Source: http://www.google.es/patents/US8083709?hl=es&dq=flatulence
Timestamp: 2013-05-20 00:05:38
Document Index: 574109569

Matched Legal Cases: ['art 12', 'art 12', 'art 12', 'art 12', 'art 12', 'art 12']

Patente US8083709 - Dialysis method having supply container autoconnection - Google PatentesB�squeda Im�genes Maps Play YouTube Noticias Gmail Drive M�s » B�squeda avanzada de patentes | Historial web | Iniciar sesi�n B�squeda avanzada de patentesPatentesA method for connecting a plurality of solution line connectors to a plurality of supply line connectors of a dialysis system includes: translating a tip protector remover in a first direction towards the plurality of supply line connectors to remove a plurality of solution line tip protectors from the...http://www.google.es/patents/US8083709?utm_source=gb-gplus-sharePatente US8083709 - Dialysis method having supply container autoconnection N�mero de publicaci�nUS8083709 B2Tipo de publicaci�nConcesi�n N�mero de solicitud12/785,069 Fecha de publicaci�n27 Dic 2011 Fecha de presentaci�n21 May 2010 Fecha de prioridad5 Jul 2007Tambi�n publicado comoEP2167160A2US7736328US8257299US20090012455US20100229366US20120067805US20120089085WO2009006471A2WO2009006471A3 InventoresRobert W. ChildersKurt HolmquistPeter A. Hopping Cesionario originalBaxter Healthcare S.A.Baxter International Inc. Clasificaci�n de EE.UU.604/29604/534604/535604/536604/533 Clasificaci�n internacionalA61M1/00 Clasificaci�n cooperativaA61M1/287A61M2205/70A61M2205/505A61M2205/128A61M1/1656A61M2209/084A61M1/28A61M2205/122 Clasificaci�n europeaA61M1/28ReferenciasCitas de patentes (101)Otras citas (1) Citada por (2)Enlaces externosUSPTO Cesi�n de USPTO EspacenetDialysis method having supply container autoconnectionUS 8083709 B2 Resumen A method for connecting a plurality of solution line connectors to a plurality of supply line connectors of a dialysis system includes: translating a tip protector remover in a first direction towards the plurality of supply line connectors to remove a plurality of solution line tip protectors from the plurality of solution line connectors; locking the tip protector remover to each of a plurality of supply line tip protectors connected to the plurality of supply line connectors; translating the tip protector remover in a second direction towards the plurality of solution line connectors to remove the plurality of supply line tip protectors from the supply line connectors; translating the tip protector remover in a third direction different from the first and second directions; translating one of the plurality of solution line connectors and the plurality of supply line connectors the other of the solution line connectors and the supply line connectors to connect each of the solution line connectors to one of the supply line connectors.
1. A method for connecting a plurality of solution line connectors to a plurality of supply line connectors of a dialysis system comprising:
translating a tip protector remover in a first direction towards the plurality of supply line connectors to remove a plurality of solution line tip protectors from the plurality of solution line connectors;
locking the tip protector remover to each of a plurality of supply line tip protectors connected to the plurality of supply line connectors;
translating the tip protector remover in a second direction towards the plurality of solution line connectors to remove the plurality of supply line tip protectors from the supply line connectors;
translating the tip protector remover in a third direction different from the first and second directions;
translating one of the plurality of solution line connectors and the plurality of supply line connectors towards the other of the solution line connectors and the supply line connectors to connect each of the solution line connectors to one of the supply line connectors.
2. The method of claim 1, which further includes:
loading the supply line connectors into a supply line connector holder;
loading the solution line connectors into a solution line connector holder; and
loading the solution line tip protector into the tip protector remover.
3. The method of claim 1, which includes fixing one of the solution line connector holder and the supply line connector holder and translating the other of the solution line connector holder and the supply line connector holder.
4. The method of claim 1, wherein each of the first and second directions is in a first plane, and which includes locating the third direction in a second plane at least substantially perpendicular to the first plane.
5. The method of claim 1, which includes initially loading the solution line connectors and the supply line connectors into an organizer.
6. The method of claim 1, which includes connecting a plurality of supply lines to a disposable cassette operable with at least one pump actuator of the dialysis system, wherein each of the plurality of supply lines includes one of the plurality of supply line connectors.
7. The method of claim 1, which includes connecting each of a plurality of dialysis fluid containers to a solution line, wherein each of the plurality of solution lines includes one of the solution line connectors.
8. The method of claim 1, which includes sealing the solution line connectors, the supply line connectors, and the tip protector remover in an isolated environment.
9. The method of claim 8, which includes injecting filtered high-efficiency-particulate-air or ultra-low-penetration-air into the isolated environment.
10. The method of claim 8, wherein said sealing includes closing tubing lines connected to the solution line and the supply line connectors.
11. The method of claim 1, further including reading information on the solution line connectors.
12. A method for connecting sets of connectors of a dialysis system comprising:
translating a tip protector remover along a path between a first tip protector holder holding a first set of tip protectors and a second tip protector holder holding a second set of tip protectors to remove each of the tip protectors of the first and second sets;
moving the tip protector remover away from the path between the first and second tip protector holders; and
moving at least one of the first and second tip protector holders along the path between the first and second tip protector holders to connect first and second sets of connectors.
13. The method of connecting sets of connectors of claim 12, including programming at least one processor to (i) translate the tip protector remover, (ii) move the tip protector remover away from the path between the first tip protector holder and the second tip protector holder, and (iii) move the at least one of the first and second tip protector holders.
14. The method of connecting sets of connectors of claim 12, including positioning the first and second sets of tip protectors on a dialysis machine of the dialysis system.
15. The method of connecting sets of connectors of claim 14, wherein moving the tip protector remover away from a path between the first and second tip protector holders includes pulling the tip protector remover into the dialysis machine.
16. The method of connecting sets of connectors of claim 12, which includes fluidly extending the connectors of the first and second sets of connectors from a disposable cassette operable with the dialysis system.
17. The method of connecting sets of connectors of claim 12, wherein the first and second sets of connectors are connected to first and second sets of tubing lines, respectively.
18. A method for connecting sets of connectors of a dialysis system comprising:
establishing a path between a first set of tip protectors connected to a first set of connectors and a second set of tip protectors connected to a first set of connectors;
translating a tip protector remover along the path to remove (i) the first set of tip protectors from the first set of connectors and (ii) the second set of tip protectors from the second set of connectors;
moving the tip protector remover away from the path; and
connecting the first set of connectors to the second set of connectors.
