Patent Publication Number: US-8968261-B2

Title: Medical valve with resilient biasing member

Description:
PRIORITY 
     This patent application claims priority from provisional U.S. patent applications: 
     Application No. 60/790,914, filed Apr. 11, 2006, entitled, “ROTATIONAL MEDICAL VALVE,” and naming Todd S. Vangsness and Jeffrey F. Kane as inventors, the disclosure of which is incorporated herein, in its entirety, by reference. 
     Application No. 60/837,442, filed Aug. 11, 2006, entitled, “ROTATIONAL MEDICAL VALVE,” and naming Todd S. Vangsness and Jeffrey F. Kane as inventors, the disclosure of which is incorporated herein, in its entirety, by reference. 
     Application No. 60/883,674, filed Jan. 5, 2007, entitled, “ROTATIONAL MEDICAL VALVE,” and naming Jeffrey F. Kane, Todd S. Vangsness, and Ian Kimball as inventors, the disclosure of which is incorporated herein, in its entirety, by reference. 
     RELATED UNITED STATES PATENT APPLICATIONS 
     This patent application is related to the following co-pending U.S. patent applications: 
     U.S. patent application Ser. No. 11/786,413, entitled, “MEDICAL VALVE WITH ROTATING MEMBER AND METHOD,” naming Todd S. Vangsness, Jeffrey F. Kane, and Ian Kimball as inventors, filed on even date herewith, now U.S. Pat. No. 7,815,168, the disclosure of which is incorporated herein, in its entirety, by reference. 
     U.S. patent application Ser. No. 11/786,457, entitled, “MEDICAL VALVE WITH RESILIENT SEALING MEMBER,” naming Jeffrey F. Kane, Ian Kimball, and Todd S. Vangsness as inventors, filed on even date herewith, now U.S. Pat. No. 7,879,012, the disclosure of which is incorporated herein, in its entirety, by reference. 
     U.S. patent application Ser. No. 11/786,425, entitled, “MEDICAL VALVE WITH MOVABLE MEMBER,” naming Ian Kimball, Todd S. Vangsness, and Jeffrey F. Kane as inventors, filed on even date herewith, now U.S. Pat. No. 7,857,284, the disclosure of which is incorporated herein, in its entirety, by reference. 
     U.S. patent application Ser. No. 11/786,452, entitled, “ANTI-DRAWBACK MEDICAL VALVE AND METHOD,” naming Todd S. Vangsness, Jeffery F. Kane, and Ian Kimball as inventors, filed on even date herewith, now U.S. Pat. No. 8,002,755, the disclosure of which is incorporated herein, in its entirety, by reference. 
    
    
     FIELD OF THE INVENTION 
     The invention generally relates to medical valves and, more particularly, the invention relates to a medical valve having a resilient biasing mechanism. 
     BACKGROUND OF THE INVENTION 
     In general terms, medical valving devices often act as a sealed port that may be repeatedly accessed to non-invasively inject fluid into (or withdraw fluid from) a patient&#39;s vasculature. During use, medical personnel may insert a syringe into the proximal port of a properly secured medical valve to inject fluid into (or withdraw fluid from) a patient. Once inserted, the syringe may freely inject or withdraw fluid to and from the patient. 
     SUMMARY OF THE INVENTION 
     In accordance with one aspect of the invention, a medical valve has an open mode that permits fluid flow, and a closed mode that prevents fluid flow. To that end, the medical valve has a housing with an inlet portion and an outlet portion, a rotating member having a protruding member, and a resilient member with a complimentary surface that mates with the protruding member. The inlet portion and outlet portion of the housing compress the protruding member against the resilient member to bias the valve to the closed mode. 
     In some embodiments, the housing has an outlet, and the resilient member has a flow path in fluid communication with the outlet. The inlet and outlet portions of the housing may compress the protruding member against the resilient member to seal the flow path of the resilient member in the dosed mode. Specifically, the rotating member may have a member channel that is in fluid communication with the distal opening of the resilient member when in the open mode. Compression of the protruding member against the resilient member thus may seal the member channel when in the open mode (e.g., about the member channel and distal opening). 
     Further, the resilient member may have a proximally located surface that contacts the inlet portion of the housing. At least a portion of that surface normally is a normal distance from the complimentary surface. The protruding member also may have a given thickness that is greater than the normal distance. Moreover, the resilient member may have an opening distal of the complimentary surface, where the opening permits deformation of the resilient member. 
     The protruding member may be formed from one member, or first and second protruding members that each respectively contact a first portion of the complimentary surface and a second portion of the complimentary surface. The complimentary surface also may have a third portion between the first and second portions. The first, second, and third portions illustratively normally form a substantially planar surface. 
     In accordance with another aspect of the invention, a medical valve has a housing with an inlet and an outlet, and a rotating member with a member channel therethrough. The rotating member is rotatable to cause the valve to transition from the closed mode to the open mode after insertion of a medical implement into the inlet. The member channel fluidly communicates the inlet and the outlet when in the open mode. The valve also has a resilient member biasing the rotating member to fluidly disconnect the inlet and the outlet (i.e., biasing the rotating member toward the closed mode). The resilient member has a complimentary portion that mates with the rotating member to substantially prevent longitudinal movement of the rotating member. 
     In accordance with another embodiment of the invention, a medical valve has a housing with an interior having an inlet, and a rotating member within the interior of the housing. The rotating member has a protruding member with a generally planar mating surface, and a generally planar implement surface that is not parallel with the mating surface. The implement surface is exposed to the inlet to permit contact with a medical implement inserted into the inlet. The valve also has a resilient member with a complimentary surface that mates with the mating surface of the protruding member to bias the rotating member to a closed mode. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Those skilled in the art should more fully appreciate advantages of various embodiments of the invention from the following “Description of Illustrative Embodiments,” discussed with reference to the drawings summarized immediately below. 
         FIG. 1  schematically shows one use of a medical valve configured in accordance with one embodiment of the present invention. 
         FIG. 2A  schematically shows a perspective view of a medical valve configured in accordance with illustrative embodiments of the present invention. 
         FIG. 2B  schematically shows a perspective view of a medical valve of  FIG. 2A  with a Y-site branch. 
         FIG. 3  schematically shows a perspective exploded view of the medical valve shown in  FIG. 2A . 
         FIGS. 4A-4G  schematically show cross-sectional views of the valve shown in  FIG. 2A  along line  4 - 4 . These figures show the general progression of the valve as it transitions between open and closed modes. 
         FIGS. 5A-5C  schematically show perspective views of an illustrative embodiment of a rotating member within the valve of  FIG. 2A . 
