This application is a national stage application of PCT/IT2014/000005, internationally filed Jan. 9, 2014, which is herein incorporated by reference in its entirety.
The disclosure pertains generally to blood processing units used in blood perfusion systems.
Blood perfusion entails encouraging blood through the vessels of the body. For such purposes, blood perfusion systems typically entail the use of one or more pumps in an extracorporeal circuit that is interconnected with the vascular system of a patient. Cardiopulmonary bypass surgery typically requires a perfusion system that provides for the temporary cessation of the heart to create a still operating field by replacing the function of the heart and lungs. Such isolation allows for the surgical correction of vascular stenosis, valvular disorders, and congenital heart defects. In perfusion systems used for cardiopulmonary bypass surgery, an extracorporeal blood circuit is established that includes at least one pump and an oxygenation device to replace the functions of the heart and lungs.
More specifically, in cardiopulmonary bypass procedures oxygen-poor blood, i.e., venous blood, is gravity-drained or vacuum suctioned from a large vein entering the heart or other veins in the body (e.g., femoral) and is transferred through a venous line in the extracorporeal circuit. The venous blood is pumped to an oxygenator that provides for oxygen transfer to the blood. Oxygen may be introduced into the blood by transfer across a membrane or, less frequently, by bubbling oxygen through the blood. Concurrently, carbon dioxide is removed across the membrane. The oxygenated blood is filtered and then returned through an arterial line to the aorta, femoral artery, or other artery.
In some embodiments, the disclosure pertains to a blood processing apparatus including a housing having a blood inlet and a blood outlet, the blood inlet extending into an interior of the housing. A heat exchanger core is arranged within the housing, the heat exchanger core including a core aperture in fluid communication with the blood inlet and configured to impart turbulence to blood passing from the blood inlet to an exterior of the heat exchanger core. Heat exchanger hollow fibers are disposed about the heat exchanger core such that a heat exchanger fluid may flow through the heat exchanger hollow fibers and blood passing from the core aperture may flow across the heat exchanger hollow fibers. A cylindrical shell extends coaxially about the heat exchanger core, the cylindrical shell including an annular shell aperture disposed near an end of the cylindrical shell opposite to an end near which the core aperture is located, the annular shell aperture configured to permit blood to pass to an exterior of the cylindrical shell. Gas exchanger hollow fibers are disposed about the cylindrical shell such that gases may flow through the gas exchange hollow fibers and blood passing from the annular shell aperture may flow across the gas exchanger hollow fibers.
While multiple embodiments are disclosed, still other embodiments of the present disclosure will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the disclosure. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
The disclosure pertains to a blood processing apparatus that, according to various exemplary embodiments, includes one or more of a heat exchanger and a gas exchanger (also commonly referred to as an oxygenator). In some embodiments, the term oxygenator may be used to refer to an integrated structure that combines a heat exchanger and a gas exchanger in a unitary device. In various embodiments, for example, the heat exchanger and gas exchanger are disposed in a concentric fashion with one component located inside of the other component. According to other embodiments, the heat exchanger and gas exchanger are structurally distinct structures operable coupled to each other. In some embodiments, an oxygenator may be used in an extracorporeal blood circuit. An extracorporeal blood circuit, such as may be used in a bypass procedure, may include several different elements such as a heart-lung machine, a blood reservoir, as well as an oxygenator.
In some embodiments, a blood inlet 18 extends into the housing 12 and a blood outlet 20 exits the housing 12. As noted, in some embodiments the blood processing apparatus 10 includes a gas exchanger and thus may include a gas inlet 22 and a gas outlet 24. In some embodiments, the blood processing apparatus 10 includes a heat exchanger and thus may include a heat exchanger fluid inlet 26 and a heat exchanger fluid outlet 28 that is behind (in the illustrated orientation) the heating fluid inlet 26. In some embodiments, the heat exchanger fluid inlet 26 may be disposed at one end of the housing 12 while the heat exchanger fluid outlet 28 may be disposed at an opposite end of the housing 12. In some embodiments, the blood processing apparatus 10 may include a purge port 30 that may be used for purging air bubbles from the interior of the blood processing apparatus 10.
