FR2532996A1 - PUMP AND PUMP CARTRIDGE AND METHOD OF USE - Google Patents

Abstract

THE INVENTION RELATES TO A PUMP AND A DISPOSABLE CARTRIDGE FOR THE PASSAGE OF MEDICAL SOLUTIONS FROM A SOURCE TO A PATIENT. ACCORDING TO THE INVENTION, THE CARTRIDGE 10 INCLUDES A PUMPING CHAMBER OF THE ELASTIC BELLOWS TYPE 72 AND A VALVE FORMING MEANS 34 TO ENSURE A FLUID FLOW IN ONE WAY THROUGH THE CHAMBER, A STEP MOTOR BEING ASSOCIATED BY CAMS , TO THE CARTRIDGE TO COOPERATIVELY TRAIN THE PUMPING CHAMBER AND THE VALVE FORMING MEANS. THE INVENTION APPLIES IN PARTICULAR TO THE MEDICAL FIELD.

Description

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  The present invention relates to an apparatus for introducing a fluid to a patient either enterally or parenterally More particularly, the invention relates to a pump and a disposable cartridge, the cartridge allowing fluid passage to a patient

  through the cartridge according to the operation of the pump.

  The cartridge is further advantageous in that it forms a seal against the bacteria, even when the pump is operating to draw fluid from the source into the cartridge or to transfer the fluid to the patient.

the cartridge.

  When a patient has had an operation and is recovering, fluids are introduced to the patient to increase the speed of healing. Such fluids can be sources of energy such as forms of sugar to feed him or they can constitute drugs to fight diseases or can constitute water to maintain the balance of the body The fluid can be introduced enterally such as for example by

  stomach or parenterally, as well as intra-

  Venous. Considerable effort has been made in recent years to produce an apparatus for intravenously introducing fluid at a precise rate and volume. For example, the intravenous fluid is introduced on a precise basis and at a controlled volume. using a pump and a cartridge as disclosed and claimed in U.S. Patent No. 03,985,133 issued Oct. 12, 1976 to Jon A. Jenkins, Orris H Flatten and Oscar E. Hyman and assigned to the present Applicant. make

  pass the fluid through the cartridge to the patient.

  The cartridge is disposable, so it is only used during

  a particular period of time like about twenty-

  four hours and only used for one patient.

  The pump and cartridge revealed and claimed in the

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  US Patent No. 3985133 have been so successful that they are now recognized as the industry standard. The invention also relates to a pump and cartridge operable to provide passage of fluid through the cartridge at a precise rate to a controlled volume to a patient. The cartridge is constructed to form a seal against bacteria, even when the fluid is transferred from a source to the cartridge or cartridge to a patient The cartridge can form this seal against bacteria because it has no moving parts and because it has no parts communicating with it the fluid and the atmosphere As the cartridge forms a seal against the bacteria in all circumstances, it can be used for enteral introduction of a fluid to a patient, as well as for the introduction

  parenteral fluid to a patient.

  In one embodiment of the invention, a disposable cartridge is constructed to pass a fluid from a source to a patient. The cartridge comprises a hollow body made of a rigid material and having an inlet and an outlet communicating with the body. hollow A bellows member is actively connected to the body and defines a closure that communicates with the body and reciprocates in one direction to expand and reduce the space in the body and the bellows.

  defines a seal against bacteria, with the body.

  First valve means is actively coupled to the body at the inlet and defines a seal against the bacteria in the body and has first and second active relationships. The first valve means is active in the first relationship to allow a flow of the fluid to flow. through the entrance to the space in the body and the bellows and are active at the second relationship to prevent such flow. Valve second homes are actively connected to the body at the outlet and define

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  a seal against bacteria with the body The second valve means has first and second active relationships and functions in the first relationship to allow fluid flow to the space outlet in the body and the bellows and operate in the second relation to prevent such flow The first and second valve means are constructed to allow operation of one of the valve means at the first relationship and the other means

  forming valve at the second relationship.

  The disposable cartridge is built to be

  driven by a pump The pump includes a step-by-step motor

  step and a housing supporting the stepper motor The control member is made of an elastic material and is provided with two transverse arms arranged in parallel and spaced relationship and one leg extending in one direction. particular and that joins the arms in an intermediate position along their length The arms of the control member are attached to the housing at the corners

legs.

  First cam means are actively connected to the pitch motor to convert the rotational motion of the stepper motor into a linear motion in the particular direction. Means are actively coupled to the first cam means to produce a coupling to the resilient means for expanding and contracting the elastic means in the particular direction Second cam means is actively coupled to the stepping motor to enable

  the operation of the valve means.

