Patent Publication Number: US-6983501-B2

Title: Ob/Gyn stretcher

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
   This application is a division of U.S. Ser. No. 10/090,723, filed Mar. 4, 2002, now U.S. Pat. No. 6,618,882 U.S. Ser. No. 10/090,723 is itself a division of U.S. Ser. No. 09/780,803, filed Feb. 9, 2001, now U.S. Pat. No. 6,412,126. U.S. Ser. No. 09/780,803 is in turn a division of U.S. Ser. No. 09/131,080, filed Aug. 7, 1998, now U.S. Pat. No. 6,282,738. U.S. Ser. No. 10/090,723; U.S. Ser. No. 09/780,803 and U.S. Ser. No. 09/131,080 are all assigned to the same assignee as this application, and are hereby incorporated in their entirety by reference. 

   BACKGROUND AND SUMMARY OF THE INVENTION 
   The present invention relates to medical stretchers, and particularly to stretchers used for patients requiring treatment or examination of the pelvic region, such as during labor and delivery or during gynecological examinations. More particularly, the present invention relates to stretchers convertible between a conventional stretcher configuration that supports the patient in a recumbent position and an Ob/Gyn configuration that supports the patient in a parturition or lithotomy position while providing medical caregivers improved patient access. 
   Hospital emergency rooms and maternity units often receive patients that require handling in both a recumbent position and in a parturition or lithotomy position. For example, a maternity patient will typically remain in a recumbent position during labor, with her legs resting on a mattress surface, and then assume a parturition or lithotomy position to facilitate childbirth. During labor there often is also a need for the medical caregiver, such as a nurse or doctor, to have access to the patient&#39;s pelvic region, for example to assess cervical dilation, after which time the patient again assumes a recumbent position. Patients and care givers thus benefit from medical stretchers that both allows the patient to lie in a conventional, recumbent position and that convert to a configuration to support the patient in a parturition or lithotomy position while simultaneously providing the care giver with improved access to the patient&#39;s pelvic region. 
   According to one aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame. The frame includes a storage portion. The deck includes a head section, a seat section and first and second laterally spaced apart outer leg support sections adjacent the seat section. The seat section and the first and second outer leg support sections being configured to define a central opening therebetween. The apparatus also includes a removable center leg support configured for movement between a first position located within the central opening and coupled to the deck to provide a portion of the deck and a second storage position detached from the deck and located in the storage portion of the frame and below the deck. 
   The illustrated embodiment includes a latch coupled to the center leg support to secure the center leg support to the deck in the first position. The illustrated latch includes a pin coupled to the center leg support. The pin is configured to enter a pin-receiving receptacle formed in the deck. The center leg support also includes an actuator coupled to the latch. The actuator is configured to move the latch between a latched position to lock the center leg support in the first position and an unlatched position. The illustrated actuator includes a cable assembly having a first end coupled to the latch and a second end coupled to a handle. The center leg support includes a bottom surface formed to include a recess configured to receive at least a portion of the cable assembly. 
   The illustrated apparatus also includes at least one pivot block coupled to the frame. The pivot block is configured to support the center leg support in the first position. The pivot block includes a pin and the center leg support includes a pin-receiving receptacle configured to engage the pin when the center leg support is in the first position. The pin-receiving receptacle is illustratively formed by a bar coupled to a bottom surface of the center leg support. 
   The center leg support includes a bottom having a support surface and at least one guide surface cooperating with the at least one pivot block to align and hold the center leg support in the first position. Illustratively, at least one ramp surface is located adjacent the support surface to facilitate movement of the center leg support onto the at least one pivot block. 
   The illustrated embodiment includes first and second pivot blocks coupled to the frame. The center leg support includes a bottom support surface configured to engage the pivot blocks and hold the center leg support in the first position. The center leg support further includes first and second spaced apart guides located adjacent the bottom support surface. The guides are configured to position the center leg support relative to the first and second pivot blocks. The first and second pivot blocks each include a pin and the center leg support includes a pin-receiving receptacle configured to engage the pins when the center leg support is in the first position. 
   The illustrated center leg support includes a first latch coupled to a first side portion of the center leg support and a second latch coupled to a second side portion of the center leg support. The first and second latches are configured to couple the center leg support section to the deck adjacent the first and second outer leg support sections, respectively. A single actuator is coupled to the first and second latches for selectively latching and unlatching both the first and second latches. 
   The illustrated embodiment also includes a siderail coupled to the frame. The siderail is formed to include a grip portion. The siderail illustratively includes a plurality of support bars pivotably coupled to the frame. At least one of the support bars is configured to define the grip portion. The illustrated grip portion is padded and located adjacent a foot end of the frame. 
   According to another aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame. The frame includes a first open channel and a second closed channel. The first and second channels are spaced apart and extend long a longitudinal axis of the frame. The deck is configured to support a patient. The apparatus also includes first and second rollers coupled to the deck. The first roller is located in the first open channel and the second roller being located in the second closed channel to permit longitudinal movement of the deck relative to the frame. 
   The apparatus further includes a latch coupled between the deck and the frame. The latch is movable between a latched position to prevent movement of the deck relative to the frame in an unlatched position to allow longitudinal movement of the deck relative to the frame. The illustrated latch is movable to a first latched position when the deck is in a first position relative to the frame. The latch also is movable to the second latched position when the deck is moved to a second position relative to the frame. 
   According to yet another aspect of the present invention, a mattress includes a head section, a seat section, and first and second outer leg support sections. The seat section and the first and second outer leg support sections are configured to define a central opening therebetween. The apparatus also includes a drip flap coupled to the seat section and first and second outer leg support sections. The drip flap is configured to extend downwardly below a bottom surface of the mattress adjacent the central opening of the mattress. 
   The illustrated first and second outer leg sections each include a heel cut-out portion. The apparatus also includes first and second flexible portions coupled between the seat section and the first and second outer leg support sections, respectively, to permit relative movement between the first and second outer leg sections and the seat section of the mattress. The head section, seat section, and first and second outer leg support sections are illustratively made from a first foam material, and the flexible portions are illustratively made from a second foam material. The second foam material has a density less than the first foam material. 
