The present disclosure relates to medical connector devices for enteral applications.
The present disclosure relates to medical connector devices for enteral applications. The devices can be used to connect non-luer catheters and non-luer syringes, such as enteral catheters and enteral irrigation syringes.
Intravenous (“I.V.”) catheters are typically used to administer I.V. medications into a patient's I.V. or arterial system using catheters having luer fittings defined by ISO 594:1986 “Conical fittings with a 6% (Luer) taper for syringes, needles and certain other medical equipment” standards (“ISO/ANSI 1986”). An ISO/ANSI 1986 compliant, or luer catheter typically has a female rigid luer fitting which will fit into a male luer I.V. syringe or I.V. extension or I.V. administration set. From the luer dimensional ISO/ANSI 1986 standards, the luer tip has an outside diameter of 4 mm, a flow path of less than 2.4 mm in diameter, and a length of less than 0.300 inches with a 6% taper.
By comparison, enteral catheters or tubes typically have randomly configured access ports, some of which may have luer-compatible access ports. As such, clinicians may inadvertently use I.V. luer tip or luer lock syringes to connect to an enteral catheter that may be I.V. luer-compatible. But, the administration of enteral formula into a patient's I.V. system can have catastrophic effects leading to serious complications and/or death.
Manufacturers have produced products which try to prevent this occurrence by providing enteral connectors which attempt to prevent connection to rigid I.V. luer ports. Examples include the Lopez® Valve marketed by ICU Medical Inc., and the ACE Connector® marketed by Dale® Medical Products, Inc. The Dale ACE Connector® is especially useful in preventing misconnection to I.V. luer syringe tips in that it utilizes embodiments of a syringe port seal as shown and described in U.S. Pat. No. 8,353,895 issued on Jan. 15, 2013 to Russo. The syringe port seal of Dale Medical Products, Inc. described in U.S. Pat. No. 8,353,895 will only accept a randomly dimensioned non-luer tip syringe typically referred to as a catheter tip syringe. It should be noted that the term “catheter tip syringe,” as used herein refers to any tapered tip syringe having dimensions, e.g., tip diameter and tip length, in excess of the ISO/ANSI 1986 standard.
While the Dale ACE Connector® is a substantial advancement in the state of the art, ISO and ANSI have gone further in proposing standards for non-luer compatible fittings of all syringes, feeding tubes, and delivery sets having small bore connector fittings with less than 8.5 mm in diameter flow path for enteral administration. These standards have been issued as proposed ISO/ANSI 80369-3 “Small-bore connectors for liquids and gases in healthcare applications—part 3: connectors for enteral applications” standards (“ISO/ANSI 80369-3”) for syringes, feeding tubes, and delivery sets having totally non-luer compatible male and female oversized screw thread type fittings.
U.S. Pat. No. 5,267,983 to Oilschlager et. al. (“Oilschlager”) titled “Enteral Adapter and Tip Protector” issued on Dec. 7, 1993, discloses an adapter for an enteral feed tube. The adapter is a multi-step adapter, where the first step is taught to be less than 0.170 inches (4.3 mm). Similarly, U.S. Pat. No. 5,776,117 to Haselhorst et. al. (“Haselhorst”) titled “Adaptor for Connection to Variously Sized Tubes, Adapters and/or Y-Ports and Method of Using the Adapter,” issued Jul. 7, 1998, also discloses an enteral adapter having a series of increased diameter barbed sections for insertion into a wide variety of varying internal diameter tubes, adapters, or Y ports. The Haselhorst adapter has a first step of 0.180 inches (4.57 mm).
The inventor has recognized that it would be especially useful to have a closed system enteral connector having multiple access connection ports wherein all access or connection ports are totally incompatible with any type of luer syringe or I.V. luer fluid delivery set, such that all ports are configured to prevent use, attachment, or mechanical engagement with any luer fitting. This configuration, the inventor has recognized, would absolutely prevent the administration of any enteral formula into any type of I.V. luer catheter or fitting whether rigid or flexibly molded.
The inventor has further recognized that the Oilschlager configuration, having a multi-step adapter, where the first step is less than 0.170 inches (4.3 mm), still permits a perfect diameter fit with the internal diameter of a standard female I.V. luer port. Similarly, Haselhorst, which does not recognize the importance of any such dimensions relative to preventing connection to any I.V. luer fitting, specifies that the first step has a dimension of 0.180 inches (5.47 mm). To overcome the I.V. luer misconnection possibility, Oilschlager depends upon a shortened length of the first step of only 0.140 inches (3.6 mm) to prevent a sustained internal grip with the I.V. luer port. In essence, the adapter of Oilschlager (and Haselhorst) provide for a partial insertion compatibility fit with an I.V. luer port, and although the connection may not be sustained, the connection can still permit the administration of enteral formula into an I.V. luer port.
