Patent Publication Number: US-2021187198-A1

Title: Spring loaded medical needle-free injection system

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority pursuant to 35 U.S.C. 119(e) to co-pending U.S. Provisional Patent Application Ser. No. 62/949,984, filed Dec. 18, 2019, the entire disclosure of which is incorporated herein by reference. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates to a medical injection device and kit. More particularly, the present invention relates to an improved spring loaded needle-free hypodermic injection device. 
     BACKGROUND OF THE INVENTION 
     Medical needle-free injection technologies do not pierce the skin of a subject with a conventional needle to deliver medication to a subject. Some benefits of needle-free injection compared to conventional injections may include: reduced risk of needle stick accidents; eliminated risk of disease transmission from re-used needles; reduced bleeding or bruising; faster and more reproducible drug delivery; not subject to needle-phobia; and better suited to self-administration. Depending on its specifications, a needle-free injection device may be suitable for subcutaneous, transdermal or intramuscular use. 
     Injection free devices inject liquid or powdered medicine through micro orifices by rapidly applied high pressure. Coil springs, gas-springs and explosives supply the rapid high pressure. Inventors are constantly improving on such devices making them safer to use by healthcare professionals and patients. 
     For instance, Thai et al. in PCT patent application WO2012154025 A2 discloses a spring-powered needle-free hypodermic injector. The spring is associated with a piston head, which are both slidably housed within the handle of the injector. When compressed, the spring is positioned in the handle opposite the open end of the device and the open end is connected to the plunger end of a needle-free syringe that holds the fluid to be injected. The compressed spring is held in place by the stopper of a trigger which is pivotally mounted to the handle near the opening of the device. When trigger-actuated by displacing the trigger stopper from piston head, the power stored in the spring drives the piston head to depress the plunger of the syringe and force the fluid from the nozzle into the subject&#39;s skin. 
     A return spring returns the trigger to the non-actuated position. A slid-able safety lock on the handle proximal the opening of the device can be slid under an end of the trigger to prevent accidentally actuating the device. The injector, however, may not b e used by users other than professionals in clinical setting. 
     Nzike et al. in U.S. Pat. No. 9,421,335 B2 proposed a clutch mechanism for rotationally locking and releasing the dose member within a drive sleeve. The clutch, however, lacks positive safety against accidental triggering. 
     Most of the marketed needle-free injectors have serious limitations. For example, the placement of a trigger on the side of the injector may not be convenient for self-injection, as it may be difficult for the user to orient the injector perpendicular to the user&#39;s skin and hold it securely there with the user&#39;s thumb pointing towards the user&#39;s body. When an injector is not held securely and perpendicularly against the skin, it may fail or cause medication leakage during injection. In addition, the spring force of some injectors is only sufficient to inject a small volume of fluid. Small volume injections are not optimal for some users/patients. In some injectors, the form factor is fixed, with the result that the injector cannot be modified to increase its spring force for higher volume injections. As an alternative to using spring power, certain needle-free injectors use compressed gas, battery power or a pyrotechnic charge to drive fluid through the nozzle and into or through the skin or tissue of the subject. 
     For example, Boyd et al. in U.S. Pat. No. 8,734,384 B2 discloses a compressed gas injector which operates by pushing the piston into a fluid filled chamber, which pressurizes the fluid and creates a fluid jet as it empties through a jet orifice. Actuation of the injector in this device is preferably triggered from pressing the device against the patient&#39;s skin. Triggering the device however is not handy and the gas pressure pistons can be misused or mishandled and require resupply with limited shelf life. 
     Some needle-free injectors are intended for disposal after a single use, while others are reloadable. Certain other needle-free injectors inject powdered substances as micro projectiles. 
     Improvement on the state of art is obviously needed. More specifically, safer and handier mechanisms are in demand which can excerpt precision metered doses at precision selected pressures for self-administering safety. Hand power reloading is preferred over prepackaged consumable power cartridges. 
