The present invention relates to a device for accessing a portal reservoir, and more particularly a portal access device that combines long term accessing of a portal reservoir with sharps protection.
Long term intravenous therapy to a patient oftentimes requires that a portal reservoir (also may be referred herein as port or portal) be implanted to the patient. The medicament stored in the port is fed slowly to the patient via a catheter connected to the portal. To refill the portal, conventionally a needle is inserted through the skin of the patient into a septum of the portal so that the portal may be refilled with the desired medicament. As with the use of any needle or sharps instruments, there is always a chance that the user, or a bystander, may be accidentally pricked by the contaminated needle when it is removed from the patient. Such accidental injury may well be serious as the tip of the needle is contaminated with the fluid from the patient.
A prior device used for shielding the contaminated tip of the needle is disclosed in U.S. Pat. No. 6,613,015, assigned to the assignee of the instant application and marketed under the trade name GRIPPER PLUS. The disclosure of the '015 patent is incorporated by reference herein. In the '015 patent, a right angle needle for accessing the portal is disclosed. The '015 device has the horizontal portion of its right angle needle embedded in an arm that has a distal portion hingedly connected to uprights of a base. The vertical portion of the needle extends through an opening at the proximal portion of the base. Medicament or fluid is fed to the right angle needle via a catheter connected to the distal end of the horizontal portion of the needle. A well or catch is formed above the main body of the base adjacent the opening so that when the arm is pivotally raised relative to the base and when the of the needle is fully pulled out of the base, the tip of the needle would flex forward so as to be entrapped in the catch adjacent to the opening. Even though surrounded by a dam, the tip of the needle nonetheless is exposed to the environment and viewable by the patient, and there is a remote chance that contaminated fluid at the tip of the needle may adhere to the well, or may be splattered unnecessarily around the area of the well or beyond. A similar right angle device is disclosed in U.S. Pat. No. 6,719,721.
After accessing the portal and refilling it, the device of the '015 patent is removed from the skin of the patient. Any subsequent refilling of the portal requires that a new right angle needle device be used to gain access to the portal. This repeated insertion of a needle to the patient tends to cause discomfort, at the very least, to the patient.
There is therefore a need for a portal access device that may be secured to the patient on a long term basis so as not to subject the patient to repeated inserts by needle sharps.
There is also a need for a sharps protection device having the tip of its needle that, once removed from the patient, will not be exposed to the environment or seen by the patient.
The portal access device of the instant invention comprises two main components that may or may not be preassembled prior to shipping. The first of these components incorporates a safety needle insertion device similar to the device disclosed in the above incorporated by referenced '015 patent, but with modifications. The second component is a low profile portal access assembly that includes an infuser or a cap, a blunt cannula extending downwardly from the infuser, and a flexible delivery tubing or catheter connected to the infuser for establishing a fluid path between the conduit and the blunt cannula. The blunt cannula, or at least a tip portion thereof, is to be piercingly coupled to the portal reservoir so that fluids, or medicaments, may be delivered to or removed from the portal reservoir by way of the infuser.
The main body of the infuser, or its cap or housing, is the portion of the component external to the patient and is meant to be positioned on or above the patient's skin surface, along with its attached tubing. The blunt cannula is attached to and extends downwardly from the infuser housing through the skin of the patient and the portal septum after placement, and establishes the fluid communication path between the external tubing of the infuser assembly and the portal reservoir implanted in the patient.
To be properly inserted to the patient, the needle sharps device is superposed, or fits, over the infuser in such a way that its needle or sharp cannula extends past the self sealing septum of the infuser, through the infuser, and axially into the blunt cannula, with the tip of the sharp cannula protruding or exposed from the end of the blunt cannula. The sharp cannula thereby serves as the means to puncture and penetrate first the patient and then the self sealing septum at the portal reservoir to provide a track for the coaxial blunt cannula. Once the sharp cannula and the blunt cannula, or at least corresponding portions of the respective tips thereof, are coaxially positioned correctly within the portal reservoir, the sharp cannula is removed from the blunt cannula. Once the sharp cannula is removed from the infuser assembly, the safety needle protection device may be removed from the infuser assembly. The tip of the needle or sharp cannula is fixedly maintained within a bore of the base of the needle insertion device that extends between the opening at the top surface and the opening at the lower surface of the base wherethrough the sharp cannula extends into the blunt cannula.
