This invention relates generally to devices for medical procedures involving liquid transfer, sterilization and mixing in a field environment. It is also particularly related to kits and to methods which employ preassembled parts to provide a sterile product without requiring confines of a laminar flow hood.
Conventionally, mixing and formulation of medications is a pharmacy or other medical laboratory performed function most often involving use of laminar flow hoods and strict aseptic technique to maintain sterility. In pharmacies, medical solutions are often passed through a medical grade sterilizing filter to assure an aseptic condition. Resulting products from these facilities are highly regarded and widely used in hospitals and other clinical facilities.
However, today, a significant portion of medical practice takes place outside sophisticated medical institutions. As an example, a new and very effective eye-wash technology is based upon mixing autologous blood serum with normal saline in exacting proportions. Commonly, blood is drawn from patients in a wide range of areas remote from pharmacies and laboratories. The expense and inconvenience of relying on such facilities to sterilize and mix is prohibitive, negatively affecting broader application of this promising technology. Thus, there exists a severe contemporary need for a process or methodology, not currently available commercially, which can, with appropriate safety and efficacy, provide such sterilizing, dispensing and mixing in a field environment.
Convenience kits have become commonly used appliances for a number of reasons. First, a convenience kit is specifically made for a given application. Contents of each such kits are prepared and provided in a form which generally reduces procedure steps and improves efficiency. Second, such kits can provide additional safety such as the kit disclosed in U.S. Pat. No. 9,449,521, titled METHODS FOR MAKING AND USING A VIAL SHIELDING CONVENIENCE KIT, issued May 28, 2013, which proved effective in providing additional safety to technicians and patients by keeping hazardous drug fumes and liquid fully contained.
Following is a list of terms and associated definitions which are provided for clarity and understanding when used to disclose precepts of the instant invention:
dead space, n: a volume of inaccessible fluid which is retained within a device after a procedure
digital, adj: relating to, or done with thumb or fingers
ETO, n: acronym for ethylen oxide, a powerful sterilizing agent
field of use, n: a location in an uncontrolled environment in which potentially health-hazardous materials are present.
filter, n: a product material having a sufficiently small porous matrix to impede passage there through of a particulate of predetermined size; a medical grade sterilizing filter generally has a 0.2 micron pore size.
filter component, n: A housing for a filter having a a pair of opposing fittings providing communicating conduits to and from the filter.
fitting, n: a medical connector
kit, n: a group of parts, provided within a single package for a designated use
laminar flow hood, n: (a fume hood) a work-place enclosure in which air flow is directed so as to prevent contamination of sterile materials by airborne organisms
luer fitting, n: a medical connector having a frustoconically shaped connecting geometry which is in common use in medical practice
luer lock fitting, n: a luer fitting having a locking mechanism whereby a male and female connector are securely, but releasibly affixed one to the other
plastic bag, n: a sturdy container made of clear pliant material which comprises an opening initially available at one end for product insertion which is sealed thereafter to provide a totally enclosed product shroud, the material being sufficiently pliant to permit digital product handling from outside the container
interface gasket, n: an elongated hollow tube that is sized, shaped and disposed to be affixed along a filter component conduit about a hole in a plastic bag and thereby provide a fluid tight seal
gasket support, n; a rigid washer shaped component which has an outer diameter which is similar to an outer diameter of a gasket and an inner diameter which interfaces with a luer connecting fitting and thereby transfers force from the connecting fitting to an interface gasket to provide a seal
port or portal, n: an orifice site where through fluid is communicated (generally associated with a sealed conduit disposed there through)
radiation, n: generally gamma radiation imposed with sufficient intensity and time to sterilize a product to a desired SAL (sterility assurance level)
subkit, n: a group of parts provided as a unit and considered to be a kit when provided alone but a lesser kit form when provided as a part of a more inclusive kit which is packaged with additional items
tray, n: a convenience kit container wherein kit parts are stored and transported
tray cover, n: a removable cover which is disposed and sealed over a tray to provide a clean shroud
unitized, adj: a plurality of separate parts permanently joined to be handled and used as a single unit
insulated wrap, n: a flexible container which may be a bag or folded shield which is sealed to provide a container in which enclosed parts can be maintained at a reduced temperature
In brief summary, this novel invention alleviates all of the known problems related to mixing, dispensing and providing a sterile liquid product in a field environment.
