Patent Publication Number: US-2023147491-A1

Title: Dermal Patch for Collecting a Physiological Sample with Removable Vial

Description:
TECHNICAL FIELD 
     The present teachings are generally directed to dermal devices that can be employed to collect a physiological sample from a subject. 
     BACKGROUND 
     Biomarkers are increasingly employed for diagnosis of various disease conditions as well as for assessing treatment protocols. In many cases, it is important to monitor the level of a biomarker over time (e.g., to assess the progression of a disease). The temporal monitoring of biomarkers via conventional techniques includes drawing a physiological fluid sample from a subject. These techniques may be cumbersome and painful to the subject. For example, the invasive nature of drawing a blood sample from a subject can cause discomfort and may lead to less cooperation from a subject, especially children, rendering multiple measurements of a target analyte difficult. 
     Some recently developed devices that allow for continuous monitoring of a target analyte (e.g., glucose monitors), typically suffer from several shortcomings, such as low sensitivity and/or specificity. Therefore, there is still a need for devices that allow collection of a physiological sample (e.g., a blood sample) for monitoring a target analyte. 
     SUMMARY 
     Aspects of the present disclosure address the above-referenced problems and/or others. 
     In one aspect, a device (herein also referred to as a dermal patch) for collecting a physiological sample from a subject includes a lancet with a needle that is configured to puncture the subject&#39;s skin. The device further includes a cartridge that is configured to couple to the lancet. The lancet is configured to automatically deploy the needle when coupled to the cartridge, which in turn allows the needle to puncture the subject&#39;s skin and draw a physiological sample. The device also includes a vial disposed within the cartridge and configured to receive the drawn physiological sample. In some embodiments the vial is removable from the cartridge. In certain embodiments, the vial is configured to be placed into a centrifuge. In some embodiments, the vial includes a lysis buffer and/or a preservative and/or an anticoagulant. 
     In some embodiments, the device further includes a plunger that is at least partially disposed within the vial and is configured to create a vacuum within the vial and the cartridge, wherein the vacuum can draw the physiological sample into the vial. In certain embodiments, the cartridge further includes a physiological sample well, and a needle in open communication with the physiological sample well and configured to carry the physiological sample from the physiological sample well to the vial. In certain embodiments, the plunger includes a snap-off joint that allows a user to separate a portion of the plunger from the rest of the plunger. By way of example, the snap-off joint can be implemented, without limitation, as a reduced diameter portion, a notch, a perforation, among other structures. 
     In some embodiments the device further includes a self-healing cap coupled to the vial. In some embodiments the self-healing cap is configured to seal the vial after being punctured. In certain embodiments, the needle is configured to puncture the self-healing cap to carry the physiological sample to the vial. In some embodiments, the cartridge includes a cover, and a base removably coupled to the cover. In certain embodiments, the cover includes a vial viewing aperture configured to provide visual access to the vial disposed within the cartridge. In other embodiments, the device includes a quick response (QR) code disposed on an outer surface of the vial. In certain embodiments the cover includes a quick response code viewing aperture configured to provide visual access to the quick response code. 
     In another aspect, a method for obtaining a physiological sample from a subject includes attaching a cartridge of a dermal patch to the skin of a subject. The cartridge includes a vial disposed therein and a plunger at least partially disposed within the vial. The method also includes engaging a lancet having a needle to the cartridge so as to activate the needle for puncturing the skin so as to draw a physiological sample (e.g., a blood sample). The method further includes moving the plunger from a first position to a second position to facilitate drawing the physiological sample into the vial. In certain embodiments, the needle of the lancet automatically retracts into the lancet after drawing the physiological sample. In some embodiments the method further includes removing the vial from the cartridge, breaking the plunger at its snap-off joint such that a portion of the plunger remains disposed within the vial, placing the vial with the portion of the plunger into a medical device, and performing an analysis of the physiological sample within the vial via the medical device. 
     In some embodiments, the vial includes a lysis buffer or a preservative or an anticoagulant. In certain embodiments, the cartridge includes a physiological sample well and the drawn physiological sample pools within the physiological sample well and wherein moving the plunger from the first position to the second position draws the physiological sample from the physiological sample to the vial. In some embodiments, the cartridge or the vial includes a quick response code, and the method further includes scanning the quick response code to update an electronic medical record associated with the quick response code. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Aspects of the present disclosure may take form in various components and arrangements of components, and in various steps and arrangements of steps. The drawings are only for illustration purpose of preferred embodiments of the present disclosure and are not to be considered as limiting. 
       Features of embodiments of the present disclosure will be more readily understood from the following detailed description take in conjunction with the accompanying drawings in which: 
         FIGS.  1 A and  1 B  depict a dermal patch system in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  2  and  3    depict a lancet of the dermal patch system in accordance with an exemplary embodiment of the present disclosure 
         FIGS.  4 A and  4 B  depict a housing of the lancet in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  5 A and  5 B  depict a cap of the lancet in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  6    depicts an inner sleeve of the lancet in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  7    diagrammatically depicts a needle frame of the lancet in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  8 A,  8 B,  9 A, and  9 B  depict a cartridge of the dermal patch system in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  10 A and  10 B- 14 A and  14 B  depict a cover of the cartridge in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  15 A and  15 B- 21 A and  21 B  depict a base of the cartridge in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  21 A and  21 B  depict a portion of the base of the cartridge in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  22 A and  22 B  depict the cover coupled to the base in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  23    diagrammatically depicts a lancet receiving element of the base in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  24 A and  24 B- 27    depict a syringe for use with the cartridge in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  28 A and  28 B  depict a plunger of the syringe with an elastomeric ring in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  29 A and  29 B- 33    depict the plunger in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  34  and  35    depict the elastomeric ring for use with the plunger in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  36 A and  36 B - FIGS.  44 A and  44 B  depict a vial assembly in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  45 A and  45 B- 52 A and  52 B  depict a vial of the vial assembly in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  53  and  54    depict a cap of the vial assembly in accordance with an exemplary embodiment of the present disclosure; 
         FIGS.  55 A and  55 B  depict a locking member of the vial assembly in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  56    depicts the lancet in an undeployed position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  57    depicts the lancet in a deployed position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  58    depicts the lancet in a retracted position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  59    depicts the lancet couped to the base wherein the lancet is in the deployed position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  60    depicts the lancet couped to the base wherein the lancet is in the retracted position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  61    depicts the dermal patch system wherein the plunger is in an undeployed position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  62    depicts the dermal patch system wherein the plunger is in a deployed position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  63    depicts the dermal patch system wherein the vial assembly is in a vial removal position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  64    depicts the dermal patch system wherein the vial assembly is in a vial storage position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  65    depicts the vial assembly in the vial storage position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  66    depicts the vial assembly in the vial storage position in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  67    depicts a lid removal tool in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  68    depicts the lid removal tool decoupling the cover from the base in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  69    depicts a broken plunger in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  70    depicts a base of a dermal patch system with a pipette in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  71    depicts a pipette for use with the dermal patch system in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  72    diagrammatically depicts an electronic medical record database, a computer system, and a physiological sample collection pad with a quick response (“QR”) code in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  73    diagrammatically depicts a computer system in accordance with an exemplary embodiment of the present disclosure; 
         FIG.  74    diagrammatically depicts a cloud computing environment in accordance with an exemplary embodiment of the present disclosure; and 
         FIG.  75    is a flow chart of a method for obtaining a physiological sample from a subject in accordance with an exemplary embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     The present disclosure generally relates to a dermal patch that may be utilized to collect and/or store a collected physiological sample. 
     In some embodiments, a dermal patch may be used to collect a physiological sample and the collected sample may then be stored within a vial of the dermal patch. Dermal patches disclosed herein may allow for the collection and analysis of a physiological sample in a variety of environments (e.g., in the home, in the field, in a medical facility, etc.). 
     Various terms are used herein in accordance with their ordinary meanings in the art, unless otherwise indicated. 
     The term “about,” as used herein, denotes a deviation of at most 10% relative to a numerical value. For example, about 100 μm means in the range of 90 μm-110 μm. 
     The term “substantially,” as used herein, refers to a deviation, if any, of at most 10% from a complete state and/or condition. 
     The term “subject” as used herein refers to a human subject or an animal subject (i.e., chicken, pig, cattle, dog, cat, etc.). 
     The term “physiological sample,” as used herein, includes fluid drawn from a subject and includes, but is not limited to, blood and interstitial fluid. 
     The term “lancet,” as used herein refers broadly to an element that can be used to provide a passageway, or facilitate the production of a passageway, in the skin for the collection of a physiological sample. 
