Shiv Jugdish Mistry was a talented student who had secured his place at prestigious Cambridge University to study medicine this fall, but anaphylaxis cut his life short on July 8, just a few weeks after his 18th birthday.
An inquest into his death was held in Beaconsfield.
Assistant coroner Ian Wade read a statement given by Mistry’s parents:
We, Shiv’s parents, do not lay any blame on Shiv’s friends who were very courageous and did everything possible to save his life and should be commended during the hearing, if appropriate.
Shiv was out with friends in a local pub in Fuengirola, Spain, near their apartment.
He had a sip of Pina Colada and it transpired that the coconut cream was replaced with cream.
He wasn’t drinking as such – he had taken a sip of a friend’s drink and passed it on to others.
He recognized immediately that he had consumed something with milk and he made his way back to the apartment. He was sweaty, hyperventilating and took cetirizine, a powerful antihistamine.
He went to the bathroom to vomit. He was weak and dazed and requested a friend to call the emergency services.
He then requested an EpiPen and an inhaler. His other friends arrived and one left to guide emergency services to the room.
Wade continued:
Each gasp was longer apart until his breathing stopped. They gave him CPR for 20 minutes and someone called his parents on WhatsApp to tell them what had happened.
They said to apply a second EpiPen. Emergency services arrived and they used a defibrillator.
The inquest heard testimony of how Shiv was taken by air ambulance to the Costa Del Sol Hospital in Marbella, Spain, where he was rushed into intensive care. Despite the best efforts of the doctors, he was pronounced dead on July 8.
The doctors listed the cause of death as anaphylactic shock. Anaphylaxis is a severe, life-threatening reaction to a food, drug, insect venom, or environmental substance.
The coroner read a series of medical documents into the record establishing that Shiv had been diagnosed with an allergy to milk and had taken precautions to avoid contact with all dairy throughout his life.
He went on to say:
Shiv was a man, or boy, who knew he had to take care of himself and did take care because he suffered from a dangerous allergy to cow’s milk.
He was invited to take a sip of Pina Colada, a drink which should not have cow’s milk in it. Unbeknownst to Shiv, it was inappropriately made with cow’s milk.
He realised he was in peril and he was given EpiPens. He was given immediate attention by friends who raised the alarm.
Police attended relatively quickly and they knew what they were doing. He was given CPR and rushed to Costa Del Sol Hospital, Marbella, but he could not be revived.
He passed away after he was effectively brain stem dead.
The anaphylactic shock was in reaction to the unexpected cow’s milk in the otherwise completely safe Pina Colada. It was unexpected and unintended after trying what should have been an otherwise harmless drink.
The coroner declared the cause of death was an accident and closed the proceedings.
Shiv’s father, Judgish Mistry, said after the inquest:
There should be more education given to this age group, as they are inexperienced and going out on their own.
Shiv was lucky, he had friends who were medically aware and could apply CPR – however, there will be young people going on holiday with friends with no medical knowledge at all.
Schools should give medical training to anyone who has a friend that suffers from a life-threatening allergy. What we’re trying to do is make more people aware that this can happen, especially amongst this age group who just want to be like their friends.
Shiv was extremely talented. He was going to study medicine and we received a letter from Clare College at Cambridge University with their condolences.
I think his entire school year group turned up at the funeral. Shiv was popular at school because he would help anyone who needed it. He was selfless. We have letters from all the people who he helped in his school.
The Mistry family has since raised over £11,000 ($13,000) for Anaphylaxis UK in Shiv’s memory.
Coincidental with the inquest into the death of Celia Marsh, the news of Shiv’s passing is a one-two punch for the food allergy community.
Another young man with his whole life ahead of him has been taken for doing nothing more than enjoying a vacation with friends and sipping a drink.
We send our deepest condolences to the Mistry family and hope they are able to take some solace in the outpouring of support from Shiv’s friends and classmates. We will not forget him.
As we do when reporting these tragedies, we look for ways to help others avoid similar occurrences.
Epinephrine is the only drug that can halt and reverse the progression of anaphylaxis. The sooner it is administered the better the outcome.
We encourage all who have been prescribed epinephrine to always take two auto-injectors along everywhere, every time, and to administer the drug when anaphylaxis is first suspected. Understand that seconds count when anaphylaxis manifests and the danger of delaying epinephrine administration far outweighs any possible side effects of the drug.
Also, epinephrine is the first drug that should be administered when anaphylaxis is suspected. The American Academy of Pediatrics (AAP) stated it clearly in their 2017 report Epinephrine for First-aid Management of Anaphylaxis:
H1-antihistamines prevent and relieve itching and hives but do not relieve life-threatening respiratory symptoms, hypotension, or shock; therefore, like H2-antihistamines and glucocorticoids, they are adjunctive treatments and are not appropriate for use as the initial treatment or the only treatment.
Epinephrine is your lifeline in case the unthinkable happens. Carry it and use it.
Last but certainly not least, we urge you never to consume a food or beverage unless you know precisely how it was prepared.
In this case, a friend — presumably with no food allergies — ordered the drink and did not preface the order with a warning of milk allergy because there was no reason to. The oversight — resulting from a single sip — led to this tragedy.
Epinephrine First, Period
