“The Pump Said It Was Working”: When an Insulin Pump Like MiniMed Fails
Summary
Insulin pumps, including Medtronic’s MiniMed range, have changed life for many people with type 1 diabetes. But when a pump or infusion set stops delivering insulin, blood sugar can rise quickly and lead to diabetic ketoacidosis. This guide explains how pumps work, with a diagram, Australian recalls and safety alerts, what your diabetes team should have taught you, and when pump failure may involve a faulty device or care that fell short.
Quick answer · updated November 2026
Because a pump is the only source of background insulin, a pump fault, a detached infusion set or an empty cartridge can quickly lead to high blood sugar and ketones. Australian safety alerts have covered MiniMed retainer rings and infusion set disconnections. If you were harmed, it may raise questions about the device, about your training and backup plan, or about how a hospital responded.
Insulin pump safety at a glance
- 1Starting a pumpTraining, a written backup plan and sick-day rules.
- 2Every dayCheck glucose, tubing and the site, especially before bed.
- 3If delivery stopsCheck ketones and follow your backup plan.
- 4Warning signsHigh glucose, ketones, vomiting or tummy pain.
- 5RecallsCheck alerts and report faults to the company and TGA.
At any stage: vomiting, tummy pain, fast breathing or drowsiness with high glucose may be DKA. Call 000.
My son Josh was fourteen and had been on his pump for two years. He loved it. No more injections at school, no more lunchtime trips to sick bay.
One Saturday night he said he felt off. His glucose was high, so he gave a correction through the pump. The screen said it had been delivered.
By two in the morning he was vomiting. I checked his glucose again; it was higher. The pump showed no alarm.
I didn’t know to check ketones. Nobody had ever really explained what to do if the pump said it was working and it wasn’t.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
If you or your child became very unwell because an insulin pump stopped working, I want you to know that your questions are reasonable. Pumps are trusted to do something vital, all day and all night. When they fail silently, it is frightening, and it is fair to ask why.
This guide covers how pumps work, how they can fail, Australian recalls and safety alerts, what training you should have had, what your records should show, and how the law looks at it.
Why I can write this
I have been a medical negligence lawyer since 2014 and have worked on many hundreds of claims, including many involving medical devices. My doctorate looked at patterns of failure in medical negligence. I am not medically qualified. The clinical facts in this article are checked against named sources, listed in the references, and I explain how I work in our editorial standards.
Start with your question
- How does an insulin pump work?
- How can an insulin pump fail?
- Have MiniMed pumps been recalled in Australia?
- What are the signs of DKA?
- What should my diabetes team have taught me?
- What if hospital staff didn’t understand the pump?
- Can I claim if my insulin pump failed?
How an insulin pump works
An insulin pump delivers rapid-acting insulin through thin tubing into a small cannula under the skin, giving a steady background dose plus extra doses for meals and corrections. Because there is no long-acting insulin on board, the pump is the only source of background insulin. If delivery stops, ketones should be checked promptly.1
An insulin pump and infusion set
The parts that can fail
Insulin travels from the pump, through the tubing, into a cannula under the skin.
- The pump. Holds the insulin and the electronics. Faults, a flat battery or an empty cartridge stop delivery.
- The tubing. Can kink, leak or detach at the connection.
- The cannula. Can bend or slip out, so insulin doesn’t reach the body even though the pump is pumping.
A simplified drawing, not to scale. Some pumps (patch pumps) have no tubing.
How pumps fail
The Royal Children’s Hospital lists causes of insulin delivery failure as including a pump malfunction, a flat battery, an empty cartridge, or running out of supplies.1 Infusion sets can also fail. A detached or blocked set may not trigger an alarm.2
Definition
Diabetic ketoacidosis (DKA) is a medical emergency in which a lack of insulin causes the body to make ketones, making the blood acidic.
In plain terms: without insulin, the body starts poisoning itself, and it can happen within hours.
Recalls and safety alerts in Australia
In October 2021, Medtronic recalled MiniMed 600 series pumps with a clear retainer ring, replacing them with pumps with an updated black ring design.3 The TGA has also published a safety alert about a potential increase in tubing disconnections with MiniMed Silhouette and Sure-T infusion sets. It noted the device is not designed to alarm if the tubing detaches, and advised checking the tubing and blood glucose before bed.2
You can ask Medtronic or your diabetes team whether your pump or sets were affected. Our medication, drug and device harm page explains how device claims work.