19. The method of connecting sets of connectors of claim 18, wherein translating the tip protector remover along the path includes translating the tip protector remover in opposite directions along the path.
20. The method of connecting sets of connectors of claim 18, which includes initially loading one of the first and second sets of tip protectors into the tip protector remover. Descripci�n
PRIORITY CLAIM This application is a continuation application and claims priority to and the benefit of U.S. patent application Ser. No. 11/773,750, entitled Dialysis Having Supply Container Autoconnection, filed Jul. 5, 2007.
As discussed in detail below, the system of the present disclosure is readily adapted for a high-volume therapy. In one implementation, the system uses four-to-one manifolds, which allow any one or more of four supply bag inlets to the disposable cassette to be increased to up to four bags for treatment. The four-to-one manifolds work in conjunction with the auto-connection and auto-identification systems described herein. Up to four, four-to-one manifolds, each manifold being able to connect to up to four (e.g., same-solution) supply bags, can accommodate a therapy volume of, for example, up to ninety-six liters.
this ratio is multiplied by an addition of the gas volume Vgas to a known volume of the tank Vtank to form a real time volume of fluid pumped Vfluid=((P1/P1′)−1) (Vtank+Vgas). P1 is initially equal to P1′, thus making the initial real time volume of fluid pumped equal to zero. As P1′ becomes increasingly less than P1 over time, ((P1/P1′)−1) becomes increasingly larger over time as does Vfluid.
If a hole develops in either the membrane gasket or the cassette sheeting, the vacuum level through the evacuation port at the leak decreases, indicating the leak. Thus the evacuation ports also serve as leak detectors that are placed in multiple places over the cassette; providing superior leak detection with the capability of indicating where on the cassette sheeting or membrane gasket the leak has occurred. This leak detection capability is present prior to the beginning of therapy as well as during therapy.
The cassette interface, in an embodiment, also integrates the pneumatic manifold with the cassette interface so that air that travels from the back side of the pumping chambers of the disposable cassette to the volumetric reference chambers (one for each pump chamber, used for volumetric accuracy calculation and air) of the pneumatic manifold does not have to travel far. The close spacing also tends to make the temperature of, air in the passageways, the reference chambers and the pump chambers equal. This is useful for a pneumatic pumping technique that assumes a constant temperature between air in the volumetric reference chambers and the medical fluid or dialysate pumped though the disposable cassette. The dialysate is located on the other side of the cassette sheeting from air in communication with the pneumatic source and the volumetric reference chamber. The fluid temperature needs to be about that of the human body, e.g., about 37� C. The air in the reference chamber therefore should be about 37� C.
Mobile cart 12 includes shelves or drawers 16, which hold the ancillary supplies needed for dialysis therapy. To move system 10, the patient needs to unplug a power cord. Mobile cart 12 accommodates the drain bag, e.g., on lower shelf 16. The self-contained drain cart allows cart 12 to be moved without having to first load the drain bag. If a drain line is run to a house drain instead of a bag, the drain line likely has to be removed from the drain and placed onto cart 12 when system 10 is moved. A handle 18 facilitates moving system 10 and in one embodiment can be rotated upwardly for movement of cart 12 and downwardly and out of the way when not needed.
FIG. 8 shows bag management system 30 with lower shelf 32, second shelf 34 and third shelf 36 folded down, first supply bag 40 a loaded onto lower shelf 32, second supply bag 40 b loaded onto second shelf 34, a third supply bag 40 c loaded onto third shelf 36, and shelve 38 hinged upwardly and out of the way. FIG. 9 shows bag management system 30 with lower shelf 32, second shelf 34, third shelf 36 and top shelf 38 all folded down, first supply bag 40 a loaded onto, lower shelf 32, second supply bag 40 b loaded onto second shelf 34, third supply bag 40 c loaded onto third shelf 36, and fourth supply bag 40 d loaded onto top shelf 38.
Each tray in the bag management system 30 folds up providing easy access to the shelf below. When used with cart 12 above, system 30 minimizes the height to which patients have to lift the solution bags. The shelf holds solution bags 40 elevationally above a heater, which can be located at the bottom of instrument 12 for example, and orients the bag so that the bag outlet port resides below the rest of the bag. The configuration causes dialysis fluid to flow from the bags until empty, leaving any air trapped in the empty bags. This shelf configuration, bag placement and orientation can enhance the volumetric pumping speed and accuracy of the fluid delivery pumps when fluid is pumped directly from the supply bags, e.g., through an inline heater, and into the patient since air does not flow downhill, e.g., from a bag 40 into a pumping chamber of cassette 28.
Pigtails 46 in one embodiment terminate in female connectors 56 protected by tip protector 66 a Connectors 56/tip protectors 66 a are held together in a single organizer in one embodiment. Patient line 52 can be a single lumen patient line (batch dialysis) or a dual lumen patient line (for batch or continuous dialysis) as desired. The first set of supply lines 48 a, patient line 52 and drain line 54 are each connected to cassette 28.
Auto-Connection Referring now to FIG. 12, instrument 20 in an embodiment includes pinch clamps or pinch valves 68 a to 68 d (referred to collectively herein as valves 68 or individually as valve 68), one valve 68 for each pigtail 46 a to 46 d of supply bags 40 a to 40 d, respectively (or manifold line 64 of four-to-one manifold 60). Valves 68 a to 68 d are positioned to hold and occlude pigtails 46 a to 46 d, respectively, when (i) connectors 56 at the end of the pigtails 46 are attached to a stationary connector holder 70 and (ii) the tip protectors 66 a protecting each connector 56 are attached initially to a tip protector removal carriage 72 of the auto-connection mechanism. Tip protector removal carriage 72 is also configured to remove spike connector 58 tip protectors 66 b as shown below. Valves 68 are opened, e.g., sequentially, to allow fluid to be withdrawn sequentially from supply bags 40. Valves 68 in an embodiment are closed automatically if there is a need to reload cassette 28 after supply bags 40 have been connected. Stationary holder 70 holds supply bag pigtail connectors 56 stationary during the auto-connection process.
