Patent Publication Number: US-7905352-B2

Title: Kits containing medicine injection devices and containers

Description:
This application is a continuation-in-part of U.S. patent application Ser. No. 11/006,382, filed on Dec. 6, 2004, now U.S. Pat. No. 7,297,136, the contents of which are incorporated herein by reference in its entirety. Priority under 35 U.S.C. 120 is claimed. 
    
    
     TECHNICAL FIELD 
     This invention relates to injection apparatus and injection of medications into body tissues. 
     BACKGROUND OF THE INVENTION 
     Self-administering a hypodermic medicine injection is a difficult task for many individuals to accomplish. Some individuals experience an aversion to driving a needle into the flesh. The result is that many individuals who have health conditions which require periodic injections or who face an emergency need for self injection, or a need to administer an injection on another human or animal will hesitate or in some instances grow faint at the prospect. At least part of the revulsion may stem from watching the needle penetrate the flesh. Another aspect comes from the act of forcing the needle into the flesh. To many, the aversion is so substantial that they simply refuse to either self inject or to administer an injection to another human or animal. 
     Thus there is a need for a device that will automatically inject medications without requiring the administering individual to watch the needle penetrate, and without requiring that the individual actually supply the force needed to drive the needle into the flesh and dispense medicine into the recipient. 
     Various automatic injection apparatus have been previously developed. Such apparatus may be used to self administer, or to administer injections to others, in such a manner that the apparatus only requires triggering. Mechanisms provided within the apparatus automatically drive the needle and dispense the medication. Many prior forms of automatic injectors are single use, although some allow for reloading of hypodermic cartridges in which an ampule is provided with a single, fixed needle that openly communicates with the medication in the ampule. 
     There is also a need for an automatic form of injector that will accommodate double needle injection cartridges in which two oppositely facing needles are slidably mounted by a hub on a medication ampule. A rearward facing one of the needles is situated adjacent a penetrable seal on the ampule so that forced motion of the syringe assembly will result in the rearward needle piercing the ampule seal and allowing the medication to flow to and out the forward needle. Such action, to be most beneficial, should be accomplished by the automatic injector. 
     Another need is for an automatic injector that can be adjusted for different penetration depths, from superficial to subcutaneous to intramuscular and deeper penetration depths. This varies according to the condition of the patient and/or the medication being administered. This is not just a need related to automatic injectors, but also for individuals who are unaware of penetration depth requirements. 
     Need also exists for automatic injectors that can be reloaded with conventional ampules to allow for administration of multiple doses. Such injectors allow for removal and replacement of the ampules and re-use of the injector mechanism. Another mode of use is as a single ampule for one injection to give a first dose, and then to reset the injector for a second injection from the same ampule for a second or other multiple doses. 
     Another pertinent need is the ability to remove the syringe subassembly from the injection device. This may be needed when the injection device malfunctions or when immediate administration of a second or subsequent dose is required. 
     There is yet another need for a container for holding an automatic injector. In particular, there is a need for a container that is relatively easy to open, but which provides adequate protection for the automatic injector in general, and for the needle and hub assembly in particular. The type of protection that is needed includes shock absorption and water protection from moisture. 
     The various embodiments of the present invention as described below addresses some or all of the above needs. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Preferred embodiments of the invention are described below with reference to the following accompanying drawings. 
         FIG. 1  is a side sectional view of a conventional prior art hypodermic syringe subassembly of the single needle variety. 
         FIG. 2  is a side sectional view of a conventional prior art double needle syringe subassembly. 
         FIG. 3  is a side sectional view of a first embodiment device according to the invention in a cocked condition. 
         FIG. 4  is a side sectional view similar to  FIG. 3  showing the needle in an extended condition. 
         FIG. 5  is a side sectional view similar to  FIG. 3  in which a double needle syringe subassembly is in a cocked condition. 
         FIG. 6  is a side sectional view similar to  FIG. 5  showing the double needle syringe assembly in an extended condition. 
         FIG. 7  is an enlarged sectional detail view of a dosage adjustment and stop arrangement by which multiple dosages may be administered from the same syringe subassembly. 
         FIG. 8  is a view similar to the detail view of  FIG. 7  showing a stop collar removed and the remaining components of  FIG. 7  in position for a second dose. 
         FIG. 9  is an enlarged sectional detail view of a sleeve penetration control embodiment used in conjunction with a single needle subassembly, with the needle in a retracted position. 
         FIG. 10  is a view similar to  FIG. 9  showing the syringe subassembly engaging the sleeve penetration control and the needle extended to a desired penetration depth. 
         FIG. 11  is an enlarged sectional detail view of a compression spring penetration control used in conjunction with a double needle subassembly, with the needle in a retracted position. 
         FIG. 12  is a view similar to  FIG. 11  only showing the ampule seal pierced, the compression spring penetration control compressed, and the forward needle in an extended position. 
         FIG. 13  is a sectional view showing an end cap and penetration control in which any of various length control sleeves can be selected and installed for variably controlling needle penetration to various selected penetration depths. 
         FIG. 14  is a sectional view showing the end cap and one compression spring penetration control installed. Various lengths and other parameters of control springs may be used for controlling needle penetration to various selected depths. 
         FIGS. 15A-15F  are side views showing different compression spring penetration controls of various lengths and helical advance rates that affect needle penetration depth. 
         FIG. 16  is a top view of a preferred stop collar. 
         FIG. 17  is a side elevational view of the stop collar of  FIG. 16 . 
         FIG. 18  is an end view of a preferred sheath remover. 
         FIG. 19  is a side view of the sheath remover of  FIG. 18 . 
         FIG. 20  is a side view of a driver shaft construction having four legs. 
         FIG. 21  is an end view of the driver shaft of  FIG. 20 . 
         FIG. 22  is an end view of a preferred penetration controller sleeve. 
         FIG. 23  is a side sectional view of the penetration controller sleeve of  FIG. 22  taken along section line  23 - 23  of  FIG. 22 . 
         FIG. 24  is an enlarged partial side sectional view of a muzzle end of a preferred injector construction having a resilient pad and load distribution and guide ring positioned between the syringe shoulder. The injector is in a cocked condition with the syringe retracted. 
         FIG. 25  is a view similar to  FIG. 24  with the injector shown with the syringe assembly in an extended position. 
         FIG. 26  is an enlarged partial side sectional view of another preferred form of the invention in a cocked condition with needle retracted. 
         FIG. 27  is a partial view similar to  FIG. 26  with the injector shown with the syringe assembly in an extended position. 
         FIG. 28  is a sectional view showing a preferred auto-injector storage case according to the inventions. 
         FIG. 29  is a side view of a bottom part of the case shown in  FIG. 28 . 
         FIG. 30  is an enlarged detail sectional view as shown in circle  30  of  FIG. 29 . 
         FIG. 31  is a side view of an upper part of the case shown in  FIG. 28 . 
         FIG. 32  is a top end view of the upper case part shown in  FIG. 31 . 
         FIG. 33  is a bottom end view of the upper case part shown in  FIG. 31 . 
         FIG. 34  is a detail view showing a mounting extension forming part of the upper case part of  FIG. 31 . 
         FIG. 35  is a side detail view of the mounting extension used to mount a clip to the upper case part of  FIG. 31 , taken at circle  35  of  FIG. 31 . 
         FIG. 36  is an enlarged sectional view taken at circle  36  of  FIG. 31 . 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     Introductory Note 
     The readers of this document should understand that the embodiments described herein may rely on terminology used in any section of this document and other terms readily apparent from the drawings and language common for such components or operations. This document is premised upon using one or more terms with one embodiment that will in general apply to other embodiments for similar structures, functions, features and aspects of the invention. Wording used in the claims as filed is also descriptive of the invention. Terminology used with one, some or all embodiments may be used for describing and defining the technology and exclusive rights associated herewith. 
     Syringe Subassemblies 
       FIGS. 1 and 2  illustrate syringe subassemblies  10  and  11  that are capable of use with the present invention. The illustrated syringe assemblies or subassemblies  10  and  11  are both of known structure and are commercially available. Exemplary commercial subassemblies have been manufactured, sold, or distributed under the trademark CARPUJECT™ by Hospira, Inc. Other subassemblies may also be suitable but may require some modification depending on the specifics of construction. 
     Both subassembly configurations include an ampule  12  that may be a small glass or plastic vial for containing a measured volume of fluid medication, medicament or other injectable substance. The quantity of the substance may be predetermined, based upon the nature of the substance and the anticipated usage. The ampule  12  may be pre-loaded with the substance and provided by the substance producer or distributor. 
