Abstract:
The present invention relates to a novel interchangeable lockable catheter having a cap, the cap locking onto a junction hub or base, and encasing at least one lumen proximally to the junction hub of a multi-lumen catheter, PICC line and the like. The interchangeable lockable catheter&#39;s cap and base may be made of more than one piece, and provide a locking mechanism sufficient to deter tampering, while providing a low profile, comfortable, sanitary, and efficient means of closing off lumens for patients leaving the treatment area.

Description:
[0001]    This application claims priority to a U.S. provisional application No. 62/334,482 filed on May 11, 2016 and which is incorporated herein in its entirety by reference. 
     
    
     COPYRIGHT NOTICE 
       [0002]    A portion of the disclosure of this patent contains material that is subject to copyright protection. The copyright owner has no objection to the reproduction by anyone of the patent document or the patent disclosure as it appears in the Patent and Trademark Office patent files or records, but otherwise reserves all copyright rights whatsoever. 
       BACKGROUND OF THE INVENTION 
     Field of the Invention 
       [0003]    The present invention relates to a novel interchangeable venous lockable catheter having a cap, the cap locking onto a junction hub or base, and encasing at least one lumen proximally to the junction hub of a multi-lumen venous catheter, peripherally inserted central catheters (PICC) line and the like. The interchangeable lockable catheter&#39;s cap and base may be made of more than one piece and provide a locking mechanism sufficient to deter tampering while providing a low profile, comfortable, sanitary, and efficient means of closing off lumens for patients leaving the treatment area. 
       Description of Related Art 
       [0004]    Intravenous (IV) access is essential in hospital medicine. IV access provides methods for fluid resuscitation, drug administration, and nutritional support in some patients. Peripheral IV access is appropriate for most patients; however, PICC and central venous catheters are needed for long term IV access and infusion of certain medications. 
         [0005]    PICCs provide a common means of maintaining IV access in hospitalized patients and are now commonly placed for discharge purposes. The utilization of PICC lines have increased significantly. According to the idata research, the PICC market was valued at $413 million in 2011 and is expected to reach $583 million in 2017. PICC use is expected to increase with the increase in the aging population and in conjunction with Medicare payment bundling which demands shorter length of stay and improved outcomes. 
         [0006]    Current PICC line apparatus are fixed one-piece devices. The number of lumens can vary from single to triple lumen for each catheter. The number of lumens is fixed, there is no technology that allows for manipulation of that number by either increasing or decreasing, without exchanging the entire catheter. Where the number of lumens must be changed, the patient is subjected to new catheter placement, increased medical spending, inconvenience, discomfort, and risk of complications. 
         [0007]    The complications and limitations with PICC lines are well documented. Infections with traditional PICCs are well known, allowing bacteria to be introduced directly into the bloodstream (known as central line-associated infections (CLABSI)). After infection has taken hold, the incidence of morbidity and mortality are high, and concomitantly, the cost of care where infection has occurred is very high. These infections, as well as thrombotic catheter occlusions, are well-known critical issues in healthcare. Central lines also put patients at risk for thrombosis (forming of blood clots), including both upper and lower extremity deep vein thrombosis. Moreover, venous catheters placed in the chest increase the patient&#39;s risk for a pneumothorax. Other complications include misplacement, embolisms, hemorrhage, and venous fusion among many others. 
         [0008]    Many advances have been made to combat risk of infection including valves, caps, and antimicrobial and antithromboic devices. Antimicrobial coatings used in the manufacture of PICC lines reduce infection risk, but it cannot eliminate it. Moreover, current venous catheters allow lumens to hang at significant length from the hub junction with a plastic cap for each lumen extending therefrom. 
         [0009]    Despite advances in the functionality of the venous catheter, the general structure of the product has not changed. The device is large, bulky, fixed in regards to number of lumens, and accessible to the patient. Currently, the junction hub terminates in the lumen, or multiple lumens. Those lumens hang from the junction hub and are closed off by a cap having at least one piece. These hang from the junction hub as the patient is discharged. Each cap, in one embodiment, measures approximately 1 cm in width and 4.0-4.5 cm in height. When a three-lumen port is prepared, the result is three tubes hanging from the outlet, each with its own cap hanging therefrom. These aspects cause inconvenience and discomfort for the patient, complicate management for the physician which result in unnecessary healthcare expenditures. 
         [0010]    Additionally, large and bulky nature of the traditional device has the added disadvantage of supplying a larger surface area. While this obviously complicates the ability to secure the device to the patient, it also increases the probability of contact with harmful bacteria and subsequent catheter associated infections. 
         [0011]    The large PICC line device also increases the risk of both intentional and accidental device movement. Decannulation is a common occurrence among patients with impaired cognition (either medically induced or otherwise). The bulky device provides a large target for such patients to remove their catheter entirely. Decannulation has its highest incidence in the morning and evening. This timing, unfortunately, provides a logistic conundrum, in that this coincides with the most difficult time to regain venous access. Thus, decannulation can result in prolonged hospital stay, wasted hospital resources, and cause unnecessary risk for the patient. It may also result in unnecessary and inconvenient short-term venous catheter placement before long-term venous access can be regained. 