  The present invention will be better understood and other purposes, details, features and advantages thereof will become more clearly apparent in the course of

  explanatory description which will follow made reference

  to the accompanying schematic drawings given solely by way of example illustrating several embodiments of the invention, and in which: FIG. 1 is a front elevational view of a pump and a cartridge for introducing a fluid to a patient ; Figure 2 is an exploded and enlarged perspective view of the cartridge shown in Figure 1; Figure 3 is an enlarged sectional elevational view of the pump of Figure 1 and also illustrates the cartridge in relation coupled to the pump; Figure 4 is an enlarged elevational view of certain components incorporated in the pump, the elements being in position to allow a passage of a fluid to a cartridge from a source; Fig. 5 is an enlarged, partially sectional elevational view of the cartridge, the members being in position to allow passage of fluid therethrough, and also illustrates certain elements in the pump for operating associated members in the cartridge. ; Figure 6 is an elevational and enlarged view, similar to that shown in Figure 4, of some components incorporated in the pump, the elements being in position to allow fluid passage of the cartridge to a patient; Fig. 7 is an enlarged elevational view similar to that shown in Fig. 5, the members being in position to allow fluid passage of the cartridge; Fig. 8 is an enlarged elevational view of certain other components of the pump and illustrates such other components in one position; Fig. 9 is an enlarged elevational view of the components shown in Fig. 8 and illustrates these components at another position; Fig. 10 is a fragmentary and enlarged sectional view of a cartridge with certain elements in position to obtain fluid transfer from the cartridge; Fig. 11 is a fragmentary sectional view of certain components in a cartridge according to another embodiment of the invention; Fig. 12 is a fragmentary and enlarged sectional view showing the operation of a valve in the embodiment of Fig. 11; and Fig. 13 is a fragmentary and enlarged sectional view of a cartridge according to a third embodiment of the invention, and particularly illustrates the operation of a valve incorporated in this embodiment. In the embodiment of the invention which is shown in FIGS. 1 to 10, a cartridge generally indicated at 10 is incorporated. The cartridge 10 comprises a body 12 preferably made of a rigid material such as acrylonitrile. 12 comprises an inlet 14 and an outlet 16 The body 12 also comprises a flange 22 facing downwards to define a chamber 23 and further comprises a catch 24 on the outer surface of the flange -The body 12 also comprises a bushing 26 at its upper surface The body 12 is further provided with two recesses 28 each of which defines a seat 30 on its surface

lower -

  Two valve members 34 made of an elastic material such as silicone rubber are integrally bonded and supported by the body. Each valve member 34 has a closure portion 36 which extends into an associated recess 28 and A lip 38 for engaging the valve seat 30 The valve member 34 also has a support portion 40 which is disposed on the body 12 at a position above the F inlet 14 and the outlet 16 A protuberance 42 s' extends from the part of

support 40 in the socket 26.

  A closure member 46 made of a rigid material such as acrylonitrile, is disposed on the body

  12, for example by pressure fitting and it is advantageous to

  attached to the body 12 at its lower surface by

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  For example, by ultrasonic welding As the closure member 46 is pressure-fitted to the body 12 and then sealed to the body, a gasket is formed against the bacteria between the body 12 and the support portion 40 of each valve member 34 Ce. seal against bacteria is facilitated by the arrangement of the protuberance 42 in

the socket 26.

  The closure member 46 is provided with openings

  at positions adjacent to the closure portions 36.

  A cap 52 of an actuating rod 54 is disposed in each of the apertures 50. Each rod is also provided with a ball portion 58 which is received in

  a bushing 60 of the closing part 36.

  A hollow retainer generally indicated at 62 and made of an elastomeric material, such as low density polyethylene, is constructed to be supported by the body 12 Retaining means 62 includes an outer flange 64 having a detent 66 for engagement with the detent 24 to hold the restraining means in fixed relationship with the body The retaining means 62 also includes an inner tongue 68 which is spaced from the flange 64 a distance allowing a press fit relationship Between Lalangue 68 and Flange 22 at Surfaces 70 (FIG. 5) This pressure fit relationship creates a seal against bacteria between body 12 and retainer 62 at a position below the inlet.

14 and exit 16.

  The retaining means 62 comprises a bellows 72 at a position below the tongue 68. The bellows 72 is provided with thickened corrugations to increase the

  linearity between the amount of expansion and contraction

  The retaining means 62 is also provided with a portion 74 configured to be coupled to a drive member (which will subsequently be provided by the bellows and the volume of the fluid flow into or out of the retaining means.

  described) for expanding or contracting the bellows 72.

