The Boston Globe reports that last week, a Natick, Massachusetts family filed suit in Middlesex Superior Court against Panera and a group of Panera franchises.

The suit alleges that the mother, Elissa Russo, used Panera’s on-line system to order a grilled cheese sandwich for her 6 year old daughter with a peanut allergy. In the order, Ms Russo noted in two separate locations that her daughter had a severe peanut allergy.

The father, John Russo, had just arrived home when the parents discovered that the sandwich their daughter had just bitten into contained a large dollop of peanut butter. As the mother frantically called the pediatrician, the girl repeatedly asked, “Am I going to Die?”

The doctor, noting that there were as yet no symptoms, told the mother to give her Benadryl. Later, when the daughter began vomiting, the pediatrician urged the parents to rush the girl to the emergency room. Later that evening, when the daughter was about to be discharged, she developed hives all over her body and was administered epinephrine. She was kept overnight and discharged the next morning.

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The manager of the Panera later apologized to Mr Russo, claiming the incident was caused by a “language issue”.

After learning of another similar incident that occurred a month later alleging that a child had ingested peanut butter from a nearby Panera in Wayland owned by the same Franchisee, the Russo family filed suit. The second incident was alleged in a post on the No Nuts Moms Group.

When contacted by the Globe, Mitchell Roberts, operating partner of the group that owns the franchises claimed he was unaware of the lawsuit and said: “They’re saying there were two different cases at two different restaurants of ours where someone ordered a grilled cheese sandwich and said they had a peanut allergy and they were served grilled cheese sandwiches with peanut butter in them?” Roberts asked. “That doesn’t sound feasible.”

Laurel Francoeur, the co-counsel that represents the Russo family, stated that the operating group should have known about the suit because Francoeur sent letters via certified mail describing both incidents to Panera’s corporate office as well as to Roberts and his partner, David Peterman, president of PR Management, the company that manages the franchisee’s outlets.

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Panera includes the following disclaimer on their website: “Please note that we cannot guarantee that any of our menu items are free of allergens because we use shared equipment and handle common allergens throughout our supply chain and bakery-cafe.”

Mary Vargas, co-counsel for the Russo family, asserts: “This isn’t a cross contamination case,” involving accidental exposure to trace amounts of peanut dust. “There was a lot of peanut butter on this sandwich.”

The incident brings up three issues that are worth discussing with your allergist. The first is what to do in case of accidental ingestion of an allergen by a severely allergic individual before symptoms are present. Details should be included in an emergency action plan developed with a medical professional and always readily available so there is no question how to proceed in such an instance.

The second is whether to avoid eateries that are known to serve dishes containing your family’s allergen of concern. Know that there is always a possibility of cross-contact that depends not only on the diligence of the wait staff but also the training of the kitchen personnel, the layout of the kitchen and the protocols in place to prevent such issues.

Last, but not least, always be aware of the possibility of a biphasic reaction where the initial symptoms of a severe reaction seem to abate only to have a second reaction occur minutes or hours later.