     The object of the invention is to improve on the state of the art by overcoming the listed and other shortcomings in needle-free liquid medicine delivery into human or animal bodies. 
     SUMMARY OF THE INVENTION 
     The above problems and others are at least partially solved and the above objects and others realized in a process, which, in some embodiments, according to the teachings of this invention, uses a medical fluid injection device, comprising: a housing having an inner surface and an outer surface which extend from a trigger end to a dispensing end along an injection axis, the trigger end comprising an external actuation surface disposed transverse to the injection axis; a syringe adapter removably or irremovably affixed to the dispensing end of the housing, the syringe adapter configured to retain a needle-free syringe such that a plunger of the needle-free syringe is movable within the housing along the injection axis; a piston retained within the housing by the syringe adapter and movable along the injection axis between a loaded position proximal to the trigger end and an unloaded position proximal the dispensing end, the piston comprising a piston head proximal to the dispensing end and a trigger catch proximal to the trigger end of the housing, the piston head being movably positioned to bias the plunger of the needle-free syringe along the injection axis; a compression spring retained around the piston by the piston head, the piston and compression spring sized relative to the housing such that the compression spring is compressible along the injection axis within the housing; and a trigger mounted within the housing proximal the trigger end and movable between a non-actuated position and an actuated position by depression of a push-button disposed at the external actuation surface of the housing, the trigger comprising a trigger latch configured to engage the trigger catch when the trigger is in the non-actuated position and the piston is in the loaded position, and to release the trigger catch when the trigger is in the actuated position, wherein the trigger catch is configured to urge the trigger latch in a direction transverse to the injection axis when the piston moves from the unloaded position to the loaded position. 
     The trigger catch of some embodiments of the fluid injection device comprises an annular engagement surface extending radially outward from the injection axis and facing towards the dispensing end of the housing. The trigger latch of some embodiments comprises an engagement surface extending inwardly towards the injection axis and facing towards the trigger end of the housing, and which engages the annular engagement surface of the trigger catch when the trigger is in the non-actuated position and clears the trigger catch when the trigger is in the actuated position. The trigger catch of the fluid injection device of some embodiments further comprises an annular beveled surface which faces away from the injection axis towards the trigger end of the housing. The trigger latch of some embodiments further comprises a beveled surface which faces towards the injection axis and towards the dispensing end of the housing. 
     The trigger of some embodiments further comprises a lever biased towards the push-button by a return spring disposed within the housing. The return spring in some embodiments is a clip spring biased against the lever of the trigger. 
     The fluid injection device of some embodiments further comprises a movable safety cap for blocking depression of the push-button. The safety cap of some such embodiments is pivotally mounted to the external actuation surface of the housing and popped up by the fingernail of the thumb of a self-injecting patient. 
     The interior surface of some embodiments of the housing of the fluid injection device comprises a portion extending towards the injection axis and which blocks the compression spring from contacting the trigger. 
     The syringe adapter of the fluid injection device of some embodiments comprises an outer surface that extends away from the injection axis beyond the outer surface of the housing. The syringe adapter of some embodiments is removable. 
     The housing of some embodiments is capable of being configured to removably accept alternatively configured syringe adaptors. 
     The piston and the compression spring of some embodiments is capable of being removable from the housing when the syringe adapter is removed from the housing. The housing of some embodiments is capable of being configured to removably accept one or both of alternatively sized pistons and springs. 
     Various embodiments of this disclosure relate to a kit comprising: a fluid injection device of the type defined above; and a loader configured to receive the fluid injection device on an interior retaining surface comprising a lip adapted to engage the outer surface of the syringe adapter of the fluid injection device, wherein the loader is movable about a hinge between an open state and a closed state to extend a plunger into an open end of the syringe adapter to contact the piston head so as to push the piston from the unloaded position into the loaded position. 