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  A pump generally indicated at 80 (FIGS. 1 and 3) is adapted to operate in conjunction with the cartridge to obtain a controlled fluid transfer of a fluid.

  Source 82 to a patient 846 The pump 80 comprises a motor.

  step 86 which is supported on a housing 880 The motor 86 has a drive shaft 90 which drives a cam plate 92 The cam plate 92 (Figure 3) includes a path

  cam 94 which controls the movement of a cam follower 96.

  A lever arm 98 is connected to the cam follower 96 to

  a linear motion on an alternative basis.

  A shaft 100 is in turn supported at the upper end of the lever arm 98 for movement therewith. A rocker arm 102 is connected at one end to the shaft 100 and

  at the other end to a rotary shaft 104.

  A drive ring 106 (FIGS. 5 and 7) is

  supported by a spring 104 and has a configuration.

  Rectangular to engage with two cleats or pushers 108 and 110 The cleats 108 and 110 are spring-loaded respectively as at 112 and 114 for the associated cleats to move upward in a direction away from the adjacent engagement rods. 54 The cleats 108 and 110 are respectively

  engaged by the opposite ends of the drive ring

  106 to place one of the catches down against the associated actuating rod and to allow the other catcher to be displaced upward, away from the associated rod

in action.

  The cam plate 92 also includes a cam track 114 (Fig. 3). A cam follower 116 is disposed

  in the cam track 114 for a linear motion in.

  vertical direction according to the rotation of the cam track

  114 The cam follower 116 is connected to a deformation gauge

  118 and a control member 120 for example by a screw 122 The deformation gauge 118 may be made of a suitable material such as an elastic steel The strain gauge 118 is rigidly attached to a branch 124

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  of the control member 120, for example by screws 126.

  The control member 120 (Figures 4 and 6) can be made of an elastic material such as low density polyethylene The control member 120 is provided with two arms 130 which are arranged in parallel and spaced relation The ends of the arms t 30 are attached to a fixed organ

  132, for example by screws 134 at its opposite ends.

  The branch 124 is integral with the arms 130 at intermediate positions on the lengths of the arms. The branch 124 is attached to one end of a coupling member 136 (FIG. 3), the other end of which is coupled to the part

174 at the bottom of the retaining means 62.

  The cam plate 92 is provided with openings

  (Figures 4 and 6) at spaced positions on its

  Annular tower A light source 142 may be disposed on one side of the cam plate 92. A photosensor 144 is disposed on the other side of the cam plate 92 to detect the movement of the openings 140 passing through the light source. The signals produced by the photosensor 144 may be counted by a counter (not shown) for

  indicate the amount of fluid introduced to a patient.

  The stepper motor 86 serves to rotate the cam plate 92 While the cam plate 92 rotates, the cam follower 96 moves the lever arm 98 in one of the two opposite directions respectively indicated on the cam plates 92. Figures 8 and 9 by arrows 148 and 150 in the lever arm The lever arm 98 drives, in turn, the rocker 102 in a reciprocating motion around the shaft

  94 as a pivot point We can see this movement-alternation

  the rocker arm 102 by its relative positions in FIGS. 8 and 9 While the rocker arm 102 has its movement

  alternative, it gives the ring 106, reciprocating.

  This forces the cleat 108 to descend and the cleat 110 to be simultaneously released for upward movement, or the cleat 110 to descend for the other reciprocating movement and the cleat 108 to be simultaneously released for

a movement upwards.

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  When the ring 106 has the position shown in Figure 5, the stopper 108 is placed downwards to

  press the associated actuating rod 54 downward.

  This forces the associated valve member 34 to be expanded and the associated lip 38 to be displaced from the valve seat 30. As a result, the fluid can flow through the inlet 14 into the chamber 23. can flow from the chamber 23 into the outlet 16 because the valve member

associate 34 is not relaxed.

  When the ring 106 is reciprocated to the position shown in FIG. 7 e, the catch 110 is moved downward, thus the associated valve member 34 is relaxed. This allows the fluid to flow from the chamber 23 to the outlet 16 However, the fluid can not flow at this time through the inlet 14 in the chamber 23-because the valve associated with the inlet

is closed.

  As previously described, a seal is formed against the bacteria between the support portion 40 of each valve member 34 and the body 12 The production of this seal against bacteria is facilitated because the support portion 40 is transverse at the closing part 36 The production of the seal against the bacteria is further facilitated by providing the bushing 26 and the arrangement of the protuberance 42 in the bushing. The bushing 26 and the protuberance 42 facilitate the production of the seal against the bacteria, because they increase the path length for fluid leakage and produce

  directional changes of this fluid leak.

