The present invention relates generally to medical devices, such as catheters, used in medical treatment and methods of use thereof The invention is particularly directed to medical devices, such as catheters, that are configured to inhibit occlusion during use and insertion into the patient with a reduced incidence of folding and occlusion.
Delivery devices such as infusion pumps and infusion sets are known for delivering a medication or drug to a patient over a prolonged period time. These devices typically include a soft flexible catheter that is inserted into the patient at a suitable depth for the drug delivery. A rigid cannula is often used as an inserter needle that extends through the catheter for penetrating the skin and positioning the catheter in the patient. After insertion, the cannula or insertion needle can be removed, leaving the catheter in the skin of the patient.
One example of an infusion set is sold under the trademark Quick-Set® infusion set by Medtronic. The infusion set includes a catheter assembly connected to a pump (e.g. MiniMed Paradigm® insulin pump by Medtronic) by a tubing set. A separate insertion device inserts and/or attaches the catheter assembly to a user by an introducer needle provided as a part of the infusion set. The catheter assembly can also be inserted manually into a user's skin. The infusion set and insertion device can also be combined, as in the Mio® infusion set sold by Medtronic that combines the infusion set and insertion device into one unit.
Another example of an insulin infusion device is referred to as a patch pump. A patch pump is an integrated device that combines most or all of the fluid components in a single housing that is adhesively attached to an infusion site, and does not require the use of a single housing that is adhesively attached to an infusion site, and does not require the use of a separate infusion or tubing set. A patch pump adheres to the skin, contains insulin or other medication, and delivers the drug or other substance over a period of time, either transdermal, or via an integrated subcutaneous catheter. Some patch pumps communicate with a separate controller device wirelessly such as one sold under the brand name OmniPod®, while others are completely self-contained. Both conventional pump infusion sets and patch pumps need to be reapplied on a frequent basis, such as every three days, as complications may otherwise occur.
These devices typically include flexible catheters that are inserted into the skin by the introducer needle, as is well known in the art. Once the introducer needle is removed, generally through the catheter, the catheter is enabled to deliver insulin. When the catheter is attached to a user, the catheter can become occluded. The tip of the catheter that dispenses the insulin to the user can become obstructed due to the formation of a blockage, such as tissue inflammation. In addition, the catheter may develop kinking, such that the catheter becomes snagged, knotted, or sharply bent to form a kink that impedes or blocks fluid flow out of the tip of the catheter.
The occlusion can be caused by mechanical problems, such as sliding back in an accordion or bellows fashion or the tip folding back on the introducer needle during insertion. In addition, kinking may also occur during deployment caused by a blunt end on the leading end of the catheter, which may cause excess force to be transmitted to the catheter as the catheter initially penetrates the outer surface of the skin. Similarly, excessive bounce or vibration in the insertion mechanization may also result in excessive force being transmitted to the catheter.
Occlusion can also be caused by biologic or pharmacologic and/or mechanical obstruction of the catheter tip by tissue structures. Depending on the level of irritation caused by the catheter and the movement allowed by the catheter adapter/hub, the tissue can become inflamed as part of a foreign body response, resulting in reduced insulin uptake. Further, there is a tendency for insulin to crystallize when flow is reduced to a minimum (low basal flow) or temporarily stopped, e.g. for bathing, swimming or extended periods, during which time the infusion set is disconnected from the pump. Insulin crystallization that is allowed to proliferate will ultimately occlude the catheter to a point at which the required pump pressure can exceed the normal flow conditions of the pump and trigger an alarm.
The tip of the catheter can also be blocked by an external force to the infusion site that can cause the open end of the catheter to press against tissue structures in the body. This phenomenon has been demonstrated in model tests in which a slight force is applied to the infusion hub in a downward direction, and it can be observed, via fluoroscopy, that the catheter is occluded at the tip.
It is highly desirable, to minimize the risks of occlusion, kinking, and other complications while maintaining a degree of comfort to the user, because once the catheter becomes fully or partially blocked, infusion therapy cannot take place at all, or can be reduced below target flow rates. Soft plastic catheters are prone to kink or occlude with normal wear, while the rigid catheters are often found to be uncomfortable to the user, because the rigid catheter tends to move around within the tissue of the user. Both soft plastic catheters and rigid catheters can also exhibit other undesired complications such as tissue inflammation and foreign body response.
