http://www.wtvr.com/news/wtvr-chesterfield-student-death-20120103,0,4150762.story?track=rss (http://www.wtvr.com/news/wtvr-chesterfield-student-death-20120103,0,4150762.story?track=rss)
Note: There were 2 topics on this subject, one in Main and one in Schools, which have been merged into one topic. ~Rebekah
oh wow. :'(
:'(
What a horrific tragedy. My heart and prayers go out to her family and to everyone involved.
A few things really caught my attention:
QuoteAt the beginning of this school year, the mother said she tried to give the clinical aid an Epipen for emergencies, but she was declined and told to keep it at home.
Quote"At 2:30 they called my wife and said somebody needed to pick Ammaria up because her tongue was swelling. My wife told them to call 911."
It sounds like the school really dropped the ball on more than one count. :disappointed:
This is just so sad. This never should have happened to this little girl.
And yes, it sounds like the staff at the school really screwed up, if what the mom said in the TV interview is accurate. How could they reject an Epi-pen? I did find a medication form on the district's website that includes references to Epi-pens, and in the comments section of one version of this story, a parent of another child in this district says her child's school holds several Epis for kids.
Also very troubling is the part of the mother's interview where she says that one version of events is that someone "made" her child eat peanut. Ugh. Hopefully more information about the exposure and the school's reaction to it will come out soon.
I hope I post this right. My sister just called to tell me. So sad!
http://www2.timesdispatch.com/news/2012/jan/04/1/tdmain01-food-allergy-fatal-to-7-year-old-ar-1585306/?referer=http://www.facebook.com/l.php?u=http%3A%2F%2Ftimesdispatch.com%2Far%2F1585306%2F&h=nAQHMXAPJAQHQSv5r8x44ISOdA6A8Pwe5UieqdJPfQBosdg&shorturl=http://bit.ly/w4MSn0 (http://www2.timesdispatch.com/news/2012/jan/04/1/tdmain01-food-allergy-fatal-to-7-year-old-ar-1585306/?referer=http://www.facebook.com/l.php?u=http%3A%2F%2Ftimesdispatch.com%2Far%2F1585306%2F&h=nAQHMXAPJAQHQSv5r8x44ISOdA6A8Pwe5UieqdJPfQBosdg&shorturl=http://bit.ly/w4MSn0)
I'm glad you raised this on the main board so more people will see. Here's a link to the thread in Schools about this.
7 yr old girl died at school in VA on 1/2/12 (http://foodallergysupport.olicentral.com/index.php/topic,4593.0.html)
So sad! :'(
All I could think when I saw the news was not AGAIN !!!
:'(
I know there is more to come out about this story, but........that little light.............I'm so sad and horrified at what her family is going through.
I've written our Sped Dir, telling him he may share any part of DS' 504 with that Sped Dir that might be helpful. That county is about two hours away from us.
This is just heart wrenching.
so sad, very upsetting to read.
http://www.cnn.com/2012/01/04/health/virginia-allergy-death/?hpt=hp_t3 (http://www.cnn.com/2012/01/04/health/virginia-allergy-death/?hpt=hp_t3)
from this one comes what I'd like to nominate for "most disheartening FA quote of the year" too:
Acebal said that while many facts aren't yet known, she was surprised that a student could die a sudden death from an allergic reaction in a school.
Really hoping that she was grossly misquoted there. Seriously-- "surprised?" What-- by the fact that anaphylaxis can actually KILL someone in a few minutes?? REALLY? Or surprised that anaphylaxis could possibly take place at school?
Either way, not a good sound-bite from the head of FAAN.
Quote from: eggallergymom on January 04, 2012, 08:58:49 AM
Also very troubling is the part of the mother's interview where she says that one version of events is that someone "made" her child eat peanut. Ugh.
In kindergarten, another girl forced my son to eat a peanut butter filled keebler sandwich cracker. He came close to dying. No one epi'ed him, they sent him to the bathroom vomiting alone, and then parked him in the office for nearly an hour. They called me and told me he had stomach flu. They insisted he hadn't eaten anything unusual. I found the cracker in his lunch pack later with a small bite taken out of it. Ten kids, two teachers.
Not an apology to be found. They expelled him later without warning as "too great a liability". Private school. But tax exempt and I coulda woulda shoulda blown their cover as a tax exempt facility violating on the basis of a recognized disability.
I hope that was taken out of context, as in that it is surprising, in general, to the general public. And then it was turned around to say she was surprised.
The way I read it was she is surprised that in this day and age with all the knowledge about food allergies she is surprised that this can still be happening.
I hope that's what she meant.
I can't imagine a school not accepting an epi unless there was no documentation with it and unless the required form was not filled out by a doctor.
But based on the CNN.com article the school did not have epi for the girl abs the school policy called for the school to call the parents. They should have called 911 FIRST. There were two body systems: hives and breathing trouble. Two.
Quote from: SilverLining on January 05, 2012, 05:39:11 AM
The way I read it was she is surprised that in this day and age with all the knowledge about food allergies she is surprised that this can still be happening.
I hope that's what she meant.
That's how it seemed to me as well. She's not surprised that someone can die from this allergy--she's well aware of that. She's surprised that it can happen in a school, where they should have the knowledge and resources to deal appropriately with an allergic reaction.
Quote from: SilverLining on January 05, 2012, 05:39:11 AM
The way I read it was she is surprised that in this day and age with all the knowledge about food allergies she is surprised that this can still be happening.
I hope that's what she meant.
Yes that is what I was thinking surprised/shocked that a school could still be so ill prepared that it lead to a death.
According to what I read this school had a "good plan" on paper that was even reviewed by an allergist. Yet it clearly wasn't implemented.
Not from what I read TC. According to the mom, the school refused to allow her to leave the epi-pen at school, and they were supposed to gice benedryl (which even that they didn't do).
The school also needs to have generic Epipens available in the Regular and Jr sizes, prescribed by the school's doctor (or county dr). One of the news reports showed that a neighboring county DID have this. It is essential in case a child has a FIRST reaction (common at this age!) and also in case the parents, who are not medical professionals, did not know enough about LTFA (many parents think their kids have a "mild" allergy) to provide Epipens to the school.
I didn't like how the school/county professionals interviewed put all the responsibility/blame on the PARENT!!! The child DIED during the school day. What exactly did the (FIRST GRADE) child eat? Did they reduce risk in the classroom/lunchroom? What procedures were in place to reduce risk? Did the child eat a shared food?
Schools constantly push back on parents by turning the requests to keep a LTFA child safe into a "negotiation". All the parties, art projects, PTO passing out food, birthday treats brought in by parents, etc.
I'd love to hear what the child ingested. Very sad for the family.
Yes, there are many things that raise red flags for me about this story. There were obviously several failures
It really sounds like a perfect storm of parents who weren't as well-educated by a physician as they might have been (benadryl isn't how you treat anaphylaxis, after all), coupled with a school process that allowed a child like this to fall through the supposed safety net. Add to that a child who has never experienced full-blown anaphylaxis and you have a scenario where nobody around the child realizes how grave the danger is.
I can guess that the school may have had an "epi-or-nothing" policy as a result of recent changes pushed by FAAN and AAAAI. Note that many of our own members have had to push back on treatment orders that include antihistamines in recent years, as well. Well, if my child's physician wants mild reactions treated that way, and the majority of her reactions (maybe all of them?) had always been of that variety...
I can see the school coming to a place where they'd tell a parent that if they want benadryl administered at school, that child can't have an epinephrine order as well.
KWIM?