In one embodiment of the present disclosure, a medical connector prevents use and mechanical engagement with an I.V. luer catheter, the connector comprising a body portion having a distal patient access fitting having a first non-luer compatible form, a proximal fluid delivery device fitting having a second non-luer compatible form, and a syringe port incorporating a normally biased closed to atmosphere valve, the syringe port having a third non-luer compatible form, the third non-luer compatible form comprising a vertical length greater than about 0.300 inches from the entrance of the syringe port to the valve, wherein the distal patient access fitting, the proximal fluid delivery device fitting, and the syringe port are all in fluid communication with a fluid flow path positioned within the body portion.
In some embodiments, the first non-luer compatible form and the second non-luer compatible form are the same form, while in others they may take different forms. The first and second non-luer compatible form may be, in some embodiments, selected from the group consisting of a female externally threaded form having an internal diameter of greater than 4.8 mm, a stepped barb form comprising at least a first stepped end barb having a first diameter of greater than about 0.190 inches (4.8 mm), and a second stepped barb having a second diameter greater than the first diameter, and a male stem form having a diameter of greater than about 0.190 inches (4.8 mm). In other embodiments, the diameters are greater than about 0.205 inches (5.2 mm).
In yet another embodiment, the medical connector has an adapter engaged with the syringe port, wherein the adapter mechanically engages with an enteral fluid delivery device. The adapter may access the normally biased closed to atmosphere valve, causing the valve to be in an open position permitting fluid flow from the enteral fluid delivery device into the fluid flow path positioned within the body portion. Further, the body portion may have an On-Off fluid flow controller disposed between the valve and the proximal fluid delivery device fitting, which may also have a manually operated turn handle. In some embodiments, the turn handle may have fixed stop positions for both the on and off fluid flow positions. In some embodiments, the valved syringe access port may accept a catheter tip syringe having a length in excess of about 0.300 inches. And, in some embodiments, the distal patient access fitting has a flow path internal diameter dimensionally in excess of 2.4 mm, and further, the proximal fluid delivery device fitting may also have a flow path internal diameter dimensionally in excess of 2.4 mm.
A connector consistent with the present disclosure may have an adapter attached to the distal patient access fitting, permitting connection of the device to an enteral feeding tube, and in some embodiments, the adapter may have a non-luer compatible form comprising a male stem having a tapered outside diameter of greater than about 4.8 mm, or in other embodiments greater than about 5.2 mm.
In still other embodiments, the proximal fluid delivery device fitting connects to an enteral feeding device. The connector may be an enteral formula delivery connector.
In some embodiments, the proximal fluid delivery device fitting may be removable from the body portion, and the removal of the proximal fluid delivery device fitting may expose an underlying auxiliary suction line connector part of the body portion.
Also consistent with the present disclosure, a medical connector kit may prevent the use and mechanical engagement with an I.V. luer catheter, the connector kit comprising a medical connector comprising a body portion having a distal patient access fitting having a first non-luer compatible form, a proximal fluid delivery device fitting having a second non-luer compatible form, and a syringe port incorporating a normally biased closed to atmosphere valve, the syringe port having a third non-luer compatible form, the third non-luer compatible form comprising a vertical length greater than about 0.300 inches from the entrance of the syringe port to the valve, wherein the distal patient access fitting, the proximal fluid delivery device fitting, and the syringe port are all in fluid communication with a fluid flow path positioned within the body portion; and at least one adapter. The at least one adapter may comprise a proximal portion comprising a taper lock wedge, the taper lock wedge having a minimum diameter in excess of about 4.8 mm, or in other embodiments about 5.2 mm, and a rearward portion comprising molded-in threads. In some embodiments, the taper lock wedge of the proximal portion of the adapter may have a vertical length greater than about 0.300 inches.
Additional objects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objects and advantages of the invention will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate one (several) embodiment(s) of the invention and together with the description, serve to explain the principles of the invention.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the description, explain the principles of the invention. In the drawings:
Reference will now be made in detail to the present exemplary embodiments, examples of which are illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.
