Patent Publication Number: US-2023135731-A1

Title: System for Reduced Buckling of a Probe During Deployment of a Blood Draw Device

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     The present application claims priority to U.S. Provisional Application Ser. No. 63/273,237, entitled “System for Reduced Buckling of a Probe During Deployment of a Blood Draw Device”, filed Oct. 29, 2021, the entire disclosure of which is hereby incorporated by reference in its&#39; entirety. 
    
    
     BACKGROUND OF THE INVENTION 
     Field of the Invention 
     The present invention is directed to a fluid transfer device for phlebotomy through a peripheral intravenous line or catheter and a method of using the fluid transfer device to draw blood or administer a drug to a patient. 
     Background of the Invention 
     The typical hospitalized patient encounters a needle every time a doctor orders a lab test. The standard procedure for blood extraction involves using a metal needle (“butterfly needle”) to “stick” patients&#39; veins in their arms or hands. Blood drawing is a manual, labor-intensive process, with the average patient requiring hours of direct skilled labor during a typical hospital stay. This needle stick is not only painful and a major source of patient dissatisfaction, but the nurses or specialized blood drawing personnel (phlebotomists) often have difficulty finding the vein in approximately 10-15% of patients, resulting in multiple, painful “stick” attempts. This results in significantly higher material and labor costs (needles and tubing must be disposed of after every attempt) and increased patient pain and bruising. 
     The current process for drawing blood is inefficient, taking on average 7-10 minutes, and more than 21 minutes for 10% of patients. These 10% of patients are referred to as Difficult Intra-Venous Access or more commonly as “tough stick” patients. If superficial veins are not readily apparent, blood can be forced into the vein by massaging the beam from wrist to elbow, tapping the site with the index and middle finger, applying a warm, damp washcloth to the site for 5 minutes, or by lowering the extremity over the bedside to allow the veins to fill. Each of these methods is time consuming and therefore costly. 
     Peripheral intravenous catheters (PIVs) are inserted into most patients while they are hospitalized and used for infusing fluids and medications. However, they are not designed for blood extractions. The failure rates for aspiration reach 20-50% when PIVs have been left inserted for more than a day. Blood extracted from PIVs is often hemolyzed, defined as the rupture of red blood cells and the release of their contents into surrounding fluid, resulting in a discarded sample and need to repeat the blood collection. 
     Several barriers can contribute to the shortcomings of extracting blood through a PIV. First, most catheters are formed from a soft bio-reactive polymer, which can lead to a potential narrowing or collapse of the catheter as the negative pressure is applied for aspiration. Another barrier is that longer indwelling times can increase debris (e.g., fibrin/platelet clots) that builds up on the tip of the catheter and within the lumen of the catheter and/or PIV. Similarly, such debris can at least partially occlude the lumen of the vein in which the PIV is placed. In some instances, this debris (e.g., fibrin/platelet clots) around the PIV can lead to reduced blood flow within portions of the vein surrounding the inserted PIV (e.g., both upstream and downstream), which in turn, results in improper and/or inefficient aspiration. Another barrier is attributed to a “suction cup” effect, wherein the negative pressure created by aspiration through the catheter and the possible curved path of a vein results in the tip of the catheter adhering to the wall of the vein. As the negative pressure increases the vein can rupture resulting in “blowing the vein,” which is a concern for phlebotomists during aspiration through a PIV. 
     By using a fluid transfer device that inserts a catheter into and/or through the PIV, several of these shortcomings can be overcome. However, during deployment the catheter of the fluid transfer device, especially when the proximal end portion of the catheter reaches the S-curve region of the PIV near where the PVI enters the skin, curves within the PIV in an upward direction, and curves again to pass along the vein, the catheter of the fluid transfer device is subject to a column load which can cause bending, kinking, and or deformation of the catheter of the fluid collection. As the catheter bends, it can move in random directions creating a sinusoidal wave, which then flattens against the sidewall of the housing of the fluid transfer device as the force increases. Additional force can then cause the catheter to double back on itself and collapse. Thus, a need exists for a fluid transfer device that at least solves this problem. 
     SUMMARY OF THE INVENTION 
     The present invention is directed to a fluid transfer device for phlebotomy through a peripheral intravenous line or catheter. The fluid transfer device comprises a catheter having a proximal end portion and a distal end portion and defining a lumen extending through the proximal end portion and the distal end portion, an introducer having a proximal end portion and a distal end portion, an actuator movably coupled to the introducer, and a catheter support movably coupled to the introducer and positioned between the actuator and the distal end portion of the introducer. The introducer defines an inner volume configured to movably receive the catheter, and the distal end portion of the introducer has a lock configured to couple the introducer to an indwelling peripheral intravenous line. The actuator has a first portion disposed outside of the introducer and a second portion disposed in the inner volume of the introducer and coupled to the proximal end portion of the catheter. The actuator is configured to move relative to the introducer to move the catheter between a first position, in which the catheter is disposed within the introducer, and a second position, in which the distal end portion of the catheter is disposed beyond the distal end portion of the introducer such that at least a first portion of the catheter is disposed within or beyond the peripheral intravenous line when the introducer is coupled to the peripheral intravenous line. The catheter support comprises a passageway, is movably coupled to the introducer, and is positioned between the actuator and the distal end portion of the introducer. The catheter extends from the second portion of the actuator through the passageway of the catheter support to the distal end portion of the introducer, and during movement of the actuator to move the catheter from the first position to the second position, the actuator contacts at least a portion of the catheter support and moves the catheter support with respect to the introducer. 
     The catheter support may comprise a bracket portion; and a hub portion including the passageway and extending from the bracket portion. A first portion of the actuator and the bracket portion of the catheter support may be positioned within a first portion of the inner volume of the introducer and a second portion of the actuator and the hub of the catheter support may be positioned within a second portion of the inner volume of the introducer. The first portion of the inner volume may define an axis that is parallel to and offset from an axis defined by the second portion of the inner volume. The bracket portion of the catheter support may have a profile corresponding to an outer surface of a flange provided on the inner surface of the introducer, such that the bracket portion fits over and at least partially covers the flange and is movable with respect to the introducer along the flange. 
     The passageway may be sized and shaped to allow the catheter to freely pass through the passageway while containing the catheter to prevent excessive movement of the catheter within the inner volume of the introducer. The passageway may comprise a proximal portion adjacent to and in fluid communication with a proximal opening of the passageway and a distal portion adjacent to and in fluid communication with a distal opening of the passageway. The distal portion of the passageway may be substantially cylindrical, and the proximal portion may be cone-shaped or funnel-shaped such that a diameter of the proximal portion decreases in a distal direction from the proximal opening to a juncture between the proximal portion of the passageway and the distal portion of the passageway. A diameter of the distal opening of the passageway may be smaller than a diameter of the proximal opening of the passageway, and the diameter of the proximal portion may decrease in a distal direction from the diameter of the proximal opening to the diameter of the distal opening of the passageway. 
     The catheter support may further comprise an engagement member extending from the bracket portion and through a slot in the introducer. 
     The hub of the catheter support may be positioned between the actuator and the distal end portion of the introducer, such that the hub divides an unsupported length of the catheter between the actuator and the distal end portion of the introducer into two smaller portions. 
     When the actuator is moved in the distal direction, partially advancing the catheter towards the second position, the actuator contacts the hub of the catheter support, and during further movement of the actuator in the distal direction, the actuator pushes the hub of the catheter support in the distal direction and the beam of the catheter support is advanced along the flange in the distal direction. A portion of the actuator may be sized and shaped to be at least partially received within a portion of the passageway of the hub. 
     The fluid transfer device may further comprise a coupling for releasably coupling the actuator to the catheter support. 
     The coupling may comprise one of a protrusion and a recess on a surface of a flexible beam at a distal end the actuator and the other of a protrusion and a recess on a surface of the catheter support. A camming surface may be provided on the distal end of the flexible beam and/or the catheter support to facilitate flexing of the flexible beam during coupling of the actuator to the catheter support. A stop may be provided on the bottom surface of the flexible beam distal to the protrusion or recess. 
     Alternatively, the coupling may comprise a protrusion on a surface of a flexible beam at a distal end the actuator and a releasable lock comprising a stop portion and an engagement portion, wherein the engagement portion of the releasable lock engages the protrusion to couple the actuator to the catheter support. The stop portion of the releasable lock may be received and movable along a groove provided in the introducer. During proximal movement of the catheter support, when the stop portion of the releasable lock abuts a proximal end of the groove, further proximal movement of the catheter support is no longer possible. Further force applied to the actuator in the proximal direction releases the engagement between the protrusion on the flexible beam and the engagement portion of the releasable lock such that the actuator is decoupled from the catheter support. 
     Alternatively, the coupling may comprise an engagement protrusion including a hook extending from a distal end of the actuator and a corresponding pivotable protrusion having a hook extending from the catheter support. The pivotable protrusion pivots around a pin that rides in a cam slot defined in the introducer, the cam slot comprising a retention portion and a movement portion. The retention portion is provided at a proximal end of the movement portion and forms a downward angle with the movement portion. The engagement protrusion defines a recess for receiving the pivotable protrusion when the actuator abuts the catheter support, and when the actuator abuts the catheter support, the pivotable protrusion is received in the recess and pivoted by a sloped bottom surface of the recess and the hook of the engagement protrusion engages the hook of the pivotable protrusion. With the pin in the retention portion, the catheter support is restricted from movement. 
     The fluid transfer device may further comprise a retraction stop to stop proximal movement of the catheter support. A flange may be provided on an inner surface of the introducer on which the actuator and the catheter support move. The retraction stop may extend upwardly from the flange and a portion of the actuator that moves along the flange may include a groove corresponding to the retraction stop, such that the actuator can move proximally past the retraction stop while proximal movement of the catheter support past the retraction stop is restricted. 
     The fluid transfer device may include a detent positioned in a slot in the introducer, wherein the detent engages the catheter support to restrict movement of the catheter support. 
     The catheter support may further comprise at least one locking protrusion extending from the catheter support through an opening in the introducer, where at least a portion of the locking protrusion extends in a distal direction along an outer surface of the introducer. The at least one locking protrusion is sized and shaped such that, when the catheter support is positioned at the distal end portion of the introducer, the locking protrusion is positioned to interfere with the release of the lock such that the catheter support must be moved in a proximal direction in order to disconnect the lock from the indwelling peripheral intravenous line. The least one locking protrusion may extend from the optional engagement member of the catheter support. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    is a perspective view of the inventive fluid transfer device in a first configuration. 
         FIG.  2    is a top view of the inventive fluid transfer device shown in  FIG.  1   . 
         FIG.  3    is an exploded view of the inventive fluid transfer device shown in  FIG.  1   . 
         FIG.  4    is a perspective view of a first member of the introducer included in the inventive fluid transfer device of  FIG.  1   . 
         FIG.  5    is a perspective view of a second member of the introducer included in the inventive fluid transfer device of  FIG.  1   . 
         FIG.  6    is a side view of the second member shown in  FIG.  5   . 
         FIG.  7    is an enlarged view of the region of the second member identified as A 1  in  FIG.  6   . 
         FIG.  8    is a rear perspective view of the introducer formed by coupling the first member illustrated in  FIG.  4    to the second member illustrated in  FIG.  5   . 
         FIG.  9    is a front perspective view of the introducer illustrated in  FIG.  8   . 
         FIG.  10    is a cross-sectional view of the introducer taken along the line  10 - 10  in  FIG.  9   . 