     In both versions, the ampule or vial  12  includes a rearward end  13  that is open to slideably receive a plunger  14 . The plunger  14  and plunger piston (not visible in this view) can be moved axially within the ampule bore  15  by application of axial force against the plunger shaft or rod  114 . The plunger  14  will thus force the substance out through a hollow needle assembly  16  at a forward end of the ampule  12  when the plunger assembly is depressed toward the forward or needle end. 
     Subassemblies  10  and  11  differ in the construction of their needle assemblies  16 . Subassembly  10  ( FIG. 1 ) is of the fixed needle variety in which a fixed hollow needle  17  is mounted by a fixed hub  21  to the associated ampule  12 . The needle  17  openly communicates with the substance within the ampule  12  and will eject the substance in response to forced contractionary motion of the plunger  14 . A sheath  19  may be included to releasably cover the fixed needle  17  for sanitary and safety reasons, and must be removed or be pierced by the needle  17  before administration of the injection. 
     Needle assembly  16  for syringe subassembly  11  ( FIG. 2 ) differs from the fixed needle assembly structure  10  described above. Syringe subassembly  11  makes use of a double needle assembly  20  in which a double needle hub  90  or  21  mounts a seal penetration needle  22  that projects rearward toward a penetrable seal  23  on the associated ampule  12 . Flesh penetration needle  24  projects forwardly. In practice, both needles  22  and  24  can be made integral. In such an integral construction both needles may be formed of the same needle tube, sharpened at both ends and immovably fixed to needle assembly hub  90 . 
     Hub  90  mounts both needles  22  and  24  and has a cup-shaped receptacle for receiving the sealed end of the ampule  12 . It also preferably has features or provisions to mount the needles in axial sliding relation to a seal retainer  25  of the associated ampule  12 . Forced sliding movement of the ampule  12  relative to hub  90  will thus cause the seal penetrating needle  22  to engage and then pierce the penetrable seal  23 . Once seal  23  is pierced, the substance within the ampule  12  may be forced through the needle or needles  23  and  24  as the injection is administered. 
     The double needle subassembly  11  may also make use of a protective needle sheath  19 . The sheath can vary or be substantially similar, or even identical to that used for the single needle subassembly  10 . For either form of subassembly, the sheath may be provided as a rigid cover, or as a flexible member that may be penetrated by the adjacent needle upon application of sufficient axial force. This is disclosed in my earlier issued U.S. Pat. Nos. 5,540,664 and 5,695,472; such disclosures being hereby incorporated by reference into this application. Also incorporated by reference are my earlier U.S. Pat. Nos. 5,358,489 and 5,665,071, each of which is also expressly incorporated herein by reference. 
     Injection Device 
     —General Configuration 
     A reloadable hypodermic injection device according to the invention is shown in the drawings and is identified therein by reference numeral  30 . Injection device  30  ( FIGS. 3-6 ) includes a barrel  31  having a muzzle end  32 , with a needle receiving aperture or passageway  34 . A syringe subassembly receiving cavity  35  is situated along and within the barrel  31 , and is preferably adjacent to and accessible from the muzzle end  32 . The cavity  35  is adapted to releasably and slidably receive a syringe subassembly  10  or  11  for movement toward and away from the muzzle end  32 . The needle assembly  16  is aligned to project through the needle receiving aperture  34  or through a protective septum (not shown) positioned across and similar to aperture  34 . 
     A syringe driver  36  has an actuator or driver contact  37  that is movable toward the muzzle end  32  extending into the syringe subassembly receiving cavity  35 . A penetration controller  38  or other penetration control is also advantageously provided. The penetration controller may include a penetration control abutment surface  39  which engages the ampule assembly  12 , such as at a shoulder or other appropriate feature thereof. The penetration controller has a suitable length and configuration from the muzzle end  32  to provide a desired needle penetration depth or forward needle stop position. 
     —The Barrel 
     As set forth by example in the drawings, barrel  31  is elongated and tubular, defining the subassembly receiving cavity  35  between a rearward end  41  and the muzzle end  32 . The barrel  31  may be formed of plastic or any other suitable medically acceptable material of suitable strength. 
     A driver guide or driver spring guide  33  can be integral with or fitted as a sleeve within the barrel  31  to maintain the driver spring or other driver force generator in a desired position, such as coaxially positioned therein. As shown, guide  33  functions to guide extension and retraction of the syringe driver spring  36 . Guide  33  as shown also advantageously functions as a positioner to accurately locate the syringe assembly  10 ,  11  coaxially within the barrel  31 . 
     In the illustrated forms, the rearward barrel end  41  is adapted to mount an annular end piece or firing bushing  43  which is used in conjunction with the driver  36 , details of which will be described further below. To facilitate assembly, the barrel rearward end  41  is preferably molded about an inward annular ridge  44 . It may alternatively be possible to produce each part separately and have the annular ridge  44  snap fit with the firing bushing  43 . 
     The muzzle end  32  in preferred forms mounts a separable nose cap  45  that defines the needle aperture  34  or other passageway through which the forward needle extends when fired. The aperture or needle puncture location of the nose cap  45  can be releasably attached to the barrel by means of inter fitting threads  46 , rings or other projections. Cap  45  may thus be separated from the barrel to permit access to the barrel cavity  35 , thereby permitting insertion and removal of the needle subassemblies  10  or  11 . 
     —Syringe Driver 
     Driver  36  is used to operate against or be connected through a plunger rod  61  to the plunger or plunger piston  14  of the needle subassembly  10  or  11 . The plunger rod may be separable or integral with the plunger piston. The driver is functional to force the subassembly in a forward direction to effect needle penetration and to operate against the plunger to inject the ampule contents. Such forces are automatically applied by spring or other suitable driver force initiated through a triggering operation initiated by the user. 
     Driver  36  as exemplified herein includes the driver bar or shaft  37  ( FIGS. 3 ,  4 ) which is shown within the barrel  31  in a rearward cocked position by a driver release mechanism  53  that may be similar or identical to that shown in U.S. Pat. Nos. 5,540,664 and 5,358,489 which are incorporated by reference herein. 
     Notwithstanding the above incorporated materials, a preferred driver is further exemplified herein as including a drive spring  50  that is compressed when ready or cocked. The drive spring  50  is preferably guided and contained within the barrel by a spring guide which is advantageously in the form of a guide sleeve  51 . As shown, the guide sleeve is tubular with the guide spring extensible within tubular guide sleeve  51  with portions of the spring slidable therewithin. Other configurations may also be suitable. 
     The drive spring is selected to provide sufficient stored energy when compressed to force the needle subassembly forwardly against downstream resistance and perform needle penetration and injection functions. It serves to displace the plunger  14  and thus expel the medicament contained in the ampule  12  through the injection needle  17 . 
     The drive spring  50  acts against and is restrained by the firing bushing  43  at one end. The opposing end bears upon the driver bar  37  which engages the plunger rod  61 . The exemplified driver bar or shaft  37  provides a spring engagement shoulder  52  (see  FIG. 3 ) against which the forward end of driver spring  51  engages. As shown, driver release  53  includes a barb or barbs  54  that fit through the firing bushing  43  central aperture. The barbs are preferably formed on flexible ends of the legs of the driver bar or shaft  37 . 
     A safety, advantageously in the form of a safety cap  55 , has a forwardly projecting pin  56  that is received between the legs of the driver shaft or stem to hold the barbs  54  in engagement with the firing bushing  43  and thereby prevent forward movement of the driver bar  37  until the safety is removed. The safety or safety cap  55  can be pulled rearward to slide the tapered safety pin  56  from between the legs of the driver bar. This frees the barbs to be forced inwardly and radially together. As shown, the barbed legs of driver bar  37  are moved inward by the rearward or end of firing sleeve  57  as will be further detailed below. The firing sleeve  57  acts as a trigger. 
       FIGS. 20 and 21  show the preferred driver shaft or stem has four legs, although other numbers are believed possible. The driver shaft or stem is preferably made using two parts  37   a  and  37   b  which fit together. These parts can alternatively be made of metal and be molded or otherwise formed as an integral piece. 
     Radial inward movement of the barbed legs causes the barbs  54  to move into a release position as effected by an exterior firing sleeve  57 . In the design illustrated, the firing sleeve  57  extends over and along the outside of the barrel. The exposed length of the firing sleeve  57  allows the user to grasp the injector by the firing sleeve  57  when the injection is to be administered. 
