Girl Dies From Allergic Reaction to Sesame Seeds

[skwdenyer]

The Mad Monk said:

PF62 said:

My understanding from reading the reports -

- Pret benefit from the exemption for not labelling intended for small outlets which would be too burdensome for them to comply but dead easy for a mega-corp like Pret.
- Pret claimed signs were on shelves advising people to ask about allergies but the following week no signs were present in that branch.
- Pret have had six previous instances of allergic reaction from that bread in the last 12 months.
- Pret label their food with "gluten free" and other information about the ingredients, but choose not to label allergens.

So Pret knew their labelling was causing serious problems, but did sweet FA about it.


- BA stored the first aid kit at one end of the aircraft and the defibrillator at the other end.
- BA cabin crew didn't bother telling the doctor the first aid kit had an epi-pen in it.
- BA training was not to bring the defibrillator out unless the cabin crew thought there was agonal breathing, so cabin crew were making medical decisions not deferring to the trained doctor in attendance.

I think BA were lucky to not get called out by the coroner, but that was probably down the evidence that the defibrillator would have made no difference as it was thought her heart had already stopped rather than having an abnormal rhythm that could be corrected by the defibrillator.


There was also the issue that the needle on the two epi-pens used had needles that were too short to guarantee effectiveness, so some serious questions for the company who made them.

Also from your understanding from reading the reports:-

What responsibility falls upon the parents to exercise care?

What responsibility falls upon the 15 year old?

Is no one responsible for the consequences of their actions?

With my wife, I have 6+ years experience in food service running a gluten-free outlet with specific focus on allergens and intolerances. My wife is allergic to soya, as well as being coeliac and suffering from lactose intolerance. My son also has some complex food issues.

As such I have a little qualification to comment. In that context, my observations:

- Pret have an "allergen matrix" available in every store, allowing one to look up what is (or should be) in each product
- *every other* food service business (compliant with the law, at least) has just such an allergen matrix
- allergen matrices are well-known tools, used by allergy sufferers on a daily basis
- nobody with an allergy who wishes to live takes a chance and does not ask
- the *only* way to guarantee a product is free of something is to completely remove that something from the supply chain and preparation / service areas - so, for instance, we had no gluten-containing products anywhere on-site, nor soya (save for soya milk, in brightly-coloured containers)
- cross-contamination is why Pizza Express now only use gluten-free flour in their kitchens to dust surfaces etc.
- product is prepared on-site; as such, Pret will seldom if ever guarantee the absence of anything they use due to cross-contamination potential
- my son (aged 12) carries an app on his phone that allows him to check every variant spelling / variant description of every ingredient to ensure it is safe - if he's not sure, he doesn't buy / eat it - a 15 year old has no problem with this stuff

I know that it is very unpopular to "victim blame" these days, but in this particular case:

- the child and/or parents are at-fault; they messed up and the child is dead

The child was not a toddler; she was 15.

Pret might have been missing a label or two, and should be called to account if so. But it is not going to be the case that this child and/or her parents had never bought food before - they did not need the constant reminder of "ask us about allergens" stickers to prompt them to ask about allergens.

Everything that has happened since then is an attempt to shift the blame from personal responsibility onto the shoulders of others - Pret, government, etc. It is not onerous to ask for an allergen matrix if your life depends upon it.

It *is* onerous to not be able to buy food that is safe for you, which is why my wife and I ran a business for 6 years in that space - it was very heartening to see the reactions of customers who realised that things we could offer them were safe for them to eat. We chose only to eliminate a couple of things, but there are still limitations in the guarantees that can be obtained from further up the supply chain even then.

As others have said, the only realistic response for Pret at this point is to put a sticker saying "may contain allergens - please ask" or even worse "may contain allergens, sorry" on ever item.

I have a great deal of sympathy for the family for their loss; I have none at all for them in their desire to blame others I'm afraid.

[Mastodon2]

The Mad Monk said:

A very sad story, but, moving on from that why do people have these allergic reactions to different types of food?