         [0012]    While posing a particular problem for the impaired patient, the large surface area increases the risk of accidental movement of the catheter by the daily activities of the patient. The dangling lumens with their stops/end caps can impact the patient&#39;s activities of daily living (ADLs), at the very least, they are inconvenient. For instance, when bathing, the dangling lumens must be covered and secured, often necessitating a caregiver to assist. Lastly, the large dangling device is tedious for the outpatient to keep for long-term access and is inconvenient for working professionals or those patients attempting to work towards their rehabilitation goals. 
         [0013]    A common issue in the inpatient setting is the number of lumens needed for the patient. Patients are commonly discharged with single lumen catheters. The amount of access can change on a daily basis depending on the patient&#39;s clinical status. A patient who receives a single lumen PICC, which is commonly placed for hospital discharge, may medically decompensate during the hospital stay or outpatients may require admission into a hospital that may require an increased lumen need if they are not clinically stable. This scenario could result in repeated unnecessary procedures, delay in care, and increases healthcare expenditures. Some have provided systems that allow for a hub with dual lumens (U.S. Pat. No. 7,901,396), or systems allowing for the manipulation of components within the hub (U.S. Patent Application Publication No. 20130204206). Others have created hub systems that are detachable, such as in U.S. Patent Application Publication NO. 20080214991. None of these systems, however, allow for the locking of one or more lumens while allowing access to desired lumens for flushing and the like. Moreover, these systems do not provide a low-profile, compact design for outpatient use, and use with impaired patients. 
         [0014]    Accessibility to the venous catheter is a very common clinical conundrum. The recent increase in intravenous drug abuse (IVDA) among the general population has only highlighted and exacerbated the issue. Patients who abuse intravenous drugs through accessing their venous catheter are at an increased risk for complications such as catheter-associated infections and detrimental impacts on outcomes. This unnecessarily results in a large waste of healthcare dollars and places added stress on providers and patients as well as their caregivers. Few documents contemplate a locking mechanism on venous catheters. For instance, U.S. Patent Application Publication No. 20050055012 describes a multi-lumen stoppage device with a locking mechanism. That lock is a leur lock, and locks the lumen separately, does not aggregate the lumens together, or provide any low-profile system. 
         [0015]    A common and controversial topic includes the discharge of the patient with a history of IVDA with a placed venous catheter. Easy access to the bloodstream can prove irresistible, resulting in the patient removing the stop to a lumen and inputting non-prescribed/illicit drugs. Access to lumens by the patient carries a significant risk of infection through the central line. Common infections include endocarditis, osteomyelitis, and discitis, treatment of which commonly requires weeks to months of antibiotics. Patients contracting these infections as a result of IVDA commonly are admitted throughout the entirety of their treatment because of their need for continued intravenous access for antibiotic therapy. This is a significant strain on healthcare resources as well as the patient and their loved ones. 
         [0016]    Inappropriate patient access of the PICC is not only an issue for patients with venous catheters in their home environment. IVDA is a common occurrence even in the hospitalized patient. Patients are commonly found to be accessing their own venous catheters while admitted into hospital to self-administer non-prescribed/illicit drugs inappropriately. This commonly results in patients being placed in monitored beds which utilizes scarce resources within the hospital and impairs overall performance of hospital staff thus impacting care for other patients. 
         [0017]    There is a need for the significant reduction in size of dangling lumen stops and lumens from the traditional multi-lumen venous catheter which is also tamper-proof and significantly inhibits detrimental bacterial colonization. The present apparatus meets such needs and provides further related advantages. 
       BRIEF SUMMARY OF THE INVENTION 
       [0018]    The present invention describes a low profile and low surface area device that caps a/the lumen(s) extending from a catheter (referred to here as an interchangeable lockable catheter, or “ILC”). The device is more convenient for the patient, provides a smaller target for patient for self-removal, and is less cumbersome for continuation of the patient&#39;s ADLs upon discharge. The cap of the ILC gives providers the chance to modulate number of lumens based on the patient&#39;s clinical status and need. The low profile cap of the ILC decreases accessibility for inappropriate use, decreases rate of infections, decreases length of hospital stay with patients with a history of IVDA, and is less prone to accidental removal. The tamper resistant and tamper evident cap decreases the need for inpatient observation thus freeing resources within staff, decreasing monitored bed use, and improving overall care. 
         [0019]    The ILC of the present invention offers a significant financial benefit when used as it includes the catheter itself, the lumen exchange, and the tamper-resistant caps. 
         [0020]    In one embodiment, the interchangeable lockable catheter offers a user the ability to up or down regulate the number of lumens at any time based on the patient&#39;s current medical need. Changing accessibility to lumens is simple and efficient, being accomplished by a nurse at bedside in a matter of minutes. 
         [0021]    In another embodiment, the ILC has a two-piece design. In this embodiment, the ILC includes the catheter itself that is inserted into the vessel in a standard PICC line fashion with the junction hub sutured or secured onto the skin. The base of the ILC has four points of contact, or each side of the device, to ensure good contact and to form a proper seal with a cap. 
