U.S. patent application number 10/700913 was filed with the patent office on 2005-01-27 for laminated patient infusion device.
Invention is credited to Flaherty, J. Christopher, Garlbotto, John T..
Application Number | 20050021005 10/700913 |
Document ID | / |
Family ID | 25525122 |
Filed Date | 2005-01-27 |
United States Patent
Application |
20050021005 |
Kind Code |
A1 |
Flaherty, J. Christopher ;
et al. |
January 27, 2005 |
Laminated patient infusion device
Abstract
A device for delivering fluid to a patient including an exit
port assembly adapted to connect to a transcutaneous patient access
tool, and a dispenser including at least two laminated layers of
material defining a passageway connected to the exit port assembly,
and an expandable accumulator in fluid communication with the
passageway for controlling fluid flow from a reservoir to the exit
port assembly. The laminated construction provides many benefits
including simplifying the design and manufacturing of the device,
in order to further reduce the size, complexity and costs of the
device so that the device lends itself to being small and
disposable in nature.
Inventors: |
Flaherty, J. Christopher;
(Topsfield, MA) ; Garlbotto, John T.;
(Charlestown, MA) |
Correspondence
Address: |
McDermott, Will & Emery
28 State Street
Boston
MA
02109
US
|
Family ID: |
25525122 |
Appl. No.: |
10/700913 |
Filed: |
November 4, 2003 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
10700913 |
Nov 4, 2003 |
|
|
|
09977434 |
Oct 12, 2001 |
|
|
|
6669669 |
|
|
|
|
Current U.S.
Class: |
604/890.1 |
Current CPC
Class: |
A61M 5/16854 20130101;
Y10S 128/12 20130101; A61M 5/14248 20130101; A61M 39/281 20130101;
A61M 2005/1403 20130101; A61M 5/14224 20130101; A61M 2205/35
20130101; A61M 2205/3569 20130101; A61M 5/16813 20130101; A61M
5/16809 20130101; A61M 2005/1405 20130101 |
Class at
Publication: |
604/890.1 |
International
Class: |
A61K 009/22 |
Claims
1. A device for delivering fluid to a patient, comprising: A) a
reservoir; B) an exit port assembly adapted to connect to a
transcutaneous patient access tool; and C) a dispenser including at
least two laminated layers of material defining a passageway
connecting the reservoir to the exit port assembly, and an
expandable accumulator in fluid communication with the
passageway.
2. A device according to claim 1, wherein at least one layer of the
dispenser comprises a resilient diaphragm.
3. A device according to claim 2, wherein the at least two
laminated layers of the dispenser further comprise: a first layer;
a second layer received against the first layer, the second and the
first layers including at least one groove defining the passageway
connected to the exit port assembly, the second layer including an
opening in fluid communication with the passageway, and wherein the
resilient diaphragm is received on the second layer covering the
opening; and a third layer received over the diaphragm on the
second layer, the third layer having an pulse chamber over the
diaphragm and in alignment with the opening of the second layer,
and a port in fluid communication with the pulse chamber.
4. A device according to claim 3, wherein the pulse chamber has a
predetermined volume.
5. A device according to claim 3, wherein one of the second and the
third layers defines a recess receiving the diaphragm, and wherein
the recess has a depth about equal to a thickness of the diaphragm
such that the diaphragm is secured in a substantially fluid-tight
manner between the second and the third layers.
6. A device according to claim 5, wherein a length and a width of
the recess are greater than a length and a width of the
diaphragm.
7. A device according to claim 2, wherein the at least two
laminated layers of the dispenser further comprise: a first layer
defining the passageway connected to the exit port assembly and an
opening in fluid communication with the passageway, and wherein the
resilient diaphragm is received on the first layer covering the
opening; a second layer received over the diaphragm on the first
layer, the second layer having an pulse chamber over the diaphragm
and in alignment with the opening of the first layer, and a port in
fluid communication with the pulse chamber; and a third layer
received on the second layer and defining a secondary chamber in
fluid communication with the port of the second layer.
8. A device according to claim 3, further comprising a spring
biasing the diaphragm away from the pulse chamber.
9. A device according to claim 2, wherein the at least two
laminated layers of the dispenser further comprise: a first layer
having a surface defining a recess and a groove extending from the
recess; wherein the resilient diaphragm is received on the surface
of the first layer such that the recess and the diaphragm define
the expandable accumulator and the groove and the diaphragm defines
the passageway connected to the exit port assembly.
10. A device according to claim 7, wherein the surface of the first
layer further defines a valve seat in the groove.
11. (Canceled)
12. (Canceled)
13. (Canceled)
14. A device according to claim 2, wherein the at least two
laminated layers of the dispenser further comprise: a first layer;
and a second layer received against the first layer, at least one
the second and the first layers having a groove defining the
passageway connected to the exit port assembly, the second layer
including a surface facing away from the first layer and having a
recess, and an opening providing fluid communication between the
recess and the passageway; wherein the resilient diaphragm is
received on the second layer covering the recess to form the
expandable accumulator.
15. A device according to claim 14, further comprising an actuator
for pushing the diaphragm into the recess to reduce the volume of
the accumulator.
16. A device according to claim 15, wherein the actuator comprises
a rotatable cam.
17. A device according to claim 14, further comprising: a third
layer received against the diaphragm and on the second layer and
having a bore aligned with the recess of the second layer; and
wherein the actuator comprises a piston slidingly received in the
bore.
18. A device according to claim 17, further comprising a magnetic
coil received in the third layer coaxial with the piston for
biasing the piston against the diaphragm upon being energized.
19. A device according to claim 17, further comprising: a fourth
layer received against the third layer and having a bore aligned
with the bore of the third layer; and wherein the dispenser
includes a gas generator received in the bore of the fourth layer
for pressurizing the bore and biasing the piston against the
diaphragm upon being actuated.
20. A device according to claim 17, comprising multiple
accumulators arranged sequentially with respect to the
passageway.
21. A device according to claim 2, wherein the at least two
laminated layers of the dispenser further comprise: first and
second layers wherein the diaphragm is positioned between the
layers, and one of the layers has a groove defining the passageway
connected to the exit port assembly, and the other of the layers
has a recess separated from the passageway by the diaphragm; and
the dispenser further includes an actuator received in the recess
for pushing the diaphragm into the passageway upon being
actuated.
22. A device according to claim 21, wherein the actuator comprises
a piece of piezoelectric material arranged to push the diaphragm
upon the piezoelectric material assuming one of a deformed state
and an undeformed state.
23. A device according to claim 22, comprising multiple pieces of
piezoelectric material arranged sequentially with respect to the
passageway.
24. A device according to claim 1, wherein the at least two
laminated layers of the dispenser comprise: a first layer; a second
layer received against the first layer, the second and the first
layers defining the passageway connected to the exit port assembly,
and one of the layers including a bore communicating with the
passageway; and the dispenser further includes a piston slidingly
received in the bore.
25. A device according to claim 24, wherein the dispenser further
comprises a spring biasing the piston towards the passageway.
26. A device according to claim 24, wherein the dispenser further
comprises a magnetic coil received in one of the layers coaxial
with the piston for biasing the piston one of towards and away from
the passageway upon being energized.
27. A device according to claim 1, further comprising an inlet
valve controlling flow from the reservoir into the accumulator, and
an outlet valve controlling flow between the accumulator and the
exit port assembly.
28. A device according to claim 27, wherein the passageway includes
openings for the valves and the valves each include a layer of
resilient fluid-tight material covering the opening and a layer of
piezoelectric material covering the layer of resilient fluid-tight
material and arranged such that upon the piezoelectric material
assuming one of a deformed state and an undeformed state, the layer
of piezoelectric material forces the layer of resilient fluid-tight
material into the opening of the passageway and substantially
closes the passageway.
29. A device according to claim 27, wherein the dispenser further
includes a bar extending parallel with the passageway and pivotally
mounted about a pivot point, and wherein the valves comprise gates
extending from the bar into the passageway on opposite sides of the
pivot point.
30. A device according to claim 27, wherein the valves comprise
one-way valves.
31. A device according to claim 30, wherein the valves comprise
duck bill valves.
32. A device according to claim 1, wherein the laminated layers
further define a bore bisecting the passageway and the dispenser
further comprises a valve assembly including: a valve member
movably received in the bore and including an opening; a spring
biasing the valve member such that the opening of the valve member
is normally offset from the passageway and the passageway is
blocked by the valve member; and an actuator for moving the valve
member upon being actuated such that the opening of the valve
member aligns with the passageway.
33. A device according to claim 32, wherein the actuator comprises
a gas generator for pressurizing the bore upon being actuated.
34. (Canceled)
35. A device according to claim 1, wherein the reservoir contains a
therapeutic fluid.
36. A device according to claim 1, further comprising a fill port
connected to the reservoir.
37. A device according to claim 1, wherein the reservoir is
pressurized.
38. A device according to claim 1, further comprising a
transcutaneous patient access tool connected to the exit port
assembly.
39. (Canceled)
40. (Canceled)
41. (Canceled)
42. (Canceled)
43. A device according to claim 1, further comprising: an inlet
valve connected to an inlet of the accumulator; a outlet valve
connecting an outlet of the accumulator to the exit port assembly;
and a priming mechanism for maintaining the inlet valve and the
outlet valve simultaneously open.
44. A device according to claim 43, wherein the priming mechanism
comprises: a pivotally movable first link operatively connected to
the inlet valve such that the inlet valve is opened upon pivoting
movement of the first link; a pivotally movable second link
operatively connected to the outlet valve such that the outlet
valve is opened upon pivoting movement of the second link; and a
movable priming rod operatively connected to the first and the
second links for pivoting the links upon movement of the rod.