Insulin infusion devices currently available on the market generally incorporate either a flexible catheter made of soft materials, such as soft plastic, fluorinated polymers, Teflon®, and so forth or a rigid catheter, such as a stainless steel cannula. A rigid cannula has a sharp tip, which is used to pierce the skin, similar to an introducer needle in a conventional inserter. Such products are recommended for individuals who have a high incidence of catheter kinking and are not recommended for use beyond two days, because they can occlude for the reasons mentioned above.
Accordingly, a need exists for an improved design, configuration and construction of medical devices to reduce the occurrence of occlusion.
The objects of the present invention are to provide medical devices configured and shaped to optimize fluid flow out of the medical device while maintaining column strength for catheter insertion, axial and radial strength for resistance to deformation, flexibility for user comfort, and tensile strength for durability, insertion and removal. The medical device in one embodiment can be a catheter and particularly a soft, flexible catheter such as those used in infusion sets for insulin injection.
These and other objects are substantially achieved by providing a medical device assembly wherein the medical device provides a tip having a shape and dimension that permits proper delivery of a fluid substance, such as insulin doses, to the user while reducing the incidence of kinking and/or occlusion of the device at the open end of the tip. In particular, one feature of the invention is to provide a device having a discharge or dispensing end having a shape and configuration that resists or inhibits the end or tip of the device from bending and folding inwardly into the fluid pathway thereby inhibiting occlusion during use.
In one embodiment, the medical device is an infusion set having a catheter that includes an elongate member having a sidewall, a first end portion, a second end portion, and an opening at each of the end portions, and a fluid pathway or lumen through the elongate member between the openings of the end portions of the elongate member, where a tip has a bevel to assist in insertion of the catheter into the patient and a thickness at a predetermined location from the tip to inhibit occlusion of the tip.
In another embodiment, the medical device is a catheter including an elongate member having a sidewall, a first end and a second end, an opening at each of the end, and a fluid pathway extending through the elongate member between the openings at the end of the elongate member, where the first end has a beveled end portion extending from a tip of the catheter and a tapered portion extending from the beveled end. The beveled end portion extends from the open end at an angle to assist in penetration of the catheter into the patient and where the radial thickness of the end portion at a bend point about equal to the radius of the fluid pathway at the tip is sufficient to inhibit folding or occlusion of the end portion of the catheter at the bend point.
Another embodiment the medical device can be a catheter having an elongate member having a tip with a beveled end at a first angle with respect to the longitudinal axis of the elongate member and a tapered portion extending from the beveled end at a second angle relative to the longitudinal axis and where the second angle is greater than the first angle to form a concave recessed profile of the end of the catheter.
A further embodiment provides a catheter having an elongate member with a rounded convex shaped end portion with a first radius of curvature and tapered portion extending from the rounded end portion with a second radius of curvature that is less than the first radius of curvature.
Another embodiment provides a method of administering a substance by a medical device such as a flexible catheter. The method includes the steps of providing a catheter with an elongate member having a sidewall, a first end, a second end, an opening at each of the ends, a fluid pathway through the elongate member between the openings of the ends of the elongate member, where the first end portion has a beveled portion with a first angle and a tapered portion extending from the beveled portion at a second angle, and where the beveled portion has a thickness to inhibit occluding of the catheter The method further includes inserting the catheter into a patient and administering a substance to the patient through the catheter.
Another embodiment provides an infusion system having a base, a hub detachably attached to the base, and a pump. The system includes a fluid tubing set that connects the pump and the base and a catheter, cannula, needle or other medical device with a fluid pathway through an elongate member.
The features of the invention are basically attained by providing a medical device comprising an elongate member comprising a sidewall, a first end portion with a first open end, second end portion with a second open end, a fluid pathway extending through the elongate member between the first open end and second open end. The first end portion has an inner surface forming the fluid pathway and an outer surface. The outer surface has a first beveled portion converging from the first open end, and where the sidewall at the first end portion has a first radial thickness at a location spaced from said first open end substantially equal to a radius of the fluid pathway to inhibit occlusion of said the open end during use.
The features of the invention are further attained by providing a medical device comprising: an elongate member comprising a sidewall, a first end portion, a second end portion, and an opening at each of the end portions; a fluid pathway extending through the elongate member between the openings at the end portions of the elongate member; and where the first end portion has a beveled end portion with a critical bend portion located a distance from the opening of the first end portion substantially equal to a radius of the fluid pathway, and where the elongate member has a radial thickness at the critical bend portion sufficient to resist folding of the end portion during insertion and use of the device.
