CROSS-REFERENCE TO RELATED APPLICATIONThis application claims the benefit of priority of U.S. Provisional Patent Application Ser. No. 60/333,721, filed Nov. 28, 2001.[0001]
FIELD OF THE INVENTIONThe present invention generally relates to syringes for use with hypodermic needles. In particular, the present invention relates to a needle-syringe assembly which withdraws the sharp point of the hypodermic needle following, use so as to render it non-reusable. An over-the-needle (OTN) catheter may also be used with the syringe assembly of the invention.[0002]
BACKGROUND OF THE INVENTIONA hypodermic needle has many applications in modern medicine. One application is to fit the hypodermic needle onto a syringe and to then insert the needle into a person's body for intra-muscular, subcutaneous, or intravenous injection of medications. Another application of the hypodermic needle is to coaxially mount a catheter over a hypodermic needle and to puncture a vein of a person's body with the needle. Following needle puncture, the over-the-needle (OTN) catheter is advanced into and retained in the vein, the needle is removed, and the catheter is connected to an intravenous line for fluid infusions into the vein.[0003]
A hypodermic needle entering into a patient's body is invariably contaminated by the patient's blood and body fluids. Following use of the needle, the needle presents a risk to physicians, nurses, and other health care personnel because the needle might transmit an infection or disease to such personnel if it were to accidentally puncture them. Thus, health care personnel are in constant danger of contracting infections and diseases, some of which may be deadly. Other potential victims of accidental needle punctures include sanitation workers who later dispose of garbage containing the hypodermic needle. The diseases which may be transmitted by a contaminated hypodermic needle include Immune Deficiency Virus, Hepatitis, Rabies, Kure, Encephalitis, and Arbor viruses. The outcome of contracting one of these diseases is often fatal because there are no known cures for any of these diseases. Often a needle puncture in a person's skin is so trivial that it remains unrecognized until the person becomes seriously ill.[0004]
Many existing OTN catheters suffer from penetration problems because of long length needles and unsecured needle supports. In addition, many existing OTN catheters still present the danger of causing needle pricks due to ineffective encasement of the puncturing needles following use.[0005]
The impact of needle stick injuries has shaken the healthcare industry. Several new products have been introduced and their disadvantages are now becoming apparent. An inventive improvement is required to remove these disadvantages.[0006]
The United States Congress has passed “Needle Stick Safety and Prevention Act (H.R.5178.ENR)”. The President has signed the bill into law that Is effective Apr. 18, 2002. The law, FDA, OSHA, Center For Disease Control, National Institute for Occupational Safety and Health and other regulatory bodies have also mandated and/or recommend several improvements in syringes.[0007]
It will be clear from the reading of the disclosure that the present invention does possess all the improvements deemed mandatory and/or recommended by regulatory agencies.[0008]
A number of improvements required and/or recommended by health care regulatory bodies contained in the present invention are listed below.[0009]
1. The syringe as well as retraction mechanism should be single hand operable, sparing another hand of physician for additional tasks. [Improved Industry Standard][0010]
2. The switches and functional components are inseparable from the syringe and available in any emergencies. [Improved Industry Standard][0011]
3. Activation of the retraction mechanism must occur from proximal plunger end. [Improved Industry Standard][0012]
4. The worker's hand must remain behind the needle as it is covered. (FDA guidance on 510(k) Submission March 1995)[0013]
5. The safety feature must be an integral part of the device. (FDA guidance on 510(k) Submission March 1995)[0014]
6. The safety feature remains activated before disassembly and disposal. (FDA guidance on 510(k) Submission March 1995)[0015]
7. The safety feature should be simple and should require as little or no user action or training to use it safely and effectively. (FDA guidance on 510(k) Submission March 1995)[0016]
8. The safety feature is an integral part of the device. National Institute of Occupational Safety and health (NIOSH) desirable characteristics DHHS (NIOSH) alert. Publication No. 2000-108, November 99[0017]
9. The device preferably works passively. DHHS (NIOSH) alert. Publication No. 2000-108, November 99[0018]
10. The user can easily tell whether the safety feature is activated. DHHS (NIOSH) alert. Publication No. 2000-108, November 99[0019]
11. The safety feature cannot be deactivated and remains protective through disposal DHHS (NIOSH) alert. Publication No. 2000-108, November 99[0020]
12. The device performs reliably. DHHS (NIOSH) alert. Publication No. 2000-108, November 99[0021]
13. The device is easy to use and practical. DHHS (NIOSH) alert. Publication No. 2000-108, November 99[0022]
14. The device is safe and effective for patient care. DHHS (NIOSH) alert. Publication No. 2000-108, November 99.[0023]
15. Cost reduction by avoiding sharp container requirement for non-safe syringes Government Regulatory Agencies mandate use of the “sharp containers” at hospitals, physician offices and clinics as well as emergency rooms. These containers are strong steel boxes with a one way window through which used non-safety syringe and needles are dropped. The sharp protection service is operated by licensed companies that pick up the contents of the “Sharp containers” and dispose them at specially run facilities. This service is expensive and impacts on the cost of health care. Two safety syringes currently on the market do retract the needles after use, however the retracted needle and spring freely floats within the plunger cavity. If by chance the plunger is pulled off by minimum efforts the potential of needle stick injury does exist. FDA requires sharp containers for these because there is a chance of the needle stick injury. It adds to the expense.[0024]
One purpose of inventing the present safety syringe is to lock the retracted needle securely within the interlocked syringe itself rather than sharp container and save the expense. It is essential that the entire syringe must be interlocked and disposed off in biological recyclable waste to avoid the expense of sharp container fees. This objective is incorporated in the present invention[0025]
16. Premature disablement of devices. Advance of plunger in the barrel is a normal function of the syringe to inject the medicine. However in two devices on market retraction of the needle and disablement of syringe results from advance of the plunger within the barrel cavity, even before physician has a chance to use the syringe for patient. The syringe is wasted. The safety mechanism incorporated in the present invention and procedure of use avoids this accidental retraction and disablement.[0026]
17. Low dead space. At the end of the injection, medicine still remains within the nozzle and the female luer end. The cost of biotechnology medicines such as Epo, and newer insulins are very high and wastage is unacceptable. The present invention avoids the female luer connector that connects hypodermic needle with the nozzle—the cause of dead space.[0027]
18. Aerosolization. In certain devices on the market, after the injection of the medicine and advance of the plunger, a spring is released and the needle and spring flies back within the air-filled plunger. When the needle shoots back the air escapes out through the open needle due to the backward momentum and causes the fluid/medicine to escape from the needle. The escaping fluid may be contaminated.[0028]
The FDA has allowed the use of such syringes only for intra-muscular and subcutaneous application. Further it requires on use of such syringes that the retraction must be initiated and completed when the needle of the syringe is still within the body of the patient.[0029]
In the present invention the proximal end of the needle is closed and glued to the needle holder. Further the exit and entry of the fluid occurs at the peripheral wall of the needle, which is a zero velocity zone during needle retraction, and heavy construction. Also, the weight of the needle holder arm dampens the retroactive velocity of the needle. A reactive aerosolization is therefore not likely to occur, i.e., the present invention avoids aerosol problems.[0030]
19. Hydraulic disablement. Robust design of the present invention prevents disablement of retractable needle syringe that could result from increased hydraulic pressure inside the barrel.[0031]
Accordingly, there exists a need for a hypodermic needle assembly which overcomes the above-noted drawbacks associated with many existing assemblies.[0032]
The problem of suffering accidental needle punctures is well recognized. As a result, enormous inventive effort has been devoted to concealing the sharp needle point of hypodermic needles. Such efforts are described in the present applicant's U.S. Pat. No. 5,338,311, issued Aug. 16, 1994 and U.S. Pat. No. 6,156,013, issued Dec. 5, 2000.[0033]
Apart from the above patents, in certain of the syringes that are in the market, the hypodermic needle is assembled within the compression spring and installed in the nozzle of the syringe by a bushing or “O” ring. After injection of the medicine the bushing is displaced forward by plunger end. The displacement of the bushing releases the spring and the needle as well as the plug in the plunger cavity. The retracted spring, hypodermic needle and plug freely float in the plunger.[0034]
