SYSTEMS AND METHODS TO ADDRESS AIR, LEAKS AND OCCLUSIONS IN AN INSULIN PUMP SYSTEM

• US 20100262078A1
• Filed: 03/23/2010
• Published: 10/14/2010
• Est. Priority Date: 03/31/2009
• Status: Active Grant

• Current Assignee: Tandem Diabetes Care Incorporated
• Original Assignee: Smiths Medical ASD, Inc. (Smiths Group International Holdings Ltd.)
• Inventors: Blomquist, Michael
• Granted Patent: US 8,608,699 B2
• Time in Patent Office: Days
• US Class Current: 604/151
• CPC Class Codes: A61M 2005/16872 Upstream occlusion sensors
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 5/14244 adapted to be carried by the patient, e.g. portable on the body
• CPC Class Codes: A61M 5/1452 pressurised by means of pistons
• CPC Class Codes: A61M 5/16831 Monitoring, detecting, signalling or eliminating infusion flow anomalies low-level float-valves causing cut-off A61M5/40; indicating or recording presence, absence or direction of flow in general G01P13/0066
• CPC Class Codes: A61M 5/16854 by monitoring line pressure
• CPC Class Codes: A61M 5/365 Air detectors A61M5/1684 takes precedence; in extracorporeal blood circuits A61M1/3626
• CPC Class Codes: G01M 3/26 by measuring rate of loss or gain of fluid, e.g. by pressure-responsive devices, by flow detectors

Abstract

A system and method for adjusting insulin infusion volume based on air in an infusion set tube includes inputting at least one location and length of an air bubble along the infusion set tube. An air bubble volume is determined in the infusion set tube. An insulin infusion volume is determined based on a desired insulin infusion. A determination is then made whether the desired insulin infusion would include the air bubble volume based on the inputted location and length of the air bubble. The air bubble volume is added to the insulin infusion volume to make an adjusted insulin infusion volume if the insulin infusion volume includes the air bubble.

Claims

1. A method for adjusting an insulin infusion volume based air in an infusion set tube comprising:

inputting at least one location and length of an air bubble along an infusion set tube;

determining an air bubble volume in the infusion set tube;

determining an insulin infusion volume based on a desired insulin infusion;

determining whether the desired insulin infusion would include the air bubble volume based on the inputted location and length of the air bubble; and

adding the air bubble volume to the insulin infusion volume to make an adjusted insulin infusion volume if the insulin infusion volume includes the air bubble based on the inputted location and length of the air bubble.

2. The method of claim 1, wherein determining whether the desired insulin infusion includes the air bubble volume includes determining an insulin infusion length in the infusion set tube from a distal end of the infusion set tube.

3. The method of claim 2, wherein determining whether the desired insulin infusion includes the air bubble volume includes comparing the insulin infusion length with the location and length of the air bubble, and the desired insulin infusion includes the air bubble volume if any part of the air bubble coincides with any part of the insulin infusion length.

4. The method of claim 1, wherein determining the air bubble volume and determining the insulin infusion volume includes determining the air bubble volume and determining the insulin infusion volume in units of insulin.

5. The method of claim 1, wherein determining the air bubble volume includes determining the air bubble volume based on an infusion set tube inner diameter and the length of the air bubble.

6. The method of claim 1 further comprising:

determining if more than a specified time elapses between inputting the at least one location and length of the air bubble and the desired time for infusing the desired insulin infusion; and

requesting at least one updated location and length of the air bubble if more than the specified time has elapsed.

7. The method of claim 1, wherein determining the insulin infusion volume based on the desired insulin infusion includes determining at least one of a basal infusion volume based on a desired basal insulin infusion and a bolus infusion volume based on a desired bolus insulin infusion.

8. The method of claim 7 further comprising alerting the user to the presence of the air bubble within the desired insulin infusion just prior to the air bubble reaching a distal end of the infusion set tube.

