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?

The thing I struggle with with this story is that the mum keeps talking about her having a milk intolerance and that she told the staff that she has a milk intolerance. The girl had an allergy not an intolerance so sounds like the seriousness was underplayed

Allergies are not mild, reactions can be mild, until they suddenly aren’t. Any allergy has the potential to trigger anaphylaxis. I’m allergic to several fruit and veg and I hold my hands up that I’ve been reckless with it in the past - I’ve never been to an allergy appointment where it wasn’t spelled out to me. I had an incident which was almost serious and gave me a bit of a wake up call but clinics and GPs definitely tell you that even if one reaction was mild there’s a good chance the next won’t be. That’s why you are at the clinic in the first place, because you have a potentially fatal allergy (even if it’s a stupid one like mine!)

When I go to Costa and ask for mine to be made with oat milk, it's marked with an O. I have been asked if this is preference or allergy. (I'm not allergic to cows milk but can't drink too much because of the amount of mucus I produce)

I have a nut allergy so I don't eat in restaurants that specialise in the kinds of foods that frequently contain nuts, ie Thai, Vietnamese, curry, Chinese. I feel like it's asking too much of a chef in a kitchen with lots of dishes contain nuts to avoid a mistake. I also won't eat in a pub that has anything with peanuts on the menu for the same reasons.

By this logic if I had a severe milk allergy I wouldn't buy drinks made at coffee shops for whom 90% of orders contain milk.

The family are certainly not to blame but I also don't think it's fair to hold a member of staff to account. The wage these jobs attract cannot possibly cover that level of responsibility.

I cannot understand why the parent of a child with a severe milk allergy would visit a coffee shop where staff are on the lowest pay scale and often receive poor training, not to mention the contamination in the food preparation area and equipment!

The last time I went through a drive through Costa the young man was incredulous that vegetarians can't eat fish and another time two of the women laughed at the idea of marshmallows being unsuitable for vegetarians - 'They're marshmallows not meat ha ha ha ha!' 😬

So the staff member didn't follow the procedure, she failed to give the customer the book about allergies.

Also the staff members understanding of English must be poor as she is using an interpreter at the tribunal.

That poor girl and her Mother.

In an ideal world, yes, people should be able to trust staff, but the world isn’t ideal. Miscommunications, misunderstandings, happen all the time, and potentially even more so in a busy, often noisy environment like a cafe. I think this is the context in which someone should make a decision about what level of risk is acceptable for them, rather than measure it against an ideal scenario, especially if the potential consequences are so severe. It is a really awful case for everyone involved.

Yes let's blame the mum.

It's always the mums fault.

😳

Sadly I think in this case the mother has to bear responsibility
She was told it contained milk.
When the daughter declared 'that's not soy' when she took a sip in the dentists, the mother continued booking the next appointment while the girl went to the toilet.
When it was clear she was having a reaction, declined their offer of an epi pen and adrenaline shot (which they were trained in administrating) and instead walked to the pharmacy to buy clarityn
The pharmacist gave the shot but it was too late.
Very sad all
Round but no I don't blame the barista

There are countless "minimum wage jobs" that have the potential to cause harm, injury or death to people. If you can't understand the risks then you are not capable of doing the job.

Don't equate "minimum wage" with brainless tasks. It's insulting to people who work those jobs.

I think there is a bit of 'she said...he said' in this and I guess a coroner's inquest is not adversarial and certainly not a criminal court. The barrista is being advised not to incriminate herself which kind of insinuates she is aware of negligence in mind sight but is mindful of any further legal ramifactions.

One thing that has to be discounted is that the barrista acted spitefully in serving milk in a 'I am hot,stressed, not fully understanding of a customer's request so f&%k it milk it is'. I doubt this is the case but would this have to discounted legally?

Yes the server failed to show the mother the book. But I can’t see how it would have made any difference. The book says the hot chocolate powder does not have milk as an ingredient. Made with soya milk the drink would be fine. The issue is the barista mistakenly used cows milk.

Toothpaste can contain milk. I learnt that the hard way.

Yep! A very cheap thickener

Re declining the EpiPen at the dentists.

https://www.google.com/amp/s/news.sky.com/story/amp/girl-who-died-after-taking-a-sip-of-costa-coffee-hot-chocolate-could-have-been-served-dairy-over-miscommunication-inquest-hears-13196432

