The Dublin District Coroner’s Court today heard testimony in the death of Giulia De Simone, a 21-year-old student from London. She was pronounced dead on March 27, 2021, a few hours after ingesting a taste of food containing peanuts.
Giulia had a known allergy to peanuts from early childhood and was coping with asthma and celiac disease as well.
Jackson Bannon, Giulia’s boyfriend, testified that the couple had been staying at the Zanzibar Locke Hotel in Dublin a few days before visiting a friend for dinner on the evening of March 26, 2021.
Bannon said his friend served them food that his mother made which he believed was a Nigerian dish with “steak marinated in a sauce.”
After taking a bite, Giulia asked what the dish contained and was informed it was made with peanuts.
Bannon said he “freaked out.” He said that despite only having been in a relationship for a month, Giulia had often spoken about how serious her allergy was and that she always carried an epinephrine auto-injector.
Unfortunately, the inquest heard that that evening, Giulia had left her auto-injector in her suitcase in their hotel room.
Bannon testified that Giulia rushed back to the hotel on a rental bike while he and the friend took a tram.
He told the coroner that Giulia was “not doing well” and was struggling to breathe by the time she managed to administer her epinephrine. Her face had swelled, and she was having difficulty breathing.
While fighting back tears, Bannon recalled how Giulia collapsed before an ambulance arrived at the hotel and how he tried to administer CPR.
He said she had just “taken a small bite off a spoon,” referring to the meat dish. “You wouldn’t think there was anything in it,” he remarked.
The inquest heard that Giulia was already in cardiac arrest when paramedics arrived at the hotel, and they administered six more doses of epinephrine before she arrived at the hospital. No heartbeat was detected upon arrival.
Christopher Galvin from the national police force testified Giulia had arrived at the hospital at 12:59AM and was pronounced dead 30 minutes later.
Mark De Simone, Giulia’s father told the inquest his daughter was diligent about keeping all the medical devices and medication she needed to treat her various medical conditions.
“She was very compliant with whatever she had to take,” he recalled.
Giulia’s father said his daughter had suffered several allergic reactions to peanuts, including one time in Israel when they were “only in the air,” referring to airborne exposure.
Her mother, Elena De Simone, said her daughter had been hospitalized on a number of occasions, with the most recent serious reaction occurring in May 2019. She said Giulia would even react if peanuts touched her skin.
Ms De Simone said her daughter had always carried her auto-injector with her, but unfortunately, “when she needed it most, she didn’t have it.”
The coroner said a post-mortem confirmed the cause of death as anaphylactic shock from a peanut allergy. He recorded a verdict of death by misadventure to reflect the fact that she had died as a result of an unintended outcome of taking a small bite of food.
The coroner said it could not be emphasized enough how important it was for people who suffer from allergies to always carry their epinephrine auto-injectors with them.
“The early administration of an EpiPen matters, and it is vital it is done in the first few minutes,” he said.
We are saddened to learn the food allergy community has lost yet another young person to anaphylaxis. We send our deepfelt condolences to the De Simone family for their terrible loss, and the subsequent pain the coroner’s proceedings must have dredged up. We wish them solace in the days to come.
As we do when we report such tragedies, we look for strategies others in the community can employ to avoid similar outcomes.
By all accounts, Giulia was aware of the seriousness of her food allergy and was vigilant in carrying her auto-injector. Unfortunately, all it takes is letting one’s guard down a single time for disaster to strike as it did for her.
The most important takeaway for those with food allergies is to take two epinephrine auto-injectors along everywhere, every time, and to administer the first as soon as you suspect anaphylaxis.
Epinephrine is the only drug that can halt and reverse the progression of anaphylaxis, but it can only help if you have it with you and administer it in time. Why two? In case the first dose is insufficient to stop the progression of anaphylaxis.
What if you’ve forgotten your epinephrine? Stop, don’t eat anything, and make it a point to retrieve your epinephrine as soon as possible, avoiding contact with all food, even if it seems innocuous.
What if you suspect anaphylaxis or are severely allergic and accidentally ingest your allergen and don’t have your epinephrine on hand? Call emergency services immediately and tell them you are suffering anaphylaxis and need epinephrine. Note that many first responders do not carry epinephrine, and warning them can save valuable time. [You can find out more about how a person suffering anaphylaxis should be positioned while awaiting help in our article “How to Properly Position a Patient Suffering Anaphylaxis While Waiting for EMS“.
And finally, never ever eat an unwrapped food unless you know precisely how it was made and are confident it had not been exposed to cross-contact with your allergens of concern during preparation and serving.
Maintaining vigilance is the only way to avoid exposure, and epinephrine is your life preserver should the unthinkable happen. Let it never be said that “When you needed it most, you didn’t have it.”