Hydraulically actuated pump for fluid administration

Information

  • Patent Grant
  • 9511187
  • Patent Number
    9,511,187
  • Date Filed
    Monday, July 27, 2015
    9 years ago
  • Date Issued
    Tuesday, December 6, 2016
    7 years ago
Abstract
A fluid delivery device comprises a hydraulic pump chamber having a hydraulic fluid. A fluid reservoir is coupled to the hydraulic pump chamber and is configured to contain a fluid deliverable to a patient. A first actuator is coupled to the hydraulic pump chamber and is configured to pressurize the hydraulic pump chamber and configured to transfer energy through the hydraulic pump chamber to the fluid reservoir. A second actuator is coupled to the hydraulic pump chamber and is configured to pressurize the hydraulic pump chamber and configured to transfer energy through the hydraulic pump chamber to the fluid reservoir.
Description
BACKGROUND OF THE INVENTION

The systems and methods described herein relate to a hydraulic pump system that can be used in medicament pumps for injectables, specifically to low-cost, miniature, single-use pump systems.


Various people, such as diabetics, require continuous or near continuous infusion of certain drugs or medicines (broadly referred to herein as medicaments).


Many attempts have been made to provide continuous or near continuous dosing of medicaments, such as insulin, using pump systems. For example, one known pumping technique uses gas generated by various means to advance a plunger in a syringe, thereby injecting the medicament through an infusion set. The infusion sets is a means for conveying medicament through the patient skin and may comprise a standard needle, a microneedle, a microneedle array, and a catheter and cannula system.


Although these systems can work quite well, patients using these systems, particularly in continuous dose mode, need to monitor closely or deactivate these devices under circumstances where the ambient air pressure may vary greatly, such as in an airplane. In particular, patients need to be careful that the infusion pump does not deliver a dangerously increased dosage in airplanes at high altitudes, where the ambient pressure is significantly reduced.


What is needed is a simple, inexpensive, single-use only medicament pump system. Such a system must have the capacity to provide variable dosing under patient control as well as safety and consistency in the metered dose at any range of ambient pressures or operating conditions.


SUMMARY

In an exemplary embodiment, the systems described herein include, inter alia, a pump device, which may be single use, and that provides for sustained low volume (preferably high potency) medicament application, such as for use by insulin-dependent diabetics and other patients. The pump may employ as an actuator a spring-compressed bellows crank, hinged plate, paired roller set, or other peristaltic mechanisms to force a volume of hydraulic fluid through a flow restrictor, such as an aperture, thereby expanding one chamber of a two chamber hydraulic cylinder. The second (fluid storage) chamber, containing a medicament, is vented through a conventional orifice as the hydraulic chamber is expanded by introduction of additional hydraulic fluid. The medicament thus expelled may then be injected or infused into a patient via any suitable injection and/or infusion mechanism.


The restrictor, in one embodiment, may be a hydraulic fluid aperture and may be a fixed micro-aperture of approximately 0.1-10 μm in diameter, or about 1-5 μm in diameter, and one ten-thousandths of an inch (0.0001″, or about 2.5 μm) in diameter. In another embodiment, the hydraulic fluid aperture may be an adjustable aperture providing either continuous orate p-wise diameter variations of approximately 0.1-10 μm in diameter, or about 1-5 μm in diameter, preferably one ten-thousandths of an inch (0.0001″, or about 2.5 μm) in diameter. Combined with a hydraulic fluid of appropriate viscosity, the micro-aperture provides precise pressure regulation that is insensitive to ambient pressure or other environmental conditions. This insensitivity, in turn, allows for highly accurate dosing and dose regulation under a wider range of conditions than previously seen in the arts.


Thus one aspect of the invention provides a hydraulically actuated fluid delivery system for sustained delivery of a liquid component, comprising: a pump chamber, and a fluid storage chamber having an orifice and being functionally connected to said pump chamber by a moveable barrier; a hydraulic fluid reservoir for storing a high viscosity fluid, said reservoir being connected to said pump chamber, via a restrictor, such as an aperture, which may be less than 10 μm in diameter, and the largest insoluble particle, if any, in said hydraulic fluid may optionally be no more than the size of said aperture; and, an actuator functionally connected to said hydraulic fluid reservoir to cause said hydraulic fluid to flow into said pump chamber through said aperture, thereby expanding the volume of said pump chamber, displacing said moveable barrier and causing a quantity of said liquid component stored in said fluid storage chamber to be delivered at a sustained rate.


In one embodiment, the pump chamber and the fluid storage chamber are both within a compartment.


In one embodiment, the moveable barrier is a piston or plunger plate.


In one embodiment, the movement of the piston or plunger plate is guided such that the piston or plunger plate does not flip or generate leakage when moving.


In one embodiment, the moveable barrier is one or more deformable membranes separating the pump and the fluid storage chambers.


In one embodiment, the liquid component is a medicament, and the wall of the fluid storage chamber is composed of bio-inert materials.


In one embodiment, the aperture has a fixed size.


In one embodiment, the aperture is adjustable in size to allow variable hydraulic pressure.


In one embodiment, the size of the aperture is adjusted by a thumbwheel control/dial.


In one embodiment, the thumbwheel control activates a miniaturized valve or iris device.


In one embodiment, the quantity of said liquid component is expelled at a rate selected from: about 100 nl-1 μl per minute, about 1-10 μl per minute, or about 10-100 μl per minute.


In one embodiment, the actuator is a miniaturized bellows crank, paired rollers, one or more piezoelectric elements, a ratchet or stepper motor driven unit, a two-plate hinged peristaltic mechanism, an electrically driven or piezoelectric mechanism.


In one embodiment, the actuator employs one or more external springs having a constant spring coefficient over its full range of motion.


In one embodiment, the fluid delivery system further comprises a connective passage linking the hydraulic fluid reservoir to the pump chamber through the aperture.


In one embodiment, the liquid component is a solution of a medicament.


In one embodiment, the medicament is insulin, an opiate, a hormone, a psychotropic therapeutic composition.


In one embodiment, the orifice of the fluid storage chamber is connected to an infusion set for delivering the liquid component to a patient.


In one embodiment, the patient is a mammalian patient selected from human or non-human animal.


In one embodiment, the infusion set is a needle, a lumen and needle set, a catheter-cannula set, or a microneedle or microneedle array attached by means of one or more lumens.


In one embodiment, the pump is manufactured with inexpensive material for single-use.


In one embodiment, the inexpensive material is latex-free and is suitable for use in a latex-intolerant patient.


In one embodiment, the inexpensive material is disposable or recyclable.


In one embodiment, the inexpensive material is glass or medical grade PVC.


In one embodiment, the fluid delivery system further comprises a second hydraulic reservoir.


In one embodiment, the second hydraulic reservoir is separately and independently controlled by a second actuator.


In one embodiment, the second hydraulic reservoir and the original reservoir are both connected via a common connective passage and through the aperture to the pump chamber.


In one embodiment, the second hydraulic reservoir is connected to the pump chamber through a second aperture.


In one embodiment, one of the two hydraulic reservoirs is used for sustained delivery of the liquid component, and the other of the two hydraulic reservoir is used for a bolus delivery of the liquid component at predetermined intervals.


In one embodiment, both apertures are independently adjustable.


In one embodiment, one of the two apertures are adjustable.


In one embodiment, the sustained delivery is over a period of: more than 5 hours, more than 24 hours, more than 3 days, or more than one week.


In one embodiment, the viscosity of the hydraulic fluid is at least about ISO VG 20, or at least about ISO VG 32, or at least about ISO VG 50, or at least about ISO VG 150, or at least about ISO VG 450, or at least about ISO VG 1000, or at least about ISO VG 1500 or more.


Another aspect of the invention provides a hydraulically actuated pump system comprising: a pump chamber functionally connected to a moveable barrier; a hydraulic fluid reservoir for storing a high viscosity fluid, said reservoir being connected to said pump chamber via an aperture of less than 10 and in some embodiments less than 3 μm in diameter, and the largest insoluble particle, if any, in said hydraulic fluid is no more than the size of said aperture; and, an actuator functionally connected to said hydraulic fluid reservoir to cause said hydraulic fluid to flow into said pump chamber through said aperture, thereby expanding the volume of said pump chamber, displacing said moveable barrier.


Another aspect of the invention provides a method of administering a medicament, comprising: compressing a hydraulic fluid reservoir to force said hydraulic fluid through a connection means; passing said hydraulic fluid through an adjustable aperture into a pump chamber, wherein said pump chamber is separated from an adjacent fluid storage chamber by a moveable barrier and wherein said fluid storage chamber is filled with a medicament; displacing said moveable barrier into said fluid storage chamber by filling said pump chamber with said hydraulic fluid, wherein said displacing causes a quantity of said medicament to be expelled from said fluid storage chamber through an output orifice.


In one embodiment, the passing is regulated by the adjustable aperture varying the flow of the hydraulic fluid and thus the quantity of the medicament expelled through the orifice.


In one embodiment, the method further comprises injecting a quantity of the medicament into a patient through an infusion set connected to the orifice.


In one embodiment, the compressing employs peristaltic compaction of the reservoir at a constant rate.


In one embodiment, the compressing employs peristaltic compaction of the reservoir at a variable rate.


In one embodiment, the method further comprises rapidly compressing a second hydraulic reservoir fluidly connected to the pump chamber to displace the moveable barrier and thus cause a bolus of the medicament to be expelled through the orifice.


In one embodiment, the method further comprises passing the hydraulic fluid from the second hydraulic reservoir through a second aperture into the pump chamber.


It should be understood that the individual embodiments described above are meant to be freely combined with one another, such that any particular combination may simultaneously contain two or more features described in different embodiments whenever appropriate. In addition, all embodiments described for one aspect of the invention (such as device) also applies to other aspects of the invention (e.g. method) whenever appropriate.





BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure may be better understood and its numerous features and advantages made apparent to those skilled in the art by referencing the accompanying drawings.



FIG. 1 is a high-level functional schematic drawing of a hydraulic pump system, according to one embodiment of the invention.



FIG. 2 is a high-level functional schematic drawing of a fluid delivery system comprising the hydraulic pump system, according to one embodiment of the invention.



FIGS. 3A-3B are schematic drawings illustrating one of the advantages of the fluid delivery system comprising the hydraulic pump system.



FIGS. 4A-4C are high-level functional schematic drawings of several fluid delivery system with various barriers.



