US20060200088A1 - Positive flow valve - Google Patents
Positive flow valve Download PDFInfo
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- US20060200088A1 US20060200088A1 US11/417,771 US41777106A US2006200088A1 US 20060200088 A1 US20060200088 A1 US 20060200088A1 US 41777106 A US41777106 A US 41777106A US 2006200088 A1 US2006200088 A1 US 2006200088A1
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- Prior art keywords
- seal
- valve
- fluid
- opening
- housing
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/22—Valves or arrangement of valves
- A61M39/26—Valves closing automatically on disconnecting the line and opening on reconnection thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/04—Access sites having pierceable self-sealing members
- A61M39/045—Access sites having pierceable self-sealing members pre-slit to be pierced by blunt instrument
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M2039/0036—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use characterised by a septum having particular features, e.g. having venting channels or being made from antimicrobial or self-lubricating elastomer
- A61M2039/0072—Means for increasing tightness of the septum, e.g. compression rings, special materials, special constructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/22—Valves or arrangement of valves
- A61M39/26—Valves closing automatically on disconnecting the line and opening on reconnection thereof
- A61M2039/263—Valves closing automatically on disconnecting the line and opening on reconnection thereof where the fluid space within the valve is decreasing upon disconnection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/22—Valves or arrangement of valves
- A61M39/26—Valves closing automatically on disconnecting the line and opening on reconnection thereof
- A61M2039/266—Valves closing automatically on disconnecting the line and opening on reconnection thereof where the valve comprises venting channels, e.g. to insure better connection, to help decreasing the fluid space upon disconnection, or to help the fluid space to remain the same during disconnection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/22—Valves or arrangement of valves
- A61M39/26—Valves closing automatically on disconnecting the line and opening on reconnection thereof
- A61M2039/267—Valves closing automatically on disconnecting the line and opening on reconnection thereof having a sealing sleeve around a tubular or solid stem portion of the connector
Definitions
- This invention relates generally to a medical valve, and in particular to a positive flow valve which, when connected between a medical implement and a catheter to facilitate fluid flow therethrough, induces a positive flow of fluid through a tip of the catheter from the valve upon disconnection of the medical implement, thereby eliminating the problem of blood-clogging or clotting in the catheter.
- Fluid connectors and valves typically employ needles or luers to pierce a septum or seal covering sterile tubing or to pierce a septum or seal of a medicament container of fluid. Fluid then passes from the container or fluid-filled tubing into a syringe or second set of tubing. Since the ready passage of fluids through the connectors and valves is often critical to patient survival, it is imperative that the connectors and valves function reliably and repeatedly. Connectors and valves that malfunction during use may be life-threatening.
- a suction force is generated by the withdrawal of the medical implement which draws blood from the patient into the catheter.
- This blood clot and clog the catheter near its tip rendering it inoperable, and may even result in a clot of blood in the patient, which may prove fatal.
- Attempts to avoid backflash by coating the inner surface of the catheter near its tip in order to prevent blood from sticking to the interior surfaces of the catheter and clogging it have not been successful.
- FIG. 1 shows an example of a catheter 50 having a small portion near the tip 52 that is inserted into the patient, and a valve 54 connected between one end of the catheter and a medical implement 56 .
- FIGS. 2 a and 2 b One way to induce a positive flow in the catheter is illustrated in FIGS. 2 a and 2 b .
- the proximal end of a valve 180 is enclosed with a stylet or displacer 182 upon withdrawal of the medical implement (not shown).
- An elongated portion 184 of the stylet 182 takes up at least a portion of the fluid space, thereby reducing the volume of the fluid space, and may eliminate the dead space therein.
- the elongated portion 184 must be sufficiently long to displace more fluid than that volume of fluid which may be drawn from the catheter towards the valve by the withdrawal of the implement, and hence may be difficult to construct for proper performance.
- valve 180 has many significant drawbacks, among them the fact that it does not have a seal with a swabbable surface that can be swabbed after each use for sterility.
- a positive flow valve which is advantageously utilized between a catheter and another medical implement, and with which the flow of a fluid between the implement and catheter (and a patient within which the catheter is employed).
- the valve of this invention has several features, no single one of which is solely responsible for its desirable attributes.
- the positive flow valve of the present invention has the attributes of safety, positive flow for eliminating dead space, reliable and repeatable performance, simplicity of manufacture and use, a seal for use in establishing fluid flow which need not be pierced with a sharp spike or cannula, suitability of high pressure applications, and employment of a valve that is swabbable after use to provide sterility and has a fluid-tight seal at high pressure.
- the present invention is a swabbable, needle-less, positive flow valve that has a fluid space which automatically expands upon insertion of a medical implement and contracts upon withdrawal of the medical implement.
- the valve When the valve is connected to a catheter, it induces a positive flow from the valve to the catheter tip upon disconnection of the medical implement to avoid the potential problems of blood-clogging.
- the valve After use, the valve is swabbed in the conventional manner with a suitable substance to maintain sterility.
- the design of the valve avoids accidental needle or spike sticks.
- the valve is particularly suited for applications with a catheter where it is desirable to avoid backflash, but may be used for other applications as well.
- the valve includes a housing having a first end adapted for receiving one end of medical implement, and having a second end in communication with a catheter.
- the valve includes means for establishing a fluid flow path through the housing and between the medical implement and the catheter, and which is also useful in occluding the flow path through the housing and thereby preventing fluid flow between the medical implement and catheter.
- this means comprises a seal movably positioned within the housing.
- the seal has a passage therethrough which defines, in at least one area, a fluid containment area.
- the seal has a first end adapted for engagement by the medical implement. In a first position, the passage through the seal is closed at its first end, and in a second position, when the medical implement is utilized to press the seal distally within the housing of the valve, the passage through the valve is opened.
- the fluid containment area therein increases in total volume, thereby retaining a fluid volume therein.
- the seal returns to its position wherein the passage is closed at the proximal end thereof, and the volume of the fluid containment area is reduced. This reduction in fluid containment volume results in a volume of fluid being forced towards the catheter (i.e. a positive flow is established).
- FIG. 1 is a schematic cross-sectional view of a valve forming a fluid connection between a syringe and a catheter.
- FIGS. 2 a and 2 b illustrate a prior art valve which includes a stylet having an elongated portion after use to induce a positive flow.
- FIG. 3 is a schematic cross-sectional view of a roller-clamp valve which may be manually activated to induce a positive flow through a catheter tip from the valve.
- FIG. 4 is a longitudinal cross-sectional view of the first embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 5 is a longitudinal cross-sectional view similar to FIG. 4 showing the valve during compression of the seal.
- FIG. 6 is a longitudinal cross-sectional view of the second embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 7 is a longitudinal cross-sectional view similar to FIG. 6 showing the valve during compression of the seal.
- FIG. 8 is a longitudinal cross-sectional view of the third embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 9 is a longitudinal cross-sectional view similar to FIG. 8 showing the valve during compression of the seal.
- FIG. 10 is a longitudinal cross-sectional view of the fourth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 11 is a longitudinal cross-sectional view similar to FIG. 10 showing the valve during compression of the seal.
- FIG. 12 is a longitudinal cross-sectional view of the fifth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 13 is a longitudinal cross-sectional view similar to FIG. 12 showing the valve during compression of the seal.
- FIG. 14 is a longitudinal cross-sectional view of the sixth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 15 is a longitudinal cross-sectional view similar to FIG. 14 showing the valve during compression of the seal.
- FIG. 16 is a longitudinal cross-sectional view of the seventh embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 17 is a longitudinal cross-sectional view similar to FIG. 16 showing the valve during compression of the seal.
- FIG. 18 is a longitudinal cross-sectional view of the eighth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 19 is a longitudinal cross-sectional view similar to FIG. 18 showing the valve during compression of the seal.
- FIG. 20 is a longitudinal cross-sectional view of the ninth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 21 is a longitudinal cross-sectional view similar to FIG. 20 showing the valve during compression of the seal.
- FIG. 22 is a longitudinal cross-sectional view of the tenth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 23 is a longitudinal cross-sectional view similar to FIG. 22 showing the valve during compression of the seal.
- FIG. 24 is a longitudinal cross-sectional view of the eleventh embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 25 is a longitudinal cross-sectional view similar to FIG. 24 showing the valve during compression of the seal.
- FIG. 26 is a longitudinal cross-sectional view of the twelfth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 27 is a longitudinal cross-sectional view similar to FIG. 26 showing the valve during compression of the seal.
- FIG. 28 is a longitudinal cross-sectional view of the thirteenth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 29 is a longitudinal cross-sectional view similar to FIG. 28 showing the valve during compression of the seal.
- FIG. 30 is a longitudinal cross-sectional view of the fourteenth embodiment of the positive-flow valve of this invention before compressing the seal.
- FIG. 31 is a longitudinal cross-sectional view similar to FIG. 30 showing the valve during compression of the seal.
- FIG. 32 is a longitudinal cross-sectional view of an alternative seal with a side wall formed with circular tires.
- a roller clamp may be used to induce a positive flow in a medical valve.
- the use of a roller clamp in a medical valve 190 to create a positive flow upon disconnection of a medical implement (not shown) is illustrated in FIG. 3 .
- the roller-clamp valve 190 is activated manually by sliding an external switch 192 to push a roller 194 against tubing 196 which connects a medical implement 198 and a catheter (not shown) to cause a positive pressure therein, thereby creating a positive flow through the catheter tip (not shown).
- the flow through the tubing 196 can be opened by sliding the switch 192 in the reverse direction.
- This valve 190 has the same disadvantage of requiring an additional step of operation as does the valve with a stylet illustrated in FIGS. 2 a and 2 b , and also does not include a seal having a swabbable surface. Furthermore, the size of the roller 194 must be sufficiently large to induce a displacement of fluid within the tube which is greater than the amount of fluid which may be drawn by the vacuum force (so as to generate a positive flow), which may require a bulky valve that is hard to operate.
- FIGS. 4 and 5 illustrate a first embodiment of a valve 210 in accordance with the present invention.
- this valve 210 includes a valve body or housing 212 , a support member 214 , a seal 216 defining an inner cavity 218 , a pair of clam shells 220 a and 220 b , and a spring 222 . These components are assembled, as depicted in FIG. 4 , without the need for a spike element.
- the inner cavity 218 forms an expandable fluid space inside the valve 210 .
- the clam shells 220 a / 220 b are constructed to cause the volume of the fluid space to expand or increase upon insertion of a medical implement and to contract or decrease upon withdrawal of the medical implement.
- the body or housing 212 has an upper conduit 226 near a proximal end 228 , desirably with a circular opening 230 that is adapted to receive the medical implement.
- a side wall portion 232 is preferably tapered to cooperate with the clam shells 220 a / 220 b .
- the body 212 has an upper ledge 234 formed between the proximal end 228 and the side wall portion 232 .
- proximal is used to denote the end of the valve 210 and other components at or near the body opening 230
- distal is used to denote the opposite end of the valve.
- the upper conduit 226 is adapted to receive the tip or nose 236 of an ANSI standard syringe 238 , as shown in phantom in FIG. 5 . It is, however, contemplated that the outer diameter of the upper conduit 226 can be of any size to accommodate the attachment of other connector devices thereto.
- the proximal end of the upper conduit 226 can be equipped with a locking mechanism to facilitate locking of the valve 210 to a variety of connector devices.
- the threaded portion of the housing 212 are preferably provided such that the housing 212 can be locked into any compatible Luer-Lock device known to those with skill in the art.
- the housing 212 of the first embodiment according to this invention includes conventional Luer-Lock threads 240 on the outer diameter of the upper conduit 226 .
- the support member 214 has at its distal end the inner conduit 242 which may be connected to a terminal end of a catheter (not shown).
- the support member 214 serves as a support and attachment device for the seal 216 by holding the seal 216 in place inside the internal cavity 244 of the housing 212 .
- the inner conduit 242 and inner cavity 218 of the seal 216 present a continuous passageway for fluid during use.
- the seal 216 is prepared from a resilient material that is flexible, inert, and impermeable to fluid, such as silicon.
- the seal 216 has a seal cap 248 with a generally flat top surface 250 , a shoulder 252 , a side wall 254 , and a base 256 .
- the side wall 254 advantageously is comprised of wall portions 258 which deform in an accordion-like fashion and assist in the reformation of the seal 216 to close the housing opening 230 upon withdrawal of the syringe 238 .
- the wall portions 258 expand outwardly in the radial direction.
- the interior of the seal 216 is hollow to provide the inner cavity 218 , as best seen in FIG. 4 .
- the shoulder 252 engages the upper ledge 234 provided in the upper conduit 226 of the housing 212 such that the upper ledge 234 confines the movement of the shoulder 252 toward the opening 230 to prevent the seal 216 from being blown through the opening 230 under high pressure in the inner cavity 218 of the seal 216 .
- the seal cap 248 reseals the valve 210 at the opening 230 , with the top surface 250 of the seal 216 approximately flush with or slightly above or below the opening 230 upon removal of the medical implement 238 .
- the seal cap 248 substantially fills the opening 230 in the top of the upper conduit 226 .
- the top surface 250 of the seal cap 248 is essentially flush with the opening 230 , so that the seal cap 248 can be swabbed with alcohol or other disinfectant without leakage of the disinfectant into the valve 210 . Therefore, it is preferable that the top surface 250 be exposed so that it may be swabbed with a disinfectant.
- the seal cap 248 has a unique shape and includes a precut slit 259 , also having a unique shape.
- the seal cap 248 desirably has an oval or elliptical shape with a major axis having a length larger than the inner diameter of the circular opening 230 such that the oval seal cap 248 substantially fills the opening 230 in the top of the upper conduit 226 in the decompressed state.
- the precut slit 259 in the seal cap 248 is squeezed shut by the circular opening 230 in the decompressed state, as seen in FIG. 4 .
- the precut slit 259 In its resting state, the precut slit 259 is open. During compression of the seal 216 by insertion of a medical implement such as the syringe 238 , as illustrated in FIG. 5 , the precut slit 259 returns to its resting state and opens, as the seal cap 248 is allowed to stretch in the portion of the upper conduit 226 which has a larger inner diameter. Fluid is thus allowed to pass through the slit 259 .
- the terms “compressed state” and “decompressed state” are used conveniently to refer to compression and decompression of the seal 216 by insertion and withdrawal of the medical implement 238 along the longitudinal axis of the seal 216 . The terms do not relate to the radial compression of the seal cap 248 by the opening 230 of the housing 212 .
- the seal 216 of FIG. 4 advantageously includes the enlarged, internal, pressure responsive member 260 which is integral with the seal cap 248 .
- the pressure responsive member 260 enables the valve 210 to maintain a fluid-tight seal even at very high pressures sometimes experienced in medical applications, particularly when the valve 210 is connected to a patient's artery.
- the clam shells 220 a / 220 b are desirably identical pieces disposed opposite one another symmetrically inside the valve body 212 . They are preferably made of a firm material such as a hard plastic.
- the external surface 264 a / 264 b of each clam shell 220 a / 220 b is tapered to cooperate with the tapered side wall portion 232 of the housing 212 , and is configured to slide along the side wall portion 232 during compression and decompression.
- the internal surfaces 266 a / 266 b of the clam shells 220 a / 220 b cooperate with one another to squeeze a portion of the seal side wall 254 , preferably adjacent the shoulder 252 , to form a constricted portion 267 of the seal 216 .
- the proximal ends 268 a / 268 b of the clam shells 220 a / 220 b engage the shoulder 252 of the seal 216 to facilitate movement of the clam shells 220 a / 220 b with the compression of the seal 216 .
- the internal surfaces 266 a / 266 b preferably are shaped to cause the constricted portion 267 to be substantially circular.
- each internal surface 266 a / 266 b has a semi-circular, longitudinal groove that squeezes the seal 216 .
- the spring 222 is disposed between the distal ends of the clam shells 220 a / 220 b and the base 256 of the seal 216 , but desirably a hard retaining disk 270 is provided adjacent the base 256 of the seal 216 to provide better support for the spring 222 and the seal 216 .
- the spring 222 may be relaxed or be in slight compression to exert a force on the seal 216 through the clam shells 220 a / 220 b to keep the seal 216 closed.
- the spring 222 is compressed and stores potential energy from the compression, as illustrated in FIG. 5 .
- the spring 222 Upon withdrawal of the syringe 238 , the spring 222 releases the potential energy and pushes the clam shells 220 a / 220 b proximally to close the seal 216 , as shown in FIG. 4 .
- the spring 222 is preferably not attached or bonded to either the clam shells 220 a / 220 b or the retaining disk 270 for ease of assembly.
- FIGS. 4-5 show a helical spring 222 , any suitable spring known to those of skill in the art may be used.
- the seal 216 is desirably relaxed longitudinally in the decompressed state ( FIG. 4 ), and compressed longitudinally in the compressed state ( FIG. 5 ).
- the seal 216 may be stretched longitudinally in tension by the spring 222 in the decompressed state and be relaxed or slightly compressed longitudinal in the compressed state.
- the base 256 of the seal 216 advantageously fits snugly and securely into a annular groove 274 provided in the retaining disk 270 and an annular groove 276 provided in the support member 214 .
- the annular grooves 274 , 276 form a locking mechanism to support and secure the seal 216 within the cavity 244 of the housing 212 .
- FIG. 5 shows the compressed state of the valve 210 upon insertion of the syringe 238 .
- a medical implement other than a syringe as known to those of skill in the art may be used.
- the nose 236 of the syringe 238 is placed on the seal cap 248 inside the opening 230 of the housing 212 .
- the application of pressure on the syringe 238 creates pressure on the seal cap 248 , and the resulting downward pressure compresses the seal 216 . This pushes the seal cap 248 away from the circular opening 230 and toward the lower portion of the housing cavity 244 which has a larger inner diameter, thereby allowing the precut slit 259 to open.
- FIG. 5 shows the valve 210 opened by insertion of the nose 236 of the syringe 238 into the opening 230 .
- the valve 210 can be oriented in the position diagramed in FIGS. 4 and 5 , or it can be rotated 180′ such that fluid flows in the opposite direction.
- the inner cavity 218 of the seal 216 In the compressed state shown in FIG. 5 , the inner cavity 218 of the seal 216 generally contracts (becomes shorter) as compared to the decompressed state shown in FIG. 4 .
- the constricted portion 267 of the inner cavity 218 defined by the clam shells 220 a / 220 b , however, expands (becomes larger) in volume when the seal 216 is in the compressed state. This results from a movement of the clam shells 220 a / 220 b apart from one another as they slide along the tapered side wall 232 of the housing 212 .
- the amount of general contraction of the seal 216 in relation to the amount of expansion of the constricted portion 267 during compression determine whether the valve 210 generates a positive, negative, or zero flow upon decompression, as discussed below.
- the seal 216 Upon removal of the syringe 238 from the upper conduit 226 , as shown in FIG. 4 , the seal 216 is free to move toward its decompressed state, and the clam shells 220 a / 220 b are pushed proximally toward the opening 230 .
- the movement causes a general expansion of the inner cavity 218 (i.e., the cavity increases in length), but causes a contraction (i.e., reduction in size) of the volume of the constricted portion 267 of the seal 216 . If the volume change associated with the contraction of the constricted portion 267 equals the volume change associated with the expansion of the inner cavity 218 , the fluid space or inner cavity will have zero flow.
- valve 210 to be a positive-flow valve requires that the clam shells be configured to allow greater expansion of the constricted portion 267 (i.e., an increase in fluid volume in that area of the seal 216 ) than the general contraction volume change associated with the expansion of the inner cavity 218 of the seal 216 upon compression and, hence, greater contraction (i.e., decrease in fluid volume within that area of the seal) of the constricted portion 267 than the general expansion (i.e., increase in fluid volume in that area of the seal) of the seal 216 upon decompression.
- the valve 210 to induce positive flow upon disconnection of the medical implement 238 therefrom, the total fluid volume within the valve 210 must decrease.
- this decrease in fluid volume is effectuated by causing the fluid volume within the seal to decrease as between its compressed (when syringe attached) and uncompressed (when syringe detached) states.
- This reduction or decrease in available fluid volume within the valve 210 causes fluid to flow towards the catheter/patient, preventing blood from being drawn into the catheter.
- valve 210 is advantageously configured to be a positive-flow valve 210 eliminates any dead space during decompression of the seal 210 as the syringe 238 is withdrawn, as illustrated in FIG. 4 . Furthermore, as the syringe 238 is withdrawn, the slit 259 remains open until the very end, i.e., until the seal cap 248 is squeezed by the circular opening 230 at the top of the upper conduit 226 . This further assists in eliminating dead space and avoiding backflash. This feature is particularly advantageous in the case where the valve 210 is connected through a catheter to a patient, because it prevents blood from being drawn into the catheter and clogging it. This invention therefore eliminates a significant risk by solving the problem of backflash.
- the seal 216 As the seal 216 is free to move to its decompressed state, it essentially fills the opening 230 .
- the ability of the seal 216 to return to its original shape and be deformed in its decompressed state is determined by the resiliency of the material used to prepare the seal 216 .
- the ability of the seal 216 to return to its decompressed state is facilitated by the spring 222 and the gaps between the wall portions 258 of the seal 216 .
- the ability of the seal 216 to deform reversibly and return to its decompressed state is particularly useful because (1) it immediately stops fluid flow through the valve 210 , and (2) it maintains sterility of the valve.
- the ability of the seal 216 to return reversibly to its decompressed state permits reuse of the valve 210 .
- the surface 250 of the seal cap 248 is essentially flush with the opening 230 of the housing 212 .
- this flush surface 250 can advantageously be sterilized with alcohol or other surface-decontaminating substances.
- the support member 214 and body 212 advantageously shield both connections from the surrounding environment to protect the sterility of the connection.
- a cover cap (not shown) can be supplied to fit over the upper conduit 226 as further protection for the surface 250 of the seal cap 248 when not in use. Such a cover cap, however, is not needed to maintain sterility since the seal 216 may be swabbed with a disinfectant before and/or after each use. Reversibility of the seal 216 makes the valve 210 particularly attractive as a connector valve to provide fluid communication between two fluid lines. Therefore, the present invention provides for placing a first fluid line in communication with a second fluid line using the valve 210 disclosed herein. The reversibility of the valve 210 permits multiple fluid lines to be successively added, for example, to a fluid line in direct communication with a patient's vein. Since the valve 210 is easily sterilized and sealable, fluid lines can be added and removed without disconnecting venous contact of the catheter.
- valve body 212 and support member 214 are preferably prepared from a hard plastic, but it is additionally contemplated that the valve 210 could be prepared from other medically inert materials known to those skilled in the art.
- Another feature of this invention is that it relies neither on a needle nor on a spike in order to establish fluid flow through the valve. This completely eliminates the risk of skin puncture or fear of puncture during use and manufacture. It also eliminates coring of the seal 216 by a spike element and all the risks associated therewith. Further, the fluid flow rate is not limited by the size of a through passage in a needle or spike, as is the case in some prior art valves.
- the upper ledge 234 confines the movement of the shoulder 252 toward the opening 250 to prevent the seal 216 from being blown through the opening 230 under high pressure in the cavity 218 . This makes the valve 210 particularly suited for high pressure applications.
- the valve 310 includes a valve body or housing 312 , a support member 314 , a skirt 316 , a seal 318 , a resilient member 320 , and a pair of clam shells 322 a / 322 b .
- the housing 312 is desirably similar to the housing 212 of FIG. 4 and has a tapered side wall 324 .
- the second embodiment of the valve 310 has a bell-shaped skirt 316 .
- the skirt 316 has an annular ring 328 which is disposed toward an inner conduit 330 of the support member 314 .
- the skirt 316 creates a shield for the inner conduit 330 .
- This inner conduit 330 is preferably cylindrical in shape and slightly tapered.
- the inner conduit may be connected to a terminal end of a catheter (not shown), which has an opposite, open end that is generally inserted into a patient.
- the support member 314 serves as a support and attachment device for the seal 318 by holding the seal 318 in place inside the housing 312 .
- the support member 314 also serves as a support and attachment device for the skirt 316 .
- the support member 314 has an edge portion 332 which engages a ledge 334 of the skirt 316 in assembly. This attachment secures the skirt 316 in place.
- the skirt 316 desirably includes a Luer-Lock portion 336 that enables the valve 310 to be removably attached to, for example, a fluid line or catheter connected to a patient.
- the valve 310 in this embodiment includes a skirt 316 separate from the housing 312 for ease of assembly.
- a different embodiment can provide a unitary member which replaces the housing 312 and skirt 316 . It is therefore contemplated that such an embodiment would fall within the scope of this invention.
- the seal 318 is similar to the seal 210 of FIG. 4 .
- the seal 318 is also preferably silicon and has a similar seal cap 340 with a precut slit 342 , shoulder 344 , and pressure responsive member 348 . These components serve the same function as those of the seal 210 .
- the seal 318 has a side wall 350 that is generally circular cylindrical and has a distal portion 352 that is sized to be slip-fitted with the proximal end 354 of the inner conduit 330 of the support member 314 . During compression of the seal 318 , the side wall 350 simply slides over the proximal end 354 of the inner conduit 330 , forming a fluid-tight seal therewith.
- the seal 318 defines an inner cavity 358 above the proximal end 354 of the inner conduit 330 .
- the inner cavity 358 forms an expandable fluid space inside the valve 310 .
- the inner conduit 330 and inner cavity 358 comprise aligned hollow tubes in fluid communication with each other when the precut slit 342 of the seal 318 opens during compression of the seal 310 .
- the clam shells 322 a / 322 b are constructed to cause an increase in fluid space upon insertion of a medical implement into the valve 310 and a decrease in fluid space upon withdrawal of the medical implement such as a syringe 362 partially shown in phantom in FIG. 7 .
- the internal surfaces 364 a / 364 b of the clam shells desirably have longitudinal grooves that cooperate with one another to squeeze a portion of the seal side wall 350 to form a constricted portion 366 thereof.
- the second embodiment employs the resilient member 320 disposed between the clam shells 322 a / 322 b and the support member 314 .
- the resilient member 320 advantageously is inert and impermeable to fluid such as silicon, and includes wall portions 368 which deform in an accordion-like fashion and assist in the reformation of the seal 318 to close the housing opening 370 upon withdrawal of the syringe 362 .
- the resilient member 320 thus is similar in construction with and serves the same function as the spring 222 of the seal 210 of FIGS. 4 and 5 . It is contemplated that a spring (not shown) similar to the spring 222 of FIG. 4 may be used in place of the resilient member 320 , as may other suitable structures known to those of skill in the art.
- the resilient member 320 has a base 346 .
- the base 346 fits snugly and securely within an annular groove 374 provided in the housing 312 and an annular groove 377 provided in the support member 314 , as shown in FIG. 6 .
- the annular grooves 376 , 377 hence form a locking mechanism to support and secure the resilient member 320 within the housing 312 .
- the shoulder 344 engages an upper ledge 382 provided in an upper conduit 384 of the housing 312 such that the upper ledge 382 confines the movement of the shoulder 344 toward the opening 370 to prevent the seal 318 from being blown through the opening 370 under high pressure in the inner cavity 358 of the seal 318 .
- the resilient member 320 is desirably relaxed or slightly compressed longitudinally in the decompressed state ( FIG. 6 ), and compressed longitudinally in the compressed state ( FIG. 7 ).
- the resilient member 320 is desirably not attached or bonded to either of the clam shells 322 a / 322 b or the housing 312 .
- FIG. 7 illustrates compression and FIG. 6 illustrates decompression during valve activation.
- the syringe 362 is placed on the seal cap 340 inside the opening 370 of the housing 312 , and the application of pressure on the syringe 362 creates pressure on the seal cap 340 .
- the downward pressure pushes the seal cap 340 away from the circular opening 370 and toward the distal lower portion of the housing 312 which has a larger inner diameter, thereby allowing the precut slit 342 to open.
- the side wall 350 slides over the proximal end 354 of the inner conduit 330 , and the resilient member 320 deforms in an accordion-like manner, storing potential energy of the compression. Fluid is able to flow into the syringe 362 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 318 shown in FIG. 7 generally causes a contraction or reduction in the volume of the inner cavity 358 of the seal 318 .
- the valve 310 has a net gain in volume of the inner cavity 318 , however, because the general reduction in volume within the inner cavity 358 is less than an increase in volume within the constricted portion 366 of the inner cavity 358 defined by the clam shells 322 a / 322 b .
- the expansion results from the movement of the clam shells 322 a / 322 b apart from one another during compression, facilitated by the tapered side wall 324 of the housing 312 .
- FIG. 6 illustrates the valve after withdrawal of the syringe 362 .
- the seal 318 returns to its decompressed state and essentially fills the opening 370 , and the clam shells 322 a / 322 b are pushed proximally toward the opening 370 by the resilient member 320 . Because of the contraction of the inner cavity 358 at the constricted portion 366 by the clam shells 322 a / 322 b , there is a net loss or reduction in fluid space, resulting in a positive flow from the valve 310 through, e.g., a catheter tip (not shown).
- the positive-flow valve 310 advantageously eliminates any dead space during decompression of the seal 318 . This is further assisted by the seal 318 with the slit 342 remaining open until the very end, i.e., until the seal cap 340 is squeezed by the upper conduit 384 .
- valve 310 can be reused because the seal 318 can return reversibly in the decompressed state.
- the seal surface 340 is also swabbable for sterility. Other features of the valve 310 are discussed previously in connection with the first embodiment of this invention and will not be repeated.
- a third embodiment of the valve 410 of the present invention comprises a valve body or housing 412 , a support member 414 , a flexible tubing 416 , a seal 418 , a ring member 420 , a pair of clam shells 422 a / 422 b , and a spring 424 .
- the flexible tubing 416 may be connected to a catheter (not shown) and, together with the seal 418 , defines an inner cavity 426 .
- the inner cavity 426 forms an expandable fluid space of the valve 410 .
- the clam shells 422 a / 422 b desirably are substantially the same as the clam shells 220 a / 220 b of FIG.
- the housing 412 is desirably similar to the housing 212 of FIG. 4 .
- the support member 414 has a hollow center 430 which supports the flexible tubing, and a proximal end 432 which encloses a distal end 434 of the housing 412 .
- the support member 414 desirably locks onto the housing 412 via any method known to those of skill in the art.
- the proximal end 432 of the support member 414 supports the spring 424 , which in turn supports the clam shells 422 a / 422 b and seal 418 .
- the seal 418 is prepared from a resilient material that is flexible, inert, and impermeable to fluid, such as silicon. Referring to FIG. 8 , the seal 418 is substantially similar to the seal 210 of FIG. 4 , with a portion of the side wall 438 cut off near the shoulder 440 region. As a result, the side wall 438 of the seal 418 is substantially shorter than the side wall 254 of the seal 210 in FIG. 4 . A distal end 442 of the side wall 254 is attached, preferably by adhesive, to a proximal end 444 of the flexible tubing 416 .
- the distal end 442 abuts the ring member 420 which is disposed between the seal 418 and the clam shells 422 a / 422 b and attached at its inner surface 446 to a portion of the tubing 416 , desirably also by adhesive. Other suitable means of attachment may be used.
- the ring member 420 is desirably made of polycarbon.
- the clam shells 422 a / 422 b desirably form a sliding contact at their proximal ends with the ring member 420 for ease of assembly, but may alternatively be affixed to the ring member 420 by adhesive or similar means.
- the clam shells 422 a / 422 b are desirably the same as the clam shells 220 a / 220 b of FIG. 4 , having tapered external surfaces 450 a / 450 b to cooperate with the tapered side wall portion 452 of the housing 412 for sliding and grooved internal surfaces 454 a / 454 b that cooperate with one another to squeeze a portion of the tubing 416 to form a constricted portion 456 .
- the spring 424 is substantially the same as the spring 222 of FIG. 4 and serves the same function, being disposed between the distal ends of the clam shells 422 a / 422 b and the proximal end 432 of the support member 414 .
- the spring 424 may be relaxed or in slight compression to exert a force on the seal 418 through the clam shells 422 a / 422 b to keep the slit 466 in the seal cap 460 closed.
- the spring 424 is compressed and stores potential energy from the compression, as illustrated in FIG. 9 .
- the spring 424 Upon withdrawal of the syringe 428 , the spring 424 releases the potential energy and pushes the clam shells 422 a / 422 b proximally to close the seal 418 , as shown in FIG. 8 .
- the spring 424 is preferably not attached or bonded to either the clam shells 422 a / 422 b or the support member 414 for ease of assembly.
- the spring 424 can be a helical spring or any other suitable spring known to those with skill in the art.
- FIG. 9 shows the compressed state of the valve 410 upon insertion of the syringe 428 .
- the syringe 428 is placed on the seal cap 460 inside the opening 464 of the housing 412 and the application of pressure on the syringe 428 creates pressure on the seal cap 460 .
- the downward pressure pushes the seal cap 460 away from the circular opening 464 and toward the distal end of the housing 412 , which has a larger inner diameter, thereby allowing the precut slit 466 of the seal cap 460 to open.
- the resilient tubing 416 and the clam shells 422 a / 422 b also move distally as the spring 424 deforms in compression, storing potential energy. Fluid is able to flow into the syringe 428 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 418 shown in FIG. 9 generally causes a reduction in the volume of the inner cavity 426 formed by the seal 418 and tubing 416 .
- the valve 410 has a net gain in fluid volume.
- the increase in fluid volume results from the movement of the clam shells 422 a / 422 b apart from one another during seal compression, facilitated by the tapered side wall 452 of the housing 412 and resiliency of the tubing 416 .
- FIG. 8 illustrates the valve 410 after withdrawal of the syringe 428 .
- the seal 418 returns to its decompressed state and essentially fills the opening 464 , and the clam shells 422 a / 422 b are pushed proximally toward the opening 464 by the spring 424 .
- the positive-flow valve 410 advantageously eliminates any dead space during decompression of the seal 418 . This is further assisted by the seal 418 , with the slit 466 remaining open until the very end, i.e., until the seal cap 460 is squeezed by upper conduit 470 .
- valve 410 can be reused because the seal 418 can return reversibly to the decompressed state.
- the seal surface 472 is also swabbable for sterility. Other features of the valve 410 are discussed previously in connection with the earlier embodiments of this invention and will not be repeated.
- a valve 510 comprises a valve body or housing 512 , a support member 514 , a skirt 516 , a retaining member 518 , a seal 520 , a pair of clam shells 522 a / 522 b , and a resilient member 524 .
- the valve 510 has several features that are the same or similar to those of the valve 310 of FIGS. 8 and 9 , having a similar resilient member 524 and clam shells 522 a / 522 b .
- the clam shells 522 a / 522 b have internal surfaces 526 a / 526 b that cooperate with one another to squeeze a portion of the seal side wall 528 to form a constricted portion 530 thereof.
- the seal 510 is preferably made of silicon and has a seal cap 532 with a precut slit 534 , shoulder 536 , lower lip 538 , and pressure responsive member 540 that are similar to the seal 210 of FIG. 4 . These components serve the same function as those of the seal 210 .
- the side wall 528 may be formed with ringed wall portions 258 , as in the seal 210 , but FIG. 4 shows the side wall 528 that is generally circular cylindrical.
- the seal 520 defines an inner cavity 542 which forms an expandable fluid space inside the valve 510 .
- the side wall 528 deforms outwardly into a circumferential cusp or bulge 544 in the unconstricted region between the clam shells 522 a / 522 b and the support member 514 .
- the side wall 528 returns to its decompressed shape upon decompression of the seal 520 .
- the seal 520 is desirably relaxed longitudinally in the decompressed state ( FIG. 10 ), and compressed longitudinally in the compressed state ( FIG. 11 ).
- the seal 520 may be stretched longitudinally in tension by the resilient member 524 in the decompressed state and be relaxed or slightly compressed longitudinal in the compressed state.
- the skirt 516 is a bell-shaped skirt that is similar to the skirt 316 of FIG. 8 .
- the skirt 516 creates a shield for an inner conduit 548 of the support member 514 .
- the inner conduit 548 may be connected to a terminal end of a catheter (not shown) which has an open end that is generally inserted into a patient.
- the support member 514 serves as a support and attachment device for the seal 520 by holding the seal 520 in place inside the housing 512 .
- the support member 514 also serves as a support and attachment device for the skirt 516 . Similar to the valve 310 of FIG. 8 , the support member 514 shown in FIG. 10 has an edge portion 550 which engages a ledge 552 of the skirt 516 in assembly. This attachment secures the skirt 516 in place.
- the skirt 516 desirably includes a Luer-Lock portion 554 that enables the valve 510 to be removably attached to, for example, a fluid line or catheter connected to a patient.
- the retaining member 518 is desirably provided to secure the lower lip 538 of the seal 520 and support the resilient member 524 .
- the retaining member 518 is held inside the housing 512 by the support member 514 , and is provided for ease of assembling the valve 510 .
- the retaining member 518 has an annular groove 556
- the support member 514 has an annular groove 558 .
- the annular grooves 556 , 558 form a locking mechanism to support and secure the seal 520 within the housing 512 by engaging the lower lip 538 snugly with the grooves 556 , 558 .
- a different embodiment may provide a unitary member which replaces the support member 514 and the retaining member 518 . It is therefore contemplated that such an embodiment would fall within the scope of this invention.
- FIG. 11 illustrates compression
- FIG. 10 illustrates decompression during valve activation.
- a medical implement such as the syringe 562 partially shown in phantom is placed on the seal cap 532 inside the opening 564 of the housing 512 , and the application of pressure on the syringe 562 creates pressure on the seal cap 532 .
- the downward pressure pushes the seal cap 532 away from the circular opening 564 and toward the lower portion of the housing 512 , which has a larger inner diameter, thereby allowing the precut slit 534 to open.
- the side wall 528 deforms outwardly at the unconstricted region into a circumferential cusp 544 , and the resilient member 524 deforms in an accordion-like manner, storing potential energy of the compression. Fluid is able to flow into the syringe 562 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 520 shown in FIG. 11 generally causes a reduction in the fluid volume of the inner cavity 542 of the seal 520 .
- the valve 510 has a net gain in volume of the inner cavity 542 , however, because the general reduction in volume within the inner cavity 542 is less than the increase in volume within the constricted portion 530 as defined by the clam shells 522 a / 522 b and of the cusp 544 at the unconstricted region of the seal 520 .
- FIG. 10 illustrates the valve 510 after withdrawal of the syringe 562 .
- the seal 520 returns to its decompressed state and essentially fills the opening 564 , and the clam shells 522 a / 522 b are pushed back up toward the opening 564 by the resilient member 524 .
- the positive-flow valve 510 advantageously eliminates any dead space during decompression of the seal 520 . This is further assisted by the seal 520 , with the slit 534 remaining open until the very end, i.e., until the seal cap 532 is squeezed by the circular opening 564 at the top of the upper conduit 570 .
- valve 510 can be reused because the seal 520 can return reversibly in the decompressed state.
- the seal surface 572 is also swabbable for sterility. Other features of the valve 510 are discussed previously in connection with the earlier embodiments of this invention.
- FIGS. 12 and 13 show a fifth embodiment valve 610 in accordance with the present invention, the valve 610 comprising a valve body or housing 612 , a seal 614 , a ring member 616 , and a spring 618 .
- the housing 612 is similar to the housing 212 of FIG. 4 , with a circular opening 620 , and a tapered side wall 622 , but may have a straight side wall instead.
- the seal 614 is similar to the seal 318 of FIG. 8 , having a substantially cylindrical side wall 624 and defining an inner cavity 626 which forms an expandable fluid space inside the valve 610 .
- the side wall 624 may have different and variable thickness (not shown).
- the components are dimensioned and configured to cause the fluid space to expand upon insertion of a medical implement and to contract upon withdrawal of the medical implement such as a syringe 630 partially shown in phantom in FIG. 13 .
- the distal portion of the seal 614 is connected to a fluid line such as a catheter (not shown), and may be secured to the housing by means known to those with skill in the art, such as by the use of a support member (not shown) similar to the support member 214 shown in FIG. 15 .
- the ring member 616 is desirably an annular disk 616 made of a hard plastic and disposed between a shoulder 634 of the seal 614 and a proximal end 636 of the spring 618 .
- the ring member 616 serves as a constraint for the seal 614 during compression and efficiently transfers the compressive force to the spring 618 , assisting in the deformation of the seal 614 .
- the ring member 616 efficiently transfers the spring force to the seal cap 638 of the seal 614 to close the opening 620 .
- the ring member 616 facilitates the deformation and reformation of the seal 614 , it is not necessary for the seal 614 to work. In that case, the spring 618 will contact the seal cap 638 directly.
- the spring 618 is substantially the same as the spring 222 of FIG. 4 and serves the same function, being disposed between the ring member 616 and a distal end 642 of the housing 612 .
- the distal end 642 may be a separate component from the housing 612 for ease of assembly.
- the spring 618 In the decompressed state shown in FIG. 12 , the spring 618 may be relaxed or be in slight compression to exert a force on the seal 614 through the ring member 616 to keep the seal 614 closed.
- the spring 618 is compressed and stores potential energy from the compression, as illustrated in FIG. 13 .
- the spring 618 Upon withdrawal of the syringe 630 , the spring 618 releases the potential energy and pushes the ring member 616 to close the seal 616 as shown in FIG. 12 .
- the spring 618 is preferably not fixed with either the ring member 616 or the distal end 642 of the housing 612 for ease of assembly.
- the spring 618 can be a helical spring or any other suitable spring known to those with skill in the art.
- the side wall 624 of the seal 614 is constrained by the ring member 616 and housing 612 , and is substantially relaxed in the decompressed state.
- the side wall 624 bulges in the unconstrained region between the ring member 616 and the distal end 642 of the housing 612 , causing an increase in the fluid space within the valve 610 .
- the side wall 624 returns to its decompressed shape upon decompression of the seal 614 .
- the side wall 624 may be stretched in tension by the spring 618 in the decompressed state and goes through a relaxed position before deforming under compression to its bulged condition.
- FIG. 13 illustrates compression and FIG. 12 illustrates decompression during valve activation.
- the syringe 630 is placed on the seal cap 638 inside the opening 620 of the housing and the application of pressure on the syringe 630 creates pressure on the seal cap 638 .
- the downward pressure pushes the seal cap 638 and the ring member 616 away from the circular opening 620 and toward the lower portion of the housing 612 which has a larger inner diameter, thereby allowing the precut slit 646 of the seal cap 638 to open.
- the side wall 624 deforms outwardly and bulges at the unconstricted region, as the spring 618 is compressed, storing potential energy of the compression.
- Fluid is able to flow into the syringe 630 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 614 shown in FIG. 13 results in a net gain in volume of the inner cavity.
- FIG. 12 illustrates the valve 610 after withdrawal of the syringe 630 .
- the seal 614 returns to its decompressed state and essentially fills the opening 620 , and the ring member 616 is pushed back up toward the opening 620 as the spring 618 releases its potential energy. Because of the contraction of the inner cavity 626 of the seal 614 , there is a net loss in fluid space, resulting in a positive flow from the valve 610 through, e.g., a catheter tip (not shown).
- the positive-flow valve 610 advantageously eliminates any dead space during decompression of the seal 614 . This is further assisted by the seal 614 with the slit 646 remaining open until the very end, i.e., until the seal cap 638 is squeezed by the circular opening 620 at the top of the upper conduit 650 of the housing 612 .
- valve 610 can be reused because the seal 614 can return reversibly in the decompressed state.
- the seal surface 652 is also swabbable for sterility. Other features of the valve 610 are discussed previously in connection with the earlier embodiments of this invention.
- FIGS. 14 and 15 A sixth embodiment of a valve 710 is illustrated in FIGS. 14 and 15 .
- the valve 710 comprises a valve body or housing 712 and a seal 714 .
- the housing 712 has an upper conduit 716 near a proximal end with a circular opening 718 that is preferably adapted to receive a medical implement.
- a side wall portion 720 is protruded to facilitate deformation of the seal 714 .
- a distal end 724 of the housing 712 forms a lower passage 726 (partially shown) which supports and constrains a distal portion 728 of the seal 714 , and is connected, for example, to a fluid line such as a catheter (not shown).
- a support member may be used to detachably lock onto the housing 712 and support the seal 714 , such as those shown in FIG. 4 ( 214 ) or FIG. 12 ( 514 ).
- the seal 714 is generally similar to the seal 614 of FIGS. 12 and 13 , and has a substantially cylindrical side wall 721 , although the side wall 732 may have a slight bulge 733 as shown in FIG. 14 . It defines an inner cavity 734 which forms an expandable fluid space inside the valve 710 .
- the seal 714 In the decompressed state, the seal 714 is constrained by the upper conduit 716 and lower passage 726 of the housing 712 , and is substantially relaxed in the decompressed state.
- the components are dimensioned and configured to cause the fluid space to expand or increase upon insertion of the medical implement and to contract or decrease upon withdrawal of the medical implement such as the syringe 730 partially shown in phantom in FIG. 15 .
- the side wall 732 bulge in the unconstrained region between the upper conduit 716 and lower passage 726 and the bulge 738 is substantially round.
- the side wall 732 return to its decompressed shape upon decompression of the seal 714 .
- FIG. 15 illustrates compression and FIG. 14 illustrates decompression during valve activation.
- the syringe 730 is placed on the seal cap 742 of the seal 714 inside the opening 718 of the housing 712 and the application of pressure on the syringe 730 creates pressure on the seal cap 742 .
- the downward pressure pushes the seal cap 742 away from the circular opening 718 and toward the protruded portion 720 of the housing 712 which has a larger inner diameter, thereby allowing the precut slit 746 of the seal cap 742 to open.
- the side wall 732 deforms outwardly and bulges at the unconstricted region 738 , storing potential energy of the compression.
- Fluid is able to flow into the syringe 730 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 714 shown in FIG. 15 generates a net gain in volume of the inner cavity.
- FIG. 14 illustrates the valve 710 after withdrawal of the syringe 730 .
- the seal 714 returns to its decompressed state and essentially fills the opening 718 . Because of the contraction of the inner cavity 734 of the seal, there is a net loss in fluid space, resulting in a positive flow from the valve 710 through, e.g., a catheter tip (not shown).
- the positive-flow valve 710 advantageously eliminates any dead space during decompression of the seal 714 . This is further assisted by the seal 714 with the slit 746 remaining open until the very end, i.e., until the seal cap 742 is squeezed by the circular opening 718 at the top of the upper conduit 716 .
- valve 710 can be reused because the seal 710 can return reversibly in the decompressed state.
- the seal surface 748 is also swabbable for sterility. Other features of the valve 710 are discussed previously in connection with the earlier embodiments of this invention.
- FIGS. 16 and 17 illustrate a valve 710 in accordance with a seventh embodiment of the present invention, the valve 756 comprising a valve body or housing 758 and a seal 760 that are substantially the same as the housing 712 and seal 714 of FIGS. 14 and 15 , with a distal portion 762 of the seal 760 connected to a fluid line such as a catheter (not shown).
- the seal 760 is configured to deform upon compression into a diamond-shaped cusp 764 instead of a round bulge 738 as illustrated in FIGS. 14 and 15 .
- This type of construction may facilitate deformation and reformation of the seal 760 , and may be more easily formed.
- the valve activation of this embodiment is virtually identical to that in FIGS.
- seal side wall 770 except for the deformed shape of the seal side wall 770 . It is contemplated, therefore, that a seal that may deform into a variety of shapes other than round and diamond shapes to achieve positive flow may be employed, as long as the it is dimensioned and configured to cause the fluid space of the valve to expand upon insertion of a medical implement and to contract upon withdrawal of the medical implement such as the syringe 774 partially shown in phantom in FIG. 28 .
- an eighth embodiment valve 810 of the present invention is similar to the embodiments shown in FIGS. 14-17 .
- the valve 810 also includes a housing 812 having an internal cavity 814 with an upper conduit 816 , and a seal 818 disposed inside the internal cavity 814 and having an inner cavity 820 that defines a fluid space.
- the housing 812 has a distal end 824 which supports a side wall 826 of the seal 818 .
- a distal portion 828 of the seal 818 is connected to a fluid line such as a catheter (not shown).
- the pressure at the inner cavity 820 of the seal 818 is P 1 .
- Between the housing 812 and the seal 818 is an enclosed pressure chamber 832 at pressure P 2 .
- the valve activation utilizes the pressure difference between P 2 in the pressure chamber 832 and P 1 in the inner cavity 820 of the seal 818 .
- the side wall 826 of the seal 818 may deform without substantial resistance or resiliency such as a membrane, or the seal is not constrained longitudinal by the distal portion 824 of the housing 812 and may slide in and out of the internal cavity 814 of the housing 812 through the distal end 824 .
- FIG. 19 illustrates compression and FIG. 18 illustrates decompression during valve activation.
- the syringe 836 is placed on the seal cap 838 of the seal 818 inside the opening 840 of the housing 812 and the application of pressure on the syringe creates pressure on the seal cap 838 .
- the downward pressure pushes the seal cap 838 away from the circular opening 840 and toward the lower portion of the housing 812 which has a larger inner diameter, thereby allowing the precut slit 844 of the seal cap 838 to open.
- the entry of the fluid causes the pressure at the inner cavity 814 of the seal 812 to increase to P 3 .
- the side wall 826 deforms outwardly and bulges at the unconstricted region 848 .
- Potential energy is stored in the change in pressure differential between the inner cavity 820 and the pressure chamber 832 .
- the side wall 826 of the seal 818 need not deform and store energy, but may do so. Fluid is able to flow into the syringe 836 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 818 shown in FIG. 19 causes a net gain or increase in fluid volume within the inner cavity.
- FIG. 18 illustrates the valve 810 after withdrawal of the syringe 836 .
- the seal 818 returns to its decompressed state and essentially fills the opening 840 , and the pressure in the inner cavity 820 returns to P 1 and releases the potential energy. Because of the contraction of the inner cavity 820 of the seal 818 , there is a net loss in fluid space, resulting in a positive flow from the valve 810 through, e.g., a catheter tip (not shown).
- the positive-flow valve 810 advantageously eliminates any dead space during decompression of the seal 818 . This is further assisted by the seal 818 with the slit 844 remaining open until the very end, i.e., until the seal cap 838 is squeezed by the circular opening 840 at the top of the upper conduit 816 .
- valve 810 can be reused because the seal 818 can return reversibly in the decompressed state.
- the seal surface 854 is also swabbable for sterility. Other features of the valve 810 are discussed previously in connection with the earlier embodiments of this invention.
- FIGS. 20 and 21 A ninth embodiment of a valve 910 comprising a housing 912 , a support member 914 , a skirt 916 , a seal 918 , and a scissor-like cross member 920 , is depicted in FIGS. 20 and 21 .
- the housing 912 has an upper conduit 924 with a circular opening 926 .
- the support member 914 has an inner conduit 928 which is connected to a fluid line such as a catheter (not shown).
- the seal 918 has a side wall 930 desirably formed of alternating wall portions 932 and defines an inner cavity 934 which forms an expandable fluid space inside the valve 910 .
- the cross member 920 is dimensioned and configured to assist in causing the fluid space to expand upon insertion of a medical implement and to contract upon withdrawal of the medical implement such as the syringe 936 partially shown in phantom in FIG. 21 .
- the cross member 920 has two longitudinal member 940 attached together which rotates with respect to one another, and is desirably made of a hard material such as a hard plastic.
- the cross member 920 is disposed at a constricted portion 942 of the seal 918 within the inner cavity 934 with the longitudinal members 940 preferably substantially disposed vertically.
- the ends 944 of the longitudinal members 940 are desirably attached to the side wall 930 as shown in FIG. 20 .
- the longitudinal members 940 rotate to a substantially horizontal orientation upon compression by the insertion of the syringe 936 as shown in FIG. 21 . This rotation is referred to as the deformation of the cross member 920 .
- the longitudinal members 940 may be attached to rotate freely with respect to one another.
- the longitudinal members 940 may be spring-loaded or attached such that they rotate under a rotational force but reform to their relaxed position upon release of the force. Upon withdrawal of the syringe 936 as shown in FIG. 20 , the longitudinal members 940 return to the substantially vertical positions, referred to as the reformation of the cross member 920 .
- the longitudinal members 940 are desirably longitudinal plates 940 with sufficient width to expand the constricted portion 942 of the seal 918 in the substantially horizontal position but not so wide that they impedes flow therethrough. Alternatively, they may contain holes (not shown) through which fluid can pass.
- FIG. 21 illustrates compression and FIG. 20 illustrates decompression during valve activation.
- the syringe 926 is placed on the seal cap 950 of the seal 918 inside the opening 926 of the housing 912 and the application of pressure on the syringe 936 creates pressure on the seal cap 950 .
- the downward pressure pushes the seal cap 950 away from the circular opening 926 and toward the lower portion of the housing 912 which has a larger inner diameter, thereby allowing the precut slit 952 of seal cap 950 to open.
- the side wall 930 of the seal 918 deforms in an accordion-like manner, and the cross member 920 deforms and opens up the constricted portion 922 of the seal 918 , storing potential energy of the compression. Fluid is able to flow into the syringe 936 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 918 and deformation of the cross 920 shown in FIG. 21 generally causes a contraction of the volume of the inner cavity 934 of the seal 918 .
- the valve 910 has a net gain in volume of the inner cavity 934 , however, because the general contraction of the inner cavity 934 is less than by the expansion of the constricted portion 942 pushed apart by the cross member 920 .
- the expansion results from the movement of the longitudinal members 940 of the cross member 920 during compression.
- FIG. 20 illustrates the valve 910 after withdrawal of the syringe 936 .
- the seal 918 returns to its decompressed state and essentially fills the opening 926 , and the cross member 920 reforms to allow the constricted region 942 of the seal 918 to narrow. Because of the contraction of the inner cavity 934 at the constricted portion 942 , there is a net loss in fluid space, resulting in a positive flow from the valve 910 through, e.g., a catheter tip (not shown).
- the positive-flow valve 910 advantageously eliminates any dead space during decompression of the seal 918 . This is further assisted by the seal 918 with the slit 952 remaining open until the very end, i.e., until the seal cap 950 is squeezed by the circular opening 926 at the top of the upper conduit 924 .
- valve 910 can be reused because the seal 918 can return reversibly in the decompressed state.
- the seal surface 960 is also swabbable for sterility. Other features of the valve 910 are discussed previously in connection with the earlier embodiments of this invention.
- FIGS. 22 and 23 illustrate a valve 1010 in accordance with a tenth embodiment of the present invention, the valve 1010 comprising a valve body or housing 1012 , a support member 1014 (partially shown), a seal 1016 , a ring member 1018 , a resilient reel 1020 , and a scissor-like cross member 1022 .
- the support member 1014 has an inner conduit (not shown) which is connected to a fluid line such as a catheter (not shown).
- the seal 1016 has a seal cap 1028 with slit 1030 , shoulder 1032 , and pressure responsive member 1034 .
- the ring member 1018 forms a sliding contact with a distal end 1036 of the seal 1016 and is preferably made from a hard plastic.
- the ring member 1018 desirably has a shoulder 1038 which is constrained by a ledge 1040 of the housing 1012 in the upward direction.
- the distal end of the ring member 1018 contacts an upper flange 1044 of the resilient reel 1020 and facilitates transfer of the compressive force due to insertion of a medical implement to cause deformation of the reel 1020 .
- the reel 1020 is made from a material that is flexible, inert, and impermeable to fluid, such as silicon. It has a lower flange 1046 that is supported and secured by the support member 1014 and a central body portion 1048 that is substantially cylindrical.
- the seal 1016 , ring member 1018 , and resilient reel 1020 define an inner cavity 1050 which forms an expandable fluid space inside the valve 1010 .
- the cross member 1022 is substantially the same of the cross member 920 of FIGS. 20 and 21 and is dimensioned and configured to assist in causing the fluid space to increase upon insertion of a medical implement and to decrease upon withdrawal of the medical implement such as the syringe 1054 partially shown in phantom in FIG. 23 .
- the cross member 1022 has two longitudinal members 1056 rotatably attached together.
- the cross member 1022 is disposed adjacent the central body portion 1048 of the reel 1020 within the inner cavity 1050 with the longitudinal members 1056 preferably pointed toward the vertical direction and desirably attached to the central body portion 1048 at its four ends 1058 as shown in FIG. 22 .
- the longitudinal members 1056 rotate to a substantially horizontal orientation upon compression by the insertion of the syringe 1054 as shown in FIG. 23 . This rotation is referred to as the deformation of the cross member 1022 .
- the longitudinal members 1050 may be attached to rotate freely with respect to one another. Alternatively, the longitudinal members 1056 may be spring-loaded or attached such that they rotate under a rotational force but reform to their relaxed position upon release of the force. Upon withdrawal of the syringe 1056 as shown in FIG. 22 , the longitudinal members 1056 return to the substantially vertical positions, referred to as the reformation of the cross member 1022 .
- the longitudinal members 1026 are desirably longitudinal plates 1056 with sufficient width to open up the central body portion 1048 of the reel 1020 in the substantially horizontal position but not so wide that they impedes flow therethrough. Alternatively, they may contain holes (not shown) through which fluid can pass.
- FIG. 23 illustrates compression and FIG. 22 illustrates decompression during valve activation.
- the syringe 1054 is placed on the seal cap 1028 inside the opening 1062 of the housing 1012 and the application of pressure on the syringe 1054 creates pressure on the seal cap 1028 .
- the downward pressure pushes the seal cap 1028 away from the circular opening 1062 and toward the lower portion of the housing 1012 which has a larger inner diameter, thereby allowing the precut slit 1030 to open.
- the ring member 1018 moves toward the support member 1014 and compresses the resilient reel 1020 .
- the upper flange 1044 of the resilient reel 1020 is pushed by the ring member 1018 toward the lower flange 1046 .
- the central body portion 1048 bulges outwardly as the cross member 1022 deforms, storing potential energy of the compression. Fluid is able to flow into the syringe 1054 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 1016 and deformation of the cross 1022 shown in FIG. 23 generally causes a reduction in the volume of the inner cavity of the seal 1016 .
- the valve 1010 has a net gain in volume of the inner cavity 1050 , however, because the expansion of the central body portion 1048 of the flexible reel 120 causes an increase in fluid volume which reduction resulting in is greater than the general contraction of the inner cavity 1050 .
- the expansion results from the movement of the longitudinal members 1056 of the cross member 1022 to open up the central body portion 1048 of the resilient reel 1020 during compression.
- FIG. 22 illustrates the valve 1010 after withdrawal of the syringe 1054 .
- the seal 1016 returns to its decompressed state and essentially fills the opening 1062 , and the cross member 1022 reforms to allow the central body region 1048 of the resilient reel 1022 to narrow. Because of the contraction of the inner cavity 1050 at the central body portion 1048 , there is a net loss in fluid space, resulting in a positive flow from the valve 1010 through, e.g., a catheter tip (not shown).
- the positive-flow valve 1010 advantageously eliminates any dead space during decompression of the seal 1016 . This is further assisted by the seal 1016 with the slit 1030 remaining open until the very end, i.e., until the seal cap 1028 is squeezed by the circular opening 1062 at the top of the upper conduit 1066 of the housing.
- valve 1010 can be reused because the seal 1016 can return reversibly in the decompressed state.
- the seal surface 1068 is also swabbable for sterility. Other features of the valve 1010 are discussed previously in connection with the earlier embodiments of this invention.
- FIGS. 24 and 25 An eleventh embodiment of a valve 1110 in accordance with the present invention is illustrated in FIGS. 24 and 25 , and comprises a valve body or housing 1112 and a seal 1114 .
- the housing 1112 has an upper conduit 1116 near a proximal end with a circular opening 1118 that is preferably adapted to receive a medical implement such as a syringe 1120 partially shown in phantom in FIG. 25 .
- the housing 1112 has a lower conduit 1124 (partially shown) near a distal end which is connected to a fluid line such as a catheter (not shown).
- the rest of the housing 1112 is desirably made of a firm material such as a hard plastic.
- the seal 1114 is generally similar to the seal 318 of FIG. 6 with a similar shoulder 1132 , seal cap 1134 , and pressure responsive element 1136 .
- the cylindrical side wall 350 of FIG. 6 is replaced with a spreader 1140 , which includes two legs 1142 a , 1142 b that extend from the shoulder 1132 outwardly at distal ends 1144 a , 1144 b that bear against the protruded right and left side walls 1126 a , 1126 b , as best seen in FIG. 24 .
- the distal end 1144 a may be attached to the protruded side wall 1126 a
- the distal end 1144 b may be attached to the protruded side wall 1126 b , by adhesives or other available means.
- An inner cavity 1150 is formed by the seal 1114 and a distal portion 1152 of the housing 1112 , and defines a fluid space of the valve 1110 .
- the spreader 1140 extends further outwardly and pushes the protruded side walls 1126 a , 1126 b outwardly.
- the seal 1114 and housing 1112 are configured and dimensioned to assist in causing the fluid space to expand upon insertion of the medical implement 1120 and to contract upon withdrawal of the medical implement 1120 .
- FIG. 25 illustrates compression and FIG. 24 illustrates decompression during valve activation.
- the syringe 1120 is placed on the seal cap 1134 inside the opening 1118 of the housing 1112 and the application of pressure on the syringe 1120 creates pressure on the seal cap 1134 .
- the downward pressure pushes the seal cap 1134 away from the circular opening 1118 and toward the lower portion of the housing 1112 which has a larger inner diameter, thereby allowing the precut slit 1156 oft he seal cap 1134 to open.
- the spreader 1140 extends outwardly, stretching the resilient ribbed portions 1128 a , 1128 b and pushing the protruded right and left side walls 1126 a , 1126 b of the housing 1112 outwardly, storing potential energy of the compression. Fluid is able to flow into the syringe 1120 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 1114 and deformation of the spreader 1140 shown in FIG. 36 results in a net gain in volume of the inner cavity 1150 .
- FIG. 24 illustrates the valve 1110 after withdrawal of the syringe 1120 .
- the seal 1114 returns to its decompressed state and essentially fills the opening 1118 , and the spreader 1140 and resilient ribbed portions 1128 a , 1128 b reform to allow the protruded right and left side walls 1126 a , 1126 b to move inwardly.
- the positive-flow valve 1110 advantageously eliminates any dead space during decompression of the seal 1114 . This is further assisted by the seal 14 with the slit 1156 remaining open until the very end, i.e., until the seal cap 1134 is squeezed by the circular opening 1156 at the top of the upper conduit 1116 .
- valve 1110 can be reused because the seal 1114 can return reversibly in the decompressed state.
- the seal surface 1160 is also swabbable for sterility. Other features of the valve 1110 are discussed previously in connection with the earlier embodiments of this invention.
- a twelfth embodiment valve 1210 is illustrated in FIGS. 26 and 27 , and comprises a valve body or housing 1212 , a support member 1214 (partially shown), a seal 1216 , a ring member 1218 , and a resilient reel 1226 .
- the housing 1212 , support member 1214 , and ring member 1218 are substantially the same as those shown in FIGS. 22 and 23 .
- the housing 1212 has an upper conduit 1224 with a circular opening 1226 .
- the support member 1214 has an inner conduit (not shown) which is connected to a fluid line such as a catheter (not shown).
- the distal end 1228 of the ring member 1218 contacts an upper flange 1232 of the resilient reel 1220 and facilitates transfer of the compressive force due to insertion of a medical implement such as a syringe to cause deformation of the reel 1220 .
- the reel 1220 further includes a central body portion 1234 and a lower flange 1236 that is desirably supported and secured by the support member 1214 .
- the seal 1216 is similar to the seal 1114 of FIGS. 24 and 25 , and has a similar seal cap 1240 with slit 1242 , shoulder 1244 , and pressure responsive member 1246 .
- the seal 1246 has a spreader 1250 that extends from the shoulder 1244 outwardly and forms a circular distal ring 1252 that bears against the central body portion 1234 of the resilient reel 1220 , as best seen in FIG. 26 .
- the distal ring 1252 may be attached to the central body portion 1234 by adhesives or other available means.
- An inner cavity 1254 is formed by the seal 1216 and a distal portion 1256 of the resilient reel, and defines a fluid space of the valve 1210 .
- the spreader 1250 extends further outwardly and pushes the central body portion 1234 of the resilient reel 1220 outwardly.
- the seal 1216 and resilient reel 1220 are configured and dimensioned to assist in causing the fluid space to increase upon insertion of a medical implement and to decrease upon withdrawal of the medical implement such as the syringe 1260 partially shown in phantom in FIG. 27 .
- FIG. 27 illustrates compression and FIG. 26 illustrates decompression during valve activation.
- the syringe 1260 is placed on the seal cap 1240 inside the opening 1226 of the housing 1212 and the application of pressure on the syringe 1260 creates pressure on the seal cap 1240 .
- the downward pressure pushes the seal cap 1240 away from the circular opening 1226 and toward the lower portion of the housing 1212 which has a larger inner diameter, thereby allowing the precut slit 1242 to open.
- the ring member 1218 moves toward the support member 1214 and compresses the resilient reel 1220 .
- the upper flange 1232 of the resilient reel 1220 is pushed by the ring member 1214 toward the lower flange 1236 .
- the central body portion 1234 bulges outwardly as the spreader 1250 deforms and pushes the central body portion 1234 outwardly, storing potential energy of the compression. Fluid is able to flow into the syringe 1260 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 1216 and deformation of the spreader 1250 and reel 1220 shown in FIG. 27 causes an increase in volume of the inner cavity 1254 because of the expansion of the central body portion 1234 of the flexible reel 1220 .
- the expansion results from the movement of the spreaders 1250 to open up the central body portion 1234 of the resilient reel 1220 during compression.
- FIG. 26 illustrates the valve 1210 after withdrawal of the syringe 1260 .
- the seal 1216 returns to its decompressed state and essentially fills the opening 1226 , and the spreader 1250 reforms to allow the central body region 1234 of the resilient reel 1220 to narrow. Because of the contraction of the inner cavity 1254 at the central body portion 1234 , there is a net loss in fluid space, resulting in a positive flow from the valve 1210 through, e.g., a catheter tip (not shown).
- the positive-flow valve 1210 advantageously eliminates any dead space during decompression of the seal 1216 . This is further assisted by the seal 1216 with the slit 1242 remaining open until the very end, i.e., until the seal cap 1240 is squeezed by the circular opening 1226 at the top of the upper conduit 1224 .
- valve 1210 can be reused because the seal 1216 can return reversibly in the decompressed state.
- the seal surface 1266 is also swabbable for sterility. Other features of the valve 1210 are discussed previously in connection with the earlier embodiments of this invention.
- FIGS. 28 and 29 A thirteenth embodiment valve 1310 in accordance with the present invention is illustrated in FIGS. 28 and 29 .
- the valve 1310 comprises a body or housing 1312 , a support member 1314 (partially shown), an upper seal 1316 , and a lower seal 1318 .
- the housing 1312 has an upper conduit 1322 near a proximal end with a circular opening 1324 that is preferably adapted to receive a medical implement such as a syringe 1326 partially shown in phantom in FIG. 40 .
- the body 1312 has an upper side wall 1330 distal to the upper conduit 1322 that is desirably circular in cross section with a diameter larger than the diameter of the circular opening 1324 .
- the body 1312 has a lower side wall 1332 distal to the upper side wall 1330 with a diameter larger than the diameter of the upper side wall 1330 .
- a middle conduit 1338 is advantageously formed between the upper side wall 1330 and lower side wall 1332 .
- the upper side wall 1330 is advantageously tapered from the upper conduit 1322 to the middle conduit 1338 and the lower side wall 1332 is advantageously tapered from the middle conduit 1338 to a distal end 1340 of the housing 1312 .
- the middle conduit 1338 has a diameter larger than the diameter of the upper conduit 1322 and smaller than the diameter of the distal end 1340 of the housing 1312 .
- the support member 1314 has at its distal end an inner conduit (not shown) which may be connected to a terminal of a catheter (not shown).
- the support member 1314 serves as a support and attachment device for the upper and lower seals 1316 , 1318 by holding the seals 1316 , 1318 in place inside the internal cavity 1346 of the housing 1312 .
- the upper and lower seals 1316 , 1318 are prepared from a resilient material that is flexible, inert, and impermeable to fluid, such as silicon.
- the upper seal 1316 has a seal cap 1350 with a generally flat top surface 1352 , a shoulder 1354 , a side wall 1356 , and a base 1358 .
- the side wall 1356 advantageously is comprised of ringed wall portions 1360 which deform in an accordion-like fashion and assist in the reformation of the seal 1316 to enclose the housing opening 1324 upon withdrawal of the syringe 1326 .
- the diameter of the ringed wall portions 1360 expand outwardly in the radial direction.
- the interior of the upper seal 1316 is hollow to provide an upper inner cavity 1362 , as best seen in FIG. 28 .
- the shoulder 1354 engages an upper ledge 1366 provided in the upper conduit 1322 of the housing 1312 such that the upper ledge 1366 confines the movement of the shoulder 1354 toward the opening 1324 to prevent the upper seal 1316 from being blown through the opening 1324 under high pressure in the upper inner cavity 1362 of the seal 1316 ,
- the seal cap 1350 of the upper seal 1316 reseals in the valve 1310 at the opening 1324 with the top surface 1352 of the seal 1316 flush with or above the opening 1324 upon removal of the medical implement 1326 .
- the seal cap 1350 substantially fills the opening 1324 in the top of the upper conduit 1322 . It is preferred the top surface 1352 be exposed after assembly so that it may be swabbed with alcohol or other disinfectant.
- the seal cap 1350 of the upper seal 1316 desirably has a unique shape with a precut slit 1370 such that the seal cap 1350 is squeezed shut by the opening 1324 when assembled and the slit 1370 opens automatically during compression.
- the seal 1316 desirably also includes a pressure responsive member 1372 to further assist in creating a fluid-tight seal in the decompressed state.
- the lower seal 1318 desirably is generally similar to the upper seal 1316 .
- the lower seal has a similar seal cap 1380 with a generally flat top surface 1382 , a shoulder 1384 , and a side wall 1386 .
- the side wall 1386 defines a lower inner cavity 1390 and may include similar ringed wall portions (not shown).
- the seal cap 1380 is disposed at the middle conduit 1338 at the decompressed state and reseals the lower inner cavity 1390 at the middle conduit 1338 upon removal of the medical implement 1326 .
- the lower inner cavity 1390 forms a fluid space of the valve 1310 , being in fluid communication through the lower conduit (not shown) to, e.g., a catheter (not shown).
- the valve components are configured and dimensioned to assist in causing the fluid space to increase upon insertion of the medical implement 1326 and to decrease upon withdrawal of the medical implement 1326 .
- the seal cap 1380 advantageously provides a fluid tight seal, having a shape and a precut slit 1394 similar to those of the upper seal 1316 .
- the lower seal 1318 also includes desirably a pressure responsive member 1396 similar to the pressure responsive member 1372 of the upper seal 1316 .
- the components of the lower seal 1318 are generally larger than those of the upper seal 1316 because of the geometry of the valve housing 1312 .
- FIG. 29 shows the compressed state of the valve 1310 upon insertion of the syringe 1326 .
- the syringe 1326 is placed on the upper seal cap 1350 inside the opening 1324 of the housing 1212 .
- the application of pressure on the syringe 1326 creates pressure on the seal cap 1330 , and the resulting downward pressure compresses the upper seal 1316 .
- the downward movement is facilitated by the compression of the ringed wall portions 1360 of the side wall 1356 of the upper seal 1316 .
- FIG. 29 shows the valve 1310 opened by insertion of the syringe 1326 into the opening 1324 .
- the fluid space In the compressed state shown in FIG. 29 , the fluid space generally contract under pressure from the decompressed state shown in FIG. 28 .
- the upper and lower seals 1316 , 1318 are free to move toward their decompressed states. The movement normally would cause a general expansion of the fluid space.
- a decrease in volume results in the lower inner cavity 1390 of the valve 1310 .
- the decrease in the fluid space advantageously generates a positive flow from the valve 1310 through, e.g., a catheter tip (not shown) to eliminate dead space.
- any dead space within the upper inner cavity 1362 is also minimized since, as the syringe 1326 is withdrawn, the slit 1370 remains open until the very end, i.e., until the seal cap 1350 is squeezed by the circular opening 1324 at the top of the upper conduit 1322 .
- the elimination of backflash is particularly advantageous in the case where the valve 1310 is connected through a catheter to a patient, because it prevents the introduction of blood into the catheter.
- the upper seals 1316 As the upper seals 1316 is free to move to its decompressed state, it essentially fills the circular opening 1324 .
- the surface 1352 of the seal cap 1316 is essentially flush with the opening 1324 of the housing 1312 .
- this flush surface 1352 can advantageously be sterilized with alcohol or other surface decontaminating substances.
- a cover cap (not shown) can further be used to fit over the upper conduit to protect the surface 1352 of the seal cap 1350 .
- FIGS. 30 and 32 A fourteenth embodiment of a valve 1410 of the present invention is illustrated in FIGS. 30 and 32 , and comprises a valve body or housing 1412 , a seal 1414 , a piston 1416 , and a spring 1418 .
- the housing 1412 has an upper conduit 1420 near a proximal end with a circular opening 1422 that is preferably adapted to receive a medical implement such as a syringe 1423 partially shown in phantom in FIG. 30 .
- the housing 1412 has a side conduit 1424 which is connected to a fluid line such as a catheter (not shown).
- a lower chamber 1426 of the housing 1412 Disposed in a lower chamber 1426 of the housing 1412 is the spring 1418 supporting the piston 1416 which bears against a distal end 1430 of the seal 1414 disposed in an upper chamber 1432 of the housing 1412 .
- the lower chamber 1426 of the housing 1412 advantageously includes an orifice 1434 for venting the air therein to facilitate movement of the spring 1418 .
- the upper chamber 1432 and lower chamber 1426 expand and contract according to the movement of the piston 1416 under pressure from the seal 1414 and the spring 1418 .
- the housing 1412 advantageously includes a side aperture 1438 additional fluid to be transferred to the patient through the upper chamber 1432 and side conduit 1424 when necessary.
- the seal 1414 has seal cap 1442 with precut slit 1444 , a shoulder 1446 , and a pressure responsive member 1448 .
- the seal has a side wall 1450 which defines an inner cavity 1452 and has the distal end 1430 that cooperates with the piston 1416 for efficient transfer of pressure between them.
- Near the distal end 1430 of the seal 1414 is desirably a transverse fluid passage 1456 for fluid communication between the seal 1414 and the upper chamber 1432 .
- FIGS. 30 and 32 illustrate that the transverse fluid passage 1456 also facilitates fluid flow between the side aperture 1438 and the side conduit 1424 , it need not do so if fluid can flow around the seal 1414 in the upper chamber 1432 .
- the upper chamber 1432 and the inner cavity 1450 of the seal 1414 forms the fluid space of the valve 1410 .
- FIG. 31 illustrates compression and FIG. 30 illustrated decompression during valve activation.
- the syringe 1423 is placed on the seal cap 1442 inside the opening 1422 of the housing 1412 and the application of pressure on the syringe 1423 creates pressure on the seal cap 1442 .
- the downward pressure pushes the seal cap 1442 away from the circular opening 1422 and toward the lower portion of the housing 1412 which has a larger inner diameter, thereby allowing the precut slit 1444 to open.
- the side wall 1450 moves further into the upper chamber 1432 and pushes the piston 1476 downward against the spring 1418 , which is compressed, storing potential energy of the compression.
- Fluid is able to flow into the syringe 1423 , or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.
- the compression of the seal 1414 shown in FIG. 42 generates a net gain or increase in volume of the fluid space of the valve 1410 .
- FIG. 30 illustrates the valve 1410 after withdrawal of the syringe 1423 .
- the seal 1414 returns to its decompressed state and essentially fills the opening 1422 , and the piston 1416 moves back to its decompressed position as the spring 1418 releases its potential energy.
- the positive-flow valve 1410 advantageously eliminates any dead space during decompression of the seal 1414 . This is further assisted by the seal 141 with the slit 1444 remaining open until the very end, i.e., until the seal cap 1442 is squeezed by the circular opening 1422 at the top of the upper conduit 1420 .
- valve 1410 can be reused because the seal 1414 can return reversibly in the decompressed state.
- the seal surface 1460 is also swabbable for sterility. Other features of the valve 1410 are discussed previously in connection with the earlier embodiments of this invention.
- valve embodiment valve may have a fluid space inside a straight tubing which bends upon insertion of a medical implement and reforms upon withdrawal of the medical implement, thereby effecting positive flow.
- many of the ringed side wall of the seals can be replaced by circular tires 1580 stacked in series one on top of an adjacent larger-diameter lower tire, as illustrated in FIG. 32 .
- the circular tires 1580 are preferably solid throughout the diameter of the cross-section thereof. Like the ringed side wall portions 1360 , these circular tires 1580 will deform and reform upon, respectively, compression and decompression of the seal.
- the fluid space inside the valve increases upon insertion of a medical implement in the compressed state and decreases upon withdrawal of the medical implement in the decompressed state.
- the structure defining the fluid space is substantially relaxed and does not store substantial amount of potential energy. Insertion of the medical implement causes a change in the structure that allows it to store potential energy. The potential energy is released upon withdrawal of the medical implement and the structure returns to a substantially relaxed condition.
- at least some components of the structure defining the fluid space stores potential energy under strain or deformation. Upon insertion of a medical implement in the compressed state, the potential energy in those components is released and is stored in other components of the structure or in another form. The stored potential energy in the compressed state is released when the medical implement is removed, and the original potential energy is restored in the structure.
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Abstract
A closed system, spikeless, positive-flow valve device includes a body defining an internal cavity. At the proximal end of the body is an opening which is preferably sufficiently large to receive an ANSI standard tip of a medical implement. The valve includes a plastic, resilient silicon seal which fills the upper cavity and opening with an oval seal cap having a slit. The opening presses the oval seal cap to keep the slit closed in the decompressed state. The slit opens as the nose of the medical implement compresses the seal into the cavity and the seal cap is free from the opening. The housing also includes a fluid space which facilitates fluid flow between the medical implement and a catheter tip. The fluid space within the valve automatically and reversibly increases upon insertion of the medical implement into the cavity and decreases upon withdrawal of the medical implement, such that a positive flow from the valve toward the catheter tip is effected upon withdrawal of the medical implement, thereby preventing a flow of blood from a patient into the catheter when the medical implement is removed from the valve.
Description
- This application is a continuation of pending U.S. application Ser. No. 11/085,808, filed Mar. 21, 2005, which in a continuation of pending U.S. application Ser. No. 10/163,719, filed Jun. 5, 2002, which is a continuation of U.S. application Ser. No. 09/411,988, filed Oct. 4, 1999, now U.S. Pat. No. 6,428,52, which is a continuation of U.S. application Ser. No. 08/767,587, filed Dec. 16, 1996, now abandoned, all of which are incorporated by reference in their entirety.
- 1. Field of the Invention
- This invention relates generally to a medical valve, and in particular to a positive flow valve which, when connected between a medical implement and a catheter to facilitate fluid flow therethrough, induces a positive flow of fluid through a tip of the catheter from the valve upon disconnection of the medical implement, thereby eliminating the problem of blood-clogging or clotting in the catheter.
- 2. Description of the Related Art
- The manipulation of fluids for parenteral administration in hospitals and medical settings routinely involves the use of connectors and valves for facilitating the movement of fluids between two points. Fluid connectors and valves typically employ needles or luers to pierce a septum or seal covering sterile tubing or to pierce a septum or seal of a medicament container of fluid. Fluid then passes from the container or fluid-filled tubing into a syringe or second set of tubing. Since the ready passage of fluids through the connectors and valves is often critical to patient survival, it is imperative that the connectors and valves function reliably and repeatedly. Connectors and valves that malfunction during use may be life-threatening.
- Many connectors or valves, especially those employing several mechanical components, have a relatively high volume of fluid space within them. There is potential for the creation of a “dead space” (i.e. an increase in the fluid containment area which will cause fluid within the patient to be drawn therein) in the fluid space during removal or disconnection of the tubing or other medical implements such as conduits, syringes, IV sets (both peripheral and central lines), piggyback lines, and similar components which can be used in connection with a medical valve. Withdrawal of the medical implement creates a suction force which draws fluid back toward the valve in a phenomenon known as “backflash.” This is particularly troublesome in the case where the valve is connected through a catheter to a patient. A suction force is generated by the withdrawal of the medical implement which draws blood from the patient into the catheter. This blood clot and clog the catheter near its tip, rendering it inoperable, and may even result in a clot of blood in the patient, which may prove fatal. Attempts to avoid backflash by coating the inner surface of the catheter near its tip in order to prevent blood from sticking to the interior surfaces of the catheter and clogging it have not been successful.
- The risk of blood clogging of the catheter is significantly heightened where the inner diameter of the catheter is small (e.g., 27 gauge). These small catheters have the advantage, however, that they reduce the trauma and discomfort caused by insertion into a patient. Because these catheters have a very small passage therethrough, even a small suction force may draw sufficient amount of fluid back through a catheter toward the valve to introduce blood into the catheter tip, which blood may clog the catheter's passage. This back flow is hereinafter referred to as a negative flow.
FIG. 1 shows an example of acatheter 50 having a small portion near thetip 52 that is inserted into the patient, and avalve 54 connected between one end of the catheter and amedical implement 56. The problem associated with the creation of “dead space” or a drawing of fluid from the catheter towards the valve is illustrated by this Figure. As illustrated therein, when the tip or nose of themedical implement 56 is withdrawn from thevalve 54, the space previously occupied by theimplement 56 becomes “dead space.” This newly created space has a lower pressure than the fluid within the valve, catheter and patient, such that fluid is drawn into that space, and thus travels from the patient in the direction of the dead space. To avoid blood from being drawn into the catheter, a zero flow or a positive flow, defined as flow or fluid displacement directed from the valve through the catheter tip to the patient, must be effected at the time the medical implement is withdrawn. For a sufficient margin of safety, a positive flow toward the patient is desirable. - To avoid negative flow or backflash, healthcare workers presently practice the method of disconnecting the valve and simultaneously transferring fluid through the catheter by manipulating the medical implement to induce positive flow. This method is clumsy and difficult, and may result in an inaccurate transfer of medicament.
- One way to induce a positive flow in the catheter is illustrated in
FIGS. 2 a and 2 b. Here, the proximal end of avalve 180 is enclosed with a stylet or displacer 182 upon withdrawal of the medical implement (not shown). Anelongated portion 184 of thestylet 182 takes up at least a portion of the fluid space, thereby reducing the volume of the fluid space, and may eliminate the dead space therein. Theelongated portion 184, however, must be sufficiently long to displace more fluid than that volume of fluid which may be drawn from the catheter towards the valve by the withdrawal of the implement, and hence may be difficult to construct for proper performance. The use of thestylet 182 further requires an additional step that may be overlooked by the nurse and thestylet 182 may be misplaced or lost. In addition, this specific type ofvalve 180 has many significant drawbacks, among them the fact that it does not have a seal with a swabbable surface that can be swabbed after each use for sterility. - In accordance with the present invention there is provided a positive flow valve which is advantageously utilized between a catheter and another medical implement, and with which the flow of a fluid between the implement and catheter (and a patient within which the catheter is employed). The valve of this invention has several features, no single one of which is solely responsible for its desirable attributes.
- In general, the positive flow valve of the present invention has the attributes of safety, positive flow for eliminating dead space, reliable and repeatable performance, simplicity of manufacture and use, a seal for use in establishing fluid flow which need not be pierced with a sharp spike or cannula, suitability of high pressure applications, and employment of a valve that is swabbable after use to provide sterility and has a fluid-tight seal at high pressure.
- The present invention is a swabbable, needle-less, positive flow valve that has a fluid space which automatically expands upon insertion of a medical implement and contracts upon withdrawal of the medical implement. When the valve is connected to a catheter, it induces a positive flow from the valve to the catheter tip upon disconnection of the medical implement to avoid the potential problems of blood-clogging. After use, the valve is swabbed in the conventional manner with a suitable substance to maintain sterility. The design of the valve avoids accidental needle or spike sticks. The valve is particularly suited for applications with a catheter where it is desirable to avoid backflash, but may be used for other applications as well.
- Preferably, the valve includes a housing having a first end adapted for receiving one end of medical implement, and having a second end in communication with a catheter. The valve includes means for establishing a fluid flow path through the housing and between the medical implement and the catheter, and which is also useful in occluding the flow path through the housing and thereby preventing fluid flow between the medical implement and catheter.
- Preferably, this means comprises a seal movably positioned within the housing. The seal has a passage therethrough which defines, in at least one area, a fluid containment area. The seal has a first end adapted for engagement by the medical implement. In a first position, the passage through the seal is closed at its first end, and in a second position, when the medical implement is utilized to press the seal distally within the housing of the valve, the passage through the valve is opened.
- Most importantly, when the medical implement is utilized to press the seal distally and establish fluid flow therethrough, the fluid containment area therein increases in total volume, thereby retaining a fluid volume therein. When the medical implement is retracted from the valve, the seal returns to its position wherein the passage is closed at the proximal end thereof, and the volume of the fluid containment area is reduced. This reduction in fluid containment volume results in a volume of fluid being forced towards the catheter (i.e. a positive flow is established).
- The preferred embodiments of this invention, illustrating all its features, will now be discussed in detail. These embodiments depict the novel and nonobvious method and valve of this invention shown in the accompanying drawings, which are for illustrative purposes only. The drawings include the following Figures, with like numerals indicating like parts:
-
FIG. 1 is a schematic cross-sectional view of a valve forming a fluid connection between a syringe and a catheter. -
FIGS. 2 a and 2 b illustrate a prior art valve which includes a stylet having an elongated portion after use to induce a positive flow. -
FIG. 3 is a schematic cross-sectional view of a roller-clamp valve which may be manually activated to induce a positive flow through a catheter tip from the valve. -
FIG. 4 is a longitudinal cross-sectional view of the first embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 5 is a longitudinal cross-sectional view similar toFIG. 4 showing the valve during compression of the seal. -
FIG. 6 is a longitudinal cross-sectional view of the second embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 7 is a longitudinal cross-sectional view similar toFIG. 6 showing the valve during compression of the seal. -
FIG. 8 is a longitudinal cross-sectional view of the third embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 9 is a longitudinal cross-sectional view similar toFIG. 8 showing the valve during compression of the seal. -
FIG. 10 is a longitudinal cross-sectional view of the fourth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 11 is a longitudinal cross-sectional view similar toFIG. 10 showing the valve during compression of the seal. -
FIG. 12 is a longitudinal cross-sectional view of the fifth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 13 is a longitudinal cross-sectional view similar toFIG. 12 showing the valve during compression of the seal. -
FIG. 14 is a longitudinal cross-sectional view of the sixth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 15 is a longitudinal cross-sectional view similar toFIG. 14 showing the valve during compression of the seal. -
FIG. 16 is a longitudinal cross-sectional view of the seventh embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 17 is a longitudinal cross-sectional view similar toFIG. 16 showing the valve during compression of the seal. -
FIG. 18 is a longitudinal cross-sectional view of the eighth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 19 is a longitudinal cross-sectional view similar toFIG. 18 showing the valve during compression of the seal. -
FIG. 20 is a longitudinal cross-sectional view of the ninth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 21 is a longitudinal cross-sectional view similar toFIG. 20 showing the valve during compression of the seal. -
FIG. 22 is a longitudinal cross-sectional view of the tenth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 23 is a longitudinal cross-sectional view similar toFIG. 22 showing the valve during compression of the seal. -
FIG. 24 is a longitudinal cross-sectional view of the eleventh embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 25 is a longitudinal cross-sectional view similar toFIG. 24 showing the valve during compression of the seal. -
FIG. 26 is a longitudinal cross-sectional view of the twelfth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 27 is a longitudinal cross-sectional view similar toFIG. 26 showing the valve during compression of the seal. -
FIG. 28 is a longitudinal cross-sectional view of the thirteenth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 29 is a longitudinal cross-sectional view similar toFIG. 28 showing the valve during compression of the seal. -
FIG. 30 is a longitudinal cross-sectional view of the fourteenth embodiment of the positive-flow valve of this invention before compressing the seal. -
FIG. 31 is a longitudinal cross-sectional view similar toFIG. 30 showing the valve during compression of the seal. -
FIG. 32 is a longitudinal cross-sectional view of an alternative seal with a side wall formed with circular tires. - The Applicant has recognized that a roller clamp may be used to induce a positive flow in a medical valve. The use of a roller clamp in a
medical valve 190 to create a positive flow upon disconnection of a medical implement (not shown) is illustrated inFIG. 3 . The roller-clamp valve 190 is activated manually by sliding anexternal switch 192 to push aroller 194 againsttubing 196 which connects a medical implement 198 and a catheter (not shown) to cause a positive pressure therein, thereby creating a positive flow through the catheter tip (not shown). The flow through thetubing 196 can be opened by sliding theswitch 192 in the reverse direction. - This
valve 190, however, has the same disadvantage of requiring an additional step of operation as does the valve with a stylet illustrated inFIGS. 2 a and 2 b, and also does not include a seal having a swabbable surface. Furthermore, the size of theroller 194 must be sufficiently large to induce a displacement of fluid within the tube which is greater than the amount of fluid which may be drawn by the vacuum force (so as to generate a positive flow), which may require a bulky valve that is hard to operate. -
FIGS. 4 and 5 illustrate a first embodiment of avalve 210 in accordance with the present invention. In general, thisvalve 210 includes a valve body orhousing 212, asupport member 214, aseal 216 defining aninner cavity 218, a pair ofclam shells 220 a and 220 b, and aspring 222. These components are assembled, as depicted inFIG. 4 , without the need for a spike element. Theinner cavity 218 forms an expandable fluid space inside thevalve 210. As discussed below, the clam shells 220 a/220 b are constructed to cause the volume of the fluid space to expand or increase upon insertion of a medical implement and to contract or decrease upon withdrawal of the medical implement. - The body or
housing 212 has anupper conduit 226 near aproximal end 228, desirably with acircular opening 230 that is adapted to receive the medical implement. Aside wall portion 232 is preferably tapered to cooperate with the clam shells 220 a/220 b. Thebody 212 has anupper ledge 234 formed between theproximal end 228 and theside wall portion 232. There is desirably a threaded portion on thehousing 212 adjacent thecircular opening 230 in the top of theupper conduit 226, as best seen inFIG. 4 . Note that “proximal” is used to denote the end of thevalve 210 and other components at or near thebody opening 230, while “distal” is used to denote the opposite end of the valve. - In the first embodiment, the
upper conduit 226 is adapted to receive the tip ornose 236 of an ANSIstandard syringe 238, as shown in phantom inFIG. 5 . It is, however, contemplated that the outer diameter of theupper conduit 226 can be of any size to accommodate the attachment of other connector devices thereto. Advantageously, the proximal end of theupper conduit 226 can be equipped with a locking mechanism to facilitate locking of thevalve 210 to a variety of connector devices. For example, referring toFIG. 4 , the threaded portion of thehousing 212 are preferably provided such that thehousing 212 can be locked into any compatible Luer-Lock device known to those with skill in the art. Thehousing 212 of the first embodiment according to this invention includes conventional Luer-Lock threads 240 on the outer diameter of theupper conduit 226. - The
support member 214 has at its distal end theinner conduit 242 which may be connected to a terminal end of a catheter (not shown). Thesupport member 214 serves as a support and attachment device for theseal 216 by holding theseal 216 in place inside theinternal cavity 244 of thehousing 212. Theinner conduit 242 andinner cavity 218 of theseal 216 present a continuous passageway for fluid during use. - The
seal 216 is prepared from a resilient material that is flexible, inert, and impermeable to fluid, such as silicon. Theseal 216 has aseal cap 248 with a generally flattop surface 250, ashoulder 252, aside wall 254, and abase 256. Theside wall 254 advantageously is comprised ofwall portions 258 which deform in an accordion-like fashion and assist in the reformation of theseal 216 to close thehousing opening 230 upon withdrawal of thesyringe 238. During compression of theseal 216, thewall portions 258 expand outwardly in the radial direction. The interior of theseal 216 is hollow to provide theinner cavity 218, as best seen inFIG. 4 . There are preferably gaps between thewall portions 258 which facilitate deformation and reformation of theseal 216. Theshoulder 252 engages theupper ledge 234 provided in theupper conduit 226 of thehousing 212 such that theupper ledge 234 confines the movement of theshoulder 252 toward theopening 230 to prevent theseal 216 from being blown through theopening 230 under high pressure in theinner cavity 218 of theseal 216. - The
seal cap 248 reseals thevalve 210 at theopening 230, with thetop surface 250 of theseal 216 approximately flush with or slightly above or below theopening 230 upon removal of the medical implement 238. Preferably, theseal cap 248 substantially fills theopening 230 in the top of theupper conduit 226. After assembly, thetop surface 250 of theseal cap 248 is essentially flush with theopening 230, so that theseal cap 248 can be swabbed with alcohol or other disinfectant without leakage of the disinfectant into thevalve 210. Therefore, it is preferable that thetop surface 250 be exposed so that it may be swabbed with a disinfectant. - To provide a fluid-tight seal at the
opening 230 and to eliminate the need for a spike element to induce fluid flow upon insertion of a medical implement, theseal cap 248 has a unique shape and includes aprecut slit 259, also having a unique shape. Theseal cap 248 desirably has an oval or elliptical shape with a major axis having a length larger than the inner diameter of thecircular opening 230 such that theoval seal cap 248 substantially fills theopening 230 in the top of theupper conduit 226 in the decompressed state. The precut slit 259 in theseal cap 248 is squeezed shut by thecircular opening 230 in the decompressed state, as seen inFIG. 4 . In its resting state, the precut slit 259 is open. During compression of theseal 216 by insertion of a medical implement such as thesyringe 238, as illustrated inFIG. 5 , the precut slit 259 returns to its resting state and opens, as theseal cap 248 is allowed to stretch in the portion of theupper conduit 226 which has a larger inner diameter. Fluid is thus allowed to pass through theslit 259. Note that the terms “compressed state” and “decompressed state” are used conveniently to refer to compression and decompression of theseal 216 by insertion and withdrawal of the medical implement 238 along the longitudinal axis of theseal 216. The terms do not relate to the radial compression of theseal cap 248 by theopening 230 of thehousing 212. - To further assist in creating a fluid-tight seal in the decompressed state, the
seal 216 ofFIG. 4 advantageously includes the enlarged, internal, pressureresponsive member 260 which is integral with theseal cap 248. The pressureresponsive member 260 enables thevalve 210 to maintain a fluid-tight seal even at very high pressures sometimes experienced in medical applications, particularly when thevalve 210 is connected to a patient's artery. - As shown in
FIGS. 4 and 5 , the clam shells 220 a/220 b are desirably identical pieces disposed opposite one another symmetrically inside thevalve body 212. They are preferably made of a firm material such as a hard plastic. The external surface 264 a/264 b of each clam shell 220 a/220 b is tapered to cooperate with the taperedside wall portion 232 of thehousing 212, and is configured to slide along theside wall portion 232 during compression and decompression. Theinternal surfaces 266 a/266 b of the clam shells 220 a/220 b cooperate with one another to squeeze a portion of theseal side wall 254, preferably adjacent theshoulder 252, to form aconstricted portion 267 of theseal 216. The proximal ends 268 a/268 b of the clam shells 220 a/220 b engage theshoulder 252 of theseal 216 to facilitate movement of the clam shells 220 a/220 b with the compression of theseal 216. Theinternal surfaces 266 a/266 b preferably are shaped to cause theconstricted portion 267 to be substantially circular. In this embodiment, eachinternal surface 266 a/266 b has a semi-circular, longitudinal groove that squeezes theseal 216. - The
spring 222 is disposed between the distal ends of the clam shells 220 a/220 b and thebase 256 of theseal 216, but desirably ahard retaining disk 270 is provided adjacent thebase 256 of theseal 216 to provide better support for thespring 222 and theseal 216. In the decompressed state shown inFIG. 4 , thespring 222 may be relaxed or be in slight compression to exert a force on theseal 216 through the clam shells 220 a/220 b to keep theseal 216 closed. During insertion of thesyringe 238, thespring 222 is compressed and stores potential energy from the compression, as illustrated inFIG. 5 . Upon withdrawal of thesyringe 238, thespring 222 releases the potential energy and pushes the clam shells 220 a/220 b proximally to close theseal 216, as shown inFIG. 4 . Thespring 222 is preferably not attached or bonded to either the clam shells 220 a/220 b or theretaining disk 270 for ease of assembly. AlthoughFIGS. 4-5 show ahelical spring 222, any suitable spring known to those of skill in the art may be used. - The
seal 216 is desirably relaxed longitudinally in the decompressed state (FIG. 4 ), and compressed longitudinally in the compressed state (FIG. 5 ). Alternatively, theseal 216 may be stretched longitudinally in tension by thespring 222 in the decompressed state and be relaxed or slightly compressed longitudinal in the compressed state. Thebase 256 of theseal 216 advantageously fits snugly and securely into aannular groove 274 provided in theretaining disk 270 and anannular groove 276 provided in thesupport member 214. Theannular grooves seal 216 within thecavity 244 of thehousing 212. - To illustrate valve activation,
FIG. 5 shows the compressed state of thevalve 210 upon insertion of thesyringe 238. A medical implement other than a syringe as known to those of skill in the art may be used. Thenose 236 of thesyringe 238 is placed on theseal cap 248 inside theopening 230 of thehousing 212. The application of pressure on thesyringe 238 creates pressure on theseal cap 248, and the resulting downward pressure compresses theseal 216. This pushes theseal cap 248 away from thecircular opening 230 and toward the lower portion of thehousing cavity 244 which has a larger inner diameter, thereby allowing the precut slit 259 to open. The downward movement is facilitated by the compression of thespring 222 which stores the potential energy of compression and by the gaps between thewall portions 258 of theside wall 254 of theseal 216. Fluid is now able to flow into thesyringe 238, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.FIG. 5 shows thevalve 210 opened by insertion of thenose 236 of thesyringe 238 into theopening 230. For intravenous applications, thevalve 210 can be oriented in the position diagramed inFIGS. 4 and 5 , or it can be rotated 180′ such that fluid flows in the opposite direction. - In the compressed state shown in
FIG. 5 , theinner cavity 218 of theseal 216 generally contracts (becomes shorter) as compared to the decompressed state shown inFIG. 4 . Theconstricted portion 267 of theinner cavity 218, defined by the clam shells 220 a/220 b, however, expands (becomes larger) in volume when theseal 216 is in the compressed state. This results from a movement of the clam shells 220 a/220 b apart from one another as they slide along the taperedside wall 232 of thehousing 212. The amount of general contraction of theseal 216 in relation to the amount of expansion of theconstricted portion 267 during compression determine whether thevalve 210 generates a positive, negative, or zero flow upon decompression, as discussed below. - Upon removal of the
syringe 238 from theupper conduit 226, as shown inFIG. 4 , theseal 216 is free to move toward its decompressed state, and the clam shells 220 a/220 b are pushed proximally toward theopening 230. The movement causes a general expansion of the inner cavity 218 (i.e., the cavity increases in length), but causes a contraction (i.e., reduction in size) of the volume of theconstricted portion 267 of theseal 216. If the volume change associated with the contraction of theconstricted portion 267 equals the volume change associated with the expansion of theinner cavity 218, the fluid space or inner cavity will have zero flow. If the increase in volume associated with the expansion of theinner cavity 218 is greater than the reduction in volume associated with the contraction of theconstricted portion 267, there will be a net gain in fluid space, resulting in an undesirable negative flow toward thevalve 210 through, e.g., a catheter tip (not shown). If the reduction in volume associated with the contraction of theconstricted portion 267 is greater than the increase in volume associated with the expansion of theinner cavity 218, there will be a desirable positive flow from thevalve 210 through the catheter tip (not shown). Thus, for thevalve 210 to be a positive-flow valve requires that the clam shells be configured to allow greater expansion of the constricted portion 267 (i.e., an increase in fluid volume in that area of the seal 216) than the general contraction volume change associated with the expansion of theinner cavity 218 of theseal 216 upon compression and, hence, greater contraction (i.e., decrease in fluid volume within that area of the seal) of theconstricted portion 267 than the general expansion (i.e., increase in fluid volume in that area of the seal) of theseal 216 upon decompression. In other words, for thevalve 210 to induce positive flow upon disconnection of the medical implement 238 therefrom, the total fluid volume within thevalve 210 must decrease. In the instant case, this decrease in fluid volume is effectuated by causing the fluid volume within the seal to decrease as between its compressed (when syringe attached) and uncompressed (when syringe detached) states. This reduction or decrease in available fluid volume within thevalve 210 causes fluid to flow towards the catheter/patient, preventing blood from being drawn into the catheter. - That the
valve 210 is advantageously configured to be a positive-flow valve 210 eliminates any dead space during decompression of theseal 210 as thesyringe 238 is withdrawn, as illustrated inFIG. 4 . Furthermore, as thesyringe 238 is withdrawn, theslit 259 remains open until the very end, i.e., until theseal cap 248 is squeezed by thecircular opening 230 at the top of theupper conduit 226. This further assists in eliminating dead space and avoiding backflash. This feature is particularly advantageous in the case where thevalve 210 is connected through a catheter to a patient, because it prevents blood from being drawn into the catheter and clogging it. This invention therefore eliminates a significant risk by solving the problem of backflash. - As the
seal 216 is free to move to its decompressed state, it essentially fills theopening 230. The ability of theseal 216 to return to its original shape and be deformed in its decompressed state is determined by the resiliency of the material used to prepare theseal 216. Advantageously, the ability of theseal 216 to return to its decompressed state is facilitated by thespring 222 and the gaps between thewall portions 258 of theseal 216. The ability of theseal 216 to deform reversibly and return to its decompressed state is particularly useful because (1) it immediately stops fluid flow through thevalve 210, and (2) it maintains sterility of the valve. - The ability of the
seal 216 to return reversibly to its decompressed state permits reuse of thevalve 210. Following disconnection, and before reuse, thesurface 250 of theseal cap 248 is essentially flush with theopening 230 of thehousing 212. Thus, thisflush surface 250 can advantageously be sterilized with alcohol or other surface-decontaminating substances. Thesupport member 214 andbody 212 advantageously shield both connections from the surrounding environment to protect the sterility of the connection. - A cover cap (not shown) can be supplied to fit over the
upper conduit 226 as further protection for thesurface 250 of theseal cap 248 when not in use. Such a cover cap, however, is not needed to maintain sterility since theseal 216 may be swabbed with a disinfectant before and/or after each use. Reversibility of theseal 216 makes thevalve 210 particularly attractive as a connector valve to provide fluid communication between two fluid lines. Therefore, the present invention provides for placing a first fluid line in communication with a second fluid line using thevalve 210 disclosed herein. The reversibility of thevalve 210 permits multiple fluid lines to be successively added, for example, to a fluid line in direct communication with a patient's vein. Since thevalve 210 is easily sterilized and sealable, fluid lines can be added and removed without disconnecting venous contact of the catheter. - The
valve body 212 andsupport member 214 are preferably prepared from a hard plastic, but it is additionally contemplated that thevalve 210 could be prepared from other medically inert materials known to those skilled in the art. Another feature of this invention is that it relies neither on a needle nor on a spike in order to establish fluid flow through the valve. This completely eliminates the risk of skin puncture or fear of puncture during use and manufacture. It also eliminates coring of theseal 216 by a spike element and all the risks associated therewith. Further, the fluid flow rate is not limited by the size of a through passage in a needle or spike, as is the case in some prior art valves. - As shown in
FIG. 4 , another feature of the invention is that theupper ledge 234 confines the movement of theshoulder 252 toward theopening 250 to prevent theseal 216 from being blown through theopening 230 under high pressure in thecavity 218. This makes thevalve 210 particularly suited for high pressure applications. - In a second embodiment of the present invention illustrated in
FIGS. 6 and 7 , the valve 310 includes a valve body orhousing 312, asupport member 314, askirt 316, aseal 318, aresilient member 320, and a pair ofclam shells 322 a/322 b. Thehousing 312 is desirably similar to thehousing 212 ofFIG. 4 and has a taperedside wall 324. - Referring to
FIGS. 6 and 7 , the second embodiment of the valve 310 has a bell-shapedskirt 316. Theskirt 316 has anannular ring 328 which is disposed toward aninner conduit 330 of thesupport member 314. Theskirt 316 creates a shield for theinner conduit 330. Thisinner conduit 330 is preferably cylindrical in shape and slightly tapered. The inner conduit may be connected to a terminal end of a catheter (not shown), which has an opposite, open end that is generally inserted into a patient. Thesupport member 314 serves as a support and attachment device for theseal 318 by holding theseal 318 in place inside thehousing 312. - The
support member 314 also serves as a support and attachment device for theskirt 316. As best seen inFIG. 6 , thesupport member 314 has anedge portion 332 which engages aledge 334 of theskirt 316 in assembly. This attachment secures theskirt 316 in place. Theskirt 316 desirably includes a Luer-Lock portion 336 that enables the valve 310 to be removably attached to, for example, a fluid line or catheter connected to a patient. It is noted that the valve 310 in this embodiment includes askirt 316 separate from thehousing 312 for ease of assembly. A different embodiment can provide a unitary member which replaces thehousing 312 andskirt 316. It is therefore contemplated that such an embodiment would fall within the scope of this invention. - The
seal 318 is similar to theseal 210 ofFIG. 4 . Theseal 318 is also preferably silicon and has asimilar seal cap 340 with aprecut slit 342,shoulder 344, and pressureresponsive member 348. These components serve the same function as those of theseal 210. Instead of a side wall formed withwall portions 258, theseal 318 has aside wall 350 that is generally circular cylindrical and has adistal portion 352 that is sized to be slip-fitted with theproximal end 354 of theinner conduit 330 of thesupport member 314. During compression of theseal 318, theside wall 350 simply slides over theproximal end 354 of theinner conduit 330, forming a fluid-tight seal therewith. Theseal 318 defines aninner cavity 358 above theproximal end 354 of theinner conduit 330. Theinner cavity 358 forms an expandable fluid space inside the valve 310. Theinner conduit 330 andinner cavity 358 comprise aligned hollow tubes in fluid communication with each other when the precut slit 342 of theseal 318 opens during compression of the seal 310. - Similar in form and function to the clam shells 220 a/220 b of
FIGS. 4 and 5 , theclam shells 322 a/322 b are constructed to cause an increase in fluid space upon insertion of a medical implement into the valve 310 and a decrease in fluid space upon withdrawal of the medical implement such as asyringe 362 partially shown in phantom inFIG. 7 . The internal surfaces 364 a/364 b of the clam shells desirably have longitudinal grooves that cooperate with one another to squeeze a portion of theseal side wall 350 to form aconstricted portion 366 thereof. - Instead of the
spring 222 inFIG. 4 , the second embodiment employs theresilient member 320 disposed between theclam shells 322 a/322 b and thesupport member 314. Theresilient member 320 advantageously is inert and impermeable to fluid such as silicon, and includeswall portions 368 which deform in an accordion-like fashion and assist in the reformation of theseal 318 to close thehousing opening 370 upon withdrawal of thesyringe 362. Theresilient member 320 thus is similar in construction with and serves the same function as thespring 222 of theseal 210 ofFIGS. 4 and 5 . It is contemplated that a spring (not shown) similar to thespring 222 ofFIG. 4 may be used in place of theresilient member 320, as may other suitable structures known to those of skill in the art. - As shown in
FIGS. 6 and 7 , theresilient member 320 has abase 346. The base 346 fits snugly and securely within anannular groove 374 provided in thehousing 312 and anannular groove 377 provided in thesupport member 314, as shown inFIG. 6 . Theannular grooves 376,377 hence form a locking mechanism to support and secure theresilient member 320 within thehousing 312. Theshoulder 344 engages an upper ledge 382 provided in anupper conduit 384 of thehousing 312 such that the upper ledge 382 confines the movement of theshoulder 344 toward theopening 370 to prevent theseal 318 from being blown through theopening 370 under high pressure in theinner cavity 358 of theseal 318. - The
resilient member 320 is desirably relaxed or slightly compressed longitudinally in the decompressed state (FIG. 6 ), and compressed longitudinally in the compressed state (FIG. 7 ). Theresilient member 320 is desirably not attached or bonded to either of theclam shells 322 a/322 b or thehousing 312. -
FIG. 7 illustrates compression andFIG. 6 illustrates decompression during valve activation. In the compressed state, thesyringe 362 is placed on theseal cap 340 inside theopening 370 of thehousing 312, and the application of pressure on thesyringe 362 creates pressure on theseal cap 340. The downward pressure pushes theseal cap 340 away from thecircular opening 370 and toward the distal lower portion of thehousing 312 which has a larger inner diameter, thereby allowing the precut slit 342 to open. Theside wall 350 slides over theproximal end 354 of theinner conduit 330, and theresilient member 320 deforms in an accordion-like manner, storing potential energy of the compression. Fluid is able to flow into thesyringe 362, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. - The compression of the
seal 318 shown inFIG. 7 generally causes a contraction or reduction in the volume of theinner cavity 358 of theseal 318. The valve 310 has a net gain in volume of theinner cavity 318, however, because the general reduction in volume within theinner cavity 358 is less than an increase in volume within theconstricted portion 366 of theinner cavity 358 defined by theclam shells 322 a/322 b. The expansion results from the movement of theclam shells 322 a/322 b apart from one another during compression, facilitated by the taperedside wall 324 of thehousing 312. -
FIG. 6 illustrates the valve after withdrawal of thesyringe 362. Theseal 318 returns to its decompressed state and essentially fills theopening 370, and theclam shells 322 a/322 b are pushed proximally toward theopening 370 by theresilient member 320. Because of the contraction of theinner cavity 358 at theconstricted portion 366 by theclam shells 322 a/322 b, there is a net loss or reduction in fluid space, resulting in a positive flow from the valve 310 through, e.g., a catheter tip (not shown). The positive-flow valve 310 advantageously eliminates any dead space during decompression of theseal 318. This is further assisted by theseal 318 with theslit 342 remaining open until the very end, i.e., until theseal cap 340 is squeezed by theupper conduit 384. - In addition, the valve 310 can be reused because the
seal 318 can return reversibly in the decompressed state. Theseal surface 340 is also swabbable for sterility. Other features of the valve 310 are discussed previously in connection with the first embodiment of this invention and will not be repeated. - As shown in
FIGS. 8 and 9 , a third embodiment of thevalve 410 of the present invention comprises a valve body orhousing 412, asupport member 414, aflexible tubing 416, aseal 418, aring member 420, a pair ofclam shells 422 a/422 b, and aspring 424. Theflexible tubing 416 may be connected to a catheter (not shown) and, together with theseal 418, defines aninner cavity 426. Theinner cavity 426 forms an expandable fluid space of thevalve 410. Theclam shells 422 a/422 b desirably are substantially the same as the clam shells 220 a/220 b ofFIG. 4 and are constructed to cause the fluid space within thevalve 410 to increase upon insertion of a medical implement and to decrease upon withdrawal of the medical implement such as asyringe 428 partially shown in phantom inFIG. 9 . Thehousing 412 is desirably similar to thehousing 212 ofFIG. 4 . - The
support member 414 has ahollow center 430 which supports the flexible tubing, and aproximal end 432 which encloses a distal end 434 of thehousing 412. Thesupport member 414 desirably locks onto thehousing 412 via any method known to those of skill in the art. Theproximal end 432 of thesupport member 414 supports thespring 424, which in turn supports theclam shells 422 a/422 b andseal 418. - The
seal 418 is prepared from a resilient material that is flexible, inert, and impermeable to fluid, such as silicon. Referring toFIG. 8 , theseal 418 is substantially similar to theseal 210 ofFIG. 4 , with a portion of theside wall 438 cut off near theshoulder 440 region. As a result, theside wall 438 of theseal 418 is substantially shorter than theside wall 254 of theseal 210 inFIG. 4 . Adistal end 442 of theside wall 254 is attached, preferably by adhesive, to aproximal end 444 of theflexible tubing 416. Thedistal end 442 abuts thering member 420 which is disposed between theseal 418 and theclam shells 422 a/422 b and attached at itsinner surface 446 to a portion of thetubing 416, desirably also by adhesive. Other suitable means of attachment may be used. Thering member 420 is desirably made of polycarbon. - The
clam shells 422 a/422 b desirably form a sliding contact at their proximal ends with thering member 420 for ease of assembly, but may alternatively be affixed to thering member 420 by adhesive or similar means. Theclam shells 422 a/422 b are desirably the same as the clam shells 220 a/220 b ofFIG. 4 , having tapered external surfaces 450 a/450 b to cooperate with the taperedside wall portion 452 of thehousing 412 for sliding and groovedinternal surfaces 454 a/454 b that cooperate with one another to squeeze a portion of thetubing 416 to form aconstricted portion 456. - The
spring 424 is substantially the same as thespring 222 ofFIG. 4 and serves the same function, being disposed between the distal ends of theclam shells 422 a/422 b and theproximal end 432 of thesupport member 414. In the decompressed state shown inFIG. 8 , thespring 424 may be relaxed or in slight compression to exert a force on theseal 418 through theclam shells 422 a/422 b to keep theslit 466 in theseal cap 460 closed. During insertion of thesyringe 428, thespring 424 is compressed and stores potential energy from the compression, as illustrated inFIG. 9 . Upon withdrawal of thesyringe 428, thespring 424 releases the potential energy and pushes theclam shells 422 a/422 b proximally to close theseal 418, as shown inFIG. 8 . Thespring 424 is preferably not attached or bonded to either theclam shells 422 a/422 b or thesupport member 414 for ease of assembly. Thespring 424 can be a helical spring or any other suitable spring known to those with skill in the art. -
FIG. 9 shows the compressed state of thevalve 410 upon insertion of thesyringe 428. In the compressed state, thesyringe 428 is placed on theseal cap 460 inside theopening 464 of thehousing 412 and the application of pressure on thesyringe 428 creates pressure on theseal cap 460. The downward pressure pushes theseal cap 460 away from thecircular opening 464 and toward the distal end of thehousing 412, which has a larger inner diameter, thereby allowing the precut slit 466 of theseal cap 460 to open. Theresilient tubing 416 and theclam shells 422 a/422 b also move distally as thespring 424 deforms in compression, storing potential energy. Fluid is able to flow into thesyringe 428, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. - The compression of the
seal 418 shown inFIG. 9 generally causes a reduction in the volume of theinner cavity 426 formed by theseal 418 andtubing 416. However, because of an expansion of theconstricted portion 456 defined by theclam shells 422 a/422 b an increase in fluid volume is created which is greater than the general reduction in fluid volume within theinner cavity 426, thevalve 410 has a net gain in fluid volume. The increase in fluid volume results from the movement of theclam shells 422 a/422 b apart from one another during seal compression, facilitated by the taperedside wall 452 of thehousing 412 and resiliency of thetubing 416. -
FIG. 8 illustrates thevalve 410 after withdrawal of thesyringe 428. Theseal 418 returns to its decompressed state and essentially fills theopening 464, and theclam shells 422 a/422 b are pushed proximally toward theopening 464 by thespring 424. Because of the contraction of theinner cavity 426 at theconstricted portion 456 by theclam shells 422 a/422 b, there is a net loss in fluid space, resulting in a positive flow from thevalve 410 through, e.g., a catheter tip (not shown). The positive-flow valve 410 advantageously eliminates any dead space during decompression of theseal 418. This is further assisted by theseal 418, with theslit 466 remaining open until the very end, i.e., until theseal cap 460 is squeezed byupper conduit 470. - In addition, the
valve 410 can be reused because theseal 418 can return reversibly to the decompressed state. Theseal surface 472 is also swabbable for sterility. Other features of thevalve 410 are discussed previously in connection with the earlier embodiments of this invention and will not be repeated. - A fourth embodiment of the present invention is illustrated in
FIGS. 10 and 11 . As illustrated therein, avalve 510, comprises a valve body orhousing 512, asupport member 514, askirt 516, a retainingmember 518, aseal 520, a pair ofclam shells 522 a/522 b, and aresilient member 524. Thevalve 510 has several features that are the same or similar to those of the valve 310 ofFIGS. 8 and 9 , having a similarresilient member 524 andclam shells 522 a/522 b. Theclam shells 522 a/522 b haveinternal surfaces 526 a/526 b that cooperate with one another to squeeze a portion of theseal side wall 528 to form aconstricted portion 530 thereof. - The
seal 510 is preferably made of silicon and has aseal cap 532 with aprecut slit 534,shoulder 536,lower lip 538, and pressureresponsive member 540 that are similar to theseal 210 ofFIG. 4 . These components serve the same function as those of theseal 210. Theside wall 528 may be formed with ringedwall portions 258, as in theseal 210, butFIG. 4 shows theside wall 528 that is generally circular cylindrical. Theseal 520 defines aninner cavity 542 which forms an expandable fluid space inside thevalve 510. During compression of theseal 520, theside wall 528 deforms outwardly into a circumferential cusp orbulge 544 in the unconstricted region between theclam shells 522 a/522 b and thesupport member 514. Theside wall 528 returns to its decompressed shape upon decompression of theseal 520. Theseal 520 is desirably relaxed longitudinally in the decompressed state (FIG. 10 ), and compressed longitudinally in the compressed state (FIG. 11 ). Alternatively, theseal 520 may be stretched longitudinally in tension by theresilient member 524 in the decompressed state and be relaxed or slightly compressed longitudinal in the compressed state. - Referring to
FIG. 10 , theskirt 516 is a bell-shaped skirt that is similar to theskirt 316 ofFIG. 8 . Theskirt 516 creates a shield for aninner conduit 548 of thesupport member 514. Theinner conduit 548 may be connected to a terminal end of a catheter (not shown) which has an open end that is generally inserted into a patient. Thesupport member 514 serves as a support and attachment device for theseal 520 by holding theseal 520 in place inside thehousing 512. - The
support member 514 also serves as a support and attachment device for theskirt 516. Similar to the valve 310 ofFIG. 8 , thesupport member 514 shown inFIG. 10 has anedge portion 550 which engages aledge 552 of theskirt 516 in assembly. This attachment secures theskirt 516 in place. Theskirt 516 desirably includes a Luer-Lock portion 554 that enables thevalve 510 to be removably attached to, for example, a fluid line or catheter connected to a patient. - The retaining
member 518 is desirably provided to secure thelower lip 538 of theseal 520 and support theresilient member 524. The retainingmember 518 is held inside thehousing 512 by thesupport member 514, and is provided for ease of assembling thevalve 510. The retainingmember 518 has anannular groove 556, and thesupport member 514 has anannular groove 558. Theannular grooves seal 520 within thehousing 512 by engaging thelower lip 538 snugly with thegrooves support member 514 and the retainingmember 518. It is therefore contemplated that such an embodiment would fall within the scope of this invention. -
FIG. 11 illustrates compression andFIG. 10 illustrates decompression during valve activation. In the compressed state, a medical implement such as thesyringe 562 partially shown in phantom is placed on theseal cap 532 inside theopening 564 of thehousing 512, and the application of pressure on thesyringe 562 creates pressure on theseal cap 532. The downward pressure pushes theseal cap 532 away from thecircular opening 564 and toward the lower portion of thehousing 512, which has a larger inner diameter, thereby allowing the precut slit 534 to open. Theside wall 528 deforms outwardly at the unconstricted region into acircumferential cusp 544, and theresilient member 524 deforms in an accordion-like manner, storing potential energy of the compression. Fluid is able to flow into thesyringe 562, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. - The compression of the
seal 520 shown inFIG. 11 generally causes a reduction in the fluid volume of theinner cavity 542 of theseal 520. Thevalve 510 has a net gain in volume of theinner cavity 542, however, because the general reduction in volume within theinner cavity 542 is less than the increase in volume within theconstricted portion 530 as defined by theclam shells 522 a/522 b and of thecusp 544 at the unconstricted region of theseal 520. -
FIG. 10 illustrates thevalve 510 after withdrawal of thesyringe 562. Theseal 520 returns to its decompressed state and essentially fills theopening 564, and theclam shells 522 a/522 b are pushed back up toward theopening 564 by theresilient member 524. Because of the contraction of theinner cavity 542 of theseal 520, there is a net loss in fluid space, resulting in a positive flow from thevalve 510 through, e.g., a catheter tip (not shown). The positive-flow valve 510 advantageously eliminates any dead space during decompression of theseal 520. This is further assisted by theseal 520, with theslit 534 remaining open until the very end, i.e., until theseal cap 532 is squeezed by thecircular opening 564 at the top of theupper conduit 570. - In addition, the
valve 510 can be reused because theseal 520 can return reversibly in the decompressed state. Theseal surface 572 is also swabbable for sterility. Other features of thevalve 510 are discussed previously in connection with the earlier embodiments of this invention. -
FIGS. 12 and 13 show afifth embodiment valve 610 in accordance with the present invention, thevalve 610 comprising a valve body orhousing 612, aseal 614, aring member 616, and aspring 618. Thehousing 612 is similar to thehousing 212 ofFIG. 4 , with acircular opening 620, and atapered side wall 622, but may have a straight side wall instead. Theseal 614 is similar to theseal 318 ofFIG. 8 , having a substantiallycylindrical side wall 624 and defining aninner cavity 626 which forms an expandable fluid space inside thevalve 610. Theside wall 624 may have different and variable thickness (not shown). The components are dimensioned and configured to cause the fluid space to expand upon insertion of a medical implement and to contract upon withdrawal of the medical implement such as asyringe 630 partially shown in phantom inFIG. 13 . The distal portion of theseal 614 is connected to a fluid line such as a catheter (not shown), and may be secured to the housing by means known to those with skill in the art, such as by the use of a support member (not shown) similar to thesupport member 214 shown inFIG. 15 . - The
ring member 616 is desirably anannular disk 616 made of a hard plastic and disposed between ashoulder 634 of theseal 614 and aproximal end 636 of thespring 618. Thering member 616 serves as a constraint for theseal 614 during compression and efficiently transfers the compressive force to thespring 618, assisting in the deformation of theseal 614. During decompression, thering member 616 efficiently transfers the spring force to theseal cap 638 of theseal 614 to close theopening 620. Although thering member 616 facilitates the deformation and reformation of theseal 614, it is not necessary for theseal 614 to work. In that case, thespring 618 will contact theseal cap 638 directly. - The
spring 618 is substantially the same as thespring 222 ofFIG. 4 and serves the same function, being disposed between thering member 616 and adistal end 642 of thehousing 612. In an alternative embodiment, thedistal end 642 may be a separate component from thehousing 612 for ease of assembly. In the decompressed state shown inFIG. 12 , thespring 618 may be relaxed or be in slight compression to exert a force on theseal 614 through thering member 616 to keep theseal 614 closed. During insertion of thesyringe 630, thespring 618 is compressed and stores potential energy from the compression, as illustrated inFIG. 13 . Upon withdrawal of thesyringe 630, thespring 618 releases the potential energy and pushes thering member 616 to close theseal 616 as shown inFIG. 12 . Thespring 618 is preferably not fixed with either thering member 616 or thedistal end 642 of thehousing 612 for ease of assembly. Thespring 618 can be a helical spring or any other suitable spring known to those with skill in the art. - The
side wall 624 of theseal 614 is constrained by thering member 616 andhousing 612, and is substantially relaxed in the decompressed state. During compression of theseal 614, theside wall 624 bulges in the unconstrained region between thering member 616 and thedistal end 642 of thehousing 612, causing an increase in the fluid space within thevalve 610. Theside wall 624 returns to its decompressed shape upon decompression of theseal 614. Alternatively, theside wall 624 may be stretched in tension by thespring 618 in the decompressed state and goes through a relaxed position before deforming under compression to its bulged condition. -
FIG. 13 illustrates compression andFIG. 12 illustrates decompression during valve activation. In the compressed state, thesyringe 630 is placed on theseal cap 638 inside theopening 620 of the housing and the application of pressure on thesyringe 630 creates pressure on theseal cap 638. The downward pressure pushes theseal cap 638 and thering member 616 away from thecircular opening 620 and toward the lower portion of thehousing 612 which has a larger inner diameter, thereby allowing the precut slit 646 of theseal cap 638 to open. Theside wall 624 deforms outwardly and bulges at the unconstricted region, as thespring 618 is compressed, storing potential energy of the compression. Fluid is able to flow into thesyringe 630, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. The compression of theseal 614 shown inFIG. 13 results in a net gain in volume of the inner cavity. -
FIG. 12 illustrates thevalve 610 after withdrawal of thesyringe 630. Theseal 614 returns to its decompressed state and essentially fills theopening 620, and thering member 616 is pushed back up toward theopening 620 as thespring 618 releases its potential energy. Because of the contraction of theinner cavity 626 of theseal 614, there is a net loss in fluid space, resulting in a positive flow from thevalve 610 through, e.g., a catheter tip (not shown). The positive-flow valve 610 advantageously eliminates any dead space during decompression of theseal 614. This is further assisted by theseal 614 with theslit 646 remaining open until the very end, i.e., until theseal cap 638 is squeezed by thecircular opening 620 at the top of theupper conduit 650 of thehousing 612. - In addition, the
valve 610 can be reused because theseal 614 can return reversibly in the decompressed state. Theseal surface 652 is also swabbable for sterility. Other features of thevalve 610 are discussed previously in connection with the earlier embodiments of this invention. - A sixth embodiment of a
valve 710 is illustrated inFIGS. 14 and 15 . Thevalve 710 comprises a valve body orhousing 712 and aseal 714. Thehousing 712 has anupper conduit 716 near a proximal end with acircular opening 718 that is preferably adapted to receive a medical implement. Aside wall portion 720 is protruded to facilitate deformation of theseal 714. Adistal end 724 of thehousing 712 forms a lower passage 726 (partially shown) which supports and constrains adistal portion 728 of theseal 714, and is connected, for example, to a fluid line such as a catheter (not shown). Alternatively, a support member (not shown) may be used to detachably lock onto thehousing 712 and support theseal 714, such as those shown inFIG. 4 (214) orFIG. 12 (514). - The
seal 714 is generally similar to theseal 614 ofFIGS. 12 and 13 , and has a substantially cylindrical side wall 721, although theside wall 732 may have a slight bulge 733 as shown inFIG. 14 . It defines aninner cavity 734 which forms an expandable fluid space inside thevalve 710. In the decompressed state, theseal 714 is constrained by theupper conduit 716 andlower passage 726 of thehousing 712, and is substantially relaxed in the decompressed state. The components are dimensioned and configured to cause the fluid space to expand or increase upon insertion of the medical implement and to contract or decrease upon withdrawal of the medical implement such as thesyringe 730 partially shown in phantom inFIG. 15 . During compression of theseal 714, theside wall 732 bulge in the unconstrained region between theupper conduit 716 andlower passage 726 and thebulge 738 is substantially round. Theside wall 732 return to its decompressed shape upon decompression of theseal 714. -
FIG. 15 illustrates compression andFIG. 14 illustrates decompression during valve activation. In the compressed state, thesyringe 730 is placed on theseal cap 742 of theseal 714 inside theopening 718 of thehousing 712 and the application of pressure on thesyringe 730 creates pressure on theseal cap 742. The downward pressure pushes theseal cap 742 away from thecircular opening 718 and toward the protrudedportion 720 of thehousing 712 which has a larger inner diameter, thereby allowing the precut slit 746 of theseal cap 742 to open. Theside wall 732 deforms outwardly and bulges at theunconstricted region 738, storing potential energy of the compression. Fluid is able to flow into thesyringe 730, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. The compression of theseal 714 shown inFIG. 15 generates a net gain in volume of the inner cavity. -
FIG. 14 illustrates thevalve 710 after withdrawal of thesyringe 730. Theseal 714 returns to its decompressed state and essentially fills theopening 718. Because of the contraction of theinner cavity 734 of the seal, there is a net loss in fluid space, resulting in a positive flow from thevalve 710 through, e.g., a catheter tip (not shown). The positive-flow valve 710 advantageously eliminates any dead space during decompression of theseal 714. This is further assisted by theseal 714 with theslit 746 remaining open until the very end, i.e., until theseal cap 742 is squeezed by thecircular opening 718 at the top of theupper conduit 716. - In addition, the
valve 710 can be reused because theseal 710 can return reversibly in the decompressed state. Theseal surface 748 is also swabbable for sterility. Other features of thevalve 710 are discussed previously in connection with the earlier embodiments of this invention. -
FIGS. 16 and 17 illustrate avalve 710 in accordance with a seventh embodiment of the present invention, thevalve 756 comprising a valve body orhousing 758 and aseal 760 that are substantially the same as thehousing 712 and seal 714 ofFIGS. 14 and 15 , with adistal portion 762 of theseal 760 connected to a fluid line such as a catheter (not shown). Theseal 760, however, is configured to deform upon compression into a diamond-shapedcusp 764 instead of around bulge 738 as illustrated inFIGS. 14 and 15 . This type of construction may facilitate deformation and reformation of theseal 760, and may be more easily formed. The valve activation of this embodiment is virtually identical to that inFIGS. 14 and 15 , except for the deformed shape of theseal side wall 770. It is contemplated, therefore, that a seal that may deform into a variety of shapes other than round and diamond shapes to achieve positive flow may be employed, as long as the it is dimensioned and configured to cause the fluid space of the valve to expand upon insertion of a medical implement and to contract upon withdrawal of the medical implement such as thesyringe 774 partially shown in phantom inFIG. 28 . - As illustrated in
FIGS. 18 and 19 , aneighth embodiment valve 810 of the present invention is similar to the embodiments shown inFIGS. 14-17 . Thevalve 810 also includes ahousing 812 having aninternal cavity 814 with anupper conduit 816, and aseal 818 disposed inside theinternal cavity 814 and having aninner cavity 820 that defines a fluid space. Thehousing 812 has adistal end 824 which supports aside wall 826 of theseal 818. Adistal portion 828 of theseal 818 is connected to a fluid line such as a catheter (not shown). The pressure at theinner cavity 820 of theseal 818 is P1. Between thehousing 812 and theseal 818 is anenclosed pressure chamber 832 at pressure P2. The valve activation utilizes the pressure difference between P2 in thepressure chamber 832 and P1 in theinner cavity 820 of theseal 818. - Upon insertion of a medical implement such as a
syringe 836 shown in phantom inFIG. 19 , the pressure at theinner cavity 820 of theseal 818 increases from P1 to P3 and the fluid space inside theseal 818 expands from the decompressed state ofFIG. 18 . The expansion of the fluid space results primarily from a difference in pressure between P3 and P2. Thisvalve 810 is particularly advantageous in the case where theside wall 826 of theseal 818 deforms without storing substantial potential energy. For instance, theside wall 826 of theseal 818 may deform without substantial resistance or resiliency such as a membrane, or the seal is not constrained longitudinal by thedistal portion 824 of thehousing 812 and may slide in and out of theinternal cavity 814 of thehousing 812 through thedistal end 824. -
FIG. 19 illustrates compression andFIG. 18 illustrates decompression during valve activation. In the compressed state, thesyringe 836 is placed on theseal cap 838 of theseal 818 inside theopening 840 of thehousing 812 and the application of pressure on the syringe creates pressure on theseal cap 838. The downward pressure pushes theseal cap 838 away from thecircular opening 840 and toward the lower portion of thehousing 812 which has a larger inner diameter, thereby allowing the precut slit 844 of theseal cap 838 to open. The entry of the fluid causes the pressure at theinner cavity 814 of theseal 812 to increase to P3. As a result, theside wall 826 deforms outwardly and bulges at theunconstricted region 848. Potential energy is stored in the change in pressure differential between theinner cavity 820 and thepressure chamber 832. Theside wall 826 of theseal 818 need not deform and store energy, but may do so. Fluid is able to flow into thesyringe 836, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. The compression of theseal 818 shown inFIG. 19 causes a net gain or increase in fluid volume within the inner cavity. -
FIG. 18 illustrates thevalve 810 after withdrawal of thesyringe 836. Theseal 818 returns to its decompressed state and essentially fills theopening 840, and the pressure in theinner cavity 820 returns to P1 and releases the potential energy. Because of the contraction of theinner cavity 820 of theseal 818, there is a net loss in fluid space, resulting in a positive flow from thevalve 810 through, e.g., a catheter tip (not shown). The positive-flow valve 810 advantageously eliminates any dead space during decompression of theseal 818. This is further assisted by theseal 818 with theslit 844 remaining open until the very end, i.e., until theseal cap 838 is squeezed by thecircular opening 840 at the top of theupper conduit 816. - In addition, the
valve 810 can be reused because theseal 818 can return reversibly in the decompressed state. Theseal surface 854 is also swabbable for sterility. Other features of thevalve 810 are discussed previously in connection with the earlier embodiments of this invention. - A ninth embodiment of a
valve 910 comprising ahousing 912, asupport member 914, askirt 916, aseal 918, and a scissor-like cross member 920, is depicted inFIGS. 20 and 21 . Thehousing 912 has anupper conduit 924 with acircular opening 926. Thesupport member 914 has aninner conduit 928 which is connected to a fluid line such as a catheter (not shown). Theseal 918 has aside wall 930 desirably formed of alternatingwall portions 932 and defines aninner cavity 934 which forms an expandable fluid space inside thevalve 910. Thecross member 920 is dimensioned and configured to assist in causing the fluid space to expand upon insertion of a medical implement and to contract upon withdrawal of the medical implement such as thesyringe 936 partially shown in phantom inFIG. 21 . - The
cross member 920 has twolongitudinal member 940 attached together which rotates with respect to one another, and is desirably made of a hard material such as a hard plastic. Thecross member 920 is disposed at aconstricted portion 942 of theseal 918 within theinner cavity 934 with thelongitudinal members 940 preferably substantially disposed vertically. The ends 944 of thelongitudinal members 940 are desirably attached to theside wall 930 as shown inFIG. 20 . Thelongitudinal members 940 rotate to a substantially horizontal orientation upon compression by the insertion of thesyringe 936 as shown inFIG. 21 . This rotation is referred to as the deformation of thecross member 920. Thelongitudinal members 940 may be attached to rotate freely with respect to one another. Alternatively, thelongitudinal members 940 may be spring-loaded or attached such that they rotate under a rotational force but reform to their relaxed position upon release of the force. Upon withdrawal of thesyringe 936 as shown inFIG. 20 , thelongitudinal members 940 return to the substantially vertical positions, referred to as the reformation of thecross member 920. Thelongitudinal members 940 are desirablylongitudinal plates 940 with sufficient width to expand theconstricted portion 942 of theseal 918 in the substantially horizontal position but not so wide that they impedes flow therethrough. Alternatively, they may contain holes (not shown) through which fluid can pass. -
FIG. 21 illustrates compression andFIG. 20 illustrates decompression during valve activation. In the compressed state, thesyringe 926 is placed on theseal cap 950 of theseal 918 inside theopening 926 of thehousing 912 and the application of pressure on thesyringe 936 creates pressure on theseal cap 950. The downward pressure pushes theseal cap 950 away from thecircular opening 926 and toward the lower portion of thehousing 912 which has a larger inner diameter, thereby allowing the precut slit 952 ofseal cap 950 to open. Theside wall 930 of theseal 918 deforms in an accordion-like manner, and thecross member 920 deforms and opens up the constricted portion 922 of theseal 918, storing potential energy of the compression. Fluid is able to flow into thesyringe 936, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. The compression of theseal 918 and deformation of thecross 920 shown inFIG. 21 generally causes a contraction of the volume of theinner cavity 934 of theseal 918. Thevalve 910 has a net gain in volume of theinner cavity 934, however, because the general contraction of theinner cavity 934 is less than by the expansion of theconstricted portion 942 pushed apart by thecross member 920. The expansion results from the movement of thelongitudinal members 940 of thecross member 920 during compression. -
FIG. 20 illustrates thevalve 910 after withdrawal of thesyringe 936. Theseal 918 returns to its decompressed state and essentially fills theopening 926, and thecross member 920 reforms to allow the constrictedregion 942 of theseal 918 to narrow. Because of the contraction of theinner cavity 934 at theconstricted portion 942, there is a net loss in fluid space, resulting in a positive flow from thevalve 910 through, e.g., a catheter tip (not shown). The positive-flow valve 910 advantageously eliminates any dead space during decompression of theseal 918. This is further assisted by theseal 918 with theslit 952 remaining open until the very end, i.e., until theseal cap 950 is squeezed by thecircular opening 926 at the top of theupper conduit 924. - In addition, the
valve 910 can be reused because theseal 918 can return reversibly in the decompressed state. Theseal surface 960 is also swabbable for sterility. Other features of thevalve 910 are discussed previously in connection with the earlier embodiments of this invention. -
FIGS. 22 and 23 illustrate avalve 1010 in accordance with a tenth embodiment of the present invention, thevalve 1010 comprising a valve body orhousing 1012, a support member 1014 (partially shown), aseal 1016, aring member 1018, aresilient reel 1020, and a scissor-like cross member 1022. Thesupport member 1014 has an inner conduit (not shown) which is connected to a fluid line such as a catheter (not shown). Theseal 1016 has aseal cap 1028 withslit 1030,shoulder 1032, and pressureresponsive member 1034. - The
ring member 1018 forms a sliding contact with adistal end 1036 of theseal 1016 and is preferably made from a hard plastic. Thering member 1018 desirably has ashoulder 1038 which is constrained by aledge 1040 of thehousing 1012 in the upward direction. The distal end of thering member 1018 contacts anupper flange 1044 of theresilient reel 1020 and facilitates transfer of the compressive force due to insertion of a medical implement to cause deformation of thereel 1020. Thereel 1020 is made from a material that is flexible, inert, and impermeable to fluid, such as silicon. It has alower flange 1046 that is supported and secured by thesupport member 1014 and acentral body portion 1048 that is substantially cylindrical. Theseal 1016,ring member 1018, andresilient reel 1020 define aninner cavity 1050 which forms an expandable fluid space inside thevalve 1010. - The
cross member 1022 is substantially the same of thecross member 920 ofFIGS. 20 and 21 and is dimensioned and configured to assist in causing the fluid space to increase upon insertion of a medical implement and to decrease upon withdrawal of the medical implement such as thesyringe 1054 partially shown in phantom inFIG. 23 . Thecross member 1022 has twolongitudinal members 1056 rotatably attached together. Thecross member 1022 is disposed adjacent thecentral body portion 1048 of thereel 1020 within theinner cavity 1050 with thelongitudinal members 1056 preferably pointed toward the vertical direction and desirably attached to thecentral body portion 1048 at its fourends 1058 as shown inFIG. 22 . Thelongitudinal members 1056 rotate to a substantially horizontal orientation upon compression by the insertion of thesyringe 1054 as shown inFIG. 23 . This rotation is referred to as the deformation of thecross member 1022. Thelongitudinal members 1050 may be attached to rotate freely with respect to one another. Alternatively, thelongitudinal members 1056 may be spring-loaded or attached such that they rotate under a rotational force but reform to their relaxed position upon release of the force. Upon withdrawal of thesyringe 1056 as shown inFIG. 22 , thelongitudinal members 1056 return to the substantially vertical positions, referred to as the reformation of thecross member 1022. The longitudinal members 1026 are desirablylongitudinal plates 1056 with sufficient width to open up thecentral body portion 1048 of thereel 1020 in the substantially horizontal position but not so wide that they impedes flow therethrough. Alternatively, they may contain holes (not shown) through which fluid can pass. -
FIG. 23 illustrates compression andFIG. 22 illustrates decompression during valve activation. In the compressed state, thesyringe 1054 is placed on theseal cap 1028 inside theopening 1062 of thehousing 1012 and the application of pressure on thesyringe 1054 creates pressure on theseal cap 1028. The downward pressure pushes theseal cap 1028 away from thecircular opening 1062 and toward the lower portion of thehousing 1012 which has a larger inner diameter, thereby allowing theprecut slit 1030 to open. Thering member 1018 moves toward thesupport member 1014 and compresses theresilient reel 1020. Theupper flange 1044 of theresilient reel 1020 is pushed by thering member 1018 toward thelower flange 1046. Thecentral body portion 1048 bulges outwardly as thecross member 1022 deforms, storing potential energy of the compression. Fluid is able to flow into thesyringe 1054, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. - The compression of the
seal 1016 and deformation of thecross 1022 shown inFIG. 23 generally causes a reduction in the volume of the inner cavity of theseal 1016. Thevalve 1010 has a net gain in volume of theinner cavity 1050, however, because the expansion of thecentral body portion 1048 of the flexible reel 120 causes an increase in fluid volume which reduction resulting in is greater than the general contraction of theinner cavity 1050. The expansion results from the movement of thelongitudinal members 1056 of thecross member 1022 to open up thecentral body portion 1048 of theresilient reel 1020 during compression. -
FIG. 22 illustrates thevalve 1010 after withdrawal of thesyringe 1054. Theseal 1016 returns to its decompressed state and essentially fills theopening 1062, and thecross member 1022 reforms to allow thecentral body region 1048 of theresilient reel 1022 to narrow. Because of the contraction of theinner cavity 1050 at thecentral body portion 1048, there is a net loss in fluid space, resulting in a positive flow from thevalve 1010 through, e.g., a catheter tip (not shown). The positive-flow valve 1010 advantageously eliminates any dead space during decompression of theseal 1016. This is further assisted by theseal 1016 with theslit 1030 remaining open until the very end, i.e., until theseal cap 1028 is squeezed by thecircular opening 1062 at the top of theupper conduit 1066 of the housing. - In addition, the
valve 1010 can be reused because theseal 1016 can return reversibly in the decompressed state. Theseal surface 1068 is also swabbable for sterility. Other features of thevalve 1010 are discussed previously in connection with the earlier embodiments of this invention. - An eleventh embodiment of a
valve 1110 in accordance with the present invention is illustrated inFIGS. 24 and 25 , and comprises a valve body orhousing 1112 and aseal 1114. Thehousing 1112 has anupper conduit 1116 near a proximal end with acircular opening 1118 that is preferably adapted to receive a medical implement such as asyringe 1120 partially shown in phantom inFIG. 25 . Thehousing 1112 has a lower conduit 1124 (partially shown) near a distal end which is connected to a fluid line such as a catheter (not shown). Disposed between theupper conduit 1116 andlower conduit 1124 are protruded right and leftside walls ribbed portions side walls ribbed portions housing 1112 is desirably made of a firm material such as a hard plastic. - The
seal 1114 is generally similar to theseal 318 ofFIG. 6 with asimilar shoulder 1132,seal cap 1134, and pressureresponsive element 1136. Thecylindrical side wall 350 ofFIG. 6 , however, is replaced with aspreader 1140, which includes twolegs shoulder 1132 outwardly atdistal ends 1144 a,1144 b that bear against the protruded right and leftside walls FIG. 24 . The distal end 1144 a may be attached to the protrudedside wall 1126 a, and thedistal end 1144 b may be attached to the protrudedside wall 1126 b, by adhesives or other available means. Aninner cavity 1150 is formed by theseal 1114 and adistal portion 1152 of thehousing 1112, and defines a fluid space of thevalve 1110. During compression of theseal 1114, thespreader 1140 extends further outwardly and pushes the protrudedside walls seal 1114 andhousing 1112 are configured and dimensioned to assist in causing the fluid space to expand upon insertion of the medical implement 1120 and to contract upon withdrawal of the medical implement 1120. -
FIG. 25 illustrates compression andFIG. 24 illustrates decompression during valve activation. In the compressed state, thesyringe 1120 is placed on theseal cap 1134 inside theopening 1118 of thehousing 1112 and the application of pressure on thesyringe 1120 creates pressure on theseal cap 1134. The downward pressure pushes theseal cap 1134 away from thecircular opening 1118 and toward the lower portion of thehousing 1112 which has a larger inner diameter, thereby allowing theprecut slit 1156 oft he sealcap 1134 to open. Thespreader 1140 extends outwardly, stretching the resilientribbed portions side walls housing 1112 outwardly, storing potential energy of the compression. Fluid is able to flow into thesyringe 1120, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. The compression of theseal 1114 and deformation of thespreader 1140 shown inFIG. 36 results in a net gain in volume of theinner cavity 1150. -
FIG. 24 illustrates thevalve 1110 after withdrawal of thesyringe 1120. Theseal 1114 returns to its decompressed state and essentially fills theopening 1118, and thespreader 1140 and resilientribbed portions side walls inner cavity 1150, there is a net loss in fluid space, resulting in a positive flow from thevalve 1110 through, e.g., a catheter tip (not shown). The positive-flow valve 1110 advantageously eliminates any dead space during decompression of theseal 1114. This is further assisted by the seal 14 with theslit 1156 remaining open until the very end, i.e., until theseal cap 1134 is squeezed by thecircular opening 1156 at the top of theupper conduit 1116. - In addition, the
valve 1110 can be reused because theseal 1114 can return reversibly in the decompressed state. Theseal surface 1160 is also swabbable for sterility. Other features of thevalve 1110 are discussed previously in connection with the earlier embodiments of this invention. - A
twelfth embodiment valve 1210 is illustrated inFIGS. 26 and 27 , and comprises a valve body orhousing 1212, a support member 1214 (partially shown), aseal 1216, aring member 1218, and aresilient reel 1226. Thehousing 1212,support member 1214, andring member 1218 are substantially the same as those shown inFIGS. 22 and 23 . Thehousing 1212 has anupper conduit 1224 with acircular opening 1226. Thesupport member 1214 has an inner conduit (not shown) which is connected to a fluid line such as a catheter (not shown). Thedistal end 1228 of thering member 1218 contacts anupper flange 1232 of theresilient reel 1220 and facilitates transfer of the compressive force due to insertion of a medical implement such as a syringe to cause deformation of thereel 1220. Thereel 1220 further includes acentral body portion 1234 and alower flange 1236 that is desirably supported and secured by thesupport member 1214. - The
seal 1216 is similar to theseal 1114 ofFIGS. 24 and 25 , and has asimilar seal cap 1240 withslit 1242,shoulder 1244, and pressureresponsive member 1246. Theseal 1246 has aspreader 1250 that extends from theshoulder 1244 outwardly and forms a circulardistal ring 1252 that bears against thecentral body portion 1234 of theresilient reel 1220, as best seen inFIG. 26 . Thedistal ring 1252 may be attached to thecentral body portion 1234 by adhesives or other available means. Aninner cavity 1254 is formed by theseal 1216 and adistal portion 1256 of the resilient reel, and defines a fluid space of thevalve 1210. During compression of theseal 1216, thespreader 1250 extends further outwardly and pushes thecentral body portion 1234 of theresilient reel 1220 outwardly. Theseal 1216 andresilient reel 1220 are configured and dimensioned to assist in causing the fluid space to increase upon insertion of a medical implement and to decrease upon withdrawal of the medical implement such as thesyringe 1260 partially shown in phantom inFIG. 27 . -
FIG. 27 illustrates compression andFIG. 26 illustrates decompression during valve activation. In the compressed state, thesyringe 1260 is placed on theseal cap 1240 inside theopening 1226 of thehousing 1212 and the application of pressure on thesyringe 1260 creates pressure on theseal cap 1240. The downward pressure pushes theseal cap 1240 away from thecircular opening 1226 and toward the lower portion of thehousing 1212 which has a larger inner diameter, thereby allowing theprecut slit 1242 to open. Thering member 1218 moves toward thesupport member 1214 and compresses theresilient reel 1220. Theupper flange 1232 of theresilient reel 1220 is pushed by thering member 1214 toward thelower flange 1236. Thecentral body portion 1234 bulges outwardly as thespreader 1250 deforms and pushes thecentral body portion 1234 outwardly, storing potential energy of the compression. Fluid is able to flow into thesyringe 1260, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. - The compression of the
seal 1216 and deformation of thespreader 1250 and reel 1220 shown inFIG. 27 causes an increase in volume of theinner cavity 1254 because of the expansion of thecentral body portion 1234 of theflexible reel 1220. The expansion results from the movement of thespreaders 1250 to open up thecentral body portion 1234 of theresilient reel 1220 during compression. -
FIG. 26 illustrates thevalve 1210 after withdrawal of thesyringe 1260. Theseal 1216 returns to its decompressed state and essentially fills theopening 1226, and thespreader 1250 reforms to allow thecentral body region 1234 of theresilient reel 1220 to narrow. Because of the contraction of theinner cavity 1254 at thecentral body portion 1234, there is a net loss in fluid space, resulting in a positive flow from thevalve 1210 through, e.g., a catheter tip (not shown). The positive-flow valve 1210 advantageously eliminates any dead space during decompression of theseal 1216. This is further assisted by theseal 1216 with theslit 1242 remaining open until the very end, i.e., until theseal cap 1240 is squeezed by thecircular opening 1226 at the top of theupper conduit 1224. - In addition, the
valve 1210 can be reused because theseal 1216 can return reversibly in the decompressed state. Theseal surface 1266 is also swabbable for sterility. Other features of thevalve 1210 are discussed previously in connection with the earlier embodiments of this invention. - A
thirteenth embodiment valve 1310 in accordance with the present invention is illustrated inFIGS. 28 and 29 . Thevalve 1310 comprises a body orhousing 1312, a support member 1314 (partially shown), anupper seal 1316, and alower seal 1318. Thehousing 1312 has anupper conduit 1322 near a proximal end with acircular opening 1324 that is preferably adapted to receive a medical implement such as asyringe 1326 partially shown in phantom inFIG. 40 . Thebody 1312 has anupper side wall 1330 distal to theupper conduit 1322 that is desirably circular in cross section with a diameter larger than the diameter of thecircular opening 1324. Thebody 1312 has alower side wall 1332 distal to theupper side wall 1330 with a diameter larger than the diameter of theupper side wall 1330. Amiddle conduit 1338 is advantageously formed between theupper side wall 1330 andlower side wall 1332. Theupper side wall 1330 is advantageously tapered from theupper conduit 1322 to themiddle conduit 1338 and thelower side wall 1332 is advantageously tapered from themiddle conduit 1338 to adistal end 1340 of thehousing 1312. Themiddle conduit 1338 has a diameter larger than the diameter of theupper conduit 1322 and smaller than the diameter of thedistal end 1340 of thehousing 1312. - The
support member 1314 has at its distal end an inner conduit (not shown) which may be connected to a terminal of a catheter (not shown). Thesupport member 1314 serves as a support and attachment device for the upper andlower seals seals internal cavity 1346 of thehousing 1312. - The upper and
lower seals upper seal 1316 has aseal cap 1350 with a generally flattop surface 1352, ashoulder 1354, aside wall 1356, and abase 1358. Theside wall 1356 advantageously is comprised of ringedwall portions 1360 which deform in an accordion-like fashion and assist in the reformation of theseal 1316 to enclose thehousing opening 1324 upon withdrawal of thesyringe 1326. During compression of theupper seal 1316, the diameter of the ringedwall portions 1360 expand outwardly in the radial direction. The interior of theupper seal 1316 is hollow to provide an upperinner cavity 1362, as best seen inFIG. 28 . Theshoulder 1354 engages anupper ledge 1366 provided in theupper conduit 1322 of thehousing 1312 such that theupper ledge 1366 confines the movement of theshoulder 1354 toward theopening 1324 to prevent theupper seal 1316 from being blown through theopening 1324 under high pressure in the upperinner cavity 1362 of theseal 1316, - The
seal cap 1350 of theupper seal 1316 reseals in thevalve 1310 at theopening 1324 with thetop surface 1352 of theseal 1316 flush with or above theopening 1324 upon removal of the medical implement 1326. Theseal cap 1350 substantially fills theopening 1324 in the top of theupper conduit 1322. It is preferred thetop surface 1352 be exposed after assembly so that it may be swabbed with alcohol or other disinfectant. Theseal cap 1350 of theupper seal 1316 desirably has a unique shape with aprecut slit 1370 such that theseal cap 1350 is squeezed shut by theopening 1324 when assembled and theslit 1370 opens automatically during compression. Theseal 1316 desirably also includes a pressureresponsive member 1372 to further assist in creating a fluid-tight seal in the decompressed state. - As shown in
FIGS. 28 and 29 , thelower seal 1318 desirably is generally similar to theupper seal 1316. The lower seal has asimilar seal cap 1380 with a generally flattop surface 1382, ashoulder 1384, and aside wall 1386. Theside wall 1386 defines a lowerinner cavity 1390 and may include similar ringed wall portions (not shown). Theseal cap 1380 is disposed at themiddle conduit 1338 at the decompressed state and reseals the lowerinner cavity 1390 at themiddle conduit 1338 upon removal of the medical implement 1326. The lowerinner cavity 1390 forms a fluid space of thevalve 1310, being in fluid communication through the lower conduit (not shown) to, e.g., a catheter (not shown). The valve components are configured and dimensioned to assist in causing the fluid space to increase upon insertion of the medical implement 1326 and to decrease upon withdrawal of the medical implement 1326. - The
seal cap 1380 advantageously provides a fluid tight seal, having a shape and aprecut slit 1394 similar to those of theupper seal 1316. Thelower seal 1318 also includes desirably a pressureresponsive member 1396 similar to the pressureresponsive member 1372 of theupper seal 1316. The components of thelower seal 1318 are generally larger than those of theupper seal 1316 because of the geometry of thevalve housing 1312. - To illustrate valve activation,
FIG. 29 shows the compressed state of thevalve 1310 upon insertion of thesyringe 1326. Thesyringe 1326 is placed on theupper seal cap 1350 inside theopening 1324 of thehousing 1212. The application of pressure on thesyringe 1326 creates pressure on theseal cap 1330, and the resulting downward pressure compresses theupper seal 1316. This pushes theseal cap 1350 away from thecircular opening 1324 and toward themiddle conduit 1338 at a region with a larger inner diameter, thereby allowing theprecut slit 1370 to open. The downward movement is facilitated by the compression of the ringedwall portions 1360 of theside wall 1356 of theupper seal 1316. The downward force is transferred to thelower seal 1318 through thebase 1358 of theupper seal 1316 which cooperates with theseal cap 1380 of thelower seal 1318. The application of the pressure pushes thelower seal cap 1380 away from themiddle conduit 1338 and toward the lower portion of thehousing 1312 which has a larger inner diameter, thereby allowing theprecut slit 1394 to open. Fluid is now able to flow into thesyringe 1326, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient.FIG. 29 shows thevalve 1310 opened by insertion of thesyringe 1326 into theopening 1324. - In the compressed state shown in
FIG. 29 , the fluid space generally contract under pressure from the decompressed state shown inFIG. 28 . Upon removal of thesyringe 1326 from theupper conduit 1322, as shown inFIG. 28 , the upper andlower seals inner cavity 1362 and lowerinner cavity 1390, and the closing of theprecut slit 1394 of thelower seal 1318 upon compression, a decrease in volume results in the lowerinner cavity 1390 of thevalve 1310. The decrease in the fluid space advantageously generates a positive flow from thevalve 1310 through, e.g., a catheter tip (not shown) to eliminate dead space. Advantageously, any dead space within the upperinner cavity 1362 is also minimized since, as thesyringe 1326 is withdrawn, theslit 1370 remains open until the very end, i.e., until theseal cap 1350 is squeezed by thecircular opening 1324 at the top of theupper conduit 1322. The elimination of backflash is particularly advantageous in the case where thevalve 1310 is connected through a catheter to a patient, because it prevents the introduction of blood into the catheter. - As the
upper seals 1316 is free to move to its decompressed state, it essentially fills thecircular opening 1324. The ability of theupper seal 1316 to return reversibly to its decompressed state, together with the resiliency of thelower seal 1318, permits the reuse of thevalve 1310. Following disconnection, and before reuse, thesurface 1352 of theseal cap 1316 is essentially flush with theopening 1324 of thehousing 1312. Thus, thisflush surface 1352 can advantageously be sterilized with alcohol or other surface decontaminating substances. A cover cap (not shown) can further be used to fit over the upper conduit to protect thesurface 1352 of theseal cap 1350. - A fourteenth embodiment of a
valve 1410 of the present invention is illustrated inFIGS. 30 and 32 , and comprises a valve body orhousing 1412, aseal 1414, apiston 1416, and aspring 1418. Thehousing 1412 has anupper conduit 1420 near a proximal end with acircular opening 1422 that is preferably adapted to receive a medical implement such as asyringe 1423 partially shown in phantom inFIG. 30 . Thehousing 1412 has aside conduit 1424 which is connected to a fluid line such as a catheter (not shown). Disposed in alower chamber 1426 of thehousing 1412 is thespring 1418 supporting thepiston 1416 which bears against adistal end 1430 of theseal 1414 disposed in anupper chamber 1432 of thehousing 1412. Thelower chamber 1426 of thehousing 1412 advantageously includes anorifice 1434 for venting the air therein to facilitate movement of thespring 1418. Theupper chamber 1432 andlower chamber 1426 expand and contract according to the movement of thepiston 1416 under pressure from theseal 1414 and thespring 1418. Thehousing 1412 advantageously includes aside aperture 1438 additional fluid to be transferred to the patient through theupper chamber 1432 andside conduit 1424 when necessary. - The
seal 1414 hasseal cap 1442 withprecut slit 1444, ashoulder 1446, and a pressureresponsive member 1448. The seal has aside wall 1450 which defines aninner cavity 1452 and has thedistal end 1430 that cooperates with thepiston 1416 for efficient transfer of pressure between them. Near thedistal end 1430 of theseal 1414 is desirably atransverse fluid passage 1456 for fluid communication between theseal 1414 and theupper chamber 1432. AlthoughFIGS. 30 and 32 illustrate that thetransverse fluid passage 1456 also facilitates fluid flow between theside aperture 1438 and theside conduit 1424, it need not do so if fluid can flow around theseal 1414 in theupper chamber 1432. Theupper chamber 1432 and theinner cavity 1450 of theseal 1414 forms the fluid space of thevalve 1410. -
FIG. 31 illustrates compression andFIG. 30 illustrated decompression during valve activation. In the compressed state, thesyringe 1423 is placed on theseal cap 1442 inside theopening 1422 of thehousing 1412 and the application of pressure on thesyringe 1423 creates pressure on theseal cap 1442. The downward pressure pushes theseal cap 1442 away from thecircular opening 1422 and toward the lower portion of thehousing 1412 which has a larger inner diameter, thereby allowing theprecut slit 1444 to open. Theside wall 1450 moves further into theupper chamber 1432 and pushes the piston 1476 downward against thespring 1418, which is compressed, storing potential energy of the compression. Fluid is able to flow into thesyringe 1423, or vice versa, depending on whether fluid is to be withdrawn from the patient or medication injected into the patient. The compression of theseal 1414 shown inFIG. 42 generates a net gain or increase in volume of the fluid space of thevalve 1410. -
FIG. 30 illustrates thevalve 1410 after withdrawal of thesyringe 1423. Theseal 1414 returns to its decompressed state and essentially fills theopening 1422, and thepiston 1416 moves back to its decompressed position as thespring 1418 releases its potential energy. Because of the contraction of theupper chamber 1432 of thehousing 1412, there is a net loss in fluid space, resulting in a positive flow from thevalve 1410 through, e.g., a catheter tip (not shown). The positive-flow valve 1410 advantageously eliminates any dead space during decompression of theseal 1414. This is further assisted by the seal 141 with theslit 1444 remaining open until the very end, i.e., until theseal cap 1442 is squeezed by thecircular opening 1422 at the top of theupper conduit 1420. - In addition, the
valve 1410 can be reused because theseal 1414 can return reversibly in the decompressed state. The seal surface 1460 is also swabbable for sterility. Other features of thevalve 1410 are discussed previously in connection with the earlier embodiments of this invention. - Additional embodiments of the present invention are contemplated without departing from the spirit and scope of the present invention. For instance, the volume inside a straight tubing contracts when the tube is bent. Thus, one valve embodiment valve may have a fluid space inside a straight tubing which bends upon insertion of a medical implement and reforms upon withdrawal of the medical implement, thereby effecting positive flow.
- In addition, many of the ringed side wall of the seals (such as the
portions 1360 of theseal 1316 ofFIG. 28 ) can be replaced bycircular tires 1580 stacked in series one on top of an adjacent larger-diameter lower tire, as illustrated inFIG. 32 . Thecircular tires 1580 are preferably solid throughout the diameter of the cross-section thereof. Like the ringedside wall portions 1360, thesecircular tires 1580 will deform and reform upon, respectively, compression and decompression of the seal. - In the embodiments described above, the fluid space inside the valve increases upon insertion of a medical implement in the compressed state and decreases upon withdrawal of the medical implement in the decompressed state. In some embodiments, the structure defining the fluid space is substantially relaxed and does not store substantial amount of potential energy. Insertion of the medical implement causes a change in the structure that allows it to store potential energy. The potential energy is released upon withdrawal of the medical implement and the structure returns to a substantially relaxed condition. In other embodiments, at least some components of the structure defining the fluid space stores potential energy under strain or deformation. Upon insertion of a medical implement in the compressed state, the potential energy in those components is released and is stored in other components of the structure or in another form. The stored potential energy in the compressed state is released when the medical implement is removed, and the original potential energy is restored in the structure.
- The above presents a description of the best mode contemplated of carrying out the present invention, and of the manner and process of using it, in such full, clear, concise, and exact terms as to enable any person skilled in the art to which it pertains to make and use this invention. This invention is, however, susceptible to modifications and alternate constructions from that discussed above which are fully equivalent. In particular, many of the features of the co-pending applications, serial nos. and can be incorporated into the present invention, and these applications are incorporated herein by reference. The embodiments described are meant to be illustrative and not exhaustive. Consequently, it is not the intention to limit this invention to the particular embodiments disclosed. On the contrary, the intention is to cover all modifications and alternate constructions coming within the spirit and scope of the invention as generally expressed by the following claims, which particularly point out and distinctly claim the subject matter of the invention.
Claims (1)
1. A positive flow medical valve comprising a body including a wall structure defining an internal cavity having a proximal end and a distal end, said proximal end having an opening sufficiently large to receive a delivery end of a medical implement which configured to transfer fluid through the delivery end;
a resilient seal element which is adapted to be moved into a second position upon insertion of a delivery end of a medical implement into said opening and returns to a first position upon removal of the delivery end, the seal element in the first position having a section which fills essentially completely a portion of the cavity adjacent the opening, with the seal element section bearing against the wall structure near the opening to impede fluid flow through the opening, and in the second position the seal element section being pushed by the delivery end of the medical implement away from the opening and into the cavity, the seal having a hollow interior and including an orifice in the seal element section, the orifice configured to be substantially open in the first position and substantially closed in the second position;
a fluid space including at least a portion of the hollow interior and disposed at least partially in the cavity;
a rigid fluid conduit arranged along a axial centerline of the valve; and
a flow control member which is configured to cooperate with the fluid conduit to reversibly expand the fluid space when the seal element is in the second position and contract the fluid space when the seal element is in the first position, such that movement of the seal element from the second position to the first position transfers fluid away from the proximal end of the cavity.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/417,771 US20060200088A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US76758796A | 1996-12-16 | 1996-12-16 | |
US09/411,988 US6428520B1 (en) | 1996-12-16 | 1999-10-04 | Positive-flow valve |
US10/163,719 US6932795B2 (en) | 1996-12-16 | 2002-06-05 | Positive flow valve |
US11/085,808 US20050222541A1 (en) | 1996-12-16 | 2005-03-21 | Positive flow valve |
US11/417,771 US20060200088A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
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US11/085,808 Continuation US20050222541A1 (en) | 1996-12-16 | 2005-03-21 | Positive flow valve |
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US20060200088A1 true US20060200088A1 (en) | 2006-09-07 |
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Family Applications (8)
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US09/411,988 Expired - Lifetime US6428520B1 (en) | 1996-12-16 | 1999-10-04 | Positive-flow valve |
US10/163,719 Expired - Lifetime US6932795B2 (en) | 1996-12-16 | 2002-06-05 | Positive flow valve |
US11/085,808 Abandoned US20050222541A1 (en) | 1996-12-16 | 2005-03-21 | Positive flow valve |
US11/417,771 Abandoned US20060200088A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
US11/418,542 Abandoned US20060206061A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
US11/417,773 Abandoned US20060200089A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
US11/417,843 Abandoned US20060264849A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
US11/417,825 Abandoned US20060200090A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
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Application Number | Title | Priority Date | Filing Date |
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US09/411,988 Expired - Lifetime US6428520B1 (en) | 1996-12-16 | 1999-10-04 | Positive-flow valve |
US10/163,719 Expired - Lifetime US6932795B2 (en) | 1996-12-16 | 2002-06-05 | Positive flow valve |
US11/085,808 Abandoned US20050222541A1 (en) | 1996-12-16 | 2005-03-21 | Positive flow valve |
Family Applications After (4)
Application Number | Title | Priority Date | Filing Date |
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US11/418,542 Abandoned US20060206061A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
US11/417,773 Abandoned US20060200089A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
US11/417,843 Abandoned US20060264849A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
US11/417,825 Abandoned US20060200090A1 (en) | 1996-12-16 | 2006-05-03 | Positive flow valve |
Country Status (13)
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US (8) | US6428520B1 (en) |
EP (1) | EP0956088B1 (en) |
JP (1) | JP2001506156A (en) |
CN (3) | CN1915451A (en) |
AT (1) | ATE475451T1 (en) |
AU (1) | AU737266B2 (en) |
CA (1) | CA2275218C (en) |
DE (1) | DE69739948D1 (en) |
HK (1) | HK1026155A1 (en) |
IL (1) | IL130482A0 (en) |
NO (1) | NO992904L (en) |
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Also Published As
Publication number | Publication date |
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US20060200090A1 (en) | 2006-09-07 |
JP2001506156A (en) | 2001-05-15 |
US20060200089A1 (en) | 2006-09-07 |
HK1026155A1 (en) | 2000-12-08 |
NO992904D0 (en) | 1999-06-14 |
NO992904L (en) | 1999-08-11 |
EP0956088A1 (en) | 1999-11-17 |
CA2275218A1 (en) | 1998-06-25 |
CA2275218C (en) | 2008-10-14 |
US20060206061A1 (en) | 2006-09-14 |
ATE475451T1 (en) | 2010-08-15 |
AU7736198A (en) | 1998-07-15 |
CN1172727C (en) | 2004-10-27 |
AU737266B2 (en) | 2001-08-16 |
US6932795B2 (en) | 2005-08-23 |
CN1768871A (en) | 2006-05-10 |
US6428520B1 (en) | 2002-08-06 |
CN1915451A (en) | 2007-02-21 |
US20050222541A1 (en) | 2005-10-06 |
WO1998026835A1 (en) | 1998-06-25 |
EP0956088B1 (en) | 2010-07-28 |
DE69739948D1 (en) | 2010-09-09 |
IL130482A0 (en) | 2000-06-01 |
US20020147431A1 (en) | 2002-10-10 |
CN1246073A (en) | 2000-03-01 |
NZ336284A (en) | 2001-05-25 |
US20060264849A1 (en) | 2006-11-23 |
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