USA Flag

Official website of the Department of Homeland Security

Transportation Security Administration

Traveling 101 for Diabetics

Archived Content

Please note that older content is archived for public record. This page may contain information that is outdated and may not reflect current policy or programs.

If you have questions about policies or procedures, please contact the TSA Contact Center.

Members of the news media may contact TSA Public Affairs.

Tuesday, March 17, 2009
insulin

I was reading a blog post today from Diabetics Daily and while this issue doesn’t pop up on our blog too often, it's apparently a concern on other diabetes related blogs and message boards.

From Diabetics Daily, Sara Knicks writes:
I just got back from a recent work trip that involved some airlines flights. I have noticed (especially on the message boards) that a lot of diabetics worry about being stopped and forced to endure extra inspections because of their diabetic supplies.

As a Type II Diabetic, I can definitely see why people would be concerned about this.

First and foremost, if you’re concerned about your disability in relation to the screening process, let a Transportation Security Officer (TSO) know what’s going on and what you’re concerned about. Of course, you don’t have to do this, but as a former TSO, I can tell you that the screening of people with disabilities goes much more smoothly if everybody involved knows what to expect.

Also, don't go lettin' the checkpoint get you all hypogleycemic. Be sure to let a TSO know if your sugar is dropping or if you need medical assistance. Tell them what you need.

If you’re concerned about any of your diabetes related items, let the TSO know what you’re traveling with. The following items are permitted for diabetic passengers:

Insulin pump and insulin pump supplies (cleaning agents, batteries, plastic tubing, infusion kit, catheter, and needle); Insulin pumps and supplies must be accompanied by insulin. If you are concerned or uncomfortable about going through the walk-through metal detector or Mill with your insulin pump, notify the TSO that you are wearing an insulin pump and would like a full-body pat-down and a visual inspection of your pump instead. Advise the Security Officer that the insulin pump cannot be removed because it is inserted with a catheter (needle) under the skin.

Insulin and insulin loaded dispensing products (vials or box of individual vials, jet injectors, biojectors, epipens, infusers, and preloaded syringes; Insulin in any form or dispenser must be clearly identified.

Unlimited number of unused syringes when accompanied by insulin or other injectable medication; lancets, blood glucose meters, blood glucose meter test strips, alcohol swabs, meter-testing solutions; Urine ketone test strips
Glucagon emergency kit;

Unlimited number of used syringes when transported in Sharps disposal container or other similar hard-surface container. Sharps disposal containers or similar hard-surface disposal container for storing used syringes and test strips.

You have the option of requesting a visual inspection of your insulin and diabetes associated supplies.

Be sure to check out another blog post titled “Diabetes and the TSA.” A passenger named “James” writes about his experiences traveling with his insulin pump. You can also read more about traveling with other disabilities at TSA.gov.

Blogger Bob

EoS Blog Team

Tags: 

Comments

Submitted by Anonymous on

"The following items are permitted for diabetic passengers:"

What recourse does a citizen with diabetes have should a TSO decide not to allow these items on board, as TSOs did with Mr. Gel-Pack's gel pack for his wife's breast milk?

What recourse does a citizen with diabetes have should a TSO decide they have too much insulin, as TSOs have in the past decided regarding baby food?

What training are TSOs given regarding the needs of citizens with diabetes?

Is a printout of this blog post considered proof of TSA's policy, or are TSOs authorized to override this at will?

Submitted by RB on

Bob, not mentioned in your remarks was the fact that insulin and Byetta (not an insulin but a newer injectable medicine becoming fairly common for control of Type II diabetes) should be kept cool.

Many people use "Frio" type wallets but some may use common gel packs or other means to keep their medicine cool.

What is TSA doing to ensure that TSO's will not confiscate gel packs,cooling wallets or other devices used to cool medicines in these cases?

TSA's track record is not perfect in these situations. I would like some assurance that I won't run into a "TSO NY" who demands a prescription for all medicines, even those that are over the counter.

Just so you know, some insulin's are available without prescription!

What would TSO NY or one of your other well qualified TSO's do in that case? Deprive the traveler of life saving medicine?

Submitted by Jay Maynard on

RB, Byetta hasn't needed to be kept cool for a couple of years now. See the Byetta site's FAQ on safety and storage:
"How do I store my BYETTA Pen when I am traveling?
After first use, your BYETTA Pen can be kept at a room temperature not to exceed 77°F (25°C). Do not freeze. Do not use BYETTA if it has been frozen. BYETTA should be protected from light."

My doctor wants to put me on an insulin pump. I've resisted because of my previous rotten experiences with the TSA. If this pst does indeed state official TSA policy, and there's some way to keep individual TSOs from arbitrarily and capriciously overriding it, then I'll reconsider. The latter is important: I've *never* had a supervisor, or a checkpoint manager, *ever* overrule an individual TSO when they've violated official TSA policy.

Submitted by RB on

RE:
Jay Maynard said...
RB, Byetta hasn't needed to be kept cool for a couple of years now. See the Byetta site's FAQ on safety and storage:
...........................

