Patent Publication Number: US-2022226615-A1

Title: Devices and Methods for Fluid Transfer Through a Placed Peripheral Intravenous Catheter

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 16/419,191 entitled “Devices and Methods for Fluid Transfer Through a Placed Peripheral Intravenous Catheter”, filed May 22, 2019, which is a continuation of U.S. patent application Ser. No. 15/014,834 entitled “Devices and Methods for Fluid Transfer Through a Placed Peripheral Intravenous Catheter”, filed Feb. 3, 2016 (now U.S. Pat. No. 10,300,247), the disclosures of each of which are incorporated herein by reference in their entirety. 
    
    
     BACKGROUND 
     The embodiments described herein relate generally to fluid transfer medical devices. More particularly, the embodiments described herein relate to devices and methods for transferring fluid to or from a patient through a placed peripheral intravenous catheter. 
     The typical hospitalized patient encounters a needle every time a doctor orders a lab test. The standard procedure for blood extraction involves using a metal needle (“butterfly needle”) to “stick” patients&#39; veins in their arms or hands. Blood drawing is a manual, labor-intensive process, with the average patient requiring hours of direct skilled labor during a typical hospital stay. This needle stick is not only painful and a major source of patient dissatisfaction, but the nurses or specialized blood drawing personnel (phlebotomists) often have difficulty finding the vein in approximately 10-15% of patients, resulting in multiple, painful “stick” attempts. This results in significantly higher material and labor costs (needles and tubing must be disposed of after every attempt) and increased patient pain and bruising. 
     The current process for drawing blood is inefficient, taking on average 7-10 minutes, and more than 21 minutes for 10% of patients. These 10% of patients are referred to as Difficult Intra-Venous Access or more commonly as “tough stick” patients. If superficial veins are not readily apparent, blood can be forced into the vein by massaging the arm from wrist to elbow, tapping the site with the index and middle finger, applying a warm, damp washcloth to the site for 5 minutes, or by lowering the extremity over the bedside to allow the veins to fill. Each of these methods is time consuming and therefore costly. 
     Peripheral IV catheters (PIVs) are inserted into most patients while they are hospitalized and used for infusing fluids and medications. However, they are not designed for blood extractions. The failure rates for aspiration reach 20-50% when PIVs have been left inserted for more than a day. Blood extracted from PIVs is often hemolyzed, defined as the rupture of red blood cells and the release of their contents into surrounding fluid, resulting in a discarded sample and need to repeat the blood collection. 
     Several barriers can contribute to the shortcomings of extracting blood through a PIV. First, most catheters are formed from a soft bio-reactive polymer, the use of this material has led to a potential narrowing or collapse of the catheter as the negative pressure is applied for aspiration. Another barrier is that longer indwelling times can increase debris (e.g., fibrin/platelet clots) that builds up on the tip of the catheter and within the lumen of the catheter and/or PIV. Similarly, such debris can at least partially occlude the lumen of the vein within which the PIV is placed. In some instances, this debris (e.g., fibrin/platelet clots) around the PIV can lead to reduced blood flow within portions of the vein surrounding the inserted PIV (e.g., both upstream and downstream), which in turn, results in improper and/or inefficient aspiration. Another barrier is attributed to a “suction cup” effect, wherein the negative pressure created by aspiration through the catheter and the possible curved path of a vein result in the tip of the catheter adhering to the wall of the vein. As the negative pressure increases the vein can rupture resulting in “blowing the vein”, which is a concern for phlebotomists during aspiration through a PIV. 
     Thus, a need exists for an improved system and method for phlebotomy through a peripheral intravenous catheter. 
     SUMMARY 
     Devices and methods for transferring fluid to or from a patient through a placed peripheral intravenous catheter are described herein. In some embodiments, an apparatus includes a catheter, an introducer, and an actuator. The catheter has a proximal end portion and a distal end portion and defines a lumen extending through the proximal end portion and the distal end portion. The introducer has a proximal end portion and a distal end portion configured to be coupled to a peripheral intravenous line. The introducer defines an inner volume having a tortuous cross-sectional shape such that an axis defined by a first portion of the inner volume is parallel to, and offset from, an axis defined by a second portion of the inner volume. The second portion of the inner volume movably receives the catheter. The actuator includes a first portion that is movably disposed in the first portion of the inner volume and a second portion that is movably disposed in the second portion of the inner volume. The second portion of the actuator is coupled to the catheter. The actuator is configured to move relative to the introducer to move the catheter between a first position, in which the catheter is disposed within the introducer, and a second position, in which the distal end portion of the catheter is disposed beyond the distal end portion of the introducer such that at least a portion of the catheter is disposed within the peripheral intravenous line when the introducer is coupled thereto. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIGS. 1 and 2  are schematic illustrations of a fluid transfer device in a first configuration and a second configuration, respectively, according to an embodiment. 
         FIG. 3  is a perspective view of a fluid transfer device in a first configuration, according to an embodiment. 
         FIG. 4  is a top view of the fluid transfer device illustrated in  FIG. 3 . 
         FIG. 5  is an exploded view of the fluid transfer device illustrated in  FIG. 3 . 
         FIG. 6  is a perspective view of a first member of an introducer included in the fluid transfer device of  FIG. 3 . 
         FIG. 7  is a perspective view of a second member of the introducer included in the fluid transfer device of  FIG. 3 . 
         FIG. 8  is a side view of the second member illustrated in  FIG. 7 . 
         FIG. 9  is an enlarged view of a portion of the second member identified in  FIG. 8  by the region A 1 . 
         FIG. 10  is a rear perspective view of the introducer formed by coupling the first member illustrated in  FIG. 6  to the second member illustrated in  FIG. 7 . 
         FIG. 11  is a front perspective view of the introducer illustrated in  FIG. 10 . 
         FIG. 12  is a cross-sectional view of the introducer taken along the line  12 - 12  in  FIG. 11 . 
         FIGS. 13 and 14  are a rear perspective view and a top view, respectively, of a lock included in the fluid transfer device of  FIG. 3 . 
         FIG. 15  is a cross-sectional view of the lock taken along the line  15 - 15  in  FIG. 14 . 
         FIG. 16  is an exploded perspective view a catheter, a secondary catheter, and an actuator included in the fluid transfer device of  FIG. 3 . 
         FIGS. 17-19  are a perspective view, a side view, and a front view, respectively, of the actuator illustrated in  FIG. 16 . 
         FIG. 20  is a cross-sectional view of the fluid transfer device taken along the line  20 - 20  in  FIG. 4 . 
         FIG. 21  is a side view of the fluid transfer device of  FIG. 3  in the first configuration. 
         FIG. 22  is a cross-sectional view of the fluid transfer device in the first configuration taken along the line  22 - 22  in  FIG. 3 . 
         FIG. 23  is an enlarged cross-sectional view of a portion of the fluid transfer device identified by the region A 2  in  FIG. 22 . 
         FIG. 24  is an enlarged cross-sectional view of a portion of the fluid transfer device identified by the region A 3  in  FIG. 22 . 
         FIG. 25  is a side view of the fluid transfer device of  FIG. 3  as the fluid transfer device is being transitioned from the first configuration to a second configuration. 
         FIG. 26  is an enlarged view of a portion of the fluid transfer device identified by the region A 4  in  FIG. 24 . 
         FIG. 27  is a side view of the fluid transfer device of  FIG. 3  in the second configuration. 
         FIG. 28  is a cross-sectional view of the fluid transfer device in the second configuration taken along the line  22 - 22  in  FIG. 3 . 
         FIG. 29  is an enlarged cross-sectional view of a portion of the fluid transfer device identified by the region A 5  in  FIG. 28 . 
         FIG. 30  is a flowchart illustrating a method of using a fluid transfer device according to an embodiment. 
     
    
    
     DETAILED DESCRIPTION 
     Devices and methods for transferring fluid to or from a patient through a placed peripheral intravenous catheter are described herein. In some embodiments, an apparatus includes a catheter, an introducer, and an actuator. The catheter has a proximal end portion and a distal end portion and defines a lumen extending through the proximal end portion and the distal end portion. The introducer has a proximal end portion and a distal end portion configured to be coupled to a peripheral intravenous line. The introducer defines an inner volume having a tortuous cross-sectional shape such that an axis defined by a first portion of the inner volume is parallel to, and offset from, an axis defined by a second portion of the inner volume. The second portion of the inner volume movably receives the catheter. The actuator includes a first portion that is movably disposed in the first portion of the inner volume and a second portion that is movably disposed in the second portion of the inner volume. The second portion of the actuator is coupled to the catheter. The actuator is configured to move relative to the introducer to move the catheter between a first position, in which the catheter is disposed within the introducer, and a second position, in which the distal end portion of the catheter is disposed beyond the distal end portion of the introducer such that at least a portion of the catheter is disposed within the peripheral intravenous line when the introducer is coupled thereto. 
     In some embodiments, an apparatus includes a catheter, an introducer, an actuator, and a lock. The catheter has a proximal end portion and a distal end portion and defines a lumen extending through the proximal end portion and the distal end portion. The introducer has a proximal end portion and a distal end portion and defines an inner volume that movably receives the catheter. The actuator has a first portion disposed outside of the inner volume and a second portion disposed within the inner volume. The second portion of the actuator is coupled to the catheter. The actuator is configured to move relative to the introducer to move the catheter between a first position and a second position. The lock is coupled to the distal end portion of the introducer. The lock has a proboscis and defines a lumen extending through the proboscis. The lock is configured to be coupled to a peripheral intravenous line such that the proboscis extends through a lumen defined by the peripheral intravenous line when the lock is coupled thereto. The lumen of the proboscis receives a portion of the catheter as the catheter is moved from the first position, in which the catheter is disposed within the inner volume of the introducer, to the second position, in which the distal end portion of the catheter extends beyond the peripheral intravenous line when the lock is coupled thereto. An inner surface of the proboscis is configured to guide the catheter as the catheter is moved from the first position to the second position. 
     In some embodiments, an apparatus includes a catheter, an introducer, and an actuator. The catheter has a proximal end portion and a distal end portion and defines a lumen extending through the proximal end portion and the distal end portion. The introducer has a first member and a second member coupled to the first member. The second member has an outer surface forming a plurality of ribs. The first member and the second member collectively define an inner volume and a slot in communication with the inner volume. The inner volume receives the catheter. A distal end portion of the introducer configured to be coupled to a peripheral intravenous line. The actuator is operatively coupled to the introducer such that a first portion of the actuator is disposed outside of the inner volume and a second portion of the actuator extends through the slot and disposed in the inner volume. The first portion of the actuator includes a surface that is in contact with the outer surface of the second member. The second portion of the actuator is coupled to the catheter. The actuator is configured to move relative to the introducer to move the catheter between a first position, in which the catheter is disposed within the introducer, and a second position, in which the distal end portion of the catheter is disposed beyond the peripheral intravenous line when the introducer is coupled to the peripheral intravenous line. The surface of the first portion of the actuator moves along the plurality of ribs as the actuator moves the catheter between the first position and the second position to provide, to a user, a haptic feedback associated with a position of the distal end portion of the catheter. 
     In some embodiments, a method includes coupling a lock of a fluid transfer device to an indwelling peripheral intravenous line. The fluid transfer device includes an introducer having a distal end portion coupled to the lock, a catheter movably disposed in an inner volume defined by the introducer, and an actuator. The actuator extends through a slot defined by the introducer such that a first portion of the actuator is disposed outside of the inner volume and in contact with an outer surface of the introducer and a second portion of the actuator is disposed within the inner volume of the introducer and coupled to the catheter. The actuator is moved relative to the introducer to advance the catheter from a first position, in which the catheter is disposed within at least one of the inner volume or the lock, toward a second position. An indication associated with a position of a distal end portion of the catheter as the actuator moves the catheter from the first position toward the second position is provided to a user. The indication is in the form of a haptic output produced by a surface of the actuator being moved along a plurality of ribs included on the outer surface of the introducer. The catheter is placed in the second position based on the indication associated with the distal end portion of the catheter. The distal end portion of the catheter is disposed beyond at least a portion of the peripheral intravenous line when the catheter is in the second position. 
