Well: Think Like a Doctor: The Man Who Wobbled

The Challenge: Can you solve the medical mystery of a man who suddenly becomes too dizzy to walk?

Every month, the Diagnosis column of The New York Times Magazine asks Well readers to try their hand at solving a medical mystery. Below you will find the story of a 56-year-old factory worker with dizziness and panic attacks. I have provided records from his two hospital visits that will give you all the information available to the doctor who finally made the diagnosis.

The first reader to offer the correct diagnosis gets a signed copy of my book, “Every Patient Tells a Story,” and the satisfaction of solving a case that stumped a roomful of specialists.

The Patient’s Story:

The middle-aged man clicked his way through the multiple reruns of late-late-night television. He should have been in bed hours ago, but lately he hadn’t been able to get to sleep. Suddenly his legs took on a life of their own. Stretched out halfway to the center of the room, they began to shake and twitch and jump around. The man watched helplessly as his legs disobeyed his mental orders to stop moving. He had no control over them. He felt nauseous, sweaty and out of breath, as if he had been running some kind of race. He called out to his wife. She hurried out of bed, took one look at him and called 911.

The Patient’s History:

By the time the man arrived at Huntsville Hospital, in Alabama, the twitching in his legs had subsided and his breathing had returned to normal. Still, he had been discharged from that same hospital for similar symptoms just two weeks earlier. They hadn’t figured out what was going on then, so they weren’t going to send him home now.

The patient considered himself pretty healthy, but the past year or so had been tough. In 2011, at the age of 54, he had had a mild stroke. He had no medical problems that put him at risk for stroke — no high blood pressure, no high cholesterol, no diabetes. A work-up at that time showed that he had a hole in his heart that allowed a tiny clot from somewhere in his body to travel to the brain and cause the stroke. He was discharged on a couple of blood thinners to keep his blood from making more clots. He hadn’t really felt completely well, though, ever since. His balance seemed a little off, and he was subject to these weird panic attacks, in which his heart would pound and he would feel short of breath whenever he got too stressed. Mostly he could manage them by just walking away and focusing on his breathing. Still, he never felt as if he was the kind of guy to panic.

And he had always been quick on his feet. The first half of his career he had been in the steel business — building huge metal trusses and supports. He and his team put together 60-plus tons of steel structures every day. For the past decade he had been machining car parts. After his stroke, work seemed to get a lot harder.

The Dizziness:

A few weeks ago, he stood up and wham — suddenly the whole world went off-kilter. He felt as if he was constantly about to fall over in a world that no longer lay down flat. His first thought was that he was having another stroke. He went straight to his doctor’s office. The doctor wasn’t sure what was going on and sent him to that same emergency room at Huntsville Hospital. After three days of testing and being evaluated by lots of specialists, his doctors still were not sure what was going on. He hadn’t had a heart attack; he hadn’t had a stroke. There was no sign of infection. All the tests they could think of were normal.

The only abnormal finding was that when he stood up, his blood pressure dropped. Why this happened wasn’t clear, but the doctors in the hospital gave him compression stockings and a pill — both could help keep his blood pressure in the normal range. Then they sent him home. He was also started on an antidepressant to help with the panic attacks he continued to have from time to time.

You can read the report from that hospital admission below.

You can also read the consultation and discharge notes from that hospital visit here.

He had been home for nearly two weeks and still he felt no better. He tried to go back to work after a week or so at home, but after driving for less than five miles, he felt he had to turn around. He wasn’t sure what was wrong; he just knew he didn’t feel right. Then his legs started jumping around, and he ended up back in the hospital.

The Doctor’s Exam:

It was nearly dawn by the time Dr. Jeremy Thompson, the first-year resident on duty that night, saw the patient. Awake but tired, the patient told his story one more time. He had been at home, watching TV, when his legs started jumping on their own and he started feeling short of breath. His wife sat at the bedside. She looked just as worried and exhausted as he did. She told the resident that when he spoke that night at home, his speech was slurred. And when the ambulance came, he could barely walk. He has never missed this much work, she told the young doctor. It’s not like him. Can’t you figure out what’s wrong?