FIG. 5 is a high-level functional schematic drawing of an alternative fluid delivery system, according to one embodiment of the invention. The alternative fluid delivery system in this embodiment features arrayed microneedles on an transdermal patch.



FIGS. 6A-6C are high-level functional schematic drawings of several actuator mechanisms that can be used with the fluid delivery system employing the hydraulic pump, according to one embodiment of the invention.



FIG. 7 is a high-level functional schematic drawing of the adjustable control for aperture opening size.



FIGS. 8A-8B are a high-level functional schematic drawings of several fluid delivery system with multiple actuators, according to one embodiment of the invention.





The use of the same reference symbols in different drawings indicates similar or identical items.


DETAILED DESCRIPTION

Described herein is a drug delivery system, uses thereof and methods for making the same. In one embodiment, the systems described herein provide pump devices for delivering a medicant, agent, fluid or some other material to a patient, typically through the skin. To this end, the system includes an actuator that operates on a reservoir of viscous fluid. The actuator causes the viscous fluid to apply pressure to the medicant being delivered. The viscous fluid is controlled by a restrictor that, in one practice, controls the rate of flow of the fluid so that an uneven application of pressure to the reservoir is mediated, and a controlled rate of fluid movement is achieved. This controlled rate of fluid movement is employed to cause a medicant to be delivered at a selected rate.


In one embodiment the systems and methods described herein include a hydraulic pump system that may include a chamber (the “pump chamber”) that can be filled with high viscosity fluid, which, when forced by pressure, enters the pump chamber through a restrictor, for example an opening/aperture, which is dimensionally adapted to control the rate of fluid flow therethrough. In one embodiment, the aperture is about the size of a 1-100 μm diameter circle (but not necessarily circular in shape). However, those of skill in the art will understand that any suitable restrictor may be employed, and that the size and the shape of the restrictor can vary to achieve the desired flow rate of the fluid being mediated under the expected conditions, including temperature and ambient pressure.


The increase in volume of the working fluid inside the pump chamber triggers the movement of a barrier mechanism, which can be coupled to other devices, such as a second (fluid storage) chamber.


One advantage of the instant hydraulic pump system resides with the restrictor through which the high viscosity working fluid flows. For example, when the restrictor is an aperture, when subjected to varying pressure, the working fluid enters the chamber through the aperture at a slow, yet relatively constant rate, thus mostly eliminating the potentially large variations in the force generating the pressure, while ensuring a substantially less variable expansion in volume of the working fluid in the chamber. This in turn leads to a relatively smooth and constant movement of the coupled barrier mechanism.


An additional advantage of the hydraulic pump system is that its relatively low requirement for a constant pressure source, or its high ability to tolerate relatively large variations in force generated by the pressure source. This is especially useful in manufacturing simple and inexpensive devices, such as single-use, disposable devices for medical use.


Partly because of the over-pressure employed in the hydraulic pump system, a further advantage is that the hydraulic pump is relatively insensitive to environmental changes, such as ambient temperature, altitude, or external pressure.


An illustrative embodiment of the hydraulic fluid system described herein is shown in the high-level functional drawing of FIG. 1. The pump chamber 110 may be shaped like, but is not limited to, a cylinder. The hatched lines represent a moveable barrier 130, which may (but need not (o) be at the distal end of aperture 152. Hydraulic fluid 112 enters aperture 152 on pump chamber wall 150 into pump chamber 110, optionally via a connective passage 116.


As used herein, the term “ultrapure” is understood to encompass, although not be limited to, a fluid wherein the largest insoluble impurity particle in the working fluid is smaller than the aperture size (which may be for example about 2-3 μm in diameter, but could be smaller or larger, and may be adjustable). In those embodiments wherein the restrictor is an aperture, the aperture need not be circular in shape, and could be an oval, a square, a rectangle, a triangle, a polygon, or irregular in shape. In those embodiments wherein the restrictor is a tube, valve, sieve, or other mechanism or combination of mechanisms, the size and shape of the restrictor may be determined empirically by testing the fluid flow of selected fluids at conditions of interest. In one particular embodiment, the largest impurity particle is no more than 1 mm in diameter, or no more than 500 nm in diameter, or no more than 100 nm in diameter. In addition, the total amount of insoluble impurity particle is less than 0.1%, or 0.01%, or 0.001% in volume.


Viscosity is ordinarily expressed in terms of the time required for a standard quantity of the fluid at a certain temperature to flow through a standard orifice. The higher the value, the more viscous the fluid. Since viscosity varies inversely with temperature, its value is less meaningful unless accompanied by the temperature at which it is determined. As used herein, “high viscosity” means the working fluid has a viscosity grade of at least about ISO VG 20, or at least about ISO VG 32, or at least about ISO VG 50, or at least about ISO VG 150, or at least about ISO VG 450, or at least about ISO VG 1000, or at least about ISO VG 1500.


The hydraulic pump system can be employed in a fluid delivery system that can be manufactured inexpensively, and could take advantage of the slow, yet relatively constant delivery rate associated with the hydraulic pump system. Partly due to the slow rate of delivery, the fluid delivery system can be used to continuously deliver a fluid over a long period of time, e.g. 6 hrs, 12 hrs, 1 clay, 3 days, 5 days, 10 days, one month, etc. The fluid delivery system comprises the hydraulic pump, coupled to a separate chamber for storing fluid to be delivered (the “fluid storage chamber” or “fluid chamber” in short). There could be various mechanisms coupling the movement of the barrier mechanism in the hydraulic pump to the fluid chamber, such that a small amount of fluid (ideally equal to, or at least proportional to the amount of the working fluid entering the hydraulic pump chamber) is expelled from the fluid chamber, through one or more orifice, in response to the movement of the barrier.


One embodiment of the fluid delivery system is illustrated in a high-level schematic drawing in FIG. 2 (see detailed description below). This type of fluid delivery system/device can be used for a broad range of applications, including but are not limited to biomedical research (e.g. microinjection into cells, nuclear or organelle transplantation, isolation of single cells or hybridomas, etc.), and clinical applications (administration of medicaments, etc.).


For example, to provide a low level or variable dose of medicine over a long period of time (e.g., hours or even days), the fluid delivery system may form a portion of a single-use dispenser for a medicament to be applied through any of the standard infusions sets available on the market today or likely to be available in the future. The fluid delivery system, formed in some embodiments as low-cost plastic parts, may comprise a hydraulic cylinder containing two chambers, one function as the pump chamber described above, the other the fluid chamber for storing medicaments. In those embodiments, the hydraulic cylinder may be configured similarly to most conventional hydraulic cylinders, and the wall, especially the inner wall of at least the chamber for storing a liquid medicament to be delivered, may be composed of bio-inert and inexpensive materials.


The following description is for principal illustration only and should not be construed as limiting in any respect. Various illustrative alternative embodiments are described further below.


Hydraulic cylinder 100, as described in FIG. 2, consists of two chambers, 110 and 120. Chamber 110 (corresponding to the pump chamber) is filled by hydraulic working fluid 112 from a hydraulic reservoir 114. Filling is accomplished by means of a connective passage 116, such as (but not limited to) a tube or lumen either flexibly or rigidly connecting hydraulic reservoir 114 and hydraulic cylinder 100. As hydraulic fluid 112 is forced out of reservoir 114 by actuator 135 (consisting, in an exemplary embodiment, of peristaltic compression plates 135A and 135B and hinge 135C), chamber 110 fills with hydraulic fluid expanding its volume and thus forcing piston element 130 (barrier mechanism) into chamber 120 (corresponding to the fluid chamber). The dotted lines in the actuator and the piston in FIG. 2 represent the later-in-time position of a plate-hinge actuating mechanism, and the later-in-time position of the barrier/piston.



FIGS. 3A-3B are schematic diagrams illustrating one advantage of the fluid delivery system, e.g., its ability to tolerate relatively large variations in force generating the over-pressure, to create a relatively constant fluid delivery rate over time or distance traveled by the barrier piston. It is apparent that without the hydraulic pump system, any direct use of force to expel fluid in the fluid chamber will be hard to control, and will be subjected to a large variation in delivery rate of the fluid (FIG. 3A). In contrast, with the hydraulic pump, the delivery rate is much more constant (FIG. 3B).


Chambers 110 and 120 can be, but are not necessarily separate, physical chambers, since both chambers can exist within the confines of a hydraulic cylinder such as the one in FIG. 2 (hydraulic cylinder 100). The chambers are separated by a moveable barrier, such as the piston element 130 in FIG. 2, where piston 130 may be a fluid-tight barrier that prevents hydraulic fluid 112 from entering the second medicament fluid storage chamber 120. However, the invention is not limited in the type of hydraulic cylinder 100 or the contours, dimensions or finishes of the interior surfaces of cylinder 100, chamber 110, or chamber 120. Furthermore, the invention is not limited to particular configurations of piston element 130. The following description illustrates several of many possible alternative embodiments that can be employed in the subject fluid delivery system.


In one embodiment, as shown in FIG. 4A, the piston element 130 in FIG. 2 is replaced by a flexible membrane 132 separating the pump chamber 110 and the fluid chamber 120. The flexible membrane can expand in response to the increased pressure from the pump chamber 110, due to the increase in volume of the working fluid entering the pump chamber 110 through aperture 152. This in turn expels fluid from the fluid chamber 120 via orifice 140.


In another embodiment, as shown in FIG. 4B, chambers 110 and 120 may each have a separate wall unit 134 and 136, respectively (such as expandable bags made from flexible materials). By virtue of being within the limited confinement of cylinder 100, the expansion in volume of chamber 110 necessarily leads to the decrease in volume of chamber 120, creating a force to expel liquid from chamber 120 via orifice 140.


In yet another embodiment, as shown in FIG. 4C, the pump chamber 110 and the fluid chamber 120 may be separated from each other, but are mechanically coupled through a barrier mechanism 138 that transmits movements in pump chamber 110 to that in the fluid chamber 120. The coupling mechanism 138 can either augment or diminish the magnitude of the initial movement in the pump chamber 110, such that the corresponding movement in the fluid chamber 120 is increased, or decreased, respectively, resulting in expelling a larger or smaller amount of medicament fluid from the fluid chamber 120. For example, the coupling mechanism 138 can be two pistons linked by a shaft, as shown in FIG. 4C. In one embodiment, the fluid chamber 120 may be detached from the pump chamber 110, so that a new fluid chamber (120′, not shown) may be re-attached.


