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?

They should have different jugs for non dairy milk. I'm surprised she used the same jug.

It wasn't trace contamination that was the issue though. (And the machine was cleaned to at least partially reduce this possibility. )

The issue is the child was served a cup of hot chocolate made with cows milk even though the server had been made aware she had a dairy allergy. Even if the server didn't hear the word soya as the mother ordered, that's a huge problem. Costa's training has gone badly wrong somewhere there.

Yes, but in this case it didn't matter what jug she used as she just poured cows milk into it anyway.

This. And I think this "get out the boo" thing is Costa covering their backs at the expense of their minimum wage staff members with EFL. I have had to go on numerous elimination diets throughout my life and the ONLY time a staff member at any food establishment got out the allergy book, is when I specifically requested it. There are so many people with allergies and intolerances, if Costa really wants them all to look at the book before ordering they should leave it out for all customers to check, not rely on a busy staff member who's paid poorly and trying to do a million jobs at once, to remember to get out the book and insist a customer reads it, especially when that customer has indicated that milk in the powder if the hot chocolate is ok?!?

Another point to be made here, is that we often use the same word for an intolerance vs sensitivity vs anaphylactic allergy.

When a server hears "allergy", they won't always assume the customer means life-threatening, as most don't.

We really need a separate term here. In the medical field, an allergy that can cause anaphylaxis is an IgE allergy, but the average person won't know this.

When I explain my child's allergies, I usually state "they have an epi pen", but even then I feel the understanding isn't always there.

One thing I would add to this is that "if in doubt, use the EpiPen"

My son's allergy consultant is very clear that it was far far better to use the pen when you don't need it than risk not using it when you do.

Any sign of a systemic or serious reaction and I would use the pen without waiting !

Even in the Telegraph article about this incident the journalist called it an intolerance at some point!

Agreed. And because of things like "nut bans" a lot of people don't realise that milk allergies are actually the leading cause of fatal anaphylaxis in children in the UK.

So many people seem to think milk is a "less serious" allergy even though it very much isn't. My son's old school used to call me every time a child brought a peanut butter sandwich into school but didn't think to call me when a child through cheese at him (my son is allergic to milk and not to nuts!)

It was a miscommunication/ language issue not a cross contamination issue

The server either did not understand or did not hear the request properly. She made it with dairy instead of soya milk. She doesn't appear to be denying that. She attempted to query it with the mum by clarifying that hot chocolate has milk in it and the mum said it would be OK as long as the jug was washed (presumably because she did not understand that her request had not got through and thought it was soy milk she was talking about). Server thought it was an odd request but complied with it because people make bizarre inconsistent requests all the time and CMP allergy is often confused with lactose intolerance.

This is a human error that has led to tragic consequences and I just feel so sorry for all involved the family but also the coffee shop server.

My DD had CMP allergy as a baby and she once had an anaphylactic reaction requiring a blue light ambulance and it was terrifying. Fortunately she later grew out of it which I understand is common with CMPA and her other allergies are milder just pet fur and grass pollen.

I have also worked minimum wage jobs in bars and hospitality as a student and I can completely see how I could have done something like that. It's busy, loud, time pressured and you are told customer knows best just do what they say. I have certainly been yelled at for order mistakes that I swear was what they asked for and turns out it wasn't.

I disagree. A good chain in my opinion has a series of protocols when a customer mentions allergies, including making sure a senior member of staff takes over the order and that the customer looks at the allergy menu and confirms that are comfortable and that allergies are written down and checked again by the customer. And the senior member of staff then brings the food and checks it again with the customer

If a restaurant doesn't do these things, we don't eat there.

