Owen Carey, 18, died in his girlfriend’s arms in front of the London Eye, in 2017
A teenager who died from an allergic reaction after eating grilled chicken at a Byron burger restaurant did not know it had been coated in buttermilk, an inquest heard.
Owen Carey, 18, from Crowborough, East Sussex, died in his girlfriend’s arms in front of the London Eye on 22 April, 2017.
Paramedics battled to save him after he was helped by passers-by but he died from anaphylactic shock.
The inquest was told he had forgotten his epipen but would not have survived even if he was carrying it.
Mr Carey was allergic to wheat and dairy products but there was no mention of buttermilk on the menu at the restaurant at the O2 in North Greenwich, Southwark Coroner’s Court heard.
Aimee Leitner Hopps, in charge of health and safety compliance at Byron, told the inquest that the allergy information on the menu met industry standards at the time.
The menu used by Byron in April 2017 was a two-sided place mat menu which asked customers to inform staff of allergies at the back.
‘Our legal obligation is to demonstrate the information can be provided,’ Ms Hopps said.
‘So we have a signpost that asks if you have any allergies,’ she said.
‘Certainly we have never been notified of any issues with the location or the size of the text.
‘It is very much what the industry standard is.’
Mr Carey (pictured) was allergic to wheat and dairy products but there was no mention of buttermilk on the menu at the restaurant at the O2 in North Greenwich, Southwark Coroner’s Court heard
The inquest heard that dishes on the menu indicated if they contained one of the 14 common allergens.
‘Most business would take the approach that the customer would notify the restaurant if they had an allergy,’ said Ms Leitner-Hopps.
Briony Ballard asked her ‘In effect you are trying to put the responsibility on the customer, aren’t you?’
Ms Leitner-Hopps replied: ‘It is not about shifting responsibility, it is about the expectation that when a customer has an allergy they would tell us.’
Byron staff go through online training which also covers allergies, which consists of them ticking a box indicating they have read the section.
The schoolboy (pictured) was popular pupil and was a prefect at Skinner’s School in Tunbridge Wells
Ms Leitner-Hopps said waiters also had a week’s restaurant training where allergens were covered.
Byron’s policy has now changed and servers ask customers if they have any allergies.
The kitchen is then notified so that proper sterilisation and procedures to avoid cross-contamination were put in place.
Food outlets have faced mounting scrutiny of their food allergy policies following an inquest last year into the death of Natasha Ednan-Laperouse, 15, who died of an allergic reaction after eating sesame seeds contianed in a Pret a Manger baguette.
Natasha’s parents, Nadim and Tanya, are supporting Owen’s family.
Paediatrician calls for national register into food allergy deaths
A leading paediatrician called for a national register of food allergy deaths after an 18-year-old lad suffered a fatal reaction to eating a Byron chicken burger.
Giving evidence at an inquest into the death of Owen Carey, Dr Robert Boyle told Southwark Coroner’s Court: ‘I do think there’s a real failure to learn from the tragic occurrence.
‘I think a lot of knowledge comes to the fore in court, detailed information around the pathology, the circumstances surrounding the event – that’s as far as it goes.
‘We probably had 150 deaths like this in the UK over the last 15 years. I just don’t think we are learning enough as it is.’
Calling for a national register for food allergy deaths, he added: ‘It would be just to understand what are the risks that lead to fatal food anaphylaxis.
‘I think the Food Standards Agency have a sort of regulatory governmental role and are quite interested in food allergies.
‘I think they would need to be involved and the Anaphylactic Campaign; they would love to be involved.’
He said The British Society for Allergy and Clinical Immunology should also be consulted.
Dr Boyle said: ‘I think your own community, the coroner’s, somehow need to engage with that.
‘Food allergy is a big deal really for the food industry, for education, health, for families. This is quite an important part of the picture for this very unpredictable and very awful thing happening, we do need to learn a little bit more about it.’
He disagreed with the medical cause of death given by Professor Lack, adding: ‘I would call this fatal food anaphylaxis, but it’s debatable.’
Owen’s cause of death was originally determined by Professor Gideon Lack, an expert in paediatric allergy at Kings College London.
The inquest heard that Owen had ordered the skinny version of the classic chicken, which did not include the bun containing gluten.
But the menu made no mention of the fact the chicken fillet was marinated in buttermilk prior to being grilled, which Owen was allergic to.
Clodagh Bradley QC, representing Mr Carey’s family, pointed out to Ms Leitner-Hopps that the allergy notice on the Byron’s children’s menu was more prominent and at the front.
‘We do not have any such notice at all on the front of the menu that sets out all the food options available in April 2017,’ said Ms Bradley.
Ms Leitner-Hopps said: ‘It is not the reverse, this menu is intended to be two-sided information.’
‘This side sets out all the food options available on April 2017.
‘On the reverse is effectively a special feature about the new burger, a Kimchi burger,’ said Ms Bradley.
The barrister added: ‘You would agree if a customer is not interested in the Kimchi burger and glanced at that side, they would not read further because they would think it relates to the burger.’
But Ms Leitner-Hopps insisted that a customer with allergies is likely to be looking for that information.
