The present invention is generally directed to tubing sets used in the administration of fluids to a patient that are commonly referred to as intravascular (“IV”) sets. More particularly, the present invention is directed to IV sets that include an air stop membrane to maintain a fluid column in the IV set even after a fluid bag has emptied. An IV set according to the invention is used broadly herein to describe tubing sets used in the arterial, intravenous, intravascular, peritoneal, and non-vascular administration of fluid. Of course, one of skill in the art may use an IV set to administer fluids to other locations within a patient's body.
One common method of administering fluids into a patient's blood flow is through an IV set. An IV set is an apparatus that generally includes a connector for connection to a fluid bag, a drip chamber used to determine the flow rate of fluid from the fluid bag, tubing for providing a connection between the fluid bag and the patient, and a connector for attachment to a catheter that may be positioned intravenously in a patient. An IV set may also include a Y-connector that allows for the piggybacking of IV sets and for the administration of medicine from a syringe into the tubing of the IV set.
It is a generally good practice to remove air from IV sets which access a patient's blood flow. While this concern is critical when accessing arterial blood, it is also a concern when accessing the venous side. Specifically, if air bubbles are allowed to enter a patient's blood stream while receiving the intravenous administration of fluids, the air bubbles can form an air embolism and cause serious injury to a patient.
Normally, in a majority of adults, the right atrium and the left atrium are completely separated from each other so that the blood and air bubbles are moved from the right atrium, to the right ventricle, and then to the lungs where the air bubbles may be safely vented. The bubble-free blood is then returned to the left atrium, where the blood is moved to the left ventricle and then sent throughout the body.
However, in infants and in a small portion of the adult population, the right atrium and left atrium are not completely separated. Consequently, air bubbles can move directly from the right atrium into the left atrium and then be dispersed throughout the body. As a result, these air bubbles may cause strokes, tissue damage, and/or death. Therefore, it is important to prevent air bubbles from entering a patient's blood stream.
In spite of the importance of removing air bubbles while priming an IV set for use in the intravenous administration of fluids, the complete removal of air bubbles can be a time consuming process. The process may also lead to contamination of the IV set by inadvertently touching a sterile end of the IV set. Typically, when an IV set is primed, a clamp is closed to prevent fluid from moving from a drip chamber through the tubing. The IV set is then attached to an IV bag or bottle. Once attached, the drip chamber, which is typically made of a clear flexible plastic, may be squeezed to draw the fluid out of the IV bag or bottle and into the drip chamber. The drip chamber is allowed to fill about ⅓ to ½ full when the clamp is opened to allow fluid to flow through the tube to an end of the IV set.
This initial process, however, typically traps air in tubing which must be removed. For example, the flow of the fluid through the tubing of the IV set may be turbulent and can entrap air within the tube as the boundary layer between the fluid and the tubing is sheared. The flow rate out of the drip chamber may be higher than the flow rate of fluid entering the drip chamber. This can cause a bubble ladder to form as air is sucked from the drip chamber into the tubing.
Additionally, air bubbles may be generated as drops of fluid strike the surface of the pool of fluid within the drip chamber. These air bubbles can be pulled into the tubing of the IV set from the drip chamber. This problem may be aggravated in pediatric applications where the drip orifice may be smaller which may result in increased turbulence.
To remove air bubbles from the IV set, fluid from the IV bag or bottle is allowed to flow through the tubing while an attendant taps the tubing to encourage the air bubbles out the end of the IV set. As the fluid is allowed to flow out of the IV set to clear air bubbles from the tubing, the fluid is generally allowed to flow into a waste basket or other receptacle. During this procedure the end of the tubing may contact the waste basket or be touched by the attendant and thus, become contaminated. An additional shortcoming of this debubbling process is that it requires attention and time that could have been used to perform other tasks that may be valuable to the patient.
Another debubbling method is to directly remove air bubbles from the IV set. More specifically, if the IV set includes a Y-connector, air bubbles may be removed at the Y-connector by a syringe.
To address the difficulties of removing bubbles from an IV set, various prior art IV set designs have employed a membrane for filtering air from the fluid as it flows through the IV set. For example, oftentimes a membrane may be placed in the bottom of the drip chamber so that fluid flowing out of the drip chamber must pass through the membrane. The membrane can be configured to allow the passage of fluid while blocking the passage of air. In this way, bubbles are prevented from passing into the tubing leading to the patient. Similarly, a membrane can be included in the connector that couples the tubing to a catheter to block any air present in the tubing from passing into the patient's vasculature.