How should I store my BYETTA Pen?
Prior to first use, store your new, unused BYETTA Pen in the refrigerator at 36°F to 46°F
(2°C to 8°C) protected from light.

After first use, your BYETTA Pen can be kept at a room temperature not to exceed 77°F
(25°C).
..............................
Jay, while your statement is partially correct there is more to it.

Prior to first use Byetta should be refrigerated as noted above.

So if one should have an extra pen or two then cooling is required!

After first use should be kept cooler that 77F degrees.

Thats not hard to exceed and use of a Frio or such is not a bad idea.

Just leaving the terminal to go to ground transportation at say Las Vegas during the summer would cause a possible issue. Or getting into a hot parked car.

I choose the conservative route.

Submitted by Anne on

How could we get the TSA to add continuous glucose monitors to the list? Personally I have had a problem with this as a traveler, but it would be great if it were officially written down.
Cheers.

Submitted by RB on

Jay, I didn't comment on the insulin pump part of your post.

I also would be concerned with TSA.

Uneven application of secret rules that cannot be challenged as you noted is a serious problem. Even here on this blog when a TSO mis-states known rules they are not corrected. Remember TSO NY?

On a side note, those who pump report greatly improved control and say life is much better.

I would probably go with the pump and if a TSO did something to cause me harm I would take ever legal action against them personally that I could.

Malpractice is not limited to doctors!

Submitted by TSORon on

Ann Said:
"How could we get the TSA to add continuous glucose monitors to the list? Personally I have had a problem with this as a traveler, but it would be great if it were officially written down."

An interesting question Ann, and to be honest I had to go to WebMD to find out what a CGMS is.

WebMD says that the device is pager sized and is worn on the hip or belt. It also says that the device is not designed for day-to-day continuous monitoring. Additionally, the device uses a plug in wire to attach to the probe and that it can be removed as the system does not monitor continuously but at intervals of between 5 minutes and an hour. I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.

Submitted by Mr Gel-pack on

Bob @"Of course, you don’t have to do this, but as a former TSO, I can tell you that the screening of people with disabilities goes much more smoothly if everybody involved knows what to expect."

How much of your medical information do you have to share with the TSA?

Does this blog advice only work for diabetics, or are people with more unusual conditions or devices required to share more detailed medical information with the TSO?

My STL TSO supervisor said I could have kept my gel-pack for medicine, just not infants. He must have missed the web-memo that said breast milk is in the same category as medicine, even though the special needs page includes "Liquids including water, juice, or liquid nutrition or gels for passengers with a disability or medical condition".

How much do you have to do to prove a "disability or medical condition" to TSA?

Submitted by Mr Gel-pack on

TSORon says: "I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem."

###

How does a passenger protect themselves from TSOs making judgements about medical care? Lawsuits after the fact?

Americans should be should be secure in their persons and effects.

Submitted by RB on

TSORon said...
Ann Said:
"How could we get the TSA to add continuous glucose monitors to the list? Personally I have had a problem with this as a traveler, but it would be great if it were officially written down."

An interesting question Ann, and to be honest I had to go to WebMD to find out what a CGMS is.
..........................

Continuous monitoring is a godsend for those who are hypoglycemic unaware Ron. It can be a real lifesaver!

In recent years effort has been expended on better glucose monitors including CGMS units intended for full time use. Technology is not quiet there yet but expect to see more of this units as time passes.

If a traveler has on of these units in use they also have a sensor that is inserted under the skin.

Submitted by Anonymous on

TSARon said (refering to CGMS): "WebMD says that the device is pager sized and is worn on the hip or belt. It also says that the device is not designed for day-to-day continuous monitoring. Additionally, the device uses a plug in wire to attach to the probe and that it can be removed as the system does not monitor continuously but at intervals of between 5 minutes and an hour. I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem."

Ron, you obviously know nothing about CGMSs. The glucose monitor is much smaller than a pager and is implanted over the skin and cannot be removed (unless you don't want to use it anymore and are exchanging it for a new one). Since you are a TSO, your lack of knowledge and belief that it is OK to ask to remove it is unacceptable.

I have had no end of trouble with insulin pumps. You may say those are your rules all you like. In practice, your people have no idea what they are, and don't know what to do about them. The best solution for me is to disconnect before going to the checkpoint. Saves me a lot of headache, although I really should not have to do that.

BTW - insulin is a very good way to kill a person. It is, effectively, a weapon, and a weapon you cannot keep off airplanes unless you want to limit airspace to non-diabetics. Get over trying to keep weapons that can hurt only individuals. They are only a threat to individuals, not to aviation.

Submitted by Bubba on

TSORon, your highly technical web search gave you a completely wrong idea of what continuous glucose monitoring is. Worse, you are now using it to come to your own little conclusion that "removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem". You are so wrong I can't even begin to explain it to you.

Meanwhile, I am STILL waiting to know what the policy is for screening small children in airports using MMW as primary. Are they, or are they not, patted down??

Submitted by Ayn R Key on

Good info.

Does the TSO at the gate know this?

If the TSO at the gate doesn't and tries to bar this, what should the passenger do?