As a parent, I know that the epinephrine isn't a negotiable thing, but does someone who's only seen 'mild' reactions up until then? It might seem like benadryl was more important, if you KWIM. Does some health "aide" know that in a peanut allergy, epi is NOT optional? Maybe. But maybe not. I notice that the mom here isn't reporting that she was told that by a school NURSE but by a health aid of some sort.
Calling home instead of 911 is also a common feature in school fatalities, I'm afraid. Often it's office or classroom staff that are simply too frightened to take action themselves.
The underlying problem, of course, is inadequate staffing and/or training. Scary as hell, sure. But it is maddeningly familiar and-- just-- AUGHHHHH.... :rant: to think that this is still happening after all this time.
I, too, hope that this was what Ms. Acebal meant, though it seems strange that it would "surprise" anyone unless they were out of touch with budgetary and staffing realities in schools. :-[
At work and not much time to post: Here's the Virginia law about self-carry and administration of asthma meds and epinephrine.
http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+22.1-274.2 (http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+22.1-274.2)
CM, there are a few things in your post I want to comment on but won't be able to until later.
Quote from: SilverLining on January 05, 2012, 11:38:17 AM
Not from what I read TC. According to the mom, the school refused to allow her to leave the epi-pen at school, and they were supposed to gice benedryl (which even that they didn't do).
Yes I know that.
What I mean is there was an"interview" with an allergist who said he had reviewed and signed of on the district allergy management plan. He said it was a "good plan on paper".
What I am saying is clearly it stayed on paper. Staff were not properly trained. Medications were not kept up to date (or in this case even accepted) safety precautions were not followed and the child's emergency plan was not followed.
We take our kids in to registrar. We are handed a nice pretty allergy management plan that SOUNDS oh so right. Schools pat themselves on the back for writing a good allergy management plan and then what?
As long as it sits on paper it means NOTHING. Yet parents feel reassured that their school is on top of things because they have a food allergy plan/policy at their school.
Horrible.
I also take the quote to mean, loosely translated "Are you freaking kidding me? Can't you people have a plan and USE it, and USE the epi!!?"
Poor baby. I feel for her family.
Quote from: CMdeux on January 05, 2012, 11:55:32 AM
Yes, there are many things that raise red flags for me about this story. There were obviously several failures
It really sounds like a perfect storm of parents who weren't as well-educated by a physician as they might have been (benadryl isn't how you treat anaphylaxis, after all), coupled with a school process that allowed a child like this to fall through the supposed safety net. Add to that a child who has never experienced full-blown anaphylaxis and you have a scenario where nobody around the child realizes how grave the danger is.
I can guess that the school may have had an "epi-or-nothing" policy as a result of recent changes pushed by FAAN and AAAAI. Note that many of our own members have had to push back on treatment orders that include antihistamines in recent years, as well. Well, if my child's physician wants mild reactions treated that way, and the majority of her reactions (maybe all of them?) had always been of that variety...I can see the school coming to a place where they'd tell a parent that if they want benadryl administered at school, that child can't have an epinephrine order as well.
KWIM?
As a parent, I know that the epinephrine isn't a negotiable thing, but does someone who's only seen 'mild' reactions up until then? It might seem like benadryl was more important, if you KWIM. Does some health "aide" know that in a peanut allergy, epi is NOT optional? Maybe. But maybe not. I notice that the mom here isn't reporting that she was told that by a school NURSE but by a health aid of some sort.
Calling home instead of 911 is also a common feature in school fatalities, I'm afraid. Often it's office or classroom staff that are simply too frightened to take action themselves.
The underlying problem, of course, is inadequate staffing and/or training. Scary as hell, sure. But it is maddeningly familiar and-- just-- AUGHHHHH.... :rant: to think that this is still happening after all this time.
I, too, hope that this was what Ms. Acebal meant, though it seems strange that it would "surprise" anyone unless they were out of touch with budgetary and staffing realities in schools. :-[
bold mine. Yes, that's what I was thinking. Back when ds started school, he often had mystery hives, environmental allergies. Back then, (now in 8th) it was daunting as a mom...they were saying all or nothing if the nurse wasn't there. So, at that time, thinking about how many times ds needed benadryl for environmental thing...I was freaked out thinking how many times he might get the epi pen.
Anyway, I wonder if the aide declined the epi pen because they have school issued ones or if she didn't understand anaphylaxis etc.
In any case it is such a terrrible story
Yes, mostly I'm just appalled that ANY person affiliated with K-12 education can be so ignorant of the potential for fatal anaphylaxis at this point in time...
and I'm feeling terribly angry and heartbroken that this family lost their precious daughter. :'(
Quote from: SilverLining on January 05, 2012, 11:38:17 AM
Not from what I read TC. According to the mom, the school refused to allow her to leave the epi-pen at school, and they were supposed to gice benedryl (which even that they didn't do).
To me it kinda sounds like one of those situations where the school staff says, "Has he/she ever had an anaphylactic reaction?" (Schools love to ask that, as if it's relevant, but it's not because peanut allergy is unpredictable and tends to get more severe w/ each reaction).
Parent answers, "Well, no but she has had hives,etc many times and Benadryl has worked".
School staff says, "OK then you can keep the Epipen at home. We have Benadryl here".
IMO, the SCHOOL is NEGLIBLE here. A neighboring district has generic Epipens on hand. Since the school made no effort to administer Epipen, and the school knew she had a peanut allergy, documented in an Allergy Action Plan, and didn't have an Epipen to use, the school is liable. The school staff did not do everything they could, and the child died during the school day.
Can anyone from VA confirm if schools in that state can keep generic Epipens on hand (not Rx'd to a certain person, but Rx'd to the school nurse)?
One article said a neighboring school *does* have extra, generically prescribed Epipens available -- for use in a 1st time reaction (25% of in-school reactions are first time!), expired Epipen, failed Epipen, or to keep in a strategic location (eg. defib box or in the lunchroom).
This is also part of the federal legislation - for schools to keep extra Epipens available.
Quote from: rainbow on January 05, 2012, 03:27:27 PM
Can anyone from VA confirm if schools in that state can keep generic Epipens on hand (not Rx'd to a certain person, but Rx'd to the school nurse)?
One article said a neighboring school *does* have extra, generically prescribed Epipens available -- for use in a 1st time reaction (25% of in-school reactions are first time!), expired Epipen, failed Epipen, or to keep in a strategic location (eg. defib box or in the lunchroom).
This is also part of the federal legislation - for schools to keep extra Epipens available.
VA schools cannot keep on hand an EpiPen that is
not prescribed to a specific person. VA does not have the legislation in place that Illinois just passed. IIRC, Illinois is really in the vanguard of having auxilliary epinephrine.
Here's a link to the Virginia Department of Education's guidance on the management of various special needs.
http://www.doe.virginia.gov/support/health_medical/specialized_health_care_procedures/special_care_issues.pdf (http://www.doe.virginia.gov/support/health_medical/specialized_health_care_procedures/special_care_issues.pdf)
OFF TOPIC_- Rainbow- are you new or returning under a new name. If your new WELCOME: either way :bye:
More from the VA code:
Quote
D. Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered nurses and licensed practical nurses to possess (i) epinephrine for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.
