US20080065007A1 - Drug pump systems and methods - Google Patents

Abstract

A menu driven reprogrammable drug pump is provided with a memory, such as flash memory, a display, a keyboard, and a communications port to allow a generic pump to be programmed with a desired pump application (therapy) program and patient specific settings. Programming and data transfer with another pump or a computer to and from the patient pump is by the communications port that allows local and/or remote communications with the pump. Flash memory stores the pump application program during use. Patient safety is provided by a cassette identification system, an occlusion detection system, and a latch/lock detection system. Automated testing of the pump is by a closed loop testing system.

Description

CROSS REFERENCE TO RELATED APPLICATIONS
• This application is a continuation of application Ser. No. 10/068,291, filed Feb. 5, 2002, which is a continuation of application Ser. No. 09/795,266, filed Feb. 27, 2001, now U.S. Pat. No. 6,475,180, which is a continuation of application Ser. No. 09/324,305, filed Jun. 2, 1999, now U.S. Pat. No. 6,241,704, which is a continuation of application Ser. No. 08/782,486, filed Jan. 10, 1997, now U.S. Pat. No. 5,935,099, which is a continuation-in-part of application Ser. No. 08/555,304, filed Nov. 8, 1995, now U.S. Pat. No. 5,658,250, which is a continuation of application Ser. No. 08/090,738, filed Jul. 13, 1993, and said application Ser. No. 08/782,486, filed Jan. 10, 1997 is a continuation-in-part of application Ser. No. 08/206,737, filed Mar. 7, 1994, now U.S. Pat. No. 5,669,877, and is a continuation-in-part of application Ser. No. 08/586,952, filed Jan. 16, 1996, which is a continuation of application Ser. No. 08/276,025, filed Jul. 15, 1994, now U.S. Pat. No. 5,485,408, which is a continuation of application Ser. No. 07/942,288, filed Sep. 9, 1992, now U.S. Pat. No. 5,338,157, and said application Ser. No. 08/782,486, filed Jan. 10, 1997 is a continuation-in-part of application Ser. No. 08/540,960, filed Oct. 11, 1995, and is a continuation-in-part of application Ser. No. 08/561,809, filed Nov. 22, 1985, now U.S. Pat. No. 5,788,669, which claims the benefit of application Ser. No. 60/010,090, filed Jan. 12, 1996, which applications are incorporated herein by reference.
FIELD OF THE INVENTION
• The present invention relates to systems and methods for operating drug delivery devices, such as drug pumps.
BACKGROUND OF THE INVENTION
• Various ambulatory medical devices are known for treating and/or monitoring patients at a remote site away from the caregiver's or clinician's office. One example of an ambulatory medical device is a drug delivery device, such as a drug pump, for providing periodic or continuous drug delivery to the patient when the patient is away from the caregiver's office.
• Certain drugs rarely achieve their maximum therapeutic action through conventional injection techniques. Many drugs reach their full potential only through precise delivery over an extended period of time. With controlled drug infusion through a drug pump, the drug can be given at a precise rate that will keep the drug concentration within the therapeutic margin and out of the toxic range. Ambulatory drug pumps can provide appropriate drug delivery to the patient at a controllable rate which does not require frequent medical attention and which allows the patient to leave the hospital or caregiver's office.
• A failure to adequately monitor the drug pump and the patient's usage of the drug pump can reduce or eliminate any benefits the patient may have received from a proper drug delivery therapy. In some cases, the drug therapies can have serious health consequences to the patient if the drugs are not administered properly.
• Various concerns arise in connection with operation of the drug pumps. One concern arises in that the drug pump must be adequately monitored when the patient utilizes the drug pump at a remote site. Another concern relates to controlling the sophisticated therapies desired by the caregivers and the patients for the ambulatory drug pumps. Additional concerns relate to accurate pumping of an appropriate drug therapy. Still further concerns relate to the costs to manufacture and maintain the drug pump.
• There is a need for drug pump operating systems and methods which address the above concerns and other concerns.
SUMMARY OF THE INVENTION
• One aspect of the present invention concerns a medical infusion pump, comprising of a pump mechanism, a programmable circuit arranged to control operation of the pump mechanism and a flash memory in electrical communication with the programmable circuit.
• Another aspect of the claimed invention is a method of programming the medical infusion pump having a pump mechanism, a programmable circuit, flash memory, and a data port. The method comprises transferring data through the data port, and storing the data in the flash memory.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a first preferred embodiment of a drug pump including a control module and a drug cassette according to the present invention.
• FIG. 1A is a right side view of the control module ofFIG. 1 showing the latch and the lock for use in attaching the drug cassette to the control module.
• FIG. 1B is a left side view of the control module ofFIG. 1 showing the external power port and the communications port.
• FIG. 2 is a side view of the pump mechanism of the control module of the drug pump ofFIG. 1.
• FIG. 3 is an alternative cassette (remote reservoir adapter) to the cassette shown inFIG. 1.
• FIG. 4 is a schematic drawing of the control system of the drug pump ofFIG. 1.
• FIG. 5 is a schematic drawing showing pump to pump communication via a local or a remote link.
• FIG. 6 is a schematic drawing showing communication between a pump and a computer system, such as a personal computer, over a local or a remote link.
• FIG. 7 is a schematic drawing showing a drug pump in a closed loop system for automated testing of the pump functions.
• FIGS. 8A and 8B together show a more detailed block diagram of the control system ofFIG. 4 for the pump shown inFIG. 1.
• FIGS. 8C-8E lay out the memory configuration of memory devices shown inFIG. 8B.
• FIG. 9 is a schematic drawing illustrating the pump to pump communication system ofFIG. 5 in greater detail.
• FIG. 10 is a schematic drawing illustrating a second system using a personal computer to communicate with a local pump and/or a remote pump. Local pump and remote pump communications capability is also shown.
• FIG. 11 is a schematic drawing of a preferred modem useful in the communication systems shown inFIGS. 9 and 10 to allow simultaneous voice and data transmission during pump-to-pump communication.
• FIG. 12A is a flow chart of an operational sequence of the patient pump with respect to the normal pumping mode for pumping fluid and the slave mode for pump to pump communication.
• FIG. 12B is a flow chart of an operational sequence of the caregiver pump with respect to the normal pumping mode for pumping fluid and the master mode for pump to pump communication.
• FIG. 13 is a flow chart of two preferred operational sequences for communication between the caregiver pump and the patient pump.
• FIG. 14 is a flow chart showing operation of an automatic lock level feature.
• FIG. 15 is a schematic drawing showing a computer screen displaying an image of a pump, as part of a computer system used for communicating with a pump.
• FIG. 16 is a schematic drawing showing a second computer screen displaying an image of a pump, as part of a computer system, and including information displayed on the screen relating to simulation sequences for use in training.
• FIG. 17 is a schematic drawing of the drug pump ofFIG. 1 shown linked to a personal computer for communication with the personal computer for programming of the flash memory of the pump.
• FIG. 18 is a schematic drawing illustrating the pump ofFIG. 17 linked to a personal computer located at a remote site.
• FIGS. 19-27 illustrate one preferred cassette identification system for the pump ofFIG. 1.FIGS. 19-21,24,25 and27 show portions of the control module and a first cassette.FIGS. 22 and 23 show a second cassette.FIG. 26 shows a third cassette.
• FIG. 28 is a schematic drawing of an automated testing system according to one embodiment of the present invention for testing the pump ofFIG. 1.
• FIG. 29 shows a schematic drawing of one embodiment of the testing device shown inFIG. 28.
• FIG. 30 is a flow chart representation of the preferred steps taken during the testing of the system shown inFIG. 28.
• FIG. 31 is a flow chart representation of the preferred steps taken during system initialization as identified in the flow chart ofFIG. 30.
• FIGS. 32A and 32B are flow chart representations of the preferred steps taken during the flow test identified in the flow chart ofFIG. 30.
• FIG. 33 is a flow chart representation of the preferred steps taken during the pressure test identified in the flow chart ofFIG. 30.
• FIGS. 34A and 34B are flow chart representations of the preferred steps taken during the maintenance test identified in the flow chart ofFIG. 30.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
• General Overview
• Referring now toFIG. 1, adrug pump100 includes acontrol module102 which is selectively mounted to a cassette orcartridge104.Cassette104 is shown as including anouter housing106 with afluid reservoir108 disposed withinouter housing106. Extending fromfluid reservoir108 and positionedadjacent control module102 is atubing110 which is connectable to a patient, such as by aLuer lock112.Cassette104 includes apressure plate114 which cooperates with a pump mechanism140 (seeFIG. 2) ofcontrol module102 to pump fluid fromfluid reservoir108 throughtubing110 to the patient. InFIG. 1,fluid reservoir108 is configured as a flexible fluid bag or pouch. Other fluid containers are possible. In addition,fluid reservoir108 is shown contained withincassette104. Aremote fluid reservoir108 separate fromcassette104 is possible.
• InFIG. 1A, latch116 ofcontrol module102 is rotatably operated to securely latchcassette104 to controlmodule102.Lock118 is operable to preventlatch116 from being unlatched, such as by an unauthorized person. In some drug therapies, a locking ofcassette104 to controlmodule102 is required.
• Control module102 includes anouter housing120 containing within the control system andpump mechanism140.Control module102 includes akeyboard122 with a plurality ofkeys124 including up and downarrow keys124a,124bfor scrolling. Tactile structures can be provided to assist a user in distinguishing thekeys124 by feel.Keyboard122 permits entry of information to pump100.Control module120 further includes adisplay126 for displaying information concerning operation ofpump100.Visual indicators128,130, such as amber and green LED indicators are provided withcontrol module120 to indicate various conditions ofpump100 to the patient or caregiver.
• Referring now toFIG. 1B, acommunications port132 allows for communication withpump100 from an external device located either locally or remotely relative to pump100. An externalpower supply port134 allows for connection of an external power supply to operatepump100.
• Pump100 is an expulsor or peristaltic infusion pump which includespump mechanism140 as shown in FIGS.2A-D. Pump mechanism140 squeezestubing110 in a particular manner to achieve pumping of fluid from the reservoir to the patient.Pump mechanism140 includes a reciprocally mountedinlet valve142, a reciprocally mountedexpulsor144 downstream ofinlet valve142, and a reciprocally mountedoutlet valve146 downstream ofexpulsor144.End148 ofinlet valve142 is moved bypump mechanism142 to alternately open andclose tubing110.End150 ofexpulsor144 is moved bypump mechanism140 to compresstubing110 to pump fluid and to allow expansion oftubing110 following compression.End152 ofoutlet valve146 is moved to compresstubing110 to alternately open andclose tubing110. Arotatable cam shaft154 is rotated bymotor156 throughgearing158. The various components ofpump mechanism140 are supported by chassis160 disposed withinhousing120 ofcontrol module102.Cam shaft154 preferably includes threerotatable cams162,164,166 configured as shown inFIG. 2.
• Preferably,cam shaft154 is constructed and arranged with double lobes (180° activation cycle) for eachcam162,164,166 for optimized energy consumption, such as described in U.S. Pat. No. 5,364,242, issued Nov. 15, 1994, the disclosure of which is incorporated herein by reference. Preferably,pump mechanism140 is made in accordance with the methods described in U.S. Pat. No. 5,364,242. Other pump mechanisms are anticipated including finger style pump mechanisms, roller pump mechanisms, and other fluid pumping arrangements. Examples of further expulsor style infusion pumps are shown in U.S. Pat. Nos. 4,559,038; 4,565,542; 4,650,469; and 5,181,910, the disclosures of which are incorporated-herein by reference.
• Referring now toFIG. 3, aremote reservoir adaptor170 is shown which is mountable to controlmodule102 in a similar manner ascassette104. However, instead of including a self-containedfluid reservoir108,adaptor170 is separate fromremote fluid reservoir172.Tubing174 linksremote fluid reservoir172 toadaptor170.
• Bothadaptor170 andcassette104 include anupper surface175 with two extendinghooks177 and aloop176 which permit releasable mounting to controlmodule102. See for example U.S. Pat. No. 4,565,542 previously incorporated by reference.Adapter170 andcassette104 may be both referred to as “cassettes.”Hooks177 engage a suspended pin assembly oncontrol module102 andloop176 is engaged bylatch116 to mount the cassette to controlmodule102.Latch116 in the latched state holdsloop176 so that the cassette cannot be pivoted away fromcontrol module102 about an axis defined byhooks177 and the suspended pin assembly.
• Referring now toFIG. 4, a schematic of acontrol system180 ofcontrol module102 is shown.Control system180 controls the operation ofpump100. Control system includes amicroprocessor182 and amemory184 programmable with selected functions for controlling operation ofpump mechanism140 and the other features ofpump100.Memory184 can be a single memory internal to controlmodule102, or it can be a plurality of memory locations withincontrol module102.Control module102 may also be designed and configured to accept one of a plurality of separate memory modules or memory cassettes containing information defining specific operational characteristics.
• Specifically,memory184 stores various programs and data related to the operation ofpump100.Memory184 is coupled tomicroprocessor182, which in turn runs the desired operating programs which control operation ofpump mechanism140. Stored inmemory184 is the program to permit communication with devices external to pump100.
• Access tomicroprocessor182 is provided throughcommunications port132.Communications port132 is preferably a standard RS232 communications port, although other communication links are possible (e.g., infrared telemetry). Information programmed intomemory184 instructs information to be transmitted or received viacommunications port132. This feature allows information being received viacommunications port132 from an external device to controlpump100. This feature also allows for the downloading of any or all information frommemory184 to an external device. An example of one type of device with which thepump100 might communicate is described in U.S. patent application Ser. No. 08/561,809, which is entitled Pump Tracking System and was filed on Nov. 22, 1995, the disclosure of which is hereby incorporated by reference.
• Control system180 also includeskeyboard122 or other operator input structure for providing information tomicroprocessor182. When a key124 is pressed onkeyboard122, the key sends a signal tomicroprocessor182 indicative of the key being pressed.Microprocessor182 responds to the signal received in the desired manner. Other such input structures may include knobs, buttons, or other like structures for performing pump functions, such as starting, stopping, andpriming pump100.
• Display126 ofcontrol system180 includes structure for displaying information to the patient or caregiver. A liquid crystal display (“LCD”) may be provided. A 4-line×21 character alpha/numeric display capable of creating 5×7 pixel characters may be used. Display signals sent frommicroprocessor182 permit display of information related to the operation ofpump100.
• Pump100 may also be provided with a variety of sensors, switches, or other devices (hereinafter “sensors”). The type of sensors provided depends on the type of pump and its intended usage. An example of such sensors includeocclusion detectors186a,186bfor detecting occlusions intubing110. Preferably, at least adownstream occlusion sensor186b, such as a pressure or force sensitive sensor for sensing pressure intubing110 is provided, along with an associated CPU or hardwired circuitry. A silicon piezo resistive sensor is an example ofocclusion detector186b. Further examples of desirable sensors forpump100 include acassette latch sensor188 for indicating whether the control module's latch is open or closed, acassette lock sensor190 for indicating whether the latch is locked, anair sensor192 for detecting air intubing110, acassette identification sensor196, and an externalcommunications cable sensor198. The sensors typically send a suitable electrical signal tomicroprocessor182 indicative of the condition sensed.Microprocessor182 andmemory184 is appropriately programmed to receive and process such signals. In addition, pump100 may also be equipped withalarm194, such as a visual alarm (e.g., lights128,130 ofFIG. 1) and/or an audible alarm (e.g. beeper) which is activated by the sensing of one of the conditions mentioned above, or other conditions.Alarm194 may be activated as a result of other triggering events, such as error conditions with respect to the power supply or pump hardware. Alarm signals sent frommicroprocessor182 permit activation ofalarm194.
• Referring now toFIGS. 5-7, various schematic drawings are shown illustrating possible uses ofpump100 in accordance with the present invention. InFIG. 5, pump100 is shown linked to asecond pump200 via acommunications link202. Communications link202 can be either a local link, or a remote link. Communication betweenpump100, andsecond pump200 is for a variety of purposes, including information transferred between a patient pump and a caregiver pump, such as in the event of an error condition, or a programming update, or a status update. The pump to pumpcommunication system203 ofFIG. 5 is useful to allow convenient communication with afunctional patient pump100.
• Referring now toFIG. 6, pump100 is linked to acomputer system204, such as a personal computer, via communications link206, either locally or remotely. Pump to computersystem communication system207 ofFIG. 6 is useful for transferring information between a functioningpatient pump100 and thecomputer system204.
