Patent Publication Number: US-2020290035-A1

Title: Point-of-care testing system for blood gases and co-oximetry

Description:
FIELD OF THE INVENTION 
     The invention relates to a disposable cartridge and an analyzer for point-of-care testing (POCT) of a patient&#39;s blood, using a combination of spectroscopic and biosensor measurements. In particular, the invention relates to POCT of blood gases and CO-oximetry. 
     BACKGROUND OF THE INVENTION 
     There are many medical diagnostic tests that require a fluid, for example, blood (sometimes referred to as whole blood), serum, plasma, cerebrospinal fluid, synovial fluid, lymphatic fluid, calibration fluid, and urine. With respect to blood, a blood sample is typically withdrawn in either an evacuated tube containing a rubber septum, or a syringe, and sent to a central laboratory for testing. The eventual transfer of blood from the collection site to the testing site results in inevitable delays. Moreover, the red blood cells are alive and continue to consume oxygen during any delay in testing, which in turn changes the chemical composition of the blood sample, from the time the blood sample is collected to the time the blood sample is analyzed, also referred to as measured or tested. 
     One example of a blood analysis technique that is affected by delay in testing and transfer of blood from the blood collection device to the analyzer, is CO-oximetry. CO-oximetry is a spectroscopic technique that is used to measure the different Hemoglobin (Hb) species present in a blood sample, for example, Oxy-Hb, Deoxy-Hb, Met-Hb, Carboxy-Hb and Total-Hb. Some Co-oximeters can also measure Sulf-Hb and Fetal-Hb. The results of CO-oximetry are used to provide Hb Oxygen Saturation (sO 2 ) measurements in two ways: 1) functional sO 2  is defined as the ratio of Oxy-Hb to the sum of Oxy-Hb and Deoxy-Hb; and 2) fractional sO 2  is defined as the ratio of Oxy-Hb to the Total-Hb. 
     If the blood sample is exposed to air, the sO 2  measurements may become falsely elevated, as oxygen from the air is absorbed into the blood sample. CO-oximetry usually requires hemolyzing the red blood cells (hemolysis) using a sound generator, in order to make the blood sample more transparent for spectroscopic measurement; blood with intact red cells scatter significantly more electromagnetic radiation (EMR) than hemolyzed blood. Hemolysis can also be accomplished by mixing a chemical, for example, a detergent, with the blood. Parameters that can be measured in blood by spectroscopic techniques (or spectroscopy, sometimes referred to as spectrometry) are limited by the amount of EMR absorbed by the analytes measured. In contrast, for example, without limitation, hydrogen ions (which determine pH) and electrolytes (e.g., sodium, potassium, and chloride) do not absorb EMR in the approximate wavelength range of about 300 nm to 2500 nm. Therefore, if this wavelength range is used to conduct spectroscopic measurements of Hb species, then these important parameters, i.e., hydrogen ions and electrolytes, must be measured by another means. 
     Another example of a blood analysis technique that is affected by the aforementioned sources of error is blood gases. Traditionally, blood gas measurement includes the partial pressure of oxygen (pO 2 ), the partial pressure of carbon dioxide (pCO 2 ), and pH. From these measurements, other parameters can be calculated, for example, sO 2 , bicarbonate, base excess and base deficit. Blood gas and electrolyte measurements usually employ biosensors, also referred to as electrochemical sensors or electrochemical detectors. Bench-top analyzers are available, which perform the following: (1) measurement of blood gases, (2) CO-oximetry, or (3) combined measurement of blood gases and CO-oximetry. Some combinations of diagnostic measurement instruments also include electrolytes, and other measurements, for example, lactate and creatinine. Because these instruments are large and expensive, they are usually located in central laboratories. Biosensor technology is also limited by the blood parameters biosensors can measure. To the inventor&#39;s knowledge, biosensors are not currently available for performing CO-oximeters. U.S. Pat. Nos. 5,096,669 and 7,094,330 to Lauks et al., as examples, describe in details cartridges that employ biosensor technology for POCT. In particular, they teach about pH measurement (a potentiometric measurement), blood gas measurement (a potentiometric and an amperometric measurement for pCO 2  and pO 2 , respectively), and hematocrit measurement (a conductivity measurement). U.S. Pat. No. 7,740,804 to Samsoondar (the present inventor) teaches disposable cartridges for spectroscopic measurement (e.g., CO-oximetry) for POCT using unaltered blood. U.S. Pat. Nos. 5,430,542 and 6,262,798 to Shepherd describes a method for making disposable cuvettes having a path length in the range of 80 to 130 micrometers for performing CO-oximetry measurement on unaltered blood. 
     Blood tests for assessing a patient&#39;s oxygenation and acid-base status may include pH, sO 2 , CO 2 , and Total Hb. The leading POCT analyzers used to assess a patients acid-base status estimate sO 2  from a measured partial pO 2 , and estimate Total Hb from a measured hematocrit. Both hematocrit and pO 2  are measured using biosensors. 
     sO 2  calculated from pO 2  is criticized in the literature because: 1) pO 2  measures the O 2  dissolved in the blood plasma, which accounts for only about 1% of the total oxygen in blood—the remaining 99% of blood oxygen is bound to Hb; 2) it is assumed that the patient&#39;s red blood cells (RBC) contain normal levels of 2,3-diphosphoglycerate; and 3) the patient has normal levels of dyshemoglobins, e.g., Carboxy-Hb and Met-Hb. Dyshemoglobins are non-functional Hbs. Temperature and pH, which are also sources of error, are usually corrected for. 
     Total Hb estimated from hematocrit measurement by conductivity is criticized in the literature because: 1) a certain RBC Hb concentration is assumed for all patients; and 2) alteration in plasma protein, electrolytes, white cells, and lipids are sources of errors in hematocrit measurement. These assumptions can lead to significant errors in managing seriously ill patients. Moreover, Hb measurement is preferred over hematocrit measurement for evaluating chronic anemia and blood loss. Unnecessary blood transfusion due to underestimation of Hb from hematocrit is a major concern. 
     In choosing a POCT analyzer, a user must understand clearly the parameters that are actually measured and the parameters that are calculated from measured parameters. Measurement of Total Hb and sO 2  performed by spectroscopy provide the best measurement of a patient&#39;s oxygenation status, because they are more accurate than results calculated from hematocrit and pO 2 , respectively. Lab analyzers can easily combine biosensor and spectroscopic technologies because analyzer size is not a limitation. Currently, no small POCT analyzer is available that provides blood gases (includes pH) and CO-oximetry. Some POCT vendors provide a solution in the form of a separate POCT analyzer just for performing CO-oximetry, which complements their blood gas POCT analyzer. 
     Since CO-oximetry measures functional Hb species, and non-functional Hb species like Carboxy-Hb and Met-Hb, a physician can continue to confidently monitor a patient&#39;s oxygenation status non-invasively using a Pulse Oximeter. According to best practice, pulse oximetry should only be used after verifying that the patient&#39;s blood does not contain significant amount of non-functional Hb. The presence of elevated non-functional hemoglobin species is a source of error in pulse oximetry. The present invention can use capillary blood as well as arterial blood, which provides a major advantage for babies. Obtaining arterial blood is painful, can cause nerve damage, must be performed by a qualified person like a physician, and the resulting blood loss in babies is clinically significant. The cartridge of the present invention can also facilitate monitoring Met-Hb in neonates during treatment with nitric oxide for respiratory distress, and facilitate measuring bilirubin for assessing neonatal jaundice. The use of capillary blood also makes the present invention an attractive tool for monitoring sO 2 , Carboxy-Hb (increased due to carbon monoxide poisoning resulting from smoke inhalation) and pH in firefighters and other victims of smoke inhalation. Most of these victims will be treated with oxygen, which elevates the pO 2 , therefore pO 2  cannot be used to assess the blood oxygen content. CO-oximetry is therefore essential to victims of smoke inhalation. Capillary blood is usually obtained from a finger, heel or ear lobe prick. The capillary blood can be altered (“arterialized”) to more closely resemble arterial blood by applying a heating pad to the site that will be pricked. 
     U.S. Pat. No. 8,206,650 to Samsoondar (the present inventor) teaches the combination of spectroscopy and biosensor technologies in one disposable cartridge, and can therefore provide pH, blood gases and CO-oximetry on a small POCT analyzer. The users are provided with the convenience of applying the sample once, as opposed to using a first analyzer that employs biosensor technology alone, and a second analyzer that employs spectroscopy alone. However, U.S. Pat. No. 8,206,650 does not provide details required by a person with ordinary skill in the art, for making a functional cartridge, and further does not provide details that can be applied to a cartridge manufacturing process. 
     U.S. Pat. No. 8,206,650 provides a single cartridge option that can be used to test blood from a syringe like arterial blood, and capillary blood at the surface of a body part, which is a very important consideration when the patient is a neonate. However, the option for obtaining capillary blood is limited. A person of ordinary skill in the art of blood gases will appreciate that the pO 2  will be overestimated significantly due to atmospheric contamination; current practice includes inserting the open end of a capillary tube inside the drop of blood, quickly sealing the ends of the capillary tube, and taking the sample to an analyzer. 
     U.S. Pat. No. 9,470,673. to Samsoondar (the present inventor), the contents of which are hereby incorporated in entirety by reference, provides improvements to the teachings of U.S. Pat. No. 8,206,650, for example, the design of a capillary adaptor for drawing capillary blood into the cartridge, the design of a more efficient capillary break, the design of the delivery system for calibration fluid, and the design of the analyzer cartridge receptor. Other limitations of the cartridge described in U.S. Pat. No. 9,470,673 will become apparent as different embodiments of the present invention are described. 
     SUMMARY OF THE INVENTION 
     In accordance with an aspect of an embodiment of the present invention there is provided a disposable cartridge for operation with a joint spectroscopic and biosensor blood analyzer for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status. The cartridge comprises a housing having at least a first housing member and a second housing member bonded together by a gasket. The housing comprises a cartridge inlet; a blood storage conduit within the housing having a proximal end close to the cartridge inlet and a distal end away from the cartridge inlet; an optical chamber within the housing for receiving the blood from the distal end of the blood storage conduit and for measuring the at least two hemoglobin species; an optical chamber overflow chamber for receiving the blood from the optical chamber; a biosensor conduit within the housing for receiving the blood from the optical chamber overflow chamber, the biosensor conduit comprising a proximal end, a distal end and at least a portion of a pH biosensor; a waste receptacle for receiving liquid waste from the biosensor conduit; a vent for relieving pressure in the waste receptacle; an air bladder and an air bladder exit port within the housing for providing pressurized air for urging blood from the blood storage conduit into the biosensor conduit; and, an optical window and an aligned optical member, the first housing member comprising one of the optical window and the aligned optical member, and the second housing member comprising the other of the optical window and the aligned optical member; the aligned optical member being one of a reflecting member or a second optical window, and being positioned to align with at least a portion of the optical chamber and at least a portion of the optical window. The gasket has at least one gasket cut-out positioned to provide fluid connection between the blood storage conduit and the optical chamber, wherein at least a portion of the at least one gasket cut-out is positioned to align with at least a portion of the optical chamber for collecting spectroscopic data from blood in that portion of the optical chamber. 
     In some embodiments, the at least one gasket cut-out has a second portion positioned to align with the active area of the pH biosensor. 
     In some embodiments, the disposable cartridge is insertable into a receptor of the joint spectroscopic and biosensor analyzer, and at least one of the first and second optical window is positioned to align with at least a portion of the optical chamber for collecting spectroscopic data from blood in that portion of the optical chamber. In these embodiments, the housing further comprises a blood shunt for providing fluid connectivity between the distal end of the blood storage conduit and the optical chamber overflow chamber. The optical chamber overflow chamber comprises: a first duct fluidly connected with the blood shunt and traversing a thickness of the second housing member; a recess disposed at the bottom of the second housing member and fluidly connected to the first duct; and, a second duct having a first cross-sectional area, and fluidly connected to the recess. In addition to that blood shunt, the housing further comprises an enlarged cavity having a second cross-sectional area parallel to the first cross-sectional area; wherein, the second cross-sectional area is substantially larger than the first cross-sectional area, whereby blood flow by capillary action slows down as the blood reaches the end of the second duct, and wherein the enlarged cavity is simultaneously in fluid connection with the optical chamber and the second duct. 
     In some embodiments, this disposable cartridge is insertable along a plane substantially defined by a surface of the gasket, into the receptor of the joint spectroscopic and biosensor analyzer, the optical chamber comprising an optical depth dimension orthogonal to the plane, the blood shunt having a maximum shunt depth dimension orthogonal to the plane, the maximum shunt depth dimension being substantially larger than the optical chamber depth dimension, and the first cross-sectional area being along the place. 
     In some embodiments of this disposable cartridge, the optical chamber overflow chamber is fluidly connected with the optical chamber, and the housing further comprises: a calibration fluid pouch for storing and releasing calibration fluid; a spike disposed in the second housing member of the cartridge for rupturing the calibration fluid pouch; a recess disposed in the opposite side of the second housing member; and a hole in the spike for permitting flow of the calibration fluid from the calibration fluid pouch to the recess for channeling the calibration fluid to the biosensor conduit. 
     In some embodiments, this cartridge further comprises a compressible member surrounding the spike, for supporting the calibration fluid pouch. 
     In accordance with another aspect of another embodiment of the present invention, there is provided a system for transferring capillary blood from a puncture site of a body part of a patient, the system comprising a capillary adaptor; and a disposable cartridge according to any of the embodiments described above. The cartridge inlet further comprises: an internal wall for receiving the capillary adaptor, the internal wall defining an airflow path for airflow between an exterior of the disposable cartridge and the blood storage conduit when the capillary adaptor is being removed from the cartridge inlet; an external wall having a cartridge inlet thread; a blood storage conduit entrance at the base of the cartridge inlet, the blood storage conduit beginning at the blood storage conduit entrance; and a cartridge inlet inner face surrounding the blood storage conduit entrance. The capillary adaptor comprises a capillary adaptor inlet member comprising a capillary adaptor tube, the capillary adaptor inlet member having a capillary adaptor inlet port for receiving the blood sample; a capillary adaptor outlet member sized to fit into the cartridge inlet; a capillary adaptor outlet port disposed at the end of the capillary adaptor outlet member; a capillary adaptor face surrounding the capillary adaptor outlet port; a capillary adaptor lumen extending from the capillary adaptor inlet port to the capillary adaptor outlet port; a handgrip for handling the capillary adaptor; and an internal wall in the hand grip having a capillary adaptor thread for engaging the cartridge inlet thread in the cartridge inlet. When the capillary adaptor thread is properly engaged with the cartridge inlet thread, the capillary adaptor face mates with the cartridge inlet inner face, sufficiently to permit flow of blood from the patient to the blood storage conduit by capillary action. 
     In some embodiments of this system, the position of the capillary adaptor face relative to the cartridge inlet inner face, when the capillary adaptor is fully engaged with the cartridge inlet, is one of no gap between the capillary adaptor face. 
     In some embodiments of this system, the cartridge inlet thread is an abbreviated thread. 
     In some embodiments of this system, the capillary adaptor thread is an abbreviated thread. 
     In some embodiments of this system, the volume of the capillary adaptor lumen is in the approximate range of about 5 microliters to about 20 microliters. 
     In some embodiments of this system, the volume of the capillary adaptor lumen is in the approximate range of about 5 microliters to about 10 microliters. 
     In some embodiments of this system, the length of the capillary adaptor inlet member is in the approximate range of about 2 millimeters to about 5 millimeters. 
