This disclosure relates to medical fluid pumping systems and related devices and methods.
Dialysis is a treatment used to support a patient with insufficient renal function. The two principal dialysis methods are hemodialysis and peritoneal dialysis.
During hemodialysis (“HD”), the patient's blood is passed through a dialyzer of a dialysis machine while also passing a dialysis solution or dialysate through the dialyzer. A semi-permeable membrane in the dialyzer separates the blood from the dialysate within the dialyzer and allows diffusion and osmosis exchanges to take place between the dialysate and the blood stream. These exchanges across the membrane result in the removal of waste products, including solutes like urea and creatinine, from the blood. These exchanges also regulate the levels of other substances, such as sodium and water, in the blood. In this way, the dialysis machine acts as an artificial kidney for cleansing the blood.
During peritoneal dialysis (“PD”), a patient's peritoneal cavity is periodically infused with dialysis solution or dialysate. The membranous lining of the patient's peritoneum acts as a natural semi-permeable membrane that allows diffusion and osmosis exchanges to take place between the solution and the blood stream. These exchanges across the patient's peritoneum, like the continuous exchange across the dialyzer in HD, result in the removal of waste products, including solutes like urea and creatinine, from the blood, and regulate the levels of other substances, such as sodium and water, in the blood.
Many PD machines are designed to automatically infuse, dwell, and drain dialysate to and from the patient's peritoneal cavity. The treatment typically lasts for several hours, often beginning with an initial drain procedure to empty the peritoneal cavity of used or spent dialysate. The sequence then proceeds through the succession of fill, dwell, and drain phases that follow one after the other. Each phase is called a cycle.
In one aspect of the invention, a medical fluid pumping system includes a medical fluid pumping machine including a piston head that can be linearly displaced and a medical fluid cassette that can be secured to the medical fluid pumping machine. The medical fluid cassette includes a base, a flexible membrane attached to the base in a manner such that the flexible membrane and the base cooperate to at least partially define a fluid pump chamber, and a fastening member attached to the flexible membrane. The fastening member defines a recess configured to receive the piston head of the medical fluid pumping machine, and the fastening member has an engagement surface that engages an engagement surface of the piston head when the piston head is disposed in the recess such that, when the piston head is disposed in the recess and is moved linearly away from the base of the cassette, the engagement surface of the piston head is engaged with the engagement surface of the fastening member and pulls the fastening member and the flexible membrane to which the fastening member is attached away from the base to increase a volume of the fluid pump chamber.
In another aspect of the invention, a medical fluid cassette includes a base, a flexible membrane attached to the base in a manner such that the flexible membrane and the base cooperate to at least partially define a fluid pump chamber, and a fastening member attached to the flexible membrane. The fastening member defines a recess configured to receive a piston head of a medical fluid pumping machine and has an engagement surface that engages the piston head when the piston head is disposed in the recess such that, when the piston head is disposed in the recess and is moved linearly away from the base of the cassette, the piston head engages the engagement surface of the fastening member to pull the fastening member and the flexible membrane to which the fastening member is attached away from the base and increase a volume of the fluid pump chamber.
In a further aspect of the invention, a medical fluid pumping machine includes a piston head that can be linearly displaced and is configured to be disposed within a recess defined by a fastening member of a medical fluid cassette. The piston head has an engagement surface configured to engage an engagement surface of the medical fluid cassette when the piston head is disposed in the recess such that, when the piston head is disposed in the recess and is moved linearly away from a base of the cassette, the engagement surface of the piston head is engaged with the engagement surface of the fastening member and pulls the fastening member and a flexible membrane to which the fastening member is attached away from the base to increase a volume of a fluid pump chamber defined in the cassette between the flexible membrane and the base.
In an additional aspect of the invention, a medical fluid pumping method includes advancing a piston head into a recessed region of a fastening member of a medical fluid cassette to mechanically connect the piston head to the fastening member, and then reciprocating the piston head to cause the fastening member to alternately retract and advance, which causes fluid to alternately be drawn into a fluid pump chamber of the cassette and forced out of the fluid pump chamber of the cassette.
Implementations can include one or more of the following features.
In some implementations, the medical fluid cassette can be secured to the medical fluid pumping machine by disposing the medical fluid cassette within a cassette compartment defined by the medical fluid pumping machine.
In certain implementations, the cassette compartment is defined between a door and a cassette interface of the medical fluid pumping machine.
In some implementations, the fastening member is substantially centered relative to the fluid pump chamber of the medical fluid cassette.
In certain implementations, the fastening member includes a substantially dome-shaped member.
In some implementations, the engagement surface of the fastening member is a surface of a radially inwardly extending projection of the substantially dome-shaped member.
In certain implementations, the projection extends continuously around a perimeter region of the substantially dome-shaped member.
In some implementations, the fastening member includes a peg extending from a surface of the dome-shaped member.
In certain implementations, the engagement surface of the fastening member is a surface of an enlarged head of the peg.
In some implementations, the piston head includes a body portion and a contact surface that extends radially beyond a perimeter of the body portion. The contact surface of the piston head is configured to contact a contact surface of the fastening member of the medical fluid cassette when the piston head is inserted into the recess of the fastening member.
In certain implementations, the contact surfaces are angled at about 30 degrees to about 60 degrees relative to a longitudinal axis of the piston head.
In some implementations, the contact surface of the piston head is configured to move radially inwardly when the piston head is inserted into the recess of the fastening member.
In certain implementations, the contact surface of the piston head is a surface of a latch that is radially moveable relative to a body portion of the piston head.
In some implementations, the contact surface of the fastening member is configured to deflect radially outwardly when the piston head is inserted into the recess of the fastening member.
In certain implementations, the contact surface of the fastening member is a surface of a radially inwardly extending projection of the fastening member.
In some implementations, the piston head includes a latch secured to a body portion of the piston head, the engagement surface of the piston head is a surface of the latch, and the latch has an extended position in which the surface of the latch is positioned radially outward of a perimeter of the body portion.
In certain implementations, the latch has a retracted position in which the surface of the latch is positioned radially inward of the perimeter of the body portion.
In some implementations, the piston head further includes a second latch that is secured to the body portion of the piston head and has an extended position in which an engagement surface of the second latch is positioned radially outward of the perimeter of the body portion and a retracted position in which the engagement surface of the latch is positioned radially inward of the perimeter of the body portion.
In certain implementations, the body portion includes front and rear members, and the latch is positioned in a space defined between the front and rear members.
In some implementations, the piston head further includes a latch lock having a first angled surface that sits adjacent an associated first angled surface of the latch such that radially inward movement of the latch causes axial movement of the latch lock in a first axial direction.
In certain implementations, the first angled surfaces are at an angle of about 30 degrees to about 60 degrees relative to a longitudinal axis of the piston head.
In some implementations, the first angled surface of the latch and the first angled surface of the latch lock are at substantially the same angle relative to a longitudinal axis of the piston head.
In certain implementations, the piston head further includes a spring disposed between the latch lock and the front member to resist the axial movement of the latch lock in the first axial direction.
In some implementations, the latch and the latch lock are configured such that when a force applied to the latch to move the latch radially inwardly and to move the latch lock axially is released, the spring expands and moves the latch lock in a second axial direction opposite the first axial direction and causes the latch to move radially outwardly.
In certain implementations, the latch lock has a second angled surface that sits adjacent an associated second angled surface of the latch such that the axial movement of the latch lock in the second axial direction causes the radially outward movement of the latch.
In some implementations, the latch defines a slot in which a leg of the latch lock is disposed, and the first and second angled surfaces of the latch lock are surfaces of the leg, and the first and second angled surfaces of the latch are surfaces that define the slot.
In certain implementations, the piston head includes a body portion and a flange that extends at least partially around a perimeter of the body portion, and the engagement surface of the piston head is a surface of the flange of the piston head.
In some implementations, the fastening member has a projection that extends at least partially around a perimeter of the recess, and the engagement surface of the fastening member is a surface of the projection of the fastening member.
In certain implementations, the fastening member is a substantially dome-shaped member.
In some implementations, the projection extends continuously around the perimeter of the recess.
In certain implementations, an outer diameter of the flange of the piston head is greater than an inner diameter of the flange of the fastening member, and the piston head and the fastening member are constructed such that at least one of the flanges deflects radially relative to the other of the flanges as the piston head is inserted into the recess of the fastening member to allow the piston head to be disposed within the recess.
In some implementations, the piston head includes a clamp, the fastening member includes a peg configured to be releasably engaged by the clamp, and the engagement surfaces of the piston head and the fastening member are surfaces of the clamp and the peg, respectively.
In certain implementations, the clamp is positioned within a bore defined by a body portion of the piston head.
In some implementations, the clamp includes first and second resilient fingers that are configured to deflect away from one another when the peg is received in the clamp.
In certain implementations, each of the first and second resilient fingers includes a first projection that extends radially inwardly from a base portion of its respective resilient finger.
In some implementations, a front surface of the first projection of each of the resilient fingers is angled relative to a longitudinal axis of the piston head to cause the first and second resilient fingers to deflect away from one another as the peg is received in the clamp and slides along the front surface of each first projection.
In certain implementations, the front surface of the first projection of each of the resilient fingers is angled at about 30 degrees to about 60 degrees relative to the longitudinal axis of the piston head.
In some implementations, a rear surface of the first projection of each of the resilient fingers is angled relative to a longitudinal axis of the piston head to cause the first and second resilient fingers to deflect away from one another as the peg is removed from the clamp and slides along the rear surface of each first projection.