     A forward end of the firing or trigger sleeve can include slots  58  (see  FIGS. 4-6 ,  9  and  10 ) that slide along retainers  59  formed on the forward end of the barrel. The retainers are advantageously in a peninsular configuration that provides flexibility to retainers  59  for assembly or possible disassembly. The interaction between retainers  59  and slots  58  prevent the firing sleeve  57  from being unintentionally removed from the barrel. Such interaction also limits the extent of axial relative movement while also allowing the parts to be assembled or disassembled by depressing retainers  59 . 
     The firing sleeve  57  includes a trigger head having an opening  60  ( FIGS. 3-6 ) which is preferably centrally located. The trigger head of sleeve  57  is advantageously beveled along the contact area with barbs  54 . Opening  60  receives and inwardly cams the barbs  54  on the legs of the driver bar  37 . This forces the barbed ends together once the safety cap  55  is removed and the firing sleeve  57  is moved forwardly with respect to the barrel. Such action triggers the driver release  53  to free drive spring  50 . Drive spring  50  thus extends longitudinally, driving the driver bar  37  into the plunger shaft and forcing the syringe subassembly forwardly to administer the injection. 
       FIGS. 3-6 ,  7  and  8  show that the driver bar  37  is configured to push against an adjustable plunger rod  61  which is attached to the plunger  14 . The plunger shaft assembly may be part of the syringe subassembly  10  or  11 . Alternatively, the plunger shaft or rod  61  may be produced as an integral part of the driver or as a separate assembly or part. The plunger shaft may also be made in a non-adjustable configuration, such as solid or as a non-adjustable assembly. 
     In the illustrated embodiments, the plunger rod  61  is advantageously made up of two axially adjustable components including an actuator or driver engaging section  62  and a plunger engaging section  63 . As shown, sections  62  and  63  are threadably engaged to allow for adjustment of the overall length of rod  61 . This is used to help adjust the dosage or volume of material dispensed during a single operation of the injection apparatus. 
     The illustrated plunger rod  61  is advantageous in that the two axially adjustable sections  62 ,  63  allow for longitudinal rod length adjustment, and for threaded or other connection to the plunger  14 . Section  62 , as shown, has a head portion and threads which are received into section  63 . Plunger rod section  63  is coupled, such as by threads, or is otherwise attached to plunger  14 . Relative rotation of the two sections  62  and  63  can effectively change the plunger rod length, thereby allowing for accurate dosage adjustment, even though the syringes vary in length until adjusted to have the same or other desired length. 
     It is also possible that a different, conventional form of plunger rods (not shown) might be provided as a part of the syringe subassemblies  10  or  11 . In such an alternative construction the adjustable rod  61  may not be needed or used. In such a construction, dosage adjustment may be sufficiently accurate by using a properly selected stop collar  64  which will be discussed further below. In either construction, plunger rod  61  or an alternative integral plunger rod (not shown) can be provided with or as a part of the plunger assembly. With an adjustable plunger rod, such as provided by parts  62  and  63 , dosage control is more accurate since each ampule  12  may vary in length and the adjustment capability can accommodate for such variations. This may be needed when medicaments are to be dispensed in very accurate dosage amounts. Other medicaments may not be sufficiently sensitive to dosage amounts and the adjustable plunger costs and adjustment in production may not be needed or justified. 
     —Dosage Adjustment 
     The present device is capable of use for single or for multiple injections. To enable such use, one or more stops in the form of dose stop collars  64  ( FIG. 7 ) can be releasably mounted to the driver  36  or, in the illustrated example, to the plunger rod  61 . In the illustrated embodiments, one such collar  64  is shown attached to the rod  61  rearward of the ampule  12 , and forward of the headed section  62  of the plunger rod. The collar  64  and possible multiple such collars are advantageously positioned in the forward path of the headed end of the plunger rod  61 . Collar or collars  64  stop forward motion of the plunger rod at such point where a selected first dosage has been expelled from the syringe subassembly  10  or  11 . 
     If a second dose remains within the ampule  12  following the first injection, the syringe subassembly  10  or  11  can be removed from the barrel to gain access to collar  64 , which then can be removed from the plunger rod  61  to permit further motion of the plunger to deliver the additional dose. 
     Following removal of the syringe and collar, the syringe driver  36  can be re-cocked, but the process of re-cocking requires holding the barrel  31  in reaction to the force needed to recompress the drive spring  50 . This may be difficult in the constructions shown and described herein due to the firing sleeve (or trigger handle)  57  extending over the majority of the length of the barrel  31 . In other embodiments or with care the syringe can be re-cocked by holding the barrel and inserting a screw driver or similar tool and depressing the driver bar  37  and associated driver spring  50 . If re-cocked, the syringe subassembly can be re-inserted into the barrel for automatic injection of a second or another dose which becomes available as the plunger is permitted further forward travel in response to subsequent triggering. 
     The-length dimension of the collar  64  or multiple collars can be selected according to the desired dosages to be administered. Although not illustrated, multiple collars may be stacked along the plunger rod, with each collar representing a dose of medicament or other substance from the ampule  12 . Separate injections may be performed following removal of successive stop collars. Alternatively, in instances where single dosages are desired, a single or even no stop collar may be selected according to the desired single dosage. 
     Stop collar  64  may be made having different sizes of arcs. In some cases the collars extend fully about the plunger shaft. A currently preferred stop collar has an arcuate size of about 180-200 arcual degrees.  FIGS. 16 and 17  show a currently preferred design having an open side and an arcuate size  110  of about 185-190 arcual degrees. The relatively open side  111  is advantageously provided with end faces  112  which are beveled to converge inwardly. These features provide easier installation of the stop during production and easier removal by a user after the first or other prior dose has been administered. 
     Another feature shown in  FIGS. 16 and 17  that facilitates removal of stop collar  64  is the provision of ribs, flutes, striations or other friction features  120 . These friction features improve manual grasping of the collar to remove it from the outside of plunger shaft  61 . This construction allows a user to remove the collar using the thumb and forefinger from a single hand. It improves the removal such that two hands are not necessary as was the case in earlier designs. This improvement greatly reduces the chance that the action of removing the stop collar does not lead to accidental depression or upward movement of the plunger which may compromise the accuracy of the second dose amount. 
     The outside of the stop collar  64  may also advantageously be provided with circumferential segments  121  between the friction features  120  and a flat segment  122 . Flat segment  122  facilitates installation of the stop collar upon the plunger rod  61 . 
     The inside surface  124  is preferably semi-cylindrical and sized to fit the plunger rod  61 . The particular size may vary depending on the size of ampule  12  and size and type of plunger rod used. 
     —Nose Cap or Muzzle End Piece 
       FIG. 6  shows that nose cap  45  is advantageously removable from the barrel to allow insertion and removal of a syringe subassembly. Cap  45  may be generally in a cup shaped form to be received upon the forward end of barrel  31 . In the illustrated embodiments, the nose cap fits over the outward surface of the barrel. The nose cap is secured thereon using threads or other suitable connection joint. Depending on the specific construction used, the nose cap may alternatively fit within the barrel. 
     It is preferred for accuracy in needle penetration depth control that the nose cap  45  be secured axially against a positive stop such as a shoulder  47  formed along the barrel  31 . Shoulder  47  can be provided along the barrel to accurately locate an installed nose cap  45  in a repeatable manner. This is preferred to provide axial accuracy to the relative location of the nose cap  45  upon the barrel. This is desirable since the nose cap may be removed and re-mounted repeatedly to enable removal and replacement of ampule  12  and needle subassemblies. 
     It is advantageous for accurate positioning of the nose cap  45  to use the threads  46 . Threads  46  are provided along the nose cap  45  and barrel  31  to facilitate secure engagement between the abutment shoulder  47  and nose cap  45 . However, fastening arrangements between the nose cap  45  and barrel  31  may be used other than the illustrated threads  46 . For example, a bayonet, barb, snap fit or other releasable connection arrangement could also be used to releasably interlock the nose cap with the adjacent forward part of barrel  31  to provide repeated accurate positioning. 
     The forward end of nose cap  45  defines the illustrated needle aperture or passageway  34 . Aperture or passageway  34  is advantageously sized to receive needle sheath  19  therein. As illustrated in  FIGS. 9 and 10 , the needle safety sheath can project through the aperture  34 . Sheath  19  may be provided with a blunt forward end which may extend forward of the muzzle end  32 . The projection of the sheath facilitates removal of the sheath immediately prior to use. 