In situations (1) when the plunger is pushed fast before medicine could escape, (2) When the medicine is viscous and needs higher gradient to escape through the needle, (3) when the needle is thin and offers resistance, (4) when there is partial block in needle or has been inserted in thick tissue, hydraulic force generated in barrel displaces the bushing causes retraction. This happens even though plunger is not advanced and medicine is still in the syringe. The present invention prevents this mishap because of mechanical continuity and robust design.[0035]
SUMMARY OF THE INVENTIONOne aspect of this invention comprises an improved needle-syringe assembly which provides a simple and reliable mechanism to retract the needle after it has been used.[0036]
One aspect of the present invention was to identify the retraction control mechanism from the conventional hypodermic injection syringe, minimally supplement it with needed components, and systematically modify existing components of the syringe while preserving their normal function yet recruiting them to transform into a precision needle retraction syringe machine. Functional elements assembled with a spring retainer and plunger become a retraction control module to be installed in a conventional barrel. Indirect coupling of a needle holder to the barrel via a “switch” forms a retraction control system.[0037]
Another aspect of the present invention comprises an improved needle-syringe assembly which facilitates fabrication, and reduces the cost, of the assembly.[0038]
Still another aspect of the present invention comprises an improved needle-syringe assembly which facilitates the operation of the assembly, particularly when it is desired to retract the needle prior to disposing of the needle-syringe assembly.[0039]
Another aspect of the present invention comprises an improved needle-syringe assembly which improves the acceptability of the assembly by providing an external appearance which is virtually the same as that of conventional hypodermic needle assemblies which do not provide for needle retraction.[0040]
Yet another aspect of the invention comprises a needle-syringe assembly which provides for conventional operation for normal use, while needle retraction, once voluntarily activated, is automatic and complete.[0041]
Still another aspect of the invention comprises a needle-syringe assembly wherein the retracted position of the needle avoids puncture of the barrel and accidental sticking of medical staff.[0042]
Other aspects and advantages of the invention will become apparent upon reading the following detailed description and upon reference to the accompanying drawings.[0043]
In accordance with one aspect of the present invention, a syringe assembly, operable in a normal mode and convertible to a retraction mode, comprises a safety syringe assembly which includes an elongated, generally cylindrical barrel having a hollow interior forming a hollow nozzle located at a distal end of said barrel and opening into the interior of said barrel, a plunger slidably mounted in said barrel and having a longitudinal cavity, a needle holder slidably mounted in said longitudinal cavity of said plunger for movement between an advanced position in which a needle on the distal end of said needle holder projects from a distal end of said nozzle and a retracted position in which said needle is retracted within said barrel, elastic biasing means mounted inside said barrel and coupled to said needle holder for urging said needle holder toward its retracted position, and a latch releasably engageable with said needle holder and movable between a closed position in which said needle holder is latched to hold said needle holder in its advanced position against the urging of said biasing means, and an open position in which said needle holder is unlatched to allow said biasing means to move said needle holder to its retracted position.[0044]
In accordance with another aspect of the invention there is further provided an retractable needle, over-the-needle catheter and means for releasably securing the catheter to the above-mentioned safety syringe assembly, as well as modification of the present invention for a prefilled syringe.[0045]
Other improvements will be apparent after reading the appended description and claims which constitute their self supporting disclosure.[0046]
BRIEF DESCRIPTION OF THE DRAWINGSIn the drawings:[0047]
FIG. 1 is an exploded view of a safety syringe in accordance with the invention;[0048]
FIG. 2 is an assembled view of the syringe of FIG. 1, partially in section;[0049]
FIG. 3 is a partial elevation of the syringe of FIGS. 1 and 2;[0050]
FIG. 4 is an elevation, partially in section, of a barrel portion of the syringe of FIGS. 1 and 2;[0051]
FIG. 5 is a sectional view rotated 90° from the view of FIG. 4;[0052]
FIG. 6 is a sectional view illustrating assembly of a switch or latch element with the barrel of FIGS. 4 and 5;[0053]
FIGS. 7 and 8 are an elevation similar to FIG. 5 and an isometric view showing an alternate embodiment of a barrel;[0054]
FIG. 9 is an elevation similar to FIG. 4 showing an alternate embodiment of a barrel;[0055]
FIG. 10 is a section through the view of FIG. 9, similar to the section shown in FIG. 7;[0056]
FIGS. 11 and 12 are respective elevations of a needle holder rotated respectively 90° from each other;[0057]
FIGS. 13 and 14 are enlarged views of portions of the needle holder of FIGS. 11 and 12;[0058]
FIGS. 15 and 16 are elevations rotated respectively by 90° from each other, of a plunger element of the syringe of the invention;[0059]
FIGS. 16[0060]aand16bshow an alternate embodiment of the plunger;
FIGS. 17 and 19 are two sections through the plunger of FIGS. 15 and 16;[0061]
FIG. 18 is an enlarged view of a portion of the plunger shown in FIG. 15;[0062]
FIGS. 20, 21 and[0063]22 are respectively a front elevation, an end or top view and a side elevation of a spring retainer element of the syringe assembly of the invention;
FIGS. 23 and 24 are a side elevation and plan view respectively of a latch or switch element in accordance with one embodiment of the invention;[0064]
FIG. 25 is a sectional view of the latch or switch element of FIGS. 23 and 24 assembled with a barrel;[0065]
FIG. 26 is a partial side elevation of a barrel showing the latch or switch element of FIGS. 23 and 24 assembled therewith;[0066]
FIGS. 27 and 28 are respective sectional views, similar to FIG. 25 showing the assembled syringe assembly with the latch or switch element respectively in a locked and unlocked positions;[0067]
FIGS. 29 and 30 are respective elevation and plan views of a latch or switch element in accordance with another embodiment of the invention;[0068]
FIGS. 31, 31[0069]a,31band31care elevation side and top views of an embodiment of a latch or switch similar to the embodiment of FIGS. 29 and 30;
FIG. 32 is a partial sectional view showing assembly of the switch element of FIGS.[0070]29-31 with a barrel;
FIGS. 33 and 34 are partial sectional views illustrating locking and unlocking positions of the switch or latch of FIGS.[0071]29-31 with respect to activating or unlocking elements on a plunger of the type shown in FIGS. 15 and 16;
FIGS. 35 and 36 are respective side and top views showing a switch or latch element in accordance with yet another embodiment;[0072]
FIG. 37 is a partial sectional view showing a portion of the latch element of FIGS. 35 and 36 assembled with a spring retainer element of the type shown in FIG. 20;[0073]
FIGS. 38 and 39 are respective sectional views showing the latch or switch element of FIGS. 35 and 36 assembled with a syringe assembly and respectively in latched and unlatched positions;[0074]
FIGS. 40 and 41 are partial side views, partially in section, illustrating further the operation of the latch element of FIGS. 35 and 36;[0075]
FIGS.[0076]42-47 illustrate a sequence of assembly of the syringe assembly of the invention;
FIGS. 48 and 49 illustrate a needle and over-the-needle catheter for use in an alternate embodiment of the syringe of the invention for placement of an over-the-needle (OTN) catheter;[0077]
FIGS.[0078]50-54 illustrate a sequence of operation utilizing the syringe of the invention to place an over-the-needle catheter with respect to a vein of a patient;
FIG. 55 is an isometric view of another embodiment of a spring retainer;[0079]
FIG. 56 is a side elevation of the spring retainer of FIG. 55;[0080]
FIG. 57 is a partial front elevation of the spring retainer of FIG. 55;[0081]
FIG. 58 is an isometric view of a second piece of the spring retainer of FIGS.[0082]55-57;
FIG. 59 is a side elevation of the spring retainer portion of FIG. 58;[0083]
FIG. 60 is a side elevation of another embodiment of a needle holder used in connection with the spring retainer of FIGS.[0084]55-59;
FIG. 61 is an isometric view of the needle holder of FIG. 60;[0085]
FIG. 62 is an enlarged top view of the spring retainer of FIGS. 60 and 61;[0086]
FIG. 63 is a top view of another embodiment of a barrel;[0087]
FIG. 64 is a partial view of an assembled syringe, partially broken away, illustrating assembly of the components of FIGS.[0088]55-63 therewith;
FIG. 65 is a front elevation of another embodiment of a spring retainer element portion which may be coupled with the second retainer portion shown in FIGS. 58 and 59 to form a spring retainer element in accordance with another embodiment of the invention;[0089]
FIG. 66 is a rear elevation of the spring retainer element of FIG. 65;[0090]
FIG. 67 is a side elevation of the spring retainer element of FIGS. 65 and 66;[0091]
FIG. 68 is a top view of another embodiment of a barrel;[0092]
FIG. 69 is a side elevation of another embodiment of a needle holder used in connection with the spring retainer element of FIGS.[0093]65-67;
FIG. 70 is an enlarged top view of the needle holder of FIG. 68;[0094]
FIG. 71 is a partial view of an assembled syringe, similar to FIG. 64 showing the spring retainer and needle holder components illustrated in FIGS.[0095]65-70;
FIG. 72 shows another embodiment of a plunger; and[0096]
FIGS.[0097]73-77 show another embodiment of a plunger for a pre-filled syringe.
DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTWhile the invention is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that it is not intended to limit the invention to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.[0098]
Several different embodiments of the invention, each with its own unique features and alternate embodiments, are described. Permutations and combinations of these features will, however, lead to further embodiments.[0099]
Turning now to the drawings, FIGS. 1 and 2 illustrate a needle-syringe assembly, including a[0100]barrel10, aplunger11, a hollow resilient (rubber)plunger cap12, ahypodermic needle13, and aneedle holder14. Thebarrel10 is a hollow cylinder which terminates in a hollow taperednozzle15 at the distal end thereof, and has a slightly enlargedouter diameter portion16 extending from about midway along its axial length to its proximal end. The interior of thenozzle15 communicates with the hollow interior of the tubular body portion of thebarrel10. The barrel has outwardly extendingflanges17 on theproximal segment16 of thebarrel10 which facilitate gripping of the barrel with the user's fingers when it is desired to move theplunger11 relative to thebarrel10 linearly for normal use. The flange may be annular or oblong. A retracting means, such as an elastic or resilient biasing means, here illustrated as acompression spring300 is mounted inside thebarrel10 and operatively contacts theneedle holder14 for urging the needle holder toward its retracted position, that is a position in which theneedle13 is retracted completely within the barrel10 (see e.g., FIGS.46-47).
In the embodiment illustrated in FIGS. 1 and 2, the elastic biasing means takes the form of an[0101]elongate compression spring300 of relatively small diameter which fits about the outer circumference of theneedle holder14. Thisspring300 is of such a diameter that it also inter-fits within an elongated channel orcavity33 of theplunger11. However, the elastic biasing means or spring may take a number of other forms without departing from the invention.
On one side of the[0102]barrel10 and distal to theflanges17, there are two square molded raiseddetents100 intended to lock a cylindrical switch308 (described later) between these detents and the flanges. During installation, recesses426 on the switch308 (see FIG. 6) clear the detents and the switch abuts theflange17. A 180-degree rotation of the switch causes it to lock against the square detents. However, engagement of theneedle holder arm32 with theswitch308 prevents its rotation beyond 12-15 degrees. Once assembled, the switch is inseparable from the syringe, a safety requirement for all medical devices. As mentioned above, theproximal segment16 of thebarrel10 beyond theflanges17 has a somewhat larger diameter. The differential of internal diameters creates astructural shelf110 that supports acylindrical spring retainer302 which can be a single piece or in twoparts302a,302b. An elevated ring is molded within the barrel cavity to prevent proximal axial displacement of the spring retainer.
On the surface of the[0103]proximal segment16 of barrel (see also FIGS.4-8), opposite to thesquare detents100 there is an open or closed channel or track19 for locking the needle holder arm32 (e.g., by switch308) at its distal end and a serving as retracting track or guide once theneedle holder14 is released. Theproximal segment16 of thebarrel10 may be about one and one half inch in length for storing the needle holder with attached hypodermic needle in fully retracted, locked and secured in straight position within the plunger channel, in the center of the syringe. The distal part of theproximal chamber16 also contains the spring retainer and spring. The needle holder, in turn is releasably locked to the barrel via theswitch308. Theneedle protector cap200 provides an air and water tight seal at the nozzle before use, while after use it will prevent leakage of any contaminant, and the entire syringe can be disposed of in biological waste. Thecap200 and nozzle may have interlocking luer tapers or, even threads to secure the caps, for example, for a pre-filled syringe.
In an alternate barrel embodiment (see FIGS.[0104]7-10), the slot that permits the retraction of the needle holder arm proximally is covered by an increaseddiameter wall segment29, which merges with the barrel circumference at its margins. The distal end of thewall segment29 may be open to permit engagement of theneedle holder arm32 by the latch/switch308, or closed, for use with an internal latch/switch described later. Such a “covered” design may be advantageous because it can be molded by straight pull tooling. This reduces the cost of tool by avoiding complex side action slides (i.e., to mold the track19), and increasing the density of the parts in the mold. The barrel without the exposedtrack19 has a more esthetic appearance and is also more hygienic. Further, the distal end of thewall29 if open, is covered by theswitch308 or408, which provides a uniform surface to the syringe.
This alternate design (FIGS.[0105]7-10) is otherwise similar to the above-described embodiment (FIGS.4-8) of the barrel.
The outer surface of the[0106]barrel10 may contain graduations114 (FIG. 2) indicating the volume level of fluid in the barrel. These graduations take into account the volume of the internal components such as theneedle holder14.
The proximal end of the[0107]plunger11 forms aknob20 that can be grasped by a user to effect linear movement of theplunger11 relative to thebarrel10. The periphery of theknob20 can be serrated or engraved to prevent slipping of the knob during the use of the plunger. The distal end of theplunger11 forms ahead21 to mount the hollowrubber plunger cap12 thereto. The outside diameter of theresilient cap12 is reduced in the central portion so that the cap engages the inside wall of thebarrel10 only at the pliable margins of the ends of the cap. The diameter of the engaging end portions of thecap12 is slightly larger than the inside diameter of thebarrel10 so that the cap presses firmly against the inside wall of the barrel to form an air-tight and liquid-tight seal at the cap/barrel interface. The inner margins of thecap12 make a similar tight contact with the outer surface of theneedle holder14. The distal end22 of thecap12 is conical to conform to the conicaldistal end23 of the inside surface of thebarrel10 when theplunger11 is fully advanced within the barrel. This reduces the dead space and assures complete emptying of medicine into the patient. The outer wall of thecap12 may be thickened somewhat to prevent its collapse during the in barrel assembly process (described later).
The[0108]head21 of theplunger11 is configured to fit within thehollow plunger cap12. With thecap12 locked onto thehead21 of the plunger, the flatproximal end24 of the cap abuts the flat surface of acircular disc25 at the base of theplunger head21. Thedisc25 transmits advancing force to therubber cap12. Due to the air-tight and liquid-tight seal between theplunger cap12 and thebarrel10, as well as theneedle holder14, advancing movement of theplunger11 inside thebarrel10 creates pressure in the interior of the barrel between the plunger cap and the distal end of the barrel. Similarly, retracting movement of theplunger11 creates a vacuum in that portion of the barrel interior.
The distal end of the[0109]plunger head21 is flat or frustoconical while the mating inner surface of thecap12 is conical with space for a lose fit. This mismatch is intentional and functional. The significance is described later in disclosure.
Referring to FIGS.[0110]11-14, thehypodermic needle13 is mounted on the distal end of theelongated needle holder14, which is detachably interlocked to the barrel10 (in channel or track19). Prior to use of the needle-syringe assembly, theneedle13 is covered by aprotective cap200 mounted on thenozzle15 which prevents needle pricks, preserves sterility prior to use, and preserves the barrel pneumatic volume. In addition, the nozzle may have an external or male luer taper that mates with an internal or female luer taper of the protective cap. When engaged they form strong locking contact to prevent accidental separation of parts during transport or handling. The luer lock also creates an air and water tight seal that prevents air from the barrel from escaping and maintaining a positive air pressure within the syringe barrel. Positive air pressure in the syringe barrel prevents intentional as well as accidental advance of the plunger in barrel. This assures that the retraction mechanism will not be activated until the user removes the protective cap from nozzle. The medicine aspirated in the syringe before expelling the air also assures that the plunger does not advance to the point of causing retraction. If these instructions are followed there is no chance of premature/accidental retraction of the hypodermic needle and disablement of the syringe.
Both the[0111]needle13 and the distal portion of theneedle holder14 are hollow, and the interior of thehollow needle13 communicates with the interior of the hollow distal portion of theneedle holder14. Theneedle holder14 further communicates with the interior of thebarrel10 through anaperture26 which extends through the side wall of a hollow portion of theneedle holder14 at a distal end thereof (FIG. 14). Prior to and during use of the needle-syringe assembly for injection of medicine (hereafter referred to as “normal use”), theaperture26 is positioned at the base of thebarrel nozzle15, sometimes within a small cylindrical cavity (not shown). Theside aperture26 permits medicine to enter or exit from thebarrel10 via theneedle holder14 and theneedle13. The proximal end ofneedle13 is not directly open to air and therefore the needle does not have an “open” end on retraction, as in some prior art arrangements. Instead it is glued within the cavity of the needle holder, and fluid transport occurs through theside hole26 at a boundary zone A small rubber O-ring202 is located against adistal shoulder27 of the barrel interior (see FIGS.3-4) to promote sealing engagement with a distal end41 of theneedle holder14 when the distal end41 is stepped down as shown in FIG. 14 to provide a shoulder. A set of luer tapers may be used as an alternate form of sealing.
During normal use of the needle-syringe assembly, the[0112]needle holder14 is directly or indirectly locked to the barrel10 (in track19), and theplunger11 with itscap12 is free to slide longitudinally back and forth along the needle holder within the barrel. In one embodiment, (see FIGS.11-13) theneedle holder14 includes a generally L-shaped rod having alongitudinal body portion30 extending to theaperture26 and hollow from theaperture26 to its distal end, and alateral arm32, supported on an enlarged,shaped end part35 of theneedle holder14, for extending radially across thebarrel10 and through thetrack19, at a proximal end of thebody30.