It never used to happen, why does it happen nowadays.

What can we do to get back to the tolerance that just about everybody used to have?

Except it has always happened.

[Mr Whippy]

otolith said:

It's interesting that prevalence of childhood food allergy seems to increase as countries westernise.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC38790...

It would appear that we are doing something that is causing this.

Less people breast feed their babies for very long now.
Then they use formula which is full of all sorts of artificial or unusual extras.
Evidence to suggest ~95% of women have no reason to not breast feed. Evidence it reduces immune stuff.

More c-sections. Evidence to suggest this reduces immune stuff.

More vaccines. Pros and cons?

More fakery crap in food generally. Less whole foods. Lots more chemical substitutes.

Cereals sprayed with weed killer pre harvesting, mmm, healthy?


The west has done great things for mortality rate improvements. Many intertwined with the above.

It’s all pros and cons... the trick would seem to be to keep out the cons, but we haven’t.

[anonymous-user]

Mastodon2 said:

Except it has always happened.

Vastly more prevalent nowadays, as are most autoimmune diseases are. Environmental and family genetics play a part.

One theory is the elimination of parasites in food, that previously kept a homeostatic balance that is now vastly imbalanced.Immune systems are now over reacting to threats, such as nuts etc which in the past would cause no illness.

[skwdenyer]

Thesprucegoose said:

Mastodon2 said:

Except it has always happened.

Vastly more prevalent nowadays, as are most autoimmune diseases are. Environmental and family genetics play a part.

One theory is the elimination of parasites in food, that previously kept a homeostatic balance that is now vastly imbalanced.Immune systems are now over reacting to threats, such as nuts etc which in the past would cause no illness.

At the expense of opening up a can of worms, we're much better at keeping people alive long enough to procreate than we were in the past, and indeed helping those who have difficulty procreating to do so. There are consequences to both.

[Ian Geary]

Breastfeeding or not: I think there's an amount of virtue signalling there. My boys had mostly formula, and have zero allergens. I was formula fed for medical reasons, and have none. Yet friends who exclusively breast fed gave sprogs who are allergic to all sorts of stuff. Hardly a conclusive study, but makes me doubt that sort of pronouncement.

Also,I recall a seller of artisan organic bread trying to claim we did have coeliac until the 50s when additives began to be added to bread. No coincidence he's trying to sell loaves for £3.50 each?

My great uncle (1 of 8, 3 died before age of 21) was in a mental hospital for the last few years of his short life, back in the 1920s. My parents recently got hold of his medical records (they had amazingly been retained). He was described as being a "sickly child", doesn't put on weight, having foul smelling runny stools.

My dad, who has coeliac, strongly suspects his uncle suffered from this, but was just unknown. No way this was an isolated thing.


Awful about the girl who died of course. The only hope can be more awareness of the risk is created for all who need it.

Ian

[anonymous-user]

skwdenyer said:

At the expense of opening up a can of worms, we're much better at keeping people alive long enough to procreate than we were in the past, and indeed helping those who have difficulty procreating to do so. There are consequences to both.

All evidence in the past 100 points clearly points to environmental factors in the rise of cases, so your statement just highlights your inner prejudices.

The immune system is developed from baby to child, not much is inherited from genes, it builds up it's self through exposure to bacteria, the gut, and white bloods cells in the blood. The foundations built as a youngster set up for rest of our lives.

A recent article of developing drugs.

One thing you mustn’t put the increase down to is genes,” he adds. Although some people are more genetically predisposed to developing food allergies, the proportion has not changed over time, he says, meaning environmental factors must be to blame. “Now we’re very interested in the beginning of a baby’s life — what they’re eating and what they’re breathing in, and we need to do more research on that.”

Edited by Thesprucegoose on Saturday 29th September 10:52

Edited by Thesprucegoose on Saturday 29th September 10:53

[21TonyK]

skwdenyer said:

With my wife, I have 6+ years experience in food service running a gluten-free outlet with specific focus on allergens and intolerances. My wife is allergic to soya, as well as being coeliac and suffering from lactose intolerance. My son also has some complex food issues.