The positions of the inlets, outlets and purge port are merely illustrative, as other arrangements and configurations are contemplated. The purge port may include a valve or a threaded cap. The purge port operates to permit gases (e.g., air bubbles) that exit the blood to be vented or aspirated and removed from the blood processing apparatus 10.
In some embodiments, as shown in
In some embodiments, as shown in
In some embodiments, one of the heat exchanger fluid inlet 26 and the heat exchanger fluid outlet 28 may be located in the first end cap 14 while the other of the heat exchanger fluid inlet 26 and the heat exchanger fluid outlet 28 may be located in the second end cap 16. In some embodiments, the heat exchanger fluid inlet 26 and outlet 28 may be located in the first end cap 14. In some embodiments, the heat exchanger fluid inlet 26 and outlet 28 may be located in the second end cap 16.
In some embodiments, the heat exchanger core 140 includes a conical deflection surface (not visible in this orientation) upon which incoming blood from the blood inlet 18 impinges. The conical deflection surface deflects the blood in a radial direction. In some embodiments, the conical deflection surface may include a divider (not shown) that assists in directing blood in particular directions. The heat exchanger core 140 includes an outer surface having one or more longitudinal ribs 153. The longitudinal ribs 153 provide mechanical support to the heat exchanger fiber bundle (not illustrated in
A core aperture 154 is formed within the outer surface 152 such that blood impinging on the conical deflection surface is deflected radially outwardly through the core aperture 154. In some embodiments, the heat exchanger core 140 may have one, two, three, four or any desired number of core apertures 154 spaced radially about the heat exchanger core 140.
In some embodiments, as illustrated, the heat exchanger core 140 includes radially disposed core ribs 152, 156. In some embodiments, the core ribs (or projections) 152, 156 deflects blood away from the outer surface of the core in a radially-outward direction. The core ribs 152, 156 are designed to impart a radial component to blood flow trajectory.
In some embodiments, the heat exchanger core 140 may also have one or more longitudinally-extending indentations 160 that are disposed ahead of the core rib 156 and one or more longitudinally-extending indentations 162 that are disposed downstream of the core rib 156. In some embodiments, a plurality of the indentations 160 and 162 are disposed circumferentially around or substantially around the outer surface 152. In some embodiments, the heat exchanger core 140 is configured to provide turbulent blood flow while providing sufficient physical support for the heat exchanger hollow fibers (not illustrated).
The indentations 160 include an angled surface 164, proximate the core rib 156, that provides a radially outward component to blood flow trajectory. The indentations 162 include a first tapered surface 166, a second tapered surface 168, a third tapered surface 170, a fourth tapered surface 172 and a bottom surface 174 that in combination assist in causing blood flow to move towards and away from the heat exchanger core 140.
In some embodiments, the heat exchanger core 240 includes a conical deflection surface (not visible in this orientation) upon which incoming blood from the blood inlet 18 impinges. The conical deflection surface deflects the blood in a radial direction. In some embodiments, the conical deflection surface may include a divider (not shown) that assists in directing blood in particular directions. The heat exchanger core 240 includes an outer surface 252. A core aperture 254 is formed within the outer surface 252 such that blood impinging on the conical deflection surface is deflected radially outwardly through the core aperture 254. In some embodiments, the heat exchanger core 240 may have one, two, three, four or any desired number of core apertures 254 spaced radially about the heat exchanger core 240.
In some embodiments, as illustrated, the heat exchanger core 240 includes a radially disposed core rib 256. In some embodiments, the core rib (or projection) 256 deflects blood away from the outer surface 252 in a radially-outward direction. The core rib 256 is designed to impart a radial component to blood flow trajectory. In some embodiments, the heat exchanger core 240 is configured to provide turbulent blood flow while providing sufficient physical support for the heat exchanger hollow fibers (not illustrated).
In some embodiments, the heat exchanger core 240 may also one or more longitudinally-extending indentations 260 that are disposed ahead of the core rib 256. In some embodiments, a plurality of the indentations 260 are disposed circumferentially around or substantially around the outer surface 252. The indentations 260 include an angled surface 264, proximate the core rib 256, that provides a radially outward component to blood flow trajectory.