     The outside of nose cap  45  may advantageously be provided with ribs, flutes, striations or other friction surface to facilitate installation and removal of the nose cap from the barrel. The construction shown uses a threaded connection between the nose cap and barrel. Thus an exterior friction surface allowing torque to be applied is preferred in such constructions. A preferred friction surface has minute linear longitudinal striations (not shown). 
     —Sheath Remover 
     Removal of the sheath  19  from the syringe sub-assembly  10  or  11  can be accomplished or facilitated by provision of a sheath remover  80  that is releasably mounted at the muzzle end  32 .  FIG. 18  shows an exemplary sheath remover  80  from the forward end.  FIG. 19  shows a side view of the sheath remover  80 . The construction illustrated includes a sheath gripper  81 . The gripper has a central aperture  85  that is disposed in substantial coaxial relation to the needle receiving aperture  34  of the nose cap. The sheath  19  is received within the central aperture  85 . The sheath remover has a substantially flat front surface  87  adjacent the central aperture  85 . The front surface  87  of the sheath remover together with a portion of sheath  19  projecting therethrough (see, for example,  FIGS. 3 and 11 ) may be referred to as a front region of a medicine injection device. 
     Gripper  81  also preferably includes radially inward projecting fingers  82  that flexibly grip the sheath  19  behind a lip  89  (see  FIG. 3 ) near the tip of the sheath remover  80 . The inwardly projecting fingers  82  provide sufficient flexibility to allow the sheath remover  80  to be pushed onto and installed over the enlarged end of the sheath near lip  89 . 
     A collar portion  84  extends rearward of the front surface  87  and is received over the nose cap  45 . The collar portion  84  may be provided with circumferential ribs  83  to improve manual grasping of the sheath remover  80  so as to facilitate pulling the sheath and sheath remover  80  from the injector. 
     Fingers  82  will flex rearward during removal of the sheath and catch on lip  89  and securely grip the sheath  19  when the remover is pulled forwardly, In doing so, the fingers will catch behind the lip and further bind and pull the sheath  19  from the needle assembly hub  90  ( FIG. 3 ) to expose the outwardly directed needle  17 . The sheath and sheath remover  80  can later be re-installed, in an instance where it becomes desirable to re-cover the needle for safety purposes. 
     —Penetration Control 
     Syringe driver  36 , when triggered, forces the syringe subassembly  10  or  11  forwardly within barrel cavity  35 . This drives the needle  17  forwardly through the aperture  34  to penetrate the flesh of the patient. Depth of penetration according to the present invention is advantageously determined using a penetration controller  38  ( FIGS. 9-15 ) and other alternative forms described herein. The penetration control or controller stops penetration at a desired repeatable penetration depth of needle  17 . This is different than dose control, since the penetration depth is gauged from the nose cap which actually contacts the flesh during automatic injection. 
     Penetration controller  38  in preferred forms is located along the barrel  31 , with an abutment surface  39  spaced from the muzzle end  32  at a selected and desired needle penetration depth stop position. The penetration control is engaged by the syringe assembly to stop forward motion of the flesh penetration needle  17  at the selected penetration depth. This is done to remove the necessity for the user to determine penetration depth. By providing a penetration control, the device can be selected or adjusted so the needle will penetrate only to a desired depth as an automatic function of the device. Adjustment is preferably provided using a penetration sleeve, spring or other penetration control element. 
     —First Exemplary Penetration Controller 
     In one preferred form, the penetration control is provided by penetration controller  38 . Penetration controller  38  may be constructed more specifically in the form having a tubular sleeve  70  portion held within the nose cap  45 .  FIGS. 22 and 23  show penetration controller  38  in detail. The penetration controller  38  includes a control sleeve  70  which has a flange  170  attached thereto. It is advantageous that the sleeve  70  and flange  170  be shaped for frictional engagement within the nose cap  45 . This is desirable so that removal of the nose cap will also result in removal of the penetration control  38 . This is facilitated by flange lobes  170   a  which tend to cant within the nose cap cavity ( FIG. 22 ). This mounting arrangement also helps to provide repeatable and accurate axial positioning of the abutment surface  39  within the barrel  31  and relative to the outer front face of the nose cap or other flesh contacting face of the injector. The flange sleeve  70  and thickness of flange  170  define the length of the controller. The end of the sleeve opposite the flange provides a syringe abutment surface  39  at a selected distance from the muzzle end  32 . In this example, the surface  39  is at the rearward end of the sleeve and faces the needle subassembly within the cavity  35 . 
     The overall length of controller  38  is typically defined by the length of sleeve  70 . The length may be selected from a group having varying axial dimensions to effect different needle penetration depths. Thus one sleeve may be useful for subcutaneous injections, while another may be selected when deeper intramuscular penetration is required. A selection of sleeves of differing axial lengths may be used dependent upon the medicine being provided in the injector or for specific depths of desired needle penetration. 
     The sleeve  70  is also useful to receive a forward or return spring  71 , preferably of the coiled compression variety, which can be disposed within the barrel, between the nose cap  45  and needle hub. The front or return spring  71  is provided to yieldably resist forward motion of the needle subassembly to hold the subassembly in the retracted position until the syringe driver  36  is triggered. Spring  71  also helps to reduce the impact of the syringe assembly with the penetration control, thus reducing or eliminating breakage of the hub or penetration controller  38 . 
     The penetration control unit  38  can be used to secure the return spring  71  in position within the barrel, using flange  170 . This also helps retain the spring for removal along with the nose cap  45  ( FIG. 13 ). To this end, the spring diameter may be enlarged at its forward end  72  in order to provide a friction fit between the spring  71 , sleeve  70  and the nose cap  45 , while allowing the remainder of the spring free movement within the confines of the sleeve portion  70 . 
     One of the important functions of the return springs is to keep the needle in a hidden, retracted position after the sheath is pulled off. This prevents the user from seeing the needle and prevents the user from being scared due to needle fright. The return spring acts quickly on removal of the sheath to return the syringe up inside the barrel such that the user has no visual reminder that there is a needle positioned in a hidden position therein. 
     By providing the return spring  71  and sleeve  70  arrangement described above, the fully compressed axial spring length will be less than the sleeve length. Thus the penetration depth is determined by the selected length of sleeve  70  and flange  170 . With proper design, the yieldable resistance offered by spring  70  will remain within suitable limits regardless of the sleeve length selected to adjust penetration depth. 
     The above arrangement (in which the return spring  71 , selected sleeve  70  and flange  170  and nose cap  45  interconnected) is advantageous to simplify attachment to and removal from the barrel  31 . A user wishing to gain access to the needle sub-assembly for replacement or for second injection purposes, need only unthread the nose cap  45  from the barrel end. The return spring  71  and sleeve  70  will move along with the nose cap to permit free access to the cavity  35 . The lobes  170   a  also may interact with the internal threads of the nose cap to help prevent the nose cap, sleeve and front spring from flying freely when disconnected from the barrel. 
     —Second Exemplary Penetration Controller 
     Another form of the penetration control may be provided in a form and construction which uses a selected spring of a particular fully compressed length dimension.  FIGS. 15A-15C  illustrate by way of example several springs  75 ,  76 ,  77  that will have different fully compressed lengths but similar lengths when installed in device  30 . In each one of the springs, one of the spring ends will function as the abutment against which the needle hub engages or other parts engage as explained further below. The needle hub will stop when the spring is fully compressed and the desired penetration depth is attained. 
     By using a spring  75  that is selected for a desired compressed length, the spring itself becomes the penetration controller  38  when fully compressed between the needle hub and the nose cap  45 . Thus the spring can have dual functions: offering yieldable resistance to slow forward motion of the adjacent needle subassembly; and stopping such forward motion once the needle reaches the selected penetration depth and the spring becomes fully compressed. 
     The selected springs  75 - 77  can be made to fit frictionally within the nose cap  45  in order to keep the spring and nose cap together. This simplifies access to the cavity  35  and a needle assembly therein. It also mitigates flying discharge of the nose cap and spring when disconnected. Thus, the cap  45  and spring can be assembled so both can be simultaneously removed from the barrel as a unit. Changing from one spring to another to accommodate different penetration depths is a simple matter of removing the nose cap from the barrel and changing the spring. Alternatively, an assembly including a nose cap and different spring can be used to change penetration depth, 
       FIGS. 15D ,  15 E and  15 F show additional novel concepts in using the forward spring for penetration control and absorption of energy from the moving drive and syringe assembly.  FIG. 15D  shows spring  78  in a free and uncompressed condition. Spring  78  has three sections,  78   a ,  78   b  and  78   c . Section  78   a  has spaced helical or spiral windings which may be collapsed due to force applied by the driver through the syringe assembly. Section  78   b  includes one or more dead windings which are close or tight and are normally not compressible due to application of axial compressive force to spring  78 . Section  78   c  is enlarged end coils or windings that are radially contracted when installed in the nose cap receptacle and serve to tie the spring and nose cap together. 