         FIG. 6A to 6D  schematically show perspective views of an illustrative embodiment of a resilient member within the valve of  FIG. 2A . 
         FIG. 6E  schematically shows a close-up view of a portion of the resilient member shown in  FIGS. 6A-6D . This close-up details a distal opening and a flange of the resilient member in a normal state (when not subjected to external forces, such as compression or stretching forces). 
         FIG. 6F  schematically shows a close-up view of the distal opening and flange when not in the normal state-in this case, with the rotating member in place and thus, compressing the flange. 
         FIG. 7  shows a process of using the medical valve shown in  FIG. 2A  in accordance with illustrative embodiments of the invention. 
         FIGS. 8A to 8C  schematically show alternative embodiments of the rotating member within the valve of  FIG. 2A . 
         FIGS. 9A and 9B  schematically show cross-sectional views an alternative embodiment the alternative rotating member shown in  FIG. 8C . These figures show the valve in the open and dosed modes. 
     
    
    
     DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS 
     In illustrative embodiments, a medical valve has a housing formed form an inlet portion and outlet portion that together form an interior containing a valve mechanism. The valve mechanism has a rotating member with a protruding member, and a resilient member with a complimentary surface that mates with the protruding member. The inlet portion and outlet portion of the housing compress the protruding member against the resilient member to bias the valve to the closed mode. Details of illustrative embodiments are discussed below. 
       FIG. 1  schematically shows one illustrative use of a medical valve  10  configured in accordance with illustrative embodiments of the invention. In this example, a catheter  70  connects the valve  10  with a patient&#39;s vein (the patient is identified by reference number  30 ). Adhesive tape or similar material may be coupled with the catheter  70  and patient&#39;s arm to ensure that the valve remains in place. 
     After the valve  10  is in place, a nurse, doctor, technician, practitioner, or other user (schematically identified by reference number  20 ) may intravenously deliver medication to the patient  30 , who is lying in a hospital bed. To that end, after the valve is properly primed and flushed (e.g., with a saline flush), the nurse  20  swabs the top surface of the valve  10  to remove contaminants. Next, the nurse  20  uses a medical instrument (e.g., a syringe having a distally located blunt, luer tip complying with ANSI/ISO standards) to inject medication into the patient  30  through the valve  10 . For example, the medical practitioner  20  may use the valve  10  to inject drugs such as heparin, antibiotic, pain medication, other intravenous medication, or other fluid deemed medically appropriate. Alternatively, the nurse  20  (or other user) may withdraw blood from the patient  30  through the valve  10 . 
     The medical valve  10  may receive medication or other fluids from other means, such as through a gravity feed system  45 . In general, traditional gravity feeding systems  45  often have a bag  50  (or bottle) containing a fluid (e.g., anesthesia medication) to be introduced into the patient  30  hanging from a pole  47 . The medical practitioner  20  then connects the bag/bottle  50  to the medical valve  10  using tubing  60  having an attached blunt tip. In illustrative embodiments, the blunt tip of the tubing has a luer taper that complies with the ANSI/ISO standard. After the tubing  60  is connected to the medical valve  10 , gravity (or a pump) causes the fluid to begin flowing into the patient  30 . In some embodiments, the feeding system  45  may include additional shut-off valves on the tubing  60  (e.g., stop-cock valves or clamps) to stop fluid flow without having to disconnect the tubing  60  from the valve  10 . Accordingly, the valve  10  can be used in long-term “indwell” procedures. 
     After administering or withdrawing fluid from the patient  30 , the nurse  20  should appropriately swab and flush the valve  10  and catheter  70  to remove contaminants and ensure proper operation. As known by those skilled in the art, there is a generally accepted valve swabbing and flushing protocol that should mitigate the likelihood of infection. Among other things, as summarized above, this protocol requires proper flushing and swabbing before and after the valve is used to deliver fluid to, or withdraw fluid from the patient. 
       FIG. 2A  schematically shows a perspective view of the medical valve  10  shown in  FIG. 1 , while  FIG. 2B  schematically shows the same valve with a Y-site branch (discussed below). In illustrative embodiments and primarily with reference to  FIG. 2A , the valve  10  is configured to have a substantially positive fluid displacement (e.g., about five to fifty microliters, or about five to fifteen microliters) during insertion of the instrument  40  into the valve  10 , and a substantially neutral fluid displacement (between about plus or minus 1 microliter of fluid displacement, discussed below) during removal of the instrument  40  from the valve. In other words, insertion of a syringe  40  causes a positive fluid displacement at the distal end of the valve  10  (distal port  120 , shown in  FIG. 2A  and discussed below), while syringe removal causes essentially no or negligible fluid displacement at the distal end of the valve  10 . 
     In this context, fluid displacement generally refers to the flow of fluid through the distal port  120  of the valve  10  (discussed below). Accordingly, a positive fluid displacement generally refers to fluid flowing in a distal direction through the distal port  120 , while a negative fluid displacement generally refers to a fluid flowing in a proximal direction through the distal port  120 . The positive/neutral nature of the valve  10  is discussed in greater detail below. Of course, not all embodiments exhibit this quality. For example, in alternative embodiments, the valve  10  may have a positive fluid displacement when the instrument  40  is inserted, and a negative fluid displacement when the instrument  40  is withdrawn. In fact, the valve  10  can exhibit other positive/negative/neutral fluid displacement qualities upon instrument insertion and withdrawal. For example, the valve  1  could exhibit a positive fluid displacement upon insertion, and a positive fluid displacement upon withdrawal. Accordingly, discussion of positive/neutral is not intended to limit all embodiments of the invention. 
     It should be noted that the fluid displacements discussed herein refer to the “net” fluid displaced through the distal port  120 . Specifically, during insertion or withdrawal of the instrument  40 , the actual flow of fluid through the distal port  120  may change direction and thus, fluctuate. However, when considering this fluctuation, the net change in fluid flow through the distal port  120  should be 1) positive when the valve exhibits a “positive fluid displacement,” and 2) negative when the valve exhibits a “negative fluid displacement.” In a similar manner, a substantially neutral fluid displacement occurs when, as noted above, the valve  10  has a net fluid displacement of about plus or minus one microliter. Of course, the fluid displacement of the valve  10  is discussed herein in terms of one stroke of the instrument  40  (i.e., insertion or withdrawal of the instrument  40 ). 
     Ideally, a valve with a neutral displacement has 0.0 microliters of positive or negative fluid displacement. As suggested above, however, in practice, a neutral displacement actually can have a very slight positive or negative displacement (e.g., caused by a manufacturing tolerance), such as a displacement on the order of positive or negative one microliter, or less. In other words, in such embodiments, the volumes of fluid forced through the distal port  120  in a neutral displacement valve are negligible (ideally zero microliters) and should have a negligible impact on the goals of the valve. 