Respective locking mechanisms are provided at the end of the arm of the needle insertion device that connects to the base and the uprights at the base to which the arm is hingedly or pivotally connected to prevent the arm from further movement, be it upwards or downwards, relative to the base once the tip of the needle is positioned within the bore of the base. The sharps protection device may then be safely and properly discarded.
The infuser assembly remains on the patient, with the septum of the infuser where the sharp cannula entered and exited self-sealed. With proper attachment to the patient, either adhesively or by tape, the low profile infuser assembly provides long term access to the portal reservoir without further risks of sharps injury, or further unnecessary pain and discomfort, to the patient due to the need for reinsertions of sharp needles to the patient.
To hide the contaminated tip of the needle or the sharp cannula from the user and also the patient, the needle insertion device of the instant invention is configured such that when the tip of the contaminated needle is withdrawn first from the portal reservoir and then the patient, as soon as it is positioned appropriately in the bore formed in the base through which the sharp needle or cannula extends, the movement of the arm that bears the sharp cannula is stopped and locked into place, so that the tip of the needle would not come into contact with any part of the base, and is not withdrawn above the top surface, or the opening at the top surface, of the base. Locking mechanisms at the end of the arm that hingedly connects to the base and at the uprights to which the arm is hingedly attached cooperatively coact to prevent any further upward and downward movements of the arm, once the tip of the needle is appropriately positioned within the bore.
The lower surface of the base of the needle insertion device is configured to form fittingly mount over the infuser, both the infuser or cap portion and the tube connecting thereto that lie over the patient's skin surface, so that the needle injection device and the infuser may be pre-assembled as a unit.
A first aspect of the instant invention is a combination of an infuser, or a fluid storage housing or body, to which a blunt cannula is connected and to which a tube extends, so that the infuser establishes a fluid communication path between the blunt cannula and the tube. The combination further includes a sharp cannula that is removably mated to the blunt cannula through the infuser with the tip of the sharp cannula protruding or extruding beyond the tip of the blunt cannula. The sharp cannula is attached to a first end of a arm, a second end of which being movably connected to a distal portion of a base. The sharp cannula extends through an opening at a proximal portion of a base which is configured to fit over the infuser when the sharp cannula is mated to the blunt cannula. The sharp cannula is removable from the blunt cannula when the first end of the arm is moved in a direction away from the proximal portion of the base.
The invention also relates to an apparatus that comprises an infuser having a blunt cannula extending downwardly therefrom and a tube connected thereto for establishing a fluid communication path between the tube and the blunt cannula; and an insertion device that includes a base having a distal portion and a proximal portion, an arm having a second end hingedly and movably connected to the distal portion of the base, a sharp cannula attached to a first end of the arm, an opening provided at the proximal portion of the base, with the base covering the infuser and the sharp cannula removably mated to the blunt cannula through the opening at the proximal portion of the base, and the tip of the sharp cannula protruding or exposed beyond the tip of the blunt cannula when the arm lies substantially longitudinally along the base. The sharp cannula is removable from the blunt cannula when the first end of the arm is moved pivotally in a direction away from the base.
The invention further relates to a method of establishing a fluid path between a fluid store and a port or portal reservoir implanted in a patient. The method comprises the steps of: (a) providing a blunt cannula extending downwardly from an infuser and a tube having one end connected to the infuser and another end connected to a fluid store so that the tube is in fluid communication with the blunt cannula, (b) providing a base having a sharp cannula, (c) superposing the base over the infuser and removably mating the sharp cannula to the blunt cannula until the tip of the sharp cannula is exposed beyond the tip of the blunt cannula, (d) inserting the combined sharp and blunt cannulas to a patient to position the respective tips of the cannula into the port, and (e) removing the sharp cannula from the blunt cannula while leaving at least the tip of the blunt cannula in the port, so as to establish a fluid communication path between the port and the fluid store through the blunt cannula and the infuser.
The invention furthermore relates to an apparatus comprising an infuser housing adaptable for storing fluids, a blunt cannula extending downwardly from the housing, and a tube connected to a side of the housing for establishing a fluid path between the tube and the blunt cannula through the housing.
