Patent Grant
11589786
Embodiments described herein relate generally to the parenteral procurement of bodily-fluid samples, and more particularly to devices and methods for parenterally-procuring bodily-fluid samples with reduced contamination from microbes or other contaminants exterior to the bodily-fluid source, such as dermally-residing microbes.
Health care practitioners routinely perform various types of microbial tests on patients using parenterally-obtained bodily-fluids. In some instances, patient samples (e.g., bodily-fluids) are tested for the presence of one or more potentially undesirable microbes, such as bacteria, fungi, or yeast (e.g., Candida). Microbial testing may include incubating patient samples in one or more sterile vessels containing culture media that is conducive to microbial growth, real-time diagnostics, and/or PCR-based approaches. Generally, when such microbes are present in the patient sample, the microbes flourish over time in the culture medium. After a pre-determined amount of time (e.g., a few hours to several days), the culture medium can be tested for the presence of the microbes. The presence of microbes in the culture medium suggests the presence of the same microbes in the patient sample which, in turn, suggests the presence of the same microbes in the bodily-fluid of the patient from which the sample was obtained. Accordingly, when microbes are determined to be present in the culture medium, the patient may be prescribed one or more antibiotics or other treatments specifically designed to treat or otherwise remove the undesired microbes from the patient.
Patient samples, however, can become contaminated during procurement. One way in which contamination of a patient sample may occur is by the transfer of microbes from a bodily surface (e.g., dermally-residing microbes) dislodged during needle insertion into a patient and subsequently transferred to a culture medium with the patient sample. The bodily surface and/or other undesirable external microbes may be dislodged either directly or via dislodged tissue fragments, hair follicles, sweat glands and other adnexal structures. Another possible source of contamination is from the person drawing the patient sample. For example, a doctor, phlebotomist, nurse, etc. can transfer contaminants from their body (e.g., finger, arms, etc.) to the patient sample. The transferred microbes may thrive in the culture medium and eventually yield a positive microbial test result, thereby falsely indicating the presence of such microbes in vivo. Such inaccurate results are a concern when attempting to diagnose or treat a suspected illness or condition. For example, false positive results from microbial tests may result in the patient being unnecessarily subjected to one or more anti-microbial therapies, which may cause serious side effects to the patient including, for example, death, as well as produce an unnecessary burden and expense to the health care system.
As such, a need exists for improved bodily-fluid transfer devices and methods that reduce microbial contamination in bodily-fluid test samples.
Devices for parenterally-procuring bodily-fluid samples with reduced contamination from microbes exterior to the bodily-fluid source, such as dermally-residing microbes, are described herein. In some embodiments, a syringe-based device for parenterally-procuring bodily fluid samples with reduced contamination from a patient includes a housing, a pre-sample reservoir, and an actuator mechanism. The housing has a proximal end portion and a distal end portion and defines an inner volume therebetween. The proximal end portion is substantially open and the distal end portion has a port configured to be coupled to a lumen-defining device for receiving bodily fluids from the patient. The pre-sample reservoir is fluidically couplable to the port and is configured to receive and isolate a first volume of bodily fluid withdrawn from the patient. The actuator mechanism is at least partially disposed in the inner volume of the housing and has a proximal end portion and a distal end portion. The distal end portion includes a sealing member and the proximal end portion includes an engagement portion configured to allow a user to selectively move the actuator mechanism between a first configuration in which the bodily fluid can flow from the port to the pre-sample reservoir, and a second configuration in which the bodily fluid can flow from the port to a sample reservoir defined at least in part by the sealing member and the housing.
Devices for parenterally-procuring bodily-fluid samples with reduced contamination from microbes exterior to the bodily-fluid source, such as dermally-residing microbes, are described herein. In some embodiments, a syringe-based device for parenterally-procuring bodily fluid samples with reduced contamination from a patient includes a housing, a pre-sample reservoir, and an actuator mechanism. The housing has a proximal end portion and a distal end portion and defines an inner volume therebetween. The proximal end portion is substantially open and the distal end portion has a port configured to be coupled to a lumen-defining device for receiving bodily fluids from the patient. The pre-sample reservoir is fluidically couplable to the port and is configured to receive and isolate a first volume of bodily fluid withdrawn from the patient. The actuator mechanism is at least partially disposed in the inner volume of the housing and has a proximal end portion and a distal end portion. The distal end portion includes a sealing member and the proximal end portion includes an engagement portion configured to allow a user to selectively move the actuator mechanism between a first configuration in which the bodily fluid can flow from the port to the pre-sample reservoir, and a second configuration in which the bodily fluid can flow from the port to a sample reservoir defined at least in part by the sealing member and the housing.
In some embodiments, a syringe-based device for parenterally-procuring bodily fluid samples with reduced contamination from a patient includes a housing and an actuator mechanism. The housing has a proximal end portion and a distal end portion and defines an inner volume therebetween. The proximal end portion is substantially open and the distal end portion has a port configured to be coupled to a lumen-defining device for receiving bodily fluids from the patient. The actuator mechanism is movably disposed in the inner volume. The actuator mechanism includes a first member having a proximal end portion and a distal end portion and defining an inner volume therebetween, and a second member movably disposed in the inner volume of the first member. The distal end portion of the first member includes a first plunger including a flow channel configured to allow selective fluid communication between the inner volume defined by the housing and the inner volume defined by the first member. The second member includes a second plunger disposed at a distal end portion of the second member and an engagement portion configured to allow a user to selectively move the actuator mechanism.
In some embodiments, a syringe-based device for parenterally-procuring bodily fluid samples with reduced contamination from a patient includes a housing, an actuator mechanism, and a piercing member. The housing has a proximal end portion and a distal end portion and defines an inner volume therebetween. The proximal end portion is substantially open and the distal end portion has a port configured to be coupled to a lumen-defining device for receiving bodily fluids from the patient. The actuator mechanism is movably disposed in the inner volume of the housing. The actuator mechanism has a proximal end portion and a distal end portion and defining an inner volume therebetween. The distal end portion includes a plunger including a flow channel. The proximal end portion is substantially open and configured to receive a vacuum-sealed sample tube. The piercing member is disposed in the inner volume of the actuator mechanism and defines a lumen fluidically coupled to the flow channel of the plunger. The flow channel of the plunger and the piercing member configured to allow selective fluid communication between the inner volume defined by the housing and the inner volume defined by the actuator mechanism.
In some embodiments, a syringe-based device for parenterally-procuring bodily fluid samples with reduced contamination from a patient includes a housing, an actuator mechanism, and a flow control mechanism. The housing has a proximal end portion and a distal end portion and defines an inner volume therebetween. The proximal end portion is substantially open and the distal end portion has a port configured to be coupled to a lumen-defining device for receiving bodily fluids from the patient. The actuator mechanism is movably disposed in the inner volume of the housing and has a proximal end portion and a distal end portion. The distal end portion includes a first plunger and the proximal end portion including an engagement portion configured to allow a user to selectively move the actuator mechanism. A second plunger is movably disposed in the inner volume of the housing and releasably coupled to the actuator mechanism. The second plunger defines a flow channel configured to be placed in selective fluid communication with the port. The flow control mechanism is operable to selectively control fluid flow between the port and a pre-sample reservoir defined by the second plunger and the housing. The flow control mechanism is configured to be moved between a first configuration in which the bodily fluid can flow through a first flow path to the pre-sample reservoir, and a second configuration in which the bodily fluid can flow through a second flow path to a sample reservoir collectively defined by the first plunger, the second plunger, and the housing.
In some embodiments, a method of using a syringe-based transfer device, including a housing with a port and an actuator mechanism movably disposed in the housing, to obtain a bodily fluid sample from a patient includes establishing fluid communication between the patient and the port of the syringe-based transfer device and establishing fluid communication between the port and a pre-sample reservoir. A first volume of bodily fluid is transferred to the pre-sample reservoir with the syringe-based transfer device. The pre-sample reservoir is fluidically isolated from the port to sequester the first volume of bodily fluid in the pre-sample reservoir. After the first volume of bodily fluid has been sequestered in the pre-sample reservoir, fluid communication is established between the port and a sample reservoir defined at least in part by the actuator mechanism and the housing. The actuator mechanism is moved from a first position to a second position to draw a second volume of bodily fluid from the patient into the sample reservoir.
In some embodiments, an apparatus includes a housing and an actuator mechanism. The apparatus further includes a first fluid reservoir and a second fluid reservoir, fluidically isolated from the first fluid reservoir, defined at least in part by the housing and/or the actuator mechanism. The housing includes a port configured to receive a bodily-fluid. The housing and the actuator mechanism collectively define a first fluid flow path and a second fluid flow path. The first fluid flow path is configured to transfer a first flow of bodily-fluid from the port to the first fluid reservoir when the actuator mechanism is in a first position relative to the housing. The second fluid flow path is configured to transfer a second flow of bodily-fluid, substantially free from undesirable microbes that are not representative of in vivo patient condition, from the port to the second fluid reservoir when the actuator mechanism is in a second position relative to the housing.
In some embodiments, a bodily-fluid transfer device can be configured to selectively divert a first, predetermined amount of a flow of a bodily-fluid to a first reservoir before permitting the flow of a second amount of the bodily-fluid into a second reservoir. In this manner, the second amount of bodily-fluid can be used for diagnostic or other testing, while the first amount of bodily-fluid, which may contain microbes from a bodily surface and/or other external source, is isolated from the bodily-fluid to be tested for microbial presence but yet can be used for other blood tests as ordered by clinician (e.g., complete blood count “CBC”, immunodiagnostic tests, cancer-cell detection tests, or the like).
As referred to herein, “bodily-fluid” can include any fluid obtained from a body of a patient, including, but not limited to, blood, cerebrospinal fluid, urine, bile, lymph, saliva, synovial fluid, serous fluid, pleural fluid, amniotic fluid, and the like, or any combination thereof.
As used herein, the term “set” can refer to multiple features or a singular feature with multiple parts. For example, when referring to set of walls, the set of walls can be considered as one wall with distinct portions, or the set of walls can be considered as multiple walls. Similarly stated, a monolithically constructed item can include a set of walls. Such a set of walls can include, for example, multiple portions that are in discontinuous from each other. A set of walls can also be fabricated from multiple items that are produced separately and are later joined together (e.g., via a weld, an adhesive or any suitable method).
As used in this specification, the words “proximal” and “distal” refer to the direction closer to and away from, respectively, a user who would place the device into contact with a patient. Thus, for example, the end of a device first touching the body of the patient would be the distal end, while the opposite end of the device (e.g., the end of the device being manipulated by the user) would be the proximal end of the device.
As used in this specification and the appended claims, the terms “first, predetermined amount,” “first amount,” and “first volume” describe an amount of bodily-fluid configured to be received or contained by a first reservoir or a pre-sample reservoir. While the terms “first amount” and “first volume” do not explicitly describe a predetermined amount, it should be understood that the first amount is the first, predetermined amount unless explicitly described differently.
As used in this specification and the appended claims, the terms “second amount” and “second volume” describe an amount of bodily-fluid configured to be received or contained by a second reservoir or sample reservoir. The second amount can be any suitable amount of bodily-fluid and need not be predetermined. Conversely, when explicitly described as such, the second amount received and contained by the second reservoir or sample reservoir can be a second, predetermined amount.