If the passenger calls the supervisor, and the supervisor backs the TSO on the grounds that TSOs are always right and passengers are always wrong, what should the passenger do?

Submitted by Anonymous on

Now that this has been officially announced on the blog that the information will be immediately read by/to every TSO at the regular "shift briefs"? Or will it be carefully round-filed by the middle-managers?

I'm sure my mother, who has been a insulin-dependent diabetic for 30 years, would appreciate it if the original post was propagated to every TSO checkpoint as required reading.

Oh, and asking a diabetic to "dose" themselves to prove an insulin pump works is pretty poor form.

Submitted by Anonymous on

Yet more proof the TSA does not have a license to practice medicine anywhere.

Submitted by Sara on

I am the author of the original post. It sounds like a lot of these comments are in regard to hypothetical worries. I didn't write about it in my original post that this article links to, but I have never had concern over the ice/gel packs that my insulin is packed with, the syringes (new and used), or any of my other diabetic supplies. We are truly much more common than we think. I have to remind myself that I am not the first diabetic a TSA screener (and especially their manager) has seen.

There is also an interesting thread about diabetes and air travel within the Diabetes Daily forum.

Submitted by Forget_the_Dram... on

Ron

Are you practicing medicine without a license again? Because your statements here are to that effect. That and the show really how much you don't know and that lack of knowledge is to the determent of the traveling public that rely on certain devices and medications to STAY ALIVE. It also brings out the point that all of the rules need to be published and that all DHS/TSA employess know what they are, and maybe even tested on a regular basis to ensure the rules aren't made up on the fly that happens with a high frequency currently (SFO and OMA in the past couple of days are a good example of this)

If you think high or low blood sugar isn't dangerous I ask that you go to the nearest county hospital or talk with EMS professionals in the field about the subject as what they have experienced and know might shock you.

Submitted by Chris Boyce on
Blogger RB said...

Jay, I didn't comment on the insulin pump part of your post.

I also would be concerned with TSA.

Uneven application of secret rules that cannot be challenged as you noted is a serious problem. Even here on this blog when a TSO mis-states known rules they are not corrected. Remember TSO NY?

On a side note, those who pump report greatly improved control and say life is much better.

I would probably go with the pump and if a TSO did something to cause me harm I would take ever legal action against them personally that I could.

Malpractice is not limited to doctors!

My fellow Americans,

Please, please, please understand that ANY screener cannot legally ask you any questions concerning your illness or treatment. That's a felony violation of HIPPA. Any screener cannot decide what medicines you can or cannot take on your flight, including breast milk. That's a felony called "practicing medicine without a license."

If this happens to you at any checkpoint in what's left of the United States of America, politely ask the screener where they got their medical degree. Politely remind them that practicing medicine without a license is a felony. If they don't back down, call over a cop and require that the screener and, if appropriate, their supervisor, be arrested for practicing medicine without a license.


We, the People, need to make an example of a few screeners, prosecute them to the fullest extent of the law, and send them to jail for a VERY long time.
Submitted by Anonymous on

@Bob,

I have type II diabetis, however I am on medication only (Amaryl and Actos) and do not require direct injection of insulin. Will I be still allowed to keep my blood glucose meter kit (lancets, blood glucose meter, test strips, alcohol swabs, and glucose tablets) on person ?

Submitted by Anonymous on

This thread is a perfect illustration of why secret rules constitute an actual threat to the safety of passengers rather than an enhancement to security.

As things now stand any rogue TSO can totally disregard the TSA policy Blogger Bob covered in the original post (if it really is TSA policy; we can't tell for sure since it it SSI!) and the passenger has absolutely no recourse.

A simple request to "show me the written rules" is more likely to result in a civil fine than an actual peek at any written rules.

I can think of no better example of an agency run amok than one which puts people at risk to their life in order to "protect" them. Sounds sort of like, "In order to save the village, we had to destroy it."

T-the-B @flyertalk

Submitted by RB on

Ayn R. Key said...
Good info.

Does the TSO at the gate know this?

If the TSO at the gate doesn't and tries to bar this, what should the passenger do?

If the passenger calls the supervisor, and the supervisor backs the TSO on the grounds that TSOs are always right and passengers are always wrong, what should the passenger do?

March 17, 2009 5:49 PM
.........................
Are could the FSD just implement different standards and procedures at their airport similar to what is happening with electronics.

When will TSA understand that certain standards must be applied equally at all airports and not left to local discretion?

If you look up the definition of a "goat rope" the letters T.S.A. will be close by!!

Submitted by George on

I'm glad to see an official blog post on this issue. I'm not diabetic, but I do need weekly injections of a very expensive "biological" medication that has to be kept refrigerated or cooled with gel packs. I am very much afraid of encountering a situation like that of our Mr. Gel-Pack.

For me, the consequences of improper TSO action would be far more severe than what the Gel-Pack family suffered. Mrs. Gel-Pack at least has ready access to a redundant set of portable manufacturing facilities that can replace what the TSO improperly confiscated. But should a TSO improperly confiscate my gel packs or open the sterile package my injections come in (which an inept TSO apparently once did to someone carrying a feeding tube), I'd either have to suffer the consequences of doing without the medication or pay thousands of dollars to replace it (which would not be covered by insurance).

