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Continuous subcutaneous insulin infusion (<jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> or insulin pump) is a diabetes treatment modality utilizing a device to aid in regulation of glycemic control. Malfunctions in device components can have rare fatal consequences. Described in this report are six fatalities due to one such malfunction, the failure of plastic cannulas of <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> devices to penetrate the skin and deliver insulin, resulting in fatal diabetic ketoacidosis (<jats:styled-content style=\"fixed-case\">DKA<\/jats:styled-content>). The cases derive from four different death investigation systems. For each case, scene and autopsy findings are presented, as well as selected toxicology and histology findings. These cases illustrate the importance of careful examination of <jats:styled-content style=\"fixed-case\">CSII<\/jats:styled-content> devices in death investigations and introduce a discussion on discrepant manner of death classifications.<\/jats:p>","DOI":"10.1111\/1556-4029.13841","type":"journal-article","created":{"date-parts":[[2018,6,25]],"date-time":"2018-06-25T22:52:23Z","timestamp":1529967143000},"page":"275-280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fatalities Due to Failure of Continuous Subcutaneous Insulin Infusion Devices: A Report of Six Cases"],"prefix":"10.1111","volume":"64","author":[{"given":"Andrew","family":"Ziegler","sequence":"first","affiliation":[{"name":"Boston University School of Medicine Department of Anatomy &amp; Neurobiology Program of Biomedical Forensic Sciences 72 E Concord Street Boston MA 02118"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Williams","sequence":"additional","affiliation":[{"name":"King County Medical Examiner's Office 908 Jefferson Street Seattle WA 98104"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Yarid","sequence":"additional","affiliation":[{"name":"Erie County Medical Examiner 501 Kensington Avenue Buffalo NY 14214"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel L.","family":"Schultz","sequence":"additional","affiliation":[{"name":"District 12 Medical Examiner Office 2001 Siesta Drive #302 Sarasota FL 34231"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Bundock","sequence":"additional","affiliation":[{"name":"Office of the Chief Medical Examiner 111 Colchester Ave # 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