Traveling With a Pump: TSA Regulations

Insulin pump manufacturers have been put in a difficult position by the new rules. Customers turn to them for advice, but without more specific guidance from the TSA, it's difficult for them to give specifics.

| Dec 23, 2010

Most holiday stories are comforting and familiar, wrapped up with the happiest of endings. But the tales that swept the nation this Thanksgiving were sometimes distressing and strange, and the one told by Laura Seay has no resolution or simple solution. Seay was one of the travelers caught in the center of the debate over the Transportation Security Administration's forceful new screening methods.

For the 18-year diabetic and insulin pump user, the debate has yielded questions aplenty, but few concrete answers. "It's extremely frustrating because you can't get anyone to say, in writing, what the deal is," Seay said. "It's frustrating because I have this medical device that's critical for my life, and because of that I'm being singled out."

Seay, an assistant professor of political science at Morehouse University in Atlanta, recognized that something was amiss in September, when she caught a flight out of Reagan National Airport in Washington, D.C. Her screening checkpoint featured a new kind of scanner -- not the simple X-ray machine of old, but a high-tech, full-body imaging system. Unfamiliar with the device or any new rules, Seay told the screeners that she had a medical device (an OmniPod insulin pump). She was then subjected to a new kind of patdown, and not a gentle one. "It's extremely invasive, extremely uncomfortable," she said.

A couple of weeks later, Seay flew out of her home city of Atlanta, Georgia. After a routine screening, she talked with security personnel and asked them about the new security procedures. Once the new machines were in place everywhere, she asked, would she have to be patted down every time she flew? Yes, they told her.

And so began Seay's struggle -- to voice her concerns about the new procedures' effect on diabetics and to find out exactly what the new screening procedures require. Three months later, despite national controversy, those goals remain elusive.

The Official Response

The TSA has been reluctant to talk about the new screening procedures in detail. To do so, it says, would give clues to terrorists and others who wish Americans harm. But that's scant comfort for travelers like Seay, who must contend with uncertainty when they fly.

When asked for comment, the agency offered some basic recommendations for diabetics. They should tell screeners that they have the disease and if they're wearing a pump. They should also have insulin with a "professionally printed label identifying the medication or manufacturer's name or pharmacy label" accompanying their supplies.

The TSA also has a curious piece of advice for pumpers: "If necessary, advise the screener that (the pump) cannot be removed since it is surgically implanted." While such pumps exist, they're not commonly available. What's missing is any sort of advice about a pump like the OmniPod, which attaches directly to the skin and cannot be removed without being deactivated.

The agency won't say, however, if such notifications from diabetics trigger enhanced security measures. And that's the key point. Does being a diabetic with a pump mean a patdown every single time you fly? (The TSA promises, for what it's worth, that diabetic travelers can have a private screening if necessary.)

In an interview with The Atlantic, TSA Administrator James Pistole made one thing very clear: The agency believes it has a right and responsibility to conduct stringent searches, and it doesn't believe they're an invasion of privacy. "If people take an affirmative act of engaging in, in this case, aviation -- they want to get on a plane -- they're taking an affirmative act to do that," Pistole said. "Then, yes, there is authority to do the administrative search for public safety purposes."

The agency's new measures, much debated over the Thanksgiving holiday, are two-pronged. In a column for USA Today, Pistole outlined them. First, there are the new body scans, performed by AIT ( Advanced Imaging Technology) machines. They look beneath a traveler's clothes with far more detail than X-ray machines.

While the machines have been certified as safe by the FDA and outside observers, travelers can choose to opt out of using them (some have raised concerns about radiation). But if passengers opt out (or if the machines raise an alarm), they are subjected to a thorough patdown. These comprehensive body searches are the second change introduced by the TSA and are the focal point of recent outrage. While the agency is vague about the specifics, passengers like Seay complain about the patdowns' intrusiveness.

Again talking to The Atlantic, Pistole acknowledged that the agency's approach isn't perfect. "I want to use the latest intelligence to inform our judgments and actions, and use the best technology when we don't have intelligence," he said. "So there's a huge gap there. So here are the threats, here are capabilities, here are gaps. So how do we fill those gaps? And right now we do it with a somewhat blunt approach."