I realize that if I did travel with my medication in a cooler with gel packs, the TSO would most likely handle it professionally and courteously, and I'd be on my way with only the minimum hassle necessary to ensure the safety of aviation. But based on two experiences with TSOs improperly confiscating items of far less importance, I consider the risk of encountering an incompetent or poorly trained TSO who acts improperly is just too much to tolerate. The risk is probably small, but the cost to me is unacceptably high if it were to happen. (It's the same assumption that drives the TSA: the risk of terrorist attacks is vanishingly small, but the effect is so devastating if it does happen that it justifies subjecting every passenger to "layers" of arbitrary hassles.) So my only practical option is to limit my trips that require air travel to a week or less, so I can avoid this problem entirely.

Yes, I'm well aware that carrying my medication in a cooler with gel packs is specifically permitted under published guidelines, and that TSOs are supposed to follow procedures to inspect it safely. But I'm just as aware that TSOs don't always do what they're supposed to, and that the rules in effect at checkpoints as implemented by TSOs aren't always consistent with what's officially published. I'm also aware that I have absolutely no effective recourse if that happens. The TSO is always right, the passenger is always at fault, and I'll have to comply with whatever the TSO decides the rules are at that moment if I want to fly today. And the fact that I have commented on this concern here once before and been completely ignored doesn't help.

The real irony is that my astronomically-priced medication gives me a nearly-normal life and allows me to travel. But my justified fear of what an inept or poorly-trained TSA officer might do if I try to carry my medication through a checkpoint is what ends up limiting my travel. The fact that this fear and risk is completely unnecessary, and that there's nothing I can really do about it, makes me very angry. It exemplifies the way the arrogant and unaccountable TSA gives citizens reason to fear their own government more than the terrorists from whom they are supposedly protecting us. That's the real tragedy of 9/11.

Submitted by Anonymous on

"It sounds like a lot of these comments are in regard to hypothetical worries."

These are legitimate concerns prompted by TSA's own bad behavior in similar situations in the past.

"I didn't write about it in my original post that this article links to, but I have never had concern over the ice/gel packs that my insulin is packed with, the syringes (new and used), or any of my other diabetic supplies."

That's very nice for you. However, Mr. Gel-pack and other cases clearly demonstrate that every citizen is at risk of rogue TSA employees deciding to make up rules on the spot, no matter the cost in life or health nor the official, stated policies of the TSA.

Submitted by TSORon on

So many opinions and so little fact. Interesting.

I openly admitted that I know nothing about CGMS's, I even had to look up what they are, and it seems that I am the only one that took the time to do that. I think I'll stick with the information I have from a reputable source like WebMD and not from the personal opinions I find here.

But here is what I know from the policies the TSA uses. If an individual says it’s a medical device, it should pass through without further comment. If it cannot be removed and causes an alarm on the WTMD, the passenger must undergo a pat-down to clear the alarm. If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. I know, not the answer that anyone here is going to like, but facts are facts. I don’t make the policies, I just enforce them.

Submitted by Irish on

TSORon said...

“WebMD says that the device is pager sized and is worn on the hip or belt. It also says that the device is not designed for day-to-day continuous monitoring. Additionally, the device uses a plug in wire to attach to the probe and that it can be removed as the system does not monitor continuously but at intervals of between 5 minutes and an hour. I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.”


Just in case you haven’t been castigated enough, Ron –

Medical decisions are made by medical practitioners in consultation with their patients. Advising a “pax” that it wouldn’t be a problem to remove any medical device for the brief period of screening is, legally, the provision of medical advice. It isn’t up to you to provide medical advice about what is or isn’t a problem with regard to any medical device. It’s particularly problematic when the individual providing the advice can be viewed as being in a “position of power” over the patient. Do you understand that you could be held personally liable for making rendering such advice if that advice has adverse consequences? And you wouldn’t have a legal leg to stand on.

You had to look the device up on WebMD. That tells me you don’t know a thing about them. Before you begin rendering medical advice based on an outdated WebMD article, you should be aware of a few things. There are several different such devices out there. They look different, and may function in different ways; it’s a rapidly evolving field. Do you understand that passing a CGM through an x-ray is likely to disrupt the interaction between the sensor and the monitoring device? (This raises an interesting question, btw. I haven’t the faintest idea whether passing through an MMW while wearing a CGM is disruptive to the system.) Do you understand that the distance between the sensor and the monitor affects the ability of the device to maintain accurate data? And that distance varies from model to model?

CGM’s aren’t mentioned on the Infallible TSA Website, so I have no idea whether TSA even considered them. It’s clear from posts on this thread that some travelers have had problems at checkpoints regarding insulin pumps and glucose monitors. Some have not. This is a reflection of the typical uneven experiences the public has. Either the handling of these devices is another example of inadequate training, or the training doesn’t address it at all so the individual TSO’s are winging it, or both.

