Abstract:
The present invention relates to a cartridge for conducting diagnostic assays. The cartridge consists of an assembly of components that are easily assembled. The cartridge provides means for receiving a patient sample, precisely controlling fluid introduction, onboard storage of assay fluid and conducting different assay protocols and detection of a plurality of analytes. Methods of use for the cartridge are described. The disclosed invention is suitable for point of care environments or any place where rapid, ultrasensitive testing is required.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims priority from U.S. provisional application No. 61/511,514, filed on Jul. 25, 2011, and incorporated herein by reference in its entirety. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The present invention relates to the field of medical devices. Specifically, the invention relates to a cartridge for use in in vitro diagnostic applications with an emphasis on testing in point of care settings. Further, the cartridge is actuated by a reader module, which together can rapidly perform multiple diagnostics assays per patient sample. 
       BACKGROUND OF THE INVENTION 
       [0003]    In vitro diagnostics, the ability to measure and monitor various biological related markers from patient samples, has continued to gain prominence as a valuable input for physician decision making. The majority of clinical diagnostic tests are performed in a centralized lab located in a hospital or through an outside testing service. This procedure often delays results and adds significant costs to the healthcare system. In particular, for certain critical bio-markers there is a pressing need for quantification in the ultrasensitive regime, analyte concentrations in the femtomolar range and below, combined with short assay times so that medical intervention can take place more efficiently. 
         [0004]    Most large and expensive clinical laboratory machinery can fulfill the quantitation aspect of testing but cannot deliver attractive turnaround time, a portable format, and attractive economics. A small but capable system that could be operated by a skilled or unskilled user could drastically improve patient outcomes. 
         [0005]    Mentioned in the art are various point of care test systems incorporating a consumable that contains sensors of types including but not limited to: electrochemical, lateral flow, fluorescent, chemiluminescent, magnetic etc. However, there remains a latent need for a test system with a consumable cartridge that provides a platform for more robust and flexible testing. This type of cartridge format would provide fast assay times, performance that meets or exceeds laboratory instrumentation, ability to conduct multiple assays, ability to conduct multiple protocols, all constructed from components made of inexpensive materials. 
       SUMMARY OF THE INVENTION 
       [0006]    The present invention describes a cartridge and methods for using said cartridge in order to conduct multiple diagnostic assays from a single input sample and does so in fashion that overcomes the aforementioned limitations. 
         [0007]    In one aspect, there is a cartridge that consists of a fluidic assembly that is made up of a top part, a spacer, and a bottom part all bonded together. The top part and bottom part have a plurality of fluidic channels. The top part may have a sample entry point that is used to fill a sample chamber, a detection channel where the diagnostic assay takes place, at least one blister peck for on-board liquid storage, a reagent channel, a waste compartment, a bubble minimizing compartment, and/or inlet holes to facilitate air or liquid movement within said channels. The bottom part may contain various fluidic channels that link features on the top part. The spacer may provide a plurality of capillary stops and/or holes to connect bottom part channels to top part channels. In particular, the cartridge may provide for opposing fluid delivery pathways for the sample versus other assay reagents in terms of their arrival to the detection channel. By this means, there can be prevention of sample leaking back into the detection zone of the detection channel during subsequent assay steps. Key to this arrangement is the position of the sample chamber relative to the sensor region, providing that the entry point hole(s) for reagents into the detection channel is not in a pathway that can be touched by the sample fluid. All reagents and mechanisms can be self-contained, thereby providing no evident means for outside tampering, and thereby ensuring reliability and reproducibility of test results. 
         [0008]    In another aspect of the invention, there is provided a method for conducting a diagnostic assay. A biological sample is obtained from a patient. Then the sample chamber of the cartridge is filed with said sample. The cartridge is docked into a reader module that is capable of electro-mechanical functions. Through the application of pressure via pumps with venting valves to inlets on the cartridge assembly, the reader can push sample to the detection channel, oscillate said sample as to agitate any present assay chemistries, then mechanically and controllably burst a liquid-containing blister peck to fill a reagent channel, alternately push air and reagent liquid through the detection channel as to wash and/or initiate a detection reaction, and take measurements by interrogating the detection channel and store test data. Additionally or alternatively, the method may include actions that pull rather than push liquids to certain locations. The operating procedures would be characterized by all combinations of pulling or pushing actions. The method of the diagnostic assay is fully automated for the exception of the sample loading step. Therefore, the process saves time and effort on the part of the user and the precise liquid and air control provides greater accuracy and precision. 
         [0009]    In an embodiment of the invention, the detection method for conducting an assay may be selected from a group including but not limited to absorbance, chemiluminescense, fluorescence, and/or magnetic, but most preferably an electrochemical means. Therefore, the cartridge can be tailored to a detection mechanism that maximizes performance for a given assay. 
