Patent Grant
11590057
This disclosure relates generally to medical fluid transfer systems, methods, and components; and specifically to electronically controlled medical fluid transfer systems, methods, and components.
Many types of medical fluids are routinely used to treat patients, including chemotherapy drugs, antibiotics, immunosuppressive drugs, antiviral drugs, hydrating fluids, nourishing fluids, anticoagulants, pain management drugs, contrast fluids for medical imaging, etc. All of these fluids, in turn, come in many different varieties with advantages and disadvantages for various types of diseases, conditions, injuries, or therapies. Moreover, particular patients require optimized dosages, concentrations, and combinations of these drugs or other medical fluids to address their specific medical needs. As a result, medical facilities are required to provide many different types of customized medical fluids on a continual basis to meet individual patient needs.
In some embodiments, an electronic medical fluid transfer device is provided. The electronic medical fluid transfer device may comprise one or more supports configured to receive a fluid transfer module comprising a first inlet fluid connector, a second outlet fluid connector, a multidirectional flow control valve, and an intermediate container or pumping region. The electronic medical fluid transfer device may comprise a sensor configured to detect whether a cavitation is present (e.g., one or more regions of at least one of a vacuum, a partial vacuum, or a gas such as air) in the fluid transfer module. The electronic medical fluid transfer device may comprise a first electromechanical driver configured to interface with and control the multidirectional flow control valve on the fluid transfer module. The electronic medical fluid transfer device may comprise a second electromechanical driver configured to be mechanically linked to and control the intermediate container or pumping region according to an operational parameter. The electronic medical fluid transfer device can include one or more sensors or monitors configured to determine the position of each of the first and/or second electromechanical drivers, and/or an amount of energy, force, or torque required to actuate or move each of the first and/or second electromechanical drivers, and/or any other information relating to the performance of the electronic medical fluid transfer device. In some embodiments, a sensor can be configured to capture and transmit information about one or more physical characteristics of a system or device, including one or more physical characteristics measured or calculated during use; and a monitor can be configured to record and store one or a series of commands, instructions, and/or process steps over time received by or given to any component or subsystem of the electronic medical fluid transfer device and any feedback provided by such component or subsystem. The electronic medical fluid transfer device may comprise one or more computer processors configured to communicate electronically with the one or more sensors or monitors and the first and second electromechanical drivers to determine one or more of the operational parameters of the electronic medical fluid transfer device based on a flow characteristic of medical fluid to be transferred, and to dynamically adjust one or more of the operational parameter based on one or more outputs of the one or more sensors or monitors.
In some embodiments, an electronic medical fluid transfer system is provided. The electronic medical fluid transfer system may comprise one or more supports configured to receive a fluid transfer module comprising a first inlet fluid connector, a second outlet fluid connector, a multidirectional flow control valve, and an intermediate container or pumping region. The electronic medical fluid transfer system may comprise a camera configured to capture an image of the intermediate container or pumping region. The electronic medical fluid transfer system may comprise a first electromechanical driver configured to interface with and control the multidirectional flow control valve on the fluid transfer module. The electronic medical fluid transfer system may comprise a second electromechanical driver configured to be mechanically linked to and control the intermediate container or pumping region according to an operational parameter. The electronic medical fluid transfer system may comprise one or more computer processors configured to communicate electronically with the first and second electromechanical drivers to transfer medical fluid to and from the intermediate container or pumping region. The electronic medical fluid transfer system may comprise a user interface configured to communicate electronically with the camera to determine an augmentation to be applied to the image based at least partly on a volume of medical fluid transferred to the intermediate container or pumping region, and display the image with the augmentation.
Embodiments will now be described with reference to the following drawings, which are provided by way of example, and not limitation. Like reference numerals indicate identical or functionally similar elements.
Various systems, methods, and components can be used in different embodiments of the inventions. Some embodiments are illustrated in the accompanying figures; however, the figures are provided for convenience of illustration only, and should not be interpreted to limit the inventions to the particular combinations of features shown. Rather, any feature, structure, material, step, or component of any embodiment described and/or illustrated in this specification can be used by itself, or with or instead of any other feature, structure, material, step, or component of any other embodiment described and/or illustrated in this specification. Nothing in this specification is essential or indispensable.
The fluid transfer module 31 can comprise a multidirectional flow-control valve 41 and an intermediate container or pumping region 40, as well as any connector(s) and/or conduit(s) that may extend between or among these or any other components of the fluid transfer module 31, and/or any connectors and/or conduits that may extend between or among the fluid transfer module 31 and the source container 39 and/or the destination container 44. For example, the fluid transfer module 31 can comprise an inlet fluid connector 32 and tubing that can be configured to removably attach the multidirectional flow-control valve 41 to the source container 39; and/or the fluid transfer module 31 can comprise an outlet fluid connector 42 and tubing that can be configured to removably attach the multidirectional flow control valve 41 to the destination container 44.
As shown in
The multidirectional flow-control valve 41 can be configured to mechanically attach to or interface with the electromechanical controller 36. For example, in some embodiments, the multidirectional flow-control valve 41 can comprise a driving interface 33 that is configured to attach with and/or interface with a corresponding electromechanical driver (see, e.g.,
In some embodiments, the multidirectional flow-control valve 41 can comprise a stopcock with a plurality of functional positions, such as a first position that enables fluid communication between the outlet fluid connector 42 and the intermediate container or pumping region 40 (but not the inlet fluid connector 32, in some embodiments); a second position that enables fluid communication between the inlet fluid connector 32 and the intermediate container or pumping region 40 (but not the outlet fluid connector 42, in some embodiments); and a third position that enables fluid communication between the outlet fluid connector 42 and the inlet fluid connector 32 (but not the intermediate container or pumping region 40, in some embodiments). For example, in some embodiments, when the stopcock is in the first position, fluid can flow from the intermediate container or pumping region 40 to the destination container 44 or vice versa; when the stopcock is in the second position, fluid can flow from the source container 39 to the intermediate container or pumping region 40 or vice versa; and when the stopcock is in the third position, fluid can flow from the source container 39 to the destination container 44 or vice versa. Further, in some embodiments, when the stopcock is in the first position, the intermediate fluid connector 38, the stopcock, and the outlet fluid connector 42 can comprise at least a portion of a flow path between the intermediate container or pumping region 40 and the destination container 44; when the stopcock is in the second or fourth position, the inlet fluid connector 32, the stopcock, and the intermediate fluid connector 38 can comprise at least a portion of a flow path between the source container 39 and the intermediate container or pumping region 40; and when the stopcock is in the third position, the inlet fluid connector 32, the stopcock, and the outlet fluid connector 42 can comprise at least a portion of a flow path between the source container 39 and the destination container 44. In some embodiments, the stopcock can comprise at least a portion of one or more flow paths between or among two or more containers (e.g., the source container 39, the intermediate container or pumping region 40, and/or the destination container 44) without the use of any connectors (e.g., the inlet fluid connector 32, the intermediate fluid connector 38, and/or the outlet fluid connector 42) when in the first, second, third, and/or fourth position. Other arrangements that can be used are also appreciated and contemplated herein, including, for example, stopcocks configured to have more or less than three positions (e.g., stopcocks configured to have 2, 4, 5, or more positions).
In some embodiments, the fluid transfer module 31 can be a single-use or limited-use, disposable device that is configured to be periodically removed from and replaced within the fluid transfer device 30, such as after a single dosage of medication for a particular patient has been transferred and/or after one particular type of medication has passed through the fluid transfer module 31 (e.g., to avoid mixing of medications when not desired).
The various components of the fluid transfer system 86 can communicate between or among themselves in any suitable manner. For example, as illustrated, the one or more patient and/or drug information storage device(s) or network(s) 70 can electronically communicate with the fluid transfer management system 74, or any components thereof, by way of an electronic communication link 72, formed by any suitable electronic communication device, such as a wired connection, a local area network, a wide area network, the Internet, and/or a wireless connection (including, e.g., Wi-Fi, Bluetooth, Ant+, ZigBee, cellular, etc.), or any other electronic communication device (collectively referred to as “electronic communicators”). As shown in
The user interface 78 can communicate with one or more fluid transfer devices 30 and/or with one or more patient and/or drug information storage device(s) or network(s) 70 by way of any suitable electronic communication device 76, including by way of any wireless device or by way of any other of the electronic communicators. In some embodiments of the fluid transfer management system 74 in which there are multiple fluid transfer devices 30, a single user interface 78 can electronically communicate with a plurality of fluid transfer devices 30 to control and/or monitor multiple fluid transfers operating generally simultaneously or generally in parallel. In some embodiments of the fluid transfer management system 74 in which there are multiple fluid transfer devices 30, one or more user interfaces 78 can electronically communicate with a plurality of fluid transfer devices 30 to control and/or monitor multiple fluid transfers operating generally simultaneously or generally in parallel. The user interface 78, like the fluid transfer device 30, can electronically communicate with or include a memory 84 by way of a wired connector 80 or any other of the electronic communicators. The memory 84 of the user interface 78 can be part of the user interface 78 in that a common housing can be provided for containing or supporting both. Each of the components of the fluid transfer management system 74 as shown in
Turning to
In some embodiments, at least one or more portions of the housing 202, such as the one or more receptacles 218 (e.g., the recess 218 illustrated in
The volume sensor can be used, for example, to control and/or to provide a record of the volume and/or type of fluid transferred to a patient, such as, for example, by sensing and/or recording the volume and/or one or more other characteristics (e.g., color, viscosity, concentration, lot number, expiration date, etc.) of the liquid in a container (e.g., the intermediate container, or pumping region 40, and/or the source container 39 and/or the destination container 44) before, during, and/or after it is transferred to a patient. For example, in some embodiments, a camera can be used to capture an image of the intermediate container or pumping region 40 to confirm or measure the volume therein. A data file can then be created and stored in a memory 84 which has one of more items of information, such as patient identifying information, the date and time the liquid was transferred and/or the volume or other characteristic(s) of the liquid was or were confirmed and recorded, the type (name, brand, and/or concentration, etc.) of medical fluid transferred, the volume of medical fluid transferred, and/or one or more images of the intermediate container or pumping region 40 with liquid inside, etc. The same or a similar data file can be created for any one of the suitable volume sensors described above. In some embodiments, the fluid transfer unit 200, the fluid transfer device 30, and/or the fluid transfer system 86 can include one or more measuring instruments, such as one or more volume sensors. In some embodiments, the one or more measuring instruments or volume sensors can be internal and/or external to the fluid transfer unit 200, or partially external and partially internal, such as when a portion of the instrument or sensor is inside of the housing 202 and a portion of the sensor protrudes from the housing 202.