Commonly, such products, as disclosed supra, are often produced by being sterilized by filtration and mixed under a fume or laminar flow hood in a pharmacy or laboratory facilities. For products which are acquired for sterilizing and mixing in a field environment, remote from such facilities, lack of a fume hood or laminar flow capability currently prohibits wide-spread manufacturing It is for the purpose of fulfilling this need that a convenience kit based upon the instant invention is intended.
The core items of this inventive kit are a conventional commercial plastic bag, having an accessible opening, which is closed and sealed after product assembly, and a sterilizing filter component which is affixed to the bag via a sealed portal to provide a solitary sterilizing fluid pathway to other components inside the so closed bag. To assure product sterility, the bag and contained articles are sterilized after assembly prior to use. Once sterilized, the only passageway inside the sealed bag is through the filter component. Therefore, all product inside the bag remains sterile for all subsequent procedures until the bag is opened.
The inventive kit may be delivered as a constituent of a larger, more inclusive kit comprising additional items for a particular procedure. In such a case, the inventive kit is part of the larger kit and is referenced as a subkit. As is clearly disclosed hereafter, other products delivered in the inclusive kit should be clean, but need not be sterilized before use with the inventive kit.
An example of components of a kit made according to the present invention may be as follows:
1. The plastic bag having an accessible opening for displacement of the articles into the bag before the opening is closed and sealed and an exterior surface which completely envelopes and protects sterility of articles disposed therein. Bag and articles disposed therein should be predisposed to digital manipulation via the bag exterior.
2. A filter component comprising a sterilizing grade filter and two opposing elongated conduits having connecting fittings at ends remote from the filter. One of the conduits, is displaced through a hole in the bag. A gasket seal is disposed about the conduit/hole interface, providing a hollow conduit as the only fluid access pathway into the bag after the bag opening is sealed. Note that the pathway leads to the filter through which all fluid must pass, thereby assuring that no non-sterile material can be introduced into the bag beyond the filter.
3. At least one vessel for receipt of dispensed liquids.
4. A cap for each at least one vessel, the cap being affixable and providing a protective seal, such that when attached to the vessel and thereafter removed from the bag, following liquid transfer, product sterility is assured.
5. A receptacle for holding each at least one vessel and associated cap in a preferred accessible position and state. (Optional)
6. A basin wherein wasted priming (waste) liquid can be delivered. (Optional)
One of the compelling purposes for basic convenience kits resulting from this invention is providing fluid flow through an associated sterilizing filter. As liquids to be mixed in a field environment can be expected to be compromised and/or contaminated, it is critical that every so-employed liquid is passed through such a filter and sterilized before being dispensed within the bag. In the case of the instant invention, retention of sterility throughout dispensing and mixing is equally as important. For this reason, all kit mixing, sterilization and subsequent packaging functions are performed within a plastic bag which retains such sterility until reopened. It is important to note that digital facility of kit use is also very important. As a consequence, final product is not removed from the bag until capped and sealed for safe transport in the field environment. Note that this requires product dispensing and capping take place within the bag.
As well as providing for field sterilization and mixing, a convenience kit according to the present invention, may be a sub-kit supplied in a more inclusive kit format, comprising parts supplied unpackaged within the confines of a kit container, for saving time and steps. Additional time may be saved by unitizing assembly of functional parts of the kit. For example, those sub-kit components which are not separated as part of the procedure are securely affixed as a unit (unitized), one to another (such as by adhesion). As an example, a fluid delivery spout can be securely affixed to an output conduit of a filter component internal to the bag and a fluid delivery control unit may be affixed to an input conduit of the filter. In this manner, sub-kit components are provided to a handler in a “ready to use” format which is inherently incorruptible.