         FIG.  11    is a rear perspective view of the lock included in the inventive fluid transfer device of  FIG.  1   . 
         FIG.  12    is a top view of the lock included in the inventive fluid transfer device of  FIG.  1   . 
         FIG.  13    is a cross-sectional view of the lock taken along the line  13 - 13  in  FIG.  12   . 
         FIG.  14    is an exploded perspective view of the catheter, the secondary catheter, and the actuator included in the inventive fluid transfer device of  FIG.  1   . 
         FIG.  15    is a perspective view of the actuator shown in  FIG.  14   . 
         FIG.  16    is a side view of the actuator shown in  FIG.  14   . 
         FIG.  17    is a front view of the actuator shown in  FIG.  14   . 
         FIG.  18    is a cross-sectional view of the inventive fluid transfer device taken along the line  18 - 18  in  FIG.  4   . 
         FIG.  19 A  is a perspective view of the catheter support shown in  FIG.  5   . 
         FIG.  19 B  is a front view of the catheter support shown in  FIG.  5    with an optional engagement member. 
         FIG.  20    is a side perspective view of the introducer of the inventive fluid transfer device of  FIG.  1    with the second member of the introducer removed. 
         FIG.  21    is a perspective view of the catheter support inside the introducer of the inventive fluid transfer device of  FIG.  1   . 
         FIG.  22 A  is a side perspective view of the introducer of the inventive fluid transfer device of  FIG.  1    in the first configuration with the second member of the introducer removed. 
         FIG.  22 B  is a side perspective view of the introducer of the inventive fluid transfer device of  FIG.  1    as the inventive fluid transfer device is being transitioned from the first configuration to a second configuration with the second member of the introducer removed. 
         FIG.  22 C  is a side perspective view of the introducer of the inventive fluid transfer device of  FIG.  1    in the second configuration with the second member of the introducer removed. 
         FIG.  23    is a side cross-sectional view of the actuator and the catheter support of the inventive fluid transfer device just prior to nesting of a portion of the actuator in a portion of the passageway of the catheter support. 
         FIG.  24    is a side view of the inventive fluid transfer device of  FIG.  1    in the first configuration. 
         FIG.  25    is a cross-sectional view of the inventive fluid transfer device in the first configuration taken along the line  25 - 25  in  FIG.  1   . 
         FIG.  26    is an enlarged cross-sectional view of a portion of the inventive fluid transfer device identified by the region A 2  in  FIG.  25   . 
         FIG.  27    is an enlarged cross-sectional view of a portion of the inventive fluid transfer device identified by the region A 3  in  FIG.  25   . 
         FIG.  28    is a side view of the inventive fluid transfer device of  FIG.  1    as the inventive fluid transfer device is being transitioned from the first configuration to a second configuration. 
         FIG.  29    is an enlarged view of a portion of the inventive fluid transfer device identified by the region A 4  in  FIG.  28   . 
         FIG.  30    is a side view of the inventive fluid transfer device of  FIG.  1    in the second configuration. 
         FIG.  31    is a cross-sectional view of the inventive fluid transfer device in the second configuration taken along the line  25 - 25  in  FIG.  1   . 
         FIG.  32    is an enlarged cross-sectional view of a portion of the inventive fluid transfer device identified by the region A 5  in  FIG.  31   . 
         FIG.  33 A  is a perspective view of a configuration for coupling the actuator to the catheter support. 
         FIG.  33 B  is a cross-sectional view of the actuator of  FIG.  33 A  including a hinge in the flexible beam. 
         FIG.  33 C  is a cross-sectional view of an alternative configuration for the catheter support of  FIG.  33 A . 
         FIG.  33 D  is a cross-sectional view of another alternative configuration for the catheter support of  FIG.  33 A . 
         FIG.  34    is a side view of an alternative configuration for coupling the actuator to the catheter support. 
         FIG.  35 A  is a top view of an inventive fluid transfer device in the first configuration, the fluid transfer device having a catheter support with a locking protrusion. 
         FIG.  35 B  is a top view of the inventive fluid transfer device of  FIG.  35 A  in the second configuration. 
         FIG.  36    is a perspective view of a catheter support with a locking protrusion. 
         FIG.  37    is a cross-sectional view of the catheter support of  FIG.  36   . 
         FIG.  38    is a cross-sectional view of the catheter support of  FIG.  36    positioned in the introducer of an inventive fluid transfer device. 
         FIG.  39 A  is a top view of an inventive fluid transfer device in the first configuration, the fluid transfer device having a catheter support with two locking protrusion. 
         FIG.  39 B  is a top view of the inventive fluid transfer device of  FIG.  39 A  in the second configuration. 
         FIG.  40    is a cross-sectional view of the catheter support of  FIGS.  39 A and  39 B . 
     
    
    
     DESCRIPTION OF THE INVENTION 
     As used herein, unless otherwise expressly specified, all numbers such as those expressing values, ranges, amounts or percentages may be read as if prefaced by the word “about”, even if the term does not expressly appear. Any numerical range recited herein is intended to include all sub-ranges subsumed therein. For example, a range of “1 to 10” is intended to include any and all sub-ranges between and including the recited minimum value of 1 and the recited maximum value of 10, that is, all subranges beginning with a minimum value equal to or greater than 1 and ending with a maximum value equal to or less than 10, and all subranges in between, e.g., 1 to 6.3, or 5.5 to 10, or 2.7 to 6.1. Plural encompasses singular and vice versa. When ranges are given, any endpoints of those ranges and/or numbers within those ranges can be combined with the scope of the present invention. “Including”, “such as”, “for example” and like terms means “including/such as/for example but not limited to”. 
     For purposes of the description hereinafter, spatial orientation terms, as used, shall relate to the referenced embodiment as it is oriented in the accompanying drawings, figures, or otherwise described in the following detailed description. However, it is to be understood that the embodiments described hereinafter may assume many alternative variations and configurations. It is also to be understood that the specific components, devices, features, and operational sequences illustrated in the accompanying drawings, figures, or otherwise described herein are simply exemplary and should not be considered as limiting. 
     As used herein, the term “catheter” are used interchangeably to describe an element configured to define a passageway for moving a bodily fluid from a first location to a second location, for example, a fluid passageway to move a bodily fluid out of the body. While catheters can be configured to receive a trocar, a guide wire, or an introducer to deliver the catheter to a volume inside the body of a patient, the catheters referred to herein need not include or receive a trocar, guide wire, or introducer. 
     As used in this specification, the terms “Y-adapter” and “T-adapter” are used to refer to a dual port IV extension set. In this manner, the terms “Y-adapter” and “T-adapter” generally describe an overall shape of the dual port IV extension set. For example, as used herein, a Y-adapter is substantially “Y” shaped including a single port at a first end and two ports angularly disposed at a second end. Furthermore, the terms “Y-adapter” and “T-adapter” are included by way of example only and not limitation. For example, in some embodiments, an apparatus can include a single port IV extension set (e.g., a single port adapter) or a multi-port IV extension set (e.g., an adapter with more than two ports). 
     As used in this specification, the words “proximal” and “distal” refer to the direction closer to and away from, respectively, a user who would place the device into contact with a patient. Thus, for example, the end of a device first touching the body of the patient would be the distal end, while the opposite end of the device being manipulated by the user would be the proximal end of the device. 
     The present invention is directed to a fluid transfer device for phlebotomy through a peripheral intravenous line or catheter and a method of using the fluid transfer device to draw blood or administer a drug to a patient. 
       FIGS.  1 - 32    illustrate a fluid transfer device  200  according to the invention. The fluid transfer device  200  can be any suitable shape, size, or configuration and can be coupled to a peripheral intravenous catheter (PIV) (not shown in  FIGS.  1 - 32   ), for example, via a lock and/or adapter. As described in further detail herein, a user can transition the fluid transfer device  200  from a first configuration to a second configuration to advance a catheter  260  through an existing, placed, and/or indwelling PIV when the fluid transfer device  200  is coupled thereto, such that at least an end portion of the catheter  260  is disposed in a distal position relative to the PIV. Moreover, with peripheral intravenous lines having a shape, size, and/or configuration that can vary based on, for example, a manufacturer of the PIV and/or its intended usage, the fluid transfer device  200  can be arranged to allow the fluid transfer device  200  to be coupled to a PIV having any suitable configuration and subsequently, to advance at least a portion of a catheter  260  through the PIV substantially without kinking, snagging, breaking, and/or otherwise reconfiguring the catheter  260  in an undesirable manner. In addition, the fluid transfer device  200  can be manipulated by a user to place a distal surface of the catheter  260  a predetermined and/or desired distance beyond a distal surface of the PIV to be disposed within a portion of a vein that receives a substantially unobstructed flow of blood. 
     As shown in  FIGS.  1 - 3   , the fluid transfer device  200  comprises an introducer  210 , a lock  240 , a catheter  260 , a secondary catheter  265 , an actuator  270 , and a catheter support  280 . The introducer  210  can be any suitable shape, size, or configuration. For example, the introducer  210  can be an elongate member having a substantially circular cross-sectional shape, or the shape of the introducer  210  and/or one or more features or surface finishes of at least a portion of an outer surface of the introducer  210  can be arranged to increase the ergonomic of the fluid transfer device  200 , which in some instances, can allow a user to manipulate the fluid transfer device  200  with one hand (i.e., single-handed use). 
     As shown in  FIGS.  3 - 10   , the introducer  210  of the fluid transfer device  200  includes a first member  220  and a second member  230  that are coupled to collectively form the introducer  210 . As shown in  FIG.  4   , the first member  220  includes a proximal end portion  221 , a distal end portion  222 , and an inner surface  223 . The inner surface  223  has a first portion  226  and a second portion  227 . The proximal end portion  221  of the first member  220 , and more specifically, a proximal wall of the first member  220  defines a notch  224  configured to selectively receive a portion of the secondary catheter  265 , as described in further detail herein. 
     As shown in  FIGS.  5 - 7   , the second member  230  has a proximal end portion  231 , a distal end portion  232 , an inner surface  233 , and an outer surface  235 . As described above with reference to the first member  220 , the proximal end portion  231  of the second member  230 , and more specifically, a proximal wall of the second member  230  defines a notch  234  configured to selectively receive a portion of the secondary catheter  265 . The outer surface  235  of the second member  230  may optionally include a set of ribs  236  distributed along a length of the second member  230 . More particularly, each rib  236  extends along a width of the second member  230  and is successively distributed along the length of the second member  230 . In this manner, the outer surface  235  defines alternating local minima and local maxima arranged along the length of the second member  230 . As described in further detail herein, a portion of the actuator  270  is configured to be advanced along the outer surface  235  forming the set of ribs  236  as a user moves the actuator  270  relative to the introducer  210 , which in turn, vibrates the actuator  270  and the catheter  260  coupled thereto. In some instances, this vibration can, for example, facilitate the advancing of the catheter  260  through a portion or the fluid transfer device  200 , a portion of the PIV, and/or a portion of the vasculature. Moreover, in some instances, the vibration can provide a user with a haptic and/or audible indicator associated with a position of the catheter  260  relative to the introducer  210  and/or PIV, as described in further detail herein. 