9. The method of claim 8, further comprising:

instructing the user to disconnect the distal end of the infusion set tube just prior to the air bubble reaching distal end of the infusion set tube;

delivering the air bubble volume of the insulin infusion volume to atmosphere; and

instructing the user to reconnect the distal end of the infusion set tube.

10. The method of claim 1, wherein inputting at least one location and length of the air bubble along the infusion set tube includes observing the air bubble relative to graduations along the infusion set tube to determine the location and length of the air bubble.

11. The method of claim 1, wherein inputting at least one location and length of the air bubble along the infusion set tube includes inputting locations and lengths of a plurality of air bubbles in the infusion set tube.

12. The method of claim 1 further comprising:

storing a first pressure measurement from within at least one of the infusion set tube and an insulin cartridge taken at a first time when the at least one location and length of the air bubble is input

monitoring the pressure within at least one of the infusion set tube and the insulin cartridge; and

re-determining at least one of the adjusted insulin infusion volume, location and length of the air bubble if the monitored pressure is outside of a specified pressure range relative to the first pressure measurement.

13. A method for adjusting insulin infusion amount based on air bubbles comprising:

inputting at least one location and length of an air bubble along an infusion set tube;

determining an insulin infusion length from a distal end of the insulin infusion set tube based on an insulin infusion volume;

comparing the location of the air bubble with the insulin infusion length;

adding an air bubble volume to the insulin infusion volume to make an adjusted insulin infusion volume if any part of the air bubble coincides with the insulin infusion length.

14. The method for adjusting insulin infusion amount based on air bubbles of claim 13, wherein inputting at least one location and length of an air bubble along an infusion set tube and determining an insulin infusion length from a distal end of the insulin infusion set tube, includes inputting at least one length of the air bubble and determining the insulin infusion length in units of insulin.

15. The method for adjusting insulin infusion amount based on air bubbles of claim 13, wherein inputting at least one length of the air bubble includes observing the air bubble relative to insulin unit graduations along the infusion set tube.

16. The method for adjusting insulin infusion amount based on air bubbles of claim 13, further comprising determining the air bubble volume based on the length of the air bubble and an inner diameter of the infusion set tube.

17. The method for adjusting insulin infusion amount based on air bubbles of claim 13 further comprising:

updating a location of the air bubble if the insulin infusion volume is not delivered within a specified time after inputting the at least one location and length of the air bubble, wherein the instant location of the air bubble is updated based on the location and length of the air bubble and insulin delivered in the time between the inputting of the location and length of the air bubble and a scheduled delivery of the insulin infusion volume; and

re-determining whether the insulin infusion volume includes the air bubble based on the updated location of the air bubble.

18. The method for adjusting insulin infusion amount based on air bubbles of claim 17 further comprising alerting the user to the presence of the air bubble within the insulin infusion volume just prior to the air bubble reaching a distal end of the infusion set tube.

19. The method for adjusting insulin infusion amount based on air bubbles of claim 13, wherein inputting at least one location and length of the air bubble along the infusion set tube includes inputting locations and lengths of a plurality of air bubbles in the infusion set tube.

20. A system for adjusting insulin infusion amount based on air bubbles comprising:

an input configured to receive at least one location and length of an air bubble along an infusion set tube; and

a controller including;

an insulin infusion length determination module configured to determine an insulin infusion length from a distal end of the infusion set tube based on an insulin infusion volume,

a comparison module configured to compare the location of the air bubble with the insulin infusion length, and

an adjusted insulin infusion module configured to add an air bubble volume to the insulin infusion volume to make an adjusted infusion volume if the comparison module shows any part of the of the air bubble coincides with the insulin infusion length.

21. The system for adjusting insulin infusion amount based on air bubbles of claim 20, the controller including

a timing module configured to determine if more than a specified time elapses between an input of the location and length of the air bubble and a desired time for infusing the desired insulin infusion, and

an alert and query module configured to request at least one updated location and length of the air bubble if more than the specified time has elapsed.

