Battery Ingestion Guidelines

Battery Exposures

Questionnaire # ________ (1-4)

Q.1 General Instructions - Battery Exposures (updated 5/1/14):
Most incidents will involve battery ingestion by a child, which resulted in the child's hospitalization.
The respondent will generally be the child's parent or guardian.
Bold type indicates what should be said to the respondent. Instructions for the interviewer will be
prefaced by "Interviewer:" and are written in non-bold type.
Interviewer: Please do not read choices or give examples unless explicitly instructed to do so for a
particular question. Also, if the respondent is unsure, then you can prompt. Do not read the
“Refused” or “Unknown” choices.

Q.2 Interviewer: Complete before dialing.
Enter task number (13 characters).
__________________________

(5-17)

Q.3 Interviewer: Complete before dialing.

Q.4

Enter Treatment Date, to be used in introduction (Ex: October 10, 2011):

__________________________________________________

(18-42)

Skip This Question - no response required.
__________________________________________________________________________________

(43-102)

Q.5 Hello, may I speak with a parent or guardian of [child's name] ?
Interviewer: If a parent or guardian is not available, please ask for a convenient time to call back.
Enter callback info on the Record of Call Sheet
(103)

q 1 Yes - continue call
q 2 No - call back
q 3 Refused
[IF THE ANSWER IS 3, THEN SKIP TO QUESTION 67]
[IF THE ANSWER IS 2, THEN SKIP TO QUESTION 68]

Q.6 Hello, I am [name] from [contracting agency], calling on behalf of the U.S. Consumer Product
Safety Commission. We are trying to learn more about battery exposure injuries in children to
prevent similar incidents from occurring in the future.
I would like to ask you some questions about a child's visit to the emergency room on
[ANSWER TO Q. 3], which involved a battery exposure.
The interview should take about 5 to 10 minutes. All answers will be kept confidential and will
be used for statistical purposes only. Your participation is voluntary.

Q.7 Are you familiar with the battery exposure incident that I just mentioned?
[Interviewer: If the parent or guardian is not familiar with the incident, ask to speak to an adult who
IS familiar with the incident. Enter callback info - including name and phone number, if different - on
the Record of Call Sheet.]
(104)

q1
q2
q3
q4

Yes - Continue interview
No - Call different respondent
Incident did not involve a battery, specify other product
Refused

[IF THE ANSWER IS 2, THEN SKIP TO QUESTION 68]
[IF THE ANSWER IS 4, THEN SKIP TO QUESTION 67]
[IF THE ANSWER IS 1, THEN SKIP TO QUESTION 9]

-2-

Q.8 Specify "other" product involved:
_________________________________________________________________________________

(105-164)

[IF THE ANSWER TO QUESTION 7 IS 3, THEN SKIP TO QUESTION 62]

Q.9 What is your relationship to the child involved in the incident?
(165)

q 1 Parent or Guardian
q 2 Other
[IF THE ANSWER IS 1, THEN SKIP TO QUESTION 11]

Q.10 Specify other relationship to the child
__________________________________________________

(166-190)

Q.11 Did you witness the child coming into contact with the battery?
[Interviewer: For example, did the respondent see the child put the battery in his/her mouth?]
(191)

q 1 Yes
q 2 No

Q.12 Did you witness the child showing symptoms from the battery exposure?
(192)

q 1 Yes
q 2 No

-3-

Q.13 As background information on the child, could you tell me if he/she had any developmental
issues before this incident, either mental or physical?
(193)

q1
q2
q3
q4

Yes
No
Unknown
Refuse to Answer

[IF THE ANSWER IS 2-4, THEN SKIP TO QUESTION 15]

Q.14 Please describe the issue(s).
_________________________________________________________________________________

(194-277)

_________________________________________________________________________________

Q.15 Please describe the incident, starting with what the child was doing just before he/she came
into contact with the battery, until the time he/she went to the emergency room.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

-4-

(278-777)

Q.16 Thank you. Now I'd like to go over some details about how the child came into contact with
the battery.
Before the incident occurred, was the battery housed in another product?
[Interviewer: Examples would be a toy, remote control, battery charging device.]
(778)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS 1, THEN SKIP TO QUESTION 20]

Q.17 Before the incident occurred, was the battery in its original packaging?
(779)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS 2 OR 3, THEN SKIP TO QUESTION 19]

Q.18 Had the battery packaging been opened prior to this incident?
(780)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS 1 OR 2 OR 3, THEN SKIP TO QUESTION 34]