         [0010]    In a further embodiment of the invention, the cartridge can perform different assays from a group that includes but is not limited to immunoassays, molecular assays, electrolytes, chemistries, coagulation and/or hematology. The flexibility of the platform permits testing of various bio-markers across assay type. For a given patient, several markers of different types may need to be interrogated to provide critical information for the physician. 
         [0011]    In yet another embodiment of the invention, the electrochemical detection method relies on a plurality of screen printed sensors. An array may be made from a multi-step process of screen printing inks and drying them onto a flexible substrate. Additionally or alternatively, an array may be made by directly printing inks on the bottom part The sensor array may consist of, for example five electrodes: a reference electrode, two control electrodes, a working sensor electrode, and a conductimetric electrode. The presence of on-board test control electrodes improves the function of calibration. With negative and/or positive controls, the test cartridge would suffer less from time dependent inaccuracies related to factory-based lot-to-lot calibration. The conductimetric electrode provides a means for detecting presence of liquid and the ability to measure its conductivity that allows calculation of hemetocrit when the sample is blood. This value can lead to a more accurately calculated analyte concentration. Alternatively, the array of five electrodes may be: a reference electrode, three working sensor electrodes, and a conductimetric electrode. The ability to do diagnostic panels via the multiple sensor electrodes, where two or more distinct tests are within the channel, is greatly appreciated in the medical community as there may be several biological indicators that contribute to a diagnosis. 
         [0012]    In another embodiment of the invention, the cartridge contains a minimum of one blister peck capable of storing necessary liquids for diagnostic assays. The contents may consist of substrate reagent, washing solutions, buffer solutions and/or combinations thereof (collectively or individually “assay fluids”). The blister pack may be cylindrical in shape and may contain a deformable top layer that provides a cavity for liquid storage and a bottom layer that seals the liquid in. The bottom layer of the pack can be ruptured given the appropriate mechanical pressure from above and contact with a sharp feature that sits underneath. The blister provides hermetic storage and physical protection of the liquid components, minimizing degradation of the reagents, which can take place. 
         [0013]    In another embodiment, the reader module may contain at least one mechanical actuator to compress a blister pack at least to the point of rupture, thereby releasing its contents to a reagent storage channel. 
         [0014]    In another embodiment, the reader module may contain an actuator coupled to a diaphragm that provides controlled pressure to the air inlets by pressing and depressing a diaphragm bladder on the cartridge. 
         [0015]    In another embodiment of the invention, the sample chamber is designed with particular dimensions and shape to control the volume that is being inputted to a certain measurable amount. This aspect permits the user to input an unmeasured volume rather than pre-measuring a specific amount. The user can be relieved of such a task and the cartridge can accurately dispense the desired amount for a given assay procedure. 
         [0016]    In yet another embodiment, the sample chamber contains a means to separate plasma from other blood components before entering the detection channel, wherein the diagnostic assay is conducted on the plasma. The sample chamber may contain a filter to separate red blood cells and extract plasma through a time dependent wicking effect or the sample can be pushed through said filter with external pressure. Alternatively, there may be a second distinct part of the sample chamber that holds the resulting filtered sample before its release to the detection channel. The non-plasma blood components convolute the measurement accuracy of the analyte concentration. By removing such species, the test may encounter reduced signal interference from said constituents. 
         [0017]    In yet another embodiment, the cartridge may contain one way valves as to prevent back flow of various liquids that could disrupt assay performance. These valves would be present between the sample chamber and the detection channel; between the detection channel and reagent storage channel; and/or in an embodiment with two blisters, between the substrate blister pack with direct connection to the detection channel and the channel itself. 
         [0018]    In a specific embodiment, the electrochemical immunoassay, the cartridge contains screen printed sensors and other regions that are modified with antibody conjugates and certain liquid storage. Specifically, each working sensor electrode is amended with capture antibodies targeting a particular analyte and/or they are modified to serve as positive or negative sensor controls. Reporter antibodies, antibodies amended with enzymes, are dried and/or stabilized either within: an external sample transfer device, the sample chamber(s), channel that connects sample chamber to detection channel and/or within the detection channel region in proximity to the sensors or on the sensor strip itself. There may be two blister packs, one containing a wash solution and the other containing an electrochemical substrate. During operation, a user submits a biological sample to the sample chamber of cartridge and inserts said cartridge into a reader module. The sample is infiltrated with reporter antibodies and allowed to form antibody “sandwich” with the analyte(s) and the capture antibodies in the detection channel. After sandwich formation, the sensor region is evacuated of sample with air and liquid wash segments. A substrate fluid is passed over the sensor region and an electrochemical measurement is recorded. The user then may take the cartridge out of the reader and dispose of it. In this cartridge format, the user has a means for conducting lab quality assays that provide high performance, rapid assay time, and attractive economics due to the simplicity, reliability, and reproducibility of the cartridge construction and method of operation. 