As noted above, chamber 120 is to be initially filled with a quantity of liquid component to be delivered, such as a medicament. In the case of a medicament, the quantity would typically be determined by a medical professional in order to provide the necessary dosing over a pre-determined period of time. The volume of the fluid chamber may be about 100 μl, 500 μl, 1 ml, 3 ml, 5 ml, 10 ml, 30 ml, 50 ml, 100 ml or more.


The depicted hydraulic cylinder 100 in FIG. 2 can be further connected to an infusion set 160 through orifice 140 at the distal end of chamber 120 (distal here meaning the end of chamber 120 distant from piston 130). In other words, the output orifice 140 of hydraulic cylinder 100 is on the opposite end of the cylinder from hydraulic fluid input aperture 152, as one would commonly expect in a hydraulic system. However, this is merely one of the preferred designs. The output orifice 140 could be located on the wall of cylinder 100 at the chamber 120 portion if desired (see FIG. 5 below).


Attached to orifice 140, in some embodiments, is an infusion device or “set” 160 selected from any of the infusion means conventionally known and used in the medical arts. Examples of infusion devices include: a needle, such as depicted in FIG. 1; a lumen and needle set; a catheter-cannula set; or a microneedle or microneedle array attached by means of one or more lumens. One of ordinary skill in the art will readily appreciate that many devices exist to convey medicaments into a body. Accordingly, the invention is not limited in the types of infusion or injection devices used therewith.


In an illustrative embodiment, as shown here in a high-level schematic drawing in FIG. 5, the fluid delivery system is affixed to a delivery area of a patient, e.g. skin 200, by an adhesive means, such as a transdermal patch. The fluid chamber 120 is connected to a microneedle or an array of microneedles 180, such as those described in U.S. Pat. No. 6,503,231 (incorporated herein by reference). Unlike what is shown in FIG. 5, the microneedle(s) need not completely enter the skin layer 200. To achieve a low profile, both the pump chamber 110 and the fluid chamber 120 may be flat in shape (rather than shaped like a cylinder), and the outer-surfaces may hug the contour of the attached skin layer 200. The orifice(s) (not shown) connecting the fluid chamber and the microneedle(s) preferably opens on a side-wall of the fluid chamber 120. Alternatively, a connective passage may link the orifice on fluid chamber 120 to the microneedle or microneedle(s) array. Barrier 130 and aperture 152 are as described above. Also shown is one embodiment of the actuator, where plates 135 actuated by spring mechanism squeeze the hydraulic fluid reservoir 114 to inject hydraulic working fluid into the pump chamber 110. Other actuators, such as those described in other parts of the specification, may be adapted for use in this embodiment.


As exemplified in FIG. 2, in operation, the fluid (e.g. medicament) is administered by compressing hydraulic fluid reservoir 114 in a controlled manner with actuator 135. FIG. 2 shows an exemplary peristaltic mechanism actuator 135. However, the actuator may be alternatively selected from any of a number of squeeze devices that apply a force on the reservoir, such as a miniaturized bellows crank or paired rollers bearing on reservoir 114 (see FIG. 6 below). Moreover, in other embodiments, the reservoir can be acted on by an expanding gas volume, thermal energy, or any other device or process that will be capable of causing the fluid to apply a pressure, either directly or indirectly, to the medicant being delivered.


In the embodiment shown in FIG. 2, plates 135A and 135B are attached by hinge 135C and forced together by means of a spring or, in some embodiments, one or more piezoelectric elements, such that flexible (e.g., elastomeric) hydraulic fluid reservoir 114 is squeezed between them. Squeezing an elastomeric reservoir forces the contents of the reservoir out through whatever aperture exists in the reservoir. In some embodiments, an aperture 152 is provided by the coupling tube 116 and the adjustable aperture 150, further described below.


Actuator 135 may also take on other forms. Ratchet or stepper motor driven units that compress plates or other structures bearing on hydraulic reservoir 114 that move hydraulic fluid may also be used without departing from the present invention. Additionally, for a two-plate hinged peristaltic mechanism such as that represented by reference designator 135 in FIG. 2, springs mounted internally or externally to the plates (not shown) may be used to force the plates together. Electrically driven or piezoelectric mechanisms, such as those described in the prior art, may also be employed.


In one embodiment, as shown in FIG. 6A, one or more external spring(s) 135D having a constant spring coefficient over its full range of motion is (are) employed, (For the sake of simplicity, a single spring configuration is described. But multiple springs may be used to adjust forces.) This spring is disposed so as to connect portions of plates 135A and 135B distant from hinge 135C and to draw them together (inwardly), thus bearing on reservoir 114. Thus, when the system is initially prepared for use, the spring is extended (i.e., placed in tension) by forcing plates 135A and 135B apart. The plates are then held in place with a removable brace or other device (not shown) to keep them from compressing hydraulic reservoir 114. Once the pump is in place and connected through infusion means 160 (see FIG. 2, but not shown here) to inject the medicament into the patient, the brace may be removed. The constant spring tension placed on plates 135A and 135B of actuator 135 will then slowly force the plates together and squeeze hydraulic fluid 112 out of reservoir 114 in a peristalsis-like action.


In another embodiment, as illustrated in FIG. 6B, a compressed spring or set of springs 260 may be used to push a piston element 250 through a guided-path to compress the hydraulic fluid reservoir 114. At the end of the reservoir, distal to the piston element 250, is an aperture 152 that allows the hydraulic fluid 112 to enter the adjacent pump chamber 110, so that barrier 130 may move accordingly. In a more simplified version, the spring mechanism 250 and 260 may be replaced by thumb force 300, just like in a traditional syringe (FIG. 6C). In both FIGS. 6B and 6C, there is no connective passage separating the fluid reservoir 114 from the pump chamber 110.


The adjustable aperture provides regulation of the hydraulic pressure and flow rate in the pump chamber 110. This regulation may be effected by allowing the aperture 152 (in FIG. 2) to be adjusted to extremely small dimensions, for example, to a diameter of one-ten thousandths of an inch (0.0001 inches, or about 2.5 μm) or less.


In one embodiment, the aperture 152 has a fixed size. It does not have to be round/circular in shape. For example, it could be roughly a square, a triangle, an oval, an irregular shape, or a polygon. Whatever the shape, the area of the opening will be sized to achieve the flow rate desired. In example, the opening may be about one-tenth thousandths of an inch (or 2-3 μm) in diameter. Depending on use, the opening size can be anything, including an opening between 200 nm-500 nm, or 500 nm-1000 nm, or 1-2 μm, or 5-10 μm. Other sizes and dimensions can be selected and the size and dimension selected will depend upon the application at hand.


In other embodiments, as shown in FIG. 7, the aperture 152 may be adjustable in size, as by means of a conventional iris mechanism (see FIG. 7), miniature valve, or paired gating slits (for example and not by way of limitation) currently known in the arts. For example, the adjustable aperture 152 may be adjusted by means of a simple thumb wheel 150 that activates the conventional, miniaturized valve or iris device discussed above. In an alternate embodiment, an electrical motor or piezoelectric device may be used to open or close the aperture, thus affecting the rate at which hydraulic fluid 112 flows into chamber 110 and moves barrier 130.


Regardless of whether the aperture is adjustable or not, the flow rate of the hydraulic fluid can be controlled to suit different needs. In certain embodiments, the quantity of the fluid in the fluid chamber is expelled at a rate selected from: about 100 nl-1 μl per minute, about 1-10 μl per minute, or about 10-100 μl per minute. In other embodiments, the fluid rate is mediated and controlled to be from 0.001 μl per hour to 100 milliliters per hour. The rate selected will depend upon the application at hand, and those of skill in the art will be able to determine the proper dosage rate for a given application.


One feature of aperture 152, whether adjustable or not, is that it can be made extremely small so that hydraulic fluid 112 enters chamber 110 at very low rates, such as but not limited to rates as low as ones or tens of micro-liters per minute. When used with a hydraulic fluid of appropriate viscosity (further discussed below), the configuration of aperture 152 enables precise pressure regulation that is insensitive to ambient pressure or other environmental conditions. This insensitivity, in turns, allows for highly accurate dosing and dose regulation under a wider range of conditions than previously seen in the arts.


Hydraulic fluid 112 is, in some embodiments, an ultrapure, high viscosity, bio-inert material. Viscosity is limited at its upper bound by the amount of force developed by the actuator. In certain embodiments, the force generated by the actuator is about 10 lb, 5 lb, 3 lb, 2 lb, 1 lb, 0.5 lb, 0.1 lb, 0.001 lb or less. At its lower bound, the fluid must be viscous enough so that the flow can remain highly regulated by the combination of actuator pressure and aperture diameter in all environment conditions, especially in the presence of low atmospheric pressure and/or high ambient temperature (where viscosity tends to decrease). A simple test may be performed to roughly determine the average flow rate of the hydraulic fluid, by fixing an aperture size and the pushing force exerted on the fluid reservoir, and determining the amount of hydraulic fluid remaining in the reservoir (and thus the amount exited) after a period of time. Consecutive periods of hydraulic fluid loss (e.g. fluid loss in consecutive 5-minute periods, etc.) may be measured to determine if the rate of hydraulic fluid loss from the reservoir is constant over time under the condition used.


Medicaments suitable for use with the system presently disclosed include: insulin, opiates and/or other palliatives, hormones, psychotropic therapeutic composition, or any other drug or chemical whose continuous low volume dosing is desirable or efficacious for use in treating patients. Note too that “patients” can be human or non-human animal; the use of continuous dosing pumps is not confined solely to human medicine, but can be equally applied to veterinarian medicines.


In an alternate embodiment of the system, two or more hydraulic reservoirs and actuators are provided (FIGS. 8A-8B). In an illustrative embodiment shown in FIG. 8A, the first reservoir 400 and actuator 235 are the same as or similar to items 114 and 135 in FIG. 2. The second reservoir 500 and actuator 235, which may use the same peristaltic actuator 135 as shown in FIG. 2 or any other conventional alternative, such as those described above, are provided with a separate control. In other words, the second actuator may be controlled independently of the first. Both fluid reservoirs are connected to the pump chamber wall 150, through apertures 154 and 156, respectively. The connection may optionally go through connective passages 116. Such a configuration is useful in situations where special, discrete doses of the medicament may be necessary. For example, an insulin-dependent diabetic may often find it necessary to receive an additional booster dose or bolus of insulin immediately after meals, in addition to and along with continuously supplied insulin during the day. The second actuator control may thus be operated independently of the first actuator control mechanism to deliver the bolus.


