Shortage of EpiPens ‘meant opportunity missed to save Costa allergy victim Hannah Jacobs’

A nationwide shortage of life-saving EpiPens has been linked to the death of a schoolgirl with a severe cow’s milk allergy, who died after drinking a single sip of Costa Coffee hot chocolate.

Earlier this month, a coroner concluded that Hannah Jacobs, 13, died after the coffee chain’s staff failed to follow allergy safety guidelines.

Hannah asked for soy milk in her drink, but real milk was used. Her mother Abimbola Duyile accused Costa Coffee of treating allergy training as a ‘tick-the-box exercise’, leading to the death of her ‘lively, caring, affectionate’ daughter.

According to The Mail on Sunday, Hannah’s life could have been saved if there had not been a dangerous shortage of prescription drugs in the UK.

The inquest into her death, which took place in February 2023, found that a pharmacist who helped her during the fatal allergic reaction had said the correct dose of an emergency medicine was “out of stock”.

Undated family photo released by lawyers Leigh Day of Hannah Jacobs, 13, from Barking, east London, who had a severe dairy allergy

Hannah’s mother, Abimbola Duyile, holds a photo of her daughter as a lawyer outside the East London coroner’s court after the conclusion of the inquest into 13-year-old Hannah Jacobs, who died after a suspected anaphylactic reaction to a hot chocolate she bought at a Costa Coffee branch in Barking.

Instead, Santokh Kahlon, of Daynight Pharmacy in Barking, Essex, said he used the “only EpiPen on the shelf” which contained 150mg of adrenaline – a third of the amount needed for a teenager. He said his staff desperately searched for another dose but were unable to find one due to a “shortage of stock” across the UK.

He began CPR on the London teen while a customer called an ambulance. But by the time Hannah was taken to hospital, it was too late. She died that afternoon.

Worryingly, experts warn that ongoing drug shortages could lead to more deaths. According to research, more than half of people in the UK have struggled to get their prescriptions filled in the past year. And around one in 12 have been unable to access vital medicines, including hormone replacement therapy, antibiotics and inhalers.

Over the past six months, the MoS has uncovered dozens of cases of patients affected by these shortages, but the government has yet to make plans to address the problem.

“What will it take for the government to act?” said Dr Leyla Hann-beck, chief executive of the Association of Independent Multiple Pharmacies. “If the right EpiPen dose had been available, this child could potentially have been saved.

“There is something very wrong in our country when there is a shortage of life-saving medicines. Patients are living on the edge, hoping to get their medicines on time. That is unacceptable.”

While shortages have largely been caused by increased global demand and production issues, experts say it is within the government’s power to alleviate the crisis. That’s why MoS has launched the End The Drug Shortage Nightmare campaign. The paper is calling on the government to give pharmacists the power to make substitutions for patients when drugs are out of stock and to force manufacturers to provide advance warning of known shortages or risk fines.

We also believe that there should be a database where patients can check which pharmacies have medicines in stock. Furthermore, we believe that all NHS patients should be able to use well-stocked hospital pharmacies to obtain essential medicines.

The inquest into Hannah’s death heard how her mother alerted staff at Costa Coffee in Station Parade Barking to her daughter’s severe dairy allergy when she ordered two hot chocolates.

A view of the Costa Coffee branch on Station Parade in Barking, east London, where Abimbola Duyile bought her 13-year-old daughter Hannah Jacobs a hot chocolate, which she suffered a serious reaction to and died in hospital

Ms Duyile claimed she apologised to the baristas for “being a nuisance” and asked for the jug and steamer to also be cleaned, the East London coroner was told.

Hannah and her mother were visiting a nearby dentist when she took a sip of the drink and ‘immediately’ began vomiting and having difficulty swallowing. They left after 10 minutes due to Hannah’s symptoms and sought help at the chemist across the road.

Mrs Duyile asked for a dose of the antihistamine gel cetirizine, which she said normally helped to calm her daughter’s symptoms. But this time it didn’t work.

Mr. Kahlon, the pharmacist, was looking for an EpiPen, which contains a dose of adrenaline, also known as epinephrine — a drug that can treat anaphylaxis, a life-threatening allergic complication.

Neither Hannah nor her mother had an EpiPen with them at the time, despite the advice for patients with severe allergies.

According to official guidelines, 10 mg per kg of body weight is required. Hannah, unconscious when the injection was given, weighed 47 kg (104 lbs).

This meant that the 150 mg dose she was given was not nearly enough to counteract the reaction.

EpiPens have been in short supply at times since 2018, according to NHS data. A spokesperson for the Department of Health and Social Care denied there was a recorded shortage of EpiPens at the time of Hannah’s death, but added: ‘We are in ongoing discussions with the Natasha Allergy Research Foundation about improving support for people with allergies and ministers are currently carefully considering the concerns raised by the coroner.’