Q.19 Please tell me anything you know about where the battery was located right before the child's
exposure:
_________________________________________________________________________________
_________________________________________________________________________________

[IF THE ANSWER TO QUESTION 16 IS 2 OR 3, THEN SKIP TO QUESTION 34]

-5-

(781-865)

Q.20 What product was the battery in? [Interviewer: Choose one. If you enter a single-digit number
response (ex: "5"), you will need to press "Enter" for it to be selected (its font will change). ]
(866-867)

q 01
q 02
q 03
q 04
q 05
q 06
q 07
q 08
q 09
q 10
q 11
q 12
q 13
q 14
q 15

Hearing Aid
Jewelry (incl. "play" jewelry)
Remote control device
Watch
Calculator
Portable light (flashlight, booklight, laser pointer, etc.)
Clock
Game
Toy
Camera
Greeting card
Book
Thermometer
Other
Unknown

[IF THE ANSWER IS NOT 14, THEN SKIP TO QUESTION 22]

Q.21 Specify "Other" product
_________________________________________________________________________________

Q.22 About how old was the product when the incident occurred?
____________________________________________________________

(928-957)

Q.23 For this product, is a tool (or coin) required to open the battery compartment?
(958)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS 1, THEN SKIP TO QUESTION 26]

-6-

(868-927)

Q.24 How does the battery compartment open?
(959)

q1
q2
q3
q4

Snap and slide (i.e., press a tab with finger and slide door open)
Unscrew and open (e.g., flashlights, penlights)
Other
Unknown
[IF THE ANSWER IS NOT 3, THEN SKIP TO QUESTION 26]

Q.25 Specify "Other" type of battery compartment
________________________________________________________________________________

(960-1044)

________________________________________________________________________________

Q.26 Was the product broken at any time before the child was exposed to the battery?
(1045)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS 2 OR 3, THEN SKIP TO QUESTION 29]

Q.27 Was the product repaired before the child was exposed to the battery?
(1046)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS 2 OR 3, THEN SKIP TO QUESTION 29]

Q.28 Please describe how the product was repaired .
_______________________________________________________________________________

-7-

(1047-1122)

Q.29 Just before the incident occurred, was the battery compartment intentionally left open? For
example, someone may have been in the middle of replacing the batteries in the product.
(1123)

q 1 Yes
q 2 No
q 3 Unknown

Q.30 Is there anything else about the product that you would like to mention?
_______________________________________________________________________________

(1124-1323)

_______________________________________________________________________________
_______________________________________________________________________________

Q.31 Who separated the battery from the product?
(1324)

q1
q2
q3
q4
q5

The child him/herself
Another child
An adult
Other
Unknown

[IF THE ANSWER IS 1 OR 3 OR 5, THEN SKIP TO QUESTION 34]
[IF THE ANSWER IS 2, THEN SKIP TO QUESTION 33]

Q.32 Specify "Other" individual/scenario that separated the battery from the product
_______________________________________________________________________________
_______________________________________________________________________________

[IF THE ANSWER TO QUESTION 31 IS 4, THEN SKIP TO QUESTION 34]

-8-

(1325-1409)

Q.33 Was the child who separated the battery from the product older, younger or the same age as
the child who was exposed to the battery?
(1410)

q1
q2
q3
q4

Older than victim
Younger than victim
Same age as victim
Unknown

Q.34 Which of the following scenarios best describes the child's battery exposure?
[Interviewer: First read the entire list through “Other”, then have the respondent choose one.]
(1411)

q1
q2
q3
q4
q5
q6

Child put battery in his/her mouth but did not swallow batter
Child swallowed battery
Child choked on battery (airway was at least partially blocked)
Child placed battery in his/her nose, ear or other body part besides mouth
Other
Unknown
[IF THE ANSWER IS NOT 5, THEN SKIP TO QUESTION 36]

Q.35 Specify "Other" hazard scenario of the battery exposure.
_______________________________________________________________________________

(1412-1496)

_______________________________________________________________________________

Q.36 Did the battery leak at any time during the child's exposure?
[Interviewer: For example, battery may have leaked during mouthing of battery or after ingestion.]
(1497)

q 1 Yes
q 2 No
q 3 Unknown

-9-

Q.37 At this point, I'd like to get some detailed information from you about the battery. So if you
need to step away for a moment to find the battery, or a battery similar to the one involved in
the incident, I can give you a minute to do that. Otherwise, I will need to rely on your memory.
[Interviewer: Choose a response below, depending on whether the respondent retrieves the battery]
Did the respondent retrieve a battery for direct reference?