The needle insertion device of the instant invention relates to an apparatus that comprises a base having a distal portion and a proximal portion, a cannula attached to a first end of an arm, a second end of the arm hingedly connected to the distal portion of the base so that the arm is pivotable relative to the base at its second end, an opening provided at the proximal portion of the base wherethrough the cannula passes, a bore extending from the opening at the proximal portion of the base, a first lock mechanism or a first portion of a lock mechanism(s) provided at the distal portion of the base and a second lock mechanism or a second portion of a lock mechanism(s) provided at the second end of the arm, the first and second lock mechanisms coacting to prevent movement of the arm relative to the base after the tip of the cannula moves past the opening and is within the bore.
The needle insertion device of the instant invention is further a safety needle device that comprises a base having a distal portion and a proximal portion, an opening provided at the proximal portion of the base, a bore extending from the opening at the proximal portion of the base, an arm having a first end and a second end, the second end of the arm being hingedly connected to the distal portion of the base so that the arm is pivotally moveable relative to the base at its second end; and a right angle cannula mounted to the arm, a vertical portion of the cannula including the tip of the cannula extending downwardly from the first end of the arm and passes through the opening of the base before use, a horizontal portion of the cannula mounted along the length of the arm, so that when the first end of the arm is moved to its upmost position, the vertical portion of the cannula is withdrawn from the opening and the tip of the cannula is positioned within the bore.
The safety needle device of the instant invention may further include a first lock mechanism having a first and second part provided at the distal portion of the base, and a second lock mechanism having a first and second part provided at the second end of the arm with the respective first parts of the first and second lock mechanisms coacting to prevent further movement of the arm relative to the base along one direction after the tip of the cannula is positioned within the bore, and the respective second parts of the first and second lock mechanisms coacting to prevent further movement of the arm relative to the base along another direction once the tip of the cannula is positioned within the bore.
It is therefore an objective of the present invention to provide a portal access device that alleviates the need to reinsert a sharp cannula in the patient every time there is a need to either remove fluid from, or infuse fluid into, the portal reservoir implanted in the patient.
It is another objective of the present invention to provide a portal access device which needle insertion portion may be safely removed after the port has been accessed.
It is yet another objective of the present invention to provide a portal access device that allows a medical personnel to readily gain access to a portal reservoir implanted in a patient to clean out any obstruction that might occlude the flow of fluid into or out of the portal reservoir.
It is a further objective of the instant invention to provide a needle insertion device configured to prevent the tip of the contaminated needle or cannula from touching any part of the base of the device, and from being exposed to the environment or viewed by the patient or the user once the sharp cannula is withdrawn from the infuser portion of the portal access device.
The present invention will become apparent and the invention itself will be best understood by reference to the following description of the present invention taken in conjunction with the accompanying drawings, wherein:
a and
a and
The first embodiment of the safety needle inserter device component of the instant invention is shown in
A needle, or sharp cannula 24, is mounted to the underside of arm 12, at its first end 14. As shown in
In particular, the lock mechanisms, or the portions of the lock mechanism, as shown in the
Due to the inherent elasticity in the medical plastics that are used for form molding the base and the arm of the safety needle insertion device, when arm 12 is moved along the direction indicated by directional arrow 22, the side surface 28a of leg 28 would bias against the surface 32a of leg 32, as boss 30 may or may not be sliding along surface 34a of groove 34, so that once the foot 28b of leg 28 passes ledge 32b of shoulder 32, shoulder 32 will return to its original position so that latch 32b and foot 28b would bias or coact against each other to prevent any downward movement, as indicated by directional arrow 36, of arm 12. At substantially the same time, once boss 30 reaches groove 34 and biases thereagainst, further upward movement of arm 12 relative to base 4 is prevented.
To enable arm 12 to lie co-planarly on base 4, a notch 36 is provided on base 4 as a rest for boss 32. Further, a channel 38 is molded into base 4 to allow the downward extending portion 12a of arm 12 to fit in alignment to base 4, when arm 12 is in the position vis-a-vis base 4 as shown in
As shown more clearly by the partial cut-away view, the tip 26 of sharp cannula 24, when withdrawn from the portal reservoir and the patient, is maintained within a bore 42 that is formed at the proximal portion 8 of base 4. As shown, bore 42 is defined between opening 44 at the underside or lower surface of base 4 and an opening 44a at the upper side or upper surface 46 of base 4. A dam 48 extends from proximal portion 8 of base 4 and serves as an additional safety feature to ensure that the tip 26 of cannula 24 could not be forcibly removed from bore 42. In addition, the top 48a of dam 48 provides a rest stop for arm 12, with end 14 thereof resting against top surface 48a, when needle 26 is axially fitted to the blunt cannula of the infuser. Dam 48 also provides a point for the needle inserter where a user can apply the force needed to insert the sharp cannula into the patient and, as will be described infra, penetrate the septum of the portal reservoir implanted to the patient. The same dam structure is provided in the earlier embodiment of the safety needle inserter.
