# Patent

## Title
Drug delivery system and method of use

## Abstract

A drug delivery system is disclosed that includes a drug delivery device having a reservoir and a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient. The drug delivery system may further include one or more sensors coupled to the drug delivery device, a wireless transmitter, and a controller coupled to the one or more sensors and the wireless transmitter. The controller may be configured to use the one or more sensors to determine a condition or an operational state of the drug delivery device, and control the wireless transmitter to wirelessly transmit one or more reports representative of the condition or the operational state of the drug delivery device. A method for use with a drug delivery device is also disclosed.

## Background
CROSS-REFERENCE TO RELATED APPLICATION
This is a continuation of U.S. application Ser. No. 15/315,817, filed Dec. 2, 2016, which is the U.S. National Phase of International Application No. PCT/US2015/033925, having an international filing date of Jun. 3, 2015, which claims the priority benefit of U.S. Provisional Patent Application No. 62/007,007, filed Jun. 3, 2014. The entire contents of each of the foregoing are incorporated herein by reference for all purposes.


BACKGROUND
This patent is directed to systems and methods for use with drug delivery devices relating to control of the drug delivery devices and communication of information obtained from the drug delivery devices.
Drugs can be administered through the use of drug delivery devices, such as autoinjectors or on-body injectors or infusers. These devices may replace older delivery systems using the combination of a syringe and a vial of the drug or medicament, or a pre-filled syringe. Autoinjectors and on-body injectors may be used to automate the injection and delivery or administration process, thereby simplifying the process for certain patient groups or sub-groups for which use of the syringe/vial combination or pre-filled syringe systems would be disadvantageous, whether because of physiological or psychological impediments.
Even with the use of drug delivery devices, such as autoinjectors, patients may experience challenges during the initial use of the drug delivery device after they have been prescribed a drug that is delivered or administered through the use of a drug delivery device. For example, the user may be uncertain whether the medication inside the drug delivery device is the medication prescribed for them. Additionally, the user may be uncertain whether the medication has expired. Further, the user may be uncertain whether the injection should be delayed after a drug delivery device has been removed from cold storage, such as in a refrigerator, and if the injection should be delayed, how long it should be delayed. The user may also be uncertain if the actions and their sequence correctly operate the drug delivery device. Even if the correct actions are performed in the correct sequence, the user may be uncertain the drug has been completely delivered, such that the injection is complete.
Other patients may experience challenges in being adherent or compliant with the treatment regimen. For example, certain patients may not perform the injections according to the treatment regimen, having forgotten to perform the injection at all. Other patients may perform the injections, but then be unable to remember whether they performed the injections because they become distracted before they are able to record that they did so. Some patients may elect not to perform the injections because of misunderstandings or miscommunications of when or how the medication will affect the patient's disease or symptoms, especially where the effects are not felt by the patient until a considerable portion of the treatment regimen has been performed. Some patients may require support and/or encouragement from others (healthcare provider, caregiver, family member, etc.), which support and/or encouragement cannot be provided because the people that would provide that support and/or encouragement do not know if the patient has performed the treatment or if the treatment regimen has been followed correctly.
In addition, the condition and use of drug delivery devices is of importance to other parties, such as drug device manufacturers, pharmacies, health care providers and insurers. For instance, information regarding the condition of the drug delivery device along the supply chain may be relevant to whether the drug delivery device will be in good working order when it arrives for use with the patient. Information regarding the location of the drug delivery device along the supply chain may be relevant to the manufacturer and the pharmacy to ensure that adequate supplies are available for the pharmacy to delivery to the user. The compliance information mentioned above may be important to the healthcare providers and insurers, as well as to the patient, because compliance with a therapy regimen may have a direct impact on the success of the therapy.
As set forth in more detail below, the present disclosure sets forth an drug delivery system embodying advantageous alternatives to existing drug delivery devices and that may address one or more of the challenges or needs mentioned above.
SUMMARY
According to an aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir and a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient. The drug delivery system also includes one or more sensors coupled to the drug delivery device, a wireless transmitter, and a controller coupled to the one or more sensors and the wireless transmitter. The controller may be configured to: use the one or more sensors to determine a condition or an operational state of the drug delivery device, and control the wireless transmitter to wirelessly transmit one or more reports representative of the condition or the operational state of the drug delivery device.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and a removable sterile barrier disposed about the distal end of the delivery cannula. The drug delivery system also includes a first sensor configured to detect movement of the removable sterile barrier, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the removable sterile barrier has been removed from the distal end of the delivery cannula, and control the wireless transmitter to wirelessly transmit a report representative of removal of the removable sterile barrier if the removable sterile barrier has been removed from the distal end of the delivery cannula.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and an actuator configured to trigger the drug delivery device. The drug delivery system also includes first sensor configured to detect movement of the actuator, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the actuator has been used to trigger the drug delivery device, and control the wireless transmitter to wirelessly transmit a report representative of triggering of the drug delivery device if the actuator has been used.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and a needle shield moveable relative to the distal end of the delivery cannula. The drug delivery system also includes a first sensor configured to detect movement of the needle shield, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the needle shield has been moved relative to the distal end of the delivery cannula, and control the wireless transmitter to wirelessly transmit a report representative of insertion of the distal end of the delivery cannula into the patient if the needle shield has been moved relative to the distal end of the delivery cannula.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and a needle shield moveable relative to the distal end of the delivery cannula. The drug delivery system also includes a first sensor configured to detect movement of the needle shield, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the needle shield is disposed about the distal end of the delivery cannula, and control the wireless transmitter to wirelessly transmit a report representative of a completion of a delivery of a medicament from the reservoir to the patient if the needle shield is disposed about the distal end of the delivery cannula
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and a plunger moveable through the reservoir to discharge a medicament from the reservoir. The drug delivery system also includes a first sensor configured to detect movement of the plunger, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the plunger has completed a delivery stroke, and control the wireless transmitter to wirelessly transmit a report representative of a completion of a delivery of a medicament from the reservoir to the patient if the needle shield is disposed about the distal end of the delivery cannula.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and a plunger moveable through the reservoir to discharge a medicament from the reservoir. The drug delivery system also includes a first sensor configured to detect movement of the plunger, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine a travel distance of the plunger, and control the wireless transmitter to wirelessly transmit a report representative of an amount of medicament delivered to the patient from the reservoir based on the travel distance of the plunger.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir and a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient. The drug delivery system also includes a first sensor configured to detect presence or absence of fluid within the reservoir, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine an amount of medicament remaining in the reservoir, and control the wireless transmitter to wirelessly transmit a report representative of an amount of medicament delivered to the patient from the reservoir based on the amount of medicament remaining in the reservoir.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and an housing having an opening for the distal end of the delivery cannula. The drug delivery system also includes a first sensor configured to detect contact between the housing and an object, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the housing contacts the patient, and control the wireless transmitter to wirelessly transmit a report representative of contact between the housing and the patient.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a reservoir and a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient. The drug delivery system also includes a first sensor configured to detect a temperature of a medicament within the reservoir, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the temperature of the medicament is greater than or less than a threshold temperature, and control the wireless transmitter to wirelessly transmit a report representative of a suitability of the medicament for delivery to the patient.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a drug delivery device comprising a reservoir and a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient. The drug delivery system also includes a first sensor configured to detect a geographic location of the drug delivery device, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine the geographic location of the drug delivery device, and control the wireless transmitter to wirelessly transmit a report representative of the geographic location of the drug delivery device.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a drug delivery device comprising a reservoir and a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient. The drug delivery system also includes a first sensor configured to detect an orientation of the delivery cannula, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine if the delivery cannula is oriented for delivering medicament in the reservoir to the patient, and control the wireless transmitter to wirelessly transmit a report representative of a proper or improper orientation of the delivery cannula for delivering the medicament to the patient.
According to another aspect of the disclosure, a drug delivery system includes a drug delivery device comprising a drug delivery device comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and a battery. The drug delivery system also includes a first sensor configured to detect a charge level of the battery, a wireless transmitter, and a controller coupled to the first sensor and the wireless transmitter. The controller may be configured to: use the first sensor to determine the charge level of the battery, and control the wireless transmitter to wirelessly transmit a report representative of the charge level of the battery.
According to a further aspect of the disclosure, a method is provided of using a drug delivery system comprising a reservoir, a delivery cannula having a proximal end in fluid communication with the reservoir and a distal end to be received within a patient, and a removable sterile barrier disposed about the second end of the delivery cannula. The method includes determining if the removable sterile barrier has been removed from the distal end of the delivery cannula, and transmitting a report representative of the removal of the removable sterile barrier if the removable sterile barrier has been removed from the distal end of the delivery cannula.



BRIEF DESCRIPTION OF THE DRAWINGS
It is believed that the disclosure will be more fully understood from the following description taken in conjunction with the accompanying drawings. Some of the figures may have been simplified by the omission of selected elements for the purpose of more clearly showing other elements. Such omissions of elements in some figures are not necessarily indicative of the presence or absence of particular elements in any of the exemplary embodiments, except as may be explicitly delineated in the corresponding written description. None of the drawings are necessarily to scale.
FIG. 1 is a schematic diagram of a drug delivery system according an embodiment of the disclosure in communication with one or more computing devices and one or more networks;
FIG. 2 is a block diagram of a method of operating the drug delivery system illustrated in FIG. 1 according to an embodiment of the disclosure;
FIGS. 3A-3C is a block diagram of a method of operating the drug delivery system illustrated in FIG. 1 according to another embodiment of the disclosure;
FIG. 4 is a block diagram of a method of operating a computing device such as is illustrated in FIG. 1 according to an embodiment of the disclosure, the computing device in communication with a drug delivery system operating according to one of the methods disclosed herein, for example;
FIG. 5 is a block diagram of a method of operating a drug delivery system according to another embodiment of the disclosure;
FIG. 6 is a block diagram of a method of operating a drug delivery system according to a still further embodiment of the disclosure;
FIG. 7 is a block diagram of a method of operating a computing device according to an embodiment of the disclosure, the computing device in communication with the drug delivery system operating according to the method of FIG. 6, for example;
FIG. 8 is a block diagram of a method carried out by a drug delivery system according to another embodiment of the disclosure;
FIG. 9 is a partial cross-sectional view illustrating an embodiment of a system used to carry out the method of FIG. 8;
FIG. 10 is a block diagram of a method carried out by a drug delivery system according to yet another embodiment of the disclosure;
FIG. 11 is a block diagram of a method carried out by a drug delivery system according to a further embodiment of the disclosure;
FIGS. 12A and 12B are schematic views of an embodiment of a system used to carry out the method of FIG. 11;
FIG. 13 is a cross-sectional view of an embodiment of a drug delivery system including an autoinjector;
FIG. 13A is a cross-sectional view of an alternative cannula subassembly for the drug delivery system of FIG. 13;
FIG. 14 is a perspective view of an embodiment of a drug delivery system including an on-body injector;
FIG. 15 is a cross-sectional view of the drug delivery device of FIG. 14 taken along line 15-15;
FIG. 16 is a cross-sectional view of the drug delivery device of FIG. 14 taken along line 16-16;
FIG. 17 is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector;
FIG. 18a is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector;
FIG. 18b is a top view of a needle shield of the autoinjector of FIG. 18a arranged in a distal position;
FIG. 18c is a top view of the needle shield of the autoinjector of FIG. 18a arranged in a proximal position;
FIG. 19 is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector;
FIG. 20 is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector;
FIG. 21a is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector in a state where delivery of a medicament is not complete;
FIG. 21b is a cross-sectional view of the drug delivery system of FIG. 21a in a state where delivery of the medicament is partially complete;
FIG. 21c is a cross-sectional view of the drug delivery system of FIG. 21a in a state where delivery of the medicament is complete;
FIG. 22a is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector in a state where delivery of a medicament is not complete;
FIG. 22b is a cross-sectional view of the drug delivery system of FIG. 22a in a state where delivery of the medicament is complete;
FIG. 22c is an enlarged view of a sensor used in the drug delivery system of FIGS. 22a and 22b; 
FIG. 23a is a cross-sectional view of another embodiment of drug delivery system including an autoinjector;
FIG. 23b is a circuit diagram depicting a controller and a sensor used by the drug delivery system of FIG. 23a; 
FIG. 24a is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector in a state where delivery of a medicament is not complete;
FIG. 24b is a cross-sectional view of the drug delivery system of FIG. 24a in a state where delivery of the medicament is complete;
FIG. 25a is a cross-sectional view of another embodiment of drug delivery system including an autoinjector in a state where delivery of a medicament is not complete;
FIG. 25b is a cross-sectional view of the drug delivery system of FIG. 25a in a state where delivery of the medicament is complete;
FIG. 26 is a cross-sectional view of another embodiment of an autoinjector;
FIG. 27a is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector in a state where delivery of a medicament is not complete;
FIG. 27b is a cross-sectional view of the autoinjector of FIG. 27a along line B-B;
FIG. 27c is a cross-sectional view of the drug delivery system of FIG. 27a in a state where delivery of the medicament is partially complete;
FIG. 27d is a cross-sectional view of the drug delivery system of FIG. 27a in a state where delivery of the medicament is complete;
FIG. 27e is a circuit diagram depicting a controller and a sensor used by the drug delivery system of FIGS. 27a-d; 
FIG. 28 is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector;
FIG. 29a is a cross-sectional view of another embodiment of a drug delivery system including an autoinjector prior to contact with a patient;
FIG. 29b is a cross-sectional view of the drug delivery system of FIG. 29a during contact with a patient;
FIG. 30a is a perspective view of another embodiment of a drug delivery system including an on-body injector;
FIG. 30b is another perspective view the drug delivery system of FIG. 30a; 
FIG. 31 is a perspective view of a drug delivery system according to a further embodiment of the disclosure including an anti-roll removable sterile barrier;
FIG. 32 is an assembly view of the anti-roll removable sterile barrier of FIG. 31.
FIG. 33 is cross-sectional view of an embodiment of a removable sterile barrier attached to a housing of a drug delivery device; and
FIG. 34 is a cross-sectional view of the removable sterile barrier of FIG. 32 after its removal from the housing of the drug delivery device.



DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS
This disclosure is directed to a plurality of systems including a drug delivery device, and to a plurality of methods for using the drug delivery system. In particular, the systems and methods involve the determination of one or more states, which states may be determined through the use of one or more sensors in combination with one or more controllers. The sensors may rely on mechanical, electrical or chemical sensing mechanisms, and the controllers may be mechanical, electrical or electro-mechanical. By way of example and not by way of limitation, the states may relate to the operation of the drug delivery device, or to the condition of the drug delivery device. The system and methods may use the state determination to control the operation of the drug delivery device, and/or may communicate the state determination to other devices, such as third-party servers that may collect, process and/or further disseminate the state determinations received from the system including the drug delivery device, the one or more sensors, and the one or more controllers. In addition or in the alternative, the systems and methods may communicate the state determination to local devices, such as a mobile computing device (e.g., cell phone).
A drug delivery system according to the disclosure may include a drug delivery device having a reservoir (which may also be referred to as a primary container, e.g. a syringe, vial or cartridge). The reservoir may contain a drug, which may also be referred to as a medication or a medicament. The drug may be, but is not limited to various biologicals such as peptides, peptibodies, or antibodies. The drug may be in a fluid or liquid form, although the disclosure is not limited to a particular state (e.g., no differentiation is intended between a solution, a gel, or a lyophilized product for example). The drug delivery device also includes delivery cannula having a first end connected to or connectable in fluid communication with the reservoir and a second end to be inserted within a patient. As used herein, the term “delivery cannula” or “cannula” is hereby defined to mean a tube that can be inserted into the body for the delivery of fluid. A cannula may include a rigid or semi-rigid needle or blunt cannula, or may be in a flexible form, by example and not by way of limitation. The cannula may be integrated with the other elements of the drug delivery device, or the cannula may be separate from the other elements of the drug delivery until immediately prior to use. According to certain embodiments, the drug delivery device may further include an inserter to introduce the second end into the patient, although this is not required according to each embodiment of the disclosure. The inserter may or may not be withdrawn back into the device, thereby leaving the cannula in a patient.
Considering the foregoing description of the drug delivery device, the device may be characterized as an autoinjector or an on-body injector or infuser (the reference to injector intended to include also a reference to an infuser, to the extent that a difference is suggested). Autoinjectors may be single-use devices, administering a single dose during a single application of the device to the user's skin, although autoinjectors are not limited to only single-use devices—they may be multi-use devices as well. On-body injectors may be multi-use devices, administering multiple doses during one or more applications of the device to the user's skin, although on-body devices may also be used as single-use devices. Either autoinjectors or on-body injectors may have assemblies or sub-assemblies that are reusable, in that the assemblies may be used and re-used by refilling the reservoir, by removing an empty reservoir and replacing it with a filled reservoir, or by replacing the cannula, for example.
As noted above, the system or method according to the disclosure will determine one or more states relative to the drug delivery device.
For example, the system or method may determine if the drug delivery device is in one or more operational states (i.e., a state relating to the operation of the drug delivery device to deliver the drug to the patient). A non-exhaustive list of the general operational states may include (i) packaged/ready for distribution; (ii) packaged/distributed; (iii) unpackaged/ready for administration; (iv) sterile barrier removed; (v) device applied; (vi) cannula injected (or inserted); (vii) drug delivery initiated; (viii) drug delivery completed; and (ix) device removed. The system or method may determine specific operational states within each of the general operational states; for example, the system or method may determine if plunger has been moved from a first end of a bore (defining a drug reservoir) to a second end of the bore to determine if the drug delivery device is in the “drug delivery complete” state.
Furthermore, the system or method may determine if the drug delivery device is in one or more condition states (i.e., a state relating to the condition of the drug delivery device, not necessarily related to the operation of the drug delivery device to deliver the drug to the patient). A non-exhaustive list of condition states may include (i) age (e.g., taken with respect to a manufacturing date or an expiration date); (ii) sterility/contamination; (iii) temperature (or temperature history); and (iv) orientation. The determination of a condition state may be considered as part of the determination of an operational state; for example, the determination of the temperature state may be considered as part of the determination of the “ready for administration” state. Alternatively, the operational and condition states may be determined separately.
These states may be determined through the use of one or more sensors. The sensors may be particular to a condition state to be determined: for example, a thermocouple disposed adjacent to the reservoir may be used to determine the temperature state of the drug delivery device. The sensors may be particular to an operational state to be determined: for example, a switch may be coupled to a needle guard to determine when a needle cap has been removed to determine the “sterile barrier removed” operational state, the switch being open when the needle cap is disposed over the second end of the cannula and the switch being closed when the needle guard is not disposed over the second end of the cannula. Sensors may be used to determine both a condition state and an operational state: for example, the thermocouple may be used to determine the temperature condition state of the device (or more particularly, the drug), and/or the thermocouple may be used to determine the “ready for administration” operational state.
The system or method may use the determined states to control the operation of the drug delivery device. For example, the system may include a controller that is coupled to the sensor and may be coupled to one or more of the assemblies or subassemblies of the drug delivery device described above, or to one or more additional assemblies or subassemblies of the drug delivery device. The controller may be adapted structurally or programmed (if electrical or electro-mechanical) to activate or to inhibit these assemblies or subassemblies in accordance with the determined states. For example, the drug delivery device may include a lockout that limits or completely inhibits the operation of the injector, and the controller may activate the lockout in a reversible fashion if the temperature state of the drug delivery device (and in particular, the drug in the reservoir) is below a threshold state.
The system or method may communicate the determined state(s) to another device or system, which communication may be performed in conjunction with use of the determined state(s) to control the operation of the drug delivery device. For example the system or method may communicate the determined state(s) with a networked device using a communication link. In this sense, a networked device is intended to include any device that communicates with at least one other device over a communication link, and might include communication with a device such as mobile device (e.g., cell phone or mobile computing device) using a Bluetooth connection or a computing device using a Wi-Fi connection, for example. The networked device may communicate the determined states to other computing devices remote from the drug delivery system over the network that includes the networked device such as a server. According to certain embodiments of the present disclosure, the system communicates directly with the network (i.e., without an intermediate networked device—the system would be a networked device) or directly with a remote computing device such as a server (using, for example, a 3G antenna). The state information communicated over network, may then be used, for example, to determine if a patient is in compliance, or if a class of drug delivery devices is exhibiting a systemic malfunction. The state information may be used in other manners as well.
The systems and methods may also include control of the drug delivery device according to information relating to the identity of the drug, the drug delivery device, or the user, and/or communication of this identity information. Identity information relating to the drug may include a drug name, a drug concentration, dose information, a lot number or serial number, and a date of manufacture and/or expiration. Identity information relating to the drug delivery device may include a device type (e.g., autoinjector, on-body injector), a lot number or serial number, and a date of manufacture. Information relating to the user may include a patient name, demographic information, and patient subgroup information. This information may be referred to as “static” information, in contrast to the state information discussed above.
As to the communication of the information, and in particular relative to the identity information discussed immediately above, it will be recognized that not all information may be useful, desired, or even accessible to every different party whether for convenience, patient privacy or data security concerns.
FIG. 1 illustrates a drug delivery system 100 according to an embodiment of the disclosure. The drug delivery system 100 may be associated with a patient 102, who may use the drug delivery system 100 to inject a drug as part of a therapeutic regime. The drug delivery system 100 may communicate with a computing device (e.g. server) 104 via one or more intermediate computing devices and/or one or more networks. In turn, the server 104 may communicate with the drug delivery system 100, the patient 102, and one or more computing devices (with their associated parties) via one or more intermediate computing devices and/or one or more networks. As is also illustrated in FIG. 1, the server 104 may communicate directly with the drug delivery system 100, using a 3G antenna for example.
For example, the drug delivery system 100 is illustrated as communicating with a mobile computing device 110 (e.g., a smartphone) via a first communication link 112, and with a computing device (e.g., a personal computer or dedicated hub) 114 via a second communication link 116. Both links 112, 116 may operate according to a near field communication protocol, such as Bluetooth, for example. The mobile computing device 110 may communicate with a cellular network 118 via a communication link 120, while the other computing device 114 may communicate with a hard-wired network (e.g., local area network or wide area network) 122 via a communication link 124. These networks 118, 122 may also communicate with the server 104.
The networks 118, 122 may facilitate communication between the server 104 and one or more parties associated with the patient 102, such as his or her caregiver 130, support giver 132, and healthcare provider 134, via their mobile computing devices (e.g., smartphones). The server 104 may also be in communication with one or more computing devices (e.g., servers) associated with one or more additional parties associated with the patient 102. For example, a healthcare system server 140, a payment server 142, a pharmacy server 144, a distributor server 146, and a governmental agency server 148 are illustrated in communication with the server 104 via the network 122. It will also be recognized that the networks 118, 122 may be in communication with each other.
FIG. 2 illustrates a method 200 of operating a drug delivery system, such as the drug delivery system 100 in FIG. 1, to determine various states of the drug delivery system, to control the drug delivery system according to those states, and to communicate the determined state information to a computing device, such as the mobile device 110 and/or the server 104. From a brief review of the flowchart of FIG. 1, it will be recognized that the method 200 according to FIG. 2 illustrates the determination of various operational states of the drug delivery device that is part of the drug delivery system, and the actions taken and communications made in association with or in regard to these operational states. It should also be recognized that while the method 200 includes the actions described herein, other embodiments of a method of operating a drug delivery system according to the disclosure may include only some of the actions described herein, as is specifically illustrated in FIG. 3, for example. Those actions outlined in FIG. 2 not included in other embodiments of a method of operating a drug delivery device according to the disclosure may be omitted or eliminated.
The actions and communications from the drug delivery system may change with the drug delivery device operational state as that device passes through the useable product life cycle from manufacture to disposal, as indicated in FIG. 2. In fact, the determination made on the basis of a single sensor may vary according to the drug delivery device's operational state. By way of example, in regard to those drug delivery devices that utilize a needle cap disposed over a second end of the cannula to preserve sterility, determination made using a needle cap sensor that the needle cap has been removed from over or about the second end of the cannula prior to package or packaging removal might indicate that primary container integrity has been compromised, whereas in removal or separation of the needle cap from over or about the second end of the cannula after package or packing removal might indicate that the device is ready to administer the drug.
The method 200 starts at block 202, and continues from block 204 to blocks 206 and 208 when it is determined that the drug delivery system has been packaged. In particular, once it is determined that the device is packaged at block 204, a communication is made at block 206 to report the operational state change of the device, and the method continues to block 208, where a determination is made whether the device has been distributed.
Between the determination that the drug delivery system has been packaged and the determination that the drug delivery system has been distributed to the user, the drug delivery device may pass through different portions of the supply chain. The portions of the supply chain through which the drug delivery system may pass may depend on the drug in the drug delivery device, the intended use of the drug delivery device by the user, which may be a patient or a healthcare professional, or other factors (such as the structure and characteristics of the drug delivery device itself).
As the packaged device emerges from manufacture, there is interest in maintaining current knowledge of the authenticity, environmental history and information about the current or historic location throughout distribution. Consequently, while the method and system await the determination of the transition to the next operational state at block 208, the system may monitor and communicate this information at block 210. By automating the collection and reporting of information in this state, supply chain partners can leverage improved information and supply chain management systems. Information such as product identification, expiration date, and counterfeiting measures might be useful for logistics, warehousing, and customs officials. This information, when added to what is known of the combination product (i.e., therapeutic and diagnostic products that combine drugs, devices, and/or biological products) during manufacture can help alert interested and authorized parties to product location in the event of field events such as product transfer or return and replacement under recall.
Depending on the route which the drug delivery system takes between the manufacturer and its distribution to the patient or healthcare provider, the drug delivery system may also pass through a pharmacy, where the system may also monitor and communicate information at block 210. If the drug delivery system passes through a pharmacy, information such as drug/dose/device, environmental history, expiration date, counterfeiting measures, and location data may provide useful information to those responsible for managing stock and ensuring product quality as delivered to the end user. Incorporation of signals which trigger access to label and instruction information can provide value in training the end user about the delivery device or drug product, provide access to user communities and provide an information stream to the user or user's network about the effectiveness of product training or associated materials. These signals, when added to what is known of the combination product during manufacture can help to alert to product location in the event of field events such as product transfer or return and replacement under recall.
Once the determination is made at block 208 that the packaged product has been distributed to the user (e.g., a patient or healthcare provider), the method 200 may continue to block 212 where the change in the operational state is communicated. The method 200 may continue with a determination as to whether the drug delivery device has been unpackaged at block 214. If the determination has not been made that the drug delivery device has been unpackaged, then the method 200 may monitor the drug delivery system, and report information at block 216. If the determination has been made that the drug delivery device has been unpackaged, then the method continues to block 218 with the communication of the operation state change.
During this operational state, information such as environmental history, instructions for use, storage instructions, product authenticity or any associated field alerts for the produced lot of materials, expiration date, medication reminders and current location or estimated arrival through shipping provide information of interest to the user. The use of sensors to provide signals for environmental condition such as temperature can help the user to understand whether the product is now suitable for use, i.e., whether the method may pass from block 214 to block 220 (with the reporting occurring at block 218). One extended example of this is a “wake-up” of the electronics into a high activity state for delivery and reporting when temperature exceeding a certain threshold such as 15 C. This could result in a message to the user (e.g., via the user's networked devices) to return to the device to cold storage or administer within 24 hours. Similarly, the sensed temperature could put the electronics back into a low energy “sleep” if the drug product drops below a preset threshold such as 15 C.
If the determination is made at block 214 that the device has been unpackaged (presumably by the user), then the method 200 may report the operational state change at block 218, and proceed to the determination at block 220. As noted above, it is possible for the method to carry out determinations other than those illustrated at block 214 before the method 200 may proceed to block 220.
In determining if the system is ready for use at block 220, it is typical to verify the quality of the product presented. While the user may perform this action, the system may also include sensors that will carry out this action. For example, the verifications may include verification of the label information to confirm authenticity, visual inspection the device for signs of damage or to confirm that the needle cap has not come free in shipping, visual inspection of the drug product container for color and clarity. The verifications may also include a determination whether the environmental history of the device is such that the device may be safely used. Such a determination may consider the environmental conditions through storage and distribution which may have compromised the drug product or the delivery device. By including sensors in the device (such as position or proximity sensors for the needle cap or temperature sensors), many of these inspection steps can be automated, providing greater ease of use to the user and greater information to the user and user's network.
According to the determination made at block 220, the method 200 may pass to block 222, where the user discards the device instead of using the device. For example, it may be determined at block 220 that the environmental history of the device is such that the device may not be safely used. In such a case, the device may indicate to the user that the device is to be discarded at block 222 and may communicate this information to a remote server that tracks such device determinations, or may communicate this with a local device (such as a mobile or cell phone or other mobile device, portable computing device or the like) that is capable of being or is networked and may communicate the information to a remote server.
On the other hand, if the determination is made at block 220 that the system is ready for administration, the method 200 may proceed to block 224 with the reporting of the change in operational state. The method 200 may then continue to block 226, wherein a determination is made whether a barrier is no longer intact, has prematurely deployed or if it has been prematurely removed or separated from the drug delivery device such that the sterility of the device is no longer preserved or can no longer be assured to be preserved. In this regard, the barrier may be a sterile barrier (i.e., the minimum package that prevents ingress of microorganisms and allows aseptic presentation of the product at the point of use), such as a needle cap. If the determination is made at block 226 that the barrier is intact, then the method 220 may continue at block 228, wherein the operational state and condition states of the system are monitored and that information is communicated to local or remote devices. If the determination is made that the barrier is no longer intact, then the method 200 may continue to block 230, wherein the operational change is reported, and the method 200 may continue to block 232.
In regard to the determination made at block 226, it is typical for autoinjectors and on-body devices to have a component or packaging product that is removed immediately before administration that maintains the sterility of the needle or injection head. Sometimes outside protective packaging is inappropriately removed and discarded days in advance of medicament administration; while normally the patient may be no more than a few minutes away from insertion and/or injection when the sterile barrier is removed from the device. This determination also provides a key opportunity to ensure the drug delivery device electronics are “awake” during the injection process without requiring excess cost and bulk to ensure adequate power through manufacture, storage, and distribution before key functions are performed.
By triggering electronics to “wake-up” to a high activity state upon removal of the sterile barrier, onboard electronics of a Smart Drug Delivery Device can provide significantly improved power consumption while in manufacture, storage and distribution. According to certain embodiments, the startup sequence may take 10-200 seconds for example, inclusive of startup, completion of preliminary checks and interaction with the patient/user in advance of attempted administration (which interaction may include waiting for the device/drug to warm to room temperature, although inclusion of this action may further increase the total time required). Conversely, one can wait for body contact or delivery actuation to wake-up onboard electronics, but this is not likely to provide an opportunity for every desired “Smart” feature. Similarly, if something such as original packaging removal is used to wake-up the electronics then there is a risk that a significant amount of power will be utilized in advance of delivery that can complicate the optimization of the device and drug delivery system.
It is possible to design a component that is removed in conjunction with the sterile barrier, which has typically provided an opportunity to increase the ease, ergonomics, or obviousness of removal. By designing a tab, or other electrically insulating feature into this component; it may be inserted into the power circuit of onboard electronics so that removal of the sterile barrier connects the battery or other power supply and wakes up the electronics to perform the required functions. Alternatively, the removal of the barrier may cause a switch to close, completing a circuit with the power supply, and thus powering up the system.
At block 232, a determination is made if the drug delivery system has been applied to the patient. In regard to an autoinjector, this determination may involve a determination as to whether the autoinjector has been held in place against the patient's skin. In regard to an on-body injector, this determination may involve a determination as to whether an adhesive has been exposed on a surface of the on-body injector and the injector has been disposed onto the surface of the patient's skin. According to certain embodiments of the method 200, if a determination is made at block 232 that the drug delivery system has not been applied within a specified time after the barrier is no longer intact, the user may be instructed to discard the device at block 234 and the event is communicated to local and/or remote devices. Alternatively, if the determination is made that the device has been applied to the patient at block 232, the operational state change is reported at block 236 and the method 200 proceeds to block 238.
In some embodiments, the determination made at block 232 regarding skin application may be performed repeatedly at pre-defined intervals (e.g., every 5 milliseconds) throughout the remainder of the method 200. By doing so, it may be possible to determine if the drug delivery device has been prematurely removed from the patient's skin prior to the completion of medicament delivery to the patient. Also, if premature removal has occurred, it may be possible to determine when it occurred relative to the start of medicament delivery. The timing of the premature removal may be used to calculate the actual amount of the medicament actually delivered to the patient prior to the removal of the drug delivery device from the patient's skin.
As was the case above, it may also be useful to know when deliberate contact has been made, because this may be a useful opportunity to “wake-up” onboard electronics from a low power state for example depending on what “smart” functions are desired by the circuitry. Alternatively, some checks to confirm that the device is ready for administration might be performed in order to provide the user with greater confidence in the value of the injection.
Additionally, there is a risk of deliberate non-compliance with therapy where many commercially available injectors can be tricked into dispensing medication by depressing the needle guard and activating the product to dispense into the air instead of the patient. There is incremental value in the knowledge that the device was in contact with the body throughout the delivery period, and particularly if additional information that is in line with the properties expected of human tissue and appropriate injection sites. The overlap of known body contact with the duration of drug delivery and completion can be used to infer the amount of dosage missed in the event of use errors as further explained in the similar state of “needle inserted”.
The method 200 determines at block 238 if the second end of the cannula has been injected or inserted into the patient. With many drug delivery devices, the injection of the cannula into the patient is not instantaneous with the application of the drug delivery device to the patient's skin. For example, there may be a delay between application and injection because of time required for various assemblies or subassemblies of the drug delivery device to recognize that the drug delivery device has been applied and to activate the injector. Alternatively, there may be a planned delay in the injection of the cannula because the administration of the drug is planned to occur after a time delay elapses after application of the drug delivery device to prevent damage to the cannula or discomfort to the patient because of the planned delay between application and injection. In yet another alternative, in an on-body drug delivery device, a needle referred to as an introducer needle may be activated to insert a cannula that can remain inserted in the patient. The needle then retracts back into the delivery device, leaving the cannula behind. The actual injection or introduction of a medicament can occur immediately thereafter or at a later desired time. As such, the method 200 may proceed to block 240 if it is determined at block 238 that the cannula has not been inserted, and the system may monitor the operational state and one or more condition states and communicate that information.
Similar to the body contact information, the injection information may be used in conjunction with other processes to achieve a higher confidence in the gathered information. In contrast to body contact information, accurately measuring needle insertion to the target administration route such as intradermal, subcutaneous, intramuscular, intravenous, ocular or others can provide direct confirmation that the drug product was delivered to the correct anatomical depth and location.
One use for needle insertion signal can be release of a delivery lockout once the needle has been inserted into the patient. Alternatively, if the completion of drug delivery occurs and the needle was inserted for the entire period of time between “delivery triggered” and “delivery completion” a very high degree of confidence in successful dosing is provided. And conversely if the timing of the events do not overlap appropriately it may be possible to predict the amount of dose that was successfully delivered based on the systems delivery characteristics. In the event that an incomplete or unsuccessful dose administration is detected and reported, there is significant incremental value if the amount of dose discrepancy is also reported. A “Smart Drug Delivery Device” might be used for many different types of medicaments with varying therapeutic effects and toxicity risk profiles. For example some medications may require urgent completion of dosing such as by a second injection for any incomplete dose if there is a low risk of toxicity but high risk of complications with a missed or incomplete dose. Alternatively, a healthcare provider may prefer to know about a missed or incomplete dose but wait for the next dose instead of scheduling a replacement if the risk of complications is low. Importantly, there may be opportunities to mitigate issues associated with incomplete dosing by administering just the amount of missed dose if it is correctly recorded and reported, offering an opportunity to maximize benefit while minimizing the overall cost of care.
If the determination is made at block 238 that the needle has been inserted, then the method 200 may communicate the operation state change at block 242 and determine if the administration of the drug has been initiated or triggered at block 244. If the cannula has been inserted, but the administration has not yet started, the method 200 may continue at block 246 to monitor the states of the drug delivery device, and communicate that information. A delay between the insertion of the cannula and the administration of the drug product may occur because of the sequential operation of the assemblies or subassemblies of the drug delivery device, or the delay may be planned, such that the cannula is inserted into the patient contemporaneous with or approximately contemporaneous with the application of the device to the patient's skin but administration occurs at least a time delay thereafter.
It is believed that successful triggering of delivery generally leads to successful dosing except when a device may be programmed to insert a cannula and then at a later time the injection of the medicament begins. Upon triggering, the patient has generally performed an action intended to provide the therapeutic result. Triggering delivery may be viewed, according to certain embodiments, as evidence of a higher level of commitment as compared to body contact or needle insertion alone. It is believed that some patients try different sites by placing the device against the body to “feel” it before triggering delivery. Many devices include a feature to ensure that delivery is not triggered for such trials. Thus it is known that triggering delivery typically indicates the patient has mentally committed to dose the prescribed therapy. Enabling features of a “Smart Drug Delivery Device” to sense when delivery has been triggered provides value to many stakeholders as an indication of compliance. While not as direct a measure of successful delivery by comparison to other methods, detecting a trigger signal can be achieved through relatively simple means, providing greater value of cost and reliability.
Once the determination has been made that administration of the drug product has been initiated at block 244, the method may proceed to block 248 where the operational state change of the device is communicated with local and/or remote devices. The method 200 then proceeds to block 250, and a determination is made that the administration of the drug product is complete. Until the determination is made that the administration of the drug product is complete, the system continues to monitor the device, and communicate the information at block 252. Once the determination is made that administration is complete at block 250, the change in operational state is communicated at block 254, and the method 200 proceeds to block 256.
Capturing the completion of administration or delivery is a useful metric, particularly in combination with other device state information. By itself there is value if a device does not have the means to capture other device states, and indeed would provide sufficient value to many stakeholders if the other states were unable to be reported. However, capturing the time and date of dose delivery completion in comparison to other device states can provide a very high level of confidence (or counterevidence) that the drug was delivered successfully. For example, if dose completion occurred while the needle was still inserted that confirms that the patient or caregiver administering the medicament did not pull the device away from the body during or after it was triggered thus compromising the dosage accuracy. Commonly available drug delivery devices may lockout to prevent drug delivery in advance of applying the device to the body, but once the device has been applied to the body there is generally no means of keeping the device secured against the body during the full time of delivery. Most often the drug will continue to deliver, spilling into the air as waste if the needle is pulled away from the body after the delivery is triggered. Sometimes a medicament may be painful or cause a certain sensation due to the specific ingredients or speed of delivery and thus cause a reflex that compromises the dose even after the needle has been inserted. Other times, an action of the delivery device itself may startle the user and cause the same reflex. It is known to be important for the user or user's network to understand the difference between slow response and noncompliance to a therapy in order to provide the patient with the evidence needed to encourage compliance with a given therapy or the evidence needed to alter a therapeutic strategy. Thus there is incredible value to the patient to a comprehensive measurement and reporting of drug delivery device performance.
Several of the embodiments disclosed below may be expanded in scope to monitor the overall progress of the delivery. For example if an optical sensor is optimized to detect the stopper material and oriented at the end of the delivery stroke that can be used to relay completion information; similarly an array of optical sensors placed parallel to the travel of a plunger through a drug reservoir might be used to monitor progress throughout the travel.
At block 256, the method 200 determines if the device has been removed from the patient. The determination at block 256 may be based on a skin sensor that determines if the device is no longer in contact with the patient's skin. According to other embodiments, the determination may be made on a needle shield or other structure that deploys after removal from the skin to prevent contact with the second end of the cannula of the drug delivery device. According to still other embodiments, the removal of the drug delivery device may be based on a change in the orientation of the drug delivery device. In any event, until it is determined that the drug delivery device has been removed, the method and system may monitor the device at block 258 and communicate information with local and/or remote devices. When it is determined that the drug delivery device has been removed, the method communicates this operational state change at block 260, and ends at block 262.
Disposal of the device, and alternatively receipt of a used device by collection center, provides a final opportunity to interrogate any stored information and/or utilize the receipt itself to function as evidence of prior state changes. Any data collected previously might be stored for download at a collection point. In addition, for situations where a return is warranted for replacement or in satisfaction of other field action, knowledge of the location of the drug delivery device through distribution and return shipping is valuable. The same signals, in combination with remote authorization of return can allow for return shipping to be electronically authorized and paid for by the appropriate partner in the user or distribution network with minimal impact to the user.
It will be recognized that according to other embodiments of the disclosure, the various operational states described in regard to FIG. 2 may be considered to be optional. For example, it may not be necessary to make the determinations at blocks 238 and 244 relative to the insertion of the cannula and the initiation of the administration of the drug product if, for example, the determinations are made at blocks 232 and 250 that the device has been applied and the drug product administration has been completed. Furthermore, while the method 200 includes communication of operational state changes after each operational state change, none of the operational state changes may be stored within the system, but the communication of each of the operational state changes may not occur until block 260. Further, while the monitoring of the drug delivery device has been illustrated as occurring while the method 200 is waiting for certain determinations to be made (e.g., block 208 and 210), this monitoring need not be performed at every instance illustrated.
Furthermore, it will be recognized that the monitoring described in FIG. 2 may include more than monitoring of the various operational state changes discussed. The monitoring may also include monitoring of condition state changes. In fact, the method and system may monitor one or more sensors to make these operational and/or condition state changes, which information or signals from the one or more sensors may be used in the determinations made at various points along the method 200.
FIGS. 3A-3C illustrate a method 300 that may be viewed as illustrating some of the mixed operational and condition state monitoring that may occur in a method and system according to the disclosure. The method 300 may also be viewed as illustrating how the one or more sensors may be used to determine the state changes described above. Furthermore, the method 300 may be viewed as providing disclosure of operational and conditions state monitoring and communication of that information not illustrated in FIG. 2.
Referring first to FIG. 3A, the method 300 may begin with the drug delivery device in the package, and the method waits at block 302 until it is determined that the package has been opened. At this point, the device may optionally be locked until such time as the system conducts one or more validations, verifications or checks to ensure that the device is ready to administer, the sterile barrier has been removed and/or the device has been (correctly) applied (see blocks 220, 226, 232 of method 220 in FIG. 2). Before conducting each of the one or more validations, verifications or checks, the method 300 may determine if the drug delivery device is adapted or programmed to carry out the validation, verification or check. For example, a determination may be made at block 304 if the drug delivery device is adapted or programmed to check the sterility of the drug delivery device; in particular, the validation or verification may be related to a sterile barrier disposed at the second end of the cannula. If the drug delivery device is adapted or programmed to perform the sterility check, the method 300 may proceed to block 306, where it is determined if the sterile barrier is disposed over or about the second end of the cannula, for example.
If it is determined at block 306 that the barrier is in place, then the method may proceed to block 308 where the user is instructed to remove the barrier. The method 300 may then determine at block 310 if the barrier has been removed. When it is determined that the barrier has been removed, a sterility timer may be started, the expiration of which may result in the drug delivery device being placed into or remaining in a locked state, preventing use of the drug delivery device.
If it is determined at block 306 that the barrier is not in place (i.e., the barrier has been prematurely removed), the method 300 may proceed to block 312, wherein the delivery device is locked (e.g., a lock or lock-out device is actuated) or the delivery device remains in a locked state if the device was previously locked. According to certain embodiments, the locking of the delivery device at block 312 may be irreversible. According to other embodiments, including the embodiment illustrated in FIGS. 3A-3C, the lock may be reversed once it is determined that the drug product (e.g., the drug product reservoir) has been replaced at block 314. If the drug product is not replaced, or in those embodiments where the drug product cannot be replaced (i.e., the lock is irreversible), information regarding the failed sterility check may be communicated by the system.
If (i) the determination is made at block 304 that the system is adapted to validate, verify or check the sterility of the device, (ii) the determination is made at block 306 that the barrier is in place and at block 310 that the barrier subsequently has been removed, or (iii) the determination is made at block 306 that the barrier is not in place but the determination is made at block 314 that the drug product had been replaced, the method 300 continues to block 316. At block 316, a determination is made if the drug delivery device is capable of performing visual and/or environmental inspections. If the device is so adapted, the method proceeds to block 318, wherein the determination is made if the visual inspection and/or environmental conditions are within desired thresholds. If the determination is made that the visual inspection and/or environmental conditions are outside desired thresholds, then the method may proceed to blocks 312, 314. If the determination is made that the visual inspection and/or environmental conditions are within desired thresholds, then the method 300 may proceed to block 320.
At block 320, a determination is made whether the drug delivery system is able to confirm the user identity. If the drug delivery system is so adapted, then the method 300 continues to block 322, and the determination is made if the user identity matches the authorization for the use of the drug delivery device. If the user is not identified as an authorized user at block 322, then the method 300 continues to block 324, where the drug delivery device is locked or remains locked, and block 326, where the information regarding the attempted unauthorized use is communicated to local and/or remote devices. If the user is identified as an authorized user, then the method 300 proceeds to FIG. 3B and block 328.
At block 328, a further determination is made as to whether the drug delivery system is enabled to confirm the temperature of the drug product. If the system is so adapted, then the method 300 continues to block 330. At block 330, a determination is made if the drug product temperature is within a range for predictable delivery (neither too high nor too low). If the determination is made at block 330 that the temperature is not within the range for predictable delivery, then the method 300 continues to block 332, wherein a determination is made if the device is capable of heating or cooling the drug product to bring the temperature of the product within the range. If the system is not so adapted, then the method proceeds to block 334, where the device may be locked or remain locked to allow passive heating or cooling to occur and the user may be alerted. Optionally, the system may also communicate the information to local and/or remote devices. If the system is enabled to permit heating or cooling, then the method proceeds to block 336, where the device may be locked or remain locked, heating or cooling may be initiated, and the user may be alerted. Whether passive or active heating or cooling (blocks 334, 336), the method 300 may continue to block 338, where delivery is delayed to provide time for the heating or cooling to occur before the method returns to block 330. According to certain embodiments, the method 300 may terminate after block 330 (in case of excessive temperature, for example) and may communicate that information to local and/or remote devices.
In some embodiments, the temperature check performed at block 330 may involve an evaluation of the temperature history of the drug product to determine the range and duration of temperatures experienced by the drug product in the past (e.g., during storage, distribution, shipping, etc.). If the temperature history of the drug product is unacceptable due to, for example, the drug product being exposed to elevated temperatures for several days or hours during shipping, the controller 350 may lockout the drug delivery device 302 so that it cannot be used to deliver the drug product to a patient, and additionally, may control the communication module 352 to transmit a report to the local computing device 304 or the remote computing device 306 representative of the unacceptability of drug product's temperature history. In some embodiments, upon a determination that the temperature of the drug product exceeds a threshold temperature, the controller may begin a timer that runs until the temperature returns below the threshold temperature. If the duration of the timer exceeds a predefined time limit, the controller 350 may lockout the drug delivery device 302 and control the communication module 352 to transmit a report representative of the unacceptability of drug product's temperature history.
Returning to FIG. 3B, if the determination is made at block 328 that the device is not adapted to perform a temperature check or at block 330 that the temperature of the drug product is within the desired range, then the method may continue to block 340, where a determination is made if the device is enabled to determine that the device is properly positioned on or oriented relative to the patient. If the device is so adapted, then the method proceeds to block 342, and a determination is made whether the device is properly disposed or oriented. In this regard, depending on the preferred insertion site, knowledge of the orientation of the device may be useful in providing a successful injection. For example, self-administration into the abdomen would most likely result in an orientation of an autoinjector axis approximately horizontal.
If the device is not properly disposed, then the method proceeds to block 344, and the device may be locked and the user instructed to reposition or reorient the device. The method 300 may then proceed to block 346 wherein a time delay is provided for the user to reposition the device before the method 300 returns to block 342 for a further determination relative to the position of the device. Alternatively, if the device is properly disposed, then the method may proceed to block 348, and any locks or lockouts that may have been actuated are removed (or the device is unlocked).
The method 300 continues at block 350, wherein a determination is made whether the system is enabled to determine if the delivery has been triggered. If the determination is made that the system is so adapted, then the method proceeds to block 352, and a determination is made if the device has been activated or triggered. If the determination is made at block 352 that the device has not been triggered, then the method 300 may proceed to block 354 and the system may instruct the user to trigger the device. According to other embodiments, the drug delivery device may wait for a predetermined and/or preprogrammed time delay to occur before triggering the device automatically upon the completion of the time delay. According to still other embodiments, the method 300 may optionally determine if a timer has elapsed at block 355 to reduce the risk of contamination and infection, for example. According to such embodiments, the timer may be started upon the determination that the barrier has been properly removed at block 310 (or may be started upon the determination that the barrier has been removed, according to still further embodiments), and if the method 300 does not determine that the device has been triggered within a certain amount of time from that event, the method 300 may return to block 312, for example, as illustrated in FIGS. 3B and 3A. If it is determined at block 350 that the trigger has occurred, then the method proceeds to block 356, where the user may be notified of the triggering of the device and/or the date, time and location of the delivery may be stored or recorded. Optionally, this information may also be communicated to local and/or remote devices in communication with the system. The method 300 then continued to FIG. 3C.
A further determination may be made at block 358 whether the system is enabled to determine if the device has remained properly positioned on or oriented relative to the body. If the system is so adapted, then the method 300 continues to block 360, and a determination is made if the device is properly positioned on or oriented relative to the body. If the device is not properly positioned or oriented, then the method 300 may continue to block 362, where the user is alerted to reposition or reorient the device, and block 364, where a time delay is provided for the user to reposition or reorient the device, before returning to block 360 wherein the position or orientation of the device on the patient's body is determined. If the device is properly positioned or oriented, the method 300 may proceed to block 366. Optionally, the method 300 may repeat block 360 periodically during the time the device is administering the drug product to ensure that the device remains correctly positioned.
At block 366, a determination is made whether the system is enabled to determine if the administration is complete. If the system is so adapted, then the method 300 continues to block 368, and a determination is made if the delivery is complete. If the determination is made at block 368 that the delivery is not complete, then a further determination is made at block 370 whether the delivery can be completed. If the delivery is not complete but may be completed, then the method 300 returns to block 368 via block 372, where the device is permitted to continue to administer the drug product. If the delivery is not complete and cannot be completed (e.g., the device has been removed from the patient's skin), then the method 300 continues to block 374, and information regarding the drug and drug delivery may be communicated to a local and/or remote device. For example, information regarding whether certain operational states occurred (cannula inserted, delivery started, delivery partially completed), the timing of the operational states, and the amount of drug product that was administered may be communicated.
If the determination is made at block 368 that the delivery has been completed, then the method proceeds to block 376, where the system indicates to the user that the delivery is complete. Furthermore, the method 300 communicates information regarding the drug delivery, the drug delivery device, and the drug product to local and/or remote devices at block 378. For example, the information may include that certain operational states occurred and the timing of the operational states. The method 300 may also verify that the device was correctly positioned throughout, where the system is enabled to make this determination. The method 300 may also pass to block 378 if the system is not enabled to determine if the administration of the drug product is complete, the assumption made that the drug delivery device having been determined to have passed through one or more of the preceding operational states necessarily leads to the conclusion that the delivery was completed.
Again, it should be noted that while the above description relates to a method including a series of states of for the devices and alternative actions that may depend on those states, the device need not determine each and every state or perform each and every action illustrated in FIGS. 3A-3C. Rather, it will be recognized that one of ordinary skill in the art may omit or eliminate the determination of certain states or performance of certain actions, so as to result in a system that may control the device based on or communicate a subset of the states described.
Having discussed the possible methods of operating the drug delivery system in the context of the illustrated methods of FIGS. 2 and 3A-3C, the possible methods of operating one or more computing devices in communication with the drug delivery system is now discussed in the context of a method 400 illustrated in FIG. 4. It will be recognized that the method 400 may be carried out by a single computing device, such as the server 104 illustrated in FIG. 1. Alternatively, the actions discussed with respect to FIG. 4 may be carried out by multiple computing devices, such as the mobile device 110 or computing device 114 in conjunction with the server 104.
The method 400 begins at block 402 with a determination as to whether a report has been received from the drug delivery system. If no report has been received, the method 400 waits at block 402 Once it is determined that a report has been received at block 402, the method 400 proceeds to block 404.
At block 404, the report received from the drug delivery system is used to update one or more records. In this regard, the one or more computing devices adapted or programmed to carry out the method 400 may perform the actions of retrieving the one or more records from storage in one or more memory storage devices, writing the information received from the drug delivery device into the one or more records, and then storing the one or more records in the one or more memory storage devices. The one or more memory storage devices may be part of the one or more computing devices, may be separate from the one or more computing devices, or may include one or more of the memory storage devices that are part of the one or more computing devices and one or more memory storage devices that are separate from the one or more computing devices (i.e., the record is stored at the computing device and in backup storage separate and possibly remote from the computing device).
As mentioned above, the report may be used to update one or more records. For example, there may be one record for the individual patient that is stored in a patient record database. The patient record may be used, for example, to track the compliance of the individual patient (e.g., patient 102) with his or her regime(s). There may also be a record for the drug delivery system used by the individual patient that is stored in a drug delivery system database. The drug delivery system record may be used to store information regarding the drug delivery system throughout the life of the drug delivery system. The drug delivery system record may be accessed by the drug delivery system manufacturer or the drug provider for quality control purposes (e.g., to monitor individual instances of the drug delivery system for faults or failures attributable for to the drug delivery system, or to track the environmental condition histories of one or more drug delivery systems for patterns that may assist in determining improvements in the design, packaging, shipment or handling of the drug delivery systems). There may also be record for drug used in the drug delivery system that is stored in a drug database. This record may be used in a similar fashion to the drug delivery system record for quality control purposes.
In addition to the updating the records at block 404, the computing device adapted or programmed to carry out the method 400 may be adapted or programmed to carry out one or more actions based on the information in the report received from the drug delivery system. For example, the computing device may be adapted or programmed to carry out an action at block 406. This action may require not only the information received in the report and/or stored previously in the record updated at block 404, but may require additional information such as from other patient records, drug system delivery records and/or drug records. If this is the case, the determination may be made at block 408 that these other records need to be accessed, and the information retrieved at block 410 (e.g., by retrieving these other records from the patient, drug delivery system and drug databases and reading the information from these records once retrieved). The action may then be carried out at block 412.
As one example, the one or more computing devices adapted or programmed to carry out the method 400 may be adapted or programmed to use the information received in the report to prepare a compliance history for the patient, which compliance history tracks uses of instances of the drug delivery system by the individual patient relative to his or her treatment regime to determine how successful the patient has been in following the treatment regime and which compliance history may be stored in the patient record. In addition, the one or more computing devices may determine if a pharmacy should be contacted to order delivery of additional drug delivery devices for the individual patient, and may generate a communication to be sent to the pharmacy to order the delivery of additional drug delivery systems. Further, the one or more computing devices may determine if a reminder should be sent to the patient, via the mobile device 110 for example, to improve or support compliance with the individual patient's treatment regime, in which case the one or more computing devices may generate a communication to be sent to the patient or user of the device. Further, the one or more computing devices may determine that the operation of the drug delivery device should be modified because of a conditional state received from the drug delivery device, for example. For example, the one or more computing devices may determine that the drug delivery system should be locked to prevent its use because of the temperature history of the drug in the drug delivery system, for example. In this case, the one or more computing devices may generate a communication, in the form of a signal for example, to be sent to the drug delivery system to lock the drug delivery device that is part of the drug delivery system. Other possible actions are discussed in detail below, although this discussion is for illustrative purposes only and is not intended to be limiting.
Depending on the action taken at block 412, or even if it is determined at block 406 that no action need be taken, the method 400 may proceed to blocks 414, 416, 418 where determinations are made if the computing device should make contact with other parties (block 414), interact with the patient (or user, if not the same as the patient) (block 416) or control the drug delivery device that is part of the drug delivery system (block 418). For example, as discussed above, the action taken at block 412 may involve the generation of communications or signals to be sent to third parties, such as the pharmacy, to the patient, or to the drug delivery device. In such a case, the one or more computing devices may carry out the actions of block 420, 422, 424 as dictated by the determinations made at blocks 414, 416, 418. Alternatively, the one or more computing devices may carry out the actions of blocks 420, 422, 424 even if it is determined that no action need be taken at block 406. For example, the one or more computing devices may forward certain information to third parties 420 based solely on the receipt of the information in a report from the drug delivery device, such that there is no need to separately determine that an action need be taken in regard to the information received (i.e., the communication is automatically sent based on the fact that the information has been received, with the one or more computing devices acting as a repeater station for such information). The receipt of information from the drug delivery device may also prompt communications to be sent to the patient/user or control signals to be sent to the drug delivery system without a separate determination that such action need be taken, the communication or control signal being sent simply because certain information and/or reports were received from the drug delivery system.
Having made the determinations at blocks 414, 416, 418 and carried out the actions of blocks 420, 422, 424, the method 400 may return to block 402 to await the next report. It will be recognized that the one or more computing devices may perform the actions of the method 400 in parallel for each of the reports received from different instances of the drug delivery system, or may perform this steps in sequence for each report. If performed in parallel, the one or more computing devices may determine if action is to be taken in regard to one report, while the one or more computing devices may be interacting with another patient in regard to the information contained in the report received from that patient. Furthermore, the one or more computing devices carrying out the method 400 need not be adapted or programmed to carry out each of the actions described above according to every embodiment of the one or more computing devices. For example, one of the one or more computing devices may be adapted or programmed to update records for each patient and to determine if an interaction with that patient is required, while another of the one or more computing devices may be adapted or programmed to update records for each drug delivery device and to determine is a control signal should be sent to the drug delivery device, while another one of the one or more computing devices does not update any record, but is adapted or programmed to access, for example, a patient record and determine if the pharmacy needs to be contacted to order additional instances of the drug delivery system for the patient associated with the patient record accessed and to generate the communication if the order of additional instances of the system is required.
It will be appreciated that the methods 200, 300, and 400, above, touch only a fraction of the possible state and identity information that may be used to control and/or monitor the drug delivery device and that may be communicated between the drug delivery system and the one or more computing devices, as well as how that information is used by the drug delivery system and the one or more computing devices. Additional embodiments are possible according to the disclosure.
For example, a non-limiting matrix of state and identity information may include the following:
Condition State Information:

