7 yr old girl died at school in VA on 1/2/12

[rainbow]

I think the school staff has a moral obligation to "do the right thing" when a child is dying. In this case, doing the right thing to save a life would have been to use another Epipen.  However, it seems the teachers/nurse aide were also not well trained because they did not seem to recognize that the child was in anaphylactic shock -- in a LIFE THREATENING situation needing IMMEDIATE help to save her life (no time to "call mom first" as the nurse aide did, and no time to wait for emergency personnel).  They failed the child.

25% of first anaphylaxis occurs at school (so those children would not have an Epipen), the fact is not all parents have seen the right specialist to prescribe the medications (I've heard many stories of pediatiatricans not prescribing Epipen, and some lower income people cannot afford Epipens.  So the fact is, it is likely that in some cases, the child having a life threatening reaction may not have an Epipen at school.   Schools must be prepared.

Logically, the school should be stocking a generically prescribed Epipen and this does happen in many places. I think the national legislation will be approved now and schools will get on board.  Waiting for a "grant" is meaningless -- schools DO have an obligation here, and I'm sure ANY school can afford in the budget $100-200 for Epipens. 

[Janelle205]

25% of first anaphylaxis occurs at school (so those children would not have an Epipen), the fact is not all parents have seen the right specialist to prescribe the medications (I've heard many stories of pediatiatricans not prescribing Epipen, and some lower income people cannot afford Epipens.  So the fact is, it is likely that in some cases, the child having a life threatening reaction may not have an Epipen at school.   Schools must be prepared.

Agreed.  I have had relatively decent doctors, and even before doing allergy testing (my former allergist did not do testing at the first appointment) my allergist prescribed me an epi pen.  While at that point he only thought I had OAS (I was pretty sure he was wrong, and he was...), he thought that my OAS reactions were severe enough, and coupled with the fact that I had scary insect bite (horsefly) reactions and severe asthma, plus living in the middle of nowhere, he thought I needed to have one.  My current pulmo has said that even if I miraculously grew out of the food allergies, which he doesn't see happening, I would be carrying epinephrine for the rest of my life for asthma.



I know I've said this before, but every camp that I have worked at had camp epis, along with doctor's orders for administration.  It was never a big deal.  They are not that expensive.  I managed to find room in my budget (which was just about 750,000) for a few epis - and schools have way more to throw around than that.  If summer camps can do it, then schools should be able to as well.  (Of course, I also had all of my staff epi, CPR, First Aid, and AED trained, which I know schools don't do either.  It was a total pain in the rear, but I did it.)

[SilverLining]

25% of first anaphylaxis occurs at school (so those children would not have an Epipen), the fact is not all parents have seen the right specialist to prescribe the medications (I've heard many stories of pediatiatricans not prescribing Epipen, and some lower income people cannot afford Epipens.  So the fact is, it is likely that in some cases, the child having a life threatening reaction may not have an Epipen at school.   Schools must be prepared.

Most likely, if I had not had an anaphylactic reaction myself, my son would not be carrying an epi-pen.  His allergic reactions to cats and mold are very severe, but neither are usually prescribed an epi.  His reaction to insects are serious, but have never been anaphylactic.  I have read, and the allergist has said that since he's had two reactions and neither were anaphylactic, it's less likely that his insect allergy will ever be anaphylactic.  But, then I pointed out that his reactions were to two different insects at which point the allergist agreed, that means he could have an ana reaction next time.  But, how many parents would have questioned beyond?  (Many from forums like this one would, but not all.)

[rainbow]

I know I've said this before, but every camp that I have worked at had camp epis, along with doctor's orders for administration.  It was never a big deal.  They are not that expensive.  I managed to find room in my budget (which was just about 750,000) for a few epis - and schools have way more to throw around than that.  If summer camps can do it, then schools should be able to as well.  (Of course, I also had all of my staff epi, CPR, First Aid, and AED trained, which I know schools don't do either.  It was a total pain in the rear, but I did it.)

Exactly. It is just not that difficult. Schools just are getting caught up in their own bureaucracies and legal fears, and in the case of many teachers/administrators, union/tenure mentality, that they lose sight of what the RIGHT THING TO DO is.

[socks on a rooster]

The argument about the cost of funding stock epi pens is just silly. Schools spend more on unnecessary pizza parties. If there was a genuine lack of funds, I'd bet any amount of money another allergy parent or someone in the community would donate the money.

We have a stock law in my state. Our school didn't have extra epis. According to the district nurse, the fire dept response time is good enough.

[nameless]

Sigh.

I just read the Allergic Living blog post where it's said there were Epi's in that office, just not one in her name.  If only those staff had realized she would die, I'm betting someone would have stepped up and just Epi'd her with another kid's epi and not worried about the consequences. (well, maybe not...easy to say in hindsight, but man oh man. I feel for the staff and the poor kid who gave her the peanut.)

