Three months after a series of deaths prompted the recall of 29 million unstable Ikea dressers, the federal government's top safety watchdog lashed out at the American furniture industry Wednesday and delivered an ultimatum: Develop stronger standards or have them forced on you.

Elliot Kaye, chairman of the Consumer Product Safety Commission, said the industry's own voluntary stability test, meant to ensure dressers remain upright if pulled on by children, is so "severely deficient" that the agency is considering taking the rare step of instituting a mandatory one.

"It's time to move forward if industry does not step up now," Kaye told reporters on a conference call. "We're serious about this because we're serious about child safety."

Such a mandate could result in costly changes for furniture manufacturers. Pushback from the industry was immediate.

"When the [CPSC] can present data to us that suggests these changes need to be made, the changes will be made," said Bill Perdue, an executive with the American Home Furnishings Alliance and chairman of the committee that creates the stability test.

He said a 64-page technical report arguing for tougher standards, prepared by the agency's engineers and released Wednesday, fails to meet that bar.

The clash set the stage for what could be a long battle between regulators and furniture manufacturers over the problem of tip-overs.

Later this month, the commission's five members will vote on the agency's 2017 operating budget, which includes a recommendation to take the first steps toward mandatory rule-making for dressers. That process can take years and is initiated primarily in cases where officials believe they can prove that a current standard is not adequately preventing deaths or is not being complied with by the industry.

On average once an hour - about 10,000 times a year - a child is rushed to an emergency room after being injured by a toppled piece of furniture, hospital data gathered by the agency show. That number skyrockets - to 33,000 injuries annually - when including tip-overs involving all ages and other products, including televisions and appliances.

Fatalities have remained consistent despite efforts to curb the threat, according to data released by the agency this week. In 2012, the last year for which complete data are available, 46 people were killed in tip-overs, most of them children. Since 2000, more than 411 children have been killed, the report showed.

In announcing a 29 million-product recall in June, Ikea cited six deaths and dozens of injuries caused by its products in the United States. (The dressers have also been recalled in Canada, China, and South Korea.) Three of the deaths involved the company's popular, low-cost Malm line. One occurred when Curren Collas, a 2-year-old from West Chester, was pinned beneath the six-drawer Malm in his bedroom in February 2014.

That product line and the others recalled do not meet the industry's voluntary stability standard, which requires that a dresser remain standing when a 50-pound weight is hung on an extended drawer.

On Wednesday, Kaye said other manufacturers were also ignoring the standard.

In a recent study, 31 of 61 dressers tested by agency engineers failed the stability test. More than 90 percent did not include adequate labels warning of the danger of tip-overs. Eighteen of the 61 units did not include tip restraints, a requirement of the standard, and eight others had tip restraints that were insufficient, the report found.

"Here's my bottom line," Kaye said. "First, it is a deeply troubling report. Second, I believe it is a call to action. And third, all options remain on the table to stop these products from killing children."

The agency declined to name the companies selling noncompliant dressers, but Kaye said the list includes members of the American Home Furnishings Alliance.

Perdue, who has said all his group's members comply, was skeptical.

"I'd like to know where his data is," he said.

Perdue on Wednesday said the safety agency's study focuses on noncompliance with the standard but does not show that the standard, which was last updated in 2014, is inefficient. He said regulators should enforce that standard through recalls and other means, rather than putting more restrictions on companies that already comply.

"Making changes to the standard will only cause compliant companies really to go even further - despite the absence of known injuries and deaths [involving their products] - while noncompliant companies continue to ignore the standard," he said.

Kaye said the agency would continue seeking recalls of noncompliant products.