A teenager who died shortly after enjoying an anniversary meal at Wagamama with her boyfriend died from a chronic asthma attack, a coroner ruled today.
The court heard how Alice Brooks, 19, suffered from a nut allergy and traces of peanut protein were found in the tofu at the high-street restaurant.
However, this was ruled out as the cause of death by coroner Dr Sean Cummings – whose verdict stated Alice died from natural causes.
Dr Cummings said: "This has been a tragic case.
"Alice Elizabeth Brooks died at Saint Thomas Hospital on November 28, 2014.
"She was identified in childhood as suffering from a number of allergies and also asthma.
"I heard clear evidence that Alice was most diligent about specifying her allergic status, checking for allergens in food and avoiding them.
"There was evidence that Alice had used a large number of blue ‘reliever’ inhalers in the year of her death.
"I also heard clear evidence from Michael Jefferies that when in his presence Alice would use purple preventer inhaler very rarely."
The coroner laid out the events surrounding the passing of Miss Brooks.
He said: "Alice and her boyfriend Michael Jefferies intended to spend the day together on November 25, 2014 to celebrate the 10th anniversary of their relationship.
"They first of all visited a cafe for breakfast, where they had something small to eat.
"Then they went to a tattoo parlour where Alice wanted to get her tattoo recoloured.
"Alice was identified as being allergic to nuts and to latex.
"The parlour was informed of this and consequently used non latex gloves during the job."
West London Coroner’s Court then heard how the couple made their way to a west London Wagamama restaurant for some lunch.
Dr Cummings said: "At 1.15 pm Alice and Michael went to Wagamama in Uxbridge.
"They drove there and parked on floor four of the Chimes carpark.
"Michael described that Alice was particular about checking for allergens.
"He said in his statement and in evidence that Alice checked the allergy symbols at the bottom of the menu.
"They informed the manager of Alice’s nut allergy and ordered nut-free meals. Michael also ordered nut-free food.
"The manager confirmed this and requested the chef take extra steps to ensure there was no contact with nuts, he then cleaned the surfaces in the kitchen.
"They then did some Christmas shopping, where they visited Wilkinsons.
"It was at this point that Michael said Alice began to feel unwell and needed to use her blue reliever inhaler.
"They made their way back to the car park. Michael could not drive and Alice sat in the drivers seat.
"Alice’s condition became worse and she took out her EpiPen, but before she could use it she passed out.
"Michael injected the EpiPen into her right thigh. On questioning he said that Alex had been specific about the site of injection.
"He then took her out of the car and left her between two parked cars and called an ambulance.
"A paramedic arrived and realised that Alice was in respiratory arrest and she then deteriorated to cardiac arrest one minutes later.
"At 3.53 pm the second and third emergency vehicles arrived they were too large to gain entry to the car park.
"The history of possible anaphylaxis and asthma was shared with the ambulance staff.
"CPR treatment was administered for asthma and anaphylaxis.
"Adrenaline was given many times during the resuscitative effort.
"Alice was removed to Hillingdon hospital she was extremely critically unwell."
The court heard how a doctor’s preferred diagnosis was bronchospasm asthma.
Dr Cummings said: "Part of the reason that was given was that Alice’s airway showed no evidence of swelling.
"Alice was then recovered to Saint Thomas Hospital for the ECMO.
"I heard evidence from Dr Runa Ali, consultant allergist.
"She gave it as her opinion that this tragic case resulted from asthma developing as a result of an accumulation of a long history of uncontrolled asthma.
"She made this judgement partly as a result of there being 19 reliever inhalers issued to Alice in the past year, and only two purple preventer inhailers.
"Dr Ali said that unfortunately asthmatics can die suddenly, without warning from long-term uncontrolled asthma."
A policeman who was first on the scene visited the restaurant and found no signs of malpractice.
Dr Cumming said: "I heard from DS Hine – he was the first police officer on the scene.
"He was clear that on questioning staff at Wagamama they were clear about the approach to allergic customers.
"There was a clear and well understood procedure for managing these."
Miss Brooks died in hospital three days later after suffering brain damage from the attack.
Dr Cumming added: "I heard from both Dr Heath consultant pathologist and Professor Lucas consultant pathologist.
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"While disagreeing over minor matters they were both of the view that the evidence pointed overwhelmingly towards asthma as being the primary calls and not allergy.
"Alice Brooks was a young woman with dangerous asthma which was not well-controlled.
"She relied, as many people do, on use of her blue reliever inhaler and did not reliably use her preventer inhaler.
"Alice had also been identified with a number of food allergies including nuts.
"Death resulted from the consequences of an acute on chronic asthma attack.
"Alice Elizabeth Brooks died as a result of natural causes."
A spokesperson for wagamama said: “The coroner’s verdict on the tragic death of Alice Brooks was that she died from acute on chronic asthma.
"This brings to an end a devastating series of events her family have had to endure for nearly four years.
"It is hard for anyone, other than them, to fully understand how they have lived with the loss of such a beautiful daughter, sister and friend. We send our sincere condolences and best wishes to all her loved ones, in particular her proud and loving mum.”
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