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Middelberg LK, Leonard JC, Shi J, Aranda A, Brown JC, Cochran CL, Eastep K, Gonzalez R, Haasz M, Herskovitz S, Hoffmann JA, Koral A, Lamoshi A, Levitte S, Lo YHJ, Montminy T, Novak I, Ng K, Novotny NM, Parrado RH, Ruan W, Shapiro J, Sinclair EM, Stewart AM, Talathi S, Tavarez MM, Townsend P, Zaytsev J, Rudolph B. High-Powered Magnet Exposures in Children: A Multi-Center Cohort Study. Pediatrics 2022; 149:184737. [PMID: 35112127 DOI: 10.1542/peds.2021-054543] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES High-powered magnets were effectively removed from the US market by the Consumer Product Safety Commission (CPSC) in 2012 but returned in 2016 after federal court decisions. The United States Court of Appeals for the 10th Circuit cited imprecise data among other reasons as justification for overturning CPSC protections. Since then, incidence of high-powered magnet exposure has increased markedly, but outcome data are limited. In this study, we aim to describe the epidemiology and outcomes in children seeking medical care for high-powered magnets after reintroduction to market. METHODS This is a multicenter, retrospective cohort study of patients aged 0 to 21 years with a confirmed high-powered magnet exposure (ie, ingestion or insertion) at 25 children's hospitals in the United States between 2017 and 2019. RESULTS Of 596 patients with high-powered magnet exposures identified, 362 (60.7%) were male and 566 (95%) were <14 years of age. Nearly all sought care for magnet ingestion (n = 574, 96.3%), whereas 17 patients (2.9%) presented for management of nasal or aural magnet foreign bodies, 4 (0.7%) for magnets in their genitourinary tract, and 1 patient (0.2%) had magnets in their respiratory tract. A total of 57 children (9.6%) had a life-threatening morbidity; 276 (46.3%) required an endoscopy, surgery, or both; and 332 (55.7%) required hospitalization. There was no reported mortality. CONCLUSIONS Despite being intended for use by those >14 years of age, high-powered magnets frequently cause morbidity and lead to high need for invasive intervention and hospitalization in children of all ages.
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Affiliation(s)
- Leah K Middelberg
- Department of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Julie C Leonard
- Department of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Junxin Shi
- Department of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Arturo Aranda
- Division of Pediatric Surgery, Dayton Children's Hospital, Dayton, Ohio
| | - Julie C Brown
- Seattle Children's Hospital, Department of Pediatrics, Division of Emergency Medicine, Seattle, Washington
| | - Christina L Cochran
- Department of Pediatrics, Division of Emergency Medicine, Children's of Alabama, University of Alabama at Birmingham College of Medicine, Birmingham, Alabama
| | - Kasi Eastep
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Norton Children's Hospital affiliated with University of Louisville School of Medicine, Louisville, Kentucky
| | - Raquel Gonzalez
- Division of Pediatric Surgery, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida
| | - Maya Haasz
- Department of APediatrics, Section of Pediatric Emergency Medicine, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Scott Herskovitz
- Department of Pediatrics, Division of Emergency Medicine, Rady Children's Hospital, San Diego, California
| | - Jennifer A Hoffmann
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Alexander Koral
- Department of Pediatrics, Section of Pediatric Gastroenterology and Hepatology, Yale New Haven Children's Hospital, Yale School of Medicine, New Haven, Connecticut
| | - Abdulraouf Lamoshi
- Division of Pediatric Surgery, Cohen Children's Medical Center; Northwell Health, Queens, New York
| | - Steven Levitte
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Lucile Packard Children's Hospital, Stanford University, Palo Alto, California
| | - Yu Hsiang J Lo
- Department of Emergency Medicine, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan
| | - Taylor Montminy
- Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Inna Novak
- Children's Hospital at Montefiore, Albert Einstein College of Medicine; Bronx, New York
| | - Kenneth Ng
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Johns Hopkins Children's Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nathan M Novotny
- Beaumont Children's, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
| | - Raphael H Parrado
- Division of Pediatric Surgery, Department of Surgery, Medical University of South Carolina Shawn Jenkins Children's Hospital, Charleston, South Carolina
| | - Wenly Ruan
- Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Joseph Shapiro
- Division of Emergency Medicine, Children's National Hospital, Washington, District of Columbia
| | - Elizabeth M Sinclair
- Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Healthcare of Atlanta, Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia
| | - Amanda M Stewart
- Department of Pediatrics, Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Saurabh Talathi
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Oklahoma Children's Hospital, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Melissa M Tavarez
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Peter Townsend
- Department of Pediatrics, Division of Gastroenterology, Connecticut Children's Hospital, University of Connecticut School of Medicine, Hartford, Connecticut
| | - Julia Zaytsev
- University of Texas Southwestern Medical School, Dallas, Texas
| | - Bryan Rudolph
- Children's Hospital at Montefiore, Albert Einstein College of Medicine; Bronx, New York
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