• Referring now toFIG. 7, pump100 is shown linked tocomputer system204 and also to pumptester210. An information transfer link is provided by communications link208 betweenpump100 andcomputer system204. An information transfer link betweenpump tester210 andcomputer system204 is provided via communications link212. Afluid line214 betweenpump100 andpump tester210 provides aclosed loop system215 for automated testing of a functioningpatient pump100.
• Referring now toFIGS. 8A and B, a more detailed block diagram forcontrol system180 ofpump100 is shown. In addition to the features ofcontrol system180 described above, see for exampleFIG. 4,control system180 also includes various other sensors, switches, or devices needed or useful in operating the various features ofpump100.
• Amotor position sensor220 is provided for monitoring the position of the motor of the pumping mechanism. An appropriate signal is generated bysensor220 and communicated tomicroprocessor182.
• Beeper222 provides an audible signal at the desired time to the user ofpump100. An appropriate signal frommicroprocessor182 activatesbeeper222 at the appropriate time.
• External communication sensor198 senses when a communications cable connection or powered external serial device connection is made with respect to pump100 atcommunications port132. An appropriate signal is generated byexternal communication sensor198 and sent toprocessor182 indicative of the connection and/or the lack of connection with the communications cable or other connection device. Such connection can automatically trigger events inpump100, such as initiation of pump to pump communications operation. Optionally,external communication sensor198 can sense when a remote dose cord is attached, or when a remote data gathering device (e.g., temperature sensor, blood pressure monitor, EKG monitor, or respiratory monitor) is attached. The remote dose cord can also be used by the patient as an event marker for storage inpump memory184. For example, the patient can note with the remote dose cord a nauseous condition.
• Motor control switch224 turns on and off the motor ofpump mechanism140 at the desired time based upon signals sent frommicroprocessor182. Pump100 can be intermittently operated a predetermined number of times at predetermined intervals according to the pump operations program provided to controlsystem180. These intervals can range from once every couple of seconds or less to as long as a couple of times an hour or more.
• Air detector port226 allows the plug in of an appropriate external sensor to sense air in the fluid conduit between the reservoir and the patient. A sensor may be provided to sense when the air sensor is attached, or when the door to the port is removed.
• AC adapter sensor228 senses when an AC adapter has been plugged intopump100 such that the pump is then powered by the alternating current power supply or a battery pack.
• Temperature sensor229 senses the temperature to provide an input to the pump operating program to increase the accuracy of the pressure sensor. Tube compression properties can be affected by the ambient air temperature.
• Battery sensor230 senses the presence of a battery supply, such as a nine volt battery.Battery sensor230 also senses when the battery supply is low.
• Auxiliarybattery output port232 is provided for supplying a source of power to an external accessory ofpump100 from the power supply ofpump100.
• Remotedose cord port234 permits interconnection of a remote dose cord arrangement to pump100. The remote dose cord arrangement permits the patient to remotely press or simulate pressing a key onkeyboard122, such as the key which manually operates the pumping mechanism, via a signal from a remote switch sent through remotedose cord port234 toprocessor182. A signal generated by an appropriate sensor atport234 is sent tomicroprocessor182 to indicate tomicroprocessor182 that the remote dose cord is connected to pump100.
• Aserial communication device236 is provided for controlling communications access with auxiliarybattery output port232, remotedose cord port234,communications port132, andsensor198 in a serial manner.
• Pump mechanism140 is illustrated as being controlled bymotor control switch224 and monitored bymotor position sensor220.Pump mechanism140 is responsible for pumping fluid from the reservoir to the patient. As noted above, one possible pumping mechanism includes a rotatable cam shaft with tube engaging followers reciprocally mounted to move as the cam shaft rotates.
• The various sensors, switches, and devices incontrol system180 generate and/or receive an appropriate signal or signals during communication withmicroprocessor182 during operation ofpump100.Microprocessor182 is electrically interconnected through anappropriate interface bus238 with all of the various sensors, switches, and other devices ofpump100.Microprocessor182 responds to input signals by generating appropriate control output signals in accordance with the program control logic stored in memory. Onepreferred microprocessor182 that may be used in connection withpump100 is an MC68HC11E9 high-density complimentary metal-oxide semiconductor (HCMOS) high performance microcontroller unit (MCU) by Motorola. Such processor includes 512 bytes of electrically erasable programmable read only memory (EEPROM), and 512 bytes of random access memory (RAM).
• Microprocessor182 is further electrically interconnected to aflash memory240, an electrically erasable programmable read only memory (EEPROM)242 and a static random access memory (RAM)244. Areal time clock246 is also provided.Battery248, such as a lithium cell, provides a power supply to thereal time clock246 and thestatic REM244.
• Microprocessor182,flash memory240,EEPROM242,static RAM244,gate array257, real-time clock246, and parallel input/output means258 comprise at least a part of the processor control circuitry ofcontrol system180.
• As shown inFIG. 8B, avoltage reference260 is provided as part ofcontrol system180 in the preferred embodiment. As shown inFIG. 8A, a low battery shutdown and resetdevice262 is provided incontrol system180 in the preferred embodiment.
• The pump system software includes software designed to reside inside the pump as well as software designed to run on a personal computer (PC). The pump is a hardware platform designed to support a variety of software which implements different infusion modes, as well as other utility features. In addition, the pump can communicate with accessory PC programs, either via a direct serial connection, over phone lines using a modem, or other communication methods. The system software includes executable programs such as pump software programs which implement an infusion mode (also called “applications”); pump software programs which implement something other than an infusion mode (also called “utilities”); and pump software which handles power-up control (also called “the boot system”).
• The pump applications also can provide different infusion modes including, but not limited to:
• 1) An infusion mode consisting of a basal-rate delivery superimposed with patient demand doses (suitable for Patient Controlled Analgesia (PCA) pain control therapy, etc.).
• 2) An infusion mode consisting of a large volume delivered over a period of time during which the delivery rate first linearly increases, then stays constant, and finally linearly decreases (suitable for Total Parenteral Nutrition (TPN) intravenous nutritional therapy, hydration therapy, etc.).
• 3) An infusion mode consisting of constant-amount automatic doses repeated at regular intervals (suitable for intermittent delivery therapies such as antibiotic therapy, etc.).
• 4) An infusion mode consisting of a constant rate (suitable for a wide variety of continuous delivery therapies such as chemotherapy, etc.).
• The pump applications/utilities and boot system also can provide features in addition to infusion modes including, but not limited to:
• 1) A feature to switch from one infusion mode to another, and to load new pump software programs under external control via a direct serial connection or other communication methods.
• 2) A feature to run diagnostic functions which can be used to test the operation of the pump hardware under external control via a direct serial connection or other communication methods.
• 3) A feature to allow an application running in the pump to be externally controlled via a remote serial connection or other connection, in order to troubleshoot the pump or monitor and adjust a patient's therapy.
• 4) A feature to control an application running in another pump via a remote serial connection or other connection, in order to troubleshoot the pump or monitor and adjust a patient's therapy.
• The PC software programs can interface to a pump via a serial connection or other connection, and provide features including, but not limited to:
• 1) A feature to load pump software programs into a pump, via a direct serial connection or other connection to software running in the pump.
• 2) A feature to test a pump's hardware, via a direct serial connection or other connection to software running in the pump.
• 3) A feature to troubleshoot a pump or monitor and adjust a patient's therapy, via a remote serial connection or other connection to an application running in the pump.
• Software Overview
• Desirable software of one preferred pump operating system and method includes software: for controlling pump power up; for implementing the pump application necessary to pump fluid to the patient; for implementing a master mode communication sequence between two pumps; for implementing a communication sequence between a PC and a patient pump; for testing the pump hardware; for controlling the pump hardware testing; and for changing resident pump applications and utilities using a PC.
• The pump software controls the pump after a power-up or power-on reset. Various inputs, processing features, and outputs are provided:
• Inputs
• 1) Motor position sensor signals
• 2) Serial cable connect signal
• 3) Serial messages
• 4) Watchdog signal
• 5) Latch and lock sensor signals
• 6) Real-time clock data and signals
• 7) Manufacturing parameters
• 8) Program look-up table data
• 9) Launch program data
• Processing Features
• 1) Initialize the microprocessor and configure the system.
• 2) Perform power-up and run-time hardware self-tests necessary for its own safe operation.
• 3) Keep the hardware watchdog circuit from timing out.
• 4) Display an error code on the LCD upon detecting an error in a hardware self-test, store the error code, and halt further execution with the device in a safe-state.
• 5) Give visual notification that the software is executing (i.e. alive) within 5 seconds after hardware reset.
• 6) Display status messages on the LCD, including but not limited to the following indications:
• • The pump model.
  • The hardware ID and the last error code which was logged.
  • The program ID of the current launch program.
  • The program IDs of all installed applications.
• 7) Operate in one of two modes: launch mode, in which an application or utility is automatically executed; and command mode, in which it shall receive command messages via the serial port and send status messages.
• 8) In launch mode, begin execution of the launch program or the hardware testing software within 35 seconds.
• 9) In command mode, determine if it is connected serially to a PC testing station, and if so, launch the pump testing utility.
• 10) In command mode, display status messages on the LCD, including but not limited to indications that:
• • No applications or utilities exist in memory
  • The pump has established communications with a PC
  • A program download is in progress
  • A program download has been completed
  • A program download has failed or been interrupted
• 11) In command mode, provide means to report which application or utility is currently the launch program via the serial port.
• 12) In command mode, provide means to report which programs exist in memory and to verify the integrity of any program via the serial port.
• 13) In command mode, provide means to retrieve the manufacturing parameters via the serial port.
• 14) In command mode, provide means to receive an application or utility program via the serial port and load it into memory.
• 15) In command mode, provide means to receive the manufacturing parameters via the serial port and program them into memory. Also provide means to receive the time and date via the serial port and store it into the real-time clock.
• 16) In command mode, provide means to enable or disable an application or utility which exists in memory via the serial port. It is preferred not to be able to launch a disabled program.
• Outputs
• 1) Audible indicator control signals
• 2) Visual indicator control signals
• 3) Display text
• 4) Watchdog strobe signal
• 5) Latch and lock sensor power control signals
• 6) Disposable type sensor power control signals
• 7) Serial messages
• 8) History log data
• 9) Error log data
• 10) Manufacturing parameters
• 11) Program look-up table data
• 12) Launch program data
• 13) Flash ROM program slots
• 14) Motor spike flag
• The pump software implements different infusion modes or applications. Various inputs, processing features, and outputs are provided:
• Inputs
• 1) Key presses
• 2) Auxiliary input signals/remote dose signals
• 3) Power source sensor signals
• 4) Motor position sensor signals
• 5) Serial cable connect signal
• 6) Serial messages
• 7) Latch and lock sensor signals
• 8) Disposable type sensor signals
• 9) Air-in-line sensor signals
• 10) Pressure sensor signals
• 11) Voltage reference signal
• 12) Real-time clock data and signals
• 13) Delivery, status, and configuration parameters
• Processing Features
• 1) Perform power-up and run-time hardware self-tests necessary for its own safe operation.
• 2) Keep the hardware watchdog circuit from timing out.
• 3) Display an error code on the LCD upon detecting an error in a hardware self-test, store the error code, and halt further execution with the device in a safe-state.
• 4) Provide means to input delivery parameters appropriate for the infusion mode.
• 5) Keep status parameters appropriate for the infusion mode.
• 6) Provide means to input configuration parameters appropriate for the infusion mode.
• 7) Control the pumping mechanism to implement the infusion mode.
• 8) Monitor hardware sensor input signals.
• 9) Issue audible and/or visual alarms to indicate certain conditions or occurrences to the user.
• 10) Provide means to determine which other programs exist in memory, and to switch to another program.
• 11) Send and receive messages through the serial port.
• 12) Include a slave mode of operation during which it is controlled via a remote serial connection, by processing received keypress messages and sending display update messages.
• 13) In slave mode, receive serial command messages, and send serial status messages for the following data: event history, error history, current delivery, status, and configuration parameters, automatic odometers, and manufacturing parameters. Allow for random access to the delivery, status, and configuration parameters, send serial paging messages to another remote pump, and respond to serial paging messages from the remote pump.
• Outputs
• 1) Audible indicator control signals
• 2) Visual indicator control signals
• 3) Display text
• 4) Motor control signals
• 5) Watchdog strobe signal
• 6) Latch and lock sensor power control signals
• 7) Disposable type sensor power control signals
• 8) Air-in-line sensor test signal
• 9) Serial messages
• 10) Real-time clock data
• 11) Delivery, status, and configuration parameters
• 12) History data
• 13) Error log data
• 14) Automatic odometer data
• 15) Manufacturing parameters
• Pump software is provided to implement a master mode of operation, during which one pump controls a pump application in another pump via a remote serial connection by sending keypress messages and receiving display update messages. Various inputs, processing features, and outputs are provided:
• Inputs
• 1) Key presses
• 2) Power source sensor signals
• 3) Serial cable connect signal
• 4) Serial messages
• 5) Watchdog signal
• 6) Real-time clock data and signals
• Processing Features
• 1) Perform power-up and run-time hardware self-tests necessary for its own safe operation.
• 2) Keep the hardware watchdog circuit from timing out.
• 3) Display an error code on the LCD upon detecting an error in a hardware self-test, store the error code, and halt further execution with the device in a safe-state.
• 4) Send serial keypress messages to another remote pump, and process received serial display update messages.
• 5) Send command messages to an external modem to initialize it and control its operation.
• 6) Provide means to send serial paging messages to another remote pump, and respond to serial paging messages from the remote pump.
• Outputs
• 1) Audible indicator control signals
• 2) Visual indicator control signals
• 3) Display text
• 4) Watchdog strobe signal
• 5) Serial messages
• 6) Error log data
• 7) History log data
• PC software is provided which controls a pump application via a remote serial connection. Various inputs, processing features and outputs are provided:
• Inputs
• 1) Keyboard input
• 2) Mouse input
• 3) Serial messages
• 4) Real-time clock
• 5) Automatic Odometer data
• 6) Manufacturing parameters
• Processing Features
• 1) Provide a graphical representation of a pump on the PC screen which has keys that can be activated using a mouse.
• 2) Send serial keypress messages to a remote pump, and process received serial display update messages by updating the pump displayed on the PC screen.
• 3) Provide means to send serial command messages to a remote pump, and store received status messages to disk for the following data: history log, error log, current delivery, status, and configuration parameters, program ID, program name, program description, serial number, and hardware ID.
• 4) Provide means to send serial messages which allow random access to a remote pump's delivery and status parameters. Provide means to send serial paging messages to another remote pump, and respond to serial paging messages from the remote pump.
• 5) Provide means to display a representation of event history status messages.
• 6) Provide means to print data retrieved from the pump, and retrieve and print data stored on disk.
• 7) Operate without requiring knowledge about the application running on the remote pump.
• Outputs
• 1) Audible indicator control signals
• 2) Display information
• 3) Serial messages
• 4) Real-time clock data
• 5) Disk files
• Pump software is provided which allows the pump hardware to be tested via a direct serial connection. Various inputs, processing features and outputs are provided:
• Inputs
• 1) Keyboard input
• 2) Auxiliary input signals
• 3) Power source sensor signals
• 4) Motor position sensor signals
• 5) Serial cable connect signal
• 6) Serial messages
• 7) Latch and lock sensor signals
• 8) Disposable type sensor signals
• 9) Air-in-line sensor signals
• 10) Pressure sensor signals
• 11) Voltage reference signal
• 12) Real-time clock data and signals
• 13) History log data
• 14) Error log data
• Processing Features
• 1) Perform power-up and run-time hardware self-tests necessary for its own safe operation.
• 2) Keep the hardware watchdog circuit from timing out.
• 3) Process received serial command messages, and send serial status messages.
