On Sunday, December 13th, I served Applegate Organics Gluten-Free Chicken Nuggets to my boys for lunch. They had not eaten this product before, but we have trusted Applegate’s organic deli meat, hot dogs, bacon, and sausage for years.
Shortly after they finished lunch, Grayson started coughing. As a long-time food allergy mom, my radar immediately went off, but I tried to not overreact immediately. After Grayson coughed a few times, he said, “I’m coughing a lot all of a sudden,” so I took a closer look. I realized his nose was running and he had a slight rash above his eyes and on his neck. We follow the guidelines that any two body systems constitute an anaphylactic reaction, so I immediately grabbed our medicine bag. Before I could even get to the Auvi-Q, Grayson said that his throat and chest felt tight. I had him lie down on the couch and gave him the first dose of epinephrine. Then I called 911.
While we waited for the ambulance, I administered his rescue inhaler. My husband was on his way home, but I also called my best friend, another food allergy mom who fortunately lives around the corner, to come be with my oldest son in case we had to leave before my husband came home. It seems like it was only two minutes before everyone arrived – the police, the ambulance, my husband, and my best friend.
After taking vitals, the ambulance crew directed me to give Grayson both a second dose of Auvi-Q and a dose of Benadryl. My wonderful best friend took my oldest son to the basement to play so that he would miss the drama. We all agreed to give Grayson a second dose of Benadryl, and then we got into the ambulance.
On the ride over, the EMTs gave Grayson his THIRD dose of epinephrine. At this point, I became terrified that the epinephrine wasn’t working, and that the reaction wasn’t slowing down. Thankfully, Grayson’s coughing and breathing were under control, but his skin was turning bright red from head to toe, including a combination of hives and eczema. His heart rate and blood pressure were off the charts – a combination of the high amount of epinephrine and the reaction itself.
The ride to the ER was a blur – I just remember being aware of the siren and the speed. Once we arrived, the hospital immediately put us in a room with a full medical team. I was asked to recall both what and when he ate and what meds he had been given in what quantity and at what time. I was trying to hold his hand and comfort him, but there were people all around his bed giving him an IV, taking all his vitals, and asking me questions.
Due to his insanely red skin, they gave him a FOURTH dose of epinephrine. They also gave him steroids, more antihistamine, Pepcid, oxygen, and a fluids drip. The first 30 minutes or so in the ER were some of the most intense of my life.
I have now seen five anaphylactic reactions between my two boys, but nothing prepared me for one of them needing FOUR DOSES OF EPINEPHRINE. My fear that this was not going to turn around was profound.
The ER staff was incredible. They were very reassuring that his lungs were clear and that his blood oxygen levels were good. At that point, we just prayed that the redness would start to subside with the additional medications. It took some time, but his skin did finally begin to calm down. The ER staff had a 5th dose of epinephrine ready, but thank God, we didn’t have to use it.
After we observed him for two hours and he was stable, we began to talk about next steps. Ultimately, the ER staff was concerned about sending him home because of risk of a biphasic reaction as well as how much medication he’d had. We spoke with the hospitalist on call and our own allergist, both of whom agreed we should stay overnight. However, our hospital is a community hospital. While it has an excellent ER, it does not have a pediatric ICU. Ultimately, everyone agreed to send us to Yale Hospital an hour away in New Haven for overnight observation.
This required another stressful ambulance ride. Thankfully, this time there were no sirens or speeding. (This made me feel better because everyone felt safe that Grayson was stable.) He continued to be hooked up to every monitor possible, and the crew on board was ICU-level trained to handle any emergency while in transit. I still didn’t breathe during the entire hour ride there.
By the time we reached Yale, I was beginning to slightly relax. Grayson had been stable for a handful of hours. And I knew we were in a world-class facility that could take care of him if anything changed. We were taken to a private room, and our new medical team came in shortly thereafter. We reviewed all the events of that day, and they decided to keep him on a steady schedule of steroids, antihistamines, and Pepcid throughout the night. They also continued to monitor his blood oxygen level.