45. A device according to claim 44, wherein: the inlet and the
outlet valves each include a valve member movable between open and
closed positions; the first link extends between the valve member
of the inlet valve and the priming rod and is pivotally movable
about a pivot point of the first link located between the valve
member of the inlet valve and the priming rod; the second link
extends between the valve member of the outlet valve and the
priming rod and is pivotally movable about a pivot point of the
second link located between the valve member of the outlet valve
and the priming rod; and the priming rod is linearly movable.
46. A device according to claim 44, further comprising: a fill port
adapted to receive a needle; and a collar connected to the priming
rod and received in the fill port, the collar adapted to receive a
needle inserted into the fill port so that the inserted needle
causes movement of the collar and the priming rod and pivoting
movement of the links.
47. A device according to claim 1, wherein the exit port assembly
comprises a transcutaneous access tool having a known internal
fluid volume.
48. A device according to claim 47, further comprising a processor
controlling the dispenser, and wherein the processor is programmed
to cause the dispenser to deliver a volume of fluid equal to the
known internal fluid volume of the access tool upon receiving a
command.
49. A device according to claim 47, further comprising a flow
detector positioned between the dispenser and the access tool.
50. A device according to claim 49, further comprising a processor
controlling the dispenser and receiving signals from the flow
detector, and wherein the processor is programmed to cause the
dispenser to deliver a predetermined flow of fluid for a
predetermined period upon receiving a command and upon receiving a
signal from the flow detector indicative of an initial flow of
fluid to the access tool, the predetermined flow of fluid for the
predetermined period producing a volume of fluid substantially
equal to the known internal fluid volume of the access tool.
51. A device according to claim 47, further comprising a fluid
detector positioned between the dispenser and the access tool.
52. A device according to claim 51, further comprising a processor
controlling the dispenser and receiving signals from the fluid
detector, and wherein the processor is programmed to cause the
dispenser to deliver a predetermined volume of fluid upon receiving
a command and upon receiving a signal from the fluid detector
indicative of fluid initially entering the fluid detector, the
predetermined volume of fluid substantially equal to the known
internal fluid volume of the access tool.
53. A device according to claim 47, wherein the access tool
comprises a needle.
54. A device according to claim 1, further comprising a gas removal
filter connected to the dispenser for removing gas bubbles from
fluid entering the dispenser.
55. (Canceled)
56. A device according to claim 1, wherein the reservoir is gas
permeable.
57. A device according to claim 1, further comprising: a fill port
including, a passageway in fluid communication with the reservoir,
a valve positioned within the passageway and allowing one-way flow
into the reservoir, and a removable septum sealing the
passageway.
58. A device according to claim 57, wherein the fill port further
comprises a funnel having a small open end removably received in
the passageway and a large open end receiving the septum.
59. A device according to claim 58, wherein the fill port further
comprises a first wall having an opening removably receiving the
large open end of the funnel when the small open end of the funnel
is removably received in the passageway.
60. A device according to claim 59, wherein the fill port further
comprises a second wall spaced from the first wall more than a
thickness of the septum and having an opening allowing passage of a
needle and preventing passage of the septum.
61. A device according to claim 57, wherein the fill port further
comprises a first wall having an opening preventing passage of the
septum, and a second wall spaced from the first wall at least about
a thickness of the septum and having an opening allowing passage of
a needle, and wherein the second wall and the opening of the second
wall are adapted to allow passage of the septum upon at least a
predetermined force applied to the septum.
62. A device according to claim 61, wherein the predetermined force
is less than a force required to pull a needle out of the
septum.
63. A device according to claim 1, wherein the exit port assembly
comprises a plurality of exit port assemblies and each assembly
comprises an independently deployable transcutaneous access tool
adapted to provide fluid communication with the dispenser upon
deployment.
64. A device according to claim 63, wherein each access tool
comprises a needle.
65. A device according to claim 63, where each access tool is
maintained in a sterile state prior to deployment.
66. (Canceled)
67. (Canceled)
68. (Canceled)
69. (Canceled)
70. (Canceled)
71. (Canceled)
72. (Canceled)
73. (Canceled)
74. (Canceled)
75. (Canceled)
76. (Canceled)
77. (Canceled)
78. (Canceled)
79. (Canceled)
80. (Canceled)
81. (Canceled)
82. (Canceled)
83. (Canceled)
84. (Canceled)
85. (Canceled)
86. (Canceled)
87. (Canceled)
88. (Canceled)
89. (Canceled)
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application is related to U.S. patent
application Ser. No. 09/943,992, filed on Aug. 31, 2001, which is
assigned to the assignee of the present application and
incorporated herein by reference.
FIELD OF THE INVENTION
[0002] The present invention relates generally to medical devices,
systems and methods, and more particularly to small, low cost,
portable infusion devices and methods that are useable to achieve
precise, sophisticated, and programmable flow patterns for the
delivery of therapeutic liquids to a mammalian patient.
BACKGROUND OF THE INVENTION
[0003] Today, there are numerous diseases and other physical
ailments that are treated by various medicines including
pharmaceuticals, nutritional formulas, biologically derived or
active agents, hormonal and gene based material and other
substances in both solid or liquid form. In the delivery of these
medicines, it is often desirable to bypass the digestive system of
a mammalian patient to avoid degradation of the active ingredients
caused by the catalytic enzymes in the digestive tract and liver.
Delivery of a medicine other than by way of the intestines is known
as parenteral delivery. Parenteral delivery of various drugs in
liquid form is often desired to enhance the effect of the substance
being delivered, insuring that the unaltered medicine reaches its
intended site at a significant concentration. Also, undesired side
effects associated with other routes of delivery, such as systemic
toxicity, can potentially be avoided.
[0004] Often, a medicine may only be available in a liquid form, or
the liquid version may have desirable characteristics that cannot
be achieved with solid or pill form. Delivery of liquid medicines
may best be accomplished by infusing directly into the
cardiovascular system via veins or arteries, into the subcutaneous
tissue or directly into organs, tumors, cavities, bones or other
site specific locations within the body.
[0005] Parenteral delivery of liquid medicines into the body is
often accomplished by administering bolus injections using a needle
and reservoir, or continuously by gravity driven dispensers or
transdermal patch technologies. Bolus injections often imperfectly
match the clinical needs of the patient, and usually require larger
individual doses than are desired at the specific time they are
given. Continuous delivery of medicine through gravity feed systems
compromise the patient's mobility and lifestyle, and limit the
therapy to simplistic flow rates and profiles. Transdermal patches
have special requirements of the medicine being delivered,
particularly as it relates to the molecular structure, and similar
to gravity feed systems, the control of the drug administration is
severely limited.
[0006] Ambulatory infusion pumps have been developed for delivering
liquid medicaments to a patient. These infusion devices have the
ability to offer sophisticated fluid delivery profiles
accomplishing bolus requirements, continuous infusion and variable
flow rate delivery. These infusion capabilities usually result in
better efficacy of the drug and therapy and less toxicity to the
patient's system. An example of a use of an ambulatory infusion
pump is for the delivery of insulin for the treatment of diabetes
mellitus. These pumps can deliver insulin on a continuous basal
basis as well as a bolus basis as is disclosed in U.S. Pat. No.
4,498,843 to Schneider et al.
[0007] The ambulatory pumps often work with a reservoir to contain
the liquid medicine, such as a cartridge or reservoir, and use
electro-mechanical pumping or metering technology to deliver the
medication to the patient via tubing from the infusion device to a
needle that is inserted transcutaneously, or through the skin of
the patient. The devices allow control and programming via
electromechanical buttons or switches located on the housing of the
device, and accessed by the patient or clinician. The devices
include visual feedback via text or graphic screens, such as liquid
crystal displays known as LCD's, and may include alert or warning
lights and audio or vibration signals and alarms. The device can be
worn in a harness or pocket or strapped to the body of the
patient.
[0008] Currently available ambulatory infusion devices are
expensive, difficult to program and prepare for infusion, and tend
to be bulky, heavy and very fragile. Filling these devices can be
difficult and require the patient to carry both the intended
medication as well as filling accessories. The devices require
specialized care, maintenance, and cleaning to assure proper
functionality and safety for their intended long term use. Due to
the high cost of existing devices, healthcare providers limit the
patient populations approved to use the devices and therapies for
which the devices can be used.
[0009] Clearly, therefore, there was a need for a programmable and
adjustable infusion system that is precise and reliable and can
offer clinicians and patients a small, low cost, light weight,
simple to use alternative for parenteral delivery of liquid
medicines.
[0010] In response, the applicant of the present application
provided a small, low cost, light weight, easy to use device for
delivering liquid medicines to a patient. The device, which is
described in detail in co-pending U.S. application Ser. No.
09/943,992, filed on Aug. 31, 2001, includes an exit port, a
dispenser for causing fluid from a reservoir to flow to the exit
port, a local processor programmed to cause a flow of fluid to the
exit port based on flow instructions from a separate, remote
control device, and a wireless receiver connected to the local
processor for receiving the flow instructions. To reduce the size,
complexity and costs of the device, the device is provided with a
housing that is free of user input components, such as a keypad,
for providing flow instructions to the local processor.
[0011] What is still desired are new and improved devices for
delivering fluid to a patient. Preferably, the fluid delivery
devices will be simple in design, and inexpensive and easy to
manufacture, in order to further reduce the size, complexity and
costs of the devices, such that the devices lend themselves to
being small and disposable in nature.