         [0022]    In yet another embodiment, the four points of contact from the interchangeable portion of the ILC rely on a hooking device and three levers on the base that lock with the cap to provide a tamper-resistant and tamper-evident cap. 
         [0023]    In most embodiments, the ILC has a locking, tamper-resistant, and tamper-evident cap. 
         [0024]    In one embodiment, interchangeable portion of the ILC houses male inserts based on the number of lumens required. 
         [0025]    In another embodiment, the ILC is a tamper resistant/evident cap having a push insert base comprising a pull-tab and breakaway twist cap attachment. 
         [0026]    In another embodiment, the ILC is manufactured using a medical grade plastic that is either antiseptic in nature or coated to be antiseptic. 
         [0027]    In these embodiments, the ILC is applied after the junction hub and allows for traditional dressing to be untouched (i.e., lumens extend beyond the junction hub before ILC placement). 
         [0028]    In an alternate embodiment, the ILC is applied and is in contact with the junction hub. 
         [0029]    In one embodiment, the ILC has a tubing carriage capable of attaching lumens to the ILC for access to lumens by a health professional. 
         [0030]    In another embodiment, the ILC comprises a female receiving piece for each lumen capable of accepting a male insert with raised knots to form a seal with the female piece and residing within the cap of the ILC. 
         [0031]    In another embodiment, the ILC has a plastic binder which secures the male inserts and provides a contact point for a screw cap. Wherein the ILC is substantially flat in nature, as in yet another embodiment, the male inserts are in the cap which has perforated clips for break away, one-time use. 
         [0032]    In some embodiments, the screw cap of the ILC has a sliding screw cap which forms a seal with the base. The sliding screw cap, in some embodiments, may allow for at least one lumen to egress from the cap while capping at least one other lumen and those capped lumens may have a capped end within the screw cap that allows for penetration for flushing purposes. 
         [0033]    In further embodiments, the base of the ILC has a threaded female accepting base having a plurality of openings adequate to accept at least one lumen and having at least one flange to further secure the screw cap of the ILC. 
         [0034]    In yet other embodiments, the ILC can be configured for use with one, two, three, four, or five lumens extending from the junction hub. 
         [0035]    These and other aspects of the present invention will become evident upon reference to the following detailed description and attached drawings. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0036]      FIG. 1  is an illustration of the ILC with a detachable tubing carriage, as in one embodiment. 
           [0037]      FIG. 2  is an illustration of the ILC with detachable tubing carriage, as in one embodiment. 
           [0038]      FIG. 3  is an illustration of the screw cap of the circular ILC, as in one embodiment. 
           [0039]      FIG. 4  is an illustration of the male inserts connecting to the extension lumen, as in one embodiment of the ILC. 
           [0040]      FIG. 5  is an illustration of the female receiving piece from the lumen, as in one embodiment of the ILC. 
           [0041]      FIG. 6  is a lateral view of the base of the ILC, as in one embodiment. 
           [0042]      FIG. 7  is a cut-away lateral view of the base of the ILC, as in one embodiment. 
           [0043]      FIG. 8  is a posterior view of the base of the ILC, as in one embodiment. 
           [0044]      FIG. 9  is a view of the flat embodiment of the ILC. 
           [0045]      FIG. 10  is a lateral view of the base portion of the ILC, as in one embodiment. 
           [0046]      FIG. 11  is a lateral view of the cap portion of the ILC, as in one embodiment. 
           [0047]      FIG. 12  is an alternate lateral view of the cap portion of the ILC, as in one embodiment. 
           [0048]      FIG. 13  is another view of the base portion of the ILC, as in one embodiment. 
           [0049]      FIG. 14  is an alternate lateral view of the cap of the ILC, as in one embodiment. 
           [0050]      FIG. 15  is a view of yet another lateral view of the cap of the ILC, as in one embodiment. 
           [0051]      FIG. 16  is a lateral view of the cap portion of the ILC, as in one embodiment. 
           [0052]      FIG. 17  is a view of yet another alternate embodiment of the ILC. 
           [0053]      FIG. 18  is a view of the cap of the ILC, as in one embodiment. 
           [0054]      FIG. 19  is a lateral view of the base of the ILC, as in one embodiment. 
           [0055]      FIG. 20  is a perspective view of an embodiment of an ILC with quick release function. 
           [0056]      FIG. 21  is a perspective view of the device of  FIG. 20  apart. 
           [0057]      FIG. 22  is a cross section of the connector in  FIG. 20 . 
           [0058]      FIG. 23  is a perspective view of a safety plug inserted into a PICC base. 
           [0059]      FIG. 24  is a cutaway perspective view of the base and catheter. 
           [0060]      FIG. 25  is a cutaway perspective of the base. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0061]    Provided herein is a description of multiple configurations of an ILC capable of locking at least one lumen, providing antiseptic support, and, relative to a traditional PICC line, a small, singular extension from the catheter. 
         [0062]    Throughout this application, references are made to various embodiments relating to the apparatus and its method of use. The various embodiments described are meant to provide a variety of illustrative examples and should not be construed as descriptions of alternative species. Rather, it should be noted that the descriptions of various embodiments provided herein may be of overlapping scope. The embodiments discussed herein are merely illustrative and are not meant to limit the scope of the interchangeable lockable catheter. 