If it were me, I’d be very circumspect about what sorts of medical advice I started handing out to the public.

Irish

Submitted by Adrian on

Does TSA trump medical privacy? Why should a diabetic be forced to disclose their medical condition? Wasn't the whole point of HIPAA that you should be allowed to keep your medical conditions and history private?

Submitted by James on

I'm the "James" from the article noted at the bottom of the post.

I've had my gripes and complaints about the TSA - but I agree with TSO Ron's comments above.

Saying "I'm a diabetic and this is an insulin pump" is not volunteering your entire medical history. if you're carring a device THROUGH the xray you do have an obligation to give a basic description of what it is. I've never been grilled on what medications or the amount of insulin I take. If I get secondary screened I point out to the TSO that I have diabetic gear, and that's as far as it goes.

There's no reason not to disclose it, and as I mentioned in my post every TSO that has noticed my OWN insulin pump understood what it was once I told them. I was once asked to remove it. I told her they are allowed to stay one, and another TSO corrected her also and I was allowed to pass.

This is a good reference also to keep in your travel bag, or bookmark on your mobile should you have any problem.

http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1374.shtm#3

Regarding CGMs - or "constant glucose monitors" I have one and use it about 50% of the time. Mine is a separate transmitter than I wear, and it sends my blood blood glucose number every five minutes to my insulin pump. (The Medtronic Guardian.)

A common question is if it automatically doses you insulin based on your reading, and the answer is no. It's not a "closed loop" system yet, and you don't want it to be. Your insulin pump doesn't account for future activies, like biking 10 miles or sitting in front ot the TV for six hours - so you are still required to control your insulin take via your pump.

Some CGMs aren't part of an insulin pump, yet are still carried around like a cell phone or pager. I agree that in this case an exception should be made, however if it were me I would just put it in my bag for a the two minutes I'm going through security. (Again since it's not an insulin pump they are untethered.)

here's some photos and some history from my experiences using it:
http://www.futuregringo.com/index.php/2008/01/02/minimed-constant-glucos...

Cheers and thanks for a good discussion.

my original post:

http://www.futuregringo.com/index.php/2008/11/25/diabetes-and-the-tsa

james...

Submitted by Ciarin on

I'm pretty sure no one said passengers would be forced to reveal their medical information. Nice strawman.

Submitted by James on

A follow up: Some of the comments here are ridiculous. And I can't believe I'm actually siding with the TSOs.

If you USE a medical device, it's simple logic that you are obligated to inform the TSO of what exactly IT IS if asked.

Again, no one's giving you a form to document your life history, but if you carry an ancillary device be prepared to explain it.

Diabetes is not an embarrassing condition or anything to be ashamed of. I have never had a problem telling any TSO that I'm diabetic. (Or "Soy diabetico, y tengo insulino conmigo" when abroad.)

I don't volunteer myself as a diabetic or offer to show my pump, (usually it can pass the xray unnoticed,) but if asked "What is that" I say what it is and move on.

Also Adrian's comment is sheer nonsense.

james...

Submitted by Harry Nicholson on
Irish said better than me:

Medical decisions are made by medical practitioners in consultation with their patients. Advising a “pax” that it wouldn’t be a problem to remove any medical device for the brief period of screening is, legally, the provision of medical advice. It isn’t up to you to provide medical advice about what is or isn’t a problem with regard to any medical device. It’s particularly problematic when the individual providing the advice can be viewed as being in a “position of power” over the patient. Do you understand that you could be held personally liable for making rendering such advice if that advice has adverse consequences? And you wouldn’t have a legal leg to stand on.

Combined with TSORon dispensing medical advice as follows:

I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.

Here is a perfect example of someone practicing medicine by making the judgment that our TSA friend has made.

Ron, just out of curiosity, where did you go to medical school? If you ever dispensed this type of medical advice at a checkpoint, and, if you are not authorized to practice medicine in the state in which your checkpoint is located, you could go to jail for a LONG time and possibly emerge as a convicted felon. If your employer has set you and your fellow screeners up to making such judgments, they are even more unethical and irresponsible than I can imagine.
Submitted by James on

Yet another thought: I myself have numerous times rolled my eyes at the TSA, and shook my head at "security theater." Based on this many now look at the TSA experience as a circus, and automatically they can do no right.

Sarah offers reason in her comments about her experience. The TSO Ron is trying to educate himself on CGMs and ask questions.

Yet some say "Don't ask me anything about anything."

You can't walk through security with a backpack full of Sudafed and say:

"I have a medical condition, so mind your own beeswax."

But that's how some above comments would want it.

Again, A 10 second summbary and an articulate explanation to a TSO about your condition is not the constitution crumbling at your knees. The black and white is just baffling - when a little cooperation goes a long way.

James...

Submitted by Bob on

Q: What recourse does a citizen with diabetes have should a TSO decide not to allow these items on board, as TSOs did with Mr. Gel-Pack's gel pack for his wife's breast milk?