22. The system for adjusting insulin infusion amount based on air bubbles of claim 20, the controller including:

a monitoring module configured to monitor a location of the air bubble if the desired insulin infusion is not delivered within a specified time after an input location and length of the air bubble, wherein the location of the air bubble is monitored based on the at least one location of the air bubble and the insulin delivered in the time between the inputting of the at least one location and length of the air bubble and the desired insulin infusion, and

the comparison module is configured to compare the location of the monitored air bubble with the insulin infusion length, and the adjusted insulin infusion module is configured to add the air bubble volume to the insulin infusion volume to make the adjusted infusion volume if the comparison module shows any part of the of the monitored air bubble coincides with the insulin infusion length.

23. The system for adjusting insulin infusion amount based on air bubbles of claim 20, wherein the infusion set tube includes graduations, the graduations of the infusion set tube sized and shaped to measure the length and location of the air bubble.

24. The system for adjusting insulin infusion amount based on air bubbles of claim 23, wherein the graduations are in units of insulin.

25. The system for adjusting insulin infusion amount based on air bubbles of claim 20, wherein the input is configured to receive at least one location and length of an air bubble in units of insulin according to the graduations on the infusion set tube.

26. The system for adjusting insulin infusion amount based on air bubbles of claim 20, further comprising an insulin pump in communication with the controller.

27. A method for determining the presence of air in an insulin cartridge or infusion tube set comprising:

inserting an insulin cartridge into a pump, at least one of the insulin cartridge and an infusion tube set are sealed;

moving a cartridge plunger a predetermined distance into the cartridge at a first time;

measuring a first pressure in the insulin cartridge and the infusion tube set while the cartridge plunger is moved the predetermined distance; and

determining at least one of the insulin cartridge and an infusion tube set contains some amount of air if the pressure measurement is less than a specified pressure.

28. The method for determining the presence of air in the insulin cartridge or infusion tube set of claim 27, wherein moving the cartridge plunger the predetermined distance includes gradually moving the plunger over a period of time until the predetermined plunger position is reached, and measuring the first pressure in the insulin cartridge and the infusion set tube includes measuring a pressure rate of change in the insulin cartridge and the infusion tube set over the period of time.

29. The method for determining the presence of air in the insulin cartridge or infusion tube set of claim 28, wherein determining at least one of the insulin cartridge and the infusion tube set contains some amount of air if the pressure measurement is less than the specified pressure includes determining at least one of the insulin cartridge and the infusion tube set contains some amount of air if the pressure rate of change is less than a specified pressure rate of change.

30. The method for determining the presence of air in the insulin cartridge or infusion tube set of claim 27, wherein inserting the insulin cartridge into the pump, at least one of the insulin cartridge and the infusion tube set are sealed includes automatically occluding at least one of an insulin cartridge outlet and the infusion tube set.

31. The method for determining the presence of air in the insulin cartridge or infusion tube set of claim 27 further comprising adjusting the specified pressure based on the elasticity of the infusion tube set.

32. The method for determining the presence of air in the insulin cartridge or infusion tube set of claim 27 further comprising adjusting the specified pressure upward or downward based on the temperature around the infusion tube set and the pump.

33. The method for determining the presence of air in the insulin cartridge or infusion tube set of claim 27 further comprising alerting the user to the presence of air in at least one of the insulin cartridge and the infusion tube set.

34. A method for determining whether there is a leak in an insulin cartridge or infusion tube set:

inserting an insulin cartridge into a pump, at least the insulin cartridge is sealed when inserted;

moving a cartridge plunger a specified distance into the insulin cartridge;

maintaining the cartridge plunger at the specified distance over a first time period;

measuring a first pressure in the insulin cartridge during the first time period;

measuring a second pressure in the insulin cartridge during the first time period and after the first pressure measurement; and

determining at least one of the insulin cartridge or the infusion tube set contains a leak if the second pressure measurement is less than the first pressure measurement.