The transfer device 100 includes a housing 101, an actuator mechanism 140, a first fluid reservoir 180 (also referred to herein as “first reservoir” or “pre-sample reservoir”), and a second fluid reservoir 190 (also referred to herein as “second reservoir” or “sample reservoir”), different from the first reservoir 180. The housing 101 can be any suitable shape, size, or configuration and is described in further detail herein with respect to specific embodiments. As shown in
As shown in
The actuator mechanism 140 can be any suitable shape, size, or configuration. For example, in some embodiments, the shape and size of at least a portion of the actuator mechanism 140 substantially corresponds to the shape and size of the walls of the housing 101 defining the inner volume 111. As described above, at least a portion of the actuator mechanism 140 is movably disposed within the inner volume 111 of the housing 101. For example, in some embodiments, a distal end portion of the actuator mechanism 140 is disposed within the inner volume 111 of the housing 101 and a proximal end portion of the actuator mechanism 140 is disposed substantially outside the housing 101. In this manner, a user can engage the proximal end portion of the actuator mechanism 140 to move the portion of the actuator mechanism 140 disposed within the inner volume 111 between the first configuration and the second configuration relative to the housing 101. In some embodiments, the actuator mechanism 140 can be disposed in a third configuration (or storage configuration) relative to the housing 101, as further described herein.
While not shown in
The first reservoir 180 can be any suitable reservoir for containing the bodily-fluid. For example, in some embodiments, the first reservoir 180 is defined by a portion of the walls of the housing 101 defining the inner volume 111 and a portion of the actuator mechanism 140. In other embodiments, the first reservoir 180 is defined by only the actuator mechanism 140. In still other embodiments, the first reservoir 180 can be a pre-sample reservoir described in detail in U.S. Pat. No. 8,197,420 (“the '420 patent”), the disclosure of which is incorporated herein by reference in its entirety. In this manner, the first reservoir 180 can be selectively placed in fluid communication with the housing 101 or the actuator mechanism 140 either directly (e.g., physically and fluidically coupled to the housing 101 or the actuator mechanism 140) or indirectly (e.g., fluidically coupled via intervening structure such as sterile flexible tubing).
The first reservoir 180 is configured to receive and contain the first, predetermined amount of the bodily-fluid. More specifically, when the actuator mechanism 140 is in the first configuration, a portion of the actuator mechanism 140 and a portion of the housing 101 can define a first fluid flow path 181 configured to fluidically couple the port 105 of the housing 101 to the first reservoir 180. In some embodiments, the actuator mechanism 140 can be moved to the first configuration (e.g., from the third configuration described above) and can introduce a vacuum that facilitates the flow of the bodily-fluid through the first flow path 181 and into the first reservoir 180. The first reservoir 180 is configured to contain the first amount of the bodily-fluid such that the first amount is fluidically isolated from a second amount of the bodily-fluid (different than the first amount of bodily-fluid) that is subsequently withdrawn from the patient.
The second reservoir 190 can be any suitable reservoir and is configured to receive and contain the second amount of the bodily-fluid. In some embodiments, the second reservoir 190 is defined by a portion of the walls of the housing 101 defining the inner volume 111 and a portion of the actuator member 140. In this manner, when the actuator mechanism 140 is in the second configuration, a portion of the actuator mechanism 140 and a portion of the housing 101 can define a second fluid flow path 191 configured to fluidically couple the port 105 to the second reservoir 190. In some embodiments, the movement of the actuator mechanism 140 to the second configuration can be such that a second vacuum force facilitates the flow of the bodily-fluid through the second flow path 191 and into the second reservoir 190. The second amount of bodily-fluid can be an amount withdrawn from the patient subsequent to withdrawal of the first amount. In some embodiments, the second reservoir 190 is configured to contain the second amount of the bodily-fluid such that the second amount is fluidically isolated from the first amount of the bodily-fluid.
As described above, the transfer device 100 can be used to transfer a bodily-fluid from a patient to the first reservoir 180 and/or second reservoir 190 included in the transfer device 100. More specifically, the flow of the first amount of bodily-fluid transferred to the first reservoir 180 can be such that dermally-residing microbes dislodged during a venipuncture event and/or other external sources (e.g. ambient airborne microbes, transferred from the skin of the practitioner collecting the sample, etc.) become entrained in the flow and are thereby transferred to the first reservoir 180. In addition, the first reservoir 180 fluidically isolates the first amount such that when the subsequent second amount is withdrawn into the second reservoir 190, the second amount is substantially free from the dermally-residing microbes. Although not shown in
In some embodiments, the transfer device 100 can be configured such that the first amount of bodily-fluid need be conveyed to the first reservoir 180 before the transfer device 100 will permit the flow of the second amount of bodily-fluid to be conveyed through the second flow path 191 to the second reservoir 180. In this manner, the transfer device 100 can be characterized as requiring compliance by a health care practitioner regarding the collection of the first, predetermined amount (e.g., a pre-sample) prior to collection of the second amount (e.g., a sample) of bodily-fluid. Similarly stated, the transfer device 100 can be configured to prevent a health care practitioner from collecting the second amount, or the sample, of bodily-fluid into the second reservoir 190 without first diverting the first amount, or pre-sample, of bodily-fluid into the first reservoir 180. In this manner, the health care practitioner is prevented from including (whether intentionally or unintentionally) the first amount of bodily-fluid, which is more likely to contain dermally-residing microbes and/or other external undesirable contaminants, in the bodily-fluid sample to be used for analysis. In other embodiments, the fluid transfer device 100 need not include a forced-compliance feature or component.
In some embodiments, the actuator mechanism 140 can have a fourth configuration, different than the first, second, and third configurations. In such embodiments, the actuator mechanism 140 can be moved towards the fourth configuration when the transfer device 100 has collected the second amount of the bodily-fluid and has been removed from contact with the patient. When in the fourth configuration, the first fluid reservoir 180 can maintain the first amount of bodily-fluid in fluid isolation and the second fluid reservoir 190 can be maintained in fluid communication with the port 105. Therefore, when the actuator mechanism 140 is moved toward the fourth configuration the transfer device 100 can transfer a portion of the second amount of the bodily-fluid from the second reservoir 190 to any suitable container (e.g., a vile, a test tube, a petri dish, a culture medium, a test apparatus, or the like) such that the portion of the second amount of bodily-fluid can be tested.
As shown in
The port 205 can be any suitable shape, size, or configuration. For example, in some embodiments, at least a portion of the port 205 can form a lock mechanism configured to be physically and fluidically coupled to a needle, a cannula, or other lumen-containing device. For example, in some embodiments, the port 205 can be a Luer-Lok® or similar locking mechanism configured to physically and fluidically couple to a needle or cannula assembly (not shown in
As described above, the actuator mechanism 240 is disposed within the inner volume 211 and is movable between a first position (e.g., a distal position relative to the housing 201) and a second position (e.g., a proximal position relative to the housing 201). Furthermore, the movement of the actuator mechanism 240 relative to the housing 201 can move the transfer device 200 between a first, second, and third configuration, as further described herein. The actuator mechanism 240 includes a first member 241 and a second member 251. The first member 241 of the actuator mechanism 240 includes a proximal end portion 242 and a distal end portion 243 and defines an inner volume 246 therebetween. At least a portion of the inner volume 246 is configured to define the first reservoir 280, as further described herein.
The proximal end portion 242 is substantially open such that at least a portion of the second member 251 can be movably disposed within the inner volume 246. The proximal end portion 242 also includes a protrusion 244 that extends from an inner surface of a wall (or set of walls) defining the inner volume 246 and is configured to selectively engage a portion of the second member 251.
The distal end portion 243 of the first member 241 includes a plunger 247. The plunger 247 is configured to form a friction fit with the inner surface of the walls defining the inner volume 211 when the actuator mechanism 240 is disposed within the housing 201. Similarly stated, the plunger 247 defines a fluidic seal with the inner surface of the walls defining the inner volume 211 such that a portion of the inner volume 211 proximal of the plunger 247 is fluidically isolated from a portion of the inner volume 211 distal of the plunger 247. The plunger 247 is further configured to define a channel 248 that extends though a distal end and a proximal end of the plunger 247. Moreover, a portion of an inner set of walls defining the channel 248 is configured to form a valve seat 249. In this manner, a portion of the channel 248 can receive a valve 270 that is in contact with the valve seat 249.
The valve 270 can be any suitable valve. For example, in some embodiments, the valve 270 is a one-way check valve configured to allow a flow of a fluid from a distal end of the valve 270 to a proximal end of the valve 270 but substantially not allow a flow of the fluid from the proximal end to the distal end. In addition, the valve 270 can be disposed within the channel 248 and can be in contact with the valve seat 249 such that the valve 270 forms a substantially fluid tight seal with the walls defining the channel 248. In some embodiments, the valve 270 can form a first fit with walls defining the channel 248. In other embodiments, the valve 270 can form a threaded coupling or the like with at least a portion of the walls. The valve 270 can also include a seal member configured to engage the valve seat 249 thereby forming at least a portion of the fluid tight seal. The arrangement of the plunger 247 and the valve 270 is such that when the valve 270 is in the open configuration, the inner volume 246 defined by the first member 241 is placed in fluid communication with the portion of the inner volume 211 of the housing 201 that is distal of the plunger 247, as further described herein.
The second member 251 of the actuator mechanism 240 includes a proximal end portion 252 and a distal end portion 253. The proximal end portion 252 includes an engagement portion 258 that can be engaged by a user (e.g., a phlebotomist, a nurse, a technician, a physician, etc.) to move at least a portion of the actuator mechanism 240 relative to the housing 201. The distal end portion 253 includes a plunger 257 configured to form a friction fit with the inner surface of the walls defining the inner volume 246 when the second member 251 is disposed with the first member 241. Similarly stated, the plunger 257 defines a fluidic seal with the inner surface of the walls defining the inner volume 246 such that a portion of the inner volume 246 proximal of the plunger 257 is fluidically isolated from a portion of the inner volume 246 distal of the plunger 257.
As described above, at least a portion the second member 251 is configured to be movably disposed within the inner volume 246 of the first member 241. More specifically, the second member 251 can be movable between a first position (e.g., a distal position) and a second position (e.g., a proximal position) thereby moving the actuator mechanism 240 between a first configuration and a second configuration, respectively. In addition, the second member 251 includes a protrusion 254 that extends in a radial direction to selectively engage the protrusion 244 of the first member 241. In this manner, the protrusion 244 of the first member 241 and the protrusion 254 of the second member 251 can be placed in contact to substantially limit a proximal movement of the second member 251 relative the first member 241.
In use, a user can engage the transfer device 200 to couple the port 205 to a proximal end portion of a lumen-defining device (not shown) such as, for example, a butterfly needle, a cannula assembly, a trocar (which is some cases is used to insert a catheter into a patient), or the like. With the port 205 physically coupled to the lumen-defining device, the port 205 is placed in fluid communication with the lumen defined by the lumen-defining device. Furthermore, the distal end portion of the lumen-defining device can be disposed within a portion of the body of a patient (e.g., a vein). In this manner, the port 205 is placed in fluid communication with the portion of the body.
With the port 205 coupled to the lumen-defining device, a user (e.g., a phlebotomist, a nurse, a technician, a physician, or the like) can move the transfer device 200 from the first configuration to the second configuration. More specifically, the user can engage the engagement portion 258 of the second member 251 included in the actuator mechanism 240 to move the actuator mechanism 240 from its first configuration to its second configuration, thereby placing the transfer device 200 in the second configuration, as indicated by the arrow AA in
The arrangement of the second member 251 within the first member 241 is such that the proximal motion of the second member 251 increases the volume of the portion of the inner volume 246 that is distal of the plunger 257, thereby defining the first reservoir 280. Furthermore, with the plunger 257 forming a fluid tight seal with the inner surface of the walls defining the inner volume 246, the increase of volume can produce a negative pressure within the first reservoir 280.
