Max McKenzie was the kind of teenager who wanted to be part of everything.

He loved kayaking, swimming and skiing. He threw himself into performing arts, played in the orchestra and sang in a choir. 

He joined cadets and once even built his own computer.

“He was such a vibrant, big character,” his mother tamara McKenzie said.

At 15, Max lived life to the fullest. 

But he was also surrounded by a constant, invisible danger.

The Melbourne teenager had a severe allergy to nuts and carried an adrenaline injector, or EpiPen.

On August 6, 2021, he was forced to use it after accidentally ingesting walnuts at a relative’s house.Max began displaying signs of anaphylaxis and was given further adrenaline when paramedics arrived. He suffered a seizure and, once at the Box Hill Hospital, staff performed emergency surgery to intubate him.

By the afternoon, he had suffered a severe brain injury from oxygen deprivation.

He was transferred to the Alfred Hospital and died 13 days later after going into cardiac arrest.

## Family feels ‘entirely let down’

Four years on,a Victorian coroner is examining if Max’s death was preventable and whether paramedics and doctors at the Box hill Hospital provided appropriate care.

On the final day of the inquest, Max’s devastated parents stepped into the witness box.

His mother

Australia’s Allergy Crisis: Why are reactions – and deaths – on the rise?

Australia is facing a growing crisis of allergic disease,with rates continuing to climb despite increased awareness and improved treatment protocols. Recent tragic cases, including the death of 14-year-old Max, are prompting questions about what more can be done to prevent severe reactions and fatalities.

The number of Australians with allergies is estimated to be around 25 per cent, costing the healthcare system an estimated $1.5 billion annually, a figure projected to reach $2.9 billion in 2024.

“We are known as the global capital of allergic disease,” said Sarah emery, the head of support group Allergy & Anaphylaxis Australia. “I don’t think that there’s one specific factor that can be pointed to … they’re all really speculatory.”

Deadly cases like Max’s are rare but not isolated. The Murdoch Children’s Research Institute estimates about 20 Australians die from anaphylaxis each year and more than 12,000 are hospitalised.

Two months before Max’s death, Melbourne teenager James Tsindos died after eating a takeaway burrito bowl containing cashews. His case remains under investigation, with the coroner considering whether restaurants and food delivery apps need stronger warnings.

Ms Emery says awareness and food labelling have improved in recent years, but more progress is needed. Consumers also need confidence to ask questions. “We have a saying to our consumers, ‘Always ask, always tell’,” she said.

She believes the health system is generally well prepared to treat severe reactions, crediting the Acute Anaphylaxis Clinical Care standard introduced in 2021.The guidelines call for anaphylaxis to be detected quickly, adrenaline to be injected without delay and to be kept on hand for further use, patients to be laid flat on their backs, constant clinical observation, and a thorough discharge plan.

Could Max’s death have been prevented?

The inquest heard that in some instances, allergic reactions were simply overwhelming even with rapid medical intervention.

Delays in Care Contributed to Max McKenzie’s Death at Box hill Hospital

An inquest into the death of 13-year-old Max McKenzie at Box Hill Hospital has revealed critical delays in his treatment. Max tragically died after a soccer ball struck his chest, causing a cardiac arrest. The inquest focused on the care provided by both Ambulance Victoria and hospital staff.

The coroner’s barrister, Rachel Ellyard, highlighted an “unreasonable delay” in intubating Max. However, she also acknowledged the severity of his condition, stating that a different course of action likely wouldn’t have changed the outcome. It’s a difficult point, but underscores the challenges faced in such critical cases.

Concerns were also raised regarding Ambulance Victoria’s response. Stanley Wallace, representing the McKenzie family, criticized the fact that a graduate paramedic was first on the scene. This paramedic required supervision and wasn’t authorized to drive under “code One” – emergency – conditions. This meant a delay in getting a more experienced paramedic to the scene quickly.

The inquest continues, and further details are expected to emerge regarding the specific timelines and decision-making processes involved in Max McKenzie’s care. The family hopes the inquest will lead to improvements in emergency care protocols.