A pharmaceutical pig is used for transportation of liquid radiopharmaceuticals. A radiopharmacy typically dispenses a liquid radiopharmaceutical into a syringe, which is placed in a pharmaceutical pig for transport to a medical facility. The pig reduces unwanted exposure from the radioactive material and protects the syringe from damage. After delivery, the pig is opened, the syringe is removed and the radiopharmaceutical is administered to a patient. The used syringe is put back in the pig and returned to the radiopharmacy for disposal. Some radiopharmacies are independently owned and others are owned and operated in nationwide networks by Cardinal Health, Inc., having a place of business at 7000 Cardinal Place, Dublin, Ohio 43017 and Mallinckrodt Inc., a business of Tyco International, Ltd. The pharmaceutical pig of the present invention may be used with a conventional syringe or a safety syringe. The pharmaceutical pig of the present invention may be used with or without liners.
Conventional pharmaceutical pigs are used on a daily basis by radiopharmacies across the country. Many of the conventional pigs in current use are formed from plastic and lead. Of course, the lead is used as shielding material for the radiopharmaceutical. Conventional plastic/lead pigs are typically configured in a two-part or a three-part design, discussed in greater detail below. Other conventional pigs are formed from plastic and tungsten. The tungsten is an alternative shielding material to lead, but it is much more expensive.
U.S. Design Pat. No. 447,213 shows a plastic/tungsten pharmaceutical pig currently in production by Syncor International Corporation of Woodland Hills, Calif. (“Syncor”), which has now been acquired by Cardinal Health, Inc. Another tungsten pharmaceutical pig from Syncor is described in U.S. Pat. No. 5,828,073. Both of these patents describe elongate pigs contoured to transport a conventional syringe. Some radiopharmaceuticals, such as radioactive iodine, are typically dispensed into capsules or vials. These capsules or vials are sometimes transported in squat cylindrical containers such as the one described in U.S. Pat. No. 5,834,788. These squat cylindrical containers are sometimes also called pharmaceutical pigs.
However, most liquid radiopharmaceuticals are dispensed into a syringe. The present invention is a method and apparatus including a pharmaceutical pig used to transport syringes filled with a liquid radiopharmaceutical. Pharmaceutical pigs currently used with syringes are elongate devices sized to enclose a single syringe that holds a dose for a single patient. Conventional two-part pharmaceutical pigs are available from Biodex Medical Systems, Inc. of Shirley, N.Y. (“Biodex”) and are commonly used in the Mallinckrodt system of radiopharmacies. Conventional three-part pharmaceutical pigs are produced by Cardinal Health, Inc. and are shown in U.S. Pat. No. 5,519,931. These conventional three-part pharmaceutical pigs are believed to be in widespread use in the Cardinal Health, Inc. system of radiopharmacies to transport conventional syringes.
The Biodex two-part pig is formed from: a) an outer plastic shell having a removable plastic top that threadibly engages a plastic base; and b) an inner shield having an upper lead section that fits in the plastic top and a lower lead section that fits in the plastic base. Conventional syringes are transported in this two-part pig. However, because of the possibility of contamination, the lower section of the pig is washed and disinfected after each use in the Mallinckrodt system of radiopharmacies.
The Syncor three-part pharmaceutical pig disclosed in U.S. Pat. No. 5,519,931 is formed from the following components: a) an outer shell having a removable plastic top that threadibly engages a plastic base; b) an inner shield having an upper lead section that fits in the plastic top and a lower lead section that fits in the plastic base; and c) an inner disposable liner having a removable plastic cap that connects to a plastic base. A conventional syringe is contained in the disposable plastic liner, which fits into the lead portion of the pig. U.S. Pat. No. 5,672,883 (Re. 36,693) is an example of a disposable plastic liner. In Re 36,693, the liner is a self-contained biohazard container designed to capture any of the radiopharmaceutical that may inadvertently leak from a conventional syringe during transit. U.S. Pat. No. 5,672,883 (Re. 36,693) is a divisional of U.S. Pat. No. 5,519,931 and contains method of use claims for the three-part pig described above. U.S. Pat. No. 5,536,945 is another divisional of U.S. Pat. No. 5,519,931 and contains apparatus claims for the aforementioned inner liner, also referred to as a sharps container, having at least one resilient snap to keep the cap attached to the base. After the pig and the used syringe are returned to the radiopharmacy, the liner and the syringe are placed in a disposal container. Other pigs have also been developed.
