Flex-stroke infusion pump

Information

  • Patent Grant
  • 12011567
  • Patent Number
    12,011,567
  • Date Filed
    Monday, April 9, 2018
    6 years ago
  • Date Issued
    Tuesday, June 18, 2024
    7 months ago
Abstract
An infusion pump including a plunger, a proximal valve located proximally to the plunger, a distal valve located distally to the plunger, and a controller configured to trigger the position of the plunger, such that both in its upper position and its lower position, the plunger squeezes a section of an infusion tube, such that opposite sides of an inner surface of the section do not contact one another.
Description
FIELD OF THE INVENTION

The present invention relates generally to the field of medical devices for providing fluid to a patient. More specifically, the present invention relates to infusion pumps configured to prevent or compensate for degradation of infusion tubes operationally connected to the pump.


BACKGROUND

Infusion pumps are configured to administer fluid to a patient via a conduit such as an infusion tube or a cassette at high accuracy and often for a prolonged period of time. Infusion tubes are accommodated in the infusion pump in such manner that a plunger can squeeze the surface of the infusion tube, thereby causing delivery of the infusion fluid.


Infusion pumps administer fluids in ways that would be impractical and expensive/unreliable if performed manually by nursing staff. For example, an infusion pump assembly may repeatedly administer small quantities of an infusible fluid (e.g., 0.1 mL per hour). However, common disposable infusion tubes are prone to deform or rupture when being continuously compressed, consequently affecting the precision of the delivery.


SUMMARY OF THE INVENTION

The hereindisclosed infusion pump advantageously includes a controller configured to control the position of a plunger in such manner that an infusion tube connected to the infusion pump remains partially squeezed dozing essentially the entire operation of the pump.


That is, in its upper position (also referred to herein as an upper squeezing position) the plunger mildly squeezes the infusion tube, such that opposite sides of an inner surface of the infusion tube do not contact each other. This is as opposed to common infusion pumps, which in their upper position (also referred to herein as an uppermost position) do not squeeze the infusion tube; in fact, the plunger is typically elevated to a position in which it does not touch the infusion tube's outer surface.


As used herein, the term “mildly squeezing” refers to the plunger pressing upon the infusion tube sufficiently to cause a change in the shape of the infusion tube's inner lumen, as compared to a hilly relaxed tube. According to some embodiments, at its upper squeezing position, when mildly squeezed, the infusion tube is more than 0% and less than 10% squeezed, as compared to a hilly squeezed infusion tube. According to some embodiments, at its upper squeezing position, when mildly squeezed, the infusion tube is more than 5% and less than 10% squeezed, as compared to a hilly squeezed infusion tube.


In the plunger's lower position (also referred to herein as a lower squeezing position), the squeezing of the infusion tube is increased, yet still the opposite sides of the inner surface of the infusion tube do not contact each other. Again, this is different than common infusion pumps, which typically are configured to squeeze the infusion tube to a maximum (also referred to herein as a lowermost position), i.e. such that the opposite sides of the inner surface of the infusion tube become basically aligned. According to some embodiments, in its lower squeezing position, the infusion tube is less than 100% squeezed and more than 80% squeezed, as compared to a fully squeezed infusion tube. According to some embodiments, in its lower squeezing position, the infusion tube is less than 95% squeezed and more than 80% squeezed, as compared to a fully squeezed infusion tube.


Advantageously switching between intermediate rather than extreme positions ensures accurate delivery even during prolonged delivery.


Complete squeezing of the infusion tube causes bottoming out and high stress to the tubing walls, which in turn leads to continuous degradation and impaired accuracy over time. This is particularly a problem when utilizing DEHP-free PVC, since PVC is an overdamped spring that does not truly hollow the plunger, as opposed to, for example, silicon tubes. Utilizing a less severe lower position advantageously prevents such degradation.


In addition, due to the plunger executing a mild squeeze even in the upper position (deeper upper position of the plunger), the tube follows the plunger to the upper position and the springiness of the tubing is thus maintained throughout the pumping cycle. As a result, the need for incorporating complicated algorithms in an attempt to compensate for changes in flow rate over time is obviated. In fact, the flow rate stability of the hereindisclosed infusion pump is far superior to that of infusion pumps utilizing flow rate compensation algorithms as further demonstrated hereinbelow.


According to some embodiments, the infusion pump, disclosed herein, is further configured to determine a wait period during which the plunger “waits” in its (deep) upper position, prior to the opening of the infusion pump's downstream valve. This allows the infusion tube to fully engage the plunger prior to the opening of the downstream valve, and thus increases accuracy, as the volume of the tube is constant. In addition, an ascending of the infusion tube whilst the downstream valve is open, causing liquids to be extracted from the patient, is beneficially prevented.


According to some embodiments, during the intake phase (suction of liquid from an IV bag or syringe), the plunger can be raised to a position above the upper position and then descended back to the upper position, mildly squeezing the infusion tube. This does not only allow more room for relaxation of the infusion tube, but also enables pumping a small bolus into the syringe, thus reducing the vacuum that is created during the intake.


Advantageously the controller may be configured to calibrate and/or optimize the upper and lower squeezing positions of the plunger, thus facilitating operation with infusion tubes of different dimensions and consistencies.


According to some embodiments, there is provided an infusion pump comprising a plunger; a proximal valve located proximally to said plunger; a distal valve located distally to said plunger; and a controller configured to control infusion fluid delivery to the subject and infusion fluid intake from a reservoir (also referred to as an infusion source). The controlling of the intake of fluid comprises: closing of said distal valve, opening of said proximal valve, moving of said plunger to an upper squeezing position, in which upper squeezing position of said plunger is configured to partially squeeze an infusion tube, while facilitating intake of fluid; and determining a “wait” period, following the intake, during which wait period said plunger remains at said upper squeezing position, thereby ensuring full recovery of the tube to engagement of the infusion tube with the plunger. The controlling delivery comprises: closing of said proximal valve and opening of said distal valve, while said plunger is at the upper squeezing position, descending of said plunger from the upper squeezing position to a lower squeezing position, wherein at both the upper squeezing position and the lower squeezing position, said plunger is configured to squeeze a section of an infusion tube, such that opposite sides of an inner surface of said section do not contact one another, thereby facilitating delivery of an essentially constant volume of infusion fluid to the subject regardless of a potential degradation of the infusion tube.


According to some embodiments, the plunger is configured to contact an outer surface of the infusion tube from the end of intake to end of delivery operation thereof.