     By adjusting the relative proportion of sections  78   a ,  78   b  and  78   c , the compression and energy absorption properties of the forward spring can be adjusted to provide different penetration control and different deceleration characteristics. More dead coils reduce energy absorption as the forward spring is compressed because there are fewer active coils to absorb energy. Thus the increase in dead coils can be used to maintain adequate syringe power for injection and dispensing of the medication. 
       FIG. 15E  shows spring  78  in a fully compressed but axially aligned and stacked condition. This occurs when the spring has stronger and/or larger spring wire. The spring made with stronger wire will thus reach a fully compressed state and then relatively abruptly stop at the demonstrated penetration depth for that design of spring. 
       FIG. 15F  shows a spring  79  similar to spring  78  with similar sections. Spring  79  does, however, demonstrate a different type of behavior upon full compression. The spring wire is made finer and less strong. This causes the spring to compress and then distort into a distorted collapsed condition. This condition provides a two-stage compression action. In the first stage or phase, the spring compresses in a typical or nearly typical stack arrangement. In the second stage or phase, the spring distorts with various windings being forced to radially change, thus distorting and collapsing with some winding either moving inside of other windings or overriding other windings. This construction effectively provides shock absorption and energy absorption capabilities that reduce shock after the spring has been fully compressed and allow energy absorption after full compression into a stacked array and helps or eliminates breakage of the syringe hub and other parts of the injector. It also provides cushioning as the syringe and driver decelerate to a stopped condition. 
     As examples, syringes made of wound or coiled music wire having wire diameter size of about 0.015 inch tend to collapse and distort as indicated in  FIG. 15F . In comparison, springs wound from music wire having a diametrical size of 0.018 inch tend to remain in a stacked coil array as indicated in  FIG. 15E . 
     These are current preferred wire sizes for injection devices using only a spring as the penetration control. Although such constructions are not as precise in demonstrating consistent penetration depth, they are sufficiently consistent for the administration of many medicines. They also are more economical to produce and eliminate the penetration control  38  having tubular sleeve  70  and flange  170  or other similar relatively inelastic penetration control elements. They are also less expensive to produce and assemble. 
     Use of finer spring wire has another beneficial effect. The springs tend to distort more easily and further reduce the risk that a nose cap and spring assembly fly away upon removal, such as when preparing for administration of a second or subsequent dose. 
     —Syringe Assembly Front Spring Load Distribution, Guidance &amp; Cushioning 
       FIGS. 24 and 25  show front portions of an injection device having many of the same features as described elsewhere herein. Description of the common features are made using the same reference numbers and the description which is common will not be repeated. 
     The embodiment of  FIGS. 24 and 25  differ in that a load distribution ring  171  is provided to act in several capacities. The first capacity is to distribute the forces developed between the front spring  75  and the syringe, particularly at the syringe assembly hub  21 . The second capacity is to act as a guide piece to help maintain the coaxial position of the syringe assembly hub within the barrel cavity. The third capacity is to also distribute and equalize force about the annular abutment  170  so that the forces developed against the syringe are not concentrated. 
     The ring  171  is preferably made about the same size as the barrel cavity portions within which the guide ring moves during operation of the injector. This is advantageously done by making the ring within a range of about −0.001 inch to about −0.004 inch compared to the adjacent barrel cavity interior diameter. Other size relationships are also believed operable. 
     Ring  171  is preferably made from a stainless steel or other suitable material which is strong and sufficiently stiff to help distribute the load evenly which is applied across the ring. 
       FIGS. 24 and 25  further show a resilient cushion in the form of a cushion or pad ring  172  which surrounds the syringe hub  90 . The cushion is preferably made from an elastomer material such as natural rubber or Santoprene 8281-45-med having a durometer value of about 45. In the uncompressed state the cushioning pad ring  172  is about 0.030 inch smaller in diameter than the load distribution and guide piece  171 . This allows the pad ring to expand outwardly in a radial direction when load is applied thereto as the syringe is driven against the front spring and resistance is developed in association with dispensing the fluid medication from the front needle. An outer diameter which is larger and closer to the adjacent barrel internal diameter may lead to lateral strain that causes the pad ring  172  to develop frictional drag against the barrel bore. This in turn requires more driver force to be provided in order to overcome the friction and creates added stress and strain on the syringe and other parts of the injector. 
       FIGS. 26 and 27  show another embodiment similar to that shown in  FIGS. 24 and 25 . The embodiment of  FIGS. 26 and 27  is not provided with a load distributor and guide ring like ring  171  of  FIGS. 24 and 25 . Instead, the cushion pad  172  directly bears on the syringe hub and the front spring. Although this construction is not as preferred as that shown in  FIGS. 24 and 25 , it is believed operable. Due to the less uniform load application a harder and more durable elastomer material may be needed to allow repeated use of an injector so constructed. 
     In either of the constructions shown in  FIGS. 24-27 , the cushion pad  172  has been found to be superior at moderating forces experienced by the syringe hub  90  and thus reduces the risks of failure or breakage of the hub or other portions of the syringe assembly. 
     —Summary of Front Return Spring Functions 
     The front or return spring thus performs a number of important functions. It maintains the syringe assembly in a retracted position prior to use, such as during, carrying by the user and other situations. Any one of these may by routine or accident cause force to be developed on the syringe and return spring. The return spring thus maintains or helps to maintain the syringe in a retracted position prior to firing but does so in a manner that absorbs shock and minimizes the risk of syringe ampule breakage. 
     The return springs also serves to help keep the injection needle up inside the nose cap or barrel to keep it in a hidden position to prevent user alarm at sight of the needle. 
     Another function of the return spring is to counteract against the drive spring upon triggering of the injection. The drive spring accelerates the syringe down the barrel and the kinetic and well as stored spring energy is preferably dissipated to prevent or reduce the risk of syringe ampule breakage or breakage of other components of the forward end of the injector which in one way or another must take the force and dissipate the energy. Dissipation of energy is particularly enhanced when the spring deforms as illustrated in  FIG. 15F . 
     Another important aspect of the forward or return spring is in some embodiments to provide for proper insertion of the seal insertion needle  22  into and through the ampule seal  23 . This is accomplished by selecting a return spring which may provide for delayed administration of the medicine until the needle penetration depth is proper. 
     In some forms of the inventions the front or return spring may by itself serve as the penetration control. This simplifies the construction of the injector and saves costs where the required consistency of penetration control for the medicine being used is within the demonstrated consistency of the penetration controller spring being used is satisfactory. Where these parameters are met the more complex penetration control sleeve can be eliminated. 
     A still further advantageous function of the front return spring is to hold or help hold the spring with the nose cap. This is accomplished in the illustrated embodiments by using a spring which has enlarged coils toward the forward end. These larger coils serve to maintain the spring with the nose cap when the nose cap is removed. This may prevent or minimize any risk of the nose cap and spring flying off. This property of retaining the spring and nose cap also simplifies handling the nose cap by keeping the nose cap, spring and any tubular penetration control together as an assembly. 
     Thus it can be seen that the front return spring performs a surprising number of different functions and advantages or combination of different functions and combinations of advantages. 
     —Considerations for Double Needle Syringe Subassembly 
     Description to this point has been generic with respect to the subassemblies  10 ,  11  because both needle forms can be utilized with the structure described. With respect to the double needle subassemblies, however, the penetration depth controller  38  and the syringe driver  36  are configured to perform an additional function of penetrating the seal  23  using penetrating needle  22 . 
     The seal penetrating task is accomplished as the triggered syringe driver  36  forces the needle subassembly forwardly. As the subassembly  11  moves forwardly, the hub  21  slides into abutment with the syringe abutment surface  39  of the penetration controller  38 . Continued applied force will cause the associated ampule  12  to slide on forwardly although the hub  21  and needles  22  will remain axially stationary in relation to the abutment  39 . The forward moving ampule  12  will thus be penetrated by the rearward projecting needle  22 . 