The[0113]lateral arm32 of theneedle holder14 may also include an enlarged diametercircumferential shoulder surface35 for engagement with outermost surfaces ofplunger ribs60,62 (described below) which form thechannel33, so as to position theneedle holder14 at the proper depth with respect to thechannel33.
A[0114]proximal part36 of thestraight portion30 of the needle holder has a larger diameter for supporting the compressed length of thespring300 within a spring retainer302 (described below). Thelateral arm32 is also heavier to resist the vertical force of thespring300 as well as to dampen the peak velocity of the retraction when released.
The[0115]end portion35 of theneedle holder14 has arectangular recess31 on the side as shown in FIGS. 12 and 13. Thisrecess31 locks with adetent75 within the plunger channel33 (see FIGS. 14 and 17) when the needle holder is retracted. This interlocks the syringe assembly in a safe position. In addition, the expansion of the spring also maintains the needle holder at this location.
Referring also to FIGS.[0116]15-19, to permit relative sliding movement between theplunger11 and theneedle holder14 in the longitudinal direction, the needle holder is mounted in a longitudinal cavity orchannel33 formed as an integral part of theplunger11. Multiple pairs of resilient retaining elements or detents (not shown) project toward each other from the opposed walls of thechannel33 to retain theneedle holder14 within the channel.
Referring also to FIG. 19, the[0117]plunger11 will be seen to have a plurality of ribs. A first pair of theseribs60,62 define thelongitudinal channel33 for receiving theneedle holder14 as described above. Asingle rib64 projects diametrically oppositely of theseribs60 and62, it forces theneedle holder arm32 through thetrack19 and assures stable engagement and retraction. A further pair of diametrically oppositely extendingribs66 and68 are formed in a plane at right angles to theribs60,62 and64. In the embodiment of FIGS. 16a-16b, in the proximal one and one half portion of the plunger, the threeribs64a,66a,68a, collectively extend transversely across the interior of thebarrel10 so as to help maintain the circular configuration of the barrel, for example, to counteract any weakness caused by thetrack19. This also helps to ensure the locking engagement of thelateral arm32 with thetrack19.
The[0118]plunger11 is the sole moving part of the syringe in normal operation, and makes contact with the fluid chamber defined in the barrel via therubber stopper12. The linear movements of the plunger within the barrel determine the amount of the fluid taken in and injected into the patient. These movements and location of the plunger can therefore be mechanically indexed to the functional outcome of the syringe, retraction of the needle holder as well as disablement of the syringe. Twotriangular projections70 and72 on the margins offlanges60 and62 are designed and located to interact with a switching mechanism or “instant switch” as explained later.
In the illustrated embodiment, the opposed walls or[0119]ribs60,62 of thechannel33 extend toward the inside wall of the barrel10 (see FIG. 19), thereby constraining thelateral arm32 of the needle holder against any angular or rotational displacement relative to theplunger11. That is, theplunger11 and theneedle holder14 can rotate if ever only in unison with each other, although they may move freely independently of each other in the longitudinal direction to permit needle restriction after normal use. At the proximal end of thechannel33, alocking detent75 locks theend portion35 of the needle holder and plunger together to prevent relative longitudinal movement after retraction of theneedle holder14 is complete.
In the illustrated embodiment, the proximal end of the[0120]needle holder14 is directly or indirectly, locked to thebarrel10, via thelateral arm32. Thisarm32 extends radially beyond theplunger channel33 and fits into thetrack19 in thebarrel10. Thearm32 can be locked to thebarrel10 at the distal end of thetrack19 and, when so locked, permits only reciprocal linear movement of theplunger11, to create vacuum to withdraw medication and pressure to deliver medication to the patient via thehypodermic needle13. When theneedle holder recess31 is locked in theplunger detent75, following use, the entire assembly is interlocked and inoperative. During normal use, the needle holder holds the needle completely advanced or projecting from thenozzle15 of thebarrel10.
When fully expanded, the[0121]compression spring300 guarantees full retraction of thehypodermic needle13 andneedle holder14 as well as subsequent maintenance of theneedle holder14 in the retracted state. The retraction force interlocks theneedle holder detent31 with the plunger detent75 (FIG. 7) as well asplunger arm32 with thebarrel track19. This renders the syringe components totally interlocked and inoperative.
The[0122]spring300 is supported on a robust foundation provided by aspring retainer302 shown in FIGS. 1 and 20-22. The spring retainer, which may be either unitary302 or two parts (302aand302b), is installed in the barrel at the shelf likeprojection110 defined by theproximal segment16 of thebarrel10.Mating detents304,306 provided on the contacting surfaces ofbarrel10 andspring retainer302 restricts rotary movements ofspring retainer302 inside thebarrel10. Proximally, an elevated ring120 (see FIG. 5) molded within the barrel just above the margins of thespring retainer302 securely locks it in place, once thespring retainer302 has been axially advanced past thering120 during assembly. A distalaxial extension303 of thespring retainer302 holds thespring300 at the margins at one end thereof while permitting theneedle holder14 to pass through acentral hole310. Thespring300 is retained in compressed state by releasably locking theneedle holder arm32, via the switch (e.g.,308) to thebarrel10. Theopening310 of thespring retainer302, thespring300 and theneedle holder14 are concentric with theplunger channel33 and with the axis of the barrel cavity.
Additional features of[0123]spring retainer302 include aproximal projection312 which extends along the inner surface of thebarrel10 and provides mechanical support. This minimizes the play with the barrel and holds the needle holder tightly locked within the barrel.
As mentioned above, a switch or latching means or[0124]mechanism308 controls the position of theneedle holder14 relative to thebarrel10 for presenting the needle either fully advanced or fully retracted with respect to the barrel. In the embodiment shown in FIGS. 1, 2 and6, thelatching mechanism308 takes one form. However, other equivalent forms may be used without departing from the invention, some of which are further described hereinbelow. In the embodiment shown in FIGS. 1 and 2, the latching means or switch comprises a needleholder locking element308, having anaperture310 which inter-fits about a free end portion of theradially projecting arm32 of theneedle holder14 which projects outwardly of thetrack19 in thebarrel10, as described above.
A number of regulatory bodies require or recommend that in the safety syringe devices, the switch is inseparable from the syringe. In general, these requirements or recommendations state that the functional attachments of a medical device which alters the functions of the device such as clamps, switches etc. should be inseparable from the device. These switches or other attachments must move and work, but they should not be removable. In the present invention, the ring switch as well as the barrel where the switch is installed were designed to comply with these medical device standards and regulations.[0125]
Referring also to FIGS.[0126]23-28, theswitch308 comprises a closed cylindrical ring with an internal diameter which interfits about the outer diameter of theproximal portion16 of the barrel. A small lock-release lever320 is molded on the outer surface of an outwardly projectingportion322 which has aninward projection323 to engage and lock theneedle holder arm32 that projects out from thetrack19.Needle holder arm32 has only linear mobility in thetrack19 along the axis of the syringe. The switch holds theneedle holder arm32 in position with the spring in a compressed state. Further, theswitch308 can not be displaced or rotated because it is engaged withneedle holder arm32 exiting from the slot on the barrel. Theswitch lever320 can rotate to disengage the needle holder by the flip of the thumb of the same hand that is also holding the syringe. The switch completely encircles the barrel between theflanges17 and the switch retainers-square detents100 so as to lock the linear movement of the switch on barrel When engaged It can only rotate one way 15-20 degrees to release the needle holder. It has no other mobility and can't go anywhere. Theswitch308 is inseparable from the syringe until the syringe itself is disabled.
The installation of the switch is as follows. Two slots or[0127]recesses324 and326 axially slide over thesquare detents100 molded on barrel wall for assembly. The switch is inserted on the barrel from the nozzle side (distal end) so that thesquare switch detents100 on the barrel are negotiated through therecesses324 and326 of the ring switch. Once the recesses are negotiated, the switch makes a contact with theflange17. At this time theswitch308 is rotated180 degrees to engage and lock with thearm32 of the needle holder and therefore with the barrel (FIG. 24). Asmall detent325 of theswitch308 engages thelateral arm32 and limits switch rotation to one direction. Thesquare detents100 are now locked againstswitch308, locking theswitch308 in place between thesedetents100 andflange17, since therecesses324,326 are now moved to a diametrically opposite location (see FIG. 25). Now, only the user can voluntarily rotate theswitch lever320, 15-20 degrees of rotation one way to retract and disable the syringe by just a flip of thumb of the same hand that is also holding the syringe. This causes retraction of needle holder, by aligning one of theslots324,326 (326 in the illustrated embodiments in FIG. 28) with thelateral arm32 and disables the syringe.