         [0019]    In certain embodiments of the present invention, a cartridge for sensing at least one analyte comprises a detection channel having a first end and second end; at least one analyte sensor, wherein said analyte sensor comprises at least one sensor electrode and said sensor electrode is within said detection channel between the first end and the second end; a reagent channel, said reagent channel connected to said detection channel between the sensor electrode and the second end; a sample chamber, said sample chamber connected to said detection channel between the sensor electrode and the first end; and a waste compartment connected to said detection channel at the first end. 
         [0020]    In certain embodiments of the present invention, the cartridge further comprises a first inlet connected to the sample chamber, wherein pressure applied to said first inlet moves a sample contained in the sample chamber from the sample chamber to the detection channel. 
         [0021]    In certain embodiments of the present invention, the cartridge further comprises a second inlet connected to the detection channel at the second end, wherein pressure applied to said second inlet pushes at least one of the sample and an assay fluid from the detection channel to the waste compartment. 
         [0022]    In certain embodiments of the present invention, the sample or the assay fluid pushed from the detection channel to the waste compartment is substantially prevented from leaking back into the detection channel. 
         [0023]    In certain embodiments of the present invention, the cartridge further comprises at least one blister pack for on-board liquid storage; and a bubble trap connecting the blister pack to the reagent channel, wherein a liquid stored in the blister pack moves from the blister pack to the reagent channel through the bubble trap, and wherein the bubble trap traps air bubbles when the liquid moves through the bubble trap. 
         [0024]    In certain embodiments of the present invention, the assay fluid is at least one of a substrate reagent, a washing solution and a buffer solution. 
         [0025]    In certain embodiments of the present invention, the blister pack is not vacuum filed. 
         [0026]    In certain embodiments of the present invention, the analyte sensor comprises an array of electrodes. The electrodes may comprise at least two of a reference electrode, a working sensor electrode and a conductimetric electrode. The electrodes may comprise at least three of a reference electrode, a working sensor electrode, a counter electrode and a conductimetric electrode. 
         [0027]    In certain embodiments of the present invention, a cartridge for sensing at least one analyte comprises a detection channel having a first end and second end; at least one analyte sensor, wherein said analyte sensor comprises at least one sensor electrode and said sensor electrode is within said detection channel between the first end and the second end; a reagent channel, said reagent channel connected to said detection channel between the sensor electrode and the second end; a sample chamber, said sample chamber connected to said detection channel between the sensor electrode and the first end; a waste compartment connected to said detection channel at the first end; and an inlet connected to the detection channel at the second end, wherein pressure applied to said inlet pushes at least one of a sample and an assay fluid from the detection channel into the waste compartment. 
         [0028]    In certain embodiments of the present invention, pressure applied to the inlet may be positive pressure or negative pressure. 
         [0029]    In certain embodiments of the present invention, pressure applied to the inlet may be used to oscillate the assay fluid. 
         [0030]    In certain embodiments of the present invention, the analyte sensor comprises at least three of a reference electrode, a working sensor electrode, a counter electrode and a conductimetric electrode. 
         [0031]    In certain embodiments of the present invention, the cartridge further comprises at least one blister peck for on-board liquid storage; and a bubble trap connected to the blister pack and to the reagent channel, wherein the bubble trap traps air bubbles within assay fluid transferred from the blister pack through the bubble trap to the reagent channel. 
         [0032]    In certain embodiments of the present invention, a method for performing a diagnostic assay on a cartridge comprises inputting a sample into a sample chamber; applying pressure to a first inlet to move the sample from the sample chamber to a detection channel connected to the sample chamber, wherein the detection channel has a first end, a second end, and at least one sensor electrode between the first end and the second end, and wherein the sample chamber is connected to the detection channel between the sensor electrode and the first end; applying pressure to a second inlet to transfer the sample from the detection channel to a waste compartment connected to the detection channel at the first end, wherein the second inlet is connected to the detection channel at the second end; and applying pressure to a third inlet to transfer reagent liquid from a reagent channel to the detection channel, wherein the reagent channel is connected to the detection channel between the sensor electrode and the second end. 
         [0033]    In certain embodiments of the present invention, the method further comprises applying pressure to a blister peck to transfer assay fluid to the reagent channel; and trapping air bubbles from the assay fluid in a bubble trap connecting the blister pack to the reagent channel. 
         [0034]    In certain embodiments of the present invention, the method further comprises oscillating the assay fluid in the detection channel by applying pressure to at least one of the first inlet, the second inlet and the third inlet. 
         [0035]    In certain embodiments of the present invention, the sample transferred to the waste compartment is substantially prevented from leaking back into the detection channel. 
         [0036]    In certain embodiments of the present invention, the method further comprises contacting the sample with at least two of a reference electrode, a working sensor electrode and a conductimetric electrode in the detection channel. 