         [0063]    In the present description, any concentration range, percentage range, ratio range or other integer range is to be understood to include the value of any integer within the recited range and, when appropriate, fractions thereof (such as one tenth and one hundredth of an integer), unless otherwise indicated. As used herein, “about” or “comprising essentially of” means+/−15%. The use of alternative (i.e., or) should be understood to mean one, both, or any combination thereof of the alternatives. As used herein, the use of an indefinite article, such as “a” or “an,” should be understood to refer to the singular and the plural of a noun or noun phrase. 
         [0064]    The term “comprising” is not intended to limit inventions to only claiming the present invention with such comprising language. Any invention using the term comprising could be separated into one or more claims using “consisting” or “consisting of” claim language and is so intended. 
         [0065]    Reference throughout this document to “one embodiment”, “certain embodiments”, and “an embodiment” or similar terms means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, the appearances of such phrases or in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments without limitation. 
         [0066]    The term “or” as used herein is to be interpreted as an inclusive or meaning any one or any combination. Therefore, “A, B or C” means any of the following: “A; B; C; A and B; A and C; B and C; A, B and C”. An exception to this definition will occur only when a combination of elements, functions, steps or acts are in some way inherently mutually exclusive. 
         [0067]    The drawings featured in the figures are for the purpose of illustrating certain convenient embodiments of the present invention, and are not to be considered as limitation thereto. Term “means” preceding a present participle of an operation indicates a desired function for which there is one or more embodiments, i.e., one or more methods, devices, or apparatuses for achieving the desired function and that one skilled in the art could select from these or their equivalent in view of the disclosure herein and use of the term “means” is not intended to be limiting. 
         [0068]    As used herein the term “interchangeable lockable catheter (ILC)” refers to a PICC line catheter which can attach one or more different tubes by means of interchangeable tubing cartridges having 1 to 190 or more tubes connecting to the single line catheter. 
         [0069]    As used herein the term “subject” refers to a patient, normally human, but in one embodiment, the subject is a mammal in need of a single venous catheter for peripheral insertion into a vessel of the subject. 
         [0070]    As used herein the term “a single venous catheter for peripheral insertion into a vessel” refers to having a proximal end for insertion into a vessel of the subject as a single venous catheter. The distal end is connected to a junction hub. 
         [0071]    As used herein the term “junction hub” refers to a connect device which attaches one or more lumens to the single venous catheter distal end. In one embodiment, it is a plurality of lumens. By attaching a tubing cartridge, one or more tubes can be connected to the single line by replacement of the tubing cartridge. 
         [0072]    As used herein the term “base” refers to a device which is removable or attached which is configured to receive the one or more lumens in the junction hub. The lumens will extend through the base to attach to one or more tubes for delivery of liquids to the single venous catheter. The base can be any shape, such as circular, rectangular, or, in one embodiment, essentially flat (rectangular looking). 
         [0073]    As used herein the term “tubing cartridge” refers to a device which attaches to the base for attaching the one or more tubing to the one or more lumens in the system thus allowing multiple sources to be fed to the single line catheter. The tubing cartridge can attach by any means but in one embodiment it attaches with a pin and spring mechanism as shown in the figures. 
         [0074]    As used herein the term “cap” refers to a device for attaching to the base to seal the base when a tubing cartridge is not attached. The cap can be screwed or snapped on or by any means. as desired. In one embodiment, it is constructed to be tamper resistant, as shown in the drawings, or otherwise. The cap can also be fitted with a penatratable layer such that tubing can be inserted through the penatratable layer. 
         [0075]    Throughout the description of the ILC, materials to manufacture the device are described as “medical grade plastics.” Medical grade plastics include polymers with capability of sterilization, long-term durability, low leaching and extractability, and long shelf life and aging. Medical grade plastics include polymers either alone or in combination of, but not limited to: polyethylene, polypropylene, polystyrene, polyester, polycarbonate, polyvinyl chloride, polyethersulfone, polyacrylate, hydrogel, polysulfone, polyetheretherketone, thermoplastic isomers, thermoset elastomers, poly-p-xylylene, and fluoropolymers. Blends of polymers include, but are not limited to: polystyrene and polyphenylene oxide, polyethylene terephthalate and polybutylene terephthalate, and PMMA and polyvinylidene fluoride. Medical grade plastics include compositions including fillers, reinforcement and composites (such as glass), mineral powders, or carbon. Medical grade plastics include compositions described above and have been treated with biocidal or biofilm resistant materials as either coatings or as permeated within the polymer itself (i.e., halogens, plasmas, etc.). 
       DRAWINGS 
       [0076]    Now referring to the drawings,  FIG. 1  is a lateral view of the ILC with detachable tubing carriage. The catheter  100  is inserted into a patient&#39;s vessel. The most anterior end has openings  110 ,  111 ,  112 . These openings correspond to lumens  103 ,  104 ,  105  which are connected to the catheter  100  at the junction hub  101 . Each opening  110 ,  111 ,  112  corresponds with its own lumen  103 ,  104 ,  105 . The junction hub  101  is configured to connect the catheter  100  with a set of lumens, and as shown, three lumens  103 ,  104 ,  105  are shown. In other embodiments, fewer or more lumens may be provided (i.e., one, two, or up to ten lumens may be provided). The openings always correspond to the number of lumens provided in any configuration. 