    
    
        Temperature
        Shock or vibration exposure
        Light exposure
        Color and/or turbidity (as relates to the drug)
        Orientation
        Geographic position
        Temporal information
    
    


Operational State Information:

    
    
        Device removed from package
        Device removed from cold storage (e.g., refrigerator)
        Device/drug temperature ready for administration
        Delivery triggered
        Device applied to patient
        Device applied at correct location/orientation on patient
        Cannula inserted into patient and/or inserted into correct tissue
        Delivery in progress
        Delivery complete
        Error has occurred
    
    


Device Identity Information:

    
    
        Drug name or identification, concentration, and/or amount
        Security and/or anti-counterfeiting information
        Patient prescription/therapeutic regime
    
    


Patient Identity Information:

    
    
        Point of Care diagnostics on patient
        Self-analyzed measure of progress
        Fingerprint, pin, or other secure identification information
    
    


This information may be used to control the drug delivery system or device, to be communicated to other computing devices, or otherwise to be used, and an exemplary listing of certain additional uses is included below. The listing and additional comments below is not intended to supersede, but to augment the discussion above, and is intended to be non-limiting.
As one example, the drug delivery system or the one or more computing devices may make a determination regarding the authenticity of the drug and its compliance with manufacturing standards. Such a determination may be made by the drug delivery device at block 220 of method 200 or block 318 of method 300, or by the one or more computing devices at block 406 of method 400, for example. The determination may be made based on the temperature, shock or vibration exposure, and/or light exposure of the drug delivery device/drug (or a history of one or more of these conditions) and color and/or turbidity of the drug (as determined by an optical inspection). This determination may result in control of the drug delivery device to either lock or unlock the device, according to the determination made. See blocks 220, 222, 224 of method 220, blocks 318, 312, 314 of method 300, and blocks 406-412 and 418, 424 of method 400.
As another example, the drug delivery system or the one or more computing devices may make a determination whether the drug is appropriate for the patient. See block 220 of method 200, block 322 of method 300, and block 406-412 of method 400. The determination may be made based on one or more of the items of device of patient identity information listed above, and may also result in control of the drug delivery device to either lock or unlock the device, according to the determination made. See blocks 220, 222, 224 of method 220, blocks 322, 324, 326 of method 300, and blocks 406-412 and 418, 424 of method 400.
As a further example, the drug delivery system or the one or more computing devices may make a determination whether the dose has been correctly administered. This determination may be carried out after determining that the drug is appropriate for the patient and/or that the drug is authentic (e.g., not counterfeit) and is in compliance with manufacturing standards. See the preceding paragraphs. The determination whether the dose has been correctly administered may depend on one or more of the types of operational state information listed above. See blocks 220-260 of method 200, and blocks 328-378 of method 300. This information may be used to update the patient record, determine the patient compliance or therapy progress, and may prompt communication with the pharmacy regarding a refill, or with the payer (e.g., insurance company) to authorize payment for the drug delivery device. See blocks 404-414 of method 400, and servers 142, 144 of FIG. 1.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination regarding the operational state of the drug delivery device, and to generate instructional messages to guide the user through the actions required for the proper use of the drug delivery device. The determination may be based on any of the operational state information listed above, and the instructions generated may be dictated by the actions that need to be performed after the operational state that has just occurred. Implementation of interactive instructions that follow the changing states of the drug delivery device may help the user have confidence in administration of the drug. See also, FIGS. 6 and 7, below.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination that other people nearby are taking the same medication. See blocks 406-412 of method 400. This determination may be made based on the drug identity information and the patient identity information, in combination with the drug delivery system geographic location information. This determination may prompt a communication with the patient (see blocks 416, 422 of method 400) regarding local support networks of persons with similar conditions and/or taking similar drugs or medication to permit the patient to receive support and encouragement from such networks. Alternatively, the determination may prompt a communication with the local support network(s) (see blocks 414, 420 of method 400) to provide support and encouragement to the patient. As a further alternative, the determination may prompt a personalized intervention communication to be sent to the patient (again, see blocks 416, 422 of method 400).
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination whether the patient is not in compliance with their therapy regime. See blocks 406-412 of method 400. The determination may be based in part on the drug identification information, such as the prescribed treatment regime, in part on condition state information, such as the passage of time, and in part on the operational state information, such as where the drug delivery device is removed from the packaging but where no additional operational state information is determined, reported or received during the passage of time from the removal from packaging operational state. Based on this information, the drug delivery system and/or the one or more computing devices may determine that an interaction with the patient should be generated, such as an alert may be displayed or sent to patient. See blocks 416, 422 of method 400. Furthermore, the drug delivery system and/or one or more computing devices may determine that a communication should be generated to be displayed or sent to a healthcare provider, caregiver, support giver and/or payer to encourage adherence to regime. See blocks 414, 420 of method 400.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination that the patient needs more medication (a refill). See blocks 406-412 of method 400. The determination may be based in part on the drug identity information, such as the prescribed treatment regime, and in part on the operational state information, such as where the drug delivery has been completed. Based on this information, the one or more computing devices may generate a communication that is sent to the payer and/or pharmacy to request a prescription refill. See blocks 414, 420 of method 400.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination that the injection was not performed correctly. See blocks 406-412 of method 400. The determination may be based in part on operational state information, in comparison with information that may be collected and stored regarding conventional norms in operation. Alternatively or additionally, a comparison between the determined, reported or received operational states may permit a determination to be made that the injection was not performed correctly. For example, the determination, reporting or receipt of operational state information indicating that the drug delivery is complete without operation state information indicating that device was triggered, that the device was applied to the patient, and/or that the cannula was inserted may indicate that the drug delivery device has failed to perform correctly, is faulty or was operated incorrectly.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination that patient's condition is improving. The determination may be based in part on patient identity information, such as point-of-care diagnostics performed on the patient (e.g., blood glucose test or other testing) or self-analysis reporting, and in part on the determination, reporting or receipt of operational state information, such as where the drug delivery has been completed. The determination may rely upon an overall trend as opposed to individual determinations or reports, as it is believed that data or reporting trends are usually more indicative of improvement in a patient's condition than the patient's condition as determined at individual instances for serious diseases. As such, the information gathered regarding the patient and the operational state of the drug delivery system/device may be combined with combined with therapy compliance history. This determination may result in individualized interventions to be generated, which interventions (such as encouraging messages and other forms of positive reinforcement) may increase persistence in therapy.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination of the time of day (or week, month, etc.) that the patient usually takes their medication. This determination may be based, in part, on the patient record in which time information is associated with operational state information, such as relates to the triggering of the drug delivery device or the completion of the drug delivery. This determination may also rely on device identity information, such as the prescribed treatment regime. Based on this determination, the one or more computing devices may generate a reminder communication that is sent, for example, to the mobile device 110 to alert the patient that the time is approaching for them to administer their next dose. As the usefulness of reminders is enhanced when there is reasonable access to the drug delivery device and an opportunity for its use, it is beneficial to reinforce a patients decision to take their medication at a particular time during the day, week, month, etc. Based on this determination, the one or more computing devices may also generate a personalized intervention, such as a message of encouragement to be used as a positive reinforcement.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination where the patient usually takes their medication. This determination may be based, in part, on the patient record in which geographic position information is associated with operational state information, such as relates to the triggering of the drug delivery device or the completion of the drug delivery. This determination may also rely on device identity information, such as the prescribed treatment regime. Based on this determination, the one or more computing devices may generate a reminder communication that is sent, for example, to the mobile device 110 to alert the patient that the time is approaching for them to administer their next dose when they are at or near the geographic location where the patient usually uses the drug delivery system. As the usefulness of reminders is enhanced when there is reasonable access to the drug delivery device and an opportunity for its use, it is beneficial to reinforce a patient's decision to take their medication when they are in the usual location where they take their medication. Based on this determination, the one or more computing devices may also generate a personalized intervention, such as a message of encouragement to be used as a positive reinforcement.
Of course, the determinations regarding the usual time and location of the use of the drug delivery device may be combined, and the one or more computing devices may generate a message only when the patient or user is at or near their usual location of use at or near the time they usually use the drug delivery device.
While the foregoing has focused principally on the determinations made by the drug delivery system and/or one or more computing devices concerning the patient or the patient's use of the drug delivery device, determinations may be made with reference to the drug delivery device or the drug before the drug delivery device is made available to the patient or user.
For example, the drug delivery system or the one or more computing devices may use the information to make a determination whether delivery of a certain number of doses of a particular drug has arrived (e.g., instances of a drug delivery device containing the particular drug), for example, at a particular distributor or pharmacy location. This determination may be made based in part on the geographic location information and in part on the drug identity information. Based on this information, the one or more computing devices may generate a communication that is sent to the pharmacy or distributor (via the pharmacy or distributor server, for example) to inform them of the delivery of the drug delivery device. The pharmacy or distributor may use such a smart drug delivery device to simplify their logistics and inventory systems, for example.
Along similar lines, the drug delivery system or the one or more computing devices may use the information to make a determination that one or more of the drug delivery devices have been damaged en route to a particular distributor or pharmacy location. The determination may be made based in part on the geographic location information and in part on the drug identity information. The determination may also be based in part on condition state information, such as the temperature, shock/vibration exposure, light exposure or color and/or turbidity of the drug, whether determined at a particular time or over a period of time (i.e., a history as established in the drug delivery device record or the drug record). The determination may also or instead be based in part on the age of the product relative to its manufacture date or expiration date. The determination may also or instead be based in part on operational state information, such as the removal of a sterility barrier from the second end of the cannula of the drug delivery device. Based on this information, the one or more computing devices may generate a communication that is sent to the pharmacy or distributor (via the pharmacy or distributor server, for example) to inform them that the drug delivery device has been damaged or expired. The pharmacy or distributor may use such a smart drug delivery device to expedite the distributor's or the pharmacy's replacement of the damaged or expired product and prevent delays in patient therapy, for example.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination that the product is as stated and has not been counterfeited. Such a determination may be based on the drug identity information, such as the name, concentration and amount of the product and the security and anti-counterfeiting measures associated with the drug. The determination made by the one or more computing devices may cause a communication to be generated, which communication may be transmitted to a governmental agency (e.g., customs/immigration officials) via the governmental agency server, to distributors and/or pharmacies via their respective servers, and/or patients and caregivers via their personal mobile devices.
As still further alternatives, certain determinations made by drug delivery systems and/or one or more computing devices operating according to embodiments of the disclosure may be used to control the drug delivery device remotely (i.e., without the controlling device being present in the same geographic location (e.g., room, building, or city) as the drug delivery device).
For example, the drug delivery system or the one or more computing devices may use the information to make a determination that the device needs to be controlled to prevent accidental operation. The determination may be based in part on the drug identity information in combination with, for example, certain patient identity information, such as biometric information in the form of a fingerprint. If it is determined that a party that is not authorized to use the drug delivery device is attempting to use the drug delivery device, then the one or more computing devices may generate a signal to be sent to the drug delivery system to lock the drug delivery device or to keep it locked until the drug delivery system is accessed by the patient or user for which it is intended.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination that the patient associated with the drug delivery device is in a particular group or subgroup of patients or users that require or prefer a particular mode of operation for the drug delivery device. This determination may be made in part using information regarding the identity of the patient and the drug. Based on this determination, the drug delivery system and/or the one or more computing devices may generate a signal that customizes the operation of the drug delivery device. For example, the drug delivery device may be customized as to the sounds and/or lights used to alert the patient to various condition or operational states according to the specific market segment or patient population associated with the patient. As one example, different sounds may be used with pediatric patients than adult patients, louder sounds may be used with patients with hearing loss, and different lights or light sequences may be used with color-blind patients. Such control of the drug delivery device through the drug delivery system and/or one or more computing devices may reduce costs for drug delivery by permitting a single drug delivery device to be used that adapts to patient via software, rather than to use a plurality of different drug delivery device types, each of which has different hardware from the other types of drug delivery devices.
As a further alternative, the drug delivery system or the one or more computing devices may use the information to make a determination that the drug delivery device has not performed properly, and to generate a communication in that regard to the manufacture of the drug delivery device. The manufacturer may then determine modifications and/or improvements to enable proper administration of drug and can implement checks for sensed information and relay errors if it is not followed or is not successful.
As has been mentioned above, the drug delivery system and/or one or more computing devices in communication with the drug delivery system need not be adapted or programmed to carry out every action listed in FIGS. 2, 3A-C and 4. Several illustrations of embodiments of a drug delivery system or computing device according to the disclosure are now discussed relative to FIGS. 5-12B. FIGS. 5-12B illustrate methods for operating the drug delivery system or the computing device that represent a subset of the actions discussed above in regard to FIGS. 2, 3A-C and 4 and associated systems. FIGS. 5-9 relate to a method concerning a sterility barrier, while FIG. 10 relates to activation of the device, and FIGS. 11 and 12A-12B relate to the needle shield.
Turning first to FIG. 5, a method 500 is illustrated wherein the drug delivery system is adapted or programmed to provide instruction to the patient or user, through the use of an output devices such as a light emitting diode, display, speaker or other device, and to communicate with a computing device (e.g., mobile device 110 or computing device 114) over a communication link (e.g., 112 or 116) to transmit a report to that computing device. The method 500 is focused on a single issue: whether the sterility of the device is intact. The method 500 determines if the sterility of the device is maintained based on whether a barrier, in the form of a needle cap, is disposed over the second end of a cannula that is intended to be inserted into the patient.
The method 500 begins by making a determination whether the needle cap is in place at block 502. This determination may be made, at least in part, on whether a signal has been received by a controller adapted or programmed to carry out the method 500 from a switch or other proximity sensor that abuts a structure of an autoinjector when the needle cap is properly disposed over the end of the needle. If the determination is made at block 502 that the needle cap is in place, then the method 500 continues to block 504 and the user may be instructed to remove the needle cap, for example by illuminating one or more light emitting diodes visible to the patient or user of the drug delivery device. The controller may also cause a transmitter (which is at least capable of one-way communication, and may be capable of two-way communication—i.e., a transceiver) to transmit a report at block 504 to one or more computing devices in communication with the transmitter representative of the fact that the sterility of the device is intact. For example, the transmitter may be a near field transmitter, such as may use the Bluetooth or similar protocol.
The method 500 may continue at block 506, where the controller determines if the needle cap has been removed after the patient or user was instructed to remove the needle cap. For example, the controller may determine that the needle cap has been removed when a different signal (or no signal) is received from the switch or other proximity sensor. When the controller determines that the needle cap has been removed, the method continues to block 508 where the controller causes the transmitter to transmit a report representative of the fact that the needle cap has been removed after the sterility of the device was confirmed.
As illustrated in FIG. 5, the method 500 includes a different set of actions if the controller determines at block 502 that the barrier is not in place, e.g., the needle cap is not disposed about the end of the needle at the beginning of the process. If such a determination is made at block 502, then the method 500 continues at block 510, where the controller locks the drug delivery device, instructs the patient or user to replace the product container, and causes the transmitter to transmit a report representative of the fact that the sterility of the device is not intact. As was the case with the action taken at block 504, the controller may instruct the patient or user to replace the product by illuminating a light emitting diode. The controller may lock the product by preventing the operation of one or more other assemblies necessary to administer the drug to the patient; for example, the controller may prevent the needle from being inserted into the patient. The controller then waits until a determination is made at block 512 that the product has been replaced. The controller may determine that the product has been replaced depending on whether a switch proximate to the container has changed states, which the switch would do only if the container was replaced. When the controller determines that the product has been replaced, the method 500 continues to block 514, and the controller causes the transmitter to transmit a report to one or more computing devices in communication with the drug delivery system representative of the fact that while the sterility of the device was not initially intact, the product has been replaced.
By contrast to the method 500 of FIG. 5 which is carried out by a drug delivery system with a controller adapted or programmed to carry out the method 500, the methods 520, 540 of FIGS. 6 and 7 are carried out by a drug delivery system and an associated computing device, which drug delivery system is adapted or programmed to carry out the method 520 and which computing device is adapted or programmed to carry out the method 540. It will be recognized that the methods 520, 540 may limit the amount of hardware required by the drug delivery system by shifting interactive events with the patient or user to the computing device, which may be in the form of a mobile device 110, to take advantage of the output devices or peripherals already associated with the computing device.
The method 520 of FIG. 6 begins at block 522, with a controller that is part of the drug delivery system determining if the barrier is intact, i.e., the needle cap is disposed over the end of the needle. If the determination is made that the needle cap is initially in place, the controller causes a transmitter to transmit a report to the computing device representative of the fact that the needle cap is disposed over the end of the needle at block 524.
The method 540 of FIG. 7 begins with receipt of the report from the drug delivery device at block 542. If the computing device determines that a report has been received and that the report received is representative of the fact that the needle cap is initially in place, the method 540 proceeds to block 544, wherein the computing device controls an associated display to display a message to the user or patient that the needle cap should be removed. According to one embodiment of the disclosure, where the computing device is a hand-held mobile device, such as a smart phone, the message may be displayed on the display associated with the mobile device in the form of an image that may include words, pictures or a combination thereof representative of the instruction to remove the needle cap. The method 540 then passes to block 546, where the computing device waits to receive a report from the drug delivery system representative of the fact that the needle cap has been removed.
Returning to FIG. 6, the method 520 continues at block 526 where the controller associated with the drug delivery device determines whether the needle cap has been removed after the initial determination was made that the needle cap had not been removed initially. The controller begins this determination upon completion the transmission of the report at block 524, and thus the determination is not dependent upon the patient or user receiving the instruction via the computing device to remove the needle cap, although according to certain embodiments the determination of the controller whether the needle cap has been removed at block 526 could be made dependent upon the user first receiving a message from the computing device that the needle cap should be removed. When the controller determines that the needle cap has been removed, the method 520 continues at block 528, where a report is transmitted to the computing device representative of the fact that the needle cap has been removed.
Returning to FIG. 7, upon determination at block 546 that a report has been received by the computing device that the needle cap has been removed, the method 540 may continue at block 548 where a report is transmitted, for example by the mobile device 110 in FIG. 1 to the server 104 in FIG. 1 via the network 118, representative of the fact that the drug delivery system is ready for use. According to other embodiments the report may be more particular, e.g., representative of the fact that the barrier was initially intact and that the needle cap had been subsequently removed.
In the alternative, the controller of the drug delivery system may determine at block 522 that the barrier is not initially in place. If so, the controller may lock the drug delivery device and cause the transmitter to transmit a report to the computing device representative of the fact that the barrier was not initially in place at block 530. The controller of the drug delivery system may then determine at block 532 if the product has been replaced.
Meanwhile, the computing device has received the report representative of the fact that the barrier is not initially in place at block 542, and the method 540 has continued to block 550, where the device controls an associated display to display a message to the user or patient that the product should be replaced. According to the embodiment of the disclosure discussed above, where the computing device is a hand-held mobile device, the message may be displayed on the display associated with the mobile device in the form of an image that may include words, pictures or a combination thereof representative of the instruction to replace the product. The method 540 then continues at block 552, where the computing device determines if a report has been received from the drug delivery system representative of the fact that the drug product has been replaced.
Shifting again to FIG. 6, once the determination is made at block 532 that the product has been replaced, the controller may cause the transmitter to transmit at block 534 a report representative of the fact that the product has been replaced. When the computing device determines that the report has been received at block 552 in FIG. 7, the method 540 continues to block 548, where a report is transmitted to the server 104, for example, representative of the fact that the drug delivery device is ready for use.
It is not a requirement of the disclosure that the determinations regarding condition state information, operational state information or other information be made by a controller that is housed in the same housing as the drug delivery device, or the computing device for that matter. In fact, the controller that makes the determination regarding a particular state of the drug delivery device may be disposed in a housing that is detachable from the drug delivery device. For example, again with reference to an embodiment that determines if a sterility barrier is intact based on whether a needle cap is disposed over the end of a needle, a method 560 is provided in FIG. 8 for a controller that is disposed in the needle cap and that is coupled to a sensor, such as a switch or other proximity sensor, that will determine when the needle cap is removed from the end of the needle.
Before discussing the method 500, it may be helpful to discuss the illustration of FIG. 9, which includes the needle cap 600 and portions of an embodiment of an autoinjector 602 with which the needle cap 600 is used. It will be recognized that much of the construction of the autoinjector 602 has been omitted to facilitate discussion of the structure and operation of the needle cap 600. The autoinjector 602 may include other structures, subassemblies, and/or assemblies that may, for example, insert a cannula into a patient and force a drug or medicament from a reservoir through the cannula into the patient. In this regard, reference is made to the embodiment of an autoinjector illustrated in FIG. 13, below.
According to the simplified presentation of the autoinjector 602 illustrated in FIG. 9, the autoinjector includes a reservoir 604 in the shape of a syringe. Thus, the reservoir 604 is defined by a substantially cylindrical wall 606 having a hub 608 in which a cannula 610 is disposed and fixed (or staked). The cannula 610 has a first end 612 in fluid communication with an interior 614 of the reservoir 604, and a second end 616 that is intended to be inserted into the patient. The reservoir 604 may also include a plunger 618 that moves along the reservoir 604 to force fluid out of the reservoir 604 through the cannula 610 into the patient. The autoinjector 602 also includes a structure 620 that cooperates with structures of the needle cap 600, which structure 620 is disposed about the cannula 610. The structure 620 may be, for example, a needle shield (explained in greater detail relative to the embodiment of FIG. 13), or a portion of a housing of the autoinjector 602.
The needle cap 600 includes an annular collar (or hub) 622 in which the hub 608 of the reservoir 604 is received. The collar 622 fits snugly about the hub 608 at one end and receives the second end 616 of the cannula 610 in an interior space 624 of the collar 622. The collar 622 may also be described as disposed about the second end 616 of the cannula 610. The collar 622 is attached to a body 626 (that may be in the form of a housing) in which is disposed a power supply 628 and a controller/communication module assembly 630. The power supply 628 and the module assembly 630 may be coupled through the use of a switch 632, which as illustrated includes first and second contacts 634, 636. When the contacts 634, 636 abut each other, the module assembly 630 is coupled to the power supply 6268.
In particular, as is illustrated in FIG. 9, the first contact 634 abuts the needle shield 620 with the needle cap 600 disposed about the second end 616 of the cannula 610, and thus does not abut an end 638 of the second contact 636 in this first state. When the needle cap 600 is removed (second state), the first contact 634 is free to move in the direction of the second contact 636 and to abut the end 638 of the second contact 636. With the contacts 634, 636 abutting each other, the circuit is closed and the module 630 is coupled to the power supply 628.
According to the method 560 of FIG. 8, the controller of the module 630 may determine based on a signal received (or not received) from the switch or sensor 632 that the needle cap 602 is disposed over the end 616 of the needle 610 at block 562. The sensor may be extremely simple in regard to this embodiment, and may even include a pair of contacts 634, 636 that are ordinarily disposed on opposite sides of the needle shield or housing 620 or are otherwise spaced apart by the needle shield or housing (see FIG. 9), but that are connected or coupled when the needle cap 602 is removed (such that the needle shield or housing 620 is no longer disposed between the contacts 634, 636 or no longer prevents their contact with each other). In fact, according to such an embodiment, the sensor 632 and the controller of the module assembly 630 may be the same structure. When the module 630 determines that the needle cap 602 has been removed, the module assembly 630 controls the associated transmitter to transmit a report representative of the fact the needle cap 602 has been removed at block 564. Again, according to the embodiment where the contacts 634, 636 are the sensor 632, the connection or coupling of the contacts 634, 636 may close a circuit including the transmitter 630 and a power supply 628 (e.g., a battery), which causes the transmitter 630 to transmit the required report.