     As used herein, the terms “catheter” and “cannula” are used interchangeably to describe an element configured to define a passageway for moving a bodily fluid from a first location to a second location (e.g., a fluid passageway to move a bodily fluid out of the body). While cannulas can be configured to receive a trocar, a guide wire, or an introducer to deliver the cannula to a volume inside the body of a patient, the cannulas referred to herein need not include or receive a trocar, guide wire, or introducer. 
     As used in this specification, the terms “Y-adapter” and “T-adapter” are used to refer to a dual port IV extension set. In this manner, the terms “Y-adapter” and “T-adapter” generally describe an overall shape of the dual port IV extension set. For example, as used herein, a Y-adapter is substantially “Y” shaped including a single port at a first end and two ports angularly disposed at a second end. Furthermore, the terms “Y-adapter” and “T-adapter” are included by way of example only and not limitation. For example, in some embodiments, an apparatus can include a single port IV extension set (e.g., a single port adapter) or a multi-port IV extension set (e.g., an adapter with more than two ports). 
     As used in this specification, the words “proximal” and “distal” refer to the direction closer to and away from, respectively, a user who would place the device into contact with a patient. Thus, for example, the end of a device first touching the body of the patient would be the distal end, while the opposite end of the device (e.g., the end of the device being manipulated by the user) would be the proximal end of the device. 
     As used herein, the term “stiffness” relates to an object&#39;s resistance to deflection, deformation, and/or displacement by an applied force. Stiffness can be characterized in terms of the amount of force applied to the object and the resulting distance through which a first portion of the object deflects, deforms, and/or displaces with respect to a second portion of the object. When characterizing the stiffness of an object, the deflected distance may be measured as the deflection of a portion of the object different from the portion of the object to which the force is directly applied. Said another way, in some objects, the point of deflection is distinct from the point where force is applied. 
     Stiffness is an extensive property of the object being described, and thus is dependent upon the material from which the object is formed as well as certain physical characteristics of the object (e.g., shape and boundary conditions). For example, the stiffness of an object can be increased or decreased by selectively including in the object a material having a desired modulus of elasticity, flexural modulus, and/or hardness. The modulus of elasticity is an intensive property of (i.e., is intrinsic to) the constituent material and describes an object&#39;s tendency to elastically (i.e., non-permanently) deform in response to an applied force. A material having a high modulus of elasticity will not deflect as much as a material having a low modulus of elasticity in the presence of an equally applied stress. Thus, the stiffness of the object can be increased, for example, by introducing into the object and/or constructing the object of a material having a high modulus of elasticity. 
     Similarly, a material&#39;s hardness is an intensive property of the constituent material and describes the measure of how resistant the material is to various kinds of permanent shape change when a force is applied. In discussing the hardness and the subsequent effect on the stiffness of a catheter, the Shore durometer scale is generally used. There are several scales for durometers with two commonly used in describing plastics, polymers, elastomers, and/or rubbers, namely, type A and type D, where type A is generally used for softer materials and type D is generally used for harder materials. The Shore durometer of a material is denoted by a number between 0 and 100, with higher numbers indicating a harder material, followed by the type of scale. For instance, a first material can be measured as having a Shore durometer of 40 Shore A and a second material can be measured as having a Shore durometer of 20 Shore D. Therefore, according to the Shore durometer scale, the second material is harder and thus, more stiff than the first material. 
       FIGS. 1 and 2  are schematic illustrations of a fluid transfer device  100  for phlebotomy through a peripheral intravenous line or catheter in a first configuration and second configuration, respectively, according to an embodiment. The fluid transfer device  100  (also referred to herein as “transfer device”) can be any suitable shape, size, and/or configuration. As described in further detail herein, the transfer device  100  is configured to couple to and/or otherwise engage an indwelling peripheral intravenous catheter (PIV)  105  to transfer fluid from (e.g., aspiration of blood) and/or transfer fluid to (e.g., infusion of a drug or substance) a portion of a patient. 
     The transfer device  100  includes at least an introducer  110 , a catheter  160  (or cannula), and an actuator  170 . The introducer  110  can be any suitable configuration. For example, in some embodiments, the introducer  110  can be an elongate member having a substantially circular cross-sectional shape. In some embodiments, the shape of the introducer  110  and/or one or more features or surface finishes of at least an outer surface of the introducer  110  can be arranged to increase the ergonomics of the transfer device  100 , which in some instances, can allow a user to manipulate the transfer device  100  with one hand (i.e., single-handed use). 
     The introducer  110  has a proximal end portion proximal end portion  111  and a distal end portion  112  and defines an inner volume  113 . Although not shown in  FIGS. 1 and 2 , the proximal end portion  111  of the introducer  110  can include an opening or port configured to movably receive a portion of the catheter  160 . As such, a first portion of the catheter  160  can be disposed within the inner volume  113  and a second portion of the catheter  160  can be disposed outside of the inner volume  113 . The opening or port can be any suitable configuration. For example, in some embodiments, the opening and/or port can include a seal or the like configured to form a substantially fluid tight seal with an outer surface of the portion of the catheter  160  disposed therein. In other embodiments, the arrangement of the opening and/or port can be such that a user can place the catheter  160  in selective contact with a surface of the proximal end portion  111  defining the opening and/or port, which in turn, can clamp and/or pinch the catheter  160  to selectively obstruct a lumen of the catheter  160 , as described in further detail herein with reference to specific embodiments. 
     The distal end portion  112  of the introducer  110  includes and/or is coupled to a lock configured to physically and fluidically couple the introducer  110  to the PIV  105  (see e.g.,  FIG. 2 ). For example, in some embodiments, the distal end portion  112  can include a coupler or the like such as a Luer Lok™ or the like configured to physically and fluidically couple to an associated coupler of the lock. In some embodiments, the lock is configured to selectively engage and/or contact the PIV  105  to couple the introducer  110  thereto. For example, in some embodiments, the shape, size, and/or arrangement of the lock is such that the lock forms three points of contact with the PIV  105 . In some embodiments, such an arrangement can provide structural rigidity and/or support to the PIV  105  as a portion of the lock (e.g., a proboscis or the like) is inserted into a portion of the PIV  105 , as described in further detail herein. 
     In some embodiments, the distal end portion  112  of the introducer  110  (and/or the lock) can include a seal or the like that can be transferred from a sealed configuration to a substantially open configuration to place at least a portion of the inner volume  113  in fluid communication with the lock. In some embodiments, the seal can include back flow prevention mechanism such as a one-way valve or the like that can allow, for example, the catheter  160  to be advanced in the distal direction therethrough while limiting and/or substantially preventing a fluid flow, outside the catheter  160 , in the proximal direction through the seal. 
     As described above, the introducer  110  defines the inner volume  113 , which extends between the proximal end portion  111  and the distal end portion  112 . The inner volume  113  has and/or defines a first portion  114  configured to receive a first portion  171  of the actuator  170  and a second portion  115  configured to receive the catheter  160  and a second portion  175  of the actuator  172 , as shown in  FIGS. 1 and 2 . More specifically, an inner surface of the introducer  110  that defines the inner volume  113  can have, for example, a tortuous cross-sectional shape (not shown in  FIGS. 1 and 2 ) such that an axis defined by the first portion  114  of the inner volume  113  is parallel to and offset from an axis defined by the second portion  115  of the inner volume  113 . In this manner, the first portion  114  of the inner volume  113  can be spaced apart from the second portion  115  of the inner volume  113  without being fluidically isolated therefrom. In some embodiments, the first portion  114  of the inner volume  113  can extend through a wall of the introducer  110 . In other words, the introducer  110  can define a slot, channel, track, opening, and/or the like that is in fluid communication with the first portion  114  of the inner volume  113 . Conversely, the second portion  115  of the inner volume  113  can be entirely defined and/or enclosed (at least in the circumferential direction) by the introducer  110 . Moreover, in some embodiments, the tortuous cross-sectional shape of the inner volume  113  is such that the second portion  115  cannot be viewed (e.g., is out of the line of sight) via the slot or the like in fluid communication with the first portion  114  of the inner volume  113 , which in turn, can limit and/or substantially prevent contamination of the catheter  160  disposed therein. 
     The catheter  160  of the transfer device  100  includes a proximal end portion  161  and a distal end portion  162  and defines a lumen  163  that extends through the proximal end portion  161  and the distal end portion  162 . The catheter  160  is movably disposed within the second portion  115  of the inner volume  113  defined by the introducer  110  and is coupled to the actuator  170 . In some embodiments, the catheter  160  can be moved (e.g., via movement of the actuator  170 ) between a first position and a second position to transition the transfer device  100  between the first configuration and the second configuration, respectively. More specifically, at least the distal end portion  162  of the catheter  160  is disposed within the second portion  115  of the inner volume  113  when the catheter  160  is in the first position ( FIG. 1 ) and at least a portion of the catheter  160  extends through the PIV  105  to place a distal end of the catheter  160  in a distal position relative to a portion of the PIV  105  when the catheter  160  is in the second position ( FIG. 2 ). Although not shown in  FIGS. 1 and 2 , in some embodiments, the transfer device  100  can include a secondary catheter or the like that is coupled to the actuator  170  and in fluid communication with the catheter  160 . In such embodiments, the secondary catheter can be, for example, disposed in a proximal position relative to the catheter  160  and can be configured to extend through the opening and/or port defined by the proximal end portion  111  of the introducer  110 . In this manner, a proximal end portion of the secondary catheter can be coupled to a fluid reservoir, fluid source, syringe, and/or the like, which in turn, places the catheter  160  in fluid communication therewith. Moreover, in embodiments including the secondary catheter, the catheter  160  can be entirely disposed within the introducer  110  when the catheter  160  is in the first position. 
     The catheter  160  can be any suitable shape, size, and/or configuration. For example, in some embodiments, at least a portion of the catheter  160  can have an outer diameter (e.g., between a 16-gauge and a 26-gauge) that is substantially similar to or slightly smaller than an inner diameter defined by a portion of the lock coupled to the distal end portion  112  of the introducer  110 . In this manner, an inner surface of the portion of the lock can guide the catheter  160  as the catheter  160  is moved between the first position and the second position. In some embodiments, such an arrangement can limit and/or can substantially prevent bending, deforming, and/or kinking of the catheter  160  as the catheter  160  is moved between the first position and the second position. In some embodiments, the catheter  160  can have a length that is sufficient to place a distal surface of the catheter  160  in a desired position relative to a distal surface of the PIV  105  when the catheter  160  is in the second position. In other words, the length of the catheter  160  can be sufficient to define a predetermined and/or desired distance between the distal surface of the catheter  160  and the distal surface of the PIV  105  when the catheter  160  is in the second position. In some instances, placing the distal surface of the catheter  160  the predetermined and/or desired distance from the distal surface of the PIV  105  can, for example, place the distal surface of the catheter  160  in a desired position within a vein, as described in further detail herein. 
     The catheter  160  can be formed from any suitable material or combination of materials, which in turn, can result in the catheter  160  having any suitable stiffness or durometer. In some embodiments, at least a portion of the catheter  160  can be formed of a braided material or the like, which can change, modify, and/or alter a flexibility of the catheter  160  in response to a bending force or the like. In some embodiments, forming the catheter  160  of the braided material or the like can reduce a likelihood of kinking and/or otherwise deforming in an undesired manner. In addition, forming at least a portion of the catheter  160  of a braided material can result in a compression and/or deformation in response to a compression force exerted in a direction of a longitudinal centerline defined by the catheter  160  (e.g., an axial force or the like). In this manner, the catheter  160  can absorb a portion of force associated with, for example, impacting an obstruction or the like. 