The resident had already reviewed the records from the patient’s previous hospital admissions. He asked a few more questions: the patient had never smoked and rarely drank; his father died at age 80; his mother was still alive and well. The patient exam was normal, as were the studies done in the E.R.

The first E.R. doctor thought that his symptoms were a result of anxiety, culminating in a full-blown panic attack. The resident thought that was probably right. In any case he would discuss the case with the attending in a couple of hours during rounds on the new patients. Till then, he told the worried couple, they should just try to get a little sleep.

An Important Clue:

Dr. Robert Centor was definitely a morning person. His cheerful enthusiasm about teaching and taking care of patients made him a favorite among residents. At 7:30 that morning, he stood outside the patient’s door as Dr. Thompson relayed the somewhat frustrating case of the middle-aged man with worsening dizziness and panic attacks. Then they went into the room to meet the patient. He was a big guy, tall and muscular with the first signs of middle-aged thickening around his middle. His complexion had the look of someone who spent a lot of time outdoors. Dr. Centor introduced himself and pulled up a chair as the rest of the team watched. He asked the patient what brought him to the hospital.

“Every time I get up, I get dizzy,” the man replied. Sure, he had had some balance problems ever since his stroke, he explained, but this felt different – somehow worse. He could hardly walk, he told the doctor. He just felt too unstable.

“Can you get up and show us how you walk?” Dr. Centor asked.

“Don’t let me fall,” the patient responded. He carefully swung his legs over the side of the bed. The resident and intern stood on either side as he slowly rose. He stood with his feet far apart. When asked to close his eyes as he stood there, he wobbled and nearly fell over. When he took a few steps, his heel and toes hit the ground at the same time, making a strange slapping sound.

Seeing that, Dr. Centor knew where the problem lay and ordered a few tests to confirm his diagnosis.

You can see the review report and notes for the patient’s second hospital visit below.

Solving the Mystery:

What tests did Dr. Centor order? Do you know what is making this middle-aged man wobble? Enter your guesses below. I’ll post the answer tomorrow.


Rules and Regulations: Post your questions and diagnosis in the Comments section below. The correct answer will appear tomorrow on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

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European Union Agrees on Plan to Cap Banker Bonuses


BRUSSELS — Bankers in Europe face a cap on bonuses as early as next year, after an agreement on Thursday to introduce what would be the world’s strictest pay curbs in a move politicians hope will address public anger at financial-sector greed.


The provisional agreement, announced by diplomats and officials after late-night talks between E.U. member representatives and the bloc’s parliament, means bankers face an automatic cap that sets bonuses at the level of their salaries.


If a majority of a bank’s shareholders vote in favor, that ceiling can be raised to two times a banker’s pay.


“For the first time in the history of E.U. financial market regulation, we will cap bankers’ bonuses,” said Othmar Karas, the Austrian lawmaker who helped negotiate the deal.


The backing of a majority of E.U. states is needed for the deal to be finalized.


Such limits, which are set to enter E.U. law as part of a wider overhaul of capital rules to make banks safer, will be popular on a continent struggling to emerge from the ruins of a 2008 financial crisis.


But it represents a setback for the British government, which had long argued against such absolute limits. The City of London, the region’s financial capital, with 144,000 banking staff and many more in related jobs, will be hit hardest.


As it stands in draft legislation, the cap would also apply to bankers employed by an E.U. institution but based elsewhere globally, for instance in New York, according to one official, who was not authorized to speak to the media.


There are also provisions for adjusting the value of long-term non-cash payments, so more bonuses could be paid that way without breaking through the new ceiling.


Ireland, which holds the rotating E.U. presidency and negotiated what it called a “breakthrough,” will now present the agreement to E.U. countries.


Irish Finance Minister Michael Noonan said he would ask his peers to back it at an EU ministers’ meeting on March 5 in Brussels.


The change in the law is set to be introduced as part of a wider body of legislation demanding banks set aside roughly three times more capital and build up cash buffers to cover the risk of unpaid loans, for example.


Some experts have criticized the E.U., however, for failing to keep to all of the so-called Basel III code of capital standards drawn up by international regulators to reform banking after the financial crash.


