Dirty Dining

Love it or hate it, fast food is a part of our lives. Tens of millions of fast food meals are served safely every day. But with 200,000 fast food restaurants, keeping them clean and the food safe can be an enormous task --  and, on occasion, mistakes can be made and customers do get sick.

In a groundbreaking report in late 2003, Dateline ranked the top ten fast food chains, and revealed which ones ran up the highest number of critical health code violations.  Critical violations are the ones that can make you sick.

Back then, we looked closely at thousands of health inspection reports, and discovered some dirty dining -- a worm in a salad, a cockroach in a soda, chewing gum in a taco. Horror stories like these are rare, but about two thirds of the restaurants we reported had at least one critical health code violation in the previous year.

Mary Adolf: “Any time there's a critical violation in a food service operation, it's of concern to us at the National Restaurant Association, but also of concern to the industry, because food safety is paramount. “

Mary Adolf is a vice president of the National Restaurant Association. She says the fast food chains are working to eliminate critical violations.

Adolf: “Food safety is non-negotiable to every single operator in the food service universe.”

After our original Dirty Dining survey, the big fast food chains promised to do better. Well, are they doing better?

The only way to find out was to "super-size" our first fast food survey. So we gathered and analyzed a year's worth of inspection reports 1,000 fast food restaurants from all across the country.  Based on our new survey, we’ll give you the fresh rankings of the ten biggest fast food chains. We'll tell you which operations are doing the best and the worst job of keeping things safe and clean.

If you eat fast food, you'll want to know what we found. While it is not common for people to get sick, some of the people we spoke with discovered that when fast food restaurants make food-handling mistakes, it can be devastating.

Patrick Johnson and about 120 other customers became very sick, very quickly, last October after eating at McDonald's in Piqua, Ohio.

Johnson: “They put me on a stretcher. And the whole time I'm puking off both sides of the stretcher all the way through the house.”

Nancy Smith thought she was having a heart attack.

Smith: “But I had never been so sick in my life. It was so violent that I just felt like my chest was going to explode.”

Courtney Ward says she was paralyzed with pain.

Ward: “I had horrible, horrible stomach cramps. It just felt literally like someone just ripped my stomach open and was tearing through my stomach with nails. It hurt that bad.”

That night, this group and many more victims overwhelmed the emergency room at Ohio's Upper Valley Medical Center.

Smith: “They had like 30 people sitting around, were holding pans and throwing up. It was chaos.”

Dr. Curtis Caughey: “Quite frankly, it really stretched us to the limit of our resources.”

Dr. Curtis Caughey was in charge. He says initially, doctors had no idea what kind of outbreak they were facing.

Dr. Caughey: “The thing you think about when the squad alarms are going off, and the ambulances are rushing in. The people are sick out in the waiting room. You know, are we dealing with a really catastrophic public health incident that requires, you know, mobilizing major resources, particularly a bioterrorism incident.”

But it wasn't bioterrorism. It was a malfunctioning ice cream machine at McDonald’s. A Health Department investigation found the ice cream had not been kept at the proper temperature and was contaminated with dangerous bacteria.

Dr. Caughey: “The Health Department went to the restaurant, obtained samples from the machine. Indeed, identified a staphylococcal entro toxin that indeed caused the illness.”

McDonald's declined an on-camera interview, but in a letter to Dateline says the Piqua incident was "an unfortunate, isolated case." and said the ice cream machine was replaced immediately. The chain also maintains out that restaurant has "an outstanding food safety and sanitation history with the local health department."

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