         [0077]    The junction hub  101  provides connection between the catheter  100  and lumen(s)  103 ,  104 ,  105 . The junction hub  101  may also have at least one suture hook  102 . As shown, two suture hooks  102  may be provided. The suture hooks  102  provide an anchor to the patient by sutures to the patient&#39;s skin. As is well known to those in the art, the junction hub  101  may be sutured to the patient through the use of the suture hooks  102 . At the posterior end of the junction hub  101 , lumens  103 ,  104 ,  105  protrude therefrom, the lumens being received by a base  106 . The base  106  is configured to receive the lumens  103 ,  104 ,  105 . In some embodiments, the base  106  may receive between one and ten lumens. In this embodiment, as shown, three lumens  103 ,  104 ,  105  come from the junction hub  101  to the base  106 . 
         [0078]    The lumens  103 ,  104 ,  105  extend from the posterior end of the junction hub  101  through the base  106 . The base  106  is adapted to receive a screw cap  107 . The screw cap  107  terminates at its posterior end in a tubing carriage  108 . The tubing carriage  108 , shown in this embodiment, is used when desired but is not necessary in other embodiments. The tubing carriage  108  houses connections to the extension lumens  113 ,  114 ,  115 . The extension lumens connect to and correspond with their associate lumens  103 ,  104 ,  105 . The extension lumens  113 ,  114 ,  115  terminate at their posterior end in a lumen stop  109 . Lumen stops  109  are well known in the art, and are a means of terminating a lumen with closure. 
         [0079]      FIG. 2  is an illustration of the ILC cap with detachable tubing carriage illustrating positioning of the extension lumens. The most anterior portion of this illustration shows the lumen junction  117  that connects the lumens ( 103 ,  104 ,  105  in  FIG. 1 ) with the lumen extensions  113 ,  114 ,  115 . The lumen junction  117  includes male inserts  116  that serve as a connection point by inserting into the posterior end of the lumens  103 ,  104 ,  105 . The anterior portion of the extension lumens  113 ,  114 ,  115  are fitted with the male inserts  116  and the lumen junction  117  and then secured within the screw cap  107  by a capped end with a penetrable layer  118 . The screw cap  107  is connected posteriorly to the tubing carriage  108 . In one embodiment, the diameter of the capped end with a penetrable layer  118  is of approximately 2.5 cm. In some embodiments, the capped end with a penetrable layer is constructed of a sterile medical grade plastic. The screw cap  107 , in one embodiment, is approximately 3 cm in diameter and is constructed of medical grade plastics, thermoset polymers, antibacterial coated, or permeated plastics and the like. In other embodiments, the tubing carriage  108  is approximately 5-6 cm in diameter and may be constructed of any number of durable impermeable plastics, such as medical grade plastics. 
         [0080]      FIG. 3  is a close up view of an embodiment of the screw cap  107  of the ILC. This illustration further depicts the male inserts  116  and the lumen junction  117  that connects the extension lumens  113 ,  114 ,  115  to the lumens (not shown in this illustration). The extension lumens are secured in placement by the capped end with penetrable layer  118  and fit within the screw cap  107 . Note, thought  FIG. 3  depicts a configuration using three extension lumens, it is contemplated that between one and ten lumen extensions may be housed within the capped end with penetrable layer  118  and the screw cap  107 . The anterior end of the screw cap  107  also shows threading  139  that is adapted to receive and connect with the flanges and threading on the base  106  (see  FIG. 8 ). 
         [0081]      FIG. 4  depicts a male insert connecting to an extension lumen. The male insert  116  has at least one protrusion serving to anchor the male insert  116  within the female insert  119  ( FIG. 5 ). The male insert  116  has a lumen junction  117  which is a raised portion adapted to meet with and be flushed with the female insert  119  ( FIG. 5 ) when connected. The male insert  116  has a posterior end that fits within the extension lumen  113 ,  114 , or  115 . In some embodiments, the interior diameter of the male insert  116  is approximately 5 mm. In those embodiments, the height of the flange from the male insert  116  is approximately 1 mm. The outer diameter of the lumen junction  117  is approximately 10 mm and the width of the lumen junction  117  is approximately 8 mm. The length of the male insert  116  is approximately 12 mm, wherein 5 mm extends within the female insert  119 , and 5 mm extends within the extension lumen  113 ,  114 ,  115 . In most embodiments, the male insert  116  and lumen junction  117  are constructed in one piece and are made of impermeable plastics such as medical grade plastics. 
         [0082]      FIG. 5  shows the connection point between the lumens  103 ,  104 ,  105  and the extension lumens  113 ,  114 ,  115 . The female insert  119  extends from an anterior end that is anchored within the lumen to a posterior end that may be received by a male insert  116  ( FIG. 4 ). The female insert  119 , in one embodiment, is approximately 5 mm in diameter at its anterior end and approximately 5 mm at its posterior end. The female insert  119  may be constructed in one piece and made of impermeable plastics, such as medical grade plastics. 