FIGS. 10 and 11 illustrate methods similar to that of FIG. 8, in that each method is focused on the determination of a single condition or operational state of the drug delivery device, and transmits a report when the condition or operational state occurs. In this regard, the method 570 focuses on determining if the drug delivery device has been triggered by determining if an actuator (e.g., a button) has been depressed, and the method 580 focuses on determining if a needle shield that is part of the drug delivery device has deployed (which needle shield deployment ordinarily occurs after the drug delivery has been completed and the drug delivery device is removed from against the skin of the patient). As was also the case with the embodiment of FIG. 9, the embodiments of FIGS. 10 and 11 may be carried out through the use of a sensor in the form of a switch or pair of contacts that closes a circuit including the transmitter and a power supply upon determination of the operational state.
Thus, according to FIG. 10, the method 570 begins at block 572, where the controller/switch determines if the actuator has been depressed according to whether the switch state has changed in accordance with the switch contacting a portion of the drug delivery device that would not ordinarily be in contact with the switch unless the button was depressed (see, e.g., switch 766 in FIG. 13). For example, the switch may be attached to and carried on the actuator (e.g., button), such that when the actuator moves relative to the housing of the drug delivery device, the switch comes in contact with a structure of the drug delivery device that changes its state. When this occurs, the method 570 continues at block 574, and the controller/switch causes the transmitter to transmit a report representative of the fact that the drug delivery device has been trigger by closing a circuit between the transmitter and a power supply (e.g., a battery, capacitor or inductive power supply). The triggering of the drug delivery device may coincide with the activation of a drive associated with a reservoir to cause a medicament to be ejected from the reservoir, although the activation of the drive need not coincide with the triggering of the drug delivery device.
In a similar fashion, according to FIG. 11, the method 580 begins at block 582, where the controller/contact pair determines if the needle shield 656 has been deployed according to whether the contact pair has been connected or coupled together. As illustrated in FIGS. 12A and 12B, an embodiment of a drug delivery device system for carrying out the method 580 may include a reservoir 650 in the form of a syringe, having a cannula 652 in the form of a needle with an end 654 that is to be inserted into the patient (see FIG. 12A) and a needle shield 656 that includes a conductive pad 658 that connects the contact pair 660, 662 when the needle shield 656 is deployed in distal position; alternatively, one of the contact pair 660, 662 may be disposed on the housing of the drug delivery device and the other of the contact pair 660, 662 may be disposed on the needle shield 656, such that when the needle shield 656 moves relative to the housing of the drug delivery device, the contacts 660, 662 are connected or coupled. More particularly, after the needle shield 656 has moved in the distal direction from a proximal position (where the needle shield 656 does not surround the distal end 654 of the delivery cannula 652) to a distal position (where the needle shield 656 surrounds the distal end 654 of the delivery cannula 652), the conductive pad 658 may contact each one of the contact pair 660, 662, thereby forming a closed electrical circuit. When this occurs, the method 580 continues at block 584, a circuit including a power supply 664 and a controller and transmitter module assembly 668 is closed, causing the transmitter of the module 668 to transmit a report representative of the fact (under most circumstances) that the drug delivery has been completed. Accordingly, the report representative of the completion of drug delivery is transmitted in response to the needle shield 656 being disposed about the distal end 654 of the delivery cannula 652 after having been moved from its proximal position to its distal position.
In some embodiments, the contact pair 660, 662 may be part of a latching circuit. The latching circuit may be configured such that, initially, contact between the conductive pad 658 and the contact pair 660, 662 powers the transmitter module assembly 668. Subsequently, after a period of time, the latching circuit powers the transmitter module assembly 668 independently of the contact between the conductive pad 658 and the contact pair 660, 662. Thus, the latching circuit helps ensure that the transmitter module assembly 668 is supplied with power even if the conductive pad 658 is inadvertently moved out of contact with the contact pair 660, 662 after its initial contact with the contact pair 660, 662.
According to one alternative embodiment, using the structure of FIGS. 12A and 12B, a repositioning of the contacts 660, 662 relative to the conductive pad 658 would permit the system of FIGS. 12A and 12B to determine if the needle shield 656 has been moved relative to the end 654 of the cannula 652 so as to determine that the cannula 652 has been inserted into the patient. Rather than movement of the needle shield 656 toward the bottom of the page causing the conductive pad 658 to close the circuit between the contacts 660, 662, movement of the needle shield 656 toward the top of the page would cause the conductive pad 658 to close the circuit between the contacts 660, 662, which would cause the module assembly 668 to transmit a report representative of the fact that the needle has been inserted. As a further alternative embodiment, two sets of contacts may be included, the sets spaced from each other in the direction of movement of the needle shield 656, with the set of contacts closest to the top of the page being used to determine if the needle shield 656 has been moved relative to the end 654 of the cannula 652 indicative of insertion of the end 654 into the patient, and the set of contacts closest to the bottom of the page being used to determine if the needle shield is disposed about the end 654 of the cannula 652 indicative of the completion of the delivery to the patient.
The methods discussed above may be carried out by a variety of different drug delivery systems. FIGS. 13 and 14-16 illustrate two examples of such systems, the embodiment of FIG. 13 including a drug delivery system including a drug delivery device in the form of an autoinjector, and the embodiment of FIGS. 14-16 including a drug delivery system including a drug delivery device in the form of an on-body injector or infuser.
Referring first to the drug delivery device of FIG. 13, the autoinjector 700 includes a housing 710 in which may be disposed assemblies or structures that insert or enable insertion of a cannula into the patient, and that inject a drug or medicament from the reservoir through the cannula into the patient. According to certain embodiments, the same assemblies or structures that insert the cannula into the patient may also allow flow of the drug or medicament from the reservoir through the cannula into the patient. The autoinjector 700 may also include assemblies or structures that connect the cannula to the reservoir, that withdraw the cannula into the housing 710, or that deploy other structures that will prevent contact with the cannula once the cannula has been removed from the patient. Further additional assemblies and structures are also possible. The specific embodiment of the autoinjector 700 discussed below is thus by way of example and not by way of limitation. For example, the autoinjector 700 may lack assemblies or structures that insert the cannula (e.g., needle) into the patient, the insertion of the cannula into the patient resulting from the cannula being substantially fixed relative to the housing of the autoinjector 700 and the autoinjector 700 being moved in the direction of the patient.
The drug delivery system 700 includes a reservoir 712 and a cannula 714 having a first end 716 that may be connected or connectable in fluid communication to the reservoir 712 and a second end 718 that may be inserted into a patient. The cannula 714 may be, for example, a rigid needle having a beveled edge that may be sized such that the second end 718 of the cannula 714 is received under the skin so as to deliver a subcutaneous injection of the drug within the reservoir 712. The first end 716 of the cannula 714 may be disposed through a wall 720 of the reservoir 712, and thus be connected in fluid communication with the reservoir 712. As illustrated, the first end 716 of the cannula 714 may be disposed only partially through the wall 720 (which wall 720 may be a resealable septum or stopper, for example) such that the first end of the cannula 714 may not be connected in fluid communication until the second end 718 of the cannula 714 is inserted into the patient. In such a circumstance, the first end 716 of the cannula 714 may thus be described as connectable in fluid communication with the reservoir 712, although it will be recognized that there are other mechanisms by which the first end 716 of the cannula 714 may be connectable, but not connected, in fluid communication with the reservoir 712.
The drug delivery device 700 includes a shield 722 that may be deployed at least after the injection has been completed to limit access to the second end 718 of the cannula 714. According to certain embodiments, the shield 722 may have a biasing element 724 (such as a spring) that extends the shield 722 from the housing 710 such that a distal end 726 of the shield 722 extends beyond the second end 718 of the cannula 714 except when the shield 722 is disposed against the skin and the injection of the cannula 714 is actuated. In fact, the injection of the cannula 714 may be actuated according to certain embodiments of the autoinjector 700 by disposing the distal end 726 of the shield on or against the skin of the patient. The autoinjector 700 may also include a lock 728 that is associated with the shield 722 and which limits the movement of the shield 722 relative to the housing 710 of the autoinjector 700 such that the distal end 726 of the shield 722 extends from the housing 710 a sufficient distance to limit or prevent contact with the second end 718 of the cannula 714 after the cannula 714 has been removed from the skin of the patient after the drug has been delivered.
The drug delivery device 700 also includes at least one drive 730 that may be used to insert the second end 718 of the cannula 714 into the skin of the patient, and to inject the drug or medicament from the reservoir 712 through the cannula 714 into the patient. The drive 730 may include one or more springs, according to certain embodiments. According to other embodiments, the drive 730 may include a source of pressurized gas or a source of a material that undergoes a phase change, such that the escaping gas or phase changing material provides a motive force that may be applied to the reservoir 712 to eject the drug therefrom. According to still other embodiments, the drive 730 may include an electromechanical system, such as may include a motor for example, although such an electromechanical system may be more appropriate for the on-body autoinjector or infuser described in greater detail below. Other embodiments for the drive 730 will be recognized.
The drive 730 may cooperate with a wall 732 of the reservoir 722 to move that wall 732 toward the patient's skin. In accordance with such an embodiment, the wall 732 may be a stopper that is received within a bore 734, and which may move along the bore 734 from a first end to a second end to inject the drug from the reservoir 712. The drive 730 may also cooperate with the stopper 732 and/or the bore 734 to move the reservoir 712 relative to the housing 710 so as to move the second end 718 of the cannula 714 relative to the housing 710 and into the patient. According to those embodiments wherein the drive 730 cooperates with the stopper 732, this may occur before the first end 716 of the cannula 714 is in fluid communication with the reservoir 712. According to those embodiments wherein the drive cooperates with the bore 734, the drive may include one component (e.g., first spring) that cooperates with the bore 734 to move the reservoir 712 and cannula 714 relative to the housing 710, and a second component (e.g., second spring) that cooperates with the stopper 732 to move the stopper 732 relative to the bore 734.
The drive 730 is associated with an actuator 740. The actuator 740 activates the drive to cause the drive 730 to insert the cannula 714 and inject the drug from the reservoir 712 through the cannula 714 into the patient. The actuator 740 may, according to certain embodiments, be the shield 722. According to other embodiments, such as the embodiment illustrated, the actuator 740 may be a button that may be depressed by the user once the autoinjector 700 is disposed on or against the patient's skin. While the embodiment illustrated in FIG. 13 has the actuator 740 disposed at one end of the device, the actuator 740 could be disposed on the side of the device as well.
As illustrated, the reservoir 712, biasing element 724, lock 728, and the drive 730 are disposed within the housing 710, along with at least part of the cannula 714. Also disposed within the housing 710 is a controller 750, a communication module 752, and at least one sensor or switch. According to the embodiment illustrated, four sensors are included: a temperature sensor 760, a proximity sensor 762 (to determine the presence of a needle cap (not shown) or the position of the needle shield 722) and two orientation sensors 764. In addition, a switch 766 is also provided to determine if the button 740 has been depressed. The controller 750 is coupled to the communication module 752, the sensors 760, 762, 764 and the switch 766. The controller 750, communication module 752, one or more of the sensors 760, 762, 764 and the switch 766 may be packaged together as a single module, or each component may be fabricated separately and coupled once the components are disposed within the housing 710. According to certain embodiments, each component may be integrated into the structure of the device 702 associated with that component (e.g., the sensors 762, 764 may be integrated into the shield 722) and the location of the sensors in FIG. 12 is merely illustrative.
The controller 750 may include at least one processor and memory. The controller 750 may also include or be coupled to a power supply, e.g. a battery. The processor may be programmed to carry out the actions that the controller is adapted to perform and the memory may include one or more tangible non-transitory readable memories having executable instructions stored thereon, which instructions when executed by the at least one processor may cause the at least one processor to carry out the actions that the controller 750 is adapted to perform. Alternatively, the controller may include other circuitry that carries out the actions that the controller is adapted to perform.
The communication module 752 may be any of a number of different communication modules used to communicate with the mobile device 110 and/or the computing device 114 (see FIG. 1). According to one embodiment, the communication module 752 may be a Bluetooth/Bluetooth Low Energy module that is on-board with the controller 750. The communication module 752 is used to transmit information from the autoinjector 700 to the mobile device 110 or computing device 114. Alternatively, other protocols may be used by the communication module 752, such as RFID, Zigbee, Wi-Fi, NFC, and others.
Given the presence of the temperature sensor 760, the proximity sensor 762, the orientation sensors 764, and the switch 766, the controller 750 may adapted or programmed to carry out most, of the method 300 illustrated in FIGS. 3A-3C, as well as the methods illustrated in FIGS. 5-7, 10 and 11, with the provision of suitable output devices, as required.
While the cannula 714 of the drug delivery system 300 illustrated in FIG. 13 is fixed relative to the reservoir 712 and thus in fluid communication with the reservoir 712 at all times, other embodiments may be arranged differently, for example, with the cannula 714 being movable relative to the reservoir 712. FIG. 13A illustrates a cannula subassembly 780 which can be implemented in the drug delivery system 700 of FIG. 13 and which allows the first end 716 of the cannula 714 to be moved into fluid communication with the reservoir 712 when the second end 718 of the cannula 714 is inserted into the patient, and to be moved out of fluid communication with the reservoir 712 when the second end 718 of the cannula 714 is removed from the patient. To achieve this functionality, the cannula subassembly 780 includes a spring seat 782 fixed to the cannula 714 and a spring 784 positioned between the spring seat 782 and the distal end of the reservoir 714. The spring seat 782 may have a distal end surface 786 configured to be pressed against the patient's skin and a proximal end surface 788 in contact with the spring 784. As illustrated in FIG. 13A, the proximal end surface 788 may include a guide channel or groove 790 to receive the distal end of the spring 784 and to prevent the spring 784 from sliding off of the spring seat 782. Prior to delivery of the medicament to the patient, the spring 784 may be in an un-compressed, natural state and bias the spring seat 782 away from the reservoir 712, as seen in FIG. 13A. Accordingly, the first end 716 of the cannula 714 is spaced apart from the reservoir 712 and not in fluid communication with the reservoir 712 when the spring 784 is not compressed. When the drug delivery system 700 is used to deliver the medicament to the patient, the patient's skin pushes against the distal end surface 786 of the spring seat 782, thereby compressing the spring 784 and moving the cannula 714 in the distal direction until the first end 716 of the cannula 714 penetrates the septum 720 and enters the interior of the reservoir 712. In this configuration, fluid communication is established between the cannula 714 and the reservoir 712 so that the cannula 714 can deliver medicament in the reservoir 712 to the patient. When the drug delivery system 700 is removed from the patient's body, the spring 784 expands and returns to its natural, un-compressed state shown in FIG. 13A. As a result, the spring 784 pushes the spring seat 786 away from the reservoir 712 and the first end 716 of the cannula 714 is removed from the reservoir 712. Accordingly, the first end 716 of the cannula 714 is moved out of fluid communication with the reservoir 712. One benefit of the cannula subassembly 780 depicted in FIG. 13A is that premature removal of the drug delivery device 700 from the patient's skin during medicament delivery is less likely to result in wasteful discharge of the medicament. This is because premature removal of the drug delivery system 700 from the patient's skin causes the cannula subassembly 700 to automatically moved the cannula 714 out of fluid communication with the reservoir 712.
FIG. 14 illustrates a drug delivery system 800. The system 800 may be a wearable, disposable system. The system 800 may include a disposable housing 802 that may be attached to a patient or wearer with adhesive, for example.
The disposable housing 802 may be made of a plastic material. As seen in FIG. 15, the housing 802 may be defined by two sections, a plate 804 that is applied against the wearer's skin, and a dome 806 that is attached to the plate 804, preferably by a seal at an interface between a peripheral edge 808 of the plate 804 and a peripheral edge 810 of the dome 806.
As shown in FIG. 15, the housing 802 has an interior surface 812 defining an interior space 814, and an exterior surface 816. In particular, the plate 804 has an interior surface 818 and an exterior surface 820, and the dome 806 has an interior surface 822 and an exterior surface 824. According to the illustrated embodiment, the interior surface 812 of the housing 802 is defined by the interior surfaces 818, 822 of the plate 804 and the dome 806, while the exterior surface 816 of the housing 802 is defined by the exterior surfaces 820, 824 of the plate 804 and dome 806.
As noted above, the housing 802 may be attached to the skin of the wearer. In particular, an adhesive may be used. The adhesive may be adapted to releasably secure the housing to skin during a single application. As shown in FIG. 15, the adhesive is disposed in a layer 826 on a portion 828 of the exterior surface 816 of the housing 802, and in particular on the exterior surface 820 of the plate 804. The adhesive is covered with a removable, disposable sheet 830 prior to application of the housing 802 to the skin of the wearer.
As seen in FIGS. 15 and 16, a reservoir 840, a drive 842, a cannula (or structure, see below) 844, and an inserter 846 are disposed in the housing 802. According to the illustrated embodiment, the reservoir 840 may be defined at least in part by a combination of a rigid-walled cylinder or bore 860 having a port 862 at a first end 864 and a plunger 866 fitted to move along a longitudinal axis 868 of the cylinder 860 between a second end 870 and the first end 864 to force drug out of the reservoir 840 through the port 862 (FIG. 14). The movement of the plunger 866 may be caused by the operation of the drive 842.
The drive 842 may be similar in structure and operation to the mechanisms for moving a plunger along a cylinder as may be found in U.S. Pat. Nos. 6,656,158; 6,656,159; 7,128,727; and 7,144,384, which patents are incorporated by reference herein for all purposes. The drive 842 may include a plunger arm, a motor, a transmission and a power supply (e.g., a battery). The plunger arm may be in contact at least at a first end with the plunger 866 to urge the plunger 866 along the cylinder 860, and the transmission may be coupled to the plunger arm and the motor to cause the plunger arm to move according to the operation of the motor. The power supply provides a source of electrical power for the motor. The combination of the motor, transmission and power supply may also be referred to as one example of an actuator. Other mechanisms, such as springs, pressurized gases, materials undergoing phase changes and the like, may also be used to apply a force to the plunger to move the plunger along the cylinder.
According to other variants, a non-rigid collapsible pouch may be substituted for the rigid-walled cylinder 860 and the plunger 866 shown in FIG. 15. It will be recognized that where the reservoir 860 is in the form of a non-rigid collapsible pouch, a spring-based mechanical system may be used to compress and pressurize the reservoir. According to still further variants, a non-mechanical system may be used to move the plunger 866 or compress the bag. For example, a gas-generating system may be used, including a two-component system wherein the components are kept apart until the gas is to be generated, in which case they are combined. As a further alternative, a swellable gel may be used, wherein the introduction of water from a source internal to the device causes the gel to increase in dimension to move the plunger or compress the pouch. As a further example, a propellant reservoir may be opened and the propellant discharged to move the plunger 866 or compress the bag. Examples of such alternative mechanisms may be found in U.S. Pat. Nos. 5,957,895; 5,858,001; and 5,814,020, which patents are incorporated by reference herein for all purposes.
According to certain embodiments, the reservoir 840 may be a pre-filled container, such as a pre-filled cartridge or a pre-filled syringe. Alternatively, the delivery system 800 may include a fill port 880 in fluid communication with the reservoir 840, the fill port 880 adapted to receive a luer tip of a syringe (e.g., syringe illustrated in FIG. 14), although a rubber septum may be used instead, for example. In use, a healthcare provider may inject the drug from the syringe through the fill port 880 into the reservoir 840, and the syringe may be provided as a pre-filled syringe (filled with any of the materials mentioned above) to the healthcare provider with the delivery system 800 as a kit.
The cannula 844 may have a retracted state wherein a pointed end 890 (in fact, the entire cannula 844) may be withdrawn inside the housing 802 and a deployed state wherein the pointed end 890 projects from the housing 802, the inserter 846 moving the needle 844 from the retracted state to the deployed state. Examples of exemplary inserters may be found in U.S. Pat. Nos. 7,128,727 and 7,144,384, which patents are incorporated by reference herein for all purposes.
The cannula 844 may be hollow, and may be used to administer the drug directly to the patient. Alternatively, the structure 844 may be used in conjunction with a cannula 892, the structure 844 being used to insert the cannula 892 into the patient through the injection site, and the drug passing through the catheter 892 into the patient during administration. Phrased slightly differently, the system 800 may, according to certain exemplary embodiments, automatically insert a soft cannula into the subcutaneous tissue.
As illustrated in FIG. 15, the housing 802 (specifically the plate 804) may have an aperture or opening 894 formed therein to permit the cannula (or structure) 844 (and optionally cannula 892) to pass therethrough. According to certain embodiments, the aperture 894 may be unobstructed, such that there is no impediment or obstacle to the movement of the cannula 844 (and catheter 892) through the opening 894. However, to better maintain the sterility of the cannula 844 and the device's container closure integrity (CCI), a septum may be disposed in or over the aperture 894.
The septum, which may be made of a rubber, may be disposed between the cannula 844 (and the space 814) and the patient's skin with the needle 844 in the retracted state. In the deployed state, at least a portion of the needle 844 (i.e., the pointed end 890) will depend from the space 814 through the septum. As such, the septum is always present as a barrier between the interior space 814 and the external environment.
The system 800 may also include a controller 900, which may include at least one processor and memory, the processor programmed to carry out the actions that the controller is adapted to perform and the memory including one or more tangible non-transitory readable memories having executable instructions stored thereon, which instructions when executed by the at least one processor may cause the at least one processor to carry out the actions that the controller is adapted to perform. Alternatively, the controller may include other circuitry that carries out the actions that the controller is adapted to perform. By way of example and not by way of limitation, the controller 900 may be adapted to carry out any one of the methods described above relative to the drug delivery system.
In addition to the controller 900, the system 800 may include a communication module 902 and at least one sensor or switch. The communication module 902 may be any of a number of different communication modules used to communicate with the mobile device 110 and/or the computing device 114 (see FIG. 1). According to one embodiment, the communication module 902 may be a Bluetooth/Bluetooth Low Energy module that is coupled to the controller 900. The communication module 902 is used to transmit information from the system 800 to the mobile device 110 or computing device 114. Alternatively, other protocols may be used by the communication module 752, such as RFID, Zigbee, Wi-Fi, NFC, and others. According to the embodiment illustrated, the system 800 also includes a temperature sensor 904 on board the controller 900, and thus may carry out at least parts of the methods described in FIGS. 2 and 3A-3C.
While a small fraction of the number of possible sensors or sensing systems have been mentioned above, further examples are provided below, grouped in accordance with the condition or operational states that may be determined using these sensors or sensing systems.
Condition State Information, Generally
Temperature may be determined using a temperature sensitive paper that changes color upon receipt of thermal energy, the paper used in conjunction with an optical sensor that can sense the color or a color change. Temperature also may be determined using a thermocouple, for example, with junctions against drug reservoir and external to device, the voltage across an in-line resistor being used to determine if the reservoir temperature or the ambient temperature is colder than that of the device and by how much. A reversible circuit may be used featuring a material such as nitinol that changes shape with temperature, the changing shape closing the circuit thereby activating a cumulative timer each time a temperature threshold is exceeded, the cumulative time used to ensure that the total time that the temperature exceeded a threshold temperature is below a predetermined threshold time period. A shape change material may also be used to actuate a flag or a shield so as to reveal a readiness indicator, such as may be read using an optical device.
Light exposure also may be determined using light sensitive paper that changes color with exposure to light, the paper used in conjunction with an optical device that can sense the color or a color change. Alternatively, a photoresistor with an associated voltage divider circuit may be used to sense the presence of light.
Orientation of the drug delivery system (and device) might be determined by using an accelerometer or a magnetometer. Additionally, the drug delivery system may use two-way communication with a computing device, such as the mobile device 110, to obtain orientation information from the mobile device 110 and thereby infer the orientation of the drug delivery device. In fact, the drug delivery system may be connected to a mobile device 110 to improve the strength of the inference that the orientation of the mobile device 110 corresponds to the orientation of the drug delivery device.
The color and/or turbidity of the product may be measured using an optical device, such as an optical transmitter/receiver pair, which pair may be disposed on the same side of the reservoir or on opposite sides of the reservoir. The measurement obtained using the optical device relative to the drug reservoir may be compared against a reference measurement. In fact, a reference may be provided within the drug device adjacent the drug reservoir such that the optical device may be used to optically inspect the drug in the reservoir and the reference, so that a comparison may be made between, for example, the measurement obtained relative to the drug product in the reservoir and relative to the reference. Alternatively, any gap in the reception of the light beam transmitted through the reservoir may indicate a cloudy product or one that has undergone a color change, as may the reception (or failure of reception) of a light beam that is deflected at a particular angle because of the presence of particulate matter in the product. Alternatively, a CCD array may be used to take a picture of the product in the reservoir, the picture being analyzed to determine color and/or turbidity, which analysis may be performed by the system or by a local device or a remote device (in which case the picture may be transmitted to the local or remote device for analysis).
Geographic position may be determined using Global Positioning Satellite transceivers. Additionally, the drug delivery system may use two-way communication with a computing device, such as the mobile device 110, to obtain geographic position information from the mobile device 110 and infer the position of the drug delivery device. In fact, the drug delivery system may be connected to a mobile device 110 to improve the strength of the inference that the position of the mobile device 110 corresponds to the position of the drug delivery device.
Temporal information may be obtained using a timer that is started at the time of manufacture, and which may be expiration date-calibrated. Alternatively, an RFID tag coded with manufacturing date may be included in package or with device, and queried by system prior to administration.
Operational State Information, Generally
The packaging may be used as a faraday cage, and the drug delivery system may include circuitry that detects interference with a signal or increased received signals as a consequence of the removal of the packaging so as to determine the operational state that the device is unpackaged.
A variety of sensors may be used to determine the operational state of application to patient. For example, back EMF through a coil from moving magnet on needle shield may indicate that the device has been applied to the patient. Alternatively, displacement of component or assembly (such as the needle shield) because of application of the drug delivery device to the patient may open or close a switch/circuit to signal this operational state. Along similar lines, the movement of components or assemblies may be detected using an optical sensor, with the light beam between a transmitter and receiver being broken by a change in the position of components, such as the needle shield or the reservoir (e.g., syringe or cartridge), upon application of the drug delivery device to the patient. As a further alternative, a capacitive or resistive sensor may be used, as may a pressure sensor. In fact, information regarding cannula (or needle) insertion may be determined by measuring the resistance through the needle and/or skin relative to external contact. Changes in temperature at the end of the drug delivery device intended to abut the patient's skin may also be used to determine the operational state of application to the patient.
A similar set of sensors associated with the needle shield may be used to determine when the needle shield has been deployed and locked in place upon completion of drug delivery.
A similar set of sensors associated with the actuator or button (instead of the needle shield) may be used to determine when the actuator or button has been depressed to trigger delivery of the drug.
An accelerometer may be used to sense the shock impulse of an actuator being manipulated or the needle shield being moved to determine one of the operational states of triggering the device, initiating drug delivery and completing drug delivery. A pressure sensor may be mounted in the reservoir to detect an increase in pressure in the reservoir that would occur upon initiation of drug delivery so as to be used to determine this operational state. As a further alternative, a microphone or audio sensor may be used to determine if the mechanical noises from components indicate activation of the device. As a still further alternative, a strain sensor may be mounted on a thin column between drive mechanism and plunger that will flex under force to sense the operational state of triggering the drug device. In fact, according to certain embodiments the strain sensor may be limited to a single use (i.e., the sensor fails or permanently deforms under flex) to “save” the fact that delivery was triggered thus eliminating the need for high frequency signal monitoring.