     In some embodiments, the syringe adapter of the fluid injection device is capable of being removable and the kit of some embodiments further comprises one or more additional compression springs, each of which is distinctly configured to provide a different spring force. In some embodiments, the syringe adapter contains features that allow the syringe adapter to work smoothly with springs designed for the appropriate size of the syringe adapter. In some embodiments, the syringe adapter of the fluid injection device is capable of being removable and the kit of some embodiments further comprises one or more additional syringe adapters, each of which is configured to retain a different needle-free syringe. 
     The foregoing and other objects are intended to be illustrative of the invention and are not meant in a limiting sense. Many possible embodiments of the invention may be made and will be readily evident upon a study of the following specification and accompanying drawings comprising a part thereof. Various features and subcombinations of invention may be employed without reference to other features and subcombinations. Other objects and advantages of this invention will become apparent from the following description taken in connection with the accompanying drawings, wherein is set forth by way of illustration and example, an embodiment of this invention and various features thereof. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       A preferred embodiment of the invention, illustrative of the best mode in which the applicant has contemplated applying the principles, is set forth in the following description and is shown in the drawings and is particularly and distinctly pointed out and set forth in the appended claims. 
         FIG. 1  shows an isometric view of a fluid injection device in accordance with an embodiment of the present invention, in a loaded state and attached to a needle-free syringe. 
         FIG. 2  shows an offset sectional view of the fluid injection device of  FIG. 1 , in a loaded and non-actuated state. 
         FIG. 3A  shows a full sectional view of a portion of the fluid injection device of  FIG. 1 , in a loaded and non-actuated state. 
         FIG. 3B  shows a full sectional view of the fluid injection device of  FIG. 1 , in an unloaded and non-actuated state. 
         FIG. 4A  shows an isometric view of an open loader retaining the fluid injection device of  FIG. 1 . 
         FIG. 4B  shows a partially exploded view of the open loader of  FIG. 4A  without the fluid injection device assembled compact. 
         FIG. 4C  shows a partially exploded view of the open loader of  FIG. 4A  without the fluid injection device disassembled and stripped apart. 
     
    
    
     DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT 
     As required, a detailed embodiment of the present invention is disclosed herein; however, it is to be understood that the disclosed embodiment is merely exemplary of the principles of the invention, which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present invention in virtually any appropriately detailed structure. 
     The following description discloses the proposed fluid injector device for use with a needle-free syringe with preferred embodiment illustrated in  FIGS. 1-3B  along with its spring loader, which is shown in  FIGS. 4A-4C . 
     Attention is now turned to  FIG. 1 , which, in isometric view, illustrates injector  10 , comprising of housing  20  with triggered spring loaded mechanism, needle-free syringe adapter  30  and needle-free syringe  40 , whereas injector  10 , housing  20 , adapter  30  and syringe  40  are all aligned along dispensing axis X, which is the injection axis. Injector  10  is shown in its loaded state. However, after injection, injector  10  looks the same. Without reloading, triggering will not cause a secondary injection. 
     The housing and other components of the fluid injector device of various embodiments are made of stainless steel, for example, or any other suitable metal (e.g. zinc/chrome-plated carbon steel) or any other suitable rigid material, such as a rigid plastic (e.g. PC/ABS plastic) or the like. In some embodiments, the housing includes a generally continuous cylindrical metal (e.g. stainless steel, zinc, carbon, etc.) material tube inner and outer surfaces with openings only at the trigger end and the dispensing end. In some such embodiments, the only non-metal components enclosing the housing are located at the openings at the trigger end (e.g. the push button  26 , clip spring  27 , housing top retainer  28 , and safety cap  29 ), and the dispensing end (e.g. the syringe). The wall thickness of the metal utilized for the housing is sufficient to support the internal components of the injector (e.g. spring, piston, etc.), and also to prevent significant sound created within the housing (e.g. from the spring/piston actuation) from escaping the sidewalls. This structure and the heavier and thicker metal material of the housing result in limiting the amount of sound that is produced by the injector during operation. The syringe itself functions to seal the dispensing end opening and absorb sound produced by the actuation mechanism (e.g. spring, etc.) during actuation. As such, the only point in which sound generated during actuation can travel outside of the housing is through the non-metal components at the trigger end (which in some embodiments is sealed by the non-metal components such as the push button, housing top retainer, safety cap, etc.). In addition to reducing the sound generated, the sound is directed away from the subject being injected, and is less likely to startle the subject during injection. 