The agreement on Thursday will also require banks to outline profits and other details of operations on a country-by-country basis.


A ceiling on bonuses, the only one of its kind globally, is perhaps the most radical aspect of the new rules.


Many in banking argue, however, that such reform will do little to lower pay in finance, where head-hunters say some annual packages in London approach £5 million, or about $7.6 million.


“If the cap is implemented, it could result in significantly more complex pay structures within banks as they try to fall outside the restrictions to remain competitive globally,” said Alex Beidas, a pay specialist with the law firm Linklaters.


An earlier attempt to limit bankers’ pay with an E.U. law forcing financiers to defer bonus payments for up to five years merely prompted lenders to increase base salaries. But it would be harder for banks to raise base pay this time around.


Hedge funds and private equity firms will be excluded from such curbs, although they face restrictions on pay later this year under another E.U. law.


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Asian-American Diversity in Potential California Race


Jim Wilson/The New York Times


Ro Khanna, a possible challenger to Representative Michael H. Honda, spoke at this rally in San Jose, Calif., against gun violence.







CUPERTINO, Calif. — Home to Apple, Google and other high-tech pioneers, the 17th Congressional District here recorded a political first in last fall’s elections, becoming the first majority Asian-American district in the mainland United States.




At the same time, voters sent candidates of Asian descent to the Legislature and to local city councils like the one here, where Asian-Americans account for 63 percent of the population.


The Congressional seat itself was easily retained by Michael M. Honda, a Democrat first elected in 2000 and one of the most influential Asian-Americans in Congress. A Japanese-American whose views on politics and civil rights were shaped by his internment during World War II, Mr. Honda, 71, helped build a network for Asian-American political aspirants here and served as a mentor to many.


But a possible challenge to Mr. Honda in 2014 — coming from Ro Khanna, 36, an Indian-American lawyer who served as a deputy assistant secretary in the Commerce Department and is a rising star in the Democratic Party — has already set off intense maneuvering inside the district. Even as Asian-Americans represent the nation’s fastest growing racial group, the attention focused on this potential contest underscores the diversity, and possibly emerging rivalries, among different Asian groups.


Mr. Khanna said he has yet to decide whether to run. Mr. Honda, perhaps in one of the earliest moves to fend off a potential challenge next year, recently secured the endorsements of President Obama, Representative Nancy Pelosi of California and other Democrats. The possible face-off has put many Asian-Americans here, especially Indian-Americans, in an awkward situation.


“I really appreciate what the congressman has done for the Asian-American community, and I have worked closely with him,” said Kamil Hasan, an Indian-American who has long been involved in the tech industry and the Democratic Party. “Ro Khanna would be a very strong candidate in whichever district he runs. The Indian community has wanted him to run for office for a long time.”


Mr. Hasan, who said he would not take a position until Mr. Khanna decided whether to run, has held fund-raisers for both Mr. Honda and Mr. Khanna.


California’s system of nonpartisan redistricting created the 17th Congressional District, where Asian-Americans total 51 percent of the population. Asian-American politicians and activists had long sought such a district from which to build power nationally.


Although the district includes parts of San Jose, suburbs like Cupertino, Milpitas and Fremont have the highest concentration of Asian-Americans, especially the most recent waves of immigrants, said James S. Lai, the director of ethnic studies at Santa Clara University. Institutions like the Silicon Valley Asian Pacific American Democratic Club remain under the leadership of more established groups like Japanese-Americans and Chinese-Americans. The San Jose airport, for example, is named after Norman Y. Mineta, the Japanese-American politician.


But newer Asian-American groups have begun exerting influence. Democrats and Republicans have especially courted Indian-Americans, many of whom work in Silicon Valley and have proved formidable fund-raisers.


“The question is what Asian Indians feel ideologically aligned with,” Mr. Lai said. “This election could be an example of whether Asian Indians see themselves along the lines of pan-Asian, progressive politics that are part of what Mike Honda stands for, or whether they will they go for his challenger’s politics, which are more conservative and pro-business.”