According to some embodiments, at the lower squeezing position, the plunger is configured to squeeze the section of the infusion tube to form a first inner tube cross section and wherein, at the upper squeezing position, the plunger is configured to squeeze the section of the infusion tube to form a second inner tube cross section, wherein the second inner tube cross section is larger than the first inner tube cross section and smaller than a cross section of the infusion tube, when not-squeezed.


According to some embodiments, the infusion pump further comprises a motor in communication with the controller, the motor configured to operate the plunger. According to some embodiments, the motor is further configured to operate the proximal valve, the distal valve or both. Additionally or alternatively, the infusion pump further comprises a second motor configured to operate the proximal valve, the distal valve or both.


According to some embodiments, the infusion tube is a DEHP-free PVC infusion tube.


According to some embodiments, the controller is configured to calibrate the upper squeezing position and the lower squeezing position of the plunger according to dimensions of the infusion tube.


According to some embodiments, controlling the intake of infusion fluid further comprises initially positioning of the plunger to a position above the upper squeezing position followed by a descending of the plunger to the upper squeezing position, while the proximal valve is open, thereby allowing residual fluid to backflow towards the reservoir.


According to some embodiments, the wait period has a maximum duration based on and/or defined by the flow continuity and flow rate.


According to some embodiments, there is provided an infusion pump comprising: a plunger; a proximal valve located proximally to the plunger; a distal valve located distally to the plunger; and a controller configured to control an infusion fluid delivery to the subject and an infusion fluid intake from a reservoir. Controlling the intake of fluid comprises: closing of said distal valve, opening of said proximal valve, moving of the plunger from the lower position to the upper position and above an upper squeezing position; and descending of the plunger to the upper squeezing position, in which upper squeezing position the plunger is configured to partially squeeze an infusion tube, while allowing intake of infusion fluid. Controlling the intake of infusion fluid further comprises determining a “wait” period, following the intake, during which wait period the plunger remains at the upper squeezing position or above it, thereby ensuring engagement of the infusion tube with the plunger.


According to some embodiments, controlling the delivery of the infusion fluid comprises: closing of the proximal valve and opening of the distal valve, while the plunger is at the upper squeezing position, descending of the plunger from the upper squeezing position to a lower squeezing position, wherein at both the upper squeezing position and the lower squeezing position, the plunger is configured to squeeze a section of an infusion tube, such that opposite sides of an inner surface of the section do not contact one another, thereby facilitating delivery of an essentially constant volume of infusion fluid to the subject regardless of a potential degradation of the infusion tube.


According to some embodiments, the plunger is configured to contact an outer surface of the infusion tube section during the entire delivery thereof.


According to some embodiments, the infusion pump further comprises a motor in communication with the controller, the motor configured to operate said plunger. According to some embodiments, the motor is further configured to operate the proximal valve, the distal valve or both. Additionally or alternatively, the infusion pump further comprises a second motor configured to operate the proximal valve, the distal valve or both.


According to some embodiments, the infusion tube is a DEHP-free PVC infusion tube.


Certain embodiments of the present disclosure may include some, all, or none of the above advantages. One or more technical advantages may be readily apparent to those skilled in the art from the figures, descriptions and claims included herein. Moreover, while specific advantages have been enumerated above, various embodiments may include all, some or none of the enumerated advantages.


In addition to the exemplary aspects and embodiments described above, further aspects and embodiments will become apparent by reference to the figures and by study of the following detailed descriptions.





BRIEF DESCRIPTION OF THE DRAWINGS

Examples illustrative of embodiments are described below with reference to figures attached hereto. In the figures, identical structures, elements or parts that appear in more than one figure are generally labeled with a same numeral in all the figures in which they appear. Alternatively, elements or parts that appear in more than one figure may be labeled with different numerals in the different figures in which they appear. Dimensions of components and features shown in the figures are generally chosen for convenience and clarity of presentation and are not necessarily shown in scale. The figures are listed below.



FIG. 1A schematically illustrates upper and lower positions of prior art plungers;



FIG. 1B shows exemplary photos of a DEHP-free PVC infusion tube prior to use (left panel), and during use with a prior art plunger at its lower position (center panel) and its upper position (right panel);



FIG. 2A schematically illustrates upper and lower positions of the hereindisclosed plunger; according to some embodiments;



FIG. 2B shows exemplary photos of a DEHP-free PVC infusion tube prior to use (left panel), and during use with the hereindisclosed plunger at its lower position (center panel) and its upper position (right panel);



FIG. 3 schematically illustrates an infusion pump with a plunger having intermediate squeezing positions, according to some embodiments;



FIG. 4 is an illustrative flowchart for operating an infusion pump, according to some embodiments;



FIG. 5A shows the flow rate over time obtained using the hereindisclosed infusion pump (NatIV);



FIG. 5B shows the flow rate over time obtained using a prior art infusion pump including compensation algorithm.





DETAILED DESCRIPTION

In the following description, various aspects of the disclosure will be described. For the purpose of explanation, specific configurations and details are set forth in order to provide a thorough understanding of the different aspects of the disclosure. However, it will also be apparent to one skilled in the art that the disclosure may be practiced without specific details being presented herein. Furthermore, well-known features may be omitted or simplified in order not to obscure the disclosure.


According to some embodiments, there is provided an infusion pump including a plunger; a proximal valve located proximally to the plunger; a distal valve located distally to the plunger; and a controller configured to control an infusion fluid delivery to the subject, wherein controlling delivery comprises triggering closing of the proximal valve, while the plunger is at an upper squeezing position, and triggering descending of the plunger from the upper squeezing position to a lower squeezing position, wherein at both the upper squeezing position and the lower squeezing position, said plunger is configured to squeeze a section of an infusion tube, such that opposite sides of an inner surface of said section do not contact one another, thereby facilitating delivery of an essentially constant volume of infusion fluid to the subject regardless of a potential degradation of the infusion tube.


As used herein, the term “upper squeezing position” refers to a position of a plunger at which an infusion tube is mildly squeezed (i.e. higher than a position at which the tube is not squeezed), without having the opposite sides of an inner surface of the squeezed section contacting one another. According to some embodiments, the delivery phase of the infusion pump is initiated at “upper squeezing position”.


As used herein, the term “lower squeezing position” refers to a position of the plunger at which an infusion tube is squeezed to a larger extent as compared to the upper squeezing position, yet still without having the opposite sides of an inner surface of the squeezed section contacting one another. According to some embodiments, the delivery phase of the infusion pump is initiated at “upper squeezing position”.