I get the people saying "just don't eat out if you have allergies" but actually that involves a huge amount of social exclusion and I feel my children are likely to choose to eat out as adults so i should teach them how to do that while managing the risks as carefully as possible

I do have food intolerance to tomatoes, peppers and strawberries. I get stomach cramps, a rash and vomiting though no life threatening reactions. One day though I ate a few Cheesy Wotsits without thinking and I ended up with weeping eyes and running nose. This is not a reaction I had ever had before and I am far more cautious now as I am aware that my intolerance could turn into an allergy. I feel horribly sad for the family as it sounds like the girl had only had mild symptoms or reactions up to that point and so the family maybe hadn’t fully understood how serious it could get.

A sit down restaurant meal is different to grabbing a Costa though and a different level of expectation and therefore risk

Costa has a lot of outlets in busy places like railway stations or hospitals where people are in a huge hurry and there are big queues. I just can't really imagine a senior staff member coming over, getting out the book, writing things down etc in the kind of fast moving outlet that I grab a coffee from.

I don't think it's unreasonable that there is a level of personal responsibility for the customer to heavily flag up that this is a life threatening allergy and rigorous care is needed. It is then on the staff member and their employer to follow the protocol but I think the customer does need to assert that the protocol is required given the many many situations, far more numerous than life threatening allergies in your average coffee shop day, where people just fancy a soy latte/ are vegan/ have an intolerance and do not want or need the allergy protocol.

I don't disagree. But the onus is also on the company to understand that they aren't dealing with benign products and to have clear processes to protect themselves and their staff as well as their customers

(I agree, I wouldnt order for my dairy allergic children from Costa, whereas I have a mild intolerance to milk since avoiding it while breastfeeding my allergic babies and I will often order using dairy free milks but would be fine to drink a milky one if they got my order wrong)

I agree @WindsurfingDreams In my experience chains are often better than independents at dealing with allergies. Zizzi is our preferred place to eat if we are away from home as we have always found them very diligent and they actually have a dessert on the menu that we know DS can have.
We never go in Costa so I have no experience there so have no idea if this was individual error or a more systemic problem but it is certainly possible for chain cafes/restaurants to operate to a good standard regarding allergies. We've been offered allergy information books or a QR code to scan in plenty of places and there's often info on websites. I never book a meal anywhere that I don't regularly use without looking them up on the Internet these days. Having had at least one person in the family with dietary restrictions for over 25 years I'd say it is easier for us to eat out now than it ever has been.
There is a long way to go of course, as this and other similar stories sadly show, and you can never let your guard down, but compared to when my children were little I find it a lot better.
I think there's a lot to learn from this case and reducing it to one person or another's fault is unhelpful. There are several points in the story where different actions could have led to a different outcome and some of those raise questions on the adequacy of health care and policy around allergy.There seems little doubt that the server made an error with the order but making an individual the scapegoat won't stop things like this happening again, it is far more complex than that.

Agree, I don't think the server should be blamed. Its down the the company to have a rigorous policy.

I made this point while being quite vigorous with my children's old school that they needed to hugely improve their policies after a couple of near misses.
Good and rigourously enforced processes dont just protect the person with allergies, they also protect the staff. Thankfully the school took my point and now have a really good paper trail of information and consents before any classroom activity involving food.

If you are practicing good food hygiene it should be perfectly possible to keep people with allergies safe.

I wouldn't eat in an establishment that couldn't manage it, because to me that tells me they are sloppy in other areas too

I would like to see the larger chain coffee shops using a separate steamer entirely for dairy free drinks.

I'm allergic to nuts and mildly allergic to soya and probably 1 in 10 coffees I buy out and about show signs of cross contamination with soya. For me it's an immediate stomach effect plus 2-3 days of sore skin. If nut milks gain popularity I won't be able to buy coffee out at all which would be a shame as it's one of the few edible treats I can enjoy when out. Cafes/restaurant food is pretty much off limits to me because since the shortage of sunflower oils, 99% of eateries are cooking in soya oil.

@muggart Gaaaah!

@WindSurfingDreams The "peanut privilege" is real. When we were first learning what my son is allergic to I remember being so grateful he wasn't allergic to peanuts (though he does have a hazelnut and cashew allergy).

