After the Recall: Reexamining Multiple Magnet Ingestion at a Large Pediatric Hospital.

OBJECTIVES: To evaluate the effectiveness of a mandatory product recall on the frequency of multiple mini-magnet ingestion at a large tertiary pediatric hospital, and to examine the morbidity and mortality associated with these ingestions. STUDY DESIGN: In this retrospective chart review, we searched our institution's electronic patient record for patients aged <18 years who had been diagnosed with ingested magnetic foreign bodies between 2002 and 2015, a period that included the mandatory product recall. We compared the frequency and character of ingestions before and after the recall. RESULTS: Comparing the postrecall years (January 1, 2014, to December 31, 2015) with the 2 years immediately preceding the recall year (January 1, 2011, to December 31, 2012) yields an incidence rate ratio of 0.34 (95% CI, 0.18-0.64) for all magnet ingestions and 0.20 (95% CI, 0.08-0.53) for ingestion of multiple magnets. Based on the Fisher exact test, the incidence of both magnet ingestion (P < .001) and multiple magnet ingestion (P < .001) decreased, and the morbidity associated with magnet ingestion decreased. There were no deaths in either study period. CONCLUSION: There was a significant decrease in multiple mini-magnet ingestion following a mandatory product recall. This study supports the effectiveness of the recall, which should bolster efforts to keep it in place in jurisdictions where it is being appealed. More broadly, the result provides general evidence of a recall helping decrease further harm from a product that carries a potential hazard.

Magnetic foreign body injuries: a large pediatric hospital experience.

OBJECTIVE: To examine trends in magnet-related injuries and hypothesize that changes are a result of new neodymium-iron-boron magnets that are smaller, stronger, and commonly sold in sets. STUDY DESIGN: In this retrospective chart review, we searched our institution's electronic patient record for patients less than 18 years old who were diagnosed with magnetic foreign body ingestion between 2002 and 2012. Cases were analyzed for patient, magnetic foreign body, and management characteristics. Incidence rates and case characteristics were compared between the first 8 years of the study period and the last 3. RESULTS: We identified 94 patients who met our search criteria. Of confirmed ingestions, the median age was 4.5 years and 65% were male. The incidence of visits increased between the 2002-2009 period and the 2010-2012 period by a factor of 2.94 (95% CI, 1.84-4.70), whereas the incidence of injuries involving multiple magnets increased by a factor of 8.40 (95% CI, 3.44-20.56). The volume of the magnets decreased from 878.6 mm3 to 259.8 mm3. Six cases required surgical removal of the magnets because of intra-abdominal sepsis or concern for imminent bowel perforation. CONCLUSIONS: Since 2002, there has been a significant increase in the incidence of magnetic foreign body injuries. These injuries have increasingly involved multiple, smaller magnets and required operative intervention.