Dolores got in a little before six because she hadn’t slept and she decided there was no reason to lie in bed not sleeping.
She turned the light on, looked at the bad one that took a minute to decide to come all the way up, and set her coffee on the bench. She had a feeling it was going to be a messy day.
The rack was full. She looked at the first pump in the rack while she took her coat off. Its screen was on. It shouldn’t have been. She had closed it out yesterday and left it off, and overnight it had turned itself on and finished something.
UPDATE COMPLETE.
She stood with one arm still in her coat and looked at it.
For two weeks these pumps had refused every update at ninety seconds with the same four words, UPDATE PACKAGE NOT VERIFIED, and she had green-tagged hundreds of them and written each one in her book. She had said out loud in a meeting that nothing in the building had taken an update in two weeks.
Now this one said it was done, with last night’s date under it, 02:51.
She hadn’t pushed anything. At 02:51 she had been home tossing and turning in bed. The laptop was on the bench where she’d left it, closed.
She picked the pump up and turned it over. Corbin 340, nine and a half pounds, with the asset tag curling at the corner. She ran it. It pumped. She pressed the test alarm button and it made the alarm. Then she looked at the screen again, at the little line of numbers along the bottom that said what was loaded, and it wasn’t a Corbin build. She had watched a thousand real ones go by. The numbers were in the wrong font and there was a menu item where there shouldn’t be one. She didn’t know what it was. She knew it wasn’t Corbin’s.
She set it down and pulled the next one off the rack. UPDATE COMPLETE. 02:51. The next. The next. She went down the whole rack and they had all updated at the same time.
Kevin came in at six with a bag from the place on the corner.
“You look like hell,” he said.
“The pumps updated last night.”
He stopped with the bag halfway to the bench. “You pushed the fix?”
“There’s no fix. Corbin’s evaluating options.” She held one up so he could see the screen. “I didn’t push anything. They did it themselves. All of them. At two fifty-one.”
Kevin put the bag down and didn’t open it.
She was already thinking about the floors. The ones in the rack were the ones nobody was using. There were three hundred and eighty-six 340s in the building and most of them were upstairs, on poles, plugged into people. If the ones down here had taken it in the night, the ones upstairs had too.
A firmware update could move the limits. It could change the library. It could turn off the thing that beeped when a nurse typed a hundred and eighty instead of eighteen. She didn’t know what this update did. She knew it wasn’t Corbin’s, it was in every pump in the building, and it had gone in while everyone was asleep.
“We have to pull them,” she said. “All of them. Now.”
“All of them? There’s people on them.”
“I know there’s people on them.”
She got the phone and called the operator and asked for the house supervisor and got a voicemail. She hung up and called Joe and it rang four times and he picked up in the car.
“Dolores. I’m ten minutes out.”
“The pumps took an update overnight. A bad one. It’s not Corbin’s. Every one in the building.”
“Slow down. They updated? That’s good, isn’t it? That’s the —”
“It’s not Corbin’s, Joe. I don’t know what it is. I didn’t send it and neither did Corbin.” She heard a truck going by on his end. “We need to get them off patients until I know what they’re doing.”
“You want to pull every pump in the hospital on a Friday morning.”
“Yes.”
“On whose say-so? You? Dolores, I can’t — I’ll call Barbara. Don’t do anything yet. Don’t touch anything on the floors. Let me get in and call Barbara.”
“Joe. There are people attached to these pumps.”
“I know. Ten minutes. Don’t do anything yet.”
She put the phone down. Kevin was watching her.
“He said don’t do anything,” she said.
She got the book down off the shelf and turned to the day’s page. Her hand was shaking. She wrote the date, and the time, and:
All 340s in shop show UPDATE COMPLETE 0251. Not a Corbin build (font, menu). I did not push it. Laptop closed on bench. Nothing has taken an update in 2 wks until now. Called Joe 0604, said wait for Barbara.
The pumps on the bench said last night they had updated. The asset system, when she opened it, said the same, a green checkmark against every one, UP TO DATE, with the time. Her book said they had been green-tagged, running, update pending, for two weeks, in her hand, every one, with the dates. The two did not agree. She didn’t write that down. She realized her heart was racing.
The overhead paged a code to 4 West at 6:31.
She was up the stairs before she thought about Joe. She heard Kevin shouting after her but she ignored him.
4 West was awake. Something was happening in one room and everybody else was pretending to chart. Terri was outside 412 with her back against the wall and her hands at her sides.
“Terri.”
Terri looked at her and it took a second to land.
“Mr. Ferraro,” Terri said. “Post-op. Cardiac. He’s on a heparin drip.” She said it flat. “Day shift came on and did rounds and his numbers were wrong and the pump — the pump says he’s getting what he’s supposed to get. It says eighteen. The bag’s almost empty, Dolores. It was full at change of shift. It ran all night and the screen says eighteen. No fucking way it ran at eighteen.”
Dolores went into the room behind the code team’s backs and looked at the pump.
The screen said 18. The bag was drained. She guessed it had probably been running at over 150. She did not touch the lines. Instead, she reached behind and found the serial and it was a 340, and along the bottom of the screen was the strange build string that was not Corbin’s, with last night’s date, 02:51.
There was no alarm history on it. Either the update had taken the alarm out, or it had told the pump that whatever it was giving was eighteen. She couldn’t tell which from the screen. She knew the screen was wrong.
She wrote the serial on the back of her hand with the pen from her pocket so she would have it, and she backed out of the room.
In the hall Terri hadn’t moved.
“Is he —”
“They’re working on him,” Terri said.
Dolores took her phone out and it was already ringing in her hand. It was Joe. She let it ring.
“Terri. Every pump on this floor has the same wrong update in it. They all took it last night while I was sleeping. You can’t trust the number on any of them. Not one.” Her voice started to go. She stopped it. “Go to every room and stop the heparin and anything that matters and count the bag by hand against the time. Don’t read the screen. The screen is wrong. Count the bag.”
“All of them.”
“All of them. Get everybody. I’ll call the other floors.”
Terri went. She didn’t say anything. She went into the next room and Dolores heard her start saying it to somebody.
Dolores stood in the hall of 4 West with the serial number drying on the back of her hand and answered the phone.
“Where are you,” Joe said. “I told you to wait.”
“4 West. There’s a man dying in 412 because of the pump update.”
Joe was quiet.
“Barbara’s standing incident command back up,” he said finally. “Nine o’clock.”
“Good,” Dolores said. “Tell her the pumps are lying and we have to count every bag by hand on every floor until they’re off patients. Tell her I said the screen is wrong. Tell her to put it in the thing she reads from so it’s in her words and not mine.”
“Dolores —”
“I have to call 5 and 6,” she said, and hung up on him.
She went down the back stairs to the shop to get the list of floors and the extensions. The light had finally come all the way up. A monitor had come down from 6 and was sitting on the bench, a sticky note on it in a hand she didn’t recognize: DEAD BATTERY. She moved it off the phone so she could use the phone, and set it aside for later.
Then she picked up the phone and started dialing 5.
She had said it in a meeting with her hand up. She had written it in a box that made her pick a word and she had picked TEMPORARY because they’re watching her for a bleed wasn’t death, and she had written IF WE DON’T FIX THIS SOMEONE WILL DIE at the end of two thousand characters that went into a system she didn’t trust. She had been right and she had filed it correctly and she had been thanked for her input.
Five picked up on the second ring.
“This is Dolores in Clinical Engineering,” she said. “Don’t read the pumps. Count the bags by hand. I’ll explain when I’m up there. Start now.”