Pump Companies Speak

Insulin pump manufacturers have been put in a difficult position by the new rules. Customers turn to them for advice, but without more specific guidance from the TSA, it's difficult for them to give specifics.

Different pump manufacturers have different levels of concern. Insulet, the Bedford, Massachusetts, company that manufactures the OmniPod, has perhaps the most difficult task. Because its pods  attach to the skin, they're not easily removed for examination.

The company recommends, in general, the same approach outlined by the TSA. If you're concerned at all, talk to security screeners at the airport and outline your situation. Tell them, if you're patted down, that your insulin pump is attached to your body and cannot be removed.

As an extra precaution, Insulet advises that you carry "a signed letter from your healthcare provider explaining you need to carry insulin supplies and OmniPod equipment," along with "prescriptions for all medications and supplies with original prescription labels."

Medtronic, the maker of MiniMed pumps, has simpler advice for its customers. That's made possible by the fact that its pumps are easily detachable from a cannula that remains inserted under the skin.

"We have conducted official testing on the effects of the new full body scanners at airports with Medtronic medical devices," said Amanda Sheldon, the company's director of public relations. "Since the new scanners include X-ray, remove your insulin pump, Guardian monitor, sensor, transmitter, meter, and remote before going through the scanner." If you don't want to remove the equipment, Medtronic recommends that you ask for a patdown instead.

A third major U.S. manufacturer of insulin pumps, Animas, could not be reached for comment.

It's worth noting that none of the measure recommended by the TSA or by insulin pump manufacturers is actually required. Travelers' experiences (including this writer's) have varied greatly. I went through one of the new full-body scan machines at Boston's Logan International Airport in August without telling anyone about my diabetes or OmniPod and had no problems whatsoever. I did, however, have OmniPod literature packed on my carry-on to show a security officer if he or she was curious about the device stuck to my abdomen.

Still Searching for Answers

Over the past three months, Laura Seay has tried to find out more. She filed a complaint with the TSA after talking with the security screeners in Atlanta. She still hasn't received a response.

She talked to the American Diabetes Association, which told her it had been unsuccessful in getting any sort of written policy from the TSA.

She contacted her U.S. representative -- John Lewis -- and her senators, Johnny Isakson and Saxby Chambliss. Isakson's office has been working to find her answers, Seay said. Lewis's staff offered her sympathy; they had seen a demonstration of the new security measures. "They had all watched a patdown and were really grossed out by it," Seay said.

Finally, she contacted FlyersRights.org's Kate Hanni. The group had successfully lobbied to limit the amount of time that airlines can keep passengers on a plane without taking off. Seay figured that the group might be able to help her find some clarity.

It ended up helping her find some fame. She was put in touch with a reporter from The New York Times, and the newspaper of record featured her in a November 18 article that helped make the furor about the new screening regulations a national story.

"I would just hope that some reasonable and sane policy prevails," Seay said. "There needs to be a balance between security and just basic common sense."

This holiday story remains unfinished and confused. The government and pump companies offer advice, but few facts. Yet Seay's simple message -- repeated over and over to government and advocates alike -- should count for something.

"If I'm a terrorist and I have a bomb strapped to my body, I'm not going to say to the TSA, ‘I'm wearing something on my body.'" she said. "If you tell them up front you have an insulin pump, and it looks like an insulin pump when you go through -- I just feel like we should have the same choices everybody else has."

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Categories: Diabetes, Diabetes, Government & Policy, Insulin, Insulin Pumps, Personal Stories, Type 1 Issues


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Comments

Posted by Anonymous on 23 December 2010

My name is FatCatAnna and I'm a T1 blogger from Canada (diagnosed in '68 - an old timer LOL). I am a frequent flyer - used to regular pat downs everytime I fly - does not cause any problems for me informing agents of my pump, etc. it's part of flying now as a diabetic. I guess not so good if you aren't into disclosing the truth - but if it makes flying safer for us all - I tell them - and educate at the same time.