  As can be seen from reading the description

  In the foregoing and by the drawings, the actuating rods 54 relax the associated valve members 34 without extending into the chamber 23. The valves are opened and closed by a distension and contraction of the valves.

  valve members 34, which communicate with the chamber 23,

  whatever their position As a result, the valves are

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  open and closed without affecting the seal against

  bacteria that is produced in the room.

  The bellows 72 is expanded and contracted in synchronism with the opening and closing of the valves partially defined by the valve members 34. For example, the bellows 72 is expanded during the time the fluid flows through the inlet 14 into the chamber. the room 23 Of a

  similarly, the bellows 72 is contracted during the -

  time o the fluid flows at the outlet 16 of the chamber 23.

  The shape of the transfer of fluid between the bellows 72 and the inlet 14 or the outlet 16 is linearly related to the pace of the expansion or contraction of the bellows 72. This is facilitated by increasing the thickness of the bellows.

bellows walls 72.

  As will be seen, the bellows 72 is expanded or contracted by driving the coupling member 136 downwardly or upwardly. The expansion or contraction of the bellows 72 is achieved by the movement of the coupling member 136 through As a result, the transfer of fluid into and out of the bellows occurs without any of it being partially in contact with the fluid in the retaining means 62 of the chamber 23 and partially in contact with the atmosphere. forces the gasket against the bacteria to be maintained between the retaining means 62 and the body 12, whatever the dilation

or the contraction of the bellows.

  The cartridge accordingly forms a seal against the bacteria at all times to prevent bacteria from communicating with the atmosphere. This results in part from the bacteria seal that is produced between the body 12 and the valve member 34 at a position at above that of the inlet 14 of the outlet 16 This also partially results from the seal against the bacteria produced between the body 12 and the retaining means 62 at a position in position.

  below entry 14 and exit 16.

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  In order to allow a fluid transfer directly related to the expansion and contraction of the bellows 72, the movement of the bellows must be restricted to the vertical direction. This is accomplished by incorporating the control member 120 due to the provision of the arms 130 in the form of a parallelogram and the elastic properties of the arms, the movement of the

  branch 134 is restricted to a vertical direction.

  As the coupling member 136 is coupled to the branch 134 and the bellows 72 is in turn coupled to the member 136, the bellows 72 may expand or contract.

only in the vertical direction.

  The strain gauge 118 is provided to determine if a constraint is imposed on the bellows

  72 in a direction other than the vertical direction.

  An electrical circuit of a conventional nature may be coupled to the strain gauge 118 to produce an alarm or to interrupt the operation of the pump when the stress on the strain gauge in a direction other than the vertical direction exceeds

a particular threshold.

  The amount of fluid cumulatively transferred to the patient can be determined by counting the number of pulses produced by the sensor 144 while the openings 140 pass in front of it. The rate of transfer of the fluid to the patient can also be determined from 144 An alarm may sound or the operation of the pump may be interrupted when the volume of fluid transferred to the patient has reached a particular limit or if the speed of the transfer of the pump is interrupted. fluid to the patient is not within preselected limits. Figs. 11 and 12 illustrate a modified embodiment of the cartridge shown in the preceding figures and described above. In the embodiment of the invention shown in Figs.

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  11 and 12, a cartridge generally indicated at 200 is provided with two rods 202 and 204 that can swing in the direction of clockwise and in the opposite direction

  between an oblique position and a vertical position.

  Each of the rods is tipped by a rocker arm 208 which corresponds to the rocker arm 102 in the preceding embodiment. The rods 202 and 204 are tilted into the rocker arm.

  clockwise to the vertical position.

  and are tipped in the opposite direction to the position

oblique.

  In the position of the rods 202 and 204 of Figure 11, the rod 202 is oblique and the rod 204 is vertical This forces a valve associated with the rod 202 to be open and a valve associated with the rod 204 to be closed by subsequently, the fluid flows through an inlet 212 into a bellows 214, but the fluid can not

  flow through the valve associated with the rod 204.

  When the rods 202 and 204 are tilted to the position shown in Figure 12, the rod 202 is vertical and the rod 204 is oblique Thus, the fluid can not flow through the valve associated with the rod 202 but the

  fluid can flow through the valve associated with the rod 204.

  As the bellows 214 is contracted at this time, the fluid-

  flows through an outlet 216 of the bellows.

  The operation of the valves may be facilitated by the arrangement of the rod 202 in an elastic liner 218 and the arrangement of the rod 204 in an elastic liner 220. The liner 218 and 220 may be made of a suitable material such as rubber. each rod relative to its associated shirt the rod forms a seal with the shirt When the stem is

  is oblique, it separates from the shirt in posi-

  below the inlet 212 or the adjacent outlet 216, so the fluid can flow between the inlet or

  associated output and bellows 214.