Described below in connection with FIGS. 17-30 are additional embodiments of sensors and sensing systems for detecting condition state information and/or operational state information related to a drug delivery device. While the sensors and sensing systems described below are configured for use with an autoinjector, one or more of these sensors and sensing systems may be configured for use with on-body injector. Furthermore, any combination of the following sensors or sensing systems may be implemented in a single autoinjector or a single on-body injector, or any other drug delivery device. Additionally, one or more of the following sensors or sensing systems may be used in combination with one or more of the sensors or sensor systems described above in connection with FIGS. 1-16.
Referring to FIG. 17, illustrated is an embodiment of an autoinjector 1700 configured to detect and report whether it has been triggered to deliver its medicament. The autoinjector 1700 includes a reservoir 1710 configured to contain a medicament and a delivery cannula 1712 having a proximal end 1714 and a distal end 1716. The proximal end 1714 of the delivery cannula 1712 is in fluid communication with the reservoir 1710, and the distal end 1716 of the delivery cannula 1712 is configured to be received within a patient. The autoinjector 1700 may also include a plunger 1720 moveable through the reservoir 1710 in a distal direction to discharge (e.g., eject) the medicament from the reservoir 1710 to the patient via the delivery cannula 1712. In some embodiments, the plunger 1720 may move linearly along a longitudinal axis A of the autoinjector 1700. The longitudinal axis A may coincide with a longitudinal axis of the reservoir 1710. The plunger 1720 may have a proximal end 1722 and a distal end 1724 including a stopper 1726. The stopper 1726 may be configured to sealingly and slidably engage an inner wall of the reservoir 1710 so that the stopper 1726 can push medicament through the reservoir 1710 and into the delivery cannula 1712. Movement of the plunger 1720 may be accomplished through a drive mechanism 1730 such as a spring, electric motor, or any other element capable of providing a motive force for moving the plunger 1720 through the reservoir 1710. In some embodiments, the plunger 1720 may be omitted, and the medicament may be discharged from the reservoir 1710 by way of pressurized air.
The autoinjector 1700 may further include an actuator 1740 configured to trigger the delivery of the medicament to the patient. As illustrated in FIG. 17, the actuator 1740 may be a button which can be manually depressed by the patient or a health care provider. In some embodiments, the actuator 1740 may be configured to activate the drive mechanism 1730 to move the plunger 1720 in the distal direction to discharge the medicament from the reservoir 1710. In an embodiment where the drive mechanism 1730 includes a spring depressing the actuator 1740 may release the spring so that it increases in length, thereby moving the plunger 1720 along the longitudinal axis A toward the distal end of the autoinjector 1700. In other embodiments, the actuator 1740 may be a switch that activates a motor for moving the plunger 1720.
The autoinjector 1700 may also include a removable sterile barrier 1750 disposed about the distal end 1716 of the delivery cannula 1712, and a needle shield 1760 moveable relative to the distal end 1716 of the delivery cannula 1712. The removable sterile barrier 1750 may be removably attached to a distal end of the reservoir 1710. In some embodiments, the removable sterile barrier 1750 may form an interference or snap fit with the distal end of the reservoir 1710. A frictional force associated with the interference or snap fit may be overcome by manually pulling the removable sterile barrier 1750 in a direction away from a housing 1762 of the autoinjector 1700. The needle shield 1760 may be biased in the distal direction by a biasing member 1764 (e.g., a spring).
In use, a patient or healthcare provider may initially remove the removable sterile barrier 1750 from the autoinjector 1700 and press the needle shield 1760 against the skin of the patient. The reaction force exerted by the patient's skin may overcome the biasing force exerted by the biasing member 1764, and thereby push the needle shield 1760 in the proximal direction, until the needle shield 1760 reaches a proximal position inside the housing 1762. This action will expose the distal end 1716 of the delivery cannula 1712 and cause it to pierce the skin of the patient. Next, the patient or healthcare provider may depress the actuator 1740 to active the drive mechanism 1730 to move the plunger 1720 in the distal direction. As a result, the plunger 1720 will discharge the medicament from the reservoir 1710 to the patient via the delivery cannula 1712. When delivery of the medicament is complete, and/or when the plunger 1720 has completed its delivery stroke, the patient or healthcare provider may remove the autoinjector 1700 from the skin, thereby allowing the biasing member 1764 to move the needle shield 1760 in the distal direction back to its distal position where it is disposed about (i.e., surrounds) the distal end 1716 of the delivery cannula 1712.
Still referring to FIG. 17, the autoinjector 1700 may additionally include a controller 1770 and a communication module 1772 coupled to the controller 1770. The controller 1770 and/or the communication module 1772 may be disposed within the housing 1762 of the autoinjector 1700. The controller 1770 may include at least one processor (e.g., a microprocessor) and at least one memory (e.g., a random access memory (RAM), a non-volatile memory such as a hard disk, a flash memory, a removable memory, a non-removable memory, etc.). The controller 1770 may also include or be coupled to a power supply (e.g., a battery). The at least one processor may be programmed to carry out the actions that the controller 1700 is configured to perform and the memory may include one or more tangible non-transitory readable memories having executable instructions stored thereon in the form of software, which instructions when executed by the at least one processor may cause the at least one processor to carry out the actions that the controller 1770 is configured to perform. Alternatively, the controller 1700 may include other circuitry that carries out the actions assigned to the controller 1700. In some embodiments, the controller 1770 may only use hardware to execute its tasks, thus avoiding the use of software.
The communication module 1772 may be coupled to the controller 1770 and may be configured to transmit and/or receive information through wireless and/or wired communications. The communication module 1772 may be any of a number of different communication modules used to communicate with the mobile device 110 and/or the computing device 114 (see FIG. 1). According to one embodiment, the communication module 1772 may be a wireless transmitter that is on-board with the controller 1770 such as a Bluetooth module or a Bluetooth Low Energy module. The communication module 1770 may be used to transmit information from the autoinjector 1700 to the mobile device 110 or the computing device 114. Alternatively, other protocols may be used by the communication module 1772, such as RFID, Zigbee, Wi-Fi, NFC, and others.
Referring to FIG. 17, the autoinjector 1700 may include a sensor 1780 configured to detect movement of the actuator 1740. The sensor 1780 may be coupled to the controller 1770 and configured to output a signal to the controller 1770 indicating that the actuator 1740 has been moved. According to one embodiment, the sensor 1780 may be an electrical switch (e.g., a latching normally-open electrical switch) positioned so that the actuator 1740 contacts and closes the electrical switch when the actuator 1740 is depressed by the patient or healthcare provider. By closing the electrical switch, a closed electrical circuit may be formed, which in turn outputs an electrical signal to the controller 1770. In response to the electrical signal, the controller 1770 may determine that the actuator 1770 has been used to trigger delivery of the medicament to the patient. The sensor 1780 is not limited to a latching normally-open electrical switch and may be any suitable sensor for detecting movement of the actuator 1740 including a Pogo pin, an optical sensor, a ferromagnetic proximity sensor, a pressure sensor, etc.
If the controller 1700 determines that the actuator 1740 has been used to trigger delivery of the medicament to the patient, the controller 1700 may generate a report representative of the triggering of the autoinjector 1700 and control the communication module 1772 to transmit the report. In an embodiment where the communication module 1772 includes a wireless transmitter, the controller 1770 may control the communication module 1772 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 1772 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
Turning to FIGS. 18a-18c, illustrated is an embodiment of an autoinjector 1800 configured to detect and report delivery of a medicament from the reservoir to the patient. The autoinjector 1800 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 1810, a delivery cannula 1812 having a proximal end 1814 and a distal end 1816, a plunger 1820 having a proximal end 1822 and a distal end 1824 including a stopper 1826, a longitudinal axis A, an actuator 1840, a drive mechanism 1830, a removable sterile barrier 1850, a needle shield 1860, a housing 1862, a biasing member 1864, a controller 1870, and a communication module 1872.
The autoinjector 1800 may further include a sensor 1880 configured to detect movement of the needle shield 1860. The sensor 1880 may be coupled to the controller 1870 and configured to output a signal to the controller 1870 indicating that the needle shield 1860 has been moved. According to one embodiment, the sensor 1880 may include an annular spring 1882 coupled to an outer circumferential surface of the needle shield 1860. Alternatively, the annular spring 1882 may be integrally formed with the needle shield 1860 such that the annular spring 1882 and the needle shield 1860 are a single component. The annular spring 1882 may include radially protruding tabs 1884, 1886 configured to be received in respective apertures 1888, 1890 formed in the housing 1862 of the autoinjector 1800. The radially protruding tabs 1884, 1886 may be arranged at diametrically opposed positions on the annular spring 1882, as shown in FIGS. 18b and 18c. In alternative embodiments, the housing 1862 may include depressions, rather than apertures, for receiving the radially protruding tabs 1884, 1886. In terms of material, the annular spring 1882 may be made of an electrically conductive and elastic material such as metal.
As illustrated in FIGS. 18a and 18b, when the needle shield 1860 is arranged at its distal position (i.e., where the needle shield 1860 is disposed about the distal end 1816 of the delivery cannula 1812), the radially protruding tabs 1884, 1886 of the annular spring 1882 may be received in their respective apertures 1880, 1890 in the housing 1862. When the needle shield 1860 is pressed against the patient's skin and moved in the proximal direction to its proximal position (see FIG. 18c), the radially protruding tabs 1884, 1886 of the annular spring 1882 may slide out of their respective apertures 1888, 1890 and may be pushed radially inwardly by the inner wall of the housing 1862. Accordingly, a gap may be formed between the annular spring 1882 and the inner wall of the housing 1862. After completion of the delivery of the medicament to the patient and removal of the autoinjector 1800 from the patient's skin, the biasing member 1864 may push the needle shield 1860 back to its distal position, thereby causing the radially protruding tabs 1884, 1886 to slide along the inner surface of the housing 1862 until they are aligned with their respective apertures 1888, 1890. The annular spring 1882 may expand radially outwardly such that the radially protruding tabs 1884, 1886 are pushed into their respective apertures 1888, 1890 (see FIG. 18b). Accordingly, the gap between the annular spring 1882 and the inner wall of the housing 1862 may be eliminated.
Referring to FIG. 18b, when the radially protruding tabs 1884, 1886 are received in their respective apertures 1888, 1890, an outer portion of the annular spring 1882 may be configured to contact a first electrical contact 1892 and a second electrical contact 1894. As a result, a closed electrical circuit may be formed between the first and second electrical contacts 1892, 1894. This closed electrical circuit may output an electrical signal to the controller 1870 via electrically conductive wires (not illustrated). In response to the electrical signal, the controller 1870 may determine that the needle shield 1860 is disposed about the distal end 1816 of the delivery cannula 1862. Subsequently, the controller 1870 may generate a report representative of completion of a delivery of medicament from the reservoir 1810 to the patient, and control the communication module 1872 to transmit the report. In an embodiment where the communication module 1872 includes a wireless transmitter, the controller 1870 may control the communication module 1872 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 1872 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIG. 19 illustrates an embodiment of an autoinjector 1900 configured to detect and report if a distal end of a delivery cannula has been inserted into a patient. The autoinjector 1900 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 1910, a delivery cannula 1912 having a proximal end 1914 and a distal end 1916, a plunger 1920 having a proximal end 1922 and a distal end 1924 including a stopper 1926, a longitudinal axis A, an actuator 1940, a drive mechanism 1930, a removable sterile barrier 1950, a needle shield 1960, a housing 1962, a biasing member 1964, a controller 1970, and a communication module 1972.
The autoinjector 1900 may further include a sensor 1980 configured to detect movement of the needle shield 1960. The sensor 1980 may be coupled to the controller 1970 and configured to output a signal to the controller 1970 indicating that the needle shield 1960 has been moved. According to one embodiment, the sensor 1980 may include a washer 1982 made of an electrically conductive material such as metal. The washer 1982 may be coupled to a proximal axial end surface of the needle shield 1960 as shown in FIG. 19. The washer 1982 may have an annular shape with a central aperture so that the reservoir 1910 can pass through the washer 1982.
When the needle shield 1960 is pressed against the patient's skin and moved in the proximal direction to its proximal position, the washer 1982 may contact a first electrical contact 1992 and a second electrical contact 1994, thereby forming a closed electrical circuit between the first and second electrical contacts 1992, 1994. This closed electrical circuit may output an electrical signal to the controller 1970 via electrically conductive wires. In response to the electrical signal, the controller 1970 may determine that the needle shield 1960 has been moved relative to the distal end 1916 of the delivery cannula 1912. Subsequently, the controller 1970 may generate a report representative of completion of the insertion of the distal end 1916 of the delivery cannula 1912 into the patient, and control the communication module 1972 to transmit the report. In an embodiment where the communication module 1972 includes a wireless transmitter, the controller 1970 may control the communication module 1972 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 1972 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIG. 20 illustrates another embodiment of an autoinjector 2000 configured to detect and report if a distal end of a delivery cannula has been inserted into a patient. The autoinjector 2000 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2010, a delivery cannula 2012 having a proximal end 2014 and a distal end 2016, a plunger 2020 having a proximal end 2022 and a distal end 2024 including a stopper 2026, a longitudinal axis A, an actuator 2040, a drive mechanism 2030, a removable sterile barrier 2050, a needle shield 2060, a housing 2062, a biasing member 2064, a controller 2070, and a communication module 2072.
The autoinjector 2000 may further include a sensor 2080 configured to detect movement of the needle shield 2060. The sensor 2080 may be coupled to the controller 2070 and configured to output a signal to the controller 2070 indicating that the needle shield 2060 has been moved. According to one embodiment, the sensor 2080 may include a Pogo pin 2082 fixed to the inner wall of the housing 2062.
When the needle shield 2060 is pressed against the patient's skin and moved in the proximal direction to its proximal position, the Pogo pin 2082 may contact and/or be depressed by a proximal axial end surface of the needle shield 2060, thereby creating a closed electrical circuit. This closed electrical circuit may output an electrical signal to the controller 2070. An electrically conductive wire (not illustrated) may couple the Pogo pin 2082 to the controller 2070. In response to the electrical signal, the controller 2070 may determine that the needle shield 2060 has been moved relative to the distal end 2016 of the delivery cannula 2012. Subsequently, the controller 2070 may generate a report representative of the completion of insertion of the distal end 2016 of the delivery cannula 2012 into the patient, and control the communication module 2072 to transmit the report. In an embodiment where the communication module 2072 includes a wireless transmitter, the controller 2070 may control the communication module 2072 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2072 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
Turning to FIGS. 21a and 21b, illustrated is another embodiment of an autoinjector 2100 configured to detect and report delivery of a medicament from the reservoir to the patient. The autoinjector 2100 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2110, a delivery cannula 2112 having a proximal end 2114 and a distal end 2116, a plunger 2120 having a proximal end 2122 and a distal end 2124 including a stopper 2126, a longitudinal axis A, an actuator 2140, a drive mechanism 2130, a removable sterile barrier 2150, a needle shield 2160, a housing 2162, a biasing member 2164, a controller 2170, and a communication module 2172.
The autoinjector 2100 may further include a sensor 2180 configured to detect movement of the plunger 2120. The sensor 2180 may be coupled to the controller 2170 and configured to output a signal to the controller 2170 indicating that the plunger 2120 has been moved. According to one embodiment, the sensor 2180 may include an optical sensor 2182 fixed to an inner wall of the needle shield 2160 as illustrated in FIGS. 21a and 21b. The optical sensor 2182 may be configured to detect infrared light radiating from one or more objects such as the stopper 2126. The optical sensor 2182 may have a field of view 2184 within which it can detect the existence one or more objects. The optical sensor 2182 may also be configured to output a signal to the controller 2170 that is representative of a distance between the optical sensor 2182 and an object in its field of view 2184.
As seen in FIG. 21a, prior to activation of the plunger 2120, the stopper 2126 may be outside the field of view 2184 of the optical sensor 2182. Thus, the optical sensor 2182 may output a signal, or no signal, to the controller 2170, which may in turn determine that the delivery of the medicament from the reservoir to the patient has not been completed. The controller 2170 may control the communication module 2172 to transmit (e.g., wirelessly transmit) a report representative of the determination that delivery of the medicament has not been completed to an external computing system.
FIG. 21b shows the plunger 2120 in the process of moving through the reservoir 2110 to deliver the medicament to the patient but has not yet completed its delivery stroke. At this stage, the stopper 2126 may be in the field of view 2184 of the optical sensor 2182. Accordingly, the optical sensor 2182 may output a signal to the controller 2170 indicative of the distance between the optical sensor 2182 and the stopper 2126. The controller 2170 may compare the measured distance with a threshold distance to determine if the measured distance is less than or equal to the threshold distance. In the configuration shown in FIG. 21b, the measured distance would be greater than or equal to the threshold distance. Accordingly, the controller 2170 would determine that the plunger 2120 has not completed its delivery stroke and generate a report representative of the fact that delivery of the medicament to the patient has not been completed. The controller 2170 may control the communication module 2172 to transmit (e.g., wirelessly transmit) the report to an external computing system.
FIG. 21c depicts the plunger 2120 having completed its delivery stroke such that delivery of the medicament to the patient is completed. Here, the stopper 2126 may be in the field of view 2184 of the optical sensor 2182 and the optical sensor 2182 may therefore output a signal to the controller 2170 indicative of the distance between the optical sensor 2182 and the stopper 2126. The controller 2170 may compare the measured distance with the threshold distance to determine if the measured distance is less than or equal to the threshold distance. In the configuration shown in FIG. 21c, the measured distance would be less than or equal to the threshold distance. Accordingly, the controller 2170 would determine that the plunger has completed its delivery stroke and generate a report representative of completion of the delivery of the medicament to the patient. The controller 2170 may control the communication module 2172 to transmit (e.g., wirelessly transmit) the report to an external computing system.
In an alternative embodiment, the optical sensor 2182 may be fixed to an inner wall of the housing 2162 proximal to the needle shield 2160. In such an embodiment, the controller 2170 may evaluate whether the measured distance is greater than or equal to a threshold distance in order to determine whether or not the plunger has completed its delivery stroke.
FIG. 22a-22c illustrate another embodiment of an autoinjector 2200 configured to detect and report delivery of a medicament from the reservoir to the patient. The autoinjector 2200 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2210, a delivery cannula 2212 having a proximal end 2214 and a distal end 2216, a plunger 2220 having a proximal end 2222 and a distal end 2224 including a stopper 2226, a longitudinal axis A, an actuator 2240, a drive mechanism 2230, a removable sterile barrier 2250, a needle shield 2260, a housing 2262, a biasing member 2264, a controller 2270, and a communication module 2272.
The autoinjector 2200 may further include a sensor 2280 configured to detect movement of the plunger 2220. The sensor 2280 may be coupled to the controller 2270 and configured to output a signal to the controller 2270 indicating that the plunger 2220 has been moved. According to one embodiment, the sensor 2280 may include a first electrically conductive member 2282 spaced apart from the plunger 2220 and a second electrically conductive member 2284 coupled to the plunger 2220 such that the second electrically conductive member 2284 moves together with the plunger 2220. The second electrically conductive member 2284 may be configured to slidably engage the first electrically conductive member 2282 during movement of the plunger 2220 prior to completion of the delivery stroke by the plunger 2220 (see FIG. 22a). While the first and second electrically conductive members 2282, 2284 are engaged, the first and second electrically conductive members 2282, 2284 may form a closed electrical circuit that outputs a signal to the controller 2270. Upon completion of the delivery stroke by the plunger 2220 (see FIG. 22b), the second electrically conductive member 2284 may disengage from the first electrically conductive member 2282 such that the first and second electrically conductive members 2282, 2284 no longer contact each other. As a result, an open electrical circuit may be formed, and consequently, no signal may be outputted from the sensor 2280 to the controller 2270.
In response to the lack of a signal from the sensor 2280, the controller 2270 may determine that the plunger 2220 has completed its delivery stroke and generate a report representative of completion of delivery of the medicament to the patient. The controller 2270 may control the communication module 2272 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2272 includes a wireless transmitter, the controller 2270 may control the communication module 2272 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2272 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
As depicted in FIG. 22c, the first electrically conductive member 2282 may include a spring-biased clip 2290 fixed to the housing 2262 of the autoinjector 2200, and the second electrically conductive member 2284 may include a wire 2292 fixed to and moveable together with the plunger 2220. The wire 2292 may be dragged behind the plunger 2220 as the plunger 2220 is moved in the distal direction to discharge the medicament from the reservoir 2210. The spring-biased clip 2290 may be configured to slidably grasp the wire 2292 as the wire 2292 translates. The length of the wire 2292 may be such that, when the plunger 2220 reaches its most distal position and thus completes the delivery stroke, the wire 2292 may not be long enough to reach the spring-based clip 2290. As a result, the wire 2292 may disengage from the spring-biased clip 2290, thereby forming the open electrical circuit.
Turning to FIGS. 23a and 23b, illustrated is an embodiment of an autoinjector 2300 configured to detect and a report an amount of medicament delivered to the patient. The autoinjector 2300 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2310, a delivery cannula 2312 having a proximal end 2314 and a distal end 2316, a plunger 2320 having a proximal end 2322 and a distal end 2324 including a stopper 2326, a longitudinal axis A, an actuator 2340, a drive mechanism 2330, a removable sterile barrier 2350, a needle shield 2360, a housing 2362, a biasing member 2364, a controller 2370, and a communication module 2372.
The autoinjector 2200 may further include a sensor 2380 configured to detect movement of the plunger 2320. The sensor 2380 may be coupled to the controller 2370 and configured to output a signal to the controller 2370 indicating that the plunger 2320 has been moved and/or the travel distance of the plunger 2320. According to one embodiment, the sensor 2380 may include a variable resistor 2382 having an adjustable electrical resistance Rx. The electrical resistance Rx of the variable resistor 2382 may be proportional to a length of the variable resistor 2382 through which an electric current must travel before reaching the controller 2370. In some embodiments, the electrical resistance Rx of the variable resistor 2382 may increase as the length of the electric current path through the variable resistor 2382 increases, and the electrical resistance Rx of the variable resistor 2382 may decrease as the length of the current path through the variable resistor 2382 decreases.
To change the length of the current path through the variable resistor 2382, an electrically conductive member 2384 may slidably engage the variable resistor 2382 as shown in FIG. 23a. The electrically conductive member 2384 may be coupled to the plunger 2320 such that the electrically conductive member 2384 moves together with the plunger 2320. Thus, movement of the plunger 2320 may cause the electrically conductive member 2384 to slide along the variable resistor 2382. This may change the length of the current path through the variable resistor 2382. Accordingly, movement of the plunger 2320 may result in a change to the electrical resistance Rx of the variable resistor 2382.
In the configuration shown in FIG. 23a, movement of the plunger 2320 in the distal direction toward the distal end of the autoinjector 2300 increases the length of the electrical path through the variable resistor 2382, thereby increasing the electrical resistance Rx. The controller 2370 may be configured to correlate the electrical resistance Rx to the travel distance of the plunger 2320 and/or the amount of medicament delivered to the patient. In some embodiments, the controller 2370 may be configured to measure the time period over which the electrical resistance Rx changes, and correlate this time period to the speed by which the medicament is delivered to the patient. Subsequently, the controller 2370 may generate a report representative of the amount of medicament delivered to the patient and/or the speed of delivery, and control the communication module 2372 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2372 includes a wireless transmitter, the controller 2370 may control the communication module 2372 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2372 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIG. 23b is a circuit diagram illustrating one example an electrical circuit including the controller 2370 and the variable resistor 2382 depicted in FIG. 23a. As shown in FIG. 23b, the controller 2370 may be arranged in parallel with a resistor R1. In this circuit, Vin may be equal to Vout*((Rx/(Rx+R1)). Thus, as the electrical resistance Rx of the variable resistor 2382 increases, Vin may increase, and vice versa. The controller 2370 may correlate Vin to the travel distance of the plunger 2320 and/or the amount of medicament delivered to the patient.
FIGS. 24a and 24b depict yet another embodiment of an autoinjector 2400 configured to detect and report delivery of a medicament from the reservoir to the patient. The autoinjector 2400 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2410, a delivery cannula 2412 having a proximal end 2414 and a distal end 2416, a plunger 2420 having a proximal end 2422 and a distal end 2424 including a stopper 2426, a longitudinal axis A, an actuator 2440, a drive mechanism 2430, a removable sterile barrier 2450, a needle shield 2460, a housing 2462, a biasing member 2464, a controller 2470, and a communication module 2472.
The autoinjector 2400 may further include a sensor 2480 configured to detect movement of the plunger 2420. The sensor 2480 may be coupled to the controller 2470 and configured to output a signal to the controller 2470 indicating that the plunger 2420 has been moved. According to one embodiment, the sensor 2480 may include a first electrically conductive member 2482 spaced apart from the plunger 2420 and a second electrically conductive member 2484 coupled to the plunger 2420 such that the second electrically conductive member 2484 moves together with the plunger 2420. The first electrically conductive member 2482 may be a deflectable electrical contact fixed to, and extending inwardly from, an inner wall of the housing 2462. The electrically conductive member 2484 may be a spring retainer lip that is fixed to the plunger 2420.
As seen in FIG. 24b, the second electrically conductive member 2484 may be configured to engage the first electrically conductive member 2482 to form a closed electrical circuit when the plunger 2420 has completed its delivery stroke. This closed electrical circuit may output a signal to the controller 2470. Prior to completion of the delivery stroke, the second electrically conductive member 2484 may be disengaged (e.g., spaced apart) from the first electrically conductive member 2482 so that an open electrical circuit is formed, and thus no signal is outputted to the controller 2470.
In response to the electrical signal created by engagement of the first and second electrically conductive members 2482, 2484, the controller 2470 may determine that the plunger 2420 has completed its delivery stroke and generate a report representative of the completion of delivery of the medicament to the patient. The controller 2470 may control the communication module 2472 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2472 includes a wireless transmitter, the controller 2470 may control the communication module 2472 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2472 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIGS. 25a and 25b illustrate another embodiment of an autoinjector 2500 configured to detect and report delivery of a medicament from the reservoir to the patient. The autoinjector 2500 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2510, a delivery cannula 2512 having a proximal end 2514 and a distal end 2516, a plunger 2520 having a proximal end 2525 and a distal end 2525 including a stopper 2526, a longitudinal axis A, an actuator 2540, a drive mechanism 2530, a removable sterile barrier 2550, a needle shield 2560, a housing 2562, a biasing member 2564, a controller 2570, and a communication module 2572.
The autoinjector 2500 may further include a sensor 2580 configured to detect movement of the plunger 2520. The sensor 2580 may be coupled to the controller 2570 and configured to output a signal to the controller 2570 indicating that the plunger 2520 has been moved. According to one embodiment, the sensor 2580 may be a resistor Rs that is electrically connected in series with a spring 2584 and a voltage source Vs. FIGS. 25a and 25b depict the resistor Rs and the voltage source Vs in schematic form and thus do not represent the actual locations or physical configurations of the resistor Rs and the voltage source Vs. In reality, the resistor Rs and the voltage source Vs may be contained with the housing 2562 of the autoinjector 2500.