Additional and/or other aspects and advantages of the present invention will be set forth in the description that follows, or will be apparent from the description, or may be learned by practice of the invention.
The various objects, advantages and novel features of the exemplary embodiments of the present invention will be more readily appreciated from the following detailed description when read in conjunction with the appended drawings, in which:
Reference will now be made in detail to embodiments of the present invention, which are illustrated in the accompanying drawings, wherein like reference numerals refer to like elements throughout. The embodiments described herein exemplify, but do not limit, the present invention by referring to the drawings. As will be understood by one skilled in the art, terms such as up, down, bottom, and top are relative, and are employed to aid illustration, but are not limiting.
The exemplary embodiments described below provide improved medical devices, such as catheters, for use with infusion sets and/or patch pumps, or as intravenous or peripheral catheters. The medical device of the invention is a device that can be inserted and positioned in the patient subcutaneously or intravenously. The medical device can be a probe, cannula, needle, catheter, and the like. The catheter can be a peripheral catheter or an intravenous catheter. In the embodiments described the medical device is a catheter for purposed of illustration but is not intended to be limiting. The medical device can be a hollow, tubular or elongated member having fluid passage or lumen capable for delivering a substance to a patient. The medical device is typically a flexible member, such as a flexible catheter. The catheter can have diameter and width suitable for use in an infusion set for delivering a substance, such as insulin.
In the embodiments shown, the medical device is a soft, flexible catheter. The invention reduces the catheter kinking, occlusion and other undesirable complications, such as tissue inflammation and foreign body response that may act to block or reduce the flow of medication fluids out of the catheter to the patient. The exemplary embodiments are presented in separate descriptions, although the individual features and construction of these embodiments can be combined in any number of ways to meet the therapeutic needs of the user.
It will be understood by one skilled in the art that this disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The embodiments herein are capable o of being modified, practiced or carried out in various ways. Also, it will be understood that the phraseology arid terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Unless limited otherwise, the terms “connected,” “coupled,” and “mounted,” and variations thereof herein are used broadly and encompass direct and indirect connections, couplings, and mountings. In addition, the terms “connected” and “coupled” and variations thereof are not limited to physical or mechanical connections or couplings. Further, terms such as up, down, bottom, and top are relative, and are employed to aid illustration, but are not limiting.
In the embodiment shown, the medical device is a catheter generally made of a flexible plastic material, and provides a high level of comfort to the user. The flexible catheters can deliver insulin or other medicaments to the target tissue or area with a reduced incidence of occlusion.
The catheter has a first end forming a tip that is configured to reduce the incidence of folding or collapsing of the tip that can cause occlusion of the catheter while maintaining a shape for ease and comfort of insertion into the skin of the patient without kinking and with reduced incidence of the tip portion folding or occluding during insertion and during use. The catheter is typically configured for use in a delivery device for delivering a drug or other medication, such as insulin to a patient.
The catheters of the invention provide a geometry, shape and configuration to provide a balance between the ease and comfort of insertion into the patient and strength to reduce the incidence of occlusion forming during insertion and during use generally caused by the end or tip of the catheter folding or deflecting inward into the fluid pathway that will restrict the dispensing of a substance. Catheters with a large bevel angle forming a large penetration angle are shown to exhibit high penetration forces during insertion while exhibiting higher strength and resistance to occlusion during use. Catheters having a tip with a lower penetration angle provide easier penetration while exhibiting a higher incidence of occlusion during use. The catheter of the invention can have various dimensions. In one embodiment, the catheter can be a 24 G catheter. In other embodiments, the catheter can be as 26 G or a 28 G catheter. The catheters can have a range of 24-28 G depending on the intended use.
One feature of the invention is to provide a medical device, such as a catheter, that has a tip for insertion into the patient where the tip has a beveled insertion end with a frustoconical angled surface. The angled surface of the tip is oriented with respect to a longitudinal axis that enables ease of insertion while reducing the occurrence of occlusion or tip collapse during use. The risk of catheter tip collapse is higher for small diameter (large gauge) catheters. The catheter is configured to avoid a blunt end that can inhibit proper insertion. The catheters are desirably small diameter, such as for example 26-28 gauge. The tip of the catheter can be configured to provide a 28 gauge flexible catheter provides a suitable time period before the tip folds over, collapses and occludes the tip during use.