     The term “transparent,” as used herein, indicates that light can substantially pass through an object (e.g., a window) to allow visualization of a material disposed behind the object. For example, in some embodiments, a transparent object allows the passageway of at least 70%, or at least 80%, or at least 90% of visible light therethrough. 
     The term “vacuum,” as used herein, refers to a pressure less than atmospheric pressure and more particularly to a pressure that can facilitate the movement of a fluid (e.g., a physiological sample) within a dermal patch. 
     The term “syringe” as used herein, refers to a device that includes a hollow barrel (also referred to as a “vial” herein) that is fitted with a plunger. A syringe may or may not include a needle. 
     The term “needle” as used herein, refers to a component with a pointed tip that is configured to pierce an outer surface of an element (e.g., skin of a subject) to provide a passageway. 
     The term “pipette” as used herein refers to an apparatus for collecting a liquid that consists of a narrow tube and a barrel that retains the liquid. Liquid may travel into the barrel via the suction or capillary action and as such, a pipette may or may not include a bulb. 
     The present disclosure generally relates to a device, which is herein also referred to as a dermal patch or a dermal patch system, for collecting a physiological sample (e.g., bodily fluids such as blood, interstitial fluids, etc.) from a subject. In some embodiments discussed below, such a dermal patch system can include a cartridge that can be affixed to a to a subject&#39;s skin (e.g., via an adhesive layer) and a separate lancet that can be engaged with the cartridge to puncture the skin, thereby providing a passageway for extracting the physiological sample. As discussed in more detail below, the lancet can include a housing in which at least one needle that is configured for puncturing the skin is disposed. The lancet can further include a mechanism that can be transitioned between at least two states, wherein in one state (herein referred to as a locked state), the mechanism retains the needle within the lancet in an undeployed position when the lancet is not engaged with the cartridge and in another state (herein referred to as a released state), the mechanism allows the needle to be deployed for puncturing the skin in response to engagement of the lancet with the cartridge. In other words, the engagement of the lancet with the cartridge transitions the mechanism from the locked state to the released state, where in the released state, the mechanism allows the needle to be deployed for puncturing the skin. For example, in some embodiments, the mechanism can include an upper locking portion that can retain an upper spring that is coupled to a needle platform (to which a needle is mounted) in a compressed state, thereby preventing the needle from transitioning into a deployed position. Further, the mechanism can include an upper interference member that prevents the movement of the needle platform when the mechanism is in the locked state. 
     Hence, the engagement of the lancet with the cartridge results in an automatic transition of the mechanism from the locked state to the released state, which transitions the needle into a deployed position in which the needle extends beyond the lancet and the cartridge housing to puncture the subject&#39;s skin. In some embodiments, the engagement of the lancet with the cartridge causes the upper locking member to release the needle platform, which in turn allows the upper spring to decompress and thus push down the needle platform thereby deploying the needle. In some embodiments, the mechanism can further include a lower interference member that restricts the downward movement of the needle platform, when the needle platform is released. In this manner the extent of the penetration of the needle into the skin can be controlled. In certain embodiments, the mechanism can also include a lower locking member that retains a lower spring in a compressed state. The downward movement of the needle platform can cause the release of the lower locking member to allow the lower spring to decompress and exert a force on the needle platform to cause the retraction of the needle into the lancet housing. 
     In this manner, the lancet remains safe before it is engaged with the cartridge as the lancet is not capable of deploying the needle when the lancet is not engaged with the cartridge. Furthermore, in this manner, the lancet remains safe after drawing a physiological sample as the needle automatically retracts back into the lancet after being deployed. 
     Referring now to  FIGS.  1 A and  1 B , a dermal patch system  10  is shown in accordance with an exemplary embodiment. The dermal patch system  10  includes a lancet  100 , a cartridge  12  that can be affixed to a subject&#39;s skin via an adhesive layer  14  ( FIGS.  9 A and  9 B ), and a syringe  16  ( FIGS.  24 A and  24 B- 27   ) that can be at least partially disposed within the cartridge  12 . As will be discussed in further detail herein, the lancet  100  can engage with the cartridge  12  to deploy a needle disposed within the lancet housing to puncture the subject&#39;s skin thereby drawing a physiological sample from the subject. 
     Referring now to  FIGS.  2  and  3   , the lancet  100  is shown in accordance with an exemplary embodiment. The lancet  100  includes a housing  102  in which various components of the lancet are disposed and a cap  104  that is coupled to the housing  102 . The lancet  100  can further include an inner sleeve  106  within the housing  102  and a needle frame  108  that is disposed within the inner sleeve  106  and onto which a needle  110  is mounted. The lancet  100  also can include an injection spring  112  and a retraction spring  114  that move a needle of the lancet between various positions. 
     With particular reference to  FIGS.  4 A and  4 B , the housing  102  includes a side wall  116  and a bottom wall  118 . The side wall  116  includes an outer surface  116   a  and an opposed inner surface  116   b . The bottom wall  118  includes an outer surface  118   a  and an opposed inner surface  118   b . The side wall  116  extends vertically from the bottom wall  118 . The side wall  116  has a generally cylindrical shape and the bottom wall  118  is generally circular in shape and is concentric relative to a longitudinal axis of the generally cylindrical side wall and covers a lower opening formed by the generally cylindrical side wall. The inner surface  116   b  of the side wall  116  and the inner surface  118   b  of the bottom wall  118  define an inner volume  120 . 
     The outer surface  116   a  defines a notch  122  that extends circumferentially around the outer surface  116   a  of the side wall  116 . As will be discussed in further detail herein, the notch  122  is shaped and dimensioned to couple to a locking member of the cartridge  12  via a snap fit. The housing  102  further includes a rim  124  that extends circumferentially around the outer surface  116   a  of the side wall  116 . The inner surface  116   b  defines a first and second column  126  that extend vertically from the inner surface  118   b  of the bottom wall  118 . The columns  126  includes an inner surface  126   a  and a top surface  126   b . The inner surface  126   a  extends vertically between the inner surface  118   b  of the bottom wall  118  and the top surface  126   b . The top surface  126   b  extends longitudinally between the inner surface  116   b  of the side wall  116  and the inner surface  126   a.    
     As will be discussed in further detail herein, before the lancet  100  is inserted into the cartridge  12  the columns  126  retain the needle  110  of the lancet  100  in an undeployed position. 
     The bottom wall  118  defines an aperture  128  that extends through the bottom wall  118 . Stated another way, the aperture  128  extends between the outer surface  118   a  and the inner surface  118   b  of the bottom wall  118 . As will be discussed in further detail herein, when the lancet is activated via engagement with the cartridge  12 , the needle of the lancet  100  is activated to extend through the aperture  128  and puncture the subject&#39;s skin thereby providing a passageway through which a physiological sample can be drawn from a subject. 
     With particular reference to  FIGS.  5 A and  5 B  the cap  104  includes a top wall  130  with an outer surfaced  130   a  and an opposed inner surface  130   b . The cap  104  also includes a side wall  132  with an outer surface  132   a  and an opposed inner surface  132   b . The top wall  130  extends longitudinally from and perpendicular to the side wall  132 . The side wall  132  extends vertically from and perpendicular to the top wall  130 . The top wall  130  and the side wall  132  are generally circular in shape and are concentric with one another. The cap  104  also includes an inner cylinder  134  with an outer surface  134   a  and an opposed outer surface  134   b . The inner cylinder  134  extends vertically from and perpendicular to the top wall  130 . The inner cylinder  134  is concentric with the top wall  130  and the side wall  132 . 
     When the cap  104  is coupled to the housing  102  the side wall  132  extends into the inner volume  120  of the housing  102  and at least a portion of the side wall  132  contacts the inner surface  116   b  of the side wall  116  such that the cap  104  couples to the housing  102  via an interference fit. 
     As depicted in  FIG.  6   , the inner sleeve  106  includes a side wall  136  and a bottom wall  138 . The side wall  136  includes an outer surface  136   a  and an opposed inner surface  136   b . The bottom wall  138  includes an outer surface  138   a  and an opposed inner surface  138   b . The side wall  136  extends vertically from the bottom wall  138 . The side wall  136  and the bottom wall  138  are generally circular in shape and are concentric with one another. The inner surface  136   b  of the side wall  136  and the inner surface  138   b  of the bottom wall  138  define an inner volume  140 . The inner surface  136   b  defines a plurality of columns  142  each of which extends vertically from and perpendicular to the inner surface  138   b  of the bottom wall  138 . As will be discussed in further detail herein, when the needle frame  108  is in a deployed position, a portion of the needle frame  108  rests upon the columns  142 . 
