Anaphylaxis Epinephrine Awareness Laws in the U.S.

Good information to share with “newly” diagnosed families and those attempting to change legislation.

I am a grieving mother of Joseph DeNicola, who passed in 2014 due to Anaphylaxis.  His journey has saved many lives and that will continue.  I am a lifetime member and a very large voice of the Anaphylaxis community.  We are driven by love. Cherishing all life and keeping all safe.  Awareness is key.  My son’s journey is know by all in the community.   I am always here to help, the new diagnosis ed, the unaware and those who need support.  This article outlines important information, you all should read and understand.

Epinephrine is not a “cure” nor does it “guarantee” life, but if used immediately, it gives your loved ones a chance to reaching medical emergency treatment that is “required”, following an Anaphylaxis reaction. No, receiving epinephrine is not the only treatment that will save a life, again it gives “TIME” for further medical treatment at the hospital, yes I am repeating this is very important to understand.  Being prepared, using quickly, and calling for the medical emergency (e.g. 911) must be a way of life to giving anyone with such illness a better chance of survival.  That everyone should be aware of and armed with if you or your loved one has been diagnosed with Anaphylaxis.  I am not a lawyer, I am a grieving mother who has watched her child die and know “factually” what could have taken place to giving him a better “chance” at survival if acted upon.  Minutes Matter, Time is the lesson and my son’s anaphylaxis journey you can read. Please watch the important videos towards the bottom of his story page.  To be aware what Anaphylaxis is, what happens during, how quickly to remove any debate about your having TIME to giving such medication, and GETTING TO the HOSPITAL, during a reaction.  Understanding “sensitization” and mild reactions, as such at any time in the future might be the “event” that takes a life.  Anaphylaxis can take place in the first reaction, to anyone, and at any age.  Feel blessed you are aware, if you are under the care of your allergist, that you have a warning, if possible since many are not aware at all.  There is no prior testing and there is no test available to determine the severity of an allergy. IgE testing is the ONLY testing that can give an indication that possible sensitization had taken place. To diagnose an allergy, allergists MUST combine a patient’s medical history with the results of skin prick or blood tests. These methods, however, cannot determine how severely the patient will react. This is why oral food challenges are the current gold standard for diagnosing food allergies or determining if a patient has outgrown a food allergy. These food challenges should only be performed by an experienced allergist at a medical facility where the appropriate medications and equipment are available.  I am attaching sited public approved legislation links.

Epinephrine Entity Stocking Laws in the U.S.

It is so important to understand the laws for the availability of epinephrine for your state and if traveling how important it is to be prepared.  It is important when reading the law to knowing the legal terms of  “permissioned  “Allowance” vs. regulated requirements “Required”.  So the terms as you read your state’s legislation and federal guidelines keep in mind always. It is very important.

Lets start with understanding the School Access to Emergency Epinephrine Act signed by POTUS Obama giving  encouragement  to schools to plan for severe asthma attacks and allergic reactions.  To give funding to schools that “if they” stock.  Again, the terms… only give Allowances, and NOT REQUIREMENTS. 

The law makes an important change to the Children’s Asthma Treatment Grants Program and other federal asthma programs, which authorizes the Department of Health and Human Services to give funding preferences to states for asthma-treatment grants if they: maintain an emergency supply of epinephrine (EpiPens), if they permit trained personnel of the school to administer epinephrine, and if they develop a plan for ensuring trained personnel are available to administer epinephrine during all hours of the school day.

So know your state school laws.

“Although many states initially focused on making EpiPens available in a school setting, more recent legislation expands the range of organizations permitted to maintain these emergency supplies. Multiple states have passed legislation that permits but does not require, various entities (restaurants, sports locations e.g.) to stock undesignated epinephrine for use in case of an emergency”  to quote from the following  PLEASE Read Epinephrine Entity Stocking Laws in the U.S. 

To find more detailed on States legislation for K-12, College, and Public entities FARE website. 

Advocating tools for your school are available on the FARE website.  Again, know the difference of “Allowed” to “Required”  I would suggest looking at the dark blue states and following their laws.  We need more blue… to save lives.



Epinephrine Proper Use and Storage



On January 1, 2006, the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) (1) took effect, making it easier for consumers to identify the eight most common food allergens. The FALCPA amended section 403 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 343), which is enforced by the Food and Drug Administration (FDA). The FALCPA requires that the labels of all FDA-regulated food products, labeled on or after January 1, 2006, clearly state whether a food or an ingredient found in a food is or contains a “major food allergen.” The FALCPA defines “major food allergen” as one of the following eight foods/food groups or an ingredient that contains protein derived from one of them: milk; eggs; fish (eg, bass, flounder, cod); crustacean shellfish (eg, crab, lobster, shrimp); tree nuts (eg, almonds, pecans, walnuts); wheat; peanuts; and soybeans.

One part of the new Act that seems to have controversy is What is cross-contact?

Cross-contact is the inadvertent introduction of an allergen into a product. It is generally the result of environmental exposure during processing or handling, which may occur when multiple foods are produced in the same facility. It may occur due to use of the same processing line, through the misuse of rework, as the result of ineffective cleaning, or from the generation of dust or aerosols containing an allergen.

During the production of pharmaceuticals, law REQUIRES to having the strongest avoidance of cross-contact! So why don’t our food? The number of recalls has been climbing annually.

So many have been working for required regulations but until such, just as you check your daily news or weather report, you must check for recalls, since it is life and death for those facing Anaphylaxis.