         [0083]      FIG. 6  is a lateral view of the base of the ILC, as in one circular embodiment. The junction hub  101  is shown with the lumens  103 ,  104 ,  105  extending from the posterior edge. As has been stated, any number of lumens between one and ten may extend from the junction hub  101 . The lumens  103 ,  104 ,  105  extend to the base  106  which houses and secures the lumens  103 ,  104 ,  105 . In some embodiments, the base is circular in shape and is approximately 5 cm in diameter. The base  106 , as in other elements of the ILC, may be made of impermeable, medically advantageous plastics and synthetics, such as medical grade plastics (see above). The base  106  has a posterior end that has threading  120  adapted to receive the screw cap  107  (see  FIG. 2  and  FIG. 3 ). 
         [0084]      FIG. 7 , similar to  FIG. 6 , shows a lateral view of the base of the ILC, as in one circular embodiment, while showing a cut-away of the lumen  103  within the base  106 . Each lumen, no matter the number in any embodiment, terminates within the base  106 . The lumen  103 , as depicted in  FIG. 6 , terminates within the base  106  with the female insert  119  described in detail by  FIG. 5 . The threading  120  is also shown in this illustration, as described further in  FIG. 6 . 
         [0085]      FIG. 8  is a posterior view of the base of the ILC, as in one circular embodiment. This posterior view shows the lumens  103 ,  104 ,  105  within the base  106  and fitted with the female insert  119 . A plurality of flanges  121  exist on the base  106 . Whereas  FIG. 8  depicts four flanges  121  on the outside of the base  106 , it is contemplated and well within the knowledge of someone of skill in the art to provide anywhere between three and twenty flanges to provide a secure fitting between the base  106  and the screw cap  107 . 
         [0086]      FIG. 9  is an alternate configuration of the ILC. This configuration is substantially flat in nature, thus providing further advantages to patients in terms of comfort and profile (being lower in profile). As in the first embodiment described in  FIGS. 1-8 , the catheter  100  is placed within the vessel of a patient. The openings  110 ,  111 ,  112 , as shown in  FIG. 1 , will be present in the most anterior end of the catheter  100  of the embodiment of  FIG. 9 . Those openings correspond to lumens  103 ,  104 ,  105  which are connected to the catheter  100  at the junction hub  101 . Each opening  110 ,  111 ,  112  corresponds with its own lumen  103 ,  104 ,  105 . The junction hub  101  is configured to connect the catheter  100  with a set of lumens, in  FIG. 1 , three lumens  103 ,  104 ,  105 . In other embodiments, fewer or more lumens may be provided (i.e., one, two, or up to ten lumens may be provided). The openings always correspond to the number of lumens provided in any configuration. 
         [0087]    Still in  FIG. 9 , the junction hub  101  provides connection between the catheter  100  and lumen(s)  103 ,  104 ,  105 . The junction hub  101  may also have at least one suture hook  102 . As shown in  FIG. 1 , two suture hooks  102  may be provided. The suture hooks  102  provide an anchor to the patient. As is well known to those in the art, the junction hub  101  may be sutured to the patient through the use of the suture hooks  102 . At the posterior end of the junction hub  101 , lumens  103 ,  104 ,  105  protrude therefrom, the lumens being received by a base  127 . The base  127  is configured to receive the lumens  103 ,  104 ,  105 . In some embodiments, the base  127  may receive between one and ten lumens. In this embodiment,  FIG. 1  shows three lumens  103 ,  104 ,  105  come from the junction hub  101  to the base  127 . Unseen in this illustration is a lower flange  128  (see  FIG. 13 ) that will connect with the lower hook like extension in the base (not shown but mirroring  131  in  FIG. 11 ). 
         [0088]    The base  127  is configured to receive a cap  130 . The cap  130 , in this embodiment, is tamper evident and tamper resistant. The cap  130  has multiple points of contact, including an upper hook like extension (and lower)  131  and multiple perforated clips  134  for break-away use. A lower hook like extension  131  is not shown but mirrors the upper hook like extension both in shape and position. In this embodiment, the posterior position of the cap  130  is impermeable and does not house extension lumens, as in the previous embodiment. However, the presence of a similar tubing carriage is contemplated and may be used in this embodiment with adjustments to the cap, including an opening to receive the tubing carriage. 
         [0089]      FIG. 10  illustrates a close up lateral view of the flat base  127 , as in one embodiment of the ILC. The anterior end of the base  127  receives the lumens  103 ,  104 ,  105 . In some embodiments, the base  127  may receive between one and ten lumens. The base  127  is equipped with a plurality of flanges  128 ,  129 . The lateral flanges  129  will connect with the cap  130  and anchor the ILC such that it is tamper resistant and tamper evident. There is also an upper flange  128  further anchoring the cap  130  to the base  127  in this embodiment of the ILC. In some embodiments, the base  127  is approximately 5 cm wide (lateral), 2 cm in length (anterior/posterior), and 10 mm thick. The lateral flanges  129  protrude 2 mm from the base  127  at their highest point and are generally shaped as an inclined rhombus with the posterior portion flushed with the base  127 . The lateral flanges  129  protrude outward to a highest point located most anterior to the base  127 . The upper and lower flange  128  may be trapezoidal in shape and similarly are flushed with the base  127  at its posterior end and extend outward from the base  127  to a measurement of approximately 2 mm at its anterior end. Unseen in this illustration is a lower flange  128  (see  FIG. 13 ) that will connect with the lower hook like extension in the base (not shown but mirroring  131  in  FIG. 11 ). As is well known in the art, other shapes that allow for the secure application of the cap are contemplated for use in the ILC. 