As such I have a little qualification to comment. In that context, my observations:

- Pret have an "allergen matrix" available in every store, allowing one to look up what is (or should be) in each product
- *every other* food service business (compliant with the law, at least) has just such an allergen matrix
- allergen matrices are well-known tools, used by allergy sufferers on a daily basis
- nobody with an allergy who wishes to live takes a chance and does not ask
- the *only* way to guarantee a product is free of something is to completely remove that something from the supply chain and preparation / service areas - so, for instance, we had no gluten-containing products anywhere on-site, nor soya (save for soya milk, in brightly-coloured containers)
- cross-contamination is why Pizza Express now only use gluten-free flour in their kitchens to dust surfaces etc.
- product is prepared on-site; as such, Pret will seldom if ever guarantee the absence of anything they use due to cross-contamination potential
- my son (aged 12) carries an app on his phone that allows him to check every variant spelling / variant description of every ingredient to ensure it is safe - if he's not sure, he doesn't buy / eat it - a 15 year old has no problem with this stuff

I know that it is very unpopular to "victim blame" these days, but in this particular case:

- the child and/or parents are at-fault; they messed up and the child is dead

The child was not a toddler; she was 15.

Pret might have been missing a label or two, and should be called to account if so. But it is not going to be the case that this child and/or her parents had never bought food before - they did not need the constant reminder of "ask us about allergens" stickers to prompt them to ask about allergens.

Everything that has happened since then is an attempt to shift the blame from personal responsibility onto the shoulders of others - Pret, government, etc. It is not onerous to ask for an allergen matrix if your life depends upon it.

It *is* onerous to not be able to buy food that is safe for you, which is why my wife and I ran a business for 6 years in that space - it was very heartening to see the reactions of customers who realised that things we could offer them were safe for them to eat. We chose only to eliminate a couple of things, but there are still limitations in the guarantees that can be obtained from further up the supply chain even then.

As others have said, the only realistic response for Pret at this point is to put a sticker saying "may contain allergens - please ask" or even worse "may contain allergens, sorry" on ever item.

I have a great deal of sympathy for the family for their loss; I have none at all for them in their desire to blame others I'm afraid.

Completely agree. Pret could and possibly should have done/do more than they do but the onus is on the consumer to make sure food is safe for them to eat if they suffer with allergies.

From what I have seen so far the parents are seeking to change the law to make it safer for allergy suffers by ensuring all packaged foods display allergen info. Fair enough.

The moment it turns into anything else is when my opinion will change.

[bloomen]

https://www.theguardian.com/commentisfree/2018/sep...

"I shouldn’t have to live in fear of others’ irresponsibility."

I couldn't imagine what it's like to have something like that hanging over me. I do know that I couldn't bring myself to place my life in the hands of people who don't understand or care until it's too late.

The average person delegates control of what goes into their mouth several thousand times a year. More than a few will slip up.

[pilotoscot]

nonsequitur said:

rxe said:

RobGT81 said:

Sounds like a massive jobsworth who thinks his role in landing is more important than it actually is. The chance of anything that needed his attention while landing was, while possible, tiny. Compared to the chance of the girl who was having cardiac arrest at the time dying.

More likely because the last time someone died, the findings were “cabin crew must be by the doors without fail”. This recommendation was taken up into the training and beaten into the cabin crew. As long as they obey their training, they did the right thing

They haven’t.
The outcome of this will be that Prets (and every other sandwich shop) will stick allergy warnings over everything. The stock answer from the staff will be “it doesn’t have nuts in it, but might have been in the same room as nuts so we are making no guarantees”.

Society wants someone or something to blame for everything that happens. Lessons must be learned, but sometimes lessons conflict. Do I stay by the door or do I get the defibrillator? Sometimes bad stuff happens and there is no one to blame.

As In Charge cabin crew I ,through the captain, authorised a couple of 'continue with medical assistance during landing' scenarios. On one, CPR was contiuous throughout descent landing and taxying until ground medics arrived. This was some time ago and systems and routines could have changed.