SUMMARY OF THE INVENTION
[0012] In response, the present invention provides a device for
delivering fluid to a patient, including an exit port assembly
adapted to connect to a transcutaneous patient access tool, and a
dispenser including at least two laminated layers of material
defining a passageway connected to the exit port assembly, and an
expandable accumulator in fluid communication with the passageway
for controlling fluid flow from a reservoir to the exit port
assembly. The laminated construction provides many benefits
including, but not limited to, simplifying the design and
manufacturing of the device, and further reducing the size,
complexity and costs of the device. The device of the present
invention, therefore, lends itself to being small and disposable in
nature.
[0013] According to one aspect of the present invention, at least
one layer of the dispenser comprises a resilient diaphragm.
According to another aspect, the at least two laminated layers of
the dispenser further include a first layer and a second layer
received against the first layer. The second and the first layers
define the passageway connected to the exit port assembly, and the
second layer includes an opening in fluid communication with the
passageway. The resilient diaphragm is received on the second layer
covering the opening, and a third layer is received over the
diaphragm on the second layer. The third layer has an pulse chamber
over the diaphragm and in alignment with the opening of the second
layer, and a port in fluid communication with the pulse
chamber.
[0014] According to another aspect, one of the second and the third
layers defines a recess receiving the diaphragm, and wherein the
recess has a depth about equal to a thickness of the diaphragm such
that the diaphragm is secured in a substantially fluid-tight manner
between the second and the third layers. Preferably, a length and a
width of the recess are greater than a length and a width of the
diaphragm in order to decrease required manufacturing tolerances of
the dispenser.
[0015] According to an additional embodiment of the present
invention, the at least two laminated layers include a first layer,
and a second layer received against the first layer. The second and
the first layers define the passageway connected to the exit port
assembly. The second layer includes a surface facing away from the
first layer and having a recess, and an opening providing fluid
communication between the recess and the passageway defined by the
first and the second layers. The resilient diaphragm is received on
the second layer covering the recess to form the expandable
accumulator.
[0016] According to one aspect, the device includes an actuator for
pushing the diaphragm into the recess to reduce the volume of the
accumulator. According to another aspect, the actuator comprises a
rotatable cam.
[0017] According to another embodiment, a third layer is received
against the diaphragm and has a bore aligned with the recess of the
second layer, and the actuator comprises a piston slidingly
received in the bore. According to one aspect, a magnetic coil is
received in the third layer coaxial with the piston for biasing the
piston against the diaphragm upon being electrified. According to
another aspect, the dispenser includes multiple accumulators
arranged sequentially with respect to the passageway, and magnetic
coils and pistons associated with each accumulator.
[0018] According to another embodiment, a third layer is received
against the diaphragm and has a bore aligned with the recess of the
second layer, and a fourth layer is received against the third
layer and has a bore aligned with the bore of the third layer, and
a gas generator is received in the bore of the fourth layer for
pressurizing the bore and biasing the piston against the diaphragm
upon being actuated. According to one aspect, the dispenser
includes multiple accumulators arranged sequentially with respect
to the passageway, and gas generators and pistons associated with
each accumulator.
[0019] According to a further embodiment, the dispenser includes a
first layer having a surface defining a groove, with the diaphragm
positioned against the surface of the first layer such that the
diaphragm and the groove define the passageway connected to the
exit port assembly. A second layer is received against the
diaphragm and includes a recess separated from the passageway by
the diaphragm, and the portion of the passageway opposite the
recess comprises the expandable accumulator. An actuator is
received in the recess of the second layer for pushing the
diaphragm towards the first layer upon being actuated to reduce the
volume of the accumulator. According to one aspect, the actuator
comprises a piece of piezoelectric material arranged to push the
diaphragm upon contracting. According to another aspect, the
actuator comprises multiple pieces of piezoelectric material
arranged sequentially with respect to the passageway within the
recess.
[0020] Another embodiment includes a first layer received against a
second layer, with the layers defining the passageway connected to
the exit port assembly, and the second layer including a recess
facing the first layer. The dispenser further includes a piston
slidingly received in the recess of the second layer, such that the
piston and the recess define the expandable accumulator. According
to one aspect, a spring biases the piston towards the first layer.
According to another aspect, a magnetic coil is received in the
second layer coaxial with the piston for biasing the piston towards
the first layer upon being electrified.
[0021] These aspects of the invention together with additional
features and advantages thereof may best be understood by reference
to the following detailed descriptions and examples taken in
connection with the accompanying illustrated drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] FIG. 1 is a perspective view of a first exemplary embodiment
of a fluid delivery device in accordance with this invention shown
secured on a patient, and a remote control device for use with the
fluid delivery device (the remote control device being enlarged
with respect to the patient and the fluid delivery device for
purposes of illustration);
[0023] FIG. 2 is a sectional side view of the fluid delivery device
of FIG. 1;
[0024] FIGS. 3a and 3b are sectional side views of a dispenser of
the fluid delivery device of FIG. 1, illustrating operation of the
dispenser;
[0025] FIGS. 4a and 4b are sectional views of another dispenser
constructed in accordance with the present invention, illustrating
operation of the dispenser;
[0026] FIGS. 5a and 5b are sectional views of an additional
dispenser constructed in accordance with the present invention,
illustrating operation of the dispenser;
[0027] FIG. 6 is a sectional view of an additional embodiment of a
dispenser constructed in accordance with the present invention;
[0028] FIG. 7 is a top plan view of a portion of fluid delivery
device constructed in accordance with the present invention;
[0029] FIG. 8 is a sectional view of the portion of the fluid
delivery device taken along line 8-8 of FIG. 7;
[0030] FIG. 9 is a sectional view of the portion of the fluid
delivery device taken along line 9-9 of FIG. 7;
[0031] FIG. 10 is a sectional view of the portion of the fluid
delivery device taken along line 10-10 of FIG. 7;
[0032] FIGS. 11a and 11b are sectional views of the entire fluid
delivery device of FIG. 7, illustrating operation of the
device;
[0033] FIGS. 12a and 12b are sectional views of an embodiment of a
valve constructed in accordance with the present disclosure,
illustrating operation of the valve;
[0034] FIGS. 13a and 13b are sectional views of another embodiment
of a valve constructed in accordance with the present disclosure,
illustrating operation of the valve;
[0035] FIG. 14 is a sectional view of a further embodiment of a
valve constructed in accordance with the present disclosure;
[0036] FIG. 15 is a sectional view of another embodiment of a valve
constructed in accordance with the present disclosure;
[0037] FIG. 16 is a sectional view of another embodiment of a
dispenser constructed in accordance with the present invention;
[0038] FIGS. 17a and 17b are sectional views of another embodiment
of a dispenser constructed in accordance with the present
disclosure, illustrating operation of the dispenser;
[0039] FIGS. 18a and 18b are sectional views of another embodiment
of a dispenser constructed in accordance with the present
disclosure, illustrating operation of the dispenser;
[0040] FIGS. 19a and 19b are sectional views of another embodiment
of a dispenser constructed in accordance with the present
disclosure, illustrating operation of the dispenser;
[0041] FIGS. 20a and 20b are sectional views of a further
embodiment of a dispenser constructed in accordance with the
present disclosure, illustrating operation of the dispenser;
[0042] FIGS. 21a, 21b and 21c are sectional views of another
embodiment of a dispenser constructed in accordance with the
present disclosure, illustrating operation of the dispenser;
[0043] FIGS. 22a and 22b are sectional views of a portion of
another embodiment of a fluid delivery device including a priming
mechanism constructed in accordance with the present disclosure,
and illustrating operation of the priming mechanism;
[0044] FIGS. 23a and 23b are sectional views of a portion of an
additional embodiment of a fluid delivery device including a
priming mechanism constructed in accordance with the present
disclosure, and illustrating operation of the priming
mechanism;
[0045] FIG. 24 is a schematic illustration of a further embodiment
of a fluid delivery device constructed in accordance with the
present disclosure;
[0046] FIG. 25 is a schematic illustration of another embodiment of
a fluid delivery device and a remote control device constructed in
accordance with the present disclosure;
[0047] FIG. 26 is a schematic illustration of an additional
embodiment of a fluid delivery device constructed in accordance
with the present disclosure;
[0048] FIG. 27 is a schematic illustration of a further embodiment
of a fluid delivery device constructed in accordance with the
present disclosure;
[0049] FIG. 28 is a schematic illustration of a further embodiment
of a fluid delivery device constructed in accordance with the
present disclosure;
[0050] FIGS. 29a through 29d are sectional views of an embodiment
of a fill port constructed in accordance with the present
disclosure, and illustrating operation of the fill port;
[0051] FIGS. 30a and 30b are sectional views of another embodiment
of a fill port constructed in accordance with the present
disclosure, and illustrating operation of the fill port;
[0052] FIG. 31 is a top sectional view of another device
constructed in accordance with the present invention; and
[0053] FIG. 32 is a side elevation view, partially cut away, of the
device of FIG. 31.
[0054] Like reference characters designate identical or
corresponding components and units throughout the several
views.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0055] Referring first to FIGS. 1 and 2, there is illustrated a
fluid delivery device 10 constructed in accordance with the present
invention. The types of liquids that can be delivered by the fluid
delivery device of the present invention include, but are not
limited to, insulin, antibiotics, nutritional fluids, total
parenteral nutrition or TPN, analgesics, morphine, hormones or
hormonal drugs, gene therapy drugs, anticoagulants, analgesics,
cardiovascular medications, AZT or chemotherapeutics. The types of
medical conditions that the fluid delivery device of the present
invention might be used to treat include, but are not limited to,
diabetes, cardiovascular disease, pain, chronic pain, cancer, AIDS,
neurological diseases, Alzheimer's Disease, ALS, Hepatitis,
Parkinson's Disease or spasticity.