The use of air filtering membranes in these prior art IV set designs have been beneficial. However, even with the use of these membranes, various drawbacks still exist. For example, if a fluid bag is allowed to empty, all of the fluid within the IV set will pass through the IV set and into the patient leaving the IV set full of air. Once this occurs, the IV set will have to be re-primed to remove the air from the IV set before a new fluid bag can be administered. To avoid having to re-prime the IV set, clinicians will therefore have to be present as a fluid bag is emptying to ensure that the fluid bag can be replaced before the drip chamber empties.
Also, if the clinician does not notice that air has entered into the tubing, he or she may fail to re-prime the IV set when connecting a new fluid bag. This may result in air passing into the patient once the new fluid bag is administered.
Embodiments of the present invention are generally directed to an IV set that includes an air stop membrane that maintains a fluid column within the IV set downstream of the membrane even after a fluid bag has emptied. By maintaining a fluid column downstream of the membrane, air is prevented from entering into the tubing that couples the IV set to the patient (e.g., via a catheter). For this reason, once a fluid bag has emptied, a new fluid bag can be coupled to the IV set without needing to re-prime the IV set. Therefore, when using an IV set in accordance with embodiments of the present invention, a clinician need not be present as a fluid bag is emptying to ensure that air does not enter the tubing.
A membrane in accordance with embodiments of the present invention can be configured to have a bubble point pressure that is sufficient to block the passage of air through the membrane once the membrane is exposed to air after the administration of a fluid bag. Because the membrane blocks the passage of air, the membrane forms a seal to maintain the negative pressure within the IV set downstream of the membrane. By maintaining this pressure, the fluid downstream of the membrane will remain within the IV set due to the surface tension between the fluid and the membrane pores.
The membrane can be positioned in different locations within an IV set including, for example, within the drip chamber, within the spike, or within a separate component positioned either below or above the drip chamber. The membrane can be formed of a hydrophilic porous material having a pore size and cross-sectional area selected to provide an adequate flow rate while also providing a sufficient bubble point pressure to maintain a fluid column. The optimal pore size and cross-sectional area of a membrane can vary based on the location of the membrane within the IV set.
An IV set that includes an air stop membrane can also include various additional components that function in conjunction with the air stop membrane to enhance the efficiency of the IV set. For example, an IV set can include an air stop membrane and a zero dead space luer access device. The use of a zero dead space luer access device minimizes the possibility that air will be trapped downstream of the air stop membrane which could otherwise inhibit the air stop membrane's ability to support or hold a fluid column and increase the likelihood of air being pushed into the patient. The use of a zero dead space luer access device also minimizes the number of steps clinicians need to take to eliminate air from the IV set.
An IV set having an air stop membrane may also include a vent cap or other throttling device to control the priming rate of the IV set. A bubble removal device could also be included to separate bubbles from the fluid. The components of the IV set can be formed of a clear material to allow a clinician to verify that air has been removed from the IV set.
An IV set having an air stop membrane may also incorporate antimicrobial components. For example, a component of the IV set that is positioned below the air stop membrane can include an antimicrobial coating or incorporate an antimicrobial insert. By positioning an antimicrobial coating or insert below the air stop membrane, the antimicrobial coating or insert will be in contact with the fluid column which may potentially remain stagnant until the empty fluid bag is replaced thereby minimizing the likelihood of microbial growth within the fluid column. Additionally or alternatively, an antimicrobial filter may be incorporated into the IV set to block the passage of microbes.
An IV set having an air stop membrane may also incorporate a precision flow controller for controlling the flow of fluid through the IV set. A precision flow controller can allow a clinician to quickly and accurately set the rate of fluid flow through the IV set while not interfering with the air stop membrane's ability to maintain a fluid column.
In one embodiment, the present invention is implemented as an IV set that includes a drip chamber; a spike for fluidly coupling the drip chamber to a fluid bag; tubing for coupling the drip chamber to a vascular access device; an air stop membrane that maintains a fluid column within the IV set below the air stop membrane after a fluid level within the IV set reaches the air stop membrane. The IV set may also include one or more of a zero dead space luer access device, a vent cap, a bubble removal component, an antimicrobial coating, insert, or filter, or a precision flow controller.