From the luer dimensional ISO/ANSI 1986 standards, the luer tip has an outside diameter of 4 mm, a fluid flow path of less than 2.4 mm in diameter, and a length of less than 0.300 inches with a 6% taper. The length and outside diameter of tip 15 on catheter tip syringe 16 is so oversized in dimensions (having length greater than about 0.300 inches, and diameter greater than 4.8 mm) such that any luer slip tip or any luer lock syringe simply cannot access entrance port 11 as illustrated in
As used herein, a stepped end barb refers to the first step in the barbed fitting, the end-most and typically smallest barb. Distal first stepped end 25 with the oversized diameter of about 5.2 mm (0.205 inches) means that distal first stepped end 25 will butt up against the smaller I.V. luer lumen of about 4 mm (0.158 inches). As such, distal first stepped end 25 simply cannot even begin to enter or form any type of partial or limited insertion fit with an I.V. luer port. Stepped barbs are particularly useful to accommodate various sized gastrostomy tubes, and a diameter of about 0.205 inches is small enough to accommodate the smallest adult gastrostomy tube of 18 FR while still preventing any type of connection with an I.V. luer fitting.
Likewise, in
The exemplary embodiments described herein show several non-luer compatible forms, including a female threaded form (e.g., 42 in
A clearer partial cross sectional view of non-luer compatible syringe port seal 30 is shown in
Syringe port seal 30 will accept a catheter tip syringe 16 having a tip 15, whose length and/or diameter are configured in excess of the male luer tip that is in accordance with ISO/ANSI 1986 standards. As used herein, the term “catheter tip syringe” is defined broadly to include any type of oversized syringe tip including oral/enteral purple/orange colored and designated syringes from Becton, Dickinson Co. and Kendall Monoject®.
Further, syringe port seal 30 is normally closed to atmosphere by silicone diaphragm slit valve 35 shown in
In an alternate embodiment, included within injection molded body 38 made from rigid clear polycarbonate is an On-Off fluid controller 36 having built-in fixed stops 37 to place turn handle 39 at either the fluid On or Off position.
From
Note a distal patient access fitting 42 with an internal diameter 48 of 5.74 mm and an external diameter 49 of 10 mm, which is way oversized in dimension to prevent use, attachment, or mechanical engagement with a much smaller dimensionally configured I.V. luer fitting 46 inserted into a patient arm 50. Further, both the distal fitting 42 and the proximal fitting 44 both have fluid flow paths in excess of 2.4 mm, which exceeds the maximum internal flow path of any luer connector.
Accordingly, as shown and described from
The proximal fitting 44 is comprised of two joined components comprising flexible silicone extruded bushing 54 of approximately Shore A 50 durometer. The proximal port 45 has a plurality of barbed elements 56 to be press fit into the flexible bushing 54. The silicone bushing 54 permits removal of proximal fitting 44 to expose the underlying auxiliary suction line connector 55 part of body portion 41 in case the clinician user wishes to attach the connector 40 to wall suction using built in suction line connector 55 to decompress the patient's stomach or GI tract.
Proximal fitting 44 can be fixedly press fit or removable and replaceable from body portion 41. Many clinicians may prefer that silicone bushing 54 be removable and replaceable especially if fitting 44 were clogged due to lack of flushing or irrigation through fitting 44. As such, the silicone bushing 54 can be packaged separately and marketed as a replaceable component.
While the barb elements 56 are press fit into the flexible bushing 54 to connect proximal port 45 with silicone bushing 54, it is easily understood that the proximal port 45 could be removable from bushing 54, but that is not the preferred embodiment of a unitized assembly between silicone bushing 54 and proximal port 45.
Likewise proximal fluid delivery fitting 44 having male port 45 can directly connect to any oversized future designed or marketed ISO/ANSI 80369-3 compliant syringe 67 having a female threaded tip 68 directly attachable to proximal port 45. In addition, the syringe port seal 43 will only accept catheter tip syringe 71 having a non-luer compatible tip 72.
In summary, connector 40 provides a medical connector wherein all access ports are totally non-luer compatible to prevent use, attachment, or engagement with any I.V. luer fittings or catheters.
In
The use of this adapter 61 into syringe port seal 43 now converts the seal 43 into use by any of the future conceived syringe or delivery sets in accordance with ISO/ANSI 80369-3 standards.
Likewise, a second adapter 61 can directly engage by one and one-quarter screw thread with distal fitting 42 to convert distal fitting 42 to be used as a direct connect to any feeding tube 74.
As can be seen, the design, development, and creation of the present disclosure provides for a unique closed system triple-ported connector with non-luer compatible access ports designed and configured for maximum patient safety for present day use as well as anticipation for meeting any future universal enteral feeding device connections as envisioned by the proposed ISO/ANSI 80369-3 standards.
Other embodiments will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.
This application claims priority under 35 U.S.C. §119 to U.S. Provisional Patent Application No. 61/966,383, filed on Feb. 24, 2014, which is herein incorporated in its entirety by reference.
Number | Date | Country | |
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61966383 | Feb 2014 | US |