5:00AM Thursday April 26, 2007
By Martin Johnston Grant Freeman sat down to a tomato entree on Tuesday night last week at a work dinner. Ten minutes later he collapsed in the toilet. Two days later he was dead, a suspected victim of a food allergy.
Now his family are speaking out to try to prevent similar tragedies. Food authorities have been alerted.
Mr Freeman, a 38-year-old Whangaparaoa father and the marketing manager of Chelsea Sugar, had had food allergies since he was 5, but he never realised his life might be at risk, his grieving family said yesterday.
On April 17 he went to dinner at a cafe southeast of Auckland. Allergic to peanuts, tree nuts, eggs, seafood and chicken, he warned the cafe, was identified as the person with allergies when he arrived, and given a specially prepared meal, his sister Donna Whittle said yesterday.
Others were given a seafood entree, but Mr Freeman had a raw-tomato dish with a sauce. She was unsure what kind of sauce.
"He had a glass of wine, then had a mouthful of entree. He said it wasn't right and he didn't feel good. He went to the bathroom and collapsed in a stall. They heard the crash from the restaurant."
A colleague found him, and an ambulance was called. Ambulance officers managed to restart his heart, Mrs Whittle said, but he had been without a pulse for some minutes.
He was taken to Middlemore Hospital where he was put into a coma, but last Thursday his life-support was stopped because he had suffered severe brain damage.
Mrs Whittle wonders whether his meal was inadvertently contaminated with a trace of one of his allergy foods, but does not blame the cafe. She named the cafe but did not want it identified.
When the Herald phoned the cafe and asked about Mr Freeman's death, a woman said: "We can't make any comment about it," then hung up.
Mrs Whittle said it might never be known what caused her brother's death.
"They were very clear at the hospital that it was anaphylaxis [a severe allergic reaction]. They can't work out definitively what the reaction was to. The fact he's always had these allergies points in that direction."
Adrenalin is given to save the lives of people suffering anaphylactic shock, which can be caused by insect stings but more often is from a food allergy. Some people at risk of the condition carry an "EpiPen" adrenalin injector. Mr Freeman did not.
His worst previous reactions were diarrhoea and vomiting, Mrs Whittle said. "He had never been diagnosed with life-threatening reactions."
When he was 5 he had breathing difficulties after eating fudge containing walnuts. He became very careful about what he ate and his home was kept free of the foods he was allergic to.
Allergy NZ has notified the Food Safety Authority about the case, which has also been referred to the coroners.
Mrs Whittle, whose 4 1/2-year-old son Thomas is allergic to peanuts and eggs, wants greater public awareness of food allergies and greater tolerance from restaurants. "People just don't take it seriously enough."
Auckland City Hospital immunologist Dr Penny Fitzharris said it was thought anaphylaxis killed one or two people a year in New Zealand, but deaths from the condition were often coded as something else, such as acute asthma.
"About 50 per cent of people who know they have a food allergy don't seek specialist referral. They should," she said. "Although you may have had a mild reaction in the past, it's very hard to predict the severity of a future reaction."
* 6-8 per cent of children and 2-4 per cent of adults have an identified food allergy.
* Eggs, dairy products, peanuts, tree nuts and seafood are among the most common food allergens.
* One in every 2500 people experience anaphylaxis, a rare, severe and life-threatening reaction, mainly to foods.
* Anaphylaxis can cause diarrhoea, constricted breathing and extremely low blood pressure.
* It is thought to kill one or two people a year in New Zealand.
Sources: Allergy NZ, Auckland City Hospital immunologists
On Apr 26, 2007
Boy, another case where someone didn't believe and hadn't been told by a Dr. that their food allergies were life-threatening, and didn't have an Epi. He had experienced breathing difficulties, vomiting and diarrhea, yet they hadn't diagnosed it as life-threatening. I suppose 30 years ago when he ate the fudge even fewer Drs. understood food allergies. This is such a shame, because he clearly went to lengths to avoid his allergens. He apparently did everything right about ordering his food.
Never let someone having a possible reaction to food go alone into a restroom. My DH just took a CPR class, and they taught him that if someone is choking and refuses help (Heimlich), which they're allowed to do, you still follow them if they go into a bathroom or somewhere else alone.
On Apr 27, 2007
A related article:
Pharmac playing 'Russian roulette' with allergies Friday April 27, 2007 By Martin Johnston Pharmac is gambling with the lives of allergy sufferers by refusing to buy them automatic adrenalin injectors, says an Auckland man who nearly died from his food allergy.
Paul Martin, who buys his own single-use EpiPen auto-injectors - and has been saved by them - spoke out yesterday after the death of Aucklander Grant Freeman.
The Herald reported yesterday that Mr Freeman, aged 38, died last Thursday after his hospital life-support was switched off. He had severe brain damage. His heart had stopped beating for several minutes two days earlier before being treated at the cafe where he had collapsed.
His sister Donna Whittle wonders if his meal was inadvertently contaminated with a trace of one of the foods he was allergic to - peanuts, tree nuts, eggs, seafood and chicken.
Mr Freeman did not realise his life was in danger. But could an EpiPen have prevented the tragedy?
EpiPens cost about $160 and have a shelf life of 18 months after manufacture. Around 6000 people in New Zealand have them.
AdvertisementAllergy New Zealand chief executive Penny Jorgensen said Pharmac should fund EpiPens for all of the estimated 20,000 people at risk of severe allergic reactions to foods - the majority - or insect stings.
So-called anaphylactic shock is a severe, life-threatening reaction. Symptoms can include diarrhoea, constricted breathing, and a drastic drop in blood pressure.
Pharmac's medical director, Dr Peter Moodie, said it had decided against funding EpiPens partly because of their cost, but mainly due to the difficulty of identifying those at greatest risk of anaphylaxis.
ACC buys EpiPens for some people who have had anaphylaxis after insect stings and some other allergy sufferers on low incomes have received funding for them from Work and Income.
Pharmac does pay for syringes and tiny bottles of adrenalin - kits worth less than $10 - but Allergy NZ, Auckland City Hospital immunologist Dr Penny Fitzharris and Mr Martin were scornful of this.
"We think it's an unsafe device and should never be prescribed," said Mrs Jorgensen.
Mr Martin, an Auckland accountant who is allergic to numerous foods, said Pharmac's position was ridiculous: "Why does Pharmac continue to play Russian roulette with our lives?
"I went through the allergy clinic at Auckland Hospital. They recommend the EpiPen and show you how to use it on the spot before you leave. It's so much easier to use than a syringe. There's no way my wife would use a syringe [on me] but she's happy to use an EpiPen. You slap it against your thigh hard and the needle pops out and does it.
"It takes about 10 seconds to use, but it can take a minute to load and inject the syringe-based subsidised solution. And that's when you're not already suffering the debilitating effects of early anaphylaxis. Once a serious allergic reaction starts you only have minutes to seek help."
Mr Martin has had two bouts of anaphylaxis; in one, he was just minutes from death.
Dr Fitzharris said Pharmac's clinical advisory committee recommended funding EpiPens, but ranked them as of only moderate priority - too low for it to happen.
"One of the factors that comes out in all studies of death by anaphylaxis is delayed use of adrenalin," she said.