Grayson slept, fitfully, through the night. I didn’t sleep one wink. I kept thinking about how in the hell this had happened. I KNEW it was the chicken nuggets because the other food he had at lunch was leftover homemade potatoes and broccoli. I checked and re-checked the Applegate website for label ingredients. I had an insane amount of mom guilt for giving my child a food that caused such a severe reaction. I thanked God over and over that night for saving my child.
We were discharged the next morning. I came home, took a long shower and a long nap, and then I got to work. I called Applegate consumer relations and couldn’t get through, but I found a number to text on their website. Here is the message I sent:
I tried calling and no one is picking up. Yesterday I gave my son the Applegate organic gluten-free chicken nuggets. The box states it is gluten and casein-free. Your website states it is free of the Top 8 allergens. But my son had an anaphylactic reaction, requiring 4 shots of epinephrine to save him. I need to speak to a senior staff member about your manufacturing process to see what he reacted to, whether it’s an ingredient not listed or cross-contamination not listed. Please call me at this number as soon as possible.
I quickly received this text back:
Hello Hillary,
Thanks for reaching out.
I’m sorry to hear about your son’s experience when consuming the gluten-free chicken nuggets. I truly hope he is doing much better. Please know I’m going to pass your message to a senior staff member and they will be in contact with you as soon as possible.
Shortly after that text message, I received a call from a senior consumer relations manager. Within several days, I had also spoken to senior communications and quality assurance staff, and then to the President of the company. Every person I spoke to conveyed the same message: they were sorry this happened to us, they wanted to help us figure out what Grayson reacted to, and they wanted to make sure this didn’t happen again. They all shared that they valued their food allergy consumers and took their responsibility to manufacture safe food seriously. With every conversation, I felt heard, validated, and reassured that we would get to the bottom of this and that good would come from it.
Thanks to the advice of my amazing allergist, we kept the box and interior packaging from the nuggets. It was still on the kitchen counter when we went to the hospital, and my allergist told me to make sure my husband didn’t toss it. Thank goodness because this was the key to finding out what caused Grayson’s reaction.
Applegate had me ship the box and packaging to a lab at the Department of Food Science & Technology at the University of Nebraska – Lincoln. They were able to test the food remains in the packaging for peanut, tree nuts, gluten, milk, egg, soy, sesame, and mustard. Applegate also later sent remnants from inside our package to a separate lab to check for chickpea and green pea. This took several weeks, mostly due to the Christmas and New Year’s break.
Ultimately, the testing came back positive for gluten.
For our family, this was a huge relief in a lot of ways. First of all, just to know what actually caused his reaction is so important to our healing and moving forward. Second, while I was certain of his allergen list (we spent all of last year participating in several food challenges, and he had just updated allergy bloodwork a few weeks prior), I was so glad to know there was nothing new we had to worry about. And third, the entire process validated my judgment to give him this product in the first place…these nuggets SHOULD have been safe for him.
It was also possibly the most shocking outcome since this product is certified Gluten Free. As a food allergy mom, I rely heavily on these certifications and feel a sense of reassurance and peace when I choose products that have them. I had also learned from all my conversations with various staff at Applegate that they do have rigorous testing protocols in place, sometimes even above and beyond what is required. So, we all were surprised by this result.
Applegate had already audited the two facilities that make these nuggets to try to determine where something had gone wrong. After the test results came back for gluten, they audited the facilities again. Unfortunately, I don’t think we’ll ever know how this slipped through.
It is a sad and scary truth for a food allergy family that, ultimately, you can’t ever completely trust a food you didn’t make yourself from scratch. Even with this company that tried to do everything right, something went wrong.
