The present invention relates to the field of fluid transfer devices. Particularly, the invention relates to apparatus for the contamination-free transfer of a hazardous drug from one container to another. More particularly, the invention relates to improvements in the connector sections that are used in fluid transfer apparatuses.
Advances in medical treatment and improved procedures constantly increase the need for improved apparatus for handling medications in liquid form. The demands relating to variety of types, quality, needle safety, microbial ingress prevention and leak prevention are constantly growing. Additionally, advances in sampling or dose dispensing technologies, automated and manual, aseptic or non-aseptic applications, call for new safe concealing solutions for the sampling needle. One extremely demanding application exists in the field where medical and pharmacological personnel that are involved in the preparation and administration of hazardous drugs suffer the risk of being exposed to drugs and to their vapors, which may escape to the surroundings.
Hazardous drugs in liquid or powder form are contained within vials, and are typically prepared in a separate room by pharmacists provided with protective clothing, a mouth mask, and a laminar flow safety cabinet. A syringe provided with a cannula, i.e. a hollow needle, is used for transferring the drug from a vial. After being prepared, the hazardous drug is added to a solution contained in a bag which is intended for parenteral administration, such as a saline solution intended for intravenous administration.
U.S. Pat. No. 8,196,614 to the applicant of the present application describes closed system liquid transfer devices designed to provide contamination-free transfer of hazardous drugs.
The proximal section of apparatus 10 is a syringe 12, which is adapted to draw or inject a desired volume of a hazardous drug from a fluid transfer component, e.g. a vial 16 or an intravenous (IV) bag in which it is contained and to subsequently transfer the drug to another fluid transfer component. At the distal end of syringe 12 is connected a connector section 14, which is in turn connected to vial 16 by means of vial adaptor 15.
Syringe 12 of apparatus 10 is comprised of a cylindrical body 18 having a tubular throat 20 that has a considerably smaller diameter than body 18, an annular rubber gasket or stopper assembly 22 fitted on the proximal end of cylindrical body 18, hollow piston rod 24 which sealingly passes through stopper 22, and proximal piston rod cap 26 by which a user can push and pull piston rod 24 up and down through stopper 22. A piston 28 made of an elastomeric material is securely attached to the distal end of piston rod 24. Cylindrical body 18 is made of a rigid material, e.g. plastic.
Piston 28, which sealingly engages the inner wall of, and is displaceable with respect to, cylindrical body 18 defines two chambers of variable volume: a distal liquid chamber 30 between the distal face of piston 28 and connector section 14 and a proximal air chamber 32 between the proximal face of piston 28 and stopper 22.
Connector section 14 is connected to the throat 20 of syringe 12 by means of a collar which proximally protrudes from the top of connector section 14 and surrounds throat 20. Note that embodiments of the apparatus do not necessarily have a throat 20. In these embodiments syringe 12 and connector section 14 are formed together as a single element at the time of manufacture, or permanently attached together, e.g. by means of glue or welding, or formed with a coupling means, such as threaded engagement or a Luer connector. Connector section 14 comprises a double membrane seal actuator which is moveable in a reciprocating manner from a normal, first configuration in which the needles are concealed when the double membrane seal actuator is disposed in a first, distal position and a second position in which the needles are exposed when the double membrane seal actuator is proximally displaced. Connector section 14 is adapted to be releasably coupled to another fluid transfer component, which can be any fluid container with a standard connector such as a drug vial, intravenous bag, or an intravenous line to produce a “fluid transfer assembly”, through which a fluid is transferred from one fluid transfer component to another component.
Connector section 14 comprises a cylindrical, hollow outer body; a distal shoulder portion, which radially protrudes from the body and terminates at the distal end with an opening through which the proximal end of a fluid transfer component is inserted for coupling; a double membrane seal actuator 34, which is reciprocally displaceable within the interior of the body; and one or more resilient arms 35 serving as locking elements, which are connected at a proximal end thereof to an intermediate portion of a cylindrical actuator casing that contains double membrane seal actuator 34. Two hollow needles that function as air conduit 38 and liquid conduit 40 are fixedly retained in needle holder 36, which protrudes into the interior of connector section 14 from a central portion of the top of connector section 14.