     The actuator  170  of the transfer device  100  can be any suitable shape, size, and/or configuration. As described above, the actuator  170  includes the first portion  171  movably disposed within the first portion  114  of the inner volume  113  and the second portion  175  movably disposed within the second portion  115  of the inner volume  113  and coupled to the catheter  160 . Although not shown in  FIGS. 1 and 2 , the actuator  170  can have a cross-sectional shape that is associated with and/or otherwise corresponds to the cross-sectional shape of the inner volume  113  (e.g., the tortuous cross-sectional shape). Thus, an axis defined by the first portion  171  of the actuator  170  is parallel to and offset from an axis defined by the second portion  175  of the actuator  170 . 
     The arrangement of the actuator  170  and the introducer  110  is such that the first portion  171  extends through the slot or the like in fluid communication with the first portion  114  of the inner volume  113 . As such, a first region of the first portion  171  of the actuator  170  is disposed outside of the introducer  110  and a second region of the first portion  171  of the actuator  170  is disposed in the first portion  114  of the inner volume  113 . In this manner, a user can engage the first region of the first portion  171  of the actuator  170  and can move the actuator  170  relative to the introducer  110  to move the catheter  160  coupled to the second portion  175  of the actuator  170  between the first position and the second position. Although not shown in  FIGS. 1 and 2 , in some embodiments, the first portion  171  of the actuator  170  can include a tab, protrusion, and/or surface that is in contact with an outer surface of the introducer  110 . In such embodiments, the outer surface of the introducer  110  can include, for example, a set of ribs, ridges, bumps, grooves, and/or the like along which the tab, protrusion, and/or surface of the first portion  171  advances when the actuator  170  is moved relative to the introducer  110 , which in turn, produces a haptic output or feedback which can provide an indication associated with a position of the distal end portion  162  of the catheter  160  to the user. 
     In some embodiments, the transfer device  100  can be disposed in the first configuration prior to use (e.g., shipped, stored, prepared, etc. in the first configuration). In use, a user can manipulate the transfer device  100  to couple the introducer  110  to the indwelling PIV  105  (e.g., via the lock coupled to and/or assembled with the introducer  110 ). With the transfer device  100  coupled to the PIV  105 , the user can engage the first portion  171  of the actuator  170  to move the actuator  170  relative to the introducer  110 , which in turn, moves the catheter  160  from the first position (e.g., disposed within the introducer  110 ) toward the second position. In some embodiments, the arrangement of the actuator  170  and the introducer  110  is such that advancing the actuator  170  relative to the introducer  110  produces a haptic output and/or feedback configured to provide and indicator associated with position of the distal end portion  162  of the catheter  160  relative to the introducer  110  and/or the PIV  105  to the user. For example, based on the haptic feedback or the any other suitable indicator, the user can place the catheter  160  in the second position such that the distal surface of the catheter  160  extends a desired distance beyond the distal surface of the PIV  105 , as described above. 
     With the catheter  160  in the second position (e.g., with the transfer device  100  in the second configuration shown in  FIG. 2 ), the user can establish fluid communication between a fluid reservoir, fluid source, syringe, and/or the like and the catheter  160 . For example, as described above, in some embodiments, the user can couple the secondary catheter (not shown) to the fluid reservoir, fluid source, syringe, and/or the like. Although described as establishing fluid communication between the catheter  160  and the fluid reservoir or fluid source after placing the catheter  160  in the second position, in other embodiments, the user can establish fluid communication between the catheter  160  and the fluid reservoir or fluid source prior to moving the actuator  170  relative to the introducer  110 . With the catheter  160  in fluid communication with the fluid reservoir and/or fluid source, the transfer device  100  can then transfer a fluid from the patient or transfer a fluid to the patient via the catheter  160  extending through and beyond the PIV  105 . 
       FIGS. 3-29  illustrate a fluid transfer device  200  according to another embodiment. The fluid transfer device  200  (also referred to herein as “transfer device”) can be any suitable shape, size, or configuration and can be coupled to a PIV (not shown in  FIGS. 3-29 ), for example, via a lock and/or adapter. As described in further detail herein, a user can transition the transfer device  200  from a first configuration to a second configuration to advance a catheter through an existing, placed, and/or indwelling PIV (i.e., when the transfer device  200  is coupled thereto) such that at least an end portion of the catheter is disposed in a distal position relative to the PIV. Moreover, with peripheral intravenous lines each having a shape, size, and/or configuration that can vary based on, for example, a manufacturer of the PIV and/or its intended usage, the transfer device  200  can be arranged to allow the transfer device  200  to be coupled to a PIV having any suitable configuration and subsequently, to advance at least a portion of a catheter through the PIV substantially without kinking, snagging, breaking, and/or otherwise reconfiguring the catheter in an undesirable manner. In addition, the transfer device  200  can be manipulated by a user to place a distal surface of the catheter a predetermined and/or desired distance beyond a distal surface of the PIV to be disposed within a portion of a vein that receives a substantially unobstructed flow of blood. 
     As shown in  FIGS. 3-5 , the transfer device  200  includes an introducer  210 , a lock  240 , a catheter  260 , a secondary catheter  265 , and an actuator  270 . The introducer  210  can be any suitable shape, size, or configuration. For example, in some embodiments, the introducer  210  can be an elongate member having a substantially circular cross-sectional shape. In some embodiments, the shape of the introducer  210  and/or one or more features or surface finishes of at least an outer surface of the introducer  210  can be arranged to increase the ergonomics of the transfer device  200 , which in some instances, can allow a user to manipulate the transfer device  200  with one hand (i.e., single-handed use). 
     As shown in  FIGS. 5-12 , the introducer  210  of the transfer device  200  includes a first member  220  and a second member  225  that are coupled to collectively form the introducer  210 . As shown in  FIG. 6 , the first member  220  includes a proximal end portion  221 , a distal end portion  222 , and an inner surface  224 . The inner surface  224  has a first portion  224  and a second portion  225 . The proximal end portion  221  of the first member  220 , and more specifically, a proximal wall of the first member  220  defines a notch  226  configured to selectively receive a portion of the secondary catheter  265 , as described in further detail herein. 
     As shown in  FIGS. 7-9 , the second member  230  has a proximal end portion  231 , a distal end portion  232 , an inner surface  233 , and an outer surface  235 . As described above with reference to the first member  220 , the proximal end portion  231  of the second member  230 , and more specifically, a proximal wall of the second member  230  defines a notch  234  configured to selectively receive a portion of the secondary catheter  265 . The outer surface  235  of the second member  230  includes a set of ribs  236  distributed along a length of the second member  230 . More particularly, each rib  236  extends along a width of the second member  230  and successively distributed along the length of the second member  230 . In this manner, the outer surface  235  defines alternating local minima and local maxima arranged along the length of the second member  230 . As described in further detail herein, a portion of the actuator  270  is configured to be advanced along the outer surface  235  forming the set of ribs  236  as a user moves the actuator  270  relative to the introducer  210 , which in turn, vibrates the actuator  270  (and the catheter  260  coupled thereto). In some instances, this vibration can, for example, facilitate the advancing of the catheter  260  through a portion or the transfer device  200 , a portion of the PIV, and/or a portion of the vasculature. Moreover, in some instances, the vibration can provide a user with a haptic and/or audible indicator associated with a position of the catheter  260  relative to the introducer  210  and/or PIV, as described in further detail herein. 
     The ribs  236  formed by the outer surface  235  of the second member  230  can be any suitable shape, size, and/or configuration. For example, as shown in  FIGS. 8 and 9 , the set of ribs  236  includes a first portion  237  having a first size and shape, and a second portion  238  having a second size and shape, different from the first size and shape. The first portion  237  of ribs  236  can have any suitable configuration and/or arrangement. For example, in this embodiment, each rib in the first portion  237  is substantially uniform having substantially the same size and shape. In other embodiments, each rib included in the first portion  237  can have a size and shape that is different from the remaining ribs of the first portion  237 . For example, in some embodiments, the size and shape of each rib in the first portion  237  can increase from a proximal most rib having the smallest size and shape to a distal most rib having the largest size and shape. Moreover, while the ribs of the first portion  237  are shown as being substantially symmetrical, in other embodiments, each rib of the first portion  237  can be asymmetrical. For example, in some embodiments, a proximal surface of each rib can have a first pitch (e.g., angle) and a distal surface of each rib can have a second pitch that is greater than the first pitch. In some embodiments, such an asymmetric arrangement can be such that the portion of the actuator  270  moves along the outer surface  235  with a first set of characteristics when moved in a distal direction and moves along the outer surface  235  with a second set of characteristics, different from the first set of characteristics, when moved in a proximal direction. For example, in some embodiments, the portion of the actuator  270  can move along the outer surface  235  in the distal direction more freely than in the proximal direction. 
     Similarly, the second portion  238  of the ribs  236  can have any suitable configuration and/or arrangement. For example, in this embodiment, each rib in the second portion  238  is substantially uniform having substantially the same size and shape as the remaining ribs in the second portion  238 . As shown in  FIG. 9 , each rib in the second portion  238  has a size and shape that is greater than the size and shape of each rib of the first portion  237 . In some instances, the greater size of the ribs of the second portion  238  can result in a larger amount of vibration as the actuator  270  is moved along the outer surface  235  (as described above). In some instances, the greater size of the ribs of the second portion  238  can result in an increase in a force otherwise sufficient to move the portion of the actuator  270  along the outer surface  235 . While the ribs of the second portion  238  are shown and described as being substantially uniform and having a larger size than the ribs of the first portion  237 , in other embodiments, the ribs of the second portion  238  can have any of the arrangements and/or configurations described above with reference to the ribs of the first portion  237 . 
     While the set of ribs  236  transitions from the first portion  237  to the second portion  238  at a given point along the length of the second member  230  (see e.g.,  FIG. 9 ), in other embodiments, the size and shape of each rib in the set of ribs  236  can increase from a proximal most rib of the first portion  237  having the smallest size and shape to a distal most rib of the second portion  238  having the largest size and shape. In other words, in some embodiments, the size and shape of each of rib in the set of ribs  236  can increase with each successive rib (e.g., in the distal direction). In still other embodiments, the set of ribs  236  can include more than the first portion  237  and the second portion  238 . For example, in some embodiments, a second member can include a set of ribs having a first portion and a second portion having a size, shape, and configuration similar to the first portion  237  of the second member  230 , and a third portion, disposed between the first portion and the second portion, having a size, shape, and configuration similar to the second portion  238  of the second member  230 . That is to say, in such embodiments, the second member includes a proximal portion of ribs and a distal end portion of ribs that are smaller than a medial portion of ribs disposed therebetween. In some embodiments, the arrangement of the set of ribs  236  of the second member  230  can be such that a proximal most rib and a distal most rib are larger and/or otherwise have a shape that operable to at least temporarily maintain the portion of the actuator  270  in a proximal position relative to the proximal most rib and a distal position relative to the distal most rib, respectively. 
     While the set of ribs  236  are shown as being formed only by the outer surface  235  of the second member  230 , in other embodiments, the first member  220  can include an outer surface that forms a set of ribs. In such embodiments, the set of ribs of the first member  220  can be and/or can have any of the configurations and/or arrangements described above with reference to the set of ribs  236  of the second member  230 . In some embodiments, the ribs of the first member  220  can be offset from the ribs  236  of the second member  230 . For example, in some embodiments, the ribs of the first member  220  can have alternating local minima and local maxima (as described above with reference to the ribs  236 ) that are distributed along a length of the first member  220  such that the local minima and local maxima of the ribs of the first member  220  are aligned with the local maxima and local minima, respectively, of the ribs  236  of the second member  230  (e.g., offset along a length of the introducer  210 ). In other embodiments, the ribs of the first member  220  can be in varying positions relative to the ribs  236  of the second member  230 . In this manner, the introducer  210  can provide a variable arrangement of ribs that can provide, for example, haptic feedback as the actuator  270  is moved relative to the introducer  210 . 