The point at which the tip of the catheter folds and collapses is referred to as the critical bend point. The critical bend point is located axially from the distal end of the catheter a distance of one catheter inner radius magnitude. The minimum distance from the tip that can fold over and occlude the catheter is equivalent to the catheter inner radius. It has been found that the thickness of the wall of the catheter can facilitate the structural integrity of the catheter tip and the ability to insert the catheter tip by streamlining the outer profile. Generally a smaller thickness at the critical bend point provides easier insertion but result in collapse and occlusion in a short period of time.
In one embodiment, the critical bend point can have a radial thickness of about 0.002 inch for a 28 gauge catheter. In an embodiment the critical bend point has a thickness of about 0.0029 to 0.004 inch for a 28 gauge catheter. In another embodiment, the critical bend thickness can be about 0.0030 to 0.0035 inch for a 28 gauge catheter.
The catheter tip is configured to provide an outer profile that provides lower penetration forces and increased insertion success while providing a thickness to reduce the incidence of collapse. In one embodiment, the outer profile has a gradual transition between the surface of the tip to reduce the potential for the skin tissue of the patient to interfere with eh insertion into the patient, The entry tip angle provides a thickness to reduce folding at the tip with gradual increased thickness at the critical bend point. Past the critical bend point, a smooth transition is provide to the body and tapered surface of the catheter.
In one embodiment of the catheter, the tip of the catheter is a 28 gauge catheter and includes a first bevel having a bevel angle of not more than 30 degrees to the longitudinal axis. In one embodiment, the bevel can at an angle of about 24 to 28 degrees. In other embodiments the bevel can has a bevel angle of about 26 to 28 degrees. The bevel angle can have a longitudinal length to provide a bevel height or thickness at the proximal end of the bevel of about 0.0034 to about 0.0004 inch. In one embodiment, the bevel height is about 0.0035 to about 0.004 inch for a 28 gauge catheter. In another embodiment, the bevel height is about 0.0038 inch and has at a bevel angle of about 26-30 degrees to provide a smooth insertion and reduced incidence of occlusion at the critical bend point. A tapered surface forms a smooth transition between the proximal end of the bevel and the tapered surface of the catheter. The tapered surface can have a taper angle of about 3-4 degrees and typically about 3.25 to 4 degrees. In one embodiment, the tapered surface has a taper angle of about 3 degrees.
One example of the medical device is a peripheral or intravenous catheter assembly and infusion set 10 as illustrated in
Referring to
Referring to
The catheter 24 has a point or location defined as a critical bend point that corresponds substantially to a point or location on the catheter that is spaced from the first open end 32 a distance corresponding substantially to the inner radius of the fluid pathway 36. The critical bend point is a location where the catheter is prone to bending inwardly toward the center of the pathway 36 resulting in occlusion or restriction of the pathway. The occlusion can be partial where one or more portions can fold inwardly to restrict the outlet of the catheter. To inhibit occlusion by the end portion folding or bending inwardly toward the center of the pathway, the invention is directed to providing a radial thickness of the catheter at the critical bend point that is sufficient to inhibit occlusion while providing a beveled angle that provides the comfort during insertion and during use of the catheter by the patient. The shape and outer dimension of the first end portion 28 are configured to provide case of insertion force into the patient while preventing or inhibiting occlusion.
As shown in
As shown in
In a second embodiment shown in
In this embodiment, the critical bending point 74 shown in
Referring to
In a preclinical study, swine were placed under anesthesia and the catheters of the invention were introduced for three days to determine the occlusion based on the shape and dimensions of the first end portion and tip of the catheters. The results showed a relationship between the penetration angle and the insertion force necessary for insertion and a relationship between the thickness at the critical bend point and the occlusion after three days. The tests showed that the catheter of
Although only a limited number of exemplary embodiments of the present invention have been described in detail above, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments without materially departing from the novel teachings and advantages of this invention. It is particularly noted that the features of different embodiments and claims may be combined with each other as long as they do not contradict each other. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the appended claims and their equivalents.
This application claims priority under 35 U.S.C. § 119(e) from U.S. Provisional Application Ser. No. 62/414,959, filed Oct. 31, 2016, which is incorporated herein by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2017/058279 | 10/25/2017 | WO | 00 |
Number | Date | Country | |
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62414959 | Oct 2016 | US |