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Does your restaurant know what to do if you have a peanut allergy?

In Natick, the family of a little girl with a peanut allergy has sued Panera, alleging negligence after a restaurant allegedly served her grilled cheese with peanut butter.
In Natick, the family of a little girl with a peanut allergy has sued Panera, alleging negligence after a restaurant allegedly served her grilled cheese with peanut butter.(Charles Krupa/Associated Press/File)

Here’s what the public knows.

In Natick, the family of a little girl with a serious peanut allergy has sued Panera and a group of New England Panera franchises, alleging negligence after a restaurant allegedly served her grilled cheese with a large dollop of peanut butter. This happened, they say, even though when ordering online, the girl’s mother twice indicated the sandwich was for someone with a peanut allergy.

Here’s what the public is wondering: In a state recognized as an early adopter of food-allergy awareness regulations, how can something like this allegedly happen?

Here’s one clue: A November 2015 survey of 110 US restaurant owners, managers, and chefs found that even though 80 percent of participants indicated they had received training about food allergies, there were big gaps in knowledge.

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More than 40 percent were not able to identify soy and fish among top allergens, according to the survey, published in the Journal of Foodservice Business Research.

Half were not able to identify arachis oil as peanut oil. About 40 percent believed that simply removing a food allergen from a plated meal could prevent an allergic reaction. And more than half thought a food allergy and a food intolerance are the same condition.

Nearly 22 percent of participants — from independent and chain restaurants — indicated food allergy reactions had occurred at their restaurants in the past year. The mean food allergy knowledge score was 19.7, while the highest possible score was 28.

In the Panera case filed last week in Middlesex Superior Court, the girl’s father, John Russo, alleges that in a phone call on Jan. 28, the night of the incident, the manager of the café apologized to him and blamed the incident on a “language” issue.

The little girl, identified only by her initials, ended up in the hospital, and has been changed by the incident, her father alleges. She was so panicky after biting into the sandwich that she asked her mother “Am I going to die?” and is no longer the carefree child she once was.

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The case against Panera comes some seven years after Governor Deval Patrick signed “The Act Relative to Food Allergy Awareness in Restaurants” into law. It requires a prominent display of a food allergy awareness poster in the staff area; a notice on menus for consumers with food allergies; and additional food allergy training for certified food protection managers.

Individual employees who are not designated as “food protection managers” aren’t required to get formal training beyond learning they should summon a manager when alerted to a patron’s allergy and “erring” on the side of caution, said Bob Luz, president of the Massachusetts Restaurant Association.

“Two, three or four managers/owners can retain and know where to get an answer much better than 40 hourly employees,” he texted the Globe. “They are also trained on what exactly to do when an order comes in with an allergen alert. That process varies to each specific item and allergy.”

But Scott Riccio, senior vice president of education and advocacy for Food Allergy Research & Education (FARE), a Virginia-based organization, says that high turnover and other issues necessitate both more and more frequent training.

Obstacles to improving allergy-safe practices — identified in the 2015 survey from the Journal of Foodservice Business Research — included a lack of commitment and interest in attending food allergy training among restaurant employees; unavailability of employees to attend training due to scheduling conflicts; and employee turnover.

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Meanwhile, another question remains to be answered: regardless of regulations, what are the consumer’s responsibilities?

Perhaps Paul Antico, the founder of AllergyEats , a popular Yelp-like website and app for people with food allergies — and the father of five children, three with food allergies — put it best: “This is a difficult dance we do,” he said.

He hasn’t read the case filed by the Russo family but he said that if there was indeed as much peanut butter as alleged on the grilled cheese, the restaurant is negligent — and parents should always be vigilant.

“I don’t believe in assigning blame,” he said. “I’ve made this mistake myself. But as parents we need to inspect food before our children eat it, even if we’ve told the restaurant our child has an allergy.

“Ninety-nine-plus percent of the time [the system in place in restaurants] works fine,” he said, “but when it breaks down, it’s not usually a single factor.”

But parents of children with allergies can find themselves up against restaurant owners or employees who are not knowledgeable, despite all the focus and training.

A Panera spokesman, Jonathan Yohannan, said the company “takes the issue of food allergens, including the reported incident at our franchise bakery-cafe, very seriously. We have procedures in place across the company to minimize exposure and risk for our guests and associates. We do not comment on pending litigation.”

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The Russos’ lawsuit, on behalf of their daughter, alleges that less than one month after the Jan. 28 episode in Natick, a similar one happened to a different family at a Panera cafe in Wayland.

Asked about the likelihood of such similar events at two nearby Paneras, Laurel Francoeur of Woburn, a lawyer for the Russos, said she did not know.

“That is something we need to find out in discovery,” she said.

More coverage:

Chefs, real sufferers want food allergy fakers to stop

Skeptics add to food allergy burden for parents

When food allergies dine out


Beth Teitell can be reached at beth.teitell@globe.com. Follow her on Twitter @BethTeitell.