In an alternative embodiment, shown in FIG. 8B, hydraulic fluid 112 from both reservoirs 400 and 500 may pass together through a common lumen 116 and thence through adjustable aperture 152 (FIG. 8B). Alternatively, as described above, the two reservoirs may lead into hydraulic chamber 110 by way of separate lumens and separately adjustable apertures 154 and 156 (FIG. 8A). In this latter configuration, the rate of dosing affected by either reservoir may be independently controlled through their respective adjustable apertures.


In a further alternative, one of the reservoirs may lead to a fixed aperture while the other leads to an adjustable aperture. In this embodiment, useful in cases such as the insulin-dependent diabetic described above, the fixed-aperture-connected hydraulic reservoir can be actuated to provide bolus dosing at discrete intervals, while the adjustable-aperture-connected hydraulic reservoir can be used to provide continuous slow dosing.


Exemplary Embodiment of Using the Fluid Delivery System


In one exemplary embodiment, there is provided a method of administering a medicament, comprising: compressing a hydraulic fluid reservoir to force said hydraulic fluid through a connection means; passing said hydraulic fluid through an adjustable aperture into a first, pump chamber, wherein said pump chamber is separated from an adjacent fluid storage chamber, for example, by a moveable barrier, and wherein said fluid storage chamber is filled with a medicament; displacing said moveable barrier into said fluid storage chamber by filling said pump chamber with said hydraulic fluid, wherein said displacing causes a quantity of said medicament to be expelled from said fluid storage chamber through an orifice.


Said passing may be regulated by said adjustable aperture varying the flow of said hydraulic fluid and thus the quantity of said medicament expelled through said orifice. Furthermore, the method may further comprise injecting a quantity of said medicament into a patient through an infusion set connected to said orifice.


In some embodiments, the step of compressing may employ peristaltic compaction of said reservoir at a constant rate. Alternatively, the compressing step may employ peristaltic compaction of said reservoir at a variable rate.


In yet another alternate embodiment, the method may further comprise rapidly compressing a second hydraulic reservoir fluidly connected to said pump chamber to displace said moveable barrier and thus cause a bolus of said medicament to be expelled through said orifice. This embodiment may further comprise passing said hydraulic fluid from said second hydraulic reservoir through a second aperture into said pump chamber.


Alternate Embodiments


The order in which the steps of the present method are performed is purely illustrative in nature, and the steps may not need to be performed in the exact sequence they are described. In fact, the steps can be performed in any suitable order or in parallel, unless otherwise indicated as inappropriate by the present disclosure.


While several illustrative embodiments of the hydraulic pump system and its use in the fluid delivery system have been shown and described, it will be apparent to those skilled in the art that changes and modifications may be made without departing from this invention in its broader aspect and, therefore, the appended claims are to encompass within their scope all such changes and modifications as fall within the true spirit of this invention.

Claims
  • 1. A fluid delivery device comprising: a hydraulic pump chamber having a rigid sidewall containing and contacting hydraulic fluid configured to urge a piston in a fluid reservoir to deliver fluid within the fluid reservoir to a patient;a first actuator;a first hydraulic reservoir chamber having a first amount of the hydraulic fluid and coupled between the first actuator and the hydraulic pump chamber, the first actuator being configured to urge the hydraulic fluid in the first hydraulic reservoir chamber into the hydraulic pump chamber;a flow restrictor fluidly coupling the first hydraulic reservoir chamber and the hydraulic pump chamber;a second hydraulic reservoir chamber having a second amount of the hydraulic fluid and fluidly coupled with the hydraulic pump chamber; anda second actuator configured to urge the hydraulic fluid from the second hydraulic reservoir chamber into the hydraulic pump chamber, independent of the first actuator.
  • 2. The fluid delivery device of claim 1, wherein the flow restrictor and the first actuator are configured to transfer the hydraulic fluid from the first hydraulic reservoir chamber to the hydraulic pump chamber to deliver the fluid from the fluid reservoir at a sustained basal rate.
  • 3. The fluid delivery device of claim 2, wherein the sustained basal rate is constant.
  • 4. The fluid delivery device of claim 2, wherein the sustained basal rate is over a period of more than 5 hours.
  • 5. The fluid delivery device of claim 2, wherein the sustained basal rate is over a period of approximately 24 hours.
  • 6. The fluid delivery device of claim 2, wherein the second actuator is configured to selectably transfer the hydraulic fluid from the second hydraulic reservoir chamber into the hydraulic pump chamber at discrete intervals to deliver a bolus dosage of the fluid in addition to the sustained basal rate.
  • 7. The fluid delivery device of claim 1, wherein the first and second actuators are compression springs.
  • 8. The fluid delivery device of claim 1, wherein the first and second actuators are coupled to the hydraulic pump chamber in parallel.
  • 9. The fluid delivery device of claim 1, wherein the first actuator includes two or more springs.
  • 10. The fluid delivery device of claim 1, wherein the hydraulic fluid has a viscosity of approximately ISO VG 1500 or more when in use.
  • 11. The fluid delivery device of claim 1, further comprising a moveable piston separating the hydraulic pump chamber and the second actuator.
  • 12. The fluid delivery device of claim 1, wherein the second hydraulic reservoir is positioned between the second actuator and the hydraulic pump chamber.
  • 13. The fluid delivery device of claim 1, wherein the flow restrictor is a fixed aperture.
  • 14. The fluid delivery device of claim 1 further comprising: the piston, the piston configured to sealingly slide along an inner wall of a hydraulic housing and separate the hydraulic housing into the hydraulic pump chamber having the rigid sidewall and the fluid reservoir.
REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No. 12/762,307, (now U.S. Pat. No. 9,125,983), filed on Apr. 17, 2010, which is a continuation of U.S. application Ser. No. 12/336,363 (now U.S. Pat. No. 8,070,726), filed on Dec. 16, 2008, which is a continuation of U.S. application Ser. No. 10/831,354 (now U.S. Pat. No. 7,530,968), filed on Apr. 23, 2004, which claims the benefit of U.S. Provisional Application No. 60/465,070, filed on Apr. 23, 2003, all of which are incorporated herein by reference in their entirety.