         [0037]    Other features and advantages of the invention will be apparent from the accompanying drawings and from the detailed description. One or more of the above-disclosed embodiments, in addition to certain alternatives, are provided in further detail below with reference to the attached figures. The invention is not limited to any particular embodiment disclosed; the present invention may be employed in not only sensor applications, but in other applications as well. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0038]    The invention is better understood from reading the following detailed description of the preferred embodiments, with reference to the accompanying figures in which: 
           [0039]      FIG. 1  is a schematic diagram depicting the top view of a fully assembled cartridge with dual blister packs. 
           [0040]      FIG. 2  is a schematic diagram depicting the top view of a fully assembled cartridge with a single blister pack. 
           [0041]      FIG. 3  is an exploded view of the cartridge showing the major components: blister pack, top pert, spacer, sensor array, bottom part. 
           [0042]      FIG. 4A-D  is schematic of a screen printed electrode sensor array and its fabrication process. 
           [0043]      FIG. 5  is a schematic diagram of the top view of the top part for the cartridge. 
           [0044]      FIG. 6  is a schematic diagram of the top view of the spacer for the cartridge. 
           [0045]      FIG. 7  is a schematic diagram of the top view of the bottom part for the cartridge. 
           [0046]      FIG. 8  is a functional diagram of electro-mechanical elements engaged with the cartridge. 
           [0047]      FIG. 9  is a data plot showing the response of the cartridge that performs an electrochemical immunoassay for Troponin I at various concentrations. 
       
    
    
       [0048]    Features, elements, and aspects of the invention that are referenced by the same numerals in different figures represent the same, equivalent, or similar features, elements, or aspects in accordance with one or more embodiments of the system. Those of ordinary skill in the art will appreciate that features, elements and aspects of the invention depicted in the figures in a similar or Identical manner may be similar or identical, even if, for example, a plurality of such features, elements and aspects are not individually labeled. 
       DETAILED DESCRIPTION OF THE EMBODIMENTS 
       [0049]    A description of the present invention along with detail for methods of operation and an example of its use is provided. The invention primarily comprises a cartridge for conducting diagnostic assays. Referring to  FIG. 1 , a cartridge consists of several components assembled together with on-board liquid storage in the form of two blister packs. One blister pack may contain washing fluid and another may contain substrate reagents. Alternatively, referring to  FIG. 2 , a cartridge can consist of those same components but with a single blister pack for on-board liquid storage. For this configuration, the substrate solution also serves as a washing agent. For the purposes of description, herein we will detail the dual blister pack cartridge. 
         [0050]    Cartridge Assembly and Components 
         [0051]    Referring to  FIG. 1 , in accordance with an experimental embodiment of the present invention, the fully assembled dual blister pack cartridge can be constructed as follows. Referring to  FIG. 3 , a sensor array  16  is placed in the inset  100  of a bottom part  14  and lined up in a rig using alignment holes  28 C. This substructure is combined and secured with a thin film spacer  12  that can be bonded or adhered to the bottom part using alignment holes  28 B,  28 C,  38 B and  38 C. The spacer contains a cut-out  56  to leave the sensor array exposed. Next, a top part  10  can be bonded and/or adhered to the top side of the spacer  12  using alignment holes  28 A,B and  38 A,B. Blister packs  18 A and  18 B containing sealed liquid may be affixed to a recess  42  in the top part by a ring shape adhesive film (not shown). A sample lid  20 , may be placed over the sample recess  22  to seal the sample chamber  26 . 
         [0052]    Referring to  FIG. 3 , the blister pack  18 A,B consists of a flat-top cylindrical shape that may be made from a cold formable material whereby a molded, defined shape is pressed upon the cold formable film as to take on the design of the mold. The cold formable material may be an aluminum foil that is laminated on either side by a thin polymeric film. The cavity that results is filed with liquid reagent solutions needed for conducting an assay. In the description, blister  18 A contains a wash solution and blister  18 B contains a substrate solution. The cavity can provide 50 uL to 3 mL of volume and the blister can be under-filled or altered in its dimensions as to adjust the volume capacity. Blister  18 A is filled to less or equal the volume of the reagent channel  46 . Blister  18 B is filled to excess of the volume of the detection channel. Once the cavity is filed, it can be hermetically sealed with by placing a thin layer of material on top of the cavity and applying pressure and/or heat. The sealing material may an aluminum film whereby the sealed side is coated with a glue-like lacquer that activates upon pressure and/or heat. The other side may have a protective lacquer that is not disrupted by heat. The use of aluminum provides ultra low vapor transmission so that no liquid escapes or enters once sealed. 