In some embodiments, the heat exchanger core 240 includes a blood turbulence section 270 that is disposed downstream of the core rib 256. The blood turbulence section 270 includes several longitudinally-extending ribs 272 that are intersected by radial ribs 274. In some embodiments, the ribs 272 and the radial ribs 274 represent portions of the outer surface 252. A plurality of voids 276 are formed within the outer surface 252, in between the ribs 272 and the radial ribs 274. Blood impinging on the blood turbulence section 270 will splash off in a variety of directions, thereby improving blood flow across the heat exchanger hollow fibers (not illustrated).
The heat exchanger core 340 includes a conical deflection surface 348 upon which incoming blood from the blood inlet 18 impinges. The conical deflection surface 348 deflects the blood in a radial direction. In some embodiments, the conical deflection surface 348 may include a divider (not illustrated) that assists in directing blood in particular directions. The heat exchanger core 340 includes an outer surface 352. A core aperture 354 is formed within the outer surface 352 such that blood impinging on the conical deflection surface 348 is deflected radially outwardly through the core aperture 354. In some embodiments, the heat exchanger core 340 may have one, two, three, four or any desired number of core apertures 354 spaced radially about the heat exchanger core 340. In some embodiments, the heat exchanger core 340 is configured to provide turbulent blood flow while providing sufficient physical support for the heat exchanger hollow fibers (not illustrated).
In some embodiments, the heat exchanger core 340 includes a blood turbulence section 370 that is disposed downstream of the core rib 356. The blood turbulence section 370 includes a recessed portion 380 extending into the outer surface 352 and a grid 382 that extends across the recessed portion 380. In some embodiments, the grid 382 extends at least substantially co-cylindrically with the outer surface 352. The grid 382 may be formed of any suitable metallic or polymeric material, and may be attached to the heat exchanger core 340 in any suitable manner. The grid 382 includes a plurality of apertures 384. The grid 382 provides mechanical support to the heat exchanger fiber bundle and provides a space for radial blood flow.
The cylindrical shell 62 includes an outer surface 68. A shell aperture 70 is formed within the outer surface 68 such that blood flowing between the outer surface 52 of the heat exchanger core 40 and an inner surface 72 of the cylindrical shell 62 can exit the cylindrical shell 62. In some embodiments, the inner surface 72 of the cylindrical shell 62 may include one or more shell ribs 80 that protrude from the inner surface 72 and extend toward the heat exchanger core 140, 240, 340. The one or more shell ribs 80 deflect blood away from the inner surface 72 in a radially inward direction. In some embodiments, the one or more shell ribs 80 may, in combination with the core ribs 56 and 58, interrupt longitudinal blood flow and impart a radial flow component to blood flow through the heat exchanger, i.e., between the outer surface 52 of the heat exchanger core 40 and the inner surface 72 of the cylindrical shell 72. In some embodiments, the heat exchanger core 140, 240, 340 may also include one or more longitudinally-extending ribs 75 that may serve to create a distance between the heat exchanger fiber bundle and the cylindrical shell 72 in order to allow a radial flow path between the heat exchanger core 140, 240, 340 and the cylindrical shell 62.
In some embodiments, the cylindrical shell 62 may have one, two, three, four, five, six or any desired number of shell apertures 70 spaced radially about the cylindrical shell 62. As illustrated in
In some embodiments, the heat exchanger element 74 includes a number of hollow fibers through which a heating fluid such as water can flow. The blood may flow around and past the hollow fibers and thus be suitably heated. In some embodiments, the hollow fibers may be polymeric. In some cases, metallic fibers may be used. In some embodiments, the hollow fibers may be formed of polyurethane, polyester, or any other suitable polymer or plastic material. According to various embodiments, the hollow fibers have an outer diameter of between about 0.2 and 1.0 millimeters or, more specifically, between about 0.25 and 0.5 millimeters. The hollow fibers may be woven into mats that can range, for example, from about 20 to about 200 millimeters in width. In some embodiments, the mats are arranged in a criss-cross configuration.
In some embodiments the gas exchanger element 76 may include a number of microporous hollow fibers through which a gas such as oxygen may flow. The blood may flow around and past the hollow fibers. Due to concentration gradients, oxygen may diffuse through the microporous hollow fibers into the blood while carbon dioxide may diffuse into the hollow fibers and out of the blood. In some embodiments, the hollow fibers are made of polypropylene, polyester, or any other suitable polymer or plastic material. According to various embodiments, the hollow fibers have an outer diameter of about 0.38 millimeters. According to other embodiments, the microporous hollow fibers having a diameter of between about 0.2 and 1.0 millimeters, or more specifically, between about 0.25 and 0.5 millimeters. The hollow fibers may be woven into mats that can range, for example, from about 20 to about 200 millimeters in width. In some embodiments, the mats are in a criss-cross configuration.