John B. Phillips is listed as the inventor on several patents for a three-part pharmaceutical pig having: a) an outer plastic shell; b) an inner lead shield; and c) a removable inner liner to hold a syringe. The Phillips' patents are as follows: U.S. Pat. No. 5,611,429; U.S. Pat. No. 5,918,443; and U.S. Pat. No. 6,155,420. The removable inner liner in the Phillips' design has a flared hexagonal shaped section sized to surround the finger grip of the syringe and hold it securely in place during transit. These patents also disclose various ways, such as a detent, to securely hold the cap and the base of the inner liner together.
Conventional three-part lead/plastic pigs, such as the Syncor design or the Phillips design described above, rely on a removable inner liner having a cap and base to contain the syringe and prevent contamination of the lead shielding material with the radiopharmaceutical. However, both the two-part lead/plastic pig and the three-part lead/plastic pig have exposed lead on the interior. There is a need for a new design that protects the lead from inadvertent contamination by the liquid radiopharmaceutical.
Conventional three-part lead/plastic pigs have a radiation shield that is generally uniform in thickness. There is a need to reduce the weight of lead pigs and still retain the shielding capability of conventional designs. In U.S. Pat. No. 5,828,073, a pig, preferably made of tungsten employs a thin wall design near the needle and the plunger of the syringe. Another problem with some prior art designs is the point of abutment of the shielding material in the cap and the shielding material in the base, which may permit radiation leakage. Some prior art designs, such as U.S. Pat. No. 3,531,644 and U.S. Pat. No. 5,611,429 provide for overlap in the shielding material to reduce radiation leakage.
Many conventional three-part lead/plastic pigs use a threaded design to connect the cap and the base. Some of these prior art designs require several turns to connect the cap and the base. In a busy radiopharmacy, there is a need for a faster and easier way to attach the cap to the base.
A label is attached to the pharmaceutical pig at the radiopharmacy prior to the transport to the hospital. The label contains important information including: the patient's name; the type of radiopharmaceutical; the dose; the name of the hospital and the address; among other things. These labels are typically attached to conventional pigs with adhesives or rubber bands. Some radiopharmacies may use several hundred pigs per day. If the labels are secured by adhesives, they must be removed, which is time consuming and tedious. If rubber bands are used, they may break or obscure important information from the view of medical personnel. There is a need for a better way to attach and remove the label from the pig. One prior art attempt to deal with labeling issues is U.S. Pat. No. 5,545,139.
The revised OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) went into effect in 2001. The Standard requires healthcare facilities under the jurisdiction of OSHA to use safer medical devices, such as sharps with engineered sharps injury protection and needleless systems. This Standard and other OSHA directives require an annual review of a facility's exposure control plan and the use of safer medical devices to help reduce needle sticks and other sharps injuries. The Needlestick Safety and Prevention Act, these federal rules and regulations as well as other state rules and regulations have encouraged the development of “safety syringes” such as the Monoject® Safety Syringe from Kendall Company LP of Mansfield, Mass., The Safety-Lok from Becton-Dickinson and Company of Franklin Lakes, N.J. (“B-D”) and the SafeSnap® from U.S. Medical Instruments of San Diego, Calif.