     Embodiments of the housing include a variety of sizes depending on its intended manner of use. For example, the housing of some embodiments is sized and shaped to be held comfortably by the user in one hand (e.g. a cylinder of approximate dimensions 13 cm long×1.5 cm diameter). The user may be someone who is self-injecting, for example in the abdomen, arm, leg or another location of the body. Alternatively, the user may be a medical professional or technician who is injecting a human or animal subject. 
     Attention is now turned to  FIG. 2 , which, in isometric partial section view, illustrates injector  10  with housing  20  with mounted syringe adapter  30  in partial disassembly with syringe  40 . Injector  10  is shown in its loaded state. 
     Housing  20  comprises body  21 , piston  22  with trigger catch shoulder  24 A and hammer tip  24 B, piston stop  23 A, loaded with coil spring  23 , trigger catch  25 , push button  26 , clip spring  27 , housing top retainer  28 , and safety cap  29 . 
     Adapter  30  comprises threaded socket  31  and threaded shoulder  32 . 
     Syringe  40  comprises liquid medicine dispenser capsule  41 , threaded head  42 , head stop shoulder  43 , dispensing tip  44  and injection nozzle  45  with one or more micro orifices. 
     The trigger end of the housing includes an external actuation surface disposed transverse to the injection axis X. This places the actuation surface in good position for the thumb of a user to actuate the device for self-injection by depression of a push-button disposed at the external actuation surface. For example, the push button of some embodiments is configured to be depressed in line or substantially in line with the injection axis. Some embodiments of the fluid injector device further comprise a movable safety cap for blocking depression of the push-button. The safety cap of various embodiments is capable of being mounted by any suitable way. For example, the safety cap of some embodiments is capable of being pivotally mounted to the external actuation surface of the housing so that it is capable of being easily lifted (e.g. with a thumb) to access the push-button when necessary and, just as easily, reseated (e.g. with a thumb or with the thumb fingernail tip) to block accidental actuation. The pivotal mount of some embodiments comprises a metal pin or in other embodiments is made of a flexible plastic or any other type of hinge. The safety cap of some embodiments is alternatively mounted by non-hinged means, e.g. via a removable friction fit or the like. Teetering of the cap (such that the cap is designed to fall back over the push-button through gravity), to prevent cap loss, is capable of being used for any removable cap. Teetering of the cap also improves safety by preventing accidental activation of the push-button if the cap were left removed or lost. 
     The dispensing end of the housing is connected to a syringe adapter configured to retain the needle-free syringe such that the plunger of the needle-free syringe is movable within the housing along the injection axis X. For example, in some embodiments, threading within the open end of the syringe adapter mates with the housing of the needle-free syringe. In certain embodiments, the threading consists of 3 threads. In other embodiments, the threading consists of 2, 3, 4, 5, 6, 7, 8 or more threads. The threading in some embodiments is configured to mate with commercially available syringes. 
     The syringe adapter is affixed to the dispensing end of the housing. In certain embodiments, the syringe adapter is removably affixed. For example, the syringe adapter of some embodiments is secured by threading on an angular position which mates with threading on the inner surface of the housing. In alternative embodiments, the syringe adapter is not removable or comprises part of the housing. 
     The triggering mechanism is explained next. 
     Attention is now turned to  FIG. 3A , which, in isometric partial section view, illustrates injector head  10 A with the trigger mechanism. 
