The most significant mechanism is the generation of hydroxide ions at the negative pole of the battery caused by the current created through the adjacent tissue. Human tissue basically acts to ‘connect the circuit’ around the two poles of the battery. The resulting hydroxide accumulation is comparable to an alkaline caustic injury, leading to tissue liquefaction and necrosis. A tissue pH of >10 can occur rapidly driven by the voltage of the battery, but this is a powered alkaline burn. The higher the voltage, the faster this process occurs. While a clinically significant outcome is 3.2 times more likely with a fresh compared to a spent cell, of particular note, cells that are “dead” or “spent” and no longer meet the specifications required to power a product, still retain sufficient residual voltage to generate hydroxide and cause severe, even fatal, tissue damage. Any button battery with a residual voltage of 1.2 V or greater can cause injuries to surrounding tissue. Systemic heavy metal or lithium poisoning from leakage of button battery contents is not typically an issue, and the pressure of the battery itself is also not a major source of injury.
The most significant mechanism is the generation of hydroxide ions at the negative pole of the battery caused by the current created through the adjacent tissue. Human tissue basically acts to ‘connect the circuit’ around the two poles of the battery. The resulting hydroxide accumulation is comparable to an alkaline caustic injury, leading to tissue liquefaction and necrosis. A tissue pH of >10 can occur rapidly driven by the voltage of the battery, but this is a powered alkaline burn. The higher the voltage, the faster this process occurs. While a clinically significant outcome is 3.2 times more likely with a fresh compared to a spent cell, of particular note, cells that are “dead” or “spent” and no longer meet the specifications required to power a product, still retain sufficient residual voltage to generate hydroxide and cause severe, even fatal, tissue damage. Any button battery with a residual voltage of 1.2 V or greater can cause injuries to surrounding tissue. Systemic heavy metal or lithium poisoning from leakage of button battery contents is not typically an issue, and the pressure of the battery itself is also not a major source of injury.
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