I think there are a lot of questions to be answered here.
Obviously the coffee shop were at fault in serving cows' milk but when asked for soya but there are other issues too. As the mother of a multi allergic child I know it's really hard. There is always some risk when you buy food and drink outside the home but you can't curtail normal life completely so you have to balance those risks. I don't like to blame the Mum, or indeed the girl herself as it feels uncomfortably like victim blaming, but they did some things that suggest to me that they were maybe not as well educated about her allergies and how to manage them as they should have been - not necessarily their fault of course.
Firstly, if I had a child who was anaphylactic to cows' milk I probably wouldn't buy any unwrapped food or drink from anywhere with a coffee machine that froths milk. There's a lot of misinformation about airborne allergens and the risk tends to be exaggerated but arerosolled milk is a genuine risk. I know that's not what happened here, but buying from Costa or similar is risky if you're anaphylactic to milk even if they do everything correctly. It's a risk I wouldn't personally take.
Secondly, if you are anaphylactic to anything you should ideally carry two adrenaline autoinjectors all the time. We also always have antihistamines on us. Of course anyone can forget but I always have at least one in my bag and DS carries his own as well. It seems that neither Mum nor daughter had one with them or were certain about what to to - maybe they weren't adequately educated when the poor girl was first diagnosed. Or maybe it was a long time ago and they'd got a bit complacent, it's easily done.
And leaving the dentist was a poor decision. If you're going to have an anaphylactic reaction then a medical setting is about the best place to do it. Ok, it wasn't a hospital but dentists are trained to recognise and in the initial management of allergic reactions so they would probably have been better off staying where they were. Earlier administration of adrenaline could have made the difference.
Of course the barista shouldn't have made the mistake but I think this case raises bigger issues around knowledge and education about allergies, even for those who have them. I had EpiPen training for my DS when he was in infant school and he's about to go to University. He gets them on repeat prescription but its over a decade since he was discharged from follow up and in that time we have had zero contact with anyone. Most of what I know has been from my own reading and contact with Allergy UK. Not everyone knows or is able to access those kind of resources for many reasons. Is that part of the problem?

That fact that she refused an epi pen would suggest she didn't know it was that serious

I do wonder if a mother would ever allow the drink to be consumed if she was clearly told it contained milk? It is this exchange where the information was given that is so ambiguous. Could the barrista be overstating the clarity of the mood message to not incriminate herself??

It's possible her mum didn't know how serious it was. My DD has a nut allergy. The allergy clinic said they don't know how serious her next reaction could be, but gave us Epipens just in case. They were not clear at all about what we should do when eating out - I asked if we should avoid may contains and we were told it was up to us. We carry epipens at all times and choose not to eat may contains. When eating in a cafe, we only eat things that come in packages, with ingredients listed on them. When drinking in Costa, my daughter usually has a bottle of fruit juice, as again it is clearly labelled. It is all a big worry though and not at all easy to deal with so I really feel for this poor Mum.

The barista told the mum hot chocolate is made of milk and she said that’s fine. Mum is at fault, why didn’t she question that then no misunderstanding would take place

The bit where the mum told the server it was okay to use the same jug once it had been washed suggests (to me), that the server thought she was asking whether it was okay to serve milk, but the mum thought she was responding to a question about whether it was okay for the same frother that's used for milk to be used to froth the soya milk.

I think a lot of people don’t realise that you can develop an allergy to something at any time, even well into adulthood. The severity of the condition can also change. Therefore I don’t think the onus was completely on the girl for needing to take such stringent care herself of a life threatening allergy. Costa and the employees do need to take some accountability for this.

From reading that Guardian article, it seems the dispute is what the mother asked for. The server seems to be saying she asked for two hot chocolates - ie didn’t say soya hot chocolate(s) - and then asked that the jug be washed out between them. The mother is saying that she specified soya in her order.

Whatever happened, all cafes and restaurants need a better system, eg a written card filled in by the customer and signed that can be passed to baristas, chefs, etc. That way any misunderstanding in the order becomes obvious from the written card because the mother here would have ticked the soya milk box.

Sounds like a serious of unfortunate events that had an utterly tragic outcome.

The girl and her family presumably didn't realise how severe her allergy had become, or they would have had epipens on them. Not to mention they probably wouldn't have gone to Costa, and would have paid closer attention to the drink being made. If she hadn't had anaphylaxis before and hadn't been told she was at risk, they weren't to blame for that. Anyone can develop a life threatening allergy or have an allergy worsen at any time.

Costa should have better training in place so that staff understand the severity of allergic reactions.

The barista should have paid more close attention to the milk type. If you're preparing food for others you do need to be allergy aware regardless of your pay level.

I read the full article . Poor girl and her family but yes the chocolate powder had milk in it and even with the best will there can be cross contamination in such a place as Costa. Obviously the barista in this case used the incorrect milk. It just seemed a weird thing to order for some one with an allergy on the way to the dentist .

I also read that they didn’t carry her own epi pen which you’d expect with such a severe allergy. Eventually one was administered in the pharmacy but the end report said it wasn’t enough and another pen should have been administered. As a first aider to children with multiple allergies it’s a sobering read.