As used herein, the term “degradation” may refer to the tube losing its springiness, becoming deformed, bottoming out, or otherwise changing its shape or consistency in a manner affecting the drug delivery accuracy. According to some embodiments, the infusion tube may be a DEHP-free PVC infusion tube, a DEHP containing infusion tube, a polyethylene (PE) tube, a silicone tube, or the like. Each possibility is a separate embodiment.


As used herein, the term “infusion fluid” may refer to any fluid delivered to the patient such as, but not limited to, insulin, nutrients, saline solution, antibiotics, analgesics, anesthetics, hormones, vasoactive drugs, and chelation drugs, and any other therapeutic fluids or combination of fluids.


According to some embodiments, the plunger is configured to contact an outer surface of the infusion tube section during essentially the entire operation of the infusion pump. According to some embodiments, the plunger is configured to contact an outer surface of the infusion tube section during essentially the entire phase of delivery of the infusion fluid to the subject. According to some embodiments, the plunger is configured to some extent squeeze the infusion tube section, without having the opposite sides of an inner surface of the squeezed section contacting one another, during essentially the entire operation of the infusion pump. According to some embodiments, the plunger is configured to some extent squeeze the infusion tube section, without having the opposite sides of an inner surface of the squeezed section contacting one another, during essentially the entire phase of delivery of the infusion fluid to the subject. According to some embodiments, the plunger does not facilitate full relaxation of the infusion tube at any point of operation. According to some embodiments, the plunger does not fully squeeze/press the infusion tube at any point of operation.


As used herein, the term “entire” may refer to at least, at least 95% or at least 98% of the operation of the infusion pump/of the delivery phase. It is thus understood that briefly elevating the plunger during operation may be within the scope of this disclosure.


As used herein, the term “to some extent” with referral to the squeezing of the infusion tube refers to a squeezing of the infusion tube rendering the cross section of the squeezed section's lumen smaller than that of the infusion tube when non-squeezed, without having the opposite sides of an inner surface of the squeezed section contacting one another.


According to some embodiments, at the upper squeezing position, the plunger is configured to squeeze the section of the infusion tube to form a first inner tube cross section and wherein at the lower squeezing position, the plunger is configured to squeeze the section of the infusion tube to form a second inner tube cross section, wherein the second inner tube cross section is smaller than the first inner tube cross section and larger than a cross section of the infusion tube when non-squeezed.


According to some embodiments, the inner tube cross section of the infusion tube when the plunger is in its upper position is 50%-90% the size of the inner tube cross section of the infusion tube when non-squeezed. Each possibility is a separate embodiment.


According to some embodiments, the inner tube cross section of the infusion tube when the plunger is in its lower position is between 50%-10%, larger than the size of the inner tube cross section. Each possibility is a separate embodiment.


Any combination of upper and lower squeezed positions is a specific embodiment.


According to some embodiments, for a typical tube of 3 mm inner diameter and a wall thickness of 0.5 mm, a typical upper squeezing position, of the plunger is positioned about 0.8 mm to 1.8 mm, lower than the diameter of a non-squeezed tube. Each possibility is a separate embodiment.


According to some embodiments, for the same tube defined above, the lower squeezing position of the plunger is positioned about 2.0 mm-2.8 mm, below the non-squeezed tube. Each possibility is a separate embodiment.


According to some embodiments, the infusion pump is configured to maintain an essentially constant flow rate during the entire delivery of an infusion fluid. As used herein, the term “essentially constant” refers to a flow rate changing by less than 2% during the entire delivery. As a non-limiting example, the infusion pump is configured to maintain a delivery of an infusion fluid at a flow rate of 1 mL/hour±0.01 mL for at least 20, at least 36 or at least 96 hours.


According to some embodiments, the controller is further configured to control the intake of an infusion fluid from a reservoir, such as, but not limited to, an IV-bag or a syringe. According to some embodiments, controlling the intake of the infusion fluid comprises triggering opening of the proximal valve, closing of the distal valve and elevating the plunger to the upper squeezing position. According to some embodiments, during the intake phase, the plunger may initially be elevated to a position above the upper squeezing position for a brief moment (e.g. 1 sec or less) and then lowered back to the upper squeezing position. This may advantageously allow more room for the infusion tube to assume a relaxed configuration. In addition, when using a syringe as the reservoir, the initial elevation of the plunger to a position above the upper squeezing position prior to assuming the upper squeezing position may pump a small bolus into the syringe, thus reducing the residual vacuum left in the syringe at the end of the intake.


According to some embodiments, the pump further includes a motor in communication with the controller, the motor configured to operate the plunger. According to some embodiments, the motor may further be configured to operate the proximal valve, the distal valve or both. Alternatively, the pump may include one or two additional motors configured to operate the proximal valve, the distal valve or both. According to some embodiments, the controller may control the operation of the motor, thereby determining the exact position of the plunger. This may advantageously allow calibrating the upper and lower squeezing positions vis-à-vis the floor against which the infusion tube is squeezed according to dimensions and/or consistency of the infusion tube.


According to some embodiments, the controller may further be configured to determine a “wait” period, during which wait period the plunger remains at the upper squeezing position, thereby ensuring full engagement of the infusion tube with the plunger, prior to the opening of the infusion pump's downstream valve. This advantageously increases the accuracy of infusion fluid delivery in that the volume delivered remains constant even if the infusion tube has undergone degradation. Furthermore, due to the infusion tube fully engaging the plunger, a persistent ascending of the infusion tube after opening of the downstream valve is essentially prevented. Extraction of liquids from the patient is prevented. The length of the wait depends on the flow continuity requirements and the flow rate. For low flow rates (1-10 mL/hr) and flow continuity of bolus every 20 sec, the wait can last up to 18 sec. For high flow rates, the wait time is shorter (e.g. about 10 sec) and for very high flow rates (999 mL/hr) it may last less than 1 second. The long wait is particularly advantageous for low flow rates where the tube squeeze duty cycle is very long.


According to some embodiments, the wait period may be at least two seconds, or at least 5 seconds. According to some embodiments, the duration of the wait is dependent on the flow rate of the infusion fluid and/or the length of the plunger.