A multidirectional flow-control valve 41, such as a fluid stopcock 230, can be particularly useful in some embodiments because it can permit variability and control of the direction and/or orientation of the fluid pathway within the fluid transfer module 31. In some embodiments, the flow-control valve 41 can be configured, as illustrated throughout this specification, to selectively enable a plurality of discrete settings, each setting enabling fluid connections within the fluid pathway of the fluid transfer module 31 among two or more different components of the fluid transfer module 31, and closing-off or isolating one or more other fluid connections of one or more other components from the fluid pathway of the fluid transfer module 31. The flow-control valve 41 can be configured to change between the plurality of discrete settings.
In some embodiments, as illustrated, such change or changes of settings or connections within the flow-control valve 41 can be accomplished electronically and independently of changes to fluid pressure within the fluid transfer module 31. For example, in some embodiments, a pressure differential can arise between two or more parts or components of the fluid transfer module 31 without causing any change of connections within the fluid transfer module 31 and/or without enabling fluid communication between different portions of the fluid transfer module 31 that, before such pressure differential, were not previously in fluid communication with each other.
In some embodiments, the multidirectional flow-control valve 41 is not a one-way valve or a series of one-way valves; rather, the multidirectional flow-control valve 41, in each particular electronically selectable setting, can provide a full two-way fluid pathway between two or more components of the fluid transfer module 31. For example, in some embodiments, in one or a plurality of discrete, electronically selectable settings, the flow-control valve 41 can provide a two-way fluid pathway between the inlet fluid connector 226 and the outlet fluid connector 234; and/or a two-way fluid pathway between the inlet fluid connector 226 and the intermediate container 40 or syringe pump 240; and/or a two-way fluid pathway between the intermediate container 40 or syringe pump 240 and the outlet fluid connector 234. In some embodiments, the multidirectional flow-control valve 41 can enable fluid withdrawn from a source container 39 to be partially or fully returned to a source container 39, in some situations, which can be particularly advantageous, such as, for example, during priming and/or purging of a fluid transfer module 31, although other situations in which this type of fluid flow are also contemplated and can be used.
In some embodiments, either or both of the fluid connectors 226, 234 can be industry standard medical connectors (e.g., luer connectors complaint with ISO 594 or compliant with any other industry standard) that are resealable and fluid-tight, such as the Clave® female medical connector or the Spiros® male medical connector or either of the male or female sides of a Chemolock® medical connector system, all sold by ICU Medical, Inc. Examples of embodiments of these and other devices, among many others, that can be used as fluid connectors 226, 234, or as any portions thereof, are included in U.S. Pat. Nos. 5,873,862; 7,998,134; and 9,933,094, all of which are incorporated by reference in this specification in their entireties. Any feature, structure, material, step, or component described and/or illustrated in any of the foregoing patents or published application can be used with or instead of any feature, structure, material, step, or component described and/or illustrated in any other portion of this specification.
In some embodiments, the fluid stopcock 230 can comprise a device that selectively permits fluid communication between and/or among multiple apertures and/or channels in the stopcock 230. For example, as shown in
Returning to
In some embodiments, as shown, for example, in
As illustrated, in some embodiments, the fluid transfer module 31 (such as the fluid pump assembly 224) can form part of or constitute a closed system, in that: (i) liquid, or fluid, and/or vapors contained or sealed within the fluid transfer module 31 are prevented from exiting or escaping from the fluid transfer module 31, and/or (ii) the exiting or escaping of liquid, or fluid, and/or vapors is resisted in a clinically significant manner to diminish or avoid one or more clinical risks or negative outcomes, when the fluid transfer module 31 is disconnected from other components of the fluid transfer device 30. As shown, in some embodiments, the entire fluid pathway within the fluid transfer device 30 can constitute a closed system or a seal system. As used in this specification, the term “closed system” or “sealed” or any similar terms are used in accordance with their customary meanings in the field of medical infusion, and these terms include the requirement that fluids stay inside of the fluid transfer module 31 or the fluid transfer device 30 (or components thereof) under normal conditions or use such that any small amount of escaping fluid or vapors would not have any significant adverse clinical effects under normal conditions or use. In some embodiments, as shown in
When the fluid transfer module 31 (e.g., the fluid pump assembly 224) is removably attached to the fluid transfer unit 200, a fluid-observation region on the conduit 238 of the fluid transfer device 30 can be positioned adjacent to or within an appropriate sensing distance from the one or more sensors 215. In the illustrated example, the fluid-observation region of the fluid transfer device 30 is at least a portion of the conduit 238 positioned between the multidirectional flow-control valve 41 (e.g., the fluid stopcock 230) and/or the intermediate container or pumping region 40 (e.g., the syringe pump 240). In some embodiments, the fluid-observation region of the fluid transfer device 30 can comprise a portion of the conduit 238 positioned between the multidirectional flow-control valve 41 (e.g., the fluid stopcock 230) and/or the intermediate container or pumping region 40 (e.g., the syringe pump 240). In some embodiments, the fluid-observation region can be positioned in another position on the fluid transfer device 30, or there can be multiple fluid-observation regions 30 located at a plurality of positions on the fluid transfer device 30.
In some embodiments, the one or more sensors 215 can be configured to determine whether there is liquid, gas (e.g., one or more bubbles), and/or a vacuum or partial vacuum, within a particular region or regions of the fluid transfer module 31 (e.g., fluid pump assembly 224). For example, as illustrated in the figures, the one or more sensors 215 can be configured to determine whether there is a medical fluid within at least a portion of the conduit 238 or whether there is a gas (e.g., ambient air or air bubbles) or a vacuum or partial vacuum within the conduit 238. In some embodiments, the one or more sensors 215 can determine whether there is a medical fluid within a portion of the conduit 238 or whether there is a gas (e.g., ambient air) or a vacuum or partial vacuum within a portion of the conduit 238. The one or more sensors 215 can be any suitable type of sensor, including but not limited to one or more acoustic sensors (e.g., ultrasonic sensors), infrared sensors, laser sensors, visual-spectrum optical sensors, motion flow sensors, or any other suitable sensors. One or more indicators 216 (shown in
In some embodiments, the stopcock handle 245 can be removably attached to the stopcock 230. In some embodiments, the handle is configured to be manipulated (e.g., rotated, slid, pushed, and/or pulled) to manually actuate the stopcock into the various positions described above with reference to, for example,
The fluid transfer unit 200 may comprise one or more computer processors 297, 298, which can form part of or be in electronic communication with any or all of the electro-mechanical controller 36 of
In some embodiments, the fluid transfer unit 200 may comprise one or more presence sensors 294a, 294b, 294c. The one or more sensors 294a, 294b, 294c can be positioned within and/or on the housing 202 and can determine the presence or absence of one or more structures. In some embodiments, one or more of the sensors 294a, 294b, 294c can be infrared sensors or any other suitable sensor. One or more of the sensors 294a, 294b can determine whether the fluid source container 39 (such as vial 246), the source adapter 250, and/or the source fluid connector are present and/or connected to the fluid transfer unit 200. In some embodiments, sensor 294a may determine if a source container 246 connector, such as a male or female side of a Chemolock® medical connector system, is properly engaged with a corresponding connector on the fluid transfer unit 200, such as a Chemolock® connector 226a. The sensor 294b may determine if an intermediate container 40, such as fluid pump assembly 224, and/or connector 226a, such as a male or female side of a Chemolock® connector, is present and/or properly engaged with the housing 202 and/or a corresponding connector on a source container 246. The sensor 294c may determine whether the destination container 44, such as IV bag 244, and/or destination fluid connector are present and/or connected to the fluid transfer unit 200. In some embodiments, sensor 294c may determine if a destination container 44 connector, such as a male or female side of a Chemolock® medical connector system, is properly engaged with a corresponding connector on the fluid transfer unit 200, such as a Chemolock® connector 234a. In some embodiments, if any of sensor 294a, 294b, 294c determine that a component of the fluid transfer unit 200 is not present, the sensor 294a, 294b, 294c may send a signal to the controller 36 to prevent initiation of the fluid transfer process and/or terminate an ongoing fluid transfer. The sensor 294a, 294b, 294c may trigger an indicator signaling to a user that not all components are present or properly engaged with the fluid transfer unit 200.
As shown in
In some embodiments, one or more of the sensors 294a, 294b, 294c can be configured to detect the presence or absence of at least a portion of a fluid transfer module attached to the electronic fluid transfer device, such as a connector on the fluid transfer device. In some embodiments, one or more of the sensors (e.g., 294a, 294b) can be configured to additionally or alternatively detect the presence or absence of or connection with at least a portion of a fluid source system, such as a connector or vial adaptor or vial or bag or conduit that forms part of or is connected to a fluid source system. In some embodiments, one or more of the sensors (e.g., 294c) can be configured to additionally or alternatively detect the presence or absence of or connection with at least a portion of a fluid destination system, such as a connector or bag or conduit that forms part of or is connected to a fluid destination system. In some embodiments, the detection of one or more of the fluid transfer module 31, the detection of the connection to the fluid source system, and/or the detection to the connection to the fluid destination system can be a gating step or a required step for the computer processor or other component of the electro-mechanical controller to permit fluid transfer to begin or continue.