• 4) Provide means to pump at a specified rate or deliver a bolus of a specified volume.
• 5) Provide means to detect a high pressure condition.
• 6) Provide means to perform hardware self-tests, and report the results on the display or via serial messages.
• 7) Provide means to perform additional interactive diagnostic hardware tests. (e.g., for the keypad, display, beeper, disposable sensors, and air-detector).
• 8) Provide means to perform an interactive, non-recoverable motor safety circuit check.
• Outputs
• 1) Audible indicator control signals
• 2) Visual indicator control signals
• 3) Display text
• 4) Motor control signals
• 5) Watchdog strobe signal
• 6) Latch and lock sensor power control signals
• 7) Disposable type sensor power control signals
• 8) Air-in-line sensor test signal
• 9) Serial messages
• 10) Real-time clock data
• 11) Delivery, status, and configuration parameters
• 12) History log data
• 13) Error log data
• PC software is provided which controls pump hardware testing via a direct serial connection. Various inputs, processing features, and outputs are provided:
• Inputs
• 1) Key presses
• 2) Mouse presses
• 3) Serial messages
• Processing Features
• 1) Communicate with a pump via a serial link.
• 2) Provide means to query a pump for diagnostic information.
• 3) Provide means to instruct a pump to perform hardware and functional tests.
• 4) Control an infusion pump analyzer.
• 5) Provide means to print and store to disk the results of pump hardware tests.
• Outputs
• 1) Audible indicator control signals
• 2) Display text
• 3) Serial messages
• 4) Disk files
• PC software is provided which changes resident pump applications and utilities via a direct serial connection. Various inputs, processing features, and outputs are provided:
• Inputs
• 1) Keyboard input
• 2) Mouse input
• 3) Serial messages
• 4) Disk files
• 5) Manual or electronic order-entry information
• Processing Features
• 1) Send command messages to a pump through the serial port and receive status messages back.
• 2) Query a pump to determine its serial number and which applications and utilities reside in the pump by program ID.
• 3) Provide means to read application or utility software from a disk file, instruct a pump to load the program into a certain program slot, and send it to the pump.
• 4) Provide means to instruct a pump to enable/disable a certain application or utility.
• 5) Maintain pump-tracking information disk files which list all application-changing activities by pump serial number.
• 6) Display status messages when communicating with a pump and loading a program.
• 7) Provide means to input the manufacturing parameters, instruct the pump to store the data, and send it to the pump.
• 8) Provide means to load pump programs corresponding to order-entry information.
• Outputs
• 1) Audible indicator control signals
• 2) Display text
• 3) Serial messages
• 4) Disk files
• 5) Manual or electronic pump-tracking information
• Pump to Pump Communication Systems and Methods
• Referring now toFIG. 5 generally, and toFIG. 9 specifically, asystem203 of communication between a local drug pump200 (or caregiver pump) and a remote drug pump100 (or patient pump) is shown. Insystem203,local pump200 is functioning as a caregiver pump for use by the caregiver at thesite300 where the caregiver is located, such as the caregiver's office.Site300 may be the caregiver's home, during on call periods, or even the caregiver's automobile, if the automobile is provided with some communications capability for sending and receiving signals with respect to another site. Insystem203, thecaregiver operating pump200 is typically a nurse, physician, therapist, or other medical personnel.
• Insystem203,remote pump100 is functioning as an ambulatory patient pump for pumping drugs to the patient and is located with the patient at a site remote fromcaregiver pump200, such as at the patient'shome302. Also,site302 may be the patient's workplace.
• Pumps100,200 each include a pumping mechanism which is capable of pumping fluid from a fluid reservoir to a patient. Specific components ofpatient pump100 are shown in greater detail inFIGS. 1-4 and8.Caregiver pump100 is preferably identical topatient pump200 with respect to the features shown inFIGS. 1-4 and8.
• Bothcaregiver pump200 andpatient pump100 can be utilized for pumping or delivering a drug to a patient when the respective pump is interconnected to the patient.Pumps100,200 are preferably identical with respect to the electrical and the mechanical fluid pumping functions. One advantage of this is thatcaregiver pump200 can be an unused sparepatient pump100. As will be discussed below, the respective control systems ofpumps100,200 may be programmed differently to operate in the appropriate desired manner during pump to pump communications. As will also be discussed, this programming can be done locally or remotely. Preferably, pumps100,200 include appropriate programs to operate either as a master pump or as a slave pump during pump to pump communications. In some cases, the programs in each pump that control operation of the pumping mechanism will be different. This will also be discussed in more detail below.
• Pumps100,200 each include operator input structure for permitting an operator of the respective pump to communicate with the control system of the pump, specifically the internal processor of the pump and the information in the internal memory. In the preferred embodiment, a plurality ofoperator keys304 oncaregiver pump200 are provided for pressing by the caregiver. Preferably, each key has at least one function.Keys304 send a signal to the control system ofcaregiver pump200 indicative of the key pressed by the caregiver. The control system ofpump200 responds in the desired manner if an acceptable key press is made by the caregiver.
• Patient pump100 haskeys124 preferably identical tokeys304.Keys124 send a signal to the control system ofpatient pump100 indicative of the key pressed. The control system ofpatient pump100 responds in the desired manner if an acceptable key press is made by the patient.
• Caregiver pump200 includes adisplay306 for displaying selected information stored in the control system. In one preferred embodiment,display306 includes an LCD dot matrix display. LCDdot matrix display306 is interconnected to the control system ofcaregiver pump200. Display signals sent from the control system ofcaregiver pump200 permit display of information related to operation ofpump200 ondisplay306.
• Patient pump100 has adisplay126 preferably identical to display306 ofcaregiver pump200. Display signals sent from the control system ofpatient pump100 display information related to operation ofpump100 ondisplay126.
• Communication port308 ofcaregiver pump200 permits interconnection of the control system ofcaregiver pump200 to amodem310 located locally with respect tocaregiver pump200.Caregiver pump200 is interconnected tomodem310 through connection structure312, such as an RS232 serial cable.Caregiver pump200 andmodem310 may be located at the caregiver'soffice300, at the caregiver's home during on-call periods, or even at a mobile site, such as the caregiver's automobile.
• Communication port132 permits interconnection of the control system ofpatient pump100 tomodem320 withconnection structure322, such as an RS232 serial cable.Patient pump100 andmodem320 are both located remotely to caregiver pump200 andmodem310, such as at the patient's home orworkplace302, or other location remote fromcaregiver pump200.
• Communication betweenpump200 and pump100 throughmodems310,320 is over communications medium324 such as conventional telephone lines, cellular phones, fiber optics links, satellite links, microwave links, or other links.Modems310,320 preferably communicate at 9600 bps and include error correction and data compression features over conventional telephone lines.
• One advantage of the present invention is that the caregiver can communicate with thepatient pump100 using a similar pump, the caregiver'spump200. The caregiver presumably has knowledge of operation ofpatient pump100. This knowledge is useful in utilizingcaregiver pump200 to communicate withpatient pump100 to access the processor ofpatient pump100 from a remote location.
• Communication between the control system of theremote patient pump100 and the control system of the local caregiver pump200 permits remote data gathering from the remote patient pump by the local caregiver pump. Such data gathering may be useful for periodic monitoring of thepatient pump100 during use of the patient pump at the remote site. Data gathering may also be useful at the end of the patient use.
• Communication between theremote patient pump100 and the local caregiver pump200 permits troubleshooting with respect to the remote patient pump, without the caregiver being located at the same location as the patient's pump. Remote troubleshooting is useful in the case where patients are unfamiliar with the some of the more sophisticated operations of their pump. Also, remote troubleshooting using the pump to pump communication system is useful for patients who have difficulty orally communicating with the caregiver over the telephone.
• Communication with the remote patient pump40 is also useful for accessing the pump operations programs for changing or adjusting the operation of the remote patient pump from the local site, thereby saving the caregiver and the patient time from not having to make an in-person visit.
• Information programmed into the control system of the caregiver pump200 permits thecaregiver pump200 to be put into a master mode from the normal pumping mode at the appropriate time. In the master mode,caregiver pump200 sends a keyboard input signal indicative of a key304 pressed by the caregiver overport308 topatient pump100. In the master mode,caregiver pump200 receives its display signals primarily frompatient pump100 viacommunication port308. In the master mode, the key presses onkeys124 ofcaregiver pump200 do not access the memory ofcaregiver pump200 for the purposes of programming the memory ofcaregiver pump200 or selecting information for display relating tocaregiver pump200. The master mode is primarily for permittingcaregiver pump200 to communicate with the controller ofpatient pump100 for the purposes of programming the memory ofpatient pump100 or selecting information for display relating to patient pump100 from the memory ofpatient pump100. The master mode is carried out by a terminal application program inpump200.
• With respect topatient pump100, information programmed into its control system permitspatient pump100 be put into a slave mode from the normal pumping mode at the appropriate time. In the slave mode,patient pump100 receives keyboard input signals primarily fromcaregiver pump200 viacommunication port132.Patient pump100 sends its display signals fromcommunication port132 tocaregiver pump200.
• To communicate betweencaregiver pump200 andpatient pump100 overmodems310,320,caregiver pump200 is out of the normal pumping mode and in the master mode. Similarly,patient pump100 is out of the normal pumping mode and in the slave mode. In some cases, control systems with sufficient capacity may be provided where thepumps200,100 operate simultaneously in the normal pumping mode and in the master or slave modes.
• Insystem203,patient pump100 is at least programmed to be operable in two modes, the normal pumping mode and the slave mode. There typically is not a need forpatient pump100 to operate in the master mode when the patient possesses the patient pump. Further, insystem203, caregiver pump20 is at least operable in the master mode. However, situations are anticipated where it is desirable to have one or bothpumps100,200 include programs for operation in the normal pumping mode, the slave mode, and the master mode. In some cases,caregiver pump200 may be an unused patient spare. At a later date, the unused patient spare may be needed as a patient pump. This would require the slave mode operating program, and a particular normal operation mode program suitable for the patient. It may be more efficient for the caregiver if the controller of eachpump100,200 is preprogrammed to include both the master mode program and the slave mode program. The selection of master or slave mode may be made by the caregiver by preconfiguring the patient'spump100 to enter the slave mode during pump to pump communication, and not enter the master mode. The caregiver would have the capability to preconfigure thecaregiver pump200 to only enter the master mode during pump to pump communication, and not the slave mode if the caregiver desired. At some point later in time, the caregiver could reconfigure thecaregiver pump200 to only enter the slave mode during pump to pump communications if thecaregiver pump200 was needed as a patient pump.
• Insystem203 ofFIG. 9 which shows linkingcaregiver pump200 topatient pump100, the caregiver is able to access the control system ofpatient pump100, make various inputs using the caregiver'spump200, and receive back display inputs frompatient pump100 such that the caregiver can see the display inputs on thedisplay306 ofcaregiver pump200. Such communication can occur when thepatient pump100 is located at a remote site fromcaregiver pump200. This is particularly advantageous in saving resources by reducing the number of in-person visits between the caregiver and the patient.
• In one embodiment, disabling structure is provided with respect to caregiver pump200 for disabling the pumping mechanism ofcaregiver pump200 such that during pump-to-pump communications, the pumping mechanism and pumping protocol is suspended. Similarly, forpatient pump100, disabling structure is provided to suspend the pumping mechanism and the pumping protocol ofpatient pump100 during pump to pump communications. This may be necessary due to processor capability limitations. This may also be a safety feature to prevent a caregiver from starting operation of the patient's pump from the remote site. However, in some situations it may be desirable forcaregiver pump200 to begin operation of the pumping mechanism ofpatient pump100 at a site remote from the location of the caregiver during pump to pump communications. If a suitable controller is provided, it may be possible to operate the pumping mechanism ofpatient pump100 whilepatient pump100 is communicating withcaregiver pump200. Suspension of operation allows the caregiver to see how the pump is configured. The pump is restarted after the pump is disconnected from pump to pump communications set up.
• Referring now toFIG. 12A, aflow chart380 is shown illustrating one preferred operational sequence ofpatient pump100 with respect to the normal pumping mode and the slave mode.FIG. 12B is aflow chart382 illustrating one preferred operational sequence ofcaregiver pump200 with respect to the normal pumping mode and the master mode.FIGS. 12A and B illustrate the operational sequences for each pump with respect to normal pumping operations mode, or pump to pump communications operations mode (slave and master modes).FIGS. 12A and B specifically show the sequences with respect to communicating the key input signals and the display signals between the pumps. If a caregiver wanted to monitor or program a patient'spump100 over thephone line324, the caregiver and the patient would first contact each other, such as by voice communication over thetelephone326,328, as shown inFIG. 9, to begin initiation of pump to pump communication.Telephones326,328 may be conventional telephones including means for dialing another phone, and a handpiece or other device for permitting voice communication with the party on the other end. Prior to initiation of pump to pump communication, bothpumps100,200 are in the normal pumping mode.
• FIG. 13 is a preferred operational sequence shown asflow chart384 for pump to pump communication.Caregiver pump200 is operated in the master mode or terminal application in accordance withsequence386. This program can be resident onmemory184 ofpump200. Once the cable is attached tocaregiver pump200, thepump200 is ready for pump to pump communication. The caregiver instructs the patient on the upcoming procedures. Both the caregiver telephone and the patient telephone are linked to thelocal modems310,320.Patient pump100 is operated in accordance withsequence388. After thecable322 is connected topatient pump100, a message is displayed onpatient pump100 “CONNECT TO PHONE.” The patient is asked to verify the screen display, wait for a tone, and then hang up. The patient selects the “CONNECT TO PHONE” option, listens for tone and then hangs up. Once the caregiver hears the tone frompatient pump100, the caregiver presses a key304 oncaregiver pump200. A communication link has been established. The caregiver can review or modifypatient pump100.Patient pump100 displays a standard message and all key beeps are suppressed. When the caregiver has completed the desired communication withpatient pump100, the caregiver logs off.Patient pump100 activates an alarm. Thedisplay126 instructs the patient to remove thecommunications cable322. The “suspended” status ofpatient pump100 is removed, and the pump resumes normal pumping operation. The caregiver can call the patient back, if desired.
• The terminal application program shall be written such that it can stand alone incaregiver pump200 which does not contain any patient pumping application program. The caregiver has the option of running a printing program on the terminal application program which prints the terminal application communications record consisting of the history of at least one pump to pump communication session withpatient pump100. This data can be saved immediately after logging on topatient pump100. Such data may include: the time and date of log on and the serial number of the pump running the terminal application program; information concerningpatient pump100 including the model number, the serial number, and the identifier of the pump application program running inpatient pump100; information concerning the specific application program running inpatient pump100 including the type of cassette attached to the pump, the status of the latch, the status of the lock, the status of the external power source, the status of the air detector, and the run/stop status of the application program. A terminal application communications record can be generated at the time of logging off including the same type of data noted above. The terminal application communications record can also include the last error code ofpatient pump100. Also, the terminal application communications record may include the pump's current time, the pump's current date, the pump's event log, the pump's error history, the pump's hardware I.D., and the pump's 9-volt battery state. In the case of a patient controlled analgesic therapy, additional reports can be generated including any demand dose or clinician lock level.