According to some embodiments, there is provided a method of operation of an infusion pump, the method comprising;

    • providing/utilizing an infusion pump comprising a plunger; a proximal valve located proximally to the plunger and a distal valve located distally to the plunger;
    • triggering opening of the proximal valve,
    • triggering closing of the distal valve; and
    • triggering the positioning of the plunger to an upper squeezing position at which the infusion tube positioned within the infusion pump is mildly squeezed yet without having opposite sides of the inner surface of its squeezed section contacting one another, thereby causing intake of fluid from a reservoir;
    • positioning/holding the plunger in the upper squeezing position;
    • triggering closing of the proximal valve, while the plunger is at the upper squeezing position; and
    • triggering descending of the plunger from the upper squeezing position to a lower squeezing position, at which the infusion tube is further squeezed, yet still without having opposite sides of the inner surface of its squeezed section contacting one another, thereby facilitating delivery of an essentially constant volume of the infusion fluid to a subject, regardless of a potential degradation of the infusion tube.


According to some embodiments, the infusion tube is at no point of operation fully squeezed/pressed by the plunger.


According to some embodiments, the method may further include briefly elevating the plunger to a position above the upper squeezing position, (while the proximal valve is open, and the distal valve closed) prior to the positioning of the plunger at the upper squeezing position, thereby allowing a small bolus of infusion fluid to flow into the syringe, thus reducing the vacuum created therein during the intake, as well as allowing more room for the infusion tube to assume a relaxed configuration.


According to some embodiments, the method may further include determining a “wait” period configured to ensure full engagement of the infusion tube with the plunger, wherein during the wait period the plunger remains at the upper squeezing position, prior to the opening of the infusion pump's downstream valve.


Reference is now made to FIG. 1A, which schematically illustrates upper and lower positions of prior art plungers. As shown in the figure, typical plungers are configured to assume an upper position (also referred to herein as an uppermost position) at which the infusion tube is fully relaxed (during fluid intake) and a lower position (also referred to herein as a lowermost position) at which the infusion tube is fully squeezed (during infusion fluid delivery).


As evident from FIG. 1B which shows exemplary photos of a DEHP-free PVC infusion tube prior to use (left panel), during use at its lower position (center panel) and during use at its upper position (center panel); during use the infusion tube undergoes degradation, i.e. loses its springiness and/or shape. That is, when the plunger fully squeezes the infusion tube, high stress is incurred, and the tube tends to bottom out. With time, when the plunger is elevated to its uppermost position (during intake), the tube acts as an overdamped spring and fails to fully engage the plunger. This, on the one hand, results in a lower volume of intake and thus to inaccurate/insufficient infusion fluid delivery, which at times may be harmful and even hazardous to the patient's health. To solve this problem, prior art pumps have been provided which include complex algorithms compensating for the changes in flow rate. However, as further demonstrated hereinbelow, such algorithms fail to accurately predict the changes in flow rate and variations therein are still prevalent. In addition, a continuous ascending of the tube towards the plunger may occur after the downstream valve has been opened, thus causing liquids to be extracted from the patient.


Reference is now made to FIG. 2A, which schematically illustrates upper and lower positions of the hereindisclosed plungers. As shown in the figure, the hereindisclosed plunger is configured to assume an upper position (also referred to herein as an upper squeezing position) at which the infusion tube is mildly squeezed (during fluid intake) and a lower position (also referred to herein as a lower squeezing position) at which the infusion tube is squeezed to a larger extent than at the upper squeezing position yet without having opposite sides of the tube's inner surface contacting each other (during infusion fluid delivery).


Advantageously and as evident from FIG. 2B which shows exemplary photos of a DEHP-free PVC infusion tube prior to use (left panel), and during use with the hereindisclosed plunger at its lower position (center panel), and its upper position (right panel); a crushing of the tube's wall is avoided, and the springiness of the tube is much less affected. That is, at the lower squeezing position, much less stress is incurred on the tubing, and the bottoming out obtained when fully squeezing the tube is essentially non-existent. In addition, due to the fact that the plunger squeezing the tube even at its upper squeezing position ensures that the tube engages the plunger at all times. As a result, the delivery flow rate remains constant during the entire use, and the need for compensating algorithms is obviated. In addition, since full engagement of the tube with the plunger is ensured, the continuous ascending of the tube towards the plunger, after opening of the downstream valve, is largely prevented. Altering between two squeezed states strengthens the minimum strength of the tube spring in the upper position and reduces the maximum tube squeeze at the lower position to reduce the degradation.


Reference is now made to FIG. 3 which schematically illustrates an infusion pump 300 with a plunger 310 having intermediate squeezing positions, according to some embodiments. Infusion pump 300 includes a proximal valve 320, also referred to herein as an inlet valve, positioned proximally/upstream to plunger 310 and configured to allow flow of infusion fluid from a reservoir (not shown) to an infusion tube 350. Infusion pump 300 further includes a distal valve 325, also referred to herein as an outlet valve, positioned distally/downstream to plunger 310 and configured to allow flow of infusion fluid from infusion tube 350 to a patient (not shown). The positioning of plunger 310, proximal valve 320 and distal valve 325 are carried out by motor 340 and associated cam shaft 342, although other embodiments, according to which positioning of plunger 310, proximal valve 320 and distal valve 325 is executed by separate motors, are also possible and within the scope of this disclosure. During intake of infusion fluid from a reservoir, a controller (not shown) is configured to control operation of motor 340 and associated cam shaft 342, which in turn brings about opening of proximal valve 320, closing of the distal valve 325, and positioning of plunger 310 in an upper squeezing position, at which infusion tube 350, positioned within infusion pump 300, is mildly squeezed, yet allowing infusion fluid intake. During delivery of infusion fluid, the controller triggers motor 340 and associated cam shaft 342 to close proximal valve 320, while plunger 310 is in its upper squeezing position; to open distal valve 325 and descending plunger 310 from the upper squeezing position to a lower squeezing position, at which the infusion tube is further squeezed, yet without having opposite sides of the inner surface of its squeezed section contacting one another, thereby facilitating delivery of an essentially constant volume of infusion fluid to the patient.


