Patient position detection apparatus for a bed

Abstract
An apparatus for supporting a patient comprises a frame, a mattress supported by the frame, and a patient position detection system including an alarm and at least one sensor configured to detect a position of the patient relative to the mattress. The patient position detection system has at least three different modes of operation.
Description




BACKGROUND SUMMARY OF THE INVENTION




The present invention relates to a patient position detection apparatus for a bed. More particularly, the present invention relates to a bed exit and patient position detection apparatus which has multiple modes of operation for providing information to a caregiver regarding a location of a patient on a support deck of the bed and for providing an indication when the patient has exited the bed.




When a patient is required to stay in a hospital bed at a hospital or other patient care facility, it is desirable for a caregiver to be able to monitor the presence, absence, and location of the patient on the bed support surface and to monitor the patient's activity level. Caregivers within a hospital or other patient care facilities are continuously responsible for more and more activities. One of these activities is monitoring patients who need to be restricted to the bed or patients that are at a risk of falling or aggravating injuries if they exit the bed. Patients having certain patient profiles, such as confusion, weakness, or disorientation, are more likely to be injured or reinjured if they exit the bed. Patients with certain types of medical conditions therefore require monitoring of both their presence on the bed and their or location on the support surface. In this instance, the present invention provides an alarm when the patient moves out of the predetermined position on the bed, prior to exiting the bed.




Some patients are allowed by doctor's orders to move about freely on the bed in order to access the bed controls, a phone, or other items or to reposition themselves for comfort. In this situation, an alarm is only required if the patient totally exits the bed.




Additional features and advantages of the invention will become apparent to those skilled in the art upon consideration of the following detailed description of illustrated embodiments exemplifying the best mode of carrying out the invention as presently perceived.











BRIEF DESCRIPTION OF THE DRAWINGS




The detailed description particularly refers to the accompanying figures in which:





FIG. 1

is a perspective view of a hospital bed which includes a patient position detection apparatus in accordance with the present invention and which includes a footboard having an electrical connector alignment apparatus of the present invention;





FIG. 2

is an end view of the footboard of

FIG. 1

illustrating further details of the electrical connector alignment apparatus;





FIG. 3

is an exploded perspective view of portions of the hospital bed of

FIG. 1

illustrating a base frame, a weigh frame, an intermediate frame, a retracting frame, an articulating deck, a first set of sensors for detecting the weight of a patient on the deck, and a second set of sensors located on the articulating deck for detecting the position of the patient on the deck;





FIG. 4

is a partial sectional view illustrating a load cell configured to connect the weigh frame to the base frame;





FIG. 5

is a perspective view of a head end siderail which includes a control panel for operating the patient position detection apparatus of the present invention;





FIG. 6

is an enlarged view of the control panel of

FIG. 5

which is used to control the mode of operation of the patient position detection apparatus and the volume of the alarms generated by the detection apparatus;





FIG. 7

is a block diagram illustrating the control electronics of the patient position detection apparatus;





FIG. 8

is a top plan view of the articulating deck of the bed with the second set of sensors mounted on the deck;





FIGS. 9 and 10

are flow charts illustrating a main loop of steps performed by the controller for monitoring inputs from the control panel and the first and second sets of sensors to control operation of the patient position detection apparatus in a position mode, an exiting mode, and an out-of-bed mode;





FIG. 11

is a flow chart illustrating steps performed by the controller in the position mode;





FIG. 12

is a flow chart illustrating steps performed by the controller in the exiting mode;





FIG. 13

is a flow chart illustrating steps performed by the controller in the out-of-bed mode;





FIG. 14

is a perspective view of a first electrical connector alignment apparatus configured to be coupled to the footboard of the bed;





FIG. 15

is a perspective view of a second electrical connector alignment apparatus configured to be coupled to the retracting frame of the bed; and





FIG. 16

is an exploded perspective view illustrating the first and second electrical connector apparatuses with electrical connectors installed therein and located on the footboard and retracting frame, respectively.











DETAILED DESCRIPTION OF THE DRAWINGS




Referring now to the drawings,

FIG. 1

illustrates a hospital bed


10


of the present invention. The bed


10


includes a base frame


12


having a plurality of casters


14


and brake/steer control pedals


16


mounted adjacent each of the casters


14


. Details of the operation of the brake/steer control mechanism are disclosed in U.S. Pat. No. 6,321,878, entitled CASTER AND BRAKING SYSTEM, which is hereby incorporated by reference.




As best shown in

FIG. 3

, the bed


10


includes a weigh frame


18


coupled to the base frame


12


, an intermediate frame


19


coupled to the weigh frame


18


, a retracting frame


20


coupled to the intermediate frame


19


, and an articulating deck


22


coupled to the intermediate frame


19


and the retracting frame


20


. Brackets


21


on opposite sides of frame


20


are configured to be coupled between the head section


106


and the thigh section


110


of deck


22


with suitable fasteners (not shown).




Referring again to

FIG. 1

, the bed


10


includes a headboard


24


mounted adjacent a head end


26


of the bed


10


and a footboard


28


mounted to the frame


20


adjacent a foot end


30


of bed


10


. Bed


10


further includes a pair of head end siderails


32


and a pair of foot end siderails


34


mounted to the articulating deck


22


on opposite sides of the bed


10


. Further details of head end siderail


32


are illustrated in FIG.


5


. Siderails


32


and


34


are coupled to the articulating deck


22


in a conventional manner using a connector mechanism


35


best shown in FIG.


5


. The siderails


32


and


34


are movable from a lowered position shown in

FIG. 1

to an elevated position (not shown) located above a top surface


36


of mattress


38


. Mattress


38


is located on articulating deck


22


for supporting a patient thereon.




The footboard


28


includes a plurality of buttons, knobs, switches or other controls


40


for controlling various functions of the bed


10


. Controls


40


are located on a top inclined panel


42


and a bottom inclined panel


44


on the footboard


28


. A cover


46


is pivotably coupled to the footboard


28


by a pivot connection


48


so that the cover can be pivoted downwardly to conceal at least the controls


40


located on the top inclined panel


42


.




One of the controls on the footboard


28


is illustratively a lockout button


61


for entertainment functions which are controlled by patient input control panels on the bed


10


. In other words, a caregiver can press button


61


to lock out entertainment functions on the bed


10


. An indicator light is provided adjacent the entertainment lockout control


61


to provide an indication when the entertainment lockout


61


is activated. When the entertainment lockout


61


is activated, the patient cannot turn on the television, radio, stereo, video player, computer or other entertainment device typically available on the bed or in the room. The entertainment lockout control


61


is illustratively located below the cover


46


on the footboard


28


. It is understood, however, that the entertainment lockout may be located at other positions on the bed.