     The ribs  236  formed by the outer surface  235  of the second member  230  can be any suitable shape, size, and/or configuration. For example, as shown in  FIGS.  6  and  7   , the set of ribs  236  includes a first portion  237  having a first size and shape, and a second portion  238  having a second size and shape, different from the first size and shape. The first portion  237  of ribs  236  can have any suitable configuration and/or arrangement. For example, each rib in the first portion  237  may be substantially uniform having substantially the same size and shape. Alternatively, each rib included in the first portion  237  can have a size and shape that is different from the remaining ribs of the first portion  237 . For example, the size and shape of each rib in the first portion  237  can increase from a proximal most rib having the smallest size and shape to a distal most rib having the largest size and shape. Moreover, while the ribs of the first portion  237  are shown as being substantially symmetrical, each rib of the first portion  237  can be asymmetrical. For example, a proximal surface of each rib can have a first pitch (angle) and a distal surface of each rib can have a second pitch that is greater than the first pitch. Such an asymmetric arrangement can be such that the portion of the actuator  270  moves along the outer surface  235  with a first set of characteristics when moved in a distal direction and moves along the outer surface  235  with a second set of characteristics, different from the first set of characteristics, when moved in a proximal direction. For example, the portion of the actuator  270  can move along the outer surface  235  in the distal direction more freely than in the proximal direction. 
     Similarly, the second portion  238  of the ribs  236  can have any suitable configuration and/or arrangement. For example, each rib  236  in the second portion  238  may be substantially uniform having substantially the same size and shape as the remaining ribs  236  in the second portion  238 . As shown in  FIG.  9   , each rib in the second portion  238  may have a size and shape that is greater than the size and shape of each rib of the first portion  237 . Increasing the size of the ribs  236  of the second portion  238  may provide a larger amount of vibration as the actuator  270  is moved along the outer surface  235  (as described above) or may result in an increase in the force otherwise sufficient to move the portion of the actuator  270  along the outer surface  235 . While the ribs  236  of the second portion  238  are shown and described as being substantially uniform and having a larger size than the ribs  236  of the first portion  237 , the ribs of the second portion  238  may have any of the arrangements and/or configurations described above with reference to the ribs of the first portion  237 . 
     While the set of ribs  236  transitions from the first portion  237  to the second portion  238  at a given point along the length of the second member  230  (see e.g.,  FIG.  7   ), the size and shape of each rib  236  in the set of ribs  236  may increase from a proximal most rib of the first portion  237  having the smallest size and shape to a distal most rib of the second portion  238  having the largest size and shape, such that the size and shape of each of rib in the set of ribs  236  increases with each successive rib, for example, in the distal direction. 
     The set of ribs  236  may further include more than the first portion  237  and the second portion  238 . For example, the second member can include a set of ribs having a first portion and a second portion having a size, shape, and configuration similar to the first portion  237  of the second member  230 , and a third portion, disposed between the first portion and the second portion, having a size, shape, and configuration similar to the second portion  238  of the second member  230 . In this configuration, the second member  230  includes a proximal portion of ribs and a distal end portion of ribs that are smaller than a medial portion of ribs disposed therebetween. 
     The arrangement of the set of ribs  236  of the second member  230  may be such that a proximal most rib and a distal most rib are larger and/or otherwise have a shape that is operable to at least temporarily maintain the portion of the actuator  270  in a proximal position relative to the proximal most rib and a distal position relative to the distal most rib, respectively. 
     While the set of ribs  236  are shown as being formed only on the outer surface  235  of the second member  230 , the first member  220  can include an outer surface that forms a set of ribs as an alternative to the set of ribs  236  on the second member  230  or in addition to the set of ribs  236  on the second member  230 . In such embodiments, the set of ribs of the first member  220  can be and/or can have any of the configurations and/or arrangements described above with reference to the set of ribs  236  of the second member  230 . When ribs are provided on the first member  220  in addition to the ribs  236  provided on the second member  230 , the ribs of the first member  220  can be offset from the ribs  236  of the second member  230 . For example, the ribs of the first member  220  can have alternating local minima and local maxima, as described above with reference to the ribs  236  that are distributed along a length of the second member  230 , such that the local minima and local maxima of the ribs of the first member  220  are aligned with the local maxima and local minima, respectively, of the ribs  236  of the second member  230 , or are offset from the local maxima and local minima, respectively, of the ribs  236  of the second member  230 . Alternatively, the ribs of the first member  220  can be in varying positions relative to the ribs  236  of the second member  230 . In this manner, the introducer  210  can provide a variable arrangement of ribs that can provide, for example, haptic feedback as the actuator  270  is moved relative to the introducer  210 . 
     As shown in  FIGS.  8 - 10   , the first member  220  is configured to be coupled to the second member  230  to collectively form the introducer  210 . For example, the first member  220  and the second member  230  can be coupled via ultrasonic welding, an adhesive, a mechanical fastener, one or more tabs, snaps, pins, and/or the like to form the introducer  210 . Coupling the first member  220  to the second member  230 , for example, during a manufacturing process, to form the introducer  210  can facilitate and/or simplify one or more manufacturing processes. For example, forming the introducer  210  from the first member  220  and the second member  230  can reduce undesirable variations in the shape and/or size of the inner surfaces  227 ,  233 , for example, due to draft angles and/or manufacturing tolerances, during manufacturing, which in some instances, can reduce a likelihood of kinks, bends, and/or deformations of the catheter  260  during use of the fluid transfer device  200 . Forming the introducer  210  from the first member  220  and the second member  230  can also allow at least the inner surface  227  of the first member  220  to form a tortuous shape that would otherwise present challenges when manufacturing the introducer  210  from a single work piece. 
     Alternatively, the introducer  210  can be monolithically formed, for example, via injection molding and/or any other suitable manufacturing process, such that the introducer  210  is formed from a single work piece rather than two work pieces, namely, the first member  220  and the second member  230 . Thus, when referring to features of the introducer  210 , such features can be formed and/or defined by the first member  220 , formed and/or defined by the second member  230 , collectively formed and/or defined by the first member  220  and the second member  230 , or, when the introducer  210  is formed from a single work piece, formed and/or defined by a corresponding portion of the introducer  210 . 
     The first member  220  and the second member  230  collectively form a proximal end portion  211  and a distal end portion  212  of the introducer  210  and collectively define an inner volume  213  of the introducer  210 . As shown in  FIG.  10   , the proximal end portion  211  of the introducer  210  defines an opening  217 . Specifically, the opening  217  is collectively formed and/or defined by the notch  224  of the first member  220  and the notch  234  of the second member  230 . The arrangement of the proximal end portion  211  may be such that a portion of the opening  217  defined by the notch  224  of the first member  220  has a first size and/or shape and a portion of the opening  217  defined by the notch  234  of the second member  230  has a second size and/or shape that is less than the first size and/or shape, such that a portion of the opening  217  is constricted, pinched, obstructed, and/or otherwise reduced. As described in further detail herein, the opening  217  is configured to receive a portion of the secondary catheter  265 , which can be moved within the opening  217  from the larger portion of the opening  217  to the reduced portion of the opening  217 , for example, the portion formed by the notch  234  of the second member  230 , to obstruct, pinch, and/or clamp the secondary catheter  265 . 
     As shown in  FIG.  9   , the distal end portion  212  of the introducer  210  includes and/or otherwise forms a coupler  216 , and the distal end portion  222  of the first member  220  and the distal end portion  232  of the second member  230  may collectively form the coupler  216  at the distal end portion  212  of the introducer  210 . The coupler  216  can be any suitable shape, size, and/or configuration. For example, the coupler  216  may form a set of threads, which can form a threaded coupling with an associated threaded portion of the lock  240 , as described in further detail herein. Although not shown in  FIG.  9   , the distal end portion  212  of the introducer  210  can include and/or can be configured to receive a seal that can selectively seal and/or fluidically isolate the inner volume  213  of the introducer  210  at least from an open portion of the coupler  216 . In use, the seal can be transitioned from a sealed or closed configuration to an open configuration to allow, for example, a portion of the catheter  260  to pass therethrough. The seal may contact an outer surface of the catheter  260  or the secondary catheter to define a seal therebetween that is operable to limit and/or substantially prevent a back flow of fluid between the outer surface of the catheter and the seal. 
     The seal can be any suitable type of seal. For example, the seal can be an O-ring, a one-way valve, a diaphragm, a self-healing diaphragm, a check valve, a single crack valve, and/or any other suitable seal or valve member. The seal may be configured to define and/or otherwise have a predetermined “cracking” pressure, such that the seal transitions from a closed and/or sealed configuration to a substantially open configuration in response to an increase in pressure, for example, within the introducer  210 . For example, the seal can be a positive pressure seal or the like. Alternatively, the seal can be a fluid seal such as a saline lock or the like. Although not shown in  FIGS.  3 - 10   , the introducer  210  may include a device, mechanism, assembly, and/or the like, which can be manipulated to increase the pressure, for example, via air or other suitable fluid or liquid, within the introducer  210  to transition the seal from the closed configuration to the open configuration. For example, the introducer  210  can include and/or can be coupled to a bulb, pump, a syringe, a fluid source, a mechanical actuator, an electric actuator, and/or the like. 
     The inner surface  223  of the first member  220  and the inner surface  233  of the second member  230  collectively define the inner volume  213  of the introducer  210 . As shown in  FIG.  12   , the arrangement of the inner surfaces  223 ,  233  is such that the inner volume  213  has and/or defines a tortuous cross-sectional shape. For example, the inner volume  213  can have a substantially S-shaped or an at least partially S-shaped cross-sectional shape. More specifically, the inner surface  223  of the first member  220  includes and/or forms a flange  225  configured to separate the first portion  226  of the inner surface  223  from the second portion  227  of the inner surface  223 . Thus, the tortuous cross-sectional shape of the inner volume  213  forms and/or defines a first portion  214  of the inner volume  213  and a second portion  215  of the inner volume  213 . In this manner, the first portion  214  of the inner volume  213  is spaced apart from the second portion  215  of the inner volume  213  without being fluidically isolated therefrom. In other words, the first portion  214  of the inner volume  213  defines an axis that is parallel to and offset from an axis defined by the second portion  215  of the inner volume  213 . 
     As shown in  FIG.  10   , the first portion  214  of the inner volume  213  extends through a wall of the introducer  210  such that a slot  218 , channel, track, opening, and/or the like that is in fluid communication with the first portion  214  of the inner volume  213  extends through the wall of the introducer  210 . Conversely, the second portion  215  of the inner volume  213  is entirely defined and/or enclosed, at least in the circumferential direction, by the introducer  210 . The tortuous cross-sectional shape of the inner volume  213  is such that the second portion  215  cannot be viewed via the slot  218  and is out of the line of sight of the slot  218  in fluid communication with the first portion  214  of the inner volume  213 , which in turn, limits and/or substantially prevents contamination of the catheter  260  disposed therein. 
     The second portion  215  of the inner volume  213  is substantially aligned with at least a portion of the opening  217  defined in the proximal end portion  211  of the introducer  210  and at least a portion of an opening defined by the coupler  216 . Moreover, the second portion  215  of the inner volume  213  is configured to be substantially aligned with the lock  240  when the lock is coupled to the coupler  216  of the introducer  210 , such that an axis defined by the second portion  215  of the inner volume  213  is substantially co-axial with an axis defined by a portion of the lock  240 , as described in further detail herein. In this manner, the second portion  215  of the inner volume  213  can receive a portion of the actuator  270  and a portion of the catheter  260 . Thus, the actuator  270  can be moved relative to the introducer  210  to move the catheter  260  between a first position, in which the catheter  260  is entirely disposed within the second portion  215  of the inner volume  213 , the coupling  216  and/or the lock  240 , and a second position, in which at least a portion of the catheter  260  extends outside of the second portion  215  of the inner volume  213  and distal to the introducer  210 , as described in further detail herein. 
