Pediatric Neodymium Magnet Ingestions: The “Field” Returns

To the Editors: Pediatric foreign body ingestion has potential for significant morbidity and mortality. Most foreign bodies pass spontaneously; however, certain ones pose a higher risk of adverse outcomes. Included among these are Neodymium magnets commonly referred to as BuckyBalls or Zen Magnets, which are stronger than ordinary magnets.

These small but powerful magnetic toys created a serious health hazard leading to the ban of their sale. However, in 2016, a federal appeals court overturned this ban. Since then, we have seen an increase in the number of multiple magnet ingestions. We reviewed 1296 cases of foreign body ingestions that were endoscopically removed at Texas Children's Hospital between 2011 and 2018. In 2012, there were 4 multiple magnet ingestions that required endoscopic intervention. After the ban, this number decreased to 2 in 2013, 1 in 2014, 1 in 2015, and 1 in 2016. This was also observed nationally with a decrease in magnet ingestion emergency department (ED) visits ⁽¹⁾. After the ban was overturned, however, there were 5 ingestions in 2017 and 7 in 2018 that required endoscopic intervention at our institution. Of all ingestions, nearly half (10) had complications, which can be attributed to increased risk of perforation because of the strength of these magnets. This striking surge in multiple magnet ingestions demonstrates the need for improved regulatory guidelines for these small magnets.

Currently, the regulation of these magnets are voluntary safety standards, which are expected to be voted on soon ⁽²⁾. More needs to be done, however, to protect children from accidental ingestion of these small but dangerous magnets.