Joel Connable Died

[Alan Mendelson]

I am in shock and disbelief. Joel Connable who worked at KCAL/KCBS with me for several years, has died. Joel currently was anchoring in Seattle at KOMO. He was 39.

Joel was an insulin-dependent diabetic and back in the days when we worked together we discussed diabetes, diabetes management, and his insulin pump. I was an insulin dependent diabetic then as well -- it was before my transplants -- but I took insulin shots.

Joel told me the "pump" was the way to go because of its convenience and health benefits.

According to a post on Facebook, his insulin pump malfunctioned, and he died. The Facebook post included comments from his parents:

With great sadness we write to tell you of the death of our son Joel. He had just started a new job at KOMO, the ABC TV station in Seattle, and he was alone in his apartment when his insulin pump malfunctioned. The lead line was disconnected without his realizing it. It was one of those accidents of fate.

I am in shock and disbelief. There are warning signs of high blood sugar and high blood sugar does not cause sudden death. A disconnection of the lead line leads me to believe that insulin was not getting into his system causing his blood sugar to rise. He could have detected that early enough to prevent this tragedy.

As soon as I read about his death, I looked on the Internet for other reports of insulin pump deaths and found that there are far too many. In some cases the malfunction caused a release of too much insulin -- causing insulin shock which can cause a fast death.

But a lack of insulin? No. There are warning signs. There are indications. Joel was a pump user for years, he would have known the danger signs. This just adds to the tragedy.

Joel also worked in Miami after he left KCAL/KCBS. I remember when he got the Miami job. Good guys like him are not supposed to die young.

I am very sad. And angry. And I hope his colleagues will investigate his passing and the cause of his death for the sake of the tens of thousands of insulin pump users.

[Alan Mendelson]

Subsequent reports that Joel called in sick the day before his death, reporting to KOMO that he caught some sort of "flu bug," is consistent with extremely high blood sugar levels. When a diabetic's blood sugar is out of control and extremely high, there is weakness, nausea, difficulty staying awake, dizziness, loss of appetite -- and these are classic flu symptoms, aren't they?

If the high blood sugar levels are not treated, the patient can black out and slip into a coma.

There were also reports of a "diabetic seizure," and I am not sure what that is supposed to be? I know from my own experiece as a diabetic, that diabetics who have either high blood sugar or low blood sugar episodes lose control -- and while this might be described as a "seizure" it does not resemble an "epileptic seizure" where there might be violent shaking and loss of muscle control. A diabetic "seizure" more likely is a black out -- whether it is caused by high or low blood sugar.

I think this is an opportunity to educate the public about diabetics and their high and low blood sugar episodes.

If you find someone who has passed out you should always summon professional emergency care immediately. 911 operators will guide you in what to do until emergency response arrives.

Diabetics might show signs of extreme sweating from low blood sugar, Diabetics who have very high blood sugar might have expressed extreme thirst or an inability to control their bladders -- extreme and frequent urination are signs of high blood sugar as the body tries to rid itself of high sugar levels through excessive urine output. Difficulty breathing and shallow breathing are symptoms of both high and low blood sugar -- and if you are following -- these also resemble symptoms of a heart attack which is why you should seek medical help for the victim.

If you know the diabetic has low blood sugar and they are wearing an insulin pump, the pump should be turned off or even removed if emergency experts tell you to. Some form of high sugar content food should be placed in the mouth of the patient if they can swallow. If the patient cannot, you risk that the patient will choke on anything put in the mouth. Some diabetics carry sugar wafers or fast-acting sugar tablets. And others carry an emergency injection that can be administered -- but only if they are unconscious.

A bottle of soda -- Coke or Pepsi -- often can stop a low blood sugar attack. So can a chocolate candy bar. Some diabetics carry a tube of cake frosting and this can be put in their mouths for a fast sugar boost.

If you find someone unconscious, 911 operators will ask you to look for identification including bracelets and chains and wallet cards that might indicate a health problem including diabetes.

A diabetic with high blood sugar needs insulin and there really isn't any "first aid" except to get them to an emergency room.

[nicolep]

I'm so confused by this. I'm a type 1 diabetic and I wear an insulin pump. I have had it for 39 years. This really doesn't add up.