     The lock  240  of the fluid transfer device  200  can be any suitable shape, size, and/or configuration. As described above, the lock  240  is configured to be physically and fluidically coupled to the introducer  210  and configured to couple the introducer  210  to the PIV and/or any suitable intermediate device or adapter coupled to the PIV. The lock  240  has a coupler  241 , a proboscis  242 , a first arm  243 , and a second arm  250 , as shown in  FIGS.  11 - 14   . In addition, the lock  240  defines a lumen  255  extending through the coupler  241  and the proboscis  242 . The coupler  241  is configured to couple the lock  240  to the coupler  216  of the introducer  210 . Specifically, the coupler  241  includes and/or forms one or more protrusions configured to selectively engage threads defined and/or formed by the coupler  216  of the introducer  210 , thereby forming a threaded coupling. 
     The proboscis  242  extends from the coupler  241  and is disposed between the first arm  243  and the second arm  250 . The proboscis  242  can be any suitable shape, size, and/or configuration. In some embodiments, the configuration of the proboscis  242  can be associated with or at least partially based on a size and/or shape of the PIV, a size and/or shape of an adapter, for example, an extension set, a Y-adapter, a T-adapter, or the like, or a collective size and/or shape of the PIV and the adapter. For example, the proboscis  242  can have a length that is sufficient to extend through at least a portion of the PIV or adapter. When an adapter is coupled to the PIV, the proboscis  242  may have sufficient length to extend through the adapter and at least partially into or through the PIV and may have sufficient length for at least a portion of the proboscis  242  to be distal to the PIV. Moreover, the proboscis  242  may have an outer diameter that is similar to or slightly smaller than an inner diameter of a portion of the PIV and/or adapter coupled thereto. For example, an outer surface of the proboscis  242  can be in contact with an inner surface of the PIV when the proboscis  242  is disposed therein. In this manner, the proboscis  242  can provide structural support to at least a portion of the PIV within which the proboscis  242  is disposed. Similarly, the proboscis  242  can have an inner diameter at least partially defining the lumen  255  that is similar to or slightly larger than an outer diameter of a portion of the catheter  260 , as described in further detail herein. 
     The first arm  243  and the second arm  250  of the lock  240  can be any suitable shape, size, and/or configuration. As shown in  FIGS.  11  and  12   , the first arm  243  has a first end portion  244 , a second end portion  245  including a tab  246 , and a pivot portion  247  disposed between the first end portion  244  and the second end portion  245 . The tab  246  disposed at and/or formed by the second end portion  245  extends from the second end portion  245  toward the proboscis  242 . In this manner, the tab  246  can selectively engage a portion of the PIV and/or a portion of an adapter coupled to the PIV to couple the lock  240  thereto, as described in further detail herein. 
     The pivot portion  247  of the first arm  243  extends from the coupler  241 , proboscis  242 , and/or second arm  250  in a lateral direction. The first end portion  244  of the first arm  243  is proximal to the pivot portion  247 , and the second end portion  245  of the first arm  243  is distal to the pivot portion  247 . As such, the first arm  243  can act as a lever configured to pivot about an axis defined by the pivot portion  247  in response to an applied force. For example, a user can exert a force on the first end portion  244  toward the coupler  241  that is sufficient to pivot the first end portion  244  of the first arm  243  toward the coupler  241  as indicated by the arrow AA in  FIG.  12    and the second end portion  245  of the first arm  243  away from the proboscis  242  as indicated by the arrow BB in  FIG.  12   . 
     As described above with reference to the first arm  243 , the second arm  250  of the lock  240  has a first end portion  251 , a second end portion  252  including a tab  253 , and a pivot portion  254  disposed between the first end portion  251  and the second end portion  252 . The first arm  243  and the second arm  250  may be substantially similar in form and function and are arranged in opposite positions and orientations relative to the coupler  241  and proboscis  242 , such that the lock  240  is substantially symmetrical about its longitudinal axis. As such, the discussion of the first arm  243  similarly applies to the second arm  250  and thus, the second arm  250  is not described in further detail herein. 
     As described above, the lock  240  is configured to be coupled to the PIV and/or an adapter coupled to the PIV. For example, a user can exert a lateral force on the first end portion  244  of the first arm  243  and the first end portion  251  of the second arm  250  to pivot the first arm  243  and the second arm  250 , respectively, from a first position toward a second position. The pivoting of the first arm  243 , therefore, increases the space defined between the proboscis  242  and the second end portion  245  and the tab  246  of the first arm  243 . Similarly, the pivoting of the second arm  250  increases the space defined between the proboscis  242  and the second end portion  252  and the tab  253  of the second arm  250 . In this manner, the increased space between the proboscis  242  and the arms  243 ,  250  is sufficient to allow a portion of the PIV and/or an adapter coupled to the PIV to be inserted within the space. Once the portion of the PIV and/or the adapter is in a desired position relative to the lock  240 , the user can remove the force and in turn, the arms  243 ,  250  pivot toward their respective first positions. As a result, the second end portions  245 ,  252  are moved toward the proboscis  242  until the tabs  246 ,  253  are placed in contact with a portion of the PIV and/or the adapter. The tabs  246 ,  253  are configured to engage the portion of the PIV and/or adapter to temporarily couple the lock  240  to the PIV and/or adapter. The lock  240  may be configured to establish three points of contact with the PIV and/or the adapter, namely, the tabs  246 ,  253 , and an outer surface of the proboscis  242  as described above. The tabs  246  and  253  may be configured to produce an audible output such as a click, a vibratory output such as a haptic bump, and/or the like when placed in contact with the portion of the PIV and/or adapter, which can indicate to a user that the lock  240  is properly coupled to the PIV and/or adapter. 
     The arms  243 ,  250  of the lock  240  may be positioned to extend horizontally with respect to the introducer  210 , i.e., the arms  243 ,  250  extend outwardly from the sides of the fluid transfer device  200  as shown in the  FIG.  1    or may be positioned to extend vertically with respect to the introducer  210 , i.e., the arms  243 ,  250  extend outwardly from the top and bottom of the fluid transfer device  20 . Providing the arms  243 ,  250  in the vertical position reduces the space needed for storing the fluid transfer device  200 . 
     As shown in  FIG.  13   , the proboscis  242  and the coupler  241  may collectively define the lumen  255 . The lumen  255  of the lock  240  defines an axis (not shown) that is aligned with and/or substantially co-axial with the axis defined by the second portion  215  of the inner volume  213 . Thus, the lumen  255  of the lock  240  receives a portion of the catheter  260  when the fluid transfer device  200  is transitioned between the first configuration and the second configuration. The lumen  255  may have a size and/or shape that is based at least in part on a size and/or shape of the catheter  260 . For example, the lumen  255  may have an inner diameter that is slightly larger than an outer diameter of at least a portion of the catheter  260 . The lock  240  acts as an external guide that supports and/or guides the catheter  260  as the catheter  260  is moved within the lumen  255 , which in turn, can reduce and/or substantially prevent undesirable bending, kinking, flexing, and/or deforming of the catheter  260 . 
     Although the lock  240  is shown and described above as including the proboscis  242 , the lock need not form a proboscis. For example, the lock may include a relatively short hub or the like configured to engage a portion of the PIV and/or an adapter coupled to the PIV. Alternatively, the fluid transfer device can include and/or can be used with a proboscis or guide member not formed with or by the lock configured to be disposed, for example, between a PIV and an adapter such as an IV extension set. For example, such a proboscis or guide member may have an inner surface that is funnel-shaped and/or is shaped similar to the inner surface of the proboscis  242 . In this manner, the inner surface of such a proboscis and/or guide member can guide a portion of the catheter  260  as the catheter  260  is moved between the first position and the second position. In some embodiments, the lock  240  including the proboscis  242  can be used in conjunction with such an external or separate proboscis and/or guide member by inserting a portion of the proboscis  242  of the lock  240  into the proboscis and/or guide member when the lock  240  is coupled to an adapter, for example, an IV extension set. 
     The actuator  270  of the fluid transfer device  200  is coupled to the catheter  260  and can be moved along a length of the introducer  210  to transition the fluid transfer device  200  between its first configuration, in which the catheter  260  is in the first position, and its second configuration, in which the catheter  260  is in the second position. The actuator  270  can be any suitable shape, size, and/or configuration. For example, the actuator  270  can have a size and shape that is associated with and/or based at least in part on a size and/or shape of the introducer  210 . 
     As shown in  FIGS.  13 - 17   , the actuator  270  includes a first portion  271 , the second portion  275 , and a wall  277  extending therebetween. The first portion  271  of the actuator  270  is at least partially disposed within the first portion  214  of the inner volume  213  defined by the introducer  210  and the second portion  275  of the actuator  270  is disposed within the second portion  215  of the inner volume  213 . 
     The first portion  271  of the actuator  270  includes an engagement member  272 . The arrangement of the actuator  270  is such that the engagement member  272  is disposed outside of the introducer  210  while the rest of the first portion  271  is within the first portion  214  of the inner volume  213  defined by the introducer  210 . As such, the engagement member  272  can be engaged and/or manipulated by a user, for example, by a finger or thumb of the user, to move the actuator  270  relative to the introducer  210 . The engagement member  272  may include a set of ridges and/or any suitable surface finish that can, for example, increase the ergonomic of the actuator  270  and/or fluid transfer device  200 . 
     The engagement member  272  includes a tab  273  disposed at or near a proximal end portion of the engagement member  272 . The tab  273  can be any suitable tab, rail, ridge, bump, protrusion, knob, roller, slider, etc. that extends from a surface of the engagement member  272 . The tab  273  is configured to selectively engage the outer surface  235  of the second member  230  of the introducer  210 . More specifically, the tab  273  is in contact with the ribs  236  formed by the second member  230  and moves along each successive rib as the actuator  270  is moved along a length of the introducer  210 . 
     As described above with reference to the set of ribs  236  of the second member  230 , the tab  273  can have any suitable shape, size, and/or configuration. For example, as shown in  FIG.  16   , the tab  273  can include a substantially rounded surface that can be moved along the set of ribs  236 . The size and/or shape of the tab  273  may be based at least in part on the size and/or shape of the ribs  236  such that a desired surface area of the tab  273  is in contact with the ribs  236  as the actuator  270  is moved relative to the introducer  210 . Further, the amount of friction defined between the set of ribs  236  and the tab  273  can be based at least in part on the surface area of the tab  273  that is in contact with the set of ribs  236 . Moreover, the amount of friction defined between the set of ribs  236  and the tab  273  can be based at least in part on a position of the tab  273  relative to each rib. For example, the amount of friction defined between the tab  273  and a rib can increase as the tab  273  moves closer to, for example, a local maxima and can decrease as the tab  273  moves away from the local maxima. The tab  273  may have a size and/or shape that allows the tab  273  to move with substantially less friction between each adjacent rib, for example, between adjacent local maximums, such that the arrangement of the tab  273  and the set of ribs  236  can allow for a desired amount of “play” between adjacent ribs  236 . 
