Occlusions and high readings using flexi cannulas

[Old_git]

I had been on an Accu-Chek Combi pump since October 2011 with no real problems (type 1 since 1971), using steel cannulas.
It came up for a 'refresh' a couple of months ago and I chose another Roche pump, the Aviva Insight. There were problems with the handset, it's batteries and error messages. Eventually sorted out so I had confidence in its reliability about the same time as the Insight Rapid steel cannulas were withdrawn due to manufacturing fault or something.
Therefore tried using the Flex type. The problem seems to be when using those that I get occlusions and/or high blood glucose levels, when I revert back to steel cannulas (against the advice from Roche) it all goes back to 'normal'- I am not convinced that the flexes work properly and perhaps get kinked when inserted or after? I follow the instructions and guidance but there is no way of telling their position when inserted - once the steel ones are in, you know exactly where they are!
I would be interested to hear if others have had similar issues........

 

[catherinecherub]

Welcome to the forum @Old_git,

I will bump your post up for a reply.

 

[sofaraway]

You could try some insight tender cannulas which go in angled so may not bend. But rumour has it adhesive isnt great on them. Or you could get Roche to swap your Insight with a Combo- they are doing this if asked

 

[Old_git]

I have thought about reverting to the Combo which I still have but not sure if the steel cannulas suffer from the same manufacturing fault that the Insight ones have.

 

[Ruth0212]

Hi, I have the same problem sometimes with the flexi cannulas. It's got to the point that If I still have high sugars 1hr after doing a correction bonus I just change the cannula automatically. They seem to be affected if there is the tiniest kink in the cannulas. I've tried the tender link ones and they are very reliable but they are scarier to insert and leave me with scars at insertion sites. (Also I found adhesive was fine)

 

[Hannibal]

My daughter changed to an Insight from a Combo and suffered a kinked cannula resulting in DKA. We have reverted to the Combo and have had no problems even though she uses the Flex-Link cannulas with the Combo. I think it's the Insight's new Flex-Link Plus cannulas at fault, probably something to do with the spring loaded retractor mechanism that folds the needle back into the cap after you pull it out. The older cannulas had a smaller adhesive footprint too which was better.

 

[Ruth0212]

I'm using the flexi link plus, so you may have a point Hannibal. (I'm sure it's the cannulas at fault rather than the pump itself-I'm using a combo) I may try the ordinary flex links to see if it makes a difference (I've had about 4 occlusions today)

 

[donnellysdogs]

Are the tenderlinks available then for the Insight? I didn't think they were yet?

I moaned years ago about one type of the flexlink for the old combo. They were withdrawn.

To me, the flex ones with the Insight look very similar to the ones that were withdrawn.

The only way you will get accuchek to listen is if you all report every cannula failure and ask them to replace them.

Also log them on the MHRA equipment failure website.

I'm another person that had huge probs with the flex insight cannulas. I also had probs with the steel in the end as well. I'm told by Accuchek that I am too lean and muscly....

My Insight is currently having a good holiday in my cupboard and I'm back to MDI.

 

[donnellysdogs]

I'm using the flexi link plus, so you may have a point Hannibal. (I'm sure it's the cannulas at fault rather than the pump itself-I'm using a combo) I may try the ordinary flex links to see if it makes a difference (I've had about 4 occlusions today)

Please report the probs you are having to Accuchek and the MHRA website. The prob is really unlikely to be the pump....

Tell Accuchek to look at this posting to realise how many people are having probs.

No way should you have 4 occlusions. Plus fact our NHS are paying for all these wasted sets. Accuchek should replace them all and these matters really need to be reported to MHRA...

 

[masonbason63]

Hello folks I used the tenders on my old pumps for14 yes without any problems but as time went on rotation of sights became more difficult, changed to insight in April when tenders weren't available so I was using the rapid which I wasn't keen on I could feel them inside if I twisted or leant against them, then I had one break inside so I was advised to stop using them, low and behold the Tenders became available at this time so I thought great I'll go back to them as they'd been fine for all those years but they were absolutely rubbish they were thicker needle and just did not stick. I had to use Elastoplast to hold in place.
I got really fed up with Roche and complaining so I got a meeting with my rep and DSN
I'm now using flex link with the inserter I've not had a problem with them at all no kinking and no pain which is brilliant.
I gave the rep a page of when I phoned what the answers were I was given "some ridiculous " etc and I've since emailed her with other issues I'd forgotten to write down.

