This disclosure relates generally to medical diagnostic instruments, such as ophthalmoscopes and otoscopes. For example, a number of known instrument designs, such as those manufactured by Welch Allyn Inc., of Skaneateles Falls, N.Y., are detailed in U.S. Pat. Nos. 6,106,457, 7,029,439, 7,399,275, and 7,670,287, each of which are incorporated herein by reference in their entirety.
Otoscopes can include a port that enables caregivers, such as clinicians, to insufflate the ear of a patient in order to provide a more complete diagnostic examination. An example of a known pneumatic otoscope 400 is partially depicted in
Successful pneumatic otoscopy requires a sealed innerformer. A typical innerformer is disposed within the interior of the instrument head and serves to support the distal insertion portion and further enables optical fibers from a contained illumination assembly to be directed to the exterior of the distal insertion portion. Leaks developed in the instrument can prevent adequate pressurization. Without proper pressurization, the ear drum will not deflect as intended and the user may thus misdiagnose fluid behind the ear when in fact it does not exist. In the case of some leaks, the user may hear air hissing from the device and try to compensate with ever more vigorous hand pumping. These quick blasts do not allow adequate pressure modulation and in fact can injure the delicate ear drum.
Prior art otoscopes tend to suffer from leaks, either at the time of manufacturing or after a period of use. Leaks occur for many reasons, but among the most common is a poor seal between an interface defined between the viewing lens at the proximal end of the instrument head and the mating innerformer surface. This interface has a large perimeter that presents many opportunities for air to escape the instrument. If either the viewing lens or the innerformer deviates from flat surface to surface contact, an air passage can result along at least a portion of the periphery of the lens and the innerformer. One possible solution would be to manufacture these parts with extremely high tolerances. This solution would drastically increase the overall cost of the assembly and also increase the number of components that would have to be discarded in order to meet the higher tolerance thresholds. Still further, nicks, scratches or other manufacturing defect on either surface (the rear of the innerformer assembly and the interior periphery of the lens) would produce the same deleterious effect. While these problems may not exist at the time of manufacture, even with high tolerance manufacture, these problems could easily result over time and use of the instrument based subjecting the instrument to shock or impact loads (e.g., drops), the usual sliding motion of the lens relative to the innerformer to effect instrumentation, and other use case scenarios.
More specifically, a drop may produce gross deflection of the innerformer within the instrument head, thereby moving the rear surface relative to the interior peripheral contacting lens surface. This dynamic motion of one component relative to the other can scratch or otherwise damage the sealing surfaces. Otoscopic instruments that do not protect the innerformer from impact forces are especially vulnerable to this latter issue.
The above noted sealing interface between the lens and the rear surface of the innerformer may also leak if the lens retention means of the instrument applies inadequate or unbalanced forces to the lens. Insufficient restraining forces allow air pressure to push the lens away from the innerformer. As a result, airleaks are produced from the resulting gap. Similarly, an unbalanced restraining force may tip the lens such that one peripheral section lifts off or away in relation to the sealing interface. As a result, the section that is lifted away also becomes prone to undesired air leakage. This latter situation can arise at the time of manufacturing due to tolerance variations, but this undesired situation may also occur because the various components warp or otherwise migrate or creep over time and changes in environmental exposure.
Other than creating a higher degree of tolerancing, an alternative technique applied in some prior art otoscopes to effectuate a proper seal is the addition of an elastomeric sealing member disposed at the above-defined interface. While employing an elastomeric seal can provide an airtight junction, this proposed solution requires the added expense of the elastomeric component, as well as other parts or features that become necessary in order to constrain the elastomeric part. Elastomeric parts can also tear or wear away (erode) when the pivoting lens repeatably slides over them in use. Further, elastomeric compounds used in the manufacture of sealing members (e.g., O-rings) can degrade with time and temperature or exhibit a residual adhesion effect (i.e., ‘stiction’), whereby the elastomeric components adhere to the lens over time and rip away or are otherwise rendered unsuitable for providing an adequate air seal with the interior of the instrument head when the user finally slides the lens
According to one aspect, a diagnostic instrument is provided that comprises a handle and an instrument head associated with the handle, the instrument head comprising a housing that includes a tab holder. An innerformer is disposed in an inner cavity of the instrument head, as well as a cushion member disposed between the innerformer and the interior of the housing in addition to a lens attached to the instrument head, the lens including a lens tab. A seal is formed between the lens and the innerformer when the lens tab is engaged with the tab holder.