     In accordance with another aspect of an embodiment of the present invention, there is provided a system for transferring blood from a syringe containing the blood. The system comprises the disposable cartridge according to any of the embodiments described above, wherein the cartridge inlet engages the syringe. The cartridge inlet further comprises an internal wall for receiving the syringe, the internal wall defining an airflow path for airflow between an exterior of the disposable cartridge and the blood storage conduit when the syringe is being removed from the cartridge inlet; an external wall; a blood storage conduit entrance at the base of the cartridge inlet, the blood storage conduit beginning at the blood storage conduit entrance; and a cartridge inlet inner face surrounding the blood storage conduit entrance. 
     In accordance with yet another aspect of an embodiment of the present invention, there is provided a joint spectroscopic and biosensor system for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status. The system comprises the disposable cartridge according to any of the embodiments described above, wherein the first optical window and the second optical window are part of the optical chamber; the optical chamber overflow chamber is fluidly connected with the optical chamber, and the housing further comprises: a pH biosensor electrical output element; and a calibration fluid pouch containing calibration fluid for at least calibrating the pH biosensor; and an analyzer comprising an analyzer housing. The analyzer housing comprises: a receptor comprising a first opening for receiving and aligning the cartridge in an operational position; a source of electromagnetic radiation; at least one photodetector; a power supply; and a processor for controlling the analyzer. The receptor further comprises: a second opening for directing the electromagnetic radiation to the first optical window when the cartridge is in the operational position; a third opening for directing electromagnetic radiation emerging from the second optical window to the at least one photodetector when the cartridge is in the operational position; a physical interface for providing electrical contact between the pH biosensor electrical output element and the processor; and a bracket mounted on the receptor for at least supporting a first stepper motor for applying force to the calibration fluid pouch against a spike for rupturing the calibration fluid pouch to release the calibration fluid, and a second stepper motor for forcing air from the air bladder through the air bladder exit port, for pushing the blood into the biosensor conduit. 
     In some embodiments of this system, the receptor further comprises a top portion and a bottom portion, and the bottom portion comprises at least one heating element layered on a surface of the bottom portion, for heating the cartridge, and the top portion comprises a spring-loaded locating element for engaging with a notch disposed at a top of the cartridge, for forcing the cartridge against the at least one heating element. 
     In some embodiments of the system, whether comprising a capillary adapter or for use with the syringe, the system further comprises a cap for covering the cartridge inlet when one of the capillary adaptor and the syringe is withdrawn from the cartridge inlet. The cap comprises a cap airflow path for airflow between an exterior of the disposable cartridge and the blood storage conduit when the cap is being engaged to impede blood in the blood storage conduit being disturbed by compression of air within the cartridge inlet during engagement of the cap. 
     Other aspects and features of the present invention will become apparent to those having ordinary skill in the art, upon review of the following description of the specific embodiments of the invention. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       For a better understanding of the present invention, and to show more clearly how it may be carried into effect, reference will now be made, by way of example, to the accompanying drawings, which illustrate aspects of embodiments of the present invention and in which: 
         FIG. 1A  is an exploded view of a first embodiment of a joint-diagnostic spectroscopic and biosensor cartridge  10  for use with a joint-diagnostic spectroscopic and biosensor analyzer; 
         FIG. 1B  is a top view of the second housing member  30  of the cartridge, with the biosensor array  80  installed in the receptacle  83 , shown in  FIG. 1A ; 
         FIG. 1C  is a bottom view of the first housing member  20  of the cartridge shown in  FIG. 1A ; 
         FIG. 1D  is a top view of gasket  100  of the cartridge shown in  FIG. 1A ; 
         FIG. 1E  is the top view of the second housing member  30  shown in  FIG. 1B , overlaid by and in alignment with the gasket  100  shown in  FIG. 1D , 
         FIG. 1F  is the bottom view of the first housing member  20  shown in  FIG. 1C , overlaid by and in alignment with the gasket  100  shown in  FIG. 1D , 
         FIG. 2A  is a perspective view of the joint-diagnostic spectroscopic and biosensor cartridge  10  shown in  FIG. 1A ; 
         FIG. 2B  is a first perspective view of an embodiment of a capillary adaptor  70  for use with cartridge  10  shown in  FIG. 2A ; 
         FIG. 2C  is a second perspective view of the capillary adaptor  70  shown in  FIG. 2B ; 
         FIG. 2D  is the capillary adaptor  70  shown in  FIG. 2B , engaged with the inlet  43  of the cartridge  10  shown in  FIG. 2A ; 
         FIG. 2E  is a detailed view of the detail E of the cartridge  10  shown in  FIG. 2A ; 
         FIG. 2F  is a first perspective view of an embodiment of a cap  60  for use with cartridge  10  shown in  FIG. 2A ; 
         FIG. 2G  is a second perspective view of the cap  60  shown in  FIG. 2F ; 
         FIG. 2H  is the cap  60  shown in  FIG. 2F , engaged with the inlet  43  of the cartridge  10  shown in  FIG. 2A ; 
         FIG. 3A  is a top view of the cartridge and capillary adaptor shown in  FIG. 2D ; 
         FIG. 3B  is a first cross-sectional view through the cartridge and capillary adaptor shown in  FIG. 3A  along line B-B; 
         FIG. 3C  is a front view of the cartridge and capillary adaptor shown in  FIG. 3A ; 
         FIG. 3D  is a second cross-sectional view through the cartridge and capillary adaptor shown in  FIG. 3A  along line D-D; 
         FIG. 3E  is a detailed view of the detail E of the cartridge and capillary adaptor shown in  FIG. 3D ; 
         FIG. 3F  is a detailed view of the detail F of the cartridge and capillary adaptor shown in  FIG. 3B ; 
         FIG. 4A  is a top view of the cap  60  shown in  FIG. 2F ; 
         FIG. 4B  is a right side view of the cap shown in  FIG. 4A ; 
         FIG. 4C  is a bottom view of the cap shown in  FIG. 4A ; 
         FIG. 4D  is a top view of the capillary adaptor  70  shown in  FIG. 2B ; 
         FIG. 4E  is a right side view of the capillary adaptor shown in  FIG. 4D ; 
         FIG. 4F  is a bottom view of the capillary adaptor shown in  FIG. 4D ; 
         FIG. 4G  is a first perspective view of the capillary adaptor shown in  FIG. 4D ; 
         FIG. 4H  is a second perspective view of the capillary adaptor shown in  FIG. 4D ; 
         FIG. 5A  is a top view of the cartridge shown in  FIG. 1A ; 
         FIG. 5B  is a first cross-sectional view through the cartridge shown in  FIG. 5A  along line B-B; 
         FIG. 5C  is a detailed view of the detail C of the cartridge shown in  FIG. 5B , 
         FIG. 5D  is a second cross-sectional view through the cartridge shown in  FIG. 5A  along line D-D; 
         FIG. 5E  is a detailed view of the detail E of the cartridge shown in  FIG. 5A ; 
         FIG. 5F  is a detailed view of the detail F of the cartridge shown in  FIG. 5D ; 
         FIG. 5G  is a third cross-sectional view through the cartridge shown in  FIG. 5A  along line G-G; 
         FIG. 5H  is a detailed view of the detail H of the cartridge shown in  FIG. 5G . 
         FIG. 6A  is an exploded view of a second embodiment of a joint-diagnostic spectroscopic and biosensor cartridge  10   a  for use with a joint-diagnostic spectroscopic and biosensor analyzer; 
         FIG. 6B  is a top view of the second housing member  30   a  of the cartridge, with the biosensor array  80   a  installed in the receptacle  83   a , shown in  FIG. 6A ; 
         FIG. 6C  is a bottom view of the first housing member  20   a  of the cartridge shown in  FIG. 6A ; 
         FIG. 6D  is a top view of gasket  100   a  of the cartridge shown in  FIG. 6A ; 
         FIG. 6E  is the top view of the second housing member  30   a  shown in  FIG. 6B , overlaid by and in alignment with the gasket  100   a  shown in  FIG. 6D ; 
         FIG. 6F  is the bottom view of the first housing member  20   a  shown in  FIG. 6C , overlaid by and in alignment with the gasket  100   a  shown in  FIG. 6D ; 
         FIG. 7A  is a perspective view of the joint-diagnostic spectroscopic and biosensor cartridge  10   a  shown in  FIG. 6A , with the first housing member  20   a  exposed and a capillary adaptor  70   a  engaged with the inlet  43   a;    
         FIG. 7B  is a second perspective view of cartridge  10   a  shown in  FIG. 7A , with air bladder cavity  86   a  and calibration fluid pouch  90   a  exposed by hiding perforated label  170 , and a cap  60   a  engaged with the inlet  43   a;    
         FIG. 7C  is a third perspective view of the joint-diagnostic spectroscopic and biosensor cartridge  10   a  shown in  FIG. 7A , with the second housing member  30   a  exposed; 
         FIG. 7D  is a fourth perspective view of cartridge  10   a  shown in  FIG. 7A , with recesses  147  and  149  in the bottom of second housing member  30   a  exposed by hiding bottom cover  150 ; 
         FIG. 7E  is a top view of cartridge  10   a , with cap  60   a  partly engaged with the inlet  43   a;    
         FIG. 7F  is a cross-sectional view through the cartridge and cap shown in  FIG. 7E  along line F-F; 
         FIG. 7G  is a detailed view of the detail G of the cartridge and cap shown in  FIG. 7F ; 
         FIG. 8A  is a top view of the cartridge  10   a  shown in  FIG. 6A ; 
         FIG. 8B  is a first cross-sectional view through the cartridge shown in  FIG. 8A  along line B-B; 
         FIG. 8C  is a second cross-sectional view through the cartridge shown in  FIG. 8A  along line C-C, 
         FIG. 8D  is a detailed view of the detail D of the cartridge shown in  FIG. 8C , 
         FIG. 8E  is a detailed view of the detail E of the cartridge shown in  FIG. 8B ; 
         FIG. 8F  is a third cross-sectional view through the cartridge shown in  FIG. 8A  along line F-F; 
         FIG. 8G  is a fourth cross-sectional view through the cartridge shown in  FIG. 8A  along line G-G; 
         FIG. 8H  is a fifth cross-sectional view through the cartridge shown in  FIG. 8A  along line H-H; 
         FIG. 8J  is a detailed view of the detail J of the cartridge shown in  FIG. 8F ; 
         FIG. 8K  is a detailed view of the detail K of the cartridge shown in  FIG. 8G ; 
         FIG. 8L  is a detailed view of the detail L of the cartridge shown in  FIG. 8H ; 
         FIG. 9A  is a perspective view of a joint-diagnostic spectroscopic and biosensor cartridge inserted in the receptor of an analyzer; 
         FIG. 9B  is a top view of a joint-diagnostic spectroscopic and biosensor cartridge inserted in the receptor of an analyzer; 
         FIG. 9C  is a first cross-sectional view through the cartridge and receptor shown in  FIG. 9B  along line C-C, 
         FIG. 9D  is a second cross-sectional view through the cartridge and receptor shown in  FIG. 9B  along line D-D; 
         FIG. 9E  is a third cross-sectional view through the cartridge and receptor shown in  FIG. 9B  along line E-E; 
         FIG. 9F  is a second perspective view a joint-diagnostic spectroscopic and biosensor cartridge inserted in the receptor of an analyzer, with the top portion of the receptor  220  hidden; 
         FIG. 9G  is a perspective of the cartridge  10   a  shown in  FIG. 9F ; 
         FIG. 9H  is a second perspective of the cartridge  10   a , showing the second housing member  30   a;    
         FIG. 9J  is a perspective view of the bottom portion  230  of the cartridge receptor  200  shown in  FIG. 9A , with the top portion of the cartridge receptor  220  and cartridge  10   a  hidden; and 
         FIG. 10  is a block diagram of an embodiment of a joint-diagnostic spectroscopic and biosensor analyzer. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED ASPECTS OF THE INVENTION 
     The invention provides a system for joint spectroscopic and biosensor measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least the blood pH by biosensor. The terms biosensor, electrochemical sensor and electrochemical detector are sometimes used interchangeably, and they have the same meaning in this description. The system comprises a disposable cartridge adapted for insertion into a receptor of an analyzer, a cap for capping the cartridge when it is inserted into the analyzer, and a capillary adaptor for drawing blood directly from the puncture site of the skin of a patient, into the cartridge. The results are used for assessing a patient&#39;s oxygenation and acid-base status. This system allows for the use of capillary blood instead of arterial blood, which is particularly useful for neonatal care. 
     Some embodiments of an analysis system include at least some of the following: an analyzer described in part in U.S. Pat. Nos. 8,206,650 and 9,470,673, the analyzer having some of the following: i) a power supply, which is optionally in the form of disposable or rechargeable batteries; ii) a source of electromagnetic radiation (EMR), for example, one or more LEDs, a tungsten lamp, one or more lasers, or any combination thereof; iii) a receptor in the analyzer housing for receiving a disposable cartridge; iv) a photodetector for measuring EMR transmitted through or reflected from a blood sample within the optical chamber of the cartridge and for providing an EMR-based signal derived from the EMR transmitted through or reflected from the blood sample; v) a processor for controlling the analyzer and in communication with the photodetector for receiving the EMR-based signal, and at least one calibration algorithm installed in the processor for transforming the EMR-based signal into a hemoglobin specie concentration; vi) a physical interface attached to the receptor for connecting with an analyzer processor and for connecting with the biosensor; vii) means for releasing the calibration fluid from the calibration fluid pouch and transporting released calibration fluid to the biosensor conduit for calibrating at least the pH biosensor prior to measuring the pH of the blood sample; viii) means for maintaining the active area of the biosensor at a pre-determined temperature; and ix) means for preheating the blood sample. 
     When the biosensor electrical contact of the cartridge is inserted into the physical interface of the receptor, the optical chamber of the cartridge becomes positioned to receive the EMR from the EMR source. 
     Some embodiments of the system also include: x) means for handling the blood sample, for example, a) a syringe containing the blood, and b) a capillary adaptor capable for transferring capillary blood directly from punctured skin of the body part of a patient to the cartridge; and xi) a cap for sealing the cartridge inlet. A syringe is required for collecting arterial blood, but capillary blood can be obtained by puncturing a body part with a lancet, and transferring the capillary blood that accumulates at the surface of the skin, to the cartridge via a capillary adaptor. In certain situations, for example when the patient is a baby, and under certain conditions, capillary blood may be used as a substitute for arterial blood. Moreover, collection arterial blood is painful, may cause nerve damage, and is usually performed by a physician. 
     The means for calibrating the at least one biosensor includes: a) a pouch within the housing containing calibration fluid; b) means for releasing fluid from the calibration pouch; and c) a calibration fluid conduit for transporting the released calibration fluid to the biosensor conduit. Those skilled in the art will appreciate that the electrical signals generated from the biosensor after it comes in contact with a calibration fluid of known composition, and the known concentration of the analyte in the calibration fluid, can be used to generate a calibration algorithm for the analyte, and therefore for the sake of brevity, the mathematics involved in biosensor calibration will not be discussed here. Some embodiments of the present invention provide biosensor calibration algorithms installed in the analyzer processor, and therefore do not require the calibration fluid. 
     The current practice when testing capillary blood on a blood gas analyzer or a CO-oximeter is to collect the capillary blood in a capillary tube, and subsequently transfer the blood from the capillary tube to the analyzer. This transfer of the blood from the capillary tube to the analyzer presents sources of error, for example: a) cellular metabolism continues after blood is collected, and the error is proportional to the delay in testing; and b) opportunity for atmospheric contamination by incorporation of air bubbles in the capillary tube, which is subsequently mixed into the blood. An external magnet is used to move a piece of wire located inside the capillary tube, forward and backward along the capillary tube, in order to mix the sample with anticoagulant deposited on the internal wall of the capillary tube. The present invention provides a capillary adaptor designed to eliminate this step of sample transfer. The atmosphere contains about 21% oxygen; therefore for direct measurement (CO-oximetry) or indirect measurement (i.e., calculating sO 2  from measured pO 2 ) of oxygen saturation, the blood must be protected from atmospheric contamination in order to minimize errors, and delay in testing must be minimized. 
     When a cartridge is inserted properly in the receptor of the analyzer, the cartridge biosensor electrical contact mates with the analyzer electrical contact (see  FIGS. 9A-9J ), bringing the optical chamber of the cartridge in position to receive EMR from the EMR source. Those skilled in the art will appreciate that the EMR could also be channeled to the optical chamber by optical fibers. The EMR transmitted through the blood sample in the cartridge, or reflected from the blood sample, impinges upon one or more photodetectors within the analyzer. Calibration algorithms for spectroscopic measurements are preferably installed within the processor of the analyzer, for transforming the spectroscopic signals into analyte measurements. Calibration algorithms for biosensor measurements are preferably installed within the processor of the analyzer, for transforming the biosensor signals into analyte measurements, but some biosensors require calibration prior to sample measurement. The measurements are usually in concentration units, but those skilled in the art will appreciate that other parameters can be measured, for example, without limitations, the ratio of the concentrations of two different analytes. 