A: If a passenger finds themselves in a situation where a TSO is not allowing them to bring something that is permissible, especially if it is an item the passenger depends on to live or stay healthy, they should ask for a supervisor. If the supervisor still does not allow the item, the passenger should ask for a manager. Please note that Mr. Gel Pack’s incident, while unfortunate, is extremely rare. To read the comments here, you would gather that this happens all the time which is simply not the case. This was an isolated incident. Our workforce is properly trained on 3-1-1 exemptions. In this isolated case, they got it wrong. This is not the norm.

Q: What recourse does a citizen with diabetes have should a TSO decide they have too much insulin, as TSOs have in the past decided regarding baby food?

A: A TSO does not have the authority to judge how much medication you require or prevent you from bringing medication on a plane.

Q: What training are TSOs given regarding the needs of citizens with diabetes?

A: TSOs receive a lengthy course on passengers with disabilities during new hire training and also receive recurrent training throughout the remainder of their employment.

Q: Is a printout of this blog post considered proof of TSA's policy, or are TSOs authorized to override this at will?

A: If you found yourself in a situation where you needed it, a printout of this blog post could help your situation. Please note that the majority of information from this post was taken directly from our public page which you can print out as well.

Q: What is TSA doing to ensure that TSO's will not confiscate gel packs, cooling wallets or other devices used to cool medicines in these cases?

A: TSOs are trained on 3-1-1 exemptions.

Q: How could we get the TSA to add continuous glucose monitors to the list?

A: I’ve put it in motion and will let you know what happens.

Q: How much of your medical information do you have to share with the TSA?

A: You don’t have to share any if you don’t want to. I’ve spent some of my time attending meetings and answering travel questions for folks with various disabilities. Some very interesting discussions have come out of these meetings. Everybody agreed that when they told the TSO about their disability and what they needed, their screening went much more smoothly.

Q: Does this blog advice only work for diabetics, or are people with more unusual conditions or devices required to share more detailed medical information with the TSO?

A: This particular blog post was focused on diabetes. Future blog posts may cover other disabilities. For more travel information for passengers with disabilities, you can go here: http://is.gd/nSrX

Q: Now that this has been officially announced on the blog that the information will be immediately read by/to every TSO at the regular "shift briefs"? Or will it be carefully round-filed by the middle-managers?

A: TSOs are already trained on this information, however, I am going to link to the post on my internal blog and suggest that the info go out in the national shift brief.

Q: I have type II diabetes, however I am on medication only (Amaryl and Actos) and do not require direct injection of insulin. Will I be still allowed to keep my blood glucose meter kit (lancets, blood glucose meter, test strips, alcohol swabs, and glucose tablets) on person?

A: All of these items are fine to go through the x-ray in your carry-on luggage or they can be physically inspected.

Thanks,

Bob

EoS Blog Team

Submitted by Bob on

Sara said... I am the author of the original post. It sounds like a lot of these comments are in regard to hypothetical worries. I didn't write about it in my original post that this article links to, but I have never had concern over the ice/gel packs that my insulin is packed with, the syringes (new and used), or any of my other diabetic supplies. We are truly much more common than we think. I have to remind myself that I am not the first diabetic a TSA screener (and especially their manager) has seen. There is also an interesting thread about diabetes and air travel within the Diabetes Daily forum. March 17, 2009 7:42 PM
---------------------------------
Nice to hear from you, Sara. Thanks for your very insightful comments. I'll be the first to admit that mistakes are made, but you are proof that they are not the norm. Thanks.
---------------------------------
TSORon said... If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. March 18, 2009 6:49 AM
----------------------------
Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device.

Bob

EoS Blog Team

Submitted by Bob on

And James, a big thanks to you as well for helping bring things into a little better perspective.

Bob

EoS Blog Team

Submitted by Bob on

This just in, this blog post will be mentioned during shift briefs nation-wide on Wednesday.

Bob

EoS Blog Team

Submitted by RB on

Q: What is TSA doing to ensure that TSO's will not confiscate gel packs, cooling wallets or other devices used to cool medicines in these cases?

A: TSOs are trained on 3-1-1 exemptions.

..................
Bob, your statement that TSO's are trained on the 3.4-1-1 exemptions provide little comfort.

On this very blog post have been made demonstrating that TSO's just don't get it.

We have Mr Gel Paks notorious event. We have TSO NY, one of your highly trained TSO's, who severely misstated TSA policy regarding medical items and even in this new thread James stated that one TSO wanted him to remove his insulin pump.

Are these examples of TSA's effective training program?

How many problems are to many? Does someone have to be injured before TSA takes action and makes sure TSO's understand the training they have received? It would seem so!

Once again this is another fine example of just why a complete set of rules that travelers must comply with should be published, posted and available to all.

Submitted by George on

@Bob: If a passenger finds themselves in a situation where a TSO is not allowing them to bring something that is permissible, especially if it is an item the passenger depends on to live or stay healthy, they should ask for a supervisor. If the supervisor still does not allow the item, the passenger should ask for a manager.

Is this an official statement of TSA policy/procedure regarding escalation and passengers' rights to escalation? You do state that a printout of this blog post could help your situation. But I already have experienced two "isolated cases" that are "not the norm." Those TSOs seemed anything but amenable either to persuasion from a blog post printout or my supposed right to escalation.