As shown in
In some embodiments, the ribs such as the core ribs 56 and 58, the shell ribs 80 and/or the housing ribs 92 may extend about 10 to about 70 percent of the distance between a surface from which they extend to an opposing surface. In some embodiments, the ribs may extend about 25 to about 50 percent of the aforementioned distance. To illustrate, the core ribs 56 and 58 may extend about 10 to about 70 percent, or about 25 to about 50 percent, of a distance between the heat exchanger core 40 and the cylindrical shell 62. In some embodiments, the ribs may form an angle with the surface from which they extend that is in the range of about 30 to about 90 degrees. In some embodiments, the ribs may form an angle of about 45 to about 60 degrees. In some embodiments, the ribs may have a height that is in the range of about 0.2 millimeters to about 3 millimeters and a width that is in the range of about 0.5 millimeters to about 10 millimeters.
As shown in
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present disclosure. For example, while the embodiments described above refer to particular features, the scope of this disclosure also includes embodiments having different combinations of features and embodiments that do not include all of the above described features.
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/IT2014/000005 | 1/9/2014 | WO |
Publishing Document | Publishing Date | Country | Kind |
---|---|---|---|
WO2015/104725 | 7/16/2015 | WO | A |
Number | Name | Date | Kind |
---|---|---|---|
3339341 | Maxwell et al. | Sep 1967 | A |
3957648 | Roget et al. | May 1976 | A |
4038190 | Baudet et al. | Jul 1977 | A |
4225439 | Spranger | Sep 1980 | A |
4229305 | Fecondini et al. | Oct 1980 | A |
4597868 | Watanabe | Jul 1986 | A |
4639353 | Takemura et al. | Jan 1987 | A |
4707268 | Shah et al. | Nov 1987 | A |
4758341 | Banner | Jul 1988 | A |
4902476 | Gordon et al. | Feb 1990 | A |
5169530 | Schucker et al. | Dec 1992 | A |
5192439 | Roth et al. | Mar 1993 | A |
5192499 | Sakai et al. | Mar 1993 | A |
5270004 | Cosentino et al. | Dec 1993 | A |
5316724 | Mathewson et al. | May 1994 | A |
5338512 | Mathewson et al. | Aug 1994 | A |
5514095 | Brightbill et al. | May 1996 | A |
5578267 | Cosentino et al. | Nov 1996 | A |
5651765 | Haworth et al. | Jul 1997 | A |
5674452 | Carson et al. | Oct 1997 | A |
5733398 | Carson et al. | Mar 1998 | A |
5762868 | Leonard | Jun 1998 | A |
5762869 | White et al. | Jun 1998 | A |
5817278 | Fini et al. | Oct 1998 | A |
5817279 | Eilers et al. | Oct 1998 | A |
5830370 | Maloney, Jr. et al. | Nov 1998 | A |
RE36774 | Cosentino et al. | Jul 2000 | E |
6105664 | Gillbrand et al. | Aug 2000 | A |
6113782 | Leonard | Sep 2000 | A |
6241945 | Owen | Jun 2001 | B1 |
6454999 | Farhangia et al. | Sep 2002 | B1 |
6459937 | Morgan et al. | Oct 2002 | B1 |
6755894 | Bikson et al. | Jun 2004 | B2 |
6960322 | Stringer et al. | Nov 2005 | B2 |
7431754 | Ogihara et al. | Oct 2008 | B2 |
7947113 | Ogihara et al. | May 2011 | B2 |
7981121 | Stegfeldt et al. | Jul 2011 | B2 |
8142546 | Ogihara et al. | Mar 2012 | B2 |
8318092 | Reggiani et al. | Nov 2012 | B2 |