In addition, the diagnostic instrument may also include an insufflation port on a portion of the housing wherein a gap or spacing is defined between at least a portion of the innerformer and the interior of the instrument head. The gap or spacing enables the innerformer to “float” such that the cushion member creates a bias that maintains the seal between the innerformer and the viewing lens and more specifically between a rear surface of the innerformer and a peripheral surface of the viewing lens. The seal is effectively maintained while pressure is applied to the interior of the instrument head through the insufflation port.
In at least one version, a light source such as an LED is also included as part of one of or both of the handle and the instrument head. In at least one version, the LED is integrated directly into the instrument head.
According to another aspect, a method of manufacturing a handheld diagnostic instrument is provided. The method includes providing a handle and an instrument head associated with the handle. An innerformer is disposed in an inner cavity of the instrument head along with a cushion member that is disposed between the innerformer and the housing. According to this method, a viewing lens is further provided that is attached to the instrument head, the viewing lens including a lens tab. A seal is formed between the viewing lens and the innerformer when the lens tab is engaged with a tab holder of the instrument head.
According to one version, a light source such as an LED is associated with at least one of the handle and the instrument head. The LED can be integrated within the instrument head. A gap is formed between the innerformer and the interior of the instrument head. This gap enables the innerformer in combination with the cushion member to create a bias against the seal formed between the viewing lens and the innerformer when the lens tab is engaged with the tab holder. This seal can be maintained when pressure is added pneumatically to the interior of the instrument head using an insufflation port provided on the instrument head.
According to yet another aspect, a method of conducting pneumatic otoscopy with a handheld otoscope is provided. The method includes providing an otoscope. The otoscope includes an instrument head associated with the handle, the instrument head having a housing, wherein the housing comprises a tab holder. The otoscope further includes an insertion portion at a distal end of the instrument head, an innerformer disposed in an inner cavity of the instrument head, a cushion member disposed between the innerformer and the housing, and a viewing lens attached to the instrument head. The viewing lens includes a lens tab, wherein a seal is formed between the lens and the innerformer when the lens tab is engaged with the tab holder. The method further includes inserting the insertion portion into an ear canal of a patient and inserting a gas into the inner cavity of the instrument head through an insufflation port located on a portion of the instrument head. The gas passes through the inner cavity, through the insertion portion, and to the ear canal.
Having thus described the invention in general terms, reference will now be made to the accompanying drawings, which are not necessarily drawn to scale, and wherein:
The present invention now will be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments of the inventions are shown. Indeed, these inventions may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Like numbers refer to like elements throughout for purposes of clarity and applicability.
Many modifications and other embodiments of the inventions set forth herein will come to mind to one skilled in the art to which these inventions pertain having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is to be understood that the inventions are not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Although a number of specific terms are employed herein, these terms are used in a generic and descriptive sense only and not for purposes of limitation, except where so specifically indicated.
The following description relates to certain embodiments of a medical diagnostic instrument having a mechanical switch assembly and other features as described for a specific type of instrument (e.g., an otoscope). As will become apparent from the discussion, however, the inventive concepts can easily be applied to literally any form or instrument design that includes a light source and at least one contained battery. Moreover, certain terms are used throughout the discussion, such as “top”, “bottom”, “above”, “below”, “upward”, “downward”, and the like that are used to provide a frame of reference with regard to the accompanying drawings. These terms, however, should not be interpreted as limiting in the sense of the scope of the invention, except where specifically indicated.
Referring to
The instrument 30 further includes a top cap portion 49 and a bottom cap portion 53 sized for covering each of the open ends 37, 39, of the hollow handle 34, respectively. In the depicted version, each of the cap portions 49, 53 are attached by means of screw threads 78, 58 that engage with mating internal threads 42, 46 that are formed in each of the open ends 37, 39 of the tubular handle 34, respectively. The handle 34 is sized to be fitted within the palm of the hand of the intended user.
More specifically, the bottom cap portion 53 includes a compression spring 57 fitted within a defined cavity for engaging the lowermost or bottom end of the stacked batteries 45. As noted, this portion 53 includes a set of external screw threads 58 on an open distal end thereof that mate releasably with corresponding internal screw threads 46 provided on the open end 39 of the handle 34.
The top cap portion 49 of the instrument 30 is defined by a substantially hollow member having an upper mating portion 72, a lower mating portion 76 and an intermediate supporting portion 80. The intermediate supporting portion 80 includes an exterior surface 60 that receives a fitted pocket clip 63 comprising a cylindrical band 64 and a vertically extending clip member 68 permitting the compact instrument 30 to be easily carried, for example, within the shirt pocket of the user. The exterior surface 60 of the intermediate supporting portion 80 further includes a vertically extending slot 65 that is sized to accommodate a portion of a movable member 87 of a mechanical switch assembly in accordance with the invention, as described in greater detail below.