Pursuant to the regulations of the Board of Health, certain emergency medical services technicians may possess and administer epinephrine in emergency cases of anaphylactic shock.
http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+54.1-3408 (http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+54.1-3408)
VA DOE Health Guidelines
Page 259 is the section on epinephrine:
http://townhall.virginia.gov/l/GetFile.cfm?File=E:%5Ctownhall%5Cdocroot%5CGuidanceDocs%5C601%5CGDoc_VDH_1768_v1.pdf (http://townhall.virginia.gov/l/GetFile.cfm?File=E:%5Ctownhall%5Cdocroot%5CGuidanceDocs%5C601%5CGDoc_VDH_1768_v1.pdf)
Great VA DOE page with various health links, including one to the manual for training staff in medication administration:
http://www.doe.virginia.gov/support/health_medical/index.shtml (http://www.doe.virginia.gov/support/health_medical/index.shtml)
VA law on school nurses, including information on nurse to student ratios
http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+22.1-274 (http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+22.1-274)
Online orientation for school nurses
http://www.doe.virginia.gov/support/health_medical/nurse_orientation/index.shtml (http://www.doe.virginia.gov/support/health_medical/nurse_orientation/index.shtml)
This is so tragic. I hope this will result in more schools having stock epis. Really, all schools should have epis on hand in case a child has anaphylaxis and doesn't have them at school.
I don't know why there wasn't an epi for this child at the school but the parents should have insisted. The only reason I can think of for a school telling a parent to keep the epi at home is that the parent did not provide the proper paperwork. My son's school's nurse is all over this and if I don't turn in the right forms on time I would get a call and be told they must have the forms in order to have the epis.
Also, not all ambulances in VA have epinephrine on board. Advanced life support ambulances will have it on board. I found this out from a coworker who is an EMT. I need to double check with him that this hasn't changed.
A better series of quotes from Maria Acebal that seems to indicate a likely funky quote in the earlier CNN bit:
I saw another interview with Maria Acebal in which she is also clearly VERY angry at the school's apparent circling of the wagons and bleating about 'protocol' as a means of diverting attention from the very clear fact that this child was in obvious anaphylaxis and no medication of any kind was given to her.
http://abcnews.go.com/Health/AllergiesFood/year-virginia-girl-dies-allergic-reaction-school/story?id=15295949 (http://abcnews.go.com/Health/AllergiesFood/year-virginia-girl-dies-allergic-reaction-school/story?id=15295949)
Quote
When it comes to a life-threatening allergic reaction, it's so simple to save that life," said Maria Acebal, chief executive officer of the Fairfax, Va.-based Food Allergy and Anaphylaxis Network, which championed the bill. "I have no doubt that the school where this little girl went had an EpiPen in the office -- it just didn't have Ammaria's name on it."
The bill would include liability protection for school officials who give epinephrine in good faith, Acebal said.
"No one in this country has ever been sued for giving epinephrine, to my knowledge," said Acebal. "All the lawsuits come about because school officials don't give it when it's needed."
In a healthy child, epinephrine can cause a rapid heart rate, nausea and light-headedness -- mild symptoms that wear off in 15 minutes. It would only be dangerous in children born with a congenital heart condition, which school officials would be aware of.
"We need to do a better job of educating the public about the safety of epinephrine," said Atkins. "Because it's an injection, it scares people. And because it's a device, it scares people. But rather than thinking, 'I might kill a kid with this,' they should be thinking, 'I could save a life.'"
Acebal, whose eldest daughter has a food allergy, said her other children learned how to inject epinephrine by age 6.
"If I can teach a 6-year-old to do it, we can teach school staff," she said.
Acebal said having epinephrine on hand in school would give students, staff and parents added peace of mind.
"My heart breaks for Ammaria's family because any parent who has a child with a food allergy knows what it's like to fear that phone call from the school," she said.
Though I don't have any school district experience, both of the camps that I worked at long-term (I don't know for the one that I just spent a summer at) we had epi-pens, as well as syringes and vials of epinephrine on hand, prescribed by the doctor that oversees our camp medical orders. You never know when someone might have a first allergic reaction, especially to stinging insects, and we weren't necessarily close to medical attention. (Though to give EMS credit, they did make it to camp in 10-15 minutes when we called because of my heart trouble, which is a REALLY quick trip from where they are located.)
For me the dots don`t connect. I have never heard of a school refusing an epi for a student there. I have to wonder if they refused it, because there was no form signed by the child`s doctor. Our school would do the same. You can only call the parents so many times and ask for the form and then you give up. I am not so sure that it is the school`s fault. Our school`s rule is that one child`s epi cannot be used for another child. I am not sure if that is district rule or specific to our school.
I agree that scenario is possible Carefulmom.
However, the school is STILL responsible to recognize anaphylaxis in the child -- especially given they knew the child had a peanut allergy.
IF the forms were the issue, they actually could have refused attendance. Plus, what about low income parents that can't afford the doctor visit to get the forms filled out?
Neighboring school district(s) are resported to have stock generic Epipens available. This school didn't. Nor did they administer another available Epipen. The nurse's aide should have known what to do in the case of anaphylaxis! (I also heard the mom was called before 911).
Imo, the school is negligent. The child died at school and the school staff did not follow proper anaphylaxis protocol. They have nicely written documents, but failed to act to save the child's life.
I know my Virginia doctor (we're about two hours away from where this happened) charges $10/form. That's if you just drop forms off in a timely manner. We have to have two filled out to administer allergy meds: the emergency action plan, listing the allergy and asthma meds used during a reaction and a med adminisration form that also lists every single med a child might need administered at school.
I can see how a mom whose child has never had a severe reaction (I don't know about that in this case) might not get this done due to time or money.
I'm just heartbroken. This poor family.
Quote from: rainbow on January 05, 2012, 09:30:52 PM
I agree that scenario is possible Carefulmom.
However, the school is STILL responsible to recognize anaphylaxis in the child -- especially given they knew the child had a peanut allergy.
IF the forms were the issue, they actually could have refused attendance. Plus, what about low income parents that can't afford the doctor visit to get the forms filled out?
Neighboring school district(s) are resported to have stock generic Epipens available. This school didn't. Nor did they administer another available Epipen. The nurse's aide should have known what to do in the case of anaphylaxis! (I also heard the mom was called before 911).
Imo, the school is negligent. The child died at school and the school staff did not follow proper anaphylaxis protocol. They have nicely written documents, but failed to act to save the child's life.
This came to mind for me as well. In addition, it's quite possible the EpiPen could have been refused because it was expired or due to expire shortly (my SD will not accept an EpiPen that does not have an expiry date past the last day of school). In addition, my school system requires that the EpiPen be left at school, which means you have to purchase additional EpiPens for home use and day care use. That's is beyond the means for many people. (For my DD, I have to supply a twinpack to school, a twinpack to aftercare, DD self-carries another twinpack, and I have a twinpack in my purse.) It's possible that the family may not have had health insurance and could have had problems purchasing an Epi or additional EpiPens.
've been ruminating over the need for a charity that helps supply EpiPens for those who do not have health insurance or who cannot afford EpiPens.
Quote from: Macabre on January 05, 2012, 10:16:00 PM
I know my Virginia doctor (we're about two hours away from where this happened) charges $10/form. That's if you just drop forms off in a timely manner. We have to have two filled out to administer allergy meds: the emergency action plan, listing the allergy and asthma meds used during a reaction and a med adminisration form that also lists every single med a child might need administered at school.
I can see how a mom whose child has never had a severe reaction (I don't know about that in this case) might not get this done due to time or money.
I'm just heartbroken. This poor family.
We're fortunate that our pediatrician does not charge for medication administration forms nor does Dr. Wood's office. Our pediatrician does charge $10 for other school/camp forms. We have to have several sets of those forms completed each year: school, aftercare, and two camps during the summer. It could add up if we had to pay for the medication administration forms (we have one form for EpiPens, one for inhalers, and one for Benadryl; that's three forms each for school, aftercare, and camps).
There's still so little known about what happened but clearly there were failures on several levels. I'm hoping a thorough investigation will shed light on what happened so that some changes can be made to ensure it doesn't happen again.