[0056] Referring to FIG. 2, the device 10 generally includes an
exit port assembly 70 adapted to connect to a transcutaneous
patient access tool such as a needle, a dispenser 40 for causing
fluid from a reservoir 30 to flow to the exit port assembly 70, and
a processor or electronic microcontroller (hereinafter referred to
as the "local" processor) 50 connected to the dispenser 40.
[0057] The local processor 50 is programmed to cause a flow of
fluid to the exit port assembly 70 based on flow instructions from
a separate, remote control device 100, an example of which is shown
in FIG. 1. Referring also to FIG. 2, the fluid delivery device 10
further includes a wireless receiver 60 connected to the local
processor 50 for receiving the flow instructions from the separate,
remote control device 100 and delivering the flow instructions to
the local processor. The device 10 also includes a housing 20
containing the exit port assembly 70, the reservoir 30, the
dispenser 40, the local processor 50, and the wireless receiver
60.
[0058] As shown, the housing 20 is free of user input components
for providing flow instructions to the local processor 50, such as
electromechanical switches or buttons on an outer surface 21 of the
housing, or interfaces otherwise accessible to a user to adjust the
programmed flow rate through the local processor 50. The lack of
user input components allows the size, complexity and costs of the
device 10 to be substantially reduced so that the device 10 lends
itself to being small and disposable in nature.
[0059] In order to program, adjust the programming of, or otherwise
communicate user inputs to the local processor 50, the fluid
delivery device 10 includes the wireless communication element, or
receiver 60 for receiving the user inputs from the separate, remote
control device 100 of FIG. 1. Signals can be sent via a
communication element (not shown) of the remote control device 100,
which can include or be connected to an antenna 130, shown in FIG.
1 as being external to the device 100.
[0060] The remote control device 100 has user input components,
including an array of electromechanical switches, such as the
membrane keypad 120 shown. The control device 100 also includes
user output components, including a visual display, such as a
liquid crystal display (LCD) 110. Alternatively, the control device
can be provided with a touch screen for both user input and output.
Although not shown in FIG. 1, the remote control device 100 has its
own processor (hereinafter referred to as the "remote" processor)
connected to the membrane keypad 120 and the LCD 110. The remote
processor receives the user inputs from the membrane keypad 120 and
provides "flow" instructions for transmission to the fluid delivery
device 10, and provides information to the LCD 110. Since the
remote control device 100 also includes a visual display 110, the
fluid delivery device 10 can be void of an information screen,
further reducing the size, complexity and costs of the device
10.
[0061] The communication element 60 of the device 10 preferably
receives electronic communication from the remote control device
100 using radio frequency or other wireless communication standards
and protocols. In a preferred embodiment, the communication element
60 is a two-way communication element, including a receiver and a
transmitter, for allowing the fluid delivery device 10 to send
information back to the remote control device 100. In such an
embodiment, the remote control device 100 also includes an integral
communication element 60 comprising a receiver and a transmitter,
for allowing the remote control device 100 to receive the
information sent by the fluid delivery device 10.
[0062] The local processor 50 of the device 10 contains all the
computer programs and electronic circuitry needed to allow a user
to program the desired flow patterns and adjust the program as
necessary. Such circuitry can include one or more microprocessors,
digital and analog integrated circuits, resistors, capacitors,
transistors and other semiconductors and other electronic
components known to those skilled in the art. The local processor
50 also includes programming, electronic circuitry and memory to
properly activate the dispenser 40 at the needed time
intervals.
[0063] In the exemplary embodiment of FIG. 2, the device 10
includes a power supply 80, such as a battery or capacitor, for
supplying power to the local processor 50. The power supply 80 is
preferably integrated into the fluid delivery device 10, but can be
provided as replaceable, e.g., a replaceable battery.
[0064] Although not shown, the device can include sensors or
transducers such as a reservoir volume transducer or a reservoir
pressure transducer, for transmitting information to the local
processor 50 to indicate how and when to activate the dispenser 40,
or to indicate other parameters determining flow, pump flowpath
prime condition, blockage in flowpath, contact sensors, rotary
motion or other motion indicators, as well as conditions such as
the reservoir 30 being empty or leaking, or the dispensing of too
much or too little fluid from the reservoir, etc.
[0065] The volume of the reservoir 30 is chosen to best suit the
therapeutic application of the fluid delivery device 10 impacted by
such factors as available concentrations of medicinal fluids to be
delivered, acceptable times between refills or disposal of the
fluid delivery device 10, size constraints and other factors. The
reservoir 30 may be prefilled by the device manufacturer or a
cooperating drug manufacturer, or may include external filling
means, such as a fill port having needle insertion septum or a Luer
connector, for example. In addition, the device 10 can be provided
with a removable reservoir.
[0066] The exit port assembly 70 can include elements to penetrate
the skin of the patient, or can be adapted to connect to a standard
infusion device that includes transcutaneous delivery means. A
needle connection tubing terminating in a skin penetrating cannula
(not shown) can be provided as an integral part of the exit port
assembly 70, for example, with the skin penetrating cannula
comprising a rigid member, such as a needle. Alternatively, the
exit port assembly 70 can be provided with a Luer connector for
connecting to a standard infusion device including a skin
penetrating cannula, such as a rigid needle. In the preferred
embodiment, the exit port assembly 70 includes injection means,
such as a spring driven mechanism, to assist in penetrating the
skin with the skin penetrating cannula. If the cannula is a
flexible tube, a rigid penetrator within the lumen of the tube is
driven through the skin by the injection means, and withdrawn
leaving the soft cannula in place, such as in the subcutaneous
tissue of the patient or other internal site. The injection means
may be integral to the device 10, or removable soon after
transcutaneous penetration. In any event, the exit port assembly 70
can also be provided with a removable plug (not shown) for
preventing leakage during storage and shipment if pre-filled, and
during priming if filled by user, and prior to use.
[0067] The device 10 can also be provided with an adhesive layer on
the outer surface of the housing 20 for securing the device 10
directly to the skin of a patient, as shown in FIG. 1. Although not
shown, the adhesive layer is preferably provided in a continuous
ring encircling the exit port assembly 70 in order to provide a
protective seal around the penetrated skin. The housing 20 can be
made from flexible material, or can be provided with flexible
hinged sections that allow the fluid delivery device 10 to flex
during patient movement to prevent detachment and aid in patient
comfort.
[0068] The dispenser 40 is connected in fluid communication with
the reservoir 30, as shown in FIG. 2. When the device 10 is
provided with a pressurized reservoir 30 (i.e., fluid maintained
within the reservoir at a pressure above atmospheric), the
dispenser 40 can include an inlet valve 41 connected to the
reservoir, an outlet valve 42 connected to the exit port assembly
70, and an accumulator 43 connected between the inlet valve and the
outlet valve, as shown in the exemplary embodiment of FIGS. 3a and
3b. Since the fluid in the reservoir 30 is maintained at a pressure
above atmospheric pressure, opening of the inlet valve 41 allows
the accumulator 43 to fill to the reservoir pressure, after which
the inlet valve is 41 is closed. At the proper time, as determined
by the local processor 50 programming and instructions received
from the remote control device 100, the outlet valve 42 can be
opened to dispense fluid to the exit port assembly 70, which is at
the pressure of the patient, or atmospheric pressure. The
accumulator 43 will then be at atmospheric pressure, and the outlet
valve 42 can be closed, ready for another repeat cycle.
[0069] The dispenser 40 of the exemplary embodiment of FIGS. 3a and
3b does not create a driving or pumping force on the fluid passing
therethrough, but rather acts as a metering device, allowing pulses
of fluid to pass from the pressurized reservoir 30, through the
dispenser 40, to the exit port assembly 70 at atmospheric pressure.
The inlet valve 41 and the outlet valve 42 of the dispenser 40 are
controlled by the local processor 50, which includes electronic
programming, controls and circuitry to allow sophisticated fluid
delivery programming and control of the dispenser 40.
[0070] FIG. 3a shows the dispenser 40 with the accumulator 43 at
atmospheric pressure. An accumulator membrane 44 is shown in a
non-distended state, caused by atmospheric pressure only. Inlet
valve 41 is closed, and outlet valve 42 may be open or closed, but
must have been opened since the last time inlet valve 41 was
opened. FIG. 3b shows the condition where outlet valve 42 is
closed, and inlet valve 41 has been opened. Because of the elevated
pressure of the fluid from the reservoir 30, the accumulator
membrane 44 is distended, thus increasing the volume of accumulator
43 by an accumulator volume 45. After the inlet valve 41 is closed,
the outlet valve 42 can be opened, to dispense the accumulator
volume 45 and allow the accumulator membrane 44 to retract to the
position shown in FIG. 3a.
[0071] The inlet valve 41 and the outlet valve 42 of the dispenser
40 and the local processor 50 are designed to prevent both valves
from being opened at the same time, precluding the reservoir 30 to
ever flow directly to the exit port assembly 70. The prevention of
both valves opening at the same time is critical and can be
accomplished via mechanical means, electrical means, or both. The
prevention can be accomplished in the dispenser 40 design, the
local processor 50 design, or both.