Operationally, these safety syringes function in different ways, but the purpose is to keep the tip of the needle out of contact with healthcare personnel before and after a medication has been administered to a patient. For example, the Monoject® Safety Syringe has an extendable outer tubular sheath that moves from a retracted position around the barrel to an extended locked position that surrounds the needle after it has been used. Safety syringes from B-D also have an extendable outer tubular sheath that moves from a retracted position to an extended locked position surrounding the needle. Other designs have retractable needles, such as the NMT available from New Medical Technology, Inc of Zionsville, Ind. (U.S. Pat. No. 5,782,804). The SafeSnap® safety syringe also has a retractable needle that can be moved from an extended position to a retracted position in the barrel after it has been used. A portion of the plunger can then be snapped off and inserted in the open end of the barrel to create a self-contained biohazard container. One or more of the following U.S. patents may cover the SafeSnap® syringe: U.S. Pat. No. 4,710,170; U.S. Pat. No. 5,205,824; U.S. Pat. No. 5,308,329 and U.S. Pat. No. 5,401,246. Other devices use different designs to shield the needle after it has been used. For example, the SafetyGlide® needle from B-D has a stainless steel latch that shields the needle after activation. (U.S. Pat. No. 5,348,544). The SafetyGlide® needle can be used with any conventional syringe to convert it to a safety syringe.
The term “safety syringe” as used herein includes any of the following products and any other syringes with a needle, not listed below that have an apparatus to protect healthcare personnel from accidental needle stick:
Extendable Sheath Designs.
Monoject® Safety Syringe from Kendall Company LP of Mansfield, Mass.
Safety Lok® syringe from B-D of Franklin Lakes, N.J.
Gettig Guard® syringe from Gettig Pharmaceutical Instrument Co. of Spring Mill, Pa.
Univec Sliding Sheath® syringe from Univec of Farmingdale, N.Y.
Retractable Needle Syringes.
SafeSnap® syringe from U.S. Medical Instruments of San Diego, Calif.
NMT™ syringe from New Medical Technology, Inc. of Zionsville, Ind.
Elite safety syringe from Medi-Hut Co., Inc of Lakewood, N.J.
Vanish Point® syringe from Retractable Technologies of Lewisville, Tex.
Needle Guards That Can Be Used With Any Syringe.
SafetyGlide® needle from Becton-Dickson and Company of Franklin Lakes, N.J.
Sterimatic™ safety needle from Sterimatic Medical Corp. of the United Kingdom.
Needle-Pro™ from SIMS Portex, Inc. of Keene, N.H. (Hinged recap) Miscellaneous Designs.
Protector Syringe and Safety Cap System from InjectiMed, Inc. of Ventura, Calif.
U.S. Pat. No. 6,425,174, assigned to Syncor International Corp. discloses the use of a separate sharps container 12 for holding a standard syringe 14 within a radiopharmaceutical pig 10. The sharps container 12 is in the form of a tubular housing.
To the applicant's knowledge, “safety syringes” have never been used to transport liquid radiopharmaceuticals in pharmaceutical pigs from a radiopharmacy to a medical facility. In one embodiment, the present invention combines an improved pharmaceutical pig with a “safety syringe” to transport liquid radiopharmaceuticals from a radiopharmacy to a medical facility.
A pharmaceutical pig is sized and arranged to transport a single syringe containing a unit dose of a radiopharmaceutical from a radiopharmacy to a medical facility such as a doctor's office, clinic or hospital. After the radiopharmaceutical has been administered to a patient, the used syringe is put back into the pig and returned to the radiopharmacy for proper disposal. The present invention can be configured in a two-part or a three-part design. The present invention may be used with conventional syringes or safety syringes.
In the two-part design, the present invention includes: a) an elongate stainless steel cap removably attached to a base; and b) inner shielding elements. The elongate cap has an inner and outer stainless steel shell to completely enclose a cap shielding element, which is typically formed from lead. The elongate base has an inner and outer stainless steel shell to completely enclose the base shielding element, which is also typically formed from lead. The shielding elements are completely enclosed and protected from inadvertent contamination from a liquid radiopharmaceutical by the stainless steel shells. A bayonet closure removably attaches the cap to the base.
