"I think there's probably a lot more of these not-straight-up labeling issues," he said. "I do think the manufacturing process is open to mistakes being made, especially when they're making multiple types of food in the same facility."
In 2001, Marler fought for a Seattle boy whose mother had to hold him down as emergency doctors gave him two shots of epinephrine. The boy had eaten a health bar that was supposedly milk-free, but he soon became nauseous and broke out in hives. His mother re-read the label looking for milk, to which her son was severely allergic, but it wasn't there.
Marler said he also remembered an old case in which a fruit basket was nut-free but caused an allergic reaction because nut dust from another fruit basket contaminated it.
"It didn't kill the kid, but it came really close," Marler said.
Dr. Donna Hummell, an allergist at the Monroe Carell Jr. Children's Hospital at Vanderbilt University said chocolate and candy are often especially risky foods for people with nut allergies to eat.
"If you can buy it with almonds in it or buy it plain or buy it with peanuts in it, it's better to watch out," Hummell said.
You don't need to tell that to Nicholas's mom. Vanech has made countless phone calls to food manufacturers over the years to keep her son safe.
She can tell you that her son can eat pretzel M&M's because they're not made in the same facility as almond M&M's. She knows that Ben and Jerry's always makes chocolate, vanilla and strawberry ice cream before making flavors with nuts, but since Nicholas is allergic to eggs, too, he can't eat their vanilla. She also knows that Breyers ice cream always sanitizes machinery between flavors, so their egg-free vanilla is safe for Nicholas to eat.
"It's not a joke," Nicholas wrote in an email."I get frustrated when someone passes off my allergy as some type of intolerance or tries to coax me into eating something."
When it comes to food labels, Nicholas's advice to younger children with new food allergies is to "READ THEM," he typed, adding that it's not worth the risk to go into anaphylactic shock. He said he never leaves home without an EpiPen and reads ingredients even before he buys food.
"I think the best advice I can give to younger children with food allergies is to not to be afraid to speak up about your allergies," he wrote. "Don't be embarrassed; you haven't done anything wrong and, yes, it is OK to tell a friend or a waiter/waitress more than once if they don't seem to 'get it.'"
Mars, Inc., which manufactures M&M's, was not immediately available to comment on its manufacturing processes at the time of Nicholas's allergic reaction.