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Canada Mom takes aim at pharmacy over daughter's close call with nut allergy

17:32  12 july  2018
17:32  12 july  2018 Source:   cbc.ca

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A mother in Delta, B.C., has filed a complaint with the province' s College of Pharmacists over what she calls "horrifying and heartbreaking" treatment her Caroline Brennan' s daughter Lily, 16, has nut allergies and ran into the pharmacy in downtown Vancouver at about 7 p.m. PT on July 4, seeking

Nut allergy is the most common type of severe food allergy . It often starts when children are very young. Most first allergic reactions take place when a child is between 14 months and two years old. A wheal takes about 15-20 minutes to reach its full size, and then fades over a few hours.

Caroline Brennan, right, becomes emotional as she hears her daughter Lily, 16, recall her attempts to get help for an anaphylactic reaction to nuts last week. © Don Marce/CBC Caroline Brennan, right, becomes emotional as she hears her daughter Lily, 16, recall her attempts to get help for an anaphylactic reaction to nuts last week.

A mother in Delta, B.C., has filed a complaint with the province's College of Pharmacists over what she calls "horrifying and heartbreaking" treatment her daughter received last week when she had a severe allergic reaction at a London Drugs pharmacy.

Caroline Brennan's daughter Lily, 16, has nut allergies and ran into the pharmacy in downtown Vancouver at about 7 p.m. PT on July 4, seeking help because she could feel the start of an anaphylactic reaction — which can be life threatening — and didn't have an EpiPen or other allergy medication with her.

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"I was already crying because I was so scared," said Lily.

a hand holding a bottle: Lily, who has severe allergies to certain nuts, holds an EpiPen, which is used to treat an anaphylactic reaction by letting a patient self-inject epinephrine, also known as adrenaline. © Don Marce/CBC Lily, who has severe allergies to certain nuts, holds an EpiPen, which is used to treat an anaphylactic reaction by letting a patient self-inject epinephrine, also known as adrenaline.

She says she and her friends twice asked at the pharmacy for an EpiPen, which injects a dose of epinephrine to treat anaphylaxis, but weren't given one until her mother got on the phone and threatened a store manager with legal action.

London Drugs is reviewing training with its staff and says the situation should have been handled differently, but says an EpiPen wasn't immediately given because the teen could speak and didn't show severe signs of anaphylaxis.

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Allergies , in a nutshell. Over 50 million Americans have allergies , according to the Centers for Disease Control and Prevention. Although peanuts are not tree nuts , people with a peanut allergy have a similar allergic reaction as those with a tree nut allergy .

Find out About Common Allergies in Kids ». Scientists took after about 11,000 members in the Growing Up Today Study II, babies conceived between January 1, 1990, and December 31, 1994. The Controversy Over Nuts : Expanding rates of nut sensitivities in the U. S . remain a riddle.

Her mother hopes others learn from Lily's frightening experience.

"For a child to go in to [a] safe place and be refused proper treatment because the pharmacist [said] that she wasn't anaphylactic — that terrifies me," she said.

"Not all children with anaphylaxis present the same way."

a person posing for the camera: Lily said she plans to be 'much more persistent' if she ever again experiences anaphylaxis for her nut allergy and needs emergency help. © Don Marce/CBC Lily said she plans to be 'much more persistent' if she ever again experiences anaphylaxis for her nut allergy and needs emergency help.

'I could feel my throat closing up'

Lily says her lips started burning and swelling and her throat grew tight after eating what she thought was a safe scoop of gelato, after a day on the beach with three friends.

And although anaphylaxis does present differently in different people, those are classic symptoms , according to Dr. Donald Stark, a Vancouver allergist and professor at UBC Medicine.  Anaphylaxis can require treatment within minutes, including an injection of epinephrine, also known as adrenaline, said Stark.

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I am having some issues with my daughter ' s preschool and their snack policies. I am actually close to taking her out and trying to find somewhere else because I feel like I am not getting anywhere. The Nut -Free Mom Blog Is an Award-Winner! Top Food Allergy Mom Blog.

