The death of a Virginia first grader has raised questions about how schools should handle severe allergies.
Ammaria Johnson, 7, died Monday after suffering an allergic reaction during recess at her Chesterfield County elementary school, Hopkins Elementary.
"She came to the school clinic after feeling she had hives and shortness of breath," Lt. Jason Elmore, a spokesman for the Chesterfield County Fire Department, told ABC News. It's unclear how long Johnson was in the clinic before school officials called 911 at 2:26 p.m.
"When emergency crews arrived, she was already in cardiac arrest in the clinic," said Elmore.
Johnson was rushed to a local hospital where she was pronounced dead.
What caused the reaction is still under investigation, but Johnson's mother, Laura Pendleton, told local reporters the girl had a peanut allergy.
"We can only assume that at this time," said Elmore. "We have EMS protocols in place for allergic reactions and we performed those in hopes of saving her life, but unfortunately this time we could not."
Calls to Pendleton were not immediately returned. She arrived at the hospital after Johnson had died, Elmore said.
The death is still under investigation by the Chesterfield County Police Department, according to a spokeswoman, but the state medical examiner will not be involved.
Experts say Johnson could have been saved by an EpiPen -- a device that injects epinephrine, currently available only by prescription.
"The epinephrine reverses severe symptoms, giving time to get the person to an emergency room for monitoring and more care," said Dr. Scott Sicherer of the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York.
But Hopkins Elementary had no such device on hand for Johnson.
Chesterfield County school policy states that parents are responsible for providing the school "with all daily and emergency medications prescribed by the student's health-care provider," and keeping medications up to date.
"For any medication, the school would have to be in possession of that medication to provide it," said Shawn Smith, a spokesman for Chesterfield County Public Schools. Even if the school had an EpiPen prescribed for another student, they would not be able to use it.
"The medication we receive, or should receive, has to be specific to that child, whether it's over-the-counter or prescription," Smith said.
Smith declined to comment on Johnson's case specifically, but said managing severe allergies starts at home.
"At the beginning of the school year, we sent information to parents outlining the different responsibilities for the family and the child, the principal, the teacher, the doctor and the nurse," he said. "First and foremost, is does begin at home. Working with their doctor, the family would outline a health care plan that deals with those severe allergies."
Pendleton told local reporters her daughter did have a plan, but said the school refused to take Johnson's EpiPen and failed to give her Benedryl -- an over-the-counter antihistamine also listed in her plan -- at the first sign of a reaction.