In the two-part design of the present invention, a conventional syringe or a safety syringe may be used to contain the radiopharmaceutical. In one embodiment, a sleeve, at least a portion of which is transparent, slips on and off at least a portion of the base to removably secure a label to the base. No adhesive or rubber bands are needed as in conventional designs. The base shielding material is tapered near the needle end to reduce the overall weight of the pig. Furthermore, the cap shielding element overlaps the base shielding element when the cap is connected to the base. This overlap reduces radiation leakage from the pig at the point the cap and base are joined together.
In the three-part design, the present invention includes: a) an elongate stainless steel cap removably attached to a base; b) inner shielding elements; and c) a lower inner liner in the base. A conventional syringe or a safety syringe may be used with this three-part design. Unlike the prior art, there is never an inner liner in the cap of the present invention. The lower inner liner may have a test tube-like shape with a slight flair at the open end or it may have a straight wall. The inner liner may have a slight bead near the open end to achieve an interference fit with the base.
The cap shielding element 20 has a closed end 24 and an open end 26. The walls 27 of the cap shielding element are of generally uniform thickness. The base shielding element 22 has a closed end 28 and an open end 30. The wall 32 of the base shielding element 22 near the closed end 28 is thinner than the wall 21. The thin wall 32 is to reduce the overall weight of the pharmaceutical pig. When assembled, the thin wall 32 is near the needle end 23 of a syringe, better seen in
The elongate cap 38 has a closed end 54 and an open end 56. The outer shell 42 is welded to the inner shell 44 at 58 to hermetically enclose the cap shielding element 20. A flange 60 is formed on the cap 38 and has a plurality of keyhole-shaped apertures 62, 64, 66 and 68 formed therein. These apertures are better seen in
The elongate base 46 has a closed end 74 and an open end 76. An end cap 78 is attached to the closed end 74. The inner shell 50 is enlarged near the open end 76 to define a shelf 80. A plurality of screws, 82, 84, 86 and 88, better seen in
The cap 38 has a hollow center section 92 sized to surround at least a portion of the plunger of the syringe, better seen in
The base 46 includes a generally cylindrical section 104. The end cap 78 defines a shoulder 106 on the base 46. The transparent flexible sleeve 52, better seen in
The base 46 flares outward and forms an enlarged neck 108 that defines a plurality of anti-roll flats 110, 112 and 114. The screws 82, 84, 86 and 88 protrude above the enlarged neck 108 of the base 46. In
The lower section 102 of the cap 38 nests in an enlarged area 77 of the base 46. A portion 122 of the cap shielding element 20 overlaps a portion 124 of the base shielding element 22 to reduce radiation leakage from the pig 120.
The label 132 also contains the volume of the radiopharmaceutical, 0.53 milliliters, and the concentration, 9.51 mCi/mL. The expiration time, 1530 (3:30 PM) and the dispensing date, May 24, 2002 are also included.
The name and address of the hospital or medical facility to which the pig will be delivered is also listed on the label, but because of space requirements, this information has been omitted from
The label contains a radioactive material warning symbol and may contain a statement that the U.S. Nuclear Regulatory Commission has approved distribution to this radiopharmaceutical to persons licensed to use by-product material listed in Paragraph 35.2000 of CFR Part 35 and to persons holding a equivalent license issued by an appropriately authorized authority. Some of this information has been omitted from
In some of the Mallinckrodt radiopharmacies, the first thing that is done after a prescription has been telephoned is to transcribe the information and enter it into a computer system, which is then followed by the printing of several labels. The first label is similar to the one shown in
The closure structure operates as follows. First, the removable cap 38 is placed on the base 46 and the keyhole-shaped apertures 62, 64, 66 and 68 are aligned with the screws, 82, 84, 86 and 88. The heads of the screws then slip through the large ends 140, 142, 146 and 148 of each keyhole-shaped aperture as shown in
The finger grips 206, are captured between the shelf 80 formed in the inner shell 50 and the terminus 210 of the cap 38. The syringe is therefore prevented from lateral movement inside the pig 120 during transit. The needle 200, shown in phantom, and at least a portion of the barrel 202, shown in phantom, are positioned in the hollow center section 94 of the base 46. At least a portion of the plunger 204 is positioned in the hollow center section 92 of the cap 38.