According to some embodiments, the controller may further be configured to define a “wait” period configured to ensure full engagement of infusion tube 350 with the plunger 310, wherein, during the wait period, plunger 310 remains at the upper squeezing position, while distal valve 325 is open. As a non-limiting example, if the maximum no flow time is set to 20 seconds and the closing of the distal and opening of the proximal valves takes 3 seconds, the controller may be configured to retain plunger 310 at the upper squeezing position for an additional 17 seconds, prior to commencing delivery by lowering plunger 310 to the lower squeezing position after the valves are switched back to delivery position. The wait period ensures full engagement of infusion tube 350 with plunger 310 prior to infusion fluid delivery and thus guarantees that an exact and constant amount of infusion fluid is delivered to the patient. In addition, by preventing continuous ascending/relaxing of infusion tube 350 during delivery (which may occur if full engagement between infusion tube 350 and plunger 310 is not achieved), liquid may be sucked from the patient into infusion tube 350. This may in turn result in blood entering the catheter and the tube, and cause occlusions in the infusion tube. In addition, the blood in the tube is also often found visually unpleasant to the patient and his/her surroundings. Defining a wait period may be of particular importance for low flow rate delivery in which case infusion tube 350 is squeezed by plunger 310 (in its lower squeezing position) for a prolonged period of time (e.g. 1-3 hours depending on the plunger length, tube ID and flow rate). The intake of the infusion fluid has a short duration (a few seconds) and, without the wait, will not be sufficient to recover the tube to the original upper position of the plunger, hence, will reduce the intake volume.


According to some embodiments, the controller may be further configured to trigger an elevating of plunger 310 to a position above the upper squeezing position (but still somewhat squeezed), while proximal valve 320 is open, and distal valve 325 closed, such that lowering of plunger 310 to the upper squeezing position causes a small bolus of infusion fluid to flow into the reservoir. Such initial backflow may be particularly advantageous when the infusion source is a syringe, in that it enables reducing the residual vacuum created within the syringe.


Reference is now made to FIG. 4 which is an illustrative flowchart 400 for operating an infusion pump, according to some embodiments.


Steps 410 to 450 are steps associated with intake of infusion fluid from a reservoir (also referred to herein as infusion source).


In step 410 an infusion tube is positioned within an infusion pump comprising a plunger, a proximal valve located proximally to the plunger, and a distal valve located distally to the plunger.


In step 420 an opening of the proximal valve and a closing of the distal valve is triggered, followed by a positioning of the plunger in an upper squeezing position at which the infusion tube is mildly squeezed (step 440), yet without having opposite sides of the inner surface of its squeezed section contacting one another, thereby causing intake of fluid from a reservoir.


Optionally, prior to positioning the plunger in its upper squeezing position, the method may include a step 430 in which the plunger is, for most of the wait time, elevated to a position above the upper squeezing position, (while the proximal valve is open, and the distal valve closed). This step may be particularly advantageous when the reservoir is a syringe in that it allows a small bolus of infusion fluid to flow into the syringe, thus reducing the residual vacuum created therein during the intake.


Optionally, after intake of infusion fluid from the reservoir is completed, the method may further include a step 450 at which the plunger “waits” at the upper squeezing position for the longest time the flow continuity and the flow rate permits, so as to ensure full engagement of the infusion tube with the plunger. According to some embodiments, the length of the wait period may depend on the length of the intake and may, for example, range between 2 seconds and 18 seconds when the required flow continuity is to have a maximum delivery every 20 seconds. If the flow continuity is defined by 10 minutes of maximum no flow time, the wait can last 10 minutes minus a few seconds. The choice of wait is the longest possible under the specific flow continuity and flow rate requirements.


Steps 460 to 470 are steps associated with delivery of the infusion fluid to a patient.


In step 460 the plunger is held in the upper squeezing position while closing of the proximal valve and opening of the distal valve is triggered. Subsequently, in step 470, a descending of the plunger from the upper squeezing position to a lower squeezing position is triggered, thereby causing the infusion tube to be further squeezed yet still without having opposite sides of the inner surface of its squeezed section contacting one another. As a result, delivery of an essentially constant volume of the infusion fluid to a subject is facilitated, regardless of a potential degradation of the infusion tube.


EXAMPLES
Example 1—Flow Rate Stability

In order to evaluate the flow rate stability of the hereindisclosed infusion pump a comparative study was set up. The study evaluated the flow rate over time of an infusion fluid delivered by the hereindisclosed infusion pump (Avoset) as compared to that obtained using a known infusion pump including a compensation algorithm configured to mathematically compensate for changes in flow rate caused by tube degradation.


As seen from FIG. 5A, when utilizing the hereindisclosed infusion pump for delivery of an infusion fluid at a flow rate of 1 mL/hr, 40 hours, a constant 1 mL/hr flow rate is obtained during the entire course of the delivery. This, as opposed to a prior art infusion pump, which despite incorporating compensation algorithms, has a declined flow rate over time, such that 30 hr after commencing the delivery, a flow rate of 0.9 mL/hr instead of 1 mL/hr is obtained, as seen in FIG. 5B.


This result clearly emphasizes the unexpected and convincing advantage of the hereindisclosed infusion pump, which is capable of ensuring a constant delivery of infusion fluid for 40 hours and more.


The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” or “comprising,” when used in this specification, specify the presence of stated features, integers, steps, operations, elements, or components, but do not preclude or rule out the presence or addition of one or more other features, integers, steps, operations, elements, components, or groups thereof.


Unless specifically stated otherwise, as apparent from the following discussions, it is appreciated that throughout the specification discussions utilizing terms such as “processing”, “computing”, “calculating”, “determining”, “estimating”, or the like, refer to the action and/or processes of a computer or computing system, or similar electronic computing device, that manipulate and/or transform data represented as physical, such as electronic, quantities within the computing system's registers and/or memories into other data similarly represented as physical quantities within the computing system's memories, registers or other such information storage, transmission or display devices.


Embodiments of the present invention may include apparatuses for performing the operations herein. This apparatus may be specially constructed for the desired purposes, or it may comprise a general purpose computer selectively activated or reconfigured by a computer program stored in the computer. Such a computer program may be stored in a computer readable storage medium, such as, but not limited to, any type of read-only memories (ROMs), random access memories (RAMs), electrically programmable read-only memories (EPROMs), electrically erasable and programmable read only memories (EEPROMs), or any other type of media suitable for storing electronic instructions, and capable of being coupled to a computer system bus.


The processes and displays presented herein are not inherently related to any particular computer or other apparatus. Various general purpose systems may be used with programs in accordance with the teachings herein, or it may prove convenient to construct a more specialized apparatus to perform the desired method. The desired structure for a variety of these systems will appear from the description below. In addition, embodiments of the present invention are not described with reference to any particular programming language. It will be appreciated that a variety of programming languages may be used to implement the teachings of the inventions as described herein.