     As shown in  FIGS. 10-12 , the first member  220  is configured to be coupled to the second member  230  to collectively form the introducer  210 . For example, in some embodiments, the first member  220  and the second member  230  can be coupled via ultrasonic welding, an adhesive, a mechanical fastener, one or more tabs, snaps, pins, and/or the like to form the introducer  210 . In some embodiments, coupling the first member  220  to the second member  230  (e.g., during a manufacturing process) to form the introducer  210  can facilitate and/or simplify one or more manufacturing processes. For example, in some embodiments, forming the introducer  210  from the first member  220  and the second member  230  can reduce undesirable variations in the shape and/or size of the inner surface  223  and  233  (e.g., due to draft angles and/or manufacturing tolerances) during manufacturing, which in some instances, can reduce a likelihood of kinks, bends, and/or deformations of the catheter  260  during use of the transfer device  200 . In some embodiments, forming the introducer  210  from the first member  220  and the second member  230  can allow at least the inner surface  223  of the first member  220  to form a tortuous shape that would otherwise present challenges when manufacturing the introducer  210  from a single workpiece. 
     In other embodiments, a first member  220  can be monolithically formed (e.g., via injection molding and/or any other suitable manufacturing process). That is to say, the first member  220  can be formed from a single workpiece or the like rather than two workpieces, namely, the first member  220  and the second member  230 . Thus, when referring to features of the first member  220 , such features can be formed and/or defined by the first member  220 , formed and/or defined by the second member  230 , collectively formed and/or defined by the first member  220  and the second member  230 , or, when the introducer  210  is formed from a single workpiece, formed and/or defined by a corresponding portion of the introducer  210 . 
     The first member  220  and the second member  230  collectively form a proximal end portion  211  and a distal end portion  212  of the introducer  210  and collectively define an inner volume  213  of the introducer  210 . As shown in  FIG. 10 , the proximal end portion  211  of the introducer  210  defines an opening  217 . Specifically, the opening  217  is collectively formed and/or defined by the notch  226  of the first member  220  and the notch  234  of the second member  230 . The arrangement of the proximal end portion  211  is such that a portion of the opening  217  defined by the notch  226  of the first member  220  has a first size and/or shape and a portion of the opening  217  defined by the notch  234  of the second member  230  has a second size and/or shape that is less than the first size and/or shape. In other words, a portion of the opening  217  is constricted, pinched, obstructed, and/or otherwise reduced. As described in further detail herein, the opening  217  is configured to receive a portion of the secondary catheter  265 , which can be moved within the opening  217  from the larger portion of the opening  217  to the reduced portion of the opening  217  (e.g., the portion formed by the notch  234  of the second member  230 ) to obstruct, pinch, and/or clamp the secondary catheter  265 . 
     As shown in  FIG. 11 , the distal end portion  212  of the introducer  210  includes and/or otherwise forms a coupler  216 . In other words, the distal end portion  222  of the first member  220  and the distal end portion  232  of the second member  230  collectively form the coupler  216  at the distal end portion  212  of the introducer  210 . The coupler  216  can be any suitable shape, size, and/or configuration. For example, in this embodiments, the coupler  216  forms a set of threads, which can form a threaded coupling with an associated threaded portion of the lock  240 , as described in further detail herein. Although not shown in  FIG. 11 , the distal end portion  211  of the introducer  210  can include and/or can be configured to receive a seal that can selectively seal and/or fluidically isolate the inner volume  213  of the introducer  210  (at least from an open portion of the coupler  216 ). In use, the seal can be transitioned from a sealed or closed configuration to an open configuration to allow, for example, a portion of the catheter  260  to pass therethrough. In some embodiments, the seal can contact an outer surface of the catheter  260  to define a seal therebetween that is operable to limit and/or substantially prevent a back flow of fluid between the outer surface of the cannula and the seal. 
     The seal can be any suitable type of seal. For example, in some embodiments, the seal can be an O-ring, a one-way valve, a diaphragm, a self-healing diaphragm, a check valve, a single crack valve, and/or any other suitable seal or valve member. In some embodiments, the seal is configured to define and/or otherwise have a predetermined “cracking” pressure. That is to say, in some embodiments, the seal can be configured to transition from a closed and/or sealed configuration to a substantially open configuration in response to an increase in pressure, for example, within the introducer  210 . In some embodiments, the seal can be a positive pressure seal or the like. In other embodiments, the seal can be a fluid seal such as a saline lock or the like. Although not shown in  FIGS. 5-12 , in some embodiments, the introducer  210  can include a device, mechanism, assembly, and/or the like, which can be manipulated to increase a pressure (e.g., via air or other suitable fluid or liquid) within the introducer  210  to transition the seal from the closed configuration to the open configuration. For example, the introducer  210  can include and/or can be coupled to a bulb, pump, a syringe, a fluid source, a mechanical actuator, an electric actuator, and/or the like. In other embodiments, the seal can be any other suitable configuration. 
     The inner surface  223  of the first member  220  and the inner surface  233  of the second member  230  collectively define the inner volume  213  of the introducer  210 . As shown in  FIG. 12 , the arrangement of the inner surfaces  223  and  233  is such that the inner volume  213  has and/or defines a tortuous cross-sectional shape. For example, the inner volume  213  can have a substantially S-shaped or an at least partially S-shaped cross-sectional shape. More specifically, the inner surface  223  of the first member  220  includes and/or forms a ridge, tab, flange, protrusion, and/or wall configured to separate the first portion  224  of the inner surface  223  from the second portion  225  of the inner surface  223 . Thus, the tortuous cross-sectional shape of the inner volume  213  forms and/or defines a first portion  214  of the inner volume  213  and a second portion  215  of the inner volume  213 . In this manner, the first portion  214  of the inner volume  213  is spaced apart from the second portion  215  of the inner volume  213  without being fluidically isolated therefrom. In other words, the first portion  214  of the inner volume  213  defines an axis that is parallel to and offset from an axis defined by the second portion  215  of the inner volume  213 . 
     As shown in  FIG. 12 , the first portion  214  of the inner volume  213  extend through a wall of the introducer  210 . Similarly stated, the introducer  210  defines (e.g., the first member  220  and the second member  230  collectively define) a slot, channel, track, opening, and/or the like that is in fluid communication with the first portion  214  of the inner volume  213 . Conversely, the second portion  215  of the inner volume  213  is entirely defined and/or enclosed (at least in the circumferential direction) by the introducer  210 . The tortuous cross-sectional shape of the inner volume  213  is such that the second portion  215  cannot be viewed (e.g., is out of the line of sight) via the slot (in fluid communication with the first portion  214  of the inner volume  213 ), which in turn, can limit and/or substantially prevent contamination of the catheter  260  disposed therein. 
     In this embodiment, the second portion  215  of the inner volume  213  is substantially aligned with, for example, a portion of the opening  217  and a portion of an opening defined by the coupler  216 . Moreover, the second portion  215  of the inner volume  213  is configured to be substantially aligned with the lock  240  when the lock is coupled to the coupler  216  of the introducer  210 . In other words, the axis defined by the second portion  215  of the inner volume  213  is substantially co-axial with an axis defined by a portion of the lock  240 , as described in further detail herein. In this manner, the second portion  215  of the inner volume  213  can movably receive, for example, a portion of the actuator  270  and a portion of the catheter  260 . Thus, the actuator  270  can be moved relative to the introducer  210  to move the catheter  260  between a first position, in which the catheter  260  is entirely disposed within the second portion  215  of the inner volume  213 , and a second position, in which at least a portion of the catheter  260  extends outside of the second portion  215  of the inner volume  213  and distal to the introducer  210 , as described in further detail herein. 
     The lock  240  of the transfer device  200  can be any suitable shape, size, and/or configuration. As described above, the lock  240  is configured to be physically and fluidically coupled to the introducer  210  and configured to couple the introducer  210  to the PIV and/or any suitable intermediate device or adapter coupled to the PIV. The lock  240  has a coupler  241 , a proboscis  242 , a first arm  243 , and a second arm  250 , as shown in  FIGS. 13-15 . In addition, the lock  240  defines a lumen  255  extending through the coupler  241  and the proboscis  242 . The coupler  241  is configured to couple the lock  240  to the coupler  216  of the introducer  210 . Specifically, in this embodiment, the coupler  241  includes and/or forms one or more protrusions configured to selectively engage the threads defined and/or formed by the coupler  216  of the introducer  210 , thereby forming a threaded coupling. 
     The proboscis  242  extends from the coupler  246  and is disposed between the first arm  243  and the second arm  250 . The proboscis  242  can be any suitable shape, size, and/or configuration. In some embodiments, the configuration of the proboscis  242  can be associated with or at least partially based on a size and/or shape of the PIV, a size and/or shape of an adapter (e.g., an extension set, a Y-adapter, a T-adapter, or the like), or a collective size and/or shape of the PIV and the adapter. For example, in some embodiments, the proboscis  242  can have a length that is sufficient to extend through at least a portion of the PIV (or adapter). In embodiments including an adapter coupled to the PIV, the proboscis  242  can be sufficiently long to extend through the adapter and at least partially into or through the PIV. In some embodiments, the proboscis  242  can be sufficiently long to extend through an adapter and the PIV such that at least a portion of the proboscis  242  is distal to the PIV. Moreover, the proboscis  242  can have an outer diameter that is similar to or slightly smaller than an inner diameter of a portion of the PIV and/or adapter coupled thereto. For example, in some embodiments, an outer surface of the proboscis  242  can be in contact with an inner surface of the PIV when the proboscis  242  is disposed therein. In this manner, the proboscis  242  can provide structural support to at least a portion of the PIV within which the proboscis  242  is disposed. Similarly, the proboscis  242  can have an inner diameter (a diameter of a surface at least partially defining the lumen  255 ) that is similar to or slightly larger than an outer diameter of a portion of the catheter  260 , as described in further detail herein. 
     The first arm  243  and the second arm  250  of the lock  240  can be any suitable shape, size, and/or configuration. As shown in  FIGS. 13 and 14 , the first arm  243  has a first end portion  244 , a second end portion  245  including a tab  246 , and a pivot portion  247  disposed between the first end portion  244  and the second end portion  245 . The tab  246  disposed at and/or formed by the second end portion  245  extends from the second end portion  245  toward, for example, the proboscis  242 . In this manner, the tab  246  can selectively engage a portion of the PIV and/or a portion of an adapter coupled to the PIV to couple the lock  240  thereto, as described in further detail herein. 
     The pivot portion  247  of the first arm  243  extends from the coupler  241 , proboscis  242 , and/or second arm  250  in a lateral direction. The first end portion  244  and the second end portion  245  of the first arm  243  are proximal to the pivot portion  247  and distal to the pivot portion  247 , respectively. As such, the first arm  243  can act as a lever or the like configured to pivot about an axis defined by the pivot portion  247  in response to an applied force. For example, in some instances, a user can exert a force on the first end portion  244  (e.g., toward the coupler  241 ) that is sufficient to pivot the first end portion  244  of the first arm  243  toward the coupler  241  (as indicated by the arrow AA in  FIG. 14 ) and the second end portion  245  of the first arm  243  away from the proboscis  242  (as indicated by the arrow BB in  FIG. 14 ), as described in further detail herein. 
     As described above with reference to the first arm  243 , the second arm  250  of the lock  240  has a first end portion  251 , a second end portion  252  including a tab  253 , and a pivot portion  254  disposed between the first end portion  251  and the second end portion  252 . In this embodiment, the first arm  243  and the second arm  250  are substantially similar in form and function and are arranged in opposite positions and orientations relative to the coupler  241  and proboscis  242  (e.g., the lock  240  is substantially symmetrical about its longitudinal axis). As such, the discussion of the first arm  243  similarly applies to the second arm  250  and thus, the second arm  250  is not described in further detail herein. 
