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?

Great - as a nursery worker can I be paid a surgeon's salary then? If a child chokes, for example I use my first aid. We have safeguarding training every year, and First Aid every 3 years. We have several children with allergies in my setting. We have a training session on epipens every year, and lots of things in place to keep these children safe. But if God forbid something went wrong, of course it would be our fault. I earn £11.44 per hour at the moment, but yes, I agree with you I should get a surgeon's salary.... Do write to your MP and suggest it, please...

If this was a case where it was cross contamination, in the milk chocolate powder, that caused the reaction it would be a very different story.

The drink wasn’t made with Soya milk. The mother asked for the jug to be washed, with the staff member did but the miss-communication appears to have been over what milk to use. It wasn’t dairy particles that were in chocolate powder.

The mother asked for soya milk. The server pointed out there could be dairy the chocolate. The mother felt this would be fine. Because it would be a tiny amount. For some reason the drink was made with cows milk. That’s the issue.

But I can only assume the mother believed the risk of cross contamination was small and if it happened, then the amount would be tiny and not cause such a huge reaction.

Whats not clear is why the mother asked for soya drinks and got cows milks ones. Thats the miscommunication. It’s not a story of cross contamination that no one could have prevented. She was given a drink that was made with cows milk after asking for one that wasn’t.

Pass is restaurant speak for an area, often under lights, where chefs put dishes that are ready to be served by waiting on staff.

In a food setting it is the business that is responsible ultimately. Hear me out. The new legislation is crystal clear about training staff, demonstrating competency and putting in robust operating procedures. If they can demonstrate all of this, BUT the server is found to be negligent, then the server would be responsible. This is assuming that the server was provided with accurate information by the customer. If the customers information is not provided, then the customer is responsible.

It's not to do with wage, but industry. Food allergy is an integral part of food service and just because it's scary, they are not without a duty to it. Much like not adhering to food hygiene legislation, could also result in death.

There's lots that doesn't add up in the story. If the server needs an interpreter, why was she involved in allergy screening? Why did the customer take such risks? And why hot choc powder (not commonly milk free)? Very sad all round.

True but as has been said there is no ‘allergy’ station as it were. The risk of picking up the wrong thing is high. Loud music and background noise of machines, orders being shouted at you whilst you’re making one. Staff jostling right next to you and moving things etc.

Lots of food in supermarkets can’t be 100% guaranteed but it’s on a completely separate production line.

But non of those things are relevant here. Cross contamination isn’t the issue. So the lack of allergy stations (which would be logistically very difficult since people can also be allergic to each of the non dairy milks. So would require a station per milk) didn’t contribute either.

Yes noise could have contributed to the miscommunication. As I said, questions haven’t been answered so it’s not clear how that happened.

It is clear, that the allergen book wasn’t shown to the customer. But again, that would only have shown the mother the chance of cross contamination. It still wouldn’t account for being given the wrong milk. That’s the key to it. How and why was she given the wrong milk. I don’t think we will get an answer to that. So it’s difficult to say whether the employee was at fault.

But I think blaming the mother isn’t right either. It appears she was managing the allergy and felt the risk of cross contamination was very small. Which it would have been had she have been given the right drink. It also appears she couldn’t have predicted such a serious reaction either. I do think if you ask for a soya milk drink you should be confident that it’s a soya milk drink. You are making your decisions based on that drink being soya milk.

Maybe the answer is to have screens for customers to order. Then the customer has to input what they want and the staff have it printed in front of them so music, other customers etc don’t impact the communication of the drink.

Yes she was ultimately killed by dairy milk being given instead of soya on this occasion. However the fact remains that even had she been given the correct milk, a single molecule of dairy or airbourne proteins may have been enough to trigger the anaphylaxis eventually anyway, it may have just occurred slightly later in the day maybe. I don't know what is involved in Costa washing out the jug. If it's a quick washout that may not even be sufficient to prevent a reaction even if correct milk is then put in the same jug. You are expecting a coffee shop to have a very controlled environment that has no allowance for human error. But it is not a hospital, or a specially built food processing factory. It's a fast food convenience chain. Prove that the reaction would not have occurred even had the correct milk been given and protocol followed! We can say at best it very likely may not have. We cannot say it absolutely wouldn't have.

So the posters saying it is unrealistic to expect a coffee shop serving gallons of milk daily to ensure absolute safety for those with severe IGE dairy allergy are still valid.

Yes but the mother was clearly fine with the risk of cross contamination, that's my point. That may well have been on medical advice based on previous reactions and the girl had probably had plenty of soy hot chocolates from Costa before.

They accepted the risk of cross contamination. They didn't accept the risk of her taking a sip of her allergen. They're two very different things.

No one who knows they are at risk of anaphylaxis from cows milk cross contamination would order a milky drink in Costa, and certainly not without epipens on them. They asked for the steps necessary to keep her safe, steps that are reasonable to expect in a coffee shop, but they weren't followed. If the drink was made as requested she'd likely still be alive.

Yes, I have RTFT. Does it feel good to be that rude?