Inclusive kits, based upon the present invention, may have a variety of components disposed within a transport tray. While such components and items can be selected and fixed for each particular application, a wide diversity of parts may be used for both components and items within the scope of the invention. However, in all cases, components are generally affixed one to another, as necessary, to provide a “ready to use” configuration. Also, if gamma radiation is used for sterilization, only radiation stable components should reside within the bag of the inventive kit.
As disclosed hereafter, various convenience kit configurations may be used for sterilizing, transferring and mixing, as the filter component permits a wide range of sterilizing applications that fit within a bag. Other application examples for the instant invention includes batch filling of antibiotic and operating room syringe kit applications, oncology drug dispensing, short half-life drug delivery and kits for home care.
Further, to show by example, a comparison of advantages and disadvantages relative to using a convenience kit made according to the present invention versus using a laminar flow hood, for a sterile transfer process, distinctions are summarized in the following two tables (i.e Tables 1 & 2).
Table 1 summarizes a comparison of general factors related to preparing an eye-wash product using a laminar flow hood and the convenience kit.
Table 2 compares a current process of producing an eyewash product to a like product production using a convenience kit made according to the present invention.
Accordingly, it is a primary object to provide convenience kit methods and apparatus for transferring and sterilizing liquids to provide a packaged, sealed, aseptic product in a field environment.
It is a principle object to provide methods and apparatus which can be used for preparing and using convenience kits for sterilizing and delivery of filled sterile liquid containing vessels into a field environment.
It is an object to provide a convenience kit and methods and apparatus for preparing a mixed eye-wash solution in a field environment.
It is an object to provide methods and apparatus which can be used for preparing and using convenience kits for sterilizing and delivery of batch filled antibiotics.
It is an object to provide methods and apparatus for preparing and using convenience kits which can be used for sterilizing and delivery of drugs in home care situations.
It is an object that a sectioned tray, having at least two recesses wherein the instant invention is stored and transported as a sub-kit and other objects are separately stored, be provided.
It is a fundamental object that the bag be sealable, be able to be opened for use of products transferred, sterilized and mixed.
It is a crucial object that connected parts disposed in the inner bag be adjoined to reduce makes and breaks after sterilization.
It is another critical object that such adjoined parts be unreleasibly affixed (unitized) to preclude separation in transport and storage.
It is a another major object that bagged parts of a convenience kit made according to the present invention be digitally accessible such that liquid sterility protecting caps can be affixed to vessels before perforating the bag barrier.
These and other objects and features of the present invention will be apparent from the detailed description taken with reference to accompanying drawings.
In this description, the term proximal is used to indicate a segment of a device normally closest to an object of the sentence describing its position. The term distal refers a segment oppositely disposed. Reference is now made to the embodiments illustrated in
While kits made according to the invention may be configured to provide assemblies for many medical procedures, such as those, for example, involved with sterile washes and drugs for home-care, antibiotics, operating room and pediatrics, disclosure of an exemplary application in the area of preparation of a specialized eye-wash is herein selected to provide examples and details of the instant invention while clearly demonstrating critically important safety and time and work saving features.
Reference is now made to
a. a sterilizing filter component 20 comprising a filter casing 22, two elongated fluid communicating conduits with luer fittings on an end disposed away from filter component 20, (i.e. a first conduit 24 comprising a female luer fitting 26 and a second conduit 28 with a male luer fitting 30). A filter (not shown) is disposed within filter component 20, through which all fluid displaced through the conduits 24 and 28 must pass. The filter is a medical grade sterilizing filter which is defined to be on the order of a 0.2 micron filter rating. Filter component 20 should have a substantially planar face 32 for interfacing with a portion of the exterior surface of an associated plastic bag. Such a filter is currently available commercially as a Merck Millipore MILLEXGS Sterilizing Filter unit.