The bed


10


also includes a plurality of lockout switches


63


which are illustratively located on the footboard


28


. It is understood that the lockout switches


63


may be located at any other position on the bed


10


. The lockout switches


63


are coupled to the controller


50


to permit a caregiver to lock out selected functions which are normally controlled by the patient. Using patient controls that are typically located on the head end siderails


32


. For example, lockout switches


63


may deactivate controls for a night light, a back light, head or knee articulation, a hi/lo mechanism, or the entertainment devices discussed above. In addition, a master lockout switch is provided to lock out the head and knee articulation and the hi/lo control mechanism controls.




Panel


42


illustratively includes an indicator light (not shown) adjacent each of the lockout switches


63


to provide an indication when a particular lockout switch


63


is pressed. In addition, the bed


10


includes a separate lockout indicator light


65


located at a location on the bed


10


spaced apart from the lockout switches


63


. In the illustrated embodiment, the separate lockout indicator light


65


is located on the head end siderail


32


as shown in FIG.


5


. Indicator light


65


provides the nurse with a visual indication that one of the lockout switches


63


has been pressed.




Footboard


28


also includes side bumpers


66


and apertures


68


. Apertures


68


provide handles to facilitate movement of the bed


10


. Illustratively, headboard


24


and footboard


28


are made from a plastic material using a blow molding process. It is understood, however, that the headboard


24


and footboard


28


may be made from other materials and from other processes, if desired.




The controls


40


on the footboard


28


are electrically coupled to a controller


50


shown in FIG.


3


. The controller


50


and other bed electronics are illustratively mounted on frame


20


. A first connector alignment apparatus


52


is coupled to the footboard


28


and a second connector alignment apparatus


54


is coupled to the frame


20


. As shown in

FIGS. 2 and 3

, footboard


28


is formed to include apertures


56


which slide over posts


58


on the frame


20


during installation of the footboard


28


onto the frame


20


in the direction of arrow


60


in FIG.


3


. Posts


58


and apertures


56


therefore provide initial alignment between the footboard


28


and the frame


20


. First and second connector alignment apparatuses


52


and


54


provide further alignment for male and female electrical connectors


62


and


64


, respectively, as discussed in detail below with reference to

FIGS. 14-16

.




The patient position detection apparatus of the present invention uses two different types of sensors


70


,


104


. A first set of sensors


70


is used to detect when a patient exits the bed


10


. A second set of sensors


104


is used to determine a position of the patient on the deck


22


of the bed


10


. In the illustrated embodiment, the first type of sensors include load cells


70


which are mounted at the four corners of the weigh frame


18


. Details of the mounting of the load cells


70


between the base frame


12


and the weigh frame


18


are illustrated in

FIGS. 3 and 4

. Base frame


12


includes side frame members


72


and transverse frame members


74


extending between the side frame members


72


. Weigh frame


18


includes a pair of hollow side frame members


76


. Load cells


70


are well known. Load cells


70


typically include a plurality of strain gauges located within a metal block.




As best shown in

FIG. 4

, a mounting ball


78


is coupled to the load cell


70


. Illustratively, mounting ball


78


includes a threaded stem which is screwed into threads in the load cell


70


. Mounting ball


78


is located within an aperture


80


formed in a mounting block


82


. Mounting blocks


82


are secured to the transverse frame members


74


by suitable fasteners


84


at the four corners of the base frame


12


. A mounting bar


86


is coupled to an arm


88


of load cell


70


by fasteners


90


. Mounting bar


86


is then secured to a top surface


92


of side frame member


76


of weigh frame


18


by suitable fasteners


94


and washers


96


. Mounting bar


86


is not coupled to arm


98


of load cell


70


. Therefore, load cell


70


may be deflected downwardly in the direction of arrow


100


when weight is applied to the weigh frame


18


. Such deflection in the direction of arrow


100


changes an output voltage which provides an indication of weight change on the weigh frame. Load cells


70


are coupled to a signal conditioner


53


by wires


102


. The signal conditioner


53


is then coupled to the controller


50


on the bed


10


by wires


102


.




Although the specification and claims of this application refer to a controller


50


, it is understood that the bed


10


will typically include several controllers which control different functions on the bed. These controllers may be located at any location on the bed and are not limited to the location illustrated in FIG.


3


. The controllers


10


typically are microprocessor based controllers. Output signals from various devices may need to be conditioned prior to being coupled to the controller. For instance, analog signals may need to be converted to digital signals for processing by the microprocessor of the controller. Therefore, the word controller is used broadly to include any type of control circuitry necessary to process the output signals and produce the desired control outputs or signals.




A second set of sensors


104


is illustrated in

FIGS. 3 and 8

. Articulating deck


22


includes a head deck section


106


, a seat deck section


108


, a thigh deck section


110


, and a leg deck section


112


. The second set of sensors


104


includes a head section sensor


104


coupled to head deck section


106


by fasteners


116


. Sensor


114


is elongated and extends along a longitudinal axis


118


of the deck


22


. Seat sensor


120


is coupled to seat deck section


108


by fasteners


116


. Sensor


120


extends in a direction transverse to the longitudinal axis


118


. Thigh sensors


122


and


124


are coupled to thigh deck section


110


by fasteners


116


. The locations of sensors


114


,


120


,


122


,


124


are further illustrated in FIG.


8


.




Illustratively, sensors


114


,


120


,


122


, and


124


are resistive pressure sensors available from Interlink Electronics. The resistive pressure sensors are formed in strips which can be cut to any desired length. The sensor strips are illustratively adhered to a stiffener and then sealed within a protective outer sleeve or cover made from a wipable material. Fasteners


116


are illustratively rivets which secure the sensors


114


,


120


,


122


, and


124


in position on the deck


22


as best shown in FIG.


8


. Sensors


114


,


120


,


122


, and


124


are coupled to the controller


50


on the bed


10


by wires


126


.




As pressure on the sensors


114


,


120


,


122


, and


124


increases, resistance of the sensors is lowered. By processing the output signals from sensors


114


,


120


,


122


, and


124


, the controller


50


determines the position of the patient on the deck


22


. In particular, the controller


50


determines when the patient moves away from a central portion of the bed and too close to the side edges


23


or


25


on the deck


22


. Controller


50


then provides an indication that the patient is at risk of exiting the bed.