35. The method for determining whether there is a leak in the insulation cartridge or infusion tube set of claim 34 further comprising determining at least one of the insulin cartridge or the infusion tube set contains a leak if the first pressure measurement is below a minimum pressure threshold.

36. The method for determining whether there is a leak in the insulin cartridge or infusion tube set of claim 34, wherein inserting the insulin cartridge into the pump includes automatically occluding at least one of an insulin cartridge outlet and an infusion tube set.

37. The method for determining whether there is a leak in the insulin cartridge or infusion tube set of claim 34, wherein moving the cartridge plunger the specified distance into the insulin cartridge includes:

moving the cartridge plunger into the insulin cartridge until a goal pressure is reached, or

where the goal pressure is not reached moving the cartridge plunger into the insulin cartridge a predetermined distance.

38. The method for determining whether there is a leak in the insulin cartridge or infusion tube set of claim 34, wherein moving the cartridge plunger the specified distance into the insulin cartridge includes moving a cartridge plunger a specified plunger travel distance.

39. The method for determining whether there is a leak in the insulin cartridge or infusion tube set of claim 34, further comprising unsealing the insulin cartridge and occluding the infusion tube set at a location near the infusion tube set distal end.

40. A method for determining the presence of air and leaks in an insulin cartridge and infusion tube set comprising:

inserting an insulin cartridge into a pump;

sealing at least one of the insulin cartridge and an infusion tube set;

gradually moving a cartridge plunger into the insulin cartridge a specified distance over a first time period;

maintaining the cartridge plunger at the specified distance over a second time period;

measuring a first pressure rate of change in the cartridge over the first period of time;

determining at least one of the insulin cartridge and an infusion tube set contains some amount of air or a substantial leak if the first pressure rate of change is less than a specified pressure rate of change;

measuring a first pressure in the cartridge over the second period of time;

measuring a second pressure in the cartridge over the second period of time; and

determining at least one of the cartridge and the infusion tube set has a leak if the second pressure measurement is less than the first pressure measurement.

41. The method for determining the presence of air and leaks in an insulin cartridge of claim 40 further comprising automatically occluding at least one of an insulin cartridge outlet and an infusion tube set prior to gradually moving the cartridge plunger into the insulin cartridge.

42. The method for determining the presence of air and leaks in an insulin cartridge of claim 40, wherein gradually moving the cartridge plunger into the insulin cartridge includes moving the cartridge plunger into the insulin cartridge until a goal pressure is reached.

43. A system for determining the presence of air in an insulin cartridge or an infusion tube set comprising:

an insulin pump housing sized and shaped to receive the insulin cartridge;

a pump mechanism within the insulin pump housing, the pump mechanism configured to gradually move a cartridge plunger into the insulin cartridge a specified distance over a first time period, the pump mechanism configured to gradually move the cartridge plunger back the specified distance over a second time period;

a pressure sensor within the insulin pump housing, the pressure sensor is configured to measure first and second pressures in the cartridge over the first period of time;

a controller coupled with the pump mechanism and the pressure sensor, the controller including;

a pressure rate of change determination module configured to determine a first pressure rate of change in the cartridge based on the first and second pressure measurements,

a comparison module configured to compare the first pressure rate of change with a specified pressure rate of change, and

an alert module configured to provide an alert indicating the presence of air or a large leak in at least one of the insulin cartridge or infusion tube set if the first pressure rate of change is less than the specified pressure rate of change.

44. The system for determining the presence of air in the insulin cartridge of claim 43 further comprising an occluding mechanism configured to occlude at least one of an insulin cartridge outlet and an infusion tube set.

45. The system for determining the presence of air in the insulin cartridge of claim 43, wherein the pump mechanism is configured to pump insulin from the insulin cartridge and through an infusion set tube.

46. The system for determining the presence of air in the insulin cartridge of claim 43, wherein the pump mechanism configured to gradually move the cartridge plunger into the insulin cartridge the specified distance is configured to move the cartridge plunger until a goal pressure is reached over the first time period.

