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[IP] (Fwd) [IPm] "Phantom" Bolus's

------- Forwarded Message Follows -------
Date:          Thu, 18 Jan 2001 10:04:40 -0500
Subject:       [IPm] "Phantom" Bolus's

One of our pumper patients called the clinic yesterday complaining
about an ongoing pattern of lows yesterday morning through 2PM.  We
did trouble shooting over the phone and started with reviewing his
basal rates and bolus's.  He is on a D-Tron. When we got to the bolus
screen, he noted a mid am bolus that he didn't remember giving. He
went back through the bolus history and found 9 bolus's within an 8
minute time frame.  They were in increments of 0.1 to 1.0 for a total
of 2.4 units. As his ISF is 60, this explained his lows.  However, he
said he gave no bolus's at that time, to his knowledge and in fact was
 driving in his car. After further investigation, calling Disetronic
tech support and the local rep, we determined that his seat belt
buckle was hitting on the "up" arrow and giving him a series of mini
bolus's.  There are 2 ways to give a bolus on the D-tron.  One is to
just hit the "up" arrow until you've reached the desired amount (his
bolus rate was set in 0.1 unit increments, but it can be set in 0.2,
and 0.5 increments).  You do not have to hit any other button to
confirm.  Once the bolus starts, the pump gives one beep and one
vibration per increment.  He did not hear these as the pump was in his
pants pocket, beneath a heavy winter coat. The other way to give a
bolus requires selecting the bolus screen, setting the bolus, and then
confirming, before delivery begins. So, moral of the story on this
one, for us, was to attach the optional adhesive backed "0-ring" over
the "up" arrow, to prevent future accidental "phantom" bolus's. It is
a great pump, so, wanted to pass along this recent lesson we learned.
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