors haven't checked the restaurant for Clostridium perfringens since April, three routine health inspections in late April and in May state that the restaurant did not reheat beef to at least 165 degrees — the minimum temperature Doyle says will kill Clostridium perfringens. But in July, the restaurant passed that portion of its inspection.

When she went back to work at Emory University's Goizueta Business School, Bonds' wife Kratzer kept hearing people murmur about her husband's strange death, according to her attorney. So she sent an e-mail to some Emory faculty members and students concerning El Azteca: "My husband died recently from ingesting contaminated food there. It is my understanding that during their investigation, the Health Department found the deadly bacteria in the food on the premises but let them stay open. ... Please pass this message on, and please, for your safety: Don't eat there."

News of Bonds' death spread via e-mail, gaining the notoriety of an urban legend. "Not sure if this is legit," writes one of several people in the forwarding e-mail chain, "but it has been making serious rounds."

Bonds himself was known to have a healthy interest in macabre myths. His IllimuNet Press publishing company released such works as Jim Keith's "Black Helicopters Over America" and spawned plots for "The X-Files" and the film "Conspiracy Theory."

Harper filed a wrongful death suit on behalf of Kratzer July 30 against El Azteca and its parent company, Aztec Travel, alleging the restaurant negligently sold unsafe food. The health department investigation and allegations in the lawsuit refer only to the El Azteca at 939 Ponce de Leon Ave., and not to eight other El Azteca restaurants in metro Atlanta.

Restaurant representative Gerald Benda says a lawsuit tells only one side of a story.

"There's probably a lot more to that [situation]," says Benda, an attorney who had not yet been served with the lawsuit when CL spoke to him. Because he may or may not be representing El Azteca in the wrongful death case, Benda declined further comment except to say food poisoning is widespread in Atlanta restaurants.

Harper admits that the type of poisoning named in his lawsuit against El Azteca likely exists elsewhere in Atlanta.

"Food poisoning can come from any restaurant," Harper says. "They just happened to be unfortunate. But not as unfortunate as Ron."??