These and other features and advantages of the present invention may be incorporated into certain embodiments of the invention and will become more fully apparent from the following description and appended claims, or may be learned by the practice of the invention as set forth hereinafter. The present invention does not require that all the advantageous features and all the advantages described herein be incorporated into every embodiment of the invention.
In order that the manner in which the above-recited and other features and advantages of the invention are obtained will be readily understood, a more particular description of the invention briefly described above will be rendered by reference to specific embodiments thereof that are illustrated in the appended drawings. These drawings depict only typical embodiments of the invention and are not therefore to be considered to limit the scope of the invention.
The presently preferred embodiments of the present invention can be understood by reference to the drawings, wherein like reference numbers indicate identical or functionally similar elements. It will be readily understood that the components of the present invention, as generally described and illustrated in the figures herein, could be arranged and designed in a wide variety of different configurations. Thus, the following more detailed description, as represented in the figures, is not intended to limit the scope of the invention as claimed, but is merely representative of presently preferred embodiments of the invention.
Moreover, the Figures may show simplified or partial views, and the dimensions of elements in the Figures may be exaggerated or otherwise not in proportion for clarity. In addition, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to a terminal includes reference to one or more terminals. In addition, where reference is made to a list of elements (e.g., elements a, b, c), such reference is intended to include any one of the listed elements by itself, any combination of less than all of the listed elements, and/or a combination of all of the listed elements.
The term “substantially” means that the recited characteristic, parameter, or value need not be achieved exactly, but that deviations or variations, including for example, tolerances, measurement error, measurement accuracy limitations and other factors known to those of skill in the art, may occur in amounts that do not preclude the effect the characteristic was intended to provide.
As used herein, the term “proximal”, “top”, “up” or “upwardly” refers to a location on the device that is closest to the clinician using the device and farthest from the patient in connection with whom the device is used when the device is used in its normal operation. Conversely, the term “distal”, “bottom”, “down” or “downwardly” refers to a location on the device that is farthest from the clinician using the device and closest to the patient in connection with whom the device is used when the device is used in its normal operation.
As used herein, the term “in” or “inwardly” refers to a location with respect to the device that, during normal use, is toward the inside of the device. Conversely, as used herein, the term “out” or “outwardly” refers to a location with respect to the device that, during normal use, is toward the outside of the device.
Referring now to
Although not shown, IV set 100 (and other IV sets described in this specification) can include additional components that are commonly employed on an IV set including a clamp for sealing or constricting tubing 103, a flow controller (other than a clamp) for controlling the flow rate of fluid through tubing 103, auto-level features, zero-dead space connectors, back-check valves, bubble and/or particulate filters, etc.
IV set 100 includes an air stop membrane 105 that is positioned within drip chamber 101. Air stop membrane 105 can be positioned at or near the bottom of drip chamber 101 to ensure that it is positioned below the fluid level during use of the IV set to administer a fluid. Air stop membrane 105 can be formed of a hydrophilic porous material that spans the fluid path of drip chamber 101 to prevent fluid from bypassing the membrane. Air stop membrane 105 can be coupled to the inside surface of drip chamber 101 in any suitable manner including using ultrasonic attachment methods.
Because it is formed of a hydrophilic porous material, air stop membrane 105 will wet quickly once fluid enters into drip chamber 101 thereby causing fluid to flow quickly into tubing 103. As such, the inclusion of air stop membrane 105 does not substantially slow the priming process.
During administration of a fluid, IV set 100 can be employed in a similar manner as prior art IV sets. For example,
Referring now to
To cause a fluid column to be maintained below air stop membrane 105, air stop membrane 105 can be configured to have a bubble point pressure that is greater than the head of the fluid column or the pressure generated from rapidly decelerating a moving fluid column. Bubble point pressure is a term of art that generally refers to the amount of pressure (or pressure differential) that is required to force air through a membrane. For purposes of this specification, the bubble point pressure can be viewed as the amount of pressure at the top surface of air stop membrane 105 that is required to cause a bubble to pass from the top surface to the bottom surface of air stop membrane 105.