     In some embodiments, the joint-diagnostic spectroscopic and biosensor analyzer further comprises a display screen for viewing the results and aiding the operator in use of the analyzer, as well as buttons for manipulating the display function. Those skilled in the art will appreciate that the analyzer could be connected to a host computer. Therefore, some embodiments of the system also comprise at least one communication port for interfacing with other instruments. Other non-limiting examples of other instruments are a printer, and diagnostic testing instruments like a pulse oximeter or some other non-invasive testing instrument. The optional communication port is also used to upgrade information in the analyzers processor, as well as to upload information from the analyzers processor. Another optional port in the housing of some embodiments of the joint-diagnostic spectroscopic and biosensor analyzer is provided for charging the power supply within the analyzer. Those skilled in the art will appreciate that a single port can be used for both data transfer and a power supply, for example, without any limitation, a USB (Universal Serial Bus) port. In some embodiments of a system, data transfer to and from the analyzer is accomplished by wireless means that are known by one of skill in the art, and therefore, for the sake of brevity, wireless communication means will not be discussed here. 
     Some embodiments of the joint-diagnostic spectroscopic and biosensor analyzer comprise one photodetector (photodiode), or more than one photodetector assembled as an array of detectors in a spectrometer, wherein the spectrometer comprises a grating for dispersing EMR emerging from the fluid sample, into wavelength components. The analyzer optionally comprises one or more focusing lenses between the disposable cartridge and the spectrometer. A person of ordinary skill in the art will appreciate that other forms of optical detection, for example, CCD (charged-coupled device), can be used, and are therefore considered to be within the scope of the invention. 
     In some embodiments, the interior walls of the cartridges are treated with a hydrophilic coating to promote even spreading of the blood within the optical chamber, and to promote movement of blood along the flow path by capillary action. An alternative to a hydrophilic coating is plasma or corona treatment of a surface for making the surface more hydrophilic. 
     The optical chamber is located along a flow path, and the optical chamber has at least one optical window for spectroscopic analysis of the blood. The at least one optical window is in alignment with at least a portion of the optical chamber. A flow path may also contain one or more reagents, anywhere along the flow path, for example, without limitation, an anticoagulant, a hemolyzing reagent, or a reagent that reacts with an analyte to enhance the absorbance of EMR. The optical chamber is specifically designed to reduce the average attenuation of EMR due to scattering of EMR by the intact red blood cells in a blood sample, without having to hemolyze the red blood cells using sound waves or hemolyzing chemicals. Preferably, the depth of the optical chamber, i.e., the internal distance between the optical windows, is in an approximate range of about 50 microns to about 200 microns. In a preferred embodiment, the depth of the optical chamber is substantially uniform across the optical windows. In some embodiments, the depth of the optical chamber is not uniform across the optical windows, and is within the scope of the present invention. A person of ordinary skill in the art will appreciate that although the optical windows are illustrated as circular elements, they can have other shapes, for example, without being limited, oval and square shapes. In some embodiments, the area of an optical window that is in alignment with an optical chamber is in an approximate range of about 1 sq. millimeter to about 100 sq. millimeters. For the sake of minimizing sample volume, a more preferred optical window area that is in alignment with the optical chamber is in an approximate range of about 1 sq. millimeter to about 10 sq. millimeters. 
     The biosensor conduit is located along a flow path, and the biosensor conduit may have one or more than one biosensors for analyzing the blood. Those skilled in the art will appreciate that biosensors may include various transducer arrangements that convert at least one property of the fluid sample into an electrical signal, wherein the transducer comprises at least one active surface for contacting the fluid sample. In some embodiments, the active surface is one of a chemical sensitive surface, or an ionic sensitive surface, and wherein the biosensor comprises at least one of a transistor, an ion-selective membrane, a membrane-bound enzyme, a membrane-bound antigen, a membrane-bound antibody, or a membrane-bound strand of nucleic acid. The disposable cartridge also comprises at least one biosensor electrical contact, and the cartridge receptor of the analyzer also comprises at least one analyzer electrical contact. Although the examples illustrated show the cartridge electrical output contact as flat pins in an array, those skilled in the art will appreciate that the electrical contacts can mate in other ways, for example, the electrical contacts described in U.S. Pat. No. 8,206,650. 
     Some embodiment of a joint-diagnostic spectroscopic and biosensor analyzer optionally comprises a barcode reader for reading a barcode on the disposable cartridge, the barcode containing at least information regarding calibration of a biosensor. The barcode also optionally contains information about the joint-diagnostic spectroscopic and biosensor analyzer. Some embodiments of disposable cartridges comprise radio frequency identification (RFID) tags. In some embodiments, the disposable cartridge further comprises a calibration fluid pouch containing a calibration fluid that is arranged in fluid connection with a biosensor conduit. For cartridges with calibration fluid pouches, the joint-diagnostic spectroscopic and biosensor system further comprises means for rupturing the calibration fluid pouches, for example, which should not be considered limiting in any way, a rotating cam, a reciprocating plunger, or a stepper motor linear actuator, and a spike in the cartridge housing. In some embodiments, the pouch itself contains an object with multiple spikes, which ruptures the calibration fluid pouch when pressure is applied to the calibration fluid pouch. In some embodiments, a portion of the seal of the calibration pouch is substantially weaker by design, than the rest of the seal, for easy rupture after pressure is applied. These weaker seal portions are sometimes referred to as frangible seals. 
     Some embodiments of cartridges also include at least one visible fill line or indicator serving as a marker providing a user with a visual indicator relating to the sufficiency of the blood sample in the optical chamber. Preferably the cartridge housing is made of transparent plastic for easy viewing of the blood inside the cartridge. 
     The means for calibrating the at least one biosensor includes a calibration fluid pouch  90  within the cartridge containing calibration fluid, means for rupturing the calibration pouch, and a calibration fluid conduit for transporting the calibration fluid from the pouch  90  to the biosensor conduit  54 . U.S. Pat. No. 5,096,669 describes analyzer means for depressing and rupturing a calibration pouch. Although the cartridge embodiments shown comprise means for calibrating the biosensors, some cartridge embodiments have factory-calibrated biosensors, and therefore do not require means for calibrating the biosensors. These cartridge embodiments are also within the scope of the invention. 
     In some embodiments of a disposable cartridge, the blood storage conduit begins at a the blood storage conduit entrance and terminates at the optical chamber, and the volume of the blood storage conduit is in an approximate range of about 50 microliters to about 100 microliters. A small sample size is preferred for babies, but for pO 2  measurement, air bubbles can create greater errors in smaller samples. Therefore the size of the samples must be balanced between allowable errors and the amount of blood the patient can provide without causing the patient harm. 
     An air bladder is used for the purpose of urging blood along a path, and means for activating the air bladder is provided. 
     In some embodiments, the blood storage conduit has a length dimension measured from the proximal end (i.e., near the inlet) to the distal end (i.e., near the optical chamber) and has a cross-sectional area orthogonal to the length dimension, the size of the cross-sectional area being sufficiently small to receive the blood by capillary action, and the size being substantially uniform throughout a substantial portion of the length dimension. Cross-sectional areas are shown as semi-circular and rectangular, but a person with ordinary skill in the art will appreciate that other shapes can be used, and are therefore considered to be within the scope of the present invention. 
     The optical chamber of an embodiment of the cartridge has a depth dimension orthogonal to a plane of insertion of the cartridge into the receptor of the analyzer, wherein the depth dimension is in an approximate range of about 50 microns to about 200 microns. In the embodiments described in details later, the optical chamber is defined by a cut-out in the gasket  100 . In some embodiments (not shown), the depth dimension of the optical chamber is greater than the thickness of the gasket. 
     Another aspect of an embodiment of a disposable cartridge (the first embodiment  10 ) for operation with a joint spectroscopic and biosensor blood analyzer for measurement of at least two hemoglobin species in blood by spectroscopy, and measurement of at least blood pH by biosensor, is a housing comprising: A) a first housing member  20 ; B) a second housing member  30 ; and C) a double-sided sticky gasket  100 , are illustrated. U.S. Pat. No. 9,470,673 to the present inventor, the contents of which are hereby incorporated in entirety by reference, describes several other embodiments of the cartridge. Although the embodiments of a disposable cartridge illustrated in U.S. Pat. No. 9,470,673 comprise a single double-sided sticky gasket, some cartridge embodiments comprise more than two housing members, and therefore require more than one double-sided sticky gasket for bonding the additional housing members, for example, the second embodiment  10   a.    
     In some embodiments of a cartridge, the double-sided sticky gasket has a thickness in the approximate range of about 50 microns to about 200 microns. Although the gaskets are described as sticky gaskets, non-sticky gaskets are considered within the scope of the invention. In embodiments using non-sticky gaskets, some form of adhesive is applied directly to the housing members at the areas where the gasket makes contact with the housing members, or some other means are used for sandwiching the gasket between the housing members. 
     The gaskets shown are flat and therefore each side of the gasket defines a plane, wherein both planes are parallel to each other. In some embodiments, the gasket is substantially flat, wherein each side substantially defines a plane, and wherein the two planes are not parallel. Therefore, it should be understood that reference to a plane orthogonal to the gasket means a plane orthogonal to either of the two planes substantially defined by the respective sides of a substantially flat gasket. As an example, a substantially flat gasket is one where most of the gasket is flat, but some sections comprise dimples and or bumps. 
     The gaskets illustrated comprise several gasket cut-outs but some embodiments of the cartridges comprise one or more than one gasket cut-out. As an example, consider gaskets  100  (according to a first embodiment of a cartridge) and  100   a  (according to a second embodiment of a cartridge) illustrated in cartridge embodiments  10  and  10   a  respectively, disclosed as examples. Cut-outs  101  and  102  in cartridge  10  are illustrated in cartridge  10   a  as a single cut-out labeled  101   a , an embodiment vented through a groove in housing (not shown) does not have cut-out  107   a ; an embodiment comprising pre-calibrated biosensors (not shown) does not have cut-out  105   a ; and a cartridge embodiment in which there is no concern about contact between the calibration fluid and the gasket (not shown) does not have cut-out  106   a . Moreover, in some embodiments cut-outs  101   a  is joined with cut-out  103   a , and in some embodiments cut-out  103   a  is further joined to cut-out  104   a  (not shown). In order to minimize contact between the sample and the adhesive in the gasket some embodiments of cartridges comprise a single gasket cut-out, wherein a first portion of the cut-out is positioned to align with at least a portion of the optical chamber, and a second portion is positioned to at least align with the active area of the pH biosensor. In some embodiments, the single gasket is transformed into two separate gasket cut-outs: a first gasket cut-out is positioned to align with at least a portion of the optical chamber, and a second gasket cut-out is positioned to at least align with the active area of the pH biosensor. It is well known that adhesives are available that are compatible with the blood sample and the calibration fluids, and more cut-outs may be desired depending on the assembly process. Therefore at least one gasket cut-out is within the scope of the present invention. 
     With respect to spectroscopic measurements, those skilled in the art will appreciate the various ways a spectroscopic measurement apparatus can be constructed, and various elements that make up such apparatus. Accordingly, for the sake of brevity, description of basic spectroscopy and a list and function of the elements that make up a spectroscopic apparatus will not be discussed here. Those skilled in the art will appreciate that when the source of EMR is a single source, the single source could be split by a multi-channel optical fiber for providing more than one light paths. An example of a system for detecting the EMR transmitted through or reflected from a sample is an array of photodiodes, but those skilled in the art will appreciate that these spectroscopic elements are just examples and should not be considered limiting for the present invention. 
     Still with respect to spectroscopic measurements, the examples shown describe an apparatus that operates in transmission mode. Those skilled in the art will appreciate that the spectroscopic apparatus of a joint-diagnostic spectroscopic and biosensor analyzer can also operate in reflectance mode by placing a reflecting member in the analyzer receptor designed for receiving the cartridge, on one side of the optical chamber, such that the EMR transmitted through the sample would be reflected off the reflecting member, whereby the reflected EMR would enter the sample for the second time. In some embodiments of diagnostic measurement instruments or analyzers operating in the reflectance mode, both the EMR source and the photodetector are on the same side of the optical chamber. Moreover, those skilled in the art will also appreciate that instead of installing a reflecting member around the receptor in the housing of the analyzer, one side of the wall-portions of the optical chamber of the cartridge could be coated with a reflecting material. 
     A blood storage conduit is defined by a first blood storage conduit groove in one of the housing members, and either the gasket or the other housing member with or without a second blood storage conduit groove. In the embodiments where the blood storage conduit allows the blood to make contact with a surface of the gasket, the gasket is preferably made of hydrophilic material for enhancing wetting of the gasket, and the gasket adhesive is compatible with the sample. The blood storage conduit in some embodiments is simply a cut-out in the gasket with no grooves in either of the housing members. For clarity, the blood storage conduit in some embodiments, comprise a groove in the first housing member aligned with the gasket cut-out, or a groove in the second housing member alignment with the gasket cut-out. In yet other embodiments, the gasket cut-out is aligned with a first groove in the first housing member and a second groove in the second housing member. The illustration of the various embodiments of the blood storage conduit can be applied to other conduits, for example, the biosensor conduit, the blood shunt and the calibration fluid conduit, and are considered to be within the scope of the invention. 
     The housing of some embodiments of the disposable cartridge comprises a blood shunt (for example,  45  in  FIG. 5H ) for bypassing the optical chamber. The blood shunt provides fluid connectivity between the distal end of the blood storage conduit and the optical chamber overflow chamber, the blood shunt having a maximum bypass depth dimension orthogonal to the plane of insertion of the cartridge into the receptor of the analyzer, and wherein the maximum bypass depth dimension is substantially larger than the optical depth dimension, for enhancing blood flow from the distal end of the blood storage conduit to the biosensor conduit. The optical chamber overflow chamber refers to the general region in the blood flow path between the optical chamber  58  in cartridge  10  (and  58   a  in cartridge  10   a ) and the enlarged cavity  56  in cartridge  10  (and  56   a  in cartridge  10   a ). 
     The details of the drawings are discussed next, to further describe specific embodiments of the invention not completely described in U.S. Pat. No. 9,470,673, filed by the inventor. Two different cartridge embodiments are described in details, as examples only, and a person of ordinary skill in the art will appreciate that other embodiments that are not explicitly illustrated are implied. For easy reference, Table 1 provides a list of the reference numerals used, and a brief description of the structural features referred to. Attempts are made to use the same reference numerals for similar elements and, in some cases, the letter “a” is appended to the end of the number to refer to the second embodiment of the cartridge. 
     