         [0090]      FIG. 11  depicts a lateral view of the cap  130  of the ILC in a flat embodiment. The cap  130  has two lateral (side) extensions terminating in a hook like extensions  132  and capable of connecting and latching to the flanges  128  and  129  of the base  127  (see  FIG. 10 ). The cap  130  also has an upper hook like extension  131  capable of receiving and locking to the upper flange  128  on the base  127 , as well as a lower hook like extension not depicted but mirroring the upper hook like extension  131 . Male inserts  133  protrude from the middle portion of the cap  130  and fit within the lumens  103 ,  104 ,  105  housed within the base  127 . A plurality of male inserts  133  may be used and should be of the same number as the number of lumens present (as stated, anywhere between one and ten). The cap  130  also has two notches  135  that may serve as insertion points for a clamp removal device (not shown). On the same plane as the two lateral hook-like extensions  132  and upper and lower hook-like extensions  131  are perforated edges  134 . These perforated edges  134  allow for the cap  130  to be excised from the base  127  through a break-away of the perforated edges  132 . In this embodiment, the lateral perforated edges extend from the hook-like extension  132  posterior to the edge of the cap  130  near the notches  135 . The medial and upper and lower hook like extensions  131  have perforated edges posterior about three quarters of the length of the entire cap  130  (as measured from the lateral hook like extensions  132  to the most posterior edge of the cap). 
         [0091]    In some embodiments, the length of the cap  130  from the most anterior edge of the lateral hook-like extension  132  to the posterior edge is approximately 1 cm. The approximate distance between the anterior edge of the lateral hook-like extension  132  to the medial edge where the male inserts  133  are housed is 4 mm. The male inserts  133  protrude approximately 1 mm from the medial edge. While the shape of the medial and upper hook and lower like extensions  131  are shown terminating in a point, it is well known to those skilled in the art that the shape may be anything adapted to receive and connect with the upper flange  128  on the base  127  (i.e. circular, rectangular, trapezoidal, rhomboid and the like). A third center lumen cap  138  is provided. 
         [0092]      FIG. 12  is an alternate lateral view of the cap portion, as in another embodiment of the ILC. In this embodiment, the lateral hook-like extensions  132  protrude from the cap  130  and two male inserts  140  are shown. In this embodiment, two lumens would be present in the base for fitting with the cap  130 . The male inserts  140  are shown with two lateral protrusions  141  which serve to further anchor the inserts  140  into the lumens. This configuration is illustrated in  FIG. 4 , and may be employed in any male insert in any of the embodiments. Also note, in this embodiment, no medial and upper hook like extension  131  (see  FIG. 11 ) is present. An edge  138  provides further contact and structural support to the cap  130  in this embodiment. Dimensions of this embodiment are similar to that depicted in  FIG. 11 . For example, the length of the cap  130  from the most anterior edge of the lateral hook-like extension  132  to the posterior edge is approximately 1 cm. Moreover, the approximate distance between the anterior edge of the lateral hook-like extension  132  to the medial edge where the male inserts  133  are housed is 5 mm. Similarly, the male inserts  133  protrude approximately 5 mm from the medial edge. 
         [0093]      FIG. 13  is a posterior view of the base portion of the ILC in a flat embodiment. In this view, positioning of the lumens  103 ,  104 ,  105  is shown within the base  127 . The lateral flanges  129  and upper and lower flanges  128  are shown protruding from the base  127  reaching their highest point near the anterior edge of the base  127 . As shown in this embodiment, the flange  128 ,  129  shape is rectangular in nature, and may have either sharp or curved edges. As described, the flanges  128 , 129  may be rhomboid in shape and serve to secure the cap  130  to the base  127 . 
         [0094]      FIG. 14  is a lateral view of the cap of yet another embodiment of the ILC. In this embodiment, the cap  125  has a break away twist cap attachment allowing for a twisting motion to loosen the cap  125 . A pull tab  123  allows for access to pull away from the push insert base  122  that would house the lumens  103 ,  104 ,  105 . The cap  125  would house male inserts for the capping of the lumens in this configuration. In this embodiment, the cap  125  is substantially circular in shape, wherein the diameter of the cap is approximately 5 cm and the length is approximately 3 cm. The cap  125  is constructed of medical grade plastics or synthetics that harbor microbially resistant elements. The insert base  122  is approximately 1 cm wide and 5 cm in length and being constructed of the same materials as the cap  125 . 
