Outcome of Zen Magnets v. Consumer Product Safety Commission

PT Reeves, B Rudolph, CM Nylund. JPGN 2020; 71:699-703. Magnet Ingestions in Children Presenting to Emergency Departments in the United States 2009–2019: A Problem in Flux

When the 10th Circuit Court, with judges Gorsuch, Ebel, and Bacharah, rolled back high-powered magnet regulations in 2016, it was expected that this would result in more suffering in children. The referenced article by Reeves et al documents the effects of this decision.

Background: In 2016, the Zen Magnets decision resulted in magnets returning to the market with warning labels “but not performance standards favored by NASPGHAN (ie, making magnets either too large to swallow or too weak to cause harm).” In this study, the authors used data from the National Electronic Injury Surveillance System (NEISS), a database of consumer product injuries.

Key findings:

  • When stratified by time period, suspected magnet ingestion (SMI)per year was 1598 during off-market period (when product was banned) compared with 2826 during on-market period.
  • An estimated 23,756 children (59% males, 42% < 5 years old) presented with a SMI from 2009 to 2019.
  • There was an average annual case increase of 6.1% (P = 0.01).
  •  After 2017, there was a 5-fold increase in the escalation of care for multiple magnet ingestions (estimated n = 1094; CI 505–1686). “Escalation of care” refers to cases designated as ‘treated and transferred,’ ‘treated and admitted/hospitalized,’ or ‘held for observation.’
  • More data on this topic from CPSC 124 page report: (Link) Informational Briefing Package Regarding Magnet Sets

My take: Regulatory action is needed to prevent harm in children from these high-powered magnets.There are two companion bills in Congress which are in committee, one entitled “Magnet Injury Prevention Act.” These are clearly needed given previous judicial branch ruling.

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Today’s Children in Crisis: YOYO

Predictive Modeling on COVID19 in U.S. from NYTimes: How Much Worse the Coronavirus Could Get, in Charts

Modeling comments from Nate Silver: It’s important to keep in mind that many of these models describe projections *without* changes in behavior. This is mentioned in the article (good for NYT, a lot of articles omit this context). So behavioral changes and testing are key. I slightly worry that some of the headlines contribute to a sense of fatalism, when the real message is more like “this is probably gonna be bad, but it could be considerably less bad if we get our act together and much worse if we don’t.”


Besides the current outbreak, what else has been happening to children:

So, is it surprising at all that there is no interest in limiting products shown to be dangerous for children?  Today’s children are being told: ‘you’re on your own’ (YOYO)

An ongoing concern for pediatric gastroenterologists, magnet ingestions, was highlighted in a Politco report -thanks to Ben Gold for sharing this report: Toddlers eat shiny objects….

Here are a few excerpts:

Once ingested, high-powered magnets find each other inside the body and shred any tissue, such as bowel, trapped in between….

In early 2012, this coalition [led by NASPGHAN] approached the Consumer Product Safety Commission with one simple ask: eliminate these high-powered magnet sets from the market…the agency ultimately recalled high-powered magnet sets …

One company, Zen Magnets, remained unconvinced, and sued the CPSC, fighting… the recall on existing magnets…

The rule [ban] set was struck down by two judges on the 10th Circuit Court of Appeals with the deciding vote cast by now-Supreme Court Justice Neil Gorsuch. These judges ignored the expertise of the CPSC epidemiologists and economists; ignored the compelling medical testimony, overwhelming expert evidence and dire safety consequences and substituted their own opinion in favor of promoting “government restraint” on regulating industry…

The nation’s poison control centers recorded six times more magnet ingestions―totaling nearly 1,600 cases in 2019 alone—after the 10th circuit court decision allowed magnets back on the market…

The article details how the CPSC’s change in regulation has also led to deaths related to delays in recalling faulty infant inclined sleeps, with defective RZR All Terrain Vehicles, and the mismanaged recall of IKEA’s Malm dressers.

A related article was published in USA Today this week by Dr. Bryan Rudolph: Children can easily swallow high-powered magnets, it’s time to ban them for good

My take: What’s next up for our children? Outlawing lifeguards for pools? Repealing seat belt laws?  Perhaps it won’t matter –there are so many bigger threats that are not even on the radar.  YOYO.

Related blog posts:

Image from Politico

Hazardous Toys: Jarts and Magnets

I had completely forgotten about Jarts until reading a recent editorial by Athos Bousvaros (J Pediatr 2017; 186: 6-7). He succinctly describes how these lawn darts were ultimately removed from the market primarily due to the advocacy of a father who became a strong advocate after the death of his daughter.

A more complete description of the effort to remove Jarts -from Mental Floss website: How One Grieving Father Got Lawn Darts Banned

Dr. Bousvaros, in commentary on a study on high-powered (neodymium) magnets (Rosenfeld D et al. J Pediatr 2017; 186: 78-81) describes the similarities between these magnets and the jarts.  Both have caused catastrophic injuries and death.  However, the recent removal of these magnets from the market was overturned.  There is no national tracking system for magnet ingestions in U.S. or Canada.  However, the referenced study demonstrated a dramatic reduction  in medical/surgical procedures in 2014-2015 (n=10) when a ban was placed compared to 2011-2012 (n=29).

For U.S physicians, all we can do currently is to report to the CPSC (Consumer Product Safety Commission) all magnet-related injuries and to publicize the dangers of these hazardous products.  To report: go to CPSC website (link: CPSC website) and “report an unsafe product” on the right side of the page.

