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Re:[IP] Snapped tubing, defective insertion set

From: Al & Mary Rebholz <email @ redacted>
     Date: Sun, 10 Oct 1999 19:22:04 -0700
Mary, Kelly's Mom, wrote:
>We were using the same tubing for the two weeks that we use one
>cartridge of insulin, but are now changing tubing with every
>other set change as I suppose most people do.
Which cartridge are you using, Glass or Plastic ?
I suggest you use one cartridge & tube weekly, loading it
with 150+ units and setting the Disetronic pump for that size,
(rather than the "full load" 315 units) by pushing ONE of
H or M while the pointer is on "cartridge initialize",
BEFORE you push S button to do that initialization.
This is easier to estimate the 150u fill on Plastic cart.
This should let you use 3 infusion sets per tubing change,
and if you get your infusion-set changes out-of-sync with
your cartridge changes, just put the new tubing on the
new cartridge, even if it is a day or two after you opened
the package for using the cannula-set (needle) portion
of that package.
>had a tender insertion set where the part attached to the
>tubing didn't "click" into the part in her stomach.
>but when we changed the site, it  was actually falling out
>of the new(3days old) set.  Anybody else ever encounter this?
Sort of, had one set that I could not insert the tubing-clip
into. Yours sounds like the tubing-clip might have lost its
"teeth" or "latch springs" with its "over-use" (maybe ?)
>we got a system alarm the other day.  We're using Disetronic.
I assume this was "Error 07" ?
>I changed the batteries, and this solved the problem,
Probably would have cleared alarm by remove and replace the
original set of batteries because they probably were not low.
>but why didn't we just get a "low Battery alarm"?
Somehow, the pump's processors had become "confused",which
is what I understand "07" as meaning, NOT low batt 02 or 03
>The system alarm was obnoxious, and Kelly was at
>school, and obviously, the alarm couldn't be silenced
>unless the batteries were taken out,
>which Kelly nor anybody else knows how,
Well, do you really WANT the 7 year old to
unscrew BOTH of them with a nickel ?
(US 5-cent coin is easiest random tool I've found for the job)
>so the alarm continued until I got to the school.
The restart probably was going to need you anyhow, even if
any school personnel had been given copy of the "Alarm card"
which came with the pump describing all the codes to stop it.
Because you probably would not have wanted even school nurse
to do the "startup" of the pump again at either 150 or 315
units, because the battery insertion includes forgetting
how much it held and previous bolus history. (Your H-Tron
Plus pumps might remember more than my older non-plus ?)
>Also, why don't we get a "NO Delivery" alarm,
That is, I believe, a MiniMed 50X term.
Unless your "Plus" are labeled differently than my older
HTron's, the term is "occlusion" for "Error 04"
>when the cannula is blocked with blood and no insulin is getting through?
You probably don't want to waste the 10 or 20 units of insulin
and 2 minutes watching it, but if you want to, take that
"blocked, encrusted cannula" and point it into either:
1) the barrel of an ordinary 25- or 30- unit syringe you've
sealed the needle from with wax or soap
2) the cover from a Novo-pen Novo-fine needle, in the fashion
of it's instructions for 20-unit measured delivery test to the
frustrum of the cones.
Do either "prime" or "bolus" as you choose, to deliver the
pump's idea of measured amount, with the cannula opening
over the measuring device to receive the emitted insulin.
Does it really not pass ANY droplets when it "looks" blocked?
Does it delver measurably short of the expected amount?
Repeat with a STRONG clamp, such as a Vise-Grip pliers,
not just a slide-clamp, on the tubing (consider this
destructive, plan to replace tube when done):
See how many units of a bolus or prime attempt,
(then count hours of basal) it takes to get the "04"

Only thing besides this demonstration I've ever gotten
this message 04 for is running the plunger into the end of
the cartridge "beyond zero", such as for having underfilled
the cartridge, say 300 units when set for 315 units.
Also if I try to use the small remainder in the end of a
cartridge by shifting to the (usual for our MiniMed using
friends) "run it to the end", by re-starting at either
150 or 315 units after I reached the
0 units "Error 01" message stoppage.

David C. Winegarden
Fremont, CA

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