b. a pliant, preferably clear plastic bag 40 comprising a continuous surface 42 and a single opening 44 which is heat sealable. Such a bag is found commercially in many forms. As an example, a 1.4 mil poly leak-proof, heat sealable bag is currently preferred. The selected bag should be sized to permit digital access to contents within the bag. Such bags can be perforated by a sharp object such as a common pin at a desired perforation site (in this example, site 50). Note that site 50 can be determined to be any desired place on the surface of bag 40 which permits desired digital maneuvering of filter component 20. At such a perforation, material characteristics of the bag permit displacement of a conduit part through the point of perforation with only an increase in hole size equivalent to circumference of the perforating member (i.e. in this case, filter conduit 28).
c. three components which can be used to seal the perforated hole at site 50.
A filter to bag fabrication tool 90 is seen to provide a walled hole 92 which has a pair of slots (not shown) disposed to fit about side wings 76 to retard component 70 from rotating as component 70 is securely affixed to conduit 28 (by conventional luer fitting attachment technique). Assembly process is as follows:
In
Attention is now referenced to
A vessel 110 for receiving and storing eyewash is seen in
A sealing and protective cap 120 for vessel 110 is seen in
Cavities 106 are sized and shaped to securely, but release-ably, retain caps 120 therein, as seen in
A first step in convenience kit assembly is displacing a filled tray 130 (see
A third and final assembly step for providing a ready to use convenience kit 200 (seen in
Thus, unless either the bag or filter barrier is perforated or ruptured all matter within the walls of bag 40 shall remain in an aseptic state. This permits dispensing fluids from an uncontrolled and potentially contaminating environment to be performed without regard to conditions exterior to kit 200.
For this reason, kit 200 may be considered superior to performance of the same function using a laminar flow hood. For, while the laminar flow hood provides an aseptic flowing gas-based environment, general achievement of an aseptic product requires careful technique and separate procedures to assure product sterility (as there is no facility which is part of a laminar flow hood, itself, which inherently sterilizes a product being produced therein).
As seen in
As seen in
Once filled each vessel must be capped to preserve sterilized product before the bag is opened to the field environment. The bag should be sized and bag material selected which permits a digital interface between cap and a users thumb and fingers to permit a cap 120 to be disengaged from a cavity 106 and displaced and be affixed to cap and seal product within a vessel 110. Sealing may involve rotating a cap, like cap 120, by threaded attachment as evidenced by vessel wall 112 (see
Due to associated functional requirements of a procedure involving the present invention, sterilized kit 200, may become a subkit if added to a more inclusive storage and shipment kit tray 230, as seen in
It is preferred to provide a cover 240 which is sealingly affixed to tray 230 to protect product cleanliness as seen in
As indicated supra, convenience kits, made according to the present invention, may be used for transferring and sterilizing liquids in many applications. To provide a broadened perception of uses of such convenience kits, a second example is seen in
Therein, a syringe 300 is sealed within a bag 40′ and sterilized with other components inside to provide a convenience kit 200′. A filter component 20 affixed to bag 40′ at a site different from site 50 (site 50′) provides a sterilizing fluid pathway into bag 40′. Thereat, component 20 is affixed to bag 40′ by the same process and manner as component 20 and components 60, 80 and 70 are affixed to bag 40. In use, all liquid dispensed through filter component 20 is sterilized before reaching pre-sterilized syringe 300. Syringe 300, being so filled, is digitally detached and a conventional luer cap 302 is digitally affixed thereto to provide a sterile liquid product for use in the field environment. In this manner, such a kit can be used to transfer questionable or contaminated liquid from a container (e.g. another syringe) to be sterilized and further dispatched to syringe 300 for delivery of a sterile product to a patient in the field environment.
The invention may be embodied in many other specific forms without departing from the spirit or essential characteristics thereof. The presently disclosed embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.
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