Riley Brown's cause of death was anaphylaxis due to peanut allergy, a post-mortem says. Photo / Supplied
By Sam Sherwood of RNZ
A post-mortem has confirmed a young man who died after suffering what he thought was an allergic reaction at a mental health respite facility had eaten a meal that contained trace amounts of peanut.
The pathologist found the man’s cause of death was anaphylaxis due to peanut allergy.
The man’s mother says she’s “horrified”, calling her son’s death a “senseless waste of a life”.
RNZ earlier revealed a review was under way into the death of Riley Brown, who was a patient at the facility in Nelson run by Pathways, a provider contracted by Health New Zealand.
Brown’s mother, Paula Brown, earlier said the 24-year-old, who had a nut allergy, believed he was having an allergic reaction before he died on June 1.
On Thursday, Brown received a copy of the post-mortem and toxicology reports from the coroner’s office.
The post-mortem, completed by pathologist Dr Mark Houghton, said at 7.20pm on June 1, the ambulance received a “non-urgent” job for Brown having a severe allergic reaction at the facility.
The ambulance summary said Brown walked to the ambulance saying he couldn’t breathe. He died at 8.15pm.
A toxicology report revealed traces of a peanut allergen – 594.9 parts per million.
“The levels we have reported exceed both the applicable regulatory thresholds and the typical concentrations expected in products labelled as free from peanut allergens.
“However, we are unable to assess the potential clinical effects of exposure at these levels, as the manifestation of allergic reactions can vary significantly between individuals depending on a range of factors and conditions.”
Results also revealed a serum tryptase level of 32.3 micrograms per litre.
Houghton said in his report that the documented history of peanut allergy was confirmed on hospital records, adding that the elevated tryptase level was “in keeping with anaphylaxis”.
“Investigation of the gastric contents has confirmed the presence of peanut allergen and investigations indicate an ingredient in the consumed meal contained trace amounts of peanut.”
Houghton said there was no evidence of drug or medication toxicity.
He said there was the presence of several medications including propranolol, a beta-blocker.
The medication had been reported to block or limit the effects of adrenaline as a treatment for acute anaphylaxis.
“In this case, intramuscular adrenaline was delivered rapidly and appropriately with limited clinical effect.”
Houghton said the cause of death was anaphylaxis due to peanut allergy and noted the presence of propranolol.
Brown told RNZ on Thursday she had a “gut feeling” that her son’s meal had contained nuts, despite earlier being told there were no nuts in the food eaten.
She was “horrified” when she read the reports.
“I just think it’s a senseless waste of a life … I want them to be made accountable for this, to take accountability.”
Brown said four months on from her son’s death she was “struggling to get on with life”.
“Riley was my life,” she said.
“It’s taken Riley’s life and has destroyed mine.”
Brown earlier told RNZ her son got in touch with the Mental Health Crisis team in Nelson a week before he died.
“He had been acting out of character, which had been noticed by family and friends.”
He stayed at the respite facility for one night, but wanted to go to Christchurch and see his friends.
“We kept in touch with the Mental Health team in Christchurch while he was there but he was keen to reconnect with the Nelson team when he returned.”
On May 31, Riley Brown went to the respite facility in Nelson and stayed for the night. The team phoned Paula Brown the following day to say he was doing well, wanted the help on offer and was happy.
Paula Brown understood her son had dinner that evening at the facility and two hours later felt unwell.
“From what I’ve been told, Riley thought he had eaten nuts and thought he was having an allergic reaction.”
An ambulance was called and Riley Brown was well enough to walk into the ambulance.
“While being attended to in the ambulance and transferring to hospital, it is thought at this stage that Riley went into cardiac arrest,” Paula Brown said.
Health New Zealand regional lead mental health and addiction Vicki Dent said on Thursday they extended their “deepest sympathies and heartfelt condolences” to Brown’s family.
“The coronial process is ongoing so we’re unable to provide additional information at this time.
“Health NZ and our providers take all adverse events seriously and a review of the care provided is under way. We are committed to implementing any recommended changes to ensure we and our providers are providing safe, high-quality care for the community.”
Mental Health Minister Matt Doocey said his thoughts were with Brown’s family.
“The loss of a child is every parent’s worst nightmare.
“I am assured that a review is under way into the care Riley received, as is absolutely appropriate. I expect that anyone under the care of New Zealand’s mental health services is provided with safe, high-quality care, and the review must examine whether that standard was met.”
– RNZ