Conduits 38 and 40 distally extend from needle holder 36, piercing the upper membrane of actuator 34. The distal ends of conduits 38 and 40 have sharp pointed ends and apertures through which air and liquid can pass into and out of the interiors of the conduits respectively as required during a fluid transfer operation. The proximal end of air conduit 38 extends within the interior of proximal air chamber 32 in syringe 12. In the embodiment shown in
Double membrane seal actuator 34 comprises a cylindrical casing that holds a proximal disc shaped membrane 34a having a rectangular cross-section and a two level distal membrane 34b having a T-shaped cross-section with disc shaped proximal portion and a disc shaped distal portion disposed radially inwards with respect to the proximal portion. The distal portion of the distal membrane 34b protrudes distally from actuator 34. Two or more equal length resilient elongated arms 35 are attached to the distal end of the casing of actuator 34. The arms terminate with distal enlarged elements. When actuator 34 is in a first position, the pointed ends of conduits 38 and 40 are retained between the proximal and distal membranes, isolating the ends of conduits 38 and 40 from the surroundings, thereby preventing contamination of the interior of syringe 12 and leakage of a harmful drug contained within its interior to the surroundings.
Vial adaptor 15 is an intermediate connection that is used to connect connector section 14 to a drug vial 16 or any other component having a suitably shaped and dimensioned port. Vial adaptor 15 comprises a disk shaped central piece to which a plurality of circumferential segments, formed with a convex lip on the inner face thereof for facilitating securement to a head portion of a vial 16, are attached at the circumference of the disk and pointing distally away from it and a longitudinal extension projecting proximally from the other side of the disk shaped central piece. Longitudinal extension fits into the opening at the distal end of connector section 14 to allow transfer of the drug as described herein below. The longitudinal extension terminates proximally with a membrane enclosure having a diameter larger than that of the extension. A central opening in the membrane enclosure retains and makes accessible a membrane 15a.
Two longitudinal channels, which are internally formed within the longitudinal extension and that extend distally from the membrane in the membrane enclosure, are adapted to receive conduits 38 and 40, respectively. A mechanical guidance mechanism is provided to insure that the conduits 38 and 40 will always enter their designated channel within the longitudinal extension when connector section 14 is mated with vial adaptor 15. The longitudinal extension terminates distally with a spike element 15b which protrudes distally. The spike element is formed with openings in communication with the internally formed channels, respectively and openings at its distal pointed end.
Vial 16 has an enlarged circular head portion attached to the main body of the vial with a neck portion. In the center of the head portion is a proximal seal 16a, which is adapted to prevent the outward leakage of a drug contained therein. When the head portion of vial 16 is inserted into the collar portion of vial adaptor 15 and a distal force is applied to vial adaptor 15, the spike element 15b of the connector section 14 pierces the seal 16a of vial 16, to allow the internal channels in the connector section 14 to communicate with the interior of drug vial 16. When this occurs, the circumferential segments at the distal end of the collar portion of the connector section are securely engaged with the head portion of vial 16. After the seal of vial 16 is pierced it seals around the spike preventing the outward leakage of the drug from the vial. At the same time the tops of the internal channels in vial adaptor 15 are sealed by the membrane 15a at the top of vial adaptor 15, preventing air or drug from entering or exiting the interior of vial 16.
The procedure for assembling drug transfer apparatus 10 is carried out as shown in
After drug transfer assembly 10 shown in
In the years since the apparatus 10 described above was invented applicant has made numerous improvements to the components of the apparatus while retaining the basic features and mode of assembly and disassembly as described above.
With respect to connector section 14, several improvements have been made leading up to the present invention. In co-pending Israeli patent application no. IL239366, is described a solution to a problem that sometimes occurred when using the apparatus.
A solution provided in WO2014/122643 to the applicant of the present application is shown in
As shown in
As shown in
PCT patent applications WO2014/181320 and WO 2016/042544, both to the applicant of the present application, describe needle valves that can be incorporated into the membrane actuator of the connector section 14. The needle valves prevent the possibility of liquid travel through the air conduit from the distal liquid chamber 30 or vial 16 to the proximal air chamber when the connector section 14 is not connected to a vial or other fluid transfer component. The needle valves also simplify the construction of the membrane actuator making it possible to use a single membrane actuator instead of a double membrane actuator as in the connector section shown in
Referring to
When the syringe and attached connector are not connected to any other component of the apparatus, as shown in
When the syringe and attached connector are connected to another component of the apparatus, such as a vial adaptor, the actuator 52 is pushed towards the proximal end of connector section 14. Since needles 38 and 40 are fixed to the connector 14 by the needle holder 36, as actuator 52 moves proximally, the tips of needles 38 and 40 and ports 56 are pushed out through the distal end of the bores in the seat 54 of the needle valve, through membrane 34b, and through the membrane at the top of the vial adaptor, thereby establishing open fluid paths in the respective channels.