   The illustrated apparatus further includes first and second foot straps coupled to the first and second outer leg support sections of the mattress, respectively. The illustrated apparatus further includes at least one fastener coupled to a bottom surface of the mattress to facilitate attachment of the mattress to a support surface. 
   The illustrated drip flap extends further downwardly below the bottom surface of the mattress adjacent the first and second outer leg support sections than adjacent the seat section. The illustrated apparatus also includes at least one bevel cut segment extending between a top surface and a bottom surface of the mattress. The first and second outer leg support sections are formed to include bevel cuts to facilitate access to a control handle when the mattress is positioned on a frame of a patient support surface. 
   According to a further aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame. The frame has a head end and a foot end. The deck is movable relative to the frame along a longitudinal axis of the frame toward the foot end of the frame. The apparatus also includes a latch coupled between the deck and the frame. The latch is movable between a latched position to prevent movement of the deck relative to the frame and an unlatched position to allow longitudinal movement of the deck relative to the frame. The apparatus further includes an actuator coupled to the latch to move the latch between the latched and unlatched positions. The actuator is coupled to the deck adjacent a foot end portion of the deck for access by a caregiver while moving the deck toward the foot end of the frame. 
   The illustrated latch includes a pin coupled to the deck which is configured to enter a receptacle formed in the frame. The illustrated deck includes a head section, a seat section and first and second laterally spaced outer leg support sections adjacent the seat section. The actuator is coupled to one of the first and second outer leg support sections. The illustrated actuator is coupled to a foot end of the first outer leg support section. 
   In the illustrated apparatus, the latch includes first and second latches. Each of the first and second latches is movable between a latched position to prevent movement of the deck relative to the frame and an unlatched position to allow longitudinal movement of the deck relative to the frame. The illustrated actuator includes a first actuator coupled to the first latch to move the first latch between the latched and unlatched positions and a second actuator coupled to second latch to move the second latch between the latched and unlatched positions. The first and second actuators are both located adjacent the foot end portion of the deck and illustratively are coupled to the first outer leg section and the second outer leg section, respectively. In this embodiment, the first and second actuators must both be actuated to release the deck from the frame. 
   The illustrated embodiment also includes a siderail pivotably coupled to the frame by first and second swing arms, and a cam surface coupled to the deck. The cam surface is configured to engage the first swing arm as the deck moves relative to the frame to pivot the siderail outwardly relative to the frame. 
   According to a still further aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame to support the patient. The deck includes a support surface pivotably coupled to the deck by a linkage. The apparatus also includes an actuator coupled to the linkage to selectively lock and unlock the linkage to permit adjustment of the orientation of the support surface, and a covering configured to surround at least a portion of the support surface and the linkage to facilitate cleaning of the linkage. 
   The illustrated deck includes a head section, a seat section, and first and second laterally spaced outer leg support sections coupled to the seat section by first and second linkages, respectively. The seat section and the first and second outer leg support sections are configured to define a central opening therebetween. First and second coverings are configured to surround at least a portion of the first and second outer leg support sections and the first and second linkages, respectively. 
   The illustrated covering includes a bellows portion located over the linkage to permit movement of the linkage. The illustrated covering also surrounds the actuator and is formed from a flexible, elastomeric material. 
   According to an additional aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck configured to support the patient. The frame is formed to include a first receptacle, and the deck is formed to include a second receptacle. The apparatus also includes a removable calf support having a mounting portion configured to be located in the first receptacle to store the removable calf support beneath the deck. The mounting portion is configured to be located in the second receptacle to support a patient&#39;s leg above the deck. 
   The illustrated mounting portion of the calf support is configured to extend in a direction generally parallel to a longitudinal axis of the frame when the removable calf support is located in the first receptacle. The mounting portion of the removable calf support is configured to extend in a direction generally perpendicular to the longitudinal axis of the frame when the removable calf support is in the second receptacle. The illustrated calf support includes a calf support surface coupled to the mounting portion by an adjustable linkage. 
   According to another aspect of the present invention, a patient support apparatus includes a base, a plurality of casters coupled to the base, a frame coupled to the base, and a deck coupled to the frame. The deck is configured to support the patient. The deck includes a head section, a seat section and first and second laterally spaced apart outer leg support sections adjacent the seat section. The seat section and the first and second outer leg support sections are configured to define a central opening therebetween. The apparatus also includes a lighting system having a light source coupled to one of the base, the frame, and the deck spaced apart from the central opening of the deck. The lighting system also includes a light head coupled to the light source. The light head is located adjacent the central opening of the deck to permit examination of the patient located on the deck. 
   The illustrated light head is positioned adjacent a foot end of the deck. The illustrated lighting system includes a fiber optic connection between the light source and the light head. A flexible connector is coupled to the light head to hold the light head in a desired position relative to the deck. The illustrated flexible connector is configured to be received within a receptacle formed in the frame. The illustrated lighting system includes a power cord coupled to the light source. The power cord is configured to be coupled to a power outlet to supply power to the light source. The illustrated apparatus further includes a clip coupled to one of the base, frame and deck. The clip is configured to hold the light head in a storage position. 
   According to a further aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame. The frame includes first and second channels which are spaced apart and configured to extend along a longitudinal axis of the frame. The deck is configured to support the patient. The apparatus also includes first and second lifting mechanisms coupled to the base. The first lifting mechanism is pivotably coupled to the frame. The apparatus further includes a coupler coupled to the second lifting mechanism. The coupler includes first and second rollers located in the first and second channels of the frame, respectively, to couple the second lifting mechanism to the frame, thereby permitting movement of the coupler and the second lifting mechanism relative to the frame. 
   The illustrated coupler includes a bar coupled to a top end of the second lifting mechanism and extending generally transverse to the longitudinal axis of the frame. The first roller is coupled to a first end of the bar, and the second roller is coupled to a second end of the bar. The first and second rollers are configured to move toward an end of the frame away from the first lifting mechanism when the first and second lifting mechanisms are adjusted to different heights relative to each other. Illustratively, the first channel is an open channel and the second channel is a closed channel. 
