By E Marla Felcher. (Pp 302; US$17.95.) Common Courage Press (PO Box 702 Monroe, Maine 04951), 2001. ISBN 1-56751-204-6.

This is a passionate, powerful, and well informed book written by an academic and journalist trying to show why the cherished child of well informed and safety conscious professionals died in a nursery product that had been declared dangerous and withdrawn years before the child died.

Seventeen month old Danny strangled in the “V”-shaped wedge formed when the portable cot he was in partially collapsed. This was not an isolated incident. The cot had been ordered from the market five years before because of child deaths. Danny is thought to be the 12th child who died because of a similar faulty design. Three months later a 13th child died.

Dr Felcher makes the case in the introduction “the issue is how a regulatory system allowed more than a dozen children to be killed by a .. cradle (chapter 1), 66 children to die in bath seats (chapter 2), and six children to die in a .. portable crib (chapter 3). . . . Manufacturers who failed to adequately test their products and a government agency that has been stripped of the authority and budget it needs were responsible for these deaths. The deaths were not accidents. And . . .(without action) these tragedies will occur again and again and again”.

The chapter headings outline the argument: (1) The Graco Converta-Cradle: A Deadly New Product Disaster; (2) Inadequately Tested Baby Products Hit the Market; (3) A Recall Process That Fails to Alert Consumers About Infant Product Dangers; (4) Corporations That Are Fined by the CPSC for Concealing Product Hazards; (5) Regulatory and Legal Systems That Allow Companies to Keep Consumers in the Dark About Dangerous Children's Products; (6) What Parents Can Do to Keep Their Infants Safe; (7) What the US Government Must Do to Improve the Safety of Baby Products, and How Parents Can Help. There are hundreds of references and sources in the endnotes and a full index.

The case histories of the deaths of named children confront the reader with the real cost of systemic failure. For example, details are given of a 1991 case in which police charged a single mother with negligence in the death of her child—she had left the 2 month old in a brand new motorised cradle in care of her 13 year old son while she went to the store. While this is something child safety organizations strongly advise against Felcher shows the contribution of system failure. She reports that three months before the baby died, the US Consumer Product Safety Commission (CPSC) had written to the manufacturer instituting a product review over two serious incidents (one death). The company stopped production but did nothing about the product in the shops and in the next four months, as the product was investigated, four more children died. By the time the product was recalled, 13 months after this child's death, the recall notice mentioned two deaths and two “near deaths” but the book reports that reporters found 12 deaths and 21 incidents of injury or near misses (p 16). The final horror of the story is that the process of legal discovery showed that the company engineers had identified the “fatal flaw” in design seven months before the product went to market and had suggested a solution.

It should be noted that some change is occurring. For example the Kids in Danger (KIDS) organization is monitoring and championing the Children's Product Safety Act, which prohibits the sale or lease of any unsafe products and requires childcare providers to certify they have checked and removed recalled products—to date the Act has been passed in five states.

Of necessity this is an American-centric book but there are strong lessons for other jurisdictions. For example, in Australia the power of regulators to mandate standards, to institute recalls, and require paid advertisements are different to those in America but there are major difficulties in knowing when problems occur and the US experience helpful. Australian product safety specialists have been arguing for over a decade that industry should be legally required to report problems to authorities as they become aware of them, similar to the system in the US.

If the system can fail so badly in a rich and well organised society then the rest of us, in a world in which US standards and preferences have such a significant role, need to seriously examine the situation in our areas of control.