The spring 2584 may correspond to the drive mechanism 2530 and thus may be responsible for moving the plunger 2520 in the distal direction to complete its delivery stroke. When released (for example, by depression of the actuator 2540), the spring 2530 may increase in length, from length L1 (see FIG. 25a) to length L2 (see FIG. 25b), thereby pushing the plunger 2520 in the distal direction and discharging the medicament from the reservoir 2510. The spring 2584 may have a plurality of helically-wound coils, with each adjacent pair of the coils being separated by a distance. The spring 2584 may behave like an inductor by virtue of its multiple coils. The inductance of the spring 2584 may vary according to the distance between each adjacent pair of the coils. In some embodiments, increasing the length of the spring 2584 from length L1 to length L2 may increase the distance between each adjacent pair of the coils and thereby decrease the inductance associated with the spring 2584. In such embodiments, the inductance of the spring 2584 may be inversely proportional to the length of the spring 2584. Moreover, in such embodiments, the inductance of the spring 2584 may be inversely proportional to the distance between each adjacent pair of the coils. As a result of a change in the inductance of the spring 2584, an electric current through the resistor Rs may change. The changing electric current through the resistor Rs may be measured by the controller 2570 (e.g., by having the controller 2570 measure a voltage drop across the resistor Rs).
In response to a change in the electric current flowing through the resistor Rs, the controller 2570 may determine that the plunger 2520 has completed its delivery stroke and generate a report representative of the completion of delivery of the medicament to the patient. The controller 2570 may control the communication module 2572 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2572 includes a wireless transmitter, the controller 2570 may control the communication module 2572 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2572 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIG. 26 illustrates another embodiment of an autoinjector 2600 configured to detect and report delivery of a medicament from the reservoir to the patient. The autoinjector 2600 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2610, a delivery cannula 2612 having a proximal end 2614 and a distal end 2616, a plunger 2620 having a proximal end 2626 and a distal end 2626 including a stopper 2626, a longitudinal axis A, an actuator 2640, a drive mechanism 2630, a removable sterile barrier 2650, a needle shield 2660, a housing 2662, a biasing member 2664, a controller 2670, and a communication module 2672.
The autoinjector 2600 may further include a sensor 2680 configured to detect movement of the plunger 2620. The sensor 2680 may be coupled to the controller 2670 and configured to output a signal to the controller 2670 indicating that the plunger 2620 has been moved. According to one embodiment, the sensor 2680 may be a ferromagnetic proximity sensor 2682 configured to output a signal indicative of the presence or absence of a metal plunger rod 2584 at a predetermined location within the autoinjector 2600.
As illustrated in FIG. 26, the ferromagnetic proximity sensor 2682 may be fixed to an inner wall of the housing 2662. The ferromagnetic proximity sensor 2682 may be positioned so that the metal plunger rod 2684 is advanced past the ferromagnetic proximity sensor 2682 when the plunger 2620 has completed its delivery stroke, as seen in FIG. 26. As a result, the ferromagnetic proximity sensor 2682 may detect an absence of the metal plunger rod 2684. On the other hand, prior to completion of the delivery stroke, the metal plunger rod 2684 may be aligned with ferromagnetic proximity sensor 2682 such that the ferromagnetic proximity sensor 2682 detects the presence of the metal plunger rod 2684.
In response to a signal from the ferromagnetic proximity sensor 2682 indicating the absence of the metal plunger rod 2684, or in response to the absence of a signal from the ferromagnetic proximity sensor 2682 indicating the presence of the metal plunger rod 2684, the controller 2670 may determine that the plunger 2620 has completed its delivery stroke and generate a report representative of the completion of the delivery of the medicament to the patient. The controller 2670 may control the communication module 2672 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2672 includes a wireless transmitter, the controller 2670 may control the communication module 2672 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2672 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIGS. 27a-e illustrate another embodiment of an autoinjector 2700 configured to detect and report an amount of medicament delivered to the patient. The autoinjector 2700 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2710, a delivery cannula 2712 having a proximal end 2714 and a distal end 2716, a plunger 2720 having a proximal end 2722 and a distal end 2724 including a stopper 2726, a longitudinal axis A, an actuator 2740, a drive mechanism 2730, a removable sterile barrier 2750, a needle shield 2760, a housing 2762, a biasing member 2764, a controller 2770, and a communication module 2772.
The autoinjector 2700 may further include a sensor 2780 configured to detect movement of the plunger 2720. The sensor 2780 may be coupled to the controller 2770 and configured to output a signal to the controller 2770 indicating that the plunger 2720 has been moved and/or the travel distance of the plunger 2720. According to one embodiment, the sensor 2780 may be comprised of a plurality of photoresistors 2782a-d. The electrical resistance of each of the photoresistors 2782a-d may decrease with increasing incident light intensity. As depicted in FIG. 27a, the photoresistors 2782a-d may be arranged adjacent one another and parallel to the longitudinal axis A of the autoinjector 2700. The photoresistors 2782a-d may be fixed to the exterior of the reservoir 2710.
To permit ambient light to be incident upon the photoresistors 2782a-d, the housing 2762 of the autoinjector 2700 may include one or more windows 2784a and 2784b as shown in FIG. 27b. The plunger 2720, including the stopper 2726, may be made of an opaque material such that the plunger 2720 obstructs the ambient light shining through the windows 2784a and 2784b as the plunger 2720 is advanced through the reservoir 2710 in the distal direction along the longitudinal axis A. The plunger 2720 may be outfitted with an opaque sleeve 2786 as shown in FIG. 27a for this purpose. The further the plunger 2720 is advanced in the distal direction, the more the windows 2784a and 2784b are covered. Thus, advancing the plunger 2720 in the distal direction along the longitudinal axis A may reduce the ambient light incident on each of the plurality of photoresistors 2782a-d in a sequential order. For example, as shown in FIG. 27c, when the plunger 2720 has completed approximately half of its delivery stroke, ambient light may be prevented from reaching the photoresistors 2782a and 2782b, whereas ambient light may still be incident on each of the photoresistors 2782c and 2782d. The lack of ambient light incident on the photoresistors 2782a and 2782b may cause the electrical resistance of each of these photoresistors to increase, potentially even causing each of the photoresistors 2782a and 2782b to stop conducting electrical current. On the other hand, the photoresistors 2782c and 2782d, which are still exposed to ambient light, may exhibit a low electrical resistance and continue to conduct electrical current. When the plunger 2720 completes its delivery stroke as shown in FIG. 27d, all ambient light through the windows 2784a and 2784b may be obstructed, thereby causing a substantial increase in the electrical resistance of all of the photoresistors 2782a-d. 
FIG. 27e is a circuit diagram illustrating one example of an electrical circuit including the controller 2770 and the photoresistors 2782a-d. The electrical circuit may include a resistor R2 having a known constant electrical resistance. The photoresistors 2782a-d may be arranged in parallel with the controller 2770. The controller 2770 may be able to measure the voltage drop across all of the photoresistors 2782a-d and thus compute their total effective electrical resistance. In some embodiments, the controller 2770 may be configured to individually determine the electrical resistance of each of the photoresistors 2782a-d. Also, in some embodiments, the autoinjector 2700 may include a reference photoresistor 2790 located on the exterior of the housing 2762 of the autoinjector, in order to calibrate the controller 2770 for the natural intensity of the ambient light.
The controller 2770 may correlate the electrical resistance of one or more of the photoresistors 2782a-d to the travel distance of the plunger 2720 and/or the amount of medicament delivered to the patient. In some embodiments, the controller 2770 may be configured to measure the time period over which the electrical resistance of one or more of the photoresistors 2782a-d changes, and then correlate this time period to the speed by which the medicament was delivered to the patient. Subsequently, the controller 2770 may generate a report representative of the amount of medicament delivered to the patient and/or the speed of delivery, and control the communication module 2772 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2772 includes a wireless transmitter, the controller 2770 may control the communication module 2772 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2772 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIG. 28 depicts yet another embodiment of an autoinjector 2800 configured to detect and report the amount of medicament delivered to a patient. The autoinjector 2800 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2810, a delivery cannula 2812 having a proximal end 2814 and a distal end 2816, a plunger 2820 having a proximal end 2822 and a distal end 2824 including a stopper 2826, a longitudinal axis A, an actuator 2840, a drive mechanism 2830, a removable sterile barrier 2850, a needle shield 2860, a housing 2862, a biasing member 2864, a controller 2870, and a communication module 2872.
The autoinjector 2800 may further include a sensor 2880 configured to detect movement of the plunger 2820. The sensor 2880 may be coupled to the controller 2870 and configured to output a signal to the controller 2870 indicating the presence or absence of fluid at various levels within the reservoir 2810. According to one embodiment, the sensor 2880 may include a capacitive fluid level sensor 2882 coupled to an exterior of the reservoir 2810. In some embodiments, the capacitive fluid level sensor 2882 may be oriented such that its longitudinal axis is parallel to the longitudinal axis of the reservoir. Therefore, as the fluid level within the reservoir 2810 decreases, the capacitive fluid level sensor 2882 may be gradually uncovered.
In response to the signal from the sensor 2880, the controller 2870 may determine an amount of medicament remaining in the reservoir 2810 and/or generate a report representative of an amount of medicament delivered to the patient from the reservoir based on the amount of medicament remaining in the reservoir. The controller 2870 may control the communication module 2872 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2872 includes a wireless transmitter, the controller 2870 may control the communication module 2872 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2872 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIGS. 29a and 29b depict an embodiment of an autoinjector 2900 configured to detect and report contact between a housing of the autoinjector 200 and the patient. The autoinjector 2900 may include some or all of the same components as the autoinjector 1700 described above, including, for example, a reservoir 2910, a delivery cannula 2912 having a proximal end 2914 and a distal end 2916, a plunger 2920 having a proximal end 2922 and a distal end 2924 including a stopper 2926, a longitudinal axis A, an actuator 2940, a drive mechanism 2930, a removable sterile barrier 2950, a needle shield 2960, a housing 2962, a biasing member 2964, a controller 2970, and a communication module 2972.
The autoinjector 2900 may further include a sensor 2980 configured to detect contact between the housing 2962 and an object (e.g., the skin of a patient or the clothing of the patient). The sensor 2980 may be coupled to the controller 2970 and configured to output a signal to the controller 2970 indicative of contact with the object. According to one embodiment, the sensor 2980 may include a first electrically conductive member 2982 coupled to an axial end face of the distal end of the housing 2962 and a second electrically conductive member 2984 coupled to an axial end face of the distal end of the needle shield 2960. In some embodiments, the first and second electrically conductive members 2982, 2984 may each include an electrically conductive adhesive. The first electrically conductive member 2982 may be spaced apart from the second electrically conductive member 2984 so that the first and second electrically conductive members 2982, 2984 do not physically contact each other, at least when the needle shield 2960 is biased by the biasing member 2964 to its distal position as shown in FIG. 29a. 
As seen in FIG. 29b, when the needle shield 2960 is pressed against the skin 2990 of the patient 2992, the needle shield 2960 may be pushed into the housing 2962 to its proximal position, and the first electrically conductive member 2982 may move into contact with the skin 2990 of the patient 2992. Thus, both the first and second electrically conductive members 2982, 2984 may contact the skin 2990 of the patient 2992 when the needle shield 2960 is pressed against the skin 2990 of the patient 2990.
The skin 2990 of the patient 2992 may conduct electricity between the first and second electrically conductive members 2982, 2984. Consequently, a closed electrical circuit may be formed between the first and second electrically conductive members 2982, 2984 when both the first and second electrically conductive members 2982, 2984 are in contact with the skin 2990 of the patient 2992. This closed electrical circuit may output a signal to the controller 2970.
In response to the signal from the sensor 2280, the controller 2970 may determine that the housing 2962 contacts the patient, and generate a report representative of contact between the housing 2962 and the patient 2992 and/or insertion of the delivery cannula into the patient 2992. The controller 2970 may control the communication module 2972 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 2972 includes a wireless transmitter, the controller 2970 may control the communication module 2972 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 2972 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
FIGS. 30a and 30b illustrate an embodiment of an on-body injector 3000 configured to detect and report contact between a housing of the on-body injector 3000 and the patient. The on-body injector 3000 may include some or all of the same components as the drug delivery system 800 illustrated in FIGS. 14-16, including, for example, the housing 802 having the exterior surface 816, the portion 828 of the exterior surface 816 which is configured to face and/or contact the skin of the patient during use of the on-body injector 3000, the controller 900, and the communication module 902. The portion 828 of the exterior surface 816 may have an opening 3004 dimensioned to receive the distal end of the delivery cannula 844.
The on-body injector 3000 may further include a sensor 3010 configured to detect contact between the housing 802 and an object (e.g., the skin of a patient or the clothing of the patient). The sensor 3010 may be coupled to the controller 900 and configured to output a signal to the controller 900 indicative of contact with the object. According to one embodiment, the sensor 3010 may include a first electrically conductive member 3012 and second electrically conductive member 3014 coupled to different parts of the portion 828 of the exterior surface 816 of the housing 802. In some embodiments, the first and second electrically conductive members 3012, 3014 may each include an electrically conductive adhesive (e.g., an electrically conductive gel adhesive pad). The first electrically conductive member 3012 may be spaced apart from the second electrically conductive member 3014 so that the first and second electrically conductive members 3012, 3014 do not physically contact each other.
When the portion 828 of the exterior surface 816 of the housing 802 is pressed against the skin of a patient, both the first and second electrically conductive members 3012, 3014 may contact the skin of the patient. The skin of the patient may conduct electricity between the first and second electrically conductive members 3012, 3014. Consequently, a closed electrical circuit may be formed between the first and second electrically conductive members 3012, 3014 when both the first and second electrically conductive members 3012, 3014 are pressed into contact with the skin of the patient. This closed electrical circuit may output a signal to the controller 900.
In response to the signal from the sensor 3010, the controller 900 may determine that the housing 802 contacts the patient, and generate a report representative of contact between the housing 802 and the patient and/or insertion of the delivery cannula into the patient. The controller 900 may control the communication module 902 to transmit (e.g., wirelessly transmit) the report to an external computing system. In an embodiment where the communication module 902 includes a wireless transmitter, the controller 900 may control the communication module 902 to wirelessly transmit the report. In some embodiments, the report may be transmitted by the communication module 902 to an external mobile device (e.g., the mobile device 110) and/or an external computing device (e.g., the computing device 114).
The foregoing methods and drug delivery systems describe locking out the drug delivery device in response to various determinations regarding the condition, the operational state, and/or the identity of the drug delivery device, the medicament contained in the drug delivery device, and/or the user of the drug delivery device. A lock for achieving this functionality may be coupled to the plunger assembly, the needle shield, and/or the actuator. In some embodiments, the lock may include a wall that can be controlled to selectively abut spaces or notches in the plunger, needle shield, or actuator to limit movement of, respectively, the plunger, needle shield, or the actuator. In some embodiments, the lock may be coupled to and selectively activated by the controller of the drug delivery device.
In addition to monitoring and reporting conditions and/or operational states of drug delivery devices, the drug delivery systems and methods of the present disclosure may include features that improve their usability by patients, particularly patients who might have difficulty gripping or handling drug delivery devices, such as elderly and disabled patients. Described below with reference to FIGS. 31 and 32 is a removable sterile barrier that, in addition to inhibiting the contamination of an interior of a drug delivery device, provides an anti-roll functionality, helps patients grip and detach the removable sterile barrier from the drug delivery device, and optionally houses various electronic components including, for example, a controller, a memory, one or more sensors, and/or a communication module.
In particular, as illustrated in FIG. 31, a drug delivery system 3100 is provided that includes a drug delivery device 3102. The drug delivery device 3102 may be in the form of an autoinjector, and thus configured for hand-held use and application against the skin of the patient. The drug delivery device 3102 may include some or all of the same components as the drug delivery devices described above in connection with FIGS. 9, 12A, 12B, 13, and 17-29. The drug delivery device 3102 may include a housing 3110 in which are disposed assemblies or structures that introduce a delivery cannula into a patient and that eject a drug or medicament from a reservoir through the delivery cannula into the patient. The drug delivery device 3102 may also include an actuator 3112 disposed at a proximal end of the housing 3110 and configured to be depressed by the patient to activate a drive to that causes a plunger to discharge the medicament from the reservoir through the delivery cannula into the patient.
The drug delivery device 3102 may further include a removable sterile barrier 3120 removably attached to a distal end of the housing 3110. The removable sterile barrier 3120 reduces the risk of contamination of the delivery cannula and other elements within the housing 3110 prior to use of the drug delivery device 3102. The removable sterile barrier 3120 may be formed by a tubular member 3122 and a cover member 3124 that covers an open end of the tubular member 3122. The tubular member 3122 and the cover member 3124 may be integrally formed as a single unitary structure, or alternatively, formed as separate components which are adhered or mechanically interconnected to each other.
The tubular member 3122 may be disposed about (e.g., surround) the distal end of the housing 3110 and/or a distal end of a delivery cannula (not illustrated), and may removably attach the removable sterile barrier 3120 to the housing 3110. As shown in FIG. 32, the tubular member 3122 may be assembled by fitting two interlocking and generally C-shaped members 3128, 3130 over the distal end of the housing 3110. In some embodiments, the removable sterile barrier 3120 may form an interference or snap fit with the distal end of the housing 3110. A frictional force associated with the interference or snap fit may be overcome by manually pulling the removable sterile barrier 3120 in a distal direction away from a housing 3110. The interference or snap fit may be formed by configuring an inner diameter of the tubular member 3122 to be slightly smaller than an outer diameter of a distal end of the housing 3110. Alternatively, or additionally, the tubular member 3122 may have a tearable or weakened member (not illustrated) that connects the tubular member 3122 to the distal end of the housing 3110 and which can be broken or torn by the patient when pulling the removable sterile barrier 3120 away from the housing 3110. The tubular member 3122 may further include a plurality of outwardly protruding ribs 3126 designed to help a patient grip the tubular member 3122 to detach it from the housing 3110. The ribs 3126 may be particularly useful to elderly and disabled patients who have below average gripping strength.
The cover member 3124 may be fixed to a distal end of the tubular member 3122 and may completely cover an opening formed at the distal end of the tubular member 3122. A distal end surface 3132 of the cover member 3124 may be planar such that the drug delivery device 3102 can be disposed on planar surface in an upright configuration without falling over. In alternative embodiments, the distal end surface 3132 of the cover member 3124 may have a slight curvature to prevent a user from standing up the drug delivery device 3102 on a planar surface. Also, an outer peripheral portion of the cover member 3124 may be wider than an outer peripheral portion of the tubular member 3122 such that a ledge or overhang 3134 is formed at the interface between the cover member 3124 and the tubular member 3122. This ledge 3134 may help prevent a patient's fingers from slipping over the cover member 3124 when trying to pull the removable sterile barrier 3120 off of the housing 3110.
Since the housing 3110 may have a circular cross section resulting in a round exterior side surface, the drug delivery device 3102 may be susceptible to unintentionally rolling across a surface when it is placed on its side. To inhibit or prevent the drug delivery device 3102 from rolling across a surface when placed on its side, the tubular member 3122 and/or the cover member 3124 may be formed with at least one roll inhibiting exterior side surface. The at least one roll inhibiting exterior side surface may extend between proximal and distal ends of the tubular member 3122 and/or between proximal and distal ends of the cover member 3124. The at least one roll inhibiting exterior side surface of the tubular member 3122 and/or the cover member 3124 may be parallel to a longitudinal axis A of the drug delivery device 3102 and/or perpendicular to the distal end surface 3132 of the cover member 3124.
In the embodiment illustrated in FIGS. 31 and 32, the tubular member 3122 has a triangular cross section formed by three planar exterior side surfaces 3140, 3142, and 3144, and the cover member 3124 has a triangular cross section formed by three planar exterior side surfaces 3150, 3152, and 3154. The cross section at issue is the one which is perpendicular to the longitudinal axis A of the drug delivery device 3102. Each of the planar exterior side surfaces 3140, 3142, 3144, 3150, 3152, and 3154 is an example of a roll inhibiting exterior side surface. This is because each of the planar exterior side surfaces 3140, 3142, 3144, 3150, 3152, and 3154 is configured to inhibit (e.g., prevent) the removable sterile barrier 3120 and/or the drug delivery device 3102 from rolling across a support surface when the respective planar exterior side surface rests against the support surface.
As used herein, the term “planar” is hereby defined to mean flat or substantially flat. As shown in FIGS. 31 and 32, each of the planar exterior side surfaces 3140, 3142, 3144, 3150, 3152, and 3154 balloons outwardly and thus has a slight curvature. While the planar exterior side surfaces 3140, 3142, 3144, 3150, 3152, and 3154 are not exactly flat, they are nonetheless substantially flat and therefore are considered to be “planar” in accordance with principles of the present disclosure. In alternative embodiments, one or more of the planar exterior side surfaces 3140, 3142, 3144, 3150, 3152, and 3154 may be exactly flat such that it does not have any curvature. Regardless of whether the planar exterior side surfaces 3140, 3142, 3144, 3150, 3152, and 3154 have a flat configuration or a substantially flat configuration, the planar exterior side surfaces 3140, 3142, 3144, 3150, 3152, and 3154 may have the ability to inhibit (e.g., prevent) rolling of the removable sterile barrier 3120 and/or the drug delivery device 3102.
The anti-roll functionality of the removable sterile barrier 3120 may be achieved through a variety of different shapes and sizes of the tubular member 3122 and/or the cover member 3124. In some embodiments, only the tubular member 3122, or only the cover member 3124, may have a triangular cross section. Other cross-sectional shapes of the tubular member 3122 and/or the cover member 3124 are capable of preventing or inhibiting rolling including, but are not limited to, a hemisphere, a square, a rectangle, a pentagon, hexagon, or any other polygonal shape. Also, the vertices or corners formed by the one or more planar exterior side surfaces of the tubular member 3122 and/or the cover member 3124 may be rounded so that the vertices or corners are not likely to cause injury or pain to a patient while gripping the removable sterile barrier 3120.
It should be noted that the particular shape of the removable sterile barrier 3120 illustrated in FIGS. 31 and 32 is an aesthetic feature not dictated by function.
In an alternative embodiment, the drug delivery device 3102 may include a second removable sterile barrier, separate from the removable sterile barrier 3120, that attaches directly to the reservoir and surrounds the delivery cannula, similar to the removable sterile barrier 1750 illustrated in FIG. 17. In such an embodiment, the removable sterile barrier 3120 may cover and/or surround the second removable sterile barrier.
Furthermore, various electronic components of the drug delivery device 3102 may be housed (e.g., embedded) within the removable sterile barrier 3120. For example, a controller, a memory, a processor (e.g., a microprocessor), a communication module (e.g., a Bluetooth module, a Bluetooth Low Energy module, etc.), a skin sensor, an orientation sensor, a fingerprint sensor, and/or a temperature sensor, configured in a manner similar to one of the embodiments discussed above in connection with FIGS. 9, 12A, 12B, 13, and 17-29, may be housed (e.g., embedded) within the removable sterile barrier 3120. In some embodiments, the removable sterile barrier 3120 may be configured to include one or more of the electronic elements 630-638 illustrated in FIG. 9.
The removable sterile barrier 3120 can be designed for single, one-time use, or for multiple uses. The embodiment of the removable sterile barrier 3120 illustrated in FIG. 32 may be assembled by fitting each of the C-shaped members 3128, 3130 separately around the distal end of the housing 3110 and then fixing the C-shaped members 3128, 3130 together with an adhesive. After the user removes the removable sterile barrier 3120 from the housing 3110, it may be difficult, if not impossible, to re-attach the removable sterile barrier 3120 to the housing 3110 (or the housing of another drug delivery device), at least not without breaking apart the C-shaped members 3128, 3130 and then re-fitting, and re-adhering, them around the housing 3110. As a result, the removable sterile barrier 3120 illustrated in FIG. 32 may be disposable and only for one-time use. In an alternative embodiment (not illustrated), the C-shaped members 3128, 3130 may be hinged together in a clam shell arrangement. In such an alternative embodiment, after removing the removable sterile barrier 3120 from the housing 3110, it may be possible to re-attach the removable sterile barrier 3120 to the housing 3110 (or the housing of another drug delivery device) by opening the C-shaped members 3128, 3130 like a clam shell and then fitting them around the distal end of the housing 3110. The non-hinged ends of the C-shaped members 3128, 3130 may include a locking mechanism (e.g., mating locking tabs and/or slots) so that the C-shaped members 3128, 3130 can be secured to each other after they are secured around the housing 3110. Substantial cost savings may be realized by the re-usable configuration of the removable sterile barrier 3120 since the electronics onboard the removable sterile barrier 3120 can be used more than once. In still further embodiments, the removable sterile barrier 3120 may be manufactured in one piece, and then installed axially onto the housing 3110 of the drug delivery device 3102.
Removal of the removable sterile barrier 3120 from the housing 3110 may trigger a mechanism that automatically turns on a communication module (e.g., a Bluetooth module, a Bluetooth Low Energy module, etc.), a controller, and/or other electronic components embedded within the removable sterile barrier 3120. In some embodiments, the mechanism may be similar in construction and/or operation to the switch 632 illustrated in FIG. 9. In other embodiments, such as the one illustrated in FIGS. 33 and 34, the removable sterile barrier 3120 may include a spring arm 3160 and a normally open momentary switch 3162 to achieve this functionality. The normally open momentary switch 3162 may selectively provide an electrical connection between a battery and a controller, a communication module, and/or other electronic components embedded in the removable sterile barrier 3120.
FIG. 33 illustrates a cross-sectional view of the removable sterile barrier 3120 prior to its removal from the housing 3110 of the drug delivery device 3102. The spring arm 3160 may have a first end 3164 fixed to an inner wall 3166 of the removable sterile barrier 3120, a second end 3168 moveable relative to the inner wall 3166 of the removable sterile barrier 3120, and a deflectable body portion 3170 that connects the first and second ends 3164, 3168. The deflectable body portion 3170 may protrude inwardly from the inner wall 3166. As shown in FIG. 33, the deflectable body portion 3170 may have triangular shape with its apex pointing inwardly away from the inner wall 3166. When the removable sterile barrier 3120 is disposed about the housing 3110, the housing 3110 may press against and deflect the deflectable body portion 3170 of the spring arm 3160 so that the deflectable body portion 3170 moves towards the inner wall 3166 and also downward in the distal axial direction. As a result, the second end 3168 of the spring arm 3160 may also move downward in the distal axial direction, such that it no longer contacts and depresses the normally open momentary switch 3162. Accordingly, in this configuration, the normally open momentary switch 3162 assumes an OFF position. When the normally open momentary switch 3162 is in its OFF position, as shown in FIG. 33, the controller, communication module, and/or other electronic components may not be supplied with electrical power from the battery.
FIG. 34 illustrates the removable sterile barrier 3120 after it has been removed from the housing 3110 of the drug delivery device 3102. The absence of the housing 3110 allows the deflectable body portion 3170 of the spring arm 3160 to elastically return to its un-compressed, natural shape. This causes the second end 3168 of the spring arm 3160 to move upward in the proximal axial direction until it contacts and depresses the normally open momentary switch 3162. By depressing the normally open momentary switch 3162, the second end 3168 of the spring arm 3160 causes the normally open momentary switch 3162 to assume its ON position. As a result, a controller, a communication module, and/or other electronic components embedded within the removable sterile barrier 3120 may be electrically connected to, and powered by, a battery embedded within the removable sterile barrier 3120. In some embodiments, the supplying the controller with electrical power may cause it to control the communication module to transmit a signal to an external computing device (e.g., a smartphone), via Bluetooth or Bluetooth Low Energy communication, representative of removal of the removable sterile barrier 3120 from the drug delivery device 3102.
During manufacturing, a delay may occur between the assembly of the removable sterile barrier 3120 and its installation on the housing 3110 of the drug delivery device 3102. During this delay, it may be desirable to prevent the second end 3168 of the spring arm 3160 from depressing the normally open momentary switch 3162 and turning on the electronics onboard the removable sterile barrier 3120. To address this concern, the deflectable body portion 3170 of the spring arm 3160 may be twisted so that the second end 3168 of the spring arm 3160 is not aligned with the normally open momentary switch 3162. A pin (not illustrated) may hold second end 3168 of the spring arm 3160 in this non-aligned configuration. Later, when the removable sterile barrier 3120 is fit over the housing 3110, the housing 3110 may deflect the deflectable body portion 3170 of the spring arm 3160, thereby moving the second end 3168 downward in the distal axial direction, in the manner discussed above. Accordingly, the second end 3168 will slip past the pin and the deflectable body portion 3170 will naturally un-twist itself due to its elasticity. This motion may re-align the second end 3168 of the spring arm 3160 with the normally open momentary switch 3162 so that when the removable sterile barrier 3120 is later removed from the housing 3110, the second end 3168 of the spring arm 3160 will depress the normally open momentary switch 3162 (as seen FIG. 34).
