Medtronic certified pump trainer killed by own malfunctioning pump

None of the pumps mentioned in either article cited here was the 670, or even the predecessor that simply shut down insulin delivery based on CGM. They were simple pumps that give insulin as commanded to do so by the owner. I think today’s smarter pumps with auto shut off would if anything be safer (but that assumes the CGM is attached). When DN posted her experience with a 670 here, it was notable that it turned off all insulin for a few hours overnight while she was asleep after a dinner over-bolus and then turned it back on when her BG rose back to normal. I think that prevented a significant low and think it is a very useful safety feature, though she had other issues with it (mostly while awake).

Face it, insulin is a dangerous drug. In my case, 3 units of rapid insulin will take me down about 75 mg/dl. An average dinner meal for me will take a varying amount of insulin, but 15 units is not unusual. If I take 15 units when I need 12, then I can end up with a BG well into the danger zone (100-75 = too low). Clearly that can happen whether I inject (which is what I’m doing) or if I were using a pump.

I don’t think pumps are inherently unsafe, since there are too many people using them safely for them to be unreliable at delivering insulin or able to mistakenly deliver massive overdoses. In one of the articles it sounds like someone was priming their pump emptying the full reservoir while it was connected to their body. How can someone do that by mistake (suicide is possible)? I do think that the cases in these articles probably boil down to operator error. The fact that everyone cited in these articles is trying to sue their pump company to get a fat settlement makes me even more suspicious. And it kind of ticks me off, since I rely on these medical companies to keep me alive and make my life better, so the more millions of dollars they pay out in settlements the more expensive their life-saving drugs and technologies are.

I don’t use a pump because my basal need is usually relatively flat and I have found a way to manage (usually) dawn phenomenon. I don’t mind injections even though I give myself six or seven every day, and I don’t like the idea of having technology devices hanging off of me. I don’t think a pump would improve my control much, so I haven’t felt the need for a pump yet. I am going to get a CGM and give that a try, plus try some of the new insulins that have come on the market (Tresiba, Fiasp, Afrezza) so I’m not a complete stick in the mud.

That said, I am not opposed to trying a pump at some time if and when it seems likely that it will give me some real benefit. Getting a pump that works well with a CGM and delivers a decent automatic pancreas is the main reason that I would go with a pump; until then a pump would be for me mostly just a complicated syringe. But I recognize that for others, especially those with varying basals, or those for whom the current partial-AP is good enough, that a pump can be very useful and a big improvement over MDI.

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