Using the two different types of sensors


70


and


104


, the patient position detection apparatus of the present invention is capable of operating in several different modes to assist the caregiver with tracking the patient position on the bed


10


. In an out-of-bed mode, only sensors


70


are used to activate an alarm when a patient completely exits the bed. In a second exiting mode, both sets of sensors


70


,


104


are used. An alarm is activated when a patient is located at a position near the sides


23


,


25


of deck


22


or on the deck


22


near the head end


26


or foot end


30


. In other words, a pre-exit alarm is sounded when the patient moves outside a central portion of the deck


22


on the bed


10


. In a third position mode, both sets of sensors


70


,


104


are also used. An alarm is activated when a patient moves away from the head sensor


114


on the deck


22


as discussed below.





FIG. 7

is a block diagram illustrating the electronic control components of the patient position detection apparatus. As discussed above, the first and second sensors


70


and


104


are each coupled to the controller


50


. The controller


50


processes signals from the first and second sensors


70


,


104


as discussed in detail below to provide various control functions. A caregiver control panel


130


is mounted on the bed


10


to control operation of the patient position detection apparatus. Preferably, the caregiver control panel


130


is mounted on the head end siderail


52


as best shown in FIG.


5


. The control panel


130


may also be on a pendant or on a remote control device electrically coupled to the controller


50


. The caregiver control panel


130


includes control buttons, switches, knobs, etc. for setting the particular type of tone for the audible alarm and for setting a volume of the alarm for each of the detection modes as illustrated at block


132


. In addition, the caregiver control panel


130


includes control buttons, switches, knobs, etc. to set the particular type of detection mode for the apparatus as discussed below. Inputs from the caregiver control panel


130


are transmitted to the controller


50


. Controller


50


also transmits signals to the caregiver control panel


130


to control indicator lights


136


on the caregiver control panel


130


.




If an alarm condition is detected by controller


50


as discussed below in detail, controller


50


controls either audible or visual local alarms


138


within the room or on the bed


10


. Controller


50


may also be used to turn on the room lights


140


when an alarm condition is detected. Finally, the controller


50


activates a nurse call alarm


142


to send an indication of the alarm condition to a nurse station located at a remote location.




The apparatus of the present invention further includes a nurse call reset or clear button


144


located on the bed


10


. This clear button


144


sends a signal to controller


50


to clear the nurse call


142


alarm once the nurse call


142


alarm has been activated at the remote nurse call station. Nurse call clear button


144


permits the caregiver to clear or reset the remote patient alarm while at the bed


10


after responding to the alarm condition. Currently, caregivers must cancel the nurse call bed exit alarm


142


by returning to the nurse call station or by deactivating the alarm somewhere else in the hospital, other than at the bed


10


. Button


144


permits the caregiver to clear the nurse call bed exit alarm


142


after responding to the alarm condition at the bed


10


. Controller


50


is also coupled to a communication network


55


so that the controller


50


can transmit output signals to a remote location.




In an alternative embodiment of the present invention, controller


50


is programmed to deactivate the local alarm


138


if the patient returns to bed


10


or returns to a correct position on the bed


10


depending upon the mode selected. This feature may encourage the patient to return to the correct position on the bed


10


since the alarm will be deactivated when the patient returns to the correct position. The nurse call alarm


142


typically remains activated so that the caregiver may still respond to the alarm, even if the local audible and visual room alarm


138


is deactivated.





FIG. 6

illustrates further details of the caregiver control panel


130


which is illustratively located on the head end siderail


132


. Control panel


130


includes a key button


150


, a mode control button


152


, and a volume control button


154


. In order to adjust the detection mode or volume of the alarm, the caregiver must depress the key button


150


and hold it down while depressing the desired mode button


152


or volume button


154


. With the key button


150


held down, the caregiver can scroll through the modes of operation by pressing the mode button


152


. Separate indicator LEDs are provided to indicate which mode is selected. The Position Mode is indicated by LED


156


, the Exiting Mode is indicated by LED


158


, and the Out-of-Bed Mode is indicated by LED


160


. If none of the LEDs


156


,


158


,


160


is lit, the patient position detection apparatus is off.




If the Position Mode is selected, all three LEDs


156


,


158


, and


160


are lit. If the Exiting Mode is selected, LEDs


158


and


160


are lit. If the Out-of-Bed Mode is selected, only LED


160


is lit. By providing a different number of indicator lights for each of the three modes, a caregiver can tell which mode is selected in the dark.




By requiring the depression of both the key button


150


and the mode button


152


or volume button


154


and by placing these buttons


150


,


152


,


154


on the caregiver side of the siderail


32


, the patient is deterred from changing modes or volumes. The caregiver can change the volume of the alarm between a high setting, a medium setting, and a low setting by pressing the key button


150


and simultaneously pressing the volume button


154


. Subsequent presses of the volume button


154


change the volume to different levels. Indicator LEDs


162


,


164


, and


166


are provided for the high, medium, and low volumes, respectively. If the high volume level is selected, all three LEDs


162


,


164


, and


168


are lit. If the medium volume level is selected, LEDs


164


and


168


are lit. If the low volume level is selected, only LED


168


is lit. By providing a different number of indicator lights for each volume level, a caregiver can tell the volume level for the alarm in the dark. When the patient position detection apparatus is off, all the volume LEDs


162


,


164


, and


168


are off.




When a local alarm condition is detected by controller


50


as discussed below. An appropriate LED for Position Mode, Exiting Mode, and Out-of-Bed Mode will flash on the control panel


30


to indicate an alarm condition for that mode. More than one of the LEDs


156


,


158


, and


160


can flash. For instance, in Position Mode, the Position Mode LED


156


may begin to flash when an alarm condition is detected by the Position Mode. Since the Out-of-Bed Mode is also run in Position Mode, the Out-of-Bed LED


160


may also be flashing if the patient has exited the bed.




Caregiver control panel


130


also includes an indicator LED


170


to provide an indication that the bed


10


is not down. This indicator LED


170


is lit when the deck


22


is not in its lowest position relative to the floor. In addition, caregiver panel


130


includes an indicator LED


172


which provides an indication when the brake on the casters


14


is not set. When positioned in a room, the bed


10


is typically set so that the deck


22


is in its lowest position and the brake is set. Therefore, indicator LEDs


170


and


172


provide the caregiver with an indication that these conditions are not met.