The invention may be described in the general context of computer-executable instructions, such as program modules, being executed by a computer. Generally, program modules include routines, programs, objects, components, data structures, and so forth, which perform particular tasks or implement particular abstract data types. The invention may also be practiced in distributed computing environments where tasks are performed by remote processing devices that are linked through a communications network. In a distributed computing environment, program modules may be located in both local and remote computer storage media including memory storage devices.


While a number of exemplary aspects and embodiments have been discussed above, those of skill in the art will recognize certain modifications, additions and sub-combinations thereof. It is therefore intended that the following appended claims and claims hereafter introduced be interpreted to include all such modifications, additions and sub-combinations as are within their true spirit and scope.

Claims
  • 1. An infusion pump comprising: a plunger;a proximal valve located proximally to said plunger;a distal valve located distally to said plunger; anda controller configured to control an infusion fluid delivery to a subject and an infusion fluid intake from a reservoir,wherein controlling the infusion fluid intake comprises: closing said distal valve,opening said proximal valve,moving said plunger to an upper squeezing position, in which said plunger is configured to partially squeeze an infusion tube disposed within the infusion pump to facilitate intake of fluid into the infusion tube; andproviding a wait period, following the infusion fluid intake, during which said plunger remains at said upper squeezing position, thereby providing time for recovery of the infusion tube such that the infusion tube engages with the plunger;wherein controlling the infusion fluid delivery comprises: closing said proximal valve and opening said distal valve, while said plunger is at the upper squeezing position, andlowering said plunger from the upper squeezing position to a lower squeezing position,wherein at both the upper squeezing position and the lower squeezing position, said plunger is configured to squeeze a section of the infusion tube, such that opposite sides of an inner surface of said section do not contact one another, andwherein the controller is configured to set a duration of the wait period as a function of a maximum no-flow time between the infusion fluid intake and the infusion fluid delivery.
  • 2. The infusion pump of claim 1, wherein said plunger is configured to contact an outer surface of the infusion tube from an end of infusion fluid intake to an end of the infusion fluid delivery.
  • 3. The infusion pump of claim 1, wherein at the lower squeezing position said plunger is configured to squeeze the section of the infusion tube to form a first inner tube cross section, and wherein at the upper squeezing position said plunger is configured to squeeze the section of the infusion tube to form a second inner tube cross section, wherein the second inner tube cross section is larger than the first inner tube cross section and smaller than a cross section of the infusion tube when not squeezed.
  • 4. The infusion pump of claim 1, further comprising a motor in communication with said controller, said motor configured to operate said plunger.
  • 5. The infusion pump of claim 4, wherein said motor is further configured to operate said proximal valve, said distal valve, or both.
  • 6. The infusion pump of claim 4, wherein the motor is a first motor and the infusion pump further comprises a second motor configured to operate said proximal valve, said distal valve, or both.
  • 7. The infusion pump of claim 1, wherein said infusion tube is a DEHP-free PVC infusion tube.
  • 8. The infusion pump of claim 1, wherein the controller is configured to calibrate the upper squeezing position and the lower squeezing position of the plunger according to dimensions of the infusion tube.
  • 9. The infusion pump of claim 1, wherein controlling the infusion fluid intake further comprises initially positioning the plunger in a position that is above the upper squeezing position, followed by lowering the plunger to the upper squeezing position while the proximal valve is open so as to allow residual infusion fluid to backflow towards the reservoir.
  • 10. An infusion pump comprising: a plunger;a proximal valve located proximally to said plunger;a distal valve located distally to said plunger; anda controller configured to control an infusion fluid delivery to a subject and an infusion fluid intake from a reservoir,wherein controlling the infusion fluid intake comprises: closing said distal valve,opening said proximal valve,moving said plunger to an upper squeezing position, in which said plunger is configured to partially squeeze an infusion tube disposed within the infusion pump to facilitate intake of fluid into the infusion tube; andproviding a wait period, following the infusion fluid intake, during which said plunger remains at said upper squeezing position, thereby providing time for recovery of the infusion tube such that the infusion tube engages with the plunger;wherein controlling the infusion fluid delivery comprises: closing said proximal valve and opening said distal valve, while said plunger is at the upper squeezing position, andlowering said plunger from the upper squeezing position to a lower squeezing position,wherein at both the upper squeezing position and the lower squeezing position, said plunger is configured to squeeze a section of the infusion tube, such that opposite sides of an inner surface of said section do not contact one another, andwherein the controller is configured to set a duration of the wait period as a function of flow rate of the infusion fluid delivery to the subject.
  • 11. The infusion pump of claim 10, wherein said plunger is configured to contact an outer surface of the infusion tube from an end of infusion fluid intake to an end of the infusion fluid delivery.
  • 12. The infusion pump of claim 10, wherein at the lower squeezing position said plunger is configured to squeeze the section of the infusion tube to form a first inner tube cross section, and wherein at the upper squeezing position said plunger is configured to squeeze the section of the infusion tube to form a second inner tube cross section, wherein the second inner tube cross section is larger than the first inner tube cross section and smaller than a cross section of the infusion tube when not squeezed.
  • 13. The infusion pump of claim 10, further comprising a motor in communication with said controller, said motor configured to operate said plunger.
  • 14. The infusion pump of claim 13, wherein said motor is further configured to operate said proximal valve, said distal valve, or both.
  • 15. The infusion pump of claim 13, wherein the motor is a first motor and the infusion pump further comprises a second motor configured to operate said proximal valve, said distal valve, or both.
  • 16. The infusion pump of claim 10, wherein said infusion tube is a DEHP-free PVC infusion tube.
  • 17. The infusion pump of claim 10, wherein the controller is configured to calibrate the upper squeezing position and the lower squeezing position of the plunger according to dimensions of the infusion tube.
  • 18. The infusion pump of claim 10, wherein the control is configured to control the infusion fluid intake by initially positioning the plunger in a position that is above the upper squeezing position, followed by lowering the plunger to the upper squeezing position while the proximal valve is open so as to allow residual infusion fluid to backflow towards the reservoir.
  • 19. The infusion pump of claim 10, wherein the controller is configured to set the duration of the wait period as a function of flow rate of the infusion fluid delivery to the subject by setting the duration of the wait period as a function of a maximum no-flow time between the infusion fluid intake and the infusion fluid delivery.
CROSS REFERENCE TO RELATED APPLICATIONS

This application is a National Phase of PCT Patent Application No. PCT/IL2018/050409 having International filing date of Apr. 9, 2018, which claims the benefit of priority of U.S. Provisional Application No. 62/629,038 filed on Feb. 11, 2018. The contents of the above applications are all incorporated by reference as if fully set forth herein in their entirety.