US Referenced Citations (816)
Number Name Date Kind
2605765 Kollsman Aug 1952 A
2702547 Glass Feb 1955 A
2828743 Ashkenaz et al. Apr 1958 A
3055362 Uytenbogaart Sep 1962 A
3187749 Sarnoff Jun 1965 A
3605745 Hodosh Sep 1971 A
3731681 Blackshear et al. May 1973 A
3886938 Szabo et al. Jun 1975 A
3963151 North, Jr. Jun 1976 A
4042153 Callahan et al. Aug 1977 A
4065230 Gezari Dec 1977 A
4085749 Chambron Apr 1978 A
4150672 Whitney et al. Apr 1979 A
4190048 Sampson Feb 1980 A
4193397 Tucker et al. Mar 1980 A
4202333 Thill et al. May 1980 A
4209014 Sefton Jun 1980 A
4258711 Tucker et al. Mar 1981 A
4267836 Whitney et al. May 1981 A
4298000 Thill et al. Nov 1981 A
4313439 Babb et al. Feb 1982 A
4323066 Bourdon Apr 1982 A
4340048 Eckenhoff Jul 1982 A
4351335 Whitney et al. Sep 1982 A
4360019 Portner et al. Nov 1982 A
4398908 Siposs Aug 1983 A
4411651 Schulman Oct 1983 A
4430079 Thill et al. Feb 1984 A
4431426 Groshong et al. Feb 1984 A
4437859 Whitehouse et al. Mar 1984 A
4443218 DeCant, Jr. et al. Apr 1984 A
4470771 Hall et al. Sep 1984 A
4490096 Box Dec 1984 A
4496343 Prosl et al. Jan 1985 A
4498843 Schneider et al. Feb 1985 A
4525165 Fischell Jun 1985 A
4529401 Leslie et al. Jul 1985 A
4548607 Harris Oct 1985 A
4552561 Eckenhoff et al. Nov 1985 A
4559038 Berg et al. Dec 1985 A
4561856 Cochran Dec 1985 A
4565542 Berg Jan 1986 A
4568335 Updike et al. Feb 1986 A
4583973 Humphrey et al. Apr 1986 A
4596575 Rosenberg et al. Jun 1986 A
4601707 Albisser et al. Jul 1986 A
H150 Hankner et al. Nov 1986 H
4627839 Young Dec 1986 A
4648872 Kamen Mar 1987 A
4650469 Berg et al. Mar 1987 A
4685902 Edwards et al. Aug 1987 A
4699615 Fischell et al. Oct 1987 A
4715852 Reinicke et al. Dec 1987 A
4718893 Dorman et al. Jan 1988 A
4723947 Konopka Feb 1988 A
4731058 Doan Mar 1988 A
4734092 Millerd Mar 1988 A
4741736 Brown May 1988 A
4744786 Hooven May 1988 A
4747824 Spinello May 1988 A
4749109 Kamen Jun 1988 A
4755172 Baldwin Jul 1988 A
4772263 Dorman et al. Sep 1988 A
4772273 Alchas Sep 1988 A
4781688 Thoma et al. Nov 1988 A
4784576 Bloom et al. Nov 1988 A
4784577 Ritson et al. Nov 1988 A
4790829 Bowden et al. Dec 1988 A
4808161 Kamen Feb 1989 A
4808167 Mann et al. Feb 1989 A
4813951 Cannon et al. Mar 1989 A
4816019 Kamen Mar 1989 A
4818186 Pastrone et al. Apr 1989 A
4822339 Tran Apr 1989 A
4826482 Kamen May 1989 A
4834704 Reinicke May 1989 A
4838857 Strowe et al. Jun 1989 A
4842584 Pastrone Jun 1989 A
4846806 Wigness et al. Jul 1989 A
4856340 Garrison Aug 1989 A
4861341 Woodburn Aug 1989 A
4874386 O'Boyle Oct 1989 A
4886499 Cirelli et al. Dec 1989 A
4894054 Miskinyar Jan 1990 A
4900305 Smith et al. Feb 1990 A
4902278 Maget et al. Feb 1990 A
4919134 Streeter Apr 1990 A
4925444 Orkin et al. May 1990 A
4927411 Pastrone et al. May 1990 A
4931050 Idriss Jun 1990 A
4952210 Alchas Aug 1990 A
4971900 Ahnell et al. Nov 1990 A
4976162 Kamen Dec 1990 A
4976696 Sanderson et al. Dec 1990 A
4998926 Alchas Mar 1991 A
5000994 Romberg et al. Mar 1991 A
5009641 Gorton Apr 1991 A
5024664 Mitchell Jun 1991 A
5037396 Streeter Aug 1991 A
5039279 Natwick et al. Aug 1991 A
5041094 Perego Aug 1991 A
5045064 Idriss Sep 1991 A
5053031 Borsanyi Oct 1991 A
5055001 Natwick et al. Oct 1991 A
5059174 Vaillancourt Oct 1991 A
5062774 Kramer et al. Nov 1991 A
5088515 Kamen Feb 1992 A
5090963 Gross et al. Feb 1992 A
5098262 Wecker et al. Mar 1992 A
5100380 Epstein et al. Mar 1992 A
5106374 Apperson et al. Apr 1992 A
5106627 Aebischer et al. Apr 1992 A
5108367 Epstein et al. Apr 1992 A
5135498 Kam Aug 1992 A
5135500 Zdeb Aug 1992 A
5144515 Frauhauf et al. Sep 1992 A
5158437 Natwick et al. Oct 1992 A
5165869 Reynolds Nov 1992 A
5167631 Thompson et al. Dec 1992 A
5169390 Athayde et al. Dec 1992 A
5176502 Sanderson et al. Jan 1993 A
5176641 Idriss Jan 1993 A
5176644 Srisathapat et al. Jan 1993 A
5178182 Kamen Jan 1993 A
5178609 Ishikawa Jan 1993 A
5180287 Natwick et al. Jan 1993 A
5181910 Scanlon Jan 1993 A
5188603 Vaillancourt Feb 1993 A
5193990 Kamen et al. Mar 1993 A
5197322 Indravudh Mar 1993 A
5207642 Orkin et al. May 1993 A
5207666 Idriss et al. May 1993 A
5211201 Kamen et al. May 1993 A
5217442 Davis Jun 1993 A
5219279 Natwick et al. Jun 1993 A
5219428 Stern Jun 1993 A
5222946 Kamen Jun 1993 A
5232449 Stern et al. Aug 1993 A
5242408 Jhuboo et al. Sep 1993 A
5248300 Bryant et al. Sep 1993 A
5250649 Onwumere et al. Oct 1993 A
5254096 Rondelet et al. Oct 1993 A
5257971 Lord et al. Nov 1993 A
5257987 Athayde et al. Nov 1993 A
5259732 Stern Nov 1993 A
5261884 Stern et al. Nov 1993 A
5263323 Maus et al. Nov 1993 A
5281210 Burke et al. Jan 1994 A
5295966 Stern et al. Mar 1994 A
5295967 Rondelet et al. Mar 1994 A
5300041 Haber et al. Apr 1994 A
5304126 Epstein et al. Apr 1994 A
5306257 Zdeb Apr 1994 A
5308334 Sancoff May 1994 A
5312364 Jacobs et al. May 1994 A
5319979 Abrahamson Jun 1994 A
5320600 Lambert Jun 1994 A
5322422 Natwick et al. Jun 1994 A
5328459 Laghi Jul 1994 A
5338157 Blomquist Aug 1994 A
5338312 Montgomery Aug 1994 A
5349852 Kamen et al. Sep 1994 A
5350357 Kamen et al. Sep 1994 A
5356379 Vaillancourt Oct 1994 A
5364242 Olsen Nov 1994 A
5368562 Blomquist et al. Nov 1994 A
5368571 Horres, Jr. Nov 1994 A
5370622 Livingston et al. Dec 1994 A
5376070 Purvis et al. Dec 1994 A
5389078 Zalesky et al. Feb 1995 A
2703084 Tomlinson Mar 1995 A
5396925 Poli Mar 1995 A
5399166 Laing Mar 1995 A
5399823 McCusker Mar 1995 A
5405614 D'Angelo et al. Apr 1995 A
5421823 Kamen et al. Jun 1995 A
5431626 Bryant et al. Jul 1995 A
5431634 Brown Jul 1995 A
5433710 VanAntwerp et al. Jul 1995 A
5438510 Bryant et al. Aug 1995 A
5445621 Poli et al. Aug 1995 A
5447286 Kamen et al. Sep 1995 A
5453099 Lee et al. Sep 1995 A
5456909 Marsh, Jr. et al. Oct 1995 A
5456940 Funderburk Oct 1995 A
5460618 Harreld Oct 1995 A
5462525 Srisathapat et al. Oct 1995 A
5464392 Epstein et al. Nov 1995 A
5466218 Srisathapat et al. Nov 1995 A
5472317 Field et al. Dec 1995 A
5474683 Bryant et al. Dec 1995 A
5480386 Brohy et al. Jan 1996 A
5485408 Blomquist Jan 1996 A
5487737 Meyer Jan 1996 A
5492534 Athayde Feb 1996 A
5505706 Maus et al. Apr 1996 A
5505709 Funderburk et al. Apr 1996 A
5505713 Van Antwerp Apr 1996 A
5507277 Rubsamen et al. Apr 1996 A
5514103 Srisathapat et al. May 1996 A
5515713 Saugues et al. May 1996 A
5526844 Kamen et al. Jun 1996 A
5527288 Gross et al. Jun 1996 A
5527307 Srisathapat et al. Jun 1996 A
5529463 Layer et al. Jun 1996 A
5531697 Olsen et al. Jul 1996 A
5531698 Olsen Jul 1996 A
5533389 Kamen et al. Jul 1996 A
5533994 Meyer et al. Jul 1996 A
5538399 Johnson Jul 1996 A
5538511 Van Antwerp Jul 1996 A
5540561 Johnson Jul 1996 A
5544519 Hammarberg et al. Aug 1996 A
5545152 Funderburk et al. Aug 1996 A
5564915 Johnson Oct 1996 A
5567119 Johnson Oct 1996 A
5567136 Johnson Oct 1996 A
5569186 Lord et al. Oct 1996 A
5570716 Kamen et al. Nov 1996 A
5574008 Johnson et al. Nov 1996 A
5575310 Kamen et al. Nov 1996 A
5575770 Melsky et al. Nov 1996 A
5578002 Slettenmark et al. Nov 1996 A
5578005 Sancoff et al. Nov 1996 A
5578012 Kamen et al. Nov 1996 A
5582591 Cheikh et al. Dec 1996 A
5584813 Livingston et al. Dec 1996 A
5584815 Pawelka et al. Dec 1996 A
5602171 Tang et al. Feb 1997 A
5607418 Arzbaecher Mar 1997 A
5614642 Tang et al. Mar 1997 A
5616123 Cheikh et al. Apr 1997 A
5628908 Kamen et al. May 1997 A
5634779 Eysymontt Jun 1997 A
5634896 Bryant et al. Jun 1997 A
5635387 Fei et al. Jun 1997 A
5637095 Nason et al. Jun 1997 A
5637099 Durdin et al. Jun 1997 A
5641892 Larkins et al. Jun 1997 A
5647853 Feldmann et al. Jul 1997 A
5647854 Olsen et al. Jul 1997 A
5655897 Neftel et al. Aug 1997 A
5656032 Kriesel et al. Aug 1997 A
5658250 Blomquist et al. Aug 1997 A
5658252 Johnson Aug 1997 A
5660846 Cheikh et al. Aug 1997 A
5665065 Colman et al. Sep 1997 A
5665070 McPhee Sep 1997 A
5669877 Blomquist Sep 1997 A
5672167 Athayde Sep 1997 A
5693018 Kriesel et al. Dec 1997 A
5694919 Rubsamen et al. Dec 1997 A
5695473 Olsen Dec 1997 A