Training and your backup plan
Before starting a pump, you should be taught how to check the site and tubing, how to check ketones, what to do if delivery stops, and how to switch to injections. You should have a written backup plan, with supplies of pens and long-acting insulin on hand.1
Questions to ask your diabetes team
- Do I have a written plan for pump failure, including doses for injections?
- When should I check ketones, and what level means hospital?
- Are my pump and infusion sets subject to any alerts?
- Who do I call after hours?
Expected, worth a call, or emergency
Check and correct
- One unexplained high reading
- An occlusion alarm
In plain terms: check the set, tubing and ketones.
Follow your backup plan
- Glucose not falling after a correction
- Ketones present
- Tubing detached or set dislodged
In plain terms: switch to injections and call your team.
Emergency
- Vomiting or tummy pain
- Fast or deep breathing
- Drowsiness or confusion
- High ketones
In plain terms: call 000. This may be DKA.
In hospital
When someone on a pump arrives at an emergency department, staff should recognise that the pump may have failed and that there may be no background insulin. DKA should be checked for and treated promptly. If hospital staff left a pump running without checking it, or didn’t check ketones, that can be part of the picture. Our guide to being sent home from hospital too soon may also help.
Reporting a fault
Keep the pump, the infusion set and any packaging. Contact the manufacturer and your diabetes team, and report the problem to the TGA. Download the pump’s history if you can; it may show what was delivered and when. See our guide to Dexcom CGM wrong readings if a sensor was also involved.
By the time the ambulance arrived Josh was breathing fast and barely making sense. He spent two days in intensive care with DKA.
When the pump was downloaded, it showed the corrections had been given. But when the nurse removed the infusion set, the cannula was bent flat. None of that insulin had gone in.
I went back through his diabetes clinic letters. There was a line saying “pump education completed”. There was no written backup plan in his file, and we’d never been given ketone strips.
My partner and I sat in the hospital car park at dawn. “We didn’t know,” she kept saying. Josh is fine now. I want other parents to know what we didn’t.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
What to look for in the records
Your records are often where the story becomes clear. You have a right to access your own health information. In NSW the Health Records and Information Privacy Act 2002 covers both public and private providers, and the Information and Privacy Commission explains how to ask.4 Our step-by-step guide to getting your medical records in Australia walks you through it.
| Record | Why it matters |
|---|---|
| Pump download | Shows insulin delivered, alarms and settings over time. |
| The pump and infusion set | Keep them; they may be tested. |
| Diabetes clinic letters | Show what training and written plans you were given. |
| Recall or alert letters | Show whether you were told about any device issue. |
| Ambulance and hospital records | Show your condition, ketones and treatment. |
| Your own notes and glucose logs | Show what you saw and did. |
| Your own diary, photos and messages | Notes made at the time are evidence too. Keep them. |
How the law looks at it
An insulin pump failure is not automatically anyone’s fault. Infusion sets can kink, and people can do everything right and still become unwell. The legal questions depend on what went wrong: whether the device was defective, whether your diabetes team trained you and gave you a backup plan, and whether hospital care was prompt.
A claim usually turns on three questions: whether the care fell below what peers would widely accept as competent practice (section 5O of the Civil Liability Act 2002 (NSW))5, whether that shortfall probably caused harm you wouldn't otherwise have had (Tabet v Gett)6, and, where it matters, whether you were told the material risks first (Rogers v Whitaker)78. Our guide to how a medical negligence claim works explains each one in plain terms.
In an insulin pump case, the questions might be: was the pump or set faulty or subject to a recall? Were you told about relevant alerts? Did your diabetes team give you training, a written backup plan and the means to check ketones? When you sought help, was DKA recognised and treated promptly?
In plain terms, the question is whether a working device, proper training, or prompt hospital care would probably have avoided or reduced the harm.
For an insulin pump, that would usually include the risks of delivery failure and DKA, and what to do if it happens.
Who can claim, and when
The person harmed can claim. For a child, a claim is usually brought by a parent on their behalf. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, not from the treatment itself, and courts can sometimes extend it, so an old injury may still count. See time limits in NSW or other states, and ask early.
More: complaint or claim? · how a claim is paid for · what a claim can cover
In my practice
In insulin pump files, the device is often only part of the story. I frequently find a clinic note saying education was completed, but no written backup plan, and a family who had never been shown how to check ketones. When the pump or set fails, they have no way of knowing until their child is very unwell. Reading the clinic letters alongside the pump download usually shows both what failed and what support was missing.