         [0053]    Referring to  FIG. 4A-D , an electrochemical sensor array  16  can be fabricated for use as the means of detection for the cartridge. The following refers to an array containing five electrodes but the arrangement may be altered to increase or decrease the number of electrodes, as well as to alter the composition and type of electrodes. For example, instead of using only one reference electrode as a mean to set solution potential, a pair of counter and reference electrodes can be used for more accurate liquid potential control. Those of ordinary skill in the art will appreciate the different formats for various electrode arrangements. 
         [0054]    Referring to  FIG. 4A , the sensor array may be fabricated by first screen-printing silver ink contact traces  202  on a plastic flexible substrate  200  and/or directly onto the bottom part  14 . 
         [0055]    Referring to  FIG. 4B , silver/silver chloride (Ag/AgCl) inks may then be screen-printed to form a reference electrode  204 . 
         [0056]    Referring to  FIG. 4C , carbon inks (e.g., proprietary inks) may then be screen-printed to form four electrodes  206 ,  208 ,  210 ,  212  that may be used as working electrodes, sensor electrodes, or conductimetric electrodes. 
         [0057]    Referring to  FIG. 4D , a dielectric insulation layer  214  may then be screen-printed, for example, to cover portions of the silver traces and expose certain regions of the carbon electrodes and reference electrode. This coverage permits the array to be exposed to liquid immersions as when conducting a diagnostic assay. The result is a printed sheet containing a plurality of electrodes that may be utilized for electrochemical sensing. 
         [0058]    For example, in an electrochemical immunoassay, electrodes  208 ,  210 ,  212  may be used respectively as positive control, negative control, and sensor. Electrode  206  would act as conductimetric sensor. Biological molecules are coated onto such electrodes in a controllable fashion by a liquid dispenser. For the positive control, a known quantity of target analyte, or reporter antibody, or anti-reporter antibody that captures constituents of reporter antibodies is affixed and saturated to the surface. For the negative control, antibodies that are not specific to the analyte or other inert moieties are affixed to the surface as to prevent any target analyte binding. Finally, the capture antibodies specific to the target analyst are affixed to the sensor electrode surface. Corresponding reporter antibodies would be introduced in another part of the cartridge. 
         [0059]    Alternatively, the array can be used for simultaneously conducting multiple assays. In this arrangement, two or more of the electrodes  206 ,  208 ,  210 ,  212  would each be modified with capture antibodies for a specific analyte. Electrodes not modified as sensors may be modified as negative or positive controls. Corresponding reporter antibodies to the specific analytes would be introduced in another pert of the cartridge. 
         [0060]    This inclusion of test control electrodes provides on-board calibration by normalizing the signal from controls to the active sensor&#39;s signal. Otherwise, shelf-life dependent calibration codes would have to be implemented on the cartridge. For example, such calibration codes may be printed directly on a label or as a bar code on a label that is stuck on the cartridge. 
         [0061]    Referring to  FIG. 5 , top part  10  contains many features for conducting a diagnostic assay. These features are produced by injection molding of plastic to form channels, contours, holes, and other 3D shapes. The channel surfaces may include irregularities (e.g., structural), for example within the reagent channel  46 , in order to facilitate mixing. For the purposes of diagnostic assays, the plastic chosen should be compatible with biological molecules and detection chemistries and have good moisture barrier properties. The plastic may be chosen from a group including but not limited to polystyrene, polycarbonate, and/or polypropylene. The plastic may be coated with chemistries or exposed to plasma in order to make it hydrophobic or hydrophilic in certain regions. The sample chamber  26 , channel  104 , sensor strip  16  and detection channel  48  may have assay conjugates dried in their regions. Additionally, the conjugates may be amended by stabilizer. For example, an assay conjugate for an electrochemical immunoassay would be reporter antibodies, antibodies amended with an enzyme that produces an electroactive product. The reagent channel  46  and/or channel  112  may have dried chemical species (e.g., substrate) that mix with liquid upon its introduction from the blister pack  18 A due to the nature of the channel. 
         [0062]    Referring to  FIG. 6 , the spacer  12  contains several cut-outs and holes. The material may be a flexible plastic film that is coated on both sides by pressure sensitive adhesive, thereby providing a sealing function. The cut-out and holes can be made by laser cutting. The holes may act as capillary stops to provide resistance to liquid flow until a certain pressure is applied. The dimensions of the holes may be tailored to specify these effects. 
         [0063]    Referring to  FIG. 7 , the bottom part  14  contains various fluidic channels and can be made from, for example, various plastics similar to the top pert  10 . In any case, the material may be fairly flexible to ensure an appropriate seal when combined with the other components. 
         [0064]    Referring to  FIGS. 1-7 , there are features present that can contribute to fluid control and manipulation by way of combining elements within the top part, spacer, and/or bottom part. Generally, this is performed by external pumps with vents that access inlets  30 ,  32 ,  34 , and  36 , use paths governed by holes acting as capillary stops in the spacer combined with channels contained within the top part and bottom pert. Alternatively, the application of pressure at the Inlets may be done by an external diaphragm displaced by an actuator. Alternatively, one-way valves may be introduced in certain locations to prevent back flow contamination. The valves may be placed in channels  104 ,  108 , and  122  of the bottom part. 