FIG. 8

shows the illustrative arrangement of the sensors


114


,


120


,


122


, and


124


on the articulating deck


22


. It is understood that other arrangements of the second set of sensors


104


may be used in accordance with the present invention. In addition, additional sensors may be provided such as a sensor


125


located on the leg deck section


112


. Although the second sensors


104


are illustratively resistive sensors, it is understood that other types of sensors may be used in accordance with the present invention. For example, capacitance sensors such as shown in U.S. Pat. No. 5,808,552 or in U.S. Pat. No. 6,067,019, which are incorporated herein by reference, may be used as the second sensors. In addition, a piezoelectric sensor such as disclosed in U.S. Pat. No. 6,252,512, filed Mar. 5, 1999, entitled A MONITORING SYSTEM AND METHOD, which is hereby incorporated by reference may also be used. In another embodiment, the sensors


104


are coupled to a stop or bottom surface of the mattress


38


or are located within an interior region of the mattress


38


.





FIGS. 9-12

are flow charts illustrating operation of the controller


50


of the present invention and each of the three patient position detection modes. The main software loop of the controller


50


is illustrated in

FIGS. 9 and 10

. The main loop begins at block


200


of FIG.


9


. Controller


50


first updates the status of the indicator lights


136


on control panel


130


or elsewhere as illustrated at block


202


. Controller


50


then determines whether the patient detection system is on at block


204


. If the detection system is not on, controller


50


advances to block


230


as illustrated at block


205


. If the patient detection system is on, controller


50


checks the mode of the detection system as illustrated at block


206


. Specifically, controller


50


determines whether the detection system is in position mode as illustrated at block


208


, exiting mode as illustrated at block


210


, or out-of-bed mode as illustrated at block


212


.




If the controller is in position mode as illustrated at block


208


or exiting mode as illustrated at block


210


, the controller


50


will run the control loops for these modes as discussed below. After running the positioning mode loop or the exiting mode loop, the controller


50


will also run the out-of-bed mode loop when the controller is set in position mode or exiting mode. In other words, if the detection system is on, the out-of-bed mode will always be checked.




Controller


50


then determines whether the mode was just activated at block


214


. If the particular mode was not just activated, the controller


50


advances to block


246


of

FIG. 11

if the system is in position mode as illustrated at block


216


. If the particular mode was not just activated, controller


50


advances to block


264


of

FIG. 12

if the system is in exiting mode as illustrated at block


218


. If the particular mode was not just activated, controller


50


advances to block


278


of

FIG. 13

if the system is in out-of-bed mode as illustrated at block


220


.




If the mode was just activated at block


214


, controller


50


reads all the sensor values from the first and second sets of sensors


70


and


104


as illustrated at block


222


. Controller


50


then determines whether the sensor values are within the preset specifications as illustrated at block


224


. In the position mode, controller


50


is only concerned with the head sensor


114


. Therefore, in position mode, the output from head sensor


114


is checked. The output value from sensor


114


is within specification if the head sensor


114


output signal corresponds to a range of weights between 50-450 lbs. Therefore, for position mode, the sensor


114


is typically not within specification if the head sensor


114


is not plugged in, shorted, or if a patient is not on the bed


10


.




For exiting mode, controller


50


checks all the load cells


70


and sensors


114


,


120


,


122


, and


124


. To be within specification for exiting mode, the weight range detected by load cells


70


must be within a predetermined range based on average human weights. Controller


50


also determines whether any of the sensors


114


,


120


,


122


, or


124


are not plugged in or are shorted. In the out-of-bed mode, controller


50


only looks at load cells


70


to make sure that at least a predetermined minimum weight reading is obtained in order to indicate that a patient is on the bed


10


.




If the values read at block


222


are not within specifications, controller


50


will send a local alarm as illustrated at block


226


so that the caregiver can investigate the problem as illustrated at block


226


. Controller


50


then turns the detection system off as illustrated at block


227


and advances to block


230


as illustrated at block


229


. If the retrieved sensor values are within the specifications at block


224


, controller


50


stores all the sensor values in memory


51


as illustrated at block


228


. Controller


50


then advances to block


230


as illustrated at block


229


.




In the illustrated embodiment, the key button


150


on control panel


130


is a hardware switch. If the key button


50


is not pressed, the controller


50


does not receive the signal from the mode button


152


or the volume button


154


. Therefore, if the key button is not pressed as illustrated at block


232


, controller


50


returns to block


200


as illustrated at block


244


. If the key button


150


and the mode button


152


are pressed as illustrated at block


234


, the controller


50


will receive an input based on the mode button press. If the key button


150


and the volume button


154


are pressed as illustrated at block


236


, the controller


50


will receive an input signal from the volume button


154


press. If the key button


150


, the mode button


152


, and the volume button


154


are all pressed as illustrated at block


238


, the controller


50


will receive input signals from both the mode button press and the volume button press. If the key button and at least one other button are pressed at blocks


234


,


236


, and


238


, controller


50


will update the mode and volume settings in memory


51


as illustrated at block


240


. Controller


50


then returns to block


200


as illustrated at block


244


.




Operation of the controller


50


in position mode is illustrated beginning at block


246


of FIG.


11


. Controller


50


first reads the current value of head sensor


114


as illustrated at block


248


. The current head sensor value is abbreviated as CV. Next, controller


50


retrieves the stored value for head sensor


114


which was stored in memory


51


at block


228


as illustrated at block


250


. The stored sensor value is abbreviated as SV. Controller


50


then determines a scaler value based upon the stored head sensor value. In the illustrated embodiment, an 8 bit A/D converter is used to convert the output from the sensors


104


. Therefore, the value SV ranges from 1-256 in the illustrated embodiment. Smaller values of SV indicate larger weight on the sensors


104


. It is understood that this range could be varied depending upon the particular A/D converter used. Therefore, the range of 1-256 is only for illustrative purposes. Controller


50


sets the scaler value as illustrated in the table at block


252


. The scaler value remains constant until the mode is reactivated. Next, controller


50


calculates the acceptable range for the current head sensor value (CV) as illustrated at block


254


. The acceptable range is:







(

SV
-


SV
·
10

SCALER


)

<
CV
<

(

SV
+


SV
·
10

SCALER


)











Controller


50


determines whether the current head sensor value CV is within the acceptable range as illustrated at block


256


. If so, controller


50


determines that the patient is in the proper position on the deck and returns to block


230


as illustrated at block


262


. If the current head sensor value is not within the acceptable range at block


256


, controller


50


determines whether a timer has expired at block


258


. If not, controller


50


advances back to block


230


. If the timer has expired, controller


50


determines that the patient is out of position and activates the local alarms


138


as illustrated at block


260


. Controller


50


also activates a nurse call alarm


142


, and may turn on the room lights


140


at block


260


. Controller


50


then advances to block


278


and runs the out-of-bed mode check as illustrated at block


262


.