       
         
           
               
               
             
               
                 TABLE 1 
               
               
                   
               
               
                 Reference 
                   
               
               
                 Numerals 
                 Description of Structural Features 
               
               
                   
               
             
            
               
                 10 
                 Cartridge housing of a first embodiment of a cartridge 
               
               
                  10a 
                 Cartridge housing of a second embodiment of a cartridge 
               
               
                 20 
                 First housing member of cartridge 10 
               
               
                  20a 
                 First housing member of cartridge 10a 
               
               
                 21 
                 Cut-out in 20a for viewing capillary break 
               
               
                 23 
                 Notch for receiving a spring-loaded cartridge locating pin 201 
               
               
                   
                 in cartridge receptor 200 
               
               
                 25 
                 Air bladder recess for receiving flexible member 120 
               
               
                 30 
                 Second housing member of cartridge 10 
               
               
                  30a 
                 Second housing member of cartridge 10a 
               
               
                 40 
                 Flexible member of cartridge 10 
               
               
                 41 
                 Paddle in first housing member 20, for facilitating rupture of 
               
               
                   
                 calibration fluid pouch 
               
               
                 42 
                 Paddle hinge in first housing member 20 
               
               
                 43 
                 Cartridge inlet of cartridge 10 
               
               
                  43a 
                 Cartridge inlet of cartridge 10a 
               
               
                 44 
                 Cartridge inlet inner face surrounding blood storage conduit 
               
               
                   
                 entrance 52 of cartridge 10 
               
               
                 45 
                 Blood shunt for bypassing optical chamber 58 (formed by the 
               
               
                   
                 distal end of the blood storage conduit groove 53 and the first 
               
               
                   
                 housing member 20) 
               
               
                  45a 
                 Blood shunt for bypassing optical chamber 58a (formed by 
               
               
                   
                 the distal end of the blood storage conduit groove 53a and 
               
               
                   
                 the first housing member 20a) 
               
               
                 46 
                 An annular surface at the top of the cartridge inlet 43 of 
               
               
                   
                 cartridge 10 
               
               
                 47 
                 Recess in the annular surface 46 of the cartridge inlet 43 
               
               
                   
                 cartridge 10 
               
               
                  47a 
                 Recess in the annular surface 46 of the cartridge inlet 43a 
               
               
                   
                 cartridge 10a 
               
               
                 48 
                 Internal wall of the cartridge inlet 43 of cartridge 10 
               
               
                 49 
                 External wall of the cartridge inlet 43 of cartridge 10 and inlet 
               
               
                   
                 43a of cartridge 10a 
               
               
                 50 
                 Cartridge inlet thread shown in this embodiment as 
               
               
                   
                 abbreviated thread on external wall 49 of inlet 43 and 43a 
               
               
                 51 
                 Blood storage conduit of cartridge 10 
               
               
                  51a 
                 Blood storage conduit of cartridge 10a 
               
               
                 52 
                 Blood storage conduit entrance of blood storage conduit 51 
               
               
                  52a 
                 Blood storage conduit entrance of blood storage conduit 51a 
               
               
                 53 
                 Blood storage conduit groove of cartridge 10 
               
               
                  53a 
                 Blood storage conduit groove of cartridge 10a 
               
               
                 54 
                 Biosensor conduit of cartridge 10 
               
               
                  54a 
                 Biosensor conduit of cartridge 10a 
               
               
                 55 
                 Biosensor conduit groove of biosensor conduit 54 
               
               
                  55a 
                 Biosensor conduit groove of biosensor conduit 54a 
               
               
                     56′ 
                 Portion of an enlarged cavity in first housing member 20 of 
               
               
                   
                 cartridge 10 
               
               
                     56a′ 
                 Portion of an enlarged cavity in first housing member 20a of 
               
               
                   
                 cartridge 10a 
               
               
                  56″ 
                 Portion of an enlarged cavity in second housing member 30 
               
               
                   
                 of cartridge 10 
               
               
                  56a″ 
                 Portion of an enlarged cavity in second housing member 30a 
               
               
                   
                 of cartridge 10a 
               
               
                 56 
                 Enlarged cavity of cartridge 10, comprising portions 56′, 56″, 
               
               
                   
                 and a gasket cut-out 101 aligned with portions 56′ and 56″ 
               
               
                  56a 
                 Enlarged cavity of cartridge 10a, comprising portions 56a′, 
               
               
                   
                 56a″, and a gasket cut-out 101a aligned with portions 56a′ 
               
               
                   
                 and 56a″ 
               
               
                 57 
                 Connecting groove positioned to provide fluid connection 
               
               
                   
                 between enlarged cavity 56 and biosensor conduit groove 55 
               
               
                   
                 of cartridge 10 
               
               
                  57a 
                 Connecting groove positioned to provide fluid connection 
               
               
                   
                 between enlarged cavity 56a and biosensor conduit groove 
               
               
                   