     Some embodiments may have a positive fluid displacement upon insertion, but a very low positive fluid displacement or very low negative fluid displacement upon withdrawal. For example, such valves  10  may have a negative fluid displacement of about one to two microliters (i.e., about one to two microliters of fluid drawback, which is proximally directed), or about one to two microliters positive fluid displacement (i.e., about one to two microliters of positively pushed fluid, which is distally directed). Although such amounts are in the positive or negative fluid displacement ranges, they still should represent a significant improvement over valves that exhibit higher positive or negative fluid displacements upon withdrawal. 
     The neutral, positive, or negative fluid displacement of a valve may be corrupted by manual handling of the valve  10 , catheter  70  or the instrument  40  during the fluid transfer. For example, a slight inward force applied to the shaft of the syringe  40  (e.g., by the nurse&#39;s hand when simply holding the syringe  40 ) can have the effect of adding a positive fluid displacement from the syringe (when the force is applied) and, ultimately, through the valve  10 . In fact, releasing this force from the syringe  40  actually may draw fluid proximally, causing a negative fluid displacement that further corrupts fluid displacement. These effects, however, should not be considered when determining the nature of fluid displacement through the distal port  120 . To overcome the problem noted above with regard to squeezing the syringe shaft, for example, the nurse  20  can hold another part of the syringe that does not contain the fluid (e.g., stubs at the proximal end of the syringe  40 ). 
     To accomplish these desired goals, the valve  10  has a housing  100  forming an interior having a proximal port  110  for receiving the instrument  40 , and the noted distal port  120  having the discussed fluid displacement properties. The valve  10  has an open mode that permits fluid flow through the valve  10 , and a closed mode that prevents fluid flow through the valve  10 . To that end, the interior contains a valve mechanism that selectively controls. (i.e., allow/permits) fluid flow through the valve  10 . The fluid passes through a complete fluid path that extends between the proximal port  110  and the distal port  120 . 
     It should be noted that although much of the discussion herein refers to the proximal port  110  as an inlet, and the distal port  120  as an outlet, the proximal and distal ports  110  and  120  also may be respectively used as outlet and inlet ports. Discussion of these ports in either configuration therefore is for illustrative purposes only. 
     The valve  10  is considered to provide a low pressure seal at its proximal end  110 . To that end, the proximal end  110  of the medical valve  10  has a resilient proximal gland  80  with a resealable aperture  130  that extends entirely through its profile. The aperture  130  may, for example, be a pierced hole or a slit. Alternatively, the proximal gland  80  may be molded with the aperture  130 . When the valve  10  is in the closed mode, as shown in  FIG. 2A , the aperture  130  may be held closed by the inner surface of the housing  100 . In that case, the inner diameter of the housing  100  at the proximal port  110  is smaller than the outer diameter of the proximal gland  80  and thus, the housing  100  squeezes the aperture  130  closed. Alternatively, the gland may be formed so that the aperture  130  normally stays closed in the absence of radially inward force provided by the inner diameter of the proximal port  110 . In other words, the proximal gland  80  is formed so that the aperture  130  normally is closed. 
     As suggested above, the proximal gland  80  is flush with or extends slightly above the exterior inlet face  140  of the inlet housing  160  ( FIG. 3 , discussed below). The proximal gland  80  and the exterior inlet face  140  thus present a swabbable surface, i.e., it may be easily wiped clean with an alcohol swab, for example, or other swab. Such valves typically have been referred to in the art as “swabbable valves.” Various other embodiments, however, may relate to other types of valves and thus, not all embodiments are limited to swabbable valves. In addition, some embodiments may be used with instruments  40  having blunt tips that do not comply with the ANSI/ISO luer standard. 
     The outside surface of the valve proximal end  110  may also have inlet threads  90  for connecting the medical instrument  40 . Alternatively or in addition, the proximal end may have a slip design for accepting instruments  40  that do not have a threaded interconnect. In a similar manner, the distal end of the valve  10  has a skirt  150  containing threads  280  (see  FIG. 4A to 4G ) for connecting a threaded port of the catheter of  FIG. 1 , or a different medical instrument, to the valve distal port  120 . The proximal end inlet threads  90  and the distal end threads  280  preferably comply with ANSI/ISO standards (e.g., they are able to receive/connect to medical instruments complying with ANSI/ISO standards). In addition to the threads described above, the internal geometry of the inlet housing  160  (e.g., shown in  FIG. 4A , discussed below) may taper in an opposite direction to that of a standard luer taper. 
       FIG. 3  schematically shows an exploded perspective view of the medical valve  10  shown in  FIG. 1 . As shown, the housing  100  includes an inlet housing  160  and an outlet housing  170  that connect to form the interior, which, as noted above, contains a valve mechanism. The inlet housing  160  and the outlet housing  170  may be joined together in a variety of ways, including a snap-fit connection, ultrasonic welding, plastic welding, or other method conventionally used in the art. 
     Generally, unlike the low pressure seal formed by the proximal gland  80 , the internal valve mechanism should be capable of withstanding relatively high pressures. Accordingly, this internal valve mechanism is referred to as a “high pressure seal.” To that end, the internal valve mechanism includes a moveable member  180  that cooperates with a resilient member  230  (without limiting scope, hereinafter referred to as “internal gland  230 ” for convenience) to selectively open and close the fluid channel through the housing  100 . In the embodiment shown in  FIG. 3 , the moveable member is a rotating member  180  formed from a relatively rigid material (e.g., medical grade plastic), while the internal gland  230  is a resilient gland member (e.g., medical grade silicone). To provide their valving function, the internal gland  230  has a concavity that supports the rotating member  180  within the interior of the valve housing  100 . Details of their interaction is discussed below. 
     Accordingly, as noted above, the valve  10  may be considered to have dual seals—a low pressure seal at the proximal end, and a high pressure seal within the interior. As an example, when used in the manner shown in  FIG. 1 , the low pressure seal may be able to withstand pressures of up to (on the order of about nine PSI and greater. The high pressure seal, however, may be able to withstand pressures up to (on the order of) about 45 PSI and greater. Of course, the materials and geometry of the internal components can be adjusted to change these values. Those skilled in the art therefore should design the valve  10  to operate effectively when subjected to pressures generally produced during anticipated uses. 
     In alternative embodiments, the rotating member  180  is formed from a relatively resilient material, while a relatively rigid member is substituted for the internal gland  230 . It also should be noted, however, that some embodiments use other types of movable members that are not primarily rotationally movable. For example, in those embodiments, the movable member may slide linearly. Accordingly, in such embodiments, a moveable member that is capable of selectively permitting fluid flow in the defined manner should be considered to be within the scope of this invention. 