5700244 Kriesel Dec 1997 A
5700904 Baker et al. Dec 1997 A
5702372 Nelson Dec 1997 A
5707361 Slettenmark et al. Jan 1998 A
5713865 Manning et al. Feb 1998 A
5716343 Kriesel Feb 1998 A
5718568 Neftel et al. Feb 1998 A
5722397 Eppstein Mar 1998 A
5722956 Sims et al. Mar 1998 A
5735263 Rubsamen et al. Apr 1998 A
5738658 Maus et al. Apr 1998 A
5741125 Neftel et al. Apr 1998 A
5749835 Glantz May 1998 A
5755683 Houle et al. May 1998 A
5764159 Neftel et al. Jun 1998 A
5772409 Johnson Jun 1998 A
5776103 Kriesel et al. Jul 1998 A
5777060 Van Antwerp Jul 1998 A
5782798 Rise Jul 1998 A
5785681 Indravudh Jul 1998 A
5785688 Joshi et al. Jul 1998 A
5788671 Johnson Aug 1998 A
5788673 Young et al. Aug 1998 A
5788678 Van Antwerp Aug 1998 A
5792123 Ensminger Aug 1998 A
5800420 Gross et al. Sep 1998 A
5800421 Lemelson Sep 1998 A
5807315 Van Antwerp et al. Sep 1998 A
5807375 Gross et al. Sep 1998 A
5810771 Blomquist Sep 1998 A
5820622 Gross et al. Oct 1998 A
5823746 Johnson Oct 1998 A
5827262 Neftel et al. Oct 1998 A
5837234 Gentile et al. Nov 1998 A
5837276 Cheikh et al. Nov 1998 A
5837680 Moses et al. Nov 1998 A
5843023 Cecchi Dec 1998 A
5848990 Cirelli et al. Dec 1998 A
5851197 Marano et al. Dec 1998 A
5858969 Marsh, Jr. et al. Jan 1999 A
5868711 Kramer et al. Feb 1999 A
5873857 Kriesel Feb 1999 A
5876370 Blomquist Mar 1999 A
5879143 Cote et al. Mar 1999 A
5882494 Van Antwerp Mar 1999 A
5891086 Weston Apr 1999 A
5906592 Kriesel et al. May 1999 A
5921962 Kriesel et al. Jul 1999 A
5928196 Johnson et al. Jul 1999 A
5935099 Peterson et al. Aug 1999 A
5935105 Manning et al. Aug 1999 A
5935106 Olsen Aug 1999 A
5935598 Sage et al. Aug 1999 A
5944695 Johnson et al. Aug 1999 A
5951521 Mastrototaro et al. Sep 1999 A
5952347 Arison et al. Sep 1999 A
5954485 Johnson et al. Sep 1999 A
5954695 Sims et al. Sep 1999 A
5957890 Mann et al. Sep 1999 A
5957895 Sage et al. Sep 1999 A
5960797 Kramer et al. Oct 1999 A
5961499 Bonutti et al. Oct 1999 A
5968014 Neftel et al. Oct 1999 A
5976109 Heruth Nov 1999 A
5989423 Kamen et al. Nov 1999 A
5995860 Sun et al. Nov 1999 A
6002954 Van Antwerp et al. Dec 1999 A
6006753 Efendic Dec 1999 A
6007555 Devine Dec 1999 A
6011984 Van Antwerp et al. Jan 2000 A
6012034 Hamparian et al. Jan 2000 A
6013057 Danby et al. Jan 2000 A
6017318 Gauthier et al. Jan 2000 A
6022316 Eppstein et al. Feb 2000 A
6024539 Blomquist Feb 2000 A
6025331 Moses et al. Feb 2000 A
6030399 Ignotz et al. Feb 2000 A
6040194 Chick et al. Mar 2000 A
6041801 Gray et al. Mar 2000 A
6043273 Duhaylongsod Mar 2000 A
6045734 Luther et al. Apr 2000 A
6048328 Haller et al. Apr 2000 A
6049727 Crothall Apr 2000 A
6051557 Drucker Apr 2000 A
6053893 Bucher et al. Apr 2000 A
6056718 Funderburk et al. May 2000 A
6056734 Jacobsen et al. May 2000 A
6057131 Marsh, Jr. et al. May 2000 A
6059753 Faust et al. May 2000 A
6065941 Gray et al. May 2000 A
6070761 Bloom et al. Jun 2000 A
6074369 Sage et al. Jun 2000 A
6077055 Vilks Jun 2000 A
6077246 Kullas et al. Jun 2000 A
6077248 Zumschlinge et al. Jun 2000 A
6077259 Caizza et al. Jun 2000 A
6083201 Skinkle Jul 2000 A
6085574 Neftel et al. Jul 2000 A
6087394 Duhaylongsod Jul 2000 A
6092249 Kamen et al. Jul 2000 A
6093167 Houben et al. Jul 2000 A
6093172 Funderburk et al. Jul 2000 A
6105829 Snodgrass et al. Aug 2000 A
6110152 Kovelman Aug 2000 A
6110427 Uffenheimer Aug 2000 A
6110721 Gibbs et al. Aug 2000 A
6112111 Glantz Aug 2000 A
RE36871 Epstein et al. Sep 2000 E
6120460 Abreu Sep 2000 A
6122536 Sun et al. Sep 2000 A
6123668 Abreu Sep 2000 A
6123685 Reynolds Sep 2000 A
6123686 Olsen et al. Sep 2000 A
6126642 Kriesel et al. Oct 2000 A
6127410 Duhaylongsod Oct 2000 A
6135978 Houben et al. Oct 2000 A
D434142 Cheney, II et al. Nov 2000 S
6142939 Eppstein et al. Nov 2000 A
6142972 Cheikh et al. Nov 2000 A
6152898 Olsen et al. Nov 2000 A
6155824 Kamen et al. Dec 2000 A
6165154 Gray et al. Dec 2000 A
6168609 Kamen et al. Jan 2001 B1
6175752 Say et al. Jan 2001 B1
6183434 Eppstein Feb 2001 B1
6183441 Kriesel et al. Feb 2001 B1
6186982 Gross et al. Feb 2001 B1
6190359 Heruth Feb 2001 B1
6191102 DiMarchi et al. Feb 2001 B1
6193704 Winters Feb 2001 B1
6202708 Bynum Mar 2001 B1
6203528 Deckert et al. Mar 2001 B1
6206850 O'Neil et al. Mar 2001 B1
6207856 Veech Mar 2001 B1
6210361 Kamen et al. Apr 2001 B1
6213943 Abreu Apr 2001 B1
6214617 Herman Apr 2001 B1
6223130 Gray et al. Apr 2001 B1
6228060 Howell May 2001 B1
6231320 Lawless et al. May 2001 B1
6231545 Kriesel et al. May 2001 B1
6234997 Kamen et al. May 2001 B1
6241704 Peterson et al. Jun 2001 B1
6248067 Causey, III et al. Jun 2001 B1
6248093 Moberg Jun 2001 B1
6251098 Rake et al. Jun 2001 B1
6253804 Safabash Jul 2001 B1
6254586 Mann et al. Jul 2001 B1
6259587 Sheldon et al. Jul 2001 B1
6261272 Gross et al. Jul 2001 B1
6261280 Houben et al. Jul 2001 B1
6267564 Rapheal Jul 2001 B1
D446854 Cheney, II et al. Aug 2001 S
6270478 Mernøe Aug 2001 B1
6283943 Dy et al. Sep 2001 B1
6284725 Coolidge et al. Sep 2001 B1
6284727 Kim et al. Sep 2001 B1
6287294 Lemelson Sep 2001 B1
6287521 Quay et al. Sep 2001 B1
6293925 Safabash et al. Sep 2001 B1
6302653 Bryant et al. Oct 2001 B1
6302990 Nelson Oct 2001 B1
6306420 Cheikh et al. Oct 2001 B1
6312393 Abreu Nov 2001 B1
6315769 Peer et al. Nov 2001 B1
6316038 Veech Nov 2001 B1
6319540 Van Antwerp et al. Nov 2001 B1
6321597 Demers et al. Nov 2001 B1
6323237 Veech Nov 2001 B1
6329336 Bridon et al. Dec 2001 B1
6334856 Allen et al. Jan 2002 B1
6338730 Bonutti et al. Jan 2002 B1
D453830 McDowell et al. Feb 2002 S
6343614 Gray et al. Feb 2002 B1
6346095 Gross et al. Feb 2002 B1
6348043 Hagen et al. Feb 2002 B1
6355019 Kriesel et al. Mar 2002 B1
6355021 Nielsen et al. Mar 2002 B1
6360888 McIvor et al. Mar 2002 B1
6362591 Moberg Mar 2002 B1
6364279 Neftel et al. Apr 2002 B1
6364857 Gray et al. Apr 2002 B1
6368274 Van Antwerp et al. Apr 2002 B1
6374876 Bynum Apr 2002 B2
6375459 Kamen et al. Apr 2002 B1
6375638 Nason et al. Apr 2002 B2
6379345 Constantz Apr 2002 B1
6382923 Gray May 2002 B1
6394981 Heruth May 2002 B2
6403558 Moses et al. Jun 2002 B1
6406455 Willis et al. Jun 2002 B1
6414018 Duhaylongsod Jul 2002 B1
6416293 Bouchard et al. Jul 2002 B1
6416495 Kriesel et al. Jul 2002 B1
6416496 Rogers et al. Jul 2002 B1
6422057 Anderson Jul 2002 B1
6423001 Abreu Jul 2002 B1
6423035 Das et al. Jul 2002 B1
6424847 Mastrototaro et al. Jul 2002 B1
6427088 Bowman, IV et al. Jul 2002 B1
D461241 Moberg et al. Aug 2002 S
D461891 Moberg Aug 2002 S
6429197 Coolidge et al. Aug 2002 B1
6432383 Modi Aug 2002 B1
6436072 Kullas et al. Aug 2002 B1
6440933 Bodor et al. Aug 2002 B1
6443942 Van Antwerp et al. Sep 2002 B2
6453956 Safabash Sep 2002 B2
6458102 Mann et al. Oct 2002 B1
6458355 Hsei et al. Oct 2002 B1
6461329 Van Antwerp et al. Oct 2002 B1
6461331 Van Antwerp Oct 2002 B1
6464667 Kamen et al. Oct 2002 B1
6464671 Elver et al. Oct 2002 B1
6465431 Thorn et al. Oct 2002 B1
6468532 Hsei et al. Oct 2002 B1
6471436 Gjata et al. Oct 2002 B1
6471674 Emig et al. Oct 2002 B1
6475180 Peterson et al. Nov 2002 B2
6475196 Vachon Nov 2002 B1
6485263 Bryant et al. Nov 2002 B1
6485461 Mason et al. Nov 2002 B1
6485465 Moberg et al. Nov 2002 B2
6495366 Briggs Dec 2002 B1
6495532 Bathurst et al. Dec 2002 B1
6500150 Gross et al. Dec 2002 B1
6503062 Gray et al. Jan 2003 B1
6503184 Ni et al. Jan 2003 B1
6503231 Prausnitz et al. Jan 2003 B1
6505059 Kollias et al. Jan 2003 B1
6512939 Colvin et al. Jan 2003 B1
6514500 Bridon et al. Feb 2003 B1
6520326 McIvor et al. Feb 2003 B2
6520747 Gray et al. Feb 2003 B2
6520936 Mann Feb 2003 B1
6520938 Funderburk et al. Feb 2003 B1
D471352 Shetler et al. Mar 2003 S
6527716 Eppstein Mar 2003 B1
6530900 Dailey et al. Mar 2003 B1
6537268 Gibson et al. Mar 2003 B1
6544193 Abreu Apr 2003 B2
6544229 Danby et al. Apr 2003 B1
6551276 Mann et al. Apr 2003 B1
6554798 Mann et al. Apr 2003 B1
6554800 Nezhadian et al. Apr 2003 B1
6555986 Moberg Apr 2003 B2
6558320 Causey, III et al. May 2003 B1
