The box at your door: Convenience, selection and quick delivery have made Amazon a trusted brand, apart from all the labor strife, mass spying and quest for world domination, of course. But what are you really buying when you make a purchase there? As of last year, nearly 60 percent of sales made by Amazon were by third-party vendors using the Amazon platform, over whom the company has limited oversight on product safety or accuracy in marketing. A team of Wall Street Journal reporters found thousands of products for sale on Amazon that wouldn’t be permitted on the shelves of big box stores because they had been deemed unsafe or were outright banned by federal regulators, or because they lacked required safety labels. Among the most egregious examples were dozens of infant sleep mats that the U.S. Food and Drug Administration has said could cause a baby to suffocate. Amazon had said it banned such mats. And, there were 44 listings for motorcycle helmets that failed safety tests in 2018, plus thousands of listings for balloons sold without a required warning that they pose a choking hazard to young children. An Amazon spokeswoman told the Journal that the company strives to provide people with the best customer experience “but not at the expense of our customers’ safety.” Most of the items were removed from the site when brought to the Amazon’s attention. Many later reappeared, sometimes sold by the same vendor under a different listing, the Journal reports.

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Vaping illness: At least 193 people have been sickened by severe lung disease linked to e-cigarette use, and officials announced on Friday that one has died. The illnesses have been spread across 22 states. Local and federal public health officials are working to determine the exact cause, but they have been so far unable to track it to specific products or a singular cause, write Matt Richtel and Sheila Kaplan of The New York Times. Symptoms include trouble breathing, chest pain, vomiting or diarrhea, and the most severe cases have required patients to be put on a ventilator. Lena H. Sun of The Washington Post tells the story of a 20-year-old man whose health failed quickly as he developed acute respiratory distress. All of the patients counted by the CDC have reported vaping. Many but not all used the devices to vape tetrahydrocannabinol, the psychoactive component of marijuana. Specialists The Times interviewed said the illnesses point to chemical inhalation injuries. “The problem is we don’t know what’s being inhaled through these devices, of which there are five or six hundred different kinds,” Dr. John Holcomb, a Texas pulmonologist said. “We have to assume that some of them may be dangerous and some may not be dangerous.” The idea that some of those sickened may have be filling unregulated e-cigarette cartridges with unregulated CBD oil, or purchasing them in that form, seems likely to increase the pressure on the FDA to act more swiftly on both fronts.

  • Also: Products that look like Juul pods in youth-friendly fruity flavors are showing up in stores even though the company said it would no longer sell them through retailers. They’re counterfeit and made in China. Adrian Punderson, Juul vice president of intellectual property protection, told CNBC that officials in that country have raided 15 factories dedicated to Juul knock-offs.
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The cost of an epidemic: Johnson & Johnson downplayed the dangers of opioid painkillers and engaged in “false, misleading, and dangerous marketing campaigns” that put people at risk, a federal judge in Oklahoma ruled Monday. He ordered the company to pay the state $572 million to support addiction treatment services. That’s far less than the state’s attorneys said it will cost Oklahoma to mitigate the public health crisis. They had proposed a $17 billion judgment, to be used over more than two decades. Judge Thad Balkman awarded 1/30 of that, to cover just one year of abatement, explains Selena Simmons-Duffin of NPR. Balkman said the state failed to provide enough evidence of the time and costs required beyond that one year. The outcome was a mixed result for Johnson & Johnson and other opioid manufacturers. It gave a boost to lawyers representing cities and states in more than 2,000 lawsuits pending against drug companies in the U.S., Jan Hoffman of The New York Times writes. But the company’s stock value climbed Monday afternoon and Tuesday morning, as investors reacted to the fact the award was under the $1 billion mark, The Wall Street Journal reports. The company’s attorneys have said they will appeal the decision. Next up in major opioid trials is a case in federal court  pitting two Ohio counties against a host of players in the drug market, which is set for trial in October. The stakes are high. Hoffman explains that case is considered a bellwether for hundreds of other federal cases brought by local municipalities, tribes, hospitals, unions, and infants with neonatal abstinence syndrome now under the jurisdiction of  U.S. District Judge Dan Aaron Polster.