Ms Bradley highlighted that the burger Owen ordered was described as grilled on the menu, with no mention of a marinade.
‘Would you accept that the description grilled chicken breast would lead the reader to believe it is a plain chicken breast,’ said Ms Bradley.
‘I believe that would be making a an assumption that is not quite valid,’ Ms Leitner-Hopps said.
‘We do not list all the ingredients in the menu, it is simplified. You do not say there is mayonnaise in coleslaw.’
Ms Leitner-Hopps denied the description was misleading, saying nobody had complained about that since the item was introduced in 2013.
Ms Bradley showed the court a picture taken of a Byron menu by Owen’s family in April last year, which showed the menu list buttermilk as an ingredient in the chicken.
Ms Leitner-Hopps said the change was made simply because buttermilk had since become a fashionable ingredient.
She insisted that listing all allergens in the menu would in fact make customers less safe, as it might lead them not to ‘assumptions’ and not disclosing their allergies.
Byron’s policy has now changed and servers ask customers if they have any allergies (stock photo)
‘We have procedures and our kitchen team have the chance to reduce cross-contamination,’ she said.
‘The benefit is having that discussion and making sure everyone is aware the customer has an allergy.’
Lucy Urquhart, from Trading Standards at the Royal Borough of Greenwich, told the court they concluded that something went wrong when staff took Owen’s order.
‘The whole matter revolves around the conversation that happened or didn’t happen at the table at the time of order,’ said Ms Urquhart.
‘For whatever reason Byron’s allergy policies were not triggered.’
Owen was due to visit the Sea Life Aquarium after visiting the Star Wars exhibition at the 02 Arena as a surprise gift earlier in the day
Owen was due to visit the Sea Life Aquarium after visiting the Star Wars exhibition at the 02 Arena as a surprise gift earlier in the day.
The schoolboy was popular pupil and was a prefect at Skinner’s School in Tunbridge Wells.
He usually carried an EpiPen but forgot to on the day of his death and had never suffered an allergic reaction before.
A post mortem revealed the cause of death was ‘asthma exacerbation in the context of a severe food allergic reaction’ – common in people who suffer a fatal anaphylactic shock, Southwark Coroner’s Court heard.
Dr Robert John Boyle, a consultant paediatric analyst at St Mary’s Hospital, told the hearing: ‘There are very few things so powerful that they can take away a young life that quickly.
‘We cannot be completely certain whether or not an epipen would have made a difference.
‘I think, personally, that it would have been unlikely that an epipen would have made a difference. It sounds like he was extremely difficult to resuscitate.’
Earlier Southwark Assistant Coroner Briony Ballard, reading paramedic Anneliese Tien-Yin Wong ‘s statement, said security staff had lowered the bollards at the London Eye to give the ambulance access to the pedestrian area.
The paramedic said: ‘The patient was located on the pavement in a pedestrian area in front of the London Eye.
‘There were three bystanders who identified themselves as doctors on scene.
‘The patient was unresponsive, silent and not breathing and pulseless.’
The doctors continued to perform CPR and paramedics extracted 1.5 litres of vomit from Owen’s airways with a suction device, the inquest heard.
Owen’s girlfriend told them he had suffered an allergic reaction, and didn’t have his epipen.
The medics administered five shots of adrenaline and one of hydrocortisol for anaphylactic shock.
Ms Wong said there was a delay to administering the drugs due to ‘managing the chaotic nature of the crowds and bystanders around us’ before Owen was rushed to nearby St Thomas’s Hospital.
Owen was rushed into A&E, but was pronounced dead shortly after arrival.
Dr Pippa Alamango, the hospital registrar who treated him in A&E, said ‘Owen’s allergic symptoms started after he ate half of his chicken burger because, according to his girlfriend, he shortly after developed symptoms of lips tingling and abdominal pain.
‘He then required his asthma inhaler.
‘His symptoms started at approximately 2.45pm and he collapsed at approximately 3.45pm.’
The inquest heard Owen had been going to hospital twice a year due to his asthma and suffered various other allergies.
Reading a post mortem report, the Assistant Coroner said the medical cause of death was found to be ‘asthma exacerbation in the context of a severe food allergic reaction.’
She added: ‘It’s estimated that half a chicken burger containing 5g of buttermilk.
‘Although this is a small amount of cow’s milk protein, it would be sufficient to cause anaphylactic reaction in a person with an allergy.
‘In the case of Owen, there was milk ingest at a dose that clearly caused an allergic reaction.
‘Having food allergies increases the risk of spontaneous fatal or life threatening asthma.
‘Owen had numerous respiratory allergies including cat, house dust mite, tree and pollen. The day of his death in Spring had high pollen.’
She added: ‘In summary the likelihood of milk allergies triggering this event is high, but the possibility of spontaneous asthma cannot be discounted.’
The inquest continues.
Simon Wilkinson, chief executive officer of Byron said: ‘Everyone at Byron would like to extend our deepest condolences to Owen’s family and friends.
‘We’ve cooperated fully with the Coroner’s investigation into Owen’s tragic death, and we will continue to do so.
‘We always take food allergies extremely seriously and have a comprehensive set of measures in place, including an allergen guide.’