     With the first portion  237  of the set of ribs  236  having a smaller size than the second portion  238  of the set of ribs  236 , a first portion or first surface area of the tab  273  can be in contact with the first portion  237  of the set of ribs  236  and a second portion or second surface area of the tab  273  can be in contact with the second portion  238  of the set of ribs  236 . In this manner, the tab  273  can move along the first portion  237  with a first set of characteristics and can move along the second portion  238  with a second set of characteristics different from the first set of characteristics. For example, a force sufficient to move the tab  273  along the second portion  238  of the set of ribs  236  can be greater than a force otherwise sufficient to move the tab  273  along the first portion  237  of the set of ribs  236 . Alternatively or in addition, the movement of the tab  273  along the second portion  238  of the set of ribs  236  may result in, for example, a larger amount of vibration of the actuator  270  than an amount of vibration otherwise resulting from the movement of the tab  273  along the first portion  237  of the set of ribs  236 . Similarly, the shape of the tab  273  can be such that the tab  273  moves along the set of ribs  236  in the distal direction in response to an applied force that is insufficient to move the tab  273  along the set of ribs  236  in the proximal direction. For example, as shown in  FIG.  16   , the tab  273  may have an asymmetric shape, wherein a proximal surface of the tab  273  has a greater pitch than a pitch of the distal surface. 
     While the engagement member  272  and tab  273  are particularly shown and described above, in other embodiments, the actuator can include an engagement member and/or tab having any suitable configuration. For example, while the tab  273  is shown as being disposed at or near a proximal end portion of the engagement member  272 , in other embodiments, the engagement member may include a first tab disposed at or near a proximal end portion and a second tab disposed at or near a distal end portion, each of which can be selectively in contact with a set of ribs disposed on an outer surface of an introducer  210 . In some embodiments, a space defined between a surface of the wall  277  and a surface of the engagement member  272  can be increased or decreased, which can result in an increase or decrease in an amount of travel of the actuator  270  relative to the introducer  210  in a direction other than an axial direction, such that the increase or decrease in space between the surface of the wall  277  and the surface of the engagement member  272  results in, for example, an increase or decrease of the amount the actuator  270  can “tilt” relative to the introducer  210 . In other embodiments, the arrangement of the engagement member  272 , the tab  273 , and/or the set of ribs  236  of the introducer  210  can be modified, altered, tuned, adjusted, and/or otherwise changed such that the actuator  270  moves relative to the introducer  210  with a desired set of characteristics. For example, the arrangement of the actuator  270  and/or introducer  210  can increase or decrease an amount the actuator  270  vibrates as it is moved relative to the introducer  210 , increase or decrease the amount of force sufficient to move the actuator  270  relative to the introducer  210 , increase or decrease the amount of movement of the actuator  270  relative to the introducer  210  in any suitable direction other than the axial direction (i.e., the proximal direction and distal direction), and/or the like. 
     As shown, in  FIGS.  17  and  18   , the second portion  275  has a cross-sectional shape that is based at least in part on a cross-sectional shape of the second portion  215  of the inner volume  213  defined by the introducer  210 , for example, at least a partially circular cross-sectional shape. In this manner, the inner surface  223  of the first member  220  and the inner surface  233  of the second member  230  can support and/or guide the second portion  275  of the actuator  270  as the actuator  270  moves relative to the introducer  210 . As shown, the second portion  275  defines an opening  276  configured to receive a proximal end portion  261  of the catheter  260  and a distal end portion  267  of the secondary catheter  265 . In some embodiments, the proximal end portion  261  of the catheter  260  can form a friction fit with an inner surface of the second portion  275  of the actuator  270  when the proximal end portion  261  is disposed in the opening  276 . Similarly, the distal end portion  267  of the secondary catheter  265  can form a friction fit with an inner surface of the second portion  275  of the actuator  270  when the distal end portion  267  is disposed in the opening  276 . As such, the catheter  260  and the secondary catheter  265  can be maintained in a fixed position relative to the actuator  270  and thus, move concurrently with the actuator  270  as the actuator  270  is moved relative to the introducer  210 . 
     The wall  277  of the actuator  270  couples the first portion  271  of the actuator  270  to the second portion  275  of the actuator  270 . As shown in  FIGS.  17  and  18   , the wall  277  has a tortuous cross-sectional shape that is based at least in part on the tortuous cross-sectional shape of the inner volume  213  defined by the introducer  210 . In this manner, the first portion  271  of the actuator  270  can define an axis that is parallel to but offset from an axis defined by the second portion  275  of the actuator  270 . For example, the wall  277  can have a substantially S-shaped or an at least partially S-shaped cross-sectional shape, or the wall  277  can form dogleg shape or the like. The tortuous cross-sectional shape of the wall  277  and thus, the actuator  270  is such that the second portion  275  of the actuator  270  cannot be viewed via the first portion  214  of the inner volume  213  and is out of the line of sight of the first portion  214  of the inner volume  213  defined by the introducer  210 . Similarly, the catheter  260  cannot be viewed via the first portion  214  of the inner volume  213  defined by the introducer  210  when the catheter  260  is in the first position. That is to say, the geometry of the actuator  270  and/or the introducer  210 , for example, the tortuous cross-sectional shape of the inner volume  213 , the height and/or width of the introducer  210 , etc. is configured such that the catheter  260  is at least partially isolated within the second portion  215  of the inner volume  213  when the catheter  260  is in the first position. In this manner, the structure of the introducer  210  and/or the actuator  270  can protect and/or isolate the catheter  260  from a volume outside of the introducer  210 , which in turn, can limit and/or substantially prevent contamination of the catheter  260 . For example, in some embodiments, the introducer  210  and/or the actuator  270  can act as a “sneeze guard” or the like configured to at least partially isolate the catheter  260  at least when the catheter  260  is in the first position. 
     As described above, at least a portion of the catheter  260  and at least a portion of the secondary catheter  265  are movably disposed within the second portion  215  of the inner volume  213  defined by the introducer  210 . As shown in  FIG.  14   , the catheter  260  has a proximal end portion  261  and a distal end portion  262  and defines a lumen  263  (see e.g.,  FIG.  28   ). The proximal end portion  261  of the catheter  260  is coupled to the second portion  275  of the actuator  270 . In this manner, the actuator  270  can be moved relative to the introducer  210  to move the catheter  260  between a first position, in which the catheter  260  is disposed within the introducer  210 , for example, with the entire catheter  260  disposed within the introducer  210  or within the introducer  210  and the lock  240 , and a second position, in which the distal end portion of the catheter  260  is at least partially disposed in a position distal to the lock  240  and/or the PIV (not shown) when the lock  240  is coupled to the PIV, as described in further detail herein. The distal end portion  262  can be any suitable shape, size, and/or configuration and can define at least one opening in fluid communication with the lumen  263 . For example, the distal end portion  262  of the catheter can be substantially similar to any of those described in U.S. Pat. No. 8,366,685 (referred to herein as the ““685 Patent”) entitled, “Systems and Methods for Phlebotomy Through a Peripheral IV Catheter,” filed on Apr. 26, 2012, the disclosure of which is incorporated herein by reference in its entirety. 
     While the invention is described herein as including a catheter and a secondary catheter, the catheter and a secondary catheter may be replace by a probe or a guidewire that is inserted into or through the PIV in the same manner as the catheter, or a probe or guidewires may be inserted through the catheter of the fluid transfer device and into or through the PIV. 
     The catheter  260  can be any suitable shape, size, and/or configuration. For example, at least a portion of the catheter  260  can have an outer diameter that is substantially similar to or slightly smaller than an inner diameter defined by the lumen  255  of the lock  240 , as described above, or an outer surface of the catheter  260  can be configured to contact an inner surface of the lock  240  that defines at least a portion of the lumen  255 . In this manner, an inner surface of the portion of the lock  240  defining the lumen  255  can guide the catheter  260  as the catheter  260  is moved between the first position and the second position. Such an arrangement can limit and/or can substantially prevent bending, deforming, flexing, and/or kinking of the catheter  260  as the catheter  260  is moved between the first position and the second position. Moreover, the length of the catheter  260  can be sufficient to define a predetermined and/or desired distance between the distal surface of the catheter  260  and the distal surface of the PIV when the catheter  260  is in the second position, as described in further detail herein. 
     The catheter  260  may be formed from any suitable material or combination of materials, which in turn, can result in the catheter  260  having any suitable stiffness or durometer. For example, the catheter  260  can be formed of a relatively flexible biocompatible material with a Shore durometer of approximately 20 Shore A to 50 Shore D, approximately 20 Shore A to 95 Shore D, approximately 70 Shore D to 85 Shore D, and/or any other suitable range of Shore durometer. At least a portion of the catheter  260  may be formed of a braided material or the like, which can modify, change, and/or alter a flexibility of the catheter  260  in response to a bending force. By forming at least a portion of the catheter  260  from the braided material, the amount of deformation of the catheter  260  in response to a bending force prior to buckling, kinking, and/or otherwise obstructing the lumen  263  of the catheter  260  can be increased. Similarly, forming at least a portion of the catheter  260  of a braided material can result in compression and/or deformation in response to a compression force exerted in a direction of a longitudinal centerline defined by the catheter  260  (e.g., an axial force or the like). In this manner, the catheter  260  can absorb a portion of the force associated with, for example, impacting an obstruction or the like. In some instances, such an arrangement can reduce buckling and/or kinking of the catheter  260  as well as reduce and/or substantially prevent damage to vascular structures that may otherwise result from an impact of the catheter  260 . Moreover, forming at least a portion of the catheter  260  from the braided material can increase the amount of vibration transmitted through the catheter  260  in response to the portion of the actuator  270  advancing along the set of ribs  236  of the introducer  210  as described above. While the catheter  260  is described above as including at least a portion formed of a braided material, at least a portion of the catheter  260  can be formed of and/or can include a support wire, a stent, a fenestrated catheter, and/or the like such as those described in the &#39;685 Patent incorporated by reference above. 
     The secondary catheter  265  has a proximal end portion  266  and a distal end portion  267  and defines a lumen  268  (see e.g.,  FIG.  25   ). A portion of the secondary catheter  265  is disposed within and extends through the opening  217  of the introducer  210 , which can be collectively defined by the notches  224 ,  234  of the first member  220  and second member  230 , respectively. As such, the proximal end portion  266  is at least partially disposed outside of the introducer  210  and the distal end portion  267  is at least partially disposed within the second portion  215  of the inner volume  213  defined by the introducer  210 . As described above, the secondary catheter  265  can be moved within the opening  217  between a first position and a second position to selectively clamp, pinch, kink, bend, and/or otherwise deform a portion of the secondary catheter  265 , which in turn, obstructs, pinches, kinks, closes, seals, etc. the lumen  268  of the secondary catheter  265 . For example, the first position can be associated and/or aligned with a first portion of the opening  217  having a larger perimeter and/or diameter than a perimeter and/or diameter of a second portion of the opening  217  associated and/or aligned with the second position. Thus, a user can manipulate the secondary catheter  265  to occlude the lumen  268  of the secondary catheter  265 , thereby limiting, restricting, and/or substantially preventing a flow of a fluid therethrough. 
     As shown in  FIG.  14   , the proximal end portion  266  of the secondary catheter  265  is coupled to and/or otherwise includes a coupler  269 . The coupler  269  is configured to physically and fluidically couple the secondary catheter  265  to any suitable device such as, for example, a fluid reservoir, fluid source, syringe, evacuated container holder (e.g., having a sheathed needle or configured to be coupled to a sheathed needle), pump, and/or the like. The distal end portion  267  of the secondary catheter  265  is at least partially disposed within the second portion  215  of the inner volume  213  defined by the introducer  210  and is coupled to the second portion  275  of the actuator  270 . In some embodiments, the secondary catheter  265  can have a larger diameter than the catheter  260  such that the proximal end portion  261  of the catheter  260  is at least partially disposed within the lumen  268  defined by the secondary catheter  265  when the catheter  260  and the secondary catheter  265  are coupled to the second portion  275  of the actuator  270 . Such an arrangement can, for example, reduce and/or substantially prevent leaks associated with fluid flowing between the catheter  260  and the secondary catheter  265 . Such an arrangement can also limit, reduce, and/or substantially prevent hemolysis of a volume of blood as the volume of blood flows through the catheter  260  and the secondary catheter  265 . In this manner, when the coupler  269  is coupled to a fluid reservoir, fluid source, syringe, evacuated container, pump, etc., the secondary catheter  265  establishes fluid communication between the reservoir, source, pump, etc. and the catheter  260 . 