The first goal for the connector is to completely eliminate the possibility of migration of liquid to the air chamber. This can happen, for example, if pressure differentials between the air and liquid chambers exist after disconnection from a vial adaptor and if the pressure in the air chamber is lower than that in the liquid chamber, resulting in undesired migration of liquid to the air chamber. The second goal is to prevent leaks or damage to the connector during accidental pushing of the syringe plunger. One of the frequently performed drug transfer operations in hospital settings is known as IV push or bolus injection. Typically the required amount of drug is prepared in a syringe in the hospital pharmacy and delivered to the ward where a qualified nurse administers the drug to the patient through a previously established IV line. A common problem associated with the procedure is that during the trip from pharmacy to ward or at bedside the piston of the syringe is sometimes unintentionally pushed expelling some of the drug from the barrel of the syringe or the piston is unintentionally pulled. High pressures of up to 20 atmospheres can be easily generated by manually pushing the plunger of small volume syringes (1-5 ml). Such pressure may cause the connector to disintegrate or the membranes to be detached. The connector shown in
Israeli Patent Application No. 237788 to the applicant of the present application describes embodiments of septum holders for use in connector sections that are used to connect syringes to other elements of liquid transfer apparatuses. All of the embodiments of the septum holders described in that patent application comprise a septum holder body, at least one resilient elongated arm that terminates with a distal enlarged element attached to the sides of the body, and a septum. The septum holders of IL237788 are characterized in that they comprise at least one bore that functions as the seat of a needle valve. The bore is created in the septum or in an insert fixed in either the body of the septum holder or in the septum. The septum holders described in IL237788 are also characterized in that the septum is attached to the bottom of the body of the septum holder projecting downwards parallel to the at least one elongated arm.
Septum 72 is made of a single piece of cylindrically shaped resilient material. The upper part of septum 72 has a hollow interior forming a cylindrical recess 74 having an inner diameter no larger than that of the outer diameter of the cylindrical section at the bottom of body 60. After insert 68 is fitted into cavity 166, septum 72 is pushed over the bottom part of body 60 until the solid part of septum 72 below recess 74 butts against the bottom of bores 70 in insert 68 thereby isolating the bottoms of the interior of the bores from the external environment.
Septum 72 is fixedly held on the body 60 of septum holder 58 by any means known in the art. For example, the resilient material of the septum may be strong enough to grip the sides of the cylindrical section at the bottom of body 60 to hold the septum in place; or, as shown in
A septum holder 58 is located inside of cylindrical outer housing 78 of the connector section. As shown, the distal ends of needles 82,84 are inserted into bores 70 in insert 68 (see
Connection of the connector section to a fluid transfer component, e.g. a vial adaptor, a spike adaptor for connection to an IV bag, or a connector for connection to an IV line, is accomplished in the same manner as in the prior art described herein above. When the septum of the fluid transfer component is pushed against septum 72, septum holder 58 begins to move upwards inside outer housing 78 and the tips of the needles begin to exit bores 70 and penetrate the solid material of septum 72. The tips of the needles pass through septum 72 and the septum of the fluid transfer component as septum holder 58 continues to be pushed upwards, thereby establishing air and liquid channels between the element of the liquid transfer system attached to the fluid transfer component and the proximal air chamber and distal liquid chamber in the syringe.
Septum holder 110 is structurally the same as that shown in
Septum 116 is made of a single piece of cylindrically shaped resilient material. The upper part of septum 116 has a hollow interior forming a cylindrical recess having an inner diameter no larger than that of the outer diameter of the cylindrical section at the bottom of body 112. After the insert is fitted into the cavity in body 112, septum 116 is fitted over the cylindrical bottom section of body 112 (much as a knitted cap is pulled over a head) until the solid part of septum 116 butts against the bottom of the bores in the insert; thereby isolating the bottoms of the interior of the bores from the external environment. Septum 116 is fixedly held facing downward on the body 112 of septum holder 110 by any means known in the art, such as described herein above.
It is noted that other septum holders, for example the other embodiments of septum holders described in the above referenced IL 23788, can be adapted mutatis mutandis, by locating the arms as described with reference to
The changes made to the attachment of the arms to the sides of the septum holder that have been described above with respect to
It is a purpose of the present invention to provide an improved septum holder that will overcome a problem in manufacture and sterilization of a product that comprises the septum holders of the prior art.
Further purposes and advantages of this invention will appear as the description proceeds.
