Standing With “Doctor Mike,” The Well-Known NY Physician Who Just Saved A Passenger From A Food Allergy Attack On A Delta Flight –That Had No EpiPen On Board— Schumer Rallies For Airlines & FAA To Immediately Stock EpiPens
Since 1986, U.S. Commercial Planes Have Been Required To Carry Emergency Medical Kits (EMKs) On Board; But Since 2001, The Airlines Routinely Sought Exemptions Of EpiPens; We Are In Midst Of A Four-Year Exemption Right Now
Schumer: Airlines & FAA Need A Shot In The Arm When It Comes To Adding EpiPens To Emergency Med Kits On Board Flights
Standing with the New York physician who recently saved the life of a passenger experiencing a serious food allergy attack aboard a Delta flight–that had no EpiPens on board—U.S. Senator Charles Schumer revealed, today, that airlines, via the airline ‘lobby,’ have successfully sought a Federal Aviation Administration (FAA) exemption requiring Epinephrine and auto-injectors known as EpiPens, as well as other life-saving drugs aboard planes since as early as 2001, with a four-year exemption that began in 2016. Schumer, today, demanded that these U.S. airlines and the FAA immediately reverse course on the exemption policy and require epinephrine and EpiPens on planes in the standard Emergency Medical Kits already on each U.S. flight.
“If the status quo continues, the airlines will not have to stock Epinephrine or EpiPens on planes until 2020 at the soonest, and that simply cannot fly,” said U.S. Senator Charles Schumer. “We are in the midst of a food allergy uptick that, for one reason or another, is making more and more people susceptible to attacks and reactions that can lead to death. We owe it to the traveling public to adjust the policy of the FAA and the exemption sought by the airlines if we are going to ensure public health, especially the health of children, many of whom might not learn of their allergy until aboard a plane where auto-injectable Epinephrine could be a true lifesaver.”
Schumer’s call for Epinephrine and EpiPens to be included in all emergency medical kits comes after a passenger on a Delta flight from New York City to Tel Aviv went into anaphylactic shock two hours into the trip. With no EpiPen on board, Dr. Mikhail Varshavski, another passenger on the flight, had to perform a life-saving procedure with a manual syringe. The syringe approach is complicated to get the correct dose of epinephrine, and it requires extensive medical training to administer effectively and safely, without contamination or accidental intravenous injection. Moreover, this current EMK version of the drug is not the right dosage for an allergy attack. Rather, it is used for a heart attack. Only the dosage of an Epinephrine auto-injector fits a food allergy attack. In the Delta case, ‘Dr. Mike’ had to manipulate the EMK dosage in a risky setting to save the patient’s life. But in Dr. Mike’s and the patients circumstance, Delta at least had a version of Epinephrine, which is an exemption successfully sought by the other airlines.
According to a June 2019 scientific study in the Journal of Allergy and Clinical Immunology, equipping all commercial aircraft with auto-injectors (EpiPens) would cost the airlines about $2 million dollars a year, or about 8 cents per passenger. As a continuing trend, domestic airlines continue to rake in billions in profits. Schumer says airlines can both afford to stock EpiPens and that they should as a matter of ensuring public health. Airlines have cited drug shortages in their pleas to seek drug exemptions from the FAA, a variable Schumer says should not sustain as a years-on-end excuse. Other drugs the airlines have sought to exclude from EMKs include Atropine, Dextrose and Lidocaine, amongst others. The airlines use their lobbying arm to push through these exemptions. These organizations include: the Airlines for America, the National Air Carrier Association and the Regional Airline Association.
Commercial planes are required to store a First Aid Kit and Emergency Medical Kit (EMK) onboard, but this does not include EpiPens nor the right pre-filled dosage of Epinephrine for a food allergy attack, which are needed by over 3.6 million Americans for allergic emergencies. Instead, the FAA only mandates that syringes, needles, and other more standard medical supplies be a part of the kits’ contents. The “do-it-yourself” syringe alternative Dr. Mike encountered on the Delta flight can be dangerous, too: the multi-step method is difficult to perform under the intense time-constrained pressure of an allergic reaction. First, you must draw up the correct amount of Epinephrine from a vial using a syringe, and then you have to switch needles and administer the medication into the allergy victim intramuscularly—the EpiPen does this all itself, with the right dosage and version on the drug.
“To keep the traveling public safe in the air, the FAA must update their medical standards and enhance outdated regulations by mandating Epinephrine and EpiPens onboard all flights. Most planes are ill-equipped to deal with allergic reactions, and as a result, flight attendants often defer to doctors or medical professionals on board to quickly manage situations that arise while in the air, and that is why Dr. Mike stepped in,” Schumer added.
Both air travel and allergy prevalence have been growing in recent years. On average, the FAA handles over 44,000 flights a day and over 16,000,000 flights a year, with these numbers only estimated to grow in coming years. About 32 million Americans have food allergies and one in six people report suffering anaphylaxis each year, a life-threatening allergic reaction that could result in the closing of one’s airways. Each year, 200,000 people in the U.S. require emergency medical care for allergic reactions to food and the number of medical procedures to treat anaphylaxis increased by 380% between 2007 and 2016, according to Food Allergy Research & Education. In addition, the Centers for Disease Control and Prevention has reported a 50% jump in the number of children with food allergies between 1997 and 2011.
Schumer’s letter, also signed by Illinois Senator Tammy Duckworth, to Airlines for America President Nicholas Calio, regarding the seriousness of food allergies and lack of EpiPens on airplanes, can be found below:
Dear Mr. Calio:
We write today to draw your attention to the serious issue of food allergy reactions aboard commercial airplanes and the life-saving medications used to suppress them, like Epinephrine.
It has come to our recent attention that the airline industry has successfully sought to limit, and or, prevent life-saving medications—like Epinephrine—from making it aboard flights. In 2016, the Federal Aviation Administration (FAA) granted the airlines operating in the U.S. a four-year exemption from providing critical medications, like auto-injectable Epinephrine, Atropine and Dextrose, in onboard emergency medical kits. This is both a concerning and dangerous policy.
Therefore, we are hopeful that you, in collaboration with the FAA, will immediately lead the charge to provide public notification of this exemption to your passengers and promptly review the need for this exemption, and the regulations regarding onboard emergency medical kits. We urge you to begin working towards inclusion of Epinephrine auto-injectors, for both adults and children, as a standard component of EMKs.
Traveling with severe allergies can be difficult, but, without access to the proper medication, it can also be deadly. Your methods, with support from the FAA, to repeatedly disregard pleas from passengers and failing to implement recommendations from the American Academy of Pediatrics, Asthma and Allergy Foundation of America, Food Allergy Research and Education Group, the Association of Flight Attendants and Emergency Nurses Association to include Epinephrine auto-injectors in EMKs, represents a problem that can simply no longer fly.