Received an email the other day say my concerns have been hand head of marketing let's wait and see!!!

I always complain it's s machine I'm wearing basically to stop me becoming very ill,
I'm doing my part so you have keep pestering

 

[iHs]

@Ruth0212 and @Hannibal

When you put a Flexlink Plus in, before you pull up the introducer housing to make the needle retract, hold yr thumb and finger from one hand on the 2 clear pieces of plastic that are visable on the set either side, underneath the introducer housing (look at the leaflet diagram of the set picture A,B,C to see the plastic protruding). With one hand on the plastic protrusions keeping the set against the skin, use the other hand to pull the housing upwards at the same 90 degree angle that the set went in. This should ensure that the introducer housing comes away with no risk to cannula kinking. Also, make sure that both sides of the insertion device are against the skin before pressing the button to release the spring. Might pay to ask Accuchek for a spare Link Assist too just in case something is wrong with the spring mechanism.

 

[donnellysdogs]

I'm sure it depends upon the persons size and activity with flexlink plus though.
Definitely everyone should have a spare inserter-mine broke!

 

[vic hill]

seem to be a matter of like and dislikes
have the same problem like steel 6 mm steel have done since first on a pump 2007 have had to flex link started at 5.30 pm just before tea b/s 8.5 bedtime up to 13 gave bolus to bring down overnight morning about b/s 9.5 got slight higher dos during day then had tea b/s back up to b/s 12.0 got tea bolus plus carbs gave bolus then the occasion happened so that was it for me ...
back to steel but as they are withdrawn so not many left .also you can not not purge insulin in any flex needle like you can the steel but nobody think s i am correct yes you can give a 7 ref the cannula but how as you can not join the cannula and line the purge insulin to come out of the needle flex if you can please let me know THE REASON I SAY IS A SMALL AMOUNT AIR
MUST GO INTO THE BODY yes or know
vic pump now on the 9 year

 

[Old_git]

I am fast coming to the conclusion thar flexi cannulas are useless and not really fit for purpose, having been forced into their use following a pump 'upgrade' (was it really?!) and withdrawal of the steel cannulas at the same time. I have been experimenting in the last couple of weeks by persevering with flexis when at home and occlusions/swaps not too much of a faff to deal with but using steel cannulas when away - I work away from home quite a lot. Conclusion - guaranteed occlusions on flexis, no problems on steel. Always very careful on insertion of the flexis, following the advice and guidance but still problems. To log onto MHRA website to make my views known, all these wasted cannulas are costing my hard up Health Authority valuable cash.

 

[donnellysdogs]

Totally agree the waste of money for cannulas... Thing is if many people get probs with certain flex cannulas... There may well be a fault... Needs reporting..

 

[Old_git]

I have reported in to MHRA on their "yellow card" scheme and received an acknowledgement, not sure what happens now or how long they take - I imagine nothing happens very quickly. I have also emailed Roche asking when their steel cannulas are coming back onto the market, but no response, they probably do not know.

 

[ono]

My daughter changed to an Insight from a Combo and suffered a kinked cannula resulting in DKA. We have reverted to the Combo and have had no problems even though she uses the Flex-Link cannulas with the Combo. I think it's the Insight's new Flex-Link Plus cannulas at fault, probably something to do with the spring loaded retractor mechanism that folds the needle back into the cap after you pull it out. The older cannulas had a smaller adhesive footprint too which was better.

Hi, I'm very concerned with this as I'm about to get the Insight for myself. One question, I was under the impression that before you get to the point of DKA the pump sounds an alarm when insulin delivery is blocked due to kinked cannula, isn't this the case?

 

[tim2000s]

Funny, I've been trialling the Flexi-cannulas on a Combo and found no issues with them occluding. Must be something in the Insight ones.

 

[iHs]

I have been ok with the Combo luer Flexlinks and the luer FlexLink Plus

 

[yingtong]

I've been OK with Medtronic flexies