As seen in FIG. 15E, device 90 includes a cover 91 and base 93 which mate (e.g., hingedly or separately) to enclose connectors 56 (with pierceable membrane) and 58 (spike) of lumens 52 a and 52 b and lines 84 and 86 when loaded into portions 92 and 94. Cover 91 and base 93 can be plastic or metal as desired. FIG. 15E also illustrates that device 90 includes one or more motor 95 having an output shaft 97 connected operably to portion 94 to move (e.g., to rotate and/or translate) portion 94 relative to portion 92, which is generally stationary. For example, output shaft 97 of motor 95 can drive a ball screw that in turn is connected threadingly to portion 94, which enables motor 95 to translate portion 94. In the illustrated embodiment, output shaft 97 of motor 95 is coupled to portion 94 in a manner such that motor 95 can rotate portion 94. A lever 99 is connected to the subassembly of motor 95 and moveable portion 94, such that the patient or caregiver can translate portion 94 back and forth with respect to stationary portion 92 via lever 99. Device 90 is alternatively fully automatic (e.g., AC or battery powered) or fully manual.
Device 90 also includes an apparatus for maintaining an aseptic environment when lumens 52 a and 52 b and lines 84 and 86 are pulled apart. For example, device 90 can employ an ultraviolet (�UV�) light or radiator described in U.S. Pat. Nos. 4,412,834 and 4,503,333, owned by the eventual assignee of the present application, the entire contents of which are incorporated herein by reference. Device 90 can also introduce HEPA or ULPA filtered air into the volume around the connector prior to connection.
In FIG. 15C, motor 95 rotates rotatable portion 94 holding female connectors 56 one-hundred-eighty degrees relative to stationary portion 92, such that return lumen 52 b of dual lumen patient line 52 is aligned with drain line 86 of transfer set 82. Also in this configuration, fill lumen 52 a of dual lumen patient line 52 is aligned with fill line 84 of transfer set 82. The aseptic apparatus of device 90 continues to be energized to prevent the tips of connectors 56 and 58 from becoming contaminated.
It should be appreciated that the sequence of FIGS. 15A to 15D works no matter which side 96 or 98 of device 90 connected lumens 52 a and 52 b and connected lines 84 and 86 are loaded in FIG. 15A.
Next, rotatable portion 94 holding female connectors 56 is rotated one-hundred-eighty degrees relative to stationary portion 92, such that now return lumen 52 b of dual lumen patient line 52 is aligned with fill lumen 52 a of dual lumen patient line 52, and drain line 86 of transfer set 82 is now aligned with fill line 84 of transfer set 82.
Cassette Improvements Referring now to FIG. 16, cassette 100 illustrates one embodiment of a cassette and method of making same, in which a rigid plastic portion 110 of the cassette is encapsulated within cassette sheeting 102. However, sheeting 102 is not welded to the sides of the rigid portion 110, sheeting 102 is instead welded to itself Plastic portion 110 in one embodiment is rigid and made of acrylonitrile butadiene styrene (�ABS�), acrylic, polyolefin, polycarbonate, polyethylene or polypropylene. Sheeting 102 in one embodiment is flexible, e.g., for flexing to pump liquid, and opening and closing valve chambers. Sheeting 102 can be made of polyvinyl chloride (�PVC�), polyethylene, kraton or polyolefin. Also, two or more plies of the different or same materials can be used, wherein the grains of the plies can flow perpendicular to each other to increase strength and minimize the potential for slits, holes and tears. For example, the outside layer opposite the cassette can have good abrasion, puncture and tear resistant properties and a middle layer having good strength properties.
Sheeting 102 is folded to produce a first side 104 a, a second side 104 b, a folded top 106 and edges 108 a to 108 c as illustrated. Folded sheet 102 is slid over rigid portion 110 as shown in FIG. 16. Next, side edges 108 a of sides 104 a and 104 b are welded together and around supply lines 48, patient lines 52 or drain line 54. Alternatively, edges 108 a of sides 104 a and 104 b are welded together and around ports extending from rigid portion 110 (not seen in FIG. 16), to which supply lines 48, patient lines 52 or drain line 54 are fitted sealingly. Bottom edges 108 b of sides 104 a and 104 b are welded together. Side edges 108 c of sides 104 a and 104 b are welded together. Flexible sheeting 102 in this manner forms a sealed pouch around rigid portion 110. Sides 104 a and 104 b are alternatively separate sheets welded together along four sides.
Rigid portion 110 includes or forms pump chambers 112. As described below, an alternative cassette includes three pump chambers. Rigid portion 110 in the illustrated embodiment also includes a plurality of valve chambers 114. Pump chambers 112 and valve chambers 114 each include ridges 116 defining the respective pump or valve chamber, which extend outwardly from a base wall 118 of rigid portion 110. The opposite side of rigid portion includes ridges 116 extending in the other direction from base wall 118 and defining flow paths (not seen) that communicate with the pump chambers 112 and valve cambers 114.
In operation, side 104 a of sheeting 102 needs to be sealed to ridges 116 of the pump and valve chambers for the pneumatic movement and control of fluid. A dialysis instrument operating with pouch cassette 100, which has sheeting 102 sealed to itself around rigid portion 110 (and to the tubes as discussed above) but not directly to raised ridges 116, applies a positive pressure across the surface 104 a relative to rigid portion 110. The positive pressure seals surface 104 a to the raised ridges 116 temporarily during operation so that pumps 112 and valves 114 can function properly. Positive pressure is also provided on reverse surface 104 b of sheeting 102 to compress surface 104 b to raised ridges 116 of the flow paths (not seen). The positive pressure can be provided pneumatically; e.g., via an inflatable bladder, and/or mechanically, e.g., via spring biasing, solenoid actuation and/or the closing of a door behind which cassette 100 is loaded.
FIG. 16 also shows that base wall 118 can include instrument loading and locating holes 120, which enable a locating guide 122 to be snapped in place after sheeting 102 has been welded to itself and to tubing 48, 52 and 54. In an embodiment, sheeting 102 is welded via a heat seal process, which uses a die. That same die can also punch aligning holes 124 through sheeting 102 to facilitate the installation of the loading/locating guide 122.
In a UF to drain mode multi-pass flow example, chamber 112 c empties fresh solution to the patient via valves V1; V28 and the to-patient valve to the patient. At the same time chamber 112 b fills with effluent from the patient through the to/from patient valve, and valves V26 and V10. At the same time, chamber 112 a empties effluent to drain via valve V6 and the drain valve. In an alternative UF bag to bag multi-pass mode, chamber 112 a alternatively empties effluent to an empty supply bag, e.g., supply 3 via valves V11, V24 and V25.
In a second state of the UF bag to bag multi-pass mode, chamber 112 c fills with fresh, e.g., premixed, solution from supply 1 through valves V17 and V7. At the same time, chamber 112 b empties fresh solution to the patient via valves V3, V28 and the to-patient valve to the patient. At the same time, chamber 112 a fills with effluent from the patient via the to/from patient valve, and valves V26 and VI2.