Edited by nonsequitur on Saturday 29th September 09:41

[FredericRobinson]

skwdenyer said:

At the expense of opening up a can of worms, we're much better at keeping people alive long enough to procreate than we were in the past, and indeed helping those who have difficulty procreating to do so. There are consequences to both.

Go on then, explain how helping those with fertility issues causes 'consequences'

[Jasandjules]

rxe said:

Lessons must be learned, but sometimes lessons conflict. Do I stay by the door or do I get the defibrillator? Sometimes bad stuff happens and there is no one to blame.

Not being funny but unless there was an emergency which was threatening the airplane or lives of the passengers requiring the door to be used, the choice is very clear. I mean, it can't be that hard to weigh up the facts and come to a conclusion on that surely?

[pilotoscot]

PF62 said:

My understanding from reading the reports -

- Pret benefit from the exemption for not labelling intended for small outlets which would be too burdensome for them to comply but dead easy for a mega-corp like Pret.
- Pret claimed signs were on shelves advising people to ask about allergies but the following week no signs were present in that branch.
- Pret have had six previous instances of allergic reaction from that bread in the last 12 months.
- Pret label their food with "gluten free" and other information about the ingredients, but choose not to label allergens.

So Pret knew their labelling was causing serious problems, but did sweet FA about it.


- BA stored the first aid kit at one end of the aircraft and the defibrillator at the other end.
- BA cabin crew didn't bother telling the doctor the first aid kit had an epi-pen in it.
- BA training was not to bring the defibrillator out unless the cabin crew thought there was agonal breathing, so cabin crew were making medical decisions not deferring to the trained doctor in attendance.

I think BA were lucky to not get called out by the coroner, but that was probably down the evidence that the defibrillator would have made no difference as it was thought her heart had already stopped rather than having an abnormal rhythm that could be corrected by the defibrillator.


There was also the issue that the needle on the two epi-pens used had needles that were too short to guarantee effectiveness, so some serious questions for the company who made them.

A fine summary, and a reminder of the value of the coroner system.

As others have said. It’s a tragedy, I hope the family are able to find peace of mind.

[skwdenyer]

FredericRobinson said:

skwdenyer said:

At the expense of opening up a can of worms, we're much better at keeping people alive long enough to procreate than we were in the past, and indeed helping those who have difficulty procreating to do so. There are consequences to both.

Go on then, explain how helping those with fertility issues causes 'consequences'

The point I was trying to make - possibly a little clumsily - was this: humans and human life are not "just the same" as they were even 50 years ago.

Children who would have been stillborn are now born alive. Children who would have died in childhood are kept alive into adulthood.

"Less robust" (for want of a better term) humans stand a greater chance of making it through to later life.

Despite what another poster has said, these aren't my "inner prejudices" - for reasons that may be partly obvious from my other answers here, and for other reasons that I choose not to elaborate at this time. Suffice it to say, however, that my family has benefited greatly from those changes in medical science that have allowed people to survive who once would not have done.

What I do not know is what effect this has on other issues. I have read a lot of correlation of allergic responses (say) to environmental factors, but I've seen surprisingly little causation. There are a great many auto-immune conditions that on the face of it seem more common than once they were; equally we now look for them more commonly than once we did.

On the specific question you asked at the end of your post: parents suffering miscarriages or stillbirths are not (in my book) suffering "fertility issues" - their fertility is just fine. Sometimes a foetus is lost for reasons connected with the Mother's health; sometimes for reasons of chromosonal abnormality; sometimes for reasons of genetic abnormality; sometimes for reasons as yet unknown (but hypothesised by some to include allergic reactions to foodstuffs ingested by the Mother, as a matter relevant to this thread). Medical science is much better at saving a wider range of those children than once was the case (depending upon stage, of course). There is a huge amount of research continuing, there is a huge amount we know we do not know, and we certainly don't have a handle on the long-term implications for the human race in general of the degree of medical intervention we are able to apply even now.