     The inner sleeve  106  further includes a plurality of ledges  144  that extend circumferentially about the side wall  136 . Each ledge  144  includes a top surface  144   a , an opposed bottom surface  144   b  and an outer surface  144   c  that extends between the top surface  144   a  and the bottom surface  144   b . The inner sleeve  106  also includes a plurality of locking members  146  that extend from the inner surface  136   b  of the side wall  136 . As will be discussed in further detail herein, the proximal end of the locking members  146  retains the retraction spring  114  in a compressed state in absence of engagement between the lancet  100  and the cartridge  12 . The side wall  136  further defines a plurality of openings  148  that extend through the side wall  136 . Stated another way, the openings  148  extend between the outer surface  136   a  and the inner surface  136   b  of the side wall  136 . Each of the openings  148  are aligned with a proximal end of a locking member  146  to allow the proximal end of a locking member  146  to extend therethrough. 
     The bottom wall  138  defines an aperture  150  that extends through the bottom wall  138 . Stated another way, the aperture  150  extends between the outer surface  138   a  and the inner surface  138   b  of the bottom wall  138 . The aperture  150  is concentric with the aperture  128  of the housing  102 . As will be discussed in further detail herein, when in a deployed position, the needle  110  of the lancet  100  extends through the aperture  150  of the inner sleeve  106  as well as the aperture  128  of the housing  102 . 
     As depicted in  FIG.  7   , the needle frame  108  includes a first cylinder  152  and a second cylinder  154  disposed vertically above the second cylinder  154   c . The first cylinder  152  includes a bottom surface  152   a  and an outer surface  152   b . The second cylinder  154   c  is disposed vertically above the first cylinder  152  and the third cylinder  156  is disposed vertically above the second cylinder  154 . The first cylinder  152  includes a bottom surface  152   a  and an outer surface  152   b  and the second cylinder  154  includes a bottom surface  154   a , an outer surface  154   b  and a top surface  154   c . The third cylinder  156  includes an outer surface  156   a  and a top surface  156   b . Similarly, the protrusion  158  includes an outer surface  158   a  and a top surface  158   b.    
     The bottom surface  152   a  of the first cylinder  152  extends circumferentially about the outer surface  152   b  of the first cylinder. The outer surface  152   b  of the first cylinder  152  extends vertically between the bottom surface  152   a  of the first cylinder  152  and the bottom surface  154   a  of the second cylinder  154 . The bottom surface  154   a  of the second cylinder  154  extends at an angle longitudinally between the outer surface  152   b  of the first cylinder and the outer surface  154   b  of the second cylinder  154 . The outer surface  154   b  extends vertically between the bottom surface  154   a  and the top surface  154   c  of the second cylinder  154 . The top surface  154   c  of the second cylinder  154  extends longitudinally between the outer surface  154   b  of the second cylinder and the outer surface  156   a  of the third cylinder  156 . The outer surface  156   a  extends vertically between the top surface  154   c  of the second cylinder and the top surface  156   b  of the third cylinder. The top surface  156   b  of the third cylinder extends longitudinally between the outer surface  156   a  of the third cylinder  156  and the outer surface  158   a  of the protrusion  158 . The outer surface  158   a  extends vertically between the top surface  156   b  of the third cylinder and the top surface  158   b  of the protrusion  158 . The top surface  158   b  of the protrusion  158  extends across a proximal end of the outer surface  158   a.    
     The injection spring  112  extends vertically between the cap  104  and the needle frame  108 . More specifically, a distal end of the injection spring  112  contacts the inner surface  130   b  of the top wall  130  and a proximal end of the injection spring  112  contacts the top surface  154   c  of the second cylinder  154 . The distal end of the injection spring  112  extends circumferentially around the outer surface  134   a  of the inner cylinder  134 . The proximal end of the injection spring  112  extends circumferentially around the third cylinder  156  and around the protrusion  158 . 
     The needle frame  108  supports the needle  110 . In some embodiments, the needle  110  is molded into the first cylinder  152  or is attached to the bottom surface  152   a  of the first cylinder  152  (e.g., via an adhesive). 
     Referring now to  FIGS.  8 A,  8 B,  9 A, and  9 B , the cartridge  12  is shown in accordance with an exemplary embodiment. 
     The cartridge  12  includes a cover  200  and a base  300  that can couple to the cover  200 . For example, the cover  200  and the base  300  can be formed as two separate components that are removably coupled to one another (e.g., via a snap fitting). In other embodiments, the cover  200  and the base  300  form an integral unitary cartridge  12 . In some of these embodiments, the cover  200  can be coupled to the base  300  via an adhesive, laser welding, etc. The dermal patch system  10  also includes the syringe  16 . The syringe  16  includes a plunger  400  and a vial assembly  500  that is coupled to the plunger  400 . As will be discussed in further detail herein, the plunger is configured to create vacuum within the vial assembly  500  and the cartridge  12 . 
     The cartridge  12  may be formed using a variety of suitable materials including, but not limited to, polymeric materials (e.g., polyolefins, polyethylene terephthalate (PET), polyurethanes, polynorbornenes, polyethers, polyacrylates, polyamides (Polyether block amide also referred to as Pebax®), polysiloxanes, polyether amides, polyether esters, trans-polyisoprenes, polymethyl methacrylates (PMMA), cross-linked trans-polyoctylenes, cross-linked polyethylenes, cross-linked polyisoprenes, cross-linked polycyclooctenes, inorganic-organic hybrid polymers, co-polymer blends with polyethylene and Kraton®, styrene-butadiene co-polymers, urethane-butadiene co-polymers, polycaprolactone or oligo caprolactone co-polymers, polylactic acid (PLLA) or polylactide (PL/DLA) co-polymers, PLLA-polyglycolic acid (PGA) co-polymers, photocross linkable polymers, etc.). In some embodiments, some of the cover  200  may be formed of poly(dimethylsiloxane) (PDMS) to allow visibility of components disposed within the cartridge  12 . 
     Referring now to  FIGS.  10 A and  10 B- 14 A and  14 B , the cover  200  is shown in accordance with an exemplary embodiment. In this embodiment, the cover  200  includes a lid  202  with an outer surface  202   a  and an opposed inner surface  202   b.    
     The lid  202  defines a U-shaped opening  204 . The U-shaped opening  204  extends through the lid  202 . Stated another way, the U-shaped opening  204  extends between the outer surface  202   a  and the inner surface  202   b  of the lid  202 . The U-shaped opening  204  is shaped and dimensioned to accommodate at least a portion of the plunger  400 . As will be discussed in further detail herein, U-shaped opening  204  allows the plunger  400  to be disposed within the cartridge  12 . That is, the U-shaped opening  204  is shaped to accommodate the plunger  400  such that at least a portion of the plunger  400  can extend through the lid  202  to be disposed within in the cartridge  12 . 
     The lid  202  defines a lancet aperture  206  that is generally circular in shape. The lancet aperture  206  extends through the lid  202 . Stated another way, the lancet aperture  206  extends between the outer surface  202   a  and the inner surface  202   b  of the lid  202 . The lancet aperture  206  is shaped to accommodate at least a portion of the lancet  100 . As will be discussed in further detail herein, the lancet aperture  206  allows the lancet  100  to couple to the base  300 . That is, the lancet aperture  206  is shaped to accommodate the lancet  100  such that at least a portion of the lancet  100  can extend through the lid  202 . 
     The lid  202  further defines a vial viewing aperture  208  and a quick response (“QR”) code viewing aperture  210 . The vial viewing aperture  208  and the QR code viewing aperture  210  extend through the lid  202 . Stated another way, the vial viewing aperture  208  and the QR code viewing aperture  210  extend between the outer surface  202   a  and the inner surface  202   b  of the lid  202 . The vial viewing aperture  208  is shaped and positioned to allow a user of the dermal patch system  10  to view the vial assembly  500  that is disposed within the cartridge  12 . The QR code viewing aperture  210  is shaped and positioned to allow a user of the dermal patch system  10  to view a QR code  18  that is located on the vial assembly  500  ( FIGS.  9 A and  9 B ). While the QR code  18  is depicted as on the vial assembly  500 , it is understood that the QR code  18  may be positioned elsewhere on the cartridge  12  (e.g., on the outer surface  202   a  of the lid  202 ). As will be discussed in further detail herein, the QR code  18  can be associated with an electronic medical record (“EMR”) stored in an electronic medical record database. 
     The cover  200  further includes a rod  212  and locking members  214  that each includes a hook  216 . The rod  212  and the locking members  214  extend vertically from and perpendicular to the inner surface  202   b  of the lid  202 . As will be discussed in further detail herein, the rod  212  and the locking members  214  couple the cover  200  to the base  300 . 