• When the software ofcaregiver pump200 detects the communication cable has been connected, the caregiver shall be presented with two connection choices, a communications mode, and a printer mode. The communications mode allows communication with a pump. The printing option allows the caregiver to print an event log including a descriptive name of the report, the name, model and serial number of the pump, the time and date the report was printed, the active application program, a label placed to write the patient's name, the patient's identification number, and the name of the drug being infused.
• Automatic selection of the slave mode and stoppage of the normal pumping mode inpatient pump100 is provided using suitable logic circuitry and sensor structure, such assensor198 inFIG. 4A, to sense the presence ofcable322. Automatic selection of the slave mode and stoppage of normal pumping mode by insertingcable322 intopatient pump100 is useful since it eliminates one or more keyboard entries that might otherwise be necessary by the patient or caregiver to placepatient pump100 in the slave mode from the normal pumping mode. Alternatively, the patient may have to hit apredetermined key124 or flip a suitable switch to exit the normal pumping mode and enter the slave mode if no automatic selection of the slave mode and automatic stoppage of the normal pumping mode is provided.
• Sensor198 may include two spaced apart pins which engage thecommunication cable322 to activatesensor198 when thecable322 is operatively positioned incommunications port132. Closure of the loop sends a suitable signal tomicroprocessor182 that thecable322 is present and pump-to-pump communications is desired, i.e. the slave mode operations program.
• The operating system ofcaregiver pump200 shall allow the pump to be placed in the caregiver mode of remote programming from the normal pumping mode of operation. Automatic selection of the master mode and automatic suspension of the normal pumping mode incaregiver pump200 is provided using suitable logic circuitry and sensor structure to sense the presence ofcable320, such as with a similar sensor tosensor198 ofpatient pump100. Alternatively, the caregiver may have to hit apredetermined key304 or flip a suitable switch to exit the normal pumping mode and enter the master mode if no automatic selection linked to insertion of cable30 is provided.
• Patient pump100 sends its current display to caregiver pump200 once the pumps are first linked together. In pump to pump communications, the control systems are preferably menu driven and the current display lets the caregiver see the current status of thepatient pump100 before the caregiver begins to send key input signals topatient pump100 to obtain the desired information from the patient pump. Following the display ondisplay306 of the current information ondisplay126,caregiver pump200 receives its displays sent to caregiver pump200 in response to the key inputs to caregiver pump200 which are sent topatient pump100.
• Instead of an automatic initiation of the modem link to patient pump100 operating in the slave mode, the caregiver and the patient could both hang up their respective phones after the modem cables were connected.Patient pump100 is programmed to instructmodem320 installed at the patient's home to answer the phone the next time it rings. The patient would then wait for the caregiver to call back.Caregiver pump200 is programmed to instructmodem310 to call the patient back. Oncemodem310 is connected withmodem320, communication between the respective controllers is provided with respect to key input signals and display signals.
• In one embodiment, display126 ofpatient pump100 displays everything that is sent to display306 ofcaregiver pump200. In another embodiment, the control system ofpatient pump100 is programmed to include a blocking program to block some or all of the information that is sent to the control system ofcaregiver pump200 from the controller ofpatient pump100 from being displayed ondisplay126 ofpatient pump100 during pump to pump communication. This may be advantageous in keeping some information from the patient, such as controller access codes used to access the processor ofpatient pump100 via thekeys124, orkeys304 during pump to pump communications.
• If the communication session were interrupted by a bad phone line,patient pump100 might remain unchanged or partially programmed. During programming ofpatient pump100,caregiver pump200 could get a continuously updated status report frompatient pump100 through appropriate programming incaregiver pump200 andpatient pump100. The caregiver could review the status report after disconnecting the pump from the modem to verify thatpatient pump100 had been programmed as desired by the caregiver.
• The control system of eachpump100,200 controls operation of therespective modem310,320 attached as a peripheral device. The control system of eachpump100,200 instructs its respective modem to go off-hook and disconnect the phone at the initiation of pump-to-pump communications.
• The control system of eachpump100,200 may be provided with masking programs to mask thekeys124,304 which are inactive during pump to pump communication.
• Attempting to start thecaregiver pump200 is one method of signaling to the control system to terminate the pump-to-pump communication. The control system ofcaregiver pump200 begins the disconnection sequence with respect tomodem310. The control system ofcaregiver pump200 further requests thatpatient pump100 begin the disconnection sequence with respect tomodem320. Alternatively, pressing another key such as a HELP key can begin a disconnection sequence.
• In some applications, the control system ofpatient pump100 is locked, at least partially, via an access code program to prevent the patient from altering the pump operations program or from accessing other information in the memory. In one preferred embodiment, the caregiver can unlock the pump lock ofpatient pump100 from a remote location via the pump to pump communication system. Preferably, the caregiver can then relock the pump lock ofpatient pump100 after the caregiver has adjusted or changed the pump operations program. Automatic relock program means may be provided to automatically relock the control system at the conclusion of the caregiver's access of the control system to change the operating programs.
• In one possible embodiment, locking thepump100 is accomplished through various lock levels that are used to limit patient access to certain programming and operating functions. Each lock level provides a different level at which the user can interact with thepump100. Each programming and operating function is executed by predetermined key strokes. If a function is not available at the lock level that is set, the microprocessor will ignore the predetermined key strokes if pressed.
• One embodiment of thepump100 has three lock levels—LL0, LL1, and LL2. When thepump100 is in LL0, the user can access all programming and operating functions of thepump100. LL1 permits limited control of the programming and operating functions. LL2 permits only minimal access of programming and operating functions. When thepump100 is running, it is usually in a predetermined lock level that offers some security against an unauthorized person from reprogramming thepump100, either LL1 or LL2.
• FIG. 14 is aflow chart401 that shows the operation of the autolock feature of thepump100. When programming thepump100, the user must stop thepump100 from operating. At this point, thepump100 is typically in the predetermined lock level, usually LL1 or LL2. The user must then change the lock level to LL0 in order to gain access to programming functions. When changing the lock level to LL0, the user must execute a predetermined sequence of key strokes including entering a password and indexing the lock level until it reaches LL0.
• The user can then reprogram thepump100. Programming in this sense is not changing the actual programming code loaded in thepump100, but is rather launching a new application program from the flash memory or changing operating parameters such as dosages and delivery rates. After programming is complete, the user can press the START/STOP key, one of the keys of thepump100, which will restart thepump100. When the START/STOP key is pressed, thepump100 will automatically return to the predetermined lock level.
• In the past, the user had to manually reset the lock level to its predetermined level. Otherwise, the lock level would stay at LL0 when thepump100 was restarted and given to the patient. In this situation, an unauthorized person could access programming and operating functions in thepump100 and change parameters such as delivery dosage and delivery rates. Thus, the present invention is advantageous because it eliminates this risk by automatically returning thepump100 to the predetermined lock level when it is restarted.
• In an alternative embodiment of the present invention, thepump100 will not automatically enter the predetermined lock level if the caregiver manually sets the lock level prior to pressing the start button to restart thepump100. Rather, thepump100 will remain at the manually set lock level. This feature is advantageous because it allows flexibility in resetting the lock level after thepump100 is reprogrammed. Another alternative embodiment of the present invention permits the caregiver to turn the automatic lock level feature on and off.
• Referring now toFIG. 10 specifically andFIG. 6 generally where an alternative embodiment is shown, the schematic diagram ofFIG. 10 illustrates acommunication system402 for communication betweenpump404 andcomputer204, both located at caregiver'soffice406. Pump404 may be a caregiver pump, likecaregiver pump200, or a patient pump, likepatient pump100.
• FIG. 10 also illustrates communication between apatient pump100, located at the patient'shome302, and bothcomputer204 and pump404. It is to be appreciated that in some applications, pump404 may not be present. Also, it is to be appreciated that in some applications pump100 may not be present. In either of those applications,computer204 would be communicating only with the remaining pump.
• An example ofcomputer204 includes an 80386 INTEL microprocessor, with 2 megabytes of RAM and operated by commercially available operations software such as DOS, UNIX, and others and further programmed with application specific program functions to communicate withpumps100,404 and carry out the specified tasks desired by the caregiver. A suitable keyboard may be provided withcomputer204 to make operator inputs to the microprocessor.
• As shown inFIG. 10,computer204 may further communicate with asecond computer408 to transfer data and or programs to and fromcomputer204 overcommunications medium410, such as conventional telephone lines. For example,computer204 may be located at the caregiver'soffice406, such as a hospital. Thesecond computer408 may be located at the pump manufacturer's/servicer'sfacilities412. The second computer may receive and transmit information to a plurality ofcomputers204. This arrangement may be useful for maintaining a plurality of patient pumps100, through a plurality of caregiver'soffices406. Also, improved drug therapies may result if the pump manufacturer/servicer has ready access to patient pump usage data.
• Pump404 is preferably identical mechanically and electrically topumps100,200 described previously. In some situations, the control system ofpump404 may be programmed differently, depending on how the pump is to be used.Pump100 is typically used as a patient pump. As a patient pump, pump100 requires the normal pumping mode operating program and the slave mode operating program at minimum.
• Insystem402, pump404 may be a patient pump or a caregiver pump. As a patient pump, pump404 requires the normal pumping mode operating program and the slave mode operating program at a minimum. Pump404 as a patient pump is present at the same site ascomputer204 such as whenpump404 is brought in by the patient. In some situations, pump404 may be a patient pump that is in the caregiver'soffice406 for data gathering, trouble shooting, and/or program changes or modifications. Also, before the patient leaves the caregiver'soffice406, pump404 is present in caregiver'soffice406 for use as a patient pump in the caregiver's office. As a caregiver pump, pump404 requires the master mode operating program at a minimum. Pump404 operating as a caregiver pump may also include the normal pumping mode operating program and the slave mode operating program.
• To permit communication betweenpump404,computer204, and pump100, amodem420 is provided. Preferablymodem420 is a conventional modem for remote communication over telephone lines.
• In another preferred embodiment, modems310,320, and420 can be replaced with a digital simultaneous voice anddata modem421 that has the capability of simultaneously transmitting voice information between the patient and caregiver, and data information between the master pump and the slave pump. As shown inFIG. 11, such amodem421 includes circuitry, i.e. an A/D converter423, for digitizing the signal containing the voice information. The voice information is received from atelephone425. The digitized voice signal is then placed in aserial FIFO buffer429 at which point amicroprocessor431 will process the data to prepare it for transmission over thetelephone line433. Such processing is well known in the art and may include adding information for an error detection scheme such as checksum. In another embodiment, themicroprocessor431 might add information for packet identification. The digital signal is then passed through amodulator435 and communicated to amultiplexer437.
• Data from thepump100 is simultaneously communicated through anRS232 interface439 and then to a secondserial FIFO buffer441 at which point themicroprocessor431 will process the data for communication. The information is then passed through asecond modulator443 and communicated to themultiplexer437. Themultiplexer437 then transmits packets of information from thepump100 and thetelephone425 to aline interface445, which communicates it over the telephone line.
• One skilled in the art will realize that the digital simultaneous voice anddata modem421 at the receiving end will essentially operate in the opposite manner. One skilled in the art will further realize thatFIG. 11 merely illustrates one possible embodiment of the digital simultaneous voice and data modem. Other embodiments of the digital simultaneous voice anddata modem421 are possible. One type of digital simultaneous voice and—data modem that can be used in the present invention is the Sportster Vi 28.8 fax modem with digital simultaneous voice and data. This modem is manufactured by U.S. Robotics of Skokie, Ill.
• One advantage of using a digital simultaneousvoice data modem421 during pump to pump communications is that oral communication between the patient and caregiver is not interrupted. As a result, the caregiver can answer questions and give instructions during pump to pump communications.
• FIG. 10 also showspump404 interconnected to its own standalone printer434 interconnected withconnection structure436, such as an RS232 serial cable. Parallel communication may be used, instead of serial communication.Printer434 produces a hard copy of information stored in the control system ofpump404. In some cases,printer434 would be useable only through the communications port which connectspump404 tomodem420, as shown inFIG. 10. In other words, pump404 may not be useable simultaneously withprinter434 andmodem420. An appropriately sized control system and two communications ports would permit such usage.
• Communication betweencomputer204 and a pump, whether remotely (with pump100) or locally (with pump404) is useful for several reasons. First,computer204 may be provided with greater memory and data processing capabilities than exist with theindividual pumps100,404. Printing capabilities may be greater with aprinter438 electrically interconnected tocomputer204. Display capabilities may be greater with amonitor440 electrically interconnected tocomputer204. Also,computer204 may be useful in the recertifying operations of the pumps periodically, as required to verify operability and accuracy of the pumps.
• Computer204 also may be useful for making program adjustments or application changes in thepumps100,404, such as described in application Ser. No. 08/561,809, previously incorporated by reference. For example, drug delivery devices may be used in a variety of normal pumping modes, or applications, such as 1) pain control; 2) nutrition; 3) chemotherapy; and 4) antibiotic therapy. Other applications are possible.
• Each of the applications may involve different operations of the pumping mechanism. Each application may have one or more patient specific variations on operation of the pumping mechanism and other pump control functions. Also, some of the applications may involve some patient input, such as is sometimes the case in pain control applications. For example, if the patient is experiencing pain at a particular time, the caregiver may provide for increased dosages as needed by the patient, within specified parameters such as time and amount. In this application, the pumping mechanism needs to be operable automatically, and at the discretion of the patient, within the specified parameters. The operating program contains the appropriate pump control commands for controlling the pumping mechanism and the functions of the keys which permit patient control of the pumping mechanism. The other applications may include different pump control commands and different functions of the keys. Within each of the four applications listed above, various different pump operations programs may exist. The control system of thepatient pump100 may be appropriately programmed by the caregiver for the specific patient usage.
• It is to be appreciated that thecaregiver pump200 and thepatient pump100 do not need to include the same application program for operating the pumping mechanism. A significant advantage of the present invention is that the caregiver can communicate successively with different patients, with each patient involving a different pump application, or each patient involving the same pump application with different patient specific functions. At a minimum, it is preferred thatcaregiver pump200 includes the master mode operations program, and thatpatient pump100 includes the slave mode operations program and one application or normal pumping mode operations program for operating the pumping mechanism to pump fluid to the patient. Preferably, it is more convenient for the caregiver ifcaregiver pump200 andpatient pump100 include both the slave mode operations program and the master mode operations program, and also at least one normal pumping mode operations program.
• It is anticipated that the caregiver can locally or remotely program the control systems ofpumps100,200,404 such that the pump operates either in 1) the normal pumping mode or slave mode, or 2) the normal pumping mode or the master mode at the initiation of the pump to pump communications sequences.
• Various pump related data may be stored in the control systems ofpumps100,200. Information which may be gathered during use ofpatient pump100 includes date and time of:
• 1) Pump Error Conditions, for example, where the pumping mechanism has stopped and a suitable sensor sends a pump stoppage signal to the processor.
