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The 17-year-old traveled 250 miles with a bloody mouth, broken teeth and a hole in his jaw, trekking from a small town in Nevada to a pediatric hospital in Utah with his mother. There, doctors rushed him into surgery, working to reconstruct and repair shattered bone.

What he told doctors shocked them: The boy was vaping when, without warning, his e-cigarette exploded in his face. The freak accident, described in a case study published Wednesday, is just one of thousands in recent years.

“People need to know before they buy these devices that there’s a possibility they’re going to blow up in your pocket, in your face,” said Dr. Katie Russell, the trauma medical director at Primary Children’s Hospital who first treated the boy.

A CT scan of the 17-year-old boy, featuring his shattered jaw and displaced teeth.
Dr. Micah Katz & Dr. Katie Russell/NEJM
A CT scan of the 17-year-old boy, featuring his shattered jaw and displaced teeth.

It’s unclear what type of e-cigarette was involved in the incident.

Thousands of explosions and fires

One study published in 2018 estimated that more than 2,000 e-cigarette explosion and burn injuries sent users to US hospital emergency departments from 2015 to 2017. But few are aware of just how serious the incidents can be.

The teen from Nevada said he had no idea his vape could explode, according to Russell. He repeated the line over and over again in the emergency room, she remembers, and he was still “pretty freaked out” hours after the explosion.

“At that time, in my career, I had never seen this. I never heard of this as a possibility” said Russell, who described the boy’s injuries in the New England Journal of Medicine.

“I just wanted to get this out there so other people could know that this was possible,” she added.

The boy Russell treated was “a tough kid,” she said, and he healed well. But others have been less fortunate.

The boy healed well after six weeks and two surgeries, although he still hasn't recieved implants for his missing teeth.
Dr. Micah Katz & Dr. Katie Russell/NEJM
The boy healed well after six weeks and two surgeries, although he still hasn't recieved implants for his missing teeth.

Two dead, others injured in e-cig explosions

In February, a Texas man died after his e-cigarette exploded and shrapnel tore through his carotid artery. Part of the device remained lodged in the man’s throat at the hospital, according to his family.

About a year ago, a Florida man was also found dead after his e-cigarette exploded during use, sending a projectile into his head. Both cases involved “mechanical mods,” larger vaporizers that have more powerful batteries than many typical devices.

Both deaths were in adults, but numerous teenagers have reported burns from similar e-cigarette explosions. The injuries have mounted as experts warn of an “epidemic” of teen vaping, with almost 40% of 12th-graders using the devices, according to a report released last year.

One teen in Oregon nearly lost his eye when his vape exploded two years ago, according to CNN affiliate KYTV. Another 17-year-old told CNN affiliate KNXV in 2016 that “it was like [a] bomb going off” before her clothes caught on fire and an e-cigarette explosion left her with burns across her chest, arms and hands.

In one case from 2017, a 14-year-old girl was burned when an e-cigarette exploded in a nearby college student’s pocket while she was on a Harry Potter ride at Universal Studios. A year earlier, another 14-year-old was blinded after an e-cigarette exploded in a Brooklyn mall, according to CNN affiliate WPIX.

’Blast injuries’ and skin grafts

While experts and advocacy groups have long raised questions about the health effects of vaping, the risk of explosions and fires has received less attention. Some researchers, though, have sounded alarms.