A teacher, Mr. Honda got his political start in 1971 when Mr. Mineta, as mayor of San Jose, appointed him to the planning commission. Mr. Honda rose steadily — from the school board to the Santa Clara County Board of Supervisors to the State Assembly — before being elected to Congress in 2000 in a district that had been represented by Mr. Mineta.


Ami Bera, an Indian-American physician elected to Congress last fall in a district near Sacramento, said he approached Mr. Honda for advice four years ago when he was considering running. Speaking after a panel on Asian-Americans and politics with Mr. Honda here recently, Mr. Bera said of the Asian-Americans serving in the House, “Each of us has our own unique story of how Mike took us under his wing, mentored us and then was out there probably the most active of any member of Congress helping us getting elected.”


Mr. Khanna has been laying the groundwork for a possible campaign by meeting influential people in the district and writing op-ed articles on subjects that resonate here, like American relations with Asia and manufacturing. Under California’s top-two primary system, Mr. Khanna and Mr. Honda, both Democrats, could end up facing each other in a general election.


This article has been revised to reflect the following correction:

Correction: February 27, 2013

Due to an editing error, a photo caption with an earlier version of this article mistakenly said that both Representative Mike Honda and his possible challenger, Ro Khannaand, were at a rally against gun violence. Mr. Khannaand spoke at the rally, but Mr. Honda did not attend.



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Greek man charged in NY Dali theft pleads guilty


NEW YORK (AP) — A Greek man has admitted to stealing a Salvador Dali painting from a New York City gallery, only to return it in the mail.


Phivos Istavrioglou pleaded guilty on Tuesday following his arrest in the theft of a work titled "Cartel de Don Juan Tenorio."


Prosecutors say the fashion industry publicist walked into the Manhattan gallery in June, put the painting valued at about $150,000 in a shopping bag and walked out. He anonymously mailed the piece back to the United States from Greece after seeing news coverage of the theft.


Under the plea deal, Istavrioglou avoids additional jail time if he remains incarcerated until his formal sentencing on March 12. He also must pay more than $9,000 in restitution.


His lawyer said it was a stupid thing to do.


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Well: What Housework Has to Do With Waistlines

Phys Ed

Gretchen Reynolds on the science of fitness.

One reason so many American women are overweight may be that we are vacuuming and doing laundry less often, according to a new study that, while scrupulously even-handed, is likely to stir controversy and emotions.

The study, published this month in PLoS One, is a follow-up to an influential 2011 report which used data from the U.S. Bureau of Labor Statistics to determine that, during the past 50 years, most American workers began sitting down on the job. Physical activity at work, such as walking or lifting, almost vanished, according to the data, with workers now spending most of their time seated before a computer or talking on the phone. Consequently, the authors found, the average American worker was burning almost 150 fewer calories daily at work than his or her employed parents had, a change that had materially contributed to the rise in obesity during the same time frame, especially among men, the authors concluded.

But that study, while fascinating, was narrow, focusing only on people with formal jobs. It overlooked a large segment of the population, namely a lot of women.

“Fifty years ago, a majority of women did not work outside of the home,” said Edward Archer, a research fellow with the Arnold School of Public Health at the University of South Carolina in Columbia, and lead author of the new study.

So, in collaboration with many of the authors of the earlier study of occupational physical activity, Dr. Archer set out to find data about how women had once spent their hours at home and whether and how their patterns of movement had changed over the years.

He found the information he needed in the American Heritage Time Use Study, a remarkable archive of “time-use diaries” provided by thousands of women beginning in 1965. Because Dr. Archer wished to examine how women in a variety of circumstances spent their time around the house, he gathered diaries from both working and non-employed women, starting with those in 1965 and extending through 2010.

He and his colleagues then pulled data from the diaries about how many hours the women were spending in various activities, how many calories they likely were expending in each of those tasks, and how the activities and associated energy expenditures changed over the years.

As it turned out, their findings broadly echoed those of the occupational time-use study. Women, they found, once had been quite physically active around the house, spending, in 1965, an average of 25.7 hours a week cleaning, cooking and doing laundry. Those activities, whatever their social freight, required the expenditure of considerable energy. (The authors did not include child care time in their calculations, since the women’s diary entries related to child care were inconsistent and often overlapped those of other activities.) In general at that time, working women devoted somewhat fewer hours to housework, while those not employed outside the home spent more.