The[0128]ring switch308 is, therefore, actuated only upon a conscious decision and voluntary effort on the part of the user to engage and rotatelever320. This avoids accidents, and reduces chance factors in retraction and disablement of the syringe.
Two other embodiments (FIGS.[0129]29-34 and35-38) of the invention are provided with an improved “instant” switch. Operation of this switch requires that contents of barrel are completely injected and that a slight additional push is given on the plunger to release needle holder and initiate retraction, and thereupon to interlock and disable the syringe. This requires some action of operator, but can be called “involuntary,” in that it does not require the operator to engage or manipulate any additional elements but only to press the plunger a bit further after completing the injection and withdrawing the needle from the patient.
During injection, the[0130]plunger11 is the sole moving part of the syringe and makes contact with thefluid chamber27 via therubber stopper12. The linear movements of the plunger within the barrel determine the amount of the fluid taken in and injected into the patient. These movements and location of the plunger can therefore be mechanically indexed to the retraction of the needle holder as well as disablement of the syringe. The twoprojections70 and72 on the margins offlanges60 and62 as shown in FIGS.15-17 are precisely designed and located. They interact with the switching mechanism of the “instant” switch as explained below.
The principle of the instant switch is based on the linear indexing of the plunger advance within the barrel that is proportioned with the force applied to the plunger head by the operator's thumb. At a normal fluid injection force of a fraction of PSI the distal[0131]circular plate25 pushes the rubber piston to the end of the barrel and injects the contained medicine via needle and one limit of the plunger advance is reached at this force. The barrel is completely emptied but it does nothing to the switching mechanism. The design of the present invention includes aflat surface21 of the plunger end that is placed within theconical cavity24 of therubber piston12 creating an empty or mismatched space. It also selects a situation specific compressible resilient rubber piston. These elements together provide an additional range for the plunger to advance within the barrel at a higher compression force-PSI. This additional travel of the plunger within the barrel creates a contact between the plunger ramps70,72 with corresponding parts of the switch resulting in the release of the instant switch and release of the needle holder and retraction of the hypodermic needle inside the barrel. This mechanism can be further fine tuned by adjusting the internal diameter of the distal end of the barrel, which will increase the force required to advance the plunger, or incorporating an internal ring or another stop or detent surface (not shown) in the barrel that will alert the operator of the peak force and imminent retraction moment. In addition placing a spring between the plunger plate and the cavity of the resilient cap will also predictably alter the linear length of plunger advance and improve the efficacy of the switch.
Referring to FIGS.[0132]29-34, the “instant”switch408 comprises a cylindrical ring, having an open circumferential portion, that partially encircles thebarrel10 just distal to theflanges17 and proximal to thesquare detents100 and holds thearm32 of the needle holder in place in the distal end of thetrack19, anchored to thebarrel10 under its distal margin. This location axially locks the switch to thebarrel10 and prevents its linear movement along the axis of thebarrel10. The only movement that is possible is the radial displacement of the switch away from thebarrel10, solely because the switch has an opening410 in its circumference. However the resilient material or memory of theswitch408 normally keeps it in contact with the barrel. In a modified form (FIGS. 31a-c), theswitch408amay be semi-cylindrical and have inwardly projectingdetents412 and414 that engageslots416,418 on theflanges17 of thebarrel10. This prevents rotation and helps to retain the switch on the barrel.
The switch[0133]408 (408a) has two ramp-like projections420 (420a) and422 (422a) which extend from its inner surface and enter thebarrel10 through twowindows424 and426 in barrel outer wall. The windows also permitsprojections420,422 (420a,422a) of the instant switch408 (408a) to make a contact with the ramps70-72, located on theplunger flanges6062. The windows are ultimately and totally covered by the switches installed on the barrel at this location as is the open channel underneath. Theprojections420,422 (420a,422a) have angled edges and juxtapose against the identicalangular ramps70 and72 projecting from the plunger plates60-62 when the plunger is fully advanced. The angles on the two sets of projections/ramps are identical but face in opposite in direction. During normal operation, theseparts420,422 (420a,422a) and70,72 have no contact with each other. It is only when the medicine is fully injected in the patient and the plunger is further advanced, that theparts420,422 and70,72 start making contact. Further distal linear movement of the plunger results in a radial outward movement of the switch408 (408a) that results in the release of theneedle holder arm32 that it was locking under its distal margin (see FIGS. 33 and 34).
Summarizing the above, movement of the switch[0134]408 (408a) away frombarrel10 releases theneedle holder32 instantly and effects the retraction of the needle. The linear advance of the plunger in the barrel causes the linear movement of the plunger to be transformed into the radial movement of the switch408 (408a) for releasing the needle holder (see FIG. 34). A normal advance ofplunger11 causes theplate25 to push therubber stopper12 distally to make contact with thebarrel cone23 and the entire medicine is injected in the patient. An additional push on theplunger head20 further advances the flat plunger end into the conical cavity of the rubber piston. The pressure squeezes theelastic rubber piston12 and permits the further advance of plunger and consequently the ramps orplates70,72 contact the switch and actuate the “instant” switch408 (408a) for retraction and release of needle holder as well as disablement of the syringe as described above.
In one example, with a 3cc syringe constructed as described above and with an “instant”[0135]switch408 a terminal 6.5 PSI force on the plunger head caused displacement of plunger head within the rubber stopper as well as some compression of rubber stopper to generate 0.040 inch distal displacement of the plunger ramps70 and72. This displacement in turn radially displaces the “instant” switch by 0.040 inch and releases the needle holder arms to retract the needle holder as well as lock it to barrel and disable the syringe. These results depend on the size and length of the syringe, elasticity and durometer of the rubber piston, durometer of the plastic polymers and amount of the force exerted on the plunger knob as well as environmental/temperature variations which affect rigidity of polymers.
Referring to FIGS.[0136]35-39, another embodiment of an “instant switch”508 comprises two thinflat plates520,522 which are connected by abridge524. Aflat projection526 extends from the bridge in a direction oppositeplates520,522 and terminates in a hook-like extension540 which projects out through a slot515 (see FIG. 20) molded in the margin of the spring retainer302 (FIG. 27) inside thebarrel10. The flat projection56 can move only in the radial direction. Theflat plates520,522 connected by thebridge524 are assembled on the outside of the plunger plates60-62. Thebridge524 hastriangular recesses530,532 that come in contact with thetriangular projections70 and72 on theplunger flanges60 and62. The plunger moves freely linearly between these flat plates. Theflat projection526 from the bridge passes under theneedle holder arm32, exits out of thebarrel10 and the hook-like extension or L-shapedlip540 extending from theprojection526 turns back to engage theneedle holder arm32 at the distal end of the track19 (FIG. 40). An additional slot (not shown) in thebarrel10 is provided for this purpose. This essentially locks the needle holder arm to the barrel via the spring retainer.
A displacement of the[0137]flat plate524 out of thebarrel track19 by linear movement of plunger distally, releases theneedle holder arm32 and retracts the hypodermic needle13 (and needle holder14) inplunger channel33. In the normal operating position, the plunger moves within the switch. When the entire medicine is injected and a final push is given to the plunger which advances theresilient cap12 as well as compresses it.Triangular projections70 &72 of the plunger engage therecesses530,532 and causes movement of theswitch508 so as to release theneedle holder arm32 and cause retraction of hypodermic needle by thespring300. A formed wire can replace the projectingflat plate526 andlip540. All that is required is a structure that can hold the needle holder against the spring force and anchor it to the barrel and be actuated by the plunger movement as described above.
Since the[0138]switch508 is located inside the syringe there is no question of its separation from the device and therefore complies with regulatory requirements and/or recommendations. Those skilled in the art may device other specific switch constructions for accomplishing their goals without departing from the invention.
Each of the above-described switch arrangements accomplishes the above-stated objectives, as well as being non-removable. In this regard, when the latch or[0139]ring308 is used to retract the needle holder, the plunger can be in any desired longitudinal position. For example, the plunger can be fully advanced, fully retracted, or at any intermediate position. This is advantageous because it might be desired to retract the needle after only a portion of a dose of medication has been injected into the patient, or it might be desired to retain all or a portion of a blood sample withdrawn from a patient within the syringe. With respect to the instant switches the plunger must be fully advanced to empty the syringe before the retraction mechanism is activated. To prevent the leakage of any fluid contained within the syringe at the time the needle is retracted, a latex seal (not shown) may be provided at the end of thenozzle15. Also, theplunger cap12 may be provided with a slit valve that engages the needle and prevents leakage. The nozzle also can be capped because the hypodermic needle is locked within the syringe. This retractable needle safety syringe is supplied sterile and ready to use.