In certain implementations, the rear surface of the first projection of each of the resilient fingers is angled at about 30 degrees to about 60 degrees relative to the longitudinal axis of the piston head.
In some implementations, each of the first and second resilient fingers further includes a second projection that extends radially inwardly from the base portion of its respective resilient finger and is axially offset from the first projection of its respective finger such that the peg rests between the first and second projections of each of the resilient fingers when the peg is disposed in the clamp.
In certain implementations, the piston head further includes a shaft, the clamp and the body portion are axially moveable relative to the shaft, and the shaft is configured to deflect the resilient fingers of the clamp away from one another when the piston head and the clamp are retracted a certain distance relative to the shaft.
In some implementations, a rear surface of the second projection of each of the resilient fingers is positioned to contact the shaft when the body portion of the piston head and the clamp are retracted the certain distance relative to the shaft, and the rear surface of the second projection of each of the resilient fingers is angled relative to a longitudinal axis of the piston head to cause the first and second resilient fingers to deflect away from one another as the body portion of the piston head and the clamp are retracted the certain distance relative to the shaft.
In certain implementations, the rear surface of the second projection of each of the resilient fingers is angled at about 30 degrees to about 60 degrees relative to the longitudinal axis of the piston head.
In some implementations, a front surface of the second projection of each of the resilient fingers is substantially perpendicular to the longitudinal axis of the piston head.
In certain implementations, the piston head and the fastening member are constructed to become mechanically connected when the piston head is moved toward the base of the cassette and to become disconnected when the piston head is moved away from the base of the cassette.
In some implementations, the piston head is disposed within the recess of the fastening member and the engagement surfaces contact one another when the piston head and the fastening member are mechanically connected.
In certain implementations, the piston head and the fastening member are constructed to require an axial force of about 5.0 lbf to about 50 lbf to dispose the piston head within the recess of the fastening member such that the piston head and fastening member become mechanically connected.
In some implementations, the piston head and the fastening member are constructed to require an axial force of at least 50 pounds to remove the piston head from the recess of the fastening member such that the piston head and fastening member become disconnected from one another.
In certain implementations, the medical fluid pumping machine is a dialysis machine.
In some implementations, the dialysis machine is a peritoneal dialysis machine.
In certain implementations, the fastening member is constructed to become mechanically connected to the piston head when the piston head is moved toward the base of the cassette and to become disconnected from the piston head when the piston head is moved away from the base of the cassette.
In some implementations, the medical fluid cassette is a dialysis fluid cassette.
In certain implementations, the dialysis fluid cassette is a peritoneal dialysis fluid cassette.
In some implementations, the piston head is advanced into the recessed region of the fastening member with an axial force of about 5 lbf to about 50 lbf.
In certain implementations, the medical fluid pumping method further includes, after reciprocating the piston head, retracting the piston head a certain distance to disconnect the piston head from the fastening member of the medical fluid cassette.
In some implementations, the piston head is retracted out of the recessed region of the fastening member with an axial force of at least 50 pounds.
In certain implementations, the medical fluid cassette includes a base, a flexible membrane attached to the base in a manner such that the flexible membrane and the base cooperate to at least partially define the fluid pump chamber, and the fastening member attached to the flexible membrane. The fastening member has an engagement surface that engages an engagement surface of the piston head when the piston head is disposed in the recess such that, when the piston head is disposed in the recess and is moved linearly away from the base of the cassette, the engagement surface of the piston head is engaged with the engagement surface of the fastening member and pulls the fastening member and the flexible membrane to which the fastening member is attached away from the base to increase a volume of the fluid pump chamber and draw fluid into the fluid pump chamber.
Implementations can include one or more of the following advantages.
In certain implementations, a relatively simple mechanical connection, such as a snap-fit connection, can be used to connect the piston head of the medical fluid pumping machine to the fastening member of the medical fluid cassette. As a result, the system can be more user-friendly, less expensive, and quieter than certain medical fluid pumping systems that utilize vacuum-based connections between a medical fluid pumping machine and a medical fluid cassette.
In some implementations, the piston head of the medical fluid pump machine can be automatically mechanically connected to the fastening member of the medical fluid cassette by simply advancing the piston head a certain distance relative to the cassette, and the piston head of the medical fluid pump machine can be automatically mechanically disconnected from the fastening member of the medical fluid cassette by simply retracting the piston head a certain distance relative to the cassette. As a result of these automatic connection and disconnection processes, the operator of the machine need not take manual steps to cause the connection or disconnection of the piston head and the fastening member, which makes the system more user-friendly and reduces the risk of human errors that might negatively affect the treatment.
In certain implementations, the piston head includes a retractable latch mechanism that allows the piston head and its associated fastening member on the cassette to be mechanically connected and disconnected while reducing (e.g., minimizing) the amount of force required to be applied to the fastening member by the piston head. This arrangement can reduce (e.g., minimize) deformation of the piston head and the fastening member resulting from the connection and disconnection processes and can thus increase the pumping accuracy of the system. In particular, reducing deformation of the piston head and the fastening member can help to ensure that a tight fit is maintained between the piston head and the fastening member and can thus reduce (e.g., minimize) movement, such as slippage, that occurs between the piston head and the fastening member during the pumping process.
In certain implementations, the engagement surface of the latch is angled relative to the longitudinal axis of the piston (e.g., angled at about 60 to about 70 degrees) relative to the longitudinal axis of the piston). This angled arrangement can enable the piston head to be mechanically connected to fastening members of slightly different sizes (e.g., due to tolerances in the manufacturing process). In particular, the angled engagement surface allows the latch to tightly engage slightly differently sized fastening members by expanding radially outward slightly different distances.
Other aspects, features, and advantages will be apparent from the description and drawings, and from the claims.
This disclosure relates generally to medical fluid pumping systems and related devices and methods. In some cases, a medical fluid pumping system (e.g., a peritoneal dialysis (“PD”) system) includes a medical fluid pumping machine (e.g., a PD cycler) having a piston with a piston head that can be mechanically connected to a medical fluid cassette (e.g., a PD fluid cassette). Typically, the cassette includes a flexible membrane and a fastening member (e.g., a dome-shaped fastening member) attached to the membrane. The membrane and the fastening member overlie a recessed region of a rigid base of the cassette to form a fluid pump chamber, and the piston of the medical fluid pumping machine is designed to be mechanically connected to the fastening member of the cassette. With the piston of the medical fluid pumping machine mechanically connected to the fastening member of the cassette, reciprocation of the piston causes fluid to be alternately drawn into and forced out of the fluid pump chamber by pulling the fastening member and membrane away from the recessed region of the base and then advancing the fastening member and membrane toward the recessed region of the base. As discussed below, in some cases, the piston can be automatically mechanically connected to the fastening member of the cassette by simply moving the piston toward the base of the cassette and into engagement with the fastening member prior to a medical treatment (e.g., PD treatment) and can be automatically disconnected from the fastening member of the cassette by simply moving the piston away from the base of the cassette and out of engagement with the fastening member after completion of the medical treatment.
Referring to
Dialysis solution bags 122 are suspended from fingers on the sides of the cart 104, and a heater bag 124 is positioned on the heater tray 116. The dialysis solution bags 122 and the heater bag 124 are connected to the cassette 112 via dialysis solution bag lines 126 and a heater bag line 128, respectively. The dialysis solution bag lines 126 can be used to pass dialysis solution from dialysis solution bags 122 to the cassette 112 during use, and the heater bag line 128 can be used to pass dialysis solution back and forth between the cassette 112 and the heater bag 124 during use. In addition, a patient line 130 and a drain line 132 are connected to the cassette 112. The patient line 130 can be connected to a patient's abdomen via a catheter and can be used to pass dialysis solution back and forth between the cassette 112 and the patient during use. The drain line 132 can be connected to a drain or drain receptacle and can be used to pass dialysis solution from the cassette 112 to the drain or drain receptacle during use.
The piston shaft 135A has a reduced diameter front portion 149A that is sized and shaped to fit within a bore formed in a stem 151A of the rear member 137A of the piston head 134A. Typically, the reduced diameter front portion 149A of the piston shaft 135A and the inner surface of the stem 151A have threads on their outer and inner surfaces, respectively, such that the piston head 134A can be secured to the piston shaft 135A by screwing the stem 151A onto the reduced diameter front portion 149A of the piston shaft 135A. This arrangement allows the piston head 134A to be easily removed from the piston shaft 135A for cleaning, repair, or replacement. Any of various other securement techniques, such as clipping, welding, adhesive bonding, etc., can alternatively or additionally be used to secure the piston head 134A to the piston shaft 135A.
Still referring to
The sliding latches 145A, 147A are slidably positioned within spaces 173A, 175A (shown in
Referring to
The dimensions of the piston head 134A and its various components will depend on many factors, including the type of cassette with which it is intended to be used. Referring to
Referring to
Referring now to
Referring to
Still referring to
The latch lock spring 143A typically has a spring rate of about 38 pounds per inch to about 67 pounds per inch and typically provides sufficient resistance to prevent radial inward forces of about 1.5 lbf to about 9.5 lbf applied to the sliding latches 145A, 147A from compressing the spring and causing the sliding latches 145A, 147A to move radially inward.