As shown by the arrow BB in
In some embodiments, the magnitude of the suction force can be modulated by increasing or decreasing the amount of a force applied to the actuation mechanism 240. For example, in some embodiments, it can be desirable to limit the amount of suction force introduced to a vein. In such embodiments, the user can reduce the amount of force applied to the engagement portion 258 of the second member 251. In this manner, the rate of change (e.g., the increase) in the volume of the first reservoir 280 can be sufficiently slow to allow time for the negative pressure differential between the vein and the fluid reservoir to come to equilibrium before further increasing the volume of the first reservoir 280. Thus, the magnitude of the suction force can be modulated.
While in the second configuration, the transfer device 200 can be configured to transfer a desired amount (e.g., a predetermined amount) of bodily-fluid transferred to the first reservoir 280. In some embodiments, the first, predetermined amount can substantially correspond to the size of the first reservoir 280. In other embodiments, the first amount can substantially correspond to an equalization of pressure within the first reservoir 280 and the portion of the patient. Moreover, in such embodiments, the equalization of the pressure can be such that the valve 270 is allowed to return to the closed configuration. Thus, the first reservoir 280 is fluidically isolated from a volume substantially outside the first reservoir 280.
With the first amount fluidically isolated, the actuator mechanism 240 can be moved from the second configuration to a third configuration by further moving the actuator mechanism 240 in the proximal direction. For example, as indicated by the arrow CC in
The arrangement of the first member 241 within the inner volume 211 of the housing 201 is such that the proximal motion of the first member 241 increases the volume of the portion of the inner volume 211 that is distal of the plunger 247, thereby defining the second reservoir 290. Furthermore, with the plunger 247 forming a fluid tight seal with the inner surface of the walls defining the inner volume 211 and with the valve 270 in the closed configuration, the increase of volume can produce a negative pressure within the second reservoir 290.
As shown by the arrow DD in
While not shown in
Although not shown in
As shown in
As described above, the actuator 341 is disposed within the inner volume 311 and is movable between a first position (e.g., a distal position relative to the housing 301) and a second position (e.g., a proximal position relative to the housing 301). The actuator 341 includes a proximal end portion 342 and a distal end portion 343 and defines an inner volume 346 therebetween. The proximal end portion 342 includes an engagement portion 350, as described above with respect to the second member 251 of the actuator mechanism 240. In addition, the proximal end 342 is substantially open such that at least a portion of the first reservoir 380 can be movably disposed within the inner volume 346.
The distal end portion 343 of the actuator 341 includes a plunger 347. The plunger 347 is configured to form a friction fit with the inner surface of the walls defining the inner volume 311 when the actuator 341 is disposed within the housing 301, as described in detail above in reference
A portion of the set of walls defining the channel 348 is configured to form a valve seat 349. In this manner, a portion of the channel 348 can receive a valve 370 such that the valve 370 is in contact with the valve seat 349. The valve 370 can be any suitable configuration, for example, the valve 370 can be similar in form and function to the valve 270 described above. In this manner, the arrangement of the plunger 347 and the valve 370 is such that when the valve 370 is in the open configuration, the port 375 is placed in fluid communication with the portion of the inner volume 311 of the housing 301 that is distal of the plunger 347, as further described herein.
In use, a user can engage the transfer device 300 to couple the port 305 to a proximal end portion of a lumen-defining device (not shown) such as, for example, a butterfly needle, a cannula assembly, a trocar (which in some cases is used to insert a catheter into a patient), or the like. With the port 305 physically coupled to the lumen-defining device, the port 305 is placed in fluid communication with the lumen defined by the lumen-defining device. Furthermore, the distal end portion of the lumen-defining device can be disposed within a portion of the body of a patient (e.g., a vein). In this manner, the port 305 is placed in fluid communication with the portion of the body.
With the port 305 coupled to the lumen-defining device, a user (e.g., a phlebotomist, a nurse, a technician, a physician, or the like) can move the transfer device 300 from the first configuration to the second configuration. In this manner, the user can engage the first reservoir 380 and place the first reservoir 380 within the inner volume 346 defined by the actuator 341. More specifically, as shown in
The insertion of the first reservoir 380 into the inner volume 346 of the actuator 341 can place the transfer device 300 in the second configuration. Furthermore, the distal end portion of the first reservoir 380 can be configured to include a pierceable septum that can receive the piercing member 377 of the port 375. While not shown in
As shown by the arrow FF in
While in the second configuration, the transfer device 300 can be configured to transfer a desired amount (e.g., a predetermined amount) of bodily-fluid transferred to the first reservoir 380. In some embodiments, the first, predetermined amount can substantially correspond to an equalization of pressure within the first reservoir 380 and the portion of the patient. Moreover, in such embodiments, the equalization the pressure can be such that the valve 370 is allowed to return to the closed configuration. Thus, the first reservoir 380 is fluidically isolated from a volume substantially outside the first reservoir 380.
With the first amount of bodily-fluid (e.g., the amount containing dermally-residing microbes) fluidically isolated, the first reservoir 380 can be removed from the inner volume 346 of the actuator 341 and discarded. In this manner, the actuator 341 can be moved from the second configuration to a third configuration by moving the actuator 341 in the proximal direction. For example, as indicated by the arrow GG in
As shown by the arrow HH in
While not shown in
While the embodiments shown above describe an actuator being operative in directing a flow of a bodily-fluid, in some embodiments, a transfer device can include a flow control mechanism configured to direct a flow of the bodily-fluid. For example,
As shown in
The distal end portion 403 of the housing 401 includes a port 405 and a diverter 409. The port 405 is configured to be coupled to or monolithically formed with a lumen-containing device, such as those described above. The diverter 409 defines a void 408 that movably receives a portion of the flow control mechanism 430. As shown in
Referring back to
The second member 435 is disposed substantially outside the void 408 and can be engaged by a user to rotate the flow control mechanism 430 between a first configuration and a second configuration. In addition, the first member 431 can be coupled to and/or otherwise engage the second member 445. For example, in some embodiments, the second member 435 can be coupled to the first member 431 via a mechanical fastener and/or adhesive. In other embodiments, the second member 435 and the first member 431 can be coupled in any suitable manner. Therefore, the first member 431 is configured to move concurrently with the second member 435 when the second member 435 is rotated relative to the housing 401. In this manner, the flow control mechanism 430 can be rotated to place the first lumen 432 or the second lumen 433 in fluid communication with the port 405, the first lumen 406, and/or the second lumen 407, as described in further detail herein.
As described above, the actuator mechanism 440 is disposed within the inner volume 411 and is movable between a first position (e.g., a distal position relative to the housing 401) and a second position (e.g., a proximal position relative to the housing 401). Furthermore, the movement of the actuator mechanism 440 relative to the housing 401 can move the transfer device 400 between a first, second, and third configuration, as further described herein. The actuator mechanism 440 includes a first member 470 and a second member 451. The first member 470 includes a shunt tube 471 and a plunger 476. The plunger 476 defines a channel 477 is configured to be movably disposed about the shunt tube 471. Similarly stated, the shunt tube 471 is disposed within the channel 477. The plunger 476 can be substantially similar in function to those described in detail above. For example, the plunger 476 can be configured to form a friction fit with a set of walls that define the inner volume 411 of the housing 401. In this manner, the plunger 476 and the walls defining the inner volume 411 form a substantially fluid tight seal. Similarly, the plunger 476 and the shunt tube 471 form a substantially fluid tight seal. Therefore, the plunger 476 fluidically isolates a portion of the inner volume 411 proximal of the plunger 476 from a portion of the inner volume 411 distal of the plunger 476.
The shunt tube 471 includes a proximal end portion 472 and a distal end portion 473. The distal end portion 473 is coupled to a portion of the diverter 409 such that a lumen 475 defined by the shunt tube 471 is in fluid communication with the second lumen 407 defined by the diverter 409. The proximal end portion 472 of the shunt tube 471 includes a protrusion 474 that is configured to engage the plunger 476 to substantially limit a proximal movement of the plunger 476 relative to the shunt tube 471, as further described herein.
The second member 451 of the actuator mechanism 440 includes a proximal end portion 452 and a distal end portion 453. The proximal end portion 452 includes an engagement portion 458 that can be engaged by a user (e.g., a phlebotomist, a nurse, a technician, a physician, etc.) to move at least a portion of the actuator mechanism 440 relative to the housing 401. The distal end portion 453 includes a plunger 457 configured to form a friction fit with the inner surface of the walls defining the inner volume 446 when the second member 451 is disposed with the inner volume 411. Similarly stated, the plunger 457 defines a fluidic seal with the inner surface of the walls defining the inner volume 411 such that a portion of the inner volume 411 proximal of the plunger 457 is fluidically isolated from a portion of the inner volume 411 distal of the plunger 457.
While not shown in
As shown in
In use, a user can engage the transfer device 400 to couple the port 405 to a proximal end portion of a lumen-defining device (not shown) such as, for example, a butterfly needle, a cannula assembly, a trocar (which in some cases is used to insert a catheter into a patient), or the like. With the port 405 physically coupled to the lumen-defining device, the port 405 is placed in fluid communication with the lumen defined by the lumen-defining device. Furthermore, the distal end portion of the lumen-defining device can be disposed within a portion of the body of a patient (e.g., a vein, spinal column, etc.). In this manner, the port 405 is placed in fluid communication with the portion of the body.
With the port 405 coupled to the lumen-defining device, a user (e.g., a phlebotomist, a nurse, a technician, a physician, or the like) can move the transfer device 400 from the first configuration to the second configuration. More specifically, the user can engage the engagement portion 458 of the second member 451 included in the actuator mechanism 440 to move the actuator mechanism 440 from its first configuration to its second configuration, thereby placing the transfer device 400 in the second configuration, as indicated by the arrow II in
The arrangement of the actuator mechanism 440 is such that the proximal motion of the second member 451 moves the plunger 476 of the first member 470 in the proximal direction relative to the shunt tube 471. Expanding further, the first member 470 can be at least temporarily coupled to the second member 451 such that the first member 470 and the second member 451 move concurrently in the proximal direction relative to the housing 401. In this manner, the first member 470 moves in the proximal direction until the first member 470 is placed in contact with the protrusion 474 included in the shunt tube 471. Moreover, the proximal movement of the plunger 476 increases the volume of the portion of the inner volume 411 of the housing 401 that is distal of the plunger 476, thereby defining the first reservoir 480, as shown in
While the transfer device 400 is placed in the second configuration, the flow control mechanism 430 can be maintained in the first configuration. In this manner, first member 431 of the flow control mechanism 430 can be disposed within the void 408 such that the first lumen 432 defined by the flow control mechanism 430 is in fluid communication with the port 405 and in fluid communication with the first lumen 406 defined by the diverter 409. In this manner, the port 405, the first lumen 432 defined by the flow control mechanism 430, and the first lumen 406 defined by the diverter 409 define a fluid flow path that places the first reservoir 480 in fluid communication with the lumen-defining device, as indicated by the arrow JJ in
In some embodiments, the magnitude of the suction force can be modulated by moving the rotating the flow control mechanism 430 relative to the diverter 409. The rotation of the flow control mechanism 330 reduces the size of the fluid pathway (e.g., an inner diameter) between the port 405 and the first lumen 432 of the flow control mechanism 430 and the first lumen 406 of the diverter 409 and the first lumen 432 of the flow control mechanism 430, thereby reducing the suction force introduced into the vein of the patient.