47. A system for determining whether there is a leak in an insulin cartridge or an infusion tube set comprising:

an insulin pump housing sized and shaped to receive the insulin cartridge;

a pump mechanism disposed within the insulin pump housing, the pump mechanism is configured to apply a specified pressure to the insulin cartridge over a first time period;

a pressure sensor disposed within the insulin pump housing, the pressure sensor is configured to measure first and second pressures in the cartridge over the first period of time, the second pressure measurement after the first pressure measurement;

a controller including;

a comparison module configured to compare the second pressure measurement with the first pressure measurement, and

an alert module configured to provide an alert indicating a leak in at least one of the insulin cartridge or an infusion tube set if the second pressure measurement is less than the first pressure measurement.

48. The system for determining whether there is a leak in the insulin cartridge or the infusion tube set of claim 47 further comprising an occluding mechanism configured to occlude at least one of an insulin cartridge outlet and the infusion tube set.

49. The system for determining whether there is a leak in the insulin cartridge or the infusion tube set of claim 47, wherein the pump mechanism is configured to pump insulin from the insulin cartridge and through the infusion set tube.

50. The system for determining whether there is a leak in the insulin cartridge or the infusion tube set of claim 47, the controller including a specified pressure adjustment module configured to adjust the specified pressure based on the elasticity of the infusion tube set.

51. The system for determining whether there is a leak in the insulin cartridge or the infusion tube set of claim 47, the controller including a specified pressure adjustment module configured to adjust the specified pressure upward or downward based on the temperature around the infusion tube set and the pump mechanism.

52. A method for removing air bubbles in an insulin cartridge comprising:

orienting an insulin cartridge in a substantially vertical orientation with a cartridge opening at an upper position, the cartridge coupled with an infusion set; and

filling an infusion set tubing with cartridge insulin, including;

moving a cartridge plunger forward and moving a cartridge plunger backward substantially identical amounts over a first period, and

moving the cartridge plunger forward a first amount and moving the cartridge plunger backward a second amount over a second period, the first amount greater than the second amount, the first amount gradually increasing over the second period, and the second amount gradually decreasing over the second period.

53. The method for removing air bubbles in the insulin cartridge of claim 52 further comprising vibrating at least the insulin cartridge.

54. The method for removing air bubbles in the insulin cartridge of claim 52, wherein moving the cartridge plunger forward and moving the cartridge plunger backward is performed at one or more specified rates.

55. The method for removing air bubbles in the insulin cartridge of claim 54, wherein moving the cartridge plunger forward and moving the cartridge plunger backward is performed at one or more specified rates includes moving the cartridge plunger forward and backward at a specified rate greater than that of an insulin infusion rate.

56. The method for removing air bubbles in the insulin cartridge of claim 54, wherein moving the cartridge plunger forward and moving the cartridge plunger backward is performed at one or more specified rates includes moving the cartridge plunger forward and backward at a specified rate of 60 Hz.

57. The method for removing air bubbles in the insulin cartridge of claim 52 further comprising unsealing at least one of the infusion set tubing and the insulin cartridge to allow for filling of the infusion set tubing from the insulin cartridge.

58. A method for removing air bubbles in an insulin cartridge comprising:

orienting an insulin cartridge in a substantially vertical orientation with a cartridge opening at an upper position, the cartridge coupled with an infusion set; and

removing air bubbles from the cartridge insulin, including;

moving a cartridge plunger forward a first amount and moving the cartridge plunger backward a second amount over a first period, wherein moving the cartridge plunger forward moves insulin in a dispensing direction, at least one of;

a frequency of forward and backward cartridge plunger movement changing according to a first schema over the first period, and

the first and second amounts changing according to a second schema over the first period, and

moving the cartridge plunger forward a third amount and moving the cartridge plunger backward a fourth amount over a second period, the third amount gradually increasing over the second period, and the fourth amount gradually decreasing over the second period.