First, a "diabetic seizure" would not be caused by an insulin pump "lead line..." (I have never referred to anything related to my pump using that term, by the way) being disconnected. You can have a seizure - which actually looks very much like an epileptic seizure - when your sugar is extremely low and an extremely low sugar can absolutely cause sudden death. But sudden death from not getting insulin? I've never heard of that at all. I guess it's possible - but if you were monitoring your sugar, the first thing you would do if you had a high blood glucose level is check your pump for any disconnects. Next step (after two consecutive highs - recommended by EVERY pump company) would be to put in a whole new infusion set (that the tubing that gets the insulin into the system)...

I'm really confused and I hope that misinformation about a "pump malfunction" doesn't panic the parents of young people or new insulin pump users.

I'm very sorry for the loss of your friend.

[Alan Mendelson]

Thank you for joining us and for your comments nicolep. Joel's death makes no sense to me, either. While I never had a pump in the 32 years I was an insulin-dependent diabetic (prior to my kidney/pancreas transplant), I am familiar with some of the information and misinformation about diabetes. The word "seizure" is often used for everything from going into diabetic shock (low blood sugar) to diabetic coma (high blood sugar) and every kind of episode in between those two extremes.

I read online some of the "manuals" for pumps to find out about malfunctions and lead lines, and all of the pumps have alarms for malfunctions. One pump said it had two alarms and only one alarm can be switched off.

You are absolutely correct about monitoring blood sugar. When I first became diabetic the "blood testing devices" that are common today (so common they are given for free by manufacturers so you will buy their test strips) didn't exist. I remember buying my first testing machine which cost $210. In the years that I had kidney failure and I was trying to preserve my kidneys as long as possible I tested my blood sugar several times a day.

When I worked with Joel he seemed to me to be very vigilant about his health and if anyone would test -- he would. It is hard for me to believe that he would ignore the warning signs, and wouldn't be testing, or that the alarm on the machine didn't operate. But it's combinations like that -- that add up to tragedy.

I am hoping that someone from the coroner's office there in Seattle made the decision to examine the machine for defects. Because it was an unattended death, that should have been done. If some sort of defect involving the alarm is discovered, it is vital that the manufacturer become aware of it.

I have a niece who uses a pump, and friends who use it. My own doctor years ago wanted me to use one -- but I resisted. Perhaps if I had used a pump I would have not had kidney failure and had to undergo dialysis. While I had transplants -- transplants are not a cure but are merely another treatment.

When I first became diabetic in 1976 there was research into islet transplants and artificial pancreas -- but here we are nearly 40 years later and we still haven't reached those goals. Islet transplants still don't have a high success rate. Take care of yourself and God bless you.

[nicolep]

I don't like to guess, but from what I'm reading in statements from his parents, etc, he may have had a seizure related to a LOW bloodsugar which caused a disconnection of his insulin pump (not necessarily a malfunction). I've had convulsions related to hypoglycemia and I can see how that might happen. But, I'm not sure the pump had anything to do with his death. I know that hypoglycemia has caused sudden death and I believe if they found his pump disconnected, it could have happened during a low bloodsugar that killed him. I do hope they try to clarify. My father and mother have both called me today wanting to know if I know of any issues with my insulin pump. Lotsa worry being caused by these headlines.

Really, really sad - he looks very happy and healthy in his photos.

Though I'm not glad you had to live through transplantation and its aftermath, I'm glad you're still alive and kicking!

My Best,
Nicole

[Alan Mendelson]

Nicole, you raised something that I started to think about at the beginning but I didn't want to comment on publicly. But since you raised the question, I am also going to comment.

If indeed he recognized he had very low blood sugar, the first thing he would want to do is turn the pump "off." But if he didn't have the ability to press the button, he might pull the line out. And that might be why there was the report that the line was not connected-- the malfunction.

My only hope is that whatever the problem was that it is revealed to help the thousands of pump users today -- either to give them a warning or reassurance. I am so sorry that we lost Joel.