Forty-five years later, in 2010, things had changed dramatically. By then, the time-use diaries showed, women were spending an average of 13.3 hours per week on housework.

More striking, the diary entries showed, women at home were now spending far more hours sitting in front of a screen. In 1965, women typically had spent about eight hours a week sitting and watching television. (Home computers weren’t invented yet.)

By 2010, those hours had more than doubled, to 16.5 hours per week. In essence, women had exchanged time spent in active pursuits, like vacuuming, for time spent being sedentary.

In the process, they had also greatly reduced the number of calories that they typically expended during their hours at home. According to the authors’ calculations, American women not employed outside the home were burning about 360 fewer calories every day in 2010 than they had in 1965, with working women burning about 132 fewer calories at home each day in 2010 than in 1965.

“Those are large reductions in energy expenditure,” Dr. Archer said, and would result, over the years, in significant weight gain without reductions in caloric intake.

What his study suggests, Dr. Archer continued, is that “we need to start finding ways to incorporate movement back into” the hours spent at home.

This does not mean, he said, that women — or men — should be doing more housework. For one thing, the effort involved is such activities today is less than it once was. Using modern, gliding vacuum cleaners is less taxing than struggling with the clunky, heavy machines once available, and thank goodness for that.

Nor is more time spent helping around the house a guarantee of more activity, over all. A telling 2012 study of television viewing habits found that when men increased the number of hours they spent on housework, they also greatly increased the hours they spent sitting in front of the TV, presumably because it was there and beckoning.

Instead, Dr. Archer said, we should start consciously tracking what we do when we are at home and try to reduce the amount of time spent sitting. “Walk to the mailbox,” he said. Chop vegetables in the kitchen. Play ball with your, or a neighbor’s, dog. Chivvy your spouse into helping you fold sheets. “The data clearly shows,” Dr. Archer said, that even at home, we need to be in motion.

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Media Decoder Blog: SFX Entertainment Buys Electronic Dance Music Site

SFX Entertainment, the company led by the media executive Robert F. X. Sillerman, has agreed to buy the music download site Beatport, part of the company’s plan to build a $1 billion empire centered on the electronic dance music craze.

Mr. Sillerman declined on Tuesday to reveal the price. But two people with direct knowledge of the transaction, who were not authorized to speak about it, said it was for a little more than $50 million.

Beatport, founded in Denver in 2004, has become the pre-eminent download store for electronic dance music, or E.D.M., with a catalog of more than one million tracks, many of them exclusive to the service. It says it has nearly 40 million users, and while the company does not disclose sales numbers, it is said to be profitable.

The site has also become an all-purpose online destination for dance music, with features like a news feed, remix contests and D.J. profiles. Those features, and its reach, could help in Mr. Sillerman’s plan to unite the disparate dance audience through media.

“Beatport gives us direct contact with the D.J.’s and lets us see what’s popular and what’s not,” Mr. Sillerman said in an interview. “Most important, it gives us a massive platform for everything related to E.D.M.”

Since the company was revived last year, SFX has focused mostly on live events, with the promoters Disco Donnie Presents and Life in Color; recently it also invested in a string of nightclubs in Miami and formed a joint venture with ID&T, the European company behind festivals like Sensation, to put on its events in North America.

In the 1990s, Mr. Sillerman spent $1.2 billion creating a nationwide network of concert promoters under the name SFX, which he sold to Clear Channel Entertainment in 2000 for $4.4 billion; those promoters are now the basis of Live Nation’s concert division.

Matthew Adell, Beatport’s chief executive, said that being part of SFX could help the company extend its business into live events, and also into countries where the dance genre is exploding, like India and Brazil.

“We already are by far the largest online destination of qualified fans and talent in the market,” Mr. Adell said, “and we can continue to grow that.”

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Gaza Militants Fire Rocket Into Israel, Police Say







JERUSALEM (AP) — A rocket fired from the Gaza Strip struck Israel on Tuesday as tensions are mounting in the region weeks ahead of President Barack Obama's visit.




