title: After the Recall: Reexamining Multiple Magnet Ingestion at a Large Pediatric Hospital.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada. Electronic address: daniel.rosenfield@utoronto.ca.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rosenfield
authors.affiliation: Department of General Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Matt
authors.initials: M
authors.lastname: Strickland
authors.affiliation: Department of Pediatrics, University of Toronto, Toronto, ON, Canada; Division of General Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Charlotte Moore
authors.initials: CM
authors.lastname: Hepburn
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D004435:Eating; D004636:Emergency Service, Hospital; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D041981:Gastrointestinal Tract; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D059346:Magnets; D008297:Male; D057051:Product Recalls and Withdrawals; D012189:Retrospective Studies
keywords: foreign bodies; injury; magnets; pediatrics; perforation