     It should be appreciated that tissue penetration depth is not derogatorily affected by the ampule piercing operation. The forward needle  24  will move toward the selected penetration depth as the hub  21  moves to engage the abutment surface  39 . Continued forward force against the syringe subassembly by the driver  36  will cause the injection needle  24  to continue being extended as the rearward needle  22  penetrates seal  23 . Hub  21  is thus seated as full penetration of the forward needle  24  occurs. Further movement of the driver causes the ampule medication to be dispensed and injected. 
     The double needle subassembly  11  may in some cases be preferable to the open communication single needle subassembly  10 . This can be visualized in that the injection needle will be fully or almost fully penetrated into the flesh before the injected medicine is dispensed into the flesh. With the single needle syringe there is a potential effect of putting medication above the final needle injection depth. So in actual operation the double ended needle may provide more controlled and/or reproducible dispensing of the medicine at the final needle depth. This is what is done in the hospital setting with a manual injection in that the doctor or nurse first places the needle to the desired depth and then presses the plunger. It also prevents loss of medicine as the injection needle passes through intermediate tissue. 
     The wire diameters for some return springs are suitable for achieving the seating and desired insertion of the ampule  12  by needle  22  at the same time the injection needles reach their desired final penetration depth. This is caused by the springs either being weak enough (lower spring rate) so that the penetration control sleeve  38  performs the final seating and insertion of needle  22  through seal  23 . In other embodiments, such as when the penetration control is solely by the spring, the spring rate of the return spring is selected to similarly provide for seating and insertion of needle  22  through seal  23  also at or near the desired final penetration depth. In either case, this provides proper administration into the tissues which are the intended tissue for the desired final penetration depth. 
     The injector also performs another important novel function when used with double needle syringe assemblies, such as  11 . Such assemblies require the needle assembly to be seated manually or with a device holder before performing manual injections. The action of firing the injector carrying a double needle syringe causes the needle assembly to seat or mate with the sealed ampule  12 . Thus a manually useful syringe is automatically formed. This indicates the multiple functions provided by injectors described herein. One function is to automatically administer the first dose. Another function is to seat the double needle syringe assembly with the sealed ampule  12  to form a manually administrable syringe from a dual needle syringe and sealed ampule  12 . A further function is to provide a reliable backup syringe for situations where the syringe may be misused and the second dose is the only dose and can be administered manually for ultimate reliability as may be dictated by difficult situations on the battle field or in other situations. 
     Storage and Carrying Case 
       FIGS. 28-36  show a preferred outer or carrying case  200  in which the injectors described herein may be carried in a protected manner.  FIG. 28  shows that the preferred carrying case  200  has a lower or bottom part  201  and an upper or top part  202 . The upper and lower parts may be referred to as first and second barrel parts. The upper and lower parts  202 ,  201  are joined by a detachable joint  210  used to keep the upper and lower parts  202 ,  201  together until such time as an injector, such as injector  30 , is needed and can be removed from the carrying case  200 . The first and second barrel parts have receptacles therein, and when joined together form a barrel cavity configured for retaining a medicine injection device (such as the device of  FIG. 3 ) therein. Before explaining the operation of the carrying case  200 , a detailed explanation of the features thereof will now be given. 
     Carrying case  200  is designed to carry an injector  30  with the driver and trigger end of the injector inserted into the upper case part  202 . The muzzle and needle end  32  of the injector  30  is inserted into the lower case part  201 . 
     In the preferred construction shown, a bottom end receptacle  205  receives the muzzle end  32  of the injector  30 . This is preferably done so that the sheath remover front surface  87  bears upon a support ledge  208 . Ledge  208  is preferably padded with an annular pad  209 , which acts as a shock absorber. This construction prevents loading of the exposed needle sheath  19  with forces that develop during movement, handling and mishandling (such as dropping) of the carrying case  200  with injector  30  supported therein. 
     The length between ledge  208  and the upper end of the case top piece  202  is nearly equal to, but longer than, the length of the injector between the safety cap  55  or other top end piece and the face surface  82  of the sheath remover  80 . This construction advantageously provides a small amount of clearance so that the injector  30  is not loaded in an axial manner when stored in the carrying case  200 . 
       FIG. 28  shows that the upper part  202  of the carrying case is advantageously provided with a clip mount  206  which can be welded to the upper part  202  or integrally formed therewith during molding of the upper part. The clip mount  206  is used to mount a clip  207 , which is similar to a clip on a pen. The clip  207  is preferably made of metal having spring properties. The clip  207  may be used to help hold the carrying case in a user&#39;s pocket or in luggage, brief cases, cosmetic bags or in or on other parts of a user&#39;s garments or accouterments. 
       FIGS. 34 and 35  show the clip mount  206  in greater detail. Other configurations are also possible. In any design the mount  206  is preferably durable and prevents the clip  207  or mount  206  from being broken from the carrying case upper part  202 . 
       FIG. 28  shows that the upper and lower case parts  202 ,  201  are preferably constructed so as to form a detachable joint  210 . Although a threaded joint is acceptable, it has been found more preferable to have a joint which can be easily and quickly disconnected so that in an emergency the injector can be accessed quickly to administer a medicine without delay. In the construction shown, the bottom part  201  includes an insertion part  220  ( FIG. 29 ) which is sized and shaped to fit within an insertion receptacle  230  ( FIG. 36 ) formed on the open complementary end of the upper case part  202 . Insertion part  220  is advantageously provided with a retainer projection or projections  221  which are received within an annular recess  231  ( FIG. 36 ) to provide a catch or mating engagement which retains the two case parts together until needed by a user. The projections  221  and annular recess  231  together form an interlocking mechanism. 
     The connection joint  210  is also advantageously provided with quick release which can be provided in the form of two projections  241  on upper part  202 , which are received in complementary receptacles  242  formed on the lower part  201 . The projections  241  are preferably semicircular to mate into complementary semicircular receptacles  242  adjacent to the insertion part  220 , although other shapes are possible. This configuration allows the case to be easily opened by twisting the two case parts  201  and  202  relative to each other only a relatively small angular displacement. The semicircular projections  241  and receptacles  242  thus interact to cam the two case parts away from one another and dislodge the retainer projections  221  from the annular recess  231 . Thus, by merely twisting the two case parts less than about 1/10th of a rotation, the carrying case is opened and the injector contained therein may be easily removed. The projections  241  and receptacles  242  may be together referred to as a cam spreader. 
     Although the embodiment shown in  FIGS. 29 and 31  has two projections  241  and two complementary receptacles  242 , it will be understood that in some embodiments the container  200  may have as few as one such complementary projection-receptacle  241 ,  242  pair, whereas in other embodiments the container there may be three, four, 6, 8, 9 or more. It is also contemplated that, while each projection  241  is depicted on the upper part  202 , one or more such projections  241  may be on the lower part  201 . Likewise, while each receptacle  242  is depicted as being on the lower part  201 , one or more such receptacles  242  may be on the upper part  202 . Moreover, the projections  241  and receptacles  242  may alternate annularly about the circumference of the upper and lower portions,  242 ,  241 , so long as each projection  241  opposes and mates into a complementary receptacle  242 . In some embodiments, alternating projections  241  and receptacles  242  alternate in such a way as to form a wave-like pattern around the annulus of the joint  210 . 
       FIG. 36  also shows a shoulder  232  which is recessed an amount so that the insertion section  220  extends into the joint receptacle bringing the end surface of the insertion part into engagement with the shoulder  232 . This also facilitates proper extension of the insertion part into the receptacle so that the projections  221  properly fit into the annular groove  231 . In some embodiments, the insertion section  220  fits snugly enough into the insertion receptacle  230  that the joint  210  formed thereby is moisture resistant. In other embodiments, the insertion section  220  and insertion receptacle  230  form a joint  210  that is water tight. In particular embodiments, the container  200  is formed of a suitable material and the joint  210  is tight enough that the container  200  is water proof and will withstand water pressures of 1, 5, 10, 25 or 50 m in depth. The person skilled in the art will recognize that such a configuration provides the advantage of protecting the apparatus carried therein from moisture, such as perspiration and environmental moisture (such as humidity and precipitation). In some embodiments, wherein the configuration is water proof, the container  200  is especially desirable, as such a device can be transported in a wide variety of outdoor settings wherein exposure to environmental moisture, including accidental immersion in water, is possible or even likely. This will allow the user to carry an automatic injector, especially an automatic injector carrying epinephrine, environments where the automatic injector will be of greatest utility, such as in environments where the user is most likely to encounter anaphylaxis-inducing allergens. Likewise, where the automatic injector is charged with atropine, the container will permit armed personnel and civilians to carry atropine automatic injectors in environments where moisture and precipitation are likely, thus extending the usefulness of the automatic injectors to their users 
     The clip  207  provides an additional advantage in that it tends to prevent the container from freely rolling on a flat surface. Thus, the invention provides a means to oppose rolling of a container on a flat surface. Additionally, grip tabs may be provided, and such grip tabs may provide an advantage of opposing free rolling of a container on a flat surface. Thus, the invention further provides a container having means for opposing the free rolling of the container on a flat surface. 