  • Also: Jake Harper of Side Effects Public Media tells a modern-day snake oil story of how some addiction clinics are selling unproven treatments to patients and their families with promises of a cure.

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Retaliation on the factory floor: A federal judge has ordered a Pennsylvania factory owner to pay more than $1 million in lost wages and penalties to two former employees who were fired for cooperating with federal safety inspectors. The firings are connected with a 2014 incident in which a worker lost parts of three fingers to a steel-bending press at the Lloyd Industries factory outside of Philadelphia. Another worker took pictures of the machine, provided them to investigators with the federal Occupational Safety and Health Administration, and was fired soon after. “I didn’t want anybody else hurt on that machine,” he later told The Philadelphia Inquirer. The plant manager, who had talked with the investigators, was fired later, on the same day in 2015 that OSHA had issued safety citations and $822,000 fine. “The significant punitive damages sends a strong message to this employer and others that deliberately violating these laws will not be tolerated,” Regional Solicitor Oscar L. Hampton III said in an OSHA press release. Bob Fernandez of The Inquirer reports that factory owner William Lloyd has a long history of disputes with OSHA. He also was ordered by a federal judge in April to pay a former worker $600,000 for firing him because he is black. Lloyd has appealed that decision.

  • Also: Five Star Roofing Systems of Indiana faces proposed penalties of $220,249 for failure to provide fall protection–a repeat violation–and other safety hazards. –– J.H. Berra Construction of Missouri faces proposed penalties of $143,206 for allowing workers at a home construction site to work in a trench without proper protection from a cave-in, and other violations.

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Lead problem ignored: The city of Newark has lead in the water, and The New York Times has taken a deep dive into how it got there and why it wasn’t dealt with sooner. Among the many missteps and systemic failures the reporters document are the decision by Mayor Ras Baraka to tell residents that the water was fine even after consecutive state tests had found elevated lead; also his choice to promote an ex-convict to oversee the city’s water department when it was in crisis. State and local officials have pledged $120 million, paid for through a county bond, to speed up the process of replacing 18,000 lead service lines within three years. That’s a gargantuan project that will require getting landlord buy-in in a city where most residents are renters, The Times reports.

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Burning up over emissions: A decision by four automakers to side with California and to make their fleets more fuel-efficient over time angered President Trump, who pressured his staff to keep more car companies from joining the pact, Coral Davenport and Hiroko Tabuchi of The New York Times report. Trump has proposed undoing much of the previous administration’s program for improving vehicle emission standards, saying the changes will save consumers money on car purchases. He also wants to take away states’ authority to determine their own standards. But those changes set the industry up for years of uncertainty as the issue plays out in court. Honda, Ford, Volkswagen and BMW have decided to stick with California. The Times reports that Mercedes is considering doing the same, and a sixth automaker has determined it will continue to comply with the existing, Obama-era standards. Trump, in a tweet, promised that “California will squeeze them to a point of business ruin.” Gov. Gavin Newsom called the president’s pressuring of private industry for his own political gain “pathetic,” the Los Angeles Times reports. “It shows the weakness of the administration,” Newsom said. “No one wants [Trump’s mileage policy] except the oil companies. And what a sad, pathetic state of affairs that they’re the ones calling the shots.”

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Endangered law: The Trump administration’s plan to roll back protections for threatened and endangered species and to allow economic factors to be used in determining whether to assign protections “undermines the fundamental purpose” of the Endangered Species Act, according to a lawsuit filed by a coalition of environmental groups to block changes to the law. The lawsuit alleges the administration also violated procedural laws by making significant changes in the final plan without first giving the public a chance to review or comment on those changes, Georgina Gustin of InsideClimate News writes. More lawsuits are expected. The attorneys general in Massachusetts and California have said they plan to file their own challenges.

Chelsea Conaboy is a FairWarning contributor and freelance writer and editor specializing in health care. Find more of her work at chelseaconaboy.com.