Meet our experts
Toby Litovitz, MD

Dr. Toby Litovitz, a medical toxicologist and emergency physician, founded the National Capital Poison Center in 1980 and served as its Executive and Medical Director until 2018, then becoming the Center’s webPOISONCONTROL Director. She also served as Executive Director of the American Association of Poison Control Centers from 1994 to 2004. She was a tenured Professor of Emergency Medicine at Georgetown University through 2018, now a regular professor (faculty since 1979) and a Clinical Professor of Emergency Medicine at The George Washington University (since 1994).
Dr. Litovitz co-founded the nation’s only poisoning surveillance database (originally called the National Data Collection System, later renamed the Toxic Exposure Surveillance System, and now called the National Poison Data System), and coordinated the compilation, development and analysis of that database for two decades (1984-2005). She authored more than a hundred publications in clinical toxicology, with a focus on hazard detection, button battery ingestions, and surveillance. She directed the National Button Battery Ingestion Hotline for 36 years, publishing extensively about this hazard, including the landmark analysis of 8,648 battery ingestions published in Pediatrics in 2010 which alerted health professionals to the seriousness of lithium coin cell ingestions.
For the past decade, Dr. Litovitz has devoted her efforts to the automation of Poison Control, through development of the innovative online webPOISONCONTROL tool and app (see www.poison.org). webPOISONCONTROL is intended for users who will not or cannot call a poison center, providing a trusted, expert resource for the public seeking do-it-yourself online help with a poison exposure and for specialists in poison information handling calls in poison centers.
Dr. Litovitz graduated from Oberlin College (1974), Washington University School of Medicine (1976), then trained in Emergency Medicine at Georgetown University before joining Georgetown’s Department of Emergency Medicine faculty.
Selected Publications
2020 webPOISONCONTROL data summary
Increasing use of the internet for health information has decreased utilization of traditional telephone-based poison centers in the United States. An analysis of 156,202 webPOISONCONTROL cases from 2020 showed that the tool provides a safe, quick and fully-automated alternative for those who are unable or unwilling to use the telephone to call a traditional poison center. It further highlights the app’s potential for health surveillance and hazard detection.
Reid NE, Johnson-Arbor K, Smolinske S, Litovitz T. 2020 webPOISONCONTROL data summary. Am J Emerg Med. 2022;54:184-195. https://doi.org/10.1016/j.ajem.2022.02.014
The American Journal of Emergency Medicine
webPOISONCONTROL: Can poison control be automated?
A free webPOISONCONTROL app allows the public to determine the appropriate triage of many poison exposures without calling a poison center. This analysis of 9,256 cases demonstrates that webPOISONCONTROL safely provides automated, accurate online access to case-specific triage and first aid guidance for poison exposures. It is quick and easy to use.
Litovitz T, Benson BE, Smolinske S. webPOISONCONTROL: can poison control be automated? Am J Emerg Med. 2016; 34(8):1614-1619. Epub 2016 Jun 7. PMID: 27321939.
The American Journal of Emergency Medicine
Emerging battery-ingestion hazard: clinical implications
Recent cases suggest that severe and fatal button battery ingestions are increasing and current treatment may be inadequate. The objective of this study was to identify battery ingestion outcome predictors and trends, define the urgency of intervention, and refine treatment guidelines.
Litovitz T, Whitaker N, Clark L, White NC, Marsolek M: Emerging battery ingestion hazard: Clinical implications. Pediatrics 2010;125(6):1168-1177. Epub 2010 May 24.
Pediatrics
Preventing battery ingestions: an analysis of 8648 cases
Outcomes of pediatric button battery ingestions have worsened substantially, predominantly related to the emergence of the 20-mm-diameter lithium cell as a common power source for household products. Button batteries lodged in the esophagus can cause severe tissue damage in just 2 hours, with delayed complications such as esophageal perforation, tracheoesophageal fistulas, exsanguination after fistulization into a major blood vessel, esophageal strictures, and vocal cord paralysis.