                 55a of cartridge 10a 
               
               
                 58 
                 Optical chamber in cartridge 10a for receiving blood from 
               
               
                   
                 blood storage conduit 51a, and positioned to align with at 
               
               
                   
                 least a portion of an optical window 
               
               
                  58a 
                 Optical chamber in cartridge 10a for receiving blood from 
               
               
                   
                 blood storage conduit 51a, and positioned to align with at 
               
               
                   
                 least a portion of an optical window 
               
               
                 60 
                 Cap for sealing cartridge inlet 43 of cartridge 10 
               
               
                  60a 
                 Cap for sealing cartridge inlet 43a of cartridge 10a 
               
               
                 61 
                 Internal wall surface of cap 60 and cap 60a 
               
               
                 62 
                 Cap thread, shown in this embodiment as abbreviated thread 
               
               
                   
                 on internal wall 61 of cap 60 and cap 60a 
               
               
                 63 
                 Underside of cap 60 and cap 60a 
               
               
                 64 
                 Blind hole at roof of biosensor conduit groove 55 for trapping 
               
               
                   
                 air 
               
               
                 65 
                 First through hole for facilitating assembly of cartridge 
               
               
                 66 
                 Second through hole for facilitating assembly of cartridge 
               
               
                 67 
                 First optical window of cartridge 10 
               
               
                  67a 
                 First optical window of cartridge 10a 
               
               
                 68 
                 Second optical window of cartridge 10 
               
               
                  68a 
                 Second optical window of cartridge 10a 
               
               
                 69 
                 Capillary adaptor handgrip for handling capillary adaptor 70 
               
               
                 70 
                 Capillary adaptor for use with cartridge 10 
               
               
                  70a 
                 Capillary adaptor for use with cartridge 10a 
               
               
                 71 
                 Capillary adaptor inlet member comprising a capillary adaptor 
               
               
                   
                 tube, of capillary adaptor 70 
               
               
                 72 
                 Capillary adaptor inlet port of capillary adaptor 70 
               
               
                 73 
                 Capillary adaptor outlet member of capillary adaptor 70 
               
               
                 74 
                 Capillary adaptor outlet port of capillary adaptor 70 
               
               
                 75 
                 Capillary adaptor face surrounding capillary adaptor outlet 
               
               
                   
                 port 74 of capillary adaptor 70 
               
               
                 76 
                 Capillary adaptor lumen of capillary adaptor 70 
               
               
                 77 
                 Underside of capillary adaptor 70 
               
               
                 78 
                 Internal wall of capillary adaptor 70 
               
               
                 79 
                 Capillary adaptor thread, shown in this embodiment as 
               
               
                   
                 abbreviated thread on internal wall 78 of capillary adaptor 70 
               
               
                 80 
                 A biosensor array of cartridge 10, comprising at least a pH 
               
               
                   
                 biosensor 
               
               
                  80a 
                 A biosensor array of cartridge 10a, comprising at least a pH 
               
               
                   
                 biosensor 
               
               
                 81 
                 Active area of biosensor array 80 
               
               
                 82 
                 Biosensor electrical contact 
               
               
                 83 
                 Biosensor receptacle for arranging one or more biosensors in 
               
               
                   
                 cartridge housing 10 
               
               
                 84 
                 Bowl in nest 92 for receiving the flat side of the pouch 90 as it 
               
               
                   
                 bulges under pressure 
               
               
                 85 
                 Air bladder of cartridge 10 
               
               
                  85a 
                 Air bladder of cartridge 10a 
               
               
                 86 
                 Air bladder cavity of cartridge 10 
               
               
                  86a 
                 Air bladder cavity of cartridge 10a 
               
               
                 87 
                 Air bladder exit port of cartridge 10 
               
               
                  87a 
                 Air bladder exit port of cartridge 10a 
               
               
                 88 
                 An air bladder conduit of cartridge 10 to provide fluid 
               
               
                   
                 connection between air bladder and air bladder exit port 87 
               
               
                  88a 
                 An air bladder conduit of cartridge 10a to provide fluid 
               
               
                   
                 connection between air bladder and air bladder exit port 87a 
               
               
                 89 
                 Air bladder conduit groove in first housing member 20 of 
               
               
                   
                 cartridge 10 to provide fluid connection between air bladder 
               
               
                   
                 and an air bladder exit port 
               
               
                  89a 
                 Air bladder conduit groove in first housing member 20a of 
               
               
                   
                 cartridge 10a to provide fluid connection between air bladder 
               
               
                   
                 and an air bladder exit port 
               
               
                 90 
                 Calibration fluid pouch for storing and releasing calibration 
               
               
                   
                 fluid, for cartridge 10 
               
               
                  90a 
                 Calibration fluid pouch for storing and releasing calibration 
               
               
                   
                 fluid, for cartridge 10a 
               
               
                 91 
                 Calibration fluid pouch cavity of pouch 90 
               
               
                 92 
                 Nest for receiving flat side of calibration fluid pouch 90 
               
               
                  92a 
                 Nest for receiving flat side of calibration fluid pouch 90a 
               
               
                 93 
                 Waste receptacle of cartridge 10 for receiving liquid waste 
               
               
                  93a 
                 Waste receptacle of cartridge 10a for receiving liquid waste 
               
               
                 94 
                 Waste receptacle cavity of cartridge 10 for forming waste 
               
               
                   
                 receptacle 93 
               
               
                  94a 
                 Waste receptacle cavity of cartridge 10a for forming waste 
               
               
                   
                 receptacle 
               
               
                 95 
                 Waste receptacle vent for relieving pressure in waste 
               
               
                   
                 receptacle 93 
               
               
                  95a 
                 Waste receptacle vent for relieving pressure in waste 
               
               
                   
                 receptacle 93a 
               
               
                 96 
                 Calibration fluid pouch spike of cartridge 10 
               
               
                  96a 
                 Calibration fluid pouch spike of cartridge 10a 
               
               
                 97 
                 Calibration fluid pouch spike recess in bowl 84 for housing 
               
               
                   
                 the spike 96 
               
               
                 98 
                 Proximal end of calibration fluid groove of cartridge 10 for 
               
               
                   
                 receiving calibration fluid from calibration fluid pouch 
               
               
                 99 
                 Distal end of calibration fluid groove for transferring 
               
               
                   
                 calibration fluid from proximal end of calibration fluid groove 
               
               
                   
                 98 to biosensor conduit 54 
               
               
                 100  
                 Double-sided sticky gasket of cartridge 10 for engaging 
               
               
                   
                 members 20 and 30 
               
               
                 100a 
                 Double-sided sticky gasket of cartridge 10a for engaging 
               
               
                   
                 members 20a and 30a 
               
               
                 101  
                 Gasket cut-out 101 positioned along blood storage conduit 
               
               
                   
                 51, optical chamber 58, and optical chamber overflow 
               
               
                   
                 chamber up to the enlarged cavity 56 (see FIGS. 5C, 5F and 
               
               
                   
                 5H). 
               
               
                 101a 
                 Gasket cut-out 101a positioned along blood storage conduit 
               
               
                   
                 51a, optical chamber 58a, and optical chamber overflow 
               
               
                   
                 chamber up to the enlarged cavity 56a (see FIGS. 8D, 8E and 
               
               
                   
                 8J). 
               
               
                 102  
                 Gasket cut-out 102 positioned along portion of connecting 
               
               
                   
                 groove 57 
               
               
                 103  
                 Gasket cut-out 103 positioned to align with a portion of the 
               
               
                   
                 biosensor conduit groove and the active area 81 of biosensor 
               
               
                   
                 array 80 
               
               
                 103a 
                 Gasket cut-out 103a positioned to align with a portion of the 
               
               
                   
                 biosensor conduit groove and the active area of biosensor 
               
               
                   
                 array 80a 
               
               
                 104  
                 Gasket cut-out 104 positioned to provide fluid connection 
               
               
                   
                 between distal end of biosensor conduit 54 and waste 
               
               
                   
                 receptacle cavity 94 
               
               
                 104a 
                 Gasket cut-out 104a positioned to provide fluid connection 
               
               
                   
                 between distal end of biosensor conduit 54a and waste 
               
               
                   
                 receptacle cavity 94a 
               
               
                 105  
                 Gasket cut-out 105 positioned to align with calibration fluid 
               
               
                   
                 pouch 90 
               
               
                 105a 
                 Gasket cut-out 105a positioned to align with calibration fluid 
               
               
                   
                 pouch 90a 
               
               
                 106  
                 Gasket cut-out 106 positioned along portion of distal end of 
               
               
                   
                 calibration fluid groove 99 
               
               
                 106a 
                 Gasket cut-out 106a positioned along portion of distal end of 
               
               
                   
                 calibration fluid groove 99a 
               
               
                 107  
                 Gasket cut-out 107 positioned to align with waste receptacle 
               
               
                   
                 vent 95 
               
               
                 107a 
                 Gasket cut-out 107a positioned to align with waste receptacle 
               
               
                   
                 vent 95a 
               
               
                 120  
                 Flexible member of cartridge 10a for construction of air 
               
               
                   
                 bladder 
               
               
                 130  
                 Double-sided sticky gasket for engaging flexible member 120 
               
               
                   
                 to member 40a 
               
               
                 140  
                 Annular compressible member surrounding spike 96a for 
               
               
                   
                 supporting calibration fluid pouch 90a 
               
               
                 141  
                 Calibration fluid pouch window 
               
               
                 143  
                 Boss in second housing member 30a surrounding calibration 
               
               
                   
                 fluid pouch 90a in cartridge 10a 
               
               
                 144  
                 Recess in first housing member 20a for receiving boss 143 
               
               
                 145  
                 Hole in spike 96a fordraining calibration fluid to bottom side 
               
               
                   
                 of second housing member 30a 
               
               
                 147  
                 Recess in bottom of member 30a for channelling calibration 
               
               
                   
                 fluid 
               
               
                 148  
                 Hole in portion 56a′ of an enlarged cavity in second housing 
               
               
                   
                 member 30a of cartridge 10a 
               
               
                 149  
                 Recess in bottom of second housing member 30a for 
               
               
                   
                 channelling blood 
               
               
                 150  
                 Bottom cover of second housing member 30a of cartridge 
               
               
                   
                 10a 
               
               
                 160  
                 Double-sided sticky gasket for engaging bottom cover 150 to 
               
               
                   
                 member 30a 
               
               
                 170  
                 Perforated label of cartridge 10a 
               
               
                 200  
                 Cartridge receptor 
               
               
                 201  
                 Spring-loaded cartridge locating pin 
               
               
                 203  
                 Air bladder depressor 
               
               
                 205  
                 Calibration fluid pouch depressor 
               
               
                 213  
                 Stepper motor for activating air bladder 
               
               
                 215  
                 Stepper motor for rupturing calibration fluid pouch 
               
               
                 216  
                 Power lines for stepper motors 
               
               
                 217  
                 Bracket mounted on cartridge receptor 200 for supporting 
               
               
                   
                 stepper motors 213 and 215 
               
               
                 218  
                 Back portion of receptor 200 
               
               
                 219  
                 A physical interface attached to portion 218 of receptor 200 
               
               
                   
                 on one side and for connecting with an analyzer processor 
               
               
                 220  
                 Top portion of cartridge receptor 200 
               
               
                 230  
                 Bottom portion of cartridge receptor 200 
               
               
                 233  
                 Ports for facilitating electrical connection between biosensors 
               
               
                   
                 80a and physical interface 219 
               
               
                 235  
                 Ports for facilitating electrical connection between physical 
               
               
                   
                 interface 219 and processor 
               
               
                 237  
                 Bed for installing first heating element 
               
               
                 239  
                 Bed for installing second heating element 
               
               
                 241  
                 Cavity for housing a thermistor for regulating first and second 
               
               
                   
                 heating elements 
               
               
                 245  
                 Shunt groove for defining blood shunt 45 for bypassing 
               
               
                   
                 optical chamber 58 
               
               
                 245a 
                 Shunt groove for defining blood shunt 45a for bypassing 
               
               
                   
                 optical chamber 58a 
               
               
                 248  
                 Hole in at the end of shunt groove 245a, traversing the 
               
               
                   
                 thickness of the second housing member 30a of cartridge 
               
               
                   
                 10a, and fluidly connected to recess 149 
               
               
                 267  
                 Opening in cartridge receptor 200 aligned with first optical 
               
               
                   
                 window 67a of cartridge 10a 
               
               
                 268  
                 Opening in cartridge receptor 200 aligned with second optical 
               
               
                   
                 window 68a of cartridge 10a 
               
               
                 270  
                 Cap airflow path, i.e,, a gap between external wall 49 of the 
               
               
                   
                 cartridge inlet 43a of cartridge 10a, and Internal wall surface 
               
               
                   
                 61 of cap 60a, and between underside 63 of cap 60a and 
               
               
                   
                 annular surface 46 at the top of the cartridge inlet 43a of 
               
               
                   
                 cartridge 10a, before underside 63 makes contact with 
               
               
                   
                 annular surface 46 (see FIG. 7G). 
               