The piston head 134A and piston shaft 135A can be formed of various different polymers, metals, and/or alloys. The rear member 137A, the front member 139A, and the latch lock 141A are typically formed of materials that are relatively rigid, resistance to wear, and have a relatively low coefficient of friction. Examples of suitable materials for these components include polyoxymethylene (e.g., Delrin), aluminum, steel, bronze, brass, and PTFE. However, other metals and plastics having relatively low coefficients of friction can alternatively or additionally be used. The sliding latches 145A, 147A are similarly typically formed of materials that are relatively rigid, resistance to wear, and have a relatively low coefficient of friction. In some implementations, the sliding latches 145A, 147A are formed of a polytetrafluoroethylene-coated 6061 aluminum alloy. Other examples of materials from which the sliding latches 145A, 147A can be formed include steel, bronze, brass, POM, and PTFE. However, it will be appreciated that certain other metals and plastics can alternatively or additionally be used.
The various components of the piston head 134A and the piston shaft 135A can be formed using any of various different techniques, including machining techniques molding techniques, and/or casting techniques.
Referring back to
Still referring to
The door 108 of the PD cycler 102, as shown in
The annular flanges 164A, 164B of the dome-shaped members 161A, 161B, as shown in
Referring to
Still referring to
The rigidity of the base 156 helps to hold the cassette 112 in place within the cassette compartment 114 of the PD cycler 102 and to prevent the base 156 from flexing and deforming in response to forces applied to the projections 154A, 154B by the dome-shaped members 161A, 161B and in response to forces applied to the planar surface of the base 156 by the inflatable members 142.
The base 156 and the dome-shaped members 161A, 161B of the cassette 112 can be formed of any of various relatively rigid materials. In some implementations, these components of the cassette 112 are formed of one or more polymers, such as polypropylene, polyvinyl chloride, polycarbonate, polysulfone, and other medical grade plastic materials. In certain implementations, these components can be formed of one or more metals or alloys, such as stainless steel. These components of can alternatively be formed of various different combinations of the above-noted polymers and metals. These components of the cassette 112 can be formed using any of various different techniques, including machining, molding, and casting techniques.
As noted above, the membrane 140 is attached to the periphery of the base 156 and to the annular flanges 164A, 164B of the dome-shaped members 161A, 161B. The portion of the membrane 140 overlying the remaining portions of the base 156 are typically not attached to the base 156. Rather, these portions of the membrane 140 sit loosely atop the raised ridges 165A, 165B, and 167 extending from the planar surface of the base 156. Any of various attachment techniques, such as adhesive bonding and thermal bonding, can be used to attach the membrane 140 to the periphery of the base 156 and to the dome-shaped members. The thickness and material(s) of the membrane 140 are selected so that the membrane 140 has sufficient flexibility to flex toward the base 156 in response to the force applied to the membrane 140 by the inflatable members 142. In certain implementations, the membrane 140 is about 0.100 micron to about 0.150 micron in thickness. However, various other thicknesses may be sufficient depending on the type of material used to form the membrane 140.
Any of various different materials that permit the membrane 140 to deflect in response to movement of the inflatable members 142 without tearing can be used to form the membrane 140. In some implementations, the membrane 140 includes a three-layer laminate. In certain implementations, for example, inner and outer layers of the laminate are formed of a compound that is made up of 60 percent Septon® 8004 thermoplastic rubber (i.e., hydrogenated styrenic block copolymer) and 40 percent ethylene, and a middle layer is formed of a compound that is made up of 25 percent Tuftec® H1062 (SEBS: hydrogenated styrenic thermoplastic elastomer), 40 percent Engage® 8003 polyolefin elastomer (ethylene octene copolymer), and 35 percent Septon® 8004 thermoplastic rubber (i.e., hydrogenated styrenic block copolymer). The membrane can alternatively include more or fewer layers and/or can be formed of different materials.
As shown in
As shown in
As the piston 133A continues to advance, the dome-shaped member 161A contacts the inner surface of the portion of the rigid base 156 that forms the recessed region 162A, as shown in
Referring to
The rear angled surfaces 190A, 193A of the sliding latches 145A, 147A permit the piston head 134A to be firmly locked within dome-shaped members of slightly different sizes. For example, due to imperfect manufacturing techniques, the thickness of the annular projection 168A along the longitudinal axis of the piston 133A may differ slightly (e.g., by about 0.003 to about 0.005 inch) amongst different molded dome-shaped members. The rear angled surfaces of the sliding latches 145A, 147A can help to ensure that a tight fit is achieved with any of those dome-shaped members.
As discussed above, as the piston 133A is being mechanically connected to the dome-shaped member 161A, the dome-shaped member 161A is advanced into the recessed region 162A of the rigid base 156 until the dome-shaped member 161A contacts the inner surface of the recessed region 162A of the base 156 of the cassette 112. This movement decreases the volume of the pump chamber 138A formed between the dome-shaped member 161A, the membrane 140, and the recessed region of the base 156, and thus causes any fluid (e.g., priming fluid) within the pump chamber 138A to be forced out of the pump chamber 138A from the fluid pathways 158 of the cassette via the inlet port 185A (shown in
Referring to
Because the volumes of the fluid pump chamber 138A and the piston head 134A are known, the linear distance travelled by the piston 133A can be used to determine the volume of dialysis solution drawn into the fluid pump chamber 138A. The linear distance travelled by the piston 133A can be determined based on the number of revolutions or steps of the motor (e.g., stepper motor) used to drive the piston 133A. Thus, the volume of solution drawn into the fluid pump chamber 138A can be determined based on the number of revolutions or steps of the motor. The tight fit between the piston head 134A and the dome-shaped member 161A ensure the accuracy of the volume of solution determined in this manner.
After drawing the dialysis solution into the pump chamber 138A, the dialysis solution is forced out of the pump chamber 138A by again advancing the piston 133A and decreasing the volume of the pump chamber 138A. The piston 133A is typically advanced until the dome-shaped member 161A contacts or nearly contacts the inner surface of the recessed region of the base 156 so that substantially all of the dialysis solution is forced out of the fluid pump chamber 138A via the outlet port 187A (shown in
This process of drawing dialysis solution into the fluid pump chamber 138A and then forcing the dialysis solution out of the fluid pump chamber 138A is repeated until a desired volume of dialysis solution has been pumped to or from a location (e.g., to or from the patient).
As noted above, while forcing dialysis solution into and out of the pump chambers 138A, 138B, certain inflatable members 142 of the PD cycler 102 can be selectively inflated to direct the pumped dialysis solution along desired pathways in the cassette 112.
Referring back to
After draining the spent dialysis solution from the patient, heated dialysis solution is transferred from the heater bag 124 to the patient. To do this, the motor or motors of the PD cycler 102 is/are activated to cause the pistons 133A, 133B to reciprocate and certain inflatable members 142 of the PD cycler 102 are inflated to cause the warmed dialysis solution to be drawn into the fluid pump chambers 138A, 138B of the cassette 112 from the heater bag 124 via the heater bag line 128. The warmed dialysis solution is then pumped from the fluid pump chambers 138A, 138B to the patient via the patient line 130.
Once the dialysis solution has been pumped from the heater bag 124 to the patient, the dialysis solution is allowed to dwell within the patient for a period of time. During this dwell period, toxins cross the peritoneum of the patient into the dialysis solution from the patient's blood. As the dialysis solution dwells within the patient, the PD cycler 102 prepares fresh dialysate for delivery to the patient in a subsequent cycle. In particular, the PD cycler 102 pumps fresh dialysis solution from one of the four full dialysis solution bags 122 into the heater bag 124 for heating. To do this, the pump of the PD cycler 102 is activated to cause the pistons 133A, 133B to reciprocate and certain inflatable members 142 of the PD cycler 102 are inflated to cause the dialysis solution to be drawn into the fluid pump chambers 138A, 138B of the cassette 112 from the selected dialysis solution bag 122 via its associated line 126. The dialysis solution is then pumped from the fluid pump chambers 138A, 138B to the heater bag 124 via the heater bag line 128.
After the dialysis solution has dwelled within the patient for the desired period of time, the spent dialysis solution is pumped from the patient to the drain. The heated dialysis solution is then pumped from the heater bag 124 to the patient where it dwells for a desired period of time. These steps are repeated with the dialysis solution from two of the three remaining dialysis solution bags 122. The dialysis solution from the last dialysis solution bag 122 is typically delivered to the patient and left in the patient until the subsequent PD treatment.
While the dialysis solution has been described as being pumped into the heater bag 124 from a single dialysis solution bag 122, dialysis solution can alternatively be pumped into the heater bag 124 from multiple dialysis solution bags 122. Such a technique may be advantageous, for example, where the dialysis solutions in the bags 122 have different concentrations (e.g., different dextrose concentrations) and a desired concentration for treatment is intermediate to the concentrations of the dialysis solution in two or more of the bags 122.
After completion of the PD treatment, the pistons 133A, 133B are retracted in a manner to disconnect the piston heads 134A, 134B from the dome-shaped members 161A, 161B of the cassette. This process will be described with reference to
The horns 170A, 172A can be used to draw the sliding latches 145A, 147A radially inward to allow the piston head 134A to be disconnected from the dome-shaped member 161A of the cassette 112.
As the piston 133A is reciprocated during treatment, the horns 170A, 172A are forwardly spaced from a vertically oriented stop or surface 174 (shown in
After the pistons 133A, 133B have been disconnected from and backed out of the dome-shaped members 161A, 161B of the cassette 112 in the manner described above, the door 108 of the PD cycler is opened and the cassette 112 is removed from the cassette compartment 114 and discarded.
Because the PD system 100 does not require a vacuum system to draw liquid into the fluid pump chambers 138A, 138B, a substantially airtight seal between the door 108 and the cassette interface 110 is typically not required. Thus, as compared to systems including a vacuum system adapted to retract portions of the cassette membrane overlying pump chambers, the door sealing mechanism of the PD cycler 102 can be simpler and more cost effective. In addition, the reduced use of vacuum pressure relative to certain conventional cyclers can result in quieter operation.