Operation of the patient detection system in exiting mode is illustrated beginning at block


264


in FIG.


12


. Controller


50


advances to block


264


from block


218


in FIG.


9


. In exiting mode, controller


50


first runs the positioning mode loop as illustrated at block


266


. In other words, the controller


50


uses head sensor


114


to check the patient's position using the flow chart discussed above in reference to FIG.


11


. Controller


50


determines whether the current head sensor value CV is within the acceptable range as illustrated at block


268


. If so, controller


50


determines that the patient is in the proper position and advances to block


278


to run the out-of-bed mode check as illustrated at block


276


in FIG.


12


.




If the head sensor value is not within the acceptable range at block


268


, controller


50


runs a sensor test for seat sensor


120


and thigh sensors


122


and


124


using a similar test as in FIG.


11


. Scaler values may be adjusted for the different sensors


120


,


122


, and


124


, if necessary. Scaler values are selected by applying a known load above a particular sensor location and taking an output reading. Next, a predetermined distance from the sensor is selected at which point it is desired to activate the alarm. The known weight is than moved to that desired alarm location and another output reading is taken. The scaler value is calculated the percentage change between the output of the sensor when the known weight applied directly over the sensor and the output of the sensor when the known weight applied at the predetermined distance perpendicular to the sensor.




Controller


50


then determines whether two of the three remaining sensors


120


,


122


, and


124


are within acceptable ranges as illustrated at block


272


by comparing the current sensor values to ranges based on the corresponding stored sensory values. If so, controller


50


determines that the patient is in an acceptable position on the deck


22


and advances at block


230


as illustrated at block


276


. If two of the three sensors are not within the acceptable ranges at block


272


, controller


50


determines that the patient is out of position and updates the local alarms


238


, activates the nurse call alarm


142


, and may turn on the room lights


140


as illustrated at block


274


. Controller


50


then advances to block


230


as illustrated at block


276


. In exiting mode, the patient position detection apparatus of the present invention permits the patient to move around more on the deck


22


before an alarm is activated compared to the position mode. Therefore, position mode is the most sensitive setting for the patient position detection apparatus of the present invention.




It is understood that other configurations may be provided for the locations of sensors


104


. A different number of sensors


104


may be used. The sensors


104


may be mounted at different locations on the deck


22


, on the mattress


38


, or elsewhere on the bed


10


.




Operation of the patient position detection system in the out-of-bed mode is illustrated beginning at block


278


in FIG.


13


. Controller


50


advances to block


278


from block


220


in FIG.


9


. In the out-of-bed mode, controller


50


detects an average current weight of the patient as illustrated at block


280


. For instance, the controller


50


can take four readings from each load cell


70


and divide by four to get an average current weight. Next, controller


50


retrieves the stored initial weight from memory


51


as illustrated at block


282


. Controller


50


subtracts the stored weight from the current weight as illustrated at block


284


.




Next, controller


286


determines whether the weight on the bed


10


detected at block


280


has increased or decreased by more than 30 lbs. compared to the initial stored weight retrieved at block


282


. If the weight has not changed by more than 30 lbs., controller returns to block


230


as illustrated at block


294


. If the weight has changed by more than 30 lbs. at block


286


, controller


50


determines whether a timer has expired at block


288


. If the timer has not expired, controller


250


advances to block


230


as illustrated at block


294


. If the timer has expired at block


288


, the controller


50


determines whether the difference calculated at block


284


is less than −30 lbs. at block


290


. If so, controller


50


determines that the patient has exited the bed


10


and updates the local alarms


138


, the nurse call alarm


142


and may turn on the room lights


140


as illustrated at block


292


. Controller


50


then returns to block


230


as illustrated at block


294


.




If the difference is not less than −30 lbs. at block


290


, controller


50


determines whether the difference calculated at block


284


is greater than 30 lbs. as illustrated at block


296


. If so, controller


50


determines that substantial additional weight has been added to the bed and updates local alarms


138


only as illustrated at block


298


. The nurse call alarm


142


may also be activated, if desired. Controller


50


then advances to block


230


as illustrated at block


294


. If the difference is not greater than 30 lbs. at block


296


, controller


50


clears the local alarm only at block


300


and then advances to block


230


as illustrated at block


294


.




It is understood that the 30 lbs. threshold value for the out-of-bed mode may be adjusted upwardly or downwardly depending upon the weight of the patient. In other words, if the patient is particularly heavy, the 30 lb. threshold may be increased, for example.




It is understood that the patient detection apparatus of the present invention may have more than three modes of operation if desired. The separate modes may have different sensitivity levels.




The out-of-bed mode of the present invention may be armed with the patient in the bed


10


. In some beds having scales, the patient must be removed in order to determine a tare weight of the bed prior to the patient getting into the bed in order to arm the bed exit detector. In the out-of-bed mode of the present invention, removing the patient from the bed is not required in order to arm the bed exit detection system.




The patient position detection system of the present invention may be quickly switched from a normal bed exit system in which an alarm is generated only when a patient exits the bed to a predictive bed exit system in which an alarm is generated when a patient moves away from a center portion of the bed. In an embodiment of the invention, the output signals from the first and second set of sensors


70


,


104


are monitored and stored, either at the bed


10


, or at a remote location to record movements of the patient. The controller


50


or a controller at the remote location monitors the sensor output values to determine whether the patient is moving on the bed


10


. In one embodiment, the controller


50


or controller at a remote location generates a caregiver alert signal or alarm if the patient has not moved on the bed within a predetermined period of time. Therefore, the caregiver can go to the bed


10


and rotate the patient in order to reduce the likelihood that the patient will get bed sores. For example, if the patient hasn't moved for a predetermined period of time, such as two hours, a signal is generated advising the caregiver to move the patient. If the sensors


70


,


104


and controller detect that the patient has moved within the predetermined period, then there is no need for the caregiver to go turn the patient. Therefore, no signal is generated. This feature saves caregiver time and reduces the likelihood of injuries due to unnecessary rotation of a patient who has been moving.