In a first aspect the invention is a septum holder. The septum holder comprises: (a) a body having an upper body part and a lower body part, the lower body part comprising a bored out interior; (b) an insert comprising at least one bore that forms the seat of a needle valve, the insert fitted loosely into the interior of the lower body part; and (c) a septum comprising an upper part attached to an exterior surface of the lower body part of the septum holder and a lower part of the septum that extends downward beyond the lower edge of the lower body part of the septum holder.
In the septum holder of the invention the insert can freely move up and down in the interior of the lower body part and the septum can freely move up and down on the exterior surface of the lower body part.
In embodiments of the septum holder of the invention the body of the septum holder comprises a disk shaped annular upper body part with at least one resilient elongated arm terminating with a distal enlarged element attached to the side of the upper body part.
In embodiments of the septum holder of the invention the body comprises a lower body part comprised of a cylindrically shaped annular section that projects downward from the upper part parallel to the at least one arm. In some of these embodiments the lower body part comprises an outwardly projecting edge at its lower end.
In embodiments of the septum holder of the invention the septum comprises an upper part having a hollow interior in the form of a cylindrical recess having an inner diameter larger than that of the outer diameter of the cylindrically shaped annular section. In some of these embodiments the upper rim of the septum is structured as an inwardly projecting edge configured such that, when pushed over the outwardly projecting edge at the lower end of the cylindrically shaped annular section of the lower body part, the upper rim of the septum interacts with the outwardly projecting edge to hold the septum on exterior surface of the septum holder.
In a second aspect the invention is a connector section for a liquid transfer apparatus. The connector section comprises: a cylindrical outer body having a proximal end adapted to be attached to syringe and an open distal end comprising a shoulder portion; at least one hollow needle fixedly attached to the proximal end of the body of the connector section, the needle having at least one port at its lower end adjacent to its pointed distal tip that allows fluid communication between the exterior and the hollow interior of the needle; and a septum holder located inside of the cylindrical body of the connector section.
The septum holder comprises: (a) a body having an upper body part and a lower body part, the lower body part comprising a bored out interior; (b) an insert comprising at least one bore that forms the seat of a needle valve, the insert fitted loosely into the interior of the lower body part; and (c) a septum comprising an upper part attached to an exterior surface of the lower body part of the septum holder and a lower part of the septum that extends downward beyond the lower edge of the lower body part of the septum holder.
In the septum holder of the connector section the insert can freely move up and down in the interior of the lower body part and the septum can freely move up and down on the exterior surface of the lower body part.
In embodiments of the connector section of the invention the body of the septum holder comprises a disk shaped annular upper body part with at least one resilient elongated arm terminating with a distal enlarged element attached to the side of the upper body part.
In embodiments of the connector section of the invention the body of the septum holder comprises a lower body part comprised of a cylindrically shaped annular section that projects downward from the upper part parallel to the at least one arm. In some of these embodiments the lower body part of the septum holder comprises an outwardly projecting edge at its lower end.
In embodiments of the connector section of the invention the septum of the septum holder comprises an upper part having a hollow interior in the form of a cylindrical recess having an inner diameter larger than that of the outer diameter of the cylindrically shaped annular section. In some of these embodiments the upper rim of the septum of the septum holder is structured as an inwardly projecting edge configured such that, when pushed over the outwardly projecting edge at the lower end of the cylindrically shaped annular section of the lower body part, the upper rim of the septum interacts with the outwardly projecting edge to hold the septum on exterior surface of the septum holder.
In embodiments of the connector section of the invention, when the connector section is not connected to another element of the liquid transfer system, the distal enlarged element of the at least one arm of the septum holder is engaged in the shoulder portion at the distal end of body of the syringe connector and the distal end of the at least one needle is inserted into the at least one bore in the insert of the septum holder.
All the above and other characteristics and advantages of the invention will be further understood through the following illustrative and non-limitative description of embodiments thereof, with reference to the appended drawings.
One of the products manufactured by the applicant of this patent application is a unit for closed transfer of liquids comprised of a syringe connected to a connector section. These units, after manufacture and assembly, are packed in blister packs and sent to be sterilized before shipment to customers. Sterilization is carried out by placing the blister packs in a closed container or room that is then filled with ethylene chloride. The blister pack is comprised of a thermoplastic front, which is impervious to gas and bacteria, sealed to a paper back, which is impervious to bacteria but allows gas molecules to pass through it. The ethylene oxide gas enters the blister pack through the paper back and enters the inside of the syringe and connector section through the needle openings and sterilizes the syringe and connector section. After a period of time a vacuum is created in the container to draw the sterilizing gas out of the blister packs and then air is introduced into the blister packs, which are then a sterile product ready for use.
