在凝珠問世后，洗衣劑造成的傷害案立刻增多。根據(jù)AAPCC的數(shù)據(jù)，2011年因洗衣劑傷害致電毒物控制中心有8186起；2013年數(shù)字上升到19753起。與洗衣劑有關的急診科就診人數(shù)增加更為明顯。2013年之后，每年至少有85%的傷害和79%的急診室就診案例中涉及6歲以下兒童。

“汰漬洗衣凝珠的設計非常吸引幼兒。”加拿大英屬哥倫比亞兒童醫(yī)院研究所的兒童心理學家瑪麗安娜·布魯索尼說。總體來看各家公司生產的洗衣凝珠“顏色、大小、手感、特別適合用手拿和放進嘴里，非常容易吸引孩子?！?/p>

布魯索尼強調，對于1歲或2歲的兒童來說風險最大，因為這么大的孩子已經可以自己走，但又分辨不出什么能吃什么不能吃。一兩歲的孩子把東西放進嘴里，“只是小小探索世界的一種方式”，而且可以減輕長牙的痛苦。如果孩子稍大一點，到了3歲或3歲以上，可能就會過了喜歡啃東西的階段，但還是會把凝珠誤認為糖果。

最嚴重的凝珠吞食案例類似于貝拉·曼西利亞斯的經歷：液體流入導致肺部積水并停止呼吸，切斷血液供氧導致大腦損傷，出現(xiàn)癲癇或昏迷癥狀。一些傷者眼部出現(xiàn)嚴重的化學燒傷。

為什么凝珠造成的傷害比洗衣液嚴重，醫(yī)療專業(yè)人士之間還沒達成共識。一種理論是，咬破凝珠時，里面的液體會噴射進喉嚨，迅速順著氣管流進肺部。另一個假設是凝珠里的洗衣液更為濃縮，例如汰漬洗衣凝珠有效成分與水的比例為90:10，而汰漬洗衣液里有效成分比例約為50%。（對醫(yī)療工作者來說比較麻煩的是，沒有法律要求制造商披露成分。）

AAPCC的總裁馬克·瑞安說，毒物控制中心第一次接到報告凝珠中毒的電話時，主要遵循洗衣液中毒的規(guī)則：讓誤食者喝點水，中心會在半小時后跟進。如果沒有嚴重癥狀，不建議誤食者去醫(yī)院。

隨著毒物控制中心發(fā)現(xiàn)凝珠導致越來越多嚴重傷害，很明顯不能再用老辦法。在瑞安負責的路易斯安那州毒物控制中心，他讓呼叫服務人員5到10分鐘后就要回電，監(jiān)測呼吸系統(tǒng)有沒有問題。如果出現(xiàn)異常，立即讓來電者送往最近的醫(yī)院就診。

然而，一些受害者最終沒撐到急診室。俄亥俄州斯普林菲爾德的丹尼斯·鮑爾斯是一位和藹有趣的老人，他女兒羅賓說，“一個陌生人也不認識”。丹尼斯是海軍老兵，俄亥俄州立大學七葉樹隊的死忠粉，1999年被診斷患有癡呆癥。2014年2月15日，他的妻子達琳回家放下一些雜貨，包括一袋汰漬洗衣凝珠，然后出去買別的東西。

達琳說，幾個小時后她回到家，發(fā)現(xiàn)丹尼斯倒在白色搖椅的靠背上。椅子上一片橙色，丹尼斯嘴里還有洗衣液，脈搏幾乎停止。達琳趕緊打911，但急救隊沒有救回丹尼斯，宣布他當場死亡，終年67歲。

Laundry detergent injuries spiked immediately after pods came out. In 2011 there were 8,186 calls to poison-control centers regarding laundry detergent exposures among the entire population, according to the AAPCC; in 2013, that figure rose to 19,753. Emergency-department visits related to laundry detergent increased even more sharply. And each year since then, at least 85% of exposures and 79% of E.R. visits have involved children under age 6.

