Did Delaying Epinephrine Kill Her?

Hello Allergy Caregivers,

I had an email from a teacher who was curious after reading about the death of Natalie Giorgio (the 13 year old who died after eating a rice krispie treat made with peanut butter).  Here is her question:

“This is so tragic, I feel for the family so much.  Melissa, did this happen because the epi’s were applied too late?  That they can be ineffective if not administered immediately??  I am curious as to why they may have waited if they knew there was peanut butter.  Even IF there was any doubt one would give the epi’s anyway wouldn’t one?  Do you have any ideas??  I’m just trying to understand this situation.”


Natalie had a known peanut allergy.  She took a bite of the treat and immediately suspected she shouldn’t have and brought it to her mom.  Her mom agreed that there was peanut butter in the treat. They waited to see what would happen – was that the fatal mistake???  Some are saying that is the reason why she died: Delaying administration of the epinephrine.

Here was my response to Jane:

My allergist has told me that most of the deaths due to allergies occur with people who had a known allergy and failed to administer epi or delayed administration.  There was another death recently where the boy also received the dose later (delayed administration) and died.   In the event that a known allergen is ingested they recommend IMMEDIATE ADMINISTRATION OF EPI.

My mom is anaphylactic to bee stings…

Her and I were discussing the tragedy of this case and the fact that they gave 3 epi-pens.  My mother mentioned that when she was in hospital the doctors told her it would be dangerous to give her any more epinephrine.  Could 3 doses have been too much?

So many questions..

  • Why did they wait?
  • It is said she started to show signs of a reaction 20 minutes after ingesting the treat.  Did they administer the epipen immediately upon these symptoms or did they wait longer?
  • Could the epi-pens have caused her death?  Were 3 doses too much? 

What do you think?  What would you do?  If you or your child ingested a known allergen do you think you would delay administering the epi-pen or would you give it right away?  Are you afraid to administer epinephrine?

Are the experts on the same page??

One of the things that I am noticing is that all of us are getting different answers from the doctors.  Some are being told to give benadryl and epi.   Some are told never to give benadryl for anaphylaxis.  Some are told to wait and see and others are told to administer immediately.

My advice?

Give epi immediately for known ingestion of a food allergen.

One more piece of advice if I may…

The common thread I see in most of the allergy deaths is that people are eating food that they have not prepared themselves.  We rarely give food to our daughter that we have not personally prepared.  It is a personal decision and it is not to say that we have never had her eat out at a restaurant or eat something prepared by another but we do it with extreme caution.

Let’s support each other, not JUDGE…

It saddened me when I saw comments below the article detailing Natalie’s death where members of our allergy community criticized the family for their actions and/or inactions.  Really?!!  Come on.  In the support group I host I advocate for non-judgement.  Those parents were doing the best they could for their daughter and they are now sharing their story with the press to publicize this death to promote advocacy and education or the public on the severity of these food allergies.  I send them my love and prayers.

If you are uncertain as to when to administer epinephrine (epi-pen), please contact your child’s allergy doctor right away and get the answers you need.   Do not be afraid to ask the same question multiple times or to approach your doctors with any uncertainties.  Often in the moments of meeting with doctors we are overwhelmed.  It is ok to go back and ask for further clarification.

 In good health,

Melissa xo

Original Post Date:  August 16, 2013.
Last Update: May 10, 2017.

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