The user interface 78 can display or convey various items of information between a user and an electronic storage medium and/or can convey one or more executable instructions to a computer processor in the fluid transfer unit 200, or to electromechanical hardware in the fluid transfer unit 200, to perform one or more actions relating to fluid transfer. For example, the user interface 78 can receive and/or store (e.g., by user input or electronic transmission) the identity of the pharmacist or technician who is performing the fluid transfer, the identity of the patient, the name of the medical fluid, the volume of medical fluid to be transferred, the lot number, the expiration date of the medical fluid, and/or the date and time on which the fluid transfer was performed, etc. Also, as other examples, the user interface 78 can assist in controlling the fluid transfer by receiving and conveying commands from the user via the user interface 78 and/or displaying messages from the fluid transfer unit 200 regarding the progress and/or status of the fluid transfer, such as commands initiating the fluid transfer and/or halting the fluid transfer, and/or one or more messages demonstrating the amount of fluid transferred at any given moment, or the history of fluid transfers for a particular patient or pharmacist over a particular period, or one or more error messages indicating that the fluid transfer was not completed or that the fluid source container 39 is not connected or is empty, or the fluid destination container 44 is not connected or is full, or any other useful message.
The fluid transfer process 400 begins at the start block 402. If a fluid transfer module 31 in the form in this example of a connector assembly (e.g., a multi-stroke pump assembly 224) has not already been attached to a source container 39, then the source container 39 is attached to the connector assembly at block 404. If the connector assembly has already been attached to a source container 39 (or if it will be attached later), then the connector assembly is attached to a fluid transfer management system 74 in the form in this example of an electronic fluid-delivery device, such as the fluid transfer unit 200 or any other type of fluid transfer unit, at block 406.
At decision block 408, it can be determined whether the connector assembly has already been used. In some situations, the connector assembly has previously been in use, such as when only a portion of the fluid in a source container 39 of a first connector assembly has been withdrawn but the connector assembly is temporarily disconnected or removed from the fluid transfer management system 74 to permit a second connector assembly to be attached to a source container 39 with a different type of therapeutic liquid to be coupled with the fluid transfer management system 74 for another type of fluid transfer. After the second connector assembly is used in the fluid transfer management system 74, the first connector assembly can be reattached in its original position in order to withdraw all or a portion of the remaining contents of the source container 39. Thus, in this example, among others, the first connector assembly has previously been in use.
If the connector assembly has not already been used, then in some instances the connector assembly can be “primed” at block 600 by filling the connector assembly with liquid and by removing gas, such as air, from the connector assembly. Priming may comprise filling the interior cavity of connector 234 and/or connecter 226 prior to transferring of fluid to a destination container 44. In some situations, gas needs to be removed from the connector assembly to avoid transferring air into a destination container 44 that will be transferred entirely into a patient's blood vessel. For example, priming may be useful where it is desirable to remove any clinically significant amount of air prior to transferring of fluid to a destination container 44, such as a syringe containing liquid that will be injected directly into a patient or into a patient's fluid line. In some situations, such as when an IV bag 248 is used, the concern of harming the patient 44 is not as severe, since an IV bag 248 is typically gravity-fed and the gas migrates to the top of the bag without entering the patient's blood vessel anyway. In some instances, the main concern is that a transfer of gas from the connector assembly into the destination container 44 might be mistakenly counted as a transfer of therapeutic liquid into the destination container 44, which may result in an undercount of the amount of therapeutic liquid provided to the patient, or it may lower the concentration of therapeutic liquid provided to the patient. In some embodiments, any one and/or all of the concerns may be resolved through various methods described in further detail below. An example of the priming process is illustrated and described more fully in
If the connector assembly has already been used, then the connector assembly does not need to be filled with liquid or primed. However, the connector assembly may have acquired air bubbles inside of it, such as during the disconnection process, or from partial vaporization of the liquid within the connector assembly, or by partial external spillage. The air bubbles can be substantially or entirely removed during a purging step in block 410. After the connector assembly has been purged of gas, it can be attached to the destination container 44 at block 412.
In some embodiments, re-use of a connector assembly or other fluid transfer module 31 may not be permitted in some or all circumstances. A previously-used connector assembly may be identified based on the presence of liquid within the connector assembly. For example, if a sensor 215 detects liquid anywhere in the fluid transfer module 31 (such as in the fluid-observation region of the conduit 238), then the connector assembly has been used previously. A notification may be generated, such as illumination of an indicator light or display of a message on the user interface 74. The process 400 may be stopped until a new connector assembly is attached and verified (e.g. by the absence of liquid). In some embodiments, an override may be permitted to allow for re-use of a connector assembly. For example, if the connector assembly has not been removed between fluid transfer operations and the same fluid is to be transferred (e.g., as verified by user entry, transfer order, photo verification of the source container 39, etc.), then the connector assembly may be re-used. As another example, an operator may manually override the stoppage (e.g., upon manual verification that the same fluid is to be transferred using the connector assembly).
After the source container 39 and the destination container 44 are attached to the fluid transfer module 31 (or connector assembly), the fluid transfer device 30 can proceed to transfer fluid from the source container 39, through the fluid transfer module 31, to the destination container 44 at block 700, which is illustrated and explained more fully in
Each of the steps illustrated and/or described in connection with
As previously discussed, priming sequences such as the one detailed in
In some embodiments, when the fluid-control valve 41 or stopcock 230 is actuated, the fluid transfer management system 74 at block 504 may actively transfer fluid into the intermediate container 40 or syringe pump 240. The computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. In some embodiments, as illustrated in 522, the actuation of the electromechanical driver can downwardly move the movable platform 222 and pull the actuating stem 241 out of the syringe pump 240, thereby increasing the volume and decreasing the pressure within the intermediate container 40 or syringe pump 240 to urge or pull liquid within the source container 39 into the intermediate container 40 or syringe pump 240. In some embodiments, after the migration of fluid from the source container 39 to the flow-control valve 41 and intermediate container 40, a small amount of air bubbles or a small air region may be present in the intermediate container 40. The air region or air bubbles generally migrate upward within the syringe pump 240, since the air is less dense than the fluid transferred from the source container 39, which is typically liquid. Additional air may still be present within the flow control valve 41.
At block 506, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. In some embodiments, as illustrated, the actuation of the electromechanical driver can upwardly move the movable platform 222 and push the actuating stem 241 into the syringe pump 240, thereby decreasing the volume and increasing the pressure within the intermediate container 40 or syringe pump 240 to urge or push liquid and any accompanying air within the intermediate container 40 or syringe pump 240 backward or in reverse from the intermediate container 40 or syringe pump 240 into the flow-control valve 41, and the inlet connector 226. This reverse or backward flow of liquid can “prime” the fluid pathway between the source container 39, the flow control valve 41, and the intermediate container 40, to remove all or a portion of the air within these components and replace it with liquid. The backward flow of liquid may remove any air present in the syringe pump 240, thereby preventing the later transfer of air to the outlet port, outlet conduit 236, and/or outlet container. The movable platform 222 may be positioned to inject sufficient flow of fluid into the source container 39 to prime the fluid pathway between the source container 39, the flow control valve 41, and the inlet connector 226, while maintaining an amount of fluid within the intermediate container 40 sufficient to prime the outlet connector 42. The amount of liquid to prime the outlet connector 42 may include a volume of liquid about at least equal to the volume of the interior cavity of the outlet connector 42. An example routine for priming the fluid pathway between the source container 39, the flow control valve 41, and the intermediate container 40 is shown in
At the beginning of block 508, the multidirectional flow-control valve 41 can be mechanically actuated by the electromechanical controller 36 of the fluid transfer device 30 to close an inlet port on the fluid-control valve 41 and open simultaneously or generally concurrently a fluid pathway between an outlet port on the fluid-control valve 41 and an intermediate outlet port on the fluid-control valve 41. The outlet connector 42, fluid-control valve 41, and intermediate container 40 can then be positioned in fluid communication with each other, while the source container 39 can be isolated or not in fluid communication with these components. An example of this configuration 526 shows an inverted vial 246 attached to a stopcock 230 by way of a male fluid connector 226 that is blocked from fluid communication with the stopcock 230 and other components, while a syringe pump 240 attached to the stopcock 230 is in fluid communication through the stopcock 230 with the outlet fluid connector 234.
In block 510, the actuation of the electromechanical driver can upwardly move the movable platform 222 and push the actuating stem 241 into the syringe pump 240, thereby decreasing the volume and increasing the pressure within the intermediate container 40 or syringe pump 240 to urge or push liquid within the intermediate container 40 or syringe pump 240 into the outlet port and outlet fluid connector 42. This flow of liquid can prime the fluid pathway between the destination container, the outlet port, and the outlet fluid connector 42, to remove all or a portion of the air within these components and replace it with liquid. In some embodiments, block 508 and 510 may evacuate any air within the outlet port and outlet fluid connector 42 or diminish the pressure within these components. The computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. In some embodiments, the actuation of the electromechanical driver can downwardly move the movable platform 222 and pull the actuating stem 241 out of the syringe pump 240, thereby increasing the volume and decreasing the pressure within the intermediate container 40 or syringe pump 240 to urge or pull liquid and any accompanying air within the outlet port and outlet fluid connector 42 into the intermediate container 40 or syringe pump 240. This reverse or backward flow of liquid can prime the fluid pathway between the destination container, the outlet port, and the outlet fluid connector 42, to remove all or a portion of the air within these components and replace it with liquid.
