Iron ingestion continues to be one of the major contributors to pediat
ric poisoning deaths, In 1995, more than 22,000 children unintentional
ly received preparations containing iron, Despite child-resistant pack
aging and education of both the public and medical personnel, the numb
er of deaths has not significantly declined. Our patient, a 13-month-o
ld child, ingested prenatal vitamins and despite aggressive efforts di
ed 13 hours after his initial presentation, The patient's 3-year-old s
ibling had been evaluated at a local hospital 12 hours earlier for iro
n ingestion, Although there have been previous reports of death from i
ron ingestion, this case report is important because of the sibling's
presentation and medical evaluation 12 hours before our patient's pres
entation. This case illustrates the need for physicians to inquire abo
ut other children in the home, possibly preventing further tragic outc
omes.