On a typical June day last year, 3-year-old Jolan Jackson was sitting at the dining room table in his booster chair waiting for his meal.
Having just boiled a cup of water in the microwave, Jolan's teenage sister poured the hot liquid into a Cup Noodle foam container and placed it on the table, according to a complaint filed in March against the maker of the soup in Los Angeles County Superior Court.
In the next few minutes, the soup cup somehow tipped over, spilling its hot contents onto Jolan's lap and leaving him with second- and third-degree burns that required 15 days in the hospital and months of follow-up surgeries, the complaint said.
"He was in tremendous pain," said Jolan's mother, Latisha Beam. "By the time I got to the hospital he was on a morphine drip and the skin had peeled and rolled off so that it was just pink and raw."
Scaldings are the most common burns suffered by children admitted to hospitals and burn units across the nation, according to national burn statistics. And although some children are scalded by boiling pots on the stove or overly hot tap water, physicians report that many others are injured by soup, including the kind made in disposable foam cups.
The injuries occur frequently enough that some scientists, doctors, victims and advocates have suggested that food companies redesign some of the soup cups so children are less likely to knock them over.
Roughly 30 to 40 percent of the kids treated for burns at Stroger Hospital "are there for hot soup scaldings," said hospital spokeswoman Marisa Kollias. "These cases remain all too common in our burn unit." Another analysis of burns at Shriners Hospitals for Children Northern California found that soup burns caused about 8 percent of all burn admissions.
Either estimate suggests that soup scalds thousands of children nationwide each year, with an estimated 30,000 people under age 20 treated for scalding of all types each year, according to a 2010 epidemiological review published in the Pediatric Annals.
According to a 2006 analysis in the Journal of Burn Care & Research, certain soup containers are more dangerous than others simply because they are easier to tip over.
Of the 11 instant soup cups tested by a team led by Dr. David Greenhalgh, professor and chief of burn surgery at the University of California at Davis School of Medicine, Cup Noodles tied for the second most tip-prone design because of its height and narrow base. Researchers measured its tipping point at an angle of about 21 degrees, whereas the least tip-prone container tipped at an angle of about 64 degrees.
"The most significant contributor to the ease of tipping over was height," the paper said. "Simple redesigning of instant soup packaging with a wider base and shorter height, along with the requirement for warnings about the risks of burns, would reduce the frequency of soup burns."
Nissin Foods, the maker of Cup Noodles (formerly called Cup O' Noodles), said its products carry prominent labels warning consumers to handle the hot soup with care, especially when serving it to children.
"Our hearts go out to children and families who have suffered burns of any type," said the statement from Nissin, whose American headquarters is just outside Los Angeles in Rosemead, Calif. "We urge parents to never leave hot products of any kind in reach of their young children."
The Jackson family's complaint against the company acknowledges that the package included warnings about putting the cup in the microwave, the potentially high heat and the need to handle with care. But it also alleges that the design of the cup is "unsafe for its intended use because of its dimensions, including an overly narrow base."
The soup's label, it said, did not sufficiently warn "of its unstable design that significantly increased the risk that the Cup Noodles would tip over and/or spill with the potential for causing severe burns."
"It never entered my mind that noodle soup could do this degree of damage to a child," said Beam, who works full time and attends nursing school at night. "But when I found out how many other children had been burned like this, I decided that I had to do something to get them to change their design. Because no child, and especially no 3-year-old, should have to suffer this degree of pain over a cup of noodles."
Nissin, which did not comment beyond its statement, said the design of its soup cup has evolved over four decades "to reflect changing consumer needs and patterns of use, all in accordance with applicable regulations and guidelines."
The family's attorney, Matthew Pawa of Newton Centre, Mass., said the fact that the product has been sold for nearly 40 years only shows that Nissin "has been marketing a defective product for a long time that continues to harm people."
"All indications from all sources is that lots and lots of kids are getting burned by this product," Pawa said. "Every burn center in the country is seeing cases every week from a company marketing this top-heavy cup with a narrow base."
Burn doctors say hot liquid burns are especially dangerous for the very young.
"Children have thinner skin and greater susceptibility to burn injury," said Loyola University Medical Center burn specialist Dr. Richard Gamelli. "Also, if they are wearing footy pajamas or fleecy things or diapers, they can end up with significant burns because they hold the heat and fluid."
Children can be more severely burned by noodle soups than other types because they retain more heat and because the noodles can stick to the skin, doctors say.
Alarmed by the prevalence of scalding injuries among kids, University of Chicago researchers in 2011 examined an additional contributing factor: small children's access to microwave ovens, where handling cups of sloshy soup can easily lead to an injury.
Marla Robinson, assistant director of inpatient therapy services at University of Chicago Medicine, and her colleagues found that all the 4-year-olds who participated in the study could reach, operate and remove food from a microwave.
"Children as young as 17 months old can turn on a microwave, open the door and remove items, putting them at significant risk for scald injuries," said the U. of C. report, published in the Journal of Trauma.
Robinson found that the hospital handled 24 cases of children burned by microwaved soup last year, up from nine in 2003. Arguing that it's too easy for small children to access hot food from a microwave oven, the report recommended that microwaves be redesigned to be more child-resistant.
Robinson and the burn unit doctors say more education is needed about the risks of scald burns to children, which can be painful and disfiguring.
In 2008, Greenhalgh and others reported in the Journal of Burn Care & Research that soup scaldings happen most often in low-income families with low education levels and multiple children in the household. Education and product design changes remained the primary recommendations for greater safety.
For now, Beam said, "these noodles are totally banned from my house, and I tell everyone I know with small kids what happened. This shouldn't happen to anyone else."