The screw 82 threadably engages the hole 170 in the retaining ring 90, as shown in
The finger grips 306 are captured between the shelf 80 formed in the inner shell 50 and the terminus 210 of the cap 38. The syringe 299 is therefore prevented from lateral movement inside the pig 120 during transit. The needle 300 and at least a portion of the barrel 302 are positioned in the hollow center section 94 of the base 46. At least a portion of the plunger 304 is positioned in the hollow center section 92 of the cap 38. An extendable outer tubular sheath 310 surrounds the barrel 302 in this view. The sheath 310 can be moved from the retracted position, shown in this figure to an extended position surrounding the needle after it has been used.
The finger grips 406 are captured between the shelf 80 formed in the inner shell 50 and the terminus 210 of the cap 38. The conventional syringe 399 is therefore prevented from lateral movement inside the pig 120 during transit. The needle 400 and at least a portion of the barrel 402 are positioned in the hollow center section 94 of the base 46. At least a portion of the plunger 404 is positioned in the hollow center section 92 of the cap 38.
The inner liner 220 with a flared lip 232 fits in the hollow center section 94 of the base 46. The flared lip 232 of the inner liner 220 is flush with the shelf 80, as shown in
The finger grips 206, are captured between the shelf 80 formed in the inner shell 50 and the terminus 210 of the cap 38. The syringe is therefore prevented from lateral movement inside the pig 120 during transit. The needle 200, shown in phantom, and at least a portion of the barrel 202, shown in phantom, are positioned in the hollow center section 94 of the base 46. At least a portion of the plunger 204 is positioned in the hollow center section 92 of the cap 38.
In an alternative configuration, not shown, the three-part pharmaceutical pig could be configured with the inner liner with straight sides 230 of
For convenience, the inner liner is intended to be disposed after each use. Regulations require that pharmaceutical pigs be inspected and cleaned as necessary after each use. The Mallinckrodt system of radiopharmacies currently wash the lead/plastic Biodex pharmaceutical pigs after each use. It is contemplated that the system of Mallinckrodt will continue to wash the present invention after each use. Apparently, the Cardinal Healthcare Ltd. system of radiopharmacies does not wash their lead/plastic pigs after each use.
The inner liner can have many different shapes, only three of which are shown in the drawings. The first embodiment of the liner 220 has a test tube-like shape with a flared lip 232 and is shown in
As also shown in
The finger grips 406 are captured between the shelf 80 formed in the inner shell 50 and the terminus 210 of the cap 38. The conventional syringe 399 is therefore prevented from lateral movement inside the pig 121 during transit. The needle 400 and at least a portion of the barrel 402 are positioned in the hollow center section 94 of the base 46. At least a portion of the plunger 404 is positioned in the hollow center section 92 of the cap 38.
The closure structure is engaged and attaches the cap 38 to the base 46. The screw 82 threadably engages the hole 170 in the retaining ring 90. The head 81 of screw 82 is locked in the recess 160 of the small end 150 of the keyhole-shaped aperture 62. The screw 86 threadably engages the hole 174 in the retaining ring 90. The head 85 of screw 86 is locked in the recess 164 of the small end 154 of the keyhole-shaped aperture 66. The o-ring 72 is under compression and acts as a spring urging the cap 38 away from the base 46.