“The Tide Pod, as it’s designed, is an ideal product for attracting toddlers,” says Mariana Brussoni, a child psychologist at the British Columbia Children’s Hospital Research Institute. With laundry pods in general, “in terms of the colors they tend to have, the size, the feel, the fact that it can easily fit in their hands and their mouths—this is something that would be very appealing.”

Brussoni emphasizes that the risk would be greatest for children 1 or 2 years old, who are old enough to be mobile but too young to know what’s appropriate to eat. For kids that age, putting things in their mouth is “just another way of doing little experiments on the world,” and can also ease the pain of teething. Slightly older children, ages 3 and up, would be past that phase—but would recognize pods as looking like candy.

The most severe of the pod-ingestion cases have involved symptoms similar to the ones suffered by Bella Mancillas: An influx of fluid causes the lungs to flood and shut down, cutting off the flow of oxygen to the blood so severely that it can cause brain injuries such as seizures or comas. Some victims also suffer severe eye injuries from chemical burns.

There’s no consensus among health professionals as to precisely why pods have caused more serious injuries than liquid detergent has. One theory is that when the packets are bitten, their contents shoot into the throat with such force that they flow quickly down the trachea into the lungs. Another hypothesis is that the concentration of packets plays a role: Tide Pods, for example, have a 90:10 active-ingredient-to-water ratio, compared with about 50% water for liquid Tide. (Another complicating factor for health care workers: Manufacturers are not legally required to disclose all of their ingredients.)

When pods first came out and poison-control centers began getting calls, the centers followed the rules of liquid detergent poisoning: The person exposed was told to drink a bit of water, and the center would follow up after a half-hour, says Mark Ryan, president of the AAPCC. If there were no serious symptoms, the person exposed was not advised to go to a health care facility.

As poison centers increasingly witnessed severe injuries from pods, it became clear that those rules no longer applied. At the Louisiana Poison Control Center, which Ryan directs, he instructed call responders to follow up after only five to 10 minutes and monitor for respiratory issues. If those were detected, the caller was directed to go immediately to the nearest emergency room.

A few victims never got that far. Dennis Powers of Springfield, Ohio, was a kind, funny man who “never knew a stranger,” according to his daughter, Robyn. A Navy veteran and die-hard Ohio State Buckeyes fan, Dennis was diagnosed with dementia in 1999. He was still in relatively good physical health on Feb. 15, 2014, when his wife, Darlene, dropped off some groceries at home, including a pouch of Tide Pods, and went out to get more supplies.

When she returned a few hours later, Darlene says, she found Dennis slumped over the back of his white rocking chair. The chair was covered in orange dye, and there was detergent coming out of Dennis’s mouth. He barely had a pulse. Darlene called 911, but EMTs couldn’t revive Dennis and pronounced him dead at the scene. He was 67.

丹尼斯的尸檢報告稱，死因是吞食凝珠導致窒息。袋子里的31個凝珠中有5個不見了，兩個在丹尼斯椅子旁的地板上，一個在酒杯里，一個在垃圾桶里，每個凝珠看起來都被咀嚼過。報告最后寫著：“剩下一個凝珠沒有找到?！?/p>

丹尼斯去世即將滿五周年時，達琳在俄亥俄州律師事務所努力保持鎮(zhèn)定，一邊回憶了整件事。達琳和羅賓說，能解釋丹尼斯吃凝珠的唯一原因就是看起來像糖果。達琳說：“他以前經常吃漩渦狀的救生圈糖果?！?/p>

Dennis’s autopsy report declares that he died from asphyxiation resulting from ingesting a pod. Of the 31 pods that came in the pouch, five were missing: Two were found on the floor next to Dennis’s chair, one in a drinking glass, and one in the trash can; all appeared to have been chewed. The report concludes: “The remaining pod was not found.”

Recounting the incident at her lawyer’s office in Ohio, just before the fifth anniversary of Dennis’s death, Darlene struggles to keep her composure. The only reason that could explain why Dennis ate a pod, Darlene and Robyn say, is that they look like candy. “He was used to eating swirled Life Savers,” says Darlene.