If the allergy became unexpectedly so severe, then it wouldn't be fair to blame the employee either, who had no way of knowing that a mistake would kill someone.

Risk of cross contamination is often acceptable for people with allergies who won’t respond to trace amounts. Legally, even products labelled “free from” don’t have to contain 0 of the allergen. They are permitted to contain trace amounts, usually less than 20 parts per million. The issue here is that the girl took a full mouthful of dairy milk, and the drink was ordered with soya not dairy.

Ok I can't argue with this point, save to say it is still foolish to go onto a coffee shop even if you do not intend to order a single thing without your epi-pen.

But you make a good point here.

The fact that a mistake doesn’t kill someone doesn’t mean the mistake is acceptable. Staff can’t go around making mistakes and saying “oh well nobody is going to die”.

She likely didn't have any epipens anywhere as her previous reactions hadn't been bad enough. Because if her allergy was severe enough to require epipens, she probably wouldn't have been in Costa, and certainly not without her meds. And her mum probably would have realised what was happening quicker and used the dentist's pen.

The cascade of events once she'd taken the sip strongly implies this was her first anaphylaxis, but if the drink had been prepared as requested that cascade of events likely wouldn't have happened.

In a surgery theatre, maybe.

In a cafe, I disagree. It's a place where they use tons of milk every day. Your child is allergic to milk. Don't fucking risk it, FGS.

It wouldn't be fair to blame the barista if the reaction was because of the cross contamination risk that the family knowingly took.

But the reaction was because the drink was made with the wrong milk. The blame lies with the barista, and/or Costa if she wasn't properly trained.

Very many people don't understand allergies well enough.

I was once on a school trip with a pupil who was severely allergic to nuts, eggs and dairy. His mum (understandably) was fretting a lot about him attending - as many posters on this thread have mentioned, she was trying to strike a balance between keeping him safe and allowing him to have the same experiences as his friends. The trip leader spoke in advance to the manager of the accommodation we were staying at to carry out a risk assessment and make sure the severity of the pupil's allergies were clearly communicated.

On the first night of the trip, the pudding was ice cream. Obviously the allergic pupil couldn't have this, but the cook had bought some dairy-free ice cream for him to have instead. Great.

Except the dairy-free ice cream was made using cashew nuts. The poor kid took one mouthful and came to find staff because he realised he was having a reaction. Luckily, staff were able to administer an epi-pen and call an ambulance, and he was ultimately okay (after a night in hospital), but it was really frightening.

The cook was sacked.

The company should be held accountable. It is their duty to ensure staff are appropriately trained and able to do the job.

If they employed someone who was genuinely unable to understand customers requirements then that is a failure on the part of the company and anything that happens as a result of that is on them.

According to the manager they (the manager, not the barista) had needed to use google translate to complete their own allergen training. And apparently one staff member needed to do the training 20 times to pass. Not sure what happened in the meantime and if they were allowed to serve customers or prepare drinks.

As I said we all make different choices. I suppose I like to control what I can and food is, largely, one of those things. Prawn Mayo, no thanks.
And it's quite hard to live without getting in a car or walking under a tree, but easy to avoid Starbucks etc. But take what risks you like.

Wow that’s disgusting. Talk about putting customers at risk! The issue here appears to be hiring people who don’t speak sufficient English to do the job safely.

If you read more detail the full story is that the child became ill at the dentist. She was offered an epipen several times but the mother refused saying she'd just get some antihistamines from the chemist. I don't think she realised how bad things were until it was too late. Apparently had she been given the epipen she would have survived.

Gluten doesn't have a risk of being inhaled unless I'm wrong.

I had years of injections for simple dustmite allergy. When it was bad I tell you I could not even walk past a charity shop that had it's doors open without it triggering an asthma attack.

As many pps have explained, it's not just surgery theatres where life and death decisions are made. You can die from food poisoning, for example. You can't just say "oh well the cook is only a cook not a Dr, so it doesn't matter". People serving food need to be properly trained in food safety, and follow that training to the letter.

I'm not saying it doesn't matter. What I am trying to say is that, in my opinion, this tragedy happened because of a number of adverse circumstances, similar to the Swiss Cheese Model. I am of the opinion that not one person or one of these circumstances are to blame. If only one of them had not happened, this child would most likely be alive today. It was not the mother's fault that her child is dead. It was not the Costa's employee's fault. It was a series of very unfortunate events and circumstances. That is why I disagree with making the Costa employee responsible for basically involuntary manslaughter. It will not bring that child back, it will not result in any lower chances of this happening again. It will not make the mum feel any less guilty.

Costa use separate jugs , the soya one has a yellow tag . Cleaning the wand takes seconds, steam is forced through and a separate cleaning cloth wipes it . Soya is a heavy head on the top, u can’t see this in a take out cup. Usually the take out is marked with an s . I’ve been shown the allergy book lots of times. Big difference in a mouthful of dairy and a product made in a factory that makes other stuff. One is all dairy one isn’t. Living a normal life and being told we serve plant milk and not been given it is at fault here.