     Although not clearly shown in  FIG. 3  (but more clearly shown in later figures), the rotating member  180  has a substantially hemispherical surface  190  supported by the internal gland  230 , and a generally proximally exposed surface  200  for contacting the instrument  40  when inserted through the inlet port  110 . As discussed below, this contact between the instrument  40  and proximally exposed surface  200  effectively actuates the rotational member  180 , thus opening the valve  10 . This proximally exposed surface  200  may be flat, or have some contour (e.g., waves, grooves, and/or protrusions) or texture. Discussion of it as a flat surface therefore is for illustrative purposes only. In a similar manner, the hemispherical surface  190  may have another shape that enables rotation (e.g., an elliptical, cylindrical, or hyperbolic shape). Discussion of a hemispherical shape therefore is for illustrative purposes only. 
     In addition to the proximally exposed surface  200  and substantially hemispherical surface  190 , the rotating member  180  also has a pair of a protruding members  210  that are not parallel to the proximally exposed surface  200 . The protruding members  210  help support the rotating member  180  within the internal gland  230 , and, as discussed in greater detail below, aid in biasing the rotating member  180  toward the closed position. To facilitate fluid flow through the fluid channel, the rotating member  180  also has a through channel  220  that, when in the open mode, channels fluid flow through the rotating member  180  and the valve  10 . 
     The internal gland  230  has a recessed surface  240  for receiving and supporting the rotating member  180 . When in the closed mode, the internal gland  230  covers the distal outlet  222  of the channel  220  through the rotating member  180 . By covering the distal outlet  222  of the channel  220 , the internal gland  230  may not necessarily seal at that point. In other words, fluid still may leak from the channel  220  and traverse along the recessed surface  240 . As discussed below, the internal gland  230  has an additional sealing feature (e.g., a flange  294  in one embodiment, discussed below) to prevent such fluid leaking to or from the channel  220  from entering the portion of the fluid path in communication with the distal port  120 . 
     In alternative embodiments, however, the internal gland  230  does seal the distal outlet  222  of member channel  220  when the valve  10  is in the dosed position. To that end, the internal gland  230  may be molded to have a relatively tight fit at that point. Such a fit, however, may increase the resistance of opening and closing the valve  10 . 
     Moreover, in preferred embodiments, the recessed surface  240  effectively is a concavity that generally conforms to the radius of the hemispherical surface  190  of the rotating member  180 . In other words, the radius of the hemispherical surface  190  is about the same as the radius of the recessed surface  240  to effectively form a close, registration fit. Other embodiments, however, do not have this relationship. In those cases, the concavity  240  can have a different radius that that of the hemispherical surface  190  (e.g., smaller or larger), or may be a different shape (e.g., elliptical, oval, etc. . . . ). Operation of and various features of the rotating member  180  and the internal gland  230  are discussed in greater detail below. 
     As discussed above,  FIG. 3  shows five pieces that form the valve  10  (i.e., the proximal gland  80 , the inlet housing  160 , the rotating member  180 , the resilient member/internal gland  230 , and the outlet housing  170 ). Different manufacturing processes form each part, which subsequently are assembled to form the valve  10 . As shown in  FIG. 4A  (discussed in detail below), the internal gland  230  is compressed between the inlet housing  160  and outlet housing  170 . This compression effectively forms a seal that mitigates the likelihood that fluid can leak in the interface between the housing portions  160 / 170  and the internal gland  230 . In other words, the internal gland  230  forms a seal between it and the housing portions  160 / 170 . 
     Alternative manufacturing techniques, however, can reduce the total number of components, and therefore simplify assembly. In particular, the proximal gland  80  and the inlet housing  160  can be manufactured in a “two-shot” or “over-mold” process. As known by those in the art, the two-shot manufacturing process creates one piece formed with two materials (i.e., the elastomeric proximal gland  80  material and the material forming the rigid inlet housing  160 ) that are chemically bonded to one another. In a similar manner, the internal gland  230  and the outlet housing  170  can be manufactured in a two-shot process to form a one-piece bottom housing. Therefore, the “two-shot” manufacturing process can reduce the total number of valve components to as few as three, significantly reducing assembly complexity. In addition, use of a two-shot process can significantly minimize the possibility of fluid leaking between the proximal gland  80  and inlet housing  160 . In a similar manner, use of a two shot process can significantly minimize the possibility of fluid leaking between the internal gland  230  and the outlet housing  170 . 
       FIGS. 4A through 4G  schematically show cross-sectional views of the valve  10  of  FIG. 2A  across line  4 - 4 . These figures schematically detail the general operation of the medical valve  10  as it transitions from the closed mode toward the open mode. Specifically,  FIG. 4A  shows the valve  10  in the closed mode when no syringe or other instrument  40  is inserted through the proximal opening  110 . In this state, the internal gland  230  substantially covers the distal opening  222  of the rotating member channel  220 . 
     This figure also details a number of additional features of the valve  10 . In particular, it shows components that, when in the open mode, ultimately make up the flow path through the housing  100 . The flow path begins at the inlet port  110  and into the interior chamber, through the member channel  220 , and extends through a member flowpath  290 , which is formed through the internal gland  230 . As discussed in greater detail below, the proximal opening  292  of the member flowpath  290  has a flange  294  that effectively seals about the periphery of the flowpath  290 . The ultimate flowpath extends through an outlet channel  122  that terminates at the distal port  120 . 
       FIG. 4A  also shows the internal gland  230  biasing the rotating member  180  to a closed position. Specifically, the resiliency of the internal gland  230  acts as a spring that, from the perspective of the configuration in  FIG. 4A , provides a generally continuous biasing force in a clockwise direction. As discussed below, a sufficient force applied by the instrument  40  against the rotating member  180  overcomes this bias to ultimately open the valve  10 . 
     Insertion of a medical instrument  40  into the proximal port  110  opens aperture  130  in the proximal gland  80  ( FIG. 4B ). The aperture  130  effectively forms a seal about the outer diameter of the luer tip  42  of the instrument  40  to prevent fluid flow proximal of the proximal gland  80 . The instrument  40  continues distally moving until it contacts the surface  200  of the rotating member  180 , which is proximally exposed, at least at the initial point of contact, shown in  FIG. 4C  as surface A. As shown, the instrument  40  takes up a significant portion of the available volume within the interior of the housing  100 . Accordingly, this produces a distally directed pressure against any priming fluid (e.g., saline) within the interior. During a corresponding withdrawal stage, this volume taken up by the instrument  40  effectively leaves a relatively small amount of fluid within the primed valve  10 . 