• 2) High Pressure Alarm for Downstream Blockages, where a suitable pressure sensor sends a high pressure signal to the processor.
• 3) Upstream Occlusion Alarm, where a suitable pressure sensor sends an occlusion signal to the processor.
• 4) Any Fluid Reservoir Removal Event, where a suitable sensor sends a reservoir removed signal to the processor.
• 5) Any Fluid Reservoir Attached Event, where a suitable signal is sent to the processor by a suitable sensor, possibly the same sensor as the sensor for sensing a reservoir removed event.
• 6) Any Internal Battery Event, where a suitable sensor senses whether the battery has been changed, is low, or is depleted.
• 7) Any AC Adaptor Event, where a suitable sensor senses whether the adapter is connected, disconnected, or unplugged from the wall outlet.
• 8) Any portable Power Pack Event, where a suitable sensor senses whether the power pack is connected, disconnected, or depleted.
• 9) Any Remote Dose Cord Event (which permits patient to remotely press a key, such as the DOSE key on the keypad), where a suitable sensor senses whether the dose cord is connected or disconnected.
• 10) Any Communications Cable Event (to permit the pump to communicate with a printer, another pump or a computer), where a suitable sensor senses whether the cable is connected or disconnected.
• 11) Anytime the Device is Successfully Stopped or Started with START/STOP key, where a suitable sensor senses whether the pump is successfully stopped or started after the key is pressed.
• 12) Any Lock Level Change and the New Lock Level, in situations where the amount of access to the processor by the patient is changed, i.e. full access, some access, no access.
• 13) Any Patient Pump Operational Program Change or Status Reset/Clear in the New Program.
• 14) Anytime the PRIME key is used and how much fluid is primed to get air out of the tubing, such as during pump start up.
• 15) Any Patient Dose Delivered and the Amount Delivered by the patient hitting the DOSE key to manually give the patient an additional amount of fluid.
• 16) Any Change in Other Features (units, time or date set, auto lock change, application change) and the New Data or State.
• 17) Anytime the Pump is Successfully Recertified.
• 18) Number of Activations of Pumping Mechanism and Duration of Use.
• 19) The status of the various other sensors ofpump100 includinglatch sensor188,lock sensor190,AC adaptor sensor228, and an air detector sensor for detecting when an air detector is attached.
• Various functions are anticipated for each of the keys on eachpump100,200. Each key has at least one function. Examples of potential functions of the different keys include:
• • 1) A NEXT SCREEN key to move through the various screens by running a next screen program;
  • 2) An ENTER/CLEAR key;
  • 3) AN UP ARROW key and a DOWN ARROW key for paging through what is displayed on the screen with a highlight bar, responding to YES/NO questions, or to page through numeric values to highlight and/or display the desired value;
  • 4) A PRIME key to run a pump prime program to prime the pump;
  • 5) A START/STOP key for operating a pump start program and a pump stop program;
  • 6) A LOCK key for providing access control to the processor through an access program;
  • 7) A DOSE key to run a patient pump control program for permitting patient control of the pumping mechanism;
  • 8) A HELP key for providing help information on the display.
    Pump Simulation Systems and Methods
• Referring now toFIG. 15, a monitor orcomputer screen450 is shown, as another embodiment of the invention. An image of pump100 (front view) is displayed onscreen450 through suitable graphics capability.Screen450 is operatively interconnected with a processor of computer system, such as the processor ofcomputer204. Theimage452 onscreen450 is able to be manipulated as if it were a pump through the use of a screen interactive program utilizing a mouse or a touch screen.Computer204 is programmed to run various programs depending on how thevarious keys454 ofpump image452 are pressed through the use of the mouse or the touch screen. This permits simulation of thepump100 with the use of acomputer204.Display area456 may then display information likedisplay126 ofpump100.
• Computer screen450 andcomputer204 are utilized to communicate with a pump located at a remote site, likepump100 ofFIG. 10. If the pump is located locally, likepump404 ofFIG. 10, then communication is direct with a straight through pass as shown inFIGS. 10 and 11.
• The arrangement involving the computer screen ofFIG. 15 is useful when the caregiver is communicating with a patient pump at a remote location or at a local location. The caregiver can more easily use the computer system since the caregiver is already familiar with the operation of a pump through the use of the keys and the display. Activating thekeys454 of theimage452 and using thedisplay456 of the pump image simulates for the caregiver the presence of an actual pump. This facilitates reductions in training time for training the caregiver to communicate with the patient's pump, since the caregiver is most likely already familiar with operation of the patient's pump.
• The computer system with the pump image program may also be used as a simulator for training the caregiver and/or the patient how to use the pump. The simulator includes various programs for simulating operation of a patient's pump to pump fluid. The simulator also includes various programs for simulating various communication situations with a patient's pump.
• As shown inFIG. 16, acomputer screen458 of a training simulator system is shown. Oncomputer screen458,pump image460 andsimulator information462 are displayed. Simulator information is used to select various conditions through simulator programs for simulating an operation of a patient pump.Pump image460 could function as a caregiver pump to permit training of a caregiver on how to use the caregiver pump to communicate with a patient pump. For example, if the caregiver trainee wanted to simulate a communications session with a remote patient pump that had a low battery, for example, the caregiver trainee would select the program insimulator information462 that would simulate a pump to pump communications situation where the caregiver would trouble shoot the patient pump to determine that a low battery situation existed. The simulator also has a simulator program for simulating at least some of the sequences to connect and disconnect the pumps according to the flow chart ofFIG. 14.
• The simulator system also includes simulation programs insimulator information462 for simulating operation of the pump on thescreen458 as a patient pump to pump fluid to a patient. This would be useful for training a patient and a caregiver how to operate the pump in the normal pumping mode.
• The present invention relates specifically to a pump communication simulator for training a pump operator comprising: a computer system including processor means, and display means electrically interconnected to the processor means of the computer system; first program means for displaying an image of the pump on the display means, the image having an input region and a display region; second program means for permitting manipulation of the input region of the image of the pump on the display means by the pump operator such that access to the processor means of the computer system is achieved; and third program means for sending a predetermined message to the display region of the image of the pump in response to manipulations of the input region of the image by the pump operator.
• Flash Memory Systems and Methods
• Flash memory240 is electrically interconnected to theprocessor182 for storing pump operation information (SeeFIGS. 8A and 8B). Theflash memory240 is electrically interconnected to thecommunications port132 to permit transfer of pump operation information to theflash memory240 from external of the pump.
• Referring now toFIG. 17,communications port132 permits the downloading of pump operation information from acomputer system470, such as a personal computer. Thecomputer system470 typically includes a processor, memory, an operator input means such as a keyboard for inputting data, a data input means such as disk, tape, or card reader, and a display means such as a monitor for displaying appropriate information to the operator ofcomputer system470.Computer system470 can also be utilized to view the pump operation information including any patient specific settings previously input to the memory inpump100 to speed the reprogramming ofpump100.
• Communication means472links computer system470 and pump100. Included in communication means472 is acable474 or other communication structureinterconnecting communications port132 ofpump100 to adevice478.Cable476 or other communicationsstructure interconnects device478 tocomputer system470.Pump100 is preferably not linked directly tocomputer system470, sincepump100 may be provided with one or more power supplies other than conventional 110 volt power supplies used topower computer system470.Device478 performs an isolation function inFIG. 17. It is desirable to electrically protectpump100 fromcomputer system470 to protectpump100 and the patient from any hazards, such as electrical shock, associated with the electrical source power forcomputer system470. InFIG. 17,device478 may communicate withcomputer system470 through an RS232 serial cable. Similarly,device478 may communicate withpump100 through an RS232 serial cable.Device478 is to be appreciated as an optional device if it is not desired to electrically isolatepump100 fromcomputer system470. In that case, an RS232 serial cable can connect pump100 andcomputer system470 directly. Alternatively, communication withpump100 viacommunications port132 can be by non-mechanical connections, such as by infrared signals transmitted to pump100 and receivable by an appropriately configured infrared signal receiver associated withcommunications port132.Device478 is also configured as a modem for use in transmitting data to and receiving data from a remote location, in addition to the structure for local communication withcomputer system470 in an isolation function, as shown inFIG. 17.
• Theoperations system480 ofFIG. 17 is useful for downloading pump operation information fromcomputer system470 to pump100. The information can be downloaded to one or more memory locations inpump100 for storage. Once the information downloading operation is complete, pump100 can be disconnected fromdevice478 andcable474. This permitspump100 to be conveniently carried about by the patient wherever the patient desires, such as around the home or around the patient's work place.Pump100 is preferred to have a disabling function for disabling the fluid delivery system untildevice478 andcable474 are disconnected frompump100. However, such operation of the pump is preferred but not mandatory.
• Referring now toFIG. 18, asecond system482 for operation ofpump100 is shown. InFIG. 18, pump100 is located at afirst site484.Computer system470 inFIG. 18 is located at asecond site486 which is remote fromsite484. Remote communication means488 permits communication between thepump100 andcomputer system470. Remote communication means488 includes afirst cable490 or other communicationstructure linking pump100 with afirst modem478a. Asecond cable492 or other communications structure linkscomputer system470 to asecond modem478b.First cable490 andsecond cable492 may be RS232 serial communication cables. First andsecond modems478a,478bmay be identical todevice478. However,modems478a,478bare not operated in the pass through configuration as isdevice478 insystem480 ofFIG. 19. First andsecond modems478a,478bpermit communication between remote sites over acommunications medium492 such as conventional telephone lines, cellular phone systems, fiber optics links, satellite links, microwave links, or other remote links. First andsecond modems478a,478bmay communicate at 9600 bps over conventional phone lines and include error correction and data compression features.
• Thesecond operations system482 inFIG. 18 is useful to download pump operation information to pump100 located atsite484 from aremote site486. Remote downloading of pump operation information is useful sincepump100 does not have to be handled by the party who is downloading the pump operation information to pump100 from the remote site.Site484 may be the patient's home or work place andsite486 may be the caregiver's office or home. Alternatively,site484 may be the caregiver's office, andsite486 may be the pump maintenance site or the pump manufacturing site.
• Device478 ofFIG. 18 permits information to be transmitted to and fromcomputer system470 located either locally withpump100 or remotely to pump100. If one mode of communications is not desired, then it is not necessary fordevice478 to include apparatus for permitting both local and remote communications capability. For example, modems478a,478bmay not need local communications capability in the pass through configuration if the modems will not be used to link a local computer system with a local pump. Also, for the system ofFIG. 17, if the only communication anticipated withpump100 is local, thendevice478 need only be constructed with the local communications apparatus to permit the pass through communications with electrical protection of the pump. Finally, if electrical protection is not needed, then only an electrical connection betweenpump100 andcomputer system470 needs to be provided in general and a direct cable download can be utilized.
• Flash memory240 is utilized to store pump operation information which is accessed by theprocessor182 for operatingpumping mechanism140 and the other sensors, switches, and devices ofpump100.Flash memory240 permits pump operation information to be initially electrically written toflash memory240 and subsequently stored inflash memory240. Storage of the pump operation information inflash memory240 is nonvolatile in that is does not require a continuous power supply toflash memory150 to maintain the information stored in the memory. At a later time,flash memory240 can be electrically erased, and rewritten with different pump operation information.
• In one preferred embodiment, the program or programs needed to runpump100 is stored in theflash memory240. Patient specific settings forpump100 can be input viakeyboard122 orcommunications port132 and stored inflash memory240, memory associated withmicroprocessor182 orEEPROM242. Examples of patient specific settings include rate of infusion, length of infusion, bolus information, security codes, and patient weight and sex. It is preferred to store such patient specific pump operation information inEEPROM242 or other memory location other thanflash memory240 due to limitations offlash memory240 with respect to the number of times the memory can be erased and rewritten. Since the patient specific information is typically frequently changed in many of the anticipated uses ofpump100, it is not desirable to store this type of information inflash memory240.Port sensor198 can be used to appropriately direct incoming data to the proper location by sensing when a cable is present. If not present, pump100 will look to itsinternal memory184 for the information needed to run the pump andkeyboard122 for patient settings if not already entered.
• Static RAM244 can be utilized to store some information relating to operation of the pump. Typically, intermediate information concerning pump operations is stored in thestatic RAM244. Intermediate information may include calculation results from the pump operations program performed bymicroprocessor182. Pump usage information regarding pump operation events may be stored instatic RAM244, such as the number of start and stop events, the number of cassettes attached, and the total dosage pumped. An additional location for storage of pump operation information is the memory associated with thereal time clock246.
• Flash memory240 preferably includes a boot program which is preferably non-erasable. The boot program permits initialization and loading of pump operation information to thepump100 viacommunications port132. Further,gate array257 and/orflash memory240 includes appropriate programming to handle incoming data fromcommunications port132 orkeyboard122 wherein the information is directed to the proper storage location if the information is not to be stored inflash memory240. For example, remote programming may be utilized to enter the patient specific information intocontrol system180. The patient specific information may be entered initially or when changes occur over time due to changes in the specific therapy needed. For example, if the patient's condition improves or worsens, changes may need to be made in the specific patient settings. Theflash memory240 may include the appropriate program or programs to direct storage of the patient specific settings to the appropriate memory device incontrol system180.
• Flash memory240 is an embedded memory associated withcontrol module102. Once installed incontrol module102,flash memory240 is not removed frompump100.Flash memory240 is electrically erasable and reprogrammable and does not require power to maintain the contents of its memory. A variety of flash memories may be used forflash memory240. An example of one preferred flash memory that is usable inpump100 is by Intel Corporation, and identified as 28F008SA 8 MBIT (1 MBIT×8) Flashfile™ memory. Such memory is useful inpump100 for handling pump operations information associated with the various features provided onpump100. The Intel product is useful in that it includes separately erasable and reprogrammable blocks of memory, at least one of which can be blocked from erasure once programmed with the desired information.
• Pump100 may be utilized for a variety of different therapy types or applications. For example, pump100 may be used as a pump in: 1) a pain control therapy, or patient controlled analgesia; 2) a nutrition therapy, or total parenteral nutrition therapy; 3) a chemotherapy program or therapy; or 4) an antibiotic therapy. Other applications are possible. All of these can be resident onpump100, or they can be uploaded to pump100 on an as needed basis. The different applications may involve different operations ofpump mechanism140 and the other switches, sensors, and other devices inpump100. For example, the volume of fluid per unit time pumped by thepumping mechanism140 may be continuous or it may be changed over time. A bolus amount (increased dosage) pumped by thepumping mechanism140 may be provided once or at periodic intervals. The bolus amounts and/or the bolus intervals may be varied over time. The patient may be given limited ability to increase the dosage when the patient desires by causing extra activations of thepumping mechanism140 through a dose key.
• As another example, there may be lock out access to the patient wherein various keys ofkeyboard122 are inoperative such that the patient cannot change the therapy prescribed by the caregiver unless the caregiver removes the lock out feature. Each application may have different lock out features.