[Smore9564]

I wanted to say that when I read about Joel, I was very sad. Although, I dont know him at all, I have been a type 1 for over 30 years and on a pump for over 12. I completely agree with Nicole and this just doesn't add up. I also feel that most likely he disconnected the pump himself because he was low. My pump has malfunctioned before. With that being said.... when it has malfunctioned, the screen has gone on the fritz. But it has never just not given me insulin or given me too much. I know people that have programmed their pumps wrong. Or forgot that they already bolused and then did it again because they didnt bother to go into their history menu, or write it down. I feel that it was very negligent of the news station to post on facebook that the pump malfunctioned and to cause a big uproar. I know they are only posting what his parents said, but I'm willing to bet, when they get to the bottom of it... they will find that its not correct. Now, please, please dont get me wrong... I feel horrible for Joel and his family. As a type 1 myself I know all the risks and I know how wrong it is that this is even happening today. Its 2012 for crying out loud. IT IS SO WRONG THAT THERE IS NOT A CURE. There is no reason Joel should be gone. But to say that he died because his pump was disconnected doesnt even make sense. If he were to die from not getting insulin... it would take a long time. DAYS. And he would have noticed that it wasnt connected. We changed our pumps every 3 days. He changes his clothes every day. He goes to the bathroom every day. He would have noticed it wasnt connected. He most he could have gone without noticing is maybe 8 hours. But even then... he should, SHOULD, have tested his blood sugar by then and noticed something was wrong.... That theory doesnt add up. AT ALL. (And, Alan, I think you already see that, but I'm just reiterating) Thanks for letting me get out my little rant!

[Alan Mendelson]

Smore9564... thank you for joining us and for your comments. What you wrote makes a lot of sense. I think that for the sake of the diabetic/pump community, the true story should be told to either warn or reassure all of the users.

And I certainly agree that it is wrong that we don't have a cure today. I don't think much real progress has been made since 1976 when I first became an insulin-dependent diabetic. I recall talking to a doctor in 1976 who said to me then "you became diabetic at the right time. Three years from now there will be a cure."

It's been a very long three years.

[Smore9564]

Oh yes, I remember being told that "we'd all have pancreas transplants by 1985"!! Still waiting lol!

I do hope the truth comes out about what really happened. Not that I think something suspicious happened. But when used correctly, the pump is a great thing. It's not for everyone, but this sure put a negative look on it. And if it was not a malfunction, I hope the news station will clarify what they wrote and let it be known.

(After I posted earlier, I remembered a time when my blood sugar was really low. I woke up during the night and could not figure out how to "suspend" (turn off) my pump because I was so out of it and the buttons didnt make any sense to me. So I was trying to disconnect the tubing. Somehow I was able to wake up my husband and was able to communicate to him to disconnect the tubing. Then he got up and got me some juice.)

[Alan Mendelson]

Smore9564... do you realize that we might now be talking about a different kind of malfunction? Instead of the tubing becoming disconnected or blocked, the malfunction might have been that the device delivered more insulin than it should have? We can't rule out "human error" either, of course.

There are many questions that stem from Joel's death, and frankly, I didn't realize that there were problems with the pumps until I checked on the various cases reported on websites.

I know that there are many media outlets with health and medical reporters. I would hope that in Seattle, Miami and Los Angeles where Joel spent much of his career, that they would be investigating and reporting -- not to mention the numerous newspapers around the country that published articles about this tragedy.

[T1mom]

I am in shock and disbelief. Joel Connable who worked at KCAL/KCBS with me for several years, has died. Joel currently was anchoring in Seattle at KOMO. He was 39.

Joel was an insulin-dependent diabetic and back in the days when we worked together we discussed diabetes, diabetes management, and his insulin pump. I was an insulin dependent diabetic then as well -- it was before my transplants -- but I took insulin shots.

Joel told me the "pump" was the way to go because of its convenience and health benefits.

According to a post on Facebook, his insulin pump malfunctioned, and he died. The Facebook post included comments from his parents:

With great sadness we write to tell you of the death of our son Joel. He had just started a new job at KOMO, the ABC TV station in Seattle, and he was alone in his apartment when his insulin pump malfunctioned. The lead line was disconnected without his realizing it. It was one of those accidents of fate.

I am in shock and disbelief. There are warning signs of high blood sugar and high blood sugar does not cause sudden death. A disconnection of the lead line leads me to believe that insulin was not getting into his system causing his blood sugar to rise. He could have detected that early enough to prevent this tragedy.