     As shown in  FIGS.  3 ,  19 - 24 ,  25 ,  31 , and  32   , the catheter support  280  includes a bracket portion  281  and a hub portion  282 . The bracket portion  281  of the catheter support  280  is at least partially disposed within the first portion  214  of the inner volume  213  defined by the introducer  210  and the hub portion  282  of the catheter support  280  is disposed within the second portion  215  of the inner volume  213 . 
     The bracket portion  281  of the catheter support  280  may optionally include an engagement member  284 . The arrangement of the catheter support  280  is such that the engagement member  284  is disposed outside of the introducer  210  while the rest of the bracket portion  281  is within the first portion  214  of the inner volume  213  of the introducer  210 . As such, the engagement member  284  can be engaged and/or manipulated by a user, for example, by a finger or thumb of the user, to move the catheter support  280  relative to the introducer  210 . The engagement member  284  may include a set of ridges and/or any suitable surface finish that can, for example, increase the ergonomic catheter support of the catheter support  280  and/or fluid transfer device  200 . 
     The engagement member  284  may optionally have any of the features described above with respect to the engagement member  272  of the actuator  270  including, but not limited to, a tab that interacts with the set of ribs  236  on the outer surface of the second member  230  of the introducer  210 . 
     The hub portion  282  has a cross-sectional shape that is based at least in part on a cross-sectional shape of the second portion  215  of the inner volume  213  defined by the introducer  210 , for example, at least a partially circular cross-sectional shape. In this manner, the inner surface  223  of the first member  220  and the inner surface  233  of the second member  230  can support and/or guide the hub portion  282  of the catheter support  280  as the catheter support  280  is moved relative to the introducer  210 . 
     The hub portion  282  defines a passageway  285  having a proximal opening  287  on the proximal end of the hub portion  282  and a distal opening  288  on the distal end of the hub portion  282 . The passageway  285  is sized and shaped to allow the catheter  260  to freely pass through the passageway  285  while being contained to prevent excessive movement of the catheter  286  within the second portion  215  of the inner volume  213  of the introducer  210 . The passageway  285  may be substantially cylindrical having a circular cross section. 
     The passageway  285  may comprise two portions with a proximal portion  289  adjacent to and in fluid communication with the proximal opening  287  and a distal portion  290  adjacent to and in fluid communication with the distal opening  288 . The proximal portion  289  of the passageway  285  may be sized and shaped to receive at least a portion of the second portion  275  of the actuator  270 . For example, the proximal opening  287  may be larger than the distal opening  288 . The distal portion  290  of the passageway  285  may be substantially cylindrical having a circular cross-section with a diameter equal to a diameter of the distal opening  288 . The proximal portion  289  may be substantially cone-shaped or funnel-shaped such that the proximal end of the proximal portion  289  of the passageway  285  has a diameter equal to a diameter of the proximal opening  287  and the diameter of the proximal portion  289  of the passageway  285  decreases until the distal end of the proximal portion  289  of the passageway  285  that is in fluid communication with the distal portion  290  of the passageway  285  has a diameter equal to the diameter of the distal portion  290  of the passageway  285 . 
     As shown in  FIG.  22   , a notch  291  may be provided in the cone-shaped or funnel-shaped proximal portion  289  of the passageway  285 . 
     As shown in  FIGS.  19 A and  19 B , the bracket portion  281  may have a tortuous cross-sectional shape that is based at least in part on the tortuous cross-sectional shape of the inner volume  213  of the introducer  210 . In this manner, the bracket portion  281  of the catheter support  280  can define an axis that is parallel to but offset from an axis defined by the hub portion  282  of the catheter support  280 . For example, the bracket portion  281  can have a substantially S-shaped or an at least partially S-shaped cross-sectional shape, or the bracket portion  281  can form dogleg shape or the like. The tortuous cross-sectional shape of the bracket portion  281  and thus, the catheter support  280 , may be such that the hub portion  275  of the catheter support  280  cannot be viewed via the first portion  214  of the inner volume  213  and is out of the line of sight of the first portion  214  of the inner volume  213  defined by the introducer  210 . The catheter support  280  may have an overall outer shape that is substantially the same as the actuator. 
     At least a portion of the bracket portion  281  of the catheter support  280  has a profile corresponding to an outer surface of the flange  225  provided on the inner surface of the introducer  210 , such that the bracket portion  281  fits over and at least partially covers the flange  225  and is movable with respect to the introducer  210  in a direction from the proximal end portion  211  of the introducer  210  to the distal end portion  212  of the introducer  210  and vice versa along the flange  225 . When the catheter support  280  is moved with respect to the introducer  210 , the bracket portion  281  moves within the first portion  214  of the inner volume  213 , and the hub portion  282  moves within the second portion  215  of the inner volume  213 . 
     The opening  276  of the actuator  270  and the passageway  285  of the catheter support  280  may be coaxial. 
     The catheter  260  is coupled with the second portion  275  of the actuator  270  and extends to the distal end portion  212  of the introducer  210 . Without the catheter support  280 , the length of the catheter  260  extending this distance would be unsupported. The force at which a catheter  260  buckles is inversely proportional to the effective length squared. Thus, as the effective length of the catheter  260  increases, the buckling force decreases making the catheter less resistant to buckling. This catheter support  280  supports the catheter  260 , thereby shortening the effective length of the catheter  280 , increasing the force required to buckle the catheter  260 , and decreasing the tendency of the catheter  260  to buckle. 
     The hub portion  282  of the catheter support  280  is positioned between the actuator  270  and the distal end portion  212  of the introducer  210  and the catheter  260  passes through the passageway  285  of the hub of the hub portion  282  such that the hub portion  282  divides the unsupported length of the catheter  260  into two smaller portions that are more resistant to bending, kinking, flexing, and/or deformation. 
     Referring now to  FIGS.  22 - 32   , the fluid transfer device  200  can be in a first configuration prior to use and can be transitioned by a user, for example, a doctor, physician, nurse, technician, phlebotomist, and the like, from the first configuration ( FIGS.  22 A and  24 - 27   ) to a second configuration ( FIGS.  22 C and  30 - 32   ) to dispose at least the distal end portion  262  of the catheter  260  in a distal position relative to the introducer  210 , for example, within an indwelling PIV (not shown) or distal to the indwelling PIV. The fluid transfer device  200  is in the first configuration when the catheter  260  is disposed in the first position within the introducer  210 . Substantially the entire catheter  260  may be disposed within the introducer  210  when the catheter  260  is in the first position. The introducer  210  can include a seal or the like (as described above) that can substantially seal the distal end portion  212  of the introducer  210  to isolate the catheter  260  within the second portion  215  of the inner volume  213 . Alternatively, as shown in  FIGS.  25    and  26 , the catheter  260  may be disposed within the introducer  210  and the lock  240  when the catheter  260  is in the first position. While the seal is described above as being included in the distal end portion  212  of the introducer  210 , in other embodiments, the lock  240  can include a seal or the like that can form a substantially fluid tight seal with an inner surface of the lock  240  that defines the lumen  255 . Thus, a seal disposed within the lock  240  can isolate the catheter  260  within the second portion  215  of the inner volume  213 . However, the introducer  210  and/or the lock  240  need not include a seal. For example, a PIV and/or an adapter, for example, an extension set coupled to the PIV can include a seal that is transitioned from a closed configuration to an open configuration when the lock  240  is coupled thereto. Although not shown, the catheter  260  may be disposed within a flexible sheath or the like that can maintain the catheter  260  in a substantially sterile environment while the catheter  260  is in the first position, for example, in embodiments in which the introducer  210  and/or lock  240  do not include a seal. 
     When the fluid transfer device  200  is in the first configuration, the actuator  270  is disposed in a proximal position and the catheter support  280  is disposed in an intermediate position between the actuator  270  and the distal end portion  212  of the introducer  210 , as shown in  FIGS.  23 A and  25   . In some embodiments, the tab  273  of the first portion  271  of the actuator  270  can be disposed within a recess or detent or otherwise in contact with a proximal most rib configured to temporarily and releasably maintain the actuator  270  in the proximal position until a force is exerted by the user to move the actuator  270  in the distal direction. 
     The proximal end portion  261  of the catheter  260  is coupled to the second portion  275  of the actuator  270 , the catheter  260  extends through the second portion  215  of the inner volume  213  of the introducer  210  and through the passageway  285  of the hub portion  282 , and the distal end portion  262  of the catheter  260  is received in the lumen of the coupler  216  and/or the lumen  255  of the lock  240 . 
     The initial, pre-use position of the catheter support  280  may be set such that, in the first configuration, the position of the hub portion  272  along the unsupported portion of the catheter  260  extending from the second portion  275  of the actuator  270  to the distal end portion  212  of the introducer  210  is at the center point of the unsupported portion of the catheter or may be offset from the center point of the unsupported length of the catheter  260 . For example, in the first configuration, the hub portion  282  of the catheter support  280  may be located in a position corresponding to a position of the actuator  270  when the advancement of the distal end portion  262  of the catheter  260  into the PIV meets resistance requiring additional force to be provided to the actuator  270  to further advance the catheter  260 . For example, the position of the hub portion  282  of the catheter support  280  may correspond to the position of the actuator  270  corresponding to the advancement of the distal end portion  262  of the catheter  260  to a point at which the distal end portion  262  encounters a region where the catheter  260  must turn a corner to pass through an S-curve, for example, the area where the catheter  260  enters the skin, curves in an upward direction, and curves again to pass along the vein. As described above, a portion of the secondary catheter  265  is disposed in the opening  217  defined by the introducer such that the distal end portion  267  of the secondary catheter  265  is at least partially disposed in the second portion  215  of the inner volume  213  and coupled to the second portion  275  of the actuator  270  while the proximal end portion  266  of the secondary catheter  265  is disposed outside of the introducer  210 . 
     With the fluid transfer device  200  in the first configuration, the user can manipulate the fluid transfer device  200  to couple the lock  240  to an indwelling PIV and/or to an adapter coupled to the PIV, for example, an extension set or the like. 
     With the fluid transfer device  200  coupled to the PIV and/or adapter, the user can engage the engagement member  272  of the first portion  271  of the actuator  270  to move the actuator  270  relative to the introducer  210 , which in turn, moves the catheter  260  from the first position disposed within the introducer  210  toward a second position in which the distal end portion  262  of the catheter  260  extends into and/or through the PIV. In this manner, the catheter  260  is moved through the second portion  215  of the inner volume  213 , the passageway  285  of the hub portion  282  of the catheter support  280 , and the lumen  255  of the lock  240  and at least the distal end portion  262  of the catheter  260  is disposed outside of and distal to the lock  240 , as indicated by the arrow CC in  FIG.  28   . 
     After partial movement of the actuator  270  in the distal direction and partial advancement of the catheter  260  towards the second position, the actuator  270  contacts the hub portion  282  of the catheter support  280 . The distal end of the second portion  275  of the actuator  270  may abut the proximal end of the hub portion  282  or may be sized and shaped to be at least partially received within the proximal portion  289  of the passageway  285  of the hub portion  282 . 
