My son Yitzi, 8 yoa, started pumping with insulin on May 2. Since that time
we have had good experiences and results with pumping. However, we have had
our first negative experience which resulted in an overnight hospital stay
so I want to share our story. My son is using the Animas pump with the
Medtronic Quickset 23" (60cm) tubing with 6mm cannula
(http://www.minimed.com/patientfam/pf_ipt_pumpinfusion_quickset.shtml
<http://www.minimed.com/patientfam/pf_ipt_pumpinfusion_quickset.shtml> ) and
Humalog insulin. I'll start the story on Shabbos Kodesh (Friday Night). I
went upstairs to sleep at about 12:35 AM when I heard the pump alarm. I
found that the pump was alerting an Occlusion, but no one else heard the
alarm and I had to pull the batteries to shut the alarm (used my teeth to
pull the strings and pushed the batteries back in with my knuckles). I was
able to do it fast enough that I didn't lose the basal settings. I tested
him and found he had a bg of 254. We had no problems the rest of Shabbos.

On Sunday, my son didn't eat breakfast until 11:00 AM. He ate and did not
bolus himself. His infusion site was changed at 1:00 PM. We realized he
didn't bolus himself as his BG went to 413 by 2:30 PM. We were having a
barbecue to celebrate our oldest son graduating elementary school. The party
was attended by 14 adults and 19 children. My son by his own admission ate
way too much (mostly protein in the form of hot dogs, burgers and chicken,
but some foods with carbs, french fries and baked beans). Based on his
correction and carb bolus we instructed Yitzi that he bolus 6 units. I work
on Sunday nights and left the house at about 5:00 PM. As usual on Sunday
nights, I tested Yitzi about 12:00 AM before I went to sleep. His BG was
324. His previous BG was 373 at 10:00 PM. I did not bolus him nor did I
check the bolus the Bolus history (if I had I may have avoided what I am
about to describe).

Yitzi awoke at about 5:30 AM on Monday and threw up. I tested his BG and it
was 245. We figured he just ate too much and that's why he threw up. I went
to shul and when I came home my wife told me that Yitzi threw up again. I
left for work still not thinking anything was wrong. At about 10:00 Am my
wife called me that Yitzi had ketones and that she spoke to the doctor and
that he felt Yizti should go to the hospital as a precaution. I called my
uncle who is a Hatzoloh EMT who came to the house and saw that my son was
dehydrated. Hatzoloh transported my son the hospital. They saw he was
dehydrated, started an IV and of course asked for the history. The initial
thought was that my son was suffering from food poisoning as my mother was
sick right after she ate (no one else at the party complained of feeling
ill). The doctors went through the menu of the barbecue, our food handling
procedures etc still thinking it was food poisoning. At about 3:00 PM we
finally looked at his infusion site and found that the cannula was bent and
crimped thereby causing him not to get enough insulin. They gave him insulin
by injection, admitted him and kept him on an IV. He slept most of the time
that he was in the ER and when he was transported to his room. He ate a
little chicken soup at 9:00 pm and went back to sleep. He awoke and kept
complaining of a headache which they gave him Tylenol. By 12:00 AM he was
feeling better and by 1:00 AM ate the rest of the food on his tray. I fell
asleep while he remained awake. He called my wife at 4:00 AM to tell that
the nurse was watching as I slept. He was discharged from the hospital at
2:00 PM on Tuesday and was riding his bike with his siblings at 7:00 PM.

Points to be learned from this episode

1. Don't be fooled by dropping BG #'s. Had I checked his boluses along
with the BG I should have figured the pump was not infusing properly.
2. When going to the hospital bring along extra infusion sets, insulin
and syringes. The ER had no Humalog, no infusion sets and no 3/10th CC
syringes.

Yehuda Y. Scheff, Supervising Special Auditor Investigator
NYS AG - MFCU
120 Broadway, 13th Floor
New York, NY 10271-0007
Tel: (212) 417-5658
Fax: (212) 417-5410
E-mail: yehuda.scheff@...
NYS AG WEBSITE www.oag.state.ny.us