Saw this report on CBS News today. A third grader wasn’t allowed to bring pre-filled syringes made by his parents to school. The school wouldn’t allow it because the syringes weren’t prepared by a pharmacist!
I wonder how the school would feel about having the child bring pens, with the application of insulin done by the school nurse? Surely they couldn’t complain about nurse-administered insulin. The child is only 8 so I would expect that the school would NOT be comfortable (and rightly so) having the child use syringes by himself. 8 shots a day sounds a little wonky if you ask me (ok, ok, no one asked me LOL!!). A practical compromise should be the way to go instead of making this a legal thing. It’s like with divorce. Once lawyers get involved a lot of money changes hands and nobody wins.
I think a big problem was the mom says the school made several potentially dangerous mistakes with his doses in 2018. I’ve heard some horror stories about kids getting full doses of insulin but only eating half their meal.
As the mother had no issues when she went to school in the same district, this probably all started over the worry of a potentially fatal error on the side of the school again in dosing.
I could be wrong, but it sounds like this all started with dosing problems by the school and an insulin pen being sent that the school still had control of the dosing would still be an issue.
I’d hope that the nurse would have the child’s recent bg data before administering any insulin. If not, that’s a huge problem in and of itself.
It says he uses diluted insulin. There aren’t any pens that can dose smaller than 0.5 units, which may be too large for him. It also sounds like maybe they don’t trust the school or nurse to correctly calculate the doses.
If the family is aiming for tight control, eight shots a day sounds totally reasonable to me. I was doing 8-10 shots a day when I was on injections, and do an average of nine boluses per day on my pump, last I checked.
I saw that as well, and agree that’s probably why they’re using syringes instead of the pens. But with 8-10 shots/day, I wonder why don’t they consider a pump? The minimum doses are lower, and if necessary, they can still fill reservoirs with diluted insulin, perhaps supplied by a pharmacy. A lot less expensive than supplying 8-10 pharmacy-prepared syringes each day.
It looks like the kid has a CGM. No excuse not to use the info. If not, that’s nonsense and negligent behavior.
I don’t have a diabetic child. From posts from parents on this forum, it looks like navigating the rules and regulations is confusing. I imagine there are constraints on what they can and can’t do that I know nothing about. Maybe some parents here can comment on this situation???
A child on diluted insulin would have extremely low insulin needs. Not all endos approve using diluted insulin in pumps. My daughter’s endo didn’t. It’s also possible even the smallest bolus increment on current pumps may be too much for this child. This child previously used a pump during kindergarten.
The mom is also T1.
The parents fought the school for 3 years before filing the suit. The school initially refused requests for a 504 plan “due to costs.” The school allowed the 504 plan after the first year.
Utah state law (https://www.diabetes.org/resources/know-your-rights/safe-at-school-state-laws/UT diabetes care in schools) states students may self-manage & carry all needed supplies, with parent & medical provider approval. Mom was sending prefilled syringes for the child to self-inject. School staff searched the child’s bag & confiscated the syringes. The school’s initial reasoning was that carrying sharps presented a danger to the other students.
Any school staff can be trained to administer insulin. Mom objected to the school’s suggestion that a janitor be trained to do her son’s injections. While I understand the mom’s objection, state law specifies only “school staff” & a janitor qualifies. I doubt she’ll win this particular argument.
Mom apparently has photos sent to her by the school nurse that prove multiple dosing mistakes, ie. one photo shows a syringe with 10 units drawn up. The dose was supposed to be 1 unit.
Mom withdrew permission for the school to contact the medical provider. She alleges the school tried to get medical orders changed. Believable. I withdrew permission for the same reason.
A school board rep contacted by the mom suggested moving the child to another school. The school eventually banned the child from attending. Public school, Federal funding. The child has a legal right to attend.
Some of this sounds very similar to my experiences with my daughter’s school. My daughter’s supply bag was searched every day. Items such as Sweet tarts & Skittles were removed because they weren’t specifically listed on the medical plan as treatments for lows. Items were removed from her lunch bag because the nurse deemed them inappropriate for a diabetic (a single homemade cookie, fruit such as peaches & grapes). My daughter was on NPH at the time & required 60g carbs for lunch, so the carb shortage led to significant lows. On one occasion, she was found wandering the hall after the teacher sent her to the nurse alone. Her BG when checked after being found was 32. When going through her meter later, I found she had checked in class & the meter reading was “low.” The teacher was aware of the 504 accommodation stating she was never to be sent anywhere alone with a low BG.
My daughter was forced to write her BG on paper anytime she tested in class, & then hold the paper over her head so the teacher could report it to the nurse. The nurse also wanted to place a wheelchair outside my daughter’s classroom & have it follow her in case of a low BG.
I could go on but honestly, 10+ years later I still get upset thinking about the hell my daughter went through the first year after dx. Many US schools do a fantastic job of caring for kids with T1. Unfortunately, many are terrible & it becomes a constant battle to keep our kids safe. As I learned early on, Section 504 & even state laws don’t guarantee good care. Filing complaints with the Office of Civil Rights for violations often results in a warning to the school, & not much more.
Every case won in suits such as this strengthens the safety net.
More details in these articles:
Wow, that’s awful. How horrible for your daughter to have gone through all that! I’m so sorry to hear that. It just goes to show you how wrong some people can be with some control and power in their hands.