     During insertion, the proximally exposed surface  200  of the rotating member  180  acts as a camming surface against the medical instrument  40 . Distally directed force applied to the proximally exposed surface  200  at surface A by the medical instrument  40  begins to rotate the rotating member  180  toward the open position/mode. Specifically, the rotating member  180  rotates about an axis that is generally orthogonally aligned with the longitudinal axis of the valve  10 . This force at surface A effectively forms a lever arm extending between surface A and the point of rotation. When the force applied by this effective lever arm overcomes the bias force applied by the interior gland  230 , the rotating member  180  begins rotating counter-clockwise toward the open mode. 
     In general, the rotating member  180  does not move longitudinally. However, some incidental longitudinal movement may occur as the result of slight compression of the valve materials. 
       FIG. 4D  shows the rotating member  180  rotated to an intermediate point in its opening stroke. To move form the position in  FIG. 4C  to the position of  FIG. 4D , the instrument  40  slides along the proximally exposed surface  200 , which, as noted above, acts as a camming surface. The noted effective lever arm gradually decreases, thus increasing opening resistance. In addition, the biasing force of the internal gland  230  also provides increased opening resistance as the rotating member  180  rotates. The threads  90  on the inlet port  110  mate with corresponding threads on the instrument  40 , thus providing an assist in providing sufficient force to rotate the rotating member  180 . 
     Also while moving between modes, the generally hemispherically shaped surface  190  of the rotating member  180  slides along the corresponding portion of the internal gland  230 . While sliding, as noted above, the member channel  220  may not be fully sealed. Fluid leaking from the member channel  220 , if any, should be blocked from passing through the flowpath  290  by the flange  294 . 
     The rotating member  180  continues to rotate, sliding along the internal gland  230 , until the leading edge  226  of the distal opening  222  of the member channel  220  almost passes the leading edge  296  of the flange  294  ( FIG. 4E ). Specifically, as shown in  FIG. 4E , the rotating member  180  has rotated a significant amount although the valve  10  still is in a closed mode because the distal opening  222  of the member channel  220  remains fluidly disconnected from the proximal opening  292  of the member flow path  290 . As the rotating member  180  rotates further ( FIG. 4F ), the valve  10  begins to open as the leading edge  226  of the distal opening  222  of the member channel  220  passes the first edge/lip  296  of the fluid path  290  through the internal gland  230 . At this point, there is fluid communication between the valve proximal port  110  and distal port  120 . Although some of the member channel  220  still is occluded at this, point, the valve  10  may be considered to be in the open mode at this point. 
     The rotating member  180  continues to rotate to the fully open position shown in  FIG. 4G , in which the distal opening  222  is substantially completely exposed to the fluid path  290 . Accordingly, in this position, the full flow path through the valve  10  is opened; namely, the member channel  220 , fluid path  290 , and the proximal port  110  and distal port  120  are in maximum fluid communication with one another, creating a fluid channel through the medical valve  10 . As an example, the rotating member  180  of some embodiments rotates between about 15 and 60 degrees to traverse from the closed position of  FIG. 4A  to a fully open position as shown in  FIG. 4G . 
     In accordance with illustrative embodiments, when the instrument  40  moves longitudinally at a constant rate, the rotating member  180  rotates at a changing rate (i.e., an increasing or decreasing rate, depending on the direction of movement of the instrument  40 ). In other words, the rotating member  180  rotates at a changing rate per longitudinal inch of movement of the instrument  40 . Specifically, if the instrument  40  were inserted distally at a constant rate, the rotating member  180  would rotate at an increasing rate until the instrument  40  reaches its maximum insertion. In a corresponding manner, if the instrument  40  were withdrawn proximally at a constant rate, the rotating member  180  would rotate at an decreasing rate until the instrument  40  loses contact with the proximally facing surface  200 . 
     In either case, the rotational speed of the rotating member  180  is at its maximum when in the fully open position. Accordingly, the distal opening  222  of the member channel  220  moves most rapidly as it rotates from the open mode ( FIG. 4G ) to the point of the closed mode shown in  FIG. 4E . For any other arc of travel of similar length, the instrument  40  traverses distally a longer longitudinal distance. Of course, in practice, there is no requirement that the person controlling the instrument  40  insert or withdraw it at a constant rate. The rate of rotation thus is completely controlled by the rate of movement of the instrument  40 , which, during use, can vary. Discussion of insertion and withdrawal at a constant rate is for illustration purposes only. 
     The rotating member  180  and internal gland  230  cooperate to cause this relationship between instrument insertion and rotating member rotation. Among other things, as noted above, as the medical instrument  40  moves longitudinally into the medical valve  10 , the point at which the tip contacts the proximally exposed surface  200  changes. This change in point of contact changes the size of the above noted effective lever arm causing rotational movement. More specifically, as the point of contact moves closer to the center of the rotating member  180 , the lever arm decreases, increasing the angular rate of rotation. In addition, the bias force of the interior gland  230  ensures that, at anticipated withdrawal speeds, the surface  200  maintains contact with the instrument  40  during withdrawal (except, of course, after the instrument  40  is withdrawn proximal of the position shown in  FIG. 4C ). Therefore, for this reason, the angular rate increases as the valve  10  transitions from the closed mode to the open mode and is at its maximum between  FIGS. 4E and 4G . 
     This varying speed has a significant performance benefit. Specifically, the instrument  40  is drawn back a minimum distance to close the distal opening  222 . Fluid drawback (i.e., negative fluid displacement), if any, through the distal port  120  therefore should be negligible because the instrument  40  moves a relatively short distance within the interior before the valve  10  closes. Accordingly, if properly configured, this should result in a substantially negligible fluid displacement (i.e., between about −1 and +1 microliters) through the distal port  120  of the valve  10 . 
     Moreover, as shown in  FIG. 4G , in a preferred embodiment, the rotating member channel distal opening  222  is located so that the trailing edge  228  of the rotating member distal opening  222  is located just past the first edge  296  of the member fluid path  290 . This is in contrast to an alternative embodiment in which the distal opening  222  of the rotating member channel  220  is centered over the gland member fluid path  290 . This positioning of the preferred embodiment provides an advantage in that a smaller amount of rotation is required to transition between the fully open to fully closed positions (e.g., from the positions of  FIGS. 4G to 4E ). In other words, compared to the noted alternative embodiment, when closing from a fully opened position, the instrument  40  does not move distally that additional distance that is required to rotate the distal opening  222  from a centered position to the position of  FIG. 4G . Accordingly, the preferred embodiment discussed above should avoid negative fluid displacement caused by that additional movement. 