With the desired amount of bodily-fluid transferred to the first reservoir 480, a user can engage the transfer device 400 to move the transfer device 400 from the second configuration to the third configuration. In some embodiments, the desired amount of bodily-fluid transferred to the first reservoir 480 is a predetermined amount of fluid (as described above). In some embodiments, the volume of the first reservoir 480 is sufficient to contain the first centiliter or few centiliters of bodily-fluid. In other embodiments, the first reservoir 480 can be configured to contain from about 0.1 ml to about 3.0 ml. In still other embodiments, the first reservoir 480 can be configured to contain from about 3.0 ml, 4.0 ml, 5.0 ml, 6.0 ml, 7.0 ml, 8.0 ml, 9.0 ml, 10.0 ml, 15.0 ml, 20.0 ml, 25.0 ml, 50 ml, or any volume or fraction of volume therebetween. In some embodiments, the predetermined amount of bodily-fluid (e.g., volume) is at least equal to the combined volume of the port 405, the first lumen 432 of the flow control mechanism 430, the first lumen 406 of the diverter 409, and the lumen-defining device. In other embodiments, the flow control mechanism 430 can be configured to automatically move from the first configuration to the second configuration to divert fluid flow without user intervention.
As shown in
With the flow control mechanism 430 placed in the second configuration, the second member 451 of the actuator mechanism 440 can be moved from the second configuration to a third configuration. Expanding further, with the plunger 476 in contact with the protrusion 474 of the shunt 471, the second member 451 can be moved in the proximal direction to decouple the second member 451 from the plunger 476 (as described above the plunger 476 is at least temporarily coupled to the first member 451). In this manner, the second member 451 can be moved in the proximal direction relative to the first member 470, as indicated by the arrow MM in
With the plunger 476 of the first member 470 and the plunger 457 of the second member 451 forming a fluid tight seal with the inner surface of the walls defining the inner volume 411, the volume increase of the portion of the inner volume 411 can produce a negative pressure within the first reservoir 490. Thus, the negative pressure within the second reservoir 490 is such that the negative pressure differential between the second reservoir 490 and the portion of the body of the patient introduces a suction force within the portion of the patient. Therefore, a desired amount of bodily-fluid is drawn through the port 405, the second lumen 433 of the flow control mechanism 430, the second lumen 407 of the diverter 409, and the lumen 475 defined by the shunt tube 471 and into the second reservoir 490. Moreover, the bodily-fluid disposed within the second reservoir 490 is fluidically isolated from the first, predetermined amount of bodily-fluid contained within the first reservoir 480.
Although not shown in
While not shown in
The method 1000 includes establishing fluid communication between the patient and the port of the syringe-based transfer device, at 1001. For example, the port can be coupled to a proximal end portion of a lumen-defining device such as, for example, a butterfly needle, a cannula assembly, or the like that is in fluid communication with the patient (e.g., at least a distal end portion of the lumen-defining device is disposed in the body of the patient). With the port physically and fluidically coupled to the lumen-defining device, the port is placed in fluid communication with the body.
With the port coupled to the lumen-defining device, a user can establish fluid communication between the port and a pre-sample reservoir included in and/or defined by the syringe-based transfer device, at 1002. For example, the user can move the actuator mechanism from a first configuration to a second configuration, thereby placing the port in fluid communication with the pre-sample reservoir. In some embodiments, the movement of the actuator mechanism can increase an inner volume which, in turn, can produce a negative pressure within the pre-sample reservoir, as described above with reference to the transfer device 200 in
The first volume of bodily-fluid can be any suitable volume. For example, in some embodiments, the first volume of bodily-fluid transferred to the pre-sample reservoir can be a predetermined volume. In some embodiments, the first volume can be, for example, about 0.1 ml, about 0.3 ml, about 0.5 ml, about 1.0 ml, about 2.0 ml, about 3.0 ml, about 4.0 ml, about 5.0 ml, about 10.0 ml, about 20 ml, about 50 ml, and/or any volume or fraction of a volume therebetween. In other embodiments, the first volume can be greater than 50 ml or less than 0.1 ml. In some embodiments, the first volume can substantially correspond to the size of the pre-sample reservoir 280. Once the first volume of bodily-fluid is transferred to the pre-sample, reservoir, the pre-sample reservoir is fluidically isolated from the port to sequester the first volume of bodily-fluid in the pre-sample reservoir, at 1004. For example, in some embodiments, the user can move the actuator mechanism and/or otherwise manipulate the syringe-based transfer device to fluidically isolate the pre-sample reservoir.
With the first amount fluidically isolated, fluid communication is established between the port and a sample reservoir defined at least in part by the actuator mechanism and the housing of the syringe-based transfer device, at 1005. For example, in some embodiments, the housing can define an inner volume in which the actuator mechanism is at least partially disposed. In some embodiments, the actuator mechanism can include a seal member or plunger that can form a substantially fluid tight seal with a set of walls defining the inner volume of the housing, thereby defining the sample reservoir. For example, the actuator mechanism and the housing can define the sample reservoir in a similar manner as described above with reference to the actuator mechanism 240, the housing 201, and the sample reservoir 290 of
While various embodiments have been described above, it should be understood that they have been presented by way of example only, and not limitation. Where methods and steps described above indicate certain events occurring in certain order, those of ordinary skill in the art having the benefit of this disclosure would recognize that the ordering of certain steps may be modified and that such modifications are in accordance with the variations of the invention. Additionally, certain steps may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. Additionally, certain steps may be partially completed before proceeding to subsequent steps. For example, while the flow control mechanism 430 of the transfer device 400 is described above (with reference to
While various embodiments have been particularly shown and described, various changes in form and details may be made. For example, while the flow control mechanism 430 is shown and described with respect to
Although various embodiments have been described as having particular features and/or combinations of components, other embodiments are possible having any combination or sub-combination of any features and/or components from any of the embodiments described herein. For example, while the transfer device 400 is shown in
The specific configurations of the various components can also be varied. For example, the size and specific shape of the various components can be different than the embodiments shown, while still providing the functions as described herein. More specifically, the size and shape of the various components can be specifically selected for a desired rate of bodily-fluid flow into a fluid reservoir.
This application is a continuation of U.S. patent application Ser. No. 17/388,979, filed Jul. 29, 2021, entitled “Syringe-Based Fluid Diversion Mechanism for Bodily Fluid Sampling,” which is a continuation of U.S. patent application Ser. No. 16/255,058, filed Jan. 23, 2019, entitled “Syringe-Based Fluid Diversion Mechanism for Bodily Fluid Sampling” (now abandoned), which is a continuation of U.S. patent application Ser. No. 14/880,397, filed Oct. 12, 2015, entitled “Syringe-Based Fluid Diversion Mechanism for Bodily Fluid Sampling” (now U.S. Pat. No. 10,206,613), which is a continuation of U.S. patent application Ser. No. 14/094,073, filed Dec. 2, 2013, entitled “Syringe-Based Fluid Diversion Mechanism for Bodily Fluid Sampling” (now U.S. Pat. No. 9,155,495), which claims priority to and the benefit of U.S. Provisional Application Ser. No. 61/731,620, entitled “Syringe Based Fluid Diversion Mechanism for Bodily-Fluid Sampling,” filed Nov. 30, 2012, the disclosure of each of which is incorporated herein by reference in its entirety.
| Number | Name | Date | Kind |
|---|---|---|---|
| 2707953 | Ryan | May 1955 | A |
| 2992974 | Belcove et al. | Jul 1961 | A |
| 3013557 | Pallotta | Dec 1961 | A |
| 3098016 | Cooper et al. | Jul 1963 | A |
| 3382865 | Worral, Jr. | May 1968 | A |
| 3405706 | Cinqualbre | Oct 1968 | A |
| 3467021 | Green | Sep 1969 | A |
| 3467095 | Ross | Sep 1969 | A |
| 3494351 | Horn | Feb 1970 | A |
| 3494352 | Russo et al. | Feb 1970 | A |
| 3577980 | Cohen | May 1971 | A |
| 3604410 | Whitacre | Sep 1971 | A |