     The cover  200  also includes a locking wall  218  and a vial guide  220 . The locking wall  218  and the vial guide  220  each extend vertically from and perpendicular to the inner surface  202   b  of the lid  202  and are disposed at opposite ends of the vial viewing aperture  208 . Furthermore, the vial guide  220  extends longitudinally between the locking members  214 . As will be discussed in further detail herein the locking wall  218  prevents movement of the vial assembly  500  when the vial assembly  500  is arranged in a first position and the vial guide  220  is shaped and dimensioned to guide movement of the vial assembly  500  when the vial assembly  500  is arranged in different position. 
     The cover  200  also includes a rotational stop  222  that extend vertically from and perpendicular to the inner surface  202   b  of the lid  202  and is disposed at a proximal end of the QR code viewing aperture  210   b . The rotational stop  222  is positioned offset from a center of the cover  200  and, as will be discussed in further detail herein, the rotational stop  222  prevents the vial assembly  500  from rotating in a counterclockwise direction. 
     The cover  200  further includes a stopping wall  224  that extends partially around the vial viewing aperture  208 . The stopping wall  224  extends around the distal end of the vial viewing aperture  208 . As will be discussed in further detail herein, the stopping wall  224  prevents horizontal movement of the vial assembly  500 . 
     With reference to  FIGS.  15 A and  15 B- 20 A and  20 B , the base  300  is shown in accordance with an exemplary embodiment. In this embodiment, the base  300  includes a bottom wall  302  with a top surface  302   a  and an opposed bottom surface  302   b . The base  300  also includes a side wall  304  with an outer surface  304   a  and an opposed inner surface  304   b . The side wall  304  extends vertically from the bottom wall  302  and the bottom wall  302  extends longitudinally from the side wall  304 . The side wall  304  has a similar shape and dimension as the lid  202  such that the lid  202  and the side wall  304  are flush with one another when the cover  200  is coupled to the base  300 . 
     The bottom wall  302  defines openings  306  that extend through the bottom wall  302 . The base  300  also includes extensions  308  that extend vertically from and perpendicular to the top surface  302   a  of the bottom wall  302 . The extensions  308  define gaps  310 . The extensions  308  are located above the openings  306  such that a gap  310  is aligned with an opening  306 . The gaps  310  and therefore the extensions  308  are shaped to accept a hook  216  of a locking member  214  such that an extension  308  couples to a hook  216  via a snap fitting thereby coupling the base  300  to the cover  200  ( FIG.  22 A and  22 B ). The base  300  also includes a rod receptacle  312 . The rod receptacle  312  is shaped and dimensioned to accept the rod  212  such when the cover  200  is coupled to the base  300 . 
     The base  300  further includes a needle aperture  314  that is generally circular in shape. The needle aperture  314  extends through the bottom wall  302 . Stated another way, the needle aperture  314  extends between the top surface  302   a  and the bottom surface  302   b  of the bottom wall  302 . As will be discussed in further detail herein, when the cover  200  is coupled to the base  300  and when the cartridge  12  is adhered to the skin of a subject, the needle aperture  314  allows the needle  110  of the lancet  100  to extend through the bottom wall  302  to pierce the skin of the subject, skin, thereby allowing extraction of a physiological sample. 
     The base  300  also includes a lancet receiving element  316  that is shaped and dimensioned to accept the proximal end of the lancet  100 . With particular reference to  FIG.  23   , the lancet receiving element  316  includes an outer circular projection  318  and an inner circular projection  320  with each extending vertically from and perpendicular to the top surface  302   a  of the bottom wall  302 . The outer circular projection  318  includes an outer surface  318   a , an opposed inner surface  318   b , and a top surface  318   c  that extends between the outer surface  318   a  and the inner surface  318   b . The top surface  318   c  extends perpendicular to and longitudinally between the outer surface  318   a  and the inner surface  318   b . The outer surface  318   a  and the inner surface  318   b  extend vertically from and perpendicular to the top surface  302   a  of the bottom wall  302  such that the outer surface  318   a  and the inner surface  318   b  extend between the top surface  302   a  and the top surface  318   c . The outer circular projection  318  is shaped to accept the lancet  100 . 
     The inner circular projection  320  is disposed around the needle aperture  314  and includes an outer surface  320   a , an opposed inner surface  320   b , and a top surface  320   c  that extends between the outer surface  320   a  and the inner surface  320   b . The top surface  320   c  extends perpendicular to and longitudinally between the outer surface  320   a  and the inner surface  320   b . The outer surface  320   a  and the inner surface  320   b  extend vertically from and perpendicular to the top surface  302   a  of the bottom wall  302  such that the outer surface  320   a  and the inner surface  320   b  extend between the top surface  302   a  and the top surface  320   c.    
     Furthermore, the outer circular projection  318  and the inner circular projection  320  are concentric with one another. As will be discussed in further detail herein, when the lancet  100  is engaged with the base  300 , the top surface  320   c  of the inner circular projection  320  contacts the outer surface  138   a  of the bottom wall  138  of the inner sleeve  106  which allows the lancet  100  to release the needle  110  so as to puncture the skin, thereby allowing the extraction of a physiological sample from the subject&#39;s skin. 
     The base  300  further includes a plurality of locking members  322  that extend vertically from and perpendicular to the top surface  318   c  of the outer circular projection  318 . Each locking member  322  includes a hook  324  that extends inwardly from a top of a locking member  322  towards the inner circular projection  320 . As will be discussed in further detail herein, the hooks  324  of the locking members  322  couple to the lancet  100  to retain the lancet  100  within the base  300 . 
     With particular reference to  FIGS.  20 A and  20 B , the base  300  includes a physiological sample well  326  and a channel  328  that that is in open communication with and extends from the physiological sample well  326 . As will be discussed in further detail herein, when a physiological sample is drawn from a subject, the physiological sample pools within the physiological sample well  326 . The channel  328  is shaped and dimensioned to retain a bent hollow needle  330 . Furthermore, the channel  328  includes an opening opposite the physiological sample well  326  which allows the needle  330  into the channel  328 . As will be discussed in further detail herein the needle  330  is configured to carry a drawn physiological sample from the physiological sample well  326  to the vial assembly  500 . 
     The base  300  further includes a first vial holder  332  and a second vial holder  334 , where each of which extends vertically from and perpendicular to the top surface  302   a  of the bottom wall  302 . The first vial holder  332  and the second vial holder  334  are separated from one another by a gap  336 . An extension member  338  extends crosses the gap  336  and extends between the first vial holder  332  and the second vial holder  334 . The first vial holder  332 , the second vial holder  334 , and the extension member  338  are shaped and dimensioned to accept and retain the vial assembly  500 . 
     The second vial holder  334  includes an end wall  340  through which the channel  328  extends. The second vial holder  334  also includes a semi-circular wall  342  that has a similar shape and dimension as the vial assembly  500 . The end wall  340  extends vertically from and perpendicular to the top surface  302   a  of the bottom wall  302 . The semi-circular wall  342  extends longitudinally from and perpendicular to the end wall  340 . Furthermore, the connection member  338  extends between the first vial holder  332  and the semi-circular wall  342 . 
     The second vial holder  334  also includes latches  344  that extend longitudinally from the semi-circular wall  342 . The latches  344  are angled inwardly towards a middle of the base  300 . As will be discussed in further detail herein, the latches  344  allow the vial assembly  500  to move from one position wherein the needle  330  extends into the vial assembly  500  to another wherein the needle  330  is removed from the vial assembly  500 . Furthermore, as will be discussed in further detail herein, the latches  344  prevent a user from transitioning the vial assembly  500  back to its original position. 
     The extension member  338  further includes a protrusion  346  that extends vertically from the extension member  338 . As will be discussed in further detail herein, when the vial assembly  500  is in the first position, a portion of the vial contacts the protrusion  346  which prevents the vial assembly  500  from transitioning to a different position until the vial assembly  500  is rotated. As depicted in  FIGS.  21 A and  21 B , the first vial holder  332  extends vertically above the extension member  338  such that the first vial holder has a proximal end surface from which the protrusion  346  extends. 
     The base  300  also includes U-shaped locking feature  348  and a plunger support  350 . The U-shaped locking feature  348  extends vertically from and perpendicular to the top surface  302   a  of the bottom wall  302 . The U-shaped locking feature  348  is shaped and dimensioned to support and guide the plunger  400 . As will be discussed in further detail herein, the U-shaped locking feature  348  prevents rotation of the plunger  400  until a physiological sample is drawn into the vial assembly  500 . The plunger support  350  extends vertically from and perpendicular to the side wall  304 . When the cover  200  is coupled to the base  300  the plunger support  350  is aligned with the U-shaped opening  204 . The plunger support  350  is shaped and dimensioned to support the plunger  400  when the plunger  400  is disposed within the cartridge  12 . 