FIG. 18A illustrates one pumping sequence for pump chambers 112 in which a chamber fill stroke (cross-hatched segments) is slightly shorter in duration than a chamber empty stroke (diagonal segments), which are separated by relatively short fluid measurement periods (dotted segments). A fluid measurement (amount of fluid pumped) method is discussed in detail below. Also discussed below is a way to eliminate the fluid measurement periods (dotted segments) occurring after the chamber empty strokes (diagonal segments).
As seen in FIG. 18A, at time t1, pump chamber 112 a is at rest for a measurement calculation from a previous emptying stroke, pump chamber 112 b is emptying fluid to the patient, and pump chamber 112 c is filling with fluid. At time t2, pump chamber 112 a is filling with fluid, pump chamber 112 b is still emptying fluid to the patient, and pump chamber 112 c is at rest for a measurement calculation from a previous filling stroke. At time t3, and pump chamber 112 a is still filling, pump chamber 112 b is starting a fill stroke, pump chamber 112 c is emptying. At time t4, pump chamber 112 a is emptying, pump chamber 112 b is filling, and pump chamber 112 c is starting a rest period for measurement calculation. At time t5, pump chamber 112 a is still emptying, pump chamber 112 b is beginning to empty, and pump chamber 112 c is filling. At time t6, pump chamber 112 a is filling, pump chamber 112 b is emptying, and pump chamber 112 c is filling. At time t7, pump chamber 112 a is still filling, pump chamber 112 b is starting a rest period for measurement calculation, and pump chamber 112 c is emptying. At time t8, pump chamber 112 a is starting an emptying stroke, pump chamber 112 b is filling, and pump chamber 112 c is emptying. At time t9, pump chamber 112 a is emptying, pump chamber 112 b is filling, and pump chamber 112 c is starting a fill stroke.
Cassette lacing surface 146 of membrane gasket 145 further includes raised ridges 152 forming an enclosed path which, in the same manner, seals around raised ridges 116 of valve chambers 114 of disposable cassette 140. FIG. 16 shows ten valve chambers 114, which are generally aligned with and have the same shape as the ten enclosed ridges 152 of cassette surface 146 of membrane gasket 145. Again, in an embodiment, enclosed ridges 152 mate with and press seal against ridges 116 of valve chambers 114 of the disposable cassette 140.
Plateau 158 defines a pair of blind pump wells 160 a and 160 b. Blind pump wells do not extend all of the way through the thickness of membrane gasket 145. Instead, pump wells 160 a and 160 b each include sidewalls 162, which extend most of the way through the thickness of membrane gasket 145 but leave a thin wall 168. As described in detail below, thin walls 168 move with sheeting 104 of cassette 140 residing within pump chambers 112 a and 112 b of the cassette.
In a similar manner, plateau 158 defines a plurality of blind valve wells 164. Blind valve wells 164 likewise do not extend all of the way through plateau 158 of membrane gasket 145. Instead, blind valve wells include sidewalls 166 that extend most of the way through plateau 158 but terminate at blind wall 168. Blind wall 168 of blind valve wells 164 in turn operate with sheeting cassette 104 a at valve chambers 114.
Membrane gasket 145 defines ports or apertures 170 that extend all of the way through plateau 158 of membrane gasket 145. Accordingly, apertures 170 are seen on both plateau 148 of FIG. 22 and surface 146 of FIG. 20. As further seen in FIG. 20, raised pump ridges 148 a and 148 b and raised valve ridges 152 on surface 146 of membrane gasket 145 enclose or encompass pneumatic ports 170. As discussed in detail below, pneumatic ports 170 enable a negative pressure asserted through membrane gasket 145 to pull surface 168 of blind pump wells 160 a and 160 b and surface 168 of valve wells 164 together with sheeting 104 a of cassette 140. The configuration makes wall 168 and sheeting 104 a operate as a single membrane for each of the individual pump chambers 112 and valve chambers 114 of the disposable cassette.
Pump chamber wells 190 a and 190 b are defined in or provided by membrane plate 185. Pump wells 190 a and 190 b cooperate with pump chambers 112 a and 112 b respectively of disposable cassette 140. In particular, pump wells 190 a and 190 b include pneumatic actuation ports 198. When negative air pressure is supplied through ports 198, the negative pressure pulls the combination of blind wall 168 and sheeting 104 a associated with the pump chamber towards the wall of well 190 aor 190 b. This expands the volume between sheet 104 a and pump chamber 112 of rigid portion 110 of cassette 140 causing a negative pressure to be formed within the cassette, which in turn causes a volume of fluid (fresh or spent) to be pulled into the pump chamber 112. Likewise, when positive pressure is applied through aperture 198, the positive pressure pushes the combination of blind wall 168 and cassette sheeting 104 a at the pump well 190/pump chamber 112 interface, pushing wall 168 and sheeting 104 a into or towards pump chamber 112 of rigid portion 110, which in turn dispels or pushes fluid from the respective pump chamber 112 to the patient or drain.
To the extent that it is feasible to use multiple pressure sensors with individual pump walls 190 a and 190 b and valve seats 194 or to multiplex one or more pressure sensors, the diagnostic ability of system 150 can, be expended to be able to pinpoint not only which component is leaking, but which area of which component is leaking. For example, the tubing running to ports 200 could be split between pump tubing and valve tubing. A first pressure sensor could multiplex between the tubing leading to the different pumps to pinpoint a leak in either the first or second pump. The conductivity sensor then tells the system if it is a cassette pump leak or a gasket pump leak. A second pressure sensor could multiplex to look for leaks in the different valves. Valve one to valve five for example might all check-out to be holding pressure, while valve six shows a leak, meaning the portion of the cassette sheeting or gasket in operation with valve six is leaking. The conductivity sensor tells the system if it is the cassette sheeting or the gasket at the valve six position that is experiencing a leak.
It is difficult to quickly and accurately measure the temperature of air when the components mounting the temperature sensor are not at the same temperature as the air that is being measured. Also at the present time, a minimum two-hour warm-up time is required before performing a volumetric calibration on the HomeChoice� Pro APD System, which requires that interface plate 185, reference chambers 210 a and 2101), pump chambers 112 in pumping cassette 110 and the fluid being pumped all be warmed to about 37� C.
