The food allergy community has been rocked by the news that Elijah Silvera, only 3 years old, was fed a grilled cheese sandwich at his New York City preschool. This caused the boy to suffer a severe reaction that took his life.
Following is a look at what has been learned, what is being investigated and what authorities are doing in the wake of this dairy allergy tragedy.
What happened to Elijah?
His parents say he was at his pre-kindergarten program on November 3 at Seventh Avenue Center for Family Services in the Harlem area of Manhattan. They say an employee of the center gave Elijah a grilled cheese sandwich to eat – despite the preschool having documentation and knowledge of the child’s severe dairy allergy, as well as other food allergies and asthma.
Elijah went into anaphylaxis after he consumed the sandwich, according to a GoFundMe page set up by a family cousin, Liz Murray. “The school didn’t call 911, they called his mother,” Murray told the New York Post. “She [Elijah’s mom] drove him to Harlem Hospital,” where doctors in the emergency department were not able to save the child.
With an anaphylaxis emergency, the standard protocol is: to use the epinephrine auto-injector, then call 911 for an ambulance, then let a parent know what’s going on. Why wasn’t this followed?
As the facts of the case are under investigation, it’s not entirely clear. The New York City Fire Department has confirmed that there was no 911 call from the preschool center about Elijah.
On November 13, the New York City Administration for Children’s Services (ACS) and the Department of Health and Mental Hygiene (DOHMH) held a press conference about steps being taken in the wake of Elijah’s death. CBS New York reports the two agencies announced “that all child-care staff will now be required to call 911 when a student has a medical emergency.”
This announcement appears to indicate that such a protocol was not in place previously.
The ACS also announced it “has issued clear guidelines to EarlyLearn Centers on caring for children with food allergies and will be reinforcing that guidance through enhanced training.” The Seventh Avenue Center falls under the EarlyLearn program, which offers subsidized child-care to eligible families with children up to 4 years old. The program includes free, nutritious meals and snacks, and special needs children are meant to be accommodated.
Was Elijah given epinephrine at the preschool?
It doesn’t appear so, but this is not entirely clear. “We carried this emergency pack that would have Benadry, that would have Tylenol, that would have his EpiPen,” Elijah’s father, Thomas Silvera, said in an interview with ABC’s Good Morning America. What hasn’t been discussed yet, and Silvera declined our interview request as the family grieves, was whether Elijah had his pack at pre-kindergarten that day.
Like his dad, Elijah also had asthma, so the family was quite aware of asthma medications. It is not clear when or if epinephrine was used, only that the child could not be saved once he got to the hospital.
What investigations are under way? And what has happened at the preschool itself?
In terms of Elijah’s death, New York City Office of Chief Medical Examiner told Time magazine that the official investigation is still underway. “An official cause of death is not expected for about a week,” it told Time on November 14.
The DOHMH shut the Seventh Avenue Center indefinitely in order to investigate the circumstances of Elijah’s reaction, including a failure to follow the center’s written allergy safety plan and failure to adequately supervise a child. Other families are having to find alternate care accommodations.
“There is nothing more important than the safety of our children and we are deeply saddened by this tragedy,” said the health department in a statement. A spokesperson for Food Allergy Research and Education (FARE) says the non-profit has reached out with an offer to provide food allergy and anaphylaxis training to city daycare personnel.
There has been no announcement as to whether any workers at Elijah’s preschool have been suspended or are specifically under investigation. While the Seventh Avenue Center has been berated over the tragedy on social media, it had no violations on record.
It is a difficult time for parents and child-care agencies in New York City. The DOHMH says it has closed a second Harlem center as the department and the ACS investigate a separate child’s death there, unrelated to food allergies.
What specific steps are being taken to ensure children’s safety as the Seventh Avenue Center investigation continues?
The ACS has taken to Twitter to tweet out some of its actions in the wake of Elijah’s passing.
Actions taken include: 1) Closing center at issue; 2) Issuing clear guidelines on food allergies to centers; 3) new City requirement that EL & pre-k providers to implement specific health & safety plan when children have medical emergency
— NYC ACS (@ACSNYC) November 13, 2017
The “clear guidelines on food allergies to centers” referenced in the tweet and at the joint press conference were sent as a letter to all the child-care centers under the ACS’s supervision. According to WNYC, the guidelines remind these centers “that every child with a food allergy should have an individual written care plan with details on prevention and treatment.”
What’s next for the family?
Thomas and his wife Dina Silvera have been very thankful for the outpouring of support of the family’s GoFundMe page, where $58,000 has been raised for funeral expenses, financial support and an independent autopsy. They also are speaking to a lawyer.
The Silveras say they will not rest until more is done to protect young kids with severe allergies at school. “As Elijah’s parents, we will use our voices to draw attention to completely preventable life-threatening allergic reactions in U.S. daycares and schools. These preventable tragedies must come to an end.”