     As described above, the lock  240  is configured to be coupled to the PIV and/or an adapter coupled to the PIV. For example, a user can exert a lateral force on the first end portion  244  of the first arm  243  and the first end portion  251  of the second arm  250  to pivot the first arm  243  and the second arm  250 , respectively, from a first position toward a second position. The pivoting of the first arm  243 , therefore, increases a space defined between the proboscis  242  and the second end portion  245  (and the tab  246 ) of the first arm  243 . Similarly, the pivoting of the second arm  250  increases a space defined between the proboscis  242  and the second end portion  252  (and the tab  253 ) of the second arm  250 . In this manner, the increased space between the proboscis  242  and the arms  243  and  250  is sufficient to allow a portion of the PIV and/or an adapter coupled to the PIV to be inserted within the space. Once the portion of the PIV and/or the adapter is in a desired position relative to the lock  240 , the user can remove the force and in turn, the arms  243  and  250  pivot toward their respective first positions. As a result, the second end portions  245  and  252  are moved toward the proboscis  242  until the tabs  246  and  253 , respectively, are placed in contact with a portion of the PIV and/or the adapter. The tabs  246  and  253  are configured to engage the portion of the PIV and/or adapter to temporarily couple the lock  240  to the PIV and/or adapter. In some embodiments, the lock  240  can be configured to establish three points of contact with the PIV and/or the adapter, namely, the tabs  246  and  253 , and an outer surface of the proboscis  242  (as described above). In some embodiments, the tabs  246  and  253  can be configured to produce an audible output such as a click, a vibratory output such as a haptic bump, and/or the like when placed in contact with the portion of the PIV and/or adapter, which can indicate to a user that the lock  240  is properly coupled to the PIV and/or adapter. 
     As shown in  FIG. 15 , the proboscis  242  and the coupler  241  collectively define the lumen  255 . The lumen  255  of the lock  240  defines an axis (not shown) that is aligned with and/or substantially co-axial with the axis defined by the second portion  215  of the inner volume  213 . Thus, the lumen  255  of the lock  240  receives a portion of the catheter  260  when the transfer device  200  is transitioned between the first configuration and the second configuration. In some embodiments, the lumen  255  can have a size and/or shape that is based at least in part on a size and/or shape of the catheter  260 . For example, the lumen  255  can have an inner diameter that is slightly larger than an outer diameter of at least a portion of the catheter  260 . In such embodiments, the lock  240  can be and external guide or the like that can support and/or guide the catheter  260  as the catheter  260  is moved within the lumen  255 , which in turn, can reduce and/or substantially prevent undesirable bending, kinking, flexing, and/or deforming of the catheter  260 . 
     Although the lock  240  is shown and described above as including the proboscis  242 , in other embodiments, a lock need not form a proboscis. For example, in some such embodiments, a lock can include a relatively short hub or the like configured to engage a portion of the PIV and/or an adapter coupled to the PIV. In some embodiments, a fluid transfer device can include and/or can be used with a proboscis or guide member (not formed with or by the lock) configured to be disposed, for example, between a PIV and an adapter such as an IV extension set. For example, such a proboscis or guide member can have an inner surface that is funnel shaped and/or is shaped similar to the inner surface of the proboscis  242 . In this manner, the inner surface of such a proboscis and/or guide member can guide a portion of the catheter  260  as the catheter  260  is moved between the first position and the second position. In some embodiments, the lock  240  (including the proboscis  242 ) can be used in conjunction with such an external or separate proboscis and/or guide member. In some such embodiments, a portion of the proboscis  242  of the lock  240  can be inserted into the proboscis and/or guide member when the lock  240  is coupled to the adapter (e.g., IV extension set). 
     As described above, at least a portion of the catheter  260  and at least a portion of the secondary catheter  265  is movably disposed within the second portion  215  of the inner volume  213  defined by the introducer  210 . As shown in  FIG. 16 , the catheter  260  has a proximal end portion  261  and a distal end portion  262  and defines a lumen  263  (see e.g.,  FIG. 24 ). The proximal end portion  261  of the catheter  260  is coupled to a second portion  275  of the actuator  270 . In this manner, the actuator  270  can be moved relative to the introducer  210  to move the catheter  260  between a first position, in which the catheter  260  is disposed within the introducer  210  (e.g., the entire catheter  260  is disposed within the introducer  210  or within the introducer  210  and the lock  240 ) and a second position, in which the distal end portion of the catheter  260  is at least partially disposed in a position distal to the lock  240  and/or the PIV (not shown) when the lock  240  is coupled to the PIV, as described in further detail herein. The distal end portion  262  can be any suitable shape, size, and/or configuration and can define at least one opening in fluid communication the lumen  263 . For example, in some embodiments, the distal end portion  262  of the catheter can be substantially similar to any of those described in U.S. Pat. No. 8,366,685 (referred to herein as the “&#39;685 patent”) entitled, “Systems and Methods for Phlebotomy Through a Peripheral IV Catheter,” filed on Apr. 26, 2012, the disclosure of which is incorporated herein by reference in its entirety. 
     The catheter  260  can be any suitable shape, size, and/or configuration. For example, in some embodiments, at least a portion of the catheter  260  can have an outer diameter that is substantially similar to or slightly smaller than an inner diameter defined by the lumen  255  of the lock  240 , as described above. In some embodiments, an outer surface of the catheter  260  can be configured to contact an inner surface of the lock  240  that defines at least a portion of the lumen  255 . In this manner, an inner surface of the portion of the lock  240  defining the lumen  255  can guide the catheter  260  as the catheter  260  is moved between the first position and the second position. In some embodiments, such an arrangement can limit and/or can substantially prevent bending, deforming, and/or kinking of the catheter  260  as the catheter  260  is moved between the first position and the second position. Moreover, in some embodiments, the catheter  260  can have a length that is sufficient to place a distal surface of the catheter  260  in a desired position relative to a distal surface of the PIV when the catheter  260  is in the second position. In other words, the length of the catheter  260  can be sufficient to define a predetermined and/or desired distance between the distal surface of the catheter  260  and the distal surface of the PIV when the catheter  260  is in the second position, as described in further detail herein. 
     The catheter  260  can be formed from any suitable material or combination of materials, which in turn, can result in the catheter  260  having any suitable stiffness or durometer. For example, in some embodiments, the catheter  260  can be formed of a relatively flexible biocompatible material with a Shore durometer of approximately 20 Shore A to 50 Shore D; approximately 20 Shore A to 95 Shore D; approximately 70 Shore D to 85 Shore D, and/or any other suitable range of Shore durometer. In some embodiments, at least a portion of the catheter  260  can be formed of a braided material or the like, which can modify, change, and/or alter a flexibility of the catheter  260  in response to a bending force or the like. In other words, forming at least a portion of the catheter  260  from the braided material can increase an amount of deformation (in response to a bending force) of the catheter  260  prior buckling, kinking, and/or otherwise obstructing the lumen  263  of the catheter  260 . Similarly, forming at least a portion of the catheter  260  of a braided material can result in a compression and/or deformation in response to a compression force exerted in a direction of a longitudinal centerline defined by the catheter  260  (e.g., an axial force or the like). In this manner, the catheter  260  can absorb a portion of force associated with, for example, impacting an obstruction or the like. In some instances, such an arrangement can reduce buckling and/or kinking of the catheter  260  as well as reduce and/or substantially prevent damage to vascular structures that may otherwise result from an impact of the catheter  260 . Moreover, in some embodiments, forming at least a portion of the catheter  260  from the braided material, for example, can increase an amount of vibration transmitted through the catheter  260  in response to the portion of the actuator  270  advancing along the set of ribs  236  of the introducer  210  (as described above). While the catheter  260  is described above as including at least a portion formed of a braided material, in other embodiments, at least a portion of the catheter  260  can be formed of and/or can include a support wire, a stent, a fenestrated catheter, and/or the like such as those described in the &#39;685 patent incorporated by reference above. 
     The secondary catheter  265  has a proximal end portion  266  and a distal end portion  267  and defines a lumen  268  (see e.g.,  FIG. 24 ). A portion of the secondary catheter  265  is disposed within and extends through the opening  217  of the introducer  210  (e.g., collectively defined by the notches  223  and  233  of the first member  220  and second member  230 , respectively). As such, the proximal end portion  266  is at least partially disposed outside of the introducer  210  and the distal end portion  267  is at least partially disposed within the second portion  215  of the inner volume  213  defined by the introducer  210 . As described above, the secondary catheter  265  can be moved within the opening  217  between a first position and a second position to selectively clamp, pinch, kink, bend, and/or otherwise deform a portion of the secondary catheter  265 , which in turn, obstructs, pinches, kinks, closes, seals, etc. the lumen  268  of the secondary catheter  265 . For example, the first position can be associated and/or aligned with a first portion of the opening  217  having a larger perimeter and/or diameter than a perimeter and/or diameter of a second portion of the opening  217  associated and/or aligned with the second position. Thus, a user can manipulate the secondary catheter  265  to occlude the lumen  268  of the secondary catheter  265 , thereby limiting, restricting, and/or substantially preventing a flow of a fluid therethrough. 
     As shown in  FIG. 16 , the proximal end portion  266  of the secondary catheter  265  is coupled to and/or otherwise includes a coupler  269 . The coupler  269  is configured to physically and fluidically couple the secondary catheter  265  to any suitable device such as, for example, a fluid reservoir, fluid source, syringe, evacuated container holder (e.g., having a sheathed needle or configured to be coupled to a sheathed needle), pump, and/or the like. The distal end portion  267  of the secondary catheter  265  is at least partially disposed within the second portion  215  of the inner volume  213  defined by the introducer  210  and is coupled to the second portion  275  of the actuator  270 . In some embodiments, the secondary catheter  265  can have a larger diameter than the catheter  260  such that the proximal end portion  261  of the catheter  260  is at least partially disposed within the lumen  268  defined by the secondary catheter  265  when the catheter  260  and the secondary catheter  265  are coupled to the second portion  275  of the actuator  270 . In some embodiments, such an arrangement can, for example, reduce and/or substantially prevent leaks associated with fluid flowing between the catheter  260  and the secondary catheter  265 . In some embodiments, such an arrangement can also limit, reduce, and/or substantially prevent hemolysis of a volume of blood as the volume of blood flows through the catheter  260  and the secondary catheter  265 . In this manner, when the coupler  269  is coupled to a fluid reservoir, fluid source, syringe, evacuated container, pump, etc., the secondary catheter  265  establishes fluid communication between the reservoir, source, pump, etc. and the catheter  260 . 
     The actuator  270  of the transfer device  200  is coupled to the catheter  260  can be moved along a length of the introducer  210  to transition the transfer device  200  between its first configuration, in which the catheter  260  is in the first position, and its second configuration, in which the catheter  260  is in the second position. The actuator  270  can be any suitable shape, size, and/or configuration. For example, in some embodiments, the actuator  270  can have a size and shape that is associated with and/or based at least in part on a size and/or shape of the introducer  210 . 
     As shown in  FIGS. 17-20 , the actuator  270  includes a first portion  271 , the second portion  275 , and a wall  277  extending therebetween. The first portion  271  of the actuator  270  is at least partially disposed within the first portion  214  of the inner volume  213  defined by the introducer  210  and the second portion  275  of the actuator  270  is disposed within the second portion  215  of the inner volume  213 , as described above. The first portion  271  of the actuator  270  includes an engagement member  272 . The arrangement of the actuator  270  is such that the engagement member  272  is disposed outside of the introducer  210  while the rest of the first portion  271  is within the first portion  214  of the inner volume  213  defined by the introducer  210 . As such, the engagement member  272  can be engaged and/or manipulated by a user (e.g., by a finger or thumb of the user) to move the actuator  270  relative to the introducer  210 . In some embodiments, the engagement member  272  can include a set of ridges and/or any suitable surface finish that can, for example, increase the ergonomics of the actuator  270  and/or transfer device  200 . 