At block 512, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the multidirectional flow-control valve 41 to close the outlet port on the fluid-control valve 41 that is in fluid communication with the outlet connector 234, and to open simultaneously or generally concurrently a fluid pathway between the inlet port on the fluid-control valve 41 that is in fluid communication with the source container 39 and the outlet port on the fluid-control valve 41 that is in fluid communication with the intermediate container 40. An example of this configuration 512 shows the inverted vial 246 in fluid communication with the stopcock and the syringe pump 240 but not the outlet fluid connector 42. At this point, the computer processor can send a signal or series of signals to the electromechanical movable platform 222 to actuate the syringe pump 240 to draw in the proper amount of therapeutic fluid to be transferred to the destination container 44. An example routine for transferring therapeutic fluid to the destination container 44 is shown in
If, at any other stage of
This back-and-forth or drawing-and-expelling movement of liquid between the source container 39 and the intermediate container 40 can help to purge air from the fluid transfer module 31 because any air present will normally rise to the top of the central chamber of the intermediate container 40, or the top of the conduit 238, or the top of the fluid-control valve 41, and/or the top of the conduit 232 (since the gas or air is less dense than the liquid surrounding it), and then the gas or air can be returned or moved into the source container 39 during the return stroke before the liquid in the central chamber of the intermediate container 40 is returned or moved into the source container 39. If a first iteration of the back-and-forth or drawing-and-expelling movement does not sufficiently purge any significant amount of air from the fluid transfer module 31, then a second iteration or a plurality of additional iterations of the back-and-forth or drawing-and-expelling movement can be performed.
At block 604, the computer processor of the fluid transfer management system 74 can determine a desired volume of liquid to be transferred from the source container for use in the priming procedure. The desired volume of liquid may be a static amount that is used for all priming operations, or a dynamically-determined amount that is associated with the connector assembly being used, the therapeutic fluid to be transferred, or the like. In some embodiments, if the position of the multidirectional flow-control valve 41 is currently set to close a fluid pathway between the source container 39 and the intermediate container 40, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 to mechanically actuate the multidirectional flow-control valve 41 to open the fluid pathway between the source container 39 and the intermediate container 40.
At block 606, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. The electronic signal sent to the electromechanical controller 36 may indicate a single unit of the desired volume of medical fluid (e.g., liquid in the source container 39) to be transferred for the current priming operation, the total desired volume of medical fluid to be transferred, the displacement of the electromechanical driver that corresponds to transfer of the current unit or total desired volume for the current priming operation, or other data used to effectuate the transfer. In some embodiments, actuation of the electromechanical driver can move the moveable platform 222 down, which can pull on the actuating stem 241 to increase the volume inside of the internal fluid chamber of the syringe pump 240, which lowers the pressure inside of the syringe pump 240 and urges liquid from the source container to flow through the stopcock 230 and into the syringe pump 240.
In some embodiments, the electromechanical driver may include, be coupled to, or otherwise be associated with a driver movement assessor that monitors driver movement and generates feedback, such as driver movement data representing movement of the driver. For example, the driver movement assessor may be or include an optical encoder that converts angular displacement of a shaft of the electromechanical driver into digital data. The shaft of the driver may be coupled to a reference component, such as disk that rotates as the driver rotates the shaft. The surface of the reference component may include a series of segments, such as a series of alternating opaque and transparent segments. Light (e.g., infrared light) from one or more diodes may reach one or more receivers (e.g., infrared receivers) of the optical encoder through the transparent segments of the rotating disc. The optical encoder may then generate driver movement data representing the movement of the driver based on the detected light. The driver movement data may represent the number of segments that have been detected by the receiver(s) in a period of time, the detection of each individual segment, an angular measurement of the movement of the driver based on the detected segments, other measurements of movement, or some combination thereof. In some embodiments, each segment or quantity of segments may correspond to a volume of fluid transferred (e.g., a predetermined quantity of segments, such as a 1, corresponds to a predetermined volume of fluid, such as 1 microliter). Thus, the electromechanical controller 36 of the fluid transfer device 30 can transfer a desired volume of fluid by actuating the electromechanical driver for a corresponding quantity of segments.
At block 608, the computer processor of the of the fluid transfer management system 74 can determine whether liquid or gas is being (or has been) transferred. The determination may be made based on evaluating output of one or more sensors 215 indicating whether there is a medical fluid within at least a portion of the conduit 238 or whether there is a gas (e.g., ambient air or air bubbles) or a vacuum or partial vacuum within the conduit 238. In some embodiments, the determination may be made on a continuous or periodic basis. For example, as the electromechanical driver moves the moveable platform 222 down, the driver movement assessor may generate driver movement data. Each time a threshold or predetermined quantity of segments (e.g., 1 segment, 10 segments, 100 segments, etc.) is detected by the optical encoder indicating movement of the electromechanical driver's shaft, the optical encoder can notify the computer processor of the fluid transfer management system 74. Each time such a message is received by the computer processor, or the computer processor otherwise determines that a quantity of segments has been detected, the computer processor may determine whether the volume transferred during the electromechanical driver movement represented by the predetermined quantity of segments was medical fluid or gas. For example, the computer processor may evaluate the current state or output of a sensor 215 monitoring one or more regions of the fluid transfer module 31, such as a fluid-observation region on the conduit 238, to determine whether a gas bubble (such as air or a vacuum) is present or has migrated into the fluid transfer module 31. Based on the current state or output of the sensor, the computer processor can determine whether liquid was transferred or whether a gas bubble was transferred. The computer processor may determine a volume of the liquid and/or gas transferred during movement of the electromechanical driver based on a correspondence of a segment or quantity of segments to a volume of fluid. The computer processor may update a measurement in memory 84 regarding the volume of fluid transferred during the process, such as by updating separate values for liquid and gas, respectively.
At decision block 610, the computer processor of the fluid transfer management system 74 can determine whether the total volume of gas transferred during the process 600, or the total quantity of electromechanical driver movement readings associated with gas transferred during the process 600, satisfies a gas limit threshold (e.g., meets or exceeds a threshold). If so, the source container 39 may not have any medical fluid remaining, and may therefore be empty and only comprise gas to be transferred. In response, the process 600 may proceed to block 612 to mitigate the transfer of gas. Otherwise, if the total volume of gas—or quantity of driver movement readings associated with gas—transferred during the process does not satisfy the gas limit threshold (e.g., is less than the threshold), then the process 600 may proceed to block 616.
At block 612, the computer processor of the fluid transfer management system 74 can initiate a procedure to expel gas from the intermediate container 40 or syringe pump. In some embodiments, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. The electromechanical driver may upwardly move the movable platform 222 and the syringe pump 240, thereby decreasing the volume and increasing the pressure within the intermediate container 40 or syringe pump 240 to urge or push liquid and any accompanying air within the intermediate container 40 or syringe pump backward or in reverse from the intermediate container 40 or syringe pump 240 into the flow-control valve 41, and the inlet connector 226. Thus, air in the intermediate container 40 or syringe pump can be purged.
At block 614, the computer processor of the fluid transfer management system 74 can determine whether to set the state of the process 600 to an empty source state. In some embodiments, determination of whether to set the state to an empty source state may be based on the number of times gas has been expelled, the volume of gas detected, the quantity of units of fluid transferred that included gas, another factor, or some combination thereof. For example, if blocks 612 and 614 are reached a threshold number of times during the process 600 (e.g., 2 times, 5 times, etc.), then the source container 39 may be empty. As another example, if the total volume of gas transferred exceeds a second threshold, above the gas limit threshold for expelling the gas and continuing with the transfer, then the source container 39 may be empty.
In some embodiments, setting the state of the process 600 may comprise changing a value of a property or variable, sending a message, another operation, or some combination thereof. For example, the computer processor may transmit, or cause transmission of, an empty source message regarding the empty source container 39 to another component of the fluid transfer management system 74, such as the user interface 78. The message may be displayed or otherwise presented by the user interface 78.
If the state of the process 600 has been set to an empty source state, the computer processor of the fluid transfer management system 74 can wait to receive a command to resume (or start over) the process 600. In some embodiments, the command may come from the user interface 78. For example, an operator or other user may receive, via the user interface 78, an empty source message indicating that the source container 39 is empty. The operator may determine the cause of the problem and perform a remedial action, such as replacing the empty source container 39 with a source container 39 that is not empty, refilling the empty source container 39, reconnecting a source container 39 or another component that has become disconnected, or the like. After addressing the problem that caused the empty source state, the operator may use the user interface 78 to indicate that the source container 39 has been replaced or that the process 600 may otherwise proceed. For example, the operator may activate a button or other touch-based control to resume or restart the process 600. The operation by the operator may cause a command to resume or restart the process the process to be provided to the computer processor. In response, the computer processor may cause the process 600 to return to block 606.
At decision block 616, the computer processor of the fluid transfer management system 74 can determine whether the total volume of liquid transferred during the process 600, or the total quantity of electromechanical driver movement readings associated with liquid transferred during the process 600, has reached the desired volume of liquid to be transferred for the current priming operation. In some embodiments, the computer processor may evaluate a measurement in memory 84 regarding the volume of liquid transferred during the process 600. If the total volume of liquid transferred during the process 600 thus far has reached the desired volume, the process 600 may proceed to block 618 to transfer the priming liquid to desired portions of the fluid transfer device 30. Otherwise, if the total volume of liquid transferred during the process 600 thus far has not reached the desired volume, the process 600 may return to block 608 to continue the transfer of liquid.