• Calculations by the processor may be needed to achieve a certain total dosage over a certain time even though the patient may be able to increase the dosages at one or more times during the therapy. Inputs to pump100 may include reservoir size, activation amount, and/or drug concentration. In some cases, it is desirable forpump100 to calculate the desired number of activations and intervals to achieve a certain drug level in a patient having a certain sex and weight. Each application may involve different calculations performed bypump100.
• Other sensors, switches, and devices ofpump100 may be operated differently in different therapies. The pump control program stored in the memory ofpump100 includingflash memory240 includes information relating to the various aspects ofpump100 needed to deliver the appropriate therapy. In onepreferred pump100,flash memory240 contains the general application or operating program (such as pain, nutrition, antibiotic, or chemotherapy) which is accessed byprocessor182 during usage ofpump100. Only one application be stored inflash memory240 as a safety precaution against the caregiver or the patient inadvertently running the wrong program. Alternatively, a plurality of different applications can be stored inflash memory240 to allow selection of the desired application for the patient's needed therapy. Also, the other pump function programs can be stored inflash memory240, such as the programs necessary for pump to pump communication or other administrative functions. Also, variations in the display language can be stored inflash memory240 so as to display messages in a desired foreign language.
• The patient specific information needed to operatepump100 for the specific application is stored in the memory associated withmicroprocessor182 and is utilized by theprocessor182 when needed with respect to the pump applications program. Any intermediate calculation information or other pump information, including specific pump usage information, may be stored in any of the various memories.Static RAM244 provides a useful memory location for storage of the intermediate information.
• Pump100 can be programmed fromcomputer system470 in a variety of different ways. In one method,computer system204 can include a single pump application program stored in its memory. The caregiver or pump supplier would load the pump application program fromcomputer system204 toflash memory240 ofpump100. Alternatively,computer system204 can include a plurality of different pump application programs. The caregiver or pump supplier can select the desired program to be loaded toflash memory240 ofpump100. Alternatively,computer system204 can include one or more pump application programs that each include options for selection by the caregiver or pump supplier for each pump application program. Once the options are selected, the caregiver can load the pump application program generated by the caregiver toflash memory240 ofpump100. In the above methods, it is anticipated that the caregiver would not generate the code for the pump application program. The code would be supplied by the pump supplier or other programming specialist. This is a safety feature as well as convenience to the caregiver. The caregiver need only be familiar enough withcomputer system204 to set up the link to pump100 and then select and download the appropriate pump application program. It is to be appreciated that, in some cases, the caregiver will have sufficient expertise to generate the code for the pump application program. Similar safety and convenience features are present with respect to any programming of the patient specific parameters downloaded fromcomputer system204. User prompts are preferably provided for requesting the caregiver to enter the particular settings when entered viacomputer system204.
• Flash memory240 is used to advantage inpump100. Unlike removable memory devices, there is no large opening in the pump housing associated with the memory which needs to be protected from tampering, contaminants or moisture. No fragile parts are accessible viacommunications port132 from a mechanical protrusion as they would in the case of card readers having relatively large openings to receive the card. Thecommunications port132 is relatively easy to protect from contaminants and moisture. There is also no loose cartridge or card that could be dislodged, tampered with, damaged or lost. The patient or the caregiver does not need to be concerned that the removable memory device, such as the card or cartridge, is properly positioned in the opening in the pump as in the case of pumps utilizing the separate memory cards or cartridges. This is especially important when the patient is using the pump in an unsupervised location. Should a card or cartridge become dislodged from the pump, there is a concern that the pump would cease operation and the patient would be unable to restart the pump. The use offlash memory240 eliminates these problems.
• Another advantage offlash memory240 is that neither the caregiver nor the patient needs to maintain any separate memory cartridges or cards for different therapies. There is no need for the caregiver to keep track of any cards, cartridges or other pieces separate from the pump. Disposal or destruction of outdated cards is no longer a problem. Since no card or cartridge reader needs to be provided, there is a reduction in the size ofpump100.
• Another advantage of providingflash memory240 is that there is no need to open up the housing and remove a chip or other wired-in-memory device in order to reprogram the pump. Changes to the applications stored onflash memory240 are done electronically via the input/output communications port132. Virtually any programmed function ofpump100 can be electrically changed if desired. As yet undeveloped improvements can be added as they are completed. Caregivers do not need to worry about their pumps becoming obsolete as long as new operating programs are developed. There are no mechanical changes needed for the memory connections to the rest of the pump control system when the flash memory is reprogrammed. Handling of the new chips prior to and during installation is no longer a concern. Disposal or destruction of the old chips is no longer a problem. Applications updates needed by the caregiver can be handled via a floppy disk mailed to the caregiver whereby the caregiver can download the updated program to the pump or the inventory of pumps maintained by the caregiver. Alternatively, the applications updates can be transmitted over the telephone lines via modems to the caregiver. No special expertise is needed to reprogram as is the case of pumps where chips must be removed and replaced to change the memory.
• Pump100 provides system of pumping fluid to a patient wherepump100 is very flexible in how thecontrol system180 operates. Unlike pumps using EPROM memory for storing the pump operating program, pump100 withcontrol system180 is easily changeable as needs and circumstances change. No chips need to be removed or specially handled to reprogram. At the same time, pump100 is tamper resistant, contamination resistant, and reliable during operation, unlike pumps with replaceable cards.
• A further advantage offlash memory240 is the ability to remotely programflash memory240. Such remote programming is not possible with cards or cartridges which need to be changed, or replaceable EPROMs which need to be physically handled and reprogrammed. Remote programming can be done initially prior to the first use of the pump or at a later date after initial operation of the pump. The applications can be easily reprogrammed if a bug is identified or if improvements are made in the application program. Applications updates needed by the caregiver can be handled via the telephone lines. Also, changes can be made to the operating program midway through the therapy to address changes in the patient's condition.
• Another advantage of the present invention is that custom programs for caregivers who desire particular operating programs for their inventory of pumps are possible through the use offlash memory240. Individual patients may require a custom program.Flash memory240 permits the custom program to be quickly downloaded to the patient either locally or remotely viacommunications port132. Once the patient no longer needs the custom program, the pump is easily electrically reprogrammed viacommunications port132.
• Flash memory240 has sufficiently large memory capability to store the operating program needed to runpump100, including all of the sensors, switches, and devices.
• Since a caregiver can reprogram thepump100 when the pump is needed for a different application, less inventory of pumps is required by the caregiver.Flash memory240 permits each pump to be utilized in more than one application over time depending on the immediate needs of the patients. Also, pump100 may be simpler to operate if only one application is stored in the memory ofpump100. With only one application program stored in the memory, it is not possible for the wrong application program to be selected, oncepump100 is properly programmed. This is a safety feature for protecting the patient from inadvertently receiving the wrong therapy even though a correct drug cartridge is attached. Blocks offlash memory240 can be used to store different applications for selection by the caregiver or patient.
• In some illnesses or treatments, a patient may desire successive different uses ofpump100. For example, some chemotherapy programs are preceded by a nutrition therapy to build up the patient's reserves of fluids or other nutrients. In that case, the memory ofpump100 does not need to simultaneously store both a nutrition therapy application and a chemotherapy application. In that case, the patient would utilize pump100 with a nutrition therapy application programmed intoflash memory240. At the appropriate time,flash memory240 could be reprogrammed with the chemotherapy application. Alternatively,flash memory240 can include all the necessary programs, and the caregiver or patient can select the desired program at the appropriate time.
• Keyboard122 can intentionally be provided with a limited number of keys to keep operation ofpump100 throughkeyboard122 simple. However, some applications and even some patient specific settings may involve numerous inputs such that the use of a standard keyboard, throughcomputer system204 may be advantageous. Downloading of this information from acomputer system204 is useful since all of the inputs of information can be made through a standard keyboard ofcomputer system204. The present invention provides the caregiver with the ability to download just applications toflash memory240, or applications toflash memory240 and patient specific settings to the other memory locations without entering information throughkeyboard122.
• Since reprogramming offlash memory240 can only take place with acomputer system204, electronically monitoring the status of the pumps is easier. An updated status check, using appropriate status check program means stored incomputer system204 and/or in pump100 (for example stored in flash memory240), can be made of the pump each time there is an application download to theflash memory240 or each time thepumps100 are returned to the caregiver after use. The status program means for tracking pump status can help monitor the pumps which are configured for specific types of therapies. The status program means can also include patient name, address and telephone number, and pump location. There are advantages for caregivers and/or pump suppliers to have quick access to status reports on the configuration of the inventory of pumps maintained by the caregiver or supplier. The caregiver or supplier may need to quickly identify particular pumps in case a problem develops where the pumps must be recalled or reprogrammed. Use ofcomputer system204 to reprogrampump100 provides a useful way to tie in status tracking software for automatic tracking of eachpump100. The status program means can include recertification tracking program means which automatically flags pumps needed for recertification of the operating systems.
• The status program means can be general to only track pump configuration and/or time since recertification. The status program means can also download specific detailed pump operation information frompump100 tocomputer system204 pertaining to the therapy given. Examples of pump operation information that may be sent tocomputer system204 frompump100 include: drug type used, amount of drug used, type of pump operating program used, any changes to pump operating program, dates of pump usage, and a record of all pump start and stop events, number of cassettes used, occurrence of alarms, and other pump usage events. Such information is useful to the caregiver and to the pump supplier/manufacturer. Some of the relevant status information can be entered via the keyboard ofcomputer system204, instead of frompump100, at the time of programming before the therapy or at the time of reprogramming after the therapy, such as date information.
• Another advantage due to the presence offlash memory240 having to be reprogrammed with acomputer system204 is that appropriate diagnostic program means for checkingpump control system180 and other features can be downloaded toflash memory240 each time a programming operation occurs. The diagnostic program means need only be temporarily downloaded toflash memory240. The diagnostic program means runs through various checks ofcontrol system180 to verify thatpump100 and the associated switches, sensors, and devices are functioning properly. The diagnostic program means is then removed or erased fromflash memory240 and the new application program is downloaded ontoflash memory240. In this manner, any errors inpump100 can be identified each time apump100 is programmed. Such diagnostic program can be downloaded to pump100 initially beforepump100 is ever programmed to operate as a pump, or at a later date whenpump100 is reprogrammed.
• Flash memory240 allows for convenient reprogramming ofpump100 such that message ondisplay126 will be in an appropriate language that can be comprehended by the caregiver or patient. For example, messages in Spanish, Japanese or Korean may be displayed to facilitate easy use by the caregiver or patient. Reprogramming of generic pumps in this regard saves on inventory or excessively large pump memory while allowing versatility in use ofpump100.Flash memory240 also allows for convenient manufacture ofpump100 by permitting a manufacturing program to be stored inflash memory240. The manufacturing program can be erased once it is no longer needed. The program allows for the various components ofpump100 to be tested during installation.
• FIG. 8C illustrates how theflash memory240 is partitioned. Specifically, theflash memory240 includes seven program slots245a-245gfor storing a boot system program, four application programs, a terminal utility program, and a testing utility program. The application programs include a PCA application, which is for delivering drugs such as pain relief medication; an intermittent application, which is for intermittent delivery of drugs such as antibiotics; TPN application program, which is for administering fluids such as nutrients; and a continuous application program, which is for continuous administration of drugs such as chemotherapy medication. An example of intermittent delivery is described in U.S. application Ser. No. 08/540,960, which is entitled Intermittent Fluid Delivery Apparatus and Method and filed on Oct. 11, 1995, the disclosure of which is hereby incorporated by reference.
• Physically, theflash memory240 is divided into sixteen banks. Each application program occupies three banks, each utility slot occupies one bank and the boot system occupies one bank. Additionally, theflash memory240 includes acore bank247. Although the programs stored in the flash memory are separate entities, they all share thecore bank247. Thecore bank247 is used to store pump drivers, a serial communication protocol, and a portion of the pump kernel. The code stored in the core bank is shared by all of the programs.
• The boot system is formed from the boot code, the pump kernel, the pump drivers, and the serial communication protocol. The boot system controls thepump100 at power up. In one possible embodiment, tasks orchestrated by the boot system include self tests or diagnostics. The boot system also generates several screens of information while performing the diagnostics and determines if thepump100 is in a launch mode or a command mode. The basic tasks performed by the boot software include:
• 1. performing time critical initializations;
• 2. performing power up self tests necessary for its own safe operation;
• 3. keeping hardware watchdogs circuitry from timing out via the drivers;
• 4. upon detecting an error in the hardware self test, displaying an error code, storing the error code, and halting further execution;
• 5. displaying various screens of information in thedisplay126; and
• 6. determining whether to launch an application, launch a utility, or entering the command mode.
• Additionally, if no peripheral device is connected to thecommunications port132, thepump100 will enter the launch mode and the boot system will pass control to the designated or launch application program. A user can change the launch application program, which will cause thepump100 to go through a warm boot. Once the launch application program is changed, thepump100 will automatically launch the new application program upon subsequent power ups. If a peripheral device is connected to thecommunications port132, thepump100 will enter command mode and the boot system will send and receive signals via thecommunication port132.
• Each application program, such as the PCA application, includes an application template, application-specific code, a pump kernel, a serial communication protocol, and pump drivers. The application program controls thepump100 after being launched by the boot system and performs additional self tests. The pump application program then begins a review sequence during which various screens are generated and displayed showing the current values of selected application parameters.
• Upon launching an application program, thepump100 will automatically stop thepump100 so that it is not in the normal pumping mode. The caregiver can then program delivery parameters that control how thepump100 delivers fluid after it is restarted by pressing the START/STOP key. While thepump100 is running, it is in the normal pumping mode. Thepump100 will deliver fluid and keep track of delivery with status parameters while in the normal pumping mode. It is preferred that none of the application parameters be changeable while thepump100 is in the normal pumping mode.
• The pump application template is a portion of the application program that provides consistency among the various pump application programs. It defines all standard application items, and the user interface structure that each application must follow to create custom application items. Standard application items define the characteristics of each application, which are added to or supplanted by the specific application. The basic tasks performed by the pump application template include:
