Ms Yvonne Moynihan:

I thank the Chairman and members for inviting us here today. I welcome the initiative to discuss the provision of EpiPens as they provide vital life-saving injections. I met Ms Sloan through the Emma’s Voice campaign because I too suffer from anaphylaxis. I did not know that I had anaphylaxis until I went into shock in a restaurant in 2010. Fortunately for me, I was able to discuss my symptoms on the phone with a doctor and she was soon able to administer and adrenaline injection.

Since that incident I have been consistently vigilant in telling members of staff in restaurants about my shellfish allergy, despite that, however, there have been occasions on which I have suffered a reaction because of cross-contamination in food. For this reason it is my submission that it is very important to have EpiPens available in restaurants.

The fact is that people have died in restaurants in this country as a result of allergies. The law is insufficient. Proof of that has been the death of Emma Sloan.

My written submissions could be distilled into four distinct categories which I will briefly summarise. First, I identify the problems with the law. In effect, there is no real legislative platform at the moment. Second, I will suggest solutions by examining the laws in other jurisdictions, in particular the US, Canada and the United Kingdom. My submissions will focus on the provision of EpiPens specifically in restaurants and schools. Amending the regulations is insufficient in itself. A comprehensive Bill is required. In my submissions I consider the Public Health (Availability of Defibrillators) Bill and suggest that any new law should model itself on the provisions of that particular Bill.

Finally, in my submissions I consider the civil liability in the administration of epinephrine in an emergency situation. That is very important. I will illuminate the importance of setting out the scope of liability in any potential legislation so that any individual who intervenes in an emergency situation need not be afraid of the threat of the proceedings. Therefore, it is very important to remember that EpiPens exist to save lives and not to create unnecessary legal woes.

In terms of the current law, regulation 8 of the Medicinal Products (Prescription and Control of Supply) Regulations 2003-2008 does provide that a pharmacist can supply epinephrine without prescription in an emergency. I submit that the legislation is restrictive because it fails to define an emergency and, furthermore, it fails to cater for people such as me who have undiagnosed allergies and do not have a prescription for an EpiPen. The only way to fix the issue is for the legislation to go further and to set out further exceptions for emergencies and extend accessibility to schools and restaurants in particular. There also needs to be provision to introduce a scheme to train first responders.

I submit that schools and restaurants in particular are a hot bed for anaphylactic reactions. Currently, there are no statutory protocols in being for dealing with food allergic customers. In addition, there are no formal guidelines in schools for the treatment and management of anaphylaxis. Deficiencies in the legislation will lead to exposure in terms of liability. The only way to minimise that is to introduce guidelines.

The US in particular has been very proactive in introducing legislation. As Ms Sloan said, President Obama signed federal legislation in December 2013 requiring schools to stockpile EpiPens. Individual states will enact their own laws. The Act permits trained staff to administer the injections and it requires schools to have a stockpile of epinephrine and furthermore to have a plan in place for the management of anaphylaxis. Most importantly, the Act outlines the scope of liability which protects trained individuals who administer an injection in an emergency. I set out the text of that in my written submissions.

The federal legislation was enacted as a result of the death of a student in Virginia. Amarria Johnson accidentally ate a nut in school. The school had an EpiPen belonging to another child but was not allowed to use it on Amarria and as a result, unfortunately, she died of anaphylaxis. Subsequently, Amarria’s Law was enacted. That allows schools to administer EpiPens and it indemnifies anyone who uses one on a child.

In Canada, Sabrina’s Law was enacted following the death of a child in school. The Act requires that every school board adopts an anaphylaxis plan dealing with life-threatening situations. The Act also provides that no action will be taken for a claim for damages in respect of any act that is done in good faith.

Across the water, in the UK, the Children and Families Act was enacted last month. It requires every school in England to ensure that children who suffer from health conditions such as anaphylaxis get the care they need in school. Once again, there is a requirement that staff are trained in respect of the medical condition and protection is provided should an allegation of negligence be made subsequently.

I do not think amending the regulations will resolve everything. I propose that a Bill would be more broadly welcomed, such as the Public Health (Availability of Defibrillators) Bill. The way the Bill is set out is of some relevance. Part 2 deals with the provision of defibrillators, which requires all owners of designated places to install defibrillators. Part 3 deals with training in the use of defibrillators. Part 5 deals with the scope of liability in order to protect anybody who does act in good faith. Part 6 is concerned with offences and penalties that may arise. The layout of the Bill is a good guide for any proposed heads of Bill.

Action is needed on the introduction of comprehensive legislation to impose, first, mandatory health plans in schools, a requirement to stock EpiPens in schools, restaurants and other places that may have a first aid kit, and a requirement to train staff. Most importantly, the scope of liability needs to be set out in any legislation so that individuals do not have to fear a claim for damages against them.

A policy combining all of the above would probably be one of a kind and if it were to be introduced, Ireland would lead the way in terms of accessibility to EpiPens. I thank the committee for inviting us before it, in particular those members who have helped Ms Sloan, especially Deputy Gerry Adams, who first brought the situation to the attention of the Minister for Health. I also thank the Minister for Health for suggesting that the regulations could be reviewed. I commend Ms Sloan for her strength of character. It takes a rare person to turn a very tragic situation into positive action and I applaud her for that.