Because air stop membrane 105 is formed of a hydrophilic porous material, fluid will be retained within the pores of the membrane even after the level of fluid 110 has reached air stop membrane 105. Due primarily to capillary action, air above air stop membrane 105 will be blocked from passing through the pores of air stop membrane 105. Since air cannot pass through air stop membrane 105, once fluid 110 reaches the top surface of air stop membrane 105, fluid 110 will cease flowing out of tubing 103 thereby maintaining the fluid column as shown in
Referring now to
As with IV set 100, IV set 200 includes a drip chamber 202 coupled to spike 202, tubing 203 coupled to drip chamber 202, and a coupler 204 configured to connect tubing 203 to a vascular access device. Spike 202 includes a distal opening 202b through which fluid drips into drip chamber 201. Similarly, drip chamber 201 includes a distal opening 201a through which fluid passes into tubing 203.
In contrast, in
The specific configuration of air stop membrane 105/205 can vary based on the dimensions and intended use of IV set 100/200. For example, air stop membrane 105/205 can be configured with a bubble point pressure that will be sufficient to hold a fluid column that is equal to the length of tubing 103/203. In preferred embodiments, the bubble point pressure of air stop membrane 105/205 can be approximately 5.0 psig, sufficient to maintain a static fluid column of up to 3.5 meters and a dynamic fluid column (e.g., when fluid flowing through tubing is decelerated) of approximately 1.5 meters using, with various infusates at different temperatures to obtain a desired bubble point pressure, air stop membrane 105/205 can be configured with a suitable pore size.
Additionally, air stop membrane 105/205 can be configured with a cross-sectional area that is sufficient to provide a desired trans-membrane flow rate. For example, because air stop membrane 105 is positioned within drip chamber 101 which typically has an inside diameter of less than 0.75 inches (which is equivalent to an area of 2.85 cm2), air stop membrane 105 can be configured to provide a trans-membrane flow rate of at least 30 mL/min/cm2/bar. With this configuration, air stop membrane 105 will allow fluid 110 to flow through IV set 100 at a rate of approximately 0.5 L/hr, which may be sufficient for specific outpatient or non-rapid infusion scenarios. Of course, variations in the area or trans-membrane flow rate can be made as necessary to obtain this rate of 0.5 L/hr.
In contrast to what is shown in
In a preferred embodiment, air stop membrane 105/205 can be a polyethersulfone membrane having an effective pore size of approximately 5 μm, yielding a bubble point pressure of approximately 5.0 psig, a trans-membrane flow rate of approximately 2000 mL/min/cm2/bar, and a cross-sectional area of approximately 1.27 cm2 (which corresponds to a 0.5 inch diameter drip chamber). With these parameters, air stop membrane 105/205 will allow a flow rate greater than 6 L/hr while maintaining a static fluid column (e.g., when fluid 110/210 has come to rest) of 3.5 meters and a dynamic fluid column (e.g., when moving fluid 110/210 is brought to rest) of at least 1.5 meters.
Referring now to
In contrast, once fluid bag 306 has emptied, the level of the pool of fluid 310 within drip chamber 301 will decrease until the level has reached the top surface of air stop membrane 305 within membrane housing 320. At this point, for the reasons provided above, air will be blocked from passing through air stop membrane 305, and as a result, fluid 310 will remain within membrane housing 320 below air stop membrane 305. Because fluid 310 remains within membrane housing 320, a fluid column will be maintained within tubing 303b and membrane housing 320. Fluid bag 306 can therefore be replaced without re-priming IV set 300.
One benefit of employing a separate membrane housing 320 is that membrane housing 320 can have a greater size than drip chamber 301 which in turn allows air stop membrane 305 to have a greater cross-sectional area. The greater cross-sectional area allows air stop membrane 305 to provide a greater trans-membrane flow rate without having to reduce the pore size, thus reducing the bubble point pressure of the membrane.
On the other hand, another benefit of employing a separate membrane housing 320 is that it allows air stop membrane 305 to be positioned closer to the patient (i.e., closer to the distal end of tubing 303b) so that the required height of the fluid column can be reduced. In other words, membrane housing 320 could be spaced up to 2 feet below drip chamber 301 so that the length of tubing 303b is no greater than 4 feet. In such a configuration, the bubble point pressure of air stop membrane 305 could be reduced as it only needs to maintain a shorter fluid column. The lower bubble point pressure membrane would in turn allow for a higher trans-membrane flow rate thereby minimizing the cross-sectional area required to provide a fluid rate of 0.5 L/hr. Preferably, membrane housing 320 would be spaced no more than 2 feet below drip chamber 301 since the time required to prime IV set 300 is dependent on the IV set internal volume and thus the length of tubing 303a.