While certain implementations have been described, other implementations are possible.
While the piston heads 134A, 134B have been described as including spring-loaded latch mechanisms with sliding latches 145A, 145B that can be move radially inward and outward to allow those piston heads 134A, 134B to be mechanically connected to the dome-shaped members 161A, 161B of the cassette 112, piston heads of simpler construction that include no such sliding latches can alternatively be used in some cases.
Still referring to
As shown in
As the piston head 234A is mechanically connected to the dome-shaped member 261A in the manner described above, the volume of the pump chamber 238A formed between the dome-shaped member 261A, the membrane 140 decreases due to the forward movement of the dome-shaped member 261A into the recessed region 162A of the base 156, and thus causes any fluid (e.g., priming fluid) within the pump chamber 238A to be forced out of the pump chamber 238A.
Referring to
After drawing the dialysis solution into the pump chamber 238A, the dialysis solution is forced out of the pump chamber 238A by again advancing the piston 233A and decreasing the volume of the pump chamber 238A. As discussed above, this process of drawing dialysis solution into the fluid pump chamber 238A and then forcing the dialysis solution out of the fluid pump chamber 238A can be repeated until a desired volume of dialysis solution has been pumped to or from a location (e.g., to or from the patient) during a PD treatment.
To mechanically disconnect the piston head 234A from the dome-shaped member 261A after treatment, the piston 233A is retracted farther than it is retracted during treatment. This retraction causes the rear surface of the peripheral flange of the dome-shaped member 261A to contact the surface 174 of the PD cycler 202 such that the dome-shaped member 261A is prevented from moving any further in the rearward direction. The piston 233A continues to retract such that the piston head 234A slides rearwardly relative to the dome-shaped member 261A. The rear surface of the flange 245A of the piston head 234A is typically angled frontwardly at about 60 to about 80 degrees (e.g., about 70 degrees) relative to the longitudinal axis of the piston 233A. The front surface of the annular projection 268A is typically angled rearwardly at about 60 to about 80 degrees (e.g., about 70 degrees) relative to the longitudinal axis of the piston 233A. As a result of the orientation of these surfaces and the inability of the dome-shaped member 261A to move further rearwardly, the rearward motion of the piston head 234A causes the portions of the dome-shaped member 261A from which the annular projection 268A extends to deflect radially outwardly. This allows the flange 245A of the piston head 234A to slide past the annular projection 268A resulting in the piston head 234A being mechanically disconnected from the dome-shaped member 261A.
While the piston head 234A and cassette 212 have been described as being constructed so that the peripheral side walls of the cassette 212 deflect outwardly as the piston head 234A is advanced into and retracted out of the dome-shaped member 261A, they can alternatively or additionally be designed so that wall of the piston head 234A from which the flange 245A extends deflects radially inwardly to allow the flange 245A of the piston head 234A to slide past the projection 268A of the cassette 212.
While the cassette 212 and the PD cycler 202 described above are designed so that the rear surface of the peripheral flange of the dome-shaped member 261 contacts the surface 174 of the PD cycler 202 during the disconnection process, in certain implementations, the membrane 140 itself may provide sufficient resistance to rearward movement of the dome-shaped member 261A to allow the piston head 234A to be disconnected from the dome-shaped member 261A.
Other structures for enabling a mechanical connection between piston heads and a cassette can also be used. As shown in
Still referring to
The front surface of each of the rear projections 351A, 355A is substantially perpendicular to the longitudinal axis of the piston such that further advanced of the piston head 334A will not cause the spring fingers 345A, 347A to spread apart when the enlarged head 372A of the peg 368A is disposed in the space between the front and rear projections of the spring fingers 345A, 347A. With the piston head 334A and the peg 368A engaged in this manner, reciprocation of the piston head 334A causes movement of the dome-shaped member 361A and the surrounding portion of the membrane 140 and thus causes fluid to be pumped into and out of the pump chamber of the cassette 312 in the same manner as described above.
Like the front surfaces of the front projections 349A, 353A of the spring fingers 345A, 347A, the rear surfaces of the rear projections 351A, 355A are angled at about 15 degrees to about 75 degrees (e.g., about 30 degrees to about 60 degrees, about 45 degrees). An internal shaft 357A sits within an axial bore formed in the piston head 334A positioned behind the bore 336A in which the clamp mechanism 338A is contained. The internal shaft 357A is fixed to the housing of the PD cycler such that the piston head 334A moves relative to the shaft 357A as the piston head 334A reciprocates. To disconnect the piston head 334A from the peg 368A after treatment, the piston head 334A is retracted into the PD cycler a sufficient distance so that the shaft 357A contacts the rear surfaces of the rear projections 351A, 355A of the spring fingers 345A, 347A. This contact, due to the angled orientation of the rear surfaces of the rear projections 351A, 355A, causes the spring fingers 345A, 347A to spread apart. Further retraction of the piston head 334A causes the front projections 349A, 353A to move back beyond the peg 368A.
Still referring to
To disconnect the piston head 434A from the peg 368A after treatment, the piston head 434A is retracted into the PD cycler. As the piston head 434A is retracted, a point is reached at which the resistance of the membrane 140 pulling on the dome-shaped member 361A is greater than the force required to spread the fingers 445A, 447A apart. At this point, continued retraction of the piston head 434A causes the chamfered rear surfaces of the projections 449A, 453A to slide axially along the enlarged head 372A of the peg 368A of the cassette 312 of the spring fingers 445A, 447A, causing the spring fingers 445A, 447A to spread apart thereby allowing the peg 368A to be released from the space behind the projections 449A, 453A of the fingers 445A, 447A.
While the cassette interface 110 of the PD cycler 102 has been described as including locating pins 148 that help to ensure that the dome-shaped members of the cassette are aligned with the pistons 133A, 133B when the cassette is positioned in the cassette compartment 114, other structures or techniques can be used to ensure this alignment. In some implementations, for example, the cassette is placed against the door of the PD cycler with the hollow projections of the cassette disposed in recesses of the PD cycler's door, and the cassette is held in this position by retainer clips attached to the door. Upon closing the door, the pistons of the PD cycler align with the dome-shaped members of the cassette.
While the door 108 of each of the PD cyclers above has been described as including an inflatable pad that, when inflated, can press the cassette against the cassette interface, the inflatable pad can alternatively be positioned behind the cassette interface such that the cassette interface can be moved toward the door 108 to compress the cassette therebetween. Similarly, as an alternative to an inflatable pad, any of various mechanisms that can be operated to move a surface of the door 108 toward the cassette interface or vice versa can be used.
While the door 108 of the PD cyclers described above are shown as being positioned on a front face of the PD cyclers, the doors can alternatively be positioned at various other locations on the PD cyclers. For example, the doors could be positioned on a top face of the PD cycler such that the cassette is slid into the cassette compartment in a substantially horizontal orientation instead of a substantially vertical orientation. In some implementations, the door and the cassette interface of the PD cycler are positioned at an angle of about 10 to about 35 degrees to vertical when the PD cycler is rested on a horizontal surface. It has been found that this configuration makes it easier for the user to load the cassette into the cassette compartment.
While the cassettes discussed above have two pump chambers, the cassettes can alternatively have more or fewer than two pump chambers.
While each of the pump chambers of the cassettes described above has been described as including a fluid inlet port and a fluid outlet port, in certain implementations, the pump chambers include a single port that is used as both an inlet and an outlet. In such implementations, the inflatable valve members of the PD cycler that act on the valve portions of the cassettes would be activated and deactivated in a slightly different sequence to allow fluid to be drawn into the pump chamber from a desired location and then to be forced out of the pump chamber to a desired location.
While certain PD cyclers above have been described as including a touch screen and associated buttons, the PD cyclers can alternatively or additionally include other types of screens and user data entry systems. In certain implementations, for example, the cycler includes a display screen with buttons (e.g., feather touch buttons) arranged on the console adjacent the display screen. Certain buttons can be arranged to be aligned with operational options displayed on the screen during use such that the user can select a desired operational option by pressing the button aligned with that operational option. Additional buttons in the form of arrow buttons can also be provided to allow the user to navigate through the various display screens and/or the various items displayed on a particular screen. Other buttons can be in the form of a numerical keypad to allow the user to input numerical values in order, for example, to input operational parameters. A select or enter button can also be provided to allow the user to select an operational option to which the user navigated by using the arrow keys and/or to allow the user to enter values that the user inputted using the numerical keypad.
While the mechanically connectable piston heads and cassettes described above have been described as being part of PD systems, these types of piston heads and cassettes can be used in any of various other types of medical fluid pumping systems. Other examples of medical fluid pumping systems in which the piston heads and cassettes described herein can be used include hemodialysis systems, blood perfusion systems, and intravenous infusion systems.
Similarly, while many of the systems above have been described as being used to pump dialysis solution, other types of dialysis fluids can be pumped through the cassettes. As an example, in the case of cassettes used with hemodialysis machines, blood can be pumped through the cassettes. In addition, priming solutions, such as saline, can similarly be pumped through cassettes using the various different systems and techniques described above. Similarly, as an alternative to dialysis fluids, any of various other types of medical fluids can be pumped through the above-described cassettes depending on the type of medical fluid pumping machines with which the cassettes are used.
This application is a continuation of U.S. Ser. No. 13/442,184, filed Apr. 9, 2012, which claims the benefit of U.S. Application Ser. No. 61/477,742, filed on Apr. 21, 2011.