Litovitz T, Whitaker N, Clark L: Preventing battery ingestions: an analysis of 8648 cases. Pediatrics 2010;125(6):1178-1185. Epub 2010 May 24.
Pediatrics
The impact of bittering agents on pediatric ingestions of antifreeze
Despite the appealing logic of limiting the ingested volume and thereby the severity of poisonings by adding aversive agents, and despite promising results in volunteer studies, bittering agents do not decrease the frequency or severity of pediatric antifreeze poisonings. The addition of bittering agents to household products cannot be justified based on actual poisoning data.
White NC, Litovitz T, Benson BE, Horowitz BZ, Marr-Lyon L, White MK: The impact of bittering agents on pediatric ingestions of antifreeze. Clin Pediatr (Phila) 2009; 48(9):913-21. Epub 2009 Jul 1.
Clinical Pediatrics
The Toxic Exposure Surveillance System (TESS): risk assessment and real-time toxicovigilance across United States poison centers
The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations.
Watson WA, Litovitz TL, Belson MG, Wolkin AB, Patel M, Schier JG, Reid NE, Kilbourne E, Rubin C. The Toxic Exposure Surveillance System (TESS): Risk assessment and real-time toxicovigilance across United States poison centers. Toxicol Appl Pharmacol. 2005;207(2):S604-S610.
Toxicology and Applied Pharmacology
2003 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System
Toxic Exposure Surveillance System (TESS) data are compiled by the American Association of Poison Control Centers (AAPCC) on behalf of US poison centers. These data are used to identify hazards early, focus prevention education, guide clinical research, direct training, and detect chem/bioterrorism incidents.
Watson WA, Litovitz TL, Klein-Schwartz W, Rodgers GC, Youniss J, Reid N, Rouse WG, Rembert RS, Borys D. 2003 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2004;22(5)335-404.
The American Journal of Emergency Medicine
Ingestion of cylindrical and button batteries: An analysis of 2382 cases
During a 7-year period, 2382 cases of battery ingestion were reported to a national registry. Button cells were ingested by 2320 of these patients; 62 patients ingested cylindrical cells. These cases are analyzed to reassess current therapeutic recommendations, hypotheses about battery-induced injury, and strategies for prevention and intervention.
Reid NE, Johnson-Arbor K, Smolinske S, Litovitz T. 2020 webPOISONCONTROL data summary. Am J Emerg Med. 2022;54:184-195. https://doi.org/10.1016/j.ajem.2022.02.014
Pediatrics
Comparison of pediatric poisoning hazards: an analysis of 3.8 million exposure incidents. A report from the American Association of Poison Control Centers
This analysis of life-threatening and fatal pediatric poisonings was conducted to aid poison prevention educational efforts, guide product reformulations and aversive agent use, reassess over-the-counter status for selected pharmaceuticals, and identify research areas for clinical advances in the treatment of pediatric poisonings.
Litovitz T, Manoguerra A: Comparison of pediatric poisoning hazards: An analysis of 3.8 million exposure incidents. Pediatrics 1992;89(6 Pt 1):999-1006.
Pediatrics
Button battery ingestion: assessment of therapeutic modalities and battery discharge state
Button batteries immersed in a simulated gastric environment (0.1N hydrochloric acid) demonstrated less crimp dissolution (corrosion of the metal can) after the addition of neutralizing doses of eight of nine antacids tested. Of 64 ingestion episodes in dogs, clinical manifestations of button battery-induced injury were limited to a single animal developing guaiac-positive stools. Endoscopic lesions included only mild gastritis, occurring with a frequency comparable to that observed in dogs prior to battery ingestion.
Litovitz T, Butterfield AB, Holloway RR, Marion LI. Button battery ingestion: Assess¬ment of therapeutic modalities and battery discharge state. J Peds 1984;105(6):868 873.
The Journal of Pediatrics