               
                 300  
                 Microprocessor of analyzer 
               
               
                 310  
                 Source of electromagnetic radiation (EMR) 
               
               
                 320  
                 Spectrometer 
               
               
                 330  
                 EMR source circuit board 
               
               
                 340  
                 Spectrometer circuit board 
               
               
                 350  
                 Biosensor circuit board 
               
               
                 360  
                 Limit switch for notifying microprocessor that cartridge is 
               
               
                   
                 fully inserted 
               
               
                 370  
                 Power supply 
               
               
                 380  
                 Heater controller 
               
               
                 390  
                 Stepper motor circuit board 
               
               
                 400  
                 Analyzer display screen 
               
               
                 410  
                 Analyzer printer 
               
               
                   
               
            
           
         
       
     
     Shown in  FIG. 1A  is an exploded view of a first embodiment of a spectroscopic and biosensor cartridge  10 . From top to bottom, components are listed as follows: a flexible member  40 , a first housing member  20  showing a cartridge inlet  43 , a calibration fluid pouch  90 , a double-sided sticky gasket  100 , a biosensor array  80 , and a second housing member  30  showing a biosensor receptacle  83 . 
     Shown collectively in  FIGS. 1B-1F  are more details of the components of the cartridge.  FIG. 1B  illustrates a top view of the second housing member  30  of the cartridge, with the biosensor array  80  installed in the receptacle  83  shown in  FIG. 1A . Also shown in  FIG. 1B  are a nest  92  for receiving the flat side of the calibration fluid pouch  90  (hidden), a bowl  84  in nest  92  for receiving the flat side of the pouch  90  as it bulges under pressure, a calibration fluid pouch spike recess  97  in bowl  84  for housing a spike  96 , the proximal end of a calibration fluid groove  98  for receiving calibration fluid from calibration fluid pouch  90  after it is ruptured by the spike  96 , a first through hole  65  and a second through hole  66  for facilitating assembly of the cartridge, and a waste receptacle cavity  94  for forming a waste receptacle  93  illustrated in  FIG. 3D . 
       FIG. 1D  illustrates the gasket  100  having several cut-outs described in Table 1. As already explained, a single gasket cut-out is considered to be within the scope of the present invention.  FIG. 1E  and  FIG. 1F  illustrate how the gasket  100  is aligned with the second housing member  30  and the first housing member  20  respectively.  FIG. 1E  illustrates a top view of the second housing member  30  shown in  FIG. 1B , overlaid by and in alignment with the gasket  100  shown in  FIG. 1D ,  FIG. 1F  illustrates a bottom view of the first housing member  20  shown in  FIG. 1C , overlaid by and in alignment with the gasket  100  shown in  FIG. 1D . 
     Illustrated in  FIG. 2A  is a perspective view of the joint-diagnostic spectroscopic and biosensor cartridge  10  shown in  FIG. 1A , showing the first housing member  20 , the second housing member  30 , the flexible member  40 , which covers the paddle  41  and paddle hinge  42 , as well as the air bladder cavity  86  (see  FIG. 1C ). Flexible member  40  is stuck on to the first housing member  20 , so as to create the air bladder  85  (see  FIG. 3D ), and seal off the nest  92  in order to direct calibration fluid from a ruptured pouch  90  into the proximal end of the calibration fluid groove  98 . Also shown in  FIG. 2A  is waste receptacle vent  95  for relieving pressure in waste receptacle  93 , a first optical window  67 , and a cartridge inlet  43  (detail E shown in  FIG. 2E ). Illustrated in  FIG. 2B  is a first perspective view of an embodiment of a capillary adaptor  70  for use with cartridge  10  shown in  FIG. 2A , showing the capillary adaptor inlet port  72 . Illustrated in  FIG. 2C  is a second perspective view of the capillary adaptor  70  shown in  FIG. 2B , showing the capillary adaptor outlet port  74 . Illustrated in  FIG. 2D  is the capillary adaptor  70  shown in  FIG. 2B , engaged with the inlet  43 . Details of inlet  43  are illustrated in  FIG. 2E , showing an annular surface  46 , a recess  47  in the annular surface  46 , an internal wall  48 , external wall  49 , and thread  50  on external wall  49 . 
     Illustrated in  FIG. 2F  is a first perspective view of an embodiment of a cap  60  for use with cartridge  10  shown in  FIG. 2A . Illustrated in  FIG. 2G  is a second perspective view of the cap  60  shown in  FIG. 2F , showing the underside  63  of the cap. Illustrated in  FIG. 2H  is the cap  60  shown in  FIG. 2F , engaged with the inlet  43  of the cartridge  10  shown in  FIG. 2A . Some embodiments of a cap comprise a gasket attached to the underside  63 , for creating an air-tight seal between the underside  63  of the cap and the annular surface  46  at the top of the cartridge inlet  43 . 
     Illustrated in  FIG. 3A  is a top view of the cartridge and capillary adaptor engaged as shown in  FIG. 2D . Illustrated in  FIG. 3B  is a first cross-sectional view through the cartridge and capillary adaptor shown in  FIG. 3A  along line B-B. Illustrated in  FIG. 3C  is a front view of the cartridge and capillary adaptor shown in  FIG. 3A . Illustrated in  FIG. 3D  is a second cross-sectional view through the cartridge and capillary adaptor shown in  FIG. 3A  along line D-D, showing the air bladder  85  and the waste receptacle  93 . 
     Illustrated in  FIG. 3E  is a detailed view of the detail E of the cartridge and capillary adaptor shown in  FIG. 3D , showing capillary adaptor inlet port  72 , capillary adaptor lumen  76 , blood storage conduit entrance  52 , blood storage conduit  51 , interface  75 / 44  of the cartridge inlet inner face  44  and the capillary adaptor face  75 , abbreviated thread  50  on external wall  49  of inlet  43 , abbreviated thread  79  on internal wall  78  of capillary adaptor  70 . In this embodiment, the cartridge inlet inner face  44  and the capillary adaptor face  75  are shown mating by design, and also by design, annular surface  46  of the cartridge inlet  43  does not mate with underside  77  of the capillary adaptor  70 . 
     Also illustrated in  FIG. 3E  in conjunction with  FIG. 2E  is the internal wall  48  (see  FIG. 2E ) defining an airflow path for airflow between an exterior of the disposable cartridge and the blood storage conduit  51  when the capillary adaptor is being removed from the cartridge inlet  43 . The airflow path in some embodiments is defined by one or more than one flute or groove in the internal wall  48  of the inlet  43 , or in the external wall of the capillary adaptor outlet member  73 . In such embodiments, there is frictional engagement between the internal wall  48  of the inlet  43  and the capillary adaptor outlet member  73 . In the embodiment illustrated in  FIG. 3E , capillary adaptor outlet member  73  could be inserted into cartridge inlet  43  with no frictional engagement. Since there is no seal between capillary adaptor outlet member  73  and the internal wall  48  of the cartridge inlet  43 , the fitting of the present invention is not characterized as a standard Luer fitting. Moreover, a standard Luer fitting is not compatible with the present invention as explained next. There are two types of Luer fittings: Luer slip and Luer lock. A Luer slip fitting consists of a tapered cone and a mating tapered cavity. A Luer lock fitting consists of a Luer slip fitting with locking threads added. The Luer lock fitting creates a more secure connection to the Luer slip connection. If the present invention was a standard Luer lock fitting, two situations would occur: 1) there would have been a gap between the cartridge inlet inner face  44  and the capillary adaptor face  75 —such a gap would impede capillary flow of blood into the blood storage conduit  51 , and is not preferred; 2) removal of the male member (in this case the capillary adaptor outlet member  73 ) would have created a vacuum—withdrawing the blood in the blood storage conduit  51 , away from the optical chamber, and attempt to refill the optical chamber has the potential to create air bubbles in the optical chamber. The inlet wall  48  also defines a similar airflow path for airflow between an exterior of the disposable cartridge and the blood storage conduit  51  when a syringe containing blood is used to fill the blood storage conduit  51 , instead of a capillary adaptor, when the syringe is being removed from the cartridge inlet  43 . 
     Illustrated in  FIG. 3F  is a detailed view of the detail F of the cartridge and capillary adaptor shown in  FIG. 3B  showing blood storage conduit entrance  52 , blood storage conduit  51 , capillary adaptor lumen  76 , air bladder conduit  88 , air bladder exit port  87 , abbreviated thread  50  on external wall  49  of inlet  43 , and abbreviated thread  79  on internal wall  78  of capillary adaptor  70 . 
     Illustrated in  FIG. 4A  is a top view of the cap  60  shown in  FIG. 2F . Illustrated in  FIG. 4B  is a right side view of the cap shown in  FIG. 4A . Illustrated in  FIG. 4C  is a bottom view of the cap shown in  FIG. 4A , showing underside  63  of cap  60 , internal wall surface  61  of cap  60 , and abbreviated thread  62  on internal wall  61  of cap  60 . 
     Illustrated in  FIG. 4D  is a top view of the capillary adaptor  70  shown in  FIG. 2B . Illustrated in  FIG. 4E  is a right side view of the capillary adaptor shown in  FIG. 4D , showing capillary adaptor inlet member  71 , capillary adaptor inlet port  72 , and capillary adaptor outlet port  74 . Illustrated in  FIG. 4F  is a bottom view of the capillary adaptor shown in  FIG. 4D  showing capillary adaptor outlet port  74 , capillary adaptor face  75  surrounding capillary adaptor outlet port  74 , underside  77  of capillary adaptor, and internal wall  78  of capillary adaptor  70 . 
     Illustrated in  FIG. 4G  is a first perspective view of the capillary adaptor  70  shown in  FIG. 4D , showing the capillary adaptor handgrip  69 , a capillary adaptor inlet member  71  comprising a capillary adaptor tube and a capillary adaptor inlet port  72 . Illustrated in  FIG. 4H  is a second perspective view of the capillary adaptor shown in  FIG. 4D , showing in addition, a capillary adaptor outlet member  73 , a capillary adaptor outlet port  74 , a capillary adaptor face  75  surrounding the capillary adaptor outlet port  74 , underside  77  and internal wall  78  of capillary adaptor  70 . 
     Illustrated in  FIG. 5A  is a top view of the cartridge shown in  FIG. 1A . Illustrated in  FIG. 5B  is a first cross-sectional view through the cartridge shown in  FIG. 5A  along line B-B, showing calibration fluid pouch cavity  91  of pouch  90 , and calibration fluid pouch spike  96 . Illustrated in  FIG. 5C  is a detailed view of the detail C of the cartridge shown in  FIG. 5B , showing biosensor conduit  54 , blood shunt  45 , biosensor array  80 , optical chamber  58 , first optical window  67 , and second optical window  68 . 
     Illustrated in  FIG. 5D  is a second cross-sectional view through the cartridge shown in  FIG. 5A  along line D-D. Illustrated in  FIG. 5E  is a detailed view of the detail E of the cartridge shown in  FIG. 5A , showing an annular surface  46 , an abbreviated thread  50 , a blood storage conduit entrance  52 , and an air bladder exit port  87 . 
     Illustrated in  FIG. 5F  is a detailed view of the detail F of the cartridge shown in  FIG. 5D , showing blood shunt  45 , optical chamber  58 , first optical window  67 , second optical window  68 , connecting groove  57  positioned to provide fluid connection between enlarged cavity  56  and biosensor conduit groove  55 , and distal end of calibration fluid groove  99  for transferring calibration fluid from proximal end of calibration fluid groove  98  to biosensor conduit  54 . 
     Illustrated in  FIG. 5G  is a third cross-sectional view through the cartridge shown in  FIG. 5A  along line G-G. Illustrated in  FIG. 5H  is a detailed view of the detail H of the cartridge shown in  FIG. 5G , showing blood shunt  45 , enlarged cavity  56 , connecting groove  57  positioned to provide fluid connection between enlarged cavity  56  and biosensor conduit groove  55 , and proximal end of calibration fluid groove  98  for receiving calibration fluid from calibration fluid pouch  90 . 
     All the previous Figures are illustration of a first embodiment of a cartridge  10 , and all subsequent Figures are illustration of various aspects of a second embodiment of a cartridge  10   a ,  FIGS. 9A-9J  also illustrate aspects of an embodiment of a cartridge receptor  200 . Attempts are made to use the same reference numerals for similar elements and, in some cases, the letter “a” is appended to the end of the number to indicate that the embodiment of the cartridge is the second embodiment. The differences between the first and second embodiments are highlighted, to illustrate various advantageous features over the prior art. Table 1 provides a list of the reference numerals used, and a brief description of the structural features referred to. 
     Illustrated in  FIG. 6A  is an exploded view of a second embodiment of a joint-diagnostic spectroscopic and biosensor cartridge  10   a  for use with a joint-diagnostic spectroscopic and biosensor analyzer. The major features in cartridge  10   a  that are not present in cartridge  10  are as follows: 1) the flexible member  120  only covers the air bladder cavity  86   a  (see  FIG. 7B ), and is attached to the first housing member  20   a  facilitated by a double-sided sticky gasket  130 ; 2) the calibration fluid pouch is only covered with a perforated label  170  (see  FIG. 7A ); 3) the calibration fluid pouch is only supported in the cartridge by an annular compressible member  140 , which surrounds spike  96   a;  4) the spike  96   a  comprises a hole  145  for draining calibration fluid to recess  147  in the bottom side of second housing member  30   a  for channeling the calibration fluid (see  FIGS. 6B and 7D ); 5) the blood shunt  45   a  (shown in  FIG. 8D ) fluidly connects with a recess  149  in second housing member  30   a  (shown in  FIG. 7D ) via a hole  248  (shown in  FIG. 6B ) in the second housing member  30   a , and re-enters the enlarged cavity  56   a  from the bottom through a hole  148  in portion  56   a ′ of the enlarged cavity, in second housing member  30   a  (see  FIG. 8J ); 6) a preferably hard plate  150  covers the recesses  147  and  149  (see  FIG. 7C ) facilitated by a double-sided sticky gasket  160 ; 7) a boss  143  in second housing member  30   a  surrounds calibration fluid pouch  90   a  by greater than 180 degrees, and during cartridge assembly, positions the calibration fluid pouch  90   a , which is supported by the annular compressible member  140 ; and 8) a recess  144  (see  FIG. 6C ) in the first housing member  20   a , for receiving boss  143 . A boss  143  surrounding the pouch  90   a  by greater than 180 degrees is as effective as 360 degrees, in preventing the pouch  90   a  from horizontal movement. 
     The advantage of the rupture mechanism described for cartridge embodiment  10   a  for releasing calibration fluid, over the rupture mechanism described for cartridge embodiment  10  and the embodiments described in U.S. Pat. No. 9,470,673, is the decreased force required to rupture the calibration fluid pouch, by direct observation. 
     The advantage of the fluid connection between the shunt  45   a  and the enlarged cavity  56   a  described for cartridge embodiment  10   a  for slowing down blood flow by capillary action, over the fluid connection between the shunt  45  and the enlarged cavity  56  described for cartridge embodiment  10  for slowing down blood flow by capillary action for cartridge embodiment  10  and the embodiments described in U.S. Pat. No. 9,470,673, is the efficiency of enlarged cavity  56   a  as a capillary break.  FIGS. 6B and 8J  collectively illustrate the progression from a small cross-sectional area of hole  148  to a substantially larger cross-sectional area of enlarged cavity  56   a . In an analogous configuration described for cartridge embodiment  10  and in the embodiments described in U.S. Pat. No. 9,470,673, the progression from small to large is only in one dimension; this is best illustrated collectively in  FIGS. 1B and 5H . In  FIG. 1B , shunt groove  245  is connected to the side of enlarged cavity portion  56 ′; in  FIG. 6B , the shunt groove  245   a  is effectively connected to the bottom of enlarged cavity portion  56   a ′, and the connection is illustrated in  FIG. 6B  as concentric circles. By direct observation, cartridge embodiment  10   a  provides a more effective capillary break than the capillary breaks in the embodiments described in U.S. Pat. No. 9,470,673. In cartridge  10   a  of the present invention, the enlarged cavity  56   a  is simultaneously in fluid connection with the optical chamber  58   a  and the blood shunt  45   a  via the hole  148  in portion  56   a ′ of an enlarged cavity. 
     Illustrated in  FIG. 6B  is a top view of the second housing member  30   a  of the cartridge, with the biosensor array  80   a  installed in the receptacle  83   a , shown in  FIG. 6A . Illustrated in  FIG. 6C  is a bottom view of the first housing member  20   a  of the cartridge shown in  FIG. 6A . Illustrated in  FIG. 6D  is a top view of gasket  100   a  of the cartridge shown in  FIG. 6A . Illustrated in  FIG. 6E  is the top view of the second housing member  30   a  shown in  FIG. 6B , overlaid by and in alignment with the gasket  100   a  shown in  FIG. 6D . Illustrated in  FIG. 6F  is the bottom view of the first housing member  20   a  shown in  FIG. 6C , overlaid by and in alignment with the gasket  100   a  shown in  FIG. 6D . 
     Illustrated in  FIG. 7A  is a perspective view of the joint-diagnostic spectroscopic and biosensor cartridge  10   a  shown in  FIG. 6A , showing the perforated label  170  attached to the first housing member  20   a , and a capillary adaptor  70   a  engaged with the inlet  43   a . The perforations are for ease of breaking the label, when stepper motors  213  and  215  (see  FIG. 9A ) respectively, activate the air bladder and pushes the calibration fluid pouch  90   a  against the spike  96   a . The punched-out portions of the label sticks to the flexible member of the air bladder and the dome of the calibration fluid pouch, and do not fall inside the receptor  200  of the analyzer. 
     Illustrated in  FIG. 7E  is a top view of cartridge  10   a , with cap  60   a  partly engaged with the inlet  43   a , and illustrated in  FIG. 7F  is a cross-sectional view through the cartridge and cap shown in  FIG. 7E  along line F-F. In order to illustrate a cap air flow path  270 , i.e, a gap between external wall  49  of the cartridge inlet  43   a  of cartridge  10   a , and Internal wall surface  61  of cap  60   a , and between underside  63  of cap  60   a  and annular surface  46  at the top of the cartridge inlet  43   a  of cartridge  10   a , before underside  63  makes contact with annular surface  46 ,  FIG. 7G  is provided. Illustrated in  FIG. 7G  is a detailed view of the detail G of the cartridge and cap shown in  FIG. 7F .  FIG. 7G  viewed in conjunction with  FIGS. 2E and 4C , illustrate the abbreviated threads  50  and  62 . These abbreviated threads assist in providing the cap air flow path  270 . In some embodiments, a cap absent threads is frictionally engaged with the external wall  49  of the cartridge; in such an embodiment, at least the inside wall of the cap or the external wall of the inlet comprise one or more flute or groove (not shown), to provide the cap air flow path  270 . 
     Illustrated in  FIG. 7B  is a second perspective view of cartridge  10   a  shown in  FIG. 7A , with air bladder cavity  86   a  and calibration fluid pouch  90   a  exposed by hiding perforated label  170 , and a cap  60   a  engaged with the inlet  43   a . The disposable cartridges illustrated in U.S. Pat. No. 9,470,673 comprise a hinged-paddle, which is absent in  FIG. 7B . Removal of the hinged-paddle contributes to decreased force requirement for rupturing the pouch  90   a.    