Number | Name | Date | Kind |
---|---|---|---|
329773 | Perry | Nov 1885 | A |
2383193 | Herbert | Aug 1945 | A |
2453590 | Poux | Nov 1948 | A |
2529028 | Landon | Nov 1950 | A |
2658526 | Porter | Nov 1953 | A |
2711134 | Hughes | Jun 1955 | A |
2755745 | Lewis | Jul 1956 | A |
2871795 | Smith | Feb 1959 | A |
2886281 | Canalizo | May 1959 | A |
3083943 | Stewart, Jr. et al. | Apr 1963 | A |
3323786 | Boschi | Jun 1967 | A |
3556465 | Little | Jan 1971 | A |
3671814 | Dick | Jun 1972 | A |
3689025 | Kiser et al. | Sep 1972 | A |
3741687 | Nystroem | Jun 1973 | A |
3777625 | Andres | Dec 1973 | A |
3781141 | Schall | Dec 1973 | A |
3880053 | Trechsel et al. | Apr 1975 | A |
3927955 | Spinosa et al. | Dec 1975 | A |
3966358 | Heimes et al. | Jun 1976 | A |
3985135 | Carpenter et al. | Oct 1976 | A |
4026669 | Leonard et al. | May 1977 | A |
4047844 | Robinson | Sep 1977 | A |
4050859 | Vork | Sep 1977 | A |
4091812 | Helixon et al. | May 1978 | A |
4121584 | Turner et al. | Oct 1978 | A |
4152098 | Moody et al. | May 1979 | A |
4158530 | Bernstein | Jun 1979 | A |
4178940 | Au | Dec 1979 | A |
4273121 | Jassawalla | Jun 1981 | A |
4303376 | Siekmann | Dec 1981 | A |
4304260 | Turner et al. | Dec 1981 | A |
4312344 | Nilson | Jan 1982 | A |
4322201 | Archibald | Mar 1982 | A |
4333452 | Au | Jun 1982 | A |
4370983 | Lichtenstein | Feb 1983 | A |
4382753 | Archibald | May 1983 | A |
4410322 | Archibald | Oct 1983 | A |
4412553 | Kopp et al. | Nov 1983 | A |
4436620 | Bellotti et al. | Mar 1984 | A |
4453932 | Pastrone | Jun 1984 | A |
4479760 | Bilstad et al. | Oct 1984 | A |
4479761 | Bilstad et al. | Oct 1984 | A |
4479762 | Bilstad et al. | Oct 1984 | A |
4490621 | Watabe et al. | Dec 1984 | A |
4536201 | Brorsson et al. | Aug 1985 | A |
4558715 | Walton et al. | Dec 1985 | A |
4569378 | Bergandy | Feb 1986 | A |
4583920 | Lindner | Apr 1986 | A |
4597412 | Stark | Jul 1986 | A |
4610605 | Hartley | Sep 1986 | A |
4623328 | Hartranft | Nov 1986 | A |
4628499 | Hammett | Dec 1986 | A |
4639245 | Pastrone et al. | Jan 1987 | A |
4643713 | Viitala | Feb 1987 | A |
4657490 | Abbott | Apr 1987 | A |
4662598 | Weingarten | May 1987 | A |
4662906 | Matkovich et al. | May 1987 | A |
4676467 | Palsulich | Jun 1987 | A |
4690621 | Swain | Sep 1987 | A |
4703913 | Hunkapiller | Nov 1987 | A |
4705259 | Dolhen et al. | Nov 1987 | A |
4710166 | Thompson et al. | Dec 1987 | A |
4735558 | Kienholz et al. | Apr 1988 | A |
4778451 | Kamen | Oct 1988 | A |
4786240 | Koroly et al. | Nov 1988 | A |
4808161 | Kamen | Feb 1989 | A |
4826482 | Kamen | May 1989 | A |
4840542 | Abbott | Jun 1989 | A |
4842584 | Pastrone | Jun 1989 | A |
4846636 | Danby et al. | Jul 1989 | A |
4850980 | Lentz et al. | Jul 1989 | A |
4858883 | Webster | Aug 1989 | A |
4902282 | Bellotti et al. | Feb 1990 | A |
4906260 | Emheiser et al. | Mar 1990 | A |
4927411 | Pastrone et al. | May 1990 | A |
4950134 | Bailey et al. | Aug 1990 | A |
4974754 | Wirz | Dec 1990 | A |
4976162 | Kamen | Dec 1990 | A |
4995864 | Bartholomew et al. | Feb 1991 | A |
4997464 | Kopf | Mar 1991 | A |
5002471 | Perlov | Mar 1991 | A |
5006050 | Cooke et al. | Apr 1991 | A |
5011380 | Kovacs et al. | Apr 1991 | A |
5036886 | Olsen et al. | Aug 1991 | A |
5061236 | Sutherland et al. | Oct 1991 | A |
5088515 | Kamen | Feb 1992 | A |
5098262 | Wecker et al. | Mar 1992 | A |
5100380 | Epstein | Mar 1992 | A |
5100699 | Roeser | Mar 1992 | A |
5116021 | Faust et al. | May 1992 | A |
5116316 | Sertic et al. | May 1992 | A |
5146713 | Grafius | Sep 1992 | A |
5151019 | Danby et al. | Sep 1992 | A |
5167837 | Snodgrass et al. | Dec 1992 | A |
5171029 | Maxwell et al. | Dec 1992 | A |
5178182 | Kamen | Jan 1993 | A |
5193990 | Kamen et al. | Mar 1993 | A |
5211201 | Kamen et al. | May 1993 | A |
5238003 | Baidwan et al. | Aug 1993 | A |
5241985 | Faust et al. | Sep 1993 | A |
5247434 | Peterson et al. | Sep 1993 | A |
5249932 | Van Bork | Oct 1993 | A |
5252044 | Raines et al. | Oct 1993 | A |
5259352 | Gerhardy et al. | Nov 1993 | A |
5267956 | Beuchat | Dec 1993 | A |
5279556 | Goi et al. | Jan 1994 | A |
5302093 | Owens et al. | Apr 1994 | A |
5324422 | Colleran et al. | Jun 1994 | A |
5330425 | Utterberg | Jul 1994 | A |
5342182 | Montoya et al. | Aug 1994 | A |
5344292 | Rabenau et al. | Sep 1994 | A |
5350357 | Kamen et al. | Sep 1994 | A |
D351470 | Scherer et al. | Oct 1994 | S |
5353837 | Faust | Oct 1994 | A |
5378126 | Abrahamson et al. | Jan 1995 | A |
5395351 | Munsch | Mar 1995 | A |
5413626 | Bartsch | May 1995 | A |
5415528 | Ogden et al. | May 1995 | A |
5421208 | Packard et al. | Jun 1995 | A |
5421823 | Kamen et al. | Jun 1995 | A |
5427509 | Chapman et al. | Jun 1995 | A |
5431626 | Bryant et al. | Jul 1995 | A |
5431627 | Pastrone et al. | Jul 1995 | A |
5431634 | Brown | Jul 1995 | A |
5438510 | Bryant et al. | Aug 1995 | A |
5441636 | Chevallet et al. | Aug 1995 | A |
5445506 | Afflerbaugh et al. | Aug 1995 | A |
5447286 | Kamen et al. | Sep 1995 | A |
5462416 | Dennehey et al. | Oct 1995 | A |
5462417 | Chapman | Oct 1995 | A |
5474683 | Bryant et al. | Dec 1995 | A |
5478211 | Dominiak et al. | Dec 1995 | A |
5480294 | Di Perna et al. | Jan 1996 | A |
5482438 | Anderson et al. | Jan 1996 | A |
5482440 | Dennehey et al. | Jan 1996 | A |
5482446 | Williamson et al. | Jan 1996 | A |
5484239 | Chapman et al. | Jan 1996 | A |
5486286 | Peterson et al. | Jan 1996 | A |
5514069 | Brown et al. | May 1996 | A |
5538405 | Patno et al. | Jul 1996 | A |
5540568 | Rosen et al. | Jul 1996 | A |
5547453 | Di Perna | Aug 1996 | A |
5551850 | Williamson et al. | Sep 1996 | A |
5551941 | Howell | Sep 1996 | A |
5551942 | Brown et al. | Sep 1996 | A |
5554013 | Owens et al. | Sep 1996 | A |
5570716 | Kamen et al. | Nov 1996 | A |
5573385 | Chevallier | Nov 1996 | A |
5578070 | Utterberg | Nov 1996 | A |
5586868 | Lawless | Dec 1996 | A |
5588816 | Abbott et al. | Dec 1996 | A |
5593290 | Greisch et al. | Jan 1997 | A |
5599174 | Cook et al. | Feb 1997 | A |
5609572 | Lang | Mar 1997 | A |
5614677 | Wamsiedler et al. | Mar 1997 | A |
5624409 | Seale | Apr 1997 | A |
5628908 | Kamen et al. | May 1997 | A |
5630710 | Tune et al. | May 1997 | A |
5634391 | Eady | Jun 1997 | A |
5634896 | Bryant et al. | Jun 1997 | A |
5640995 | Packard et al. | Jun 1997 | A |
5641405 | Keshaviah et al. | Jun 1997 | A |
5641892 | Larkins et al. | Jun 1997 | A |
5643205 | Utterberg | Jul 1997 | A |
5645531 | Thompson et al. | Jul 1997 | A |
5658133 | Anderson et al. | Aug 1997 | A |
5669764 | Behringer et al. | Sep 1997 | A |