6558343 Neftel et al. May 2003 B1
6558345 Houben et al. May 2003 B1
6558351 Steil et al. May 2003 B1
6560471 Heller et al. May 2003 B1
6562001 Lebel et al. May 2003 B2
6564105 Starkweather et al. May 2003 B2
6565509 Say et al. May 2003 B1
6565531 Mori et al. May 2003 B1
6565534 Winters May 2003 B1
6565535 Zaias et al. May 2003 B2
6565885 Tarara et al. May 2003 B1
6571128 Lebel et al. May 2003 B2
6572586 Wojcik Jun 2003 B1
6577899 Lebel et al. Jun 2003 B2
6579690 Bonnecaze et al. Jun 2003 B1
6585644 Lebel et al. Jul 2003 B2
6585695 Adair et al. Jul 2003 B1
6586401 Thorn et al. Jul 2003 B1
6589229 Connelly et al. Jul 2003 B1
6589936 Thorn et al. Jul 2003 B1
6591876 Safabash Jul 2003 B2
6593295 Bridon et al. Jul 2003 B2
6595202 Ganan-Calvo et al. Jul 2003 B2
6595756 Gray et al. Jul 2003 B2
6595956 Gross et al. Jul 2003 B1
6604908 Bryant et al. Aug 2003 B1
6607509 Bobroff et al. Aug 2003 B2
6608101 Ni et al. Aug 2003 B1
6609898 Bury Aug 2003 B1
6610288 Edge et al. Aug 2003 B1
6611707 Prausnitz et al. Aug 2003 B1
6613026 Palasis et al. Sep 2003 B1
6613038 Bonutti et al. Sep 2003 B2
6616627 Willis et al. Sep 2003 B2
6617450 Stocker et al. Sep 2003 B1
6622732 Constantz Sep 2003 B2
6629954 Heruth Oct 2003 B1
6632215 Lemelson Oct 2003 B1
6635049 Robinson et al. Oct 2003 B1
6635743 Ebner et al. Oct 2003 B1
6641533 Causey, III et al. Nov 2003 B2
6641562 Peterson Nov 2003 B1
6642015 Vachon et al. Nov 2003 B2
6645175 Kriesel et al. Nov 2003 B2
6648821 Lebel et al. Nov 2003 B2
6651656 Demers et al. Nov 2003 B2
6652493 Das Nov 2003 B1
6652510 Lord et al. Nov 2003 B2
6653283 Moses et al. Nov 2003 B1
6656148 Das et al. Dec 2003 B2
6656158 Mahoney et al. Dec 2003 B2
6656159 Flaherty Dec 2003 B2
6659948 Lebel et al. Dec 2003 B2
6659982 Douglas et al. Dec 2003 B2
6660509 Herman et al. Dec 2003 B1
6663359 Gray Dec 2003 B2
6665909 Collins et al. Dec 2003 B2
6666845 Hooper et al. Dec 2003 B2
6669663 Thompson Dec 2003 B1
6669668 Kleeman et al. Dec 2003 B1
6669669 Flaherty et al. Dec 2003 B2
6671554 Gibson et al. Dec 2003 B2
6685664 Levin et al. Feb 2004 B2
6687546 Lebel et al. Feb 2004 B2
6689073 Quay Feb 2004 B2
6689100 Connelly et al. Feb 2004 B2
6689108 Lavi et al. Feb 2004 B2
6689607 Ni et al. Feb 2004 B2
6689747 Filvaroff et al. Feb 2004 B2
6692456 Eppstein et al. Feb 2004 B1
6692457 Flaherty Feb 2004 B2
6694191 Starkweather et al. Feb 2004 B2
6699219 Emig et al. Mar 2004 B2
6702779 Connelly et al. Mar 2004 B2
6703217 Herman et al. Mar 2004 B2
6709417 Houle et al. Mar 2004 B1
6711436 Duhaylongsod Mar 2004 B1
6712587 Gerhardt et al. Mar 2004 B2
6716190 Glines et al. Apr 2004 B1
6716193 Neftel Apr 2004 B1
6721582 Trepagnier et al. Apr 2004 B2
6723072 Mahoney et al. Apr 2004 B2
6726656 Kamen et al. Apr 2004 B2
6728560 Kollias et al. Apr 2004 B2
6733446 Lebel et al. May 2004 B2
6734162 Van Antwerp et al. May 2004 B2
6734186 Maw et al. May 2004 B1
6736795 Michel May 2004 B2
6737401 Kim et al. May 2004 B2
6740059 Flaherty May 2004 B2
6740072 Starkweather et al. May 2004 B2
6740075 Lebel et al. May 2004 B2
6740655 Magee et al. May 2004 B2
6749403 Bryant et al. Jun 2004 B2
6749587 Flaherty Jun 2004 B2
6750311 Van Antwerp et al. Jun 2004 B1
6752299 Shetler et al. Jun 2004 B2
6752785 Van Antwerp et al. Jun 2004 B2
6752787 Causey, III et al. Jun 2004 B1
6753177 Stocker et al. Jun 2004 B1
6753328 Wands et al. Jun 2004 B2
6755811 Constantz Jun 2004 B1
6758810 Lebel et al. Jul 2004 B2
6766183 Walsh et al. Jul 2004 B2
6768425 Flaherty et al. Jul 2004 B2
6770067 Lorenzen et al. Aug 2004 B2
6770729 Van Antwerp Aug 2004 B2
6774120 Ferber et al. Aug 2004 B1
6784274 Van Antwerp et al. Aug 2004 B2
6792982 Lincoln et al. Sep 2004 B2
6796956 Hartlaub et al. Sep 2004 B2
6796957 Carpenter et al. Sep 2004 B2
6800071 McConnell et al. Oct 2004 B1
6800663 Asgarzadeh et al. Oct 2004 B2
6801420 Talbot et al. Oct 2004 B2
6802823 Mason Oct 2004 B2
6804544 Van Antwerp et al. Oct 2004 B2
6805687 Dextradeur et al. Oct 2004 B2
6805693 Gray et al. Oct 2004 B2
6808369 Gray et al. Oct 2004 B2
6808506 Lastovich et al. Oct 2004 B2
6809507 Morgan et al. Oct 2004 B2
6809653 Mann et al. Oct 2004 B1
6810290 Lebel et al. Oct 2004 B2
6811533 Lebel et al. Nov 2004 B2
6811534 Bowman, IV et al. Nov 2004 B2
6813519 Lebel et al. Nov 2004 B2
6814715 Bonutti et al. Nov 2004 B2
6817990 Yap et al. Nov 2004 B2
6821949 Bridon et al. Nov 2004 B2
6824529 Gross et al. Nov 2004 B2
6827702 Lebel et al. Dec 2004 B2
6830558 Flaherty et al. Dec 2004 B2
6830564 Gray Dec 2004 B2
6840922 Nielsen et al. Jan 2005 B2
6843782 Gross et al. Jan 2005 B2
6849718 Kaelin, Jr. et al. Feb 2005 B2
6849719 Shi et al. Feb 2005 B2
6902544 Ludin et al. Jun 2005 B2
6936029 Mann et al. Aug 2005 B2
6939324 Gonnelli et al. Sep 2005 B2
6960184 Willis et al. Nov 2005 B2
6979316 Rubin et al. Dec 2005 B1
7011234 Stradella Mar 2006 B2
7014625 Bengtsson Mar 2006 B2
7022107 Christensen et al. Apr 2006 B1
7108686 Burke et al. Sep 2006 B2
7150409 Gonnelli et al. Dec 2006 B2
7204823 Estes et al. Apr 2007 B2
7250037 Shermer et al. Jul 2007 B2
7337922 Rake et al. Mar 2008 B2
7367968 Rosenberg et al. May 2008 B2
7481792 Gonnelli et al. Jan 2009 B2
7530968 Gonnelli May 2009 B2
7534226 Mernoe et al. May 2009 B2
7566320 Duchon Jul 2009 B2
7678079 Shermer et al. Mar 2010 B2
8070726 Gonnelli Dec 2011 B2
9072828 Gonnelli Jul 2015 B2
9125983 Gonnelli Sep 2015 B2
20010005781 Bergens et al. Jun 2001 A1
20010010238 Bynum Aug 2001 A1
20010016710 Nason et al. Aug 2001 A1
20010027287 Shmulewitz et al. Oct 2001 A1
20010031944 Peterson et al. Oct 2001 A1
20010037083 Hartlaub et al. Nov 2001 A1
20010053891 Ackley Dec 2001 A1
20010056259 Skinkle et al. Dec 2001 A1
20020004015 Carlisle et al. Jan 2002 A1
20020019612 Watanabe et al. Feb 2002 A1
20020040208 Flaherty et al. Apr 2002 A1
20020045867 Nielsen et al. Apr 2002 A1
20020055460 Coolidge et al. May 2002 A1
20020061838 Holmquist et al. May 2002 A1
20020072733 Flaherty Jun 2002 A1
20020077599 Wojcik Jun 2002 A1
20020091358 Klitmose Jul 2002 A1
20020095124 Palasis et al. Jul 2002 A1
20020123716 VanDiver et al. Sep 2002 A1
20020123735 Rake Sep 2002 A1
20020123740 Flaherty et al. Sep 2002 A1
20020128594 Das et al. Sep 2002 A1
20020138049 Allen et al. Sep 2002 A1
20020147131 Coolidge et al. Oct 2002 A1
20020151842 Gonnelli et al. Oct 2002 A1
20020151846 Christenson et al. Oct 2002 A1
20020156418 Gonnelli et al. Oct 2002 A1
20020156464 Blischak et al. Oct 2002 A1
20020177809 Kriesel et al. Nov 2002 A1
20020183693 Peterson et al. Dec 2002 A1
20020188259 Hickle et al. Dec 2002 A1
20020198493 Diaz et al. Dec 2002 A1
20020198494 Diaz et al. Dec 2002 A1
20030009133 Ramey Jan 2003 A1
20030022823 Efendic Jan 2003 A1
20030024508 Hellar et al. Feb 2003 A1
20030050237 Kim et al. Mar 2003 A1
20030050623 Lord et al. Mar 2003 A1
20030073626 Hathaway et al. Apr 2003 A1
20030100888 Spinello May 2003 A1
20030125669 Safabash et al. Jul 2003 A1
20030130619 Safabash et al. Jul 2003 A1
20030130647 Gray et al. Jul 2003 A1
20030135158 Gonnelli Jul 2003 A1
20030135160 Gray et al. Jul 2003 A1
20030158520 Safabash et al. Aug 2003 A1
20030163223 Blomquist Aug 2003 A1
20030167039 Moberg Sep 2003 A1
20030195157 Natarajan et al. Oct 2003 A1
20030199445 Knudsen et al. Oct 2003 A1
20030199823 Bobroff et al. Oct 2003 A1
20030212000 Van Antwerp Nov 2003 A1
20030216714 Gill Nov 2003 A1
20030220610 Lastovich et al. Nov 2003 A1
20030225373 Bobroff et al. Dec 2003 A1
20030229309 Babkes et al. Dec 2003 A1
20030233069 Gillespie et al. Dec 2003 A1
20040002682 Kovelman et al. Jan 2004 A1
20040029784 Hathaway Feb 2004 A1
20040064086 Gottlieb et al. Apr 2004 A1
20040064096 Flaherty et al. Apr 2004 A1
20040064097 Peterson Apr 2004 A1
20040073161 Tachibana Apr 2004 A1
20040077000 Stocker et al. Apr 2004 A1
20040085215 Moberg et al. May 2004 A1
20040091374 Gray May 2004 A1
20040092873 Moberg May 2004 A1
20040092893 Haider et al. May 2004 A1
20040094823 Matsuno May 2004 A1