Is it Safe to Eat Packaged Foods “Processed in a Facility” with Your Allergen?


Always avoid May contains:

To help Americans avoid the health risks posed by food allergens, FDA enforces the Food Allergen Labeling and Consumer Protection Act of 2004 (the Act). The Act applies to the labeling of foods regulated by FDA which includes all foods except poultry, most meats, certain egg products, and most alcoholic beverages which are regulated by other Federal agencies. The Act requires that food labels must clearly identify the food source names of any ingredients that are one of the major food allergens or contain any protein derived from a major food allergen.

Do they make drugs on the same lines and are we facing such cross contaminations? Again, no SINCE “required”  regulated guidelines by the FDA are law!

“A section within 21 CFR 211 requires drugmakers to institute building and facility controls to prevent cross-contamination of drug products, and the regulation describes the establishment of separate areas for operations as necessary to prevent contamination during manufacturing or processing. In addition, 21 CFR § 211.42(d) requires that operations relating to the manufacture, processing, and packing of penicillin be performed in facilities separate from those used for other drug products. These provisions are similar to those in the ICH Q7 guidance, which recommends dedicated production areas (e.g., facilities, air-handling equipment, or processing equipment) in the production of highly sensitizing materials.” 

That is why it is so important to know your “states” legislation and FDA guidelines.  Why it is very important to keep in mind to the word “Required” vs. “Allowance”.

If you are attempting to make a change, Please, avoid using allowances and “Require” legislation change.

I see many new parents that have life taking events that get legislation passed easily since they are only asking for “allowance” laws.  I have had the door slam in my face since I start off with “require” and if so then regulation is as well required.  I do see the need for a lot of change to allowances, still.   Baby steps, awareness, and keeping to advocacy in areas we can make differences is our goal, so I will sign and help those that I do see come across my path.  I do ask direct questions if they can update to “required”.

Again, I am a grieving mom and not a lawyer, but I have researched areas and read just about everything I can get my hands on. I am a life timer in the Anaphylaxis community.  My life into in-depth research started in 2007 when my son was the first diagnosed and I will remain here always.  I have grown with the community, have seen many come and go, have cried and shared many joyous moments with millions of you.  I remain open from any advocacy group to be universal, to supplying all information, and I talk and attempt to help in any way I can.

Many reach out to me daily.  I am a truth seeker, so expect direct feedback from me.  I love learning new areas of research so I can share with many that have come to follow Joseph’s Journey.  I brought the importance of “TIME” to be the difference between life and death.  That was our path to help the next to understand.  I speak it daily.  Joseph lost his life due to a delay in receiving his auto-injector.  I had always given such first and fast and called 911. ALWAYS. A mother’s worst nightmare as I worked hard during a divorce to keeping all to know the severity of his allergies, why I needed to be with him, I fought endlessly.

The last time, he was not in my direct care, due to divorce arrangements and he was placed on his asthma medications a few moments before his auto-injector, 911 was not called, he was then driven to the hospital.  Those events and in turn just the period of delay and actions caused his death. They did their best to what they knew. I had always said EPI fast and first, I can only still say such and hope that people understand and listen.   That is why I will continue to advocate being prepared and armed with knowledge, with Epi and acting quickly (Epi first and all medication next) call 911.  It is the only chance to saving a life.

At one point, I had a family that reached out to me, taken back that they had moved from a “required” school state to an “allowance” both with the 504 laws, but the stocking requirements very different.  They had been so angry when they had been called to “pick up” their child until they brought in proper medication.  Know the state you are living, just as you decide to move to a state that has a reputable safe crime rate and known good school systems, learn the most important in the lives of those that live with life taking Anaphylaxis.



#BeAware How everyone at any age is at risk of a first-time reaction of Anaphylaxis. Anaphylaxis develops rapidly, usually reaching peak severity within 5 to 30 minutes. Please read about life taking Anaphylaxis it is not just about food.

Allergic Diseases

Anaphylaxis in Pediatric Patients video Study Author: Carla M. Davis, MD

Anaphylaxis in Adults Study Author: Phillip Lieberman, MD

#BePrepared Always go to an Allergist. NOT your pediatrician! If your pediatrician does not refer you to an allergist, get a new pediatrician! NEVER leave without an auto-injector script!  If your doctor allows you to walk out the door without such, get a new doctor and report them, bring it into our community social media groups so we are aware of the doctor so others do know.  This is a known issue, so no you are not being an alarmist.  The industry is aware of the problem and awareness and education is still needed The only chance at life after exposure is to act quickly, with self-administration of TIMELY Auto-injector epinephrine. Carry two always. 

Epinephrine Description and Brand Names

Epinephrine Proper Use and StorageEpinephrine Proper Use and Storage 

#MinutesMatter Never delay the administration of the only life-saving drug.  It is the difference between life and death. I CANNOT STRESS THE IMPORTANCE OF HOW TIME IS KEY TO SURVIVAL YOU DO NOT HAVE MUCH TIME.

Call 911 or your Counties emergency departments. It is very important to be monitored since the second reaction can take place hours later. There is no debate to this.

There is no time for the “Not me or my kid” syndrome. YES, you are at risk.

Joseph’s journey continues to save lives daily.

Images are of public domain
Source links on Public Web pages found as follows :
Epinephrine Entity Stocking Laws in the U.S.
States laws for K-12, College, and Public entities FARE website:
May Contains’ on Food Labels: What You Need to Know US AND CANADA