At block 618, the computer processor of the fluid transfer management system 74 can proceed with transferring desired volume of priming liquid. For example, the computer processor can proceed with transferring some or all of the priming liquid to the destination container 44, the source container 39, conduit 232, conduit 236, conduit 238, fluid connector 226, fluid connector 234, other vessels, or some combination thereof, as shown and discussed with respect to
At decision block 704, the computer processor of the fluid transfer management system 74 can determine whether the remaining desired volume of liquid to be transferred to the destination container 44 exceeds a maximum available volume of the intermediate container 40. If the remaining desired volume of liquid to be transferred to the destination container 44 is less than or equal to the maximum available volume of the intermediate container 40, the process 700 can proceed to block 706 where the computer processor sets the volume to be transferred to the intermediate container 40 equal to the entire remaining desired volume of liquid to be transferred to the destination container 44. Otherwise, if the remaining desired volume of liquid to be transferred to the destination container 44 exceeds the maximum available volume of the intermediate container 40, the process 700 can proceed to block 708 where the computer processor sets the volume to be transferred to the intermediate container 40 equal to the maximum available volume of the intermediate container 40. In this latter case, portions of the process 700 may be iteratively repeated to ensure that the entire remaining desired volume of liquid is eventually transferred to the destination container 44 in multiple steps. Each iteration of portions of the process 700 may include reducing the remaining desired volume of liquid to be transferred by the volume of liquid transferred during the prior iteration. For example, if the maximum available volume of the intermediate container 40 is 20 ml and the total desired volume of liquid to be transferred to the destination container is 55 ml, then the remaining desired volume of liquid to be transferred may be reduced by 20 ml (to a total of 30 ml) after the first iteration and reduced by 20 ml (to a total of 10 ml) after the second iteration. On the third iteration, the entire remaining desired volume of 10 ml may be transferred.
In some embodiments, the maximum available volume of the intermediate container 40 may be a static value for all instances of the process 700, while the total desired volume of liquid to be transferred to the destination container 44 may be configurable from instance to instance. In some embodiments, the maximum available volume of the intermediate container 40 may also be configurable from instance to instance.
At block 710, if the position of the multidirectional flow-control valve 41 is currently set to close a fluid pathway between the source container 39 and the intermediate container 40, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 to mechanically actuate the multidirectional flow-control valve 41 to open the fluid pathway between the source container 39 and the intermediate container 40.
At block 712, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. In some embodiments, the electronic signal sent to the electromechanical controller 36 may indicate a single unit of the volume of medical fluid to be transferred during the current iteration as determined above in block 706 or 708, the entire volume of medical fluid to be transferred during the current iteration as determined above, or the displacement of the electromechanical driver to effectuate transfer of the unit or total volume for the current iteration. As described in greater detail above, actuation of the electromechanical driver can move the moveable platform 222 down, which can pull on the actuating stem 241 to increase the volume inside of the internal fluid chamber of the syringe pump 240, which lowers the pressure inside of the syringe pump 240 and urges liquid from the source container to flow through the stopcock 230 and into the syringe pump 240. As the electromechanical driver moves the movable platform, an optical encoder or other driver movement assessor may generate driver movement data representing the movement of the driver. The electromechanical controller 36 of the fluid transfer device 30 can transfer a particular volume of fluid by actuating the electromechanical driver for a corresponding quantity of segments detected by the optical encoder.
In some embodiments, the speed at which the electromechanical driver moves the movable platform 222 down and/or the acceleration used to reach that speed may be configurable. For example, some medical fluids have a greater viscosity or are otherwise more likely to cause the occurrence of a vacuum or the formation of gas bubbles when transferred from a source container 39 to an intermediate container 40. The occurrence of a vacuum under such circumstances may be referred to as cavitation. When vacuum or gas bubbles occur, they can affect the accuracy of the fluid transfer and result in purging and re-transfer operations that reduce overall efficiency of the transfer process. To reduce the occurrence of vacuum or gas bubbles when transferring fluids with relatively high viscosity, the speed at which the transfer is performed and/or the acceleration to that speed may be set to a lower level than that used for other medical fluids with relatively low viscosity. To reduce the time to transfer lower viscosity fluids that are less likely to experience the occurrence of vacuum or gas bubbles, the speed at which the transfer is performed and/or the acceleration to that speed may be set to a higher level than that used for medical fluids with high viscosity. Thus, by allowing for configuration of the speed and/or acceleration parameters, the fluid transfer management system 74 can provide efficient transfer processes for medical fluids over a range of viscosities. An example process for using configurable parameters during the transfer of medical fluids is shown in
At block 714, the computer processor of the of the fluid transfer management system 74 can determine whether liquid or gas is being (or has been) transferred. The determination may be made based on evaluating output of one or more sensors 215 indicating whether there is a medical fluid within at least a portion of the conduit 238 or whether there is a gas (e.g., ambient air or air bubbles) or a vacuum or partial vacuum within the conduit 238. In some embodiments, the determination may be made on a continuous or periodic basis. For example, as the electromechanical driver moves the moveable platform 222 down, the driver movement assessor may generate driver movement data. Each time a threshold quantity or predetermined quantity of segments (e.g., 1 segment, 10 segments, 100 segments, etc.) is detected by the optical encoder indicating movement of the electromechanical driver's shaft, the optical encoder can notify the computer processor of the fluid transfer management system 74. Each time the computer processor is so notified or otherwise determines that a quantity of segments has been detected, the computer processor may evaluate sensor data from the one or more sensors 215 to determine whether the volume transferred during the electromechanical driver movement represented by the predetermined quantity of segments was medical fluid or gas. The computer processor may determine a volume of the liquid and/or gas transferred during movement of the electromechanical driver based on a correspondence of a segment or quantity of segments to a volume of fluid. The computer processor may update a measurement in memory 84 regarding the volume of fluid transferred during the process, such as by updating separate values for liquid and gas, respectively.
At decision block 716, the computer processor of the fluid transfer management system 74 can determine whether the total volume of gas, or the total quantity of electromechanical driving movement readings associated with gas, transferred during the process 700 (or the current iteration of this portion of the process 700) satisfies a gas limit threshold (e.g., meets or exceeds a threshold). If so, the source container 39 may not have any medical fluid remaining, and may therefore be empty and only comprise gas to be transferred. In response, the process 700 may proceed to block 718 to mitigate the transfer of gas. Otherwise, if the total volume of gas (or quantity of driver movement readings associated with gas) transferred during the process or current iteration thereof does not satisfy the gas limit threshold (e.g., is less than the threshold), then the process 700 may proceed to decision block 722.
At block 718, the computer processor of the fluid transfer management system 74 can initiate a procedure to expel gas from the intermediate container 40 or syringe pump. In some embodiments, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. The electromechanical driver may upwardly move the movable platform 222 and the syringe pump 240, thereby decreasing the volume and increasing the pressure within the intermediate container 40 or syringe pump 240 to urge or push liquid and any accompanying air within the intermediate container 40 or syringe pump backward or in reverse from the intermediate container 40 or syringe pump 240 into the flow-control valve 41, and the inlet connector 226. Thus, air in the intermediate container 40 or syringe pump can be purged.
At block 720, the computer processor of the fluid transfer management system 74 can determine whether to set the state of the process 700 to an empty source state. In some embodiments, determination of whether to set the state to an empty source state may be based on the number of times gas has been expelled, the volume of gas detected, the quantity of units of fluid transferred that included gas, another factor, or some combination thereof. For example, if blocks 718 and 720 are reached a threshold number of times during the current iteration of the process 700 (e.g., 2 times, 5 times, etc.), then the source container 39 may be empty. As another example, if the total volume of gas transferred exceeds a second threshold, above the gas limit threshold for expelling the gas and continuing with the transfer, then the source container 39 may be empty.
In some embodiments, setting the state of the process 700 may comprise changing a value of a property or variable, sending a message, another operation, or some combination thereof. For example, the computer processor may transmit, or cause transmission of, an empty source message regarding the empty source container 39 to another component of the fluid transfer management system 74, such as the user interface 78. The message may be displayed or otherwise presented by the user interface 78 as described in greater detail above.
If the state of the process 700 has been set to an empty source state, the computer processor of the fluid transfer management system 74 can wait to receive a command to resume (or start over) the process 700. In some embodiments, the command may come from the user interface 78. For example, as described in greater detail above, an operator may receive, via the user interface 78, an empty source message indicating that the source container 39 is empty, and perform a remedial action. After addressing the problem that caused the empty source state, the operator may use the user interface 78 to indicate that the source container 39 has been replaced or that the process 700 may otherwise proceed at block 712.
At decision block 722, the computer processor of the fluid transfer management system 74 can determine whether the total volume of liquid transferred from the source container 39 to the intermediate container 40 has reached the volume determined above at block 706 or 708. In some embodiments, the computer processor may evaluate a measurement in memory 84 regarding the volume of liquid transferred during the current iteration of this portion of the process 700. If the volume of liquid transferred thus far has reached the volume determined in block 706 or 708, the process 700 may proceed to block 724 to record the transfer. Otherwise, if the volume of liquid transferred during the current iteration of the process 700 has not yet reached the volume determined in block 706 or 708, fluid may continue to be transferred from the source container 39 to the intermediate container 40 and the process 700 may return to block 714 to continue to monitor the transfer.
At block 724, the computer processor of the fluid transfer management system 74 can initiate an operation to create a record of the fluid transferred to the intermediate container 40. In some embodiments, the computer processor may send an electronic signal to a measuring instrument such as a sensor 225. For example, the sensor 225 may be a camera, and the electronic signal may cause the camera to capture an image of the intermediate container 40. The image may be captured to create a visual record of the volume of fluid that has been transferred to the intermediate container 40 during the current iteration of the process 700. The image may be stored, such as a file in memory 84. Additional data may be stored with or otherwise associated with the image. For example, data indicating the volume of fluid that has been transferred to the intermediate container 40 shown in the image may be stored and used during subsequent processes as a confirmation of the volume shown in the image.
