Christmas bow pins: a potential inhaled foreign body made safer by industrial modifications

The 3M Company (Minnesota Mining and Manufacturing Company) has produced about three billion plastic Christmas bow pins over 20 years. When it was reported that inhalation of these pins had resulted in two deaths, the company sought otolaryngologic consultation to suggest design modifications which would decrease the risk of aspiration asphyxia. The circular base of the bow pin was modified into the form of a cross so that it would not completely obstruct the airway. Barium was added to render the bow pin radiopaque. When the unmodified bow pin was inserted into the larynx of ten cats, six died. The modified pin caused no deaths in nine cats. We regard this as an example of responsible cooperation between industry and medicine.