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Pump malfunction?

Discussion in 'Parents of Children with Type 1' started by Lovemyboys, Oct 25, 2012.

  1. Lovemyboys

    Lovemyboys Approved members

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    We have an Animas Ping and we're having trouble with the combo boluses. We almost always use combo boluses and last April we noticed that the IOB didn't seem correct when using a combo bolus. I called Animas and they immediately replaced the pump. All seemed good for a few months, then we noticed the IOB again didn't seem right. Called Animas again and they sent out yet another pump. We got the pump yesterday and today with both pumps in hand, did the exact same combo bolus and now when it's finished one pump says IOB=0.22 and the other says IOB= 0.02. For us that's a big difference considering 0.2 units of insulin with theoretically bring down his bg 70 mg/dl. We've double and triple checked that the settings are the same and both pumps. We're on hold with Animas again, does anyone have any suggestions about who else to contact to help get this resolved? Anyone else notice anything like this? I now have no confidence in these pumps as now the "old" one now seems to be doing it right and the "new" one is not.
     
  2. mmgirls

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    you have IOB turned on, on both pumps ?

    You have duration set at the same length of time, on both pumps?

    My DD with her pump is at school so I can't look at a pump right now.
     
  3. momtojess

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    was there other IOB on one pump from a previous bolus?

    We've never had a problem with it, but we very rarely use combo bolus.
     
  4. Lovemyboys

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    Good questions. The IOB is turned on, on both pumps - set for 2.5 hours. There was 0.05 on board the "new" pump when we bolused for the combo. But it was the one that said the 0.02 at the end and the other one, the old one, the one that was higher at the end (0.22), had no IOB when we bolused.

    They are going to send us yet another pump, but that really doesn't help. We're also going to get an engineers report on the first pump they replaced. But, now we're really wanting to switch to a different manufacturer. I don't know if that's possible or not.
     
  5. mmgirls

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    what I would do is take the battery out of both pumps and put it back in, this will wipe out all IOB and then try your experiment again after checking that they are set up in the same exact way. make sure both combos are done the same way, maybe one was done with a higher % upfront portion?
     
  6. Lovemyboys

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    We just did another combo, but for only 30 min. this time, with 0 IOB on both pumps and they were within 0.05 of each other, which I think is an acceptable difference. We're going to try another longer combo for dinner and make sure there's no IOB again and see if it happens again. We took screen shots with a camera of both pumps the first time so we could double check the durations, percentages, etc. and have some "proof" (for us even, sometimes we think we're "seeing" things).
     
  7. Flutterby

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    Still not acceptable, should be the same exact IOB, .05 is still .05, that DOES make a difference. I hope you get this straightened out.
     
  8. Lovemyboys

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    You're right. I guess I was just glad it was better than 0.2 difference, but they really should be the same. They are sending yet another pump. sigh. I set up a meeting with a medtronic rep, as I don't have any confidence that this issue is going to be resolved.
     
  9. mmgirls

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    The .05 difference could be from the differeence in the timing of the delievery of the basal. I believe that the initial upfrom part of a combo is given immediately and the combo portion that is extended is added to the basal delivery doses, so every 3 minutes. It could just be the lag between the two. but definately something to be looking into.
     
  10. lizzie

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    I had problems with my animas pump and was able to get insurance to cover a minimed pump before my warranty was up. It just took a letter from the doctors office explaining why a different pump was necessary and it was approved no questions asked.
     
  11. Lovemyboys

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    That would explain the being a "little" off. Today every time I gave him a bolus on the one he was wearing, I gave it on the other one to. The IOB was the same until I gave the combo bolus and now it's only 1/2 an hour into the combo and they are 0.1 apart, and if the same thing happens as yesterday, by the end of the combo they will be 0.2 off again. It would appear that he is not getting the second part of the combo on one of the pumps. It says he's getting it when I look under the combo bolus, how much is given of the combo. But it's not reflecting it in the IOB, so we don't know if he is getting it or not.

    Good to know, we might be trying to switch soon. Are you satisfied with the minimed pump?
     
  12. Flutterby

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    I don't think that would show a difference, if boluses were given at the same time on two different machines, you should get the same active. unless they were given 15 or more minutes apart.. 30 sec, 1 minute, that shouldn't make a difference in active.
     
  13. Lovemyboys

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    I've narrowed down what the problem is. Sometimes the pump is not delivering the second half of the bolus. Now with two extra pumps in the house I'm running tests on them before I send them back (the paperwork said we have to return the old ones by 14 days, so I'm going to do a lot of testing with them). Here's what I got today:

    I did a .55u combo for 1.5 hrs. 30/70 on both extra pumps, both starting with 0 IOB. At the end of 1.5 hours one pump said 0.19 and the other said 0.04. So then I took the battery out to clear IOB and did a straight bolus for .15 (the first part of the bolus) and then at the end of 1.5 hours it says 0.04u. Whiched matched one of the pumps, so I believe that the pump it matched with failed to deliver (or failed to reflect in the IOB) the second half of the bolus.

    On both pumps though, when you go to the combo bolus it will say, for example .50 of .55 delivered, like it was delivering it. But on one of the pumps it's not reflected in the IOB, so I don't know if he's actually getting it or not.

    When I do a straight bolus the numbers match, it's when I do the combo bolus that it's hit or miss. Sometimes it seems to do it, and other times it won't.

    My next experiment is going to be with a bigger bolus on the two pumps not attached to him and see if I see a problem there, or if it's just in the little boluses we usually use.
     
  14. Beach bum

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    This is incredible. I am watching this post closely. We do a lot of combo bolusing, so I will be very careful.
     
  15. Lovemyboys

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    Probably a good idea, I'd be interested if anyone else has this problem.

    In my testing bigger combos, the result on both pumps didn't match exactly, but was within tolerance (I looked in the Animas manual and the tolerance for basal and bolus is + or - 5%). I gave a 4.15 unit bolus on the extra pumps 30/70 for 1.5 hrs. At the end of the combo (1 1/5 hrs.) the IOB was 2.62 and 2.47.

    I'm thinking that it's just the limitations of the pump to give these very small bolus combos accurately, and that with bigger boluses there is not going to be a problem.

    We're asking for the engineers report and hopefully will know more then, but it could take months. I'm thinking now of maybe pumping diluted insulin so we don't have to deal with these very small boluses and combos.
     
  16. Lovemyboys

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    We finally got to talk to someone at Animas that knew something about the problem we were having. It seems that if the combo bolus is less that .2/hr then it will not show up in the IOB. Also there is a 3-5% tolerance in the accuracy. They also said that every pump would perform slightly different.

    So here's our speculation: when we would give that particular bolus (for some reason, we use that one a lot): 0.55 with 0.16 up front and 0.39 on the extended (for 1.5 hrs), it comes to about .25/hr. Then maybe with the 3-5% accuracy sometimes it would put it in the IOB and othertimes not? I'm not sure what to think now. But we did give a slightly bigger bolus and it did show on the iob, then we just cancelled it when it got to what we needed it to be. I'm thinking it's not something that they can fix, just a limitation of the pump, but I'm glad to know that and now we can adjust for it.
     

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