Original ArticleMalicious Use of Pharmaceuticals in Children
Section snippets
Methods
This is a retrospective database study characterizing all pharmaceutical exposures in children <7 years old reported to the National Poison Data System (NPDS) and coded as “malicious.” The University of Colorado Institutional Review Board approved this study.
Cases were identified from the NPDS (a database of all calls to US poison centers). A query was performed for the years 2000 to 2008 for all cases meeting the following criteria: the intent was coded as “malicious,” age was <7 years old,
Results
Of approximately 21.4 million exposures reported to NPDS during the study period, 1439 (0.007%) cases met inclusion criteria comprising 1634 total exposures. The mean number of cases per year was 160 (range, 124 to 189). Cases increased over time in a linear model (P = .006). Boys were involved in 56.6% of the cases. The median (IQR) age was 2 years (1.5). Table I shows the distribution of ages and outcomes. Outcome data were available for 1244 (86.4%) patients. Of these cases, 13.8% resulted
Discussion
On average, 160 cases per year were reported to US poison centers during the study period, including an average of two deaths per year. Cases reported to poison centers increased over time. As a practical matter, only exposures to pharmaceuticals were included in this study. This would only underestimate the true incidence of child maltreatment by poisoning as cases with nonpharmaceuticals such as caustic agents,17 rodenticides,18 and ethylene glycol19 have been reported. Although Kempe et al20
References (31)
- et al.
Criminal poisoning: Munchausen by proxy
Clin Lab Med
(2006) - et al.
Pediatric fatalities associated with over the counter (nonprescription) cough and cold medications
Ann Emerg Med
(2009) - et al.
Drug facilitated sexual assault using an over-the-counter ocular solution containing tetrahydrozoline (Visine)
Leg Med (Tokyo)
(2007) - et al.
Infant crying and abuse
Lancet
(2004) - et al.
Surveillance of poisoning and drug overdose through hospital discharge coding, poison control center reporting, and the Drug Abuse Warning Network
Am J Emerg Med
(1993) - et al.
Child abuse and neglect
Curr Probl Pediatr Adolesc Health Care
(2009) - et al.
Trends in postneonatal mortality attributable to injury, United States, 1988-1998
Pediatrics
(2003) Evaluation of suspected child physical abuse
Pediatrics
(2007)- et al.
Underascertainment of child abuse mortality in the United States
JAMA
(1999) - et al.
Pediatric toxicologic deaths: a 10-year retrospective study
Am J Forensic Med Pathol
(2001)
Child and adolescent victims in forensic autopsy: a 5-year retrospective study
J Forensic Sci
A study of drug detection in a postmortem pediatric population
J Forensic Sci
Factitious hyperinsulinism leading to pancreatectomy: severe forms of Munchausen syndrome by proxy
Pediatrics
Munchausen syndrome by proxy
Arch Dis Child
Over-the-counter cold medications-postmortem findings in infants and the relationship to cause of death
J Anal Toxicol
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The authors declare no conflicts of interest.