     As the actuator  270  is advanced further in the distal direction, the actuator  270  pushes the hub portion  282  of the catheter support  280  in the distal direction and the catheter support  280  is advanced in the second portion  215  of the inner volume  213  of the introducer  210  until the catheter support  280  abuts the distal wall of the introducer  210 . 
     As described above, the arrangement of the actuator  270  and the introducer  210  is such that advancing the actuator  270  relative to the introducer  210  advances the tab  273  along the outer surface  235  and more specifically, the set of ribs  236  of the second member  230  of the introducer  210 . As shown, for example, in  FIG.  27   , the tab  273  is in contact with the set of ribs  236 , which can produce a vibration of the actuator  270  as the actuator  270  is moved relative to the introducer  210 . In some instances, the vibration of the actuator  270  can produce, for example, a haptic, tactile, and/or audible output that can provide an indication associated with a position of the distal end portion  262  of the catheter  260  relative to the introducer  210 , lock  240 , and/or PIV. For example, the tab  273  of the actuator  270  and the set of ribs  236  can collectively produce a “click” sound as the tab  273  moves past each rib, the introducer  210  can include indicia or the like that can indicate to the user the relative position of the distal end portion  262  of the catheter  260 , or the amount of times the actuator  270  has vibrated due to being moved relative to the number of ribs can be associated with and/or otherwise provide an indication of the relative position of the distal end portion  262  of the catheter  260 . 
     In some instances, the user can stop moving the actuator  270  relative to the introducer  210  based on the haptic, tactile, and/or audible output indicating a desired placement of the distal end portion  262  of the catheter  260  relative to the PIV, such that the catheter  260  is placed in the second position prior to the actuator  270  being advanced to a distal most position. As described in further detail herein, the catheter  260  is disposed in the second position when the distal end portion  262  of the catheter  260  is placed in a desired position relative to a distal end portion of the PIV. For example, a distal surface of the catheter  260  can be substantially flush with a distal end of the PIV, the distal surface of the catheter  260  can extend a predetermined distance beyond the distal end of the PIV, or the distal surface of the catheter  260  can be disposed within the PIV proximal to the distal end of the PIV when the catheter  260  is in the second position. 
     As shown in  FIGS.  22 C and  30 - 32   , in some instances, the catheter  260  may be in the second position when the actuator  270  is in a distal most position. In this manner, the distal surface of the catheter  260  is positioned within the vein at a predetermined distance beyond the distal surface of the PIV. In some instances, placing the distal surface of the catheter  260  the predetermined and/or desired distance from the distal surface of the PIV can place the distal surface of the catheter  260  in a position within a vein that is substantially free from debris, for example, fibrin/blood clots, otherwise surrounding the distal surface of the PIV. 
     In some instances, the indwelling PIV can substantially occlude at least a portion of the vein within which the PIV is disposed. As such, PIVs are often suited for delivering a fluid rather than aspirating blood. The venous system, however, is a capacitance system and thus, reroutes blood flow through a different vein by forming a bypass around the occlusion or substantial occlusion. Moreover, the alternate venous structure typically rejoins the vein in which the PIV is disposed at a given distance downstream of the PIV and thus, delivers at least a portion of the flow of blood that would otherwise be flowing through the vein in which the PIV is disposed. Similarly, veins typically have many branch vessels coupled thereto that similarly deliver a flow of blood to the vein within which the PIV is disposed. 
     As such, the predetermined and/or desired distance between the distal surface of the catheter  260  and the distal surface of the PIV can be sufficient to place the distal surface of the catheter  260  downstream of one or more branch vessels in fluid communication with the vein within which the PIV is disposed, such that the distal surface of the catheter  260  can extend beyond the distal surface of the PIV and at least one branch vessel is disposed between the distal surface of the catheter  260  and the distal surface of the PIV when the catheter  260  is in the second position. Therefore, with the lumen  263  of the catheter  260  extending through the proximal end portion  261  and the distal end portion  262  of the catheter  260 , placing the distal surface of the catheter  260  the predetermined and/or desired distance from the distal surface of the PIV places the lumen  263  of the catheter  260  in fluid communication with a portion of the vein receiving a substantially unobstructed or unrestricted flow of blood, for example a portion of the vein unobstructed by the PIV and/or debris associated with the indwelling of the PIV. 
     The predetermined and/or desired distance can be about 0.0 millimeters when the distal surfaces are flush and up to about 100 millimeters (mm), for example, 10 mm to about 90 mm, about 20 mm to about 80 mm, about 30 mm to about 70 mm, about 30 mm to about 60 mm, or about 40 mm to about 50 mm. For example, the fluid transfer device  200  may be configured such that the actuator  270  moves about 95 mm along the introducer  210  to position the distal surface of the catheter  260  about 40 mm beyond the distal surface of the PIV to which the fluid transfer device  200  is coupled, the fluid transfer device  200  may be configured such that the actuator  270  moves about 47 mm along the introducer  210  to position the distal surface of the catheter  260  at about 20 mm beyond the distal surface of the PIV to which the fluid transfer device  200  is coupled, or the fluid transfer device  200  can have any suitable stroke length to position the distal surface of the catheter  260  at the predetermined and/or desired distance from the distal surface of the PIV. 
     Although the predetermined and/or desired distance is described above as being a positive distance, that is, the distal surface of the catheter  260  is distal to the distal surface of the PIV, the predetermined and/or desired distance can be associated with a negative distance in which the distal surface of the catheter  260  is in a proximal position relative to the distal surface of the PIV. For example, in some instances, the predetermined and/or desired distance can be about 0.0 mm when the distal surfaces are flush and up to about −50 mm, for example, about −10 mm to about −40 mm, or about −20 mm to about −30 mm. In some instances, the predetermined and/or desired distance can be less than −50 mm when the distal surface of the catheter  260  is more than 50 mm proximal to the distal surface of the PIV. The catheter  260  may be placed in the second position such that the distal end portion  262  of the catheter  260  remains within the PIV in a position distal to, for example, a kink or the like. For example, indwelling PIVs can have one or more portions that are kinked such as a portion of the PIV where the peripheral intravenous catheter couples to a hub. In such instances, the predetermined and/or desired distance can be such that the distal surface of the catheter  260  is distal to the portion of the PIV that forms the kink, for example the position where the peripheral intravenous catheter couples to the hub. By placing the distal surface of the catheter  260  distal to the kinked portion of the PIV but remaining within the PIV a fluid flow path that is sufficiently unrestricted to allow blood to be aspirated through the catheter  260  can be formed. 
     With the catheter  260  in the second position and the fluid transfer device  200  in the second configuration shown, for example, as shown in  FIGS.  22 C and  30 - 32   , the user can establish fluid communication between a fluid reservoir, fluid source, syringe, and/or the like and the catheter  260 . For example, as described above, the user can physically and fluidically couple the coupler  269  of the secondary catheter  265  to a fluid reservoir, fluid source, syringe, and/or the like. Although described as establishing fluid communication between the catheter  260  and the fluid reservoir or fluid source after placing the catheter  260  in the second position, the user can establish fluid communication between the catheter  260  and the fluid reservoir or fluid source prior to moving the actuator  270  relative to the introducer  210 . With the catheter  260  in fluid communication with the fluid reservoir and/or fluid source, the fluid transfer device  200  can then transfer a fluid from the patient or transfer a fluid to the patient via the catheter  260  extending through and beyond the PIV. For example, the user can physically and fluidically couple the fluid transfer device  200  to a fluid reservoir, evacuated container, syringe, and/or the like and then can aspirate a volume of blood from the vein based at least in part on disposing the distal surface of the catheter  260  at the predetermined and/or desired distance beyond the distal surface of the PIV. 
     In other instances, the user can physically and fluidically couple the fluid transfer device  200  to a fluid source or the like and then can deliver a volume of fluid from the fluid source to a portion of the vein at a position downstream of the PIV that receives a substantially uninhibited and/or unrestricted flow of blood. Disposing the distal surface of the catheter  260  at the predetermined and/or desired distance beyond the distal surface of the PIV can reduce potential harm associated with infusion of caustic drugs. By positioning the distal surface of the catheter  260  within a portion of the vein receiving a flow of blood that would otherwise be inhibited and/or restricted by the indwelling PIV, the caustic drug can be entrained in the flow of blood and delivered to the target location. As such, a volume of the caustic drug is not retained within the debris or otherwise disposed in a position within the vein receiving little blood flow. 
     Once a desired amount of blood has been collected and/or once a desired volume of a drug has been delivered to the patient, the user can move the actuator  270  in the proximal direction, thereby placing the fluid transfer device  200  in a third (used) configuration. The catheter support  280  may remain stationary at the distal end portion  212  of the introducer  210  or may be coupled to the actuator  270  such that the movement of the actuator  270  in the proximal direction pulls the catheter support  280  in the proximal direction. 
     If the catheter support  280  is not coupled to the actuator  270  and the catheter support  280  includes an engagement member  284 , the engagement member  284  may be engaged and/or manipulated by the user to manually move the catheter support  280  in the proximal direction. 
     When the actuator  270  is coupled to the catheter support  280 , the opening  276  of the actuator  270  and the passageway  285  of the catheter support  280  are coaxial. 
     The actuator  270  may be coupled to the catheter support  280  when the actuator  270  and the catheter support  280  first make contact when both are in the intermediate position, or the actuator  270  may be coupled to the catheter support  280  when the catheter support  280  abuts the distal end wall of the introducer  210 . 
     Any suitable coupling may be provided to couple the actuator  270  to the catheter support  280 . For example, when the actuator  270  contacts the catheter support  280 , a portion of the second portion  275  of the actuator  270  may be received in the proximal portion  289  of the passageway  285  of the hub portion  282  of the catheter support  280 . For example, the portion of the second portion  275  of the actuator  270  may be coupled to the hub portion  282  of the catheter support  280  by an interference fit, snap fit, or friction fit between an inner surface of the hub portion  282  of the catheter support  280  and an outer surface of the second portion  275  of the actuator  270 . 
     In another example, as shown in  FIG.  33 A , one of a protrusion and a recess may be provided on a surface of a flexible beam  293  at the distal end of the engagement member  272  of the actuator  270  and the other of a protrusion and a recess may be provided on a surface of the bracket portion  281  of the catheter support  280  exposed in the slot  218  of the introducer  210  or on the optional engagement member  284  of the catheter support  280 . For example, as shown in  FIG.  33   , the protrusion  294  may be provided on the bottom surface of the flexible beam  293  and the recess  295  may be provided on the top of the catheter support  280 . Alternatively, the recess may be provided on the side or another surface of the catheter support  280 . When the catheter support  280  abuts the distal end wall of the introducer  210 , and the user continues to move the actuator  270  in the distal direction, the flexible beam  293  is deflected upwardly a small amount such that the flexible beam  293  moves over the catheter support  280  and the protrusion  294  is received in the recess  295 . Camming surfaces  296  may be provided on the distal end of the flexible beam  293  and/or the proximal end of the catheter support  280  to facilitate the flexing of the flexible beam  293 . 
     A stop  297  may be provided on the flexible beam  293  distal to the protrusion  294 . When the actuator  270  has been advanced such that the stop  297  abuts the catheter support  280 , further advancement of the actuator  270  with respect to the catheter support  280  will be restricted to avoid disengagement of the protrusion  294  from the recess  295 . 
     As shown in  FIG.  33 B , the flexible beam  293  may optionally include a hinge  320  comprising a thinned region that allows tuning of the force required to couple and uncouple the actuator  270  and the catheter support  280 . 
