Iron ingestion continues to be one of the major contributors to pediatric poisoning deaths. In 1995, more than 22,000 children unintentionally received preparations containing iron. Despite child-resistant packaging and education of both the public and medical personnel, the number of deaths has not significantly declined. Our patient, a 13-month-old child, ingested prenatal vitamins and despite aggressive efforts died 13 hours after his initial presentation. The patient's 3-year-old sibling had been evaluated at a local hospital 12 hours earlier for iron ingestion. Although there have been previous reports of death from iron ingestion, this case report is important because of the sibling's presentation and medical evaluation 12 hours before our patient's presentation. This case illustrates the need for physicians to inquire about other children in the home, possibly preventing further tragic outcomes.