[0072] The dispenser 40 shown in FIGS. 3a and 3b dispenses finite
pulses of fluid volume, called pulse volume (PV), with each
activation. The PV is determined by the properties, materials and
construction of the accumulator 43 and the accumulator membrane 44.
PV's delivered by infusion devices are typically chosen to be small
relative to what would be considered a clinically significant
volume. For insulin applications at a concentration of 100 units
per ml, a PV of less than 2 microliter, and typically 0.5
microliter, is appropriate. If the fluid delivery device 10 is
programmed via the remote control device 100 to deliver 2 units an
hour, the dispenser will deliver 40 pulses an hour, or a pulse
every 1.5 minutes. Such pulsitile flow is considered continuous if
the PV is small enough. Other drugs or concentrations may permit a
much larger PV. Various flow rates are achieved by adjusting the
time between pulses. To give a fixed volume or bolus, multiple
pulses are given in rapid succession until the bolus volume is
reached.
[0073] The PV may not always be constant enough to be within the
accuracy requirements of the fluid delivery device 10. One factor
impacting the PV is the pressure of the reservoir 30. The fluid
delivery device 10 may include means for monitoring reservoir 30
pressure and adjust the timing between pulses to achieve the desire
flow pattern. An example of such compensation would be to decrease
time between pulses as the reservoir 30 pressure decreases to
maintain the programmed flow rate. An alternative to monitoring
reservoir 30 pressure is monitoring the volume of the reservoir 30.
Each time a pulse or series of pulses are delivered, a measurement
of reservoir 30 volume can indicate whether a proper amount of
fluid has been delivered, both for individual pulses and cumulative
pulses. The system could also be designed to compensate fluid flow
as errors are detected.
[0074] Referring now to FIGS. 4a and 4b, the present invention
provides an improved dispenser 240 for use with the fluid delivery
device 10 of FIGS. 1 and 2. Operation of the dispenser 240 of FIGS.
4a and 4b is similar to operation of the dispenser 40 of FIGS. 3a
and 3b. In addition, some elements of the dispenser 240 of FIGS. 4a
and 4b are similar to the dispenser 40 of FIGS. 3a and 3b such that
similar elements have the same reference numeral preceded by a
"2".
[0075] The dispenser 240 of FIGS. 4a and 4b, however, includes at
least two laminated layers 252, 254 of material defining a
passageway 250 for connection to the exit port assembly 70, and an
expandable accumulator 243 in fluid communication with the
passageway 250 for controlling fluid flow from the reservoir 30 to
the exit port assembly 70. The laminated construction provides many
benefits including, but not limited to, simplifying the design and
manufacturing of the dispenser 240, and further reducing the size,
complexity and costs of the dispenser 240. The dispenser 240 of the
present invention, therefore, lends itself to being small and
disposable in nature.
[0076] In the embodiment of FIGS. 4a and 4b, the layers of the
dispenser 240 include a first layer 252 and a second layer 254
received against the first layer. At least one of the second and
the first layers 252, 254 includes a surface groove between the
layers which defines the passageway 250 connected to the exit port
assembly 70. The second layer 254 includes an opening 246 in fluid
communication with the passageway 250. The layers 252, 254 also
include a resilient diaphragm 244 received on the second layer 254
covering the opening, and a third layer 256 received over the
diaphragm 244 on the second layer 254. The third layer 256 has a
pulse chamber 245 over the diaphragm 244 and in alignment with the
opening 246 of the second layer 254, and a relief port 247 in fluid
communication with the pulse chamber 245.
[0077] FIG. 4a shows the dispenser 240 with the accumulator 243 at
atmospheric pressure with the resilient diaphragm 244 in a
non-distended state. Inlet valve 241 is closed, and outlet valve
242 may be open or closed, but must have been opened since the last
time the inlet valve 241 was opened. FIG. 4b shows the condition
wherein the outlet valve 242 is closed, and the inlet valve 241 has
been opened. Because of the elevated pressure of the fluid from the
reservoir 30, the fluid expands the resilient diaphragm 244 into
the pulse chamber 245 (with the relief port 247 allowing evacuation
of the pulse chamber 245), thus increasing the volume of the
accumulator 243 by about a volume of the pulse chamber 245. After
the inlet valve 241 is closed, the outlet valve 242 can be opened,
to dispense the accumulator volume 245 and allow the resilient
diaphragm 244 to return to the position shown in FIG. 4a.
[0078] The laminated construction of the dispenser 240 allows most
manufacturing tolerances of the dispenser 240 to be lowered, and
the manufacturing process to be simplified, without effecting the
performance and reliability of the dispenser 240. High tolerances
are required for only the volume of the pulse chamber 245 and the
resilience of the diaphragm 244, since those dimensions affect the
resulting PV produced by the dispenser 240. Other dimensions and
properties of the dispenser 240 can be relatively relaxed to reduce
the costs of the dispenser. For example, in the embodiment shown,
at least one of the second and the third layers 254, 256 defines a
recess 260 receiving the diaphragm 244. The recess 260 has a depth
about equal to a thickness of the diaphragm 244 such that the
diaphragm is secured in a substantially fluid-tight manner between
the second and the third layers 254, 256. However, a length and a
width of the recess 260 are greater than a length and a width of
the diaphragm 244 in order to decrease the required manufacturing
tolerances of the dispenser 240.
[0079] Manufacturing the dispenser 240 is preferably a "drop down"
process. First the layers 252, 254, 256 are individually formed
with the necessary openings, groove, and recesses. The first layer
252 is then laid down and the valves 241, 242 are dropped into
recesses (not shown) in the first layer and correctly positioned
within the groove 250. Then the second layer 254 is placed on the
first layer 252, and the diaphragm 244 is placed in the recess 260
of the second layer. Finally, the third layer 256 is positioned
over the diaphragm 244 and the second layer 254. The layers 252,
254, 256 can be made from a suitably strong and rigid material such
as plastic or stainless steel, and can be secured together in a
suitable manner, such as with adhesives or by welding. The
diaphragm 244 can be made from a suitably expandable yet resilient
material, such as rubber or a synthetic rubber.
[0080] Referring to FIGS. 5a and 5b, another dispenser 270
according to the present invention is shown. The dispenser 270 is
similar to the dispenser 240 of FIGS. 4a and 4b such that similar
elements have the same reference numerals. A first layer 252
defines the passageway 250 connected to the exit port assembly 70
and an opening 246 in fluid communication with the passageway. The
resilient diaphragm 244 is received on the first layer 252 covering
the opening 246, and a second layer 254 is received over the
diaphragm 244 on the first layer. The second layer 254 has a pulse
chamber 245 over the diaphragm 244 and in alignment with the
opening 246 of the first layer 252, and a relief port 247 in fluid
communication with the pulse chamber 245. A third layer 256 is
received on the second layer 254 and defines a relief chamber 248
in fluid communication with the relief port 247 of the second layer
252. The relief chamber 248 allows the pulse chamber 245 to be
evacuated upon expansion of the diaphragm 244, yet keeps the pulse
chamber sealed and the relief port protected. The relief chamber
248 can also be pressurized to further regulate the PV produced by
the dispenser 270.
[0081] FIG. 6 shows another dispenser 280 according to the present
invention. The dispenser 280 is similar to the dispenser 240 of
FIGS. 4a and 4b such that similar elements have the same reference
numerals. The dispenser 280, however, further includes a
compression spring 282 biasing the diaphragm 244 away from the
pulse chamber 245. The strength of the spring is set along with the
volume of the pulse chamber 245 and the resilience of the diaphragm
244, to provide a predetermined PV.
[0082] FIGS. 7 through 11a and 11b show an entire fluid delivery
device 290 incorporating the laminated construction provided by the
present invention. The device 290 is similar to the device of FIGS.
1 and 2, but includes a first layer 252 and a resilient diaphragm
288 received on a surface of the first layer. The surface of the
layer 252 has a recess and a groove extending from the recess to
the exit port assembly 70, such that the recess of the layer 252
and a portion 244 of the diaphragm 288 define the expandable
accumulator 243, and the groove of the layer 252 and the diaphragm
288 define the passageway 250 connected to the exit port assembly
70.
[0083] As shown best on FIG. 7, the surface of the first layer 252
also has a valve seat 292 in the groove and an occlusion sensor
recess 294 in the groove, between the valve seat 292 and the exit
port assembly 70. The surface of the first layer 252 further
includes a reservoir recess 296, a groove 298 extending between the
reservoir and the accumulator 243, and a valve seat 291 in the
groove 298. In addition, the surface of the first layer 252
includes a bubble removal bay 300, a groove 302 extending between
the bubble removal bay 300 and the reservoir recess 296, a fill
port recess 304, and a groove 298 extending between the fill port
recess 304 and the bubble removal bay 300.
[0084] As also shown in FIGS. 8 through 11a and 11b, the diaphragm
288 and the first layer 252, therefore, define an occlusion sensor
chamber 294, the reservoir 296, a bubble removal chamber 300, and
connecting passageways 298, 302, 306. In between the recesses and
grooves, the diaphragm 288 is secured to the surface of the layer
252 in a fluid-tight manner, such as with an adhesive. As best
shown in FIGS. 8 through 10, the portion 244 of the diaphragm 288
expands when the reservoir 296 is filled in order to pressurize the
fluid within the reservoir. In addition, upon the incidence of an
occlusion, fluid backs up in the occlusion sensor chamber 294 and
causes the portion of the diaphragm 288 over the chamber 294 to
expand and increase pressure within the chamber. A switch 308 is
positioned in the chamber 294 to monitor for an occlusion, as shown
in FIG. 9. The switch 308 is arranged such that when that portion
of the diaphragm 288 over the chamber 294 expands, the switch
closes to indicate an occlusion. Alternatively, a strain gage can
be attached to that portion of the diaphragm 288 over the chamber
294, or a pressure sensor can be positioned in the chamber 294 to
monitor for an occlusion.