At block 726, the computer processor of the fluid transfer management system 74 can cause the multidirectional flow-control valve 41 to close the fluid between the source container 39 and the intermediate container 40, and open the fluid pathway between the intermediate container 40 and the destination container 44. For example, the computer processor can send an electronic signal to the to the electromechanical controller 36 to mechanically actuate the multidirectional flow-control valve 41 to close and open the appropriate fluid pathways.
At block 728, the computer processor of the fluid transfer management system 74 can proceed with transferring the fluid from the intermediate container 40 to the destination container 44. In some embodiments, the computer processor of the fluid transfer management system 74 can send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver. The electromechanical driver may upwardly move the movable platform 222 and the syringe pump 240, thereby decreasing the volume and increasing the pressure within the intermediate container 40 or syringe pump 240 to urge or push the fluid from the intermediate container 40 or syringe pump 240 into the destination container 44.
As the electromechanical driver moves the movable platform 222, an optical encoder or other driver movement assessor may generate driver movement data representing the movement of the driver. In some embodiments, the computer processor of the of the fluid transfer management system 74 can evaluate sensor data from one or more sensors 215 to determine whether the volume transferred during the electromechanical driver movement represented by the driver movement data was medical fluid or gas. For each segment or set of segments that are detected by the optical encoder and associated with movement of liquid as detected by the one or more sensors 215, the computer processor may determine the corresponding volume of liquid that has been transferred and update the total transferred volume of liquid that has been transferred to the destination container 44. For example, the computer processor may update a value stored in memory 84. For each segment or set of segments that are detected by the optical encoder and associated with movement of gas as detected by the one or more sensors 215, the computer processor may not add to the total transferred volume of liquid that has been transferred to the destination container 44. When calculated in this manner, the data regarding the total transferred volume can more accurately reflect the actual volume of liquid that has been transferred to the destination container 44, and will exclude the volume of gas (if any) that is transferred to the destination container 44, exclude the volume of liquid (if any) that remains in the intermediate container 40, etc.
At decision block 730, the computer processor of the fluid transfer management system 74 can determine whether the total desired volume of liquid to be transferred to the destination container 44 has been transferred. For example, the computer processor can subtract the total transferred volume from the total desired volume. If the difference is zero, the process 700 may end. Otherwise, if the total desired volume is greater than the total transferred volume, the difference may be used as the remaining desired volume and the process 700 may return to block 704.
In some embodiments, a process similar to the fluid transfer process 700 in reverse may be performed to remove air from a destination container 44. For example, a user may desire to transfer medical fluid to a destination container 44 that was previously used, delivered without being purged, etc. Prior to transferring the medical fluid, the air in the destination container 44 may be removed. To remove the air from the destination container 44, the computer processor of the fluid transfer management system 74 may cause a fluid path to be opened between the destination container 44 and the intermediate container 40. The computer processor may then cause mechanical actuation of the electromechanical driver that in turn causes the moveable platform 222 to move down, pull on the actuating stem 241 to increase the volume inside of the internal fluid chamber of the syringe pump 240, lower the pressure inside of the syringe pump 240, and urge air from the destination container 44 to flow through the stopcock 230 and into the syringe pump 240. Once the desired volume of air has been transferred to the intermediate container 40, the computer processor of the fluid transfer management system 74 may cause a fluid path to be opened between the intermediate container and a source container 39 (or the environment). The computer processor may then cause mechanical actuation of the electromechanical driver that in turn causes the moveable platform 222 to move up, push on the actuating stem 241 to decrease the volume inside of the internal fluid chamber of the syringe pump 240, raise the pressure inside of the syringe pump 240, and urge air from the syringe pump 240 to flow through the stopcock 230 and into the source container 39 (or the environment). This process may be repeated as needed to remove the desired volume of air from the destination container 44. Once the destination container 44 has been sufficiently purged of air, medical fluid may be transferred to the destination container 44 as described herein.
The process 800 beings at block 802. In some embodiments, the process 800 may be initiated during any transfer operation performed by the fluid transfer management system 74, such as during the priming process 600 or transfer process 700 described herein. For example, some portions of the process 800 may be performed prior to block 712 of the transfer process 700, and other portions may be performed during and after blocks 712-722.
At block 804, the computer processor of the fluid transfer management system 74 can determine one or more flow characteristics of the fluid to be transferred from the source container 39 to the intermediate container 40. In some embodiments, flow characteristic data representing a flow characteristic such as the viscosity of the fluid may be provided by a user or from a look-up table or other form of transmitted or stored data when a transfer operation is initiated. For example, an operator may initiate a transfer operation and indicate a measurement of the viscosity (e.g., in centipoise or “cP”) of the fluid to be transferred. In some embodiments, the computer processor can determine the viscosity based on information provided to initiate the transfer operation. For example, an operator may provide an identifier or other indication of the fluid to be transferred, and the computer processor can access a viscosity measurement for the fluid in a cross-reference table or other database. A table may include different records for different fluids or groups of fluids, and each record may include values or ranges of viscosities for the corresponding fluids. In some embodiments, the viscosity of the fluid can be determined using a sensor. In some embodiments, the computer processor may not determine the viscosity prior to determining the operational parameters to be used for the current fluid transfer process, as described below.
At block 806, the computer processor of the fluid transfer management system 74 can determine operational parameters for the transfer process. The operational parameters may include the speed at which the fluid is to be transferred, the acceleration to be used to reach the speed, some other parameter, or some combination thereof. In some embodiments, the computer processor can access one or more operational parameters for the current flow characteristic(s) in a cross-reference table or other database. For example, a table may include different records for different viscosities or ranges of viscosities, and each record may include values of one or more operational parameters such as speed and/or acceleration. In some embodiments, the operational parameters may be provided or otherwise determined without necessarily referencing the flow characteristic(s) of the fluid. For example, an operator may initiate a transfer operation and indicate the operational parameter(s) to be used. As another example, the computer processor may access a cross-reference table or other database that includes records indicating the operational parameter(s) to be used for different fluids that are to be transferred without necessarily referencing the viscosity or other flow characteristics of the fluids.
At block 808, the computer processor may initiate or perform certain portions of a fluid transfer operation using the determined operational parameter(s). As described above, the computer processor may send an electronic signal to the electromechanical controller 36 of the fluid transfer device 30 to mechanically actuate the electromechanical driver, which causes the moveable platform 222 to move down, pull on the actuating stem 241 to increase the volume inside of the internal fluid chamber of the syringe pump 240, lower the pressure inside of the syringe pump 240, and urge liquid from the source container to flow through the stopcock 230 and into the syringe pump 240. In some embodiments, the electronic signal (or another electronic signal) may indicate certain operational parameters to be used to effectuate the transfer of liquid from the source container to the intermediate container. For example, the electronic signal may indicate the speed at which the electromechanical driver is to move the moveable platform 222 down, the acceleration to be used to arrive at the speed, or the like. The electromechanical controller 36 may then manage the electromechanical driver according to the operational parameters.
At decision block 810, the computer processor may determine whether to adjust one or more operational parameters of the fluid transfer operation. In some embodiments, as described in greater detail above, as the electromechanical driver moves the movable platform 222, the computer processor of the of the fluid transfer management system 74 can evaluate sensor data from one or more sensors 215 or obtain monitored data from a memory regarding previous commands and/or responses to previous commands communicated over time between different components or subsystems of the electronic transfer system, such as between an electronic controller and one or more motors. The sensor or monitor data may help determine whether a volume of fluid transferred during the electromechanical driver movement (e.g., during a quantity of segments detected by the driver movement assessor) was medical fluid or bubbles of gas or vacuum. The computer processor can determine whether a volume of bubbles (of gas or vacuum) satisfies a gas limit threshold (e.g., meets or exceeds a threshold). If the volume of bubbles satisfies the threshold, the process 800 may proceed to block 812 to implement a change in one or more operational parameters of the fluid transfer process, such as in the example provided below. Otherwise, if the desired volume of fluid is transferred and the volume of bubbles does not satisfy the gas limit threshold, the process 800 may complete.
At block 812, the computer processor of the fluid transfer management system 74 may initiate or adjust one or more operational parameters of the fluid transfer process. In some embodiments, the computer processor may initiate with a particular speed or acceleration based upon information received or inputted from one or more reference sources (e.g., user input, look-up tables, data from a remote source, etc.) and/or implement a reduction in speed or acceleration in response to detecting gas or vacuum bubbles during the fluid transfer process. For example, the computer processor may reduce the speed by a predetermined or dynamically determined amount or percentage if any gas is detected or if any threshold amount of gas over a particular time is detected. The process 800 may then return to decision block 810 to monitor the fluid transfer operation and determine whether to further adjust one or more operational parameters. In some embodiments, the computer processor may stop the fluid transfer process 800 by sending an electronic signal to the electromechanical controller to mechanically stop the electromechanical driver, which causes the moveable platform 222 to stop moving down and stops the flow of fluid through the stopcock 230 and into the syringe pump 240. The stopping operation may be performed and held on a temporary basis before restarting the fluid transfer process using the same operational parameters, or operational parameters that have been adjusted at block 812.
At block 814, the computer processor of the fluid transfer management system 74 may analyze the feedback data regarding fluid transfer operations and adjustments implemented to one or more operational parameters of the fluid transfer operations. Based on this analysis, the computer processor may modify the operational parameters that may be used for future transfers of the same medical fluid and/or fluids with the same or similar flow characteristics as the fluid transferred during the current operation. In some embodiments, feedback data generated during or after the fluid transfer may represent, among other things: the fluid and/or viscosity of the fluid transferred, the volume of fluid transferred, the operational parameters used during the transfer of a portion of the volume of fluid, detection or non-detection of gas bubbles (air or vacuum) during transfer of the portion of the volume of fluid, changes implemented to operational parameters based on detection of the gas bubbles, detection or non-detection of gas bubbles (air or vacuum) during transfer of a subsequent portion of the volume of fluid, changes implemented to operational parameters based on detection of the gas bubbles in the subsequent portion of the volume of fluid, and the like. The feedback data may be stored in a database, such as in memory 84 of the fluid transfer management system 74.