Police spokesman Micky Rosenfeld said remains of the rocket were found south of the city of Ashkelon, in southern Israel. The attack caused damage to a road but no injuries, he said. It was the first such projectile from the Palestinian territory to hit Israel since Israel-Gaza hostilities last November.


The rocket fire came one day after Israeli troops injured two Palestinian teenagers near a holy site close to Bethlehem, during one of the many demonstrations Palestinians in the West Bank have staged in recent days.


Initially, West Bank street protests broke out in support of Palestinians held in Israeli jails, particularly in support of four inmates on lengthy hunger strikes. Then, over the weekend, a Palestinian prisoner who was not on hunger strike died under disputed circumstances, prompting more demonstrations.


Israeli and Palestinian officials have traded barbs, each side saying the other is trying to exploit the latest unrest for political gains.


A statement from the Palestinian president's office said President Mahmoud Abbas instructed Palestinian security officials Monday night to preserve security and order in the West Bank, but placed the blame on Israel for "dragging the area into violence and chaos."


Adnan Damiri, the spokesman of the Palestinian security apparatus, said Palestinian officials were committed to prevent fighting, saying that his forces had recently detained members of the militant Hamas group who were planning "violent confrontations."


"The only one(s) seeking violence in West Bank is Netanyahu and Hamas, but we will not be dragged to that," said Damiri. "Our struggle will always be peaceful."


The clashes come weeks before Obama is scheduled to arrive in Israel and the West Bank, his first presidential visit to the region. U.S. State Department spokesman Patrick Ventrell said the U.S. has asked Israeli and Palestinian officials to exercise "maximum restraint" at this time of high tension in the West Bank.


"All parties should seriously consider the consequences of their actions, particularly at this very difficult moment," Ventrell said Monday.


An Israeli military official, speaking on condition of anonymity in line with military policy, said protestors gathered Monday and hurled "improvised hand grenades" towards a holy site in the Bethlehem area, endangering Israeli worshippers inside.


Soldiers responded by firing at the legs of a Palestinian throwing grenades, lightly wounding him. Later, soldiers fired rubber bullets at demonstrators, seriously injuring one Palestinian who was then rushed to an Israeli hospital, the official said.


Palestinian medical officials said two Palestinian youths, one 13 years old and one 16, were seriously wounded by live fire. Palestinian medic Abdelhaleem Jaarah said the 16-year-old, Odai Sarhan, was hit in the head and rushed to Hadassah hospital in Jerusalem.


Etti Dvir, spokeswoman for Hadassah hospital in Jerusalem, said doctors operated overnight on the boy and that he was in critical condition.


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Singer Morrissey says no to Kimmel, 'Duck Dynasty'


LOS ANGELES (AP) — The TV series "Duck Dynasty" is coming between Morrissey and Jimmy Kimmel.


The singer and animal rights activist says he canceled his appearance Tuesday on ABC's "Jimmy Kimmel Live" because "Duck Dynasty" cast members will be on the talk show.


Morrissey says he can't perform on a show with what he called people who "amount to animal serial killers."


A&E's "Duck Dynasty" reality show follows a Louisiana family with a business selling duck calls and decoys.


A&E did not immediately respond to requests for comment from it and the Robertson family.


A person familiar with the Kimmel show's plans confirmed that Morrissey was to appear. The person lacked authority to discuss the matter publicly and spoke on condition of anonymity.


The person says Morrissey's performance will be rescheduled.


ABC says the Churchill band will perform Tuesday on Kimmel's show but declined comment on the switch.


___


Reach AP Television Writer Lynn Elber at http://www.twitter.com/lynnelber .


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Horse Meat in European Beef Raises Questions on U.S. Exposure





The alarm in Europe over the discovery of horse meat in beef products escalated again Monday, when the Swedish furniture giant Ikea withdrew an estimated 1,670 pounds of meatballs from sale in 14 European countries.




Ikea acted after authorities in the Czech Republic detected horse meat in its meatballs. The company said it had made the decision even though its tests two weeks ago did not detect horse DNA.