     Head  10 A comprises housing body  21  with inner surface  21 A, which guides spring  23  which guides piston  22  having neck  22 A with beveled trigger catch shoulder  24 A, trigger latch  25  pivoting on pin  25 A and catching at contact  24 C, push button  26  with front sliding guide  26 A and rear sliding guide  26 B and restrainer protrusion  26 C and lever contact  26 D, button position restoring clip spring  27  with end fixture  27 A and sliding tip  27 B, housing top retainer  28  with lower stop socket  28 A and upper pop-in socket  28 B and venting slot  28 C, and safety cap  29  with pivot hinge  29 A and snap-in recess lock  29 B. 
     The piston is retained within the housing and is movable along the injection axis between a loaded position (as shown) proximal the trigger end and an unloaded position (as will be shown next) proximal the dispensing end. 
     The piston comprises a piston head proximal to the dispensing end. The syringe adapter is configured to retain the piston in the housing. For example, the piston head in some embodiments is larger than the opening in the syringe adapter (e.g. formed by the annular portion of the syringe adapter. 
     The piston head in some embodiments includes a portion sized to extend into the opening of the syringe adapter when the piston is in the unloaded position for contacting the plunger of a needle free syringe. 
     The compression spring is retained within the housing and around the piston. The compression spring is retained around the piston and is further retained by the piston head proximal to the dispensing end. The interior surface of the housing in some embodiments comprises a portion extending towards the injection axis shown in  FIG. 1  which blocks the compression spring from contacting the trigger. The piston and compression spring are sized relative to the housing such that the compression spring is compressible along injection axis X within the housing. For example, the outer surfaces of the spring and the piston head in some embodiments slide along the inner surface of the housing. 
     The configuration of the compression spring in some embodiments is capable of being varied to modify the force in which the piston head will depress the plunger of the needle-free syringe. As a result, it is possible to target different injection depths by choosing different configurations. For example, for subcutaneous injection, the compression spring is capable of being varied depending on the desired depth of penetration. Typical non-limiting examples of spring forces for subcutaneous injection range between 185-10 N to 165-8 N, depending on the degree of fat under the skin. Typical non-limiting examples of spring forces for intramuscular injection are around 200-20 N. Typical non-limiting spring forces for intradermal injection range between 60-5 N and 90-5 N, depending on the age of the subject. The compression spring of various embodiments is capable of thus being configured to provide a spring force of 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, 125, 130, 135, 140, 145, 150, 155, 160, 165, 170, 175, 180, 185, 190, 195, 200, 205, 210, 215, 220, 225, 230, 235, 240, 245 or 250 N, or greater. 
     The choice of materials, gauge and coil number to produce a suitable spring to generate these forces is well within the common general knowledge of a person of skill in the art. In one non-limiting example of a spring, the spring material is high carbon spring wire with a wire diameter of 0.4 mm, a mean coil diameter of 3.2 mm, 9 active coils and 11 total coils, a spring stiffness of 0.86 N/mm, and free, working and assembly lengths 25 mm, 19.4 mm and 12.4 mm, respectively. These metrics are merely exemplary, however. 
     Where the syringe adapter is removable, the housing of some embodiments is capable of being configured to removably accept one or more of alternatively configured syringe adapters, pistons and springs. 
     The piston is retained in the loaded position by the trigger, which is mounted within the housing proximal to the trigger end and which is movable between a non-actuated position (shown) and an actuated position (not shown) by depression of the push-button. The trigger of some embodiments comprises a lever biased towards the push-button by a return spring disposed within the housing. The return spring in some embodiments is a clip spring, e.g. mounted to the interior surface of the housing or elsewhere in the housing. 