We've had enough mishaps at our own pretty enlightened school. I think some school systems become overconfident in their written procedures and past experience and can become complacent about the continuous vigilance that is required when managing LTFAs.
Quote from: lakeswimr on January 05, 2012, 04:25:55 PM
This is so tragic. I hope this will result in more schools having stock epis. Really, all schools should have epis on hand in case a child has anaphylaxis and doesn't have them at school.
My SIL just wrote on FB that the Florida school where she works sent an email home to parents that the school will not store extra epipens for students. All students are to bring their own epipens. It is due to extreme budget cutting.
My SIL also pointed out that, "...Crazy they probably spend that amount on "lunch workshops" in a weeks time, but no money to save a life if needed."
How much does it cost to save a life? $80? Maybe $400 depending on the response time or extra epis being needed in a bad reaction? Saving $400 is more important than saving a life ?!?!
Ah...the world we live in! And some of my points were, "...that really is a travesty because not all kids get adequate healthcare, nor does every doc prescribe an epipen. And for the ones that do, *if* the family has a good prescription program with their healthplan, they're the lucky ones. ..."
QuoteIF the forms were the issue, they actually could have refused attendance. Plus, what about low income parents that can't afford the doctor visit to get the forms filled out?
I wouldn't be as worried about "low income" families as the I would the moderate. Chips and medicare both provide good coverage for such things and for epi-pens, in home health training (if you know who to ask).
Then there are the families that live just above the cutoffs. They are not considered low income or at need. No housing assistance, no food stamps, no school lunch program and NO CHIPS. Often they have health insurance but that doesn't mean that they can afford the out of pockets to access needed care.
I don't know if this is where this family falls but I believe that it could certainly contribute to a situation unfolding like this one has.
... Yes, it could, Tabi.
Or it could result in even a low-income family being unable to leave an epipen at school-- because of ridiculous (dangerous) program restrictions on how many refills are allowed, and WHEN.
We now have prescription restrictions like that even on our so-called cadillac healthcare plan. I can't imagine that low-income healthcare plans offer better prescription coverage.
So if the school "can't accept" medications that don't have an expiry past the end of the school year, I can see how it could result in "nothing" being on hand as the only alternative.
That is heartbreaking and just--
unspeakably evil in the way that only faceless bureaucratic decision-making can be. :-[
I have worked in clinics for low income people. They have better health coverage than the rest of us middle class. There are clinics where truly low income people can get all of their health care for free or for $1 per visit. Medications are free. There is no charge for medication forms. I would love to have the health benefits that low income people have.
I still believe that there was a reason that the school refused to take the epi, other than they just didn`t feel like it. Expired, almost expired, no necessary forms, you name it. Still they should have called 911 first. And how the child got the food we don`t know. The school probably messed up there also.
I am not sure what what happens now. As of two and a half years ago when I last assisted a family on CHIPS with this issue as long as the DR wrote the RX for two twin packs with refills than the family could get two sets for their very low copay. Otherwise it would be out of pocket and we all know what that means.
So the parent would need to be aware to TELL the Dr to write that way because often they don't think about the logistics.
This is also what I have to do otherwise it will bite me in the tush.
QuoteI would love to have the health benefits that low income people have.
I have thought the same recently but that is for another thread (actually 2 down in OT)
When my son started middle school, I went the first day and dropped of his spare epi-pen and the required medical forms. While I was in the office a student brought in her epi, but no forms. The school refused to accept them, BUT made it very clear why. She was given the forms and told to bring the epi back with the forms.
fyi....in June they return the forms when the epi is picked up. In September they will accept those forms back. If they want newer ones they will still accept the old ones temporarily. (Here, doctors can charge patients for filling out those forms and some people flip out over needed new ones.)
I have to have new forms with a new date each year same for the action plan.
If I get the forms filled out at an appointment I don't pay extra. If it is already in the file and all they need to do is fax it over I don't pay extra. If I have to send something in to be filled out and faxed back I pay $10.
I haven't been able to post about this yet.
Right now all I can say is
this could EASILY have been in Fairfax County ,
THANK YOU VERY MUCH!!!
Crossposting.
I haven't been able to post about this yet.
Right now all I can say is
this could EASILY have been in
Fairfax County ,
THANK YOU VERY MUCH!!!Here's why:
Area schools guard against students' allergic reactionsThursday - 1/5/2012, 4:47pm ET
Darci Marchese, wtop.com
From the article:
QuoteFairfax County Public Schools spokesperson Mary Shaw says the system, which serves nearly 178,000 students, is in the middle of producing district-wide guidelines on how to deal with and treat students with allergies.
Shaw says officials want parents, teachers and school leaders to be on the same page, and students in general are treated on a case-by-case basis. Some are allowed to keep epinephrine -- which can be used to treat reactions caused by things like insect bites and foods -- with them while other students will have to get the treatment from the school nurse.
Shaw says students who need them will have "individualized health plans."
http://www.wtop.com/?nid=120&sid=2693335 (http://www.wtop.com/?nid=120&sid=2693335)
People, SAME sh** NEW DAY.
Nearly 4 years since our hideous experiences with Fairfax County began.
Same sh**.
Let me also say that Shaw has SERIOUSLY misspoken:
There are NOT school NURSES in FFX schools. Same set up as in Chesterfield -- PHN's who over see multiple schools and just "trained" laypersons in the schools on the front lines.
The epipens are LOCKED UP in the "health room" -- no longer called a clinic as there are NO MEANINGFUL HEALTH SERVICES PROVIDED.
But maeve, doesn't this say that a nurse CAN stock generic Epipen if prescribed by a medical doctor? (You said before VA schools could only take Rx for specific person).
Quote from: maeve on January 05, 2012, 04:23:49 PM
More from the VA code:
Quote
D. Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered nurses and licensed practical nurses to possess (i) epinephrine for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.
Pursuant to the regulations of the Board of Health, certain emergency medical services technicians may possess and administer epinephrine in emergency cases of anaphylactic shock.
PS tabi, pm me ... I can't figure out pm on this site.
I continue to read that it was a "Clinic Aide" and not necessarily a nurse. We have neighboring counties without a true nurse in the clinic, just someone whose training was just short of kissing boo-boos.
Could that have been the case?
Or could there have been a miscommunication between the school and the mother that epi's were not needed. I thought there was a dr reviewed allergy action plan in place?
I have been told by more than one "official" in 2 different school districts in Virginia that the epipen may only be at school if prescribed for that student and with ALL (there is more than one) of the "official" forms completed and signed by physician.
No stock epipens in either district.
In Virginia it is always interesting, informative, and then maddening to read the separate school district's "policy" and procedure and fine print so far as all the LTFA forms and info.
Appearances are deceiving and ground truth can be deadly, as my husband and I went on RECORD stating.
So, now another child has died.
How many more will it take?
No school nurse in that school.
The Public Health Nurse is just an overseer and rarely IN the school preforming duties.
Quote from: rainbow on January 06, 2012, 03:53:10 PM
But maeve, doesn't this say that a nurse CAN stock generic Epipen if prescribed by a medical doctor? (You said before VA schools could only take Rx for specific person).
Quote from: maeve on January 05, 2012, 04:23:49 PM
More from the VA code:
Quote
D. Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered nurses and licensed practical nurses to possess (i) epinephrine for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.
Pursuant to the regulations of the Board of Health, certain emergency medical services technicians may possess and administer epinephrine in emergency cases of anaphylactic shock.
PS tabi, pm me ... I can't figure out pm on this site.
Hey where did that quote come from I can't believe I missed that SO sorry maeve I'll be right on it.
Important to note that in Virginia each school district adopts its own codes/laws and rules as to epipens and meds -- possible that some schools/districts will NOT allow stock epipens, I think -- they get around it with the forms required.
