Bruce Kelly avoided peanuts all his life because of allergies. But, with so many foods now containing nut warning labels, the 22-year-old Ramsey man had found he could eat many labeled foods without a reaction.
On Monday, chocolate packaged with that warning killed Kelly, even though he had already eaten several chocolates from the same package with no adverse effects.
"Nearly every chocolate bar you buy has the peanut warning on it," Kelly's father, Brian, said Thursday. "It's like crying wolf too many times." But Bruce and his twin brother, who also has a peanut allergy, had never had a reaction to such foods.
"But no more ignoring labels just because it didn't bother them before," said Brian Kelly, who wants to protect his surviving son, Ryan, from the same fate.
"There's not going to be any more of that at my house," he said, his voice cracking with grief. "That's about all I can do. But I can't stop everything he's going to eat, because he's 22."
As many as 15 million Americans have food allergies, according to the Food Allergy Research & Education organization, based in Virginia. Every year, 200,000 visits are made to U.S. emergency rooms because of food allergy reactions, said Martha Hartz, a doctor of pediatric allergy and immunology at the Mayo Clinic.
But deaths from allergies are rare in the United States — 150 to 200 a year, she said.
"Peanuts are the most common cause of fatal food anaphylaxis," Hartz said. "Probably because [peanuts are so] common. It's in foods that kids eat. There are more patients with egg and milk allergies, but they often outgrow it. And with peanuts, people can react to a small amount, and they don't often outgrow it."
The number of people allergic to peanuts has tripled since 1997, Hartz said.
There's no cure for food allergies. The mainstay recommendation is to avoid food allergens and to keep a peanut-free house if someone is allergic, Hartz said. In addition, she said, those at risk should always have two epinephrine injectors, such as an EpiPen, on hand. One injection will stop the reaction immediately, she said, adding that it's temporary and a second injection might be necessary before the patient arrives at the hospital.
"It saves lives," Hartz said.
Some people give victims Benadryl to try to stop allergic reactions. Hartz's advice: Don't, "because it could take 40 minutes for Benadryl to work." If it appears to have worked in the past, the allergic reaction was probably mild enough to have cleared up on its own, she said.
Fatal reactions can occur when an allergy hasn't been diagnosed, when a teenager or young adult who has been prescribed epinephrine doesn't have it, or when there's a delay in administering the epinephrine, Hartz said.
Minutes are precious, she said. "Nothing bad will happen if you give it too soon," she said. Patients who have asthma — like Bruce Kelly — are at especially high risk for severe reactions, Hartz said.
'It was just panic'
Last Friday, Bruce Kelly ate a piece of chocolate from a candy box with a warning label at his mother's home in Ramsey. Beth Kelly said her son had no adverse reaction to the chocolate on Friday.
The Kelly twins, whose peanut allergies were diagnosed when they were 10 months old, were diligent about avoiding foods with actual peanuts because they knew they could be deadly. Over their lifetimes, they had suffered a few allergic reactions after accidentally eating foods with peanuts, such as a cookie at a friend's home. But Bruce Kelly recovered each of those times without having to go to the hospital, their parents said.
So when her son had no adverse reaction to the chocolate he ate on Friday, he had another piece from the same box on Saturday. Again, he didn't have an allergic reaction to it.
When he arrived at her home Monday, he was hungry and grabbed three or four pieces of chocolate from the same box. He was fine when he left his mother's home one to two hours later and headed to his father's house about 20 minutes away in Coon Rapids, she said.
He took the box of chocolates with him.
Bruce Kelly had no phone with him, so no one knew he was suffering a reaction. When he arrived at his father's house, he vomited and asked his brother, Ryan, for an inhaler because he was having trouble breathing, Brian Kelly said.
Within two minutes, Ryan yelled to his father for help. They called 911. "In those moments, it was just panic. Pure panic," Brian Kelly said.
Bruce lay unconscious on the floor, his neck swollen, his lips purple, his face blue.
Brian Kelly knew immediately that his son was suffering an allergic reaction and ordered Ryan to get the EpiPen while he did chest compressions. Within minutes, emergency workers arrived.
At the hospital, the family prayed and hoped for the best. But eventually, they were told: "There's nothing more we can do," Beth recalled. "I can't imagine life without my son."