     The piston further comprises a trigger catch, disposed proximal the trigger end of the housing, i.e. opposite the piston head. The trigger further comprises a trigger latch configured to engage the trigger catch when the trigger is in the non-actuated position and the piston is in the loaded position and to release the trigger catch when the trigger is in the actuated position (not shown). In some embodiments, the trigger catch of the piston comprises an annular engagement surface extending outward from the injection axis X and facing towards the dispensing end of the housing of the fluid injection device. The annular engagement surface in some embodiments extends radially outward from the injection axis. The trigger latch in some embodiments comprises an engagement surface extending inwardly towards the injection axis and facing towards the trigger end of the housing. In such embodiments, the engagement surface of the trigger latch engages the annular engagement surface of the trigger catch when the trigger is in the non-actuated position and clears the trigger catch while the trigger is in the actuated position (not shown). 
     To facilitate loading of the fluid injection device, the trigger catch of some embodiments is capable of being configured to urge the trigger latch in a direction transverse to the injection axis X when the piston moves from the unloaded position to the loaded position. In some embodiments, the annular engagement surface of the trigger catch comprises an annular beveled surface which faces away from the injection axis towards the trigger end of the housing and the engagement surface of the trigger latch of some embodiments further comprises a beveled surface which faces towards the injection axis and towards the dispensing end of the housing. A loader device further facilitates loading. That is explained further on and illustrated by  FIGS. 4A-4C . 
     Attention is now turned to  FIG. 3B , which, in isometric partial section view, illustrates injector  10 B, which is injector  10  in unloaded position. Likewise components labeled likewise. Syringe adapter  30  is shown here in section view with housing tread  31 B and syringe socket shoulder  31 . The loader is explained next. 
     Attention is now turned to  FIG. 4A , which, in isometric view, illustrates loader assembly  50 A with injector  10 B positioned to be loaded and lever assembly  60  with loader mechanism  70 . 
     The loader of some embodiments takes the form of a hinged case comprised of top and bottom halves. The loader is movable between an open (as shown) and closed state (not shown). Further details are disclosed in  FIGS. 4B and 4C . 
     Attention is now turned to  FIG. 4B , which, in isometric view, illustrates loader compact assembly  50 B without injector, readied to load. 
     Lever assembly  60  comprises lower arm  61 , upper arm  62 , and arms connector hinge  63 . The lower arm has injector receiving socket  61 A and sliding guides  61 B formed from its body. The upper arm has sliding guide  62 As formed between stiffener ribs. Parts of mechanism  70  slide on said guides. 
     Attention is finally turned to  FIG. 4 c   , which, in isometric view, illustrates loader disassembled assembly  50 C without injector, stripped apart for clarity. Likewise components labeled likewise. 
     Loading mechanism  70  comprises caddy  71  which is abutted by reaction wall  61 C, framed plunger  72  with push pin  72 A, forcing arm  73  with hinge  73 A and slider tips  73 B. 
     To reduce or eliminate force on the external actuation surface of the fluid injection device during loading, the loader of some embodiments is capable of being configured to retain the syringe adapter and prevent movement of the fluid injection device during loading. For example, the syringe adapter of some embodiments comprises an outer surface that extends away from the injection axis beyond the outer surface of the housing. The loader of some embodiments is capable of being configured to receive the fluid injector device on an interior retaining surface comprising a lip adapted to engage the outer surface of the syringe adapter of the fluid injector device. Since the lip of the interior retaining surface of the loader is adapted to engage the extended outer surface of the syringe adapter of the fluid injector device, none of the push-button, safety cap and external actuation surface are stressed against the interior surface of the loader during loading. 
     Finally, a kit is also disclosed (not shown). The kit comprises a fluid injector device and a loader. The syringe adapter of the fluid injector device of some embodiments is capable of being removable. In some of these embodiments, the kit includes one or more additional compression springs, each of which is distinctly configured to provide a different spring force. Where the syringe adapter is removable, the kit of some embodiments includes one or more additional syringe adapters, each of which is distinctly configured to retain different needle-free syringes, preferably labeled for 0.1-0.5 ml intervals for fluid delivery. 
