Retrospective analysis of 215 deaths in the bathtub (Institute of Forensic Medicine, University of Cologne, 1980-1993) revealed 12 fatalities involving children, seven boys and five girls, aged from 9 months to 13 years. The manner and cause of death was seven accidents (five by drowning, two by scalding burns), two natural deaths (epilepsy, heart failure due to Hurler's syndrome), one homicide (stabbing) and two undetermined cases (one probable seizure, one subdural hematoma associated with signs of maltreatment). Seven children < 4 years old died without exception from accidental drowning or scalding. Three toddlers had been left alone and unattended in the bathtub for a 'short time' (< or = 15 min) and two in the care of elder siblings. The immersion time and the amount of water required to cause lethal drowning are expressed in the terms of pathophysiology.