• 1. providing all standard menus and help screens, which are available for any specific pump application to use;
• 2. providing all standard application features, which are available for any specific pump application to use;
• 3. providing all standard application delivery, status, and configuration parameters, which are available for any specific pump application to use; and
• 4. providing all standard application alarms, which are available for any specific pump application to use.
• The application-specific code is a portion of application program that provides custom application items that are particular to the specific application. The application-specific code is used to customize the pump's100 behavior and can be programmed only while thepump100 is stopped. Custom application items may either replace or supplement the standard items provided by the pump application template. Basic tasks performed by a specific pump application include:
• 1. providing all custom menus and help screens to the kernel, including a start up menu to the kernel that lists the name and/or number of the specific pump applications;
• 2. providing all custom application features;
• 3. providing all custom application delivery, status, and configuration parameters to the kernel; and
• 4. providing all custom application alarms.
• Additionally, each application program is an event driven system. The pump drivers provide all hardware interface, and the pump kernel provides support services that include an event scheduling and a dispatching system. The serial communication protocol provides serial communication services with peripherals that are connected to thecommunications port132.
• Each application program also includes code for communication with a remote pump during pump to pump communications. The pump to pump communication code included in the application program interfaces with the serial communication protocol and is used when thepump100 is in the slave mode as described above.
• The terminal utility is formed from the terminal code, the drivers, the kernel, and the serial communication protocol. The terminal controls the external modem and one of the applications running in thepump100 via the remote serial connection during pump to pump communication. Thepump100 is in the master mode when the terminal utility is providing serial communication with a remote pump that is in the slave mode.
• The testing utility is formed from the testing code, the drivers, the kernel, and the serial communication protocol. The testing utility is a stand alone program that performs various tests on the pump hardware during closed-loop testing.
• FIG. 8D illustrates the basic configuration of theRAM244, which has four memory banks, Banks0-4249a-249d.Bank0249ais dedicated to a scratch memory.Bank1249bhas four sets of addresses dedicated to configuration parameters for one of the application programs, a set of addresses dedicated to configuration of the application template, a set of addresses dedicated to the delivery status and parameters of the launch application, and a set of addresses dedicated to kernel data.Bank2249cis dedicated to a history log.Bank3249dis primarily dedicated to the history log. However, a set of addresses inBank3249dare dedicated to kernel data.
• The scratch memory serves as a second layer of buffer that provides protection if there is a power failure while data is being written to theRAM244. During the write process, destination addresses will be designated to receive the data. However, data is first saved in the scratch memory. After the data is saved in the scratch memory, it will be saved to the destination addresses. In one embodiment, data is written to and read from the scratch memory in blocks using an error checking scheme or algorithm such as cyclic redundancy code (“CRC”).
• A first flag will be set while data is being written to the scratch memory. A second flag is set after the write process is complete at which time it is written from the scratch memory to the destination addresses. Because theRAM244 is a static RAM, either the first or second flag will be saved of thepump100 has a power failure.
• When power is returned to thepump100, the flag will be read. If the first flag is set, thepump100 either can disregard the data in the scratch memory or can complete the process of saving data to the scratch memory. If the second flag is set when power is returned to thepump100, thepump100 either can rewrite all of the data from the scratch memory to the destination address or can merely complete the write process from the scratch memory to the destination addresses.
• An advantage of using the scratch memory in this manner is that the integrity of the data is maintained while being written to the RAM, which will help minimize the risk of a pump failure or faulty information stored in the history log.
• The scratch memory is also used for system diagnostics during power up. The boot program will initially test the scratch memory, which isBank0249a. Data fromBank1249bis then transferred to the scratch memory so that thepump100 can run diagnostics on that bank. A similar procedure is followed withbanks2 and3249cand249d.
• The four sets of addresses inBank1249bfor application configuration parameters are used to store persistent data, i.e., parameters that typically remain constant when a particular application program is being used. An example of such data might include the maximum and minimum flow rates or the maximum or minimum concentration settings.
• A set of addresses for the application template configuration includes the data that is common between application programs. An application might include the lock level setting or a flag that activates the automatic lock level feature. Addresses for the delivery status and parameter of the launch program are used to store data that is not persistent, including various settings for the launch program. Examples of such data include the delivery rate and dosage. The history log is used to track various historical events such as a change in the delivery rate or when apump100 is powered up with time and date stamps.
• FIG. 8E illustrates the configuration of theEEPROM242, which is less volatile than theRAM244. Thus, theEEPROM242 is used to store data that is more sensitive than the data stored in theRAM244. Examples of such data include various look-up tables, manufacturer parameters such as the pump serial number, odometers that record data such as hours of use and amount of drug delivered, and an error log to record system faults and nonrecoverable errors. The EEPROM has sets of addresses dedicated to application configuration parameters, application template configuration parameters, launch application delivery and status parameters, kernel data, error log, and manufacturing parameters.
• Cassette Identification Systems and Methods
• This aspect of the present invention relates to systems and methods for automatically identifying acassette104 mounted to controlmodule102 ofpump100. The identification system can identify indicia on the cassette relating to the type of drug, the concentration of the drug, the volume of the fluid reservoir, or the amount of drug pumped per activation of the pump, i.e., tube size. Such information is important to safe and effective drug therapy. When the information is entered automatically to the control module, such as with the indicia identifying system, a safer and more effective system results. There is less chance for human error, as would be the case if such information were entered manually. Also, the indicia identifying system can be used to prevent operation of the pump if an unauthorized cassette is attached.
• Various cassettes are provided to be identified by the control module. The control module identifies the cassettes in one of a variety of manners, including engagement with a projection on the cassette or sensing optical signals or the absence of optical signals due to the presence of the cassette. Other structures and methods are provided to identify the cassettes such as described in U.S. Pat. No. 5,531,697 issued Jul. 2, 1996, the disclosure of which is incorporated by reference.
• FIG. 4 also shows alock sensor190 and alatch sensor188 interconnected toprocessor182.Latch sensor188 senses whencassette104 has been latched to controlmodule102 through the operator activatedlatch structure174,176 which holdscassette104adjacent control module102.FIG. 4 further showsocclusion sensors186a, binterconnected toprocessor182.Occlusion sensors186a, bare utilized to sense pressure intubing110.Occlusion sensors186a, bandlatch sensor188 are optional with respect to cassette identification. However, these sensors are used to advantage during cassette identification. These sensors can be utilized bymicroprocessor182 to identify if there happens to be a malfunction of the cassette identification system.Microprocessor182 will know whencassette104 has been mounted to controlmodule102 by receipt of a latch signal and an appropriate pressure signal (i.e., a pressure sensed within an acceptable operating range). If both upstream and downstream sensing is provided, then an appropriate pressure sensed in each location is determined before pumping can begin. At that point,microprocessor182 can begin looking for an appropriate signal fromcassette identification sensor196 for identifying indicia oncassette104. If no identification signal is present,microprocessor182 does not permit initiation or continuation of the pumping operation bypump mechanism140.Microprocessor182 may also send an appropriate error signal to display126, oralarm194.Microprocessor182 checks for a cassette identification signal periodically or continuously. Periodic is preferred as a manner of reducing energy consumption ofpump100.
• While the preferred system for identifying cassettes is by identifying a single indicia on each cassette, it is to be understood that the identification system could look for two indicia, such as two projections, for each cassette. A redundant system could still be provided in that case since the control module would request that two signals be received. Less than two or more than two would indicate an error condition. Moreover, the invention is not to be limited to three sensors. More than three, or less than three, are possible whether the systems sense the presence of one indicia, the absence of one indicia, or variations in the number of indicia sensed, such as zero, one, two, three, etc. corresponding to the number of sensors provided and the possible combinations thereof.
• Referring now toFIGS. 19-27, a preferred cassette identification system is shown.Cassette identifier sensor196 includes three reciprocally mountedplungers530,532,534 and slotted optical sensors likesensor536 ofFIG. 20. The preferred indicia oncassette104 is one or more projections to engageplungers530,532,534.FIGS. 1, 21, and22 show apreferred control module102, a preferredcassette sensing mechanism538, and a firstpreferred cassette104.FIG. 1 showsfirst cassette104 assembled and mounted to controlmodule102.FIGS. 24, 25 and27 show various side and top views of abase plate542 ofcassette104, and a perspective view of abase544 ofcassette104.FIG. 19 shows onlychassis540 with the various plungers mounted thereto.FIG. 21 is an enlarged view of a portion ofchassis540 with a slottedoptical sensor536 shown in its relative position toplunger532.FIGS. 22 and 23 show asecond cassette550 in side and top views, respectively.FIG. 26 shows a third cassette portion,base plate552, useable withbase544 ofFIG. 27 to form athird cassette554 in a similar manner asfirst cassette104. These second and third cassettes are also part of the preferred cassette identification system.Cassette sensing mechanism538 can distinguish betweencassettes104,550,554. For example,first cassette104 can have a first pumping volume per activation, i.e., 50 ml.Second cassette550 can have a second pumping volume per activation, different from the first pumping volume, i.e., 100 ml. It is critical forcontrol module102 to know how much fluid is pumped per activation of the pumping mechanism to deliver the desired drug therapy. In an improper drug therapy, either too much or too little drug can be harmful, and in some cases, fatal.
• As shown inFIG. 21,first cassette104 includesbase plate542 andbase544 mounted thereto.Base plate542 is shown in greater detail inFIGS. 24 and 25.Base544 is shown in greater detail inFIG. 27.Base plate542 is adhesively or ultrasonically attachable tobase544. Alternatively, a snap arrangement can be provided. In a further alternative, a snap arrangement and adhesive can be utilized. In a further alternative,base plate542 andbase544 can be integrally formed as a single unit, such as by molding in the case of plastics.
• Control module102 includes achassis540 and anouter housing560. Aseal562 seals betweenchassis540 andhousing560. Acomponent board564 is mounted tochassis540 viascrews566,spacers568, and alignment pins570. Afirst plunger530 is reciprocally mounted tochassis540.Second plunger532 andthird plunger534 are also reciprocally mounted tochassis540.Plungers530,532,534 are similarly configured and operated.FIG. 20 showssecond plunger532 in greater detail. Aseal580 seals an end ofsecond plunger532. Aspring582 biasessecond plunger532 to the position shown inFIGS. 19-20. Abezel584traps spring582 in position as shown. Aflange586 limitssecond plunger532 from being pulled downwardly out of the position shown inFIGS. 19-20. During operation, a projection extending from the cassette engagesend588 and causes upward movement ofsecond plunger532 such thatend590 ofsecond plunger532 moves into a new position relative to slottedoptical sensor536, which causes a signal to be sent to the processor ofcontrol module102 that a projection has been sensed.
• First plunger530 andthird plunger534 are provided for sensing additional projections. In particular,first plunger530 engagesprojection592 extending from themain surface594 ofbase plate542 offirst cassette104.Second plunger532 engagessecond projection596 extending frommain surface636 ofbase plate552 ofsecond cassette550.Third plunger534 engagesprojection598 extending frombase plate552 ofthird cassette554. In this manner,control module102 can identify at least threedifferent cassettes102,550,554.
• Referring in particular toFIGS. 21, 24,25 and27,base plate542, andbase544 are shown. Extending frommain surface594 are a pair ofhooks600 adjacent to a firsttransverse end602. Aloop538 extends from themain surface594 adjacent to a secondtransverse end604. A plurality of tube guide pairs606,608,610,612 extend frommain surface594 and are spaced apart to receive a flexible tube, in a general direction parallel to first and secondlongitudinal sides614,616 ofmain surface594. InFIG. 24, background portions have been removed behind the cross-sectional portion for clarity. InFIG. 25, atube618 is shown in dashed lines.
• Referring now toFIGS. 22 and 23,base plate556, andbase544 are shown in greater detail. Extending frommain surface636 are a pair ofhooks638 adjacent to a firsttransverse end640. Aloop642 extends frommain surface636 adjacent to a secondtransverse end644. A plurality of tube guide pairs645,646,647,648 extend frommain surface636 and are spaced apart to receive a flexible tube, in a general direction parallel to first and secondlongitudinal sides641,643 ofsecond cassette550. InFIG. 23, atube649 is shown in dashed lines.
• As shown by a comparison ofFIGS. 22 and 23 withFIGS. 24 and 25,projection592 is in a different relative location toprojection596 in a direction parallel tolongitudinal sides641,643. It should also be noted thatFIGS. 22 and 23 illustrate the integral construction betweenbase plate556 andbase544.Cassette550 also includes features for more accurate centering oftube649 which is larger thantube618, such as the V-shaped passages provided in connection with guide pairs645,646,647,648.
• Also,cassette550 includes clip features for releasablygripping tube649 to provide a mechanical hold down during adhesive attachment oftube649 tocassette550. In particular,first clip650 andsecond clip652 provide hold down oftube649 tocassette550.First clip650 andsecond clip652 hold the tube in place during assembly, allowing the adhesive to set up without the need for special clamps or external fixtures.
• Referring now toFIG. 26,third cassette554 is shown. With respect toFIG. 26, abase plate552 is illustrated.Base544 shown inFIG. 27 is useable withbase plate552 shown inFIG. 26.Projection598 is in a different relative location onbase plate552 thanprojection592 ofbase plate542 andprojection596 ofbase plate556.Projection598 can be indicative of a different cassette property to differentiatecassette554 fromcassettes550,104. For example,cassette554 may include an indication that an air filter is present to identify to the control module when the cassette is utilized with a reservoir including an in-line air filter.
• The cassette identification system ofFIGS. 19-27 may be advantageous over mechanical switches, such as microswitches, since little or no emphasis need be placed on overtravel, individual adjustment, arcing problems, and mechanical wearing of the switch. Inductive, magnetic, or reflective systems may require the placement of an additional element on the cassette during manufacture. A projection as inFIGS. 19-27 can be integrally formed on the cassette during manufacture, possibly simplifying manufacture. Force sensitive resistors may be prone to problems due to typical range of necessary movement and the typical tolerances of the disposable cassettes. Also, the plastics associated with the FSR or its spring may be subject to creep problems over time, possibly further complicating the range of motion and tolerance problems. Make or break switches where the contacts are mounted to a moveable plunger, for example, may be prone to failure due to the failure of the contact points, such as due to pitting or corrosion, or due to the components getting stuck open or closed.
• Reciprocally mounted plungers and slotted optical sensors are useful to solve some of the above possible problems and other problems with cassette identification systems. However, it is to appreciated that in some instances the use of microswitches, FSR's, inductive switches, magnetic switches, reflective elements, moving contacts, or other systems noted above may be desirable.
• Automated Testing Systems and Methods
• This aspect of the present invention concerns a system for automated testing of a pump, which includes a computer electrically connected to both a testing device and a pump. The pump is connected to the testing device by the pump's fluid tube so that a closed loop configuration is obtained. The medical device is programmed to conduct a variety of tests upon receiving commands from the computer. The testing device provides for measurement of various parameters during the performance of these tests, such as flow rate and pressure. The medical device and/or computer may be programmed to store the test results. By providing a central place for storing such information, not only can each pump be tracked as it moves from location to location, information relating to that pump can be automatically updated. With such a configuration, the testing of the pump is substantially automated.
