A flow restrictor on liquid medicine bottles could prevent accidental ingestions, but drugmakers have yet to promise or deliver such protection on many pediatric medicines

Flow Restrictors: Using a syringe, Daniel Budnitz measures out a dose of medicine from a bottle fitted with a flow restrictor. Image: Bryan Metz/ProPublica

Starting in 2007, Dr. Daniel Budnitz, a scientist at the Centers for Disease Control and Preventions Medication Safety Program, began tracking an obscure but unsettling statistic about childrens health.

Each year, more and more kids were being rushed to emergency rooms after swallowing potentially toxic doses of medication. By 2011, federal estimates put the figure at about 74,000, eclipsing the number of kids under 6 sent to ERs from car crashes.

In most cases, children experienced no lasting harm from accidentally ingesting pills or liquids from the family medicine cabinet, but about 1 in 5 had to be hospitalized for further evaluation. About 20 children died each year from such accidents, CDC data showed.

As an epidemiologist and the father of two kids, including one who had a penchant for putting things in his mouth, Budnitz became fixated on reducing drug overdoses.

In particular, he saw an easy solution for the roughly 10,000 emergency room visits a year involving liquids, such as over-the-counter pain relievers and prescription cough syrups.

It was a type of safety valve called a flow restrictor. The small plastic device fits into the neck of a medicine bottle and slows the release of fluid, providing a backup if caregivers leave child-resistant caps unfastened or kids pry them off.

In 2008, Budnitz persuaded drug makers, federal regulators and poison experts to come together on an initiative to add flow restrictors, which cost pennies apiece, to medicine bottles.

Today, however, that promise to make medicine safer for kids remains largely unfulfilled, hindered by industry cost concerns and inaction by federal regulators, an examination by ProPublica found.

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Why a Safety Device That Can Stop Overdoses by Kids Isn't Widely Used