20040115067 Rush et al. Jun 2004 A1
20040116905 Pedersen et al. Jun 2004 A1
20040126372 Banerjee et al. Jul 2004 A1
20040126373 Banerjee et al. Jul 2004 A1
20040133163 Schiffmann Jul 2004 A1
20040143216 Douglas et al. Jul 2004 A1
20040143217 Michel Jul 2004 A1
20040143218 Das Jul 2004 A1
20040153032 Garribotto et al. Aug 2004 A1
20040155079 Shetler et al. Aug 2004 A1
20040167464 Ireland et al. Aug 2004 A1
20040167470 Emig et al. Aug 2004 A1
20040176725 Stutz et al. Sep 2004 A1
20040209801 Brand et al. Oct 2004 A1
20040220456 Eppstein Nov 2004 A1
20040220525 Willis et al. Nov 2004 A1
20040225281 Lorenzen et al. Nov 2004 A1
20040247445 Nelson et al. Dec 2004 A1
20040249363 Burke et al. Dec 2004 A1
20040250382 Collins et al. Dec 2004 A1
20040254525 Uber et al. Dec 2004 A1
20040260234 Srinivasan et al. Dec 2004 A1
20040266678 Beeley et al. Dec 2004 A1
20040267201 Agerup Dec 2004 A1
20050008661 Fereira et al. Jan 2005 A1
20050024175 Gray et al. Feb 2005 A1
20050033232 Kriesel Feb 2005 A1
20050054988 Rosenberg et al. Mar 2005 A1
20050065472 Cindrich et al. Mar 2005 A1
20050070875 Kulessa Mar 2005 A1
20050112188 Eliaz et al. May 2005 A1
20050137530 Campbell et al. Jun 2005 A1
20050137578 Heruth et al. Jun 2005 A1
20050171477 Rubin et al. Aug 2005 A1
20050171512 Flaherty Aug 2005 A1
20050177109 Azzolini Aug 2005 A1
20050215850 Klein et al. Sep 2005 A1
20050234428 Spohn et al. Oct 2005 A1
20050245904 Estes et al. Nov 2005 A1
20050273083 Lebel et al. Dec 2005 A1
20050277912 John Dec 2005 A1
20050278073 Roth Dec 2005 A1
20060030838 Gonnelli Feb 2006 A1
20060069382 Pedersen Mar 2006 A1
20060079862 Genosar Apr 2006 A1
20060100578 Lieberman May 2006 A1
20060122628 Solar et al. Jun 2006 A1
20060150747 Mallett Jul 2006 A1
20060184119 Remde et al. Aug 2006 A1
20060184154 Moberg et al. Aug 2006 A1
20060189939 Gonnelli et al. Aug 2006 A1
20060200112 Paul Sep 2006 A1
20060264831 Skwarek et al. Nov 2006 A1
20060264835 Nielsen et al. Nov 2006 A1
20070016170 Kovelman Jan 2007 A1
20070060894 Dai et al. Mar 2007 A1
20070073236 Mernoe et al. Mar 2007 A1
20070100283 Causey, III et al. May 2007 A1
20070149925 Edwards et al. Jun 2007 A1
20070167912 Causey et al. Jul 2007 A1
20070173761 Kanderian, Jr. et al. Jul 2007 A1
20070179444 Causey et al. Aug 2007 A1
20070239114 Edwards et al. Oct 2007 A1
20070287958 McKenzie et al. Dec 2007 A1
20070287985 Estes et al. Dec 2007 A1
20080058719 Edwards et al. Mar 2008 A1
20080091176 Alessi et al. Apr 2008 A1
20080106431 Blomquist May 2008 A1
20080125701 Moberg et al. May 2008 A1
20080139910 Mastrototaro et al. Jun 2008 A1
20080183060 Steil et al. Jul 2008 A1
20080215006 Thorkild Sep 2008 A1
20080249468 Edwards et al. Oct 2008 A1
20080306436 Edwards et al. Dec 2008 A1
20080312512 Brukalo et al. Dec 2008 A1
20080319383 Byland et al. Dec 2008 A1
20090054867 Gravesen et al. Feb 2009 A1
20090062747 Saul Mar 2009 A1
20090088689 Carter Apr 2009 A1
20090088692 Adams et al. Apr 2009 A1
20090093772 Genosar et al. Apr 2009 A1
20090182277 Carter Jul 2009 A1
20090202608 Alessi et al. Aug 2009 A1
20090220358 Krivsky et al. Sep 2009 A1
20090240232 Gonnelli et al. Sep 2009 A1
20090247982 Krulevitch et al. Oct 2009 A1
20090281528 Grovender et al. Nov 2009 A1
Foreign Referenced Citations (48)
Number Date Country
3634725 Apr 1988 DE
3739657 May 1988 DE
3634725 Apr 1998 DE
0209677 Jan 1987 EP
0401179 Dec 1990 EP
0513879 Nov 1992 EP
0098592 Jan 1994 EP
0638324 Feb 1995 EP
0937475 Aug 1999 EP
0902696 Mar 2002 EP
1173197 Dec 2004 EP
1512410 Mar 2005 EP
1210136 Jan 2006 EP
2054381 Feb 1981 GB
62270167 Nov 1987 JP
7-503162 Aug 1993 JP
7310455 Feb 1974 NL
2248223 Mar 2005 RU
WO8314797 Aug 1993 WO
9728835 Aug 1997 WO
8503232 Jan 1998 WO
9808871 Mar 1998 WO
9810129 Dec 1998 WO
9947161 Sep 1999 WO
9948546 Sep 1999 WO
0066138 Nov 2000 WO
0066142 Nov 2000 WO
0100223 Jan 2001 WO
0187322 Nov 2001 WO
02085406 Oct 2002 WO
03008023 Jan 2003 WO
03050846 Jun 2003 WO
03061362 Jul 2003 WO
03080160 Oct 2003 WO
2004037195 May 2004 WO
2004089335 Oct 2004 WO
2004094823 Nov 2004 WO
2005046716 May 2005 WO
2005048952 Jun 2005 WO
2005060986 Jul 2005 WO
2007051139 May 2007 WO
2007129317 Nov 2007 WO
2008036509 Mar 2008 WO
2008139458 Nov 2008 WO
2009013735 Jan 2009 WO
2009016637 Feb 2009 WO
2009081403 Jul 2009 WO
2009125398 Oct 2009 WO
Non-Patent Literature Citations (27)
Entry
Gonnelli, Robert R. Barnett International Needle-Free Injection Systems presentation materials, Mar. 25, 2004, BioValve Technologies, Inc. (10 pages).
Banks et al., Brain uptake of the glucago-like peptide-1 antagonist exendin(9-39) after intranasal administration. J Pharmacol Exp. Ther. 309(2): 469-75, 2004.
Capaldi, Treatments and devices for future diabetes management. Nurs Times. 101(18): 30-2, 2005.
Choi et al., Control of blood glucose by novel GLP-1 delivery using biodegradable triblock copolymer of PLGA-PEG-PLGA in type 2 diabetic rats. Pharm Res. 21(5): 827-31, 2004.
Donahey et al., Intraventricular GLP-1 reduces short-but not long-term food intake or body weight in lean and obese rats. Brain Res. 779(1-2): 75-83, 1998.
Drucker, Development of glucagon-like peptide-1 based pharmaceuticals as therapeutic agents for the treatment of diabets. Curr Pharm Des. 7(14): 1399-412, 2001.
Gappa et al., The effect of zinc-crystallized glucagon-like peptide-1 on insulin secretion of macroencapsulated pancreatic islets. Tissue Eng. 7(1): 35-44, 2001.
Haak, New developments in the treatment of type 1 diabetes mellitus. Exp Clin Endocrinol Diabetes. 107 Suppl 3: S108-13, 1999.
Holst et al., On the treatment of diabetes mellitus with glucagon-like peptide-1. Ann N Y Acad Sci. 865: 336-43, 1998.
Hui et al., The short half-life of glucagon-like peptide-1 in plasma does not reflect its long-lasting beneficial effects. Eur J Endocrinol. 146(6): 863-9, 2002.
Joseph et al., Oral delivery of glucagon-like peptide-1 in a modified polymer preparation normalizes basal glycaemia in diabetic db/db mice. Diabetologia. 43(10); 1319-28, 2000.
Toft-Nielsen et al., Continuous subcutaneous infusion of glucagon-like peptide 1 lowers plasma glucose and reduces appetite in type 2 diabetic patients. Diabetes Care. 22(7): 1137-43, 1999.
Wang et al., Glucago-like peptide-1 can reverse the age-related decline in glucose tolerance in rats. J Clin Invest. 99 (1): 2883-9, 1997.
International Search Report for PCT/US2005/023818 dated Nov. 18, 2005.
International Search Report for PCT/US2007/65363 dated Sep. 18, 2008.
Office Action for U.S. Appl. No. 11/175,990 dated Nov. 10, 2009.
Office Action for U.S. Appl. No. 12/295,173 dated Jan. 26, 2010.
Singapore Written Opinion from Singapore Pat. App. No. 2008070302-5 dated Jan. 6, 2010.
Notice of Reasons for Rejection for Japanese Patent Application No. 2014-255376 dated Dec. 7, 2015.
English Translation of Notice of Reasons for Rejection for Japanese Patent Application No. 2014-255376 dated Dec. 7, 2015.
Office Action for U.S. Appl. No. 11/175,990 mailed Mar. 27, 2014.
USPTO Non-Final Rejection mailed Jun. 10, 2010 in connection with U.S. Appl. No. 12/295,173.
Third Official Examiner's Report for Australian patent application No. 2009202856 dated Dec. 6, 2011.
First EPO Examination Report issued in connection with European Application No. 01988242.2.
English Translation of First Office Action issued in connection with Chinese Application No. 200780020245.9.
International Search Report and Written Opinion mailed Dec. 10, 2010 in connection with International Application No. PCT/US10/52352.
Office Action for U.S. Appl. No. 12/336,395 dated Sep. 21, 2011.
Related Publications (1)
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20150328400 A1 Nov 2015 US
Provisional Applications (1)
Number Date Country
60465070 Apr 2003 US
Continuations (3)
Number Date Country
Parent 12762307 Apr 2010 US
Child 14809436 US
Parent 12336363 Dec 2008 US
Child 12762307 US
Parent 10831354 Apr 2004 US
Child 12336363 US