Knowing what I know now, I'd happily trade his milk for a peanut allergy.

I constantly have people telling me peanut allergies are "more severe" or only nut allergies are airborne.

As you say, milk allergies are sadly the leading cause of anaphylaxis in children.

And we've dealt with an airborne milk anaphylactic reaction when milk was being steamed, so milk can certainly be airborne.

Milk is basically unavoidable and in nursery he was surrounded by cups of milk and cheesy sandwiches and yoghurts. But the staff were always reassuring me there would be no peanuts, as if this means anything to a child who doesn't have a peanut allergy!

If one tiny thing comes from this tragedy, I hope awareness of severe milk allergies is raised.

Because of the seriousness of allergies, only staff who's first language is English should be employed. Or an english test, to confirm they hold a high level of english. There cannot be any fatal mistakes.

You'd think that, but there have been so many tragic deaths linked to milk and still the "nuts are the only severe allergy" perception persists.

My son had a skin contact reaction to a child smearing cheesy wotsits powder on him, it wasn't anaphylactic but it was as serious as I would be comfortable with before getting the EpiPen out.

It's hugely dangerous that milk is still perceived as benign or "not serious"

I'm so very sad that this has happened, it's absolutely tragic. My DP has an unpleasant dairy allergy but not life threatening. We run the gauntlet of eating out and are often promised dairy free but are let down. It's very easy to tell when DP has eaten dairy but I won't go into details. One notable occasion at a local pub I questioned if the garlic butter was dairy free. The reply I got was "is butter dairy then?"

Nah. It's an intelligence test that's needed.

As a recent PP said, some people don't understand that butter is dairy. So what good is it being fluent if you're also just an idiot?

In my opinion, the bosses are responsible and should have the book thrown at them. No system is completely full proof, but there are many things which could have been put in place to try to stop this happening. Restaurants use different chopping boards and even different stations for allergies. So Costa can, People are routinely asked if they have an allergy in restaurants, however this Mum had to specify it.

Costa doing their standard spiel of "our people are trained... " is not good enough, when was the last time they checked to make sure people follow the training? A Policy has to be policed, training has to be confirmed to be working.
They will have known that there was a risk that poor training can lead to deaths, so they just get their lawyers to make sure it's a franchisee's responsibility.. That just means they don't care if someone dies. The Franchisee also bears responsibility for inadequate training. A Book under the counter is pointless, there is no guarantee that's coming out. So they could either have a system where everyone has to confirm that they have specified any allergies and what they are, ticking a box on a tablet screen whilst doing the order would work and at which point more guidance can be given to the "Barrista" and the patron. But it would cost Costa a bit of money to implement.
In my line of work, we try to not blame the individual but work out why something happened, and how to stop it happening again. That doesn't seem to have happened even though there are prior (less devastating) examples.

Jugs should be labelled with what is to be put into them. Chopping boards for example are labelled differently (by colour) as to what will be chopped on them. If that means that they need more jugs then so be it.

Totally agree.

It would be simple to have a system where they always had a record of what the customer disclosed in terms of allergies etc.

I was really clear with my childrens school that the best way to take care of their staff was to always have clear paper trail each time they used food in class etc that showed that all the ingredients were sent to parents and that each parent had consented. This doesn't just protect their children, it also protects the teachers (or restaurant staff in this case) because in the aftermath of a fatality or near miss those records are powerful

They would need multiple separate machines if they did that. My DD has milk, soya, and oat allergies, the main three milks used in coffee shops. Almond or coconut milk would be fine but I don't trust coffee machines to be cleaned properly so we don't get hot drinks. It would be nice if we could though.

None of her allergies are life threatening so far, but that shouldn't be the main consideration, she would still be very sick for a few days after eating it. Which is what good food hygiene is supposed to avoid. I wish allergies, even the non life threatening ones, were taken as seriously as food poisoning is.