During normal use of the needle-syringe assembly, the[0140]barrel10 and theneedle holder14 are held stationary, and theplunger11 is free to move axially relative to both thebarrel10 and theneedle holder14. Advancing movement of theplunger11 is limited by contact of theplunger cap12 with theend wall23 of thebarrel10. Theneedle holder14 is releasably locked to thebarrel10 by the locking engagement of thelateral arm32 to the wall of the barrel by a latch such as thelatch308. Also, when used, the locking luer taper releasably locks theneedle holder14 to thebarrel10. Theplunger11 is also free to move longitudinally relative to theneedle holder14, because the needle holder is not locked to the plunger in that direction. However, the locking of thelateral arm32 by the latch mechanism at the barrel wall, prevents rotation of the plunger. As long as thelateral arm32 of the needle holder is locked to the barrel wall, the needle-syringe assembly is in its normal operating mode.
Following normal use of the needle-syringe assembly, the[0141]needle13 can be retracted into theplunger11 and thebarrel10. This requires axial movement of theneedle holder14 within thebarrel10 toward the proximal end thereof, which in turn requires that theneedle holder14 be unlocked for movement, under the influence of the biasing or retracting means such asspring300, within the channel. Thus, to initiate retraction of theneedle holder14, thearm32 is unlocked by releasing thelatching mechanism308,408 or508.
The illustrative syringe need not be any longer than a conventional syringe because conventional syringes are made longer than required to provide more than the desired fluid volume, so as to avoid inadvertent withdrawal of the plunger and the resultant spillage of the syringe contents. The extra plunger barrel length to accommodate the user's fingers in the space between the plunger knob and the finger flanges contributes to excess length in conventional syringes. In the present invention, the extended barrel length is used to lock and store the retracted needle holder and the entire needle.[0142]
FIG. 2 illustrates the assembled syringe and needle assembly with the[0143]cap200 as it might be provided for use.
To operate the needle-syringe assembly, the[0144]protective cap200 is removed from theneedle13, and the required amount of medication is aspirated into thebarrel10 without advancing the plunger. Air bubbles if any are removed and quantity of medicine is adjusted. Next, the injection site on the body of a patient is determined and the skin is cleaned with an antiseptic solution. Following percutaneous entry of the needle into the patient, location of the needle tip in the vein is confirmed by aspirating a small amount of blood into thetransparent barrel10. Theplunger11 is then advanced to inject the medication from thebarrel10 into the vein. After the medication is administered, theneedle13 is withdrawn from the patient, the latch mechanism308 (408,508) is released and thespring300 or other retracting means retracts theneedle holder14 and theneedle13 and locks the needle holder in theplunger detent75. With theneedle13 completely retracted inside thebarrel10, all the components of the syringe are automatically interlocked and non-reusable, and the needle-syringe assembly can be safely discarded in its entirety. Thecap200 can be replaced to prevent leakage of any remaining fluid within thebarrel10.
It can be seen from the foregoing description that the needle-syringe assembly performs all the conventional functions of injection syringes and yet, upon completion of injection, the[0145]hypodermic needle13 is concealed within thebarrel10. The needle-syringe assembly withswitch308 can receive and dispense medications any number of times for a given patient by reciprocal longitudinal movement of theplunger11 within thebarrel10. However, once the latch is released it cannot be reused.
The needle-syringe assembly of this invention is easy to manufacture, cost effective, and easy to use in the field. The parts can all be made by conventional plastic molding and using readily available medical grade stainless steel needles and compression springs. The plastic parts are made by injection molding of medical grade, gamma stable polymers such as polypropylene. The needle holder and spring retainer that require higher strength are molded from polycarbonate. The plunger seal or cap and “O” ring can be molded from non latex thermoplastics synthetic elastomers or silicones. The switches that require smooth friction free movements is made from HDPE. Of course the material selection is guided by the strength and functional requirement of components. The disclosed materials can be substituted by alternate or improved compounds that may or may not be presently available. The needle is glued by using ultraviolet cured adhesives. Syringes are assembled and packaged in a clean room and sterilized by gamma radiation.[0146]
While the drawings of components and description, for simplicity, show a syringe with central nozzle, the axis of all the components can be shifted to generate a syringe with an eccentric nozzle without altering the concepts or components. Likewise, the cross-sectional shape of syringe components can also be modified without deviating from inventive description.[0147]
Because of the unique features of this invention the method of assembly is modified from the conventional syringe assembly. The method is illustrated in FIGS.[0148]42-49. The pre-capped plunger is oriented withopen channel33 facing up, is placed on a peg passing through the proximal window of the plunger whilespring retainer half302ais placed under the plunger. Since the proximal part of the plunger channel has adetent75 that interlocks with the retracted needle holder, their contact is prevented by placing aspacer602 between the components to prevent interlocking (FIGS.43-44). The spacer is placed in the plunger channel and is taken out only after the assembly, by pulling the plunger out of the barrel. A sub-assembly consisting of the needle holder surrounded by the compression spring and spring retainer is then placed inplunger channel33. Insertion of the plunger containing the foregoing assembled components in the barrel completes the assembly by rearranging each component because of the localized restrictions and structural geometry of the barrel.
In FIG. 42, the[0149]switch308 is inserted on thebarrel10 from thenozzle15 side past thedetent100, and rotated 160 degrees, ready to receive and lock the Needle Holder Arm. In FIG. 43, therubber cap12 is aligned and pressed on theplunger11.Spring retainer302 is aligned under theplunger11 adjacent to the distal plunger plate.25. In FIG. 44, the plunger withopen channel33 is placed on a square indexing pin600 passing through a detent window or opening601 in the plunger provided for this purpose. It blocks thedetent75 and keeps plunger channel open for assembly of parts. Also, aspacer rod602 is placed in plunger channel adjacent to the square indexing pin. In FIG. 45, a sub-assembly including the needle holder andspring300 inserted into thespring retainer302 is placed in the plunger channel next to thespacer rod602, and thespring retainer parts302a,302bare snapped together. In FIGS.45-46, the plunger assembly is inserted in thebarrel10 andswitch308 is rotated to lock the needle holder arm. All the components are now properly re-arranged, aligned and assembled automatically. In FIG. 47, theplunger11 is pulled out to discard thespacer rod602.
Because the[0150]needle holder14 is retracted directly into theplunger11 itself, the rather than into the barrel cavity, theplunger11 need not be fully extended out of the barrel for needle retraction to occur. Thus, when discarded following use, the needle-syringe assembly contributes minimally to the bulk of refuse. Since retraction of theneedle13 is effected by the spring or other elastic biasing means, upon releasing the latch, the hand of a user does not come into the vicinity of the needle point, thereby minimizing the possibility of a needle prick during retraction. Moreover, the assembly employs substantially the same number of components as conventional syringes, and does not require additional guards, sheaths, sleeves, etc. to conceal the needle following use.
Intravenous Catheter Insertion Syringe.Intravenous access is a lifeline of critically ill patients as a primary avenue of administration of fluids and medicines, yet it can be a difficult procedure. There is therefore a need to place a catheter consisting of a non-traumatic flexible polymeric tube in a patient's vein. Since polymeric catheters, although non-traumatic to veins, can not penetrate the skin and vein, a hypodermic needle has to be used first to create an initial puncture and guide the catheter by sliding over it. This over-the-needle (OTN) catheter placement syringe is disclosed in FIG. 48-[0151]54 and has essentially the same components of the retractable needle syringe as shown and described above. However, theneedle holder14 is replaced by anintegral needle713 which also functions asneedle holder714 and has all the functional features of the above-describedneedle holder14 including aside hole713alocated in barrel cavity close to the nozzle. The remaining proximal part of the needle714ais blocked beyond theside hole713a. It has an insert-moldedhead730 to support thespring300 as well asside arm732 to engage to the barrel via a switch. The “O”ring202 is replaced by a synthetic elastomeric gasket702 press fit in thenozzle15 of the syringe. A step between the needle and needle holder is avoided to prevent back flow of the fluids when the plunger is advanced over the retracted needle that has a smaller diameter than the opening in the rubber stopper.
Veins are mobile and slippery structures. They are also tortuous. Hence a straight hypodermic needle cannot be pushed too far because of the danger of double puncture. A soft and non-traumatic catheter, once in vein can however be advanced for longer length. However, it is also essential to confirm that the fluid path is continuous, and that the catheter is in vein. A free flow of the heparinized saline indicates that the catheter is located in the vein and that it is open. Heparinized saline also prevents the clotting of blood in catheter as well as the vein. Infusion of heparinised saline as soon as venous access is obtained to prevent clotting of the vein by blood is a good strategy and is universally followed. Saline filled syringe to obtain venous access is good practice, and will be clear from the method of use depicted in FIGS.[0152]50-54.