   According to a further aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame to support the patient. The deck is movable relative to the frame along a longitudinal axis of the frame. The deck includes support surface pivotably coupled to the deck by a linkage. The apparatus also includes a latch coupled between the deck and the frame. The latch is movable between a latched position to prevent movement of the deck relative to the frame and an unlatched position to allow longitudinal movement of the deck relative to the frame. The apparatus further includes a locking mechanism coupled to the support surface to hold the support surface in a selected position relative to the deck, and an actuator coupled to the locking mechanism to selectively release the locking mechanism. The actuator also is coupled to the latch to move the latch between the latched and unlatched positions so that when the actuator is actuated, the latch is unlatched to permit movement of the deck relative to the frame and the locking mechanism is released to permit movement of the support surface relative to the deck. 
   In the illustrated embodiment, the actuator is located adjacent a foot end of the deck on the support surface. The illustrated support surface is a leg support surface, and the actuator is located adjacent a foot end of the leg support surface. The illustrative actuator includes a first cable having a first end coupled to the latch and a second end coupled to a handle of the actuator and a second cable having a first end coupled to the locking mechanism and a second end coupled to the handle of the actuator. 
   According to a further aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame. The deck is movable relative to the frame along a longitudinal axis of the frame. The deck includes a head section, a seat section and first and second laterally spaced apart outer leg support sections adjacent the seat section. The first and second outer leg support sections are pivotable relative to the seat section of the deck. The apparatus also includes a latch coupled between the deck and the frame. The latch is movable between a latched position to prevent movement of the deck relative to the frame and an unlatched position to allow longitudinal movement of the deck relative to the frame. The apparatus further includes first and second locking mechanisms coupled to the first and second outer leg support sections, respectively, to hold the first and second outer leg support sections in selected positions relative to the seat section, and first and second actuators located on the first and second outer leg support sections, respectively. The first and second actuators are coupled to the first and second locking mechanisms, respectively. The first and second actuators are configured to release the first and second locking mechanisms and allow pivotable movement of the first and second outer leg support sections. The first actuator is also coupled to the latch to move the latch between the latched and unlatched positions. 
   In the illustrated embodiment, the first and second actuators are coupled to a foot end of the first and second outer leg support sections, respectively. The illustrative latch includes first and second latches, each of the first and second latches being movable between a latched position to prevent movement of the deck relative to the frame and an unlatched position to allow longitudinal movement of the deck relative to the frame. The first actuator is coupled to the first latch to move the first latch between the latched and unlatched positions. The second actuator is coupled to second latch to move the second latch between the latched and unlatched positions. The first and second actuators must both be actuated to release the deck from the frame. 
   According to a further aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame. The deck includes a head section, a seat section, and first and second laterally spaced apart outer leg support sections. The first and second outer leg support sections are each pivotably coupled to the seat section about a first and second pivot axes, the first pivot axis being transverse to the second pivot axis. The apparatus also includes first and second locking mechanisms coupled to each outer leg support section. The first and second locking mechanisms are configured to prevent movement of the outer leg support sections about the first and second pivot axes, respectively, to hold the outer leg support sections in selected positions relative to the seat section. The apparatus further includes first and second actuators located adjacent a foot end of each of the outer leg support sections. The first and second actuators are coupled to the first and second locking mechanisms, respectively, to selectively release the first and second locking mechanisms and allow pivotable movement of the outer leg support sections about the first and second pivot axes. 
   In the illustrated embodiment, the first locking mechanism includes a mechanical lock having a cylinder pivotably coupled to the seat section, a movable rod pivotably coupled to the outer leg support section, and a release mechanism for selectively permitting movement of the rod relative to the cylinder to allow pivoting movement of the outer leg support section about the first pivot axis. The first actuator is coupled to the release mechanism. The second locking mechanism includes a piston and cylinder having first and second ends pivotably coupled to the outer leg support section. The piston is selectively releasable to permit pivoting movement of the outer leg support section about the second pivot axis. The second actuator is coupled to the piston and cylinder arrangement to selectively release the piston. 
   According to a still further aspect of the present invention, a patient support apparatus includes a base, a frame coupled to the base, and a deck coupled to the frame. The deck is movable relative to the frame along a longitudinal axis of the frame. The deck include a head section, a seat section, and first and second laterally spaced apart outer leg support sections adjacent the seat section. The seat section and the first and second outer leg support sections are configured to define a central opening therebetween. The first and second outer leg support sections are pivotable relative to the seat section of the deck. The apparatus also includes a center leg support configured for movement between a first position located within the central opening to provide a portion of the deck and a second storage position, a first latch coupled between the deck and the frame, and a second latch coupled to the center leg support. The first latch is movable between a latched position to prevent movement of the deck relative to the frame and an unlatched position to allow longitudinal movement of the deck relative to the frame, and the second latch being movable between a latched position to lock the center leg support in the first position and an unlatched position. The apparatus further includes first and second locking mechanisms coupled to the first and second outer leg support sections, respectively, to hold the first and second outer leg support sections in selected positions relative to the seat section of the deck, and a plurality of actuators located adjacent a foot end of the deck for access to a caregiver located at the foot end of the deck. The plurality of actuators are configured to move the first and second latches between the latched and unlatched positions and to release the first and second locking mechanisms and allow pivotable movement of the first and second outer leg support sections. 
   In the illustrated embodiment, the first and second locking mechanisms are each configured to prevent movement of the outer leg support sections about first and second pivot axes to hold the outer leg support sections in selected positions relative to the seat section. The plurality of actuators includes first and second actuators located adjacent a foot end of each of the outer leg support sections. The first and second actuators are configured to release the first and second locking mechanisms and allow pivotable movement of the outer leg support sections about the first and second pivot axes, respectively. 