FIGS. 19 and 20 illustrate that pneumatic solenoid valves 202 are mounted directly to plate 182. FIG. 23 illustrates that volumetric reference chambers 210 a and 210 b, which hold a known volume of air, are located on the reverse side 204 of interface plate 185 in one embodiment. The purposes and operation of volumetric reference chambers 210 a and 210 b is discussed in the '482 patent and in detail below in connection with FIGS. 27, 28A to 28F and 29, which disclose an improvement over the '482 patent method. It is enough now to understand that chambers 210 a and 210 b are used to calculate a volume of fluid pumped through the cassette. The advantage here is that valves 202 and volumetric reference chambers 210 a and 210 b are placed in close proximity to each other and to the pneumatic pathways to membrane gasket 145.
Referring now to FIGS. 24, 25A, 25B, 26A and 26B, system 210 illustrates an alternative heated cassette interface embodiment that connects to a remotely located valve manifold, such as that used in the HomeChoice� Pro APD System. System 210 includes alternative interface plate 215 and a separate heated reference chamber module 220. FIG. 24 illustrates module 220 attached to alternative interface plate 215. FIGS. 25A and 25B illustrate alternative interface plate 215 from the front and back, respectively. FIGS. 26A and 268 illustrate the reference chamber module 220 from the front and back, respectively.
For reference, a piston bellows, which can be located in the door of instrument 20, pushes the cassette against the interface plate and an occluder bellows which can unclamp all lines (fail closed) are shown. Both bellows and the occluder are actuated pneumatically in one embodiment.
V gas, full=(P ref, final −P ref, initial)/(P press1, initial −P press1, final)*V ref, wherein
Ppump,initial is an initial pressure in the pressure chamber before the fluid pump is allowed to pressurize the volumetric reference chamber (e.g., VSL), here 7 psig. Ppress1, final is a final pressure in the pressure chamber after the medical fluid pump is allowed to pressurize the volumetric reference chamber (e.g., VSL), here 2.4 psig; and
Thus Vgas, full=(2.4−0)/(7−2.4)*16.5 milliliters=8.6 milliliters.
In FIG. 28D, the valve states switch such that valve (or valves) between chamber X-POS T and the pump chamber (e.g., left pump chamber) is (are) closed. The valve (or valves) between the pump chamber and the associated volumetric reference chamber (e.g., VSL) is (are) opened. Vent valve (e.g., A 1) is closed. This allows the pump chamber to pressurize the volumetric reference chamber (e.g., VSL) to 4.2 psig, causing the pump pressure to drop from 7 psig to 4.2 psig.
Vgas, empty=(4.2−0)/(7−4.2)*16.5 milliliters=24.75 milliliters.
The volume of fluid pumped between the measurement periods of FIGS. 28B and 28C is then: fluid moved Vfluid=empty chamber air volume Vgas, empty-full chamber air volume Vgas, full, which is 24.75 milliliters−8.6 milliliters=16.15 milliliters.
The steps of FIGS. 28E and 28F are made between the before and after calculations above, that is, between the steps of FIGS. 28B and 28C. In FIG. 28E, at the beginning of the pump-out stroke, the valve (or valves) between chamber POS T and the pump chamber (e.g., left pump chamber) is (are) closed. The valve (or valves) between chamber POS T and the associated volumetric reference chamber (e.g., VSL) is (are) closed. Vent valve (e.g., A1 in FIG. 27) is also closed. The volume of air in the pump chamber Vgas, full is known to be 8.6 milliliters as discussed above in connection with FIG. 28B. The volume of fixed volume tank POS P-L or POS P-R is known, e.g., 500 milliliters. The initial pressure Phos p,initial is known, e.g., 1.5 psig.
The valve (or valves) between chamber POS P-L or POS P-R is (are) opened beginning the pump-out stroke. At this moment the pressure begins to decay. The processor is configured to sample the pressure readings (PPOS, P,t) from pressure transducer X-POS P-L or X-POS P-R, for example every twenty milliseconds. The processor also calculates the real time amount of fluid pumped using the above equation and the measurement of PPOS P,t. FIG. 28F shows an end of the pump-out stroke and a corresponding end of the pressure decay.
At the sixth and final pump stroke time in FIG. 29, which is also illustrated in FIG. 28F, PPOS, Pt has dropped to 15.70 psia (1.0 psig), making the first term in the equation above equal to 0.0318, which when multiplied by the combined volume of tank POS P-L or POS P-R (500 milliliters) and the initial volume of air in the pump chamber (8.6 milliliters) yields an absolute volume pumped of (0.0318)*508.6=16.19 milliliters.
As'discussed above, the real time fluid volume calculation can be used in combination with the before and after fluid volume calculation. It should be appreciated however that the real time fluid volume calculation does not have to be used in combination with the before and after fluid volume calculation. That is, after the determination of Vgas, full in FIG. 28B, the system can perform the real time calculation shown in FIGS. 28E, 28F and 29, without thereafter doing the post stroke reference chamber pressurization and calculation. It is therefore expressly contemplated to not use the post stroke reference chamber pressurization and calculation, which would negate the need for the post stroke fluid measurement periods shown for example in connection with FIGS. 18A and 18B for both fill and empty strokes. The post stroke fluid measurement period can be eliminated for systems that have any number of pump chambers, e.g., one, two or three pump chambers.
If the cumulative delivered volumes when compared are outside of the threshold range, the processor adjusts the volume for the next pump stroke by calculating a correction factor in step 346. For example, if the normal target pump stroke volume is 15 milliliters, the system 300 will actually deliver a volume of 15 minus the correction factor for the dextrose. If the cumulative dextrose delivered volume exceeds the cumulative delivered bicarbonate volume by 1.2 milliliters, the correction factor is 1.2 milliliters and the next target stroke volume for dextrose is 15 −1.2 milliliters=13.8 milliliters.
If the measured total is outside the range of the prescribed total, the processor determines whether the cumulative measured volume is less than the prescribed pump empty volume by more than the next scheduled set of pump strokes, e.g., 30 milliliters, in step 352. If it is, another set of pump strokes is delivered and step 352 is reached again. Steps 354 and 356 calculate the targeted fill volume for the next set of pump strokes. Step 356 calculates each targeted volume at 15 milliliters less the correction factors calculated in step 346. Step 354 calculates the fill volume to be � of the remaining volume (programmed fill-cumulative measured dextrose and bicarbonate). If the remaining volume is 20 milliliters, and the correction factor for dextrose is 1.2 milliliters, the next stroke target volumes for the last set of pump strokes are calculated to be, for example:
Draining method 400 determines if the drain is flowing properly and if air is present. In step 402, left pump chamber is filled with effluent. In step 404, the processor determines the real time effluent volume and flow for the fill in the manner described above. In step 406, if flowrate is greater than a normal flow minimum rate threshold, e.g., 50 milliliters/minute, method 400 determines whether the real time volume calculation of effluent fill exceeds a minimum pump stroke volume threshold, e.g., 12 milliliters, in step 408. If not, left pump chamber continues to till with effluent in step 402, forming a loop that cycles until the real time volume calculation of effluent fill exceeds the threshold in step 408.