In a preferred embodiment, air stop membrane 305 can be a polyethersulfone membrane having an effective pore size of approximately 3-5 μm, a bubble point pressure of approximately 5.0 psig or more, a trans-membrane flow rate of approximately 2000 mL/min/cm2/bar, and a cross-sectional area of approximately 60 cm2 (which corresponds to a 3.5 inch diameter membrane housing). With these parameters, air stop membrane 305 will allow a flow rate significantly greater than 6.0 L/hr.
Although not shown in the figures, a separate membrane housing 320/420 could be used in an IV set that employs a remote spike. In other words, membrane housing 320/420 could be positioned between the drip chamber and a remote spike. In such embodiments, air stop membrane 305/405 would maintain a fluid column in a similar manner as shown in
Membrane housing 320/420 can be configured as two-piece components. Membrane 305/405 can be placed between the two pieces and the two pieces can be adhered in any suitable manner (e.g., ultrasonic welding, heat staking, laser welding, etc.) to form a seal around membrane 305/405. Also, when membrane housing 320/420 is formed from two pieces, membrane housing 320/420 can preferably be configured with a round shape so that alignment is not required when coupling the two pieces. However, membrane housing 320/420 can be in any shape including square and rectangular shapes.
In embodiments where IV set 100/200/300 is not configured to auto prime, air stop membrane 105/205/305/405 can be configured to have a wet time that is greater than one second to ensure proper flushing of tubing 103/203/303a/303d (and any connected components) during priming. This ensures that air is not introduced into the tubing below the membrane if the drip chamber is squeezed multiple times during priming. The air stop membrane 105/205/305/405 can be configured to have a wet time that is not more than 60 seconds so as to not interfere with the time required to prime IV set 100/200/300.
In any of the above described embodiments, the air stop membrane can be including in a PVC, DEHP-free, or PVC-free IV set. The air stop membrane may also be included in an IV set that is gravity-fed or pump compatible. The air stop membrane may also be included in an IV set that is used to administer hazardous drugs, or light-sensitive drugs. Any of spikes 102, 202, or 302 can be a macro drip spike that provides 20 drops/mL or a micro drip spike that provides 60 drops/mL.
In any of the above described embodiments, the air stop membrane can be replaced with another component that provides an air stop function for maintaining a fluid column. For example, a check valve with or without a biasing spring, a ball valve, or a needle and seat design could be employed. With each of these alternatives, the components can be configured to provide a suitable bubble point pressure and flow rate as described above.
An IV set in accordance with one or more embodiments of the invention can include one or more additional components to enhance the efficiency of the IV set when an air stop membrane is used to maintain a fluid column. These additional components include a zero dead space luer access device, a vent cap or other throttling device for controlling the priming rate of the IV set, a bubble removal component to separate bubbles from the fluid, an antimicrobial insert, coating, or filter to inhibit growth of microorganisms within the fluid column, or a precision flow controller for controlling the rate of fluid flow through the tubing.
As stated above, an air stop membrane can prevent air from entering the tubing of an IV set even after the fluid bag has emptied by maintaining a fluid column. The use of a zero dead space luer access device prevents air from being trapped within the tubing both during and after priming of the IV set. For example, if tubing 103 included a luer access device (e.g., a y or t-adapter) that was not a zero dead space device, it would be possible that air could be trapped within the branch of the luer access device. This trapped air could migrate into the flow of fluid and into the patient thereby defeating a purpose of the air stop membrane. Also, the trapped air could migrate upstream towards the air stop membrane where it could interfere with the membrane's ability to maintain the fluid column. Therefore, in accordance with one or more embodiments of the present invention, a zero dead space luer access device can be coupled in line with the tubing of the IV set to minimize the possibility that air will be trapped.
