While restaurant management may have good intentions to develop a food allergy accommodation program, it may never be fully instituted or fully communicated to the staff. The Model Retail Food Code which was modified by the FDA in 2009, states that the “Person in Charge” of a food establishment must know and understand food allergens. They are also required to make sure that their employees are trained how to handle food allergy guests and how to recognize allergy symptoms.
The first food allergy case I consulted on involved a man who told his server that he was allergic to seafood. She recommended that he order the French fries. The restaurant was extremely busy, which means the kitchen was very busy too. She eventually served him the French fries. The patron consumed them. Within 10 to 15 minutes he began to feel uncomfortable and made his way to the ER. Shortly after he arrived, the man expired. The cause of death was attributed to anaphylactic shock due to a seafood allergy. The fries were cooked in the same oil as the calamari. The restaurant had written policies in place which stated that the food for anyone with a seafood allergy was supposed to be fried in a separate pot with fresh oil. However, no one enforced or followed the rules. The restaurant was so inundated that there isn’t a clear idea of how or when the policy was violated. Either way, the lack of communication between the staff on food allergies probably resulted in the death of the man. Since the man was 72 years old, his family agreed to settle for $1.2 million. If the person had been younger, the settlement would have been considerably larger. All in all, had the restaurant followed the established allergy program, this tragedy could have been avoided.
The major food allergens to watch out for include: milk, eggs, peanuts, tree nuts (such as almonds, walnuts and pecans), soybeans, wheat, fish and shellfish (such as crab, lobster and shrimp). The latest allergy trend appears to be guests that request gluten-free products.
Some tips to manage allergy accommodation include having a written policy that has been fully communicated to the entire staff. All allergy training should be documented and employees should be evaluated for competency. The wait staff should be trained on how to effectively listen to the allergy concerns of their patrons and how to communicate their allergy needs to the kitchen staff. The restaurant needs to have a master menu that lists all of the ingredients required for that dish in case a patron inquires. The days of “Secret Recipes” are long gone. Transparency is the new standard. All servers should know who the most knowledgeable (PIC) about food allergies or ingredients on any given day if a patron has any questions.
Any allergy training should include a section that reviews the signs and symptoms of allergic reactions. It’s important that the staff understands that the symptoms of a food allergy tend to develop within minutes of exposure, but may take as long as two hours. The most frequent signs include: a) hives, itching, or skin rash; b) swelling of the lips, face, tongue and throat, or other parts of the body; c) wheezing, nasal congestion or trouble breathing; d) abdominal pain, diarrhea, nausea or vomiting; e) dizziness, light-headedness or fainting.
Of all the issues that a restaurant must deal with, it can seem like allergy accommodation is not a priority. However, this can be a life threatening matter. There are roughly between 200 to 300 reported deaths due to food allergies. In addition, there are over 30,000 ER admissions, half of which are due to restaurant related situations. One way to combat this situation is to purchase and provide kitchen staff with a purple allergy tool prep kit. Another way is to have an advisory notice on the menu that states if you have a medical condition or food allergy please inform your server. One best practice to institute would be to designate one person in the front of the house to deliver allergy safe orders to patrons and one person in the back of the house to prepare it. Since there are many issues to be confronted in regards to allergy accommodation, allergy programs should be reviewed by a food health and safety expert before training and implementation begins.
When the inevitable happens call 911 and report that a guest is having an anaphylactic shock at your establishment.
Food allergies are as unique as each individual who has them. To avoid problems in the future, food safety and allergy training are imperative to the success and safety of your restaurant.
Peanuts is the most common food allergen for children
Shellfish and peanuts are the most common food allergens with adults
Allergens can be transmitted in frying oil or steam
Sanitize menu jackets between uses
Replace condiment containers and holder with a set that has been sanitized
Set up a code on order slips that indicates the specific allergen to avoid for the kitchen
Have mock allergy rehearsals to test the efficacy of your allergy program
Check labels – tuna may contain casein, Worcestershire contains anchovies, soy sauce contains wheat