         [0065]    The top part  10  contains a sample chamber  26  with sample inlet  24  that provides an opening for depositing a biological sample via a sample transfer device. A sample transfer device may include a volumetric pipette, a but pipette, a syringe or other device for holding and depositing fluid. A recess  22  is positioned around the perimeter of the Inlet  24  such that a lid  20  can be affixed on top as to close the sample chamber. The lid can be a removable plastic piece that can be coated with a weak adhesive. Additionally or alternatively, the lid can be incorporated within the top part during plastic molding in the format of a living hinge (not shown). A plastic ribbon would connect top part to the lid and a user may fold over the ribbon to cover or plug the sample inlet  24  with the lid portion. 
         [0066]    The sample chamber  26  is a domain that may be defined to be a particular volume ranging from 5-500 uL. The sample chamber may contain a filter in its bottom to extract plasma from an input sample of whole blood. The filtration may act by wicking the blood over time or the liquid is forced through the filter by external pressure. 
         [0067]    To move sample from the chamber to the detection channel, pressure can be applied by an external pump to inlet  30 , which follows the path from holes  58 ,  60  via channel  102 . The liquid then travel from holes  62 ,  64  via channel  104  and enters the detection channel  48 . In a possible method, the sample is detected by a conductimetric electrode at position  206  and the displacement is stopped with the sample fully covering the sensor array  16 . 
         [0068]    From inlet  32 , the sample in the detection channel  48  can be oscillated by applying pressure from holes  66 ,  68  via channel  106 . The oscillation can be performed by an external pump and can displace air at varying frequencies for a specified duration. Additionally, pressure through inlet  32  from holes  66 ,  68  via channel  106  can force sample from the detection channel  48  to the waste compartment  54  from hole  94  to cutout  96  via channel  120 . For this defined pathway, air segments of known volume may also be generated and pass through after liquid has been removed. Alternatively, a dedicated air inlet may be introduced next to inlet  32  (not shown) that would serve the air oscillator function exclusively. In this manner, the dead volume from a shared inlet would be minimized. 
         [0069]    For blister packs  18 A,  18 B, an external mechanical actuator applies downward pressure to the top of the individual pecks until compressed. For example, this may be a pneumatic or hydraulic piston. The blisters sit in recess  42  and a sharp molded feature  44  punctures the bottom of the blister upon this external pressure. The liquid from the blister is then forced through an opening  40 . 
         [0070]    For blister pack  18 A, the wash liquid that enters opening  40  may be moved from holes  88 ,  86  through channel  114  arriving at bubble trap  52  and then continue from hole  84 ,  82  via channel  110  and fills the reagent channel  46 . The bubble trap is an oblong domain that is meant to trap any air bubbles that form within the liquid released from said blister from either dead volume within the blister or bubbles generated from piercing of the bottom blister layer. The trap can minimize bubbles from entering the detection region and prevent fouling of the assay process. Inclusion of the bubble trap can obviate the need to vacuum fill the blister(s). 
         [0071]    During compression of blister pack  18 B, the substrate liquid is moved from holes  80 ,  78  through channel  112  to enter bubble trap  50  and continues flowing by exiting from hole  72 ,  70  via channel  108  and fills the detection channel  48 . 
         [0072]    Referring to  FIG. 2 , a cartridge with a single blister pack would follow the same path for blister pack  18 A. In this configuration, the wash and substrate solution are stored as one mixed liquid and released from the blister into the reagent channel. 
         [0073]    Regardless of dual or single blister packs, once the reagent channel  46  is filled, this fluid can be pushed in controlled segment volumes, that is, a portion of the total volume in the reagent channel is released at a given flow rate and the process repeated. The force is provided by applying pressure to inlet  34  from holes  98 ,  100  via channel  118 . The liquid residing in the reagent channel moves from holes  76 ,  74  through channel  122  to get to the detection channel  48 . The liquid that is passed over this area may be used to periodically wash the sensor array and/or introduce substrate reactant to yield an electroactive product for detection. Ultimately, all liquid ends up in the waste compartment  54  through the channel pathway that was stated for the sample flush. 
         [0074]    The waste compartment  54  is a domain that can hold, for example, 100-6000 uL of liquid. The compartment contains an absorbent pad (not shown) that is cut to match the dimensions of the compartment. The pad soaks up the different assay liquid components and substantially prevents the fluids from leaking back into the detection channel. Absorbent materials such as cellulose fibers, hydrophilic-modified olefin fibers, and/or super absorbent polymers may be used to form such pad. Air inlet  36  has access to the waste compartment via channel  116  through holes  90 ,  92 . The purpose of this inlet is to permit venting of the compartment during certain operations. An external valve can administer this action by connection to inlet  36 . In other operating modes, this inlet can be used to apply negative pressure, so fluid is pulled from the detection channel  48  to the waste compartment  54 . 