     The engagement member  272  includes a tab  273  disposed at or near a proximal end portion of the engagement member  272 . The tab  273  can be any suitable tab, rail, ridge, bump, protrusion, knob, roller, slider, etc. that extends from a surface of the engagement member  272 . The tab  273  is configured to selectively engage the outer surface  235  of the second member  230  of the introducer  210 . More specifically, the tab  273  is in contact with the ribs  236  formed by the second member  230  and moves along each successive rib as the actuator  270  is moved along a length of the introducer  210 . 
     As described above with reference to the set of ribs  236  of the second member  230 , the tab  273  can have any suitable shape, size, and/or configuration. For example, as shown in  FIG. 18 , the tab  273  can include a substantially rounded surface that can be moved along the set of ribs  236 . In some embodiments, the size and/or shape of the tab  273  is based at least in part on a size and/or shape of the ribs  236  such that a desired surface area of the tab  273  is in contact with the ribs  236  as the actuator  270  is moved relative to the introducer  210 . In some embodiments, an amount of friction defined between the set of ribs  236  and the tab  273  can be based at least in part on a surface area of the tab  273  that is in contact with the set of ribs  236 . Moreover, an amount of friction defined between the set of ribs  236  and the tab  273  can be based at least in part on a position of the tab  273  relative to each rib. For example, in some embodiments, an amount of friction defined between the tab  273  and a rib can increase at the tab  273  moves closer to, for example, a local maxima and can decrease as the tab  273  moves away from the local maxima. In some embodiments, the tab  273  can have a size and/or shape that allows the tab  273  to move with substantially less friction between each adjacent rib (e.g., between adjacent local maximums). In other words, the arrangement of the tab  273  and the set of ribs  236  can allow for a desired amount of “play” between adjacent ribs. 
     With the first portion  237  of the set of ribs  236  having a smaller size than the second portion  238  of the set of ribs  236 , a first portion or first surface area of the tab  273  can be in contact with the first portion  237  of the set of ribs  236  and a second portion or second surface area of the tab  273  can be in contact with the second portion  238  of the set of ribs  236 . In this manner, the tab  273  can move along the first portion  237  with a first set of characteristics and can move along the second portion  238  with a second set of characteristics different from the first set of characteristics. In some embodiments, for example, a force sufficient to move the tab  273  along the second portion  238  of the set of rib  236  can be greater than a force otherwise sufficient to move the tab  273  along the first portion  237  of the set of ribs  236 . In some embodiments, the movement of the tab  273  along the second portion  238  of the set of ribs  236  can result in, for example, a larger amount of vibration of the actuator  270  than an amount of vibration otherwise resulting from the movement of the tab  273  along the first portion  237  of the set of ribs  236 . Similarly, the shape of the tab  273  can be such that the tab  273  moves along the set of ribs  236  in the distal direction in response to an applied force that is insufficient to move the tab  273  along the set of ribs  236  in the proximal direction. For example, as shown in  FIG. 18 , the tab  273  has an asymmetric shape, wherein a proximal surface of the tab  273  has a greater pitch than a pitch of its distal surface. 
     While the engagement member  272  and tab  273  are particularly shown and described above, in other embodiments, an actuator can include an engagement member and/or tab having any suitable configuration. For example, while the tab  273  is shown as being disposed at or near a proximal end portion of the engagement member  272 , in other embodiments, an engagement member can include a first tab disposed at or near a proximal end portion and a second tab disposed at or near a distal end portion, each of which can be selectively in contact with a set of ribs disposed on an outer surface of an introducer. In some embodiments, a space defined between a surface of the wall  277  and a surface of the engagement member  272  can be increased or decreased, which can result in an increase or decrease in an amount of travel of the actuator  270  relative to the introducer  210  in a direction other than an axial direction. That is to say, the increase or decrease in space between the surface of the wall  277  and a surface of the engagement member  272  can result in, for example, an increase or decrease of an amount the actuator  270  can “tilt” relative to the introducer  210 . In other embodiments, the arrangement of the engagement member  272 , the tab  273 , and/or the set of ribs  236  of the introducer  210  can be modified, altered, tuned, adjusted, and/or otherwise changed such that the actuator  270  moves relative to the introducer  210  with a desired set of characteristics. For example, in some embodiments, the arrangement of the actuator  270  and/or introducer  210  can increase or decrease an amount the actuator  270  vibrates as it is moved relative to the introducer  210 , increase or decrease an amount of force sufficient to move the actuator  270  relative to the introducer  210 , increase or decrease an amount of movement of the actuator  270  relative to the introducer  210  in any suitable direction other than the axial direction (e.g., proximal direction or distal direction), and/or the like. 
     As shown, for example, in  FIGS. 19 and 20 , the second portion  275  has a cross-sectional shape that is based at least in part on a cross-sectional shape of the second portion  215  of the inner volume  213  defined by the introducer  210  (e.g., at least a partially circular cross-sectional shape). In this manner, the inner surface  223  of the first member  220  and the inner surface  233  of the second member  230  can support and/or guide the second portion  275  of the actuator  270  as the actuator  270  moves relative to the introducer  210 . As shown, the second portion  275  defines an opening  276  configured to receive a proximal end portion  261  of the catheter  260  and a distal end portion  267  of the secondary catheter  265 . In some embodiments, the proximal end portion  261  of the catheter  260  can form a friction fit with an inner surface of the second portion  275  of the actuator  270  when the proximal end portion  261  is disposed in the opening  276 . Similarly, the distal end portion  267  of the secondary catheter  265  can form a friction fit with an inner surface of the second portion  275  of the actuator  270  when the distal end portion  267  is disposed in the opening  276 . As such, the catheter  260  and the secondary catheter  265  can be maintained in a fixed position relative to the actuator  270  and thus, move concurrently with the actuator  270  as the actuator  270  is moved relative to the introducer  210 . 
     The wall  277  of the actuator  270  couples the first portion  271  of the actuator  270  to the second portion  275  of the actuator  270 . As shown in  FIGS. 19 and 20 , the wall  277  has a tortuous cross-sectional shape that is based at least in part on the tortuous cross-sectional shape of the inner volume  213  defined by the introducer  210 . In this manner, the first portion  271  of the actuator  270  can define an axis that is parallel to but offset from an axis defined by the second portion  275  of the actuator  270 . In some embodiments, for example, the wall  277  can have a substantially S-shaped or an at least partially S-shaped cross-sectional shape. In some embodiments, the wall  277  can form, for example, a dogleg or the like. The tortuous cross-sectional shape of the wall  277  (and thus, the actuator  270 ) is such that the second portion  275  of the actuator  270  cannot be viewed (e.g., is out of the line of sight) via the first portion  214  of the inner volume  213  defined by the introducer  210 . Similarly, the catheter  260  cannot be viewed via the first portion  214  of the inner volume  213  defined by the introducer  210  when the catheter  260  is in the first position. That is to say, the geometry of the actuator  270  and/or the introducer  210  (e.g., the tortuous cross-sectional shape of the inner volume  213 , the height and/or width of the introducer  210 , etc.) is configured such that the catheter  260  is at least partially isolated within the second portion  215  of the inner volume  213  when the catheter  260  is in the first position. In this manner, the structure of the introducer  210  and/or the actuator  260  can protect and/or isolate the catheter  260  from a volume outside of the introducer  210 , which in turn, can limit and/or substantially prevent contamination of the catheter  260 . For example, in some embodiments, the introducer  210  and/or the actuator  270  can act as a “sneeze guard” or the like configured to at least partially isolate the catheter  260  at least when the catheter  260  is in the first position. 
     Referring now to  FIGS. 21-29 , the transfer device  200  can be in the first configuration prior to use and can be transitioned by a user (e.g., a doctor, physician, nurse, technician, phlebotomist, and/or the like) from the first configuration ( FIGS. 21-24 ) to the second configuration ( FIGS. 27-29 ) to dispose at least the distal end portion  262  of the catheter  260  in a distal position relative to the introducer  210  (e.g., within an indwelling PIV (not shown) or distal to the indwelling PIV). The transfer device  200  is in the first configuration when the catheter  260  is disposed in the first position  260  within the introducer  210 . In some embodiments, substantially the entire catheter  260  is disposed within the introducer  210  when the catheter  260  is in the first position. In such embodiments, the introducer  210  can include the seal or the like (as described above) that can substantially seal the distal end portion  212  of the introducer  210  to isolate the catheter  260  within the second portion  215  of the inner volume  213 . In the embodiment shown in  FIGS. 22 and 23 , however, the catheter  260  is disposed within the introducer  210  and the lock  240  when catheter  260  is in the first position. While the seal is described above as being included in the distal end portion  212  of the introducer  210 , in other embodiments, the lock  240  can include a seal or the like that can form a substantially fluid tight seal with an inner surface of the lock  240  that defines the lumen  243 . Thus, the seal disposed within the lock  240  can isolate the catheter  260  within the second portion  215  of the inner volume  213 . In still other embodiments, the introducer  210  and/or the lock  240  need not include a seal. For example, in some embodiments, a PIV and/or an adapter (e.g., extension set) coupled to the PIV can include a seal that is transitioned from a closed configuration to an open configuration when the lock  240  is coupled thereto. Although not shown, in some embodiments, the catheter  260  can be disposed within a flexible sheath or the like that can maintain the catheter  260  in a substantially sterile environment while the catheter  260  is in the first position (e.g., such as those embodiments in which the introducer  210  and/or lock  240  do not include a seal). 
     The actuator  270  is disposed in a proximal position when the transfer device  200  is in the first configuration, as shown in  FIG. 24 . In some embodiments, the tab  273  of the first portion  271  of the actuator  270  can be disposed within a recess or detent or otherwise in contact with a proximal most rib configured to temporarily maintain the actuator  270  in the proximal position until a force is exerted (e.g., by the user) to move the actuator  270  in the distal direction. Moreover, as described above, a portion of the secondary catheter  265  is disposed in the opening  217  defined by the introducer such that the distal end portion  267  is at least partially disposed in the second portion  215  of the inner volume  213  and coupled to the second portion  275  of the actuator  270  while the proximal end portion  266  of the secondary catheter  265  is disposed outside of the introducer  210  (see e.g.,  FIGS. 21 and 22 ). 
     With the transfer device  200  in the first configuration, the user can manipulate the transfer device  200  to couple the lock  240  to an indwelling PIV and/or to an adapter coupled to the PIV (e.g., an extension set or the like). For example, in some embodiments, the user can exert a force sufficient to pivot the first arm  243  and the second arm  250  of the lock  240  such that a portion of the PIV and/or the adapter can be inserted into the space defined between the arms  243  and  250  and, for example, the proboscis  242 . In some embodiments, the proboscis  242  can be inserted into the PIV and/or the adapter when the lock  240  is coupled thereto. For example, in some embodiments, a portion of the proboscis  242  can be inserted into a hub or basket of the PIV and/or adapter. As described above, in some embodiments, the proboscis  242  that is sufficiently long to dispose at least a portion of the proboscis  242  within the PIV, which in turn, supports and/or provides structural rigidity to the PIV. Once the PIV and/or adapter is disposed in the desired position relative to the lock  240 , the user can remove the force on the arms  243  and  250  of the lock  240 , which in turn, move toward proboscis  242  until the tab  246  of the first arm  243  and the tab  253  of the second arm  250  are placed in contact with a surface of the PIV and/or adapter. In some embodiments, the arrangement of the lock  240  is such that the tabs  246  and  253  and the proboscis  242  form three points of contact with the PIV and/or adapter that collectively coupled the lock  240  thereto. 