     The rounded surface of the first vial holder  332 , the rounded surface of the extension member  338 , and the surface of the semi-circular wall  342  angle downward at an angle of about 85° away from the plunger support  350  and towards the end wall  340  such that the vial assembly  500  has an angled orientation when disposed within the cartridge  12 . Furthermore, the plunger support  350  and the U-shaped locking feature  348  are oriented such that the plunger  400  has an angled orientation when disposed within the cartridge  12 . 
     With respect to  FIGS.  24 A and  24 B- 27   , the syringe  16  is shown in accordance with an exemplary embodiment. As previously discussed herein, the syringe  16  includes the plunger  400  and the vial assembly  500 . 
     As depicted in  FIGS.  27 A and  27 B- 32   , the plunger  400  includes a handle  402 , a shaft  404 , a rod  406 , and an elastomeric ring  408 . The handle  402  defines a proximal end of the plunger  400 , the shaft  404  extends between the handle  402  and the rod  406 , and the rod  406  extends from the shaft  404  and defines a proximal end of the plunger  400 . Furthermore, the elastomeric ring  408  surrounds the proximal end of the rod  406 . 
     The shaft  404  is generally cylindrical in shape and includes opposing rounded surfaces  410  and opposing flat surfaces  412  that are disposed between the opposing rounded surfaces  410 . As will be discussed in further detail herein, the profile of the shaft  404  prevents the plunger  400  from rotating until the plunger  400  is moved from a first position to a second position. 
     The rod  406  is generally cylindrical in shape and has a smaller diameter than the shaft  404 . As will be discussed in further detail herein, this smaller diameter allows the rod  406  to rotate when the syringe  16  is disposed within the cartridge  12 . The rod  406  includes a plurality of projection members  414  that are disposed within a groove  416  of the rod  406 . Each projection member  414  includes an angled top surface  418  and a first projection member and a second projection members each include a side surface  420  that extends vertically from a top surface  418 . The rod  406  further includes a stopping wall  422  that is also disposed within the groove  416 . The stopping wall  422  includes a top surface  424  and a side surface  426  that extends vertically from and perpendicular to the top surface  424 . 
     The rod  406  also includes a snap-off joint  428 . As will be discussed in further detail herein, the snap-off joint  428  serves as a break point of the plunger  400  ( FIG.  31   ) which allows the handle  402  and the shaft  404  to sperate from a remainder of the plunger  400 . The plunger  400  also includes a projection  430  that extends longitudinally from the proximal end of the rod  406 . The projection  430  is shaped and dimensioned to be inserted into the elastomeric ring  408 . 
     Referring now to  FIGS.  34  and  35   , the elastomeric ring  408  is shown in accordance with an exemplary embodiment. In this embodiment, the elastomeric ring  408  is generally cylindrical in shape and includes a first end surface  432 , an opposed second end surface  434 , and an outer wall  436 . The outer wall  436  extends longitudinally between the first end surface  432  and the second end surface  434 . 
     The elastomeric ring  408  also includes a bore  438  that extends from the second end surface  434  and into the elastomeric ring  408 . The outer wall  436  includes an outer surface  436   a  and an inner surface  436   b . The inner surface  436   b  defines a length of the bore  438  and further defines an inner volume  440  that is in open communication with the bore  438 . The bore  438  and the inner volume  440  is shaped and dimensioned to accept the projection  430 . That is, when the projection  430  is inserted into the elastomeric ring  408 , the projection  430  is disposed within the bore  438  and the inner volume  440 . The elastomeric ring  408  further includes a first and second band  442  that extend vertically from and perpendicular to the outer surface  436   a . The bands  442  extend circumferentially around the outer wall  436 . As will be discussed in further detail herein, when the plunger  400  is inserted into the vial assembly  500 , the bands  442  provide an airtight seal within the vial assembly  500 . 
     Referring now to  FIGS.  36 A and  36 B - FIGS.  44 A and  44 B , the vial assembly  500  is shown in accordance with an exemplary embodiment. In this embodiment, the vial assembly  500  includes a vial  502 , an elastomeric cap  504 , and a stopping member  506 . In some embodiments the vial  502  is formed of PDMS such that the vial  502  is transparent. Furthermore, in some embodiments, the elastomeric cap  504  is formed of a self-healing material. 
     With particular reference to  FIGS.  44 A and  44 B- 51 A and  52 B , the vial  502  includes a top wall  508  and a side wall  510  that extends vertically from and perpendicular to the top wall  508 . The top wall  508  and the side wall  510  are generally cylindrical in shape and are concentric with one another. 
     The top wall  508  includes a top surface  508   a , an opposed bottom surface  508   b , and a side surface  508   c  that extends between the top surface  508   a  and the bottom surface  508   b . The side surface  508   c  extends longitudinally from and perpendicular to the top surface  508   a  and the bottom surface  508   b . Opposing sides of the top wall  508  extend beyond the side wall  510  such that the top wall  508  includes flanges  512 . As will be discussed in further detail herein, the flanges  512  prevent the vial assembly  500  from moving from one position to another position until the vial assembly  500  is rotated. The top surface  508   a  of the top wall  508  defines an opening  514  that is shaped and dimensioned to accept a portion of the elastomeric cap  504 . 
     The vial  502  also includes a first cap retention member  516  and a second cap retention member  518 . The first cap retention member  516  and the second cap retention member  518  extend vertically from and perpendicular to the top surface  508   a  of the top wall  508 . The first cap retention member  516  and the second cap retention member  518  are shaped and dimensioned to retain the elastomeric cap  504  on top of and within the vial  502 . Furthermore, the first cap retention member  516  includes a notch  520  that extends through the top wall  508 . The notch  520  is shaped and dimensioned to accept a proximal portion of the stopping member  506 . 
     The side wall  510  includes an outer surface  510   a , an opposed inner surface  510   b , and the bottom surface  510   c . The outer surface  510   a  and the inner surface  510   b  extend vertically from and perpendicular to the bottom surface  508   b  of the top wall  508  and the bottom surface  510   c . The vial  502  further includes a notch  522  that extends vertically from the bottom surface  510   c  and extends between the outer surface  510   a  and the inner surface  510   b . The notch  522  is shaped and dimensioned to accept a distal portion of the stopping member  506 . The notch  520  and the notch  522  are aligned with one another such that the notches  520  and  522  retain the stopping member  506  when the stopping member  506  is coupled to the vial  502 . 
     The bottom surface  510   c  of the side wall  510  defines an opening  524  that is shaped and dimensioned to accept the elastomeric ring  408  and a portion of the plunger  400 . The inner surface  510   b  defines a bore  526  that extends between the opening  514  and the opening  524 . When the plunger  400  is disposed within the bore  526  the bands  442  contact the inner surface  510   b  of the side wall  510 . 
     The vial  502  further includes a plurality of ribs  528   a - 528   e  that extend from and along the outer surface  510   a  of the side wall  510 . In this embodiment, the ribs  528   a - 528   c  have the same length. The ribs  528   d  and  528   e  have a shorter length than the ribs  528   a - 258   c . As will be discussed in further detail herein, at least two of the ribs  528  prevent the vial assembly  500  from rotating beyond a given position. 
     With particular reference to  FIGS.  53  and  54   , the elastomeric cap  504  includes a top wall  530  and a side wall  532  that extends vertically from the top wall  530 . The top wall  530  includes a top surface  530   a , an opposed bottom surface  530   b , and a side surface  530   c  that extends between the top surface  530   a  and the bottom surface  530   b . The side wall  532  includes an outer surface  532   a , an opposed inner surface  532   b , and a bottom surface  532   c  that extends longitudinally from and perpendicular to the outer surface  532   a  and the inner surface  532   b . The outer surface  532   a  and the inner surface  532   b  extends vertically from the bottom surface  530   b  of the top wall  530  and the bottom surface  532   c.    
     The top wall  530  is shaped and dimensioned to fit between the first cap retention member  516  and the second cap retention member  518  such that the first cap retention member  516  and the second cap retention member  518  couple the elastomeric cap  504  to the vial  502 . When the elastomeric cap  504  is coupled to the vial  502 , the side wall  532  extends into the bore  526  such that the outer surface  532   a  of the side wall  532  contacts the inner surface  510   b  of the side wall  510  of the vial  502 . Furthermore, when both the elastomeric ring  408  of the plunger  400  and the elastomeric cap  504  are disposed within the bore  526 , the elastomeric ring  408  and the elastomeric cap  504  provide an airtight seal. As such, the region of the bore  526  between the elastomeric ring  408  and the elastomeric cap  504  includes an airtight environment. 
