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We have not encountered this problem with the tube-spacer device, and so we are grateful to Dr Johnson for bringing it to our attention. Similar to the situation with reporting the side effects of pharmacologic preparations, we need to be vigilant in detecting problems with new devices. Additonal problems may also arise with the other auxiliary aerosol-delivery systems. One hopes the manufacturers will be able and willing to correct these problems.
Tobin MJ. Spacer Inhalers-Reply. Arch Intern Med. 1986;146(4):805-809. doi:10.1001/archinte.1986.00360160261041