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CO0054845 (2)
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1600 - Food Program
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CO0054845 (2)
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Entry Properties
Last modified
6/29/2022 2:23:01 PM
Creation date
6/29/2022 2:20:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0054845
PE
1600
FACILITY_ID
FA0017683
FACILITY_NAME
PANERA BREAD #968
STREET_NUMBER
2533
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
02742014
ENTERED_DATE
4/26/2022 12:00:00 AM
SITE_LOCATION
2533 KETTLEMAN LN
RECEIVED_DATE
4/26/2022 12:00:00 AM
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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Complaint Investigation Summary Report #: 5105 <br />COMPLAINT ID: C00054845 <br /> <br />Site Location: 2533 KETTLEMAN LN <br /> <br />Recpived by: EE0009830 SAUERS Received Date: 4/26/2022 Complaint Received Via: PHONE <br />Assigned To: EE0001084 RAMIREZ <br /> Assigned Date: 4/26/2022 <br />Program/Element Code 1600 - FOOD PROGRAM <br />Nature of complaint: <br />COMPLAINANT ORDERED A NAPA CHICKEN SALAD SANDWICH ON 4/20/22 AT AROUND 1:30 PM AND ATE IT AT AROUND 2:00 PM. AROUND <br />5:30 PM COMPLAINANT BEGAN TO EXPERIENCE SEVERE GUT PAIN. BY 6:00 PM COMPLAINANT BEGAN TO EXPERIENCE VOMITING, <br />CHILLS, AND GUT PAIN INTENSIFIED. STOMACH SWELLED UP AND COMPLAINANT WENT TO ER AROUND 1:30 AM COMPLAINANT GOT CT <br />SCAN AND DIAGNOSED WITH AN INFLAMED COLON. COMPLAINANT STATES THAT THEY DID NOT RESPOND TO ANTIBIOTICS SO <br />DOCTORS PRESCRIBED THEM AN ANTI FUNGAL AND COMPLAINANT DID A LITTLE BETTER. COMPLAINANT BELIEVES THERE MUST HAVE <br />BEEN SOME SORT OF MYCOTOXIN OR TOXIC MOLD IN THE IN THE SOURDOUGH BREAD. COMPLAINANT IS STILL EXPERIENCING <br />SYMPTOMS SIX DAYS AFTER CONSUMING SANDWICH. <br />***PLEASE CALL COMPLAINANT WITH FINDINGS. <br />PROPERTY INFORMATION <br />Facility: FA0017683 - PANERA BREAD #968 <br />Site Location 2533 KETTLEMAN LN <br /> District 004 - WINN, CHARLES <br />LODI, CA 95242 <br /> Location Code 02 - LODI <br />Cross Street LOWER SACRAMENTO <br /> APN 02742014 <br />Complaint Status: <br />Q.14,1A.AA rel Date Abated; Abated By: <br />Activity Summary <br />Activity Date <br />05/03/2022 Complaint investigation. <br />No major violations. <br />No re-inspection. <br />Report emailed to cafe0968@panerabread.com <br />Recorded by <br />RAMIREZ <br />05/04/2022 I called the complainant and discussed observations. RAMIREZ <br />5105.rpt Page 1 of 1
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