If the connector section comprises a septum holder such as shown in
After sterilization the boxed product is delivered from the sterilization site to the manufacturing site and the blister packs need to be taken out from the boxes in order to move the septum holder to its correct position and then pack the blisters back into the boxes. Moving the septum holder to its correct position inside the connector section while both are sealed inside the blister pack is a difficult and very time-consuming task that can only be done manually. All of this extra handling adds a great deal of expense to the manufacturing process.
The same problem exists for all embodiments of the prior art connectors shown in the background section of this application.
The present invention is a septum holder that was invented to overcome this problem. It can be used, for example in connector section 92 shown in
Septum holder 158 is comprised of a body 160 comprising a disk shaped annular upper part. Two equal length resilient elongated arms 162 are attached at the sides of the upper part of body 160. The arms terminate with distal enlarged elements 163. The bottom part of body 160 is comprised of a cylindrically shaped annular section 202 that projects downward from the upper part between arms 162. At the lower end of annular section 202 is an outwardly projecting edge 204. An insert 168 comprising two bores 170 that form the seat of a needle valve is fitted loosely into the center of annular section 202 so that the insert is free to move up and down in annular section 202.
Septum 172 is made of a single piece of cylindrically shaped resilient material. The upper part of septum 172 has a hollow interior forming a cylindrical recess 206 having an inner diameter larger than that of the outer diameter of annular section 202 at the bottom of body 160. The upper rim of the septum 172 is structured as an inwardly projecting edge 208 that, when pushed over outwardly projecting edge 204 at the bottom of annular section 202, interacts with edge 204 to hold septum 172 on septum holder 158. Because of the length of the wall of annular section 202, septum 172 can move up or down on the septum holder between the two limiting positions shown in
After the prior art connector sections described herein as well as those shown in
The quality control check described above provides an additional benefit. The act of puncturing the septum greatly reduces the amount of force that the end user is required to exert to assemble the drug transfer apparatus in the pharmacy, clinic, or hospital ward. It has been found that a considerable amount of force is needed to puncture the septum the first time. The second time that the needle passes through the septum requires significantly less force than the first time and the third and subsequent times that the needle passes through the septum requires significantly less force than the second time.
The syringe-connector section unit is sealed in the blister pack with septum 172 pulled down as shown in
After the sterilization procedure is completed the product can be delivered to a customer as is and without the need to be sent to the manufacturing site for moving the septum holder to re-seal the ports 56. Re-sealing of the ports 56 is accomplished automatically when septum 172 and insert 168 are pushed upward from the location shown in
The connection is accomplished in the same manner as in the prior art described herein above. When the septum of the fluid transfer component is pushed against the bottom of septum 172, septum 172 and insert 168 will move upwards until insert 168 is fully inserted into the annular section 202. As the connector section and fluid transfer component continue to be pushed together, septum holder 158 begins to move upwards inside outer housing 78/140 and the tips of the needles begin to exit the bottoms of bores 170 and penetrate the solid material of septum 172. The tips of the needles pass through septum 172 and the septum at the top of the fluid transfer component as septum holder 158 continues to be pushed upwards, thereby establishing air and liquid channels between the element of the liquid transfer system attached to the fluid transfer component and the proximal air chamber and distal liquid chamber in the syringe.
Although embodiments of the invention have been described by way of illustration, it will be understood that the invention may be carried out with many variations, modifications, and adaptations, without exceeding the scope of the claims.
Number | Date | Country | Kind |
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245289 | Apr 2016 | IL | national |
Filing Document | Filing Date | Country | Kind |
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PCT/IL2017/050457 | 4/19/2017 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
---|---|---|---|
WO2017/183031 | 10/26/2017 | WO | A |
Number | Name | Date | Kind |
---|---|---|---|
4768568 | Fournier | Sep 1988 | A |
8196614 | Kriheli | Jun 2012 | B2 |
20100218846 | Kriheli | Sep 2010 | A1 |
20180028402 | Kriheli | Feb 2018 | A1 |
Number | Date | Country |
---|---|---|
2606872 | Jun 2013 | EP |
237788 | Sep 2016 | IL |
239366 | Jul 2018 | IL |
2014122643 | Aug 2014 | WO |
2014181320 | Nov 2014 | WO |
2016042544 | Mar 2016 | WO |
2016147178 | Sep 2016 | WO |
Entry |
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International Search Report for PCT/IL2017/050457, dated Jul. 25, 2017, 4 pages. |
Written Opinion of the International Searching Authority for PCT/IL2017/050457, dated Jul. 25, 2017, 4 pages. |
Number | Date | Country | |
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20190060170 A1 | Feb 2019 | US |