In FIGS.[0153]48-54, over-the-needle (“OTN”) catheter assembly includes anOTN catheter80 and the above-described syringe assembly with ahypodermic needle13 modified as noted above mounted therein. Thecatheter80 is a polymeric catheter having anelongated tip82. Prior to use of the OTN catheter assembly, a proximal endfemale connector84 of theOTN catheter80 is coaxially mounted over thenozzle15 and thehypodermic needle713 protrudes through both thenozzle15 and theOTN catheter80. Prior to and during normal use of the OTN catheter assembly, theOTN catheter80 is held engaged over thenozzle15 of the syringe assembly by suitable means, such as locking luer tapers on the outer surface of thenozzle15 and theinner surface81 of theend84 of thecatheter80. Theelongated tip82 of thecatheter80 follows the beveled tip ofhypodermic needle713. Prior to use, i.e., prior to inserting theneedle713 andcatheter tip82 into a vein, theneedle713 andcatheter tip80 are enclosed by a removable cap similar to thecap200.
The illustrated embodiment of the[0154]catheter80 includes aninternal valve85 that normally closes the cavity of thefemale luer end84 of the catheter to prevent back flow of blood when disconnected from syringe or fluid line. Thevalve85 opens to permit the entry of the nozzle end of the syringe and permits fluid communication. It again stops the back flow of fluids when the syringe nozzle is withdrawn from the catheter. When another fluid line that also has a male luer end is subsequently connected to theluer end84, thevalve85 may be opened to permits fluid communication.
The purpose of the locking means, such as luer tapers, is to assure mechanical unity of the syringe with the OTN catheter so that insertion force applied to the syringe barrel is directly transmitted to the[0155]hypodermic needle713 andcatheter80. Release of the locking luer taper disassociates this mechanical unity, permitting the syringe (with the retracted needle713) to be removed from thecatheter80.
To use the OTN catheter-syringe assembly, as shown in FIGS.[0156]50-54, the skin of a patient is first prepared and aperipheral vein800 is made prominent and cleaned with antiseptics.
Under aseptic precautions, the[0157]OTN syringe cap200 is removed and syringe is partially filled with heparinised saline. The vein is punctured with theneedle713 projecting at the catheter tip82 (FIG. 51), and the location of the needle tip is judged by the change in color under the catheter or by the appearance of blood in the catheter and/or the flashback or aspiration of blood in the syringe.
Once the location of the needle tip in the vein is confirmed, by aspiration of blood and injection of saline in the vein, the needle holder is retracted by release of the switch as described above (FIG. 52). At this stage the plastic catheter can be advanced in the vein without fear of trauma since the sharp needle is already retracted, in the manner described above.[0158]
Continuity of catheter and its location and, confirmation that the[0159]needle713 andcatheter tip82 are located in the vein can be made by viewing blood entering thecatheter80 by capillary action. It, however, is also possible to confirm a flashback within the syringe barrel by partially retracting theplunger11 relative to thebarrel10 to assure that continuity between thebarrel nozzle15 and the vein is still established. In this regard, the side aperture of theneedle holder714 opens into the syringe. Confirmation of proper insertion in the vein therefore is indicated by blood entering the barrel chamber via the side aperture in theneedle holder714.
When fluid path is continuous, the entire heparinised saline in the syringe is infused in the vein to fill the vein with anticoagulants to prevent clotting.[0160]
While securing and retaining the[0161]OTN catheter82 in the vein, and blocking the female end of OTN by thevalve85 the syringe assembly is removed (FIG. 54) and an intravenous line is connected to thecatheter80, as conventional. Finally, thecatheter80 is secured to the skin of the patient by adhesive tape. The syringe with the retracted and lo locked needle is then disposed of as biological waste. In order to prevent leakage of the fluid the syringe may be capped.
Without the improvements recited herein it was not possible to ascertain with certainty [1] the catheter is in fact in vein after the puncturing needle is withdrawn [2] that there is no false passage [3] that the vein is filled with anti-coagulant saline and that it is open—not clotted.[0162]
The various novel and improved syringe assemblies as described above offer a number of advantageous features, including but not limited to various combinations of the following:[0163]
The[0164]plunger channel33 adds precision to the needle holder movement. For example, straight axial retraction of the needle in theplunger channel33 avoids angulation of the needle and puncture of the barrel cavity. It does not require extending the overall length of the syringe as a result of the plunger being pulled out, and avoids the need for special measures such as breaking the plunger to prevent re-use. The linear movements of the plunger in the barrel are mechanically indexed to actuate retraction of the needle after the medicine is injected in the patient.
The number of the components in the present invention is not significantly different from a conventional syringe to keep it cost effective.[0165]
Use of the sliding needle holder eliminates the usual female needle holder on the barrel nozzle, which eliminates the associated dead-space and quantity of wasted medications left over in the syringe nozzle and the conventional needle holder.[0166]
The operation of the syringe is one-way so that accidental misuse is minimized, i.e, once retracted the needle holder is locked in place, so the needle cannot be re-extended.[0167]
Operation of the syringe is particularly safe because all the required manipulations of the various parts of the syringe are performed at or near the proximal end of the syringe, well away of the needle, during both the normal and retracting modes of operation.[0168]
In the rare event when only a partial dose of medicine is given to the patient, the syringe with leftover medicine can be rendered safe by retraction of the needle holder, while capping of the nozzle will prevent spillage.[0169]
It should be noted that the syringe assembly as described may be used to dispense medication or as a blood collection device. It may also be used to place an over-the-needle catheter, as described above.[0170]
With a few innovative modifications, present invention can be converted into a pre-filled retractable needle, single use safety syringe. These syringes are used in the pharmaceutical industry. Instead of packaging the injectable medications in vials or ampoules the sterile medications are filled in the syringe itself. It saves the entire packaging cost of ampoules and vials, as well as cost of professionals, who transfer the medication from the vials to the syringes in sterile atmosphere, before it is injected in the patients. With a pre-filled syringe, it is just inject the medicine and dispose of the syringe. One of the major problems involved in the pre-filled syringe technology is the compatibility of the syringe components with the medications stored in syringe for long shelf life. Newer plastics that can be used in this invention are sufficiently neutral, nonreactive and address that problem. A second consideration is that the medicine filled in a syringe should not leak, either from nozzle end or from rubber piston end. Further, the sterility of medicine must be preserved, and an accidental discharge of medicine must be avoided, until use. In addition, the syringe used to inject the medicine in patient must comply with the “needle stick” prevention regulations mentioned above.[0171]
Prevention of fluid leak is an important function of the syringe. The problem is that of maintaining a seal at either end over a long period of time. The nozzle of the present syringe invention can be provided with male (external) luer taper to install a tight[0172]fitting cap200 with female (internal) luer taper for protection of needle point, as well as preventing accidental needle stick, because the hypodermic needle emerges from within the nozzle. The luer taper lock requires an intentional compound roto-linear movement to disengage. It therefore resists vibratory as well as other forces ordinarily tending to separate the components.
A luer lock when re-enforced with a screw thread molded on contacting surfaces of the[0173]nozzle15 as well asinside cap200, is further assurance that cap would not separate once installed to maintain the seal. Theprotective cap200, intended for the pre-filled syringe, is in addition partially filled with a nontoxic, tissue-compatible, inert, elastic non coring, material such as silicone to an appropriate length sufficient to enclose the tip portion part of the hypodermic needle of the retractable needle syringe. When such a needle protector is installed on the nozzle of the retractable needle syringe, it assures a perfect seal both to prevent the leak of air as well as any fluid contained within the prefilled barrel despite a modest in-advertent push on the plunger.
The[0174]rubber piston12, installed on theplunger head21, seals the needle holder in its center and seals with the barrel along its periphery. When the syringe is pre-filled with medicine, the rubber piston is supported by thespring retainer302. Further, the needle holder anchors it to the barrel of the syringe. Accordingly, the plunger and the rubber cap cannot be pulled out beyond this pre-filled location, unless this locking mechanism is intentionally and voluntarily disabled, so there is no chance of a leak from the proximal end.
The effective sealing at the nozzle as well as the above-mentioned mechanical anchoring of the rubber piston is not likely to permit movement of the plunger to effect a fluid leak. However, another barrel-plunger lock mechanism consisting of a clip that anchors to the barrel and a 90 degrees angled plate that engages with the linear slots on the proximal part of the[0175]plunger flange64 immobilizes the plunger in relation to the barrel. This prevents any inadvertant pull or push to be transmitted to the medicine chamber and assures additional security against advancement of plunger within the barrel.
Since prefilled medicine obligates that the plunger be pulled out, and since the pulled out plunger is unprotected because it is out of the barrel, this assembly is further fortified. Referring to FIGS.[0176]73-77, theplunger portion111 projecting out ofbarrel10 is split in twohalves111a,111b. Each half is provided with ahinge113a,113bthat permits each half to be folded by the side of the barrel (see FIG. 77). The hinge mechanism is such that in normal use the hinge gets pushed within the barrel and can not come out nor can it be unfolded unless pulled out of the barrel. This mechanical arrangement offers ultimate security to the operation of the prefilled syringe.
