Recurance · prevention of future deaths reports
Pre-inquest brief
Undeclared allergens leading to anaphylaxis in food businesses
The earlier warning
Dylan Hill · 4 Jan 2018 · Tanyka Rawden, South Yorkshire (West)
“Evidence was given that there are no procedures in place for such communications between the health services and Trading Standards in cases of non fatal anaphylactic reactions.”
What was promised
Stated action 1 · response to Dylan Hill (4 Jan 2018) · stated timescale: March
“In March, we will be meeting with representatives from other government departments (including the Department of Health and Social Care and Public Health England) and organisations involved in food allergy to discuss how we can better tackle the issue.”
judiciary.uk/…/2018-0004-Response-by-Food-Standards-Agency.pdf
Stated action 2 · response to Dylan Hill (4 Jan 2018) · stated timescale: 23 March 2018
“Our revised anaphylaxis draft protocol includes a referral form to inform Trading Standards of cases of anaphylactic reaction as a result of consuming food from commercial premises.”
judiciary.uk/…/2018-0004-Response-by-Barnsley-Hospital-NHS-Trus…
What recurred
- 21 Nov 2022 · Celia Marsh · Maria Voisin · Closely related · confidence 0.90 (high)
The clearest link, quoted from both reports:
Earlier · Dylan Hill · 4 Jan 2018
“Evidence was given that there are no procedures in place for such communications between the health services and Trading Standards in cases of non fatal anaphylactic reactions.”
Later · Celia Marsh · 21 Nov 2022
“- To establish a robust system of capturing and recording cases of anaphylaxis, and specifically, fatal and near-fatal anaphylaxis, to provide an early warning of the risk posed to allergic individual by products with undeclared allergen content.”
What happened next
No web check of the stated actions has been published for this chain.