5690602 | Brown et al. | Nov 1997 | A |
D390654 | Alsberg et al. | Feb 1998 | S |
5713865 | Manning et al. | Feb 1998 | A |
5713888 | Neuenfeldt et al. | Feb 1998 | A |
5718567 | Rapp et al. | Feb 1998 | A |
5741125 | Neftel et al. | Apr 1998 | A |
5743169 | Yamada | Apr 1998 | A |
5746708 | Giesler et al. | May 1998 | A |
5755683 | Houle et al. | May 1998 | A |
5764034 | Bowman et al. | Jun 1998 | A |
5769387 | Perez | Jun 1998 | A |
5771914 | Ling et al. | Jun 1998 | A |
5772635 | Dastur et al. | Jun 1998 | A |
5772637 | Heinzmann et al. | Jun 1998 | A |
5775371 | Pan et al. | Jul 1998 | A |
5782575 | Vincent et al. | Jul 1998 | A |
5782805 | Meinzer et al. | Jul 1998 | A |
5799207 | Wang et al. | Aug 1998 | A |
5816779 | Lawless et al. | Oct 1998 | A |
5840151 | Munsch | Nov 1998 | A |
5842841 | Danby et al. | Dec 1998 | A |
5843035 | Bowman et al. | Dec 1998 | A |
5868696 | Giesler et al. | Feb 1999 | A |
5873853 | Keilman et al. | Feb 1999 | A |
5902096 | Behringer et al. | May 1999 | A |
5906598 | Giesler et al. | May 1999 | A |
5921951 | Morris | Jul 1999 | A |
5925011 | Faict et al. | Jul 1999 | A |
5934885 | Farrell et al. | Aug 1999 | A |
5935099 | Peterson et al. | Aug 1999 | A |
5938634 | Packard | Aug 1999 | A |
5984897 | Petersen et al. | Nov 1999 | A |
5989423 | Kamen | Nov 1999 | A |
5993174 | Konishi | Nov 1999 | A |
5996634 | Dennehey et al. | Dec 1999 | A |
6013057 | Danby et al. | Jan 2000 | A |
6036668 | Mathis | Mar 2000 | A |
6036680 | Horne et al. | Mar 2000 | A |
6041801 | Gray et al. | Mar 2000 | A |
6053191 | Hussey | Apr 2000 | A |
6065389 | Riedlinger | May 2000 | A |
6065941 | Gray et al. | May 2000 | A |
6068612 | Bowman et al. | May 2000 | A |
6074359 | Keshaviah et al. | Jun 2000 | A |
6079959 | Kingsford et al. | Jun 2000 | A |
6099492 | Le Boeuf | Aug 2000 | A |
6106246 | Steck et al. | Aug 2000 | A |
6110410 | Owens et al. | Aug 2000 | A |
6118207 | Ormerod et al. | Sep 2000 | A |
6129517 | Danby et al. | Oct 2000 | A |
6132187 | Ericson | Oct 2000 | A |
6136565 | Best et al. | Oct 2000 | A |
6152705 | Kennedy et al. | Nov 2000 | A |
6154605 | Aonuma | Nov 2000 | A |
6164621 | Bouchard et al. | Dec 2000 | A |
6165154 | Gray et al. | Dec 2000 | A |
6168394 | Forman et al. | Jan 2001 | B1 |
6178996 | Suzuki | Jan 2001 | B1 |
6179801 | Holmes et al. | Jan 2001 | B1 |
6184356 | Anderson et al. | Feb 2001 | B1 |
6189857 | Zeger et al. | Feb 2001 | B1 |
6196987 | Holmes et al. | Mar 2001 | B1 |
6200287 | Keller et al. | Mar 2001 | B1 |
6206644 | Pereira et al. | Mar 2001 | B1 |
6208107 | Maske et al. | Mar 2001 | B1 |
6208497 | Seale et al. | Mar 2001 | B1 |
6210361 | Kamen et al. | Apr 2001 | B1 |
6220295 | Bouchard et al. | Apr 2001 | B1 |
6223130 | Gray et al. | Apr 2001 | B1 |
6227807 | Chase | May 2001 | B1 |
6227824 | Stehr | May 2001 | B1 |
6228047 | Dadson | May 2001 | B1 |
6229753 | Kono et al. | May 2001 | B1 |
6231537 | Holmes et al. | May 2001 | B1 |
6234989 | Brierton et al. | May 2001 | B1 |
6250502 | Cote et al. | Jun 2001 | B1 |
6258078 | Thilly | Jul 2001 | B1 |
6261065 | Nayak et al. | Jul 2001 | B1 |
6267242 | Nagata et al. | Jul 2001 | B1 |
6270673 | Belt et al. | Aug 2001 | B1 |
6280406 | Dolecek et al. | Aug 2001 | B1 |
6281145 | Deguchi et al. | Aug 2001 | B1 |
6284142 | Muller | Sep 2001 | B1 |
6285155 | Maske et al. | Sep 2001 | B1 |
6286566 | Cline et al. | Sep 2001 | B1 |
6294094 | Muller et al. | Sep 2001 | B1 |
6296450 | Westberg et al. | Oct 2001 | B1 |
6297322 | Ding et al. | Oct 2001 | B1 |
6312412 | Saied et al. | Nov 2001 | B1 |
6315707 | Smith et al. | Nov 2001 | B1 |
6315754 | Daoud et al. | Nov 2001 | B1 |
6316864 | Ormerod | Nov 2001 | B1 |
6322488 | Westberg et al. | Nov 2001 | B1 |
6325775 | Thom et al. | Dec 2001 | B1 |
6337049 | Tamari | Jan 2002 | B1 |
RE37553 | Ciavarini et al. | Feb 2002 | E |
6343614 | Gray et al. | Feb 2002 | B1 |
6348156 | Vishnoi et al. | Feb 2002 | B1 |
6361518 | Brierton et al. | Mar 2002 | B1 |
6364857 | Gray et al. | Apr 2002 | B1 |
6367669 | Au et al. | Apr 2002 | B1 |
6382923 | Gray | May 2002 | B1 |
6383158 | Utterberg | May 2002 | B1 |
6402486 | Steck et al. | Jun 2002 | B1 |
6406276 | Normand et al. | Jun 2002 | B1 |
6409696 | Toavs et al. | Jun 2002 | B1 |
6416293 | Bouchard et al. | Jul 2002 | B1 |
6419822 | Muller et al. | Jul 2002 | B2 |
6455676 | Weickert et al. | Sep 2002 | B1 |
6471855 | Odak et al. | Oct 2002 | B1 |
6481980 | Vandlik et al. | Nov 2002 | B1 |
6484383 | Herklotz | Nov 2002 | B1 |
6489896 | Platt et al. | Dec 2002 | B1 |
6491656 | Morris | Dec 2002 | B1 |
6494694 | Lawless et al. | Dec 2002 | B2 |
6497674 | Steele et al. | Dec 2002 | B1 |
6497676 | Childers et al. | Dec 2002 | B1 |
6503062 | Gray et al. | Jan 2003 | B1 |
6514225 | Utterberg et al. | Feb 2003 | B1 |
6519569 | White et al. | Feb 2003 | B1 |
6520747 | Gray et al. | Feb 2003 | B2 |
6524231 | Westberg et al. | Feb 2003 | B1 |
6529573 | Olsher et al. | Mar 2003 | B2 |
6537445 | Muller | Mar 2003 | B2 |
6542761 | Jahn et al. | Apr 2003 | B1 |
6558343 | Neftel | May 2003 | B1 |
6572604 | Platt et al. | Jun 2003 | B1 |
6579253 | Burbank et al. | Jun 2003 | B1 |
6582399 | Smith | Jun 2003 | B1 |
6592542 | Childers et al. | Jul 2003 | B2 |
6595948 | Suzuki et al. | Jul 2003 | B2 |
6603229 | Toye, IV | Aug 2003 | B1 |
6604908 | Bryant et al. | Aug 2003 | B1 |
6645166 | Scheunert et al. | Nov 2003 | B2 |
6645177 | Shearn | Nov 2003 | B1 |
6648861 | Platt et al. | Nov 2003 | B2 |
6663359 | Gray | Dec 2003 | B2 |
6670323 | Looker et al. | Dec 2003 | B1 |
6672841 | Herklotz et al. | Jan 2004 | B1 |
6695593 | Steck et al. | Feb 2004 | B1 |
6695803 | Robinson et al. | Feb 2004 | B1 |
6709417 | Houle et al. | Mar 2004 | B1 |
6716004 | Vandlik et al. | Apr 2004 | B2 |
6723062 | Westberg et al. | Apr 2004 | B1 |
6725726 | Adolfs et al. | Apr 2004 | B1 |
6726656 | Kamen et al. | Apr 2004 | B2 |
6730055 | Bainbridge et al. | May 2004 | B2 |
6743201 | Doenig et al. | Jun 2004 | B1 |
6746514 | Bedingfield et al. | Jun 2004 | B2 |
6746637 | Huss et al. | Jun 2004 | B1 |
6749403 | Bryant et al. | Jun 2004 | B2 |
6752172 | Lauer | Jun 2004 | B2 |
6752599 | Park | Jun 2004 | B2 |
6755801 | Utterberg et al. | Jun 2004 | B2 |
6758975 | Peabody et al. | Jul 2004 | B2 |
6759007 | Westberg et al. | Jul 2004 | B1 |
6759014 | Dales et al. | Jul 2004 | B2 |
6764460 | Dolecek et al. | Jul 2004 | B2 |
6764761 | Eu et al. | Jul 2004 | B2 |
6768425 | Flaherty et al. | Jul 2004 | B2 |
6774517 | Kowalski et al. | Aug 2004 | B2 |
6790014 | Bowen | Sep 2004 | B2 |
6790195 | Steele et al. | Sep 2004 | B2 |