The computer processor may access the feedback data at the conclusion of the fluid transfer operation, on a predetermined or dynamically determined schedule, upon initiation by a user, or in response to some other event. The computer processor may determine whether the adjustments to the operational parameters implemented during the fluid transfer operation were effective. For example, the computer processor may determine whether the adjustments resulted in the elimination of substantially all gas bubbles, or resulted in a reduction of the occurrence of gas bubbles that satisfies a criterion such as bringing the volume of gas below a threshold. If the adjustments are determined to be successful, the computer processor may modify the operational parameters used during future transfers of the same medical fluid and/or fluids with the same or similar flow characteristics as the fluid transferred during the current operation. The modification may be to set the operational parameters equal to the adjusted operational parameters that resulted in the desired elimination or reduction in gas bubbles.
In some embodiments, the computer processor may not modify the operational parameters until a threshold number of fluid transfer operations result in dynamic adjustments to operational parameters being implemented. For example, the computer processor may only implement modifications after 2, 5, 10, or more fluid transfer operations for a particular medical fluid (or fluid with a particular flow characteristic) result in the dynamic adjustment of operational parameters. The computer processor may then modify the operational parameters based on an analysis of the set of observed adjustments, such as by calculating the average adjustment, the median adjustment, the minimum adjustment, or the maximum adjustment.
In some embodiments, the feedback data and/or modifications made to operational parameters for future fluid transfer operations may be sent to a centralized system, such as a remote network-accessible server or “cloud” system, that is in communication with multiple fluid transfer management systems 74. The centralized system may aggregate the feedback data and/or modifications made to operational parameters, and determine when modifications to operational parameters are to be distributed to the various fluid transfer management systems 74. The centralized system may not distribute modified operational parameters until a threshold number of fluid transfer operations result in dynamic adjustments to operational parameters being implemented. For example, the centralized system may only distribute modifications after 20, 50, 100, or more fluid transfer operations for a particular medical fluid (or fluid with a particular flow characteristic) result in the dynamic adjustment of operational parameters. The centralized system may then modify the operational parameters based on an analysis of the set of observed adjustments, such as by calculating the average adjustment, the median adjustment, the minimum adjustment, or the maximum adjustment. The modified operational parameters may be distributed to, and implemented by, one or more of the fluid transfer management systems 74.
The process 900 beings at block 902. In some embodiments, the process 900 may be initiated when the fluid transfer system 74 is powered up or otherwise begins operation, or in response to some other event such as a stall condition of the electromechanical driver.
At block 904, the computer processor of the fluid transfer management system 74 may send an electronic signal to the electromechanical controller 36 to actuate the electromechanical driver for the component to be homed (e.g., the multidirectional flow-control valve 41 or moveable platform 222). The electronic signal may cause the electromechanical driver to move the component in a predetermined direction. For example, the electromechanical driver may be configured to move the component in two directions: a first direction and a second direction. If the component rotates, then the two directions may be determined with respect to direction of rotation around a rotation axis. If the component moves linearly, the two direction may be determined with respect to direction of movement along a linear axis. During the homing operation, the electromechanical driver may always be instructed to first move the component in the first direction and not the second direction. The electromechanical driver may be instructed to move the component in the first direction until reaching the limit of movement in that direction.
At block 906, the electromechanical driver may reach the limit of movement in the first direction for the component being homed. The computer processor may determine that the electromechanical driver has reached the limit based on the driver entering a stall condition. In some embodiments, rather than the electrotechnical driving moving the component in the first direction until a stall condition occurs, there may be a limit sensor that detects when the electromechanical driver has moved the component to the limit in the homing direction. The computer processor may be notified when the limit sensor detects that the electromechanical driver has moved the component to the limit in the first direction.
At block 908, the computer processor of the fluid transfer management system 74 may determine the distance that the component being homed is to be moved in a second direction to reach the home position. In some embodiments, as described above, the driver may include, be coupled to, or otherwise be associated with a driver movement assessor such as an optical encoder or stepper. The computer processor may determine the distance that driver is to move the component to reach the home position in terms of the number of segments that are to be detected by the driver movement assessor. When the component is first moved to the limit in the first direction, and when the home position is a predetermined position between the limits in each direction, there may be a corresponding predetermined quantity of segments to be detected by the driver movement assessor to reach the home position.
At block 910, the computer processor of the fluid transfer management system 74 may send an electronic signal to the electromechanical controller 36 to cause the component being homed to move to the home position. In some embodiments, the electronic signal may be a signal to actuate the electromechanical driver for the component to be homed to move the component for the distance determined above at block 908. The distance may be provided in terms of the quantity of segments to be detected by the driver movement assessor to reach the home position. The electromechanical controller 36 may then cause the component being homed to move the home position by controlling the electromechanical driver to move the component in the second direction until the quantity of segments determined above have been detected.
In some embodiments, the pharmacist interface 1004 may be used from a remote location, such as a different room or building than the operator tablet. In some embodiments, data regarding fluid transfer orders, drug libraries, records of prior fluid transfer operations, and the like may be stored on one or more of the user interfaces 78. For example, the pharmacist interface 1004 may serve as the central data store, and may include one or more databases for storing preparation data, drug library information (e.g., names, identifiers, concentrations, lot numbers, expiration dates, dosage limits, etc.), operational parameters for transferring medical fluids (e.g., speed, acceleration), records of fluid transfer operations (including images, volume data, user logging data, etc.), and the like. The operator interface 1002 may access any needed data via a network connection to the pharmacist interface 1004. In some embodiments, data stored on one user interface, such as the pharmacist interface 1004, may be replicated or synchronized to another user interface, such as the operator interface 1002. In this case, the user interface that does not serve as a central data store may nevertheless have local access to a copy of some or all data stored at the central data store.
Although only one operator interface 1002 and one pharmacist interface 1004 are shown, in some embodiments additional operator interfaces 1002, pharmacist interfaces 1004, and/or other types of interfaces 78 may be used. In addition, although only one type of fluid transfer unit 200 is shown in
In one illustrative, non-limiting embodiment, a fluid transfer operation may be coordinated among the user interfaces and a fluid transfer unit 200 using the following protocol: [1] data regarding the fluid transfer operation (e.g., drug library record(s) for fluids to be transferred, order information, etc.) may be communicated from the pharmacist interface 1004 to the operator interface 1002, either upon request from the operator interface 1002 or as a push delivery from the pharmacist interface 1004; [2] initial operation setup data may be generated and stored by the operator interface 1002, such as images of input containers 39 to be used; [3] operational parameters may be communicated from the operator interface 1002 to the fluid transfer unit 200 upon initiation by a user of the operator interface 1002, such as the volume of fluid to be transferred, and the speed and acceleration with which the fluid is to be transferred; [4] the fluid transfer unit 200 may confirm receipt of the operational parameters, and stand by for a command to begin the transfer; [5] the operator interface 1002 may send a command to the fluid transfer unit 200 to begin the transfer, such as in response to user activation of a user interface control on the operator interface 1002; [6] the fluid transfer unit 200 may perform the fluid transfer operation, and provide status updates to the operator interface 1002 continuously or periodically throughout the operation, such as data about the volume transferred thus far, any priming or purging operations performed, etc.; [7] the operator interface 1002 can update its display to provide status information to the user of the operator interface 1002; [8] if the fluid transfer unit 200 encounters an error, such as an empty source state, the fluid transfer unit 200 may send an error message to the operator interface 1002 and stand by for a command to resume the transfer or perform some other operation; [9] the operator interface 1002 can send a command to resume the transfer, such as after a user has corrected the cause of the error (e.g., attached a new source container 39); [10] the fluid transfer unit 200 can resume the transfer; [11] upon successful completion of the transfer, the fluid transfer unit 200 can provide a notification to the operator interface 1002, and additional data such as images captured during the transfer process; [12] the operator interface 1002 can provide data regarding the transfer process to the pharmacist interface 1004.
The process 1100 beings at block 1102. In some embodiments, the process 1100 may be initiated during user interaction with a user interface 78, such as an operator interface 1002 or pharmacist interface 1004 shown in
At block 1104, the user interface 78 or some other component of the fluid transfer management system 74 can receive a request to view a record regarding a particular medication preparation or other fluid transfer operation. In some embodiments, the request may include an identifier of the operation to which the request applies. For example, a user may select a particular fluid transfer operation from a list of completed and/or in-progress fluid transfer operations. Selection of a particular operation may include activating a link or tapping a button on the user interface 78, which may initiate a request including an identifier of the fluid transfer operation selected by the user.
At block 1106, the user interface 78 can access one or more images created during the transfer operation. In some embodiments, the images may be stored as files in memory 84 or another data store, and associated with an identifier of the fluid transfer operation. For example, names of the image files may be configured using a naming convention that includes the identifier of the fluid transfer operation. As another example, a database record that references the identifier of the fluid transfer operation may identify the file name and/or location of the image files(s) for the fluid transfer operation. The user interface 78 may use this information to load the image files.
At block 1108, the user interface 78 can access volume data indicating the volume of fluid that was transferred to the intermediate container 40 depicted in each image file. In some embodiments, the volume data may be embedded into or stored in connection with each image file. For example, a naming convention of an image file or metadata stored with the file may include the volume represented by the image. In some embodiments, the volume data may be stored separately from the image files, such as in a database that includes data regarding the fluid transfer operation.
