Patent Description:
The catheter may include an over-the-needle peripheral intravenous ("IV") catheter. In this case, the catheter may be mounted over an introducer needle having a sharp distal tip. The catheter and the introducer needle may be assembled so that the distal tip of the introducer needle extends beyond the distal tip of the catheter with the bevel of the needle facing up away from skin of the patient. The catheter and introducer needle are generally inserted at a shallow angle through the skin into vasculature of the patient.

Blood withdrawal using the catheter may be difficult for several reasons, particularly when a dwell time of the catheter within the vasculature is more than one day. When the catheter is left inserted in the patient for a prolonged period of time, the catheter or vein may be more susceptible to narrowing, collapse, kinking, blockage by debris (e.g., fibrin or platelet clots), and adhering of a tip of the catheter to the vasculature. Due to this, the catheter is often used for acquiring a blood sample at a time of catheter placement, but the catheter is less frequently used for acquiring a blood sample during the catheter dwell period. Therefore, when a blood sample is required, an additional needle stick is often needed to provide vein access for blood collection, which may be painful for the patient and result in higher material costs.

In some instances, in order to avoid the additional needle stick, a tubular instrument may be used to access the vasculature of the patient via the catheter. The tubular instrument may be inserted through the catheter and into the vasculature to extend a life of the catheter and allow blood withdrawal through the catheter without the additional needle stick.

<CIT>, <CIT>, <CIT> and <CIT> show relevant background art for the present invention.

The invention refers to a blood draw kit as defined by the features of claim <NUM>. Preferred embodiment are defined by the features of the dependent claims. The present invention is defined in independent claim <NUM>. The present disclosure relates generally to one or more delivery devices that provide access to vasculature of a patient, as well as related systems and non-claimed methods. In some embodiments, the delivery devices may each deliver a tubular instrument through a catheter. In some embodiments, the tubular instrument may facilitate an increased dwell period of the catheter within the vasculature of the patient. In some embodiments, the delivery devices may be used to advance the tubular instrument into the catheter and/or beyond a distal tip of the catheter when the catheter is compromised or nearing an end of its life to overcome obstructions such as thrombus, valves, and/or a fibrin sheath in or around the catheter that may otherwise prevent blood draw.

In some embodiments, the delivery devices may provide needle-free delivery of the tubular instrument to the vasculature of the patient for blood collection, fluid delivery, patient or device monitoring, or other clinical needs by utilizing an existing catheter dwelling within the vasculature. In some embodiments, the tubular instruments of the delivery devices may be different lengths, and delivery devices with longer tubular instruments may be used after delivery devices with shorter tubular instruments to increase a likelihood of the tubular instruments passing through a thrombus, which may increase in size with time.

In some embodiments, a non-claimed method may include coupling a first delivery device to a catheter assembly. In some embodiments, the catheter assembly may include a catheter that is dwelling within the vasculature of the patient. In some embodiments, the first delivery device may include a first housing and a first tubular instrument. In some embodiments, the first tubular instrument may include a distal end, a proximal end, and a lumen extending between the distal end of the first tubular instrument and the proximal end of the first tubular instrument. In some embodiments, the proximal end of the first tubular instrument may be secured within the first housing.

In some embodiments, the first tubular instrument may be configured to advance distally from a proximal position to a distal position with respect to the first housing and the catheter assembly. In some embodiments, in response to the first tubular instrument being in the proximal position, the first tubular instrument may be proximal to the catheter assembly. In some embodiments, in response to the first tubular instrument being in the distal position, a distal surface of the distal end of first tubular instrument may be disposed distal to a distal tip of the catheter and at a first distance beyond the distal tip of the catheter. In some embodiments, the first tubular instrument may be fully advanced with respect to the first housing in response to the first tubular instrument being in the distal position.

In some embodiments, after transferring a first volume of blood via the first tubular instrument to a first blood collection container and moving the tubular instrument from the distal position toward the proximal position, the method may include decoupling the first delivery device from the catheter assembly. In some embodiments, after decoupling the first delivery device from the catheter assembly, the method may include coupling a second delivery device to the catheter assembly.

In some embodiments, the second delivery device may include a second housing and a second tubular instrument. In some embodiments, the second tubular instrument may include a distal end, a proximal end, and a lumen extending between the distal end of the second tubular instrument and the proximal end of the second tubular instrument. In some embodiments, the proximal end of the second tubular instrument may be secured within the second housing. In some embodiments, the second tubular instrument may be configured to advance distally from the proximal position to the distal position with respect to the second housing and the catheter assembly. In some embodiments, the second tubular instrument may be fully advanced with respect to the second housing in response to the second tubular instrument being in the distal position.

In some embodiments, in response to the second tubular instrument being in the proximal position, the second tubular instrument may be proximal to the catheter assembly. In some embodiments, in response to the second tubular instrument being in the distal position, a distal surface of the distal end of the second tubular instrument may be disposed distal to the distal tip of the catheter and at a second distance beyond the distal tip of the catheter. In some embodiments, the second distance may be greater than the first distance.

In some embodiments, after transferring a second volume of blood via the second tubular instrument to a second blood collection container and moving the second tubular instrument from the distal position toward the proximal position, the method may include decoupling the second delivery device from the catheter assembly. In some embodiments, after decoupling the second delivery device from the catheter assembly, the method may include coupling a third delivery device to the catheter assembly.

In some embodiments, the third delivery device may include a third housing and a third tubular instrument. In some embodiments, the third tubular instrument may include a distal end, a proximal end, and a lumen extending between the distal end of the third tubular instrument and the proximal end of the third tubular instrument. In some embodiments, the proximal end of the third tubular instrument may be secured within the third housing. In some embodiments, the third tubular instrument may be configured to advance distally from the proximal position to the distal position with respect to the third housing and the catheter assembly. In some embodiments, the third tubular instrument may be fully advanced with respect to the third housing in response to the third tubular instrument being in the distal position.

In some embodiments, in response to the third tubular instrument being in the proximal position, the third tubular instrument may be proximal to the catheter assembly. In some embodiments, in response to the third tubular instrument being in the distal position, a distal surface of the distal end of the third tubular instrument may be disposed distal to the distal tip of the catheter and at a third distance beyond the distal tip of the catheter. In some embodiments, the third distance may be greater than the second distance. In some embodiments, after transferring a third volume of blood via the third tubular instrument to a third blood collection container and moving the third tubular instrument from the distal position toward the proximal position, the method may include decoupling the third delivery device from the catheter assembly.

In some embodiments, a difference between the first distance and the second distance may be <NUM> (<NUM> inches), which may facilitate extension through the thrombus that may be formed near the distal tip of the catheter and establishment of a fluid pathway through the catheter assembly. In further detail, in some embodiments, a size of the thrombus may increase over time, so the second distance may be greater than the first distance to increase a likelihood of passing through the thrombus when the second delivery device is coupled to the catheter assembly, which after the first delivery device is coupled to the catheter assembly. In some embodiments, the first distance may be <NUM> (<NUM> inch) or less. In some embodiments, the second distance may be <NUM> (<NUