WO2011076281A1 - Removal of a needle protection cap from a needle - Google Patents

Removal of a needle protection cap from a needle Download PDF

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Publication number
WO2011076281A1
WO2011076281A1 PCT/EP2009/067886 EP2009067886W WO2011076281A1 WO 2011076281 A1 WO2011076281 A1 WO 2011076281A1 EP 2009067886 W EP2009067886 W EP 2009067886W WO 2011076281 A1 WO2011076281 A1 WO 2011076281A1
Authority
WO
WIPO (PCT)
Prior art keywords
needle
housing
needle guard
preceding
needle protection
Prior art date
Application number
PCT/EP2009/067886
Other languages
German (de)
French (fr)
Inventor
Fritz Kirchhofer
Original Assignee
Tecpharma Licensing Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tecpharma Licensing Ag filed Critical Tecpharma Licensing Ag
Priority to PCT/EP2009/067886 priority Critical patent/WO2011076281A1/en
Publication of WO2011076281A1 publication Critical patent/WO2011076281A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/32Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/3202Devices for protection of the needle before use, e.g. caps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/32Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/3205Apparatus for removing or disposing of used needles or syringes, e.g. containers; Means for protection against accidental injuries from used needles
    • A61M5/321Means for protection against accidental injuries by used needles
    • A61M5/3243Means for protection against accidental injuries by used needles being axially-extensible, e.g. protective sleeves coaxially slidable on the syringe barrel
    • A61M5/326Fully automatic sleeve extension, i.e. in which triggering of the sleeve does not require a deliberate action by the user
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/32Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/3205Apparatus for removing or disposing of used needles or syringes, e.g. containers; Means for protection against accidental injuries from used needles
    • A61M5/321Means for protection against accidental injuries by used needles
    • A61M5/3243Means for protection against accidental injuries by used needles being axially-extensible, e.g. protective sleeves coaxially slidable on the syringe barrel
    • A61M5/3245Constructional features thereof, e.g. to improve manipulation or functioning
    • A61M2005/3247Means to impede repositioning of protection sleeve from needle covering to needle uncovering position
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/32Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/3205Apparatus for removing or disposing of used needles or syringes, e.g. containers; Means for protection against accidental injuries from used needles
    • A61M5/321Means for protection against accidental injuries by used needles
    • A61M5/3243Means for protection against accidental injuries by used needles being axially-extensible, e.g. protective sleeves coaxially slidable on the syringe barrel
    • A61M5/326Fully automatic sleeve extension, i.e. in which triggering of the sleeve does not require a deliberate action by the user
    • A61M2005/3267Biased sleeves where the needle is uncovered by insertion of the needle into a patient's body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/315Pistons; Piston-rods; Guiding, blocking or restricting the movement of the rod or piston; Appliances on the rod for facilitating dosing ; Dosing mechanisms
    • A61M5/31533Dosing mechanisms, i.e. setting a dose
    • A61M5/31545Setting modes for dosing
    • A61M5/31548Mechanically operated dose setting member
    • A61M5/3155Mechanically operated dose setting member by rotational movement of dose setting member, e.g. during setting or filling of a syringe
    • A61M5/31553Mechanically operated dose setting member by rotational movement of dose setting member, e.g. during setting or filling of a syringe without axial movement of dose setting member
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/315Pistons; Piston-rods; Guiding, blocking or restricting the movement of the rod or piston; Appliances on the rod for facilitating dosing ; Dosing mechanisms
    • A61M5/31533Dosing mechanisms, i.e. setting a dose
    • A61M5/31545Setting modes for dosing
    • A61M5/31548Mechanically operated dose setting member
    • A61M5/3156Mechanically operated dose setting member using volume steps only adjustable in discrete intervals, i.e. individually distinct intervals
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/315Pistons; Piston-rods; Guiding, blocking or restricting the movement of the rod or piston; Appliances on the rod for facilitating dosing ; Dosing mechanisms
    • A61M5/31565Administration mechanisms, i.e. constructional features, modes of administering a dose
    • A61M5/31576Constructional features or modes of drive mechanisms for piston rods
    • A61M5/31578Constructional features or modes of drive mechanisms for piston rods based on axial translation, i.e. components directly operatively associated and axially moved with plunger rod
    • A61M5/3158Constructional features or modes of drive mechanisms for piston rods based on axial translation, i.e. components directly operatively associated and axially moved with plunger rod performed by axially moving actuator operated by user, e.g. an injection button
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/315Pistons; Piston-rods; Guiding, blocking or restricting the movement of the rod or piston; Appliances on the rod for facilitating dosing ; Dosing mechanisms
    • A61M5/31565Administration mechanisms, i.e. constructional features, modes of administering a dose
    • A61M5/3159Dose expelling manners
    • A61M5/31591Single dose, i.e. individually set dose administered only once from the same medicament reservoir, e.g. including single stroke limiting means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/32Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/3202Devices for protection of the needle before use, e.g. caps
    • A61M5/3204Needle cap remover, i.e. devices to dislodge protection cover from needle or needle hub, e.g. deshielding devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178Syringes
    • A61M5/31Details
    • A61M5/32Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/3205Apparatus for removing or disposing of used needles or syringes, e.g. containers; Means for protection against accidental injuries from used needles
    • A61M5/321Means for protection against accidental injuries by used needles
    • A61M5/3243Means for protection against accidental injuries by used needles being axially-extensible, e.g. protective sleeves coaxially slidable on the syringe barrel
    • A61M5/3271Means for protection against accidental injuries by used needles being axially-extensible, e.g. protective sleeves coaxially slidable on the syringe barrel with guiding tracks for controlled sliding of needle protective sleeve from needle exposing to needle covering position
    • A61M5/3272Means for protection against accidental injuries by used needles being axially-extensible, e.g. protective sleeves coaxially slidable on the syringe barrel with guiding tracks for controlled sliding of needle protective sleeve from needle exposing to needle covering position having projections following labyrinth paths

Abstract

The invention relates to a device for removing a needle protection cap (3) from a needle (10), said device comprising a housing (1), a needle (10) for injecting a liquid product, a needle protection cap (3) covering the needle (10), and a needle protection sleeve (2) which is or can be coupled to the needle protection cap (3) in such a way that the needle protection cap (3) can be removed from the needle (10) by a movement of the needle protection sleeve (2).

Description

 DEVICE FOR REMOVING A NEEDLE PROTECTION CAP FROM A NEEDLE

The invention relates to a device for removing a needle protection sleeve from an injection needle with which a liquid product, preferably a medicament, can be injected into a patient. The invention further relates to an administration device, in particular with such a device, wherein the device is particularly suitable for dispensing a medicament based on FSH or an FSH variant. Furthermore, the device may be suitable for the release of neuroleptics, vasodilating agents, blood products, medicaments for the treatment of rheumatic diseases, oncologics or drugs for the treatment of infectious diseases. For the purposes of the invention, liquid medicaments are not only liquids in the narrower sense, but also paste and gelatinous medicaments, as long as such medicaments can only be promoted comparable to a liquid. The administration device is preferably an injection device for administration by means of an infusing injection needle, preferably for a subcutaneous injection, but in principle may also be an injection device for needleless administration or, for example, also an inhalation device. Injection devices in the form of so-called Injektionspens are particularly preferred embodiments.

A known from WO 2005/115508 AI injection device receives a syringe on the distal end of a needle cap is attached, which covers an injection needle. The injection device further includes a cap which engages the needle guard, the cap being rotated for withdrawal, thereby moving the cap axially away from the housing of the device. This rotational and axial movement turns and pulls the needle cap from the syringe. The cap is an additional part that initially holds the use of the device after removal in the hand. From EP 0 956 875 A2 a device for the metered administration of an injectable product is known. In this device, a scraper is pushed against the force of a spring in a needle protection sleeve for removing the needle cap, wherein an attached to the scraper engaging member engages the needle cap and this cap with a movement of the scraper from the needle guard in the distal direction and carries away from the needle away.

The invention is based on the object to provide a device for removing a needle cap from a needle that is simple and inexpensive and intuitive to use by the user.

The object is solved with the objects of the independent claims. Advantageous developments emerge from the dependent claims, the description and the figures.

The invention relates to a device for removing a needle cap from a needle. The device may be part of an injection device, that is, the invention may start from an injection device, in which the device for removing a needle protection sleeve is integrated by a needle. The housing of the injection device can correspond to the housing of the device for removing the needle protection cap. Alternatively, the device may be a separate unit attachable to an injection device, such as an autoinjector or other injection device. For this purpose, the device z. B. have a housing which is connectable to the housing of the injection device.

The device comprises a housing and a needle, which is preferably arranged in the longitudinal direction of the preferably sleeve-shaped housing. The needle may be a needle attachable to a product container, for example with a luer-lock connection, in particular a cannula. The cannula may comprise a needle carrier which is connectable to the carpule or to a carpule holder which receives the carpule. The carpule may have a septum that can be pierced by the needle of the cannula when the cannula is attached to the carpule or cartridge holder. At the proximal end this is Medicine in the carpule with an elastic piston, the sealing and slidably against the inner wall of the carpule rests closed.

The product container may be a syringe in a preferred alternative, at the front end of the needle is fixed. However, a syringe is also conceivable on which the needle, e.g. as a cannula, attachable. A syringe usually has no septum but a piston like the carpule. The syringe may be at its rear, i. proximal end have an outwardly projecting flange, which is also referred to as a finger flange, because it strikes against a manual use of the syringe against index and middle finger, while with the thumb a pressure z. B. is exerted on the piston via a piston rod.

The needle for injecting the preferably liquid product may be covered by a needle cap. The needle cap is mainly used for the purpose of keeping the needle sterile and possibly also to protect against mechanical damage. The needle cap is preferably form and / or frictionally engaged with the needle carrier, which is separately attachable to the product container or part of the product container preferably designed as a syringe, attached or fastened. The needle carrier can also be referred to as a fastening section. The needle protection cap is preferably arranged in an initial state of the device on the needle. The needle cap can for example be made of an elastic material, such. As rubber or rubber or at least have such a material. For example, a composite needle shield may be advantageous in which the cap formed from the elastic material is surrounded by a plastic that is rigid with respect to the cap. The needle cap is thus more stable and can better protect the needle from mechanical damage. The needle cap is removed from the needle prior to injection.

The device further comprises a needle protection sleeve, which is coupled to the needle protection cap or coupled, that with a movement of the needle protection sleeve, the needle protection cap is removable from the needle. This is advantageous because the needle cap in certain mounting positions by the user of the device is difficult or impossible, whereby the removal of the needle cap is difficult. The invention facilitates this Remove the needle cap as the user can remove them from the needle even if the needle cap is barely accessible or not accessible.

Unlike technical solutions with a cap attached to the distal end of the device, which is removed from the distal end prior to use of the device, thereby entraining the needle guard, in the invention the needle shield remains on the device. The needle guard serves at least after an injection to protect the user from accidental needle sticks. Since the needle tip would be exposed after removal from the body tissue without needle protection sleeve, there would be a risk of injury or risk of injection for third parties. To reduce these dangers, the needle guard is positioned over the needle protruding beyond the distal end of the housing. In particular, the needle protection sleeve surrounds the needle laterally. In particular, the needle guard sleeve may extend distally beyond the distal end of the needle, i. H. survive the needle tip. The needle guard can be moved relative to the housing with a movement in the distal direction, i. in the direction in which the needle tip points to be moved, in particular extended. In the extended position, the needle guard is preferably disposed over the needle and the needle tip.

The needle guard may be movable between an extended position relative to the housing to a retracted position in which the needle protrudes beyond the distal end of the needle guard, such as in a manual product dispensing pen, or at least in a protruding position. such as in an auto-injector, in which the needle is inserted automatically and in particular the product is automatically distributed. Preferably, the needle cap is movable by pressing its distal end to an injection site in the retracted position, whereby the needle is pierceable into the body tissue. By moving the needle guard to the retracted position, the needle fixed relative to the housing may protrude from the needle guard, or a propelling mechanism, such as a propulsion spring, may be deployed to displace the needle distally relative to the housing, thereby removing the needle from the needle guard emerges. In the latter alternative, the needle guard can also serve as a trigger element. The needle guard is preferably movable from its retracted position to an extended position by moving the needle guard in the distal direction. The extended positions before and after movement of the needle guard to the retracted position may be the same or different. In particular, the needle protection sleeve can protrude differently far from the distal end of the housing in different extended positions. Generally preferred in the extended positions, the needle tip is covered by the needle guard. In particular, the needle guard is mounted in its extended relative to the housing positions on the device, in particular on the housing of the device.

In preferred embodiments, the needle guard is removable from the needle by movement of the needle guard relative to the housing toward an extended position of the needle guard. In particular, the needle guard can be moved from an initial position of the needle guard, which occupies the needle guard in a delivery state or initial state of the device in the extended position. The home position may be the retracted position or a position in which the needle guard is disposed axially between the retracted position and an extended position of the needle guard.

Preferably, the needle protection sleeve by the user of the device, in particular from the starting position of the needle guard, pulled out of the housing in the direction of extended position, in particular with a movement in the distal direction. The needle guard can surround the needle guard in its initial state and during movement to the extended position. When pulling out the needle guard, the needle guard can be stripped or removed from the needle. In particular, the needle guard can take the needle cap. In particular, when removing the needle protection sleeve from the housing for removing or stripping the needle cap takes place no or no significant relative movement between the needle cap and needle protection sleeve. The extraction of the needle cap can take place exclusively or proportionately with muscle power of the user. The user can grasp the needle guard and pull it out of the housing. The needle protection sleeve can this purpose a gripping element, such as. B. have a structured surface or in particular annularly around the needle protection sleeve and outwardly directed Abragung. For example, such a projection can also serve for a stop, in which they in the retracted position of the needle guard with z. B. appliance, the distal end of the housing. In particular, the device can have a spring element, such as a compression spring designed as a coil spring, which exerts an energy stored in it as a force acting in the distal direction on the needle protection sleeve, in particular in the starting position and / or the retracted position of the needle protection sleeve and / or the extended positoin (s). Particularly preferably, the needle protection sleeve is arranged on the device such that movement of the needle protection sleeve from its initial position in the direction of its extended position by applying a force acting in the distal direction, in particular in addition to the force exerted by the prestressed spring on the needle protection sleeve force is movable. The spring element is particularly preferably configured such that the force exerted by it on the needle protection sleeve is smaller than the force which is necessary for a movement of the needle protection sleeve from its starting position in the direction of the extended position. As a result, it can be prevented that the needle protection sleeve moves from its initial position due to the spring force in the extended position. Only when in addition the muscle force is exerted on the needle guard, the holding force of the needle guard is overcome in its initial position, so that the needle guard is moved in the distal direction.

In preferred embodiments, the device may comprise an engagement member which in the initial position of the needle guard is in engagement with a distal-acting stop, for example the housing. The engagement is such, or the engagement member and the stop are formed so that movement of the needle guard from its initial position towards its extended position only by applying a force acting in the distal direction force on the needle guard, in particular in addition to that produced by the prestressed spring Force is solvable. The stop is not an end stop which prevents any movement of the needle guard in the axial direction, but a releasable stop or intermediate stop which impedes movement of the needle guard in the distal direction. The engaging member can snap at a sufficiently large force over the stop and / or on the stop be moved past. In other words, the engagement with a force which is increased in relation to the force required for displacement movement of the needle guard, detachable.

The engagement member, which is preferably cam-shaped, may be resiliently mounted relative to the needle guard. In particular, the resilient mounting may allow a movement of the engaging member transverse to the longitudinal axis of the device or the needle guard, wherein the engaging member preferably in the longitudinal direction of the device or the needle guard, in particular relative to the needle guard can perform no or only a negligible movement. This can be achieved in particular by an arm which is fastened in one piece in particular to the needle protection sleeve at one end and has the engagement member at the other end. The arm may extend in the longitudinal direction of the needle guard or the device and preferably in the proximal direction from the proximal end of the needle guard. In particular, needle guard, arm and engaging member are integral, such as. B. a manufactured by injection molding plastic part.

The device may further comprise an engagement element which engages on or in the needle cap. The needle guard and the engagement member are preferably coupled such that the needle guard moves the needle guard to its extended position. As a result, the needle cap can be stripped from the needle. The engagement element can, for. B. may be a separate part which is coupled to the needle guard, such. B. a metal ring which engages laterally in the needle cap, in particular by material deformation in the needle cap. Particularly preferably, the engagement element is integral with the needle guard. The engagement element is preferably arranged at one end of an arm, which is fastened with another end to the needle protection sleeve. The arm may extend in the longitudinal direction of the needle guard or the device and preferably in the proximal direction from the proximal end of the needle guard. Again, it is advantageous to mold the needle protection sleeve by injection molding of plastic. In particular, the engagement element may be hook-shaped, so that it engages in or on the needle cap. The engagement element particularly preferably engages in the flank of the needle protection cap or on the proximal end of the needle protection cap, in particular between the needle protection cap and a medicament section of the needle protection cap Product container. In particular, the section of the product container in which the piston is displaceable or / and in which the medicament is received can be defined as the medicament section. During the movement of the needle protection sleeve from its starting position to the extended position, the needle protection cap which is positively and / or non-positively attached to the needle carrier or the fastening section is stripped off the needle or from the needle carrier or the fastening section via the engagement of the at least one engagement element. The engagement of the at least one engagement element with the needle protection cap preferably remains until the needle protection sleeve is detached from the needle carrier or the attachment section.

Preferably, the needle guard is in a position to be moved from the home position in the distal direction into engagement with a stop acting in the distal direction. The stop acting in the distal direction can also be regarded as an end stop, as it blocks movement of the needle protection sleeve in the distal direction. In particular, the needle guard is in this position in an extended position. In particular, a movement of the needle protection sleeve from the extended position in the proximal direction may be possible in principle.

Preferably, the needle guard is locked at the end of the movement from the extended position to the retracted position back to an extended position on a movement in the distal and proximal directions, ie, that the needle guard is axially fixed after use, in particular with and relative to the housing , As a result, the needle guard can not be pushed back into the housing, whereby the needle can no longer emerge from the distal end of the needle guard and thereby reducing the risk of injury from the needle is reduced.

For ease of understanding, the extended position in which the needle guard is moved from the home position in the distal direction and in particular into engagement with the stop acting in the proximal direction is referred to as the first extended position. The position of the needle guard, in which it moves from the retracted position to the extended position and in particular is axially locked, is referred to as the second extended position. First and second extended position may be regarding their position relative to the housing to be the same, but it must not. For example, in the first extended position, the needle guard may be further from the housing than in the second extended position, or vice versa. Preferably, the engagement member of the needle guard in the first extended position is engageable with or operable to engage or disengage the proximal direction stop, which complicates movement of the needle guard in the proximal direction, wherein the engagement by applying one to the needle guard and in proximal Direction-acting force is solvable. In particular, the engagement member can snap over the stop and / or be moved past the stop when a sufficiently large force acting in the proximal direction force is exerted on the needle guard. For example, the sufficiently large force is significantly greater than the force exerted by the spring element on the needle protection sleeve. The needle protection sleeve can be displaceable against the force of the spring element, that is, by the displacement of the needle protection sleeve in the proximal direction, in particular from the first extended position to the retracted position, the spring element is tensioned.

The spring element may be a separate spring or a spring formed integrally on the needle protection sleeve. A separate spring may, for. Example, a plastic spring or a metal spring, which acts between the housing and the needle guard or is arranged. For example, a plastic spring can be integrally connected to the needle protection sleeve, in particular spring and needle protection sleeve can be made by an injection molding of plastic. Alternatively, a metal spring during injection molding of the needle guard in the needle guard is embeddable or at least partially encapsulated by plastic.

In preferred embodiments, the spring-mounted engagement member is deflectable in a movement of the needle guard from the first extended position in the proximal direction of a guide surface, wherein the engagement member in or upon reaching the retracted position of the needle guard from the deflected position springs back. Once the engaging member is spring back, the needle guard can not be in the first extended position, but only to be moved to the second extended position. It is generally preferred that the needle protection sleeve can only be moved into the second deflected position when the needle tip has emerged beyond the distal end of the needle protection sleeve and / or the needle protection sleeve has been pushed back into its retracted position, in particular into a stop with the housing. In particular, the engagement element can spring transversely to the longitudinal axis of the needle protection sleeve, in particular askew to the longitudinal axis.

In preferred embodiments, the engagement member in a distal movement of the needle guard from its retracted position, d. H. during the movement into the second extended position, be deflected by one, in particular further guide surface, wherein the engagement member springs back in the extended position of the needle guard from the deflected position. In particular, the engagement member is transversely to the longitudinal axis in particular skewed deflected and zurückfederbar.

Particularly preferably, the engagement member is in the second extended position of the needle guard between a distal acting stop, which blocks a movement of the needle guard in the distal direction and may be referred to as an end stop, and a stop acting in the proximal direction, the movement of the Needle sleeve locks in the proximal direction. As a result, the needle guard is prevented from moving in the distal and in the proximal direction and locked relative to the housing.

It is generally preferred that at least one, preferably each of the stops for the engagement member and / or at least one, preferably each of the guide surfaces for the engagement member is formed by a guideway. The guideway may include or may be a guideway and / or include or may be a guideway. The guideway is preferably formed by the housing. In particular, the guideway is open to the inside of the housing recess, the z. B. may be groove-shaped. The groove may be a blind groove with a groove bottom or a through groove through the wall of the housing or recess. For example, the continuous groove may be visible from the outside, wherein the blind groove may not be visible from the outside. The least a stop and / or the at least one guide surface can be formed in a blind groove of the groove bottom and / or the groove flanks or in a continuous groove of the groove flanks. The preferably cam-shaped engagement member engages in the guideway, in particular from the inside of the housing. Alternatively, the engagement member engage from the outside in the guideway, which is then open to the outside of the housing recess. This alternative arrangement protects in particular from the fact that the engaging member can be released manually. The engagement member can engage only in a part of the displacement movements of the needle guard in the guideway or groove. However, it is preferred that the engagement member engages during all displacement movements of the needle guard in the guideway or groove.

The invention also opens up routes for the safe administration of liquid medicaments whose active substance (s) in air is subject to the risk of contamination, in particular formulations which contain FSH or FSH variant as essential active substance, or another active substance or medicament mentioned herein. It is particularly important to avoid the use of preservatives, not least in terms of negative effects on the respective active ingredient (s), but also on the additional costs that result from the admixture of preservatives. According to the invention, the product container, which may also be referred to as a reservoir, is delivered to the patient with the non-preserved liquid medicament, preferably in the form of a complete administering device or a device part which can be assembled with simple handles. The non-preserved, in the presence of air-contaminated drug is safely stored in the sterile until immediately before administration closed reservoir so that it can be stored in this state over a period of several days or even months or years. Sterility is not reversed until immediately before use by the patient or an administering physician.

Preferred is a delivery device with sequential control, the reservoir is sterile closed and contains a liquid drug in the form of, for example, a liquid formulation of FSH or FSH variant, or other drug referred to herein. The use of cartridges or syringes, which is an unpreserved Medicament, for example FSH or an unpreserved FSH variant, contained in a sterile and therefore preservative-free condition, but is also as such an object of the invention. Also preferred is an administration device without metering capability, that is to say without metering element, although the possibility of individual metering by the patient himself is also of great advantage for the administration of such medicaments. Other drugs that can be stored according to the invention in an unconserved state in a sterile sealed reservoir of the administering device and thus virtually indefinitely commercially, the doctor or even the respective patient are, for example, Neuroleptica (Fluphenazini decanoas), vasodilators (Adrenalinum ), Blood products (etamsylate, epoetin alfa, filgrastim (G-CSF), nadroparinum calcium, desmopressini acetas), medicines for rheumatic diseases (methotrexate, etanerceptum), oncologica (cladribinum, interferonum humanum gammalb ADN) and drugs for infectious diseases (herpes simplex Typl / type 2, human immunoglobulin). In parentheses are given usual or preferred active ingredients for each group of drugs.

An FSH based drug preferably contains an alpha and a beta subunit. The proteins for the useful formulations can be obtained by various methods. Preferably, the FSH to be used is a heterodimer comprising an oc-subunit and a β-subunit, as described in more detail in EP 1 188 444 A1. Preferably, the device according to the invention is used to administer a formulation of FSH and / or an FSH variant in an aqueous solvent. The term "aqueous solvent" refers to a liquid solvent containing water. Aqueous solvent systems may consist only of water or may consist of water and one or more miscible solvents and may contain other solutes, such as sugars or other adjuvants. The conventionally used miscible solvents are the short chain organic alcohols such as methanol, ethanol, propanol, short chain ketones such as acetone, and polyalcohols such as glycerine. Preferably, the solvent system consists only of water for injections. Auxiliaries may be selected from isotonicity agents, preservatives, buffer systems, in particular phosphate buffers, thioether compounds such as methionine as antioxidant, Dispersants or emulsifiers such as poloxamers and mixtures thereof. The formulation contains no preservatives, especially no preservative of the group consisting of phenol, m-cresol, chlorocresol, a paraben selected from methyl, ethyl, propyl or butylparaben, benzalkonium chloride, benzethonium chloride, sodium dehydroacetate, benzyl alcohol and thimerosal. It is furthermore preferred if the formulation is free of poly-, oligo- and dicarboxylic acids as well as glycine and / or glycerol.

In particular for the administration of non-preserved liquid medicaments, such as the administration of liquid formulations of FSH or an FSH variant, it is advantageous if only a quantity of medicament is stored in the sterile closed reservoir which is at most as large as a daily dose, more preferably as one Maximum dose (monodose) in which the drug in question is administered in a single administration of at most a few minutes' duration, preferably a single injection. The reservoir and thus also the administering device are therefore preferably a reservoir and a delivery device for a monodose of the medicament. The maximum dose for drugs based on, for example, FSH or an FSH variant is typically 300 IU, in exceptional cases 500 IU, measured across a variety of patients. In the case of such a medicament, therefore, the amount of medicament present in the reservoir corresponds at most to a dose of 500 IU, more preferably at most 300 IU, in preferred embodiments. Since a majority of patients manage with significantly lower doses per single administration, for example with at most 200 IU or even at most 100 IU, the filling quantity in such a therapy can advantageously also correspond at most to this dose.

In a further development, the administration devices are each provided with a reservoir which has a more accurate fit to the actual needs of the respective patient. For example, identical administration devices can be used, for example, in two, three or more different filling quantity variants. In the case of, for example, an FSH-based therapy, administration devices of the same type can be offered, which essentially differ from each other only in terms of the capacity of their reservoir, for example a device with a reservoir, the 300 IU of the drug, another device that contains 200 IU of the same drug and another device that contains 100 IU of the drug, each in the sterile state. It can also be made a second subdivision into intermediates, for example in the form of a fourth filling variant with a reservoir containing 150 IU of the drug in the sterile state. In general, doses for FSH may range from 75 IU to 300 IU, in exceptional cases up to 500 IU. The device is preferably designed for single use, as a disposable item, and can be advantageously disposed of with household waste. Immediately prior to administration, the drug is placed in contact with the external environment in the reservoir, which has until then been sterile.

For the sterile closure of the reservoir in particular two variants come into consideration. In the first variant, a carpule forms the reservoir, which has an outlet for administration, which is sterile-closed by a pierceable septum. The medicament is sterile enclosed in such embodiments between the septum and an axially movable piston. With such a reservoir, a needle unit is used with a needle holder and an injection needle projecting through the needle holder. The needle holder serves to hold the injection needle and to establish the fluid connection of the needle to the reservoir. For the connection, the reservoir or preferably the housing may directly have a connection section in the region of the outlet of the reservoir. The connecting portion and a connecting portion of the needle holder are cooperatively formed, so that upon establishment of the mechanical connection between the needle holder and the connecting portion of the reservoir or the housing, the injection needle pierces the septum. After piercing, the interior of the reservoir is connected to the environment via the needle. Following the preparation of this fluid connection the drug is administered as possible without delay. Subsequently, the administration device or at least one part of the device containing the completely or partially empty reservoir, if appropriate only the reservoir, is disposed of. In the second variant, a syringe or syringe-like structure forms the reservoir. In contrast to the first variant, the reservoir of the second variant already has an injection needle at its distal end, so that the fluid connection between the reservoir and a downstream outlet of the reservoir already exists from home Injection needle exists. The sterile closure is provided by an external sealing member, such as the needle shield described herein, which seals the needle outlet in a sterile manner. The sealing element is removed immediately before use. In a simplest embodiment, in which the medicament is already contained, for example, in exactly the dose in the reservoir which is to be distributed by means of a single administration, it is possible to dispense with the feature of meterability, and the dosing member can accordingly be dispensed with. Even in such embodiments, it is advantageous if the administration device has a priming function. The priming function can be performed by the delivery member by blocking it in the initial state of the delivery device in a releasable blocking engagement, from which it has to be moved by applying a force or a torque. Due to the short priming stroke, a volume predetermined by the length of the priming stroke is expelled from the reservoir. The end of the priming stroke is preferably determined by a priming stop. In contact with the priming stop, the conveyor member can then perform the Ausschüttbewegung. The dispensing movement is preferably an axial movement in a direction of advance. The priming stroke is preferably also an axial movement in the advancing direction. Between the priming stroke and the Ausschütthub a transverse movement of the conveying member is advantageously required and also possible after execution of the priming stroke, whereby the priming and pouring are securely separated.

It is also advantageous for therapies with unpreserved medicament or a reservoir filled for a single administration, a monodose, if the administering device has the ability to be metered, that is to say has the aforementioned metering element. In this way, despite an optional variety of variants in terms of the filling amount for each only a single administration in each variant again the dose can be set more accurately. In other words, by providing multiple fill variations, the amount of drug seen across many patients can be reduced overall, as compared to implementations in which the reservoir contains the maximum dose that is actually distributed in a single administration within therapy. On the other hand, the individual patient within the suitably selected filling quantity again set individually the dose tailored to him and even administer this only.

The invention has been explained with reference to several embodiments. Hereinafter, a particularly preferred embodiment of the invention will be explained with reference to figures. The features which become apparent in this case individually and in each combination of features advantageously further form the subjects of the claims and also the embodiments described above. Show it:

Figures la and lb a device in the delivery state with a

 Needle guard in its initial position,

Figure 2 shows the device of Figure 1 during the withdrawal of a

 Needle cap,

 Figures 3a and 3b, the device of Figure 1 with a withdrawn or removed

 Needle cap and the needle guard in their first extended position,

Figures 4a to 4c, the device with a retracted into the housing

 Needle guard,

 Figure 5 shows the device of Figure 1 with a needle guard in its second extended position.

With reference to FIGS. 1 a and 1 b, a device designed as an injection device is shown, which has a housing 1 in which a product container 9 in the form of a syringe with a needle 10 fastened undetachably thereto is arranged. The needle 10 is held by a needle carrier or attachment portion 9c formed on the product container 9. The distal end of the needle 10 is used for piercing a patient, the proximal end of the needle 10 opening into the product container 9, in particular to a product 9e accommodated in the product container 9, in particular medicament. The medicament 9e is disposed in a medicament portion 9a which is substantially cylindrical and in which a piston 9d is longitudinally slidably abutting against the inner circumference of the medicament portion 9a. At the proximal end of the Product container 9 is formed a finger flange 9d, which projects transversely to the longitudinal axis of the device to the outside and rests against a shoulder formed by the housing 1.

On the piston 9d acts a delivery member 5, which is formed in this example as a piston rod. The conveying member 5 is displaceable relative to the housing 1, wherein in a distal displacement of the piston rod 5, the piston 9d is displaced relative to the product container 9, whereby the product 9e can be released from the product container 9 through the needle 10. On the housing 1, a needle protection sleeve 2 is mounted, which is movable relative to the housing 1. The needle guard 2 has engaging elements 2a which are inwardly, d. H. protrude toward the longitudinal axis of the device and are arranged on arms, so that the engagement elements 2a can spring radially outward, which is particularly advantageous for the assembly of the needle guard 2 on the housing 1. For assembly, the needle guard 2 is inserted from the distal end of the housing 1 forth in the housing 1, wherein the engagement elements 2a can spring outwardly due to the arms when the engagement elements 2a pass through a arranged on the mounting portion 9c of the product container 9 needle cap 3. The needle cap 3 is non-positively and frictionally arranged on the mounting portion 9c of the product container 9. The needle cap 3 protects the needle 10 from contamination or contamination and mechanical damage. Before an injection, the needle cap 3 is removed.

On the proximal end of the needle cap 2 acts the distal end of a spring 8, wherein the proximal end of the spring 8 is supported on the housing 1.

In the initial position shown in the figures la and lb of the needle guard 2, which occupies the needle guard in delivery state of Inj ektions device with respect to the housing 1, the needle guard 2 engages with the engaging elements 2a to the proximal end of the needle cap 3, in particular between the Medication section 9 a and the proximal end of the needle cap 3. As can best be seen in FIG. 1 a, the needle protection sleeve 2 has an arm extending in the proximal direction from the proximal end of the needle protection sleeve 2, on the proximal end of which an engagement member 2 b is formed which forms a guide track 4 formed by the housing 1 is engaged. As a result of the arrangement on the arm, the engagement element 2b is resilient transversely to the longitudinal axis of the device, while it is substantially fixed along the longitudinal axis relative to the needle protection sleeve 2. The engaging member 2b is cam-shaped and has radially outward in the direction of the inside of the housing 1 open towards guideway 4 on the flank of the groove-shaped guideway 4, a stop acting in the distal direction 4a for engagement with the engaging member 2b is formed. The engagement is designed so that it is not solvable only with the force of the prestressed spring 8.

By applying an additional force, in particular a muscular force of the user, to the needle guard 2 in the distal direction, engagement with the stopper 4a is released by the engagement member 2b snapping over the stopper 4a. As a result, the needle protection sleeve 2 is moved from its starting position in the distal direction into its first extended position and past the stop 4a. In order, among other things, to improve the graspability of the needle protection sleeve 2 for the user, the needle protection sleeve 2 has a projection 2c which points radially outwards.

The engaging member 2b beats at the end of the movement of the needle guard 2 in its first extended position on an end stop 4c, which acts in the distal direction, but blocks movement of the needle guard 2 in the distal direction, even with increased force. It should be noted that this stop could probably be destroyed with a very high force, whereby in normal use such a force is not exerted on the needle guard 2.

During the movement in the distal direction, the needle protection sleeve 2 takes over the needle protection cap 3 via the engagement elements 2a, so that it is detached or stripped off from the product container 9 or the attachment section 9c. The needle cap 3 can thus be removed from the device (Figures 3a and 3b). In the first extended position of the needle guard 2, which is shown in Figures 3a and 3b, movement of the needle guard 2 in the proximal direction, ie in a retracted position by engagement of the engagement member 2b to the stop 4b difficult. By applying a force acting in the proximal direction, for example, is significantly greater than the force that would be required if the needle guard 2 would only be pushed against the spring force of the spring 8, the engaging member 2 b snaps over the stop 4 b, causing the At its distal end pressed to the injection site needle protection sleeve 2 is jerkily moved into the housing until the Abragung 2 c abuts the distal end of the housing 1. When pushing back the needle guard 2 in the housing or the retracted position (Figures 4a to 4c) is the needle 10 corresponding to the desired injection depth, which is preferably adapted for a subcutaneous injection, over the distal end of the needle guard 2. By the jerky pushing back the Needle sleeve 2, which is achieved by the engagement of the engaging member 2b to the stopper 4b, the needle 10 is pricked into the patient. The guideway 4 has a flank 4d, which deflects the engagement member 2b transversely to the longitudinal axis of the device when pushing back the needle guard 2 from the first extended position (Figures 3a and 3b) in the retracted position (Figures 4a to 4c) and the arm to the engaging member 2b is arranged resiliently biased. When or before reaching the retracted position of the needle guard 2, the engaging member 2b snaps back from its deflected position. In particular, the arm on which the engagement member 2b springs back after retraction of the needle guard 2, in a relaxed position. In particular, the spring-back engagement member 2b is in axial alignment with a switching section 4e of the guideway 4, which prevents a deflection of the engagement member 2b back in the direction in which the retraction movement of the needle guard 2 snaps. Further, the switching portion 4e is formed, particularly with an inclined surface, that when the needle guard 2 is moved from the retracted position in the distal direction, particularly to a second extended position, the engaging member 2b is deflected in the same direction in which the Engagement member 2b during retraction, in particular after passing the guide surface 4d of the needle guard 2 springs back. Upon movement of the needle guard 2 from the retracted position to the second extended position which takes place when the needle 10 is withdrawn from the patient with the biased spring 8 holding the needle guard 2 pressed at the injection site, the engagement member 2b becomes the switching portion 4e and another Führungsfiäche 4f deflected transversely to the longitudinal direction of the injection device, whereby the acting as a spring arm which connects the engaging member 2b and the needle guard 2, is biased.

At the end of the movement of the needle guard 2 into the second extended position, the engagement member 2b springs back transversely to the longitudinal axis of the apparatus, in the direction from which the engagement member 2b has been deflected from its retracted position to its second extended position upon movement of the needle guard 2 , A movement of the needle guard 2 in the distal direction is prevented by acting in the distal direction end stop 4g. A movement of the needle guard 2 in the proximal direction is prevented by a stop acting in the proximal direction 4h. In the second extended position, the engagement member 2b is located between the stops 4g and 4h, so that the needle protection sleeve - apart from a small game - axially locked to the housing 1 is locked (Figure 5). After use of the device this is disposed of, with the locked needle guard 2, the risk of injury to the needle 10 is reduced.

Claims

claims
Device for removing a needle protection cap (3) from a needle (10), the device comprising a housing (1), a needle (10) for injecting a liquid product, a needle protection cap (3) covering the needle (10), and a needle protection sleeve (2) which is so coupled or coupled to the needle protection cap (3) that with a movement of the needle protection sleeve (2) the needle protection cap (3) from the needle (10) is removable.
Apparatus according to claim 1, characterized in that the needle protection cap (3) by means of a movement of the needle guard (2) relative to the housing (1) in the direction of an extended position of the needle guard (2) of the needle (10) is removable.
Device according to one of the preceding claims, characterized in that the needle protection sleeve (2) in its relative to the housing (1) extended position on the device, in particular on the housing (1) is attached.
Device according to one of the preceding claims, characterized in that the needle protection sleeve (2) can be pulled out of the housing (1) in the direction of the extended position by the user of the device.
Device according to one of the preceding claims, characterized in that the needle protection sleeve (2) is arranged in its initial position axially between a retracted position and an extended position of the needle protection sleeve.
Device according to one of the preceding claims, characterized in that the needle protection sleeve (2) is coupled to an engagement element (2a) which engages on or into the needle protection cap (3) so that the needle protection cap (3) controls the movement of the needle protection sleeve (2). join in their extended position.
7. Device according to one of the preceding claims, characterized in that an engagement element in the flank of the needle cap (3) or to the proximal end of the needle cap (3), in particular between the needle cap and a medicament portion of a product container (9) engages.
8. Device according to one of the preceding claims, characterized by an engaging member (2 b) which is in the starting position of the needle guard (2) in engagement with a stop acting in the distal direction (4 a), which is formed so that a movement of the Needle protection sleeve (2) from its initial position in the direction of its extended position by applying a force acting in the distal direction, in particular to a prestressed spring (8) additional force to the needle protection sleeve (2) is releasable.
9. Device according to one of the preceding claims, characterized in that the needle protection sleeve (2) in a position in which it is moved from the starting position in the distal direction, in engagement with a stop acting in the distal direction (4 c), the a movement of the needle guard (2) locks in the distal direction and in particular forms an end stop.
10. Device according to one of the preceding claims, characterized in that the engagement member (2b) in the moved from the starting position in the distal direction position of the needle protection sleeve (2) in engagement with a stop acting in the proximal direction (4b), the one Movement of the needle guard (2) in the proximal direction difficult, the engagement by applying a force acting on the needle guard (2) and in the proximal direction force is releasable.
11. Device according to one of the preceding claims, characterized in that the engagement member (2b) is resiliently arranged, wherein the engagement member (2b) in a movement of the needle guard (2) in the proximal direction of a guide surface (4d) is deflected, said Engagement member (2b) in relation to the starting position in Proximal direction moving position of the needle guard (2) spring back from the deflected position.
12. Device according to one of the preceding claims, characterized in that the engagement member (2b) in a movement of the needle guard (2) from its retracted position in the distal direction of a guide surface (4f) is deflectable, wherein the engaging member (2b) in the extended position of the needle guard (2) spring back from the deflected position.
13. Device according to one of the preceding claims, characterized in that the engagement member (2b) from the retracted position in the extended position moving needle guard (2) between a stop acting in the distal direction (4g), the movement of the needle protection sleeve (2 ) in the distal direction, and a proximal acting stop (4h), which blocks a movement of the needle guard (2) in the proximal direction, is arranged.
14. Device according to one of the preceding claims, characterized in that at least one of the stops (4a, 4b, 4c, 4g, 4h) and / or at least one of the guide surfaces (4d, 4f) of a guideway (4) is formed, wherein the guideway is preferably formed by the housing (1) and in the guide track (4) engages the cam-shaped engagement member (2b), in particular during all displacement movements of the needle guard (2).
15. Device according to one of the preceding claims, characterized in that the housing (1) is a housing of an injection device or is connectable to the housing of an injection device.
16. administering device, which preferably comprises the device according to one of the preceding claims, comprising
a) a housing (1), b) a product container (9) or reservoir formed by the housing (1), preferably a capule or syringe, in which a liquid medicament (9e), preferably based on FSH or an FSH variant, is contained,
 c) and a conveyor (5) with a delivery member for dispensing the medicament (9e),
 d) where the drug (9e) is not preserved and
 e) the product container (9) or reservoir is sterile closed.
17. Administration device according to the preceding claim, characterized in that the product container (9) in the sterile closed state contains the medicament (9e) in an amount which is at most as large as a maximum dose, in which the medicament (9e) in a single Injection is administered.
18. Use of the device or the administering device according to one of the preceding claims with at least one of the following, in particular non-preserved medicaments or active substances:
 Drug based on FSH or FSH variant,
 - neuroleptic,
 vasodilator,
 - blood product,
 Drug for the treatment of a rheumatic disease,
 Onkologikum,
 Drug for the treatment of an infectious disease.
PCT/EP2009/067886 2009-12-23 2009-12-23 Removal of a needle protection cap from a needle WO2011076281A1 (en)

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