   Additional features of the invention will become apparent to those skilled in the art upon consideration of the following detailed description of the presently perceived best mode of carrying out the invention. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The detailed description particularly refers to the accompanying figures in which: 
       FIG. 1  is a side elevation view of an Ob/Gyn stretcher according to the present invention showing a base, a frame coupled to the base, a deck coupled to the frame, a mattress located on the deck, a siderail and a catch basin coupled to the frame, and an articulating head section of the deck in a raised position; 
       FIG. 2  is a perspective view of a portion of the stretcher of  FIG. 1  showing a foot end section of the stretcher, with portions cut away to show a movable central leg section of the deck having a releasable latching mechanism to allow for movement of the movable section to a stowed position beneath a central portion of the deck; 
       FIG. 3  is a side elevation view of the foot end portion of the stretcher of  FIG. 1 , with a portion broken away to show the movable central leg section in an intermediate position during movement to the stowed position; 
       FIG. 4  is side elevation view of the foot end portion of the stretcher of  FIG. 1 , with a portion broken away to show the movable central leg section moved to the stowed position; 
       FIG. 5  is a side elevation view of the foot end portion of the stretcher of  FIG. 1 , with a portion broken away to show the movable central leg section in the stowed position and an adjustable outer leg section raised to support a patient in a lithotomy or parturition position; 
       FIG. 6  is a perspective view of the foot end portion of the stretcher of  FIG. 1 , with a portion broken away to show an outer leg section adjustment mechanism and showing a removable, adjustable calf support assembly; 
       FIG. 7  is side elevation view of the stretcher of  FIG. 1 , with a portion broken away to illustrate the deck moved toward the foot end portion of the frame and an outer leg section in a raised position to support a patient in a birthing position or for an Ob/Gyn examination; 
       FIG. 8  is a perspective view of the foot end portion of the deck and mattress of  FIG. 1 , showing operator adjustment of the outer leg sections; 
       FIG. 9  is a perspective view of the stretcher of  FIG. 1 , showing the deck, mattress, and calf supports configured for a patient in a birthing position or for an Ob/Gyn examination; 
       FIG. 10  is a perspective view showing an alternative leg support embodiment, with the outer leg sections adjusted to a calf support configuration to support a patient in a birthing position or for an Ob/Gyn examination; 
       FIG. 11  is a detail perspective view of another alternative leg support embodiment similar to  FIG. 10 , showing a hinged calf support section and a hinged outer leg section handle configured as a foot support; 
       FIG. 12  is a detail perspective view of the left outer leg deck section of  FIG. 1 , with a portion of a flexible cover broken away to show vertical and horizontal hinge assemblies; 
       FIG. 13  is a plan view showing a control mechanism for vertical and horizontal hinge assemblies for the right outer leg deck section of  FIG. 1 ; 
       FIG. 14  is an end view of the stretcher frame of  FIG. 1 , showing open and closed channels for receiving rollers from the deck and circular openings for stowing removable calf supports; 
       FIG. 15  is a perspective view of a stretcher according to the present invention with a deck and mattress moved forward on a frame to provide access to an Ob/Gyn patient and with portions broken away to show a lighting system; 
       FIG. 16  is perspective view looking down towards the top of a mattress assembly according to the present invention, showing foot straps and heel cut-outs in two outer leg mattress sections, a drip flap extending around an opening between the outer leg mattress sections and a central mattress section, and a head mattress section coupled to the central mattress section for articulated movement; 
       FIG. 17  is a perspective view looking up towards the bottom of the mattress assembly of  FIG. 16 , showing the foot straps, drip flap, and Velcro strips for coupling the mattress to a deck; 
       FIG. 18  is a top plan view of the mattress assembly of  FIG. 16 , showing the heel cut-outs and a pair of soft foam mattress portions coupled between outer leg mattress sections and the central mattress section; 
       FIG. 19  is a side profile view of the mattress assembly of  FIG. 16 , showing the drip flaps extending below the mattress bottom and bevels on the outer leg and head mattress sections; 
       FIG. 20  is a bottom plan view of the mattress assembly of  FIG. 16 , showing foot straps, velcro strips, and flaps for installing foam into mattress covers for the central and head mattress sections; 
       FIG. 21  is a bottom plan view of an alternative embodiment center leg support, showing latch control cable assemblies within a channel formed on the support bottom; 
       FIG. 22  is a side elevation of a stretcher, showing a base, a frame, a deck, vertically adjustable head and foot end supports coupled between the base and frame, and a roller assembly coupled between the frame and the head end support to allow for tilting of the frame relative to the base; and 
       FIG. 23  is a top plan view, with portions broken away, illustrating a cam formed on the deck for moving a siderail outwardly relative to the frame. 
   

   DETAILED DESCRIPTION OF DRAWINGS 
   Although the specification of this application discusses the present invention in terms of a stretcher, the features have applicability in other patient support apparatus such as beds, tables, etc. A stretcher  10  according to the present invention includes a base  12 , a frame  14 , a deck  16 , and a mattress  18 , as shown for example in  FIG. 1 . Stretcher  10  further includes a movable center leg support  17  that selectively can be coupled to deck  16  as shown for example in  FIGS. 1–2  or stowed beneath deck  16  as shown in  FIGS. 3–4 . Deck  16 , leg support  17 , and mattress  18  are configured to allow stretcher  10  to convert between a conventional stretcher configuration and an Ob/Gyn configuration in which a medical caregiver is provided with improved access to a patient&#39;s pelvic region. 
   Deck  16  includes a head section  20 , a seat section  22 , and left and right outer leg sections  24 ,  26 . Seat section  22  and outer leg sections  24 ,  26  define between them an opening  15  configured to receive center leg support  17 . Head section  20  is pivotably coupled to seat section  22  by a pivot  28  and outer leg sections  24 ,  26  are each pivotably coupled to seat section  22  by hinge assemblies  30  that provide for rotation about two axes. Head section  20  can thus be rotated vertically with respect to seat section  22 , as shown for example in  FIG. 1  to elevate a patient&#39;s head. Outer leg sections  24 ,  26  can be rotated both horizontally and vertically with respect to seat section  22 , as shown for example in  FIG. 8 . 
   As discussed in more detail below, deck  16  is coupled for longitudinal movement with respect to frame  14 . Briefly, deck  16  includes two downwardly extending lateral carriage plates  32  and two or three rollers  34  coupled to each plate  32 . Frame  14  includes two laterally spaced, longitudinally extending channels  36 ,  38  configured to receive rollers  34 . A deck release mechanism  40  allows for selectively latching or unlatching frame  14  to deck  16  to enable or prevent relative longitudinal movement relative to deck  16 . Deck  16  further includes a pair of gas/cylinders  42  coupled between carriage plates  32  and deck head section  20  to allow for selectively adjusting an angle between head section  20  and seat section  22  around pivot  28  through use of a release handle  44  coupled to the piston of cylinder  42 . 