Oh I thought they were like TX and couldn't stock. I guess I misread something.
Quote from: rainbow on January 06, 2012, 03:53:10 PM
But maeve, doesn't this say that a nurse CAN stock generic Epipen if prescribed by a medical doctor? (You said before VA schools could only take Rx for specific person).
Quote from: maeve on January 05, 2012, 04:23:49 PM
More from the VA code:
Quote
D. Pursuant to an oral or written order or standing protocol issued by the prescriber within the course of his professional practice, such prescriber may authorize registered nurses and licensed practical nurses to possess (i) epinephrine for administration in treatment of emergency medical conditions and (ii) heparin and sterile normal saline to use for the maintenance of intravenous access lines.
Pursuant to the regulations of the Board of Health, certain emergency medical services technicians may possess and administer epinephrine in emergency cases of anaphylactic shock.
PS tabi, pm me ... I can't figure out pm on this site.
Rainbow,
It says RNs and LPNs. Many school systems do not have an RN or LPN in the school. My school district has health clinic assistants at the elementary school level but doesn't put RNs in schools until middle school but I think it's really at the HS level that all schools have RNs. So for an ES in my SD, there are no RNs. When my DD was in kindergarten her school had an RN because the RN's child attended the school, but they were redistricted to another school the next year. Now, I wasn't very impressed with that RN and have found the current health clinic assistant (who's been there since DD was in 1st grade) to be wonderful. Despite the fact that there are 1,100 students in the school, many with health issues, this HCA will email me when DD has used her inhaler more than once per day or when the inhaler is getting close to needing a refill; she'll also make copies of the log she keeps through the year of DD's inhaler use so that I can provide that to our allergist. She's been a partner in DD's care and was the one who finally put the hammer down on DD's teacher not having the class wash hands after lunch last year.
Quote from: Arkadia on January 05, 2012, 01:06:56 AM
Quote from: eggallergymom on January 04, 2012, 08:58:49 AM
Also very troubling is the part of the mother's interview where she says that one version of events is that someone "made" her child eat peanut. Ugh.
In kindergarten, another girl forced my son to eat a peanut butter filled keebler sandwich cracker. He came close to dying. No one epi'ed him, they sent him to the bathroom vomiting alone, and then parked him in the office for nearly an hour. They called me and told me he had stomach flu. They insisted he hadn't eaten anything unusual. I found the cracker in his lunch pack later with a small bite taken out of it. Ten kids, two teachers.
Not an apology to be found. They expelled him later without warning as "too great a liability". Private school. But tax exempt and I coulda woulda shoulda blown their cover as a tax exempt facility violating on the basis of a recognized disability.
This really scares me as my DD is dealing with some serious FA bullying at school right now. This kid absolutely does not care about punishments and just keeps coming back at her like the terminator. I'm terrified that something like this could happen next. I thought maybe second grade was too young for something like that, but if it happened to your son in kindergarten...
Yeah I read it reported (by someone claiming to be another parent) that she was Dared to eat a peanut or piece of a peanut at recess.
We have to be careful to not assign adult motive and understanding to kids. We think kinder or second is too young for this to happen because we think it is too young to intentionally harm and that maybe true. However, at that age they don't understand it that way. They don't get the permanency the REAL danger the would be JUST as likely to chase one of our kids with peanuts as a boy chasing the girls with a bug and not see the difference. IMO they are MORE at risk of these kinds of dears, taunting, and bullying in k-3rd than when older precisely because the kids don't fully understand. Unfortunately their lack of understanding makes things MORE dangerous not LESS.
Quote from: TabiCat on January 06, 2012, 05:22:37 PM
Yeah I read it reported (by someone claiming to be another parent) that she was Dared to eat a peanut or piece of a peanut at recess.
We have to be careful to not assign adult motive and understanding to kids. We think kinder or second is too young for this to happen because we think it is too young to intentionally harm and that maybe true. However, at that age they don't understand it that way. They don't get the permanency the REAL danger the would be JUST as likely to chase one of our kids with peanuts as a boy chasing the girls with a bug and not see the difference. IMO they are MORE at risk of these kinds of dears, taunting, and bullying in k-3rd than when older precisely because the kids don't fully understand. Unfortunately their lack of understanding makes things MORE dangerous not LESS.
Good point Tabi.
Our situation is that the principal addressed a situation yesterday and literally 10 minutes later the kid did it again. That is just inconceivable to me, but I'm not 7.
Does anyone know if it is possible to figure out how many epis were administered in schools (national, state, or even district) level in a year?
I really wish that every epi administration would make the news -- for so many reasons.
Aouda,
The county next door to mine keeps such stats but my county does not. I imagine, that without some sort of federal requirement to track that data, that it will be hard to gather that information. Even tracking how many cases of anaphylaxsis lead to a trip to the hospital or how many anaphylactic reactions lead to death is not accurate because there's no consistent reporting standard and the CDC does not require that hospitals report that data (in the way that admission of a person with TB is).
Where / which interview did the mother say her child was dared to eat a peanut? I can't find this. That is really bad!
Ok I just found this: Police Say Peanut Was Cause of Young Girls Death
http://www.nbc12.com/story/16465115/police-say-peanut-was-cause-of-young-girls-death (http://www.nbc12.com/story/16465115/police-say-peanut-was-cause-of-young-girls-death)
CHESTERFIELD, VA (WWBT) –Police conclude the death of 7-year-old Amarria Johnson's was caused by eating a peanut.
Johnson, who is allergic to peanuts, died last week after police say she ate a peanut handed to her by another child on the playground of Hopkins Elementary School.
Police say that classmate was not aware of her allergy.
Upon realizing what occurred, police say Johnson approached a teacher and was taken to the school clinic.
Police say a clinic aide was attempting to help Johnson when she stopped breathing.
School personnel and emergency responders performed CPR and used an AED, but were unable to revive her.
Police say no crime or criminal negligence was committed by the child who shared the peanut, school personnel or Johnson's mother.
The only state that I know keeps such stats-- state-wide, that is-- is MA.
I found the information extremely enlightening the one time that I looked at the numbers.
Thank you for your replies. So in your district (Maeve) or in MA (CMD), do you remember approx how many school epi shots were given over x months? What I am wondering is if these shots are ever administered. If the answer is never, I don't know whether to be elated or terrified.
So the emergency responders used an AED but no epi? Can this possibly be true? That is horrible!
Quote from: ajasfolks2 on January 06, 2012, 03:53:00 PM
Crossposting.
I haven't been able to post about this yet.
Right now all I can say is
this could EASILY have been in Fairfax County ,
THANK YOU VERY MUCH!!!
Here's why:
Area schools guard against students' allergic reactions
Thursday - 1/5/2012, 4:47pm ET
Darci Marchese, wtop.com
From the article:
QuoteFairfax County Public Schools spokesperson Mary Shaw says the system, which serves nearly 178,000 students, is in the middle of producing district-wide guidelines on how to deal with and treat students with allergies.
Shaw says officials want parents, teachers and school leaders to be on the same page, and students in general are treated on a case-by-case basis. Some are allowed to keep epinephrine -- which can be used to treat reactions caused by things like insect bites and foods -- with them while other students will have to get the treatment from the school nurse.
Shaw says students who need them will have "individualized health plans."
http://www.wtop.com/?nid=120&sid=2693335 (http://www.wtop.com/?nid=120&sid=2693335)
People, SAME sh** NEW DAY.
Nearly 4 years since our hideous experiences with Fairfax County began.
Same sh**.
