(Received 11 September 1998; accepted 5 January 1999)
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A toddler died as the result of choking on a toy ball that occluded his upper airway. The size of this toy was within the federal safety standards for use by children under the age of three years. Though it has been recognized since 1987 that the minimum safe diameter set by the Federal Hazardous Substances Act may be too small, no change has been made to the regulation (1). In 1995 a comprehensive review of asphyxia related to the size of the foreign object found 4.44 cm diameter and 7.62 cm length a more comprehensive standard (1). Currently federal warning labels are required on some items that contain balls smaller than 4.44 cm to prevent use by children less than three years of age (2). The small parts fixture test in use by the federal government is available as a safety tool for parents to use at home. Unfortunately the “safe” diameter of 3.17 cm is too small to provide assurance that a toy is not a choking hazard.
Chief medical examiner, Onondaga County, Syracuse, New York
Stock #: JFS12047J