In another embodiment of the present invention, the output signals from the four sensors


70


located at the corners of the base frame


12


are used to provide an indication when one of the frames or the deck hits an obstruction when moving from the high position to a low position. In particular, the processor


50


determines when an output signal from one of the sensors


70


at the corners generates a negative value or a greatly reduced weight reading within a short period of time. This rapid change in the output signal indicates that an obstruction has been hit. Therefore, controller


50


can provide an output signal to stop the hi/lo mechanism from lowering the frames and deck. An alarm signal is also provided, if desired.




In another embodiment of the present invention, the controller


50


is configured to transmit data to a nurse station located at a remote location over the communication network


55


. This data illustratively includes information related to at least one of patient weight, the patient's position on the support surface of the bed


10


, a bed exit indicator, the mode of operation of the patient position detection apparatus, a brake not set indicator, a bed not down indicator, or other data related to the status of the bed or the status of the patient. This permits the nurse to detect the information related to the status of the bed or the status of the patient at the central nurse station without having to check each bed separately.





FIGS. 14-16

further illustrate the connector alignment apparatus of the present invention. The first connector alignment apparatus


52


is illustrated in

FIG. 14

, and the second connector alignment apparatus


54


is illustrated in FIG.


15


. Connector alignment apparatus


52


is configured to receive a first pair of electrical connectors


62


shown in

FIG. 16

which include a housing


304


having a first pair of spaced-apart flanges


306


and a second pair of spaced-apart flanges


308


. Flanges


308


are each formed to include an aperture


310


. Connectors


302


include a plurality of electrical terminals


312


extending away from housing


304


. Alignment posts


313


extend from housing


304


of connector


62


further than terminals


312


. The terminals


312


are electrically connected to conductors of a cable


314


. Cable


314


of connectors


62


are connected to controls


40


. Connector alignment apparatus


54


is configured to receive female electrical connectors


64


. Those numbers referenced by numbers on connectors


62


perform the same or similar function. Connectors


64


include female socket contacts


318


configured to receive terminals


312


of connector


302


. Illustratively, cables extending from connectors


64


are coupled to the controller


50


on bed


10


.




Referring now to

FIG. 14

, connector alignment apparatus


52


includes a base plate


320


having outwardly extending alignment posts


322


located at opposite ends. Posts


322


each include tapered head portions


324


. Alignment apparatus


52


includes a pair of connector receiving portions


326


. Connector receiving portions


326


each include a pair of center posts


328


. Each post


328


includes a pair of spring arms


330


. Each spring arm


330


has a head portion


332


including a ramp surface


334


and a bottom lip


336


. Each connector receiving portion


326


also includes a pair of posts


338


.




Electrical connectors


62


are installed into the connector receiving portions


326


by locating the apertures


310


on flanges


308


over the posts


338


and pushing the connector


62


toward base


320


. Flanges


306


engage ramp surfaces


334


of heads


332


and cause the spring arms


330


to be deflected. Once the flanges


306


move past the heads


332


, heads


332


then move over flanges


306


to retain the connectors


302


within the connector alignment apparatus


52


as best shown in FIG.


16


.




Second connector alignment apparatus


54


is best illustrated in FIG.


15


. The alignment apparatus includes a body portion


340


having a pair of downwardly extending alignment posts


342


. Body portion


340


is formed to include apertures


344


at opposite ends. Apertures


344


are configured to receive the posts


322


of first connector alignment apparatus


52


as discussed below. Lead-in ramp surfaces


346


are formed around the apertures


344


. Body portion


340


further includes a pair of connector receiving portions


348


which function the same as connector receiving portions


326


described above. Reference numbers the same as in

FIG. 14

perform the same or similar function. Apertures


310


formed in flanges


308


of connectors


64


are inserted over the posts


338


of the connector receiving portions


348


. The connectors


64


are then pushed downwardly to deflect the heads


332


until the lips


336


move over flanges


306


to lock the connectors


64


within the housing


340


as discussed above.




The first connector alignment apparatus


52


and the second connector alignment apparatus


54


each may include a key shown diagrammatically at locations


349


and


351


, respectively. Certain beds have different features which are controlled by controller


50


and actuated by controls


40


on the footboard. Therefore, different footboards


28


may be required depending upon the particular type of bed


10


being used. The keys


349


and


351


on the first and second connector alignment apparatuses


52


and


54


only permit connection between an appropriate type of footboard


28


for the particular bed


10


. Therefore, the keys


349


and


351


ensure that the right type of footboard


28


is attached to the bed


10


.




First connector alignment apparatus


52


is rigidly coupled within a recessed portion


350


formed in footboard


28


as best shown in FIG.


16


. The base


320


is secured to the footboard


28


by a fastener


352


which extends through an aperture


354


formed in the base


320


. The second connector alignment apparatus


54


is loosely connected to an end surface


356


of the frame


20


. A fastener


358


is configured to extend through an oversized central opening


360


formed in housing


340


. Posts


342


at opposite ends of the housing


340


are located within apertures


362


formed in the surface


356


of the frame


20


. Housing


340


is therefore not rigidly coupled to frame


20


and can float slightly due to the oversized apertures


362


and the oversized aperture


360


.




During installation of the footboard


28


on to the frame


20


, initial alignment is provided by posts


58


on frame


20


extending into the apertures


56


formed in the footboard


28


. As the footboard


28


moves downwardly over the posts


58


, the posts


322


on first connector alignment apparatus


52


enter the apertures


344


in the second connector alignment apparatus


54


. Tapered surfaces


324


on posts


22


and tapered surfaces


346


of apertures


344


facilitate insertion of the posts


322


into the apertures


344


. Since the housing


340


of second connector alignment apparatus


54


can float on the frame


20


, the housing


340


moves into proper alignment with the first connector alignment apparatus


52


as the footboard


28


is installed. This ensures proper alignment between connectors


62


and


64


. Typically, connectors


62


and


64


include further alignment posts


313


and apertures


315


, respectively, which mate to make sure that each of the terminals


312


line up with the socket contacts


318


. Therefore, the connector alignment apparatus of the present invention includes a combination of posts


58


on the frame


20


which mate with aperture


56


on the footboard


28


, posts


322


on the first connector alignment apparatus


52


which mate with apertures


344


on the second connector alignment apparatus


54


, and posts


313


on connectors


62


which mate with apertures


315


on the connectors


64


to provide further alignment.