When the real time volume calculation of effluent fill exceeds the threshold in step 408, the measurement of the effluent fill volume using the before and after pump stroke method of FIGS. 28A to 28D is performed in step 410. If the real time fluid volume moved is greater than the before and after stroke method of FIGS. 28A to 28D, air may have been drawn into the pump chamber when the chamber filled with fluid. The before and after pump stroke method of 28A to 28D will not be able to distinguish a pump chamber that contains 13 milliliters of fluid and 2 milliliters of air from a pump chamber that contains only 13 milliliters of fluid because the air will compress regardless of which side of the flexible sheeting it resides on, resulting in the same volume calculation. However, the flexible sheeting will move more when it accepts 13 milliliters of fluid and 2 milliliters of air than it would if it had only accepted 13 milliliters. The HomeChoice� System marketed by eventual assignee of the present disclosure attempts to complete the fill of the pump chamber using an alternate source if the pump chamber fill volume is more than 3 milliliters short of the full volume. If the HomeChoice� System cannot fill the pump chamber completely, air is assumed to be present. The contents of the pump chamber are then pumped to drain to eliminate the air. The HomeChoice� System remedy accordingly wastes time and fluid. The pump air detection and discharge regime occurring after step 410 is discussed below as step 438 eliminates.
Returning to step 406, if flowrate calculated via the real time calculation is less than the normal flow minimum rate threshold, e.g., 50 milliliters/minute, method 400 determines if the real time flowrate is greater than an intermediate or low flowrate threshold, e.g., 30 milliliters/minute, in step 412. If the real time flowrate is greater than the intermediate threshold, method 400 determines if a time T1 at which the flowrate is between the intermediate and high-end thresholds (e.g., between 30 and 50 milliliters/minute) is less than a preset time, e.g., 5:00 minutes in step 414. If the flowrate has remained between the intermediate and high-end thresholds for longer than the preset time, method 400 assumes that the patient line may be partially occluded and will attempt to clear the line pushing fresh dialysate toward the patient. If the pushback is unsuccessful an alarm will beposted (step 476). If the pushback is successful (determined via the volume using the before and after pump stroke method of FIGS. 28A to 28D in step 416) the method either advances to fill (step 300) or posts a low drain volume alarm (step 482). This routine is discussed in detail below.
Returning to step 412, if flowrate calculated via the real time calculation is less than the intermediate threshold, e.g., 30 milliliters/minute, method 400 determines if the real time flowrate is greater than a low end no-flow flowrate threshold, e.g. 12 milliliters/minute, in step 422. If the real time flowrate is greater than the low end threshold, method 400 determines if a time T2, at which the flowrate is between the low end and intermediate thresholds (e.g., between 12 and 30 milliliters/minute), is less than a second preset time, e.g., 3:00 minutes in step 424. In the illustrated embodiment T2 is less than T1, meaning method 400 does not wait as long at the lower flowrate before running the occlusion routine at step 416 because an occlusion is more likely at the lower flowrate.
Step 448 creates a loop in which left pump chamber continues to empty to drain as long as the drain flow is greater than a threshold value, e.g. 80 milliliters/minute. When drain flow falls below the threshold, method 400 determines if the real time volume calculation of effluent sent to drain exceeds a threshold volume, e.g., 12 milliliters, in step 450. If not, method 400 determines if drain flow has fallen below a low end threshold, e.g., 12 milliliters/minute, in step 452.
In the illustrated embodiment, housing 502 includes electromagnets 514. When energized, the electromagnets will push and/or pull on a metal portion of magnetized pivot arm 516. Reversing the polarity will cause the polarity orientation to change. Arm 508 includes a magnetic, e.g., steel, portion 516, which is pulled towards one of the electromagnets 514 when that electromagnet is energized. Electromagnets control the orientation of the infrared temperature sensor so that infrared temperature sensor 510 can be pointed selectively (i) at opaque portion 506 to take a first temperature reading, tempwall, of the sheeting 102 only as seen in FIG. 32 or (ii) at clear portion 504 to take a second temperature reading, temp wall and fluid, which is a combination (A*tempwall+B*tempfluid) of the sheeting 102 and the fluid within the sheeting 102 as seen in FIG. 33. A and B are constants dependent upon the film or tube thickness and composition and are determined experimentally.
Because tempwall is measured and known, the fluid temperature tempfluid can be calculated using measured tempwall and measured temp wall and fluid according to the equation:
temp fluid = [ measured ⁢ ⁢ temp wall ⁢ ⁢ and ⁢ ⁢ fluid - ( A ) * ( measured ⁢ ⁢ temp wall ) ] B A processor and memory on a temperature controller or at a central processing unit store constants A and B and perform the above calculation. Temperature sensing system 500 should provide near real time, non-invasive monitoring of the fluid temperature.
A signal (voltage or current) generator 536 excites transmitter coil 532 with a signal that varies with time, such as sine wave, square wave, sawtooth wave or other time variable wave. Generator 536 can be for example (i) a logic level oscillator, (ii) a combination of oscillator and filter or (iii) a waveform generator circuit. One suitable voltage range includes four to twenty volts. Transmitter coil 532 induces small currents in the dialysate while receiver coil 534 senses those currents. The intensity of the currents that receiver coil 534 senses depends on the type of solution and the degree of electrical coupling between bags and coils 532 and 534. For example, if the shape of the supply bag or container is such that its footprint does not project on top of a receiver coil, the receiver coil will not sense any current. If the shape of the supply bag or container is such that its footprint does not project on top of a transmitter coil, the transmitter coil will induce no current or relatively little current into the solution.
The improperly loaded bag 540 of FIG. 37B on the other hand results in a different inductive coupling pattern of (i) high coupling, (ii) high coupling, (iii) high coupling, and (iv) high coupling because all four coupling coils are located on one side of frangible seal 542. The improperly loaded bag 540 of FIG. 37C results in still a different inductive coupling pattern of (i) low coupling, (ii) low coupling, (iii) high coupling, and (iv) high coupling due the position of seal 542 relative to the coils�illustrated in FIG. 37C. The improperly loaded bag 540 of FIG. 37D results in the same inductive coupling pattern of FIG. 37C, namely, (i) low coupling, (ii) low coupling, (iii) high coupling, and (iv) high coupling due the position of seal 542 relative to the coils illustrated in FIG. 37D.