(1498)

q 1 Yes
q 2 No

Q.38 Was the battery a rechargeable type?
(1499)

q 1 Yes
q 2 No
q 3 Unknown

-10-

Q.39 What size was the battery?
[Interviewer: Please read the list of battery sizes through “Other”, then ask the respondent to select
one.
If respondent is uncertain about the difference between a "button" or “coin” size battery, please refer
to the photo provided and offer the following descriptions:
Button battery: squat cylinder shape, smaller than a nickel, LESS than a half-inch/1 cm wide
Coin battery (e.g., nickel size): flat round disc-shape, size of a nickel or wider, MORE than a halfinch/1 cm wide
If you enter a single-digit number for a response (ex: "5"), you will need to press "Enter" for it to be
selected (its font will change).]
(1500-1501)

q 01
q 02
q 03
q 04
q 05
q 06
q 07
q 08
q 09
q 10

Button (less than a half-inch/1 cm wide)
Coin (half-inch/1 cm wide or more)
AA (double "A")
AAA (triple "A")
AAAA (quadruple "A")
C
D
9-volt (rectangular)
Other
Unknown

[IF THE ANSWER IS NOT 9, THEN SKIP TO QUESTION 41]

Q.40 Specify "Other" battery size.
_______________________________________________________________________________

Q.41 What was the voltage of the battery?
[Interviewer: This information is typically found on the battery, ending in “V”.]
______________________________

(1542-1556)

-11-

(1502-1541)

Q.42 What was the battery manufacturer or brand name?
[Interviewer: This information is typically found on the battery.]
_______________________________________________________________________________

(1557-1616)

Q.43 What was the model name and number of the battery?
[Interviewer: This information is typically found on the battery. On button or coin batteries, the
information is located on the positive (+) terminal of the battery. Do not read the following examples
unless asked:
-

CR 2032: lithium
CR 2016: lithium
SR516: silver
LR44 or AG13: alkaline]
_______________________________________________________________________________

(1617-1676)

Q.44 What material or materials was the battery made from?
[Interviewer: Do not read the choices unless respondent is uncertain . This information is typically
found on the battery in the form of abbreviations . Choose all that apply. After you enter each
number for a response, its font should change to show that it has been selected. ]
(1677-1684)

q1
q2
q3
q4
q5
q6
q7
q8
q9

Alkaline (ALK)
Lithium (Li)
Silver oxide (Ag2O)
Zinc (Z)
Manganese dioxide (MnO2)
Nickel (Ni)
Cadmium (Cd / Cad)
Other
Unknown

[IF THE ANSWER IS NOT 8, THEN SKIP TO QUESTION 46]

-12-

Q.45 Specify any "Other" material in the battery.
________________________________________

(1685-1704)

Q.46 Thank you for your patience. My final set of questions is about the child's symptoms and any
medical treatment received for the battery exposure.

Q.47 During the incident, did the child have any of the following symptoms?
[Interviewer: Read each choice (excl. “Unknown”), then enter the number of the response, if it
applies. If you enter a single-digit number response (ex: "5"), you will need to press "Enter" for it to
be selected (its font will change). Enter the numbers corresponding to all responses that apply.]
(1705-1726)

q 01
q 02
q 03
q 04
q 05
q 06
q 07
q 08
q 09
q 10
q 11
q 12

Vomiting
Drooling
Difficulty swallowing / gagging
Wheezing / difficulty breathing
Choking
Coughing
Loss of appetite / refusal to eat
Lethargy/Loss of energy
Chest discomfort
Burns, internal or external
Other
Unknown

[IF THE ANSWER IS NOT 11, THEN SKIP TO QUESTION 49]

Q.48 Specify any "Other" symptoms.
_______________________________________________________________________________

-13-

(1727-1786)

Q.49 Please describe any medical treatment the child received at the emergency room and any
additional treatment he/she received for the battery exposure.
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Q.50 Did the child have an x-ray?
(2287)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS NOT 1, THEN SKIP TO QUESTION 54]

Q.51 Was the battery found by the x-ray?
(2288)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS NOT 1, THEN SKIP TO QUESTION 54]

-14-

(1787-2286)

Q.52 In what area of the child's body was the battery found?
(2289)

q1
q2
q3
q4
q5

Esophagus/Throat (i.e., the tube that connects the mouth with the stomach)
Stomach (not including the intestines)
Intestines (includes small and large, "colon", etc.)
Other
Unknown
[IF THE ANSWER IS NOT 4, THEN SKIP TO QUESTION 54]