         [0095]      FIG. 15  is yet another embodiment of the cap of the ILC as viewed laterally. In this embodiment, the cap  125  has a removable portion  124  at its anterior end which may be accessed by pulling a protruding tab  123  that will then be stripped from the main body of the cap  125  through two perimeters of the cap  125 . The cap  125  is adaptable to receive a push insert base  122  (see  FIG. 14 ) that houses the lumen(s). Not shown are the male inserts within the cap  125  for filling and capping the lumen(s) in this embodiment. In this embodiment, the cap  125  is substantially circular in shape, wherein diameter of the cap is approximately 5 cm. The cap  125  is constructed of medical grade plastics or synthetics that harbor microbially resistant elements. The tab  123  and removable portion  124  are approximately 10 mm in length. 
         [0096]      FIG. 16  shows the embodiment as in  FIG. 15 , wherein the tab  123  has been pulled and a portion of the anterior end of the cap  125  has been removed, thus revealing the male inserts  126  contained therein. While this illustration depicts the inserts  126  in a conical and sloped type shape which can be used in any of the embodiments described herein, the inserts  126  may be adjacent and lateral to one another. Whatever configuration is chosen for the male inserts  126 , the cap  125  will be mirrored by the corresponding push insert base  122 . 
         [0097]      FIG. 17  is an alternate embodiment of the ILC. In this embodiment, the catheter  100  is within the vessel of the patient and the dashed line represents the insertion point into the skin. The junction hub  101  is shown with two lateral suture hooks  102 . The lumens are not visible and would be positioned by a push insert base (see  FIG. 14 ) to be received by the cap  125  (having male inserts  126  to cap off the lumens). This embodiment shows the pull tab  123  removal system, where the tab may be pulled to expose the anterior end of the cap for removal by a medical caregiver. 
         [0098]      FIG. 18  is a cap of a circular embodiment of the ILC. The cap  107  is circular and constructed of medical grade plastics. The interior of the cap has a recessed portion  139  capable of receiving threading located on the base (see  FIG. 19 ). In one preferred embodiment, the diameter is approximately 5 cm. As will be understood by those skilled in the art, this embodiment will receive a base  106  (see  FIG. 19 ) housing three lumens. As different numbers of lumens are used, the diameter may change (i.e., where ten lumens are contemplated the diameter will necessarily larger, by proportion). 
         [0099]    As shown in  FIG. 19 , the base  106  houses the lumens  103 ,  104 , and  105 , and has threading  120  on the exterior and posterior end of the base  106 . A ridge is shown delineating the threaded portion of the base  106  in this embodiment of the ILC. As has been stated, the number of lumens housed within the base  106  will vary in many embodiments and contain between one and ten lumens. The base  106  is constructed of medical grade plastics and is of similar diameter to the cap  107  thus creating a seamless piece when the base  106  is connected to the cap  107 . 
         [0100]    As shown in  FIG. 20 , the base  106  is a two-piece  201  and  202  connection that is spring operated by pressing button  203 . In other embodiments, fewer or more lumens may be provided as taught herein (i.e. one, two, or up to ten lumens or more may be provided). Lumen openings correspond, as in other embodiments shown herein. 
         [0101]      FIG. 21  is a perspective view of the two piece base separated showing locking pin  210  which inserts into hole  210   a  and locks, as shown in  FIG. 22 . Lumen connections  212  fit into holes  211  for making a connection with extension lumens  113 ,  114 ,  115 . 
         [0102]      FIG. 22  is an x-ray view of the base in  FIG. 20  in the locked position. In this view, one can see that spring  220  operates locking pin  221  which holds the locking pin  210  in place via hole  210   a  thus locking the two-piece pins  201  and  202  connection together unless button  203  is pressed compressing spring  220  and releasing locking pin  221  so that the base can be separated into two pieces. 
         [0103]      FIG. 23  is a perspective view of a safety plug  231  inserted into a PICC base  230  holding catheter tube  232 . 
         [0104]      FIG. 24  is a cutaway perspective view of a base  240  and catheter  241 . In this view, an adjustable valve  242  is shown having three valve positions. It is held in place via stainless steel retainer  243 . The valves allow for opening and closing each valve. 
         [0105]      FIG. 25  is a cutaway perspective view of the base. In this view, base  250  has adjustable valve  252  to open and close anything coming from each of tubes  253 . A metal tube  254  connects tubing  253  to the adjustable valve  252 . 
         [0106]    While the compositions and methods of this disclosure have been described in terms of particular embodiments, it will be apparent to those of skill in the art that variations may be applied to the structures and/or methods and in the steps or in the sequence of steps of the method described herein without departing from the concept, spirit, and scope of the disclosure. All such similar substitutes and modifications apparent to those skilled in the art are deemed to be within the spirit, scope, and concept of the disclosure as defined by the appended claims. It will be understood that particular embodiments described herein are shown by way of illustration and not as limitations of the disclosure. 
         [0107]    The principal features of this disclosure can be employed in various embodiments without departing from the scope of the disclosure. Those skilled in the art will recognize, or be able to ascertain using no more than routine study, numerous equivalents to the specific structures described herein. Such equivalents are considered to be within the scope of this disclosure and are covered by the claims. All publications and patent applications mentioned in the specification are indicative of the level of skill of those skilled in the art to which this disclosure pertains. All publications and patent applications are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.