Citas de patentes Patente citada Fecha de presentaci�n Fecha de publicaci�n Solicitante T�tuloUS189637917 Nov 19307 Feb 1933Ross James CSterilizing apparatusUS214519626 Jun 193424 Ene 1939Hygrade Sylvania CorporationApparatus for treating foodstuffsUS224947312 Jul 193915 Jul 1941Herbert WolcottElectric sterilizerUS322787730 Ene 19634 Ene 1966Barnes Engineering CompanyCooled infrared detector system with means to eliminate radiation from the instrument itselfUS33919517 Dic 19669 Jul 1968The Weatherhead CompanyDiaphragm sealed couplingUS341309718 May 196526 Nov 1968Centrala Automationslaboratoriet Ab CalabAutomatic pipette-system arrangement, the action of which is controlled, for transferring liquid from one test to anotherUS362693830 Jun 197014 Dic 1971Antonio A. VersaciHemodialysis shunt valve device with body connecting meansUS369462424 Jun 197026 Sep 1972Beckman Instruments Gmbh.Infrared radiator arrangementUS370922228 Dic 19709 Ene 1973Minnesota Mining And Manufacturing Company, A Corp. Of De.Method and apparatus for automatic peritoneal dialysisUS378073620 Oct 197225 Dic 1973Chen A,UsSurgical valve assembly for urinary bladder irrigation and drainageUS38146806 May 19714 Jun 1974Meltzer H,UsProcess and apparatus for purification of materialsUS38400116 Ago 19738 Oct 1974Wright F,UsAdjustable syringe dose aidUS391695017 Ene 19744 Nov 1975Moen IncorporatedSeal constructionUS392655630 May 197316 Dic 1975Boucher; Raymond Marcel GutBiocidal electromagnetic synergistic processUS39559226 Jun 197511 May 1976Robert J. PatchSterilizer for bathroom articlesUS395708226 Sep 197418 May 1976Arbrook, Inc.Six-way stopcockUS39865086 Nov 197419 Oct 1976Abcor, Inc.Sterilizable, medical connector for blood processingUS399468611 Mar 197530 Nov 1976Ab ZiristorHelical bifilar wound ultra-violet sterilization for tube shaped materialUS40561168 Sep 19761 Nov 1977Baxter Travenol Laboratories, Inc.Valve for interconnecting sterile containers and the likeUS406389028 Abr 197620 Dic 1977Baron; Neville A.Method and apparatus for sterilizing and storing contact lensesUS40691534 Nov 197617 Ene 1978American Sterilizer CompanyMethod of destroying pyrogensUS408096530 Sep 197628 Mar 1978Baxter Travenol Laboratories, Inc.In-line cannula valve assemblyUS40968594 Abr 197727 Jun 1978Medionics International Inc.Apparatus for peritoneal dialysisUS412110718 Abr 197717 Oct 1978Bbc Brown, Boveri & Company LimitedApparatus for automatic low-bacteria to aseptic filling and packing of foodstuffsUS414168624 Mar 197727 Feb 1979Grotech Inc.Disposable liquid sterilizer unitUS41694747 Jul 19772 Oct 1979Wolfgang WagnerLiquid medicine dispensers with dose mechanisms for oral and injection therapyUS417323425 Nov 19776 Nov 1979Waterous CompanyTransfer valveUS41967301 Ago 19778 Abr 1980Wilson, Dennis RLiquid drug dispenserUS420191712 Jul 19786 May 1980Graentzel, AlfredApparatus for irradiation of fluidsUS421905521 Ene 197726 Ago 1980Wright, George RSyringe filling aidUS421922126 Feb 197926 Ago 1980General Electric CompanyCoupling for rejoining sealed tubingUS42390414 Ago 197816 Dic 1980Nationsbank Of Texas, N.A.Method for continuous ambulatory peritoneal dialysisUS424231013 Nov 197830 Dic 1980Baxter Travenol Laboratories, Inc.Sterile connection apparatusUS429170111 Jul 197829 Sep 1981Bell & Howell CompanyPressure transducing and methods and apparatus for filling a cavityUS430697617 Dic 197922 Dic 1981Bieffe S.P.A.Method and device for ambulatory peritoneal dialysisUS433893322 Dic 198013 Jul 1982Abbott LaboratoriesCombination quick disconnect coupling and liquid cutoff valveUS434670315 Sep 198031 Ago 1982Baxter Travenol Laboratories, Inc.Solution container for continuous ambulatory peritoneal dialysisUS438787916 Jul 198114 Jun 1983Eduard Fresenius Chemisch Pharmazeutische Industrie KgSelf-sealing connector for use with plastic cannulas and vessel cathetersUS440531523 Abr 198220 Sep 1983Stephen R. AshSpike exchanger for continuous ambulatory peritoneal dialysisUS44128345 Jun 19811 Nov 1983Baxter Travenol LaboratoriesAntimicrobial ultraviolet irradiation of connector for continuous ambulatory peritoneal dialysisUS443324419 Mar 198221 Feb 1984Baxter Travenol Laboratories, Inc.Apparatus for irradiating tubing connectionsUS443919319 Feb 198227 Mar 1984Abbott LaboratoriesApparatus for connecting medical liquid containersUS44759005 Jun 19819 Oct 1984Moncrief; Jack W.Method of peritoneal dialysis involving ultraviolet radiation of dialysis apparatusUS450078819 Ago 198319 Feb 1985Baxter Travenol Laboratories, Inc.Device for providing antibacterial radiationUS450333324 Feb 19835 Mar 1985Baxter Travenol LaboratoriesAntimicrobial ultraviolet irradiation of connector for continuous ambulatory peritoneal dialysisUS454182916 Abr 198417 Sep 1985Baxter Travenol Laboratories, Inc.Automatic connection and disconnectionUS455772713 Sep 198310 Dic 1985Handt; Alan E.Spike exchanger for continuous ambulatory peritoneal dialysisUS45965515 Dic 198324 Jun 1986Baxter Travenol Laboratories, Inc.Tubing clampUS461701229 Oct 198514 Oct 1986Manresa, Inc.Sterile connector with movable connection memberUS462624530 Ago 19852 Dic 1986Cordis CorporationHemostatis valve comprising an elastomeric partition having opposed intersecting slitsUS462684521 Ene 19862 Dic 1986Epic Systems, Inc.Subscriber validation systemUS465575327 Nov 19857 Abr 1987Baxter Travenol Laboratories, Inc.Connection deviceUS46557622 May 19837 Abr 1987Baxter International Inc.Ambulatory dialysis system and connectorUS46750073 Oct 198523 Jun 1987Concept, Inc.Coupling device for