In Reply:-We concur with the Drs. Reddy and Cook-Sather that clinicians caring for infants and children should make every effort to minimize opportunities for ingestion or aspiration of foreign bodies. This represents a substantial challenge to the bedside care of this patient population, particularly in an era during which so many disposables are used.

We would like to thank the authors for bringing this incident to our attention, which they did promptly after the actual clinical event. This is the first report of its kind after 10 yr of market experience with these sensor accessories. We provide the referenced adhesive dots as a convenience for our customers who wish to extend the service life of an oximetry sensor for a given patient. Because the sensor frequently remains with the child as he or she progresses through hospitalization, we have provided the adhesives on a small card that is attached to the oximetry cable itself, making them accessible for use in each new location. We might suggest that this card be intentionally secured by the involved clinicians at the opposite end of the oximetry cable to keep it out of a child's reach. Additionally, the card containing the adhesive dots can be removed entirely if there is concern about accessibility to the child.

We thank the authors for bringing this event to our attention. It will receive both recognition and serious consideration as we continually strive to make our products the best and safest available.

Arthur H. Combs, M.D., F.C.C.P., F.C.C.M.

Director, Respiratory Care & Product Safety; Nellcor Puritan Bennett, Inc.; Pleasanton, California

(Accepted for publication August 7, 1998.)