     The person skilled in the art will recognize that the number of receptacles  242  need not be equal to the number of projections  241 , so long as there are sufficient receptacles  242  to accommodate all of the projections  241 . 
     In some embodiments the container  200  may have grip tabs, whereas in other embodiments the tabs may be absent. When present, the grip tab provides a rest for a thumb or other digit, which improves the users grip on the parts of the container  200 , thereby making it easier to turn the parts relative to one another. In this regard, it is noted that it is the motion of the parts relative to one another and not the absolute motion of any isolated part that is important. Thus, it is immaterial whether the lower part  201  were held static while the upper part  202  was turned or vice versa, so long as at least two parts are moved relative to each other. The grip tabs may have a tear drop-like shape. The tear drop-like shape is considered advantageous, in that it provides an excellent purchase for a thumb or other digit of a user&#39;s hand. However the person skilled in the art will recognize that other embodiments are possible. 
     Sharps Disposal 
     The novel constructions shown herein are also advantageous in that they are adapted to provide a sharps container or containers for holding the syringe assembly after the medicine has been injected. In one form the syringe assembly is removed or withdrawn from the injector through the muzzle end  32  without a needle sheath thereon: The return spring and related parts forward of the syringe assembly are also removed. With the needle end of the syringe first, the syringe is then inserted into the barrel cavity in reverse orientation. The nose cap  45  without return spring and any penetration control sleeve is then connected or attached to the barrel to secure the syringe therein for safe handling and proper disposal. 
     In another form the syringe assembly is inserted into the carrying case and the two parts of the carrying case are rejoined. The carrying case acts as a portable sharps container. Thus the invention may also provide a safe means for carrying the syringe and associated needle or needles to a larger sharps disposal container for shipping and disposal. It may also be placed in the carrying case to provide a combination which is extremely resistant to breakage and needle exposure. 
     Added Methods and Operation 
     In addition to the various descriptions given elsewhere herein concerning methods and operation of the inventive components, the following added explanation is provided to supplement the description. 
     A method aspect according to the present invention is provided for driving a syringe needle  24  or  17  to a selected penetration depth. Aspects of the method will be discussed along with a description of operation and use of the invention. 
     The process initially includes placing the injector in a cocked position. This is preferably done during manufacture. The injector is cocked with the safety cap  55  removed and pressing the driver bar  37  rearward. The barbs  54  on the driver shaft are moving and then extending into hole  60  at the trigger end of firing sleeve  57 . This performs a compressing of the drive spring  50  and catching of the barbs  54  upon annular piece  43 . Once the device is cocked, the safety cap  55  can be installed to prevent accidental firing of the driver. This action places the pin  56  between the barbed legs of the driver bar  37 . Pin  56  prevents the barbed ends from moving toward one another and releasing the driver bar or shaft. This readies the apparatus for reception of the selected syringe assembly. 
     Then the process involves selecting a suitable syringe subassembly. The selecting involves syringes having the desired fluid volume, injection needle length and durability for the intended purposes. In preparation for installation of the syringe subassembly, the plunger rod  62  may be attached to the syringe plunger  14 , which allows for performance of a step in which at least one stop collar  64  maybe attached to the plunger rod  61  for dosage control if the syringe is provided with a multiple dose charge. If the plunger rod  61  can be adjusted for axial length, then adjusting the plunger rod occurs at this time to provide a desired or consistent discharge volume or dose. Thus a step of determining a dosage to be dispensed from the apparatus is accomplished. Once adjusting and/or determining step has been completed, the dose setting step is complete. 
     Further preferred methods include inserting a selected syringe subassembly through the open forward end of barrel  31 . The methods further include locating and installing the syringe subassembly to a desired position within the interior of barrel  31 . This is accomplished with the nose cap  45  removed and by sliding the selected syringe subassembly with the open end  13  first, into the barrel cavity. 
     The above steps and procedures according to the inventions may in general be accomplished with either the fixed needle or double needle syringe subassemblies  10  or  11 . 
     Further processes according to the invention may also include adjusting penetration depth. Adjusting penetration may be accomplished by selecting a desired penetration controller  38 , spring penetration control or other penetration control, having a length which positions the abutment surface  39  at a desired location. This may include a selectable number of penetration stop positions. This can be accomplished while the nose cap  45  is separated from the barrel  31  either by placing a selected length of penetration control sleeve  38  into the nose cap, or by placing a selected penetration control spring  75 - 79  into the nose cap. A combination of control spring and fixed control element may also be possible. 
     In the example illustrated in  FIGS. 3-6 , the sleeve type penetration controller  38  is used, and is frictionally positioned within the cap to abut the nose cap interior front wall adjacent the needle aperture  34 . Return spring  71  is also placed within sleeve  70 , prior to installing the controller and spring subassembly into the nose cap interior cavity. This is preferably done with the enlarged end of the spring engaging the front, flanged end  170  of sleeve  38 . 
     The spring, penetration controller  38  and nose cap assembly can then be installed to the barrel. This is advantageously done in the illustrated embodiments by threading the nose cap onto the barrel until the stop shoulder  47  is engaged by the rearward end of the nose cap, to assure proper axial spacing between the syringe abutment surface  39  and the syringe hub. The return spring may be made to abut a ring-shaped stainless steel guide and load distributor  171  ( FIGS. 24 and 25 ) to help assure accurate firing and less decelerated stopping of the syringe subassembly. 
     Alternatively, a spring of selected compression length (for example, one of the springs  75 - 79 ) can be used to determine penetration depth. In this aspect, a spring is selected that has a compressed axial length related to a desired needle penetration depth. The selected spring is then mounted to the nose cap  45 , such as by frictionally sliding the spring into place within the cap and/or along with the guide  171 . Now the end of the spring facing the syringe hub becomes the syringe abutment surface and the penetration depth will be gauged by the fully compressed length of the spring. The spring may have various number of active coils and in some designs dead coils to help provide desired penetration with sufficient energy for penetration. Once the selected spring is mounted within the nose cap, the assembly can be threaded onto the barrel to a point where the stop shoulder  47  is engaged. 
     The sheath remover  80 , if not already in position on the nose cap  45 , can be slid into position on the nose cap  45 , to position the sheath engaging fingers  82  over the sheath. The fingers will perform by flexing, thereby allowing the sheath remover  80  to act by sliding over the extent of the needle sheath  19  that is exposed forwardly of the nose cap  45 . 
     Once the nose cap  45  and sheath remover  80  are in place and the safety  55  is attached, the device is loaded, cocked and in a safe condition nearly ready for use. The device can be safely carried or stored in this condition until such time that an injection is to be administered. 
     The following discussion will describe a single dose use, and a double dose use of the illustrated and other auto-injectors according to the invention. The described uses are both possible using the same or similar procedures with both a single fixed needle syringe subassembly  10 , or the double needle subassembly  11 . 
     Prior to injection, the user can remove the protective sheath  19  from the needle subassembly by moving, such as by sliding, the sheath remover  80  forwardly. This performs a disengaging step, freeing the sheath remover  80  from the nose cap  45 . The sheath remover  80  fingers  82  perform by engaging and catching or binding against the sheath lip  89 . Further removal of the sheath remover  80  applies axial forces upon the sheath that act by pulling the sheath outwardly through the needle aperture  34  in the nose cap  45 . The sheath remover  80  thus performs an action of removing the sheath from the syringe assembly and other parts of the auto-injector. 
     The user may perform a removing step to remove the safety  55  form the opposite end of the barrel. This is advantageously done by pulling the safety and attached safety pin  56  from between the barbed legs of the driver bar  37  or other driver shaft assembly. This arming step involves removing or disabling the safety, thus readying the injection device for dose administration. 