| 3635798 | Kirkham et al. | Jan 1972 | A |
| 3648684 | Barnwell et al. | Mar 1972 | A |
| 3680558 | Kapelowitz | Aug 1972 | A |
| 3730168 | Mcwhorter | May 1973 | A |
| 3741197 | Sanz et al. | Jun 1973 | A |
| 3777773 | Tolbert | Dec 1973 | A |
| 3803810 | Rosenberg | Apr 1974 | A |
| 3817240 | Ayres | Jun 1974 | A |
| 3831602 | Broadwin | Aug 1974 | A |
| 3834372 | Turney | Sep 1974 | A |
| 3835835 | Thompson et al. | Sep 1974 | A |
| 3848579 | Villa-Real | Nov 1974 | A |
| 3848581 | Cinqualbre et al. | Nov 1974 | A |
| 3874367 | Ayres | Apr 1975 | A |
| 3886930 | Ryan | Jun 1975 | A |
| 3890203 | Mehl | Jun 1975 | A |
| 3890968 | Pierce et al. | Jun 1975 | A |
| 3937211 | Merten | Feb 1976 | A |
| 3945380 | Dabney et al. | May 1976 | A |
| 3960139 | Bailey | Jun 1976 | A |
| 3978846 | Bailey | Sep 1976 | A |
| 3996923 | Guerra | Dec 1976 | A |
| 4056101 | Geissler et al. | Nov 1977 | A |
| 4057050 | Sarstedt | Nov 1977 | A |
| 4063460 | Svensson | Dec 1977 | A |
| 4077395 | Woolner | Mar 1978 | A |
| 4106497 | Percarpio | Aug 1978 | A |
| 4133304 | Bailey | Jan 1979 | A |
| 4133863 | Koenig | Jan 1979 | A |
| 4150089 | Linet | Apr 1979 | A |
| 4154229 | Nugent | May 1979 | A |
| 4166450 | Abramson | Sep 1979 | A |
| 4190426 | Ruschke | Feb 1980 | A |
| 4193400 | Loveless et al. | Mar 1980 | A |
| 4207870 | Eldridge | Jun 1980 | A |
| 4210173 | Choksi et al. | Jul 1980 | A |
| 4212308 | Percarpio | Jul 1980 | A |
| 4238207 | Ruschke | Dec 1980 | A |
| 4257416 | Prager | Mar 1981 | A |
| 4275730 | Hussein | Jun 1981 | A |
| 4298358 | Ruschke | Nov 1981 | A |
| 4312362 | Kaufman | Jan 1982 | A |
| 4327746 | Feaster | May 1982 | A |
| 4340067 | Rattenborg | Jul 1982 | A |
| 4340068 | Kaufman | Jul 1982 | A |
| 4349035 | Thomas et al. | Sep 1982 | A |
| 4354507 | Raitto | Oct 1982 | A |
| 4370987 | Bazell et al. | Feb 1983 | A |
| 4398544 | Nugent et al. | Aug 1983 | A |
| 4411275 | Raitto | Oct 1983 | A |
| 4412548 | Hoch | Nov 1983 | A |
| 4416290 | Lutkowski | Nov 1983 | A |
| 4416291 | Kaufman | Nov 1983 | A |
| 4425235 | Cornell et al. | Jan 1984 | A |
| 4436098 | Kaufman | Mar 1984 | A |
| 4444203 | Engelman | Apr 1984 | A |
| 4459997 | Sarstedt | Jul 1984 | A |
| 4509534 | Tassin, Jr. | Apr 1985 | A |
| 4608996 | Brown | Sep 1986 | A |
| 4654027 | Dragan et al. | Mar 1987 | A |
| 4657027 | Paulsen | Apr 1987 | A |
| 4657160 | Woods et al. | Apr 1987 | A |
| 4673386 | Gordon | Jun 1987 | A |
| 4676256 | Golden | Jun 1987 | A |
| 4679571 | Frankel et al. | Jul 1987 | A |
| 4705497 | Shitaokoshi et al. | Oct 1987 | A |
| 4714461 | Gabel | Dec 1987 | A |
| 4715854 | Vaillancourt | Dec 1987 | A |
| 4772273 | Alchas | Sep 1988 | A |
| 4820287 | Leonard | Apr 1989 | A |
| 4865583 | Tu | Sep 1989 | A |
| 4879098 | Oberhardt et al. | Nov 1989 | A |
| 4886072 | Percarpio et al. | Dec 1989 | A |
| 4890627 | Haber et al. | Jan 1990 | A |
| 4904240 | Hoover | Feb 1990 | A |
| 4980297 | Haynes et al. | Dec 1990 | A |
| 4988339 | Vadher | Jan 1991 | A |
| 5027827 | Cody et al. | Jul 1991 | A |
| 5032116 | Peterson et al. | Jul 1991 | A |
| 5045185 | Ohnaka et al. | Sep 1991 | A |
| 5052403 | Haber et al. | Oct 1991 | A |
| 5066284 | Mersch et al. | Nov 1991 | A |
| 5084034 | Zanotti | Jan 1992 | A |
| 5097842 | Bonn | Mar 1992 | A |
| 5100394 | Dudar et al. | Mar 1992 | A |
| 5108927 | Dom | Apr 1992 | A |
| 5116323 | Kreuzer et al. | May 1992 | A |
| 5122129 | Olson et al. | Jun 1992 | A |
| 5135489 | Jepson et al. | Aug 1992 | A |
| 5222502 | Kurose | Jun 1993 | A |
| 5269317 | Bennett | Dec 1993 | A |
| 5330464 | Mathias et al. | Jul 1994 | A |
| 5354537 | Moreno | Oct 1994 | A |
| 5360011 | McCallister | Nov 1994 | A |
| 5395339 | Talonn et al. | Mar 1995 | A |
| 5417673 | Gordon | May 1995 | A |
| 5429610 | Vaillancourt | Jul 1995 | A |
| 5431811 | Tusini et al. | Jul 1995 | A |
| 5439450 | Haedt | Aug 1995 | A |
| 5450856 | Norris | Sep 1995 | A |
| 5454786 | Harris | Oct 1995 | A |
| 5466228 | Evans | Nov 1995 | A |
| 5472605 | Zuk, Jr. | Dec 1995 | A |
| 5485854 | Hollister | Jan 1996 | A |
| 5507299 | Roland | Apr 1996 | A |
| 5520193 | Suzuki et al. | May 1996 | A |
| 5522804 | Lynn | Jun 1996 | A |
| 5573510 | Isaacson | Nov 1996 | A |
| 5575777 | Cover et al. | Nov 1996 | A |
| 5577513 | Van Vlasselaer | Nov 1996 | A |
| 5603700 | Daneshvar | Feb 1997 | A |
| 5632906 | Ishida et al. | May 1997 | A |
| 5649912 | Peterson | Jul 1997 | A |
| 5691486 | Behringer et al. | Nov 1997 | A |
| 5749857 | Cuppy | May 1998 | A |
| 5762633 | Whisson | Jun 1998 | A |
| 5772608 | Dhas | Jun 1998 | A |
| 5785682 | Grabenkort | Jul 1998 | A |
| 5811658 | Van Driel et al. | Sep 1998 | A |
| 5824001 | Erskine | Oct 1998 | A |
| 5857983 | Douglas et al. | Jan 1999 | A |
| 5865812 | Correia | Feb 1999 | A |
| 5871699 | Ruggeri | Feb 1999 | A |
| 5876926 | Beecham | Mar 1999 | A |
| 5882318 | Boyde | Mar 1999 | A |
| 5911705 | Howell | Jun 1999 | A |
| 5922551 | Durbin et al. | Jul 1999 | A |
| 5961472 | Swendson et al. | Oct 1999 | A |
| 5971956 | Epstein | Oct 1999 | A |
| 5980830 | Savage et al. | Nov 1999 | A |
| 6001307 | Naka et al. | Dec 1999 | A |
| 6010633 | Zuk, Jr. et al. | Jan 2000 | A |
| 6013037 | Brannon | Jan 2000 | A |
| 6016712 | Warden et al. | Jan 2000 | A |
| 6050957 | Desch | Apr 2000 | A |
| 6106509 | Loubser | Aug 2000 | A |
| 6126643 | Vaillancouert | Oct 2000 | A |
| 6159164 | Neese et al. | Dec 2000 | A |
| 6210909 | Guirguis | Apr 2001 | B1 |
| 6224561 | Swendson et al. | May 2001 | B1 |
| 6254581 | Scott | Jul 2001 | B1 |
| 6299131 | Ryan | Oct 2001 | B1 |
| 6306614 | Romaschin et al. | Oct 2001 | B1 |
| 6325975 | Naka et al. | Dec 2001 | B1 |
| 6328726 | Ishida et al. | Dec 2001 | B1 |
| 6355023 | Roth et al. | Mar 2002 | B1 |
| 6364890 | Lum et al. | Apr 2002 | B1 |
| 6368306 | Koska | Apr 2002 | B1 |
| 6387086 | Mathias et al. | May 2002 | B2 |
| 6398743 | Halseth et al. | Jun 2002 | B1 |
| 6403381 | Mann et al. | Jun 2002 | B1 |
| 6478775 | Galt et al. | Nov 2002 | B1 |
| 6506182 | Estabrook et al. | Jan 2003 | B2 |
| 6511439 | Tabata et al. | Jan 2003 | B1 |
| 6520948 | Mathias et al. | Feb 2003 | B1 |
| 6569117 | Ziv et al. | May 2003 | B1 |
| 6592555 | Wen-Pi | Jul 2003 | B1 |
| 6626884 | Dillon et al. | Sep 2003 | B1 |
| 6638252 | Moulton et al. | Oct 2003 | B2 |
| 6648835 | Shemesh | Nov 2003 | B1 |
| 6692479 | Kraus et al. | Feb 2004 | B2 |
| 6695004 | Raybuck | Feb 2004 | B1 |
| 6716187 | Jorgensen et al. | Apr 2004 | B1 |
| 6733433 | Fell | May 2004 | B1 |
| 6736783 | Blake et al. | May 2004 | B2 |
| 6746420 | Prestidge et al. | Jun 2004 | B1 |
| 6843775 | Hyun | Jan 2005 | B2 |
| 6860871 | Kuracina et al. | Mar 2005 | B2 |
| 6905483 | Newby et al. | Jun 2005 | B2 |
| 6913580 | Stone | Jul 2005 | B2 |
| 6945948 | Bainbridge et al. | Sep 2005 | B2 |
| 7044941 | Mathias et al. | May 2006 | B2 |
| 7052603 | Schick | May 2006 | B2 |
| 7055401 | Prybella et al. | Jun 2006 | B2 |
| 7087047 | Kraus et al. | Aug 2006 | B2 |
| 7141097 | Leahey | Nov 2006 | B2 |
| 7241281 | Coelho et al. | Jul 2007 | B2 |
| 7306736 | Collins et al. | Dec 2007 | B2 |
| 7314452 | Madonia | Jan 2008 | B2 |
| 7316662 | Delnevo et al. | Jan 2008 | B2 |
| 7335188 | Graf | Feb 2008 | B2 |
| 7351228 | Keane et al. | Apr 2008 | B2 |
| 7384416 | Goudaliez et al. | Jun 2008 | B2 |
| 7461671 | Ehwald et al. | Dec 2008 | B2 |
| 7479131 | Mathias et al. | Jan 2009 | B2 |
| 7614857 | Fuechslin et al. | Nov 2009 | B2 |
| 7615033 | Leong | Nov 2009 | B2 |
| 7618407 | Demay et al. | Nov 2009 | B2 |
| 7648491 | Rogers | Jan 2010 | B2 |
| 7666166 | Emmert et al. | Feb 2010 | B1 |
| 7744573 | Gordon et al. | Jun 2010 | B2 |
| 7766879 | Tan et al. | Aug 2010 | B2 |
| 8070725 | Christensen | Dec 2011 | B2 |
| 8197420 | Patton | Jun 2012 | B2 |
| 8231546 | Patton | Jul 2012 | B2 |
| 8282605 | Tan et al. | Oct 2012 | B2 |
| 8287499 | Miyasaka | Oct 2012 | B2 |
| 8337418 | Patton | Dec 2012 | B2 |
| 8349254 | Hoshino et al. | Jan 2013 | B2 |
| 8377040 | Burkholz et al. | Feb 2013 | B2 |
| 8382712 | Kim | Feb 2013 | B2 |
| 8383044 | Davis et al. | Feb 2013 | B2 |
| 8412300 | Sonderegger | Apr 2013 | B2 |
| 8523826 | Layton, Jr. | Sep 2013 | B2 |
| 8535241 | Bullington et al. | Sep 2013 | B2 |
| 8540663 | Davey et al. | Sep 2013 | B2 |
| 8568371 | Siopes et al. | Oct 2013 | B2 |
| 8574203 | Stout et al. | Nov 2013 | B2 |
| 8603009 | Tan et al. | Dec 2013 | B2 |
| 8647286 | Patton | Feb 2014 | B2 |
| 8795198 | Tan et al. | Aug 2014 | B2 |
| 8827958 | Bierman et al. | Sep 2014 | B2 |
| 8864684 | Bullington et al. | Oct 2014 | B2 |
| 8876734 | Patton | Nov 2014 | B2 |
| 8992505 | Thorne et al. | Mar 2015 | B2 |
| 9003879 | Honan et al. | Apr 2015 | B1 |
| 9022950 | Bullington et al. | May 2015 | B2 |
| 9022951 | Bullington et al. | May 2015 | B2 |
| 9060724 | Bullington et al. | Jun 2015 | B2 |
| 9060725 | Bullington et al. | Jun 2015 | B2 |
| 9138572 | Zeytoonian et al. | Sep 2015 | B2 |
| 9149576 | Bullington et al. | Oct 2015 | B2 |
| 9155495 | Bullington et al. | Oct 2015 | B2 |
| 9204864 | Bullington et al. | Dec 2015 | B2 |
| 9314201 | Burkholz et al. | Apr 2016 | B2 |
| 9855001 | Patton | Jan 2018 | B2 |
| 9855002 | Patton | Jan 2018 | B2 |
| 9855386 | Close et al. | Jan 2018 | B2 |
| 9861306 | Patton | Jan 2018 | B2 |
| 9872645 | Patton | Jan 2018 | B2 |
| 9877675 | Baid | Jan 2018 | B2 |