Because the effectiveness of an air stop membrane is dependent on the presence of air downstream of the air stop membrane, an IV set in accordance with one or more embodiments of the present invention can include a vent cap to control the priming rate of the IV set so that air is adequately removed from the IV set below the air stop membrane. For example, IV set 500 includes a vent cap 502 that is coupled to coupler 104. Vent cap 502 can include a distal opening that is sized to control the rate of fluid flow through the vent cap during the priming process. By controlling the priming rate, air can be prevented from passing through air stop membrane 105.
In some embodiments, an IV set can include a bubble removing component such as bubble removing membrane 503. Bubble removing membrane 503 can be a hydrophobic material that allows air but not fluid to pass. Bubble removing membrane 503 can therefore allow any air that is present within tubing 103 to escape. Although
In some embodiments, some or all of the components of an IV set can be formed of a clear material to allow a clinician to see whether air is present within the fluid downstream of an air stop membrane. For example, one or more of tubing 103, zero dead space luer access device 501, coupler 104, or vent cap 502 could be formed of a clear material.
When employing an IV set that includes an air stop membrane, it is possible that a fluid column will be stagnant for a period of time. As the fluid column remains stagnant, it is more likely that microorganisms can develop within the IV set. To address this possibility, one or more components of an IV set that are positioned below an air stop membrane can be formed of an antimicrobial material, can include an antimicrobial coating, or can include an antimicrobial insert. The antimicrobial material, coating, or insert can be configured to elute an antimicrobial agent into the fluid to inhibit the growth of microorganisms.
Although not depicted in the Figures, any of the components of an IV set can be formed of an antimicrobial material. For example, tubing 103/203/303a/303b could be formed by extruding a material that includes one or more antimicrobial chemicals which will be eluted when the tubing is in contact with a fluid.
In some embodiments, antimicrobial benefits can be provided by including an antimicrobial filter within an IV set. For example, a filter having a pore size of approximately 0.22 μm or less could be included within the fluid pathway thereby blocking the passage of any microorganisms. Preferably, such a filter could be positioned near or at a distal end of the tubing of the IV set.
Any of the above described antimicrobial inserts, coatings, or filters can be incorporated into any of the IV sets that are depicted in the figures or described herein. Also, one or more antimicrobial inserts, coatings, or filters can be included in conjunction with any of the zero dead space luer access device, vent cap, or bubble removing component described above.
In some embodiments, an IV set that includes an air stop membrane can also include a precision flow controller. A precision flow controller can facilitate setting the flow rate of fluid through the IV set. In many IV sets, a roller clamp is used to control the flow rate. These roller clamps are positioned around the tubing and include a roller that when rolled causes the tubing to be constricted.
If a roller clamp is used on an IV set that also includes an air stop membrane, the roller clamp can potentially prevent the air stop membrane from maintaining a fluid column. For example, once a fluid bag has emptied and a fluid column is maintained, closing the roller clamp can create a substantial vacuum within the tubing below the air stop membrane. This vacuum is a result of the peristaltic pumping action of the roller clamp. In other words, as it is rolled downward to constrict the tubing, a chamber is formed between the air stop membrane and the roller clamp within which the pressure may be at least temporarily reduced. If the reduction in pressure exceeds the bubble point pressure of the air stop membrane, air will be allowed to pass through the air stop membrane thereby causing the fluid column to flow out of the tubing.
A precision flow controller can be used in an IV set having an air stop membrane to minimize the likelihood that the fluid column will be disturbed since a precision flow controller does not use a rolling action along the axis of the tubing to constrict the tubing.
A precision flow controller could be used on any of the IV sets depicted in the figures or described herein. A precision flow controller could also be used in combination with one or more of a zero dead space luer access device, vent cap, bubble removing component, or antimicrobial insert, coating, or filter as described above
The present invention may be embodied in other specific forms without departing from its structures, methods, or other essential characteristics as broadly described herein and claimed hereinafter. The described embodiments are to be considered in all respects only as illustrative, and not restrictive. The scope of the invention is, therefore, indicated by the appended claims, rather than by the foregoing description. All changes that come within the meaning and range of equivalency of the claims are to be embraced within their scope.
This application claims priority to U.S. Provisional Patent Application Ser. No. 62/108,416, filed Jan. 27, 2015, and entitled IV SET HAVING AN AIR STOP MEMBRANE, which is incorporated herein in its entirety.
Number | Date | Country | |
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62108416 | Jan 2015 | US |