     To the skilled in the art of needle free injecting, it shall be obvious that the disclosed and proposed novel features of the invention, including the trigger mechanism, its safety cap, the spring force graduation, the spring loader and the spring-piston kit, all facilitate safer use, simpler mechanism, lesser cost and more ease and speed of use, thus represent great improvement on the state of art. 
     The present invention is described above with reference to a preferred embodiment. However, those skilled in the art will recognize that changes and modifications may be made in the described embodiment without departing from the nature and scope of the present invention. 
     For instance, replacing the coil spring with crest-to-crest wave spring is intuitive and thus instructive as being within the scope of the invention. Crest-to-crest springs, known as Smalley Wave Springs, fit smaller space than coil springs for being half as short for the same force, and allow for the proposed force graduation by wave clipping, which greatly reduces manufacturing cost. Wave springs use flat, not round but rolled from round, wires and, in essence, are a series of leaf springs in contact and continuation around a circular path, fitting into a cylindrical space. Wave springs can be laminated to give damping which reduces recoil felt on the push button of the device. 
     Furthermore, it is also considered within the scope storing one or more springs, pistons or spring-piston sets in the loader in sockets or compartments to be handy for the one who needs only a few different spring force settings. That is, it is considered intuitive and hereby instructive to combine the kit with the loader. 
     Also considered within the scope accessories facilitating the syringe fill-up from a vial and collar sets enlarging the syringe tip area to be pushed against the skin. In some embodiments, a syringe fill-up accessory includes a vial adapter that creates an appropriate transition/connection between the injection nozzle of the syringe and the opening of a vial from which the syringe is to be filled. In some such embodiments, the vial adapter includes three components, a main body, a lid and an insert. In such embodiments the lid covers a syringe fill side of the main body to protect from contaminants. The lid is removable for filling, to expose a retention mechanism on the main body that positively engages with the injection nozzle of the syringe to hold the syringe in proper position during filling. The main body includes a straw that protrudes from the vial-side of the main body, which opposes the syringe fill side of the main body. The straw extends into the vial for filling the syringe. The main body includes an O-ring seal at the top of the straw for engagement with the syringe nozzle. The vial-side of the main body is sized and shaped to engage with the opening of a large vial, as well as with a first end of the vial adapter. The opposing second end of the vial adapter is sized and shaped to engage with the opening of a smaller vial. In operation, the insert is removed from the main body to connect the vial adapter to a large vial. The insert is left connected to the vial adapter to connect the vial adapter to a small vial. 
     In the foregoing description, certain terms have been used for brevity, clearness and understanding; but no unnecessary limitations are to be implied therefrom beyond the requirements of the prior art, because such terms are used for descriptive purposes and are intended to be broadly construed. Moreover, the description and illustration of the inventions is by way of example, and the scope of the inventions is not limited to the exact details shown or described. 
     Although the foregoing detailed description of the present invention has been described by reference to an exemplary embodiment, and the best mode contemplated for carrying out the present invention has been shown and described, it will be understood that certain changes, modification or variations may be made in embodying the above invention, and in the construction thereof, other than those specifically set forth herein, may be achieved by those skilled in the art without departing from the spirit and scope of the invention, and that such changes, modification or variations are to be considered as being within the overall scope of the present invention. Therefore, it is contemplated to cover the present invention and any and all changes, modifications, variations, or equivalents that fall with in the true spirit and scope of the underlying principles disclosed and claimed herein. Consequently, the scope of the present invention is intended to be limited only by the attached claims, all matter contained in the above description and shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense. 
     Having now described the features, discoveries and principles of the invention, the manner in which the invention is constructed and used, the characteristics of the construction, and advantageous, new and useful results obtained; the new and useful structures, devices, elements, arrangements, parts and combinations, are set forth in the appended claims. 
     It is also to be understood that the following claims are intended to cover all of the generic and specific features of the invention herein described, and all statements of the scope of the invention which, as a matter of language, might be said to fall therebetween.