[0085] The diaphragm 288 can be provided with consistent
properties, such as resilience, throughout, or can include
inconsistent properties. For example, the portion 244 of the
diaphragm 288 over the reservoir recess 296 can be provided with a
greater thickness to increase the resilience of that portion, while
the thickness of the diaphragm 288 over the valve seats 291, 292
may be made thinner to decrease the resilience of those portions.
In addition, the diaphragm 288 can be made from a material that
allows gas to pass through yet prevents liquid from passing
through, such that the diaphragm 288 also acts as a bubble removal
filter. Furthermore, the diaphragm 288 can be provided with
coatings. For example, surfaces of the diaphragm 288 in contact
with flow paths can be coated with material that promotes flow and
avoids precipitation (such as insulin crystallization). The
diaphragm 288 can also be coated with lines of conductive material,
for example, to support transmission of electrical signals between
the local processor and other components of the device.
[0086] As shown in FIG. 7, the first layer 252 also defines
recesses 310, 312, 314, which are not covered by the diaphragm 288,
for other components of the device including the local processor
50, the wireless communication unit 60 and the battery 80. FIGS.
11a and 11b show a cover 316 attached to the first layer 252 to
complete the housing 20 of the fluid deliver device 290. The cover
316 contains the power source 80, the wireless communication unit
60 and the local processor 50 of the device 290. The cover 316 also
includes the inlet and the outlet valves 241, 242 aligned over the
valve seats 291, 292 of the first layer 252. The valves 241, 242
and the accumulator 243 comprise the dispenser 320 for use with the
pressurized reservoir 296. As shown, the cover 316 also provides an
enclosed space that allows for expansion of the diaphragm portion
244 over the reservoir 296.
[0087] FIGS. 12a and 12b show a valve 330 constructed in accordance
with the present invention for use as part of a laminated dispenser
or part of a laminated fluid delivery device. The valve 330, for
example, can comprise the inlet valve of the dispenser controlling
flow from a reservoir into the accumulator. The valve 330 is part
of a passageway 250 formed from first and second layers 252, 254,
wherein the second layer 254 includes an opening 332 communicating
with the passageway. The valve 330 includes a layer of resilient
fluid-tight material 334 covering the opening, and a layer of
piezoelectric material 336 covering the layer of resilient
fluid-tight material.
[0088] The layers of resilient fluid-tight material 334 and
piezoelectric material 336 are arranged such that upon contracting,
the layer of piezoelectric material 336 forces the layer of
resilient fluid-tight material 334 into the opening 332 of the
passageway 250 and substantially closes the passageway, as shown in
FIG. 12a. As shown, the piezoelectric material 336 includes a wire
338 for connection to a power source (not shown). When power is
applied to the piezoelectric material 336, the piezoelectric
material straightens out, thereby opening the passageway 250, as
shown in FIG. 12b. The resilient fluid-tight material 334 can be
provided as part of the resilient diaphragm forming the accumulator
of the dispenser. In the preferred embodiment, the piezoelectric
material 336 is normally curved when de-energized, and deforms to a
straight geometry when energized, such that the passageway 250 is
normally closed.
[0089] FIGS. 13a and 13b show another valve 340 constructed in
accordance with the present invention. The valve 340 is similar to
the valve 330 of FIGS. 12a and 12b such that similar elements have
the same reference numerals. The valve 340 of FIGS. 13a and 13b,
however, further includes an opening 332 in the first layer 252,
and a layer of resilient fluid-tight material 334 covering the
opening in the first layer, and a layer of piezoelectric material
336 covering the layer of resilient fluid-tight material. As shown,
the layers of piezoelectric material 336 react together to close
the passageway 250 when de-energized (FIG. 13a), and to open the
passageway when energized (FIG. 13b). An alternative embodiment can
include a tubular layer of resilient fluid-tight material and a
tubular layer of piezoelectric material positioned over an annular
opening in the passageway.
[0090] A valve assembly 350 constructed in accordance with the
present invention is shown in FIG. 14. The valve assembly 350 is
shown as part of a laminated dispenser having first, second and
third layers 252, 254, 256. The first layer 252 defines the pulse
chamber 245, the evacuation port 247, and the enlarged recess 260
receiving the diaphragm 244 over the pulse chamber to form the
accumulator 243. The second layer 254 defines the groove for the
passageway 250, an opening 246 communicating with the groove in
alignment with the pulse chamber 245, and a recess 351 on the
surface of the second layer 254 in alignment with the opening. The
third layer 256 defines a valve assembly chamber 352 facing the
second layer 254 in alignment with the recess 351 of the second
layer.
[0091] The valve assembly 350 includes a valve member 354, springs
356 and a fluid resistant cover 358. The valve member 354 is
received in the valve assembly chamber 352 of the third layer 256
and includes a bar 360 extending parallel with the passageway 250
and pivotally mounted on the third layer about a pivot point 364
aligned with the accumulator 243. An inlet valve 361 and an outlet
valve 362 extend from the bar 360 into the passageway 250 on
opposite sides of the pivot point 364 (and on opposite sides of the
accumulator 243). The springs 356 are positioned between the ends
of the bar 360 and the third layer 256 to bias each end towards the
second layer 254. The fluid resistant cover 358 is received in the
recess 351 of the second layer 254 (the recess preferably being
oversized with respect to the cover to reduce manufacturing
tolerances), and provides a water-tight seal between the passageway
250 and the valve assembly 350.
[0092] Although not shown, the valve assembly 350 also includes an
actuator for causing the valve member 354 to pivot. The actuator
can comprise a rotary motor, a linear motor, a clock spring, and
piezoelectric material, for example. Many different types of
actuators can be used for causing the valve member 354 to pivot
when desired. The pivoting valve assembly 354 provides the benefit
of the valves 361, 362 alternatively blocking the passageway 250 at
all times, such that unregulated flow to the exit port assembly is
not permitted. As shown in FIG. 14, the valve assembly 350 also
utilizes "drop down" construction, wherein all elements of the
valve assembly are assembled from above the second layer 254, to
simplify manufacturing.
[0093] Another valve assembly 370 constructed in accordance with
the present invention is shown in FIG. 15. The valve assembly 370
is shown as part of a laminated dispenser having first and second
layers 252, 254, with the passageway 250 defined between the
layers. The laminated layers 252, 254 also define a bore 372
bisecting the passageway 250 and receiving the valve assembly
370.
[0094] The valve assembly 370 includes a valve member 374 movably
received in the bore 372 and including an opening 376, and a spring
378 biasing the valve member such that the opening 376 of the valve
member is normally offset from the passageway 250 and the
passageway is blocked by the valve member 374. The assembly 370
also includes an actuator 380 for moving the valve member 374 upon
being actuated such that the opening 376 of the valve member 374
aligns with the passageway 250 to thereby allow flow through the
passageway. In the embodiment shown, the actuator comprises a gas
generator 380 for pressurizing the bore 372 upon being actuated.
The gas generator 380 is mounted in a plug 382 fitted in the second
layer 254 and having a gas release port 384 communicating with the
bore 372. As shown in FIG. 15, the valve assembly 370 also utilizes
"drop down" construction, wherein all elements of the valve
assembly can be assembled from above the second layer 254, to
simplify manufacturing.
[0095] During operation, the actuated gas generator 380 pressurizes
the bore 372 above the valve member 374 and forces the valve member
to move against the spring 378, so that the opening 376 aligns with
the passageway 250 and opens the passageway. The gas release port
384 allows a predetermined rate of gas to exit the bore 372 in
order to limit the total pressure in the bore and allow a
controlled decay of pressure. In one embodiment, the valve assembly
370 is positioned near the exit port assembly of a fluid delivery
device to limit the useable life of the fluid delivery device. For
example, the fluid delivery device can include automatic or manual
means for actuating the gas generator 380 upon the device being
secured to a patient's skin, and the gas generator can be provided
with enough fuel to maintain the valve member 374 open for three
days. When the fuel in the gas generator 380 is depleted, the valve
member 374 closes and the fluid delivery device must be replaced
with a new device. The valve 370 can also be used to pulse fluid as
long as the gas generation rate of the gas generator 380 and the
gas release rate of the gas release port 384 have time constants
slightly smaller than the maximum pulse rate.
[0096] Referring now to FIG. 16, another laminated dispenser 390
constructed in accordance with the present invention is shown. The
dispenser 390 is for use with a pressurized reservoir and includes
an inlet valve 241, an accumulator 243 and an outlet valve 242. The
dispenser includes three layers 252, 254, 256. The second and the
first layers 252, 254 define the passageway 250 connected to the
exit port assembly, and the second layer 254 defines the pulse
chamber 245 communicating with the passageway.
[0097] A piston 392 is slidingly received in the pulse chamber 245,
and a substantially fluid tight seal is provided between the piston
and the wall of the pulse chamber. The piston 392 in effect
comprises the expandable membrane of the accumulator 243. The third
layer 256 is received on the second layer 254 and closes the pulse
chamber 245, and springs 394 are positioned between the third layer
and the piston 392 and bias the piston away from the third layer.
During operation, the outlet valve 242 is closed and the inlet
valve 241 is opened to allow pressurized fluid from the reservoir
to move the piston 392 against the springs 392 and into the pulse
chamber 245 to expand the accumulator 243 by the predetermined
pulse volume. Then the inlet valve 241 is closed and the outlet
valve 242 is opened such that the biased piston 392 can force the
pulse volume of liquid to the exit port assembly.