The upper mating portion 72 is a tubular cylindrical section having a diameter that is smaller than that of the remainder of the top cap portion 49, the upper mating portion 72 further including a set of external screw threads 74. The lower mating portion 76 also includes a set of screw threads 78 and is sized to directly engage the internal screw threads 42 of the open top end 37 of the handle 34, wherein the lower mating portion 76 is positioned within the handle when assembled thereto. Each of the top and bottom cap portions 49, 53 are made from an electrically conductive metal, such as stainless steel or a die cast zinc alloy. The handle 34 according to this version is made from an extruded metal, such as aluminum or brass.
The instrument head 43 includes a housing 59 having a frusto-conical insertion portion 61 provided on a distal end that is sized for receiving a disposable speculum (not shown) permitting insertion thereof to a predetermined distance into the ear canal. The insertion portion 61 includes a defined distal tip opening 66 encircled with a ring of light transmitting ends (not shown) from a bundle of optical fibers (not shown), the bundle extending through the substantially hollow exterior of the instrument head 43 in proximity to a contained lamp assembly 69 installed at the base of the head 43. The head 43 further includes a magnifying eyepiece 73 that is mounted on a proximal end 77 along a defined optical path aligned with the distal tip opening 66. An opening (not shown) is also defined in one of the sides of the instrument head 43 for inclusion of a pneumatic or other pressurized source (not shown) for insufflation of a patient's ear during examination. It should be noted that the overall design and features of the otoscopic instrument head, as described in this paragraph, are commonly known to those in the field and require no further discussion, except where needed, in regard to the present invention.
The lamp assembly 69,
In this embodiment, the lamp assembly 69 is fixedly attached to the base of the instrument head 43 in a vertical orientation, such that the electrical contact 89 projects downwardly therefrom and the glass envelope of the lamp 81 is positioned at the top extending from the distal end of the assembly housing 75. The instrument head 43 further includes a set of internal screw threads 103 that engage with the external screw threads 74 provided on the upper mating portion 72 of the top cap portion 49, permitting releasable assembly thereto. When fully assembled, a through opening of the top cap portion 49 permits the top (e.g., the cathode) of the contained batteries 45 to make electrical contact with the extending electrical contact 89 of the lamp assembly 69. As previously noted, the contained batteries 45 are biased into contact with the electrical contact 89 of the lamp assembly 69 by means of the compression spring 57 located in the bottom cap portion 53. In passing, it should be noted that the lamp assembly 69, though described as being part of the instrument head 43, could alternately be attached directly to the top cap portion 49.
As shown in
The movable member 87 further includes an extending or exterior lever portion 101 that can be rotated between a first or OFF position and a second or ON position by the user. According to the depicted embodiment, the top cap portion 49 includes a pair of stop plates 86, 88,
As shown, the threads of the instrument head 43 and the mating top cap portion 49 are designed in terms of their overall length and pitch such that, when assembled, the insertion portion 61 is juxtaposed relative to the movable member 87. That is, the eyepiece 73, in the case of the instrument head 43, is directly above the exterior lever portion 101 of the movable member 87.
In operation, the lamp 81 is energized when the exterior lever portion 101 is in the ON position of
Rotation of the exterior lever portion 101 of the movable member 87, in this instance, using a clockwise direction by the user, as shown by arrows 102,
Typically known hand-held diagnostic instruments utilize a metal top cap. To insure the tight tolerances, this part is typically machined from a material such as brass. The handle of the instrument is also typically made from brass, and more typically plated machined brass. Because of the relative lack of complexity afforded the instrument of the present invention, these components can be fabricated using a metal die cast process (for the top cap) or extruded aluminum (for the handle), thereby providing a substantial cost reduction. The metal die cast process is similar to injection molding, in that a hard tool is created and the material is injected in a molten state in order to fill the tool. The resulting product of manufacture is a high tolerance, very repeatable part. This same process can be utilized to make parts for any other diagnostic instrument utilizing the present invention. To our knowledge, metal die cast bases are currently not utilized in diagnostic products today.
Referring to
A number of alternative embodiments to the switch assembly 83 of
As shown in
The switch assembly 130 according to this embodiment includes a movable pin-like member 134 having an angled wedge portion or section 138 at one end. The pin-like movable member 134 is movable within aligned openings that are provided in the top cap portion 49 in a direction that is substantially perpendicular to the vertical or battery axis of the instrument.