I am aware of the information about travelers with disabilities on the TSA website. But I don't recall anything about an official escalation procedure, or the right of passengers to ask for a supervisor or manager. Ordinarily, citing the relevant chapter and section of an official published policy would be more persuasive. But as the TSA regards the secrecy of its policies and procedures as key to their effectiveness, that isn't available to the public. So we can only rely on statements from a TSA blogger, posted on a blog in response to public comments and hope that the TSO is persuaded. That isn't reassuring at all, especially when the consequences of encountering a TSO who is "not the norm" are so severe.

TSOs are trained on 3-1-1 exemptions.

Yes, we all know how TSOs are supposed to be trained, and what they're supposed to do. But enough of us have encountered situations contrary to how the TSA supposed to operate, to suggest that we can't always rely on TSOs being properly trained. Most TSOs probably are correctly trained. But the minority who aren't are nonetheless enough to make air travel needlessly worrisome.

This just in, this blog post will be mentioned during shift briefs nation-wide on Wednesday.

That's good. But what does "mention" actually mean? Is it specific to diabetes, or are you addressing the more general problem of ensuring that passengers who carry medications are correctly handled according to whatever (SSI?) rules apply?

Also, I think your response here is encouraging. It provides some hope that the TSA will improve its consistency and procedures so that those of us who are "exceptions" need not fear the consequences of TSO actions that are "not the norm." You've taken a step in that direction, but the road is many miles long.

Submitted by TSORon on

Blogger Bob said:
“Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device.”

You are 100% correct Bob. I have never and never will require anyone who says that the device is a medical one to remove such. Nor have I ever told someone that they could not take their insulin through the checkpoint, or any other medically necessary item (as claimed by a passenger. Additionally, I have never claimed to be a medical expert, never claimed to have a medical license (as some here intentionally misconstrued my comments to mean), and so I need not worry about being party to a suit of any kind based on these claims.

But I have to admit, its kind of fun to watch some of the posters here intentionally jump off the cliff of hysterics to attempt to make a point. Thanks Bob for your efforts here.

Submitted by Anonymous on

Does this blog advice only work for diabetics, or are people with more unusual conditions or devices required to share more detailed medical information with the TSO?
___________________________________

I would hope that all TSO's are the same as me. People's medical conditions are their business. Nothing has to be explained to me. If someone has concerns about going through the walk through or about what they have in their bag, all they have to state to me is,"I have a medical condition". For example they walk up and say, "I have a medical condition, there is medicine in my bag". Okay that is enough you do not have to tell me about it. If you can not take off your shoes and I ask why and you say for medical reasons. Okay that is all that you have to say. A TSO should not question anyones medical conditions.

Submitted by Anonymous on

Oh, and asking a diabetic to "dose" themselves to prove an insulin pump works is pretty poor form.
___________________________________
Why would someone do that?!

Submitted by Anonymous on

I am the author of the original post. It sounds like a lot of these comments are in regard to hypothetical worries.
___________________________________

Thats how it always is on this blog.

Submitted by Anonymous on

I have type II diabetis, however I am on medication only (Amaryl and Actos) and do not require direct injection of insulin. Will I be still allowed to keep my blood glucose meter kit (lancets, blood glucose meter, test strips, alcohol swabs, and glucose tablets) on person ?
___________________________________
Yes you can have anything that has to do with your illness. It goes through the xray with your property.

Submitted by Anonymous on

This thread is a perfect illustration of why secret rules constitute an actual threat to the safety of passengers rather than an enhancement to security.

As things now stand any rogue TSO can totally disregard the TSA policy Blogger Bob covered in the original post (if it really is TSA policy; we can't tell for sure since it it SSI!) and the passenger has absolutely no recourse.

A simple request to "show me the written rules" is more likely to result in a civil fine than an actual peek at any written rules.

I can think of no better example of an agency run amok than one which puts people at risk to their life in order to "protect" them. Sounds sort of like, "In order to save the village, we had to destroy it."

T-the-B @flyertalk
___________________________________

Nothing in this post has any relevance. What do you mean "This thread is a perfect illustration of why secret rules constitute an actual threat to the safety of passengers rather than an enhancement to security"?
There are no secret rules about medicine or anything for that matter. This blog states the rules. Its no secret that there are TSO's that have no clue what they are doing and take passengers items that they should not. That is not a secret rule, it is stupidity! I know the reason that the request of knowledge of secret rules is not given to the public. Because there are not secret rules. Just the ones plainly stated on the TSA web page. Read them and stop the broken record routine.

Submitted by Mr Gel-pack on

Bob said "Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device."

TSA makes woman remove leg brace: http://www.keprtv.com/news/local/31366239.html

TSA contaminates spare feeding tube: http://www.wftv.com/irresistible/15511359/detail.html

Rare means something very different when you do things to 2,000,000 people per day.

And Bob, you missed one question:

Q: How much do you have to do to prove a "disability or medical condition" to TSA?