The silver lining is that some good will come of this. Based on this event, Applegate just announced their new testing protocols, which will hopefully ensure this doesn’t happen ever again. They also announced a new partnership with FARE, with a commitment to increase food allergy education in their own organization and transparency in external communications, including labeling. You can read their article about this incident here. While I wish this had all happened more quickly (it’s now been 11 weeks since Grayson’s reaction), I am grateful as a mom and inspired as an advocate that his terrifying reaction will result in such impactful, fundamental change for this huge organization.
I want to say a heartfelt and grateful THANK YOU to my beloved FARE family. I informed them about what happened to Grayson the day after his reaction, and they immediately offered to step in and help with Applegate. They put a full team behind us and helped me work with Applegate in the most efficient and productive way to ensure that this horrible experience would result in a positive outcome in our ongoing shared goal of keeping the food allergy community safe. From the bottom of my heart, thank you to Lisa, Michael, Sherry, Jonathan, Steve, Deb, and Kevin. My family and I are forever grateful for ALL you do for food allergy families like ours.
My family and I are healing from this traumatic event. I’ve had a lot of time to review and process everything that happened, and I have several learnings to share with hope that it helps others in their own future potential reaction scenarios.
EPI FIRST, EPI FAST. I gave Grayson his first shot of epinephrine within a few short minutes of his first symptoms, and he STILL needed four total doses. I shudder to think of what the outcome would have been if I had hesitated or, God forbid, we didn’t have access to epinephrine. DO NOT HESITATE! If you haven’t reviewed your emergency action plan with your allergist recently or updated your epinephrine devices, take our experience as a sign to make that call and get yourself organized and prepared. (Reminder, of course, that I am not a doctor. Please seek medical advice from your board-certified allergist.)
SAVE THE FOOD AND/OR PACKAGING. If you or your child has a reaction, save the leftover food that was consumed. If the food isn’t available, then save the packaging. We were able to discover what Grayson reacted to from just a swab of the plastic wrapper. Science is amazing! Don’t toss out your evidence!
CONTACT THE MANUFACTURER. If you or your child has a reaction to a processed food, it’s so important to LET THEM KNOW. Companies can’t change their protocols if they don’t know there is a problem. Ask to speak to a senior consumer relations staff member who will take you seriously.
KEEP YOUR EMOTIONS IN CHECK. If you or your child has a reaction, especially if it’s a severe one, you have every right to be angry, sad, scared, and all the above. But a hysterical call is going to get you nowhere. I tried, to the best of my ability, to handle every interaction with Applegate wearing my professional corporate communications hat, not my terrified mom hat. Being calm and rational will just be more effective, as hard as it might be. That being said, you can still be clear and direct about the ramifications of what a reaction like this does to your family – just try your best to be controlled in your communications.
ALLOW TIME TO HEAL. Anyone who has been through an anaphylactic reaction knows that the emotional toll can last for a long time…even forever. Give yourself the time you need to heal. Sit with the emotions and let them work through you. If children have a reaction, it’s important to speak to them about how they are feeling. Honor whatever they need to feel safe and comfortable. Grayson is definitely dealing with post-event anxiety and asking lots of questions about all his food. I am being super patient and answering all questions with calm certainty. We also took almost all packaged food back out of his diet. We are relying on homemade, whole foods meals with very few “treats” from mostly food allergy-friendly companies that we deeply trust. This really has always been his diet, anyway, but we were trying to continue to branch out and just got unlucky with the chicken nuggets. He says he doesn’t want to try any new foods this year, and I am OK with that. There is no need to rush the process. Give yourself and your child space and grace.
I am still shocked this happened to us. I am still thankful to God, every moment of every day, that he saved Grayson. And, ultimately, I am grateful that Applegate took this seriously and that their new testing protocols will make their products safer for food allergy families.
I hope our experience will help others avoid future allergic reactions, or at least, have the tools to be able to investigate what caused them. Above all else, I hope our story provides inspiration to SPEAK UP if you or your child has an allergic reaction to a packaged food that is supposed to be “safe.” We as advocates CAN make a difference. The louder our collective voices are, the more change we will be able to create.
Thank you for reading.