Let me also say that Shaw has SERIOUSLY misspoken:
There are NOT school NURSES in FFX schools. Same set up as in Chesterfield -- PHN's who over see multiple schools and just "trained" laypersons in the schools on the front lines.
The epipens are LOCKED UP in the "health room" -- no longer called a clinic as there are NO MEANINGFUL HEALTH SERVICES PROVIDED.
After reading some of Chesterfield County School's NEW (as of spring 2011) food allergy policy, there is a MAJOR, MAJOR distinction between it and Fairfax County:
Chesterfield allows and trains for SYMPTOM RECOGNITION by the layperson/"aide" such that there is supposed to be allergic reaction recognition and treatment according to written physician plan.
UNLESS Fairfax County's "new" food allergy policy has the major CHANGE of allowing SYMPTOM RECOGNITION so far as when to administer epipen, there still exists an incredibly flawed and dangerous policy.
From the epipen form for FFX County:
Quote
Emergency injections are usually administered in FCPS or SACC by nonhealth professionals. These persons are trained by the school public health nurse to administer the injection. For this reason, only premeasured doses of epinephrine may be given. It should be noted that these staff members are not trained observers. They cannot observe for the development of symptoms before administering the injection.
http://www.fcps.edu/it/forms/se64.pdf (http://www.fcps.edu/it/forms/se64.pdf)
In Fairfax, either the child OR a staff member
must report that an exposure has occurred in order for the epipen to be administered, according to policy and in direct contradiction to any/all current best practices. OF course, this allows for the staff member taking such report to make a decision as to veracity of the report and then refusing to give epipen . . .
and then to try to talk the child OUT of the child's position that there has been an exposure AND that there is a reaction underway . . .
and then to call the parents of said child to COME ASSESS THE SITUATION at the school.
All the while the reaction may progress.
And nothing is done to potentially save the child's life.
Nothing.
In MA, the number was startlingly high-- dozens and dozends annually, in fact-- but that's actually more worrisome when you stop to consider how poorly anaphylaxis is recognized and appropriately treated even by medical professionals. There is ZERO reason to think that school personnel are better at administering epinephrine than ER physicians, after all.
The problem is that the killer symptoms don't really scream "this child is dying of an allergic reaction-- NOW" until it's very nearly too late. Cardiovascular collapse is particularly challenging as it is a point of essentially no return outside of a hospital setting-- and it can happen with terrifying speed and virtually no outward signs that suggest anaphylaxis is taking place. :-[
The fact that there are not more fatalities isn't necessarily a reason for schools (or anyone else) to be congratulating themselves; anaphylaxis is MOSTLY self-resolving, after all. That doesn't mean that the appropriate treatment is "wait and see," since that is effectively "wait and see how lucky we're going to be, here." Clearly not a good management policy.
:dunce:
I think the number from Fairfax County, Virginia for 2009 was 59 epipen administrations?
I'll see if I can get link here.
ETA
Well, well well.
The link I had to the report is now defunct. That's pretty recent.
Right-- if the number is low then you have to wonder why. Is it that schools are not administering when they SHOULD?
Probably.
But if the number is high, that might be even MORE worrisome in its own way, since it suggests that while response is good-- prevention SUCKETH mightily, and frankly, without prevention getting better, it's only a matter of time before other failures in an individual instance result in a child's (preventable) death.
Of course, this may also be heavily dependent in an individual school district on the individual students involved. I can easily see a kid like my DD needing two to five Epi administrations annually at school-- even with good allergen control measures in place, I mean.
Here is link to OLD discussion as to LTFA policy in Virginia, in Resources at OLD boards.
http://allergy.hyperboards.com/action/view_topic/topic_id/4247/start/121 (http://allergy.hyperboards.com/action/view_topic/topic_id/4247/start/121)
I am finding that MANY of the old links from Fairfax are now not working.
Crap.
Latest article at Richmond paper has this quote from the school district:
Quote
Earlier this week, a school spokesman said a little more than 600 students out of a total student enrollment of 60,000 have health plans on file that permit school officials to give them an epinephrine injection if they have an allergic reaction to food, bee stings or latex.
Given the latest studies and numbers of allergic, shouldn't this number be MUCH higher?
Quote from: Carefulmom on January 06, 2012, 10:21:20 PM
So the emergency responders used an AED but no epi? Can this possibly be true? That is horrible!
My Dr warned us that not all ambluance companies carry epi. So if she didn't have her's well. I have never understood that why wouldn't paramedics and EMT's be able to have and use epi. We are always talking about how simple andsafe the use of epi is so why so much fear of it out there.
Are we worng?
Tabi it is not really a matter of right/wrong here. It's not that simple.
It's all about the route of administration. Inhaled or intramuscular epinephrine is VERY safe. Even in those who might ordinarily have cardiac contraindications to epi otherwise.
Intravenous administration, say, in a hospital setting, uses epinephrine as a drug of last resort. (Welllll...not "last" resort, certainly, but it is higher risk than some others...)
So yes, Epinephrine is a powerful, indiscriminant beta agonist and potent cardiac and CNS stimulant.
It is also a locally-acting, instant and effective asthma drug that opens airways like little else.
It is also a VERY safe intramuscular drug for treating the widespread effects of anaphylaxis.
Beta agonists are also used very safely as adjuncts in dental anesthesia so that the anesthetizing agents have better longevity clinically.
Pharmacologists, well-trained pharmacists, and physicians with a good understanding of pharmacology probably do not regard epinephrine only as a cardiac drug with a (relatively) narrow dosing window. KWIM? But volunteer EMTs, nurse's assistants, pharmacy technicians? They well may, and so does the general public. They all seem to envision the scene from Pulp Fiction without realizing that while plausible (though just very barely so) it's not exactly realistic, nevermind 'normative.'
Quote from: Carefulmom on January 06, 2012, 10:21:20 PM
So the emergency responders used an AED but no epi? Can this possibly be true? That is horrible!
my guess is they werent ALS, in which case most likely its closest definitive care/ grab and go.
Yes, what you get when you call 911 is state-dependent and highly variable. We were horrified to realize that in MN (when we lived there) only EMT-C's were epinephrine authorized, and that included IM administration. Most ambulances weren't equipped with Epi at all.
This is the same thing that killed a girl in WA state over a decade ago. http://www.pbs.org/newshour/bb/health/jan-june99/medicine_6-8.html (http://www.pbs.org/newshour/bb/health/jan-june99/medicine_6-8.html)
It's just appalling to me that we're more than a decade past that and this is STILL happening. :disappointed:
It makes me so sad that rules and regulations were given higher priority than a child's life. There must have been an epipen in that office someone could have used on her. :'(
Quote from: CMdeux on January 07, 2012, 01:12:22 PM
Yes, what you get when you call 911 is state-dependent and highly variable. We were horrified to realize that in MN (when we lived there) only EMT-C's were epinephrine authorized, and that included IM administration. Most ambulances weren't equipped with Epi at all.
This is the same thing that killed a girl in WA state over a decade ago. http://www.pbs.org/newshour/bb/health/jan-june99/medicine_6-8.html (http://www.pbs.org/newshour/bb/health/jan-june99/medicine_6-8.html)
It's just appalling to me that we're more than a decade past that and this is STILL happening. :disappointed:
Just FYI - I have been told by a local fire fighter that while they cannot administer epi, if they saw I had one they would "assist" me, even if I was unconscious or otherwise unable to use it, by first wrapping my hand around it.
There was a death in NJ that spurred bill to allow epi in ambulance.
I'll look for the story I'm thinking of....not long after the bill was introduced/implemented, having an epi in the ambulance saved a boy in Princeton area
Just FYI - I have been told by a local fire fighter that while they cannot administer epi, if they saw I had one they would "assist" me, even if I was unconscious or otherwise unable to use it, by first wrapping my hand around it.