Although the invention has been described in detail with reference to certain illustrated embodiments, variations and modifications exist within the scope and spirit of the invention as described and as defined in the following claims.



Claims
  • 1. An apparatus for supporting a patient, the apparatus comprising:a frame, a mattress supported by the frame, and a patient position detection system including an alarm and at least one sensor, the patient position detection system being configured to detect a position of the patient relative to the mattress, the patient position detection system having at least first, second, and third alarm modes of operation, the patient position detection system being configured to provide for selection of one of the first, second, and third modes as a selected mode, the first mode of operation resulting in an alarm being activated in the event the first mode is the selected mode and the patient moves by a first amount, the second mode of operation resulting in the alarm being activated in the event the second mode is the selected mode and the patient moves by a second amount greater than the first amount, and the third mode of operation resulting in the alarm hem activated in the event the third mode is the selected mode and the patient moves a third amount greater than the second amount.
  • 2. The apparatus of claim 1, wherein the third mode of operation results in the alarm being activated in the event the patient exits the mattress.
  • 3. The apparatus of claim 1, wherein the patient position detection system includes at least one first sensor coupled to the frame, the at least one first sensor having an output signal witch is variable in response to changes in a weight applied to the mattress, at least one second sensor located adjacent the mattress, the at least one second sensor having an output signal which is variable in response to changes in the position of the patient on the mattress, and a controller having inputs configured to receive the output signals from the first and second sensors, the controller being configured to monitor the output signals, to provide an indication of changes in the position of the patient relative to the mattress, and to activate the alarm.
  • 4. The apparatus of claim 3, wherein the at least one first sensor is a load cell and the at least one second sensor is one of a resistive pressure sensor, a capacitance sensor, and a piezoelectric sensor.
  • 5. The apparatus of claim 1, further comprising a deck coupled to the frame, the mattress being located on the deck, the deck including a head deck section, a seat deck section, a thigh deck section, and a leg deck section, and wherein at least one head sensor is coupled to the head deck section, at least one seat sensor is coupled to the seat deck section, and at least one thigh sensor is coupled to the thigh deck section.
  • 6. The apparatus of claim 1, wherein the patient position detection system includes a controller coupled to the at least one sensor and first, second, and third mode indicator lights which correspond to first, second, and third modes of operation of the patient position detection system, respectively, the controller being coupled to the first, second, and third mode indicator lights to indicate which mode has been selected.
  • 7. The apparatus of claim 1, wherein the patient position detection system includes a controller coupled to the at least one sensor and further comprising a control panel coupled to the controller to permit a caregiver to select between the first, second and third modes of operation.
  • 8. The apparatus of claim 7, wherein the control panel includes an actuator to permit the caregiver to adjust a volume of the alarm.
  • 9. The apparatus of claim 7, wherein the control panel includes a key button and a separate mode button, the controller permitting the caregiver to change the mode of operation by pressing the mode button only in the event the key button is also pressed.
  • 10. The apparatus of claim 7, wherein the control panel includes a key button and a separate a volume control button to permit the caregiver to adjust a volume of the alarm, the controller being configured to permit the caregiver to adjust the volume of the alarm using the volume control button only in the event the key button is also pressed.
  • 11. The apparatus of claim 1, wherein the patient position detection system is coupled to a communication port to provide a nurse call alarm to a remote location when the alarm is activated.
  • 12. The apparatus of claim 1, wherein the first mode of operation results in the alarm being activated in the event the patient moves away from a central region of the mattress by a first distance, the second mode of operation results in the alarm being activated in the event the patient moves away from the central region of the mattress by a second distance greater than the first distance, and the third mode of operation results in the alarm being activated in the event the patient exits the mattress.
  • 13. The apparatus of claim 1, wherein the patient position detection system is configured to activate the alarm in the event the system is in one of the modes and a patient approaches exiting the mattress.
  • 14. The apparatus of claim 1, wherein the patient position detection system further includes a single mode selector configured to permit scrolling selection of the first, second, and third modes.
  • 15. The apparatus of claim 1, wherein the patient position detection system includes a plurality of sensors and a controller that receives signals from the plurality of sensors and determines whether to activate the alarm based on the signals and the selected mode.
  • 16. The apparatus of claim 15, wherein each of the plurality of sensors has an electrical resistance that varies with the position of a patient on the mattress.
  • 17. The apparatus of claim 15, further comprising a deck positioned over the frame, wherein the mattress is positioned on the deck and the plurality of sensors includes a plurality of load cells supporting the weight of the deck and mattress.
  • 18. The apparatus of claim 1, further comprising a footboard positioned on a foot end of the apparatus and a display coupled to the footboard wherein the patient position detection system includes a plurality of sensors, the display is configured to indicate the weight of a patient positioned on the mattress based on signals generated by the plurality of sensors.
  • 19. The apparatus of claim 1, wherein the patient position sensor further includes a digital controller and an A/D converter configured to convert an analog signal from the at least one sensor to a digital signal.
  • 20. An apparatus for supporting a patient, the apparatus comprising:a frame, a mattress supported by the frame, and a patient position detection system including an alarm and the patient position detector having first, second, and third modes of operation, the first, second, and third modes being selectable to permit adjustment of a sensitivity of the patient position detection system, in the event the first mode is selected, the alarm is activated in response to the patient moving a first distance, in the event the second mode is selected, the alarm is activated in response to the patient moving a second distance greater than the first distance, and in the event the third mode is selected, the alarm is activated in response to the patient moving a third distance greater than the second distance.
  • 21. The apparatus of claim 20, wherein the third mode of operation results in the alarm being activated in the event the patient exits the mattress.
  • 22. The apparatus of claim 20, wherein the patient position detector includes a plurality of sensors configured to generate an output signal which is variable in response to changes in a weight applied to the mattress and an output signal which is variable in response to changes in the position of the patient on the mattress, and patient position detector further includes a controller configured to receive the output signals from the plurality of sensors, the controller being configured to monitor the output signals, to provide an indication of changes in the position of the patient relative to the mattress, and to activate the alarm.
  • 23. The apparatus of claim 20, wherein the the first mode of operation results in the alarm being activated in the event the patient moves away from a central region of the mattress by the first distance, the second mode of operation results in the alarm being activated in the event the patient moves away from the central region of the mattress by the second distance, the third mode of operation results in the alarm being activated in the event the patient exits the mattress.