     Furthermore, the top surface  530   a  of the top wall  530  defines a top recess  534  and the inner surface  532   b  of the side wall  532  defines a bottom recess  536  such that the elastomeric cap  504  includes a region of elastomeric material between the recesses  534  and  536 . As will be discussed in further detail herein, when the syringe  16  is coupled to the needle  330 , the needle  330  extends through the region of the elastomeric cap  504  between the recesses  534  and  536  and into the bore  526  of the vial  502 . Since the elastomeric cap  504  can be formed of a self-healing material, in these embodiments, after the needle  330  pierces the elastomeric cap  504  and the needle has been removed from the elastomeric cap  504 , the elastomeric cap  504  heals to seal the vial  502 . The top wall  530  also includes a notch  538  that extends between the top surface  530   a  and the bottom surface  530   b . The notch  538  is shaped and dimensioned to accept a proximal end of the stopping member  506  such that the notch  538  retains a portion of the stopping member  506  when the stopping member  506  is coupled to the vial  502 . 
     With particular reference to  FIGS.  55 A and  55 B , the stopping member  506  includes a plunger interface  540 , a neck  542 , and a hook  544 . The plunger interface  540  defines a distal end and a proximal end of the stopping member  506  and the neck  542  extends between the plunger interface  540  and the hook  544 . 
     The plunger interface  540  includes a distal end surface  546 , a bottom surface  548 , and a proximal end surface  550 . The bottom surface  548  extends between the distal end surface  546  and the proximal end surface  550 . The distal end surface  546  is positioned opposite to the proximal end surface  550 . The bottom surface  548  has a similar shape and dimension as the top surface  418  of a projection member  414 . When the vial assembly  500  is coupled to the plunger  400 , the plunger interface  540  is disposed within the groove  416  such that at least a portion of the bottom surface  548  of the plunger interface  540  contacts a top surface  418  of a projection member  414 . The plunger interface  540  and the neck  542  define a notch  552 . When the stopping member  506  is coupled to the vial  502  the plunger interface  540  is disposed within the notch  522  of the  502 . Furthermore, when the stopping member  506  is coupled to the vial  502 , the notch  522  contacts a portion of the side wall  510  that defines an end of the notch  522 . As such, in this position, the notch  522  retains the stopping member  506 . 
     The neck  542  has a length that is similar to a distance between the notch  522  and the top surface  508   a  of the vial  502 . As such, when the stopping member  506  is coupled to the vial  502 , a portion of the neck  542  extends through the notch  520  of the first cap retention member  516  and the hook  544  extends over and contacts the top surface  508   a  to couple the stopping member  506  to the vial  502 . 
     As depicted in  FIGS.  56 - 57   , the lancet  100  is moveable between an undeployed position ( FIG.  56   ), a deployed position ( FIG.  57   ), and a retracted position ( FIG.  58   ). 
     In the undeployed position (before the lancet  100  is inserted into the cartridge  12 ;  FIG.  56   ) the injection spring  112  and the retraction spring  114  are in a compressed state. In the compressed state, the retraction spring  114  extends vertically between the bottom wall  138  ( FIG.  56   ) and a proximal end of the locking members  146 . More specifically, a distal end of the retraction spring  114  contacts a lower surface of the proximal end of the locking members  146  and a proximal end of the retraction spring  114  contacts the inner surface  138   b  ( FIG.  56   ) of the bottom wall  138 . 
     When in the undeployed position the outer surface  144   c  contacts the inner surface  126   a  of the columns  126  which compresses the side wall  136  inwardly. Furthermore, the bottom surface  154   a  of the second cylinder  154  contacts and rests upon the top surfaces  144   a  of the ledges  144  ( FIG.  56   ) such that the ledges  144  support the needle frame  108  in the undeployed position. In this position, the injection spring  112  is prevented from decompressing (due to the second cylinder  154  ( FIG.  56   ) resting upon the ledges  144 ) and the needle  110  is disposed completely within the inner volume  140  ( FIG.  56   ) of the inner sleeve  106 . 
     When the lancet  100  is inserted into the cartridge  12 , the engagement of the lancet with the cartridge  12  causes the lancet  100  to automatically move from the undeployed position to the deployed position. Furthermore, when the lancet  100  is inserted into the cartridge  12 , the hooks  324  of the locking members  322  are disposed within and coupled to the notch  122  via a snap fit ( FIG.  59   ). 
     When the lancet  100  is coupled to the base  300  ( FIGS.  59  and  60   ), the inner circular projection  320  ( FIGS.  59  and  60   ) extends through the aperture  128  to contact the bottom wall  138 . Specifically, the top surface  320   c  of the inner circular projection  329  ( FIGS.  59  and  60   ) contacts the outer surface  138   a  of the bottom wall  138  ( FIGS.  59  and  60   ) which forces the inner sleeve  106  to move vertically upward in the direction of arrow A ( FIG.  57   ) within the housing  102 . This vertical movement causes the ledges  144  to extend vertically above the top surfaces  126   b  of the columns  126 . Moving beyond the top surfaces  126   b  of the columns  126  allows the side wall  136  to decompress and expand in the direction of arrow B ( FIGS.  58  and  60   ) and extend toward the inner surface  116   b  of the side wall  116 . In this position, the bottom surface  144   b  of the ledges  144  rest upon the top surfaces  126   b  of the columns  126  and the outer surfaces  144   c  of the ledges  144  contact the inner surface  116   b  of the side wall  116 . 
     The expansion of the side wall  136  causes the inner volume  140  of the inner sleeve  106  to have a larger width relative to when the inner sleeve  106  is in the undeployed position such that at least a portion of the side wall  136  has a larger width than the second cylinder  154  (the widest portion of the needle frame  108  which allows the needle frame  108  to move vertically downward in the direction of arrow C). 
     Furthermore, the injection spring  112  also causes the needle frame  108  to move in the direction of arrow C as the ledges  144  no longer prevent the injection spring  112  from expanding. The force applied by the injection spring  112  causes the needle frame  108  (and therefore the needle  110 ) to travel with a force that is sufficient to cause the needle  110  to puncture the skin of a subject wearing the dermal patch system  10 . Stated another way, the injection spring  112  causes the needle  110  to extend through the aperture  150  of the inner sleeve  106 , through the aperture  128  of the housing  102 , and through the needle aperture  314  of the base  300  to puncture the skin of a subject. In the deployed position, the bottom surface  154   a  of the second cylinder  154  rests upon the columns  142  and at least a portion of the outer surface  154   b  of the second cylinder  154  contacts the inner surface  136   b  of the side wall  136 . 
     While moving in the direction of arrow C, the outer surface  152   b  contacts the locking members  146  which causes a proximal portion of locking members  146  that is aligned with an opening  148  to extend into the opening. In this position, the locking members  146  no longer contact the retraction spring  114  thereby allowing the retraction spring  114  to decompress and expand. When decompressed, the retraction spring  114  contacts the outer surface  152   b  of the first cylinder  152  which causes needle frame  108  to also move in the direction of arrow D. That is after moving to the deployed position, the retraction spring  114  causes the needle  110  to retract back into the inner volume  140  of the inner sleeve  106  via the needle aperture  314  of the base  300  and the apertures  128  and  150  of the lancet  100 . After penetrating the skin of a subject, the refraction spring  114  causes the needle  110  to automatically retract back into the housing of the lancet  100  thereby placing the lancet  100  in the retraced position ( FIGS.  58  and  60   ). 
     Subsequent to puncturing the skin, the needle  110  retracts into the lancet  100  and a physiological sample pools within the physiological sample well  326  of the base  300 . When the physiological sample is within the physiological sample well  326 , a user pulls the plunger  400  in the direction of arrow E to move the plunger from a first position ( FIG.  61   ) to a second position ( FIG.  62   ). Stated another way, when the physiological sample is within the physiological sample well  326 , a user moves the plunger  400  from an undeployed position to a deployed position. Moving the plunger from the undeployed position to the deployed position creates a vacuum within the vial  502 . This vacuum causes the physiological sample to travel to the vial  502  via the needle  330 . Furthermore, as depicted in  FIGS.  61  and  62   , when the vial assembly is in a first position (also referred to as a “sample collection position”) a flange  512  of the vial  502  contacts a proximal surface of the protrusion  346  of the base  300  and another flange  512  of the vial  502  contacts a proximal surface of the locking wall  218  of the cover  200 . This contact prevents the vial assembly  500  from moving with the plunger  400  when a user pulls the plunger  400 . Before or after pulling the plunger  400  to draw the physiological sample into the vial  502 , the user may verify that the physiological sample has been drawn by viewing the physiological sample in the vial  502  via the vial viewing aperture  208 . 