• Referring now toFIG. 28, asystem810 fortesting pump100 is shown. Thesystem810 includes three major components: acomputer812, apump100, and atesting device814.
• As shown inFIG. 28, pump100 is connected totesting device814 viatube816, such as a flexible, compressible tube made of polymeric material. In the case of a peristaltic pump, tube engaging members of drug delivery mechanism engagetube816 to pump fluid during use.
• Major components oftesting device814 are illustrated inFIG. 29.Testing device814 is connected totube816 ofpump100 viafluid inlet818.Testing device814 includes aflow rate tester820 and apressure tester822.Flow rate tester820 tests the accuracy of the flow rate of a drug being delivered bypump100.Pressure tester822 tests the accuracy of medical device's occlusion detector186 and/oralarms194 in response to an occlusion intube816.Pressure tester822 measures the pressure generated over time untilpump100 stops,alarm194 sounds, or pump100 reaches a certain predetermined test pressure set bycomputer812.Computer812 then compares the pressure measured bytesting device814 to the pressure ofpump100 oncealarm194 sounds or the predetermined test pressure has been reached to determine pressure accuracy. In a preferred embodiment,pressure tester822 can test at multiple test pressures, such as a range from a low pressure to a high pressure.Testing device814 is equipped with afluid outlet830 for releasing the fluid which runs throughtesting device814 during or after the flow rate and pressure tests.
• Access totesting device814 is provided throughcommunications port826. Preferably,communications port826 is a standard RS232 communications port. This feature allows information being received viacommunications port826 fromcomputer812 to controltesting device814.
• Acontrol system828 is provided for controlling operation offlow rate tester820 andpressure tester822, as well as for controlling communication betweentesting device814 andcomputer812.Control system828 includes a microprocessor and associated memory for controlling operation oftesting device814.Testing device814 may also include an optional display, for displaying information, such as that related to the tests conducted byflow rate tester820 andpressure tester822.
• One preferred testing device which may be used insystem810 is an Infusion Device Analyzer (IDA) made by Ultramedic, Ltd. of Liverpool, England, and distributed by Bio-Tek Instrument, Inc. of Winooski, Vt. The IDA tests a variety of drug delivery devices, such as infusion pumps.
• As is further shown inFIG. 28, both pump100 andtesting device814 are interconnected tocomputer812 viacommunications links832 and824 to form a closed loop testing system. Preferably,computer812 is a personal computer andcommunications links832 and824 are RS232 cables.Communication links832 and824 connect tocomputer812 viacommunications ports834 and826, respectively.
• Computer812 further includes amonitor840 for displaying information related to the operation of system10, such as test instructions, test results, etc. Such information may also be delivered via hard copy printout toprinter836 attached tocomputer812.Computer812 may also include akeyboard838 for inputting information intocomputer812. Data may also be input intocomputer812 via disk, tape, or card reader.
• Computer812 preferably includes a control system for controlling operation of the computer. The control system includes at least a microprocessor and an associated memory with selected functions for controlling operation of the computer. In particular, the memory stores various programs and data needed to run the tests performed onpump100, such as those performed byflow rate tester820 andpressure tester822. Such programs and data may also be stored via disks which may be inserted intocomputer112.
• Information programmed intocomputer112 permits an operator to communicate overcommunications links832 and824 with both pump100 andtesting device814, respectively. Via communications link824,computer812 instructstesting device814 to measure the flow rate and/or pressure and requests the results of such measurements. With the addition of communications link832, however, many of the steps performed onpump100 byflow rate tester820 andpressure tester822, which would otherwise have to be performed manually, are now automated.
• Communications link832 also allows for the automation of tests other than the flow rate and pressure tests previously mentioned herein. In particular, via communications link832,computer812 can instruct pump100 to pump fluid for a flow rate test or a pressure test, or to perform internal tests, such as a self-test898 (seeFIG. 45) and a maintenance test866 (seeFIGS. 48A and 48B). Self-test898 tests the diagnostics of the medical device, such asmemory184 and motor control circuitry (not shown).Maintenance test866 tests whether operator input structure, sensors, and/oralarms194 ofpump100 is operating properly. It also tests the structural integrity ofpump100 via operator feedback, including such items as the frame of the device, any power cord, the cassette latch/lock, and any knobs or buttons. As a result of this closed loop configuration, the testing ofpump100 is substantially automated.
• Referring now toFIG. 30, a flow chart is shown illustrating one preferred operational sequence oftesting system810 as shown inFIG. 28 forpump100. The sequence assumes that all components are connected. Alternatively,computer812 could instruct the user viamonitor840 to verify the connections between components before beginning the testing process. Once all the components ofsystem110 are properly connected,system810 may begin testing.
• Specifically, at850, the system is initialized. At852, a check is made whetherpump100 successfully completedsystem initialization850. If not, at862, a message is displayed onmonitor840 ofcomputer812 detailing the error and requesting service, and at878, the testing procedures are ended. Ifsystem initialization850 is successful,system810 then conducts a series of tests, such as those performed byflow rate tester820 andpressure tester822, as well asmaintenance test864. The list of tests mentioned above, however, is not exclusive. Depending on the medical device being tested, cost constraints, and/or the testing history of the device, more or fewer tests may be performed. Moreover, as those skilled in the art can appreciate, the order in which the tests are performed is not critical.
• At854, a check is made to determine whether the flow rate ofpump100 should be tested. If so, at856,flow rate tester820 performs a flow rate test. If not, at858, a check is made to determine whether the pressure ofpump100 should be tested. If so, at860,pressure tester822 performs a pressure test. If not, at822, a check is made to determine whether a maintenance test should be performed. If so, at866, a maintenance test is performed. If not, at868, after all desired tests have been performed, a check is made whether test results should be printed. If so, at870, a signal is sent toprinter836 to start printing the test results. If not, at872, a check is made whether the test results should be recorded. If so, at874,computer112 records the results. If not, at700, the testing process is ended.
• The flow charts ofFIGS. 31-34 show more specific operational sequences of each of the tests identified inFIG. 30. The flow charts represent the communication betweencomputer812 and both pump100 andtesting device814, as well as any operator interaction withcomputer812, pump100 andtesting device814.
• Referring now toFIG. 31, which illustrates a flow chart representation of the steps in apreferred system initialization850, at880,computer112 sends a signal to pump100 requesting pump specific information frompump100. Such information may include the device type (syringe, peristaltic, volumetric, etc.), the device's serial number, the manufacturer of the device, and the date of the last test. In the case wherepump100 is dedicated to a patient for extended periods of time, such information may also include the patient's name and address, as well as the name and address of the referring physician. At882, pump100 downloads the requested information tocomputer812. Such information is useful for device tracking withcomputer112.
• At884, a check is made to determine whethercomputer812 received the information from the pump. If not, at140, a further check is made to determine whetherpump100 andcomputer812 are in fact connected. If so, at890, a message is displayed onmonitor840 detailing the error and requesting service, and at878, the testing process is ended. If not, at888,computer812 instructs the operator to connectpump100 tocomputer812, and then repeatssteps880 through884.
• If the information is received bycomputer812, at892, the operator has the option of including additional information, such as the operator's name, and the date and location of the test. If the operator chooses to add information, at180, he or she may input the information intocomputer812 viakeyboard838. If no additional information is added, at898,computer812 sends a signal to pump100 to begin self-test898. At900, pump100 sends a signal back tocomputer812 representative of the results of self-test898. At902, system initialization850 is complete.
• FIGS. 32A and 32B illustrate a flow chart representation of steps in a preferred flow rate test. In order to perform this test,system810 must be primed. Accordingly, at904,computer812 sends a signal to pump100 instructing it to start priming the system. At906, a check is made to determine whethertesting device814 is already primed. If not, at908,computer812 sends a signal to pump100 to prime the testing device. If so, at910,testing device814 sends a signal back tocomputer112 indicating that the testing device is primed.
• At912,computer812 instructs the operator to input a test flow rate.Computer812 may be programmed to provide the operator with a menu listing a variety of commonly tested flow rates from which to choose. In a preferred embodiment,computer812 may automatically commandpump100 to test the flow rate at a single test flow rate or at several test flow rates, such as in a range from a low flow rate to a high flow rate. At914,computer812 sends a signal to pump100 setting the pump at the flow rate chosen by the operator. At916,computer812 sends a signal to pump100 to start pumping. At918,computer812 sends a signal to flowrate tester820 oftesting device814 to begin the flow rate test. After a predetermined period of time, at920,testing device814 sends a signal viacomputer112 to pump100 to stop pumping. If the flow rate is automatically selected,steps912,914, and916 are not necessary.
• At922,testing device814 sends a signal tocomputer112 representative of the flow rate measurements taken by the testing device. Such measurements may include the duration of the test, instantaneous and average flow rate, and cumulative volume. It should be appreciated that signals representing real time test data can be sent tocomputer812 anytime throughout the duration of the test, provided the infusion is continuous.
• At924,computer812 compares the measured flow rate with the test flow rate to determine flow rate accuracy. At926,computer812 records the test results. At928, a check is made whether to print the test results. If so, at930 the results are printed toprinter836. If not, at932, a check is made whether other flow rates should be tested. If so,computer812 repeatssteps912 through930 until all desired testing is complete. Alternatively, the flow rate test results can be printed at the conclusion of all the test procedures (seeFIG. 44). Once all flow rate testing is complete, at934, the flow rate test is ended.
• FIG. 33 illustrates a flow chart representation of steps taken in a preferred pressure test. As withflow rate tester820,system810 must be primed in order to perform this test. Accordingly, at936,computer812 sends a signal to pump100 instructing it to start priming. At938, a check is made to determine whethertesting device814 is already primed. If not, at940,computer812 sends a signal totesting device814 to prime the testing device. If so, at942,testing device814 sends a signal back tocomputer112 indicating that the testing device is primed.
• At944,computer812 sends a signal to pump100 to start pumping. At946,computer812 sends a signal to pressuretester822 oftesting device814 to begin the pressure test.Pump100 is set to stop pumping due to an occlusion in tube when the pressure ofpump100 reaches a predetermined level due to the activation of occlusion detector186 at a predetermined pressure sensed by occlusion detector186. As previously mentioned, pump100 may also be set to pump to test one or more pre-selected test pressure settings below the predetermined level where pumping will cease.
• At948, oncepump100 has stopped pumping or has reached the predetermined pressure or pre-selected test pressure, pump100 sends a signal tocomputer812 representative of the pressure sensed by occlusion detector186. At950,computer812 sends a signal totesting device814 requesting the pressure measured by the testing device. At952,testing device814 sends a signal tocomputer812 representative of the pressure measured. It should be appreciated, however, that signals representing real time test data can be sent tocomputer812 anytime throughout the duration ofpressure tester822.
• At954,computer112 compares the pressure measured bytesting device814 with the pressure received frompump100 to determine the accuracy of the response ofpump100 to the occlusion in tube and the accuracy of occlusion detector186. In an alternate but less desirable mode of operation, the operator himself or herself can read the measured pressure and compare it to the pressure ofpump100 to determine pressure accuracy.
• At956,computer812 records the tests results. At958, a check is made whether to print the test results. Alternatively, the pressure test results can be printed at the conclusion of all test procedures (seeFIG. 44). If so, at960, the results are printed toprinter836. If not, at962,pressure test822 is ended.
• FIGS. 34A and 34B illustrate a flow chart representative of steps taken during apreferred maintenance test866. At964, a check is made to determine whether the keyboard (input structure) ofpump100 should be tested. If so, at966,computer112 sends a signal to the operator to press a key. At968, pump100 sends a signal back tocomputer112 indicating which key was pressed. At970, a check is made to determine whether the key pressed is the same as the key being tested. If not, at972, a message is displayed onmonitor840 ofcomputer112 indicating the error. At974,computer812 records the results. At976, a check is made to determine whether to test more keys. If so,steps966 through974 are repeated until all the desired keys have been tested.
• If no more keys are to be tested, at978, a check is made to determine whether to test any of the sensors ofpump100. If so, at980,computer812 instructs the operator to select the sensor to be tested. At982,computer112 sends a signal to pump100 requesting the status of that sensor. At984, pump100 sends a signal back tocomputer812 indicating the status of the sensor. At986,computer812 instructs the operator to input the status of the sensor being tested. At988,computer812 determines whether the status of the sensor is consistent with the condition inputted by the operator.
• Computer812 could instruct the operator to change the status of the sensor. For example, if the latch on the cassette door was closed, the operator could be instructed to unlatch the cassette door.Computer812 could then determine whether the status of the sensor changed accordingly.
• At990,computer812 records the results. At992, a check is made to determine whether the operator wishes to-test another sensor. If so,steps980 through990 are repeated until all the desired sensors have been tested.
• If no more sensors are to be tested, at994, a check is made to determine whether to test the structural integrity ofpump100. If so, at996,computer812 instructs the operator to input the name of the component to be tested. Alternatively,computer812 could be programmed to provide the operator with a menu from which to chose which components to test. At998,computer812 instructs the operator to inspect the component selected. This inspection may be visual and/or physical. At1000,computer112 instructs the operator to input the condition of the component. Alternatively,computer812 could be programmed to provide the user with a rating system from which to rate the component's condition. Such ratings, for example, could include: broken, damaged but operable, fair, etc. At1002,computer812 records the result. At1004, a check is made to determine whether another component should30 be tested. If so,steps996 through1002 are repeated until all desired components are tested. At1006, a check is made to determine whether to print the test results. Alternatively, the maintenance test results can be printed at the conclusion of all test procedures. If so, at1008, the results are printed toprinter836. If not, at1010maintenance test866 is ended.
• In a preferred embodiment,computer812 is also preferably programmed to provide the operator with other instructions relating to the particular component being tested, such as how to clean it, how to repair it, if possible, and other related instructions.
• While the present invention has been described in connection with the preferred embodiments thereof, it will be understood many modifications will be readily apparent to those skilled in the art, and this application is intended to cover any adaptations or variations thereof. It is manifestly intended this invention be limited only by the claims and equivalents thereof.

Claims (9)

1. A medical infusion pump, comprising:

a pump mechanism;

a programmable circuit arranged to control operation of the pump mechanism; and

flash memory in electrical communication with the programmable circuit.

2. The medical infusion pump ofclaim 1, wherein the flash memory stores a program for controlling operation of the pump mechanism.

3. The medical infusion pump ofclaim 1, wherein the flash memory stores pump parameters for defining operation of the pump mechanism.

4. The medical infusion pump ofclaim 1, wherein data is stored in blocks of data.

5. A method of programming a medical infusion pump having a pump mechanism, a programmable circuit, flash memory, and a data port, the method comprising:

transferring data through the data port; and

storing the data in the flash memory.

6. The method ofclaim 5 wherein the data comprises a pump parameter.

7. The method ofclaim 5 wherein the data comprises a pump program.

8. The method ofclaim 5 wherein storing the data in the flash memory comprises storing the data in blocks of data.

9. The method ofclaim 5 further comprising storing the data in transient memory before storing the data in the flash memory and the act of storing the data in the flash memory comprises transferring the data from the transient memory to the flash memory.

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