   Channel  36  includes top and bottom flanges  33 ,  35  configured to retain rollers  34  against lateral movement as shown in  FIG. 14 . Top flange  33  has a downwardly extending lip  31  and bottom flange  35  has an upwardly extending lip  37  to provide channel  36  with a generally C-shaped or closed profile. Channel  38  includes flat top and bottom flanges  39 ,  41  to provide an open profile that allows for lateral movement of rollers  34  within channel  38 . The complementary open and closed profiles of channels  36 ,  38  reduces the tendency of rollers  34  to bind while deck  16  moves longitudinally with respect to frame  14 . 
   Base  12  includes four casters  46  and is coupled to frame  14  by hydraulic lifting mechanisms or supports  48 ,  50 . Base  12  further includes foot pedals  52  for selectively raising or lowering either or both supports  48 ,  50  so that stretcher  10  can be placed in a variety of orientations such as a Trendelenburg or reverse Trendelenburg position. Stretcher  10  has a head end  54  and a foot end  56  and includes a catch basin  62  coupled to frame  14  at foot end  56 , a combination bumper and push handle  58  at head end  54 , and a siderail assembly  60 . 
   Channels  36 ,  38  are further used to facilitate tilting of frame  14  relative to base  12  as best shown in  FIG. 22 . Head end lifting support  48  is slidably coupled to frame  14  by a roller coupling assembly  49  fixed to head end support  48 . Roller coupling assembly  49  includes a bar  47  (see  FIG. 15 ) coupled to a top end of the support  48  and rollers  55  coupled to opposite ends of the bar  47 . The rollers  55  are located in each channel  36 ,  38 . Foot end support  50  is coupled to frame  14  by a pivot assembly  51 . Frame  14  is raised, lowered and tilted relative to base  12  by moving supports  48 ,  50  vertically up and down. When frame  14  is tilted to a Trendelenburg position (dotted position) as shown by arrow  57 , the distance between rollers  55  and pivot assembly  51  increases by a distance  53 . In other words, as frame  14  tilts to the Trendelenburg position or reverse Trendelenburg position, rollers  55  move in the channels  36 ,  38  toward head end  54 . As discussed above, the complementary open and closed profiles of channels  36 ,  38  facilitates movement of rollers  55 . It is understood that rollers  55  can be provided with separate channels to accommodate tilting frame  14 , or roller assembly  49  can be replaced by other suitable mechanisms such as a hinged linkage assembly. 
   Center leg support  17  is configured to be coupled to deck  16  within opening  15  to provide for a conventional stretcher configuration as shown in  FIG. 2 . Center leg support  17  illustratively includes a release handle  64  coupled to a pair of cable assemblies  66  that control a pair of latching pins  68 . Pins  68  enter holes  70  in seat section  22  of deck  16  to latch support  17  to deck  16 . When release handle  64  is moved toward the foot end of stretcher  10  as illustrated by arrow  72 , a linkage  74  causes cables within cable assemblies  66  to retract latching pins  68  from holes  70 . Center leg support  17  can then be moved to the stowed configuration as shown in  FIGS. 3–4  to allow stretcher  10  to assume an Ob/Gyn configuration. It is understood that any suitable mechanism for latching center leg support  17  in a conventional support position can be used. Similarly, release handle  64  and the associated components for releasing center leg support  17  for movement to the stowed position can be replaced by other suitable mechanisms. Center leg support  17  is illustratively formed from relatively light weight metal components including a tubular perimeter frame  76 , longitudinal center support beams  78 , and a sheet metal top surface  80 . 
   An alternative embodiment center leg support  117  is formed from molded plastic as shown in  FIG. 21 . Center leg support  117  includes a release handle  164 , cable assemblies  166 , and latching pins  168  that are similar to corresponding components of leg support  17 . Center leg support  117  has a bottom surface  167  that includes a channel  170  extending longitudinally from release handle  164  and branching laterally towards latching pins  168  for receiving cable assemblies  166 . Recesses  172 ,  174  and plates  176 ,  178  are provided to retain cable assembly  166  hardware from extending below the bottom surface  167  of center leg support  117 . An ergonomic hand opening  180  is provided including finger grips  182  to facilitate operation of handle  164 . Similar in operation to center leg support  17 , when handle  164  is moved in direction  184 , latching pins  168  retract in direction  186  to release the center leg support  117  from the holes  70  formed in the deck. 
   Center leg support  117  further includes a pair of bottom supports  171  that extend downwardly from bottom surface  167  to provide support surfaces  179   a  and  179   b  that engage frame  14  when support  117  is in the conventional stretcher configuration. Support surfaces  179   a  and  179   b  extend below the bottom surface  167 . A forward ramp surface  173  extends between bottom surface  167  and each support surface  179   a  and  179   b . Guide surfaces  181  are located below bottom surface  167  and below support surfaces  179   a  and  179   b . A forward ramp surface  175  and lateral ramp surface  177  extend between the bottom surface  167  and each guide surface  181 . 
   Ramp surfaces  173 ,  175 ,  177  facilitate movement and alignment of support  117  when being moved from between the stowed position to a conventional stretcher configuration. Center leg support  117  is illustratively formed in a rotational plastic mold and is foam filled to produce a lightweight component with suitable rigidity, although it is understood that any conventional manufacturing or forming technique can be used. 
   When center leg supports  17 ,  117  are positioned to provide a conventional stretcher configuration, latching pins  68 ,  168  extend into holes  70  and a top surface of center leg supports  17 ,  117  is generally flush with the top surfaces of seat and outer leg deck sections  22 ,  24 ,  26 . A center leg support mattress  19  is configured to lie atop center leg supports  17 ,  117  with a top surface of mattress  19  generally flush with a top surface of mattress  18 . Frame  14  further includes a pair of center leg support pivot blocks  82  positioned above foot end hydraulic support  50  as shown in  FIG. 2 . Pivot blocks  82  support the bottom of center leg supports  17 ,  117  when in the conventional stretcher configuration and, as discussed below, facilitate moving center leg supports  17 ,  117  between the conventional stretcher configuration and the stowed configuration. 