PCT Information
Filing Document Filing Date Country Kind
PCT/IL2018/050409 4/9/2018 WO
Publishing Document Publishing Date Country Kind
WO2019/155453 8/15/2019 WO A
US Referenced Citations (198)
Number Name Date Kind
3379950 Friedline Apr 1968 A
3778195 Bamberg Dec 1973 A
4236880 Archibald Dec 1980 A
4314567 Cannon Feb 1982 A
4322668 Trussler et al. Mar 1982 A
4391600 Archibald Jul 1983 A
4650469 Berg et al. Mar 1987 A
5018945 D'Silva May 1991 A
5049047 Polaschegg et al. Sep 1991 A
5096385 Georgi et al. Mar 1992 A
5116203 Natwick May 1992 A
5340951 Hungerbuhler et al. Aug 1994 A
5437642 Thill et al. Aug 1995 A
5807075 Jacobsen et al. Sep 1998 A
5807322 Lindsey et al. Sep 1998 A
5843035 Bowman et al. Dec 1998 A
5924852 Moubayed et al. Jul 1999 A
5954485 Johnson et al. Sep 1999 A
6312227 Davis Nov 2001 B1
6494864 Kerwin et al. Dec 2002 B1
6523414 Malmstrom et al. Feb 2003 B1
6531708 Malmstrom et al. Mar 2003 B1
6554806 Butterfield et al. Apr 2003 B2
6659976 Beck et al. Dec 2003 B2
6679862 Diaz et al. Jan 2004 B2
6702779 Connelly et al. Mar 2004 B2
6750468 Malmstrom et al. Jun 2004 B2
6852094 Beck et al. Feb 2005 B2
6889556 Steger May 2005 B2
6907788 Malmstrom et al. Jun 2005 B2
6908452 Diaz et al. Jun 2005 B2
6979311 Miles et al. Dec 2005 B2
7048715 Diaz et al. May 2006 B2
7059840 Corwin et al. Jun 2006 B2
7070575 Beck et al. Jul 2006 B2
7092796 Vanderveen Aug 2006 B2
7121143 Malmstrom et al. Oct 2006 B2
7163381 Barak Jan 2007 B1
7356382 Vanderveen Apr 2008 B2
7384408 Barak Jun 2008 B2
7497842 Diaz et al. Mar 2009 B2
7695448 Cassidy et al. Apr 2010 B2
7726174 Riley et al. Jun 2010 B2
7758551 Wiesner et al. Jul 2010 B2
7819838 Ziegler et al. Oct 2010 B2
7875004 Yodfat et al. Jan 2011 B2
7881883 Remde Feb 2011 B2
7892199 Mhatre et al. Feb 2011 B2
7896197 Furey et al. Mar 2011 B2
7921718 Malmstrom et al. Apr 2011 B2
7922700 Evans et al. Apr 2011 B2
7967773 Amborn et al. Jun 2011 B2
7981082 Wang et al. Jul 2011 B2
8025654 Barak Sep 2011 B2
8034020 Dewey Oct 2011 B2
8048022 Moy et al. Nov 2011 B2
8081069 Haueter et al. Dec 2011 B2
8105269 Zhou Jan 2012 B2
8142400 Rotem et al. Mar 2012 B2
8152780 Evans et al. Apr 2012 B2
8167832 Bowman et al. May 2012 B2
8182461 Pope et al. May 2012 B2
8225639 Riley et al. Jul 2012 B2
8232484 Hauck Jul 2012 B2
8286505 Wade Oct 2012 B2
8287495 Michaud et al. Oct 2012 B2
8298184 Diperna et al. Oct 2012 B2
8328786 Strickler et al. Dec 2012 B2
8343111 Beck et al. Jan 2013 B2
8361021 Wang et al. Jan 2013 B2
8378837 Wang et al. Feb 2013 B2
8394051 Geipel Mar 2013 B2
8419676 Evans et al. Apr 2013 B2
8448523 Richter May 2013 B2
8486005 Yodfat et al. Jul 2013 B2
8486020 Hills et al. Jul 2013 B2
8496613 Zhou Jul 2013 B2
8539672 Eggers et al. Sep 2013 B2
8567235 Bojan et al. Oct 2013 B2
8641671 Michaud et al. Feb 2014 B2
8657778 Ziegler et al. Feb 2014 B2
8690014 Haueter et al. Apr 2014 B2
8690860 Abal Apr 2014 B2
8733178 Bivans et al. May 2014 B2
8752436 Beck et al. Jun 2014 B2
8758323 Michaud et al. Jun 2014 B2
8771227 Connelly et al. Jul 2014 B2
8795225 Lewis et al. Aug 2014 B2
8808230 Rotstein Aug 2014 B2
8821432 Unverdorben Sep 2014 B2
8852141 Mhatre et al. Oct 2014 B2
8859972 Cummings et al. Oct 2014 B2
8876787 Beck et al. Nov 2014 B2
8900213 Pope et al. Dec 2014 B2
8926561 Verhoef et al. Jan 2015 B2
8943894 Geipel Feb 2015 B2
8945064 Gravesen et al. Feb 2015 B2
8961453 Bowman et al. Feb 2015 B2
8974415 Robert et al. Mar 2015 B2
8986253 Diperna et al. Mar 2015 B2
9004886 Beck et al. Apr 2015 B2
9005153 Kopperschmidt et al. Apr 2015 B2
9017296 Beck et al. Apr 2015 B2
9033923 Hartman et al. May 2015 B2
9101712 Denis et al. Aug 2015 B2
9109966 Duits Aug 2015 B2
9132230 Blomquist Sep 2015 B2
9162023 Barnes et al. Oct 2015 B2
9173998 Rosinko et al. Nov 2015 B2
9211377 Diperna et al. Dec 2015 B2
9227008 Magnenat et al. Jan 2016 B2
9234850 Hammond et al. Jan 2016 B2
9248230 Geipel et al. Feb 2016 B2
9272087 Halbert et al. Mar 2016 B2
9285324 Leuenberger Jockel Mar 2016 B2
9308323 Adams Apr 2016 B2
9375531 Lee et al. Jun 2016 B1
9408968 Browne et al. Aug 2016 B2
9415158 Miller et al. Aug 2016 B2
9427521 Pope et al. Aug 2016 B2
9468713 Hoenninger, III et al. Oct 2016 B2
9474854 Mhatre et al. Oct 2016 B2
9480793 Mhatre et al. Nov 2016 B2
9480794 Keith et al. Nov 2016 B2
9545478 Abal Jan 2017 B2
9561323 Plahey et al. Feb 2017 B2
9603998 Geipel et al. Mar 2017 B2
9610404 Rotstein Apr 2017 B2