6790198 | White et al. | Sep 2004 | B1 |
6800054 | Westberg et al. | Oct 2004 | B2 |
6808369 | Gray et al. | Oct 2004 | B2 |
6814547 | Childers et al. | Nov 2004 | B2 |
6821432 | Metzner | Nov 2004 | B2 |
6828125 | Hoffman et al. | Dec 2004 | B1 |
6846161 | Kline et al. | Jan 2005 | B2 |
6852090 | Burbank et al. | Feb 2005 | B2 |
6869538 | Yu et al. | Mar 2005 | B2 |
6905479 | Bouchard et al. | Jun 2005 | B1 |
6929751 | Bowman, Jr. et al. | Aug 2005 | B2 |
6939111 | Huitt et al. | Sep 2005 | B2 |
6949079 | Westberg et al. | Sep 2005 | B1 |
6953323 | Childers et al. | Oct 2005 | B2 |
6957952 | Steck et al. | Oct 2005 | B1 |
6984218 | Nayak et al. | Jan 2006 | B2 |
7021148 | Kuhn et al. | Apr 2006 | B2 |
7029245 | Maianti et al. | Apr 2006 | B2 |
7033539 | Krensky et al. | Apr 2006 | B2 |
7041076 | Westberg et al. | May 2006 | B1 |
7044432 | Beden et al. | May 2006 | B2 |
7049406 | Weickert et al. | May 2006 | B2 |
7083719 | Bowman, Jr. et al. | Aug 2006 | B2 |
7087036 | Busby et al. | Aug 2006 | B2 |
7107837 | Lauman et al. | Sep 2006 | B2 |
7115107 | Delnevo et al. | Oct 2006 | B2 |
7115228 | Lundtveit et al. | Oct 2006 | B2 |
7147613 | Burbank et al. | Dec 2006 | B2 |
7153286 | Busby et al. | Dec 2006 | B2 |
7160087 | Fathallah et al. | Jan 2007 | B2 |
7166231 | Westberg et al. | Jan 2007 | B2 |
7175606 | Bowman et al. | Feb 2007 | B2 |
7195607 | Westberg et al. | Mar 2007 | B2 |
7211560 | Looker et al. | May 2007 | B2 |
7232435 | Hildebrand et al. | Jun 2007 | B2 |
7236936 | White et al. | Jun 2007 | B2 |
7238164 | Childers et al. | Jul 2007 | B2 |
7255680 | Gharib | Aug 2007 | B1 |
7258534 | Fathallah et al. | Aug 2007 | B2 |
7261559 | Smith et al. | Aug 2007 | B2 |
7267661 | Susi | Sep 2007 | B2 |
7273465 | Ash | Sep 2007 | B2 |
7306578 | Gray et al. | Dec 2007 | B2 |
7331935 | Barere | Feb 2008 | B2 |
7338469 | Barker et al. | Mar 2008 | B2 |
7338472 | Shearn | Mar 2008 | B2 |
7345025 | Symonds et al. | Mar 2008 | B2 |
7347836 | Peterson et al. | Mar 2008 | B2 |
7390311 | Hildebrand et al. | Jun 2008 | B2 |
7398183 | Holland et al. | Jul 2008 | B2 |
7399637 | Wright et al. | Jul 2008 | B2 |
7404809 | Susi | Jul 2008 | B2 |
7410475 | Krensky et al. | Aug 2008 | B2 |
7422905 | Clague et al. | Sep 2008 | B2 |
7454314 | Holland et al. | Nov 2008 | B2 |
7461968 | Demers et al. | Dec 2008 | B2 |
7490021 | Holland et al. | Feb 2009 | B2 |
7500962 | Childers et al. | Mar 2009 | B2 |
7517387 | Chevallet et al. | Apr 2009 | B2 |
7553295 | Susi | Jun 2009 | B2 |
7556616 | Fathallah et al. | Jul 2009 | B2 |
7575564 | Childers | Aug 2009 | B2 |
7618948 | Kaemmerer | Nov 2009 | B2 |
7645258 | White et al. | Jan 2010 | B2 |
7648627 | Beden et al. | Jan 2010 | B2 |
7654976 | Peterson et al. | Feb 2010 | B2 |
7662133 | Scarborough et al. | Feb 2010 | B2 |
7662286 | Childers et al. | Feb 2010 | B2 |
7699966 | Qin et al. | Apr 2010 | B2 |
7717682 | Orr | May 2010 | B2 |
7789849 | Busby et al. | Sep 2010 | B2 |
7815595 | Busby et al. | Oct 2010 | B2 |
8038640 | Orr | Oct 2011 | B2 |
8142653 | Beden et al. | Mar 2012 | B2 |
8192401 | Morris et al. | Jun 2012 | B2 |
8197231 | Orr | Jun 2012 | B2 |
8197439 | Wang et al. | Jun 2012 | B2 |
8206338 | Childers et al. | Jun 2012 | B2 |
8292594 | Tracey et al. | Oct 2012 | B2 |
8366921 | Beden et al. | Feb 2013 | B2 |
8377293 | Beden et al. | Feb 2013 | B2 |
8409441 | Wilt | Apr 2013 | B2 |
8435408 | Beden et al. | May 2013 | B2 |
8562834 | Kamen et al. | Oct 2013 | B2 |
8721879 | van der Merwe et al. | May 2014 | B2 |
8721883 | Lauer | May 2014 | B2 |
8926835 | Beden et al. | Jan 2015 | B2 |
8932032 | Orr | Jan 2015 | B2 |
8986254 | Morris et al. | Mar 2015 | B2 |
9011114 | Farrell et al. | Apr 2015 | B2 |
9101709 | Beden et al. | Aug 2015 | B2 |
9180240 | Farrell et al. | Nov 2015 | B2 |
9421314 | Plahey et al. | Aug 2016 | B2 |
9500188 | Ly et al. | Nov 2016 | B2 |
9610392 | Farrell et al. | Apr 2017 | B2 |
9624915 | Medina | Apr 2017 | B2 |
20010034502 | Moberg et al. | Oct 2001 | A1 |
20010037763 | Deguchi et al. | Nov 2001 | A1 |
20010043450 | Seale et al. | Nov 2001 | A1 |
20020045851 | Suzuki et al. | Apr 2002 | A1 |
20020062109 | Lauer | May 2002 | A1 |
20020072718 | Brugger et al. | Jun 2002 | A1 |
20020098097 | Singh | Jul 2002 | A1 |
20020107474 | Noack | Aug 2002 | A1 |
20020147423 | Burbank et al. | Oct 2002 | A1 |
20030018395 | Crnkovich et al. | Jan 2003 | A1 |
20030028144 | Duchon et al. | Feb 2003 | A1 |
20030029451 | Blair et al. | Feb 2003 | A1 |
20030042181 | Metzner | Mar 2003 | A1 |
20030100882 | Beden et al. | May 2003 | A1 |
20030136189 | Lauman et al. | Jul 2003 | A1 |
20030194332 | Jahn et al. | Oct 2003 | A1 |
20030200812 | Kuhn et al. | Oct 2003 | A1 |
20030204162 | Childers et al. | Oct 2003 | A1 |
20030217957 | Bowman et al. | Nov 2003 | A1 |
20030217961 | Hopping et al. | Nov 2003 | A1 |
20030217975 | Yu et al. | Nov 2003 | A1 |
20030218623 | Krensky et al. | Nov 2003 | A1 |
20030220599 | Lundtveit et al. | Nov 2003 | A1 |
20030220605 | Bowman et al. | Nov 2003 | A1 |
20030220607 | Busby et al. | Nov 2003 | A1 |
20030220608 | Huitt et al. | Nov 2003 | A1 |
20030220609 | Childers et al. | Nov 2003 | A1 |
20030220627 | Distler et al. | Nov 2003 | A1 |
20040001766 | Maianti et al. | Jan 2004 | A1 |
20040010223 | Busby et al. | Jan 2004 | A1 |
20040019313 | Childers et al. | Jan 2004 | A1 |
20040019320 | Childers et al. | Jan 2004 | A1 |
20040031756 | Suzuki et al. | Feb 2004 | A1 |
20040064080 | Cruz et al. | Apr 2004 | A1 |
20040067161 | Axelsson | Apr 2004 | A1 |
20040082903 | Micheli et al. | Apr 2004 | A1 |
20040084647 | Beden et al. | May 2004 | A1 |
20040109769 | Jahn et al. | Jun 2004 | A1 |
20040115068 | Hansen et al. | Jun 2004 | A1 |
20040135078 | Mandro et al. | Jul 2004 | A1 |
20040136843 | Jahn et al. | Jul 2004 | A1 |
20040156745 | Vandlik et al. | Aug 2004 | A1 |
20040195190 | Min et al. | Oct 2004 | A1 |
20040238416 | Burbank et al. | Dec 2004 | A1 |
20050054968 | Giannella | Mar 2005 | A1 |
20050230292 | Beden et al. | Oct 2005 | A1 |
20060002823 | Feldstein | Jan 2006 | A1 |
20060079766 | Neer et al. | Apr 2006 | A1 |
20060079826 | Beden et al. | Apr 2006 | A1 |
20060195064 | Plahey et al. | Aug 2006 | A1 |
20070040454 | Freudenberger et al. | Feb 2007 | A1 |
20070112297 | Plahey et al. | May 2007 | A1 |
20070149913 | Busby, Jr. et al. | Jun 2007 | A1 |
20070193940 | Duchamp et al. | Aug 2007 | A1 |
20070213651 | Busby, Jr. et al. | Sep 2007 | A1 |
20070213653 | Childers et al. | Sep 2007 | A1 |
20070269340 | Dannenmaier et al. | Nov 2007 | A1 |
20070278155 | Lo et al. | Dec 2007 | A1 |