| 9895092 | Burkholz | Feb 2018 | B2 |
| 9931466 | Bullington et al. | Apr 2018 | B2 |
| 9980878 | Marici et al. | May 2018 | B2 |
| 9999383 | Bullington et al. | Jun 2018 | B2 |
| 10022530 | Tekeste | Jul 2018 | B2 |
| 10028687 | Patton | Jul 2018 | B2 |
| 10028688 | Patton | Jul 2018 | B2 |
| 10028689 | Patton | Jul 2018 | B2 |
| 10039483 | Bullington et al. | Aug 2018 | B2 |
| 10045724 | Patton | Aug 2018 | B2 |
| 10052053 | Patton | Aug 2018 | B2 |
| 10086142 | Tekeste | Oct 2018 | B2 |
| 10206613 | Bullington et al. | Feb 2019 | B2 |
| 10219982 | Weir et al. | Mar 2019 | B2 |
| 10220139 | Bullington et al. | Mar 2019 | B2 |
| 10251590 | Bullington et al. | Apr 2019 | B2 |
| 10265007 | Bullington et al. | Apr 2019 | B2 |
| 10292633 | Bullington et al. | May 2019 | B2 |
| 10299713 | Patton | May 2019 | B2 |
| 10433779 | Bullington et al. | Oct 2019 | B2 |
| 10596315 | Bullington et al. | Mar 2020 | B2 |
| 10736554 | Bullington et al. | Aug 2020 | B2 |
| 10772548 | Bullington et al. | Sep 2020 | B2 |
| 11259727 | Bullington et al. | Mar 2022 | B2 |
| 11317838 | Bullington et al. | May 2022 | B2 |
| 11395611 | Bullington et al. | Jul 2022 | B2 |
| 11395612 | Bullington et al. | Jul 2022 | B2 |
| 20020002349 | Flaherty et al. | Jan 2002 | A1 |
| 20020004647 | Leong | Jan 2002 | A1 |
| 20020107469 | Bolan et al. | Aug 2002 | A1 |
| 20020183651 | Hyun | Dec 2002 | A1 |
| 20020193751 | Theeuwes et al. | Dec 2002 | A1 |
| 20030013991 | Stone | Jan 2003 | A1 |
| 20030055381 | Wilkinson | Mar 2003 | A1 |
| 20030069543 | Carpenter et al. | Apr 2003 | A1 |
| 20030105414 | Leong | Jun 2003 | A1 |
| 20030208151 | Kraus et al. | Nov 2003 | A1 |
| 20040009542 | Dumont et al. | Jan 2004 | A1 |
| 20040010228 | Swenson et al. | Jan 2004 | A1 |
| 20040054283 | Corey et al. | Mar 2004 | A1 |
| 20040054333 | Theeuwes et al. | Mar 2004 | A1 |
| 20040127816 | Galvao | Jul 2004 | A1 |
| 20040147855 | Marsden | Jul 2004 | A1 |
| 20050004524 | Newby et al. | Jan 2005 | A1 |
| 20050148993 | Mathias et al. | Jul 2005 | A1 |
| 20050154368 | Lim et al. | Jul 2005 | A1 |
| 20050161112 | Ehwald et al. | Jul 2005 | A1 |
| 20050199077 | Prybella et al. | Sep 2005 | A1 |
| 20050240161 | Crawford | Oct 2005 | A1 |
| 20050245885 | Brown | Nov 2005 | A1 |
| 20050273019 | Conway et al. | Dec 2005 | A1 |
| 20050281713 | Hampsch et al. | Dec 2005 | A1 |
| 20060155212 | Madonia | Jul 2006 | A1 |
| 20060251622 | Suzuki et al. | Nov 2006 | A1 |
| 20060287639 | Sharp | Dec 2006 | A1 |
| 20070083162 | O'Reagan et al. | Apr 2007 | A1 |
| 20070088279 | Shue et al. | Apr 2007 | A1 |
| 20070100250 | Kline | May 2007 | A1 |
| 20070119508 | West et al. | May 2007 | A1 |
| 20070287948 | Sakiewicz | Dec 2007 | A1 |
| 20080086085 | Brown | Apr 2008 | A1 |
| 20080108954 | Mathias et al. | May 2008 | A1 |
| 20080167577 | Weilbacher et al. | Jul 2008 | A1 |
| 20080200837 | Frazier et al. | Aug 2008 | A1 |
| 20080254471 | Bordano | Oct 2008 | A1 |
| 20080255523 | Grinberg | Oct 2008 | A1 |
| 20080312576 | McKinnon et al. | Dec 2008 | A1 |
| 20080319346 | Crawford et al. | Dec 2008 | A1 |
| 20090192447 | Andersen et al. | Jul 2009 | A1 |
| 20090227896 | Tan et al. | Sep 2009 | A1 |
| 20090301317 | Andrews | Dec 2009 | A1 |
| 20090306601 | Shaw et al. | Dec 2009 | A1 |
| 20100010372 | Brown et al. | Jan 2010 | A1 |
| 20100042048 | Christensen | Feb 2010 | A1 |
| 20100057004 | Christensen et al. | Mar 2010 | A1 |
| 20100094171 | Conway et al. | Apr 2010 | A1 |
| 20100152681 | Mathias | Jun 2010 | A1 |
| 20100234768 | Uchiyama et al. | Sep 2010 | A1 |
| 20100268118 | Schweiger | Oct 2010 | A1 |
| 20100286513 | Pollard et al. | Nov 2010 | A1 |
| 20110306899 | Brown et al. | Dec 2011 | A1 |
| 20120004619 | Stephens et al. | Jan 2012 | A1 |
| 20120016266 | Burkholz | Jan 2012 | A1 |
| 20120022404 | Fojtik | Jan 2012 | A1 |
| 20120035540 | Ferren et al. | Feb 2012 | A1 |
| 20120265099 | Goodnow, II et al. | Oct 2012 | A1 |
| 20120265128 | Kolln | Oct 2012 | A1 |
| 20130158506 | Harris et al. | Jun 2013 | A1 |
| 20140066880 | Prince et al. | Mar 2014 | A1 |
| 20140124542 | Kojima et al. | May 2014 | A1 |
| 20140221873 | Hayakawa et al. | Aug 2014 | A1 |
| 20150018715 | Walterspiel | Jan 2015 | A1 |
| 20150025454 | Wetzel et al. | Jan 2015 | A1 |
| 20150025455 | Shetty et al. | Jan 2015 | A1 |
| 20150025456 | Shetty et al. | Jan 2015 | A1 |
| 20160081606 | Russ et al. | Mar 2016 | A1 |
| 20160113560 | Bullington et al. | Apr 2016 | A1 |
| 20160174888 | Berthier et al. | Jun 2016 | A1 |
| 20160213294 | Patton | Jul 2016 | A1 |
| 20170071519 | Gelfand et al. | Mar 2017 | A1 |
| 20180160958 | Baid | Jun 2018 | A1 |
| 20190049442 | Guirguis | Feb 2019 | A1 |
| 20190150818 | Bullington et al. | May 2019 | A1 |
| 20190209066 | Bullington et al. | Jul 2019 | A1 |
| 20200060595 | Bullington et al. | Feb 2020 | A1 |
| 20200060596 | Patton | Feb 2020 | A1 |
| 20210008280 | Bullington et al. | Jan 2021 | A1 |
| 20210169387 | Bullington et al. | Jun 2021 | A1 |
| 20210186392 | Bullington et al. | Jun 2021 | A1 |
| 20210353193 | Bullington et al. | Nov 2021 | A1 |
| 20210353194 | Bullington et al. | Nov 2021 | A1 |
| 20210361206 | Bullington et al. | Nov 2021 | A1 |
| 20220183600 | Bullington et al. | Jun 2022 | A1 |
| 20220218248 | Bullington et al. | Jul 2022 | A1 |
| 20220218250 | Bullington et al. | Jul 2022 | A1 |
| Number | Date | Country |
|---|---|---|
| 2115767 | Sep 1992 | CN |
| 2907683 | Jun 2007 | CN |
| 101309641 | Nov 2008 | CN |
| 101352357 | Jan 2009 | CN |
| 101437450 | May 2009 | CN |
| 101676001 | Mar 2010 | CN |
| 101801445 | Aug 2010 | CN |
| 102548524 | Jul 2012 | CN |
| 102971040 | Mar 2013 | CN |
| 103027727 | Apr 2013 | CN |
| 103477201 | Dec 2013 | CN |
| 105090005 | Nov 2015 | CN |
| 105612346 | May 2016 | CN |
| 2 203 858 | May 1973 | DE |
| 2 541 494 | Mar 1977 | DE |
| 299 13 417 | Dec 2000 | DE |
| 100 38 026 | Feb 2001 | DE |
| 102 43 129 | Apr 2004 | DE |
| 0 207 304 | Jan 1987 | EP |
| 0 448 795 | Oct 1991 | EP |
| 1 980 204 | Oct 2008 | EP |
| 2 110 516 | Jun 1972 | FR |
| S53-097289 | Aug 1978 | JP |
| S57-089869 | Jun 1982 | JP |
| S64-58241 | Mar 1989 | JP |
| H07-16219 | Jan 1995 | JP |
| 2002-116201 | Apr 2002 | JP |
| 2005-237617 | Sep 2005 | JP |
| 2008-149076 | Jul 2008 | JP |
| WO 1986005568 | Sep 1986 | WO |
| WO 1990004351 | May 1990 | WO |
| WO 1991018632 | Dec 1991 | WO |
| WO 1992016144 | Oct 1992 | WO |
| WO 1995016395 | Jun 1995 | WO |
| WO 1997018845 | May 1997 | WO |
| WO 1998046136 | Oct 1998 | WO |
| WO 1999013925 | Mar 1999 | WO |
| WO 1999048425 | Sep 1999 | WO |
| WO 1999055232 | Nov 1999 | WO |
| WO 2000041624 | Jul 2000 | WO |
| WO 2001008546 | Feb 2001 | WO |
| WO 2001091829 | Dec 2001 | WO |
| WO 2002051520 | Jul 2002 | WO |
| WO 2003008012 | Jan 2003 | WO |
| WO 2003047660 | Jun 2003 | WO |
| WO 2003078964 | Sep 2003 | WO |
| WO 2005068011 | Jul 2005 | WO |
| WO 2006031500 | Mar 2006 | WO |
| WO 2007033319 | Mar 2007 | WO |
| WO 2008101025 | Aug 2008 | WO |
| WO 2011069145 | Jun 2011 | WO |
| WO 2012012127 | Jan 2012 | WO |
| WO 2014022750 | Feb 2014 | WO |
| WO 2014085800 | Jun 2014 | WO |
| WO 2016054252 | Apr 2016 | WO |
| Entry |
|---|
| Office Action for U.S. Appl. No. 11/955,635, dated Jul. 22, 2010, 11 pages. |
| Office Action for U.S. Appl. No. 11/955,635, dated Dec. 3, 2010, 11 pages. |
| Office Action for U.S. Appl. No. 13/335,241, dated Apr. 20, 2012, 12 pages. |
| Office Action for U.S. Appl. No. 13/458,508, dated Jul. 24, 2012, 13 pages. |
| Office Action for U.S. Appl. No. 13/675,295, dated May 23, 2013, 15 pages. |
| Office Action for U.S. Appl. No. 14/089,267, dated Jun. 19, 2014, 13 pages. |
| Office Action for U.S. Appl. No. 14/498,102, dated Oct. 17, 2017, 20 pages. |
| Office Action for U.S. Appl. No. 14/498,102, dated Sep. 24, 2018, 18 pages. |
| Office Action for U.S. Appl. No. 15/088,842, dated Nov. 23, 2016, 20 pages. |
| Office Action for U.S. Appl. No. 15/432,310, dated Apr. 12, 2017, 14 pages. |
| Office Action for U.S. Appl. No. 15/435,684, dated Jun. 12, 2017, 19 pages. |
| Office Action for U.S. Appl. No. 15/448,891, dated Jun. 16, 2017, 25 pages. |
| Office Action for U.S. Appl. No. 15/457,082, dated Jun. 15, 2017, 22 pages. |
| Office Action for U.S. Appl. No. 15/829,015, dated Feb. 6, 2018, 24 pages. |
| Office Action for U.S. Appl. No. 15/829,018, dated Feb. 16, 2018, 13 pages. |
| Office Action for U.S. Appl. No. 15/829,023, dated Feb. 7, 2018, 25 pages. |
| Office Action for U.S. Appl. No. 15/832,055, dated Feb. 8, 2018, 21 pages. |
| Office Action for U.S. Appl. No. 15/832,087, dated Feb. 7, 2018, 24 pages. |
| Office Action for U.S. Appl. No. 13/954,528, dated Mar. 17, 2014, 10 pages. |
| Office Action for U.S. Appl. No. 15/832,091, dated Feb. 22, 2018, 16 pages. |
| Office Action for U.S. Appl. No. 16/299,962, dated May 2, 2019, 14 pages. |
| Office Action for U.S. Appl. No. 16/299,962, dated Dec. 26, 2019, 14 pages. |
| Office Action for U.S. Appl. No. 16/299,962, dated Dec. 9, 2020, 15 pages. |
| Office Action for U.S. Appl. No. 16/299,962, dated Jun. 15, 2021, 17 pages. |
| Office Action for U.S. Appl. No. 14/493,796, dated Jan. 27, 2015, 7 pages. |
| Office Action for U.S. Appl. No. 14/494,208, dated Jan. 27, 2015, 7 pages. |
| Office Action for U.S. Appl. No. 14/662,676, dated Sep. 5, 2018, 25 pages. |
| Office Action for U.S. Appl. No. 14/712,437 dated Oct. 25, 2018, 20 pages. |