As soon as I read about his death, I looked on the Internet for other reports of insulin pump deaths and found that there are far too many. In some cases the malfunction caused a release of too much insulin -- causing insulin shock which can cause a fast death.

But a lack of insulin? No. There are warning signs. There are indications. Joel was a pump user for years, he would have known the danger signs. This just adds to the tragedy.

Joel also worked in Miami after he left KCAL/KCBS. I remember when he got the Miami job. Good guys like him are not supposed to die young.

I am very sad. And angry. And I hope his colleagues will investigate his passing and the cause of his death for the sake of the tens of thousands of insulin pump users.

I saw the Facebook post about Joel's death earlier today - I too am saddened and angry. As a mom of a child with type 1, I'm also scared to death. We need a cure, now. You mentioned that you've had transplants...can you give more information on this?
I hope KOMO TV here in Seattle investigates. At the very least, more attention needs to be paid to type 1. May Joel rest in peace and may his tragic death lead to increased awareness.

[Alan Mendelson]

My kidneys failed after being an insulin-dependent diabetic for more than 30 years. I wrote about my kidney transplant on the main part of my website www.alanbestbuys.com and here is the direct link:

http://alanbestbuys.com/id92.html

I had no idea that pancreas transplants were possible. But when I went for my first consultation with a kidney transplant doctor, just before I went on dialysis, he said to me "if we find you a kidney, do you also want the pancreas?"

I was both shocked and amazed and didn't know this was possible.

Since my transplants more than four years ago, I've been trying to persuade my doctors/surgeons at the St. Vincent Medical Center here in L.A. to come on my TV show so more could become aware of pancreas transplants.

After more than 4 years, both transplants are 100%. I thank God and think about the donor and the donor's family every day. It breaks my heart that someone died so that I could have another chance at a normal life.

[T1mom]

My kidneys failed after being an insulin-dependent diabetic for more than 30 years. I wrote about my kidney transplant on the main part of my website www.alanbestbuys.com and here is the direct link:

http://alanbestbuys.com/id92.html

I had no idea that pancreas transplants were possible. But when I went for my first consultation with a kidney transplant doctor, just before I went on dialysis, he said to me "if we find you a kidney, do you also want the pancreas?"

I was both shocked and amazed and didn't know this was possible.

Since my transplants more than four years ago, I've been trying to persuade my doctors/surgeons at the St. Vincent Medical Center here in L.A. to come on my TV show so more could become aware of pancreas transplants.

After more than 4 years, both transplants are 100%. I thank God and think about the donor and the donor's family every day. It breaks my heart that someone died so that I could have another chance at a normal life.

Thanks for the info - I didn't know that either! I volunteer for the PNDRI here in Seattle - one of our researchers recently received a patent for newborn screenings for type 1. His goal is then to prevent these kids from ever becoming diabetic. I'm thinking a new pancreas combined with his research....hmm....
A woman I know received a portion of her healthy sister's pancreas many years ago. She was diabetes free for several years and her sister never experienced any side effects from donating a portion of her pancreas. The diabetes eventually returned, but even this is something I'd consider for my son. Just getting him though the horrible teenaged years long enough to develop the maturity he apparently lacks to take care of himself would be amazing. Diabetes sucks...diabetes and a rebellious teen REALLY sucks!

[Smore9564]

Smore9564... do you realize that we might now be talking about a different kind of malfunction? Instead of the tubing becoming disconnected or blocked, the malfunction might have been that the device delivered more insulin than it should have? We can't rule out "human error" either, of course.
.

Yah, I am just going off of what his parents said, and so far, that is all that I have seen. If you do hear something different, please post it! I live near Vancouver, WA. Not Seattle, but heard about this through the diabetic community.

[nicolep]

Alan, again, I am so very sorry for your loss.

I'm going to walk you through how an insulin pump works... Maybe that will help. The pump has an infusion set that is injected into the body every 2-3 days. It has tubing that connects to the small, beeper-sized machine. The machine is programmed to deliver a basal dose of insulin (say .5 to 3 or 4 units) each hour. When a person with diabetes eats or has an elevated sugar, the pump is used to deliver a bolus dose (with most pumps can be up to 10-15 units at a time).