     Since the vial assembly  500  remains stationary as the plunger  400  is pulled, the plunger interface  540  of the stopping member  506  contacts various projection members  414  until the plunger interface  540  contacts the top surface  424  and the side surface  426  of the stopping wall  422 . In this position, the plunger  400  cannot be pulled further as the flanges  512 , the locking wall  218  of the cover  200 , and the protrusion  346  of the base  300  prevent further movement of the plunger  400 . The amount the plunger moves can determine the strength of the generated vacuum and an amount of physiological sample drawn into the vial  502 . An amount of physiological sample drawn into the vial  502  may be controlled by a distance between an initial and a final position of the plunger  400  as allowing the plunger  400  to travel further allows more physiological sample to be drawn into the vial  502 . Accordingly, the dermal patch system  10  can be configured to draw various amounts of physiological sample into the vial  502  (e.g., 50 μL, 100 μL, 200 μL, etc.). By way of example, in various embodiments, the volume of the physiological sample that is received by the vial can be, for example, in a range of about 10 μL to about 200 μL, e.g., in a range of about 50 μL to about 100 μL. 
     Also, the inner diameter of the needle  330  can be varied between approximately 0.159 mm to 0.603 mm to control an amount of physiological sample drawn into the vial  502 . Furthermore, the shape of the projection members  414  of the plunger  400  and the shape of the plunger interface  540  of the stopping member  506  can prevent a user from pushing the plunger  400  into the vial  502  which may cause an inadvertent ejection of physiological sample. 
     As noted above, in various embodiments, an amount of the physiological sample drawn into the vial  502  is proportional to a distance travel by plunger  400  when using the plunger to generate a vacuum. That is, the greater the distance traveled by the plunger  400  the greater an amount of physiological sample drawn into the vial  502 . The distance traveled by the plunger  400  can be determined by a position of the stopping member  506  and a position of the plunger interface  540 . While the stopping member  506  and the plunger interface  540  are depicted in one position, in other embodiments, the stopping member  506  and the plunger interface  540  may have a different position which allows the plunger  400  to draw more or less physiological sample into the vial  502  than the embodiment depicted herein. 
     The vial assembly  500  can be placed in a vial storage position, which allows a user to store the vial assembly  500  within the cartridge  12 . As will be discussed in further detail herein, the user can rotate the vial assembly  500  by rotating the plunger  400 . However, it is undesirable to place the vial assembly  500  in the vial storage position before drawing the physiological sample into the vial  502 . In this embodiment, the shape and dimension of the shaft  404  and the U-shaped locking feature  348  can prevent the user from rotating the plunger  400  until after the user has moved the plunger to the deployed position. That is, in the undeployed position, the flat surfaces  412  of the shaft  404  are vertically disposed within the U-shaped locking feature  348  which prevents a user from rotating the plunger  400 . If a user attempts to rotate the plunger  400  while the plunger  400  is in the undeployed position, the flat surfaces contact the U-shaped locking feature  348  thereby preventing rotation. When the plunger  400  is moved to the deployed position, the rod  406  is disposed within the U-shaped locking feature  348 . The rod  406  has a smaller diameter than the U-shaped locking feature  348  which allows a user to rotate the plunger  400  when the plunger  400  is in the deployed position. Stated another way, features of the base  300  and the plunger  400  prevent a user placing the vial assembly  500  in a vial storage position until after a physiological sample has been drawn into the vial  502 . 
     After the user moves the plunger  400  to the deployed position, the user can rotate the vial assembly  500  by rotating plunger  400 . Before rotation (i.e., when the vial assembly  500  is in the collection position), a side of the rib  528   e  contacts the rotational stop  222  which prevents a user from rotating the plunger  400  (and therefore the vial assembly  500 ) in a clockwise direction (when viewing the distal end of the plunger  400 ). After the user draws the physiological sample into the vial  502 , the user can rotate the plunger  400  in a counterclockwise direction to place the vial assembly  500  in a second position (also referred to as a “vial removal position”) ( FIG.  63   ). During rotation the length of the rib  528   d  allows the rib  528   d  to rotate beyond the rotational stop  222 . The vial assembly  500  is allowed to continue to rotate until the rotational stop  222  contacts the rib  526   c  which prevents the user from further rotating the vial assembly  500  thereby placing the vial assembly  500  in the vial removal position. 
     In the vial removal position, the flanges  512  rotate such that they do not contact the locking wall  218  or the protrusion  346 . As such, the vial assembly  500  is free to move horizontally within the cartridge  12 . The shape of the plunger interface  540  of the stopping member  506  and the shape of the projection members  414  of the plunger  400  allow a user to pull the vial assembly  500  when the vial assembly  500  is in the vial removal position. That is, the distal end surface  546  of the plunger interface  540  contacts the side surface  420  of a projection member  414  which causes the vial  502  to move with the plunger  400  when a user pulls the plunger  400 . 
     When the vial assembly  500  is in the vial removal position, a user can continue pulling the plunger  400  in the direction of arrow F ( FIG.  63   ) to place the vial assembly  500  in a third position (also referred to as a “vial storage position”) ( FIG.  64   ). 
     In the vial storage position, the vial assembly  500  contacts the stopping wall  224  and a proximal end surface of the first vial holder  332  from which the protrusion  346  extends which prevents further movement of the vial assembly  500  ( FIG.  65   ). Furthermore, in this position, the vial assembly  500  no longer contacts the needle  330 , thereby allowing the elastomeric cap  504  to heal and seal the vial  502 . Also in this position, the latches  344  prevent a user from pushing the vial assembly  500  towards the needle  330  ( FIG.  66   ). That is, when pushed from the vial storage position, the top surface  508   a  of the top wall  508  contacts the latches  344  which prevents the user from pushing the vial assembly  500  back onto the needle  330 . 
     A user may remove the dermal patch system  10  from the skin of the subject immediately after drawing the physiological sample into the vial  502 , or the user may remove the dermal patch system  10  after placing the vial assembly  500  in the vial storage position. After the vial assembly  500  has been placed in the vial storage position, the user may send the vial assembly system  10  to a laboratory for sample analysis. 
     In some embodiments, the vial  502  can be prefilled with a solution used for preserving the physiological sample (e.g., an anticoagulant), or another solution used for processing a physiological sample for further analysis by a medical device (e.g., a lysis buffer). 
     Referring now to  FIG.  67   , a lid removal tool  600  is shown in accordance with an exemplary embodiment. 
     The lid removal tool  600  includes a base  602  and extensions  604 . The base  602  includes a top wall  602   a , an opposed bottom wall  602   b , and a side wall  602   c  that extends between the top wall  602   a  and the bottom wall  602   b . The side wall  602   c  extends vertically between and perpendicular to the top wall  602   a  and the bottom wall  602   b . The extensions  604  extend vertically from and perpendicular to the top wall  602   a . The extensions  604  are shaped and dimensioned to fit into the openings  306  of the base  300 . 
     The lid removal tool  600  is configured to decouple the cover  200  from the base  300  which allows a medical professional to access the vial assembly  500  disposed therein. To decouple the cover  200  from the base  300 , a medical professional inserts the extensions  604  of the lid removal tool  600  into the openings  306  of the base  300  ( FIG.  68   ). When inserted, the extensions  604  contact the hooks  216  of the locking members  214  and push the locking members  214  towards the center of the cover  200  and away from the extensions  308  of the base  300 . This movement separates the locking members  214  from the extensions  308  which allows the medical professional to lift cover  200  from the base  300 . Once the cover  200  has been removed from the base  300 , the medical professional can remove the plunger  400  and the vial assembly  500  from the base  300 . 
     As previously discussed herein, the plunger  400  includes a snap-off joint  428  that serves as a break point for the plunger  400  ( FIG.  31   ). After removing the vial assembly  500  from the base  300 , the medical professional can break the plunger  400  at the snap-off joint  428  to separate the handle  402  and the shaft  404  from a remainder of the plunger  400  ( FIG.  69   ). Furthermore, the vial  502  can have a similar shape and dimension as a vial that can be placed into a centrifuge machine (e.g., a 1.5 mL Eppendorf tube) or another medical device. Accordingly, after breaking the plunger  400 , a medical professional can place the sealed vial assembly into a medical device to analyze the stored physiological sample. The analysis can include, but is not limited to, DNA sequencing. 