| Office Action for U.S. Appl. No. 15/854,273, dated Sep. 7, 2018, 15 pages. |
| Office Action for U.S. Appl. No. 15/854,273, dated Mar. 15, 2019, 19 pages. |
| Office Action for U.S. Appl. No. 15/854,273, dated Jan. 13, 2020, 13 pages. |
| Office Action for U.S. Appl. No. 16/376,745, dated May 14, 2021, 13 pages. |
| Office Action for U.S. Appl. No. 16/255,055, dated Mar. 18, 2019, 16 pages. |
| Office Action for U.S. Appl. No. 13/952,964, dated Mar. 20, 2015, 11 pages. |
| Office Action for U.S. Appl. No. 14/926,784, dated May 25, 2018, 15 pages. |
| Office Action for U.S. Appl. No. 14/926,784, dated Jan. 15, 2019, 15 pages. |
| Office Action for U.S. Appl. No. 14/926,784, dated Jan. 21, 2020, 17 pages. |
| Office Action for U.S. Appl. No. 14/264,481, dated Jul. 1, 2015, 13 pages. |
| Office Action for U.S. Appl. No. 14/264,481, dated Feb. 26, 2016, 10 pages. |
| Office Action for U.S. Appl. No. 14/264,481, dated Jul. 14, 2016, 9 pages. |
| Office Action for U.S. Appl. No. 14/264,481, dated Oct. 21, 2016, 10 pages. |
| Office Action for U.S. Appl. No. 14/264,481, dated Apr. 13, 2017, 14 pages. |
| Office Action for U.S. Appl. No. 14/264,481, dated Sep. 7, 2017, 12 pages. |
| Office Action for U.S. Appl. No. 14/880,397, dated Apr. 17, 2018, 6 pages. |
| Office Action for U.S. Appl. No. 14/880,397, dated Sep. 24, 2018, 5 pages. |
| Office Action for U.S. Appl. No. 16/255,058, dated Mar. 30, 2021, 16 pages. |
| Office Action for U.S. Appl. No. 17/388,971, dated Nov. 23, 2021, 19 pages. |
| Office Action for U.S. Appl. No. 17/388,979, dated Dec. 8, 2021, 21 pages. |
| International Search Report and Written Opinion for International Application No. PCT/US2007/087951, dated May 16, 2008, 8 pages. |
| Examination Report for United Kingdom Application No. GB1805101.1, dated May 25, 2018, 8 pages. |
| International Search Report and Written Opinion for International Application No. PCT/US2013/071491, dated Aug. 5, 2014, 9 pages. |
| Notification of the First Office Action for Chinese Application No. 201380040468.7, dated Jun. 30, 2016, 9 pages. |
| Supplementary European Search Report for EP Application No. 13797732.8, dated Dec. 7, 2015, 5 pages. |
| International Search Report and Written Opinion for International Application No. PCT/US2013/043289, dated Oct. 24, 2013, 15 pages. |
| Notice of Reasons for Rejection for Japanese Application No. 2020-075727, dated Jul. 21, 2021, with English translation, 37 pages. |
| Extended European Search Report for European Application No. 21167069.0, dated Nov. 10, 2021, 9 pages. |
| Extended European Search Report for European Application No. 21167625.9, dated Oct. 8, 2021, 7 pages. |
| International Search Report and Written Opinion for International Application No. PCT/US2013/052493, dated Nov. 27, 2013, 7 pages. |
| Office Action for Canadian Application No. 2,931,983, dated Oct. 16, 2019, 4 pages. |
| Office Action for Canadian Application No. 2,931,983, dated Oct. 1, 2020, 3 pages. |
| Notification of the First Office Action for Chinese Application No. 201380071681.4, dated Aug. 16, 2016, 9 pages. |
| Notification of the Second Office Action for Chinese Application No. 201380071681.4, dated Jun. 28, 2017, 9 pages. |
| Extended European Search Report for EP Application No. 13859067.4, dated Jun. 7, 2016, 4 pages. |
| Extended European Search Report for EP Application No. 13859067.4, dated Jan. 27, 2017, 4 pages. |
| Extended European Search Report for EP Application No. 13859067.4, dated Aug. 16, 2017, 6 pages. |
| Office Action for Israeli Application No. 238991, dated Nov. 12, 2018, 3 pages. |
| Office Action for Israeli Application No. 238991, dated Feb. 13, 2020, 5 pages. |
| Notice of Reasons for Rejection for Japanese Application No. 2015-545494, dated Jun. 19, 2017, 9 pages. |
| Office Action for Chinese Application No. 201811146373.4, dated Nov. 4, 2020, with English language translation, 17 pages. |
| Office Action for Chinese Application No. 201811146373.4, dated Aug. 25, 2021, with English language translation, 10 pages. |
| Office Action for Chinese Application No. 201811146373.4, dated Jan. 29, 2022, with English language translation, 21 pages. |
| Extended European Search Report for EP Application No. 18188136.8, dated May 16, 2019, 9 pages. |
| Notice of Reasons for Rejection for Japanese Application No. 2018-081980, dated Feb. 21, 2019, 9 pages. |
| Decision of Rejection for Japanese Application No. 2018-081980, dated Jan. 30, 2020, 11 pages. |
| Notice of Reasons for Rejection for Japanese Application No. 2020-094488, dated Aug. 2, 2021, 4 pages. |
| International Search Report and Written Opinion for International Application No. PCT/US2013/072563, dated Feb. 7, 2014, 11 pages. |
| Extended European Search Report dated Aug. 30, 2021 for European Application No. 20207898.6, 8 pages. |
| Arkin, C. F. et al., “Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard,” Fifth Edition, Clinical and Laboratory Standards Institute, vol. 23, No. 32 (2003), 52 pages. |
| Barnard, D. R. & Arthur, M. M., “Fibronectin (cold insoluble globulin) in the neonate,” Clinical and Laboratory Observations, 102(3): 453-455 (1983). |
| Baxter, “IV Tubing and Access Devices” authored by and published by Baxter, dated Nov. 6, 2006, 105 pages. |
| BD Saf-T-Intima Closed IV Catheter System, Becton, Dickinson and Company, 2015 Brochure. Retrieved from the Internet (Sep. 11, 2019) <https://www.bd.com/en-us/offerings/capabilities/infusion-therapy/iv-catheters/bd-saf-tintima-closed-iv-catheter-system>, 2 pages. |
| BD Vacutainer Passive Shielding Blood Collection Needle Brochure; Becton Dickinson and Company (2005), 2 pages. |
| Brecher, M. E. et al., “Bacterial Contamination of Blood Components,” Clinical Microbiology Reviews, 18(1):195-204 (2005). |
| Calam, R. R., “Recommended ‘Order of Draw’ for Collecting Blood Specimens into Additive-Containing Tubes,” Letter to the Editor, Clinical Chemistry, 28(6):1399 (1982), 1 page. |
| Cartridge and Test Information, Abbott, Art: 714258-01O Rev. Date: Aug. 15, 2016, 6 pages. |
| Challiner, A. et al., Queen Alexandra Hospital, Portsmouth P06 3LY, “Venous/arterial blood management protection system,” Correspondence, p. 169. |
| De Korte, D. et al., “Diversion of first blood volume results in a reduction of bacterial contamination for whole-blood collections,” Vox Sanguinis, 83:13-16 (2002). |
| De Korte, D. et al., “Effects of skin disinfection method, deviation bag, and bacterial screening on clinical safety of platelet transfusions in the Netherlands,” Transfusion, 46: 476-485 (2006). |
| Edwards Lifesciences, “Conservation. Safety. Simplicity. Edwards VAMP and VAMP Jr. Systems,” 2002 Brochure. Retrieved from the Internet (Sep. 11, 2019) <https://www.medline.com/media/catalog/Docs/MKT/VAMPSYSTEMBROCHURE.PDF>, 4 pages. |
| Ernst, D. J. et al., “NCCLS simplifies the order of draw: a brief history,” MLO, 26-27 (2004). |
| Gottlieb, T., “Hazards of Bacterial Contamination of Blood Products,” Anaesth Intens Care, 21:20-23 (1993). |
| Hall, K. K. et al., “Updated Review of Blood Culture Contamination,” Clinical Microbiology Reviews, 19(4):788-802 (2006). |
| Hillyer, C. D. et al., “Bacterial Contamination of Blood Components Risks, Strategies, and Regulation,” Hematology, 575-589 (2003). |
| Kim, J. Y. et al., “The Sum of the Parts is Greater Than the Whole: Reducing Blood Culture Contamination,” Annals of Internal Medicine, 154:202-203 (2011). |
| Levin, P. D. et al., “Use of the Nonwire Central Line Hub to Reduce Blood Culture Contamination,” Chest, 143(3):640-645 (2013). |
| Pall Corp., “Leukotrap Filtration Systems for Whole Blood Derived Platelets: Leukotrap RC PL and Leukotrap PL Systems,” 2005 Brochure, 2 pages. |
| Li, Y. et al., “Direct labeling and visualization of blood vessels with lipophilic carbocyanine dye Dil,” Nature Protocols, 3(11): 1703-1708 (2008). |
| Liumbruno, G. M. et al., “Reduction of the risk of bacterial contamination of blood components through diversion of the first part of the donation of blood and blood components,” Blood Transfus, 7: 86-93 (2009). |
| Mayer, G. A., “A Method for the Reliable Determination of Clotting Time in Whole Blood,” Can Med Assoc J., 72(12): 927-929 (1955). |
| McDonald, C. P., “Interventions Implemented to Reduce the Risk of Transmission of Bacteria by Transfusion in the English National Blood Service,” Transfus Med Hemother, 38:255-258 (2011). |
| Meissner, G. F. et al., “A Method Based on the Use of Whole Venous Blood in Capillary Tubes,” American Journal of Clinical Pathology, 33(2): 29-31 (1963). |
| Murphy, M., “Better Blood Transfusion,” Journal of the Intensive Core Society, 4(3): 78-80 (2003). |
| Napolitano, M. et al., “Quality control of bacterial contamination of blood components: the feasibility of diversion system testing,” Blood Transfus, 2: 231-232 (2004). |
| Norberg, A. et al., “Contamination Rates of Blood Cultures Obtained by Dedicated Phlebotomy vs Intravenous Catheter,” JAMA, 289(6): 726-729 (2003). |
| Order of Draw for Multiple Tube Collections, LabNotes, a newsletter from BD Diagnostics,—Preanalytical Systems, 17(1):3 (2007). |
| Page, C. et al., “Blood conservation devices in critical care: a narrative review,” Annals of Intensive Care, 3:14 (2013), 6 pages. |
| Palavecino, E. L. et al., “Detecting Bacterial Contamination in Platelet Products,” Clin. Lab., 52:443-456 (2006). |