With my pump, and in fact with all pumps, delivering a dose of insulin takes multiple steps. With mine, I start by telling the pump what my bloodsugar is (that takes 2 button pushes), then I have to tell it what I eat (2 more button pushes), then the pump recommends and amount of insulin (which I can push one button to accept or multiple buttons to change and then accept).

The pump simply CAN'T deliver too much insulin without a user seeing it's happening. There are multiple safety measures in place to prevent an accidental overdose of insulin.

Now, that doesn't account for the completely inexplicable dips and elevations in bloodsugar that come with diabetes. Especially if a person is sick. I wonder if the illness and the way you have to dose extra for insulin when you're sick might have had something to do with this. If he gave extra insulin and then his body ended up with a way too low bloodsugar he could have seized and pulled his pump line out.

I really don't think it's responsible to have these headlines out there. A pump malfunction implies that something happened where the device did something it shouldn't have, if that was the case, then we should all be hearing from our device companies to let us know if this has potential to happen to us.

Sadly, I think that when someone dies so young and so tragically, people don't know where to assign blame. I feel like his parents and family would (naturally and understandably) want people to know it wasn't his fault. But to blame it solely on the pump causes panic amongst those of us who use one - I did call my pump company to try to see if there is anyway the pump could overdose me on its own by way of a malfunction. They've assured me that could not happen that there have been no reported cases of that happening.

His death is the FAULT of this ridiculous disease and no one/thing else.

Still hoping for clarification of some sort on this malfunction.

I hate diabetes. I hate that it takes so many beautiful people so young.

[Rob.Singer]

Alan, I'm not at all familiar with this subject, but I just read this thread and think it has some relation to what I saw last Sunday. We met the man in the RV nearby ours the day after we arrived. That day, his wife died in the hospital of something called a septic infection, and he blamed it on the diabetes. She was 38. Does this make any sense? These are not full-timers, they were just taking two months off to do some travel when she got violently ill starting with some kind of flu-like symptons. They have 3 teenage sons back in N. California. A depressing way to begin our new life here.

[Smore9564]

I really don't think it's responsible to have these headlines out there. A pump malfunction implies that something happened where the device did something it shouldn't have, if that was the case, then we should all be hearing from our device companies to let us know if this has potential to happen to us.

I hate diabetes. I hate that it takes so many beautiful people so young.

Nicole.... I completely agree with you. I couldn't read all 650+ comments on the fb posting KOMO wrote, but I saw plenty of people saying they will never use a pump now due to this story. I'm so tired of mis information re: diabetes. I know there is really no changing that. And you are so right, people NEED someone/something to blame. I would too. The disease is to blame. Not the pump.

[Alan Mendelson]

his wife died in the hospital of something called a septic infection, and he blamed it on the diabetes. She was 38. Does this make any sense?

Diabetics have lower resistance to infection, so yes it is possible.

[Alan Mendelson]

Nicole.... I completely agree with you. I couldn't read all 650+ comments on the fb posting KOMO wrote, but I saw plenty of people saying they will never use a pump now due to this story. I'm so tired of mis information re: diabetes. I know there is really no changing that. And you are so right, people NEED someone/something to blame. I would too. The disease is to blame. Not the pump.

I understand your concern about inaccurate reporting about the pump... but if you do a Google search for insulin pump malfunctions you will find that there are cases where there were malfunctions. This doesn't mean that pumps should not be used. It does mean that you should show the appropriate care and concern. The pump is a treatment and you must monitor treatments.

[nicolep]

Alan, googling for pump malfunctions, the VAST majority are issues with motor failure (where the pump alarms to let you know it's failed and your bloodsugars would be enormously high for DAYS if that happened) or with shut downs - where the screen just fades out all together and you see and are able to do nothing (again, you'd be able to see that just looking at your pump and your bloodsugars would be enormously high for DAYS if that happened). I couldn't find even one report of an insulin pump over delivering insulin (enough to kill someone, that is). The description his parents gave of a "lead line" pulling out without someone realizing it either means 1) a low could have caused a seizure where the pump site pulled out and then he wasn't getting insulin or 2)his pump site pulled out and for some reason he never tested his bloodsugar to or checked the site to ensure he was getting his medication. But a pump site "pulling out" is NOT a pump malfunction.... That's just the wrong term to use.

There's a discussion here that points out how odd it all seems:
http://www.tudiabetes.org/forum/topi...ource=activity