59. The method for removing air bubbles in the insulin cartridge of claim 58, wherein moving the cartridge plunger forward the first amount and moving the cartridge plunger backward the second amount, the first and second amounts changing according to the second schema over the first period includes randomly changing the first and second amounts over the first period.

60. The method for removing air bubbles in the insulin cartridge of claim 59, wherein randomly changing the first and second amounts over the first period includes constraining the first amount to be the same or less than the second amount.

61. The method for removing air bubbles in the insulin cartridge of claim 58, wherein moving the cartridge plunger forward the first amount and moving the cartridge plunger backward the second amount, the frequency of forward and backward cartridge plunger movement changing according to the first schema over the first period includes changing the frequency of moving the cartridge plunger forward and backward randomly over the first period.

62. The method for removing air bubbles in the insulin cartridge of claim 58, wherein moving the cartridge plunger forward the first amount and moving the cartridge plunger backward the second amount over the first period, the frequency of forward and backward cartridge plunger movement changing according to the first schema over the first period includes:

moving the cartridge plunger forward and backward at a first frequency during the first period,

moving the cartridge plunger forward and backward at a second frequency during the first period, the second frequency less than the first frequency, and

moving the cartridge plunger forward and backward at a third frequency during the first period, the third frequency greater than the second frequency

63. The method for removing air bubbles in the insulin cartridge of claim 58, wherein moving the cartridge plunger forward the first amount and moving the cartridge plunger backward the second amount over the first period, the frequency of forward and backward cartridge plunger movement changing according to the first schema over the first period includes changing the frequency of moving the cartridge plunger forward and backward over a frequency range over the first period.

64. A method for clearing occlusions in infusion set tubing comprising:

flushing the infusion set tubing with rapid forward and reverse pumping action;

forward pumping an insulin infusion;

alerting the user to an occlusion in the infusion set tubing if the insulin infusion is not successfully delivered; and

alerting the user to change the infusion set tubing within a specified time if the insulin infusion is successfully delivered.

65. The method for clearing occlusions in infusion set tubing of claim 64 further comprising:

measuring a pressure in at least one of an infusion tube set and an insulin cartridge;

determining there is an occlusion in the infusion tube set if the pressure measurement is over a specified pressure threshold.

66. The method for clearing occlusions in infusion set tubing of claim 64 further comprising reversing the pumping action prior to forward pumping the insulin infusion.

67. The method for clearing occlusions in infusion set tubing of claim 64, wherein flushing the infusion set tubing includes forward pumping and reverse pumping at a plurality of frequencies.

68. The method for clearing occlusions in infusion set tubing of claim 67, wherein flushing the infusion set tubing includes forward pumping and reverse pumping at a plurality of frequencies within a frequency range over a period of time.

69. The method for clearing occlusions in infusion set tubing of claim 64, wherein flushing the infusion set tubing includes forward pumping a first amount and reverse pumping a second amount, the first amount equal to or less than the second amount.

70. The method for clearing occlusions in infusion set tubing of claim 64, wherein flushing the infusion set tubing includes forward pumping a first amount and reverse pumping a second amount, at least one of the first amount and the second amount changing over a first period.

71. The method for clearing occlusions in infusion set tubing of claim 64 further comprising:

attempting to deliver an insulin infusion; and

reversing an insulin pump action a specified amount if an occlusion is detected.

72. A system for removing air bubbles in an insulin cartridge comprising:

an insulin pump housing sized and shaped to receive the insulin cartridge;

a pump mechanism configured to apply pressure to the insulin cartridge; and

a controller configured to operate the pump mechanism, the controller having an infusion tube filling algorithm including;

an air bubble removing module, the air bubble removing module configured to operate the pump mechanism to alternately move a cartridge plunger forward and backward for a zero net insulin delivery, and

an infusion tube filling module, the infusion tube filling module configured to operate the pump mechanism to fill an infusion tube set.

73. The system for removing air bubbles in the insulin cartridge of claim 72, wherein the air bubble removing module is configured to operate the pump mechanism to move the cartridge plunger differing amounts, a forward movement amount less than or equal to a backward movement amount.