   Center leg supports  17 ,  117  illustratively include a bottom U-shaped rod  84  configured to define a rod pocket  86  between rod  84  and the bottom of center leg support  17 ,  117 . Pivot blocks  82  each include an inwardly extending stop pin  88  that is retained within rod pocket  86  when center leg support  17 ,  117  is in the conventional stretcher configuration as shown in  FIG. 3 . As shown in  FIG. 21 , support surfaces  179   a  and  179   b  slide over pivot blocks  82  when center leg support  17  is moved from a stowed position to a conventional stretcher position. Outer guides  171  engage outer portions of the pivot blocks  82  to align the center leg support  117  relative to the frame  14 . Rod  84  engages stops  88  when the  117  leg support is moved fully toward the foot end of frame  14 . Center leg support  117  is then pivoted around pivot blocks  82  until latch pins  168  engage apertures  70  of frame  14 . Center leg support  17  includes similar support surfaces  79  and ramp surfaces  73  for engaging pivot blocks  82  as shown in  FIGS. 3–5 . 
   Referring now to  FIG. 3 , when center leg support  17  is unlatched from deck  14  by pulling handle  64  in direction  72  to retract pins  68 , the foot end of center leg support  17  can be rotated upwardly in direction  90  so that the opposite end rotates downwardly in direction  92  as center leg support  17  rotates about pivot blocks  82 . A storage cavity  94  configured to receive center leg support  17  is defined between deck  16  and frame  14 . After rotating center leg support  17  about pins  88 , center leg support  17  can be moved as shown by arrows  96 ,  98  in  FIG. 3  to its stowed position within cavity  94  as shown in  FIG. 4 . Although the illustrated embodiments employ pivot blocks  82  and rod  84 , it is understood that other suitable mechanisms can be used to facilitate moving center leg support  17  between the conventional stretcher and stowed configurations. 
   Center leg support  17 ,  117  is moved from the stowed configuration to the conventional stretcher configuration by reversing the above-described steps. In this sequence, pivot blocks  82  guide movement of center leg support  17 ,  117  and also provide a stop to prevent center leg support  17  from being pulled out past the point where it is rotated into the conventional stretcher configuration. This stop function is accomplished when pins  88  engage rod  84  to stop center leg support  17  from extending past the point at which it is rotated back up to couple to deck  16  in the conventional stretcher configuration. 
   Deck release mechanism  40  illustratively is a cable-actuated mechanism and includes a lever  102  coupled to each of the deck outer leg sections  24 ,  26  as best shown in the view of right outer leg deck section  26  in  FIG. 6 . As discussed in more detail below, a second cable-actuated mechanism coupled to levers  102  also enables horizontal rotation in hinge assembly  30  of outer leg deck sections  24 ,  26 . 
   Outer leg deck sections  24 ,  26  include gripping handles  104  that are coupled to deck sections  24 ,  26 . Gripping handles  104  and levers  102  provide an ergonomic mechanism that allows an operator to actuate levers  102  while gripping handles  104 . Pulling each lever  102  enables horizontal rotation of a respective one of outer leg deck sections  24 ,  26  about pivot connection  124  by releasing a mechanical lock  128  and also retracts a frame latching pin  106 . When both levers  102  are pulled simultaneously, both frame latching pins  106  are retracted from apertures in the frame  14 , and deck  16  can be moved longitudinally relative to frame  14  in the direction of arrow  103  as shown for example in  FIG. 7 . As discussed above, rollers  34  roll in channels  36 ,  38  as the deck  16  moves relative to the frame  14 . Since both levers  102  adjacent handles  104  of outer leg deck sections  24 ,  26  must be activated to release the deck  16 , a caregiver must be positioned at a foot end  56  of stretcher  10  to release the deck  16 . This positioning of the caregiver provides improved control for movement of the deck  16 . 
   It is understood that levers  102  can be replaced by other suitable mechanisms, such as a single button or two buttons that perform the functions of enabling horizontal rotation of outer leg deck sections  24 ,  26  and horizontal movement of deck  16  relative to frame  14 . Furthermore, although center leg support  17  in the illustrated embodiment prevents deck  16  from moving toward foot end  56  when stretcher  10  is in the conventional stretcher configuration, it is understood that alternative leg supports could be coupled to deck  16  to allow such movement. 
   Each lever  102  is coupled to a control cable  108  that is coupled to frame latching pin  106 . Frame latching pins  106  are each mounted to a bracket  110  that is coupled to an inside wall  112  of deck carriage plate  32  so that latching pins  106  and brackets  110  move along with deck  16  relative to frame  14 . Latching pins  106  are configured to enter holes (not shown) in channels  36 ,  38  to latch deck  16  in first and second predefined positions relative to frame  14 . Pins  106  lock in a first pair of apertures in channels  36 ,  38  when the deck  16  is in a conventional stretcher position of  FIG. 1 . Pins  106  lock in a second pair of apertures formed in channels  36 ,  38  when the deck  16  is rolled to its examination position shown in  FIG. 7 . When lever  102  is pulled, cable  108  releases the pin  106  from the channel  36  or  38  allowing the deck  16  to move relative to the frame  14 . It is understood that other suitable mechanisms can be provided, such as a latching mechanism that provides for infinite longitudinal adjustment instead of predefined positions defined by holes in channels  36 ,  38 . 
   As mentioned above, hinge assembly  30  of outer leg deck sections  36 ,  38  provides for both horizontal and vertical rotation. Each hinge assembly  30  includes a vertical pivot  112  and a horizontal pivot  114  as best shown in FIGS.  6  and  12 – 13 . Vertical pivot  112  is formed by a horizontal pin  116  coupled between an end of deck outer leg sections  24 ,  26  and hinge assembly bracket  118 . A vertical adjustment cylinder  120  is pivotably coupled at one end to bracket  118  by connection  119 . A piston  121  extends from each cylinder  120 . A piston  121  is coupled to each outer leg section  24 ,  26 . An actuation button  122  underneath outer leg sections  24 ,  26  is pressed to release piston  121  to move within cylinder  120 . Each outer leg section  24 ,  26  can be rotated vertically upon actuation of button  122  and is infinitely adjustable within its range of vertical rotation by releasing button  122  to lock the piston  121  and hold the leg section  24 ,  26  at a desired orientation. 
