In reviewing oleander toxicity cases seen in-hospital, Lanford and Boor[39] concluded that, except for children who might be at greater risk, "the human mortality associated with oleander ingestion is generally very low, even in cases of moderate intentional consumption (suicide attempts)".[39] In 2000, a rare instance of death from oleander poisoning occurred when two toddlers adopted from a Siberianorphanage ate the leaves from a neighbor's shrub in El Segundo, California.[40]