Milk allergy death- should the book be thrown at the staff involved?

[mids2019]

....or if you are minimum wage staff member working in a stressed environment without English as a first language there should be leniency. Doctors are paid for life and death decisions but are Costa staff?

My daughter has CMPA…if she has some milk she’ll probably have a sore tummy and runny poos. If we ever eat or drink out I’m very careful about what we order and explain why and check when it’s servers too. She loves a babycino, I’ve noticed that in chains like Costa the person making it often misses that it’s dairy free and just goes to use regular milk, so I watch and tell them. No one has ever offered me an allergy book. To be honest I have very low expectations of service. If my daughters allergy were more severe I wouldn’t risk it and I don’t bother if I’m ever met with an answer that suggests they don’t know what is in something (at a buffet abroad).

A lot of people are big fans of "if I or my child had a severe allergy I would never do X, Y or Z perfectly normal activity", but once you're dealing with it that's not how life works. You can't put yourself or your child in a bubble.

Families with allergies have layers of risk mitigations, in two main groups:

1. Don't consume the allergen
2. If step 1 fails, follow medication plan

In this case there was error in step 1 in the Costa and on behalf of the girl and her mum by not being more vigilant with the drink prep - presumably because they never had to be before. Costa shouldn't have been blasé about it though, they should have assumed a potentially fatal allergy.

And then a catalogue of errors at step 2 as they didn't realise what was happening.

They were very very unlucky by the sounds of things.

The people making grand claims about never eating out and the like are actually more likely to find themselves in this family's shoes as a reaction would take them by surprise. For those of us dealing with allergies day to day we have a whole detailed plan to follow to mitigate the risk.

Absolutely this. We are a family of several coeliacs.

Every time you trust someone else with food prep there is some degree of risk. I very rarely risk it for myself, and never on behalf of one of the others. Mistakes do happen, and more often than you might think.

If I had something more life threatening than coeliac, I would never even eat out. I just wouldn't.

This sounds like the correct explanation

I did not realise they left the dentists, that's such a shame as they are medical professionals and would have a lot of equipment as well as epi-pens for anaphylaxis as it can happen during dental treatment.

Everything about this is a shame.

As human error can come into it or risk of being misheard in a noisy coffee shop I would not trust anywhere other than home if one sip could be fatal.

It's likely that the mum had never seen her daughter have such a severe reaction like that before. They had been avoiding dairy since she was a baby so she may have only experienced a mild reaction before this and hadn't quite realised how critical the situation was this time. People do go from having a mild itchy reaction one day to full-blown anaphylaxis the next time.

It seems as though the mother is also responsible, both for really unclear communication and then failure to take the appropriate action after the allergic reaction. Sometimes, allergic responses escalate very quickly from one attack to the next, and sometimes it’s not really down to just one person. I don’t think the Costa staff member was wholly unreasonable in assuming (a) that the mother knew what she was talking about or (b) not giving her the allergen book in this case.

They might have allergen friendly but they aren’t going to be allergen free. Nor should they be advertised as being so. There’s a reason that the U.K. allergy societies recommend against schools advertising themselves as ‘nut free’ etc.

She must have never had anaphylaxis before otherwise she would already be carrying two Epipens

There were quite a few questions the server refused to answer, so I don’t think she did everything she should have per Costa’s instructions. She was supposed to show them the whole book and walk them through the process step by step.
Also the fact that she said she needed a Bengali interpreter doesn’t mean that she ACTUALLY needs one and doesn’t understand simple conversation in a coffee shop. It could be just a defense tactic.

What an absolutely devastating thing to happen.

Because, for the thousandth time, based on the facts available, the overwhelming likelihood is that they had no idea her allergy had become so severe.

As usual lots of people have made inaccurate comments as they have not read the article.

I realise some people would prefer to be litigious than take any responsibility for themselves. As someone with a severe nut allergy, I do not put that responsibility on anyone but myself. I’m sorry the woman lost her daughter but she needs to own up to her part in this.

It’s such a sad case. It’s very easy to say you’d never do x or y but people with severe allergies have to live. I do wonder though if the water is muddied at coffee shops now by the amount of people without allergies preferring soy, oat or nut milks. You could have an ‘alternative’ order pretty regularly whereas even if a few years ago it would have stood out much more to say no dairy.

The epi pen situation unfortunately seems to be where things really fell apart. By the sounds of it she’d have stood more of a chance if she’d stayed in the dentist and had the shot there.

That isn’t an allergy thats out of the ordinary.

My daughter has a severe milk allergy requiring epipen and medical supervision at school. It’s very easy for somebody to say I would never eat out or it’s the mum’s fault for putting her at risk. The problem is that, like all risks in life, we have to find a balance. And, one day, they won’t be children but adults having to navigate this themselves and we have to teach them how to live with an allergy, not just exist. It’s like never getting in a car because of the risk of accidents. We take calculated risks all the time because otherwise our children can’t fully live life. For example, if travelling it’s very difficult to avoid having to buy any food out. It can be incredibly isolating never being able to take part in activities or eat with your friends because of cross contamination. My daughter can’t usually attend birthday parties for instance, she’s currently 4, but when she’s older and her friends understand more they can’t run their ice cream hands on her I will probably let her go and see how it goes. Maybe she will be able to try school dinners if I speak to the chef. But blanket saying everything will be prepared at home is just not practical. She might have a reaction, but what will her mental health be like if she is never able to attend anything? It’s a balancing act. Stories like this in the news are terrifying for allergy parents and people with allergies. What we don’t need is people berating us for ever letting our kids out the door and experiencing things. We do that every day to ourselves. What seems to be needed here is clearer guidance for everybody on what should be done in the case of suspected anaphylaxis. If there was public health messaging around the ABCs of anaphylaxis and how to tell the difference between needing an epipen or just an antihistamine. And how it’s often better to just give the epipen if you’re not sure. The messaging differs from health trust to trust and country to country.

You might be right. I do wonder if with a severe milk allergy you can actually drink in this places because surely there is cross contamination. They don’t clean the utensils between uses they just wipe the nozzle with a cloth?

Regardless though it’s horrific, her poor family.

The mum will have to live with that decision for the rest of her life, I’m sure that’s worse than any jail time. Its very sad.

Yes but she didn’t decide that cows milk was ok! She asked for soya and didn’t get what she ordered.

Yes, in most products

When DD1 was about 10, we took the girls into a coffee shop for hot chocolate and DD1 drank hers and promptly vomited all over the table. I remember the sheer panic of trying to get vomity child out of the coffee shop and trying to clear up the mess...it never crossed my mind to worry about whether she was 'ill' as such. I wonder if the Mum just went into autopilot of 'get vomity child home and pop in and get some antihistamines on the way...', having never experienced anaphylaxis and never having used an epi-pen before.

The thought of agreeing to stab your child with a needle can seem quite extreme to someone who has never faced such a situation, and the anaphylaxis campaigns often focus on collapsed people, not children who are 'complaining' about their drink and able to talk. So she may well have thought her child wasn't too ill.

I would also add on a random note for people with children with allergies- I was very impressed that the staff at my daughter’s Camp Beaumont camps checked all of the children’s lunch boxes and removed food containing nuts and gave those children alternatives. They had a child with a severe allergy and despite parents being told to send nut free, some obviously didn’t. That’s the first time my children have said that anyone has ever checked their lunchboxes at any camp they’ve been to but they were clearly taking the child’s allergy seriously.