The
A third embodiment of the safety needle inserter of the instant invention is shown in
Further, similar to the embodiment shown in
As with the other embodiments, a foam layer or pad 10 with an adhesive underside may be provided to the safety needle inserter for enhancing the comfort to the patient, when the inserter is used individually. However, as will be discussed infra, the fact that the safety needle inserter is a component of the overall portal access device of the instant invention, and its lower surface does not come into contact with the patient when used with the infuser component, foam 10 is not needed when the safety needle inserter is to be used with the infuser.
With reference to
In operation, tube 66 is connected to a fluid store 70, which may be a syringe or a pump or some other storage device that is adapted for storing fluids or medicaments to be infused to the patient. Alternatively, instead of infusing fluid to the patient, or more particularly to the portal reservoir which is punctured by blunt cannula 64, fluid in the portal reservoir may be retrieved by means of the fluid communication path established between blunt cannula 64 and tube 66 via infuser body 62.
The safety needle inserter component of the portal access device of the instant invention, for the
The operation of the safety needle inserter component of the portal access device as shown in
Once it is determined that portal reservoir 78 has been properly punctured and connected to infuser body 62 by way of the concentric blunt/sharp cannulas, the safety needle inserter may be removed from the infuser assembly by lifting arm 12 of the needle inserter relative to its base 4, per shown in
Once arm 12 is locked into place, with tip 26 of the needle 24 properly positioned within bore 42 of base 4, the safety needle inserter may be removed from infuser assembly 60. To ensure that infuser body 62 and tube 66 would remain in place while needle inserter 2 is being removed, infuser body 62 may be provided with a pair of wings 82, either by bonding or molding, so that the user can hold wings 82 against the body or the skin surface of the patient, while lifting safety needle inserter 2 away from infuser assembly 60.
After removal of the safety needle inserter 2, infuser assembly 60 may be secured to the skin surface of the patient, by an adhesive layer preformed at the underside of infuser body 62 or an adhesive tape for example, so that a fluid communication path is continuously established between the portal reservoir 78 implanted in the patient and the fluid store 70. As a consequence, medicaments and other fluids are easily and readily infused to the patient through portal reservoir 78 and its associated catheter or tubing 79. Moreover, infuser assembly 60 provides a long term access to the portal reservoir 78 without further risks of sharps injury, as the safety needle inserter 2 has been removed and no further reinsertion is needed. Furthermore, given that the cannula 64 for infuser assembly 60 is a blunt cannula, when the infuser assembly is removed, there is no risk of injury to the patient or the user, and therefore no sharps protection is required.
Yet furthermore, given that septum 68 of the infuser assembly is self-sealing, infuser assembly 60 may be re-accessed through the self-sealing septum 68, either to provide direct coaxial access to the chamber of the portal reservoir 78, or access to the portal outlet catheter 79, for example by a radially flexible and axially stiff (pushable) wire or rod so that the fluid communication path may be threaded or rodded to clear any obstructions that may have occurred in either the portal reservoir or catheter 79 connected to the portal reservoir though which the medicament is fed to the patient.
Moreover, if a particular type of medicament is required, instead of providing the medicament through the fluid store 70, which feeds to tube 66 of the infuser assembly, a right angle needle insertion device such as that described earlier, or as disclosed in the above-discussed '015 patent, may be used to directly access the internal chamber of the portal reservoir, either via the blunt cannula of the infuser assembly or separate from the infuser assembly, so that the particular fluid may be fed through the catheter or tubing connected to the horizontal portion of the right angle needle directly into the portal reservoir. Also, the removal of fluid from the portal reservoir may be effected in the reverse manner by suctioning the fluid in the portal reservoir through a right angle needle inserter, by applying suction to the catheter connected to the horizontal portion of the right angle needle while the vertical portion of the right angle needle is in fluid communication with the partial reservoir.