Horse meat mixed with beef was first found last month in Ireland, then Britain, and has now expanded steadily across the Continent. The situation in Europe has created unease among American consumers over whether horse meat might also find its way into the food supply in the United States. Here are answers to commonly asked questions on the subject.


Has horse meat been found in any meatballs sold in Ikea stores in the United States?


Ikea says there is no horse meat in the meatballs it sells in the United States. The company issued a statement on Monday saying meatballs sold in its 38 stores in the United States were bought from an American supplier and contained beef and pork from animals raised in the United States and Canada.


“We do not tolerate any other ingredients than the ones stipulated in our recipes or specifications, secured through set standards, certifications and product analysis by accredited laboratories,” Ikea said in its statement.


Mona Liss, a spokeswoman for Ikea, said by e-mail that all of the businesses that supply meat to its meatball maker  issue letters guaranteeing that they will not misbrand or adulterate their products. “Additionally, as an abundance of caution, we are in the process of DNA-testing our meatballs,” Ms. Liss wrote. “Results should be concluded in 30 days.”


Does the United States import any beef from countries where horse meat has been found?


No. According to the Department of Agriculture, the United States imports no beef from any of the European countries involved in the scandal. Brian K. Mabry, a spokesman for the department’s Food Safety and Inspection Service, said: “Following a decision by Congress in November 2011 to lift the ban on horse slaughter, two establishments, one located in New Mexico and one in Missouri, have applied for a grant of inspection exclusively for equine slaughter. The Food Safety and Inspection Service (F.S.I.S.) is currently reviewing those applications.”


Has horse meat been found in ground meat products sold in the United States?


No. Meat products sold in the United States must pass Department of Agriculture inspections, whether produced domestically or imported. No government financing has been available for inspection of horse meat for human consumption in the United States since 2005, when the Humane Society of the United States got a rider forbidding financing for inspection of horse meat inserted in the annual appropriations bill for the Agriculture Department. Without inspection, such plants may not operate legally.


The rider was attached to every subsequent agriculture appropriations bill until 2011, when it was left out of an omnibus spending bill signed by President Obama on Nov. 18. The U.S.D.A.  has not committed any money for the inspection of horse meat.


“We’re real close to getting some processing plants up and running, but there are no inspectors because the U.S.D.A. is working on protocols,” said Dave Duquette, a horse trader in Oregon and president of United Horsemen, a small group that works to retrain and rehabilitate unwanted horses and advocates the slaughter of horses for meat. “We believe very strongly that the U.S.D.A. is going to bring inspectors online directly.”


Are horses slaughtered for meat for human consumption in the United States?


Not currently, although live horses from the United States are exported to slaughterhouses in Canada and Mexico. The lack of inspection effectively ended the slaughter of horse meat for human consumption in the United States; 2007 was the last year horses were slaughtered in the United States. At the time financing of inspections was banned, a Belgian company operated three horse meat processing plants — in Fort Worth and Kaufman, Tex., and DeKalb, Ill. — but exported the meat it produced in them.


Since 2011, efforts have been made to re-establish the processing of horse meat for human consumption in the United States. A small plant in Roswell, N.M., which used to process beef cattle into meat has been retooled to slaughter 20 to 25 horses a day. But legal challenges have prevented it from opening, Mr. Duquette said. Gov. Susana Martinez of New Mexico opposes opening the plant and has asked the U.S.D.A. to block it.


Last month, the two houses of the Oklahoma Legislature passed separate bills to override a law against the slaughter of horses for meat but kept the law’s ban on consumption of such meat by state residents. California, Illinois, New Jersey, Tennessee and Texas prohibit horse slaughter for human consumption.


Is there a market for horse meat in the United States?


Mr. Duquette said horse meat was popular among several growing demographic groups in the United States, including Tongans, Mongolians and various Hispanic populations. He said he knew of at least 10 restaurants that wanted to buy horse meat. “People are very polarized on this issue,” he said. Wayne Pacelle, chief executive of the Humane Society of the United States, disagreed, saying demand in the United States was limited. Italy is the largest consumer of horse meat, he said, followed by France and Belgium.


Is horse meat safe to eat?