   Horizontal pivot  114  is formed by a vertical pip  124  coupled between hinge assembly bracket  118  and a bracket  126  mounted to deck seat section  22 . A horizontal adjustment mechanical lock includes an outer cylinder  128  pivotably coupled to seat section  22  by pivot pin  123  as shown in  FIGS. 6 and 13 . A rod  125  moves back and forth within the cylinder  128  of the mechanical lock when an actuator  127  is released by control wire  109  when lever  102  is pulled. When lever  102  is released, the actuator holds the rod  125  in a locked position relative to cylinder  128 . An end of rod  125  is pivotably coupled to a flange of bracket  118  by pivot pin  129  as best shown in  FIGS. 12 and 13 . It is understood that other mechanisms for hinge assembly  30  can be provided, such as a single universal joint with a single actuation and latching mechanism for enabling rotation about two or more axes. 
   Outer leg sections  24 ,  26  are surrounded by a flexible covering  132  that includes a generally bellows-shaped section  133  located over hinge assembly  30 . Bellows  133  therefore permits pivotable movement of the leg sections  24 ,  26 . Covering  132  also surrounds actuator  122  as best shown in  FIG. 12 . Covering  132  is illustratively formed from a rubber material, although it is understood that any suitable covering may be used. Covering  132  facilitates cleaning of the outer leg sections  24 ,  26 . 
   Stretcher  10  includes removable calf supports  134  as best shown in  FIG. 6 . Support  134  includes a calf support tray  136  configured with a rounded perimeter  138 , a concave calf support surface  140 . A mounting rod  142  is coupled at one end to support tray  136  and has a generally spherical joint ball  144  at another end. Support  134  further includes a mounting shaft  146 , a raised gripping surface  148 , an offset arm  150 , and a joint socket  152 . Mounting shaft  146  is configured to be removably retained within a calf support socket  154  coupled to an outside surface of deck seat section  22 . Ball  144  and socket  152  provide for dual axis rotational adjustment of support tray  136  in directions  156 ,  158 . Furthermore, rotation of mounting shaft  146  in direction  160  combined with offset arm  150  provides for a wide range of horizontal adjustment of calf support  134 . When not in use, calf supports  134  are stored in a pair of storage receptacles  135  in frame  14  as shown in  FIG. 14  with at least a portion of each calf support extending from the storage receptacles. Receptacles  135  are formed from openings  137  in frame  14  that are spaced laterally inward from channels  36 ,  38 . Mounting shafts  146  are inserted into openings  137 , and L-shaped members  139  that extend longitudinally from atop openings  137  engage shafts  146  to retain calf supports  134  within frame  14 . 
   Stretcher  10  can thus be configured to provide improved access to a patient&#39;s pelvic region while supporting the patient in a lithotomy or parturition position as shown  FIG. 9 . An alternative embodiment calf support  234  is shown in  FIG. 10 . An outer leg deck section  224  includes top and bottom sections  225 ,  227  coupled by a pivot  229 . Bottom section  227  includes a plurality of notches  231  and top section  225  includes a hinged plate  233  so that when top section  225  is rotated upwardly in direction  235 , plate  233  is rotated down to enter one of notches  231  to retain top section  225  at a desired angle with respect to bottom section  227 . An alternative handle  204  is configured to provide a foot support as shown in  FIG. 11 . A hinge  203  allows for rotating handle  204  upwardly in direction  205  to provide a support for a patient&#39;s foot. It is understood that other mechanisms can be provided to include a calf support within outer leg sections  24 ,  26 , such as various linkage assemblies to adjust all or part of the deck section as required to conform to a desired orientation for calf support. 
   Stretcher  10  can further be configured with an examination light system  190  as shown in  FIG. 15 . Light system  190  illustratively includes a flexible connector  192  coupled to a light head  194 . Once positioned, the flexible connector  192  holds the light head  194  at the foot end  56  of stretcher  10  to allow for directing light in a convenient manner. Light system  190  further illustratively includes a light source  196  coupled to frame  14  adjacent head end  54  and a fiber-optic supply link coupled between cable  192  and source  196 . The light source  196  may also be coupled to the deck  16  or base  12 . It is understood that other suitable light systems can be used for light system  190 , and that it can be attached or incorporated into frame  14  as desired. Stretcher  10  can be wheeled from place to place within a hospital or other facility. A particular room may not have adequate lighting for the stretcher  10 . Since the light system  190  is incorporated into the frame of the stretcher  10 , a suitable light source for examination is always available regardless of the location of the stretcher  10 . 
   The light source  196  includes a power cord (not shown) configured to be coupled to a power outlet of a wall. The light source  196  is coupled to the base  12 , frame  14 , or deck  16  at a location spaced apart from the central opening  15  formed in the deck  16 . Therefore, the light source  196  is located at a remote location from the area that is likely to be exposed to fluids during an examination or medical procedure. The light head  194  is located adjacent the central opening  15  to provide light for the examination. The flexible connector  192  is configured to be received within a first receptacle  193  formed in the frame  14  to position the flexible connector adjacent the foot end of the frame  14 . A retaining clip  195  is configured to engage neck portion,  197  of connector  192  to hold the light head  194  in a storage position when not in use. 
   Mattress  18  as shown in  FIGS. 17–20  is configured to be coupled atop deck  16 . Mattress  18  includes a head section  310 , a seat section  312 , and left and right outer leg sections  314 ,  316  that are sized to cover respective deck head, seat, and outer leg sections  20 ,  22 ,  24 ,  26 . Head and seat sections  310 ,  312  are coupled by a V-shaped hinge  311  to facilitate rotation between them. Seat and outer leg sections  312 ,  314 ,  316  are coupled by soft foam portions  315  illustrated in  FIGS. 18 and 19  that allow for both horizontal and vertical rotation over hinge assemblies  30 . 
   Seat and outer leg sections  312 ,  314 ,  316  define between them a center leg opening  318 . Mattress  18  includes a drip flap  320  that extends downwardly around a portion of opening  318 . Drip flap  320  reduces exposure of deck  16  and frame  14  adjacent opening  318  to moisture when center leg support  17  is in the stowed configuration. Drip flap  320  illustratively includes two outer segments  319 , two bevel segments  321 , and an inner segment  323  as best shown in  FIGS. 16–17 . Outer segments  319  illustratively extend downwardly farther than bevel and inner segments  321 ,  323 . Drip flap  320  in conjunction with catch basin  62  facilitates containment of fluids often encountered during procedures such as childbirth. 