This bothers me. Why does our legal system think this is an effective solution for liability avoidance ? Is it tacitly saying it is okay to lie? (I did not really administer it, the unconscious, or struggling person did). Not to go off on a tangent -- but this is New York states solution for camps. I was baldfacedl told that my three yr old would have to "self -administer" in order to go on a two hour nature walk. And ever since, camp after camp has adapted this. My problem is -- it leaves no clear-cut action plan. And, how much time gets wasted in wrapping fingers and correctly choreographing the charade ? And it means either 'wink, wink", of course we'd save your kid, or FU - go away. BUT in an ambulance ? I geuss its better than saying we cannot administer period. But it is silly.
Quote from: hopecha on January 08, 2012, 12:04:40 PM
This bothers me. Why does our legal system think this is an effective solution for liability avoidance ? Is it tacitly saying it is okay to lie? (I did not really administer it, the unconscious, or struggling person did). Not to go off on a tangent -- but this is New York states solution for camps. I was baldfacedl told that my three yr old would have to "self -administer" in order to go on a two hour nature walk. And ever since, camp after camp has adapted this. My problem is -- it leaves no clear-cut action plan. And, how much time gets wasted in wrapping fingers and correctly choreographing the charade ? And it means either 'wink, wink", of course we'd save your kid, or FU - go away. BUT in an ambulance ? I geuss its better than saying we cannot administer period. But it is silly.
That is exactly my attitude. I wish all rescue squads had epi and would give it, but at a minimum i'm glad someone with a known allergy would be given their meds. I'd rather they bend their rules to help than just stand there. I'm not sure if it is general firemen have this limit or how wide spread the limit is in California.
I just merged the two different discussions on this topic. The discussion from Schools was merged in and moved here.
I hope the district gets stock epi pens into schools, esp with their numbers they gave--must be many more in their schools with FAs and other ana who don't have epis at the school. SCARY.
Quote from: ajasfolks2 on January 07, 2012, 12:05:37 AM
Latest article at Richmond paper has this quote from the school district:
Quote
Earlier this week, a school spokesman said a little more than 600 students out of a total student enrollment of 60,000 have health plans on file that permit school officials to give them an epinephrine injection if they have an allergic reaction to food, bee stings or latex.
Given the latest studies and numbers of allergic, shouldn't this number be MUCH higher?
I'm thinking there is a LARGE undiagnosed LTFA population in these schools . . .
and they are playing Russian Roulette by not having stock epipens and better training for staff.
http://www.cnn.com/2012/01/11/health/living-well/food-allergies-schools/?hpt=hp_bn10 (http://www.cnn.com/2012/01/11/health/living-well/food-allergies-schools/?hpt=hp_bn10)
Thanks for updated CNN article. I think CNN must be pulling some posts. Interesting.
Not sure if this link is in here.
http://thestir.cafemom.com/big_kid/131093/peanut_allergy_kills_7yearold_at?next=21 (http://thestir.cafemom.com/big_kid/131093/peanut_allergy_kills_7yearold_at?next=21)
http://www.huffingtonpost.com/karen-latimer/epipens-and-why-schools-s_b_1197082.html (http://www.huffingtonpost.com/karen-latimer/epipens-and-why-schools-s_b_1197082.html)
Quote from the article:
"Would you make sure a life-preserver belonged to a drowning child before tossing it to her? Still, if there was a dose of epinephrine in the vicinity, I can't place all the blame on the adults in that school. I blame you. I blame me. I blame society. We live in a world where the fear of litigation paralyzes us to the point of watching a child die. Shame on us."
Unfortunately, what the Huffingtonpost article author fails to realize is that if school officials had used another child's EpiPen, that child would be without his/her life-saving medication (unbeknownst to the child and his/her parents). Not to mention, that it is illegal to give a medicine prescribed for one person to another person.
This clearly points to the need for having injectable epinepherine prescribed to the school for use by any student. The answer is not dipping into the medicine cabinet and grabbing another child's life-saving medicine. The answer is also having all ambulance crews trained in recognizing anaphylaxsis and having all ambulances equipped with EpiPens.
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 thought, Ajas.
I wonder. It seems to me that they would, in fact, be within their rights to declare such a student "medically unfit" for the environment of the school or some such thing, no?
Surely there is legal precedent here with either diabetes or asthma. Now I'm very curious, though. What does happen when/if a parent refuses to provide life-saving/maintenance meds for a life-threatening and unpredictable medical condition?
It's obvious that it does happen, after all.
The trouble with that is that 20-25% of all first time anaphylaxis happens at school and we know that emergency staff will not always arrive in time to save a person's life. Schools should have extra epi pens on hand because of this for children who have their first reactions at school and for children like this who don't have epi pens at school for whatever reason. I personally would grab any epi to save a child's life. I can't imagine standing there and saying, "oh well" as the child goes unconscious.
Quote from: maeve on January 13, 2012, 03:28:23 PM
Unfortunately, what the Huffingtonpost article author fails to realize is that if school officials had used another child's EpiPen, that child would be without his/her life-saving medication (unbeknownst to the child and his/her parents). Not to mention, that it is illegal to give a medicine prescribed for one person to another person.
This clearly points to the need for having injectable epinepherine prescribed to the school for use by any student. The answer is not dipping into the medicine cabinet and grabbing another child's life-saving medicine. The answer is also having all ambulance crews trained in recognizing anaphylaxsis and having all ambulances equipped with EpiPens.
I can't, either, Lakeswimr. I can't imagine not volunteering my daughter's OWN meds under those conditions, even knowing that it'd leave her without them temporarily.
It makes me ILL every time I put it together in my head what had to have transpired. I was actually paradoxically somewhat pleased to hear Maria Acebal's comments resonate in that same vein. There were trained adults standing in a room with the means to save her and they...
did...
nothing? Unfathomable. :disappointed:
I think there it might not have been *as* bad as I can imagine. It might have been a very swift moving anaphylaxis. I think of times DS had reactions and we hemmed and hawed about giving the epi when we should have. He was lucky but reactions can progress very swiftly and can turn on a dime. She was already having breathing trouble and tongue swelling then they supposedly called the child's mother instead of 911, though.
One more scary part for me is that this district, on paper, seemed so with it! They have what reads as an outstanding allergy management district plan!
I don't get why the mother didn't have epi pens at school. I don't get why the school didn't push her until she brought them. I don't understand why another child could have offered this chid a peanut. My son's friends have known not to do that since he was 2 and they were 2 and 3! Seriously! We used to go to school and teach his classmates about FAs and never to offer him food. None of the kids would have done that and DS has known not to accept food from others. We role played this out when he was little and still do sometime.s I don't get a lot of things about this. It's so tragic.
I really hope the new act about stock epi pens passes so it will prevent any more of these PREVENTABLE fatalities.
Moral acts are not always legal, and vice versa.
Having read the proposed law, I don't think it will change anything except to underscore the inequities in our educational system. Schools have to compete for grants for lifesaving medications!? Guess which schools will receive the money: that's right--the ones who need it least. :dunce: Should we offer grants for schools to install fire extinguishers?
This is more political posturing to make the public feel like something is being done about the problem. Now we can all pat ourselves on the back that kids will have access to epinephrine and if they didn't... well, it's the school's fault for not applying for a grant. Right?
Probably eight years ago at one of the previous websites i posted schools had an obligation to refuse attendance to any child whose parents had not adequately assisted to provide the standard of care or who prevented access to it.or at least pursue the adjuncts to get it even via state mediated action. hell the district threatened to pursue "state mediated" access to a "full eval, not limited in scope" if i chose to have him "remain enrolled in districtwide programming".