| Patton, R. G. et al., “Innovation for Reducing Blood Culture Contamination: Initial Specimen Diversion Technique,” Journal of Clinical Microbiology, 48(12):4501-4503 (2010). |
| Perez, P. et al., “Multivariate analysis of determinants of bacterial contamination of whole-blood donations,” Vox Sanguinis, 82:55-60 (2002). |
| Proehl, J. A. et al., “Clinical Practice Guideline: Prevention of Blood Culture Contamination, Full Version,” 2012 ENA Emergency Nurses Resources Development Committee, Emergency Nurses Association (Dec. 2012), 14 pages. |
| Quilici, N. et al., “Differential Quantitative Blood Cultures in the Diagnosis of Catheter-Related Sepsis in Intensive Care Units,” Clinical Infectious Diseases 25:1066-1070 (1997). |
| Schuur, J., “Blood Cultures: When Do they Help and When Do They Harm?” Brigham & Women's Hospital, Department of Emergency Medicine, (Jun. 21-23, 2012), 42 pages. |
| Sheppard, C. A. et al., “Bacterial Contamination of Platelets for Transfusion: Recent Advances and Issues,” LabMedicine, 36(12):767-770 (2005). |
| Shulman, G., “Quality of Processed Blood for Autotransfusion,” The Journal of Extra-Corporeal Technology, 32(1): 11-19 (2000). |
| Sibley, C. D. et al., “Molecular Methods for Pathogen and Microbial Community Detection and Characterization: Current and Potential Application in Diagnostic Microbiology,” Infection, Genetics and Evolution 12:505-521 (2012). |
| Stohl, S. et al., “Blood Cultures at Central Line Insertion in the Intensive Care Unit: Comparison with Peripheral Venipuncture,” Journal of Clinical Microbiology, 49(7):2398-2403 (2011). |
| Tang, M. et al., “Closed Blood Conservation Device for Reducing Catheter-Related Infections in Children After Cardiac Surgery,” Critical Care Nurse, 34(5): 53-61 (2014). |
| Wagner et al., “Diversion of Initial Blood Flow to Prevent Whole-Blood Contamination by Skin Surface Bacteria: an in vitro model,” Transfusion, 40:335-338 (2000). |
| Wang, P. et al., “Strategies on Reducing Blood Culture Contamination,” Reviews in Medical Microbiology, 23:63-66 (2012). |
| Weinbaum, F. I. et al., “Doing It Right the First Time: Quality Improvement and the Contaminant Blood Culture,” Journal of Clinical Microbiology, 35(3): 563-565 (1997). |
| Weinstein, M. P., “Current Blood Culture Methods and Systems: Clinical Concepts, Technology, and Interpretation of Results,” Clinical Infectious Diseases, 23: 40-46 (1996). |
| Weinstein, M. P., “Minireview: Blood Culture Contamination: Persisting Problems and Partial Progress,” Journal of Clinical Microbiology, 41(6): 2275-2278 (2003). |
| Weinstein, M. P. et al., “The Clinical Significance of Positive Blood Cultures in the 1990s: A Prospective Comprehensive Evaluation of the Microbiology, Epidemiology, and Outcome of Bacteremia and Fungemia in Adults,” Clinical Infectious Diseases, 24:584-602 (1997). |
| Ziegler, et al., “Controlled Clinical Laboratory Comparison of Two Supplemented Aerobic and Anaerobic Media Used in Automated Blood Culture Systems to Detect Bloodstream Infections,” J. Clinical Microbiology, 36(3):657-661 (1998). |
| Zimmon, D. S. et al., “Effect of Portal Venous Blood Flow Diversion on Portal Pressure,” J Clin Invest, 65(6):1388-1397 (1980). |
| Zundert, A. V., “New Closed IV Catheter System,” Acta Anaesth. Belg., 56: 283-285 (2005). |
| Exhibit 01—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs Barnard NPL, Aug. 30, 2019, 8 pages. |
| Exhibit 02—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs BD Needle NPL, Aug. 30, 2019, 7 pages. |
| Exhibit 03—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs U.S. Pat. No. 6,626,884, Aug. 30, 2019, 11 pages. |
| Exhibit 04—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs U.S. Pat. Pub. No. 2005/161112, Aug. 30, 2019, 22 pages. |
| Exhibit 05—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs U.S. Pat. No. 4,673,386, Aug. 30, 2019, 21 pages. |
| Exhibit 06—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs U.S. Pat. No. 4,904,240, Aug. 30, 2019, 15 pages. |
| Exhibit 07—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs Leukotrap NPL, Aug. 30, 2019, 38 pages. |
| Exhibit 09—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs U.S. Pat. No. 4,106,497, Aug. 30, 2019, 22 pages. |
| Exhibit 10—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs Stopcock-Syringe NPL, Aug. 30, 2019, 85 pages. |
| Exhibit 11—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 9,855,001 vs Ziegler NPL, Aug. 30, 2019, 8 pages. |
| Exhibit 12—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs Barnard NPL, Aug. 30, 2019, 12 pages. |
| Exhibit 13—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs U.S. Pat. No. 6,626,884, Aug. 30, 2019, 29 pages. |
| Exhibit 14—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs U.S. Pat. Pub. No. 2005/161112, Aug. 30, 2019, 48 pages. |
| Exhibit 15—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs U.S. Pat. No. 4,673,386, Aug. 30, 2019, 44 pages. |
| Exhibit 16—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs U.S. Pat. No. 4,904,240, Aug. 30, 2019, 31 pages. |
| Exhibit 17—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs Leukotrap NPL, Aug. 30, 2019, 113 pages. |
| Exhibit 19—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs U.S. Pat. No. 4,106,497, Aug. 30, 2019, 38 pages. |
| Exhibit 20—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,028,689 vs Stopcock-Syringe NPL, Aug. 30, 2019, 268 pages. |
| Exhibit 21—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. No. 6,626,884, Aug. 30, 2019, 35 pages. |
| Exhibit 22—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. Pub. No. 2005/161112, Aug. 30, 2019, 46 pages. |
| Exhibit 23—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. No. 4,207,870, Aug. 30, 2019, 20 pages. |
| Exhibit 24—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. No. 6,506,182, Aug. 30, 2019, 15 pages. |
| Exhibit 25—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. No. 4,673,386, Aug. 30, 2019, 53 pages. |
| Exhibit 26—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. No. 4,904,240, Aug. 30, 2019, 39 pages. |
| Exhibit 27—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs Leukotrap NPL, Aug. 30, 2019, 115 pages. |
| Exhibit 29—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. No. 4,106,497, Aug. 30, 2019, 45 pages. |
| Exhibit 30—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs Stopcock-Syringe NPL, Aug. 30, 2019, 246 pages. |
| Exhibit 31—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. No. 4,349,035, Aug. 30, 2019, 26 pages. |
| Exhibit 32—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,220,139 vs U.S. Pat. Pub. No. 2008/0145933A1, Aug. 30, 2019, 39 pages. |
| Exhibit 33—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs Barnard NPL, Aug. 30, 2019, 14 pages. |
| Exhibit 34—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs U.S. Pat. No. 6,626,884, Aug. 30, 2019, 22 pages. |
| Exhibit 35—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs U.S. Pat. Pub. No. 2005/161112, Aug. 30, 2019, 45 pages. |
| Exhibit 36—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs U.S. Pat. No. 4,673,386, Aug. 30, 2019, 47 pages. |
| Exhibit 37—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs U.S. Pat. No. 4,904,240, Aug. 30, 2019, 30 pages. |
| Exhibit 38—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs Leukotrap NPL, Aug. 30, 2019, 115 pages. |
| Exhibit 40—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs U.S. Pat. No. 4,106,497, Aug. 30, 2019, 45 pages. |
| Exhibit 41—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs Stopcock-Syringe NPL, Aug. 30, 2019, 214 pages. |
| Exhibit 42—Defendant's Invalidity Contentions, Invalidity Claim Chart—U.S. Pat. No. 10,039,483 vs U.S. Pat. Pub. No. 2008/0145933A1, Aug. 30, 2019, 38 pages. |
| Office Action for U.S. Appl. No. 16/379,128, dated Apr. 26, 2022, 14 pages. |
| Office Action for U.S. Appl. No. 17/684,920, dated Jul. 11, 2022, 12 pages. |
| Office Action for U.S. Appl. No. 17/525,682, dated Feb. 7, 2022, 12 pages. |
| Office Action for U.S. Appl. No. 17/532,382, dated Feb. 7, 2022, 10 pages. |
| Office Action for U.S. Appl. No. 17/710,389, dated Jun. 16, 2022, 25 pages. |
| Office Action for U.S. Appl. No. 17/710,411, dated Jul. 6, 2022, 22 pages. |
| Notice of Reasons for Rejection for Japanese Application No. 2020-094488, dated Mar. 31, 2022, 6 pages, with English translation. |
| Extended European Search Report for EP Application No. 16808502.5, dated Jan. 23, 2019, 5 pages. |
| Extended European Search Report for EP Application No. 20176877.7, dated Dec. 1, 2020, 9 pages. |
| Extended European Search Report for EP Application No. 22158983.1, dated Aug. 1, 2022, 9 pages. |
| International Search Report and Written Opinion for International Application No. PCT/US2016/037160, dated Sep. 30, 2016, 15 pages. |
| Number | Date | Country | |
|---|---|---|---|
| 20220218249 A1 | Jul 2022 | US |
| Number | Date | Country | |
|---|---|---|---|
| 61731620 | Nov 2012 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 17388979 | Jul 2021 | US |
| Child | 17710401 | US | |
| Parent | 16255058 | Jan 2019 | US |
| Child | 17388979 | US | |
| Parent | 14880397 | Oct 2015 | US |
| Child | 16255058 | US | |
| Parent | 14094073 | Dec 2013 | US |
| Child | 14880397 | US |