It is relevant to your answer to this question bringing up the baby food incident:

Q: What recourse does a citizen with diabetes have should a TSO decide they have too much insulin, as TSOs have in the past decided regarding baby food?

A: A TSO does not have the authority to judge how much medication you require or prevent you from bringing medication on a plane.

Who gets to determine whether a person's disability or medical condition enables them to what quantity of medication, OTC, or "Liquids including water, juice, or liquid nutrition or gels for passengers with a disability or medical condition"? The parent?, The passenger? The passenger's doctor?

Or does it all come down to relying on some random TSO to realize that they "[do] not have the authority to judge how much medication you require or prevent you from bringing medication on a plane."

TSA should publish the rules, and make them available to passengers at the checkpoints.

Submitted by TSOREED on

He is right. A TSO should not question your medical condition unless he has good reason to believe you are being suspicious. Gel packs to cool medicine is medical and is exempt from the 3-1-1 rule. If a passenger has any sort of medical device on them and by chance are asked if they are able to remove it, all they should have to do is say no I can not remove it. Of course this means they have to experience a hand wanding or pat down because they are going to set off the WTMD. I am a TSO going on 8 months now and I gotta say, most of these stories of horrible TSO's I have heard of come from large airports. TSO's at checkpoints being put under stress by the airlines and passengers to get nearly 2000 people through 1 checkpoint in 8 hours. Passengers yelling at them to hurry, children creating chaos and distractions, everyone shout in their heads "I am not a bad guy just let me through!". All we ask for as TSO's is to please be calm, relax, the rules are posted on signs, pay attention to whats going on and we will work to get everyone through calmly and orderly. If you get a TSO who is a jerk then grab a supervisor, doesn't even have to be the one on that checkpoint, and write him up so we can fire him. We do not want people like that working for us. In TSOrons case obviously he needs more education on medical devices, so help us TSO's by telling us about your device while your at the checkpoint most of us are willing to learn and the more we learn the better we can do our job.

Submitted by Anonymous on

I would think that removing the device for the 20 seconds required to pass through the walk through metal detector would not be a problem.

Here is a perfect example of someone practicing medicine by making the judgment that our TSA friend has made.

Ron, just out of curiosity, where did you go to medical school? If you ever dispensed this type of medical advice at a checkpoint, and, if you are not authorized to practice medicine in the state in which your checkpoint is located, you could go to jail for a LONG time and possibly emerge as a convicted felon. If your employer has set you and your fellow screeners up to making such judgments, they are even more unethical and irresponsible than I can imagine.
___________________________________

Oh Harry Nicholson, what a post! You must be a lawyer, along with every other person preaching the LAW on here. If you ask Ron where he went to medical school, then I ask you Mr. Nicholson, where did you attend LAW school?
I am pretty sure that Ron has not tried to practice medicine. In fact the first words he stated are, "I would think". Now that does not sound like someone practicing medicine to me. It sounds like someone who is inquiring about something and simply stating what they think may be correct. And if he is incorrect, then may he be corrected. But not ridiculed because he is trying to understand the subject.
Everyone on here is so judgmental. At least Ron has the nerve to post with his name and job title. That is more than I could say for me. For one I would not want to be ridiculed by name like Ron and for two it is no ones business who I am.
Thanks Harry and everyone giving there legal advise.

Submitted by Dunstan on

" Anonymous said...

Oh, and asking a diabetic to "dose" themselves to prove an insulin pump works is pretty poor form.
___________________________________
Why would someone do that?!"

Just a general lack of specific training, or a poor attention span during training would probably do the trick.

Submitted by Dunstan on

"I would hope that all TSO's are the same as me. People's medical conditions are their business. Nothing has to be explained to me. If someone has concerns about going through the walk through or about what they have in their bag, all they have to state to me is,"I have a medical condition". For example they walk up and say, "I have a medical condition, there is medicine in my bag". Okay that is enough you do not have to tell me about it. If you can not take off your shoes and I ask why and you say for medical reasons. Okay that is all that you have to say. A TSO should not question anyones medical conditions."

Two thumbs up for you!

Submitted by Dunstan on

So, is Jack Kevorkian free to pass through with his medical devices?

Submitted by Tomas on
Blogger Bob wrote...
TSORon said... "If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. March 18, 2009 6:49 AM"
----------------------------
Ron, I think you need to take this a little further and explain that the chances of this happening are extremely, extremely rare and at no time would we ever require somebody to remove a medical device. In the rare event that this would happen, we would take every measure available to clear the device.
________________

Bob, I believe you are correct on that in most cases, but I'm just not sure that "TSORon, Blog MD," would really go the extra distance to clear the device/passenger instead of just playing unbending automaton "If the alarm cannot be resolved then the passenger must make a choice, remove the device or find another way to travel. I know, not the answer that anyone here is going to like, but facts are facts. I don’t make the policies, I just enforce them."

From the record of comments TSORon has made over time on this blog, I would not trust the quality of the results.
________________

Thank you very much, Blogger Bob, for getting in here and directly responding to some of the questions from the public in this topic. This is much more how I would envision a useful "dialogue" to be here on EoS.

Tom (1 of 5-6)

Pages