[0098] Referring to FIGS. 17a and 17b, an additional laminated
dispenser 400 constructed in accordance with the present invention
is shown. The dispenser 400 is for use with a non-pressurized
reservoir (not shown) and, therefore, is designed to act as a pump
instead of simply a regulator. The dispenser 400 includes an inlet
valve 402, an accumulator 404, and an outlet valve 406. The valves
402, 406 comprise one-way valves, such as duckbill valves, and the
accumulator 404 is an "active" accumulator, as opposed to the
"passive" accumulators used in the previously described
dispensers.
[0099] The second and the first layers 252, 254 of the dispenser
400 define the passageway 250 connected between the reservoir and
the exit port assembly, and the second layer 254 defines a bore 408
communicating with the passageway 250. A piston 410 is slidingly
received in the bore 408 and acts as the expandable membrane of the
accumulator 404. The dispenser 400 also includes an actuator 412
for moving the piston 410 in the bore 408 to draw fluid from the
reservoir through the inlet valve 402 (the one-way outlet valve 406
prevents fluid from being draw though the outlet valve 406) and
expel liquid through the outlet valve 406 to the exit port assembly
(the one-way inlet valve 402 prevents fluid from being expelled
though the inlet valve 402).
[0100] In the embodiment show, the actuator comprises a magnetic
coil 412 received in an annular groove provided in the second layer
254, coaxial with the piston 410, which is made from magnetic
material. A plug 414 seals the piston 410 and the coil 412 in the
second layer 254, such that the portion of the bore 408 between the
piston 410 and the plug 414 comprises the pulse chamber of the
accumulator 404. The dispenser 400 includes a coiled compression
spring 416 positioned between the plug 414 and the piston 410
biasing the piston towards the passageway 250. The coil 412 is
arranged to bias the piston 410 against the spring 416 upon being
energized.
[0101] During operation of the dispenser 400, the coil 412 is
energized such that movement of the piston 410 expands the
accumulator 404, and draws fluid from the reservoir, through the
one-way inlet valve 402 and into the bore 408, as shown in FIG.
17a. The one-way inlet valve 402 closes when the accumulator 404 is
fully expanded. Then the coil 412 is de-energized, so that the
spring 416 is allowed to push the piston 410 back towards the
passageway 250, compress the accumulator 404, and expel the liquid
through the one-way outlet valve 406 to the exit port assembly, as
shown in FIG. 17b.
[0102] FIGS. 18a and 18b, show another laminated dispenser 420
constructed in accordance with the present invention, and which
operates in a manner similar to the dispenser 400 of FIGS. 17a and
17b. The dispenser 420 includes a one-way inlet valve 402, an
"active" accumulator 424, and a one-way outlet valve 406. The
second and the first layers 252, 254 of the dispenser 420 define
the passageway 250 connected between the reservoir (not shown) and
the exit port assembly (not shown).
[0103] The accumulator 424 includes a pulse chamber 426 formed in a
surface of the second layer 254 facing away from the first layer
252, and an opening 428 providing fluid communication between the
pulse chamber 426 and the passageway 250. A resilient diaphragm 430
is received on the second layer 254 and covering the pulse chamber
426 in a fluid-tight manner.
[0104] The dispenser 420 also includes an actuator 432 for pushing
the diaphragm 430 into the pulse chamber 426 to reduce the volume
of the accumulator 424 and produce a pulse volume. In the
embodiment shown, the actuator comprises a rotatable cam 432 and a
motor (not shown) or other rotational device for rotating the cam.
During operation, the cam 432 is rotated away from the diaphragm
430 such that the diaphragm expands the accumulator 424, and draws
fluid from the reservoir, through the inlet valve 402 and into the
pulse chamber 426, as shown in FIG. 18a. The inlet valve 402 closes
when the accumulator 424 is fully expanded. Then the cam 432 is
rotated back into the diaphragm 430, so that the diaphragm
compresses the pulse chamber 426 and expels the liquid through the
outlet valve 406 to the exit port assembly, as shown in FIG.
18b.
[0105] Referring to FIGS. 19a and 19b, an additional laminated
dispenser 440 constructed in accordance with the present invention
is shown. The dispenser 440 is for use with a non-pressurized
reservoir (not shown) and, therefore, is designed to act as a pump
instead of simply a regulator. The dispenser 440 includes a
plurality of "active" accumulators 442 and no inlet valve or outlet
valve. The accumulators 442 are arranged successively with respect
to the passageway 250 and operate one after another such that the
dispenser 440 operates as a linear peristaltic pump.
[0106] The second and the first layers 252, 254 of the dispenser
440 define the passageway 250 connected between the reservoir and
the exit port assembly. The resilient diaphragm 444 is positioned
between the second layer 254 and the third layer 256 in a
liquid-tight manner. For each accumulator 442, the second layer 254
defines a pulse chamber 446 communicating with the passageway 250,
and the third layer 256 defines a bore 448 aligned with the pulse
chamber.
[0107] The dispenser 440 also includes actuators for compressing
the pulse chambers 446 and expelling pulse volumes of liquid
towards the exit port assembly. In the embodiment shown, the
actuators comprise pistons 450 made from magnetic material and
slidingly received in the bores 448, and magnetic coils 452
received in annular grooves provided in the third layer 256,
coaxial with the pistons 450. Each coil 452 is arranged such that,
upon being energized, the coil 452 forces the piston 450 against
the diaphragm 444 to collapse the pulse chamber 446 and expel a
pulse volume of fluid from the accumulator 442 into the passageway
250. Upon being de-energized, the coil 452 releases the piston 450
and allows the diaphragm 444 to push the piston back, and draw a
pulse volume of fluid into the pulse chamber 446. During operation
of the dispenser 440, the coils 452 are successively energized and
de-energized so that fluid is drawn from the reservoir, expelled
and drawn successively into the accumulators 442, and expelled to
the exit port assembly. Preferably, at least one of the pistons 450
is always in a closed position to occlude the fluid path and
prevent the free flow of fluid through the passageway to the exit
port assembly. In an alternative embodiment, the pistons 450 can be
biased closed, with a spring, and the coils 452 arranged to pull
the pistons away from the passageway when energized.
[0108] FIGS. 20a and 20b show another laminated dispenser 460
according to the present invention. The dispenser 460 is similar to
the dispenser 440 of FIGS. 19a and 19b, but includes a fourth layer
258 defining bores 462 aligned with the bores 448 of the third
layer 256. In addition, the actuators comprise the pistons 450, and
gas generators 464 received in the bores 462 of the fourth layer
258. The gas generators 464 pressurize the bores 448, 462 and
biasing the piston 450 against the diaphragm 444 upon being
actuated. The fourth layer 258 also includes gas release ports 466
communicating with the bores 462.
[0109] Referring to FIGS. 21a, 21b, and 21c, a further embodiment
of a laminated dispenser 470 constructed in accordance with the
present invention is shown. The dispenser 470 is also for use with
a non-pressurized reservoir and acts as a pump instead of simply a
regulator. The dispenser 470 includes a plurality of "active"
accumulators 472 and no inlet valve or outlet valve. The
accumulators 472 are arranged successively with respect to the
passageway 250 and operate one after another such that the
dispenser 470 operates as a linear peristaltic pump.
[0110] The dispenser 470 includes a first layer 252 having a recess
476, with a diaphragm 474 positioned against the surface of the
first layer 252. The second layer 254 is received against the
diaphragm 474 and includes a surface defining a groove, such that
the diaphragm and the groove define the passageway 250 connecting
the reservoir to the exit port assembly.
[0111] Each accumulator 472 includes an actuator 478. The actuators
478 are successively positioned with respect to the passageway 250
within the recess 476 of the first layer 252. The actuators 478 are
arranged to push the diaphragm 474 towards the second layer 254
upon being actuated. The portion of the recess 476 above the
diaphragm 474 comprises the pulse chambers of the accumulators
472.
[0112] In the embodiment shown, the actuators comprise segments of
piezoelectric material 478. Each segment 478 is mounted and
arranged such that, when de-energized, the segment 478 normally
assumes a curved geometry to push the diaphragm 474 towards the
second layer, and when energized, deforms to a straight geometry to
allow the diaphragm to return to its original position. In the
preferred embodiment all of the piezoelectric elements 478 are
normally in a curved state when de-energized, to occlude the
passageway 250 and prevent the free flow of fluid through the
passageway to the exit port assembly.
[0113] Referring now to FIGS. 22a and 22b, the present invention
also provides a priming mechanism 500 for simultaneously
maintaining an inlet valve 502 and an outlet valve 504 of a
dispenser 506 open, such that fluid can flow through the dispenser
(also having an accumulator 507) to the exit port assembly 70
during filling of the reservoir 30. Priming ensures that the entire
volume of the fluid delivery passages of the fluid delivery device
are filled with fluid prior to operation, so that an accurate
volume of fluid can be delivered by the device.
[0114] In the specific embodiment shown, the priming mechanism 500
includes a pivotally movable first link 508 operatively connected
to the inlet valve 502 such that the inlet valve is opened upon
pivoting movement of the first link 508. A pivotally movable second
link 510 is operatively connected to the outlet valve 504 such that
the outlet valve is opened upon pivoting movement of the second
link. The priming mechanism 500 also includes a movable priming rod
516 operatively connected to the first and the second links 508,
510 for pivoting the links upon movement of the rod 516.