attachment to an end of a catheterUS469527630 Oct 198522 Sep 1987Terumo Kabushiki KaishaMedical instrumentUS473866829 Ago 198319 Abr 1988Baxter Travenol Laboratories, Inc.Conduit connectors having antiseptic application meansUS475529211 Ago 19865 Jul 1988Merriam; Theodore D.Portable ultraviolet water sterilizerUS476901729 Ene 19876 Sep 1988Darbut; Alex L.Self-sealing infusion manifold and catheter connectorUS477441520 Ene 198727 Sep 1988Fresenius AgDevice for sterilization of a hose coupling device in the connected conditionUS484062119 Ene 198820 Jun 1989Abbott LaboratoriesPiercing pin transfer deviceUS486928625 Abr 198826 Sep 1989Surgikos, Inc.Fluid injection system coupling and injector valveUS48734466 Jul 198810 Oct 1989Kreitmair; AlbertDevice for irradiating denture partsUS48785167 Oct 19887 Nov 1989Fresenius AgArrangement for peritoneal dialysis and connector thereforeUS488249629 Abr 198821 Nov 1989Baxter International Inc.Apparatus for exchanging and irradiating tubing connectionsUS48956575 Oct 198823 Ene 1990Fresenius AgApparatus for hemodialysisUS49528122 May 198928 Ago 1990Baxter International Inc.Irradiation of blood productsUS501449427 Sep 198814 May 1991Sherwood Medical CompanyMethod of sterilizing medical articlesUS504701120 Feb 199010 Sep 1991Abbott LaboratoriesPiercing pin transfer device for continuous ambulatory peritoneal dialysisUS505707425 May 199015 Oct 1991Terumo Kabushiki KaishaMedical container replacing methodUS512591120 Feb 199030 Jun 1992Hospira, Inc.Spike holderUS518402026 Oct 19892 Feb 1993Steritech, Inc.Device and method for photoactivationUS525004116 Ene 19925 Oct 1993Fresenius Usa, Inc.Tubing administration set for use in peritoneal dialysisUS527960517 Ene 199118 Ene 1994Baxter International Inc.Frangible spike connector for a solution bagUS531189924 Feb 199317 May 1994Mitsubishi Kasei CorporationCoupling deviceUS53341393 Feb 19942 Ago 1994Gambro AbMethod of peritoneal dialysis using a tube setUS53503573 Mar 199327 Sep 1994Deka Products Limited PartnershipPeritoneal dialysis systems employing a liquid distribution and pumping cassette that emulates gravity flowUS539915614 Jun 199321 Mar 1995Minnesota Mining And Manufacturing CompanyQuick-changeover blood handling apparatusUS547272016 Oct 19925 Dic 1995Mitec Scientific CorporationTreatment of materials with infrared radiationUS554026523 Jun 199330 Jul 1996Fresenius AgContainer for collection of concentrateUS554291330 Sep 19946 Ago 1996Minnesota Mining And Manufacturing CompanyIn-line quick connect apparatus for medical fluid circulating systemsUS55429195 Jun 19956 Ago 1996Fresenius AgPeritoneal dialysis deviceUS55729922 Mar 199512 Nov 1996Instrumentarium Corp.Method and apparatus for identifying an anesthetic fluid container and/or for detecting a connection between the container and a conduit supplying a gas to a patientUS558394812 Oct 199410 Dic 1996Sumitomo Wiring Systems, Ltd.Connecting element inspecting method and connecting element inspecting deviceUS561150625 Jul 199518 Mar 1997Berger; MariaDialysis assist deviceUS56120013 Oct 199518 Mar 1997Molecucare Inc.Apparatus and method for germicidal cleansing of airUS56479847 Jun 199515 Jul 1997Cobe Laboratories, Inc.Extracorporeal fluid treatment systems selectively operable in a treatment mode or a disinfecting modeUS57079116 Jun 199513 Ene 1998Mitech Scientific Corp.Infrared radiation generating ceramic compositionsUS571411924 Mar 19953 Feb 1998Yoshihiro KiuchiSterilizerUS57334575 Dic 199631 Mar 1998Cobe Labortories, Inc.Technique for disinfecting extracorporeal fluid treatment systemsUS579241927 Mar 199711 Ago 1998University Of HawaiiMechanically loaded direct air circulation commodity disinfestation chamberUS58433794 Sep 19951 Dic 1998Danfoss A/SSampling device for a chemical analysis apparatusUS590021131 Oct 19964 May 1999Purepulse TechnologiesDeactivation of organisms using high-intensity pulsed polychromatic lightUS592501425 Abr 199420 Jul 1999Teeple Jr.; EdwardMethod and apparatus for preparing and administering intravenous anesthesia infusionsUS59482476 Jun 19957 Sep 1999Gambro AbDisinfection arrangement for dialysis machinesUS601391819 Feb 199811 Ene 2000Purepulse Technologies, Inc.Deactivation of microorganismsUS61466004 Ene 199914 Nov 2000University Of HawaiiSide body disingestation chamberUS617156112 Feb 19989 Ene 2001University Of HawaiiMechanically loaded direct air circulation commodity disinfestation chamberUS622833218 Feb 19988 May 2001Purepulse TechnologiesDeactivation of organisms using high-intensity pulsed polychromatic lightUS623453828 Jun 199922 May 2001Fresenius Medical Care Deutschland GmbhConnector elementUS62939216 Jul 199825 Sep 2001Jms Company, Ltd.Automatic exchanger for peritoneal dialysisUSD31088115 Ene 198825 Sep 1990Abbott LaboratoriesSpike transfer housing for use in peritoneal dialysis or the likeOtras citasReferencia1International Search Report and the Written Opinion for International Application No. PCT/US2008/068908 mailed on Mar. 19, 2009. Citada por Patente citante Fecha de presentaci�n Fecha de publicaci�n Solicitante T�tuloUS83305795 Jul 200711 Dic 2012Baxter International Inc.Radio-frequency auto-identification system for dialysis systemsUS200900092905 Jul 20078 Ene 2009Baxter International Inc.Radio frequency auto-identification systemGirarImagen originalP�gina principal de Google - Sitemap - Descargas masivas de USPTO - Pol�tica de privacidad - Condiciones de servicio - Acerca de Google Patentes - Danos tu opini�nDatos proporcionados por IFI CLAIMS Patent Services©2012 Google