     Illustrated in  FIG. 7C  is a third perspective view of the joint-diagnostic spectroscopic and biosensor cartridge  10   a  shown in  FIG. 7A , with the second housing member  30   a  exposed, showing a bottom cover  150 . Illustrated in  FIG. 7D  is a fourth perspective view of cartridge  10   a  shown in  FIG. 7A , with recesses  147  and  149  in the bottom of second housing member  30   a  exposed by hiding the bottom cover  150 . Preferably, the cover  150  is made of hard material for strength, and has a small thickness in order to minimize the cartridge thickness. 
     Illustrated in  FIG. 8A  is a top view of the cartridge shown in  FIG. 6A , showing a notch  23  for receiving a spring-loaded cartridge locating pin  201  in cartridge receptor  200 , illustrated in  FIG. 9D . Also shown is a cut-out  21  in  20   a  for viewing capillary break, in order to observe that blood has reached the entrance of the enlarged cavity  56   a . Illustrated in  FIG. 8B  is a first cross-sectional view through the cartridge shown in  FIG. 8A  along line B-B. Illustrated in  FIG. 8C  is a second cross-sectional view through the cartridge shown in  FIG. 8A  along line C-C. Illustrated in  FIG. 8D  is a detailed view of the detail D of the cartridge shown in  FIG. 8C , illustrating that the width of the blood shunt  45   a  is substantially larger than the width of the optical chamber  58   a . Also shown is the biosensor conduit  54   a.    
     Illustrated in  FIG. 8E  is a detailed view of the detail E of the cartridge shown in  FIG. 8B . Illustrated in  FIG. 8F  is a third cross-sectional view through the cartridge shown in  FIG. 8A  along line F-F. Illustrated in  FIG. 8G  is a fourth cross-sectional view through the cartridge shown in  FIG. 8A  along line G-G. Illustrated in  FIG. 8H  is a fifth cross-sectional view through the cartridge shown in  FIG. 8A  along line H-H. Illustrated in  FIG. 8J  is a detailed view of the detail J of the cartridge shown in  FIG. 8F . When  FIG. 8J  is viewed in conjunction with  FIG. 6B , it is illustrated that the enlarged cavity  56   a  has a second cross-sectional area substantially larger than the cross-sectional area of the hole  148 , whereby blood flow by capillary action slows down as the blood reaches the hole  148 , and wherein the enlarged cavity  56   a  is simultaneously in fluid connection with the optical chamber  58   a  and the blood shunt  45   a  via the hole  148 . It was observed that this arrangement provides a more effective capillary break that the capillary breaks described in U.S. Pat. No. 9,470,673. 
     Illustrated in  FIG. 8K  is a detailed view of the detail K of the cartridge shown in  FIG. 8G , illustrating the annular compressible member  140  surrounding spike  96   a  for supporting calibration fluid pouch  90   a , and a hole  145  in the spike  96   a  and in fluid connection with a recess  147  (see  FIG. 7D ). U.S. Pat. No. 9,470,673 does not disclose a hole in the spike, and it was observed that the present arrangement decreases the force required to rupture the pouch  90   a . Although the compressible member  140  is illustrated as annular in shape, other shapes, for example, square and triangular, are considered to be within the scope of the present invention. 
     Illustrated in  FIG. 8L  is a detailed view of the detail L of the cartridge shown in  FIG. 8A . Illustrated in conjunction with  FIGS. 8A and 8E , is the association of the air bladder exit port  87   a  and the blood storage conduit  51   a.    
     Illustrated collectively in  FIGS. 9A-10  is an embodiment of a joint spectroscopic and biosensor system for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status, comprising: a) an analyzer; b) a disposable cartridge  10   a , and  c ) a cap for sealing the cartridge inlet  43   a.    
     A block diagram of an embodiment of an analyzer for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status, is provided in  FIG. 10 . The analyzer comprises a housing illustrated in U.S. Pat. No. 9,470,673 in  FIGS. 14A-14C , which does not disclose details of the analyzer components. The housing comprises some of the following components: i) a power supply, which is optionally in the form of disposable or rechargeable batteries; ii) a source of electromagnetic radiation (EMR), for example, one or more LEDs, a tungsten lamp, one or more lasers, or any combination thereof; iii) a receptor in the analyzer housing for receiving a disposable cartridge; iv) a photodetector for measuring EMR transmitted through or reflected from a blood sample within the optical chamber of the cartridge and for providing an EMR-based signal derived from the EMR transmitted through or reflected from the blood sample; v) a processor or microprocessor for controlling the analyzer and in communication with the photodetector for receiving the EMR-based signal, and at least one calibration algorithm installed in the processor for transforming the EMR-based signal into a hemoglobin specie concentration; vi) a physical interface attached to the receptor for connecting with an analyzer processor and for connecting with the biosensor; vii) means for releasing the calibration fluid from the calibration fluid pouch and transporting released calibration fluid to the biosensor conduit for calibrating at least the pH biosensor prior to measuring the pH of the blood sample; viii) means for maintaining the active area of the biosensor at a pre-determined temperature; ix) means for preheating the blood sample; x) a display screen; and xi) a barcode reader. An optional printer is included in  FIG. 10 . 
     Illustrated in  FIG. 9A  is a perspective view of an embodiment of a joint-diagnostic spectroscopic and biosensor cartridge inserted in the receptor  200  of an analyzer. Illustrated in  FIG. 9B  is a top view of a joint-diagnostic spectroscopic and biosensor cartridge inserted in the receptor of an analyzer. Illustrated in  FIG. 9C  is a first cross-sectional view through the cartridge shown in  FIG. 9B  along line C-C. Illustrated in  FIG. 9D  is a second cross-sectional view through the cartridge shown in  FIG. 9B  along line D-D. Illustrated in  FIG. 9E  is a third cross-sectional view through the cartridge shown in  FIG. 9B  along line E-E. 
     Referring collectively to  FIGS. 9A-9E , the analyzer receptor  200  is illustrated, comprising: a) an opening for receiving and aligning a capped disposable cartridge  10   a  containing the patient&#39;s blood in the cartridge, in an operational position (the opening refers to the front portion of receptor  200 , occupied by the cartridge  10   a ), b) an opening  267  (or  268 ) for directing the electromagnetic radiation to the first optical window when the cartridge is in the operational position; c) and an opening  268  (or  267 ) for directing electromagnetic radiation emerging from the optical chamber to the at least one photodetector when the cartridge is in the operational position; d) a physical interface  219  for facilitating electrical connection with the biosensor electrical output element(s) and the processor; and e) a bracket  217  mounted on the receptor for at least supporting a stepper motor  215  for applying force to the calibration fluid pouch against a spike, and a stepper motor  213  for forcing air from the air bladder  85   a  through the air bladder exit port, for pushing the blood into the biosensor conduit. In some embodiments, the opening defines at least one surface for cooperating with a corresponding at least one surface of the cartridge to define an insertion direction and orientation for mating the cartridge with the opening. The embodiment of the receptor  200  further comprises a top portion  220  and a bottom portion  230 . In one embodiment, the at least one photodetector is a spectrometer comprising linear diode array (each diode is referred to as a photodector), a reflecting grating and 256 pixels, and fiber optic connection to the spectrometer. Since the bend radius of fiber optic cables are limited, prisms are used to bend the EMR 90 degrees. As an example, the EMR is admitted through opening  267 , and since there is sufficient space for bending the fiber optic cable, no prism is required. However, EMR emerging through opening  268  enters the spectrometer via a prism, in order to minimize the space between the receptor and the base of the analyzer. 
     Referring to  FIG. 9J  is illustrated a third perspective view of the receptor of a joint-diagnostic spectroscopic and biosensor analyzer shown in  FIG. 9F , with the top portion of the receptor  220  and cartridge  10   a  hidden. The bottom portion  230  comprises a bed  237  for installing an optional heating element (not shown) for heating the biosensor conduit of the cartridge  10   a , and a bed  239  for installing an optional heating element (not shown) for pre-heating the blood in the blood storage conduit  51   a  (see  FIG. 8E ). Also shown is a cavity  241  for housing a thermistor for regulating the heating elements. In this embodiment, the optional heaters are flexible heating elements having a plastic substrate and a layer of aluminum on the top. The aluminum functions as a heat spreader and makes the heater more durable for repeated insertion and removal of cartridges into the receptor. Attached to the substrate is pressure sensitive adhesive (PSA), for attaching the heater to the beds  237  and  239 . In this embodiment, two heaters are connected and the thermistor for controlling the heaters is stuck to the PSA of the heater at bed  237 . The thermistor (not shown), fits in the recess  241 . Sufficient space is shown to the left of recess  241  for electrical connections. 
     Referring collectively to  FIGS. 9F and 9J  is shown a physical interface  219  attached to back portion  218  (see  FIG. 9B ) of receptor  200 . Ports  233  are for facilitating electrical connection between biosensors  80   a  and physical interface  219 , and ports  235  are for facilitating electrical connection between physical interface  219  and the analyzer processor. Although in this embodiment, the biosensors are configured to fit in the slot shown in  233 , a person of ordinary skill in the art will appreciate that the analyzer input electrical contact can mate with the cartridge biosensor output electrical in different ways, for example, the input contact can be mechanically brought into contact with the top of the cartridge biosensor output electrical after the cartridge is in an operational position in the analyzer. 
     Referring to  FIG. 9D  is shown the top portion  220  of the receptor  200  comprises a spring-loaded locating element  201  for engaging with a notch  23  disposed at the top of the cartridge (see  FIG. 8A ) for forcing the cartridge against the heating elements. 
     Referring to  FIGS. 9F-9J  are illustrations of the bottom portion  230  of receptor  200 , the cartridge  10   a , and the association between the cartridge and receptor bottom portion  230 . Illustrated in  FIG. 9F  is a second perspective view of a joint-diagnostic spectroscopic and biosensor cartridge  10   a  inserted in the receptor of an analyzer, with the top portion of the receptor hidden, and only showing the bottom portion  230 . Illustrated in  FIG. 9G  is a perspective view of the cartridge  10   a  shown in  FIG. 9F . Illustrated in  FIG. 9H  is a second perspective view of the cartridge  10   a , showing the bottom cartridge housing member  30   a.    
     Referring collectively to  FIGS. 6A-8K , illustrated is an embodiment of a disposable cartridge  10   a  adapted for insertion along an insertion plane, substantially defined by the gasket  100   a , into the receptor of a joint spectroscopic and biosensor analyzer for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status. The gasket, may, for example, define an external surface of the cartridge that can cooperate with a surface of the receptor (or the opening of the receptor) to define the insertion plane. The cartridge comprises a housing having at least a first housing member  20   a  and a second housing member  30   a  bonded together by a gasket  100   a . The housing comprises: a) a cartridge inlet  43   a  for receiving the blood sample; b) a blood storage conduit  51   a  (see  FIG. 8E ) having a proximal end close to the cartridge inlet and a distal end away from the cartridge inlet; c) an optical chamber  58   a  (see  FIG. 8D ) for receiving the blood from the distal end of the blood storage conduit and for measuring the at least two hemoglobin species, the optical chamber comprising an optical depth dimension orthogonal to the insertion plane; d) optical windows  67   a  and  38   a  positioned to align with at least a portion of the optical chamber  58   a  for collecting spectroscopic data from blood in that portion of the optical chamber; e) a biosensor conduit  54   a  (see  FIG. 8D ) for receiving the blood from the optical chamber overflow chamber, the biosensor conduit  54   a  having at least one biosensor for measuring the at least pH of the blood sample; f) a blood shunt  45   a  for providing fluid connectivity between the distal end of the blood storage conduit and the optical chamber overflow chamber, the blood shunt having a maximum shunt depth dimension orthogonal to the insertion plane, and wherein the maximum shunt depth dimension is substantially larger than the optical chamber depth dimension (see  FIGS. 8D and 8J ); g) an air bladder  85   a  and an air bladder exit port  87   a  within the housing (see  FIGS. 8B, 8E and 8L ) for providing pressurized air for urging blood from the blood storage conduit  51   a  into the biosensor conduit  54   a ; h) a waste receptacle  93   a  (see  FIG. 8B ) for receiving waste liquid from the biosensor conduit  54   a ; and i) a waste receptacle vent  95   a  (see  FIG. 7B ) for relieving pressure in the waste receptacle  93   a.    
     Referring collectively to  FIGS. 6B, 7D, 8D and 8J  is illustrated the optical chamber overflow chamber comprising: a) a first duct shown as a hole  248  (see  FIG. 6B ) fluidly connected with the shunt  45   a  and traversing the thickness of the second housing member  30   a ; b) a recess  149  (see  FIG. 7D ) disposed at the bottom of the second housing member  30   a  and fluidly connected to the first duct  248 ; c) a second duct shown as a hole  148  (see  FIG. 6B ) having a first cross-sectional area along the cartridge insertion plane, and fluidly connected to the recess; and d) an enlarged cavity  56   a  having a second cross-sectional area parallel to the first cross-sectional area. The second cross-sectional area is substantially larger than the first cross-sectional area, whereby blood flow by capillary action slows down as the blood reaches the end of the second duct, and wherein the enlarged cavity is simultaneously in fluid connection with the optical chamber and the second duct. 
     Another embodiment of a disposable cartridge for operation with a joint spectroscopic and biosensor blood analyzer for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status, comprises a housing having at least a first housing member and a second housing member bonded together by a gasket, wherein the housing comprises: a) a cartridge inlet; b) a blood storage conduit within the housing having a proximal end close to the cartridge inlet and a distal end away from the cartridge inlet; c) an optical chamber within the housing for receiving the blood from the distal end of the blood storage conduit and for measuring the at least two hemoglobin species; d) an optical chamber overflow chamber fluidly connected with the optical chamber; e) a biosensor conduit within the housing for receiving the blood from the optical chamber overflow chamber, the biosensor conduit comprising a proximal end, a distal end and at least a portion of a pH biosensor; f) a calibration fluid pouch for storing and releasing calibration fluid, a spike disposed in the second housing member of the cartridge for rupturing the pouch, a recess disposed in the opposite side of the second housing member, a hole in the spike for permitting flow of the calibration fluid from the pouch to the recess for channeling the calibration fluid to the biosensor conduit; g) a waste receptacle for receiving liquid waste from the biosensor conduit; h) a vent for relieving pressure in the waste receptacle; and i) an air bladder and an air bladder exit port within the housing for providing pressurized air for urging blood from the blood storage conduit into the biosensor conduit. The cartridge further comprises a compressible member surrounding the spike, for supporting the calibration fluid pouch. 
     Illustrated in  FIG. 10  is a block diagram of an embodiment of a joint-diagnostic spectroscopic and biosensor analyzer. The embodiment comprises the following components: 1) cartridge receptor  200 ; 2) microprocessor  300 ; 3) source of electromagnetic radiation (EMR)  310 ; 4) spectrometer  320 ; 5) EMR source circuit board  330 ; 6) spectrometer circuit board  340 ; 7) biosensor circuit board  350 ; 8) limit switch  360  for notifying microprocessor that cartridge is fully inserted; 9) power supply  370 ; 10) heater controller  380 ; 11) stepper motor circuit board  390 ; 12) analyzer display screen  400 ; and 13) analyzer printer  410 . 
     An embodiment of a joint spectroscopic and biosensor system for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status comprises a disposable cartridge and an analyzer. The cartridge comprises a cartridge housing and the cartridge housing comprises: a) cartridge inlet; b) a blood storage conduit having a proximal end close to the cartridge inlet and a distal end away from the cartridge inlet; c) an optical chamber for receiving the blood from the distal end of the blood storage conduit and for measuring the at least two hemoglobin species, the optical chamber comprising a first optical window and a second optical window; d) an optical chamber overflow chamber fluidly connected with the optical chamber; e) a biosensor conduit for receiving the blood from the optical chamber overflow chamber, the biosensor conduit comprising a proximal end, a distal end and at least a portion of a pH biosensor; f) a pH biosensor electrical output element; g) a calibration fluid pouch containing calibration fluid for at least calibrating the pH biosensor; and h) an air bladder and an air bladder exit port. 
     The analyzer comprises an analyzer housing, the analyzer housing comprising: a) a receptor comprising a first opening for receiving and aligning the cartridge in an operational position; b) a source of electromagnetic radiation; c) at least one photodetector; d) a power supply; and e) a processor for controlling the analyzer. The receptor further comprises: i) a second opening for directing the electromagnetic radiation to the first optical window when the cartridge is in the operational position; ii) a third opening for directing electromagnetic radiation emerging from the second optical window to the at least one photodetector when the cartridge is in the operational position; iii) a physical interface for providing electrical contact between the pH biosensor electrical output element and the processor; and iv) a bracket mounted on the receptor for at least supporting a first stepper motor for applying force to the calibration fluid pouch against a spike for rupturing the spike and releasing calibration fluid, and a second stepper motor for forcing air from the air bladder through the air bladder exit port, for pushing the blood into the biosensor conduit. 
     In some embodiments, the receptor further comprises a top portion and a bottom portion, and the bottom portion comprises at least one heating element layered on the surface of the bottom portion, for heating the cartridge, and the top portion comprises a spring-loaded locating element for engaging with a notch disposed at the top of the cartridge, for forcing the cartridge against the at least one heating element. 
     The procedures for operating a joint spectroscopic and biosensor system comprising the analyzer illustrated in  FIG. 10  and the cartridge illustrated collectively in  FIGS. 1A-8K  for measurement of at least two hemoglobin species in a patient&#39;s blood sample by spectroscopy, and measurement of at least pH of the blood sample by biosensor, for assessing the patient&#39;s oxygenation and acid-base status, comprises the following steps:
         1. With cartridge placed on table (for blood in a syringe) or cartridge kept horizontal for capillary blood (via a Capillary Adaptor), fill blood storage conduit up to the Capillary Break (see  148  and  56   a  in  FIG. 8J );   2. Use cap to make an air-tight seal with cartridge inlet (see  FIG. 7B ); and   3. Insert capped cartridge into receptor of analyzer (see  FIG. 9A ).
 