       FIGS. 5A-5C  and  6 A- 6 F respectively schematically show additional views of the rotating member  180  and internal gland  230 . Specifically,  FIGS. 5A-5C  schematically show more details of the rotating member  180  in the previous figures. As discussed above, the rotating member  180  may be generally hemispherical in shape and have protruding members  210  that interact with the internal gland  230  to bias the rotating member  180  toward the dosed position. The protruding members  210  can be wing-like structures located on either side of the rotating member  180 . Alternatively, the protruding members  210  may also be a single continuous structure that wraps around all or part of the rotating member  180 . The protruding members  210  still may take on other arrangements. The discussed arrangements therefore are for illustrative purposes and not intended to limit the scope of all embodiments. 
     As shown in  FIGS. 5A and 5C , the protruding members  210  are oriented so that they are not parallel to the proximally exposed surface  200 . Instead, the protruding members  210  diverge from the surface  200 . This orientation causes the proximally exposed surface  200  to be oriented at an angle, relative to a transverse axis of the longitudinal axis, when the valve  10  is in the closed mode (see  FIG. 4A ). 
     In some embodiments, the rotating member  180  may also include a generally straight-walled portion  215  near its top, as shown in  FIG. 5C . This straight walled portion  215  essentially forms a small cylinder at the top of the hemispherical surface  190  of the rotating member  180 . This portion provides another benefit-it enhances sealing. Specifically, as the rotating member  180  slides along the internal gland  230 , the straight-walled portion  215  projects slightly into the internal gland  230 . This effectively creates an additional seal between the rotating member  180  and the internal gland  230  to mitigate fluid leakage between the two members. In some embodiments, the length of this straight-walled portion  215  is approximately 0.020 inches. 
     The protruding members  210  also may be off-set from the center of the rotating member  180 . For example, as shown in  FIGS. 5A and 5C , the protruding members  210  (e.g., “wings  210 ”) may start at the top of the rotating member  180  at the proximally exposed surface  200 , and then protrude outwardly and downwardly at an angle so that the wing  210  ends at edge  213 , which is a distance away from the top and center of the rotational valve  10 . Such a wing design is one embodiment that ensures that 1) the rotating member  180  is biased toward the closed position, and 2) the proximally exposed surface  200  is angled as noted above and still facing the proximal end of the valve  10 . 
     In various figures, the proximally exposed surface  200  is substantially uninterrupted (e.g., no channels or grooves). However, in alternative embodiments, the proximally exposed surface  200  may include grooves  810 A and  810 B ( FIG. 8A ) to improve flushing and for directing fluid toward the inlet  224  of the member channel  220 . The channels may extend radially outward from the center of the proximally exposed surface  200 . 
     As mentioned above and shown in  FIGS. 5A and 5B , the rotating member  180  has a member channel  220  extending from the proximally exposed surface  200  to the hemispherical surface  190 . In preferred embodiments, the inlet  224  of the member channel  220  has a larger area than the distal opening  222 . In fact, inlet  224  preferably has an area that is larger than that of the opening of the blunt tip of the medical instrument  40  used to open the valve  10 . For example, the inlet  224  may have a greater area than that of the distal opening of a standard luer. In alternative embodiments, the inlet  224  has an area that is greater than the area defined by the outer dimension of the blunt tip  42  of the instrument  40 . 
     As the member channel  220  transitions from the inlet  224  toward the distal opening  222 , the channel  220  has a generally distally decreasing inner dimension. In other words, as the channel  220  transitions from inlet  224  toward the distal opening  222 , the cross-sectional area of substantially the majority of the channel  220  generally decreases. This decrease may be gradual (e.g., a taper), stepped, irregular, or some other configuration. 
     In some embodiments, the distal opening  222  of the channel  220  is a different size and/or shape than that of the inlet  224 . In accordance with illustrative embodiments of the invention, the distal opening  222  of the member channel  220  is configured to maximize fluid flow while permitting a relatively quick valve shut-off capability. To that end, as shown in  FIG. 5B , the distal opening  222  preferably has a relatively large first inner dimension generally orthogonal to the direction of motion. This large dimension should enable the valve  10  to provide reasonably high flow rates. Conversely, the distal opening  222  has a corresponding relatively small dimension that is generally parallel to the direction of motion (“parallel dimension”). This parallel dimension should be selected to ensure that the valve turns off relatively quickly. In other words, because of the small size of this dimension, the rotating member  180  rotates a relatively small distance to fully transition from the fully open mode to the closed mode (e.g.,  FIG. 4E ). 
     To those ends, the distal opening  222  may take on a number of shapes. Among others, it may be elliptical and configured so that its major axis is generally orthogonal to the direction of the rotational movement, and its minor axis is generally parallel to the direction of the rotational movement. In this orientation, the major axis provides the noted high fluid flow rate through the channel  220 , while the minor axis allows for quick opening and closing, as described below. Although, an elliptical distal opening  222  is described, other shapes may be used to provide the same results. For example, among other shapes, the distal opening  222  may be substantially rectangular, rectangular with rounded corners, or oval. In some embodiments, the major axis may be about two or more times the length of the minor axis. 
     As best shown in  FIG. 4G , the distal opening  222  illustratively is smaller than the proximal opening of the fluid path  290 . The proximal opening of the fluid path  290  can be defined by a first lip and a second lip. The distance between the lips is greater than the minor axis of the distal opening  222 , which allows the lips to seal around the outside of the distal opening  222 . The proximal opening of the fluid path  290  can be a number of shapes (e.g., circular). In such embodiments, the first and second lips may be portions of the circle (e.g., each lip is one half of the circular opening). Sealing in this manner provides an essentially fluid tight fluid path between the rotating member  180  and the internal gland  230  when in the open mode. 
     Moreover, as also shown in  FIG. 4G , the center line of the distal opening  222  of various embodiments is not aligned with the center of the proximal opening  292  of the fluid path  290 . Instead, in various embodiments, the member channel  220  is tapered so that the distal opening  222  effectively is positioned toward one side of the fluid path proximal opening  292 . For example, the center line of the distal opening  222  may be to the left of the fluid path proximal opening center line. As noted above, this helps to ensure that the trailing edge  228  of the distal opening  222  remains substantially aligned with or just past the first edge  296  of the fluid path  290  in the internal gland  230 , and that minimal rotation is required to close the valve  10 . 
     The rotating member  180  mates with and is supported by the internal gland  230 , which is schematically shown in  FIGS. 6A-6F . As mentioned above, the internal gland  230  has a concavity  240  that at least partially supports the rotating member  180 , and may be a variety of shapes and sizes. For example, the size and shape of the concavity  240  may conform to the size and shape of the rotating member  180 . Alternatively, the concavity  240  may be smaller or larger than the rotating member  180  and may be a different shape, such as elliptical, cylindrical, parabolic, or oval. 