That is a matter of much debate between proponents and opponents of horse meat consumption. Mr. Duquette said that horse meat, some derived from American animals processed abroad, was eaten widely around the world without health problems. “It’s high in protein, low in fat and has a whole lot of omega 3s,” he said.


The Humane Society says that because horse meat is not consumed in the United States, the animals’ flesh is likely to contain residues of many drugs that are unsafe for humans to eat. The organization’s list of drugs given to horses runs to 29 pages.


“We’ve been warning the Europeans about this for years,” Mr. Pacelle said. “You have all these food safety standards in Europe — they do not import chicken carcasses from the U.S. because they are bathed in chlorine, and won’t take pork because of the use of ractopamine in our industry — but you’ve thrown out the book when it comes to importing horse meat from North America.”


The society has filed petitions with the Department of Agriculture and Food and Drug Administration, arguing that they should test horse meat before allowing it to be marketed in the United States for humans to eat.


This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated how many pounds of meatballs Ikea was withdrawing from sale in 14 European countries. It is 1,670 pounds, not 1.67 billion pounds.

This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated the last year that horses were slaughtered in the United States. It is 2007, not 2006.




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DealBook: Confirmation Hearing for Mary Jo White Said to Be Scheduled for March

Mary Jo White appears poised to face a Senate confirmation hearing next month, a crucial step for the former federal prosecutor on her path to becoming the top Wall Street regulator.

Ms. White, whose nomination to lead the Securities and Exchange Commission has lingered for over a month, plans to testify in March before the Senate Banking Committee, three Congressional officials briefed on the matter said on Monday. The committee has not set a firm date for the confirmation hearing, the officials said, though lawmakers have tentatively scheduled her to appear the week of March 11.

At the hearing, one official said, Ms. White will most likely join Richard Cordray, who is in line to become director of the Consumer Financial Protection Bureau. In January, when the White House nominated Ms. White to the S.E.C. spot, it reappointed Mr. Cordray to a position he has held for the last year under a temporary recess appointment.

The Senate last year declined to confirm him in the face of Republican and Wall Street opposition to the newly created consumer bureau. Republicans are likely to voice similar skepticism at the hearing next month.

While some officials have quietly expressed concerns about Ms. White’s role as a Wall Street defense lawyer, her nomination is not expected to face major complications. An S.E.C. spokesman did not immediately respond to a request for comment.

The timetable laid out on Monday offers Ms. White additional weeks to prepare. Over the last couple of weeks, she has received multiple briefings from agency staff members about new securities rules and the structure of the stock market, an official said. The briefings will in part prepare her for the confirmation hearing, which is expected to cover a broad scope of topics.

While Ms. White is a skilled litigator, she lacks experience in financial rule-writing and regulatory minutiae, a potential stumbling block for her nomination. Lawmakers also expect to raise questions about her movements through the revolving door that bridges government service and private practice. Some Democrats, a person briefed on the matter said, will question whether she is cozy with Wall Street.

In private practice, Ms. White defended some of Wall Street’s biggest names, including Kenneth D. Lewis, a former chief of Bank of America. As the head of litigation at Debevoise & Plimpton, she also represented JPMorgan Chase and the board of Morgan Stanley. Her husband, John W. White, is co-chairman of the corporate governance practice at Cravath, Swaine & Moore, where he represents many of the companies that the S.E.C. regulates.

(Ms. White has agreed to recuse herself from many matters that involve former clients, while her husband has agreed to convert his partnership at Cravath from equity to nonequity status.)

Despite some reservations, she is expected to receive broad support on Capitol Hill. When President Obama nominated her last month, Senator Charles E. Schumer of New York was one of several Democrats to praise her prosecutorial prowess, calling her “tough as nails” during stints as a federal prosecutor in Brooklyn and as the first female United States attorney in Manhattan.

While she handled some white-collar and securities cases, her specialty was terrorism and organized crime. As a federal prosecutor in New York City for more than a decade, she helped oversee the prosecution of the crime figure John Gotti and directed the case against those responsible for the 1993 World Trade Center bombing. She also supervised the original investigation into Osama bin Laden and Al Qaeda.

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