Coroner examines how James Tsindos’ mild allergy symptoms ended in cardiac arrest

James Tsindos was given two adrenaline shots in an ambulance to treat mild nut allergy symptoms, but in hospital his heart stopped and he never woke up. Now a coroner is trying to unpick what went wrong.

James Tsindos (right), pictured with his family, died from anaphylaxis after eating a burrito bowl he ordered online in.

Within just 20 minutes, beloved Brighton Grammar student James Tsindos went from experiencing mild allergy symptoms to entering severe respiratory distress from which he never recovered.

The 17-year-old had a tree nut sensitivity which he took seriously and would conscientiously flag before consuming meals.

But on March 27, 2021, those inquiries weren’t made when he ordered from food delivery app Deliveroo a burrito bowl with a vegan cheese sauce containing cashew nuts.

At first, James’ symptoms were mild, improving with two adrenaline shots administered by paramedics on the way to Holmesglen Private Hospital.

But once inside, his condition deteriorated, with James telling nurses he “couldn’t breathe” and wanted to speak to his mother before losing consciousness and entering cardiac arrest.

James suffered a catastrophic brain injury and was taken off life support on June 1.

James was a talented pianist in the final year of his VCE studies at Brighton Grammar.

Cradling framed images of James, heartbroken parents Harry and Venetia and sisters Kristina, Elpida and Georgia stood outside the Coroners Court on Friday ahead of a four-day inquest probing the appropriateness of medical care given to the teen.

The family is desperately seeking answers over the death of James, a talented pianist in his final year of VCE whose last weeks were spent preparing for the school’s Mamamia production.

“He was a boy filled with laughter and joy and hope and his family is devastated by his loss,” Slater and Gordon’s senior medical lawyer Shari Liby said on behalf of the family.

“The Tsindos family are very committed to ensuring that systems are in place so that other families don’t suffer a similar loss under these circumstances.”

Counsel assisting the coroner Rachel Ellyard said “hard and difficult questions need to be asked and answered” by healthcare workers who treated James.

Slater and Gordon’s Shari Liby (front) with James’ family outside the Coroners Court.

“James went from being apparently well with no signs of respiratory distress to severely unwell, requiring intubation and CPR within 20 minutes,” Ms Ellyard said.

A critical focus of the inquest revolves around discrepancies in triage admission times and patient handover briefings between paramedics and hospital staff.

Advanced life support paramedic Jonathon Hammond told the inquest soon after arriving at Holmesglen hospital with James, he told the triage nurse the teen felt “wheezy” and that he needed to use his Ventolin inhaler.

However, Vioala Katotas, the lawyer for the triage nurse, told the inquest that information was not offered during the patient handover.

A younger James with family.

Mr Hammond doubled down on his recollection, saying he was “certain” he disclosed James’ wheezing – a symptom consistent with anaphylaxis.

“I see that as pertinent information important to handover. I am certain of that,” the paramedic said.

Royal Children’s Hospital intensive care consultant Professor Warwick Butt told the inquest this was a “sliding doors moment” and James should have received an immediate third dose of adrenalin.

“The wheeze changed the category (of seriousness). His condition was likely to become very severe, very quickly - he needed immediate treatment,” Mr Butt said.

“Had he received adrenalin earlier and repeated doses, it’s likely the cardiac arrest could have been avoided.”

A third dose of adrenalin had been drawn up by paramedics but not administered as James had not reported worsening symptoms during the ambulance transfer.

James was unwell the day he ate the burrito bowl. He tested for Covid-19 and was later diagnosed as Respiratory Syncytial Virus (RSV).

Under current regulations, restaurants and takeaway outlets are not required to tell customers of ingredients including known allergens such as nuts.

The inquest will examine whether food outlets should be required to disclose potentially lethal ingredients in meals.

Asked by coroner Sarah Gerbert if James’ family wanted to say anything ahead of the inquest, his mother Venetia simply replied: “I am really proud of James”.

The inquest continues.