Without her EpiPen and a long transit ride from home, Lily turned to the pharmacy on Robson Street.

"I explained to the man behind the counter what had happened, and that I could feel my throat closing up," she said. "I knew I needed an EpiPen."

According to London Drugs, the pharmacist decided that since she could answer his questions coherently, she wasn't in anaphylaxis. He gave her two tablets of the antihistamine Benadryl.

"He told me to wait and see if that helped and if things got worse he would call 911," said Lily.

But with her throat growing tighter by the minute, she says she didn't have time.

a group of people walking down the street in front of a store: Lily sought help at a London Drugs pharmacy on Robson Street in downtown Vancouver. © Don Marce/CBC Lily sought help at a London Drugs pharmacy on Robson Street in downtown Vancouver.

Differing accounts

There are differing accounts of what happened next, and how the teen eventually got the injection that may have saved her life.

According to London Drugs, Lily came back to the counter about five minutes after taking the Benadryl and said it was getting worse, so the pharmacist called a "code red" which summoned a supervisor to help.

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Read 31 responses to: "What is your take on this: My daughter has a severe " Find the best answer on Mamapedia - mom trusted since 2006. I'm the one with a really bad nut allergy . My MIL and a couple of my SIL often "forget" but the reality is that over the past 20 years no matter how I explain it

The supervisor found her on the floor, asked the pharmacist for an EpiPen, who got one off the shelf for Brennan to inject herself with.

"It's not that we didn't give an EpiPen, we did give the EpiPen when the situation turned quickly," said general manager of pharmacy Chris Chiew.

The company has reviewed security video of the incident, but declined to show it to CBC News citing privacy policy.

According to Lily, when she returned to the counter, she asked for an EpiPen but was told the pharmacist couldn't find one.

a man wearing glasses and looking at the camera: Chris Chiew, general manager of pharmacy for London Drugs, said the company is reviewing training with its staff on how to handle emergency anaphylactic situations. © CBC Chris Chiew, general manager of pharmacy for London Drugs, said the company is reviewing training with its staff on how to handle emergency anaphylactic situations.

She called her mom in tears, who instructed one friend to call 911 and another to find a store manager for her to talk to.

"I actually had to roar at the manager ... I had to threaten them with legal action," said Caroline. "I was horrified."

"And that's when I heard scrambling and shouting, 'Grab an EpiPen, grab one off the shelf!'"

Shortly after the injection, paramedics arrived and took Lily to hospital for treatment.

Caroline was relieved her daughter's allergic reaction could be successfully treated but calls the encounter 'horrifying and heartbreaking.' © Don Marce/CBC Caroline was relieved her daughter's allergic reaction could be successfully treated but calls the encounter 'horrifying and heartbreaking.'

'Much more persistent'

The College of Pharmacists of B.C. says it investigates every complaint it receives, but isn't commenting now on the specifics of this case.

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The country' s largest airline is notorious among the nut allergy community. This year, a nonprofit called Food Allergy Research & Education, or FARE, is taking on American Airlines over their policies facing those with Abortion rights advocates tweet coat hangers pics aimed at swing-vote senator.

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However, it is part of a pharmacist's job to help patients, including those needing emergency care, said college registrar Bob Nakagawa.

"My expectation is that they would assess what they see in front of them and provide advice… to meet their needs," he said. "If it was a dire emergency they might choose to call 911."

Chiew, of London Drugs, said the pharmacist could have started looking for an EpiPen when the teen first arrived, and should have called 911 right away when the code red was called.

Stark advises patients to call an ambulance and get help from either paramedics or a hospital ER, as some pharmacies won't have EpiPens due to an ongoing shortage, and oral antihistamines like Benadryl can take 30 minutes or more to take effect.

"The sooner you get adrenaline the better the response will be," said Stark.

For Lily, she hopes never to forget her EpiPen again, but plans to be "much more persistent" if she ever needs to convince someone her allergic reaction is serious and urgent.

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