Picture this: you’re a pediatric emergency medicine doctor with years of experience. You’ve handled crises, trained teams, and saved lives. And yet, mid-flight from Frankfurt, Germany to New York on Singapore Airlines, you take a few bites of an airline meal that was supposed to be free of shrimp – and suddenly everything spirals out of control.
That’s what Dr. Doreen Benary of Manhattan says happened to her. The plane didn’t land at JFK International Airport as planned. Instead, the pilot diverted to Paris because Benary was in full-blown anaphylaxis.
Her lawsuit, filed recently, describes that she became “violently ill” and required emergency care at two separate Paris hospitals after the rerouted landing. All because a meal containing her allergen – shrimp – made it onto her tray.
Benary boarded the flight as a seasoned physician. She was taken off the flight as a critically ill patient. Her experience is a cautionary tale about airlines’ food allergy protocols and the allergy risks with in-flight meals. And it’s more.
This is also a legal test case that could influence how airlines are held accountable if an error on the part of airline staff triggers a severe medical condition.
Benary’s lawsuit accuses Singapore Airlines of gross negligence and failure to accommodate her medical needs. The case cites the Montreal Convention, a treaty that allows passengers to sue for injury or death during international travel.
In-Flight Reaction to Shrimp Severe
According to the complaint, on October 8, 2024, Benary boarded the New York-bound flight as a business class passenger. It says she informed at least one member of the cabin crew upon boarding that she had an allergy to shrimp. The crew had actual notice. Yet, despite this, a meal that included shrimp was served to her. Unaware of this, Benary began eating, then thought she tasted shrimp.
The lawsuit says the doctor questioned the flight attendant “who admitted that she had made an error and apologized” for serving the wrong food.
Almost immediately, Benary began to react, and her condition rapidly worsened. The lawsuit describes that her symptoms became severe enough that the pilot diverted the flight to Paris for emergency medical care. Upon landing, Benary was transported by ambulance and received emergency care at two different medical facilities.
I reached out to Singapore Airlines about this incident, and their spokesperson said they are “unable to comment on matters before the court.”
Benary’s lawsuit, filed in the U.S. District Court of Eastern New York, says the “negligence, carelessness, and recklessness” of the airline and its staff led to the severe allergic reaction. Since Benary informed a crew member of her allergy, it says the attendant “had a duty of care” to ensure her meal was safe.
Under the Montreal Convention, experts say “an accident” during air travel is defined as “an unusual or unexpected event external to the passenger.” So having a heart attack is unlikely to be deemed the airline’s fault. However, could an error with food service count when it causes a severe allergic reaction?
Benary’s attorney Abraham Bohrer takes the view in the lawsuit that it does. As Singapore Airlines isn’t commenting, we do not know their view of this stance.
Airline Meals: No Labels Required
Bohrer also details his client’s trauma: severe pain, emotional distress, and the lingering impact of a medical crisis that was preventable.
I asked Benary to comment on her case, but she has yet to reply. I can, however, imagine how terrifying the experience would have been.
Too many people, often including healthcare providers, still don’t realize that airlines in general are ill-equipped to manage severe allergic reactions. As of 2025, many carriers still do not carry easy-to-use epinephrine, such as auto-injectors or nasal sprays, in their Emergency Medical Kits. In the United States, only vials of epinephrine are required, and these are under an exemption from the Federal Aviation Administration (FAA).
These are not niche medications; they are frontline, lifesaving tools. The food allergy epidemic is growing globally. So, the absence of these devices at 30,000 feet isn’t just inconvenient, it’s downright dangerous.
At Allergic Living, we’ve reported on the gaps in airline food safety. In the U.S., there is no legal requirement for airline caterers to label in-flight restaurant-style meals. The FDA may encourage transparency, but there is no obligation for airlines to provide full ingredient lists.
Imagine an allergy passenger presented with a neatly printed ingredients list on a meal. Most would reasonably assume that list meets the same labeling standards as packaged grocery foods. But it doesn’t. And that gap in understanding could lead to a preventable anaphylaxis tragedy.
Cross-contact issues only add to the reaction risks. Meals are usually prepped in large catering kitchens, cooked in shared ovens, and often plated with shared utensils.
In-Flight Reactions and Epinephrine
What we don’t know yet is whether Dr. Benary used her own auto-injectors. What I do know from my research is that Singapore Airlines carries a single epinephrine auto-injector onboard, along with four vials of epinephrine. That is a start, but it is far from sufficient.
Vials take time to prepare and must be administered by a trained medical professional. That is a risky bet, counting on a doctor being on every flight. Even with an auto-injector, one dose may not be enough to stop a severe reaction.
At 30,000 feet, the safest solution is prevention: strong, clear protocols that stop allergic reactions from happening in the first place.
When I reached out directly to Singapore Airlines for a previous article, they told me their crews are trained to monitor allergic emergencies and assist if the passenger has brought their own medication. In case of crisis, they can page a doctor onboard or contact their ground medical service provider for advice.
Let’s be clear: even if an airline has an epinephrine device available, the burden still falls squarely on the passenger. You bring your own meds. You alert the crew. You hope someone on board can help.
A global study conducted by Northwestern University’s Center for Food Allergy and Asthma Research found that 8.5 percent of the 4,704 people with food allergies surveyed had experienced an in-flight reaction. Of those with reactions, 43 percent did not inform the crew of their medical distress.
The study’s authors noted that many respondents who experienced in-flight allergic reactions also didn’t alert the airline after landing. This has likely led to what they called ‘systematic under-documentation‘ of these medical emergencies. And that means more airlines and passengers aren’t hearing the message: anaphylaxis in the skies is serious, growing and urgently needs to be addressed.
What We Need for Allergies in the Skies
We need at least two auto-injectors or epinephrine nasal sprays in every Emergency Medical Kit, globally. These devices are fast, effective, and require no specialized training to administer.
We need mandatory, industry-wide crew training, not just so staff can recognize anaphylaxis, but so they can respond swiftly and correctly. This isn’t just about known allergies; many reactions happen for the first time in-flight.
And we need global airlines consistency. A patchwork of vague “can’t guarantee” disclaimers and optional accommodations is not enough. Food allergy safety must be standardized, enforced, and treated as seriously as other in-flight medical risks.
In her profile for NYU Langone Health, Dr. Doreen Benary writes that she loves teaching the next generation of physicians and aims to inspire a culture of empathy in medicine. Her work in simulation training allows her to prepare others for medical emergencies, realistic, high-pressure scenarios meant to save lives.
But on that flight, the emergency medicine expert found herself trapped in a simulation she couldn’t control. One no patient, and no doctor, should ever have to live through. This time, she wasn’t guiding the training. She was surviving it.
And that should rattle all of us.
Lianne Mandelbaum is Allergic Living’s airlines correspondent, and the founder of NoNutTraveler.com.
Related Reading:
The Trouble with Airline Meals and Food Allergies
Anaphylaxis Over Ocean: MD Finds No Epinephrine Vial in Plane’s Kit