         [0075]    Operation Modes of the Cartridge 
         [0076]    Generally, for a mode of operation, the cartridge is manipulated by a corresponding reader module. Referring to  FIG. 8 , the reader according to an embodiment of the present invention contains vent valves  312 ,  314 ,  316 , and  318  and/or pumps  306 ,  308 , and  310  that access the cartridge through inlets  30 ,  32 ,  34 ,  36 . Herein the valve or pump that addresses a particular inlet will be denoted. The open/close valves may be of pinch or diaphragm types or other variety. The pump may be a syringe pump, solenoid pump, diaphragm pump, piezoelectric pump or other variety. 
         [0077]    At the onset, all four valves  312 ,  314 ,  316  and  318  are opened. The sample pump  306  has approximately 1 mL of air. The air pump  308  and the reagent pump  310  each have approximately 3 mL of air. 
         [0078]    A cartridge is loaded with sample and engaged with the reader. The loaded sample may be of volume 50-500 uL (preferably 30-100 uL). There is an initial setup routine to make sure that the cartridge aligns with fixtures and that the cartridge&#39;s contact pads are registered with an electrical connector. The pumps  306 ,  308 , and  310  are connected to their corresponding inlets with tubing with inner diameter 1/32″- 1/16″ and a fitting compliant with the Inlet opening. The tubing may be flexible plastic or rubber. 
         [0079]    For sample movement from the sample chamber  26  to the detection channel  48 , valve  314  is opened and valves  312 ,  316 , and  318  are closed. Pump  306  pushes air at a rate of 1-100 uL/s and that drives the sample. Simultaneously, the electrical conductivity between reference electrode  204  and conductimetric electrode  206  is recorded. When conductivity is measured over a particular threshold value, pump  306  pushes an additional volume of 0-50 uL, preferably 20 uL until stopping. If the sample is blood, then a calculation of hematocrit is made from the conductivity measurement. 
         [0080]    In the next step, valves  312 ,  314 ,  316 , and  318  are dosed or alternatively valve  318  is opened and valves  312 ,  314 , and  316  are closed. An air oscillator  300 , a separate pump that is capable of displacing air in the range of 1-200 uL, preferably 25-50 uL, is switched on for 2-30 minutes or preferably 8-12 minutes. The oscillator has access to inlet  32  but is not managed by valve  314 . The frequency range is 0.1-1000 Hz, preferably 2-20 Hz. Diaphragm or piezoelectric pumps can be used for oscillation. The oscillation facilitates the assay chemistry. After the oscillations are completed, valve  318  is opened and valves  312 ,  314 , and  316  are closed. Then pump  308  introduces 300 uL of air at a rate of 100 uL/s. By doing so, nearly the entire sample is sent to waste compartment  54 . 
         [0081]    After this, valve  316  is opened and valves  312 ,  314 , and  318  are closed. An actuator  304 , either a hydraulic or pneumatic piston compresses blister pack  18 A and fills the reagent channel  46 . The compression may be controlled by monitoring the pressure reached in the hydraulic or pneumatic system. 
         [0082]    For the washing procedure, valves  312 ,  314 , and  316  are closed and valve  318  is opened. Pump  310  introduces 100-1000 uL of air at rate of 50-500, uL/s, preferably 500 uL at 300 uL/s. As a result, a portion of the liquid in the reagent channel  46  is delivered to the detection channel  48 . Then after waiting 0-10 seconds, preferably 5 seconds, pump  308  introduces 10-500 uL of air at a rate of 5-500 uL/s, or preferably 200 uL at 25 uL/s. This flushes the reagent out of the detection channel  48  to the waste compartment  54 . These steps are then repeated 2-10 times, preferably 5 times, in order to introduce alternating liquid and air segments to the detection channel. 
         [0083]    The measurement is done by first compressing the blister pack  188  by an actuator  302  similar to the one that addresses blister pack  18 A. The substrate fluid fills the detection channel  48 . The reader records the electrochemical signal, for example amperometrically, for a predetermined time 1-100 seconds, preferably 30 seconds. Using an internal algorithm, the signal is processed to report an analyte concentration. 
         [0084]    After the measurement, all valves are opened, the actuators are withdrawn and all pumps are reset to the start configuration. The cartridge now can be removed from the reader and discarded. The total operation time per assay (assay turnaround time) can be less than 15 minutes. 