  FIG. 13 illustrates a modification of the valve shown in FIGS. 1 to 10. In the modification of FIG. 13, the valve member 34 is moved from the seat 30 in a manner similar to the embodiment of FIGS. When the valve member is relaxed, however, the valve member 34 is also

  moved at such times, walls defining the recess

  This further facilitates fluid flow through inlet 14 to bellows 72 or bellows 72

to exit 16.

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Claims (41)

  A pump and cartridge assembly for passing a fluid to a patient, characterized in that it comprises: a body (12) defining an inlet (14) and an outlet (16) and a valve seat (30), a valve member (34) which is made of an elastic material having a first portion (36) forced against the seat to define a valve closed with the seat and movable away from the seat to open the valve, the valve member having a second portion (40) disposed in transverse relation to the first portion and disposed on the body to form a support for retaining the first portion against the seat and movement of the first portion away from the seat, and a lid portion (46) on the second portion of the valve member and attached to the body for exerting pressure on the second portion of the valve member to maintain a seal against the bacteria, in the body.   2 assembly according to claim 1, characterized in that: -   the body has a hollow chamber part (23) and defines the valve seat in the chamber part and in that the second part of the valve member and the body hold the seal against the bacteria in the part hollow chamber.   3 An assembly according to claim 1, characterized in that it comprises means cooperating with the body and de-terminating a chamber to allow passage of the fluidedan E the chamber by the entry in the open position of the valve and to prevent a fluid passage between the inlet   and the chamber in the closed position of the valve. 2532996 1   4 assembly according to claim 1, characterized in that it comprises means cooperating with the body and defining a chamber for producing a fluid passage of the chamber through the outlet in the open position of the valve and to prevent a passage of fluid between the   outlet and the chamber in the closed position of the valve.   An assembly according to claim 1, characterized in that the second portion of the valve member is disposed on the body at a position above the inlet and outlet and is pressed by the body portion against the body to define the seal against bacteria in the body.   An assembly according to claim 2, characterized in that the body has a hollow chamber portion and defines the valve seat in the chamber portion and that means are associated with the body at a position below the inlet and the exit to maintain a seal against the bacteria in the body in one position   below the entrance and the exit.   Pump and cartridge assembly for the passage of a fluid towards a patient, characterized in that it comprises a body (12) made of a rigid material and defining an inlet and an outlet and a hollow chamber communicating with the body. entrance and exit; the hollow chamber (23) being defined by an inner wall; the body having an outer wall (22) and having a detent (24) on the outer wall; an elastic member comprising a bellows (72) and a retaining means (62) at the end of the bellows and a stop portion (66) spaced from the retaining portion the retaining portion being disposed in the hollow chamber and being press fit against the inner wall 2532996 1   of the chamber to define a seal in the chamber against the bacteria, the stop portion on the retaining means being retained by the stop portion on the body to hold the retaining portion in sealed relation against the bacteria with the room.   An assembly according to claim 7, characterized in that the retaining portion is disposed below the inlet and the outlet to define the seal against the bacteria at a position below the inlet and from the exit.   9 assembly according to claim 8, characterized in that the elastic member is provided with a coupling portion (136) at a position below the bellows, the coupling portion being configured to be engaged by a drive member to give the bellows an alternative motion to dilate and contract it. Assembly according to claim 9, characterized in that it comprises a means coupled to the body for defining a valve arrangement having first and second active relationships and serving, in the first relationship, to allow a flow of fluid into the chamber through the inlet and to prevent a flow of fluid through the outlet and serving, in the second relationship, to allow fluid flow from the chamber through the outlet and to   prevent a flow of fluid-into the chamber through the inlet.   Assembly according to claim 10, characterized in that the valve arrangement is constructed to define a seal against the bacteria with the body in a position   below the entrance and the exit.   Pump and cartridge assembly for the passage of fluid to a patient, characterized in that it comprises: 2532996 1   a body defining an inlet and an outlet and a hollow chamber communicating with the inlet and outlet, a valve means associated with the body and having first and second relationships and serving, in the first relationship, to permit the imposition of a seal between the inlet and the chamber and to allow communication between the chamber and the outlet and serving the second relationship, to allow -inosition of a seal between the outlet and the-chamber and a communication between the inlet and the chamber, the valve means being constructed to define, with the body, a seal against the bacteria,   a means that can be constrained cooperating with-   body for defining, with the body, an extension of the hollow chamber, said means being constrained according to the operation of the valve means in the first and second relationships to allow transfer of fluid through the chamber inlet to the first relationship active means of the valve means and to allow fluid transfer from the chamber outlet to the second active relationship of the valve means, the constraint means being constructed to   define a seal against bacteria ', with the body.   