He got through a few bites. Then, his lips tingled. His stomach churned. After leaving the restaurant, he collapsed near the London Eye less than an hour later, the BBC reported. He later died in a hospital.

The 2017 incident sparked sadness and outrage among Carey’s family members, who searched for answers about how his death could have happened.

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On Friday, they received an answer at the Southwark Coroner’s Court.

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Carey died of severe, food-induced anaphylaxis, “despite making staff aware of his allergies,” wrote coroner Briony Ballard in a statement read aloud in court, the British Press Association reported.

“The menu was reassuring in that it made no reference to any marinade or potential allergenic ingredient in the food selected,” and Carey “was not informed that there were allergens in the order,” Ballard wrote.

“Owen was the shining light in our family, and his death should not have happened,” his sister Emma Carey said outside court.

Carey family members said Carey’s death, and the inquest revelation, should prompt new laws that make allergen labeling in restaurants more prominent and detailed. Discussions with staff in noisy restaurants with young staff members do not suffice, they said.

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“This leaves far too much room for error on an issue we know far too well can cost lives,” Emma Carey said.

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Byron chief executive Simon Wilkinson said in a statement after the inquest that his restaurants “have robust procedures” to deal with patrons with allergies but did not defend the circumstances that led to Carey’s death.

“It is a matter of great regret and sadness that our high standards of communicating with our customers were not met during Owen’s visit,” Wilkinson said Friday.

Clodagh Bradley, an attorney for the family, said during the inquest that the menu’s allergy information was printed “at the very bottom, in a really very small font, in black print, on a royal blue background,” the BBC reported.

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In a response to the BBC, Byron representative Aimee Leitner-Hopps said, “It’s perfectly legible in my opinion,” and “the expectation is that a customer with an allergy should inform us.” The corner said Carey did, in fact, inform the staff about his allergy.

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Byron’s online menu now makes reference to the buttermilk marinade for chicken and includes information about allergens.

It also includes a disclaimer.

“We’ll do our very best to accommodate you but we cannot guarantee that our kitchens or our suppliers are 100% allergen-free,” the menu reads. Twice.