  • 24. The apparatus of claim 20, further comprising a deck coupled to the frame, the mattress being located on the deck, the deck including a head deck section, a seat deck section, a thigh deck section, and a leg deck section, and wherein the patient position detector includes at least one head sensor coupled to the head deck section, at least one seat sensor coupled to the seat deck section, and at least one thigh sensor coupled to the thigh deck section.
  • 25. The apparatus of claim 20, further comprising first, second, and third mode indicator lights which correspond to the first, second, and third modes of operation of the patient position detector, respectively, the patient position detector being coupled to the first, second, and third mode indicator lights to indicate which mode has been selected.
  • 26. The apparatus of claim 20, further comprising a control panel coupled to the patient position detector to permit a caregiver to select between the first, second and third modes of operation.
  • 27. The apparatus of claim 26, wherein the control panel includes a key button and a separate mode button, the patient position detector being configured to permit the caregiver to change the mode of operation by pressing the mode button only in the event the key button is also pressed.
  • 28. The apparatus of claim 20, wherein the patient position detection system is configured to activate the alarm in the event the system is in one of the modes and a patient approaches exiting the mattress.
  • 29. The apparatus of claim 20, wherein the patient position detection system further includes a single mode selector configured to permit scrolling selection of the first, second, and third modes.
  • 30. The apparatus of claim 20, wherein the patient position detection system includes a plurality of sensors and a controller that receives signals from the plurality of sensors and determines whether to activate the alarm based on the signals and the selected mode.
  • 31. The apparatus of claim 30, wherein each of the plurality of sensors has an electrical resistance that varies with the position of a patient on the mattress.
  • 32. The apparatus of claim 30, further comprising a deck positioned over the frame, wherein the mattress is positioned on the deck and the plurality of sensors includes a plurality of load cells supporting the weight of the deck and mattress.
  • 33. The apparatus of claim 20, further comprising a footboard positioned on a foot end of the apparatus and a display coupled to the footboard, wherein the patient position detection system includes a plurality of sensors, the display is configured to indicate the weight of a patient positioned on the mattress based on signals generated by the plurality of sensors.
  • 34. The apparatus of claim 20, wherein the patient position sensor further includes a digital controller and an A/D converter configured to convert an analog signal from the at least one sensor to a digital signal.
  • 35. A patient support comprising:a frame, a mattress supported by the frame, and a patient position detection system including a controller, an alarm, and a plurality of sensors, the controller being configured to receive data from the plurality of sensors indicative of the position of the patient relative to the mattress, the patient position detection system having a first mode of operation in which the controller activates the alarm to indicate that the patient is in a first position relative to the mattress, the patient position detection system having a second mode of operation in which the controller activates the alarm to indicate that the patient is in a second position relative to the mattress, the patient position detection system having a third mode of operation in which the controller activates the alarm to indicate that the patient is in a third position relative to the mattress, the data received by the controller from the plurality of sensors also being used by the controller to determine a weight of the patient resting on the mattress.
  • 36. The patient support of claim 35, further comprising a display configured to display the weight of the patient.
  • 37. The patient support of claim 36, further comprising a footboard positioned adjacent a foot end of the patient support, wherein the display is supported by the footboard.
  • 38. The patient support of claim 37, wherein the footboard is removable from the frame, the frame includes a first electrical connector, the footboard includes a second electrical connector that couples with the first electrical connector when the footboard is coupled to the frame to provide electrical communication to the display, and the second electrical connector is spaced apart from the first electrical connector when the footboard is removed from the frame.
  • 39. The patient support of claim 35, further comprising a barrier positioned adjacent a perimeter of the mattress, the barrier including a selector in communication with the controller, the selector being configured to permit a user to select one of the first, second, and third modes as a selected mode.
  • 40. The apparatus of claim 39, wherein the selector is configured to permit scrolling selection of the first, second, and third modes.
  • 41. The patient support of claim 35, wherein the plurality of sensors includes a plurality of load cells in communication with the controller to determine the weight and position of the patient.
  • 42. The patient support of claim 41, further comprising a deck supporting the mattress, wherein the plurality of load cells support the weight of the deck and the mattress.
  • 43. A patient support comprising:a frame, a deck positioned above the frame, a mattress positioned above the deck, and a patient position detection system including a controller, an alarm, and a plurality of sensors, the controller being configured to receive data from the plurality of sensors indicative of the position of the patient relative to the mattress, the patient position detection system having a first mode of operation in which the controller activates the alarm to indicate that the patient has moved a first distance from a location on the mattress, the patient position detection system having a second mode of operation in which the controller activates the alarm to indicate that the patient has moved a second distance from the location on the mattress, the patient position detection system having a third mode of operation in which the controller activates the alarm to indicate the patient has moved a third distance from the location on the mattress, the second distance being greater than the first distance, the third distance being greater than the second distance, the patient position detection system being configured to permit selection of the mode of operation to permit adjustment of a sensitivity of the system before the alarm is activated, the plurality of sensors including a plurality of load cells supporting the weight of the deck and providing data to the controller to determine the position of the patient and a weight of the patient resting on the mattress.
  • 44. The patient support of claim 43, further comprising a footboard positioned adjacent a foot end of the patient support and a display supported by the footboard.
  • 45. The patient support of claim 44, wherein the footboard is removable from the frame, the frame includes a first electrical connector, the footboard includes a second electrical connector that couples with the first electrical connector when the footboard is coupled to the frame to provide electrical communication to the display, and the second electrical connector is spaced apart from the first electrical connector when the footboard is removed from the frame.
Parent Case Info

This application is a continuation of U.S. patent application Ser. No. 09/737,111, filed Dec. 14, 2000, now U.S. Pat. No. 6,320,510, which is a divisional of U.S. patent application Ser. No. 09/264,174, filed Mar. 5, 1999, now U.S. Pat. No. 6,208,250, the disclosures of which are incorporated herein by reference.

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Number Name Date Kind
3325799 Farris Jun 1967 A
3836900 Mansfield Sep 1974 A
3926177 Hardway, Jr. et al. Dec 1975 A
RE28754 Cook et al. Mar 1976 E
3961201 Rosenthal Jun 1976 A
3991414 Moran Nov 1976 A
3991746 Hanna Nov 1976 A
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Continuations (1)
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Parent 09/737111 Dec 2000 US
Child 10/038986 US