Commentary: Button Batteries in Fidget Spinners
For every hazard that is reduced however, another hazard may enter the marketplace. The important series of papers in this month's Journal of Pediatric Gastroenterology and Nutrition describe cases of button battery ingestion, where the button battery was hidden inside a “fidget spinner” that was broken open by a child, and the battery swallowed (4–6). Children underwent emergent evaluation and were found to have significant esophageal or gastric ulceration that required endoscopy, imaging, and medical management. Fortunately, the most feared complications of button battery ingestion (esophageal perforation or aorto esophageal fistula) did not occur with any of these children. As is well known, button battery ingestion can, however, lead to these life-threatening complications. According to the authors, these “fidget spinners” did not have any warning label that they contained button batteries, nor did they discuss the potential life-threatening complications of battery ingestion. Having an unlabeled button battery in a toy or product that children can handle and break poses a potential danger to children.
Which should a pediatrician or other provider do when faced with such a hazard to children? A provider who simply treats the individual child and ignores advocating on a public health level is doing our community a dis-service. This is one clear area where public advocacy can be beneficial. The first step an physician in the United States should take when coming across such a hazard is to notify the United States Consumer Product Safety Commission at their website (www.cpsc.gov) by clicking on the link on the right side of the screen: “report an unsafe product.” Details on the ingestion can then be provided to the regulatory agency. This is the primary tool through which the Commission identifies potential hazards. It is unlikely that the commission will react if a single case is noted. Multiple cases will, however, often get their attention, as we learned from the high-powered magnet advocacy effort of a few years ago. In addition, we would suggest contacting your local NASPGHAN counselor or advocacy committee member because our NASPGHAN advocate often meets with other groups that may be central to the effort, including the Consumers Union and the American Academy of Pediatrics.
Once a regulatory authority is notified of a potential hazard, they have a number of options. The first option is to take no action.