An assembly according to claim 12, characterized in that: the anti-bacteria between the valve means and the body is below the inlet and the outlet 1 and the seal against the bacteria between the constraint means and the body is below the entrance and from the exit.   Assembly according to claim 13, characterized in that the constraining means comprises a bellows in communication with the chamber and in that the bellows comprises a coupling part constructed to be driven in an alternative direction for 2532996 1   expanding and contracting the bellows in such an alternative drive and in that the inlet communicates through the valve means with the chamber and the bellows to the second active relationship of the valve means and the common output with the chamber and the bellows by the valve means   at the first active relationship of the valve means.   Assembly according to Claim 13, characterized in that: the body O comprises a first stop means and the constraintable means comprises a second stop means cooperating with the first stop means for holding the means that can be constrained on the body and in that the constraining means is pressure fitted in the hollow chamber to define, with the   body, the seal against the bacteria.   Assembly according to claim 15, characterized in that: the valve means comprises an elastic means and the body comprises at least one seat cooperating with the elastic means for defining the open and closed relationships of the valve means and that the means forming a valve comprises a support means integral with the elastic means and disposed on the body in transverse relationship with it to define the joint   against bacteria with said body.   Pump and cartridge assembly for the passage of a fluid towards a patient, characterized in that it comprises: a hollow body made of a rigid material and having an inlet and an outlet communicating with the hollow body, an organ forming a bellows actively coupled to the body and defining a closure communicating with the body and reciprocating in a direction to expand and reduce the space in the body 2532996 1   and the bellows and defining a seal against the bacteria with the body, a first valve means-actively coupled to the body at the entrance and defining a seal against the bacteria with the body and having first and second active relationships and serving, the first relation, to allow a flow of fluid through the inlet to the space in the body and the bellows and serving, in the second relation, to prevent such flow, and a second valve means actively coupled to the body at the exit and defining a seal against the bacteria with the body and having first and second active relations and serving, in the first relationship, to allow a flow of fluid to the outlet, space in the body and the bellows and serving, in the second relationship, to prevent such flow, the first and second valve means being constructed to allow simultaneous operation of the first and second means forming valves to allow operation of one of the valve means at the first relationship and the other means for forming vanna at the second relationship.   Assembly according to claim 17, characterized in that the first and second valve means define the seal against the bacteria with the body at a position above the inlet and the outlet and the bellows member defines a seal against bacteria with the body in a position below the entrance and exit.   An assembly according to claim 18, characterized in that the bellows member is constructed to be expanded in synchronism with the operation of the first valve means at the first relationship and the second valve means at the second relationship and to be contracted. in synchronism with the operation 2532996 '1 of the first valve means to the second relationship and   second valve means to the first relationship.   An assembly according to claim 19, characterized in that the bellows member allows pressure fitting with the hollow interior of the body to define the seal against the bacteria and that the bellows member has a detent and the body has a detent which co-operates with the detent on the bellows member to retain the bellows member in an adjusting relation to pressure with the body.   An assembly according to claim 20, characterized in that the body has first and second seats, and each of the first and second valve means comprises a dilatable member which is disposed against a valve seat associated with the second active relationship and which is moved from the seat associated with the first active relationship. 22 assembly according to claim 21, characterized in that each elastic member comprises a sleeve and first and second rods are provided: each resting in one of the sleeves for moving the organ   associated elastic of the associated seat.   Pump and cartridge assembly for passing a fluid to a patient, characterized in that it comprises: a hollow body defining an inlet in the hollow body and an outlet of the hollow body, a valve means supported on the body and defining a seal against bacteria with the body and having first and second active relationships and serving, in the first relationship, to allow passage of the fluid through the entry into the body and to prevent passage of fluid from the body into the outlet and serving, at 2532996 1   second relation, to allow a passage of fluid from the body to the outlet and to prevent the passage of fluid from the inlet to the body, and a storage medium supported on the body and defining a seal against bacteria with the body and expandable according to the flow of the fluid in the body through the inlet and contractable according to the flow of the fluid of the body by the exit.   Assembly according to Claim 23, characterized   in that the valve means is constructed to be   Mandated to the first and second active relationships of an outer position to the body and the unaffected valve means, the seal against the bacteria between the valve means and the body and in that the storage means is constructed to expand and contract from a position external to the body and the storage means without affecting the seal against   the bacteria between the storage medium and the body.   An assembly according to claim 24, characterized in that the valve means defines the seal against the bacteria with the body at a position above the inlet and the outlet, and the storage means defines the seal against the bacteria with the body at a position below the inlet and outlet 26 Assembly according to claim 24, characterized   in that the body is made of a rigid material and   that the valve means and the storage means are made of elastic materials.   