The following steps are programmed in the microprocessor of the analyzer:
   1. Optical reading begins when cartridge triggers limit switch  360  in  FIG. 10  that indicates complete cartridge insertion;   2. Preferably following optical reading, since the time for optical reading is relatively short, stepper motor  215  ruptures the calibration fluid pouch  90   a  (see  FIG. 9E ), releasing calibration fluid into the biosensor conduit for wet-up of the biosensors and calibration of hydrated biosensors, facilitated by calibration fluid pouch depressor  205 ;   3. Following calibration of biosensors, with calibration fluid pouch depressor  205  in its last position, stepper motor  213  activates air bladder, facilitated by air bladder depressor  203 , pushing the trailing end of blood sample, so that the blood displaces the calibration fluid and biosensor measurement of the blood is conducted.       

     An air bubble created in the enlarged cavity  56   a  and the conduit formed by connecting groove  57   a  positioned to provide fluid connection between enlarged cavity  56   a  and biosensor conduit groove  55   a  of cartridge  10   a  (see  FIG. 6C ) separates the blood and calibration fluid. The air bubble assists in purging the calibration fluid out of the biosensor conduit. With blood occupying the biosensor conduit (in place of calibration fluid), biosensor measurements are performed and analyzer informs user to remove and discard cartridge. 
     While the above description provides example embodiments, it will be appreciated that the present invention is susceptible to modification and change without departing from the fair meaning and scope of the accompanying claims. Accordingly, what has been described is merely illustrative of the application of aspects of embodiments of the invention. Numerous modifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that within the scope of the appended claims, the invention may be practiced otherwise than as specifically described herein. Furthermore, the discussed combination of features might not be absolutely necessary for the inventive solution.