Ask D"Mine: Whose Insulin Pump Is It Anyway?

http://type2diabetestreatment.net/diabetes-mellitus/ask-dmine-whose-insulin-pump-is-it-anyway/

Got questions about life with diabetes? So do we! That"s why we offer our weekly diabetes advice column, Ask D"Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

This week, Wil focuses on issues that arise when it"s time to replace your insulin pump. Are warranties in place to protect us patients, or the manufacturer, or both? Read on to hear Wil"s POV...

Got your own questions? Email us at AskDMine@diabetesmine.com

Pat, type 1 from Idaho, writes: My Revel pump recently gave me an error code. When I called Medtronic, they recommended I discontinue using the pump because it was a memory error. Since I had a new backup that I had ordered after the warranty on this one was up, I switched. Generally speaking the pump people at Medtronic seem nice, informed and helpful. But they insisted that I return the first pump to them so that they could “get information about what went wrong.” That would help them, and me as well, they said. They also said they didn’t want me using the pump as a backup because they didn’t consider it reliable and they want me “to be safe.”

All of this sounds reasonable enough. But to be honest -- I don’t trust drug companies or medical supply companies anymore. They seem to have gone rogue -- gouging people on the price of blood so to speak. I paid $7,000 for that machine. Do they really want it back for the reasons they gave me? I would be willing to take the chance on using it as a backup since I think it would be easier to handle problems with a pump than problems with going back to long-acting insulin temporarily. Maybe I’m wrong. But I am suspicious in any case, and I’m very interested in what you think.

Wil@Ask D’Mine answers: I think that Medtronic is genuinely interested when something goes wrong with their gear. More on that in a moment. But first, let’s admit to the one thing that we’d rather not accept about our life support systems: Things do go wrong with them. Insulin pumps are crazy-complicated. While they are thoughtfully designed, well-tested, FDA-approved, carefully built and all of that, they sometimes still fail out in the real world.

So what is Med-T’s motivation when this happens? Is their desire to understand gear failure greed-based? Partly, sure. They want to avoid lawsuits, bad PR, and the lost business that can come from gear failure. They are running a business after all, and it’s bad for businesses when your product starts killing people. But that’s not their only motivation. I’ve visited Medtronic"s Southern California headquarters more than once. There are a lot of type 1s working in that building, and a lot more folks under that roof who have family members wearing insulin pumps.

A number of years ago, in a moment of frustration over an insulin pump issue I was having, I said some nasty things to a pump executive about what I thought of his company’s soul. Basically, I said that they were placing profits over patient safety. Of course I said it with language that would have made a sailor blush. His simple protest stayed with me. He said, “That’s not fair, Wil. For God’s sake, our children wear these pumps.”

So yes, Med-T may be a profit-driven, price-gouging rogue behemoth on the one hand, but on the other hand, they’re still part of the family. Sorta of like the greedy ultra-successful (but stingy) distant uncle that you both despise and secretly admire at the same time. The difference being your uncle may not view himself as part of the family anymore.

I guarantee you that Medtronic views itself as part of our diabetes family.

So while their motives are probably a mix of purity and profit, on balance I think it’s a good thing that they want to do a postmortem on your old pump. Note that if the pump is still fairly new when it fails, and you suspect the problem could be part of a larger issue that might lead to a product recall, for example, we"ve been given the advice to keep the device as a key piece of evidence.

But assuming you"re not thinking litigation, then maybe sending your dead pump back can allow the manufacturer to figure out what happened, understand under what circumstances it happened, and make sure they take whatever action is needed to ensure that it doesn’t happen to one of your other brothers or sisters in the future. Whether it’s a deadly serious error or an annoying false alarm, it’s a risk or stress that none of us needs in our lives.

But it’s still your hard-earned $7,000 pump. As it’s out of warranty, and as you have a new one, I’m sure that they felt no need to offer you a replacement pump as compensation. But, just like you, I have a problem with that. Let’s face it, ever since the Titanic, people are kinda queasy about taking to the ocean in ships that don’t have enough lifeboats, much less ships that don’t have any lifeboats at all.

And diabetes is a big ocean.

To their credit, pump companies do the best they can to get replacement pumps out to us promptly when something goes wrong. But we aren’t at the Star Trek, “Scotty beam me a replacement pump” point yet. FedEx is only so fast. Pumps tend to crap out on weekends and holidays, and sometimes even a perfectly nice spring day is ruined by crazy weather that shuts down all the highways and a major airport.

But even when everything goes smoothly in getting a replacement pump shipped out, let’s not lose sight of the fact that a single day pumpless is an eternity to us. Once you’ve been on a pump for any period of time, you lose your ability to manage your diabetes old-school. Hell, even with a gun pointed to my head, I doubt I could pull from memory my current total daily basal insulin, much less remember how to reverse-engineer that number into a basal dose from a syringe.

Never mind the fact that my backup vial of Lantus expired in 2008.

So I’m with you in thinking that nothing beats a backup pump. That’s what I loved most about Roche’s old Spirit pump system. It came with two pumps in the box. The handsome denim blue one was your primary. The white one was your lifeboat. It was identical in every way to the main pump except for the fact that it had a self-destruct mechanism: The backup pump would only work for a couple of months.

What’s up with that? Well, it gave everyone time to sort out the problem and get a faulty pump replaced without paying heaps of money for overnight packages that get tied up in holidays, weekends, and snow storms, or leaving the pumper pumpless and dealing with a bottle of Lantus that expired seven years ago. Why the self-destruct? Roche, fairly enough, didn’t want us poor diabetes folks inventing a two-for-one prescribing strategy.

I thought it was a beautiful, fair and balanced solution. A safe one. It was probably the best thing Roche ever did in its entire corporate history. I wish they’d go back to that approach with their new pumps.

Oh, off topic, but I want to remind everyone that if you’re traveling overseas (or in some cases just over the sea to Hawaii), most pump companies do have a lifeboat loaner program that allows you to carry a spare pump for the duration of your trip.

But back to you, Pat, and Medtronic’s desire to deprive you of your possibly faulty and life-threatening spare pump. What to do? I think you should refuse to return the old pump to them unless they agree to a trade: Your old ticking lawsuit of a pump for a used, refurbished backup pump.

It’s a fair solution: They get to dismantle your faulty pump, which benefits them, and you get to sleep at night knowing there’s a seaworthy lifeboat outside your cabin window.

One that you’ve already paid for.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

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