The above description describes various systems and methods for use with a drug delivery device. It should be clear that the system, drug delivery device or methods can further comprise use of a medicament listed below with the caveat that the following list should neither be considered to be all inclusive nor limiting. The medicament will be contained in a reservoir. In some instances, the reservoir is a primary container that is either filled or pre-filled for treatment with the medicament. The primary container can be a cartridge or a pre-filled syringe.
For example, the drug delivery device or more specifically the reservoir of the device may be filled with colony stimulating factors, such as granulocyte colony-stimulating factor (G-CSF). Such G-CSF agents include, but are not limited to, Neupogen® (filgrastim) and Neulasta® (pegfilgrastim). In various other embodiments, the drug delivery device may be used with various pharmaceutical products, such as an erythropoiesis stimulating agent (ESA), which may be in a liquid or a lyophilized form. An ESA is any molecule that stimulates erythropoiesis, such as Epogen® (epoetin alfa), Aranesp® (darbepoetin alfa), Dynepo® (epoetin delta), Mircera® (methyoxy polyethylene glycol-epoetin beta), Hematide®, MRK-2578, INS-22, Retacrit® (epoetin zeta), Neorecormon® (epoetin beta), Silapo® (epoetin zeta), Binocrit® (epoetin alfa), epoetin alfa Hexal, Abseamed® (epoetin alfa), Ratioepo® (epoetin theta), Eporatio® (epoetin theta), Biopoin® (epoetin theta), epoetin alfa, epoetin beta, epoetin zeta, epoetin theta, and epoetin delta, as well as the molecules or variants or analogs thereof as disclosed in the following patents or patent applications, each of which is herein incorporated by reference in its entirety: U.S. Pat. Nos. 4,703,008; 5,441,868; 5,547,933; 5,618,698; 5,621,080; 5,756,349; 5,767,078; 5,773,569; 5,955,422; 5,986,047; 6,583,272; 7,084,245; and 7,271,689; and PCT Publication Nos. WO 91/05867; WO 95/05465; WO 96/40772; WO 00/24893; WO 01/81405; and WO 2007/136752.
An ESA can be an erythropoiesis stimulating protein. As used herein, “erythropoiesis stimulating protein” means any protein that directly or indirectly causes activation of the erythropoietin receptor, for example, by binding to and causing dimerization of the receptor. Erythropoiesis stimulating proteins include erythropoietin and variants, analogs, or derivatives thereof that bind to and activate erythropoietin receptor; antibodies that bind to erythropoietin receptor and activate the receptor; or peptides that bind to and activate erythropoietin receptor. Erythropoiesis stimulating proteins include, but are not limited to, epoetin alfa, epoetin beta, epoetin delta, epoetin omega, epoetin iota, epoetin zeta, and analogs thereof, pegylated erythropoietin, carbamylated erythropoietin, mimetic peptides (including EMP1/hematide), and mimetic antibodies. Exemplary erythropoiesis stimulating proteins include erythropoietin, darbepoetin, erythropoietin agonist variants, and peptides or antibodies that bind and activate erythropoietin receptor (and include compounds reported in U.S. Publication Nos. 2003/0215444 and 2006/0040858, the disclosures of each of which is incorporated herein by reference in its entirety) as well as erythropoietin molecules or variants or analogs thereof as disclosed in the following patents or patent applications, which are each herein incorporated by reference in its entirety: U.S. Pat. Nos. 4,703,008; 5,441,868; 5,547,933; 5,618,698; 5,621,080; 5,756,349; 5,767,078; 5,773,569; 5,955,422; 5,830,851; 5,856,298; 5,986,047; 6,030,086; 6,310,078; 6,391,633; 6,583,272; 6,586,398; 6,900,292; 6,750,369; 7,030,226; 7,084,245; and 7,217,689; U.S. Publication Nos. 2002/0155998; 2003/0077753; 2003/0082749; 2003/0143202; 2004/0009902; 2004/0071694; 2004/0091961; 2004/0143857; 2004/0157293; 2004/0175379; 2004/0175824; 2004/0229318; 2004/0248815; 2004/0266690; 2005/0019914; 2005/0026834; 2005/0096461; 2005/0107297; 2005/0107591; 2005/0124045; 2005/0124564; 2005/0137329; 2005/0142642; 2005/0143292; 2005/0153879; 2005/0158822; 2005/0158832; 2005/0170457; 2005/0181359; 2005/0181482; 2005/0192211; 2005/0202538; 2005/0227289; 2005/0244409; 2006/0088906; and 2006/0111279; and PCT Publication Nos. WO 91/05867; WO 95/05465; WO 99/66054; WO 00/24893; WO 01/81405; WO 00/61637; WO 01/36489; WO 02/014356; WO 02/19963; WO 02/20034; WO 02/49673; WO 02/085940; WO 03/029291; WO 2003/055526; WO 2003/084477; WO 2003/094858; WO 2004/002417; WO 2004/002424; WO 2004/009627; WO 2004/024761; WO 2004/033651; WO 2004/035603; WO 2004/043382; WO 2004/101600; WO 2004/101606; WO 2004/101611; WO 2004/106373; WO 2004/018667; WO 2005/001025; WO 2005/001136; WO 2005/021579; WO 2005/025606; WO 2005/032460; WO 2005/051327; WO 2005/063808; WO 2005/063809; WO 2005/070451; WO 2005/081687; WO 2005/084711; WO 2005/103076; WO 2005/100403; WO 2005/092369; WO 2006/50959; WO 2006/02646; and WO 2006/29094.
Examples of other pharmaceutical products for use with the device may include, but are not limited to, antibodies such as Vectibix® (panitumumab), XgevaTM (denosumab) and ProliaTM (denosamab); other biological agents such as Enbrel® (etanercept, TNF-receptor/Fc fusion protein, TNF blocker), Neulasta® (pegfilgrastim, pegylated filgastrim, pegylated G-CSF, pegylated hu-Met-G-CSF), Neupogen® (filgrastim, G-CSF, hu-MetG-CSF), and Nplate® (romiplostim); small molecule drugs such as Sensipar® (cinacalcet). The device may also be used with a therapeutic antibody, a polypeptide, a protein or other chemical, such as an iron, for example, ferumoxytol, iron dextrans, ferric glyconate, and iron sucrose. The pharmaceutical product may be in liquid form, or reconstituted from lyophilized form.
Among particular illustrative proteins are the specific proteins set forth below, including fusions, fragments, analogs, variants or derivatives thereof:
OPGL specific antibodies, peptibodies, and related proteins, and the like (also referred to as RANKL specific antibodies, peptibodies and the like), including fully humanized and human OPGL specific antibodies, particularly fully humanized monoclonal antibodies, including but not limited to the antibodies described in PCT Publication No. WO 03/002713, which is incorporated herein in its entirety as to OPGL specific antibodies and antibody related proteins, particularly those having the sequences set forth therein, particularly, but not limited to, those denoted therein: 9H7; 18B2; 2D8; 2E11; 16E1; and 22B3, including the OPGL specific antibodies having either the light chain of SEQ ID NO:2 as set forth therein in FIG. 2 and/or the heavy chain of SEQ ID NO:4, as set forth therein in FIG. 4, each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publication;
Myostatin binding proteins, peptibodies, and related proteins, and the like, including myostatin specific peptibodies, particularly those described in U.S. Publication No. 2004/0181033 and PCT Publication No. WO 2004/058988, which are incorporated by reference herein in their entirety particularly in parts pertinent to myostatin specific peptibodies, including but not limited to peptibodies of the mTN8-19 family, including those of SEQ ID NOS:305-351, including TN8-19-1 through TN8-19-40, TN8-19 con1 and TN8-19 con2; peptibodies of the mL2 family of SEQ ID NOS:357-383; the mL15 family of SEQ ID NOS:384-409; the mL17 family of SEQ ID NOS:410-438; the mL20 family of SEQ ID NOS:439-446; the mL21 family of SEQ ID NOS:447-452; the mL24 family of SEQ ID NOS:453-454; and those of SEQ ID NOS:615-631, each of which is individually and specifically incorporated by reference herein in their entirety fully as disclosed in the foregoing publication;
IL-4 receptor specific antibodies, peptibodies, and related proteins, and the like, particularly those that inhibit activities mediated by binding of IL-4 and/or IL-13 to the receptor, including those described in PCT Publication No. WO 2005/047331 or PCT Application No. PCT/US2004/37242 and in U.S. Publication No. 2005/112694, which are incorporated herein by reference in their entirety particularly in parts pertinent to IL-4 receptor specific antibodies, particularly such antibodies as are described therein, particularly, and without limitation, those designated therein: L1H1; L1H2; L1H3; L1H4; L1H5; L1H6; L1H7; L1H8; L1H9; L1H10; L1H11; L2H1; L2H2; L2H3; L2H4; L2H5; L2H6; L2H7; L2H8; L2H9; L2H10; L2H11; L2H12; L2H13; L2H14; L3H1; L4H1; L5H1; L6H1, each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publication;
Interleukin 1-receptor 1 (“IL1-R”) specific antibodies, peptibodies, and related proteins, and the like, including but not limited to those described in U.S. Publication No. 2004/097712, which is incorporated herein by reference in its entirety in parts pertinent to IL1-R1 specific binding proteins, monoclonal antibodies in particular, especially, without limitation, those designated therein: 15CA, 26F5, 27F2, 24E12, and 10H7, each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the aforementioned publication;
Ang2 specific antibodies, peptibodies, and related proteins, and the like, including but not limited to those described in PCT Publication No. WO 03/057134 and U.S. Publication No. 2003/0229023, each of which is incorporated herein by reference in its entirety particularly in parts pertinent to Ang2 specific antibodies and peptibodies and the like, especially those of sequences described therein and including but not limited to: L1(N); L1(N) WT; L1(N) 1K WT; 2xL1(N); 2xL1(N) WT; Con4 (N), Con4 (N) 1K WT, 2xCon4 (N) 1K; L1C; L1C 1K; 2xL1C; Con4C; Con4C 1K; 2xCon4C 1K; Con4-L1 (N); Con4-L1C; TN-12-9 (N); C17 (N); TN8-8(N); TN8-14 (N); Con 1 (N), also including anti-Ang 2 antibodies and formulations such as those described in PCT Publication No. WO 2003/030833 which is incorporated herein by reference in its entirety as to the same, particularly Ab526; Ab528; Ab531; Ab533; Ab535; Ab536; Ab537; Ab540; Ab543; Ab544; Ab545; Ab546; A551; Ab553; Ab555; Ab558; Ab559; Ab565; AbF1AbFD; AbFE; AbFJ; AbFK; AbG1D4; AbGC1E8; AbH1C12; Ab1A1; Ab1F; Ab1K, Ab1P; and Ab1P, in their various permutations as described therein, each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publication;
NGF specific antibodies, peptibodies, and related proteins, and the like including, in particular, but not limited to those described in U.S. Publication No. 2005/0074821 and U.S. Pat. No. 6,919,426, which are incorporated herein by reference in their entirety particularly as to NGF-specific antibodies and related proteins in this regard, including in particular, but not limited to, the NGF-specific antibodies therein designated 4D4, 4G6, 6H9, 7H2, 14D10 and 14D11, each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publication;
CD22 specific antibodies, peptibodies, and related proteins, and the like, such as those described in U.S. Pat. No. 5,789,554, which is incorporated herein by reference in its entirety as to CD22 specific antibodies and related proteins, particularly human CD22 specific antibodies, such as but not limited to humanized and fully human antibodies, including but not limited to humanized and fully human monoclonal antibodies, particularly including but not limited to human CD22 specific IgG antibodies, such as, for instance, a dimer of a human-mouse monoclonal hLL2 gamma-chain disulfide linked to a human-mouse monoclonal hLL2 kappa-chain, including, but limited to, for example, the human CD22 specific fully humanized antibody in Epratuzumab, CAS registry number 501423-23-0;
IGF-1 receptor specific antibodies, peptibodies, and related proteins, and the like, such as those described in PCT Publication No. WO 06/069202, which is incorporated herein by reference in its entirety as to IGF-1 receptor specific antibodies and related proteins, including but not limited to the IGF-1 specific antibodies therein designated L1H1, L2H2, L3H3, L4H4, L5H5, L6H6, L7H7, L8H8, L9H9, L10H10, L11H11, L12H12, L13H13, L14H14, L15H15, L16H16, L17H17, L18H18, L19H19, L20H20, L21H21, L22H22, L23H23, L24H24, L25H25, L26H26, L27H27, L28H28, L29H29, L30H30, L31H31, L32H32, L33H33, L34H34, L35H35, L36H36, L37H37, L38H38, L39H39, L40H40, L41H41, L42H42, L43H43, L44H44, L45H45, L46H46, L47H47, L48H48, L49H49, L50H50, L51H51, L52H52, and IGF-1R-binding fragments and derivatives thereof, each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publication;
Also among non-limiting examples of anti-IGF-1R antibodies for use in the methods and compositions of the present invention are each and all of those described in:
(i) U.S. Publication No. 2006/0040358 (published Feb. 23, 2006), 2005/0008642 (published Jan. 13, 2005), 2004/0228859 (published Nov. 18, 2004), including but not limited to, for instance, antibody 1A (DSMZ Deposit No. DSM ACC 2586), antibody 8 (DSMZ Deposit No. DSM ACC 2589), antibody 23 (DSMZ Deposit No. DSM ACC 2588) and antibody 18 as described therein;
(ii) PCT Publication No. WO 06/138729 (published Dec. 28, 2006) and WO 05/016970 (published Feb. 24, 2005), and Lu et al. (2004), J. Biol. Chem. 279:2856-2865, including but not limited to antibodies 2F8, A12, and IMC-A12 as described therein;
(iii) PCT Publication No. WO 07/012614 (published Feb. 1, 2007), WO 07/000328 (published Jan. 4, 2007), WO 06/013472 (published Feb. 9, 2006), WO 05/058967 (published Jun. 30, 2005), and WO 03/059951 (published Jul. 24, 2003);
(iv) U.S. Publication No. 2005/0084906 (published Apr. 21, 2005), including but not limited to antibody 7C10, chimaeric antibody C7C10, antibody h7C10, antibody 7H2M, chimaeric antibody *7C10, antibody GM 607, humanized antibody 7C10 version 1, humanized antibody 7C10 version 2, humanized antibody 7C10 version 3, and antibody 7H2HM, as described therein;
(v) U.S. Publication Nos. 2005/0249728 (published Nov. 10, 2005), 2005/0186203 (published Aug. 25, 2005), 2004/0265307 (published Dec. 30, 2004), and 2003/0235582 (published Dec. 25, 2003) and Maloney et al. (2003), Cancer Res. 63:5073-5083, including but not limited to antibody EM164, resurfaced EM164, humanized EM164, huEM164 v1.0, huEM164 v1.1, huEM164 v1.2, and huEM164 v1.3 as described therein;
(vi) U.S. Pat. No. 7,037,498 (issued May 2, 2006), U.S. Publication Nos. 2005/0244408 (published Nov. 30, 2005) and 2004/0086503 (published May 6, 2004), and Cohen, et al. (2005), Clinical Cancer Res. 11:2063-2073, e.g., antibody CP-751,871, including but not limited to each of the antibodies produced by the hybridomas having the ATCC accession numbers PTA-2792, PTA-2788, PTA-2790, PTA-2791, PTA-2789, PTA-2793, and antibodies 2.12.1, 2.13.2, 2.14.3, 3.1.1, 4.9.2, and 4.17.3, as described therein;
(vii) U.S. Publication Nos. 2005/0136063 (published Jun. 23, 2005) and 2004/0018191 (published Jan. 29, 2004), including but not limited to antibody 19D12 and an antibody comprising a heavy chain encoded by a polynucleotide in plasmid 15H12/19D12 HCA (γ4), deposited at the ATCC under number PTA-5214, and a light chain encoded by a polynucleotide in plasmid 15H12/19D12 LCF (K), deposited at the ATCC under number PTA-5220, as described therein; and
(viii) U.S. Publication No. 2004/0202655 (published Oct. 14, 2004), including but not limited to antibodies PINT-6A1, PINT-7A2, PINT-7A4, PINT-7A5, PINT-7A6, PINT-8A1, PINT-9A2, PINT-11A1, PINT-11A2, PINT-11A3, PINT-11A4, PINT-11A5, PINT-11A7, PINT-11A12, PINT-12A1, PINT-12A2, PINT-12A3, PINT-12A4, and PINT-12A5, as described therein; each and all of which are herein incorporated by reference in their entireties, particularly as to the aforementioned antibodies, peptibodies, and related proteins and the like that target IGF-1 receptors;
B-7 related protein 1 specific antibodies, peptibodies, related proteins and the like (“B7RP-1,” also is referred to in the literature as B7H2, ICOSL, B7h, and CD275), particularly B7RP-specific fully human monoclonal IgG2 antibodies, particularly fully human IgG2 monoclonal antibody that binds an epitope in the first immunoglobulin-like domain of B7RP-1, especially those that inhibit the interaction of B7RP-1 with its natural receptor, ICOS, on activated T cells in particular, especially, in all of the foregoing regards, those disclosed in U.S. Publication No. 2008/0166352 and PCT Publication No. WO 07/011941, which are incorporated herein by reference in their entireties as to such antibodies and related proteins, including but not limited to antibodies designated therein as follow: 16H (having light chain variable and heavy chain variable sequences SEQ ID NO:1 and SEQ ID NO:7 respectively therein); 5D (having light chain variable and heavy chain variable sequences SEQ ID NO:2 and SEQ ID NO:9 respectively therein); 2H (having light chain variable and heavy chain variable sequences SEQ ID NO:3 and SEQ ID NO:10 respectively therein); 43H (having light chain variable and heavy chain variable sequences SEQ ID NO:6 and SEQ ID NO:14 respectively therein); 41H (having light chain variable and heavy chain variable sequences SEQ ID NO:5 and SEQ ID NO:13 respectively therein); and 15H (having light chain variable and heavy chain variable sequences SEQ ID NO:4 and SEQ ID NO:12 respectively therein), each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publication;
IL-15 specific antibodies, peptibodies, and related proteins, and the like, such as, in particular, humanized monoclonal antibodies, particularly antibodies such as those disclosed in U.S. Publication Nos. 2003/0138421; 2003/023586; and 2004/0071702; and U.S. Pat. No. 7,153,507, each of which is incorporated herein by reference in its entirety as to IL-15 specific antibodies and related proteins, including peptibodies, including particularly, for instance, but not limited to, HuMax IL-15 antibodies and related proteins, such as, for instance, 146B7;
IFN gamma specific antibodies, peptibodies, and related proteins and the like, especially human IFN gamma specific antibodies, particularly fully human anti-IFN gamma antibodies, such as, for instance, those described in U.S. Publication No. 2005/0004353, which is incorporated herein by reference in its entirety as to IFN gamma specific antibodies, particularly, for example, the antibodies therein designated 1118; 1118*; 1119; 1121; and 1121*. The entire sequences of the heavy and light chains of each of these antibodies, as well as the sequences of their heavy and light chain variable regions and complementarity determining regions, are each individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publication and in Thakur et al. (1999), Mol. Immunol. 36:1107-1115. In addition, description of the properties of these antibodies provided in the foregoing publication is also incorporated by reference herein in its entirety. Specific antibodies include those having the heavy chain of SEQ ID NO:17 and the light chain of SEQ ID NO:18; those having the heavy chain variable region of SEQ ID NO:6 and the light chain variable region of SEQ ID NO:8; those having the heavy chain of SEQ ID NO:19 and the light chain of SEQ ID NO:20; those having the heavy chain variable region of SEQ ID NO:10 and the light chain variable region of SEQ ID NO:12; those having the heavy chain of SEQ ID NO:32 and the light chain of SEQ ID NO:20; those having the heavy chain variable region of SEQ ID NO:30 and the light chain variable region of SEQ ID NO:12; those having the heavy chain sequence of SEQ ID NO:21 and the light chain sequence of SEQ ID NO:22; those having the heavy chain variable region of SEQ ID NO:14 and the light chain variable region of SEQ ID NO:16; those having the heavy chain of SEQ ID NO:21 and the light chain of SEQ ID NO:33; and those having the heavy chain variable region of SEQ ID NO:14 and the light chain variable region of SEQ ID NO:31, as disclosed in the foregoing publication. A specific antibody contemplated is antibody 1119 as disclosed in the foregoing U.S. publication and having a complete heavy chain of SEQ ID NO:17 as disclosed therein and having a complete light chain of SEQ ID NO:18 as disclosed therein;
TALL-1 specific antibodies, peptibodies, and the related proteins, and the like, and other TALL specific binding proteins, such as those described in U.S. Publication Nos. 2003/0195156 and 2006/0135431, each of which is incorporated herein by reference in its entirety as to TALL-1 binding proteins, particularly the molecules of Tables 4 and 5B, each of which is individually and specifically incorporated by reference herein in its entirety fully as disclosed in the foregoing publications;
Parathyroid hormone (“PTH”) specific antibodies, peptibodies, and related proteins, and the like, such as those described in U.S. Pat. No. 6,756,480, which is incorporated herein by reference in its entirety, particularly in parts pertinent to proteins that bind PTH;
Thrombopoietin receptor (“TPO-R”) specific antibodies, peptibodies, and related proteins, and the like, such as those described in U.S. Pat. No. 6,835,809, which is herein incorporated by reference in its entirety, particularly in parts pertinent to proteins that bind TPO-R;
Hepatocyte growth factor (“HGF”) specific antibodies, peptibodies, and related proteins, and the like, including those that target the HGF/SF:cMet axis (HGF/SF:c-Met), such as the fully human monoclonal antibodies that neutralize hepatocyte growth factor/scatter (HGF/SF) described in U.S. Publication No. 2005/0118643 and PCT Publication No. WO 2005/017107, huL2G7 described in U.S. Pat. No. 7,220,410 and OA-5d5 described in U.S. Pat. Nos. 5,686,292 and 6,468,529 and in PCT Publication No. WO 96/38557, each of which is incorporated herein by reference in its entirety, particularly in parts pertinent to proteins that bind HGF;
TRAIL-R2 specific antibodies, peptibodies, related proteins and the like, such as those described in U.S. Pat. No. 7,521,048, which is herein incorporated by reference in its entirety, particularly in parts pertinent to proteins that bind TRAIL-R2;
Activin A specific antibodies, peptibodies, related proteins, and the like, including but not limited to those described in U.S. Publication No. 2009/0234106, which is herein incorporated by reference in its entirety, particularly in parts pertinent to proteins that bind Activin A;
TGF-beta specific antibodies, peptibodies, related proteins, and the like, including but not limited to those described in U.S. Pat. No. 6,803,453 and U.S. Publication No. 2007/0110747, each of which is herein incorporated by reference in its entirety, particularly in parts pertinent to proteins that bind TGF-beta;
Amyloid-beta protein specific antibodies, peptibodies, related proteins, and the like, including but not limited to those described in PCT Publication No. WO 2006/081171, which is herein incorporated by reference in its entirety, particularly in parts pertinent to proteins that bind amyloid-beta proteins. One antibody contemplated is an antibody having a heavy chain variable region comprising SEQ ID NO:8 and a light chain variable region having SEQ ID NO:6 as disclosed in the foregoing publication;
c-Kit specific antibodies, peptibodies, related proteins, and the like, including but not limited to those described in U.S. Publication No. 2007/0253951, which is incorporated herein by reference in its entirety, particularly in parts pertinent to proteins that bind c-Kit and/or other stem cell factor receptors;
OX40L specific antibodies, peptibodies, related proteins, and the like, including but not limited to those described in U.S. Publication No. 2006/0002929, which is incorporated herein by reference in its entirety, particularly in parts pertinent to proteins that bind OX40L and/or other ligands of the OX40 receptor; and
Other exemplary proteins, including Activase® (alteplase, tPA); Aranesp® (darbepoetin alfa); Epogen® (epoetin alfa, or erythropoietin); GLP-1, Avonex® (interferon beta-1a); Bexxar® (tositumomab, anti-CD22 monoclonal antibody); Betaseron® (interferon-beta); Campath® (alemtuzumab, anti-CD52 monoclonal antibody); Dynepo® (epoetin delta); Velcade® (bortezomib); MLN0002 (anti-α4B7 mAb); MLN1202 (anti-CCR2 chemokine receptor mAb); Enbrel® (etanercept, TNF-receptor/Fc fusion protein, TNF blocker); Eprex® (epoetin alfa); Erbitux® (cetuximab, anti-EGFR/HER1/c-ErbB-1); Genotropin® (somatropin, Human Growth Hormone); Herceptin® (trastuzumab, anti-HER2/neu (erbB2) receptor mAb); Humatrope® (somatropin, Human Growth Hormone); Humira® (adalimumab); insulin in solution; Infergen® (interferon alfacon-1); Natrecor® (nesiritide; recombinant human B-type natriuretic peptide (hBNP); Kineret® (anakinra); Leukine® (sargamostim, rhuGM-CSF); LymphoCide® (epratuzumab, anti-CD22 mAb); BenlystaTM (lymphostat B, belimumab, anti-BlyS mAb); Metalyse® (tenecteplase, t-PA analog); Mircera® (methoxy polyethylene glycol-epoetin beta); Mylotarg® (gemtuzumab ozogamicin); Raptiva® (efalizumab); Cimzia® (certolizumab pegol, CDP 870); SolirisTM (eculizumab); pexelizumab (anti-C5 complement); Numax® (MEDI-524); Lucentis® (ranibizumab); Panorex® (17-1A, edrecolomab); Trabio® (lerdelimumab); TheraCim hR3 (nimotuzumab); Omnitarg (pertuzumab, 2C4); Osidem® (IDM-1); OvaRex® (B43.13); Nuvion® (visilizumab); cantuzumab mertansine (huC242-DM1); NeoRecormon® (epoetin beta); Neumega® (oprelvekin, human interleukin-11); Neulasta® (pegylated filgastrim, pegylated G-CSF, pegylated hu-Met-G-CSF); Neupogen® (filgrastim, G-CSF, hu-MetG-CSF); Orthoclone OKT3® (muromonab-CD3, anti-CD3 monoclonal antibody); Procrit® (epoetin alfa); Remicade® (infliximab, anti-TNFα monoclonal antibody); Reopro® (abciximab, anti-GP IIb/IIIa receptor monoclonal antibody); Actemra® (anti-IL6 Receptor mAb); Avastin® (bevacizumab), HuMax-CD4 (zanolimumab); Rituxan® (rituximab, anti-CD20 mAb); Tarceva® (erlotinib); Roferon-A®-(interferon alfa-2a); Simulect® (basiliximab); Prexige® (lumiracoxib); Synagis® (palivizumab); 146B7-CHO (anti-IL15 antibody, see U.S. Pat. No. 7,153,507); Tysabri® (natalizumab, anti-α4integrin mAb); Valortim® (MDX-1303, anti-B. anthracis protective antigen mAb); ABthraxTM; Vectibix® (panitumumab); Xolair® (omalizumab); ETI211 (anti-MRSA mAb); IL-1 trap (the Fc portion of human IgG1 and the extracellular domains of both IL-1 receptor components (the Type I receptor and receptor accessory protein)); VEGF trap (Ig domains of VEGFR1 fused to IgG Fc); Zenapax® (daclizumab); Zenapax® (daclizumab, anti-IL-2Rα mAb); Zevalin® (ibritumomab tiuxetan); Zetia® (ezetimibe); Orencia® (atacicept, TACI-Ig); anti-CD80 monoclonal antibody (galiximab); anti-CD23 mAb (lumiliximab); BR2-Fc (huBR3/huFc fusion protein, soluble BAFF antagonist); CNTO 148 (golimumab, anti-TNFα mAb); HGS-ETR1 (mapatumumab; human anti-TRAIL Receptor-1 mAb); HuMax-CD20 (ocrelizumab, anti-CD20 human mAb); HuMax-EGFR (zalutumumab); M200 (volociximab, anti-α5β1 integrin mAb); MDX-010 (ipilimumab, anti-CTLA-4 mAb and VEGFR-1 (IMC-18F1); anti-BR3 mAb; anti-C. difficile Toxin A and Toxin B C mAbs MDX-066 (CDA-1) and MDX-1388); anti-CD22 dsFv-PE38 conjugates (CAT-3888 and CAT-8015); anti-CD25 mAb (HuMax-TAC); anti-CD3 mAb (NI-0401); adecatumumab; anti-CD30 mAb (MDX-060); MDX-1333 (anti-IFNAR); anti-CD38 mAb (HuMax CD38); anti-CD40L mAb; anti-Cripto mAb; anti-CTGF Idiopathic Pulmonary Fibrosis Phase I Fibrogen (FG-3019); anti-CTLA4 mAb; anti-eotaxinl mAb (CAT-213); anti-FGF8 mAb; anti-ganglioside GD2 mAb; anti-ganglioside GM2 mAb; anti-GDF-8 human mAb (MYO-029); anti-GM-CSF Receptor mAb (CAM-3001); anti-HepC mAb (HuMax HepC); anti-IFNα mAb (MEDI-545, MDX-1103); anti-IGF1R mAb; anti-IGF-1R mAb (HuMax-Inflam); anti-IL12 mAb (ABT-874); anti-IL12/IL23 mAb (CNTO 1275); anti-IL13 mAb (CAT-354); anti-IL2Ra mAb (HuMax-TAC); anti-IL5 Receptor mAb; anti-integrin receptors mAb (MDX-018, CNTO 95); anti-IP10 Ulcerative Colitis mAb (MDX-1100); anti-LLY antibody; BMS-66513; anti-Mannose Receptor/hCGβ mAb (MDX-1307); anti-mesothelin dsFv-PE38 conjugate (CAT-5001); anti-PD1mAb (MDX-1106 (ONO-4538)); anti-PDGFRa antibody (IMC-3G3); anti-TGFß mAb (GC-1008); anti-TRAIL Receptor-2 human mAb (HGS-ETR2); anti-TWEAK mAb; anti-VEGFR/Flt-1 mAb; anti-ZP3 mAb (HuMax-ZP3); NVS Antibody #1; and NVS Antibody #2.
Also included can be a sclerostin antibody, such as but not limited to romosozumab, blosozumab, or BPS 804 (Novartis). Further included can be therapeutics such as rilotumumab, bixalomer, trebananib, ganitumab, conatumumab, motesanib diphosphate, brodalumab, vidupiprant, panitumumab, denosumab, NPLATE, PROLIA, VECTIBIX or XGEVA. Additionally, included in the device can be a monoclonal antibody (IgG) that binds human Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9), e.g. U.S. Pat. No. 8,030,547, U.S. Publication No. 2013/0064825, WO2008/057457, WO2008/057458, WO2008/057459, WO2008/063382, WO2008/133647, WO2009/100297, WO2009/100318, WO2011/037791, WO2011/053759, WO2011/053783, WO2008/125623, WO2011/072263, WO2009/055783, WO2012/0544438, WO2010/029513, WO2011/111007, WO2010/077854, WO2012/088313, WO2012/101251, WO2012/101252, WO2012/101253, WO2012/109530, and WO2001/031007.
Also included can be talimogene laherparepvec or another oncolytic HSV for the treatment of melanoma or other cancers. Examples of oncolytic HSV include, but are not limited to talimogene laherparepvec (U.S. Pat. Nos. 7,223,593 and 7,537,924); OncoVEXGALV/CD (U.S. Pat. No. 7,981,669); OrienX010 (Lei et al. (2013), World J. Gastroenterol., 19:5138-5143); G207, 1716; NV1020; NV12023; NV1034 and NV1042 (Vargehes et al. (2002), Cancer Gene Ther., 9(12):967-978).
Also included are TIMPs. TIMPs are endogenous tissue inhibitors of metalloproteinases (TIMPs) and are important in many natural processes. TIMP-3 is expressed by various cells or and is present in the extracellular matrix; it inhibits all the major cartilage-degrading metalloproteases, and may play a role in role in many degradative diseases of connective tissue, including rheumatoid arthritis and osteoarthritis, as well as in cancer and cardiovascular conditions. The amino acid sequence of TIMP-3, and the nucleic acid sequence of a DNA that encodes TIMP-3, are disclosed in U.S. Pat. No. 6,562,596, issued May 13, 2003, the disclosure of which is incorporated by reference herein. Description of TIMP mutations can be found in U.S. Publication No. 2014/0274874 and PCT Publication No. WO 2014/152012.
Also included are antagonistic antibodies for human calcitonin gene-related peptide (CGRP) receptor and bispecific antibody molecule that target the CGRP receptor and other headache targets. Further information concerning these molecules can be found in PCT Application No. WO 2010/075238.
Additionally, a bispecific T cell engager antibody (BiTe), e.g. Blinotumomab can be used in the device. Alternatively, included can be an APJ large molecule agonist e.g., apelin or analogues thereof in the device. Information relating to such molecules can be found in PCT Publication No. WO 2014/099984.
In certain embodiments, the medicament comprises a therapeutically effective amount of an anti-thymic stromal lymphopoietin (TSLP) or TSLP receptor antibody. Examples of anti-TSLP antibodies that may be used in such embodiments include, but are not limited to, those described in U.S. Pat. Nos. 7,982,016, and 8,232,372, and U.S. Publication No. 2009/0186022. Examples of anti-TSLP receptor antibodies include, but are not limited to, those described in U.S. Pat. No. 8,101,182. In particularly preferred embodiments, the medicament comprises a therapeutically effective amount of the anti-TSLP antibody designated as A5 within U.S. Pat. No. 7,982,016.
It should be noted that the configurations of the various embodiments of the drug delivery devices and drug delivery systems described herein are illustrative only. Although only a few embodiments of the of the drug delivery devices and drug delivery systems have been described in detail in this disclosure, those skilled in the art who review this disclosure will readily appreciate that many modifications are possible (e.g., variations in sizes, dimensions, structures, shapes and proportions of the various elements, values of parameters, mounting arrangements, use of materials, orientations, etc.) without materially departing from the novel teachings and advantages of the subject matter of this disclosure. For example, any combination of one or more of the sensors and sensor systems described herein may be incorporated into one or more of the drug delivery systems and drug delivery devices described herein. Also, the order or sequence of any process or method steps described herein may be varied or re-sequenced, in any combination, according to alternative embodiments. Furthermore, any combination of one or more of the elements of one or more of the claims set forth at the end of this disclosure is possible.
Although the preceding text sets forth a detailed description of different embodiments of the invention, it should be understood that the legal scope of the invention is defined by the words of the claims set forth at the end of this patent. The detailed description is to be construed as exemplary only and does not describe every possible embodiment of the invention because describing every possible embodiment would be impractical, if not impossible. Numerous alternative embodiments could be implemented, using either current technology or technology developed after the filing date of this patent, that would still fall within the scope of the claims defining the invention.
It should also be understood that, unless a term is expressly defined in this patent using the sentence “As used herein, the term ‘——————’ is hereby defined to mean . . . ” or a similar sentence, there is no intent to limit the meaning of that term, either expressly or by implication, beyond its plain or ordinary meaning, and such term should not be interpreted to be limited in scope based on any statement made in any section of this patent (other than the language of the claims). To the extent that any term recited in the claims at the end of this patent is referred to in this patent in a manner consistent with a single meaning, that is done for sake of clarity only so as to not confuse the reader, and it is not intended that such claim term be limited, by implication or otherwise, to that single meaning. Finally, unless a claim element is defined by reciting the word “means” and a function without the recital of any structure, it is not intended that the scope of any claim element be interpreted based on the application of 35 U.S.C. § 112, sixth paragraph.

