People with severe allergies may need 2nd EpiPen: coroner

One EpiPenmight not be enough to save people with severe allergies, a coroner warned after a doctor was stung by a wasp while golfing and died despite a shot of epinephrine.

Anallergy expert who studied the case added the warningthat an out-of-datedose of epinephrine might be "not much better than water."

Quebec coroner Jacques Ramsay issued his warning on Thursday as he released his inquest's final report into the death of Dr. Pierre Drolet, 61, who diedin July 2003 in Magog, Que.

People with severe allergies generally carry an EpiPen, a pen-like disposable needle that lets them inject themselves with an emergency dose ofthe hormone epinephrine to head off potentially life-threatening reactions. The reactions can be caused by contact with certain foods, medications, insect venom or latex.

Drolet had an EpiPen and used the one shot of epinephrine, but still died before paramedics could reach him.

'A person may need another injection'

Ramsay said Thursday that a second shot could have saved Drolet's life.

"In a third of cases similar to Monsieur Drolet, we know that one injection will not be enough, and a person may need another injection," Ramsay said.

"Therefore, I think it would be very wise [for people with severe allergies] to carry with them two injections rather than one."

Ramsay said there were other factors in Drolet's death.

He said the ambulance took too long to reach Drolet, who was alsotaking heart medication that interfered with the epinephrine.

Dose loses potency fast, expert warns

Dr. Christine McCuster, an allergy expert at Montreal's Children's Hospital, said another factor needs to be considered.

McCuster told CBC News on Thursday that Drolet's epinephrine dose had passed its expiry date.

"Studies have shown that within a month of the date of expiry, the epinephrine loses so much of its potency as to be not much better than water," she said.

"So, rather than carrying two epinephrine shots that are expired, it would be better to carry one that is current."

McCusteragreed with the coroner that carrying a second dose could be crucial incertain situations.

"In very severely allergic individuals, or individuals who have a very big contact with the allergen involved, epinephrine may only control symptoms for a maximum of 20 minutes."

She pointed out that there are situations when medical help may not be available in that length of time and the second dose would be needed.

Always check expiry date

McCuster stressed the need for people who use EpiPens to be aware of the expiry date.

She said the injectors generally have an expiry date of about two years after they leave the company where they are made.

But they may then sitfor a long time on a pharmacy shelf so consumers should alwayscheck the expiry date before buying, McCuster warned.