20080033346 | Childers et al. | Feb 2008 | A1 |
20080077068 | Orr | Mar 2008 | A1 |
20080125693 | Gavin et al. | May 2008 | A1 |
20080208103 | Demers et al. | Aug 2008 | A1 |
20080216898 | Grant et al. | Sep 2008 | A1 |
20080253912 | Demers et al. | Oct 2008 | A1 |
20090004033 | Demers et al. | Jan 2009 | A1 |
20090099498 | Demers et al. | Apr 2009 | A1 |
20090137940 | Orr | May 2009 | A1 |
20090169402 | Stenberg et al. | Jul 2009 | A1 |
20090212248 | Kozak | Aug 2009 | A1 |
20100021313 | Devan et al. | Jan 2010 | A1 |
20100133153 | Beden et al. | Jun 2010 | A1 |
20100211044 | Dacquay et al. | Aug 2010 | A1 |
20100241062 | Morris | Sep 2010 | A1 |
20100286614 | Ring | Nov 2010 | A1 |
20110015610 | Plahey et al. | Jan 2011 | A1 |
20110020156 | Van et al. | Jan 2011 | A1 |
20110092895 | Yardimci et al. | Apr 2011 | A1 |
20110125085 | McGill et al. | May 2011 | A1 |
20110137237 | Prisco et al. | Jun 2011 | A1 |
20110152785 | Chattaraj et al. | Jun 2011 | A1 |
20110274566 | Amirouche et al. | Nov 2011 | A1 |
20110293450 | Grimes et al. | Dec 2011 | A1 |
20120022354 | Beyer et al. | Jan 2012 | A1 |
20120061310 | Beden et al. | Mar 2012 | A1 |
20120065581 | Childers et al. | Mar 2012 | A1 |
20120073432 | Ingersoll et al. | Mar 2012 | A1 |
20120123322 | Scarpaci et al. | May 2012 | A1 |
20120136298 | Bendix | May 2012 | A1 |
20120156097 | Beden et al. | Jun 2012 | A1 |
20120181225 | Weis | Jul 2012 | A1 |
20120181226 | Lauer | Jul 2012 | A1 |
20120181231 | Beden et al. | Jul 2012 | A1 |
20120209169 | Morris et al. | Aug 2012 | A1 |
20120224984 | Orr | Sep 2012 | A1 |
20120230844 | Farrell et al. | Sep 2012 | A1 |
20120232469 | Medina | Sep 2012 | A1 |
20120271226 | Farrell et al. | Oct 2012 | A1 |
20120308412 | Rochat | Dec 2012 | A1 |
20130118961 | Beden et al. | May 2013 | A1 |
20130118970 | Beden et al. | May 2013 | A1 |
20130183170 | Laermer | Jul 2013 | A1 |
20130184638 | Scarpaci et al. | Jul 2013 | A1 |
20130330208 | Ly et al. | Dec 2013 | A1 |
20130331774 | Farrell et al. | Dec 2013 | A1 |
20150098846 | Orr | Apr 2015 | A1 |
20150165105 | Beden et al. | Aug 2015 | A1 |
20160331883 | Plahey et al. | Nov 2016 | A1 |
20170203023 | Farrell et al. | Jul 2017 | A1 |
Number | Date | Country |
---|---|---|
2628238 | Jan 1978 | DE |
2827648 | Jan 1979 | DE |
4006785 | Sep 1990 | DE |
4336336 | May 1994 | DE |
19837667 | Mar 2000 | DE |
19919572 | Nov 2000 | DE |
10042324 | Feb 2002 | DE |
10046651 | Apr 2002 | DE |
19919572 | Apr 2002 | DE |
10053441 | May 2002 | DE |
69618766 | Aug 2002 | DE |
10143137 | Apr 2003 | DE |
10157924 | Jun 2003 | DE |
102007059239 | Jun 2009 | DE |
0257279 | Mar 1988 | EP |
0314379 | Feb 1991 | EP |
0410125 | Aug 1993 | EP |
0728509 | Aug 1996 | EP |
0848193 | Jun 1998 | EP |
0856321 | Aug 1998 | EP |
0947814 | Oct 1999 | EP |
0956876 | Nov 1999 | EP |
1529545 | May 2005 | EP |
1483702 | Aug 1977 | GB |
2101232 | Jan 1983 | GB |
2331796 | Jun 1999 | GB |
0396850 | Apr 1991 | JP |
04191755 | Jul 1992 | JP |
06154314 | Jun 1994 | JP |
06002650 | Nov 1994 | JP |
08028722 | Feb 1996 | JP |
1068383 | Mar 1998 | JP |
11347115 | Dec 1999 | JP |
2000070358 | Mar 2000 | JP |
2000346214 | Dec 2000 | JP |
8402473 | Jul 1984 | WO |
8601115 | Feb 1986 | WO |
WO1994015660 | Jul 1994 | WO |
9420155 | Sep 1994 | WO |
9625064 | Aug 1996 | WO |
1997016214 | May 1997 | WO |
9737703 | Oct 1997 | WO |
9822165 | May 1998 | WO |
WO1998022167 | May 1998 | WO |
0023140 | Apr 2000 | WO |
0033898 | Jun 2000 | WO |
0117605 | Mar 2001 | WO |
0225146 | Mar 2002 | WO |
0225225 | Mar 2002 | WO |
WO2007006030 | Jun 2007 | WO |
2009071069 | Jun 2009 | WO |
WO2010128914 | Nov 2010 | WO |
WO2011045167 | Apr 2011 | WO |
Entry |
---|
Gambro®, “DEHP-free cartridge blood sets,” © Nov. 2004, Gambro, Inc., Lakewood, CO, 4 pp. |
Gambro®, “Prisma® HF 1000, For Increased Filtration Capacity”, © Aug. 2001, Gambro Renal Products, Inc., Lakewood, CO, 2 pp. |
Gambro®, “Prisma® M60 and M100 Pre-Pump Infusion Sets—Introducing: The unique solution that enables Physicians to choose a predilution method that meets the needs of their patients”, © 2004, Gambro Inc., Lakewood, CO, 4 pp. |
Gambro®, “Prismaflex™ anticipating critical care needs and taking our innovative response . . . to new heights,” © 2004, Gambro Inc., Lakewood, CO, 8 pp. |
Glenn Avolio, “Principles of Rotary Optical Encoders,” Sensors Journal of Machine Perception, vol. 10, No. 4, pp. 10-18, 1993. |
Manns, Markus et al., “The acu-men: A new device for continuous renal replacement therapy in acute renal failure,” Kidney International, vol. 54, pp. 268-274, 1998. |
Liberty Cycler Operator's Manual, 2003-2004. |
Newton IQ Cycler Operator Manual, Part No. 470203 Rev. F, 2000-2006. |
Operator's Instructions, Fresenius 90/2 Peritoneal Therapy Cycler, Part No. 470016, Rev. B, 1991. |
Operator's Manual, Serena, Program Version 3.xx—English, 2002. |
Sleep Safe Operating Instructions, Software Version 0.9, Part No. 677 801 1; Aug. 2000. |
Sleep Safe Technical Manual, Part No. 677 807 1; Aug. 2000. |
Notification Concerning Transmittal of International Preliminary Report on Patentability for corresponding PCT Application No. PCT/US2012/032672, dated Oct. 31, 2013, 9 pages. |
Bolegoh, Gordon, “Pumps: Reference Guide”, p. 24, 3rd edition, 2001. |
Ronco et al., “Evolution of Machines for Automated Peritoneal Dialysis”, in Automated Peritoneal Dialysis, Contributions to Nephrology, vol. 129, pp. 142-161, 1999. |
Sleep Safe Operating Instructions, Software Version 0.5, Apr. 1999. |
Sleep Safe Operating Instructions, Software Version 1.0, Oct. 2000. |
Sleep Safe Technical Manual, Dec. 2001. |
Sleep Safe Operating Instructions, Jan. 2002. |
Sleep Safe Communicating Therapy, Mar. 1998. |
Sleep Safe Kommunizierte Therapie, May 1998. |
Innovative Technologies in Peritoneal Dialysis, Sleep Safe Concept, Oct. 13, 1999 (4 attachments). |
TL™ Pump Brochure, TL Systems Corporation, Apr. 1975. |
Google definition for Hall Effect Sensor, accessed Jul. 30, 2015. |
Hall Sensor Effect—NPL Wayback Mar. 11, 2011. www.movingmagnet.com, Technologies, Magnetic and Hall effect Position Sensors. |
International Search Report and Written Opinion for PCT Application No. PCT/US2012/032672, dated Jun. 13, 2012, 13 pages. |
International Search Report and Written Opinion, PCT/US2010 /041976, dated Dec. 2, 2010. |
Number | Date | Country | |
---|---|---|---|
20160015882 A1 | Jan 2016 | US |
Number | Date | Country | |
---|---|---|---|
61477742 | Apr 2011 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 13442184 | Apr 2012 | US |
Child | 14870926 | US |