Assembly according to Claim 24, characterized in that stop means are incorporated on the storage means and on the body and cooperate to maintain the storage means in a sealed relation from the point of view bacteria, with the body.   A method of forming a flow of fluid to a patient, characterized in that it comprises the following steps: foamer a chamber constructed to contain a fluid and expandable to receive the fluid for storage and can be contracted for allowing flow of fluid from the chamber without any exposure of the fluid to the atmosphere, forming an arrangement of valves operating in first and second relationships to allow flow of fluid into the chamber at the first relationship without exposure of the fluid to the fluid atmosphere and usable at the second relationship to form a flow of fluid from the chamber without exposing the fluid to the atmosphere, and operate the chamber and the valve arrangement in synchronism to expand the chamber with the valve arrangement at the first relationship and to contract the   room with the arrangement of valves at the second relationship.   The method of claim 28, characterized in that it comprises the steps of: allowing expansion and contraction of the chamber from a position external to the chamber, and allowing the operation of the valve arrangement in the first and second relations from a position outside the valve arrangement and according to   dilatation and contraction of the chamber.   A process according to claim 29, characterized in that: a seal against the bacteria is formed for the arrangement of valves independently of the operation of the valve arrangement in the first and second relationship, and a seal against the bacteria is provided for the chamber regardless of the dilation or contraction of the bedroom. 2 2532996   31 A device for the passage of a fluid towards a patient characterized in that it comprises a hollow body defining an inlet in the hollow body and an outlet of the hollow body, a vapor-forming means supported on the body and defining a seal against the bacteria with the body and having first and second active relationships and allowing, at the first relationship, the passage of the fluid through the entry into the body by preventing the passage of fluid from the body to the outlet and allowing, in the second relationship, the passage of fluid from the body to the outlet by preventing the passage of the entry into the body, a storage medium supported on the body and   defining a seal against bacteria with the body.   and expandable according to the flow of fluid in the body   through the entrance and can contract according to the   the storage medium being made of an elastic material and having a configuration to allow the transfer of the fluid into and out of the storage means directly in relation to the amount of expansion or contraction of the medium. storage in a particular direction, a retaining means actively coupled to the storage means to allow expansion and contraction of the storage means only in the particular direction, and means actively coupled to the valve means to achieve an operation of the means forming a valve at the first relationship during expansion of the storage means and to obtain operation of the valve means at the second relationship during contraction storage means.   Assembly according to claim 31, characterized in that it comprises means associated with the storage means for indicating when said storage means has been forced to expand and contract in the particular direction.   Assembly according to claim 31, characterized in that the hollow body, the storage means and the retaining means are incorporated in a disposable cartridge and in that drive means are incorporated for expanding and contracting the storage means and for operating the valve means between the first and second active relationships, and and that means are provided on the storage means and the coupling means for coupling   removable storage means to the drive means.   34 An assembly according to claim 33, characterized in that the body is provided with the aforesaid valve seat, the valve means comprises a resilient means disposed in cooperative relation with the valve seat and expandable and capable of being contracted relative to the seat of valve for enabling operation of the valve means in the first and second active relationships and in that means are supported by the resilient means in cooperative relation with the elastic means and   the means of training to dilate and contract the- elastic medium.   An assembly according to claim 34, characterized in that the valve means defines the seal against the bacteria with the body at a position above the inlet and the outlet, and the storage means defines the seal against the bacteria with the body at a position below the inlet and the outlet, and the driving means expands and contracts the elastic means without affecting the gasket against the bacteria between the valve means and the body, and the means for drive expands and contracts the storage medium without affecting the seal against   bacteria between the storage medium and the body.   36 A device for passing a fluid towards a patient characterized in that it comprises: a body made of a rigid material and defining   an entrance and an exit and a hollow chamber communicates   as with centered J 2 and the outlet, the hollow chamber being defined by an inner wall, the body having an outer wall and having a detent on the outer wall, an elastic member comprising a bellows and a retaining portion on the outer wall, end of the bellows and a detent spaced apart from the retaining portion, the retaining portion being disposed in the hollow chamber and being press fit against the inner wall of the chamber to define a seal against the bacteria with the chamber, the stopper on the retaining portion being retained by the detent on the body to hold the retaining portion in tight relationship against the bacteria with the chamber, and   2 F = the bellows being expandable and contractable.   