9642777 Lewis et al. May 2017 B2
9662437 Moosai May 2017 B2
9675756 Kamen et al. Jun 2017 B2
9677555 Kamen et al. Jun 2017 B2
9682192 Marsh et al. Jun 2017 B2
9683562 Davis et al. Jun 2017 B2
9717849 Mhatre et al. Aug 2017 B2
9757517 Eberhard Sep 2017 B2
9770552 Hartman et al. Sep 2017 B2
9775947 Keith et al. Oct 2017 B2
9789251 Robert et al. Oct 2017 B2
9839744 Muto et al. Dec 2017 B2
9879668 Yavorsky et al. Jan 2018 B2
9901676 Mijers et al. Feb 2018 B2
9932977 Bresina et al. Apr 2018 B2
9937290 Connelly et al. Apr 2018 B2
9937291 Eberhard Apr 2018 B2
9958344 Burkhard May 2018 B2
9962486 Rosinko et al. May 2018 B2
9987424 Kim Jun 2018 B2
9995642 Shimoyama et al. Jun 2018 B2
10004847 Wander et al. Jun 2018 B2
10006453 Girard et al. Jun 2018 B2
10022494 Shimizu Jul 2018 B2
10022495 Halbert et al. Jul 2018 B2
10022496 Geipel et al. Jul 2018 B2
10046112 Oruklu et al. Aug 2018 B2
10080836 Juretich et al. Sep 2018 B2
10092697 Nessel et al. Oct 2018 B2
10112009 Dudar et al. Oct 2018 B2
10151646 Heo et al. Dec 2018 B2
10539453 Hauck Jan 2020 B2
20030141468 Malmstrom et al. Jul 2003 A1
20050107923 Vanderveen May 2005 A1
20060173412 Susi Aug 2006 A1
20060189926 Hall et al. Aug 2006 A1
20060206054 Shekalim Sep 2006 A1
20060229531 Goldberger Oct 2006 A1
20070123781 Callahan et al. May 2007 A1
20070179435 Braig et al. Aug 2007 A1
20080283296 Zamora et al. Nov 2008 A1
20090221964 Rotem et al. Sep 2009 A1
20090240201 Rotem et al. Sep 2009 A1
20090293588 Riley et al. Dec 2009 A1
20100106082 Zhou Apr 2010 A1
20100114001 O'Mahony May 2010 A1
20100212407 Stringham et al. Aug 2010 A1
20100280446 Kalpin Nov 2010 A1
20110087165 Amborn et al. Apr 2011 A1
20110152772 Rotem et al. Jun 2011 A1
20110190606 Gable et al. Aug 2011 A1
20120205312 Hogard Aug 2012 A1
20120238949 Kalpin Sep 2012 A1
20120330574 Ruiter et al. Dec 2012 A1
20130035659 Hungerford et al. Feb 2013 A1
20130071271 Rosen et al. Mar 2013 A1
20130226129 Unverdorben Aug 2013 A1
20130336814 Kamen et al. Dec 2013 A1
20140066850 Robert et al. Mar 2014 A1
20140119954 Schweitzer et al. May 2014 A1
20140121639 Lowery et al. May 2014 A1
20140228755 Darrah et al. Aug 2014 A1
20150005732 Halbert et al. Jan 2015 A1
20150238689 Shimizu Aug 2015 A1
20150292500 Girard et al. Oct 2015 A1
20150367120 Kusters et al. Dec 2015 A1
20180140770 Hetchler et al. May 2018 A1
20180200456 Eitan et al. Jul 2018 A1
20180318505 Eitan et al. Nov 2018 A1
20200282138 Eitan et al. Sep 2020 A1
Foreign Referenced Citations (13)
Number Date Country
0182502 May 1986 EP
1381843 Mar 2009 EP
2040056 Sep 2010 EP
1381889 Mar 2016 EP
2570826 Aug 2016 EP
3705148 Sep 2020 EP
2553151 Apr 1985 FR
2150644 Jul 1985 GB
103727021 Apr 2014 IN
02068018 Sep 2002 WO
2012126744 Sep 2012 WO
2019155453 Aug 2019 WO
2020178824 Sep 2020 WO
Non-Patent Literature Citations (13)
Entry
Extended European Search Report for European Application No. 21194042.4, dated Feb. 17, 2022., 7 pp.
An Office Action dated Sep. 30, 2019, which issued during the prosecution of U.S. Appl. No. 15/740,365.
European Search Report dated Jun. 21, 2019 which issued during the prosecution of European Application No. 16817348.2.
An International Search Report and a Written Opinion both dated Aug. 5, 2018, which issued during the prosecution of Applicant's PCT/IL2018/050409.
U.S. Appl. No. 62/813,292, filed Mar. 4, 2019.
European Search Report dated Jun. 4, 2020, which issued during the prosecution of Applicant's European App No. 20160966.6.
An Office Action dated Jun. 22, 2020, which issued during the prosecution of U.S. Appl. No. 15/740,365.
An International Search Report and a Written Opinion both dated Jun. 9, 2020, which issued during the prosecution of Applicant's PCT/IL2020/050246.
An International Search Report and a Written Opinion both dated May 15, 2020, which issued during the prosecution of Applicant's PCT/IL2020/050249.
U.S. Appl. No. 62/629,038, filed Feb. 11, 2018.
European Search Report dated May 12, 2021 which issued during the prosecution of Applicant's European App No. 20212979.7.
European Search Report dated Oct. 8, 2021 which issued during the prosecution of Applicant's European App No. 18905766.4., 8pp.
Notice of Allowance dated Aug. 4, 2021, which issued during the prosecution of U.S. Appl. No. 16/808,652, 79pp.
Related Publications (1)
Number Date Country
20210001036 A1 Jan 2021 US
Provisional Applications (1)
Number Date Country
62629038 Feb 2018 US