     With the transfer device  200  coupled to the PIV and/or adapter, the user can engage the engagement member  272  of the first portion  271  of the actuator  270  to move the actuator  270  relative to the introducer  210 , which in turn, moves the catheter  260  from the first position (e.g., disposed within the introducer  210 ) toward the second position. In this manner, the catheter  260  is moved through the second portion  215  of the inner volume  213  and the lumen  255  of the lock  240  and as such, at least the distal end portion  262  of the catheter  260  is disposed outside of and distal to the lock  240 , as indicated by the arrow CC in  FIG. 25 . In some embodiments, the arrangement of the lumen  255  of the lock  240  and the catheter  260  can be such that an inner surface of the lock  240  defining the lumen  255  contacts, supports, and/or otherwise guides the catheter  260  as the catheter  260  is moved in the distal direction toward the second position. Moreover, in some embodiments, moving the catheter  260  from the first position toward the second position can be operable to transition the seal (e.g., disposed in the lock  240 ) from a closed or sealed configuration to an open configuration. In other embodiments, the user can manipulate the transfer device  200  (e.g., prior to moving the catheter  260  from the first position) to transition the seal from the sealed configuration to the open configuration. For example, in some embodiments, the user can increase a pressure within at least a portion of the transfer device  200  (e.g., the catheter  260  and/or the lock  240 ) beyond a predetermined threshold to transition the seal to the open configuration. In some embodiments, the seal can be a one way valve (e.g., a positive pressure valve or seal) that can be transitioned from the sealed configuration to the open configuration, for example, when a pressure exerted on a proximal portion of the seal exceeds a pressure exerted on a distal portion of the seal (e.g., venous pressure exerted on the seal). 
     As described above, the arrangement of the actuator  270  and the introducer  210  is such that advancing the actuator  270  relative to the introducer  210  advances the tab  273  along the outer surface  235  and more specifically, the set of ribs  236  of the second member  230  of the introducer  210 . As shown, for example, in  FIG. 26 , the tab  273  is in contact with the set of ribs  236 , which can produce a vibration of the actuator  270  as the actuator  270  is moved relative to the introducer  210 . In some instances, the vibration of the actuator  270  can produce, for example, a haptic, tactile, and/or audible output that can provide an indication associated with a position of the distal end portion  262  of the catheter  260  relative to the introducer  210 , lock  240 , and/or PIV. For example, in some embodiments, the tab  273  of the actuator  270  and the set of ribs  236  can collectively produce a “click” sound as the tab  273  moves past each rib. In some embodiments, the introducer  210  can include indicia or the like that can indicate to the user the relative position of the distal end portion  262  of the catheter  260 . In other embodiments, the amount of times the actuator  270  has vibrated due to being moved relative to that number of ribs can be associated with and/or otherwise provide an indication of the relative position of the distal end portion  262  of the catheter  260 . 
     In some instances, the user can stop moving the actuator  270  relative to the introducer  210  based on the haptic, tactile, and/or audible output indicating a desired placement of the distal end portion  262  of the catheter  260  relative to the PIV (e.g., the second position). In other words, the catheter  260  can be placed in the second position prior to the actuator  270  being advanced, for example, to a distal most position. As described in further detail herein, the catheter  260  is disposed in the second position when the distal end portion  262  of the catheter  260  is placed in a desired position relative to a distal end portion of the PIV. In some instances, for example, a distal end of the catheter  260  can be substantially flush with a distal end of the PIV when the catheter  260  is in the second position. In other instances, the distal end of the catheter  260  can extend a predetermined distance beyond the distal end of the PIV (e.g., distal to the distal end of the PIV). In still other instances, the distal end of the catheter  260  can be disposed within the PIV (e.g., proximal to the distal end of the PIV) when the catheter  260  is in the second position. 
     As shown in  FIGS. 27-29 , in some instances, the catheter  260  can be in the second position when the actuator  270  is in a distal most position. In this manner, the distal surface of the catheter  260  is positioned within the vein at a predetermined distance beyond the distal surface of the catheter  260 . In some instances, placing the distal surface of the catheter  260  the predetermined and/or desired distance from the distal surface of the PIV can, for example, place the distal surface of the catheter  260  in a position within a vein that is substantially free from debris (e.g., fibrin/blood clots) otherwise surrounding the distal end portion of the PIV. 
     In some instances, the indwelling PIV can substantially occlude at least a portion of the vein within which the PIV is disposed. As such, PIVs are often suited for delivering a fluid rather than aspirating blood. The venous system, however, is a capacitance system and thus, reroutes blood flow through a different vein (e.g., forms a bypass around the occlusion or substantial occlusion). Moreover, the alternate venous structure typically rejoins the vein in which the PIV is disposed at a given distance downstream of the PIV and thus, delivers at least portion of the flow of blood that would otherwise be flowing through the vein in which the PIV is disposed. Similarly, veins typically have many branch vessels coupled to thereto that similarly deliver a flow of blood to the vein within which the PIV is disposed. 
     As such, in some instances, the predetermined and/or desired distance between the distal surface of the catheter  260  and the distal surface of the PIV can be sufficient to place the distal surface of the catheter  260  downstream of one or more branch vessels in fluid communication with the vein within which the PIV is disposed. In other words, the distal surface of the catheter  260  can extend beyond the distal surface of the catheter  260  such that at least one branch vessel is disposed between the distal surface of the catheter  260  and the distal surface of the PIV when the catheter  260  is in the second position. Therefore, with the lumen  263  of the catheter  260  extending through the proximal end portion  261  and the distal end portion  262  of the catheter  260 , placing the distal surface of the catheter  260  the predetermined and/or desired distance from the distal surface of the PIV places the lumen  263  of the catheter  260  in fluid communication with a portion of the vein receiving a substantially unobstructed or unrestricted flow of blood (e.g., unobstructed by the PIV and/or debris associated with the indwelling of the PIV). 
     In some instances, for example, the predetermined and/or desired distance can be between about 0.0 millimeters (e.g., the distal surfaces are flush) and about 100 millimeters (mm). In other embodiments, the predetermined and/or desired distance can be between about 10 mm and about 90 mm, between about 20 mm and about 80 mm, between about 30 mm and about 70 mm, between about 30 mm and about 60 mm, between about 40 mm and about 50 mm, or between any other suitable range or subranges therebetween. In some embodiments, for example, the transfer device  200  can be configured such that the actuator  270  can move about 95 mm along the introducer  210  (e.g., the transfer device  200  has a 95 mm stroke) to position the distal surface of the catheter  260  at about 40 mm beyond the distal surface of the PIV to which the transfer device  200  is coupled. In other embodiments, for example, the transfer device  200  can have a 47 mm stroke that positions the distal surface of the catheter  260  at about 20 mm beyond the distal surface of the PIV to which the transfer device  200  is coupled. In still other embodiments, the transfer device  200  can have any suitable stroke length to position the distal surface of the catheter  260  at the predetermined and/or desired distance from the distal surface of the PIV. 
     Although the predetermined and/or desired distance is described above as being a positive distance, that is, the distal surface of the catheter  260  is distal to the distal surface of the PIV, in other embodiments, the predetermined and/or desired distance can be associated with the distal surface of the catheter  260  being in a proximal position relative to the distal surface of the PIV (e.g., a negative distance). For example, in some instances, the predetermined and/or desired distance can be between about 0.0 mm (e.g., the distal surfaces are flush) to about −50 mm, between about −10 mm and about −40 mm, between about −20 mm and about −30 mm, or between any other suitable range or subranges therebetween. In some instances, the predetermined and/or desired distance can be less than −50 mm (e.g., the distal surface of the catheter  260  is more than 50 mm proximal to the distal surface of the PIV). In some instances, the catheter  260  can be placed in the second position such that the distal end portion  262  of the catheter  260  remains within the PIV in a position distal to, for example, a kink or the like. For example, in some instances, indwelling PIVs can have one or more portions that are kinked such as a portion of the PIV where the peripheral intravenous catheter couples to a hub. In such instances, the predetermined and/or desired distance can be such that the distal surface of the catheter  260  is distal to the portion of the PIV that forms the kink (e.g., where the peripheral intravenous catheter couples to the hub). In some such instances, placing the distal surface of the catheter  260  distal to the kinked portion of the PIV but remaining within the PIV can result in a fluid flow path being sufficiently unrestricted to allow blood to be aspirated through the catheter  260 . 
     With the catheter  260  in the second position (e.g., with the transfer device  200  in the second configuration shown, for example, in  FIGS. 25 and 26  or  FIGS. 27-29 ), the user can establish fluid communication between a fluid reservoir, fluid source, syringe, and/or the like and the catheter  260 . For example, as described above, in some embodiments, the user can physically and fluidically couple the coupler  269  of the secondary catheter  265  to a fluid reservoir, fluid source, syringe, and/or the like. Although described as establishing fluid communication between the catheter  260  and the fluid reservoir or fluid source after placing the catheter  260  in the second position, in other embodiments, the user can establish fluid communication between the catheter  260  and the fluid reservoir or fluid source prior to moving the actuator  270  relative to the introducer  210 . With the catheter  260  in fluid communication with the fluid reservoir and/or fluid source, the transfer device  200  can then transfer a fluid from the patient or transfer a fluid to the patient via the catheter  260  extending through and beyond the PIV. For example, in some instances, the user can physically and fluidically couple the transfer device  200  to a fluid reservoir, evacuated container, syringe, and/or the like and then can aspirate a volume of blood from the vein based at least in part on disposing the distal surface of the catheter  260  at the predetermined and/or desired distance beyond the distal surface of the PIV. 
     In other instances, the user can physically and fluidically coupled the transfer device  200  to a fluid source or the like and then can deliver a volume of fluid from the fluid source to a portion of the vein at a position downstream of the PIV that receives a substantially uninhibited and/or unrestricted flow of blood. In some instances, disposing the distal surface of the catheter  260  at the predetermined and/or desired distance beyond the distal surface of the PIV, for example, can reduce potential harm associated with infusion of caustic drugs. For example, by positioning the distal surface of the catheter  260  within a portion of the vein receiving a flow of blood that would otherwise be inhibited and/or restricted by the indwelling PIV, the caustic drug can be entrained in the flow of blood and delivered to the target location. As such, a volume of the caustic drug is not retained within the debris or otherwise disposed in a position within the vein receiving little blood flow. 
     In some instances, once a desired amount of blood has been collected and/or once a desired volume of a drug has been delivered to the patient, the user can move the actuator  270  in the proximal direction, thereby placing the transfer device  200  in a third (used) configuration. In the third configuration, the catheter  260  can be disposed within the introducer  210  (e.g., distal to the seal or the like) and isolated therein. For example, in some embodiments, the actuator  270  can be placed in it proximal most position, in which the catheter  260  is in the first position. Moreover, once the actuator  270  and catheter  260  are in the desired position, the user can, for example, manipulate the secondary catheter  265  within the opening  217  such that a surface of the introducer  210  that defines the smaller portion of the opening  217  contacts and clamps the secondary catheter  265 . As such, the lumen  268  of the secondary catheter  265  can be substantially obstructed, occluded, blocked, pinched, etc. to limit and/or substantially prevent a flow of fluid therethrough. In some instances, clamping the secondary catheter  265  as described, for example, can reduce and/or substantially prevent fluid from leaking through the secondary catheter  265 . In some instances, the transfer device  200  can then be decoupled from the fluid reservoir, fluid source, syringe, etc. and safely discarded. 
       FIG. 30  is a flowchart illustrating a method  10  of using a fluid transfer device to transfer a fluid through a peripheral intravenous line, according to an embodiment. The method includes coupling a lock of the fluid transfer device to an indwelling peripheral intravenous line (PIV), at  11 . The fluid transfer device can be any suitable device configured for fluid transfer through a PIV. For example, in this embodiment, the fluid transfer device can be substantially similar to the fluid transfer device  200  described above with reference to  FIGS. 3-29 . As such, the fluid transfer device includes an introducer coupled to the lock, a catheter movably disposed in the introducer, and an actuator coupled to the catheter and in contact with an outer surface of the introducer. In some embodiments, the introducer includes a first member and a second member that collectively form the introducer. In such embodiments, the second member can have an outer surface that defines a set of ribs or the like, as described above with reference to the second member  230  in  FIGS. 7-12 . In this manner, the actuator can be in contact with the ribs formed by the second member of the introducer. Moreover, as described above with reference to the transfer device  200 , the introducer can define an inner volume having a tortuous cross-sectional shape configured to at least partially isolate the catheter disposed in the inner volume from a volume outside of the introducer. 