Adrienne

[Carefulmom]

I am in the same state as Socks.  Our school has 2500 kids and only 4 or 5 kids known to have epis.  We all know the statistics and can do the math.  Our nurse said that although the school is allowed to have general epis to be used on any child, there is no money for this.  I was floored.  This was a couple of months ago.  I knew that we did not have general epis, but thought that was because it is not legal.  In my opinion, it is all about priorities.  Our school is mostly poor kids and there are probably several who have LFTA and no epi.  I cannot believe that the school won`t spend $80 to get a couple of epis.  They would not even have to get epi juniors, because it is high school.  They would only have to get one size.  The nurse said that if a child has a reaction she is not allowed to use another child`s epi, because then if the child whose epi it was has a reaction, then there will be no epi for that child.  I guess they all only have one epi at school?  Cannot figure that out.

[rainbow]

I agree. The "there is no money in the budget" argument is a cop-out.  Schools waste LOTS of money on other things (extracurriculars, unused supplies, incentives, fluffy training classes to get teachers out of class, food parties, and who knows what else).  And if they were *resourceful*, they'd reach out to the community to seek donations.  I'd call them on their cop-out.  I bet more schools will be stocking it, after the VA death. But then again, unless it happened in their own district, the administrators don't always pay attention.

[CMdeux]

I agree. The "there is no money in the budget" argument is a cop-out.  Schools waste LOTS of money on other things (extracurriculars, unused supplies, incentives, fluffy training classes to get teachers out of class, food parties, and who knows what else).  And if they were *resourceful*, they'd reach out to the community to seek donations.  I'd call them on their cop-out.  I bet more schools will be stocking it, after the VA death. But then again, unless it happened in their own district, the administrators don't always pay attention.

THIS.  SOOOOOOOOOOOOOOO much.


Pollyannas, each and every one that I've ever dealt with.  Lots of cheesy smiles and soothing noises and lots of vague "I'm sure it'll be fine... children with allergies in the district before... always been just fine... we have policies...."   

[Mfamom]

holy crap.  how much would the school spend for a "general use" 2 pack of epi pens?  $100?  Our schools put defib machines in back 7 years ago after an adult using an elem school gym for adult basketball clinic had a heart attack.  I still remember being irritated (because I was hitting the wall with allergy advocacy). 

[Mfamom]

Can a school refuse a child's attendance if they have known LTFA and NO unexpired epipen on the property?

I'm wondering about this today.


Would the school have to provide for homebound education (huge bucks $$!) unless/until an epipen is on property (either for the child or generally available)?

interesting and I keep wondering what the protocol is if the forms aren't with the epi pen and they are refused by the nurse.  Does nurse call parents and say, I don't have orders with the epi pen, therefore, I cannot administer it and I cannot keep it in my room.  I would think it would be in best interest of everyone if that student didn't go to school unless meds in order. 

[rainbow]

I agree and that is why i think the school is liable here. I don't see the mom as soley at fault.  I suspect there was an income issue as well as a discussion about Benadryl always working in previous reactions.  The NURSE is  a medical professional wheras the mom is not.  The NURSE is responsible to have the medication available, and/or nag the mother daily and/or issue a letter to the family. Short of that, the school is liable.  Hope the mom has a good lawyer.  An effective lawsuit could also result in more awareness, passing of the federal Epipen law to stock in all schools, and schools actually doing it instead of making excuses about the $100-200 it costs to save a life.

[socks on a rooster]

My gut tells me income was a factor. The school would have declined taking the epi if there weren't current forms from the Dr. Maybe mom didn't have insurance and couldn't afford an appt with the Dr.? Maybe her Dr. charged money to sign forms...some do. Maybe she'd gotten an epi from someone else, and it was not prescribed in the child's name. (I have a friend who gets surplus epis, unprescribed, from someone in the medical profession). What if the school called mom daily asking for medication? If she can't afford it, then what? I can't see a SD requiring a child to stay home.

It was just a perfect horrible storm.

[lala]

I don't know about VA, but in Illinois the recourse would be to call DCFS and report medical neglect.  A SD cannot MAKE a parent give medication nor deny the child access to school because no meds.  In order to be eligible for homebound instruction, a doctor would have to write a note to the school requesting such services.  I doubt a doc would do so for a parent not sending in an Epi.

[rainbow]

I don't know about VA, but in Illinois the recourse would be to call DCFS and report medical neglect.  A SD cannot MAKE a parent give medication nor deny the child access to school because no meds. 

I don't see that as likely, though, given there are many students in schools without Epipens.