According to this embodiment, one end of the movable member 134 extends from the exterior of the top cap portion 49 of the handle 34 and is accessible by the user, wherein the angled wedge section 138 can selectively be interposed between the top surface of the upper or topmost battery 45 and the lamp electrical contact 89, thereby creating respective ON and OFF positions. Preferably, the angled wedge section 138 is insulated electrically. As in the preceding and in the absence of the angled wedge section 138, the biasing force of the compression spring 57 is sufficient to create necessary engagement between the electrical contact 89 of the lamp assembly 69 and the batteries 45. Features similar to the detent features described in the preceding embodiment can be added to insure positive engagement in one or both of the ON and OFF positions.
As noted, the preceding describes various examples of switch assemblies and it is anticipated that other similar approaches could be contemplated for moving either one or both of the batteries and/or the lamp assembly.
Moreover, it should be pointed out that the location of the herein described switch assembly can easily be varied. For example, a lever or other movable element (not shown) made in accordance with the inventive concepts discussed herein could be alternatively be provided that breaks the electrical connection at the bottom of the instrument handle. Furthermore, all movements described herein have related to those of the stacked batteries. It should be readily apparent that similar mechanisms could be developed for moving the lamp assembly in lieu of the batteries to selectively break electrical contact or that each of the batteries and the lamp assembly can be made movable relative to one another.
As noted, the preceding instrument included an otoscopic instrument head, but other instrument heads can be similarly attached to the handle 34. By way of a nonlimiting example, an ophthalmoscopic head (not shown) can be attached in lieu of an otoscopic head.
With reference to
The otoscope 200 is defined by an instrument head 204 that is releasably and securably attached to the upper end of a handle (partially shown in
A viewing lens 232, including a magnifying optic, is attached to the proximal end 224 of the instrument head 204. In one version, the viewing lens 232 is manufactured as a single component that is pivotally attached to the proximal end 224 of the instrument head 204 and more specifically to the rear housing 212, the latter having a rear or proximal opening that is aligned with the smaller front opening of the instrument 200, as well as openings in the distal insertion portion 228 and attached speculum tip element (not shown) to enable viewing of the ear by a caregiver. When assembled, the viewing lens 232 is sized to fully cover the rear opening of the instrument head 204. Optionally, the viewing lens 232 can include a peripheral bumper (not shown). As best shown in
As shown most clearly in
When assembled, the exterior surface of the innerformer 254 engages the interior surfaces of the front and rear housings 208, 212 as well as an attachment portion 218 at the lower end of the instrument head 204. In this assembled position, the peripheral rear surface 267 of the innerformer and an inner peripheral surface 272 of the viewing lens 232 form a junction 274 that defines a seal. According to this specific embodiment, a conformal member (also referred to as a cushion member 262), is attached to an external surface portion of the innerformer 254. The cushion member 262 according to this specific embodiment is a contoured section of urethane foam, such as Poron™ that is adhesively attached to the exterior of the innerformer 254 for engaging an interior surface of the front housing 208.
As discussed herein, the cushion member 262 added to the innerformer 254 helps ensure the device 200 can maintain a pneumatic seal to facilitate insufflation by a clinician. In a version, the innerformer 254 can include a set of guides 263 that define a recess 266 to facilitate the placement/positioning of the cushion member 262. Alternatively, the cushion member 262 can be integrated with the innerformer 254. In use the cushion member 262 acts as a spring that can absorb impact loads and urges the innerformer 254 toward the rear of the instrument 200, as herein described.
That is, the innerformer 254 having the attached cushion member 262 acts to basically “float” within the confines of the instrument head 204 with the innerformer 254 being disposed within the front and rear housings 208, 212 and having a defined space based on the compressibility of the attached cushion member 262 in which the innerformer 254 can move. As shown in the enlarged
In the embodiments illustrated in
With further review to
The illumination assembly components are further connected to a switch (not shown) on the handle of the instrument 200 for purposes of energization. A polarity protection component 300,
It will be readily apparent that the embodiments described herein are examples for purposes of relating and conveying the inventive concepts. As a result, other variations and modifications are readily discernible that embody these concepts, and as further defined by the following claims.
This application claims priority under relevant portions of 35 U.S.C. § 119 to U.S. Patent Application No. 62/076,761, filed Nov. 7, 2014 and entitled: Medical Diagnostic Instrument. The entire contents of this referenced application is herein incorporated by reference.
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