74. The system for removing air bubbles in the insulin cartridge of claim 72, wherein the air bubble removing module is configured to operate the pump mechanism to move the cartridge plunger forward and backward differing amounts over a period of time, a forward movement amount and a backward movement amount changing over the period of time.

75. The system for removing air bubbles in the insulin cartridge of claim 74, wherein the air bubble removing module is configured to randomly change the forward movement amount and the backward movement amount over the period of time.

76. The system for removing air bubbles in the insulin cartridge of claim 72, wherein the air bubble removing module is configured to operate the pump mechanism to move the cartridge plunger forward and backward at one or more specified frequencies over a period of time.

77. The system for removing air bubbles in the insulin cartridge of claim 72, wherein the air bubble removing module is configured to operate the pump mechanism to alternately move the cartridge plunger forward and backward at random frequencies over a period of time.

78. The system for removing air bubbles in the insulin cartridge of claim 72, wherein the air bubble removing module is configured to operate the pump mechanism to alternately move the cartridge plunger forward and backward at a plurality of frequencies in a frequency range over a period of time.

79. The system for removing air bubbles in the insulin cartridge of claim 72, wherein the infusion tube filling module is configured to operate the pump mechanism to move the cartridge plunger forward a first amount and move the cartridge plunger backward a second amount over a second period, the first amount greater than the second amount, the first amount gradually increasing over the second period, and the second amount gradually decreasing over the second period.

80. The system for removing air bubbles in the insulin cartridge of claim 72, further comprising a vibrating mechanism configured to vibrate at least the insulin cartridge.

81. A system for clearing occlusions in infusion set tubing comprising:

a pump mechanism configured to pump insulin;

an infusion set tube coupled with the insulin pump; and

a controller configured to operate the pump mechanism, the controller including;

a flushing module configured to flush the infusion set tubing, the flushing module operating the pump mechanism to provide a rapid forward and reverse pumping action,

a delivery module configured to deliver an insulin infusion after the rapid forward and reverse flushing action,

an occlusion alert module configured to alert the user to an occlusion in the infusion set tube if the insulin infusion is not successfully delivered, and

an infusion set tube change alert module configured to alert the user to change the infusion set tube within a specified time if the insulin infusion is successfully delivered.

82. The system for clearing occlusions in infusion set tubing of claim 81 further comprising:

a pressure sensor configured to measure an insulin pressure; and

the controller further includes a comparison module, the comparison module is configured to compare the insulin pressure with at least one specified pressure, and

the occlusion alert module is configured to alert the user to an occlusion in the infusion set tube if the insulin pressure is greater than the at least one specified pressure.

83. The system for clearing occlusions in infusion set tubing of claim 81 further comprising:

a pressure sensor configured to measure an insulin pressure; and

the controller further includes a comparison module, the comparison module is configured to compare the insulin pressure with at least one specified pressure, and the flushing module is configured to flush the infusion set tubing if the insulin pressure is greater than the specified pressure.

84. The system for clearing occlusions in infusion set tubing of claim 81, the controller further including a reversing module, the reversing module configured to reverse a previous insulin delivery pumping action prior to the flushing module operating the pump mechanism to provide the rapid forward and reverse pumping action.

85. The system for clearing occlusions in infusion set tubing of claim 81, wherein the flushing module is configured to operate the pump mechanism to provide the rapid forward and reverse pumping action at a plurality of frequencies within a frequency range over a period of time.

86. The system for clearing occlusions in infusion set tubing of claim 81, wherein the flushing module is configured to operate the pump mechanism to provide the rapid forward and reverse pumping action including forward pumping a first amount and reverse pumping a second amount, the first amount equal to or less than the second amount.

87. The system for clearing occlusions in infusion set tubing of claim 81, wherein the flushing module is configured to operate the pump mechanism to provide the rapid forward and reverse pumping action including forward pumping a first amount and reverse pumping a second amount, at least one of the first amount and the second amount changing over a first period.