Testimony in Support of HB 200 Epinephrine auto injectors-stored for emergency use Before the House Health and Aging Committee Oct 7, 2015 Respectfully submitted by: Elizabeth D. Muckley, O.D., F.A.A.O. Director of Optometric Services NE Ohio Eye Surgeons Kent, Ohio [email protected] Representative Gonzales and Committee Members, Thank you for allowing me the opportunity to present written testimony in support of HB 200. I am at the Academy of Optometry Annual Meeting in New Orleans this week and apologize I cannot be there in person today. Many of you have met me through the Ohio Optometric Association, where I have served for 4 years on the Board of Trustees and as past Legislative Chair. Today I come to you not as an optometrist, but as a mother of a 10 year old boy that has lived with a severe allergy to peanuts most of his life. I want to thank Rep. Hagan for bringing forth this important piece of legislation. I have known and cared for members of her family for many years , and appreciate her service to our community. A year ago, you passed an emergency epinephrine access bill so schools could buy and keep undesignated epinephrine auto-injectors in stock to be used in case of an emergency allergic reaction at school. Already, 2 children in the Akron public schools were saved this past April because of your action. HB 200 goes further by expanding undesignated emergency epinephrine access to restaurants, daycares, sports facilities, and other public places, should they choose to participate. This is much like having a defibrillator on site in case of an emergency cardiac event. Many places now have this life saving tool easily accessible should it be needed. Similarly, the auto-injector would be part of a first aid kit. A new epipen auto-injector when opened, called the Auvi-Q talks you through what to do in case you have an allergic reaction. This is fantastic because you do not need any special training to use it. The automated, voice-activated device instructs you on administration, much like the defibrillators. The Ohio Good Samaritan Law already protects individuals from repercussion of administering life saving medications or treatment in case of an emergency. Training is not an issue. Many children as well as adults may not realize they have food or insect allergies until they ingest the offender or get stung. Until you have a severe reaction, you wouldn’t carry an epipen. The epipen is only prescribed once a reaction occurs. The first time reaction can be in a public place. Anaphylaxis, a severe, life threatening allergic reaction typically occurs with foods or venom. It is not like being allergic to pollen or dust. Within minutes, you break out into severe hives. Your tongue and lips swell, followed by your airways starting to close. It happens so fast that you have only minutes to react. Many of you may have heard of the recent passing of a veteran Ohio dental lobbyist, Darryl Dever last month. He accidentally stepped on a bee hive golfing, and suffered over 2 dozen stings. He immediately went into anaphylaxis and passed. What if there would have been stocked epinephrine at that golf course? It may have bought him time for EMS to arrive and help. My son Max, tested positive for the marker for anaphylaxis to peanut protein when he was 4 years old. We are vigilant and read every ingredient prior to eating. The auto injector must be present or he is not allowed to eat. There were a few times we accidentally left the house without it. Max could not have anything to eat or we would come back home to retrieve it. How great it would have been to know a restaurant had a back up injector already there. What if we had not realized we were without the epipen and something accidentally happened? Even cross- contamination of a knife used in a jar of peanut butter, then dipped into a jar of jelly now makes that jar of jelly unsafe for my son. What if no one realized someone contaminated the jar and Max was served that jelly on a piece of toast with regular butter? Even though the jelly itself contained no peanuts, the cross contamination would have caused him to react, and possibly die. Even reading ingredients may not be enough. That epipen is the only life line my son has. We currently provide the school and day care with one. Prior to last year’s law passing, I always gave permission to our school nurse to use Max’s epipen on any student in case there was an unknown, 1st time allergic reaction at school. HB 200 now goes further allowing other public entities to choose to stock one. If I were a restaurant owner, I would want to have one on hand to reduce my liability in case of an unforeseen reaction or mistake by a chef. I too stock an epipen in my optometric office because we administer dilation drops and fluorescein dye that can trigger reactions. It would be no different for any other public place. HB 200 is budget neutral. There is no financial implication to this bill. The public is protected under Good Samaritan laws, and this bill does not mandate any business to provide an epipen. It only allows them to do so if they choose. If anything, this bill increases awareness of life threatening allergies in the community. My son was one of the first children in our rural school to have a food allergy. Over the years, this has unfortunately changed because 1 in 8 children now have a severe food allergy. Prior to him starting kindergarten, there was no food allergy policy in our district despite national and state recommendations for food allergy awareness in the classroom. This law would make other business owners aware of risk of severe allergic reactions and validate anaphylaxis as a true emergency. Thank you for taking the time to read my testimony. I appreciate the opportunity to tell you more about severe allergic reactions. We don’t know why more people are acquiring risk of anaphylaxis, but we can make epinephrine more accessible in case of an unforeseen emergency. I urge you to pass this out of committee so the House can vote yes to HB 200. Respectfully, Elizabeth D. Muckley, O.D., F.A.A.O.