I mean, does anyone still question the obligation to the "patient".
I too used to talk in questions but not so much anymore.
I don't know if this is legal. I do know that in a district in MA some people who had a child who had gotten minor hives around his mouth a few times but didn't have epi pens or an allergist had a district that told his parents they had to see an allergist and get epi pens, paperwork, etc or the school could not give any accommodations. At the time they had only seen a pediatrician who didn't think the child needed epi pens, etc and who had not told them that hives in response to ingestion could mean the child is at risk of full on anaphylaxis later. They didn't have enough info to know to protect their child. They did go to the allergist to satisfy the district thinking it was a bother. The child later had serious reactions and they are now very careful. But in this time in America it is EASY to be a parent who doesn't have the right info because so many general doctors do not know the right info and don't give it to people.
I have also worked in schools and have seen children who have parents who are not taking proper care of them. Yes, these parents have responsibilities but it doesn't mean the parents will fulfill these responsibilities. There is one school I know that has a long list of children with allergies and out of those only a few have epi pens. Dangerous situation. And the number with allergies is lower than the number it should be if we go with the 6 to 8% that should have them just for food, never mind other causes of ana.
We know that 24% of first ana will happen at school. Those parents don't even have the chance to get epi pens. We know some people lack proper education and information about their allergies because their doctors don't give them the right info (because they don't know it themselves) and we know some parents are not responsible. $100 for a 2 pack to save the life of a child is a good investment for every school district. Yes, the parents should be the ones who provide epis but that isn't always going to happen. It isn't always possible for parents to know to do this (esp if the children have their very first reaction in school.)
I do not understand the actions of the mother of this child. I feel very sorry for her and also upset that she did not push to have the epi there. I feel very upset that the school didn't push to have epis there. I can't let myself really think about the whole thing--too disturbing.
Quote from: Arkadia on January 15, 2012, 01:20:23 AM
Probably eight years ago at one of the previous websites i posted schools had an obligation to refuse attendance to any child whose parents had not adequately assisted to provide the standard of care or who prevented access to it.or at least pursue the adjuncts to get it even via state mediated action. hell the district threatened to pursue "state mediated" access to a "full eval, not limited in scope" if i chose to have him "remain enrolled in districtwide programming".
I mean, does anyone still question the obligation to the "patient".
I too used to talk in questions but not so much anymore.
is this a silly ? but did the little girl know what a peanut looked like? quite a lot of peanut allergic kids never get to see them as we keep them away from them. this is a minor point, but i did wonder as she was 7 yrs old .
Quote from: CMdeux on January 05, 2012, 11:55:32 AM
I can guess that the school may have had an "epi-or-nothing" policy as a result of recent changes pushed by FAAN and AAAAI. Note that many of our own members have had to push back on treatment orders that include antihistamines in recent years, as well.
Does anyone have a link to either of these?
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.
Quote from: rainbow on January 16, 2012, 11:01:52 AM
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.)
Quote from: rainbow on January 16, 2012, 11:01:52 AM
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.)
Quote from: Janelle205 on January 16, 2012, 12:37:57 PM
Quote from: rainbow on January 16, 2012, 11:01:52 AM
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.
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.
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
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.
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.
Quote from: rainbow on January 19, 2012, 10:22:47 AM
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...."
:disappointed:
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).
Quote from: ajasfolks2 on January 13, 2012, 03:35:07 PM
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.
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.
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.
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.
Quote from: lala on January 19, 2012, 07:21:47 PM
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.
Quote from: Carefulmom on January 18, 2012, 08:20:15 PM
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.
My son carries one and has a spare in the office. He rarely forgets his (abut once per year). If his was used on someone else, that could mean he doesn't have the spare at school for a few days. The pharmacy doesn't stock them, and I don't always have extra scripts with the pharmacy.
I'd be pretty po'd if he ever needed his and it wasn't available because the school gave it to someone else. Either the school or that other parent didn't pay for one for that child, so am I going to be on the hook to pay for the replacement?
Call me nasty. Call me heartless. But, each parent should be supplying their own child's epi's and each school should be keeping extras that they (the school) provide.
And I'll include as part of the risk the fact that in dealing with a child in anaphylaxis and calling 9-1-1 and contacting the parents of that child....what are the chances the parent that purchased the epi gets overlooked in all the commotion and doesn't get a call?
This article from Psychology Today addresses the moral responsibility of school staff. Interesting that Psych Today is publishing a viewpoint, so this is getting some needed attention.
http://www.psychologytoday.com/blog/here-there-and-everywhere/201201/allergy-death-school-when-do-morals-override-policy (http://www.psychologytoday.com/blog/here-there-and-everywhere/201201/allergy-death-school-when-do-morals-override-policy)
Not sure if this was posted previously, but find it interesting
http://www.wtvr.com/news/wtvr-doctor-death-of-7yearold-serves-as-a-lesson-to-schools-20120105,0,6978677.story (http://www.wtvr.com/news/wtvr-doctor-death-of-7yearold-serves-as-a-lesson-to-schools-20120105,0,6978677.story)
moving to other thread
Tweeted by @NutFreeWok
"Schools to face jury in allergy death suit"
http://www.chesterfieldobserver.com/news/2014-07-30/News/Schools_to_face_jury_in_allergy_death_suit.html (http://www.chesterfieldobserver.com/news/2014-07-30/News/Schools_to_face_jury_in_allergy_death_suit.html)
QuoteLaura Pendleton's $10 million wrongful death lawsuit against a public health nurse and a school clinic assistant has been scheduled for trial in Chesterfield Circuit Court April 20.
Quotedaughter, Amarria Johnson, died Jan. 2, 2012
I'd go sit in that court room and spectate if my life would allow the time . . .
I'll bet it settles before court date, though.
Note to self, and anyone else interested:
court date, per that article, set for April 20, 2015
Don't know how to search the court docket there, but will try to figure it out, so can post changes to date if publicized.
Tweeted by @IgECPD
"Mom's lawsuit against Chesterfield Schools revived after daughter's peanut allergy death"
http://wtvr.com/2015/06/04/peanut-allergy-defamation-lawsuit/ (http://wtvr.com/2015/06/04/peanut-allergy-defamation-lawsuit/)
QuoteA defamation lawsuit filed by a Chesterfield mother against Chesterfield County Schools officials will go to trial now after the Virginia Supreme Court reversed a lower court's decision to throw out the case.
Quotedeclared that Ms. Pendleton was a bad mother — the most hurtful and disparaging of labels
QuotePendleton's wrongful death lawsuit against Chesterfield School is scheduled for October in Chesterfield County Court.
Fuckers. Nothing more.
In her lawsuit, Pendleton maintains that she brought an EpiPen to Hopkins Elementary prior to her daughter's death, only to be rebuffed by a clinic aide who stated that the school already had one that Johnson could use in case of an allergic reaction.
Despite Pendleton's attempt to give the school her daughter's life-saving medication, the suit claims, school officials made a series of public statements in the days following Johnson's death that focused solely on parents' role in the execution of the school system's severe allergy plan.
"I think you have to evaluate their words in the context of what was going on," Krudys said during a hearing last year. "They were unmistakably saying, 'We can't do anything unless the parent brings in an EpiPen.' They knew the significance of their statements. They were clearly saying that this woman is to blame.
I cannot get over how hateful it is for the school to have issued public statements engineered to blame the mother. This seems unnecessary even if the school's version of the facts (that Pendleton didn't bring the epis in) is true - you don't have to get that information OUT to the public to win the inevitable law suit and you don't elevate the school in anyone's eyes by doing so. These statements were intended to intimidate as well as re-victimize.