in a particular direction and being constructed to allow transfer of fluid into and out of the elastic member at a volume directly related to the magnitude of the expansion and contraction of the   the elastic member in the particular direction.   37. An assembly according to claim 36, characterized in that the retaining member is provided with a coupling part at the end opposite to the detent, the coupling part being constructed to be coupled to a coupling member. training to dilate and   contract the bellows in the particular direction.   38. An assembly according to claim 37, characterized in that it comprises a drive member actively coupled to the coupling portion of the retaining member of the retaining member and movable in the particular direction to expand and contracting the bellows in the particular direction, and means actively coupled to the driving member for driving the drive member in the direction special.   39 assembly according to claim 38, characterized in that it comprises a means actively coupled to the drive member and the retaining member to limit the expansion and contraction of the bellows   only in the particular direction.   Assembly according to claim 39, characterized in that it comprises a means actively coupled to the drive member for producing a signal when the bellows is forced in a direction other than than the particular direction.   A fluid-to-patient assembly, characterized by comprising: a body defining an inlet and an outlet and a valve seat, a valve member made of an elastic material having a first forced portion against the seat to define a valve closed with the seat and movable away from the seat to open the valve, the valve member having a second portion disposed in transverse relation to the first and placed on the body to provide support for the restraint. the first part against the seat and allowing the movement of the first part away from the seat, a lid part disposed on the second part of the valve member and attached to the body to exert pressure on the second part of the seat 2532996 '   valve assembly for maintaining a seal against bacteria in the body, means supported on the valve member from a position external to the valve member and the body for forcing the first portion of the valve member opening the valve, the lid portion being provided with an opening for allowing engagement of the retaining means, and driving means engaging the retaining means for retaining the first portion   of the valve member to open the valve.   42. An assembly according to claim 41, characterized in that it comprises a means actively coupled to the body for storing fluid and made of an elastic and expandable material that can be contracted, the elastic means being expandable to allow an increase in the volume of the body. fluid in the elastic means and can be contracted to allow a decrease in the volume of the fluid in the elastic means, and a means actively: rcouplé the elastic means to obtain a controlled expansion and contraction elastic means.   43. An assembly according to claim 42, characterized in that it comprises a means actively coupled to the elastic means to obtain an expansion and a contraction of the elastic means in a particular direction, the elastic means being constructed to allow a transfer of the fluid in and out of the elastic medium in a volume directly related to the   movement of the elastic means in the particular direction.   An assembly for passing fluid to a patient through a cartridge having a valve means and resilient means for cooperating with the valve means for fluid transfer into and out of the cartridge, characterized in that comprises a stepping motor producing a rotational movement, a first camming means actively coupled to the stepper motor for converting the rotary motion of the stepper motor into a linear motion; a coupling means actively coupled to the first cam means and constructed to be coupled to the resilient means for driving the medium   elastic in linear direction, and -   a second cam means actively coupled to the stepper motor and including a rocker arm for him   reciprocate in order to obtain a function of the valve means.   An assembly according to claim 44, characterized in that it comprises: a stepper motor supporting body, first cam means, coupling means and second cam means, means actively coupled to the body and at first   cam means to ensure that the coupling means   movement only in the linear direction.   46 assembly according to claim 45, characterized in that it comprises   a deformation gauge coupled to the means of coupling   to indicate any change in position -   coupling means with respect to the linear direction. 47. The assembly of claim 45, characterized in that it comprises a means coupled to the stepper motor to give an indication of the number of steps of   step motor operation.   An assembly for fluid passage to a patient through a cartridge having valve means and resilient means for cooperating with the valve means for fluid transfer into and out of the cartridge, characterized in that it comprises a stepping motor producing a rotational movement, and a housing supporting the stepping motor, a control member made of an elastic material and having two transverse arms arranged in parallel and spaced relation and defining in addition a branch extending in a particular direction and joining the arms in an intermediate position along the arms, means attaching the arms of the control member to the housing at the ends of the arms, a first cam means actively coupled to the motor not to not to convert the rotary motion of the stepper motor into a linear motion in the particular direction, a means actively coupled to the first means: e to allow coupling to the elastic means to obtain expansion and contraction of the elastic means in the particular direction, and second cam means actively coupled to the stepper motor to enable operation valve means.   49 The assembly of claim 48, characterized in that it comprises a rotary member with the stepper motor and v built to give indications of the increments of the rotary member.   Assembly according to claim 48, characterized in that it comprises a strain gauge actively coupled to the coupling member to indicate any deviation of the coupling member relative to a   movement in the particular direction.