     With reference to  FIGS.  70  and  71   , the dermal patch system  10  can be modified to include a different system for blood collection. In some embodiments, the dermal patch system  10  can include a pipette  700 . In these embodiments, the syringe  16  is omitted and the base  300  is modified to accommodate the pipette  700 . Furthermore, in the embodiment depicted in  FIGS.  70  and  71   , the physiological sample is drawn into the pipette via capillary action. 
     The pipette  700  includes a tube  702  with an opening for accepting the drawn physiological sample and a barrel  704  in open communication with the tube  702 . The pipette  700  further includes a piston  706  that aids in drawing the physiological sample into the barrel  704  partially disposed within the barrel  704 . The pipette  700  further includes a filter  708  disposed within the tube  702 . The filter  708  prevents the drawn physiological sample from traveling further into the barrel  704 . 
     In this embodiment, the base  300  is modified to accommodate the pipette  700 . In particular, the base  300  includes a first pipette support  350 , a second pipette support  352 , and a third pipette support  354 . Each of the pipette supports  350 - 354  extends vertically from and perpendicular to the top surface  302   a  and each of the pipette supports  350 - 354  has a different height such that when the pipette  700  rests upon the pipette supports  350 - 354  the pipette  700  is angled downward towards the needle  330 . Furthermore, in this embodiment, the needle  330  is omitted and the base  300  is further modified to include a channel (not shown) that allows at least a portion of the tube  702  to extend into the physiological sample well  326 , which allows the  702  to carry the drawn physiological into the barrel  704  via capillary action. 
     With reference to  FIG.  72   , in some embodiments wherein the dermal patch system  10  includes the QR code  18 , a user of a computer system  26  may scan the QR code  18  to determine a test to be perform on the stored physiological sample and/or to view and/or update an EMR  28  that is associated with the QR code  18 . In these embodiments, the EMR  28  is stored in an EMR database  30  that is in communication with the computer system  26 . Furthermore, the QR code  18  may be employed to preserve the chain of custody of the drawn physiological sample. 
     In these embodiments, the computer system  26  may include an application that provides access to the EMR database  28  via a network connection and allows a user to photograph or scan the QR code  18 . As shown in  FIG.  72   , the EMR database  30  includes a plurality of EMRs  28  each of which is associated with an individual subject. The application causes the computer system  26  to scan or retrieve an image of the QR code  18 , analyze the QR code  18  and associate the QR code  18  with an EMR  28 . In some embodiments, the computer system  26  may then update the associated EMR  28  to indicate a physiological sample has been obtained. The computer system  26  may update the EMR  28  automatically or based on a user input. In some embodiments, after associating an EMR  28  with the QR code  18 , the computer system  26  may analyze information within the EMR  28  to determine a test to be performed on the physiological sample stored in the vial  502  (e.g., DNA sequencing). After determining the test to be performed, the computer system  28  may instruct the medical professional to perform the test via the application. 
     Referring now to  FIG.  73   , a computer system  800  is shown in accordance with an exemplary embodiment. The computer system  800  may serve as any computer system disclosed herein (e.g., the computer system  20 ). As used herein a computer system (or device) is any system/device capable of receiving, processing, and/or sending data. Computer systems include, but are not limited to, microprocessor-based systems, personal computers, servers, hand-held computing devices, tablets, smartphones, multiprocessor-based systems, mainframe computer systems, virtual reality (“VR”) headsets and the like. 
     As shown in  FIG.  73   , the computer system  800  includes one or more processors or processing units  802 , a system memory  804 , and a bus  806  that couples the various components of the computer system  800  including the system memory  804  to the processor  802 . The system memory  804  includes a computer readable storage medium  808  and volatile memory  810  (e.g., Random Access Memory, cache, etc.). As used herein, a computer readable storage medium includes any media that is capable of storing computer readable; program instructions and is accessible by a processor. The computer readable storage medium  808  includes non-volatile and non-transitory storage media (e.g., flash memory, read only memory (ROM), hard disk drives, etc.). Computer program instructions as described herein include program modules (e.g., routines, programs, objects, components, logic, data structures, etc.) that are executable by a processor. Furthermore, computer readable program instructions, when executed by a processor, can direct a computer system to function in a particular manner such that a computer readable storage medium comprises an article of manufacture. Specifically, the computer readable program instructions when executed by a processor can create a means for carrying out at least a portion of the steps of the methods disclosed herein. 
     The bus  806  may be one or more of any type of bus structure capable of transmitting data between components of the computer system  800  (e.g., a memory bus, a memory controller, a peripheral bus, an accelerated graphics port, etc.). 
     The computer system  800  may further include a communication adapter  812  which allows the computer system  800  to communicate with one or more other computer systems/devices via one or more communication protocols (e.g., Wi-Fi, BTLE, etc.) and in some embodiments may allow the computer system  800  to communicate with one or more other computer systems/devices over one or more networks (e.g., a local area network (LAN), a wide area network (WAN), a public network (the Internet), etc.). 
     In some embodiments, the computer system  800  may be connected to one or more external devices  814  and a display  816 . As used herein, an external device includes any device that allows a user to interact with a computer system (e.g., mouse, keyboard, touch screen, etc.). An external device  814  and the display  816  may be in communication with the processor  802  and the system memory  804  via an Input/Output (I/O) interface  818 . 
     The display  816  may display a graphical user interface (GUI) that may include a plurality of selectable icons and/or editable fields. A user may use an external device  814  (e.g., a mouse) to select one or more icons and/or edit one or more editable fields. Selecting an icon and/or editing a field may cause the processor  802  to execute computer readable program instructions stored in the computer readable storage medium  808 . In one example, a user may use an external device  814  to interact with the computer system  800  and cause the processor  802  to execute computer readable program instructions relating to at least a portion of the steps of the methods disclosed herein. 
     Referring now to  FIG.  74   , a cloud computing environment  900  is depicted in accordance with an exemplary embodiment. The cloud computing environment  900  is connected to one or more user computer systems  902  and provides access to shared computer resources (e.g., storage, memory, applications, virtual machines, etc.) to the user computer systems  902 . As depicted in  FIG.  74   , the cloud computing environment includes one or more interconnected nodes  904 . Each node  904  may be a computer system or device local processing and storage capabilities. The nodes  904  may be grouped and in communication with one another via one or more networks. This allows the cloud computing environment  900  to offer software services to the one or more computer services to the one or more user computer systems  902  and as such, a user computer system  902  does not need to maintain resources locally. 
     In one embodiment, a node  904  includes computer readable program instructions for carrying out various steps of various methods disclosed herein. In these embodiments, a user of a user computer system  902  that is connected to the cloud computing environment may cause a node  904  to execute the computer readable program instructions to carry out various steps of various methods disclosed herein. 
     Referring now to  FIG.  75   , a method  1000  for obtaining a physiological sample is shown in accordance with an exemplary embodiment. 
     At  1002 , a user e.g., a medical professional, a subject, etc.) applies the cartridge  12  to the skin of the subject via the adhesive layer  14  at a suitable location (e.g., on a leg, arm, etc.) as previously discussed herein. 
     At  1004 , the user inserts the lancet  100  into the cartridge  12  thereby causing the needle  110  of the lancet  100  to draw a physiological sample (e.g., a blood sample, a sample of interstitial fluid, etc.) from the subject as previously discussed herein. 
     At  1006 , the user pulls the plunger  400  to draw the physiological sample into the vial  502  as previously discussed herein. 
     At  1008 , the user rotates the plunger  400  to place the vial assembly  500  in the vial removal position as previously discussed herein. 
     At  1010 , the user pulls the plunger  400  to place the vial assembly in the vial storage position as previously discussed herein. 
     At  1012 , the user removes the dermal patch system  10  from the skin of the subject as previously discussed herein. 
     At  1014 , the user sends the dermal patch system  10  to a medical professional as previously discussed herein. 
     At  1016 , a medical professional uses the lid removal tool  600  to remove the vial assembly  500  from the cartridge  12  and scans the QR code  18  to update an EMR as previously discussed herein. 
     At  1018 , the medical professional breaks the plunger and performs a test on the physiological sample as previously discussed herein. 
     As previously discussed, some of the steps of the various methods disclosed herein may be implemented by way of computer readable instructions, encoded or embedded on computer readable storage medium (which excludes transitory medium), which, when executed by a processor(s), cause the processor(s) to carry out various steps of the methods of the present disclosure. 
     While various embodiments have been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive; embodiments of the present disclosure are not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing embodiments of the present disclosure, from a study of the drawings, the disclosure, and the appended claims. 
     In the claims, the word “comprising” does not exclude other elements or steps, and the indefinite article “a” or “an” does not exclude a plurality. A single processor or other processing unit may fulfill the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measured cannot be used to advantage. Any reference signs in the claims should not be construed as limiting the scope.