     With the lock coupled to the PIV (and/or an adapter coupled to the PIV), the actuator is moved relative to the introducer to advance the catheter from a first position, in which the catheter is disposed within at least one of an inner volume defined by the introducer or the lock, toward a second position, in which at least a portion of the catheter is disposed beyond at least a portion of the PIV, at  12 . In this manner, the catheter can be advanced, for example, in the distal direction. In some embodiments, the lock can include an inner surface that defines a lumen configured to receive the catheter as the catheter is moved toward the second position. In some embodiments, the inner surface of the lock can contact, support, and/or otherwise guide the catheter as the catheter is moved in the distal direction toward the second position. 
     As described above with reference to the transfer device  200  in some embodiments, the arrangement of the actuator and the introducer is such that advancing the actuator relative to the introducer advances a portion of the actuator along the ribs formed by the outer surface of the introducer. In some embodiments, moving the actuator along the ribs can produce a vibration of the actuator, which in turn, can produce, for example, a haptic, tactile, and/or audible output. Thus, an indication associated with a position of a distal end portion of the catheter as the actuator moves the catheter from the first position toward the second position is provided to the user, at  13 . For example, in some embodiments, the actuator and the set of ribs can collectively produce a “click” sound, a haptic vibration, and/or the like. In some embodiments, the introducer can include indicia or the like that can indicate to the user the relative position of the distal end portion of the catheter. In other embodiments, the amount of times the actuator has vibrated due to being moved along the ribs can be associated with and/or otherwise provide an indication of the relative position of the distal end portion of the catheter. 
     Based at least in part on the indication, the catheter is placed in the second position such that the distal end portion of the catheter is disposed at a predetermined and/or desired distance beyond at least a portion of the PIV (e.g., beyond a distal surface of the PIV), at  14 . For example, the catheter can be placed in the second position after moving the actuator at least a portion of the length of the introducer. In some embodiments, the catheter can be disposed in the second position when the actuator is placed in a distal most position. As described above with reference to the transfer device  200 , in some instances, the predetermined and/or desired distance beyond the portion of the PIV can position a distal surface of the catheter within a portion of the vein that is substantially free from debris (e.g., fibrin/blood clots) otherwise surrounding a distal end portion of the PIV. Similarly, in some instances, disposing the distal end portion of the catheter at the predetermined and/or desired distance from, for example, the distal end portion of the PIV can place the lumen of the catheter in fluid communication with a portion of the vein receiving a substantially unobstructed or unrestricted flow of blood (e.g., unobstructed by the PIV and/or debris associated with the indwelling of the PIV), as described in detail above. In this manner, a user can couple the transfer device to a fluid reservoir and/or fluid source to transfer fluid from and/or to, respectively, the patient. 
     Although not shown in  FIGS. 1 and 2  with reference to the transfer device  100  or  FIGS. 3-29  with reference to the transfer device  200 , the transfer devices  100  and  200  can be coupled to any suitable peripheral intravenous line (PIV). In some instances, use of a PIV can include coupling the PIV to an IV extension set and/or an adapter (e.g., a single port adapter, a Y-adapter, a T-adapter, or the like). Thus, while the transfer devices  100  and  200  are described herein as being coupled to a PIV, it should be understood that the transfer devices  100  and  200  can be coupled to either a PIV or an adapter coupled thereto based on the situation and/or configuration. The transfer devices  100  and  200  can be configured to couple to any suitable commercially available PIV, adapter, and/or extension set. For example, while the first arm  243  and the second arm  250  of the lock  240  are shown (e.g., in  FIGS. 13 and 14 ) and described above as having a given shape and/or configuration, in other embodiments, a lock can include a first arm and a second arm that have a size, shape, and/or configuration that can allow the lock to be coupled to various PIVs, adapters, and/or extension sets. By way of example, in some embodiments, the arms of a lock can be rounded, bent, bowed, widened, and/or the like to allow the lock to receive a portion of any suitable PIV, adapter, and/or extension set. In some embodiments, the arrangement of the arms  243  and  250  of the lock  240  can allow the lock  240  to be rotated substantially 360° about any suitable PIV, adapter, and/or extension set when coupled thereto. Moreover, while the proboscis  242  is shown and described above as having a particular size and/or shape, in other embodiments, a lock can include a proboscis that has any suitable length (e.g., longer or shorter than the proboscis  242 ), width (e.g., wider or narrower than the proboscis  242 ), and/or shape (e.g., curved, tapered, flared, etc.). In some embodiments, a proboscis can have a surface finish or feature such as one or more threads, flighting (e.g., an auger flighting), ribs, grooves, and/or the like. 
     The embodiments described herein can be used to transfer fluid from a patient or to the patient by accessing a vein via an indwelling PIV. As described above, the transfer devices  100  and/or  200 , for example, can be manipulated to place a distal surface of a catheter at a predetermined and/or desired distance from a distal surface of the PIV. In some instances, the embodiments described herein allow for efficient blood draw while maintaining the integrity of the sample. While extracting blood, the transfer devices  100  and/or  200  can be configured to receive and/or produce a substantially laminar (e.g., non-turbulent or low turbulent) flow of blood through the transfer device  100  and/or  200 , respectively, to reduce and/or substantially prevent hemolysis of the blood as the blood flows through the transfer devices  100  and/or  200 , respectively. 
     While the embodiments described herein can be used in a variety of settings (ER, in-patient, etc.), the following scenario of withdrawing a sample volume of blood from a patient is provided by way of example. In some instances, for example, a peripheral intravenous line and/or catheter (PIV) is inserted into a vein of a patient following standard guidelines and an extension set and/or adapter is attached. The PIV can remain within the vein for an extended period and can provide access to the vein for the transfer of fluids (e.g., saline, blood, drug compounds, etc.) to the patient. When it is time to draw blood, a user (e.g., nurse, physician, phlebotomist, and/or the like) can stop the transfer of fluid to the patient, if it is transferring fluid, for approximately 1-5 minutes to allow the fluid to disperse from the blood-drawing site. To draw the blood sample, the user attaches a transfer device (e.g., the transfer devices  100  and/or  200 ) to a port and/or suitable portion of the extension set and/or adapter and transitions the transfer device to from a first configuration (e.g., a storage configuration) to a second configuration, in which a portion of a catheter included in the transfer device extends through the peripheral IV and into the vein. 
     As described in detail above with reference to the transfer device  200 , an end of the catheter can be disposed at a predetermined and/or desired distance from an end of the PIV when the transfer device is in the second configuration to place the catheter in fluid communication with a portion of the vein that receives an unobstructed and/or uninhibited flow of blood. For example, the end of the catheter can be in a distal position relative to the end portion of the PIV and at least one branch vessel, valve, and/or the like in fluid communication with the vein. Once the catheter is in the desired position, the user can attach one or more negative pressure collection containers, tubes, and/or syringes to the transfer device to extract a volume of blood. In some instances, the volume of blood can be a first volume of blood that can be discarded and/or at least temporarily stored apart from a subsequent sample volume of blood (e.g., typically a volume of about 1-3 milliliters (mL) but up to 8-10 mL of blood can be a “waste” or “pre-sample” volume). In some instance, the waste volume can include contaminants, non-dispersed residual fluids, and/or the like. After the collective of the waste volume, the user can couple one or more negative pressure containers (e.g., sample containers) to the transfer device to collect a desired blood sample volume. Once the sample volume is collected, the transfer device can be transitioned from the second configuration toward the first configuration and/or a third configuration (e.g., a “used” configuration). The transfer device can then be decoupled from the extension set and/or adapter and safely discarded. In some instances, after collecting the sample volume but prior to transitioning the transfer device from the second configuration, the waste or pre-sample volume, for example, can be reinfused into the vein. 
     In some instances, the transfer devices described herein can be assembled during one or more manufacturing processes and packaged in a pre-assembled configuration. For example, in some instances, the transfer device  200  can be assembled by coupling the catheter  260  and the secondary catheter  265  to the actuator  270 ; positioning the catheter  260 , secondary catheter  265 , and actuator  270  relative to the first member  220  or second member  230  of the introducer  210 ; coupling the first member  220  and the second member  230  to form the introducer  210  with the actuator  270  and at least a portion of the catheter  260  and secondary catheter  265  disposed in the inner volume  213  of the introducer  210 ; and coupling the lock  240  to the introducer  210 . In some instances, the assembly of the transfer device  200  can be performed in a substantially sterile environment such as, for example, an ethylene oxide environment, or the like. In other embodiments, the transfer devices described herein can be packaged in a non-assembled configuration (e.g., a user can open the package and assemble the components to form the transfer device). The components of the transfer devices can be packaged together or separately. In some embodiments, the transfer devices can be packaged with, for example, a PIV, an extension set, a Y-adapter or T-adapter, and/or any other suitable component. 
     While various embodiments have been described above, it should be understood that they have been presented by way of example only, and not limitation. Where schematics and/or embodiments described above indicate certain components arranged in certain orientations or positions, the arrangement of components may be modified. Although various embodiments have been described as having particular features and/or combinations of components, other embodiments are possible having a combination of any features and/or components from any of embodiments as discussed above. 
     While the embodiments have been particularly shown and described, it will be understood that various changes in form and details may be made. For example, while the transfer device  200  is shown and described above as including the catheter  260  and the secondary catheter  265 , each of which being coupled to the actuator  270 , in other embodiments, the transfer device  200  can include a single catheter (e.g., the catheter  260 ). For example, in some embodiments, at least the second portion  275  of the actuator  270  can be configured to transition between an open configuration and a closed configuration. In such embodiments, the catheter  260  can be placed in a desired position relative to the second portion  275  when the second portion  275  is in the open configuration. The second portion  275  can then be transitioned from the open configuration to the closed configuration to retain at least a portion of the catheter  260  within the opening  276  defined by the second portion  275 . In such embodiments, the second portion  275  and the portion of the catheter  260  disposed in the opening  276  can form a friction fit operable to retain the catheter  260  in a fixed position relative to the actuator  270 . Moreover, the friction fit defined between the second portion  275  of the actuator  270  and the catheter  260  can isolate a portion of the catheter  260  that is distal to the actuator  270  from a portion of the catheter  260  that is proximal to the actuator  270 . Thus, the portion of the catheter  260  that is proximal to the actuator  270  can extend through the opening  217  and at least partially outside of the introducer  210  without contaminating the portion of the catheter  260  distal to the actuator  270 . 
     Any of the aspects and/or features of the embodiments shown and described herein can be modified to affect the performance of the transfer device. For example, the ribs in the set of ribs  236  of the introducer  210  and the tab  273  of the actuator  270  can have any suitable shape, size, configuration, and/or arrangement to produce a desired set of characteristics associated with the movement of the actuator  270  relative to the introducer  210 , as described above. By way of another example, any of the components of the transfer devices  100  and/or  200  can be formed from any suitable material that can result in a desired hardness, durometer, and/or stiffness of that component. For example, in some embodiments, at least the proboscis  242  of the lock  240  can be formed from a substantially rigid material such as a metal or hard plastic. In such embodiments, forming at least the proboscis  242  from the substantially rigid material can increase the structure support provided by the proboscis  242  to a PIV when the proboscis  242  is at least partially disposed therein. Similarly, the proboscis  242  can provide support to and/or otherwise can guide the catheter  260  when the catheter  260  is moved therethrough. 
     Where methods and/or schematics described above indicate certain events and/or flow patterns occurring in certain order, the ordering of certain events and/or flow patterns may be modified. Additionally certain events may be performed concurrently in parallel processes when possible, as well as performed sequentially.