At block 1110, the user interface 78 can determine an augmentation to be displayed with the image file. The augmentation may provide a visual indication of the volume of fluid in the intermediate container 40 depicted in the image file. Such an augmentation can be helpful to users in quickly ascertaining the volume of fluid depicted in the image, particularly in cases where the fluid level, syringe plunger, syringe stem, or other aspects of the image are difficult to see or not visible.
In some embodiments, the augmentation may be a graphical indicator, such as a line or arrow, that is superimposed onto the image to help indicate the fluid level of the intermediate container 40. The user interface 78 can determine the location at which to display the augmentation within the image using a function or mapping of fluid volume to image location. For example, each image may be taken using a camera, such as sensor 225, that is positioned at static location. The camera may produce images that are each of the same resolution, level of zoom, angle of perspective, etc., regardless of the operational parameters used to transfer the fluid and regardless of the fluid that is transferred. In addition, the intermediate container 40 in each image may have the same shape and dimensions. Therefore, due to the static nature of the camera location, image parameters, and intermediate container 40 characteristics, a particular volume of fluid may have a fluid level depicted at the same location of an image each time the particular volume of fluid is imaged (e.g., a volume of x1 milliliters will always or substantially always result in a fluid level that is y1 pixels from a reference location such as the top or bottom of the image, a volume of x2 milliliters will always or substantially always result in a fluid level that is y2 pixels from the reference location, etc.). The correspondence of fluid level image locations to fluid volumes may be stored in a cross-reference table or other database, or it may be modeled by a function that is evaluated using the fluid volume as input. To determine the fluid level image location at which the augmentation is to be displayed, the user interface 78 may query the database for the fluid level image location (e.g., pixel offset or coordinates) that corresponds to the fluid volume depicted in the image, or evaluate a function to obtain the fluid level image location that corresponds to the fluid volume.
The relationship between fluid volume and fluid level image locations may in some embodiments be linear, such that a volume of x milliliters will always or substantially always result in a fluid level that is y pixels from the top or bottom of the image, a volume of 2x milliliters will always or substantially always result in a fluid level that is 2y pixels from the top or bottom of the image, etc. For example, the camera may be positioned such that its optical axis is orthogonal (or substantially orthogonal) to an axis of movement of the syringe plunger or syringe stem of the intermediate container 40, and the fluid level is typically in or near the center of the camera's field of view. In some embodiments, the relationship between fluid volume and fluid level may not be linear. For example, if the camera is positioned such that its optical axis forms a non-orthogonal angle with an axis of movement of the syringe plunger or syringe stem of the intermediate container 40 and/or the fluid level is not typically near the center of the camera's field of view, then the relationship between fluid volume and fluid level image location may not be linear over the range of volumes to be imaged (e.g., the relationship may be modeled by a polynomial instead of a linear function).
In some embodiments, the augmentation may be an alphanumeric indicator of fluid volume that is to be superimposed onto the image, displayed adjacent to the image, or otherwise displayed in connection with the image. For example, instead of or in addition to determining a display location of a graphical indicator of the fluid level, the user interface 78 may generate a label to present the fluid volume measurement.
At block 1112, the user interface 78 may display the requested fluid transfer record and augmented fluid transfer image(s). Examples of augmented fluid transfer images are shown in
As shown in
A fluid transfer image 1206 may depict an intermediate container 40 used during the fluid transfer operation. The depicted intermediate container 40 may have medical fluid 1208 that has been transferred from the source container 39. The intermediate container 40 may also have a stem, such as a plunger 1210 if the intermediate container 40 is a syringe, that was moved to urge the medical fluid 1208 into the intermediate container 40 during the fluid transfer operation. The augmentation 1212 may be displayed as superimposed over the portion of the intermediate container 40 at which the fluid level is expected to be for the volume of fluid transferred into the intermediate container 40. As shown, the augmentation 1212 may be a graphical line that is offset from the top or bottom of the image by a number of pixels, or displayed at image coordinates, determined by the user interface 78 based on the fluid volume that was transferred to the intermediate container 40. In some embodiments, the fluid transfer image 1206 may be zoomed (e.g., using a reverse-pinch gesture, interacting with a graphical interface control, etc.) to aid a user in seeing the fluid level. During such a zoom operation, the location of the augmentation 1212 may be dynamically changed to remain at a location that represents the fluid level within the intermediate container 40.
In some embodiments, as shown in
Depending on the embodiment, certain acts, events, or functions of any of the processes or algorithms described herein can be performed in a different sequence, can be added, merged, or left out altogether (e.g., not all described operations or events are necessary for the practice of the algorithm). Moreover, in certain embodiments, operations or events can be performed concurrently, e.g., through multi-threaded processing, interrupt processing, or multiple processors or processor cores or on other parallel architectures, rather than sequentially.
The various illustrative logical blocks, modules, routines, and algorithm steps described in connection with the embodiments disclosed herein can be implemented as electronic hardware, or combinations of electronic hardware and computer software. To clearly illustrate this interchangeability, various illustrative components, blocks, modules, and steps have been described above generally in terms of their functionality. Whether such functionality is implemented as hardware, or as software that runs on hardware, depends upon the particular application and design constraints imposed on the overall system. The described functionality can be implemented in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the disclosure.
Moreover, the various illustrative logical blocks and modules described in connection with the embodiments disclosed herein can be implemented or performed by a machine, such as programmable computer central processing unit (CPU), a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A processor device can be a microprocessor, but in the alternative, the processor device can be a controller, microcontroller, or state machine, combinations of the same, or the like. A processor device can include electrical circuitry configured to process computer-executable instructions. In another embodiment, a processor device includes an FPGA or other programmable device that performs logic operations without processing computer-executable instructions. A processor device can also be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration. Although described herein primarily with respect to digital technology, a processor device may also include primarily analog components. For example, some or all of the algorithms described herein may be implemented in analog circuitry or mixed analog and digital circuitry. A computing environment can include any type of computer system, including, but not limited to, a computer system based on a microprocessor, a mainframe computer, a digital signal processor, a portable computing device, a device controller, or a computational engine within an appliance, to name a few.
The elements of a method, process, routine, or algorithm described in connection with the embodiments disclosed herein can be embodied directly in hardware, in a software module executed by a processor device, or in a combination of the two. A software module can reside in RAM memory, flash memory, ROM memory, EPROM memory, EEPROM memory, registers, hard disk, a removable disk, a CD-ROM, or any other form of a non-transitory computer-readable storage medium. An exemplary storage medium can be coupled to the processor device such that the processor device can read information from, and write information to, the storage medium. When a method, process, routine, or algorithm is to be executed, executable instructions may be loaded to or accessed at a storage medium and executed by one or more processors. In some embodiments, the storage medium can be integral to the processor device. The processor device and the storage medium can reside in an ASIC. The ASIC can reside in a user terminal.
Conditional language used herein, such as, among others, “can,” “could,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or steps. Thus, such conditional language is not generally intended to imply that features, elements and/or steps are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without other input or prompting, whether these features, elements and/or steps are included or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list.
Disjunctive language such as the phrase “at least one of X, Y, Z,” unless specifically stated otherwise, is otherwise understood with the context as used in general to present that an item, term, etc., may be either X, Y, or Z, or any combination thereof (e.g., X, Y, and/or Z). Thus, such disjunctive language is not generally intended to, and should not, imply that certain embodiments require at least one of X, at least one of Y, or at least one of Z to each be present.
Unless otherwise explicitly stated, articles such as “a” or “an” should generally be interpreted to include one or more described items. Accordingly, phrases such as “a device configured to” are intended to include one or more recited devices. Such one or more recited devices can also be collectively configured to carry out the stated recitations. For example, “a processor configured to carry out recitations A, B and C” can include a first processor configured to carry out recitation A working in conjunction with a second processor configured to carry out recitations B and C.
While the above detailed description has shown, described, and pointed out novel features as applied to various embodiments, it can be understood that various omissions, substitutions, and changes in the form and details of the devices or algorithms illustrated can be made without departing from the spirit of the disclosure. As can be recognized, certain embodiments described herein can be embodied within a form that does not provide all of the features and benefits set forth herein, as some features can be used or practiced separately from others. The scope of certain embodiments disclosed herein is indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.
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| WO 2009130147 | Oct 2009 | WO |
| WO 2009140511 | Nov 2009 | WO |
| WO 2010111546 | Sep 2010 | WO |
| WO 2011002853 | Jan 2011 | WO |
| WO 2011012313 | Feb 2011 | WO |
| WO 2011014525 | Feb 2011 | WO |
| WO 2011058545 | May 2011 | WO |
| WO 2011058548 | May 2011 | WO |
| WO 2011091542 | Aug 2011 | WO |
| WO 2011091543 | Aug 2011 | WO |
| WO 2011104711 | Sep 2011 | WO |
| WO 2011104712 | Sep 2011 | WO |
| WO 2011150037 | Dec 2011 | WO |
| WO 2012119225 | Sep 2012 | WO |
| WO 2013096911 | Jun 2013 | WO |
| WO 2014122643 | Aug 2014 | WO |
| WO 2014126473 | Aug 2014 | WO |
| WO 2014177347 | Nov 2014 | WO |
| WO 2014181320 | Nov 2014 | WO |
| WO 2015029020 | Mar 2015 | WO |
| WO 2015077184 | May 2015 | WO |
| WO 2015077466 | May 2015 | WO |
| WO 2015122921 | Aug 2015 | WO |
| WO 2016010909 | Jan 2016 | WO |
| WO 2017096072 | Jun 2017 | WO |
| WO 2018009996 | Jan 2018 | WO |
| WO 2018022640 | Feb 2018 | WO |
| WO 2019018195 | Jan 2019 | WO |
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| Number | Date | Country | |
|---|---|---|---|
| 20210308012 A1 | Oct 2021 | US |