Method of Use Two-Part Pig
A prescription is called in, faxed in, or otherwise given to a radiopharmacy. The pharmacist enters the prescription in a computer and prints out the labels previously mentioned. A self-adhesive label can be attached to the pig in conventional fashion. In the alternative, a label can be attached to the pig with the flexible sleeve, without the need for adhesives. A separate label is affixed to a safety syringe or a conventional syringe. The syringe is filled with a radiopharmaceutical in accordance with the prescription. The filled syringe is assayed. In other words, the activity of the radiopharmaceutical in the syringe is measured in a dose calibrator to verify that it complies with the prescription. The filled syringe is put in the two-part pig and closed. The pig is wipe tested for contamination. If the pig passes the wipe test, it is placed in a delivery container.
The delivery containers used by some Mallinckrodt pharmacies have interior padding of rubber foam. Several pigs may be placed in a single delivery container. Before leaving the radiopharmacy, the delivery container and the pigs are wipe tested and surveyed. If the delivery container passes, a DOT label is affixed to the outside of the delivery container and it is delivered to a medical facility.
The pigs are then opened and the syringe is placed in an injection shield. The radiopharmaceutical is administered to the patient. Biodex produces a cylindrical injection shield that fits the B-D safety syringe and the Monoject® Safety Syringe. Cardinal Healthcare Ltd. recommends a clamp style safety syringe as disclosed in U.S. Pat. No. 6,162,198 for conventional syringes. After all the pigs have been opened and the radiopharmaceuticals have been administered, the DOT label is reversed. The reverse of the label clearly states BIOHAZARD and the following: “This package conforms to the conditions and limitations specified in 49 CFR 173.421 for radioactive material, excepted package—limited quantity of material, UN 2910.” The delivery case with the pigs and used syringes are then returned to the radiopharmacy. If a self-adhesive label has been applied to the base it is removed and discarded. If a non-adhesive label has been attached with the flexible sleeve, the sleeve is removed from the base and the label is discarded. The syringe is removed from the pig and placed in a disposal bin. The flexible sleeve is removed from the base and the label is thrown away. The pig is washed and dried. The pig is then ready to be reused.
Method of Use Three-Part Pig
The method of use for the three-part pig is the same as the two-part pig except an inner liner is inserted in the pig. A prescription is called in, faxed in, or otherwise given to a radiopharmacy. The pharmacist enters the prescription in a computer and prints out the labels previously mentioned. One label is attached to the pig with the flexible sleeve, and another is affixed to the safety syringe. The safety syringe or a conventional syringe is filled with a radiopharmaceutical in accordance with the prescription. The filled syringe is assayed. In other words, the activity of the radiopharmaceutical in the syringe is measured in a dose calibrator to verify that it complies with the prescription. The filled safety syringe is put in the three-part pig, which includes an inner liner in the base, never the cap. The pig is then closed. The pig is wipe tested for unwanted activity. If the pig passes the wipe test, it is placed in a delivery container.
The delivery containers used by some Mallinckrodt pharmacies have interior padding of rubber foam. A plurality of receptacles are formed in the foam and each is shaped to receive a pig. Several pigs may be placed in a single delivery container. Before leaving the radiopharmacy, the delivery container and the pigs are wipe tested and surveyed. If the delivery container passes, a DOT label is affixed to the outside of the delivery container. The DOT label contains the radioactivity symbol and the word Radioactive. The container is delivered to a medical facility.
The pigs are opened and typically, the syringe is placed in an injection shield. The radiopharmaceutical is then administered to the patient. The used syringe is then returned to the pig. After all the pigs have been opened and the radiopharmaceuticals have been administered, the DOT label is reversed. The reverse of the label clearly states BIOHAZARD and the following: “This package conforms to the conditions and limitations specified in 49 CFR 173.421 for radioactive material, excepted package—limited quantity of material, UN 2910.” The delivery case with the pigs and used syringes is then returned to the radiopharmacy. Each of the used syringes and the inner liners are removed from pigs and placed in a disposal bin. If a self-adhesive label has been applied to the base it is removed and discarded. If a non-adhesive label has been attached with the flexible sleeve, the sleeve is removed from the base and the label is discarded. The pig is washed and dried. The pig is then ready to be reused.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US03/30227 | 9/24/2003 | WO | 3/7/2005 |