   Mattress  18  further includes heel cut-outs  322  and foot straps  324  in outer leg sections  314 ,  316 . Cut-outs  322  provide a support surface for a patient&#39;s foot when outer leg sections  314 ,  316  are in a raised position, as shown for example in  FIGS. 5 and 7 . Mattress  18  illustratively includes foot end bevels  326  and head end bevels  328  as best shown in  FIGS. 18–20  and is formed with a foam core and a washable outer cover, although any suitable materials can be used. Foot end bevels  326  facilitate access to handles  104  as shown in  FIG. 19 . Mattress  18  further illustratively includes Velcro strips  330  on its bottom surface that couple to matching strips (not shown) on deck seat portion  22  to provide for removably coupling mattress  18  to deck  16 . 
   In operation, when a patient is first placed on stretcher  10 , the stretcher  10  is located in the conventional stretcher configuration illustrated in  FIG. 1 . The deck  16  can be articulated to adjust the position of the patient on the stretcher  10 . When it is desired to move the stretcher to the OB/GYN configuration, a caregiver will typically first move the outer leg sections  24  and  26  upwardly relative to the seat section  22  by depressing buttons  122  beneath the outer leg sections  24 ,  26 . This releases pistons  121  and permits the outer leg sections to be pivoted upwardly as shown in  FIGS. 7–8 . 
   Next, the center leg support  17 ,  117  is stowed. To stow the center leg support  17 ,  117 , a caregiver pulls the release handles  64 ,  164 , respectively, toward the foot end  56  of stretcher  10 . This releases pins  68 ,  168  from apertures  70  formed in deck  16 . Therefore, the center leg support  17 ,  117  can be pivoted downwardly about pivot blocks  82  as shown in  FIG. 3 . Center leg support  117  is then pushed toward the head end  54  of stretcher  10  in the direction of arrow  96  and arrow  98  of  FIG. 3  to a storage position as shown in  FIGS. 4 and 5 . 
   Next, the caregiver located at foot end  56  of stretcher  10  grips both handles  104  as shown in  FIG. 8 . Caregiver then actuates levers  102  by moving the levers  102  toward the foot end  56  of stretcher  10 . Actuation of levers  102  simultaneously releases the latches  106  and mechanical locks  128  coupled to control wires  108  and  109 , respectively. When pins  106  are released from both sides of the deck  16 , rollers  34  can roll in channels  36 ,  38  toward the foot end  56  of the stretcher  10  to an examination position shown in  FIG. 7 . Pins  106  will latch into apertures in channels  36 ,  38  to maintain the deck in the examination position shown in  FIG. 7 . Siderail  60  includes a padded bar  61  which is configured to provide a grip handle for the patient as best shown in  FIG. 7 . Illustratively, the grip handle is formed by a generally S-shaped section formed in the bar  61 . However, the padded grip handle may be formed on a straight tube or bar of the siderail. 
   The caregiver can then adjust the leg sections  26  outwardly about pivot  24  while levers  102  are actuated. In other words, the caregiver can move the leg sections  24 ,  26  to the dotted position shown in  FIG. 8  to improve access to a pelvic region of the patient. Next, patient&#39;s legs can be adjusted using one of the various illustrated calf supports. The leg sections  24  and  26  and calf supports can be adjusted to a desired location throughout the examination. 
   Once the procedure is over, the stretcher  10  can be converted back to a conventional stretcher configuration by the caregiver by gripping both handles  104  on outer leg sections  24 ,  26  and actuating levers  102 . The outer leg sections  24 ,  26  are first adjusted to be parallel with the remainder of the deck  16  using levers  102  and actuator  122 . Actuating levers  102  also release pins  106  from the first set of apertures formed in channels  36 ,  38  to permit the rollers  34  on deck  16  to roll in channels  36 ,  38  back to the conventional stretcher position shown in  FIG. 1 . Pins  106  then latch in the second set of apertures formed in channels  36 ,  38  to hold the deck  16  in the conventional stretcher configuration. Center leg support  17 ,  117  is then retrieved from the storage position as shown in  FIG. 4 . The caregiver pulls the center leg support  17 ,  117  outwardly in the direction of arrow  72  of  FIG. 3  until the bar  84  latches over locking pins  88  of pivot blocks  82 . The center leg support  17 ,  117  is then pivoted upwardly about pivot blocks  82  until pins  68 ,  168  engage apertures  70  formed in deck  16  to lock the center leg support  17 ,  117 , in position. 
   It is understood that the locations of pins  68  and holes  70  could be reversed. In addition, latch pins  106  could be formed on the frame and configured to enter apertures formed in the deck. Other types of latches may also be used, if desired. 
   Another aspect of the present invention is illustrated in  FIG. 23 . The siderail  60  includes a mounting rail  350  and an outer rail  352 . The tubes or bars  61  of the siderail are pivotably coupled between the mounting rail  350  and the outer rail  352 . Swing arms  354  are mounted on each end of the siderails  60 . Each swing arm  354  includes a first end pivotably coupled to the frame  14  at location  356  and a second end pivotably coupled to the mounting rail  350  at location  358 . A separate siderail  60  is mounted on both sides of the frame  14  in a conventional manner. 
     FIG. 23  also illustrates a cam  360  coupled to the carriage plate  32  of the deck  16 . A cam  360  is coupled to carriage plates  32  on both sides of the deck  16 . When the deck  16  slides toward the foot end of the frame  14  in the direction of arrow  362  as discussed above, the carriage  32  and the cams  360  also move in the direction of arrow  362 . When the carriage  32  and cams  360  approach a foot end of the frame  14 , the cams  360  engage the swing arms  354  of the siderail  60  to pivot the siderails  60  outwardly relative to the frame  14  in the direction of arrow  364  to the dotted location illustrated in  FIG. 23 . This movement of the siderails  60  provides clearance to permit the deck  16  to continue to move toward the foot end of the stretcher  10 . 
   Although the invention has been described in detail with reference to certain illustrated embodiments, variations and modifications exist within the scope and spirit of the present invention as described and defined in the following claims.