I am very surprised Animas did not cough up info - as here in Canada - they did to me - you can check out what I was told - in a nutshell do NOT send their pump thru' x-ray (in my case - loaner pump) - and full body scanner - DO NOT go thru' it wearing pump. They couldn't really specify why - but with x-ray - it can do damange to spring that pushes insulin thru' cartridge in their pump.

Here's the blog I wrote - with more information - http://www.diabetes1.org/blogs/Annas_Blog/Flying_With_Salvador_Dali_aka_my_insuin_pump_is_such_a_thrill_NOT

You can read about my recent experience with TSA / CATSCA week's TSA that I posted the other day - http://www.diabetes1.org/blogs/Annas_Blog/Smooth_sailing_with_CATSCA_TSA

Happy Holidays everyone!

FatCatAnna \\^^// from Diabetes1.org / Twitter / Facebook / Tudiabetes / Children With Diabetes and many other D-OC's

Posted by Anonymous on 23 December 2010

Thank you fatcatana...I was just popping in to clarify! Insulin pumps die in xray exposure! I've had to get 3 replacements in my life, one from xray back scatter @ the chiropractor, and the other two from xray screening @ the airport.
Arguing with a TSA employee over the facts regarding type 1 diabetes and insulin/pump requirements has been nothing but frustration and thousands of dollars spent on replacement devices.
Now, I either drive, or stay home.

There's a problem when the only solution available to keep you alive is viewed as a standard reason to assume questionable intentions.

Boycott travel that involves TSA screening as best you can, and pressure from the industry will force changes in their procedures and policy.

Posted by Anonymous on 23 December 2010

My name is FatCatAnna and I'm a T1 blogger from Canada (diagnosed in '68 - an old timer LOL). I am a frequent flyer - used to regular pat downs everytime I fly - does not cause any problems for me informing agents of my pump, etc. it's part of flying now as a diabetic. I guess not so good if you aren't into disclosing the truth - but if it makes flying safer for us all - I tell them - and educate at the same time.

I am very surprised Animas did not cough up info - as here in Canada - they did to me - you can check out what I was told - in a nutshell do NOT send their pump thru' x-ray (in my case - loaner pump) - and full body scanner - DO NOT go thru' it wearing pump. They couldn't really specify why - but with x-ray - it can do damange to spring that pushes insulin thru' cartridge in their pump.

Here's the blog I wrote - with more information - http://www.diabetes1.org/blogs/Annas_Blog/Flying_With_Salvador_Dali_aka_my_insuin_pump_is_such_a_thrill_NOT

You can read about my recent experience with TSA / CATSCA week's TSA that I posted the other day - http://www.diabetes1.org/blogs/Annas_Blog/Smooth_sailing_with_CATSCA_TSA

Happy Holidays everyone!

FatCatAnna \\^^// from Diabetes1.org / Twitter / Facebook / Tudiabetes / Children With Diabetes and many other D-OC's

Posted by Anonymous on 23 December 2010

I have removed my medtronic pump and sent it thru the X-ray scanner without any problems. I have chosen to do this rather than educate the TSA personnel since they could care less. The longer I am forced to deal with ignorance in life the more I'd rather become a recluse anddeal with no one. It's amazing that there are only 3 pump manufacturers and the TSA is clueless as to what they are.

Posted by Anonymous on 31 December 2010

What if terrorists are planning they next attack tryingn to disguise themselves as diabetic patients that use insulin pumps. After the media found out how those terrorists had managed to 'get in' who's to blame? TSA? Diabetics? the pump? if it's a X-ray, people complain they'll get cancer, if people are patted, they cry out for privacy. What do you want, America? everything as usual? (btw, I am T1D and fly, too)

Posted by chanson3633 on 3 January 2011

I have never had a problem sending my pump though the X-ray scanner (with my carry on baggage). I do feel a little uncomfortable every time I dis-connect, but it is a minor anxiety. I have to say the TSA employees have gotten more knowledgeable about the pump. I have rarely been questioned, although 5 or 6 years ago it happened frequently.


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