8388566 | Reggiani et al. | Mar 2013 | B2 |
8394049 | Reggiani | Mar 2013 | B2 |
8425838 | Mizoguchi et al. | Apr 2013 | B2 |
8652406 | Reggiani et al. | Feb 2014 | B2 |
8685319 | Olson et al. | Apr 2014 | B2 |
8795220 | Reggiani et al. | Aug 2014 | B2 |
8865067 | Olson et al. | Oct 2014 | B2 |
8911666 | Mizoguchi et al. | Dec 2014 | B2 |
9162022 | Reggiani et al. | Oct 2015 | B2 |
9402943 | Reggiani et al. | Aug 2016 | B2 |
20020039543 | Ikeda et al. | Apr 2002 | A1 |
20020049401 | Ghelli et al. | Apr 2002 | A1 |
20030080047 | Watkins et al. | May 2003 | A1 |
20030175149 | Searles et al. | Sep 2003 | A1 |
20040149645 | Sunohara et al. | Aug 2004 | A1 |
20040175292 | Ghelli et al. | Sep 2004 | A1 |
20040251011 | Kudo | Dec 2004 | A1 |
20050198801 | Schmid | Sep 2005 | A1 |
20070107884 | Sirkar et al. | May 2007 | A1 |
20070166190 | Ogihara et al. | Jul 2007 | A1 |
20070231203 | Mizoguchi et al. | Oct 2007 | A1 |
20080234623 | Strauss et al. | Sep 2008 | A1 |
20100106072 | Kashefi-Khorasani et al. | Apr 2010 | A1 |
20100269342 | Carpenter et al. | Oct 2010 | A1 |
20100272606 | Carpenter et al. | Oct 2010 | A1 |
20100272607 | Carpenter et al. | Oct 2010 | A1 |
20110268608 | Reggiani et al. | Nov 2011 | A1 |
20110268609 | Reggiani et al. | Nov 2011 | A1 |
20120046594 | Reggiani | Feb 2012 | A1 |
20120121463 | Reggiani et al. | May 2012 | A1 |
20120294761 | Reggiani et al. | Nov 2012 | A1 |
20130142695 | Reggiani et al. | Jun 2013 | A1 |
20130142696 | Reggiani et al. | Jun 2013 | A1 |
20140030146 | Takeuchi | Jan 2014 | A1 |
20140227133 | Reggiani et al. | Aug 2014 | A1 |
20150068670 | Mizoguchi et al. | Mar 2015 | A1 |
20170072123 | Reggiani | Mar 2017 | A1 |
Number | Date | Country |
---|---|---|
1042082 | May 1990 | CN |
2511309 | Sep 2002 | CN |
1308549 | Sep 2005 | CN |
2772515 | Apr 2006 | CN |
1907508 | Feb 2007 | CN |
1914474 | Feb 2007 | CN |
1308549 | Apr 2007 | CN |
201510571 | Jun 2010 | CN |
103180032 | Jun 2013 | CN |
10322019 | Sep 2013 | CN |
103328019 | Sep 2013 | CN |
103547298 | Jan 2014 | CN |
19782098 | Nov 1999 | DE |
102007010112 | Sep 2008 | DE |
10201002973 | Oct 2011 | DE |
102010027973 | Oct 2011 | DE |
0170210 | Feb 1986 | EP |
0170210 | Feb 1986 | EP |
0312125 | Apr 1989 | EP |
0170210 | Sep 1991 | EP |
0582959 | Feb 1994 | EP |
0895786 | Feb 1999 | EP |
1108462 | Jun 2001 | EP |
1180374 | Feb 2002 | EP |
1371381 | Dec 2003 | EP |
1618906 | Jan 2006 | EP |
1715279 | Oct 2006 | EP |
1741458 | Jan 2007 | EP |
1834656 | Sep 2007 | EP |
1618906 | Sep 2008 | EP |
1834656 | May 2010 | EP |
2420262 | Feb 2012 | EP |
2524712 | Nov 2012 | EP |
2537543 | Dec 2012 | EP |
2420262 | Apr 2013 | EP |
445526 | Mar 1969 | JP |
S5216681 | Feb 1977 | JP |
S52126681 | Oct 1977 | JP |
S59147603 | Aug 1984 | JP |
60053156 | Mar 1985 | JP |
S6178407 | Apr 1986 | JP |
S63139562 | Jun 1988 | JP |
S63283709 | Nov 1988 | JP |
03169329 | Jul 1991 | JP |
H03169329 | Jul 1991 | JP |
H042067 | Jan 1992 | JP |
H0439862 | Jun 1992 | JP |
H04215761 | Aug 1992 | JP |
H05177117 | Jul 1993 | JP |
H0788178 | Apr 1995 | JP |
H08168525 | Jul 1996 | JP |
H11508476 | Jul 1999 | JP |
2000501954 | Feb 2000 | JP |
200093510 | Apr 2000 | JP |