Both things can be true
A pump may have given your family years of better life, and still have failed on one night. Your diabetes team may have cared deeply and still not given you everything you needed to stay safe.
The bigger picture
Device alerts are published by the Therapeutic Goods Administration and shared by the National Diabetes Services Scheme.3 You can check practitioners on the Ahpra public register,9 and complaints about care in NSW can go to the Health Care Complaints Commission.10 See also our guides to pacemaker failure and the Exactech knee recall.
Support
You don't have to work through this alone. These services can help:
- Lifeline, 24-hour crisis support: 13 11 14 (listed on healthdirect's helplines page)11
- Beyond Blue, anxiety and depression support: 1300 22 4636
- Medicare Mental Health, help finding mental health support: 1800 595 212
- healthdirect, 24-hour nurse advice: 1800 022 222
- Health Care Complaints Commission (NSW): 1800 043 159
A parent in a hospital car park now knows that a bent cannula, not their family, was why the pump failed. You deserve that understanding too.
With care,
Rosemary
Frequently asked questions
How can an insulin pump fail?
Through a device fault, a flat battery, an empty cartridge, or an infusion set that kinks, blocks or detaches.
Will my pump alarm if the tubing comes off?
Not always. The TGA has noted some infusion sets are not designed to alarm if the tubing detaches.
Have MiniMed pumps been recalled in Australia?
In 2021, MiniMed 600 series pumps with a clear retainer ring were recalled and replaced.
What are the signs of DKA?
Vomiting, tummy pain, fast breathing and drowsiness, usually with high glucose and ketones.
Should I have a backup plan for pump failure?
Yes. Your diabetes team should give you a written plan and supplies for injections.
Can I claim if my insulin pump failed?
You may well have a claim against the manufacturer for a faulty device, or against care providers if training or treatment fell short.
Questions about an insulin pump failure?
When you're ready, and not before, I can look at what happened and help you understand your options.
Medical device guides
- “The pump said it was working”: When an insulin pump like MiniMed fails (you are here)
- When a Dexcom CGM gives a wrong reading
- When a pacemaker fails, moves or isn’t checked: what should happen next
- The Exactech knee recall: what it means if your knee is failing
- Spinal cord stimulator lead migration
- When a Nexplanon implant is inserted incorrectly
Part of our guide to medication, drug and device harm. Not sure where you stand? Try the free claim checker.
References
- The Royal Children’s Hospital Melbourne. Insulin pump malfunction.
- Therapeutic Goods Administration. MiniMed Silhouette and MiniMed Sure-T infusion sets. Safety alert.
- National Diabetes Services Scheme. Urgent medical device recall: MiniMed 600 series insulin pump retainer ring. 8 October 2021 (TGA ref RC-2021-RN-01995-1).
- Information and Privacy Commission NSW. Fact sheet: Accessing your health information in NSW.
- Civil Liability Act 2002 (NSW) s 5O, Standard of care for professionals.
- Tabet v Gett [2010] HCA 12.
- Rogers v Whitaker [1992] HCA 58; (1992) 175 CLR 479.
- Australian Commission on Safety and Quality in Health Care. Informed consent.
- Australian Health Practitioner Regulation Agency. Register of practitioners.
- Health Care Complaints Commission NSW. Home page.
- healthdirect Australia. Mental health helplines.
Stories in this article are composites, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. They do not describe any individual client.
Dr Rosemary Listing, PhD (Law), Medical negligence lawyer since 2014 · Of Counsel, Peter Evans & Associates. Rosemary's doctorate examined patterns of failure in medical negligence, and she teaches health law at the University of Newcastle. She is not medically qualified. About Rosemary.
Last updated: 10 November 2026 · First published: 10 November 2026 · Next review: May 2027
Cite this article: Listing R. “The pump said it was working”: When an insulin pump like MiniMed fails. Reframe Legal. Published 10 November 2026. https://reframelegal.com/insulin-pump-failure/
This article is general information, not legal or medical advice. It does not create a lawyer–client relationship. Speak to your treating clinicians about your health, and get legal advice about your own situation.
If you are in danger or need urgent medical help, call 000. For crisis support, call Lifeline on 13 11 14.
Legal services are provided by Peter Evans & Associates.