[0115] As shown, the inlet and the outlet valves 502, 504 each
include a valve member 512, 514 movable between open and closed
positions. The first link 508 extends between the first valve
member 512 and the priming rod 516 and is pivotally movable about a
pivot point 518 of the first link located between the valve member
512 and the priming rod. The second link 510 extends between the
second valve member 514 and the priming rod 516 and is pivotally
movable about a pivot point 520 of the second link located between
the valve member 514 and the priming rod. The priming rod 516 is
linearly movable to pivot the links 508, 510 and open the valve
members 512, 514. The priming rod 516 extends out of the housing 20
of the fluid delivery device, and is depressed into the housing 20
by a user to open the valves 502, 504 prior to filling the
reservoir 30 through fill port 522. One-way valves, such as
duckbill valves 524, are positioned within the fill port 522 and a
passageway 526 of the dispenser 506. FIG. 22b shows the priming rod
516 depressed into the housing 20 and the valves 502, 504 opened,
while FIG. 22a shows the priming rod 516 extending out of the
housing 20 and the valves 502, 504 closed.
[0116] FIGS. 23a and 23b shown another priming mechanism 530
according to the present invention. The mechanism 530 is similar to
the mechanism 500 of FIGS. 22a and 22b such that similar elements
have the same reference numerals. The mechanism 530, however,
further includes a collar 532 connected to the priming rod 516 and
received in the fill port 522 of the device. The fill port 522 is
connected to the reservoir 30 and adapted for receiving a needle
534 for filling the reservoir. The collar 532 is adapted to
frictionally receive the needle 534 inserted into the fill port 522
so that the inserted needle causes movement of the collar 532 and
the priming rod 516 and pivoting movement of the links 508, 510.
The dispenser valves 502, 504 are therefore opened and the device
is primed automatically upon filling of the reservoir 30, shown in
FIG. 23b.
[0117] Referring to FIGS. 24 to 26, the present invention also
provides fluid delivery devices 10 having automatic priming systems
600, 610, 620. Each device 10 is provided with an exit port
assembly comprising an integrated transcutaneous patient access
tool 670 having a known internal volume. In the particular
embodiments shown, the patient access tool is a needle 670. Because
the volume to the tip of the needle 670 is known, the local
processor 50 of the device 10 can be programmed to prime the needle
670 automatically.
[0118] In the preferred embodiment of FIG. 24, the local processor
50 is programmed to instruct the dispenser 40 to deliver a volume
of fluid to the needle 670 equal to the known internal volume of
the needle 670. Preferably, the remote controller 100 is provided
with a "PRIME" command for a user to select. In the embodiment of
the controller 100 illustrated in FIG. 24, a prime command button
111 is shown provided on a touch screen 110 after an "INITIALIZE"
command 112. When the prime command 111 is selected, the remote
controller 100 communicates with the fluid delivery device 10 and
instructs the local processor 50 to prime the needle 670.
[0119] The fluid delivery device 610 of FIG. 25 further includes a
flow sensor 612 arranged to provide a signal to the local processor
50 indicative of the volume of fluid passing from the dispenser 40
to the needle 670. The local processor 50 is programmed to prime
the needle 670 by instructing the dispenser 40 to deliver fluid
until the flow sensor 612 indicates to the local processor that a
volume of fluid equal to the known internal volume of the needle
670 has been delivered to the needle. The local processor 50 is
also programmed to utilize the signals from the flow sensor 612 to
monitor the needle 670 for occlusions once the needle has been
primed.
[0120] The device 620 of FIG. 26 is similar to the device 600 of
FIG. 24, but further includes a fluid detector 622 positioned
between the dispenser 40 and the needle 670 for providing a signal
to the local processor 50 indicative of fluid passing into the
needle 670. The local processor 50 is programmed to prime the
needle 670 by instructing the dispenser 40 to deliver fluid for a
predetermined period and at a predetermined flow rate after
receiving an initial indication from the fluid detector 622 that
fluid has reached the fluid detector 622. In addition, the local
processor 50 can be programmed to provide a signal that air has
been detected in the fluid path when the fluid detector 622 stops
indicating the presence of fluid upon operation of the dispenser 40
and after the needle 670 has been primed.
[0121] Referring now to FIGS. 27 and 28, the invention also
provides embodiments 700, 710 of the fluid delivery device
including gas removal filters 702 for removing gas (e.g., air)
bubbles from fluid injected into the devices from a patient. In
general the gas removal filters 702 are constructed of material
that allows the passage of gas therethrough, yet prevents fluid
from passing therethrough. Gas removal filters are available, for
example, from Pall Corporation of East Hills, N.Y. (www.pall.com).
In the embodiment 700 of FIG. 27, the gas removal filter 702 is
positioned between the reservoir 30 and the dispenser 40. In the
embodiment 720 of FIG. 28, however, the gas removal filter 702 is
positioned between a fill port 31 and the reservoir 30. Other
embodiments are possible. For example, the device can be provided
with a reservoir made from gas removal material instead of having a
separate gas removal filter.
[0122] Due to issues of infection and contamination, it may be
desirable to limit the fluid delivery device of the present
invention to a single use. Referring to FIGS. 29a through 29d, the
present invention, therefore, also provides a "single-use" fill
port 800 for allowing the reservoir 30 of the fluid device to be
filled only once. The fill port 800 includes a passageway 802 in
fluid communication with the reservoir 30, a valve 804 positioned
within the passageway and allowing one-way flow into the reservoir
30, and a removable needle insertion septum 806 sealing the
passageway 802. The needle insertion septum 806 may be constructed
of a resealing elastomer such as silicone that allows a needle 150
to puncture the septum 806 to add fluid to the reservoir 30, yet
provides a seal around the needle 150.
[0123] In the embodiment of FIGS. 29a through 29b, the fill port
800 includes a funnel 808 having a small open end 810 removably
received in the passageway 802 and a large open end 812 receiving
the septum 806. The fill port 800 also includes a first wall 814
having an opening 816 removably receiving the large open end 812 of
the funnel when the small open end 810 of the funnel 808 is
removably received in the passageway 802, as shown in FIGS. 29a and
29b. A second wall 818 is spaced from the first wall 814 more than
a thickness of the septum 806 and has an opening 820 sized to allow
passage of a needle 150, but prevent passage of the septum 806, as
shown in FIGS. 29c and 29d. As shown in FIGS. 29c and 29d, removal
of the needle 150 from the fill port 800 pulls the funnel 808 out
of the passageway 802, and thus prevents further refills of the
reservoir 30 through the fill port 800.
[0124] FIGS. 30a and 30b show another fill port 850 constructed in
accordance with the present invention. The fill port 850 includes a
first wall 852 having an opening 854 preventing passage of the
septum 806, as shown in FIG. 30a, and a second wall 856 spaced from
the first wall 852 at least about a thickness of the septum and
having an opening 858 allowing passage of a needle 150. The second
wall 856 and the opening of the second wall 858 are adapted to
allow passage of the septum 806 upon at least a predetermined force
applied to the septum. Preferably, the predetermined force is less
than a force required to pull a needle 150 out of the septum 806,
such that a withdrawn needle 150 pulls the septum 806 out of the
fill port 850, as shown in FIG. 30b.
[0125] Referring to FIG. 31, the present invention also provides a
fluid delivery device 900 having multiple subcutaneous access tools
970. Each access tool 970 is independently connected to the
dispenser 40 through a passageway 972, and is initially retracted
such that the passageway 972 is occluded. Each access tool 970 is
also independently deployable. Upon deployment of each access tool
970, the passageway 972 of the deployed tool is released to allow
fluid flow through the deployed tool. Preferably each access tool
includes a rigid needle 974, as shown in FIG. 32.
[0126] The multiple, independently deployable needles 974
beneficially extend the useful life of the fluid delivery device
900. According to standards set by the Center for Disease Control
(CDC), a single needle, such as an infusion needle or intravenous
needle, should not remain deployed in a patient for more than three
days, to minimize the chances for infection at the injection site
through the skin of the patient. The present invention, therefore,
increases the useable life of a single fluid delivery device 900 by
providing the device with multiple, independently deployable
needles 974. If the device is provided with three retractable
needles 974, and each needle is used for the maximum allowable
period of three days in accordance to CDC standards, for example,
the life of the device 900 can be extended to nine days. The
embodiment 900 of FIG. 31 is provided with three needles 974, but
can be provided with two needles or more than three needles, as
desired and appropriate.
[0127] Referring to the specific embodiment 900 as shown in FIG.
32, each needle 974 is manually deployable and includes a slidable
lever 976 secured to the needle and extending out of the housing 20
of the device for patient access. The needle 974 is shown retracted
in FIG. 32, with the passageway 972 occluded by an occlusion member
978 extending from the lever 976 and pinching the passageway 972
against a boss 980 extending from the housing wall 20. When the
device 900 is attached to a skin surface of a patient, the patient
simply slides the lever 976 towards the skin to release the
passageway 972 and inject the needle 974 into the skin. After three
days, the patient slides the lever 976 away from the skin to
withdraw the needle 974 from the skin and occlude the passageway
972. The next needle can then be deployed. The device can also be
provided with means for maintaining each of the needles 974 in an
independent sterile condition prior to deployment, such as separate
sealed membranes covering the needle opening in the housing 20 and
that the needles puncture through during deployment.
[0128] Although exemplary embodiments of the invention have been
shown and described, many changes, modifications and substitutions
may be made by those having ordinary skill in the art without
necessarily departing from the spirit and scope of this
invention.
* * * * *