Related blog posts:

NASPGHAN Statement on High-Powered Magnet Court Ruling

NASPGHAN Statement on High-Powered Magnet Court Ruling

 The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) is shocked and deeply disappointed by the decision of the U.S. Court of Appeals for the Tenth Circuit to overturn the federal government’s strict safety standard for small, high-powered magnets.  This legal ruling does not change the hazard these products pose to children.

Representing pediatric gastroenterologists who are on the front lines of treating children who accidentally ingest these magnets, NASPGHAN is calling on U.S. retailers, including online retailers, to boycott the sale of products that do not meet the safety standard for magnet sets issued by the Consumer Product Safety Commission in 2014.

 Prior to the new safety standard, pediatric gastroenterologists witnessed a rise in the number of ingestions of high-powered magnets by toddlers and teenagers, often with severe medical consequences. These magnets were sold as part of magnet sets sold as desk toys.

 Kids ingest a lot of things they shouldn’t. High-powered magnet ingestions are different than other ingested foreign bodies. Most foreign bodies will pass through the digestive tract without incident. When two or more magnets are ingested, their attractive force allows the magnets to “find” each other once inside the digestive tract. Consequently, there is a high risk of a fold of intestine becoming trapped between the magnets. When this occurs, ulceration and bowel perforation can occur and lead to death.

 NASPGHAN recommends that high-powered magnet sets should not be stored or used in homes or other settings where children are present. Because these high-powered magnets often come in sets of 100 or more, missing magnets are not easily accounted for and can get lost in carpet or furniture where they can be found by small children.

 Children should receive immediate medical attention for a known or suspected magnet ingestion. Consumers and health care providers are strongly encouraged to report incidents of ingestions to www.saferproducts.gov.

Related blog posts:

Magnetic Foreign Bodies –Still a Problem

After reading a recent article on swallowed magnetic foreign bodies (J Pediatr 2014; 165: 332-35), I was thinking quite tangentially about an article from The Onion a few years ago: Falling Down Laundry Chute And Breaking Neck Remains America .‘s No. 548,221 Killer.  In this Onion article, the author sarcastically bemoans the attitude that many people adopt that “this could never happen to me.”

What this Journal of Pediatrics study adds to the literature is that swallowed magnetic foreign bodies remain a significant health threat and are likely to remain that way despite recent recalls.

Key finding: 94 pediatric patients were identified at this single center as having infested magnetic foreign bodies between 2002-2012, with increasing incidence in the last three years of the study period.  The median age was 4.5 years. Six patients required surgical removal.

Bottomline: Magnet ingestions are a much more serious health threat than falling down a laundry chute.

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Buckyball Recall –It’s Official

From NASPGHAN twitter feed, 5/13/14: consumerfed.org/news/785

Consumer advocates and pediatric gastroenterologists applaud the Consumer Product Safety Commission’s announcement today that a settlement has been reached with Craig Zucker, the former CEO and President of the company that manufactured Buckyballs and Buckycubes, Maxfield and Oberton, which was dissolved in 2012.

High powered magnets, such as Buckyballs or Buckycubes, are bb-shaped smooth balls or cubes that connect to one another with a strong magnetic bond.  The magnets are individual balls or cubes that are sold in packages of many individual balls.  These products were originally sold as toys to children over 13 years of age, but after a recall in 2010, these products are sold to teens and adults age14 and older.  The new warning label that has appeared on the package of Buckyballs since the recall has not resulted in a decrease in serious injuries to children.  In November of 2011, CPSC issued a safety warning to consumers about this product but the injuries continue to occur.  In July of 2012, CPSC filed a law suit against the manufacturer of Buckyballs to issue a recall of these products. The settlement announced today is a resolution of that complaint…

Consumers will have six months to participate in the recall by requesting a refund.  The recall trust will be funded by Craig Zucker and will be overseen by the CPSC.

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“Fatal attraction”

Today’s 33Charts topic Children and Magnets: a Fatal Attraction gives an update on rare earth magnet ingestions (neodymium) along with some other useful links.

Addendum: Also a link from NY Times on 8/17/12: http://www.nytimes.com/2012/08/17/business/for-buckyballs-toys-child-safety-is-a-growing-issue.html?_r=1&nl=todaysheadlines

Previous posts on this topic:

More on magnet ingestions

Magnet ingestion –urgent removal needed

More on magnet ingestions

Magnet ingestion has been a popular topic this past week on the pediatric GI listserv and follows a recent post on this blog as well (Magnet ingestion –urgent removal needed).  Two useful links are listed below:

Magnet ingestion –urgent removal needed

This month’s Gastroenterology has an interesting picture of magnet(s) ingestion (Gastroenterology 2012; 142: 701, 1044).  This case report describes an ingestion by a 3-year-old boy who had swallowed 5 ball-shaped magnets.  The authors considered this an emergency even though it appeared that all 5 balls were in the stomach. As it turns out, a gastric mucosa fold was trapped in between the balls.  By taking the child for emergency removal, the authors averted a gastric perforation.

When multiple magnets are ingested, they may attract each other and cause pressure and subsequent damage. Magnet ingestion has become an important ingestion with case reports that have even included a death secondary to sepsis as well as perforations, fistulas, and volvulus.  Due to the potential for severe harm, they should be retrieved when possible ASAP.

Additional references: