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PostPosted: Thu Aug 10, 2017 6:22 pm 

Joined: Thu Dec 20, 2007 7:23 pm
Posts: 1099
Location: Kingston
Story in Allergic Living:
Alabama Boy, 3, Dies of Severe Reaction During Baked Milk Challenge Test ... enge-test/

A Response on WebMD :

Alabama Boy's Death Worries Food Allergy Parents

Dr. Kaufmann does an average of nine food challenges a month for individual patients and is doing research studies for the FDA. The duo received lots of questions upon news of Alastair Watson’s death.

According to a story in Allergic Living, Alastair died on July 30 after an anaphylactic reaction during an oral food challenge test at Children’s Hospital of Alabama at Birmingham.

Anaphylaxis is a sudden and severe reaction.

I was not warned of this possibility.
Pamela Watson, mother of a boy who died during an oral food challenge.
His mother contacted the magazine and said her son had multiple food allergies and asthma and he died while having the challenge test to see if he could tolerate foods containing baked milk, the magazine says. A hospital representative says federal privacy laws do not allow it to comment.

“It is my understanding that this has never happened before. I was not warned of this possibility,” Alastair’s mother, Pamela, told the magazine.

No details about Alastair’s death have been released. It’s not clear what went wrong during his test, and that lack of information is part of what is fueling parents’ concerns.

Impact Is Felt Far and Wide

Jamie Kaufmann says the news of Alastair’s death has echoed through the food allergy community.

“Many of our readers turned to us because we specialize in milk allergy and it happened with a milk challenge,” she explains. “I got several individual messages asking for Dr. Bob’s opinion, and it was incredibly emotional. We had families wanting to cancel challenges the next day or within the week.”

Kaufmann usually makes her Q&A videos available only to subscribers of a private group she created offering resources for families dealing with milk allergies. But demand for answers was so overwhelming that she posted the video on her public Milk Allergy Mom Facebook page, where it’s been viewed thousands of times. “It is the most viewed post we've ever had,” she says.

Dr. Kaufmann, who has never had a patient go into anaphylaxis during an oral food challenge, says he felt it was important to reassure families. “This is a sad case. We are still at the place where we don’t know for sure what he died of or how he died. But relative risk of death with a food challenge is very low,” he says.

In the wake of Alastair’s death, the American College of Allergy, Asthma & Immunology (ACAAI), the American Academy of Allergy, Asthma & Immunology, and the Canadian Society of Allergy and Clinical Immunology released a statement calling the boy’s death a tragedy and confirming that this is the first reported fatality associated with oral food allergy challenges.

“We cannot even imagine the horror of this loss," the statement says. “While critical details surrounding this tragedy are not available, nor should they be out of respect for the family and all involved, this is an important time to address oral food challenges in general."

The groups say oral food challenges have been done for decades and are "the 'gold standard' test to determine if someone is allergic to a food.” But the president of the American College of Allergy, Asthma & Immunology says the groups understand that families now have many questions and concerns about them in light of Alastair’s death.

"It's important to realize that this option is still really important for a lot of patients and I think at this stage it makes us all the more committed to our protocols of safety," says association president Stephen A. Tilles, MD, an allergist in Washington state.

"Things typically go extremely well so it reminds us how important it is to be vigilant about the rules," he says.

Tilles says that includes being careful about measuring how much food is given at challenges and making sure patients are OK before going home.

In their joint statement, the ACAAI, the American Academy of Allergy, Asthma & Immunology, and the Canadian Society of Allergy and Clinical Immunology Allergy say there are guidelines for oral food challenges. They stress they should only be done if:

A well-trained provider of food allergy and anaphylaxis management, who has performed oral food challenges, does them.
There is an established procedure for doing the challenge.
It's done in an office or hospital that includes well-trained and experienced staff, plenty of supervision for the patient, a plan for treatment of any reaction, and an observation period afterward.
Life-saving equipment is on hand.
There is documentation that the patient or family members were told beforehand of the risks and benefits of the test.
There is a plan to explain the results after the procedure.
The story in Allergic Living says Watson had asthma and allergists warn that can also increase the risk of a reaction and its severity. ... gy-parents


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