         [0085]    Alternatively, the operation described can be used for a single blister pack cartridge as in  FIG. 2  with limited alteration to the protocol. In this case, the content of the blister is a combined wash/substrate solution. For this procedure, the blister  18 A is applied for both the washing procedure and measurement steps according to nearly the same parameters specified for the dual reagent cartridge. This blister&#39;s solution fills the reagent channel  46  and is addressed by valve  316  and pump  310 . Therefore, during the washing step where liquid and air segment are alternated in the detection channel  48 , there is now a final liquid introduction where the solution is kept in the detection channel. At this point, the solution is allowed to initiate the electrochemical reaction and a measurement is carried out similar to the dual reagent procedure. 
         [0086]    The aforementioned operation modes are characterized by a so-called “push” format because of positive air pressure that is used to “push” actions to the inlets. Alternatively, the procedure may apply negative air pressure and “pull” fluid through the same mechanisms of pumps and valves. Those of ordinary skill in the art will appreciate the different formats for conducting additional yet functionally equivalent procedures that employ combinations of pulling or pushing through the cartridge inlets. 
         [0087]    Example of Diagnostic Assay—Troponin I 
         [0088]    Troponin I is a specific marker for the degradation of heart tissue. Therefore, quantitative measurement of cardiac Troponin I is used to aid in the diagnosis of acute myocardial infarction (AMI) or heart attack. Because of the time sensitive and critical nature of AMI, it is important to have highly accurate and precise readings, especially for ultra low concentrations of Troponin I, such as those less than 20 pg/mL. The following example is put forth so as to provide disclosure of how to construct and use the diagnostic cartridge for an electrochemical immunoassay for the analyte, Troponin I. This example is intended as a nonlimiting example of the invention. 
         [0089]    The sensor array  16  is prepared to provide conductivity sensor, positive control, troponin sensor, and negative control as  206 ,  208 ,  210 , and  212 , respectively. Blocking solution alone or blocking and nonspecific antibodies are deposited onto electrode  206 . A saturated known quantity of reporter antibody, anti-troponin I amended with enzyme label, is deposited and affixed in place on electrode  208 . Capture antibodies, anti-troponin I, is deposited onto electrode  210 . Antibodies not specific to troponin I, anti-prostate specific antigen, is deposited into place on electrode  212 . After each deposition, a solution that can contain bovine serum albumin (BSA), casein, fish serum, human serum, trehalose, sucrose and detergents like Tween20 may be applied to block any open attachment sites on the electrode surface. 
         [0090]    An excess of assay conjugate, reporter antibody, can be deposited and dried in the sample chamber  26  and/or the detection channel  48 . The reporter antibody is anti-troponin I amended with an enzyme. The deposited area may be further coated with saccharides like trehalose and sucrose or stabilizer solution to preserve the antibody integrity. Depending on the electrochemical scheme, the enzyme can be horse radish peroxidase (HRP), alkaline phosphatase (ALP), or others. For HRP, the corresponding substrates may be OPD, TMB, and ABTS. For ALP, the corresponding substrates may be PAPP, BCIP/NBT, and 1-Naphthyl phosphate. For example, an HRP enzyme with a TMB solution may be used. 
         [0091]    The blister packs  18 A,  18 B are filled with a wash and substrate solution, respectively. The wash solution may be a PBS buffer solution with 0.05% Tween20 (PBST). The substrate solution may be TMB solvated in buffer solution. 
         [0092]    To conduct an assay, a sample is deposited into the sample chamber and inserted into a reader module. The sample is moved to the detection channel. Next, the sample is oscillated within the chamber to reconstitute any dried reporter antibodies and accelerate antibody sandwich formation. Thereby, troponin binds to the capture antibodies and the reporter antibodies bind to the troponin. Once the sandwich complex is formed, the sample is evacuated to waste by an air segment. A small volume of wash solution is passed through the detection channel to remove unbound biological species such as reporters and other non-troponin sample constituents. Alternating air and wash liquid segments are employed to perform a rigorous wash and minimize non-specific binding. Finally, the substrate solution is released into the detection channel. The HRP enzyme of the reporter antibody reacts with TMB component in the substrate. The product of such an enzymatic reaction can be detected amperometrically or through other electrochemical methods by the electronic reader. The measured signal can be processed by the reader to output a troponin concentration reading. 
         [0093]    Referring to  FIG. 9 , such a cartridge can be prepared and tested with known concentrations of Troponin I in various sample matrices, whole blood, plasma, or buffer solution. The data plot shows the sensor response in whole blood and demonstrates the cartridge&#39;s ability to provide high performance over a low troponin concentration range. The concentration curve shows linear behavior and can be calibrated with such a function. One can calculate the limit of detection to be approximately 3 pg/mL using a standard procedure, thereby classifying the assay as ultrasensitive. In addition, the coefficient of variation (CV) for measurements of across low concentrations is approximately 7%. The CV is an indicator of precision and a value less than 20% at low concentrations indicates high capability for use in diagnosis of cardiac-related events.