## Claims

1. A drug delivery device comprising:
a housing having an exterior surface;
an opening formed in the exterior surface of the housing;
a reservoir disposed at least partially within the housing;
a delivery member having a proximal end connected or configured to be connected in fluid communication with the reservoir and a distal end configured to extend through the opening in an operative state;
an adhesive disposed at the exterior surface of the housing for releasably attaching the drug delivery device to skin of a patient;
a removable cover coupled with the housing;
an electrical skin contact sensor disposed at the exterior surface of the housing; and
the drug delivery device being configured or programmed to:
(a) determine if the removable cover has been removed from the housing prior to or independent of use of the electrical skin contact sensor for sensing contact with the skin of the patient,
(b) alert the patient if or when the removable cover has been removed from the housing, and
(c) subsequent to (b), alert the patient if or when the drug delivery device has been triggered to deliver a drug to the patient.

2. The drug delivery device of claim 1, comprising a controller coupled to the electrical skin contact sensor.

3. The drug delivery device of claim 2, comprising a wireless transmitter coupled to the controller.

4. The drug delivery device of claim 3, the controller being configured to determine if the drug delivery device is in contact with the skin of the patient based on output from the electrical skin contact sensor and control the wireless transmitter to wirelessly transmit a report representative of contact between the drug delivery device and the skin of the patient.

5. The drug delivery device of claim 2, wherein the controller is programmed to repetitively determine at predefined time intervals if the drug delivery device is in contact with the patient.

6. The drug delivery device of claim 1, wherein the removable cover comprises a sheet covering the adhesive and configured for removal by the patient or a user to expose the adhesive.

7. The drug delivery device of claim 6, comprising a controller programmed to determine (a) if the adhesive has been exposed and (b) if the drug delivery device is in contact with skin of the patient and, if (b) does not occur within a predefined time period after (a), output a control signal to a controllable element.

8. The drug delivery device of claim 1, the electrical skin contact sensor comprising a first electrically conductive member.

9. The drug delivery device of claim 8, the electrical skin contact sensor comprising a second electrically conductive member.

10. The drug delivery device of claim 9, wherein the first electrically conductive member, the second electrically conductive member, and the skin of the patient form a closed electrical circuit when the housing is in contact with the skin of the patient.

11. The drug delivery device of claim 9, the opening being disposed between the first and second electrically conductive members.

12. The drug delivery device of claim 1, wherein the adhesive and the electrical skin contact sensor are integrally formed.

13. The drug delivery device of claim 1, wherein the drug delivery device is configured or programmed to alert the patient, via at least one light and/or at least one sound, if or when the removable cover has been removed from the housing.

14. The drug delivery device of claim 13, wherein the drug delivery device is configured or programmed to alert the patient, via at least one light and/or at least one sound, if or when the drug delivery device has been triggered to deliver a drug to the patient.

15. The drug delivery device of claim 1, wherein the drug delivery device is configured or programmed to alert the patient, via at least one light and/or at least one sound, if or when the drug delivery device has been triggered to deliver a drug to the patient.

16. The drug delivery device of claim 1, wherein the drug delivery device is configured or programmed to alert the patient if or when the drug delivery device has been triggered to deliver the drug to the patient distinctly or separately from alerting the patient if or when the removable cover has been removed from the housing.