     Optionally, a retraction stop  298  to stop the proximal movement of the catheter support  280  may extend from the introducer  210 , for example, the retraction stop  298  may extend upwardly from the flange  225  of the introducer  210  ( FIG.  33   ). A groove  299  may be provided in the portion of the first portion  271  of the actuator  270  that slides along the flange  225  of the introducer  210  as the actuator  270  is moved to advance the catheter  260 . No such groove is provided in the bracket portion  281  of the catheter support  280 . When the coupled actuator  270  and catheter support  280  are moved in the proximal direction, the actuator  270  passes over the retraction stop  298  which is received in the groove  299 , while the catheter support  280  abuts the retraction stop  298 , stopping the proximal movement of the catheter support  280 . The actuator  270  can then be moved further in the proximal direction while the catheter support  280  remains stationary. If the retraction stop  298  is provided in combination with the coupling described above as shown in  FIG.  33   , further force placed on the engagement member  272  of the actuator  270  will cause the flexible beam  293  to flex, disengaging the protrusion  294  from the recess  295  and the actuator  270  from the catheter support  280 . The retraction stop  298  may be positioned to stop the catheter support  280  in the same position that the catheter support  280  was in when the catheter  260  was in the first position. 
     Alternatively, as shown in  FIG.  21   , the retraction stop may comprise a detent  327  extending with in a slot  328  in the introducer  210 . The slot  328  maybe provided in flange  225  provided on the inner surface of the introducer  210 . The detent  327  engages the bracket portion  281  of the catheter support  280  to restrict movement of the catheter support  280 . When the actuator  270  is moved in the proximal direction and abuts the catheter support  280 , the proximal force placed on the catheter support  280  by the actuator  270  overcomes the force of the detent  327  on the catheter support  280  releasing the catheter support  280  from the detent  327 , and the actuator  270  pushes the catheter support  280  in the proximal direction until the catheter support  280  abuts the distal end portion  212  of the introducer  210 . If the actuator  270  is coupled to the catheter support  280 , when the actuator  270  is moved in the proximal direction, pulling the catheter support  280  in the proximal direction, and the catheter support  280  encounters the detent  327 , the proximal movement of the catheter support  280  is restricted. 
     In another example, as shown in  FIGS.  33 C and  33 D , instead of the recess  295 , the catheter support may include releasable lock  322  that is engaged by the protrusion  294  on the flexible beam  293 . The releasable lock  322  comprises a stop portion  323  and an engagement portion  324 . The stop portion  323  extends from the catheter support  280  and is received in and moves along a groove in the introducer  210  when the catheter support  280  is moved with respect to the introducer  210 . When the stop portion  323  abuts the proximal end of the groove, further proximal movement of the catheter support  280  is no longer possible. The engagement portion  324  of the releasable lock  322  may comprise a bulge that interacts with the protrusion  294  on the flexible beam  293  of the actuator  270 . As shown in  FIG.  33 C , the stop portion  323  of the releasable lock  322  may extend from the bottom surface of the bracket portion  281  of the catheter support  280  and the engagement portion  324  of the releasable lock  322  may extend from the top surface of the bracket portion  281  of the catheter support  280 . In this configuration, the flexible beam  293  deflects in an upward direction during coupling and uncoupling of the actuator  270  and the catheter support  280 , and the stop portion  323  may ride in a groove on the flange  225  provided on the inner surface of the introducer  210 . Alternatively, as shown in  FIG.  33 D , the stop portion  323  of the releasable lock  322  may extend from the bottom surface of the bracket portion  281  of the catheter support  280  and the engagement portion  324  of the releasable lock  322  may extend laterally from the side of the bracket portion  281  of the catheter support  280 . In this configuration, the flexible beam  293  deflects in a lateral direction during coupling and uncoupling of the actuator  270  and the catheter support  280 . 
     When the actuator  270  is moved in the proximal direction and abuts the catheter support  280 , the actuator  270  pushes the catheter support in the proximal direction until the catheter support  280  abuts the distal end portion  212  of the introducer  210 . When the catheter support  280  abuts the distal end wall of the introducer  210 , and the user continues to move the actuator  270  in the distal direction, the flexible beam  293  is deflected upwardly a small amount and the protrusion  294  is forced over the engagement portion  324  of the releasable lock  322 . The surface of the protrusion  294  on the flexible beam  293  and/or the engagement portion  324  of the releasable lock  322  may be rounded and/or included camming surfaces to facilitate the movement of the protrusion  294  over the engagement portion  324 . When the actuator  270  is then moved in the proximal direction, the engagement between the protrusion  294  and the engagement portion  324  of the releasable lock  322  allows the actuator  270  to pull the catheter support  280  in the proximal direction until the catheter support  280  abuts the proximal end of the groove stopping the advancement of the catheter support  280  in the proximal direction. When the user continues to move the actuator  270  in the proximal direction, the flexible beam  293  is deflected upwardly a small amount and the protrusion  294  is forced over the engagement portion  324  of the releasable lock  322 , thereby uncoupling the actuator  270  from the catheter support. 
     In another example, as shown in  FIG.  34   , an engagement protrusion  301  including a hook  302  may extend from a distal end of the engagement member  272  of the actuator  270 , and a corresponding pivotable protrusion  303  having a hook  304  may extend from a proximal end of the catheter support  280 . The engagement protrusion  301  on the actuator  270  defines a recess  305  for receiving the pivotable protrusion  303  of the catheter support  280 . The recess  305  has a sloped bottom surface  306  closest to the engagement member  272  of the actuator  270 . The pivotable protrusion  303  pivots around a pin  307  that rides in a cam slot  308  defined in the introducer  210 . The cam slot  308  comprises two portions, a retention portion  309  and a movement portion  310 . The retention portion  309  is provided at the proximal end of the movement portion  310  and forms a downward angle, for example, a right angle, with the movement portion  310 . The retention portion  309  is located in a position corresponding to the desired position of the catheter support  280  when the catheter  260  is in the first position. The movement portion  310  extends from the retention portion  309  to the distal end portion  212  of the introducer  210 . 
     When the actuator  270  is moved in a distal direction and abuts the catheter support  280 , the pivotable protrusion  303  is received in the recess  305  defined by the engagement protrusion  301 . The pivotable protrusion  303  is pivoted in a clockwise direction by the sloped bottom surface  306  of the recess  305 . The hook  302  of the engagement protrusion  301  engages the hook  304  of the pivotable protrusion  303  and the sloped bottom surface  306  causes the pin  307  to transition from the retention portion  309  of the cam slot  308  into the movement portion  310  of the cam slot  308 . Further distal movement of the actuator  270  moves the catheter support  280  in the distal direction with the pin  307  riding in the movement portion  310  of the cam slot  308 . 
     When the coupled actuator  270  and catheter support  280  are moved in a proximal direction and the pin  307  reaches the proximal end of the movement portion  310  of the cam slot  308 , the pin  307  will transition into the retention portion  309  of the cam slot  308  and the pivotable protrusion  309  will rotate in a counterclockwise direction disengaging the hook  304  of the pivotable protrusion  303  from the hook  302  of the engagement protrusion  301 . The actuator  270  can then be moved further in the proximal direction while the catheter support  280  remains stationary. 
     In the third configuration, the catheter  260  can be disposed within the introducer  210 , for example, distal to the seal or the like, and isolated therein. For example, the actuator  270  can be located in a proximal most position, in which the catheter  260  is in the first position. Moreover, once the actuator  270  and catheter  260  are in the desired position, the user can, manipulate the secondary catheter  265  within the opening  217  such that a surface of the introducer  210  that defines the smaller portion of the opening  217  contacts and clamps the secondary catheter  265 . As such, the lumen  268  of the secondary catheter  265  can be substantially obstructed, occluded, blocked, pinched, etc., to limit and/or substantially prevent a flow of fluid therethrough. Clamping the secondary catheter  265  can reduce and/or substantially prevent fluid from leaking through the secondary catheter  265 . The fluid transfer device  200  can then be decoupled from the fluid reservoir, fluid source, syringe, etc., and safely discarded. 
     As shown in  FIGS.  35 - 38   , the catheter support  280   a  may include at least one locking protrusion  312  extending outwardly from the catheter support  280   a . The locking protrusion  312  is sized and shaped such that, when the fluid transfer device  300  is in the second configuration with the catheter support  280  at the distal end portion  212  of the introducer  210  and the catheter  260  introduced into the PIV, the locking protrusion  312  is received in the space between one of the arms  243 ,  250  of the lock  240  and the coupler  241  and blocks the first end portion  244 ,  251  of the arm  243 ,  250  of the lock  240  from being depressed and releasing the lock  240  from the PIV. The interference of the locking protrusion  312  with the release of the lock  240  requires the user to retract the catheter support  280  and the actuator  270 , thereby retracting the catheter  260  from the PIV, prior to disconnecting the lock  240  from the PIV. This assures that the introducer  210  is not removed from the PIV while the catheter  260  is received within the PIV and possibly the vein of the patient. 
     The locking protrusion  312  may extend out of the slot  218  in the introducer  210  and include a first portion  313  extending outwardly in a lateral direction, a second portion  314  extending downwardly from the first portion  313 , and a third portion  315  extending distally from the second portion  314 , where the third portion  315  enters the space between one of the arms  243 ,  250  of the lock  240  and the coupler  241 . The first portion  316  may be connected to the bracket portion  281  of the catheter support  280  via the slot  218 , and, if an engagement member  284  is provided for the catheter support  280 , may be the engagement member  284 . 
     Alternatively, if the lock  240  is positioned vertically, the protrusion may extend out of the slot  218  provided in the first member  220  of the introducer  210  through which the wall  277  of the actuator  270  passes. 
     As shown in  FIGS.  39  and  40   , the catheter support  280   b  may have more than one protrusion  312   a ,  312   b  may be provided, for example, one protrusion  312   a  corresponding to the first arm  243  of the lock  240  and one protrusion  312   b  corresponding to the second arm  250  of the lock  240 . The protrusions  312   a ,  312   b  may include a common first portion  316  extending outwardly in a lateral direction above the top outer surface of the introducer  210 , second portions  317  extending downwardly from the first portion  316  on opposite sides of the outer surface of the introducer  310 , and third portions  318  extending distally from the second portions  317 , where the third portions  318  enter the spaces between the arms  243 ,  250  of the lock  240  and the coupler  241 . The first portion  316  is connected to the bracket portion  281  of the catheter support  280  via the slot  218 , and, if an engagement member  284  is provided for the catheter support  280 , may be the engagement member  284 . The second protrusion  312   b  may be a mirror image of the first protrusion  312   a.    
     In use, as described above, the proximal end portion of the secondary catheter is coupled to a fluid reservoir, fluid source, syringe, evacuated container holder (e.g., having a sheathed needle or configured to be coupled to a sheathed needle), pump, and/or the like and the lock of the fluid transfer device is coupled to the PIV. The actuator is moved relative to the introducer to advance the catheter from the first position, in which the catheter is disposed within at least one of an inner volume of the introducer and the lock, toward the second position, in which at least a portion of the catheter is disposed beyond at least a portion of the PIV and the distal surface of the catheter is located at the desired distance within the PIV or the vein of the patient. When the catheter has been inserted through the PIV the desired distance, a blood sample is drawn from the patient or a drug is injected into the patient. When the sample draw or injection is complete, the actuator is moved relative to the introducer to retract the catheter from the PIV until at least the distal surface of the catheter is received within the lock, and the lock is disengaged from the PIV.