To the Editor.—
We recently cared for an 11-month-old child who drank up to 2 mL of a 20% benzocaine anesthetic teething gel, which was believed to be cherry-flavored acetaminophen. He was admitted to our institution for tachycardia (200 beats per minute, on average), which resolved over 24 hours, but otherwise suffered no untoward effects, including methemoglobinemia.
However, we were surprised to find that the potential poison was in a nonchildproof container.
The toxicity of benzocaine and has been well described and includes the potential for life-threatening and severe methemoglobinemia.1,2 While fatalities are rare, they do occur.3 For this reason, benzocaine is cited by multiple authors as a drug that can be lethal to children in small doses.4,5
Yet the Poison Prevention Act of 1970, which regulates which substances require childproof packaging, currently leaves benzocaine off the list.6 Other topical anesthetics...