     To perform injecting, the user presses the nose cap against the tissue area to be injected. The pressing action causes movement of the firing sleeve  57  forwardly relative to the barrel. The barbs on the driver bar or shaft assembly will move toward one another collapsing inwardly by engaging the barbs against the walls of opening  60 . This action releases the driver bar, which is now allowed to move forwardly, such as by sliding, in response to force applied by the driver. This forcing of the driver shaft serves to free the driver release into a driving action wherein the driver bar moves forward and acts by engaging the plunger rod. The driving action also forces the needle subassembly forward. This acts by penetrating the adjacent tissue of the user with the needle and also serves by penetrating any second needle through the seal of the ampule  12 . 
     As the needle subassembly moves forwardly, the return spring  71  or selected penetration control springs  75 - 79  are acted upon to perform a compressing of the forward spring. The spring, nose cap and any penetration control acts by restraining and stopping the forwardly moving needle hub. In arrangements in which the engaged end of the return spring also constitutes the syringe abutment surface, the selected spring will fully compress at a pre-selected axial location, stopping needle penetration at the desired penetration depth. The same penetration depth can be effected in arrangements in which the return spring  71  compresses to a point where the needle hub engages the fixed abutment surface  39  on the selected sleeve type penetration controller  70 . Penetration depth is determined by the selected axial position of the abutment surface, whether it be on a penetration control sleeve or by fully collapsing a spring having a desired fully compressed length. 
     Once the abutment surface or full spring compression point is reached, the drive spring  50  will continue pushing the plunger rod forwardly, dispensing medicine. In instances where a single needle syringe subassembly  10  is used, continued forward motion of the plunger will result in injection of the medication. Medication is also injected when a double needle assembly  11  is provided within the barrel  31 , but after the ampule  12  is driven forward onto the seal penetrating needle  22 . 
     Medication will be injected as the spring  36  performs by forcing the plunger forwardly. Such forcing continues until such time that the plunger shaft engagement head engages any desired stop collar  64  or stack of stop collars. This marks the end of the injection, and the prescribed dosage amount will have been injected at the selected injection penetration depth. The device is now ready for either re-cocking and reloading with another syringe subassembly, or for preparation to inject a second dose or subsequent doses of medication which are still within the ampule  12  due to stopping action performed by one or more stop collars  64 . 
     The penetration depth and the dosage amount are controllable as discussed above. This is advantageously done by provision of the removable or adjustable stop arrangements within the barrel  31 . The dosage can be selectively controlled by the stop collar  64  and the adjustable length plunger rod  61 . Penetration depth can be controlled by selecting the axial position at which the needle hub is stopped within the barrel  31  as a function of the selected or adjusted penetration control, such as by penetration controller  38  or the collapsed condition of a penetration control spring. 
     The novel methods may also include administering a second injection. According to some forms of the invention, this can be done with the same syringe assembly. Alternatively it may be done using a second or subsequent syringe assembly. When using a single syringe, the user performs by removing the nose cap  45  and sliding or extracting the syringe assembly from the barrel cavity. Any stop collar  64 , collars or portions thereof can then be removed, such as by laterally removing the collar, collars or portions thereof from the plunger rod, thereby allowing the plunger to be pushed further forward within the ampule  12  to inject another dose. This is preferably used to administer a second dose in a manual mode of operation. 
     If the injector is to be used for administering the second dose, then the injector is re-cocked by removing the syringe assembly and then holding the barrel and depressing the driver using a screw driver or other tool which is extended into contact with the driver bar or shaft  37 . 
     The safety, such as safety cap  55 , can now be placed back over the rearward end of the device. This safety placing action causes inserting of safety pin  56  wherein the driver bar legs form a safety opening receiving the safety pin  56 . The installed safety pin performs by holding them apart and rendering the device into a safe condition, thereby avoiding unintentional firing. 
     When the syringe subassembly  10  or  11  is received back in the barrel (such as with stop collar  64  removed), the ampule  12  will slide back further into the barrel until it abuts with the spring guide sleeve  33  ( FIG. 8 ). The subassembly will be held in this position by the spring  71  (or by the selected other springs  75 - 79 ) as the nose cap  45  is replaced. Replacement of the nose cap completes the needed steps for a second or subsequent use of the device to deliver a second auto-injected dose. If the injection is to be given immediately, there is no need to replace the sheath and sheath remover  80 . However if the second injection is to be delayed for a time, it is possible for the sheath  19  and sheath remover  80  to be re-installed even though the needle is now carried safely within the nose cap. Alternatively, the sheath and sheath remover  80  are not reinstalled to reduce risks of injury or contamination. 
     Administration of the second dose may be accomplished automatically in the same manner as described above. In such operation the driver will function to depress the plunger through the axial distance previously occupied by the stop collar  64 . 
     The injection apparatuses according to this invention may also allow the administering of a second or subsequent dose in a manual manner. In such alternative mode of operation the syringe assembly is removed from the barrel in a manner the same as or similar to that described above. If the initial dose does not work with sufficient effectiveness, then the user may manually insert the forward needle into the flesh of the patient and depress the plunger rod with the thumb. This procedure may be used when re-cocking the driver is difficult or impossible, or to speed administration of the second or subsequent doses. 
     More than one stop collar can be provided, and more than two injections from the same syringe may be administered. It is also noted that the injection device may be provided without a stop collar, so the syringe would be used only for one auto-injection. Excess medicine can be provided in the syringe for manual administration. Dosage amounts can be more accurately determined by axially adjusting the headed part  62  of the plunger rod  61 . In either case, the device can be re-used. In a first mode of operation, the device can be reset by re-cocking and installing the same syringe previously used. In a second mode of operation, the device can be reset in the manner described above and a second syringe subassembly can be installed and used and operated as done with the first syringe. 
     Manner of Making 
     Many of the components of the auto-injector are preferably made by molding, such as injection molding, a suitable medical grade transparent plastic into the configurations shown and described herein. Metal pieces are turned or fabricated according to various well-known metal working techniques. Preferred components for the injector are detailed below or stated above. 
     The plunger shaft  63  is preferably made from a metal material, such as 2024 grade aluminum which is anodized with a clear material per military specification MIL A 8625 C clear. 
     The tubular penetration control sleeve is preferably made from a suitable plastic material which is molded into the desired shape and size. A preferred material is sold under the name Celcon TX90 Plus. Others are possible such as Nylon 6 (Capron 8253), or M270 Celcon. 
     The springs are preferably made from steel music wire having high strength for the small size and excellent spring retention capabilities. The return spring may vary, but in some forms 0.015 inch diameter has been preferred, type A228; however, heavier wire may be preferred in various constructions. The drive spring is preferably ASTM-A313 type 17-7 PH stainless steel wire, 0.033 inch diameter. 
     The driver release annular piece  43  is preferably made from a suitable steel, such as 12L14 Grade A steel, which is preferably zinc plated per ASTM B633-85 Type III SEI. 
     The nose cap, safety cap  55  piece and sheath remover  80  are preferably made from a molded plastic such as Amoco #4039 polypropylene or Polymerland #1120. 
     The needle sheath is preferably made from high density polyethylene Spec. #MS-4079. 
     The carrying case is preferably made from a non-transparent or opaque colored plastic material, such as polypropylene, for example, Rexene #17C9A polypropylene. 
     The spring clip on the carrying case is preferably made from a suitable steel, such as a chrome or other plated steel which does not easily rust, or from a suitable stainless steel, such as 0.010 inch 301 stainless steel half hardness with #2 finish. 
     The sheath remover  80  and safety cap  55  are preferably made from DuPont Zytel 101L. 
     The firing sleeve  57  and plunger adjustment screw are preferably made of Bayer Markrolon #2607-1112 polycarbonate. 
     The drive spring bushing is preferably made from Amoco #4039 polypropylene. 
     The barrel is preferably made from Plexiglas DR 101 Acrylic. The spring guide for the drive spring is preferably made from Dow 478-27-W high impact polystyrene. 
     The stop collar and bushing edge against which it bears are preferably made from Amoco #4039 polypropylene or Polymerland #1120. 
     The spring release is preferably made from 8 NOS high density 70/30 brass CL C2600 per ASTM 1336-91A. 
     FURTHER ASPECTS AND FEATURES 
     The above description has set out various features and aspects of the inventions and the preferred embodiments thereof. Such aspects and features may further be defined according to the following claims which may individually or in various combinations of the recited features help to define the inventions in accordance herewith. 
     INTERPRETATION NOTE 
     The invention has been described in language directed to the current embodiments shown and described with regard to various structural and methodological features. The scope of protection as defined by the claims is not intended to be necessarily limited to the specific features shown and described. Other forms and equivalents for implementing the inventions can be made without departing from the scope of concepts properly protected hereby.