     As noted above, the internal gland  230  normally has a flange  294  generally surrounding the proximal opening  292  of the gland fluid path  290 . In this context, the term “normally” is used to connote the shape of a resilient member (e.g., the internal gland  230 ) when not subjected to external forces (e.g., when the internal gland  230  is separated from the valve  10 ). For example,  FIG. 6E  shows the flange  294  as extending outwardly and over the proximal end of the gland fluid path  290 . This view thus shows the internal gland  230  when the rotating member  180  is not compressing the flange  294 . In contrast,  FIG. 6F  shows the flange  294  when compressed by the rotating member  180 .  FIGS. 6E and 6F  show the flange  294  as being integral to the resilient member  230  (e.g., formed as part of the resilient member  230 ). However, the flange  294  can be another type of structure that performs the described function and extends from the proximal end of the gland fluid path  290 . For example, the flange  294  may be an o-ring located around the proximal end of the gland fluid path  290 . 
     Specifically, the flange  294  normally not only protrudes upwardly into the concavity  240 , it also protrudes out over the proximal opening  292  of the member flow path  290 . As a result, both normally and when within the valve  10 , the flange  294  narrows the proximal opening  292  as compared to the remainder of the flow path  290 . As described in greater detail below, the flange  294  seals against the hemispherical surface  190  of the rotating member  180  as the valve  10  transitions between modes. Accordingly, when in the closed mode of  FIG. 4A , the flange  294  prevents fluid leaking from the channel  220  from entering the flow path  290 . In other words, when in the dosed mode, the flange  294  maintains the fluid seal of the valve  10 . 
     In a corresponding manner, when in the open mode of  FIG. 4G , the flange  294  seals the perimeter of the distal opening  222  of the member channel  220 . This ensures a substantially leak free connection between the member channel  220  and the flow path  290  in the open mode of  FIG. 4G . 
     The internal gland  230  also has a mating surface  250  that mates with the wings  210  of the rotating member  180 . The mating surface  250  may be recessed from the top surface  255  of the internal gland  230  to create vertical walls  257  between the top surface  255  and the mating surface  250 . In a preferred embodiment, the wings  210  sit at surfaces B and C, which are considered “complimentary portions” of the internal gland  230  (i.e., complimentary to the wings  210 ). These surfaces B and C support the rotating member  180  within the internal gland  230  and cooperate to provide the bias to the rotating member  180 . Specifically, the edges  211  of wings  210  preferably maintain contact with the vertical walls  257  at all times, even as the valve  10  transitions between open and closed. Alternatively, some embodiments have no such constant contact. Moreover, as known by those in the art, silicone is not compressible. Accordingly, the internal gland  230  has a pair of recesses  310  below surfaces B and C that allow gland material (e.g., above the recesses  310 ) to deform into their space as the valve  10  transitions from the open to the dosed mode. 
     Assembly processes position the rotating member  180  in the concavity  240  of the internal gland  230  so that the hemispherical surface  190  of the rotating member  180  sits within the cavity  240  and the wings  210  sit at surfaces B and C above the gland member recesses  310 . The wings  210  are oriented so that the bottom surface  212  of each wing  210  lies flat on the mating surface  250 , thus causing the proximally exposed surface  200  of the rotating member  180  to be proximally exposed and positioned at the above noted angle (see  FIGS. 4A-4G ). When fully assembled, the inlet and outlet housing  160  and  170  squeeze the wings  210  to hold the rotating member  180  in place, effectively biasing the rotating member  230  as discussed above. This connection also substantially limits axial and linear movement of the rotating member  230 . 
     In certain embodiments, the wings  210  may be thicker than the height of the vertical walls  257 . In such embodiments, the inlet and outlet housings  160  and  170  slightly compress the wings  210  into gland material when the valve  10  is assembled. This creates a seal between the bottom surface  212  of the wings  210  and the mating surface  250 , which prevents fluid leakage. This connection also holds the rotating member  180  in place to seal the distal opening  222  of the rotating member  180  in the closed mode, and the member channel  290  when in the closed mode. 
     As an example, the rotating member  180  and internal gland  230  may be designed so that the wings  210  extend a small distance (e.g., about 0.005 inches) above the mating surface  255  when the valve  10  is not fully assembled. When the inlet and outlet housings  160  and  170  are coupled, the rotating member  180  will compress slightly into the gland material in the cavity  240 , causing the bottom surface  212  of the wings  210  to contact the mating surface  250 . This also creates a seal between the hemispherical surface  190  of the rotating member  180  and the concavity  240 . 
     In certain embodiments, the mating surface  250  and the vertical walls  257  may be in the form of a C-shaped grove  320  cut into the top surface  255  of the internal gland  230 .  FIGS. 6A and 6B  show an exemplary C-shaped grove  320 ; however, the grove may be any shape capable of receiving the wings  210 . The C-shaped groove  320  may improve valve flushing by providing a uniform plane, thus minimizing places (e.g., crevices or corners) in which debris and fluids can collect. 
     As noted above and shown in  FIG. 6F , the rotating member  180  compresses the flange  294 , creating a contour that generally conforms to the hemispherical surface  190  of the rotating member  180 . During operation, the flange  294  maintains contact with the hemispherical surface  190  and essentially wipes across the surface. By doing so, the flange  294  effectively creates a wiper seal against the hemispherical surface  190  of the rotating member  180 . As also shown in  FIG. 6F , the gland member flow path  290  is narrowed at the proximal end  292 . Therefore, the inner dimension of the gland member flow path  290  increases from the proximal end  292  to the distal end  294 . 
     Referring back to  FIGS. 4A-4G , to reiterate with additional detail, as a user inserts the medical instrument  40  into the valve  10  and the rotating member  180  begins to rotate, the wings  210  begin to depress the gland material at surfaces B and C into the recesses  310 . The recesses  310  and the elastomeric properties of the gland material provide a spring force in a direction opposing the motion of the wings  210 , and bias the valve  10  toward the closed mode. The vertical walls  257  between the top surface  255  and the mating surface  250  substantially prevent the rotating member  180  from sliding, and essentially allow only rotational movement. The vertical walls  257  also cooperate to prevent the rotating member  180  from twisting generally about the longitudinal axis of the valve (or generally about an axis that is generally parallel with the longitudinal axis of the valve). In other embodiments, the vertical walls  257  are not necessary to prevent such sliding. 