[Halb]

La Liga said:

I've read about this and I find the reasoning for not getting the defibrillator very questionable - what's the point of having it when you don't get it?

https://www.bbc.co.uk/news/uk-england-london-45653...

yes, that's shady

Burwood said:

You do wonder. A good friend I've known for 20 years came over for lunch which I 'cooked'
she starts eating it and says 'had this got fish in it', err yes. She's severely allergic to fish (carry a pen) allergic. I never knew. I felt terrible but did say, why didn't you ask or tell me about your allergy!

What did she say?

[Bigends]

Thesprucegoose said:

skwdenyer said:

At the expense of opening up a can of worms, we're much better at keeping people alive long enough to procreate than we were in the past, and indeed helping those who have difficulty procreating to do so. There are consequences to both.

All evidence in the past 100 points clearly points to environmental factors in the rise of cases, so your statement just highlights your inner prejudices.

The immune system is developed from baby to child, not much is inherited from genes, it builds up it's self through exposure to bacteria, the gut, and white bloods cells in the blood. The foundations built as a youngster set up for rest of our lives.

A recent article of developing drugs.

One thing you mustn’t put the increase down to is genes,” he adds. Although some people are more genetically predisposed to developing food allergies, the proportion has not changed over time, he says, meaning environmental factors must be to blame. “Now we’re very interested in the beginning of a baby’s life — what they’re eating and what they’re breathing in, and we need to do more research on that.”

Edited by Thesprucegoose on Saturday 29th September 10:52

Edited by Thesprucegoose on Saturday 29th September 10:53

There was an interesting radio discussion on this information a couple of years back - babys getting their first bugs whilst passing through the birth canal - something c section deliveries dont receive

https://www.smh.com.au/lifestyle/health-and-wellne...

[Gareth79]

andy_s said:

I struggle to see why you would carry around 2 Epipens because your allergy is so severe and then eat a sandwich (a likely source of the allergen) that didn't have a label on it. Mind boggling.

Quite - there was quite a lot of discussion in court about the existence and size of the "ask us about allergens" stickers, but you'd expect that a lack of stickers wouldn't make somebody assume all the products are free of allergens.

The other complication was that the father claimed he saw an ingredients list on the product, something that would have been impossible.

[skwdenyer]

Bigends said:

There was an interesting radio discussion on this information a couple of years back - babys getting their first bugs whilst passing through the birth canal - something c section deliveries dont receive

https://www.smh.com.au/lifestyle/health-and-wellne...

Yes, I heard of it, thought it interesting, then promptly forgot all about it! Thanks for the reminder.

I heard it in the context of women complaining that they weren't being permitted to have elective c-sections; not all of the medical profession believe c-sections should be a matter of election, for this and other reasons.

That nature of humanity and health is that, by the time we have enough evidence to understand the true impact of something like this it is often far too late to put the genie back in the bottle.

[PF62]

Gareth79 said:

The other complication was that the father claimed he saw an ingredients list on the product, something that would have been impossible.

Pret do list the ingredients by describing the product, but a key issue was Pret chose to label items with "Gluten free" but not products with allergens.

So why would Pret chose to label the gluten free food for coeliacs, but not label their food with allergens?

Is it because Pret had made a business decision to exploit the gluten free fad as it was a nice little earner and had nothing at all to do with coeliacs, but didn't stop to think that by labelling some food and not others that customers could be mislead - and they were - six people suffered from eating the same type of bread in the previous 12 months.

[loafer123]

I listened to a lady on R4 talking about her citrus allergy. Terrifying.

The point, however, is that saying something is Gluten Free is not the same at all as saying it is safe for everyone, as there are many different types of allergy.

The death of the girl in question was tragic, because it reminded me of the daughter of a friend who died in similar circumstances. I keep a card from her father next to my desk, even though I never met her, because it touched me so much, but fundamentally, having had sleepless nights thinking about it, it is the responsibility of the user/eater, not the retailer, if you have a severe allergy.