3228518 | Nov 2001 | JP |
2002506692 | Mar 2002 | JP |
3284568 | May 2002 | JP |
2002306592 | Oct 2002 | JP |
2003520617 | Jul 2003 | JP |
2003525736 | Sep 2003 | JP |
2004216143 | Aug 2004 | JP |
2006034466 | Feb 2006 | JP |
2007190218 | Feb 2007 | JP |
2007190218 | Aug 2007 | JP |
2007244880 | Sep 2007 | JP |
3992377 | Oct 2007 | JP |
2007260151 | Oct 2007 | JP |
2007328114 | Dec 2007 | JP |
4455260 | Apr 2010 | JP |
201147269 | Mar 2011 | JP |
5020111 | Sep 2012 | JP |
201363121 | Apr 2013 | JP |
2015144857 | Aug 2015 | JP |
9004419 | May 1990 | WO |
9716213 | May 1997 | WO |
9719714 | Jun 1997 | WO |
9700636 | Sep 1997 | WO |
WO1997033636 | Sep 1997 | WO |
9822161 | May 1998 | WO |
9947189 | Sep 1999 | WO |
9958171 | Nov 1999 | WO |
0006357 | Feb 2000 | WO |
0166237 | Sep 2001 | WO |
20100124087 | Oct 2010 | WO |
WO2010124087 | Oct 2010 | WO |
2012066439 | May 2012 | WO |
2012133372 | Oct 2012 | WO |
2015107486 | Jul 2015 | WO |
20151047486 | Jul 2015 | WO |
2015128886 | Sep 2015 | WO |
Entry |
---|
International Search Report and Written Opinion issued in Search Report and Written Opinion issued in PCT/IT2014/000005, dated Sep. 26, 2014, 9 pages. |
International Preliminary Report on Patentability issued in PCT/IB20141065987, dated May 26, 2017, 9 pages. |
European Search Report issued in EP Application No. 10161451, dated Sep. 28, 2010, 5 pages. |
European Search Report issued in EP Application No. 10173436, dated Feb. 14, 2011, 7 pages. |
European Search Report issued in EP Application No. 10186550, dated Jan. 27, 2011, 7 pages. |
European Search Report issued in EP Application No. 10191140, dated Nov. 30, 2011, 8 pages. |
European Search Report issued in EP Application No. 12187501, dated Nov. 20, 2013, 6 pages. |
European Search Report issued in EP Application No. 13161841, dated Jun. 11, 2013, 6 pages. |
International Preliminary Report on Patentability issued in PCT/IT2014/000005, dated Jul. 12, 2016, 6 pages. |
International Search Report and Written Opinion issued in PCT/IB2012/052424, dated Oct. 24, 2012, 17 pages. |
International Search Report and Written Opinion issued in PCT/IT2014/000058, dated Dec. 8, 2014, 14 pages. |
International Search Report issued in PCT/IB2011/054725, dated Feb. 9, 2012, 12 pages. |
Italian Search Report issued in IT Application No. IT MO20140010, completed Sep. 23, 2014, 7 pages. |
International Search Report and Written Opinion issued in PCT/IT2014/000005, dated Sep. 26, 2014, 9 pages. |
International Preliminary Report on Patentability issued in PCT/IT2014/000058, dated Sep. 6, 2016, 10 pages. |
International Preliminary Report on Patentabiiity issued in PCT/IB20141065987, dated May 26, 2017, 9 pages. |
International Search Report and Written Opinion issued in PCT/IB2014/065987, dated Jul. 6, 2015, 10 pages. |
International Preliminary Report on Patentability issued in PCT/IB2015/053493, dated Nov. 23, 2017, 9 pages. |
International Search Report and Written Opinion issued in PCT/IB2015/053493, dated Jan. 18, 2016, 13 pages. |
Number | Date | Country | |
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Parent | 15110684 | Jan 2014 | US |
Child | 17068190 | US |