     The hemispherical surface  190  of the rotating member  180  will continue to slide along the surface of the cavity  240  until the valve  10  is fully open, and the member channel  220  fluidly communicates with the member fluid path  290 . When the valve  10  is in the open mode, the flange  294  surrounding the member fluid path  290  creates a seal around the member channel  220 , preventing fluid leakage between the rotating member  180  and the internal gland  230 , and back through the valve  10 . 
       FIG. 7  shows a process illustrating one of a plurality of illustrative uses of the medical valve  10 . It is important to reiterate that, according to good medical practice, the proximal port  110  and distal port  120  of medical valve  10  should be cleaned (e.g., swabbed) prior to any connection and after any disconnection. After properly swabbing the distal port  120  of the medical valve  10 , a medical practitioner  20  connects the medical valve  10  to the patient  30  (step  710 ). To do so, the medical practitioner  20  may connect the distal port  120  of the medical valve  10  to the catheter  70 , which terminates at a needle inserted into the patient  30  (see  FIG. 1 ). 
     After connecting the valve  10  to the patient  30 , the medical practitioner  20  swabs the valve proximal port  110  and inserts the medical instrument  40  into the proximal port  110  (step  720 ). Connection and insertion of the medical instrument  40  creates a positive displacement at the distal port  120  of the medical valve  10 . As the medical practitioner  20  moves the medical instrument distally (step  730 ) into the medical valve  10 , the tip of the instrument  40  slides along the proximally exposed surface  200  of the rotating member  180  to rotate the rotating member  180 . The rotating member  180  continues to rotate until the member channel  220  is in fluid communication with the fluid path  290 . At this point, the proximal port  110  and distal port  120  are also in fluid communication, and the valve  10  is open. 
     As noted above, the valve  10  requires a relatively low prime volume because medical instruments  40  used to open the medical valve  10  take up most of the volume within the medical valve  10  (see  FIGS. 4A to 4G ). Additionally, because the disconnect and valve closing time is short, a vacuum may be formed in the void volume when the medical instrument  40  is disconnected. 
     Once the valve  10  is open and the proximal port  110  and distal port  120  are in fluid communication, the medical practitioner  20  can transfer fluids to or from the patient (step  740 ). For example, if the medical practitioner  20  wishes to administer a medication to the patient  30 , he/she may depress the syringe plunger and transfer the medication into the patient  30 . Alternatively, the medical practitioner  20  may withdraw blood from the patient  30 . 
     After completing the fluid transfer(s), the medical practitioner  20  can remove the medical instrument (step  750 ). As discussed above, the medical practitioner  20  should take care not to squeeze the sides of the syringe or medical instrument  40 . Doing so may create a positive or negative displacement at the distal port  120  of the medical valve  10 . If done properly, removal of the medical instrument  40  should result in a substantially neutral displacement at the valve distal port  120 . 
     As discussed above with reference to  FIGS. 4A to 4G , the rotating member  180  will begin to rotate back toward the closed position as the medical practitioner  30  withdraws the medical instrument  40  from the medical valve  10 . Only a small amount of rotation is required to fully close the valve  10 , although the rotating member  180  will continue to rotate back to the rest position shown in  FIG. 4A . 
     It should be noted that the above embodiments describe a medical valve  10  in which the proximal port  110  and the distal port  120  are aligned with one another. However, in various other embodiments of the present invention, the medical valve  10  can include a Y-site branch  100 A (e.g., see  FIG. 2B ). The Y-site branch  100 A may extend from the housing  100  to form a Y-site channel. The Y-site channel may be in fluid communication with the valve distal port  120 . To ensure sterility, the Y-site channel may have a resilient diaphragm, or a valve of some type. Alternatively, the Y-site channel may have no valving means. 
     It is also important to note that the embodiments discussed above refer to the use of the medical valve  10  in patient or hospital type setting. However, the medical valve  10  can also be used in the bio-pharmaceutical industry or other non-patient setting. For example, a technician  20  can use valve  10  as an injection or aspiration site in a bio-pharmaceutical manufacturing or R&amp;D process. 
     In addition, as noted above, although most of the embodiments above describe a rotating member  180  made from a rigid material and a internal gland  230  made from a resilient or elastomeric material, the material characteristics may be reversed. For instance, the rotating member  180  can be a resilient material while the gland may be a rigid material. In such embodiments, the valve operation will be very similar in many respects, but complimentary to that discussed. For example, the interaction between the wings  210  and the mating surface  250  on the internal gland  230  differ. Specifically, instead of the rigid wings  210  deforming the elastomeric gland material into the recesses  310 , the rigid gland material will deform the elastomeric wings. However, the gland will still bias the valve  10  toward the closed position. The deformation of the wings  210  will create the spring force, rather than the gland material deformation. 
       FIGS. 8A to 8C  show alternative embodiments of the rotating member  180 . As mentioned above and as shown in  FIG. 8A , the rotating member  180  may have grooves  810 A and  810 B ( FIG. 8A ) to improve flushing and/or for directing fluid toward the inlet  224  of the member channel  220 . Among other ways, the channels may extend radially outwardly from the center of the proximally exposed surface  200 . 
     As shown in  FIG. 8B , the rotating member  180  may also have protrusions  820 A and  820 B extending out from the proximally exposed surface  200 . The protrusions may be any number of sizes and/or shapes and may be located in a variety of places on the proximally exposed surface  200 . For example, as shown in  FIG. 8B , the rotating member  180  may have a triangular shaped protrusion  820 A located on one side of the member channel  220  and a hemispherical shaped protrusion  820 B located on the other side of the member channel  220 . 
     As shown in  FIG. 8C , in some embodiments, the member channel  220  does not pass through the rotating member  180 . Instead, the rotating member  180  may have a member channel  220 B that extends between the proximally exposed surface  200  and the hemispherical surface  180  along the outer surface of the rotating member  180 . 
       FIGS. 9A and 9B  show a cross sectional view of the medical valve  10  with the rotational member shown in  FIG. 8C .  FIG. 9A  shows the medical valve  10  in the closed mode, and  FIG. 9B  shows the medical valve  10  in the open mode. The operation of this embodiment of the valve  10  is substantially similar to the operation described above. The leading edge  226 B of member channel  220 B passes the first edge  296  of the fluid path  290 , thus causing the valve  10  to open. As with some other embodiments, only a small amount of rotation is required to transition the valve back to the closed mode (e.g., only a small amount of rotation is required to fluidly disconnect the leading edge  226 B of the member channel  220 B from the fluid path  290 ). 
     Although the above discussion discloses various exemplary embodiments of the invention, it should be apparent that those skilled in the art can make various modifications that will achieve some of the advantages of the invention without departing from the true scope of the invention.