Q.53 Specify "Other" area of the child's body where the battery was found.
_______________________________________________________________________________

(2290-2349)

Q.54 Was the child admitted to a hospital?
(2350)

q 1 Yes
q 2 No
q 3 Unknown
[IF THE ANSWER IS NOT 1, THEN SKIP TO QUESTION 57]

Q.55 What was the reason given for the hospitalization?
_______________________________________________________________________________
_______________________________________________________________________________

-15-

(2351-2500)

Q.56 How many nights was the child hospitalized? If there were multiple hospitalizations, please
include the total number of nights the child stayed in a hospital.
[Interviewer: Write down the answer in whatever unit of time the respondent uses, e.g., "2 nights",
"3 months", "2 weeks"]
_______________________________________________________________________________

(2501-2660)

_______________________________________________________________________________
_______________________________________________________________________________

Q.57 Was the child ever sent home from the ER or a hospitalization while he/she was still in
contact with the battery?
[Interviewer: For example, child may have been sent home to wait for an ingested battery to pass
on its own.]
(2661)

q 1 Yes
q 2 No
q 3 Unknown

Q.58 How much time passed between when child was first exposed to the battery and when the
exposure ended?
[Interviewer: For example, in the case of ingestion, the battery may have naturally passed or been
surgically removed. Write down the respondent's answer using the time units they give.]
_______________________________________________________________________________

-16-

(2662-2721)

Q.59 Did the child experience any of the following complications from the battery exposure?
[Interviewer: Read each choice excl. “No complications” and “Unknown”, then check it if it applies.
Check all that apply. As you enter each number corresponding to a response, the font will change,
showing that the response was selected. ]
(2722-2726)

q1
q2
q3
q4
q5
q6
q7

Bleeding/Hemorrhaging
Damage to the esophagus (ulceration, perforation, etc.)
Pneumonia
Paralysis of vocal cords
Other
No complications
Unknown

[IF THE ANSWER IS 6-7, THEN SKIP TO QUESTION 62]

[IF THE ANSWER TO QUESTION 59 IS NOT 5, THEN SKIP TO QUESTION 61]

Q.60 Specify any "Other" complications.
_______________________________________________________________________________

(2727-2796)

Q.61 How were the complications treated?
_______________________________________________________________________________
_______________________________________________________________________________

-17-

(2797-2946)

Q.62 Due to the cultural diversity in the U.S., we sometimes have difficulty communicating
important product safety information to consumers. The following race and ethnicity
questions will help us to better educate the public on consumer product safety.
Do you consider the child in this incident to be Hispanic or Latino?
(2947)

q1
q2
q3
q4

Yes
No
Unknown
Refuse to answer

Q.63 What race or races do you consider the patient to be?
[Interviewer: Please read race choices aloud and ask respondent to
select ALL categories that apply.
The "Other" response may be selected by itself or in addition to the pre-defined race categories.
As you enter the number for each response, the font will change, showing that the response was
selected.
If the respondent only states "biracial" or "multiracial", please prompt for specifics (country of origin,
nationality, etc.). Otherwise, simply check "Other" and record "biracial" or "multiracial" as the answer
to the next question (Specify "Other" race").]
(2948-2953)

q1
q2
q3
q4
q5
q6
q7
q8

White
Black or African American
American Indian or Alaska Native
Native Hawaiian or Pacific Islander
Asian
Other
Unknown
Refuse to answer

[IF THE ANSWER IS NOT 6, THEN SKIP TO QUESTION 65]

-18-

Q.64 Specify any "Other" race of the child
________________________________________

(2954-2973)

[IF THE ANSWER TO QUESTION 7 IS 3, THEN SKIP TO QUESTION 67]

Q.65 Is there anything else you would like to add regarding this incident?
_______________________________________________________________________________

(2974-3173)

_______________________________________________________________________________
_______________________________________________________________________________

Q.66 On behalf of the Consumer Product Safety Commission, I thank you very much for your help.
If I missed anything, may I call you back at this number?
[Interviewer: If the respondent prefers you to call back at another number, record it on the Record of
Call sheet.]
(3174)

q 1 Yes
q 2 No

Q.67 Thank you for your time.
[Interviewer: Enter the interview completion date (mm/dd/yyyy).]
____________________

(3175-3184)

Q.68 End of Call. Interviewer: If call back needed, enter call back information on Record of Call Sheet.

-19-