The mechanical structures of the present invention described herein assure that the retraction mechanism cannot be disabled by the hydraulic pressure generated inside the barrel. Operation of a pre-filled syringe is simple in that everyone removes the protective cap before injection, and plunger lock invariably reminds one to rotate the locking ring to initiate the injection of medicine under aseptic precautions.[0177]
FIGS.[0178]55-64 and FIGS.65-71 illustrate two further embodiments of a retractable needle, single use safety syringe in accordance with the invention. These two additional embodiments differ from the embodiments heretofore described, in that the latch or switch arrangement is entirely internal to thebarrel10 of the syringe. The barrel therefore has no need for and therefore omits the slot or guidetrack19 shown in the previous figures of drawing. In this regard, the barrel for use with the embodiment of FIGS.55-64 is generally cylindrical and circular in cross-section without any breaks in the outer wall, as indicated generally by FIG. 63, while the barrel for use with the embodiment of FIGS.65-70 is of the type shown in FIG. 68, with anenlarged wall portion29 along one side thereof, similar to the barrel shown in FIGS. 8 and 9 described above, however, without thedetent elements100, such that the external surface is relatively smooth, having one enlarged diameter segment at the extended or radially outwardly extendingwall portion29.
Referring initially to FIGS.[0179]55-58, an alternate embodiment of a two-piecespring retainer element1302a,1302bis illustrated. Theelements1302aand1302bbecome one structure when snapped together. They can also be molded as a single piece with an identical function. Thespring retainer element1302ais similar to the spring retainer shown in FIGS. 20 and 21, in that it includes a generallysemi-cylindrical body portion812 havingconnector members814 which mate with similar or complementary connectors on the secondspring retainer element1302b. Thespring retainer element1302aalso includes anextension1303 which terminates in a spring support or retainingelement1310 with a through opening for receiving the needle holder axially movable therethrough. An oppositely projectingextension1312 functions to engage the needle holder within the plunger channel in fixed position in normal operative state. It retracts the needle holder at the point of plunger advance when the ramps deflect the plate radially. This structure eliminates the requirement of a switch for causing retraction and can be used with a conventional barrel.
In this regard, the[0180]extension1312 terminates in a gripping lip orflange804 which has a right angle805 (that is, at right angles to the extension plate1312) for overlying a complementaryflat surface portion1037 at a top surface of aneedle holder element1014 shown in FIGS.60-62, and further described below. The retaininglip804 also has a leadingbeveled surface806 to facilitate initial passage of theenlarged head1035 of theneedle holder1014 thereby for engagement with theflat top portion1037 of the top surface of theenlarged head1035 of the needle holder1014 (see FIGS.60-62).
The[0181]extension1303 has asemi-cylindrical channel810 for receiving and holding in place thecompression spring300 described above.
The proximal extension plate or[0182]wall1312 has opposing side surfaces802 located and sized so as to span over thewalls60,62 of thechannel33 of theplunger11. An upper edge surface of theplate1312 to either side of the retaininglip806 has a generally V-shaped, rampedgroove808 which is of complementary form for gaging the upper ramped and V-shaped surfaces of theprojections70 and72 of theplunger11.
Referring briefly to FIGS. 58 and 59, the second segment or portion of the spring retainers indicated by[0183]reference numeral1302band has asemi-cylindrical portion820 which hasmating projections815 for engaging with theapertures814 in theportion1302ashown in FIG. 55 to assemble the two portions of the spring retainer together. In other respects, thespring retainer1302bis substantially identical to the spring retainer element orportion302b. However, thespring retainer portion1302bhas an additional axially extending reducedthickness portion830 which has an elongatedwindow832 for interfitting with adetent842 formed in abottom rib64aof a modifiedplunger11b(see FIG. 72) which includes aramp840 which leads into arecess842, such that theramp840 will pass into and engage thewindow832 upon the over-extension or over-advancement of the plunger for retraction of the needle as described above. The reduction in the thickness ofextension plate830 offers a spring-like action for positive engagement of thedetent842 on therib64 of the plunger.
Referring briefly to FIG. 64, the elements of FIGS.[0184]55-63 are shown in assembled condition. Upon the above-described over-advancement of theplunger11, theprojections70 and72 engage thegrooved edges808 of theextension1312, resiliently bending back the top portion of the plate so as to release engagement of the retaininglip806 from theflat area1037 on the top1035 of theneedle holder1014, thereby allowing thespring300 to expand and retract the needle holder and needle. As also shown in FIG. 64, when this occurs, the detent comprising theramp840 andrecess842 engages thewindow832 to hold the assembly in a locked condition so as to render it completely locked and nonreusable and prevent retraction of the plunger, as well.
Referring next to FIGS.[0185]65-70, another embodiment of aspring retainer2302a,needle holder2014 andbarrel10 for achieving for “instant” retraction entirely internally of the barrel, is shown. This embodiment, as also shown in the assembled view of FIG. 71, operates for releasing the needle holder to retract the needle and locking the components, including the plunger, in place in similar fashion to the embodiment of FIGS.55-64 described above. That is, all of the mechanisms are carried internally of the barrel whereby no channel, slot, track or other opening in the barrel is needed or provided. In order to accommodate the mechanism of this embodiment, however, the barrel has a radially narrow increaseddiameter portion29 as shown in FIG. 68, and mentioned above.
Referring initially to FIGS.[0186]65-67, thespring retainer portion2302ainterfits with thespring retainer portion1302bas shown in FIGS. 58 and 59. In this regard, thewindow832 in thespring retainer element1302binterlocks in the same fashion as described above with respect to thedetent portion840,842 of theplunger11bof FIG. 72, as also illustrated in FIG. 71. In this regard, thespring retainer portion2302aincludes asemi-cylindrical portion812 which interfits snugly within the interior wall of thebarrel10 and is retained in place by a raisedring120 as mentioned hereinabove. Anextension2303 andspring supporting portion2310 with through aperture for receiving the needle holder are the same as in the above described embodiments. Also, as in the above described embodiments, a small slot or groove2304 interfits with a mating projection within the barrel to properly index or position the spring holder and prevent rotation thereof with respect to thebarrel10.
In the embodiment of FIGS. 65 and 66, a proximal[0187]flexible extension plate902 similar to theplate802 is provided and also is of a width to span and slidably engage the two walls orribs60,62 which form thechannel33 in theplunger11. In this regard, theplunger11bof FIG. 72 is utilized in connection with this spring retainer. In the same fashion as the embodiment of FIG. 55, thespring retainer2302ahas at an end of the plate orprojection902 a pair of shaped recesses orgrooves908 which are of complementary shape for engaging the upper edge portions of thespring release projections70 and72 of theplunger11b.
Finally, in order to releasably retain the needle holder, a through opening or[0188]window905 is defined betweenflexible plate902 and asupport plate903. Theflexible plate902 has an arch902aand is rendered flexible by two slots s1 and s2. The slots separate theplate902 and offer flexibility so that it can flex radially outwardly in response to a mechanical push of theprojections70 and72 located on the plunger. With the deflexion of the arch902a, the needle holder locked underneath is released. Thesupport plate903 is fixed to thespring retainer2302aand extends proximally to form a concave margin to accomodate the needle holder which is locked under theplate902.
As best viewed in FIG. 71, the[0189]opening905 releasably engages a radially projecting, relativelyshort arm2032 of theneedle holder2014 shown in FIGS. 69 and 70. This needle holder is substantially similar in all other respects to theneedle holders14 and1014, having a recess orslot2041 formed by an elongate L-shapedextension2039. Thisextension2039 mounts thelateral arm2032 at its distal end. The slot oropening2041 receives and guides one end of thecompression spring300. Theslot2031 performs the same function as theslot31 of theneedle holder11 described above, and theparts2026,2030,2036 are also substantially the same as theparts26,30 and36 of the needle holder described hereinabove. The top surface of theenlarged head2035 of theneedle holder2014 does not require, and is therefore shown without, the flat surface portion1017 of the embodiment of FIGS.50,60-62. It will be noted that theenlarged portion29 of the barrel is aligned, upon assembly and during operation, with thelateral arm32 of the needle holder, and with theplate902 of the spring retainer to provide a relief space for the plate to flex back sufficiently to release theradially extending arm2032 upon overadvancement of the plunger in the manner described hereinabove for release of the needle holder assembly. This results in retraction of the needle and locking of the parts in a retracted and nonreusable condition, including locking the plunger in an advanced position, as described above.
While particular embodiments and applications of the present invention have been illustrated and described, it is to be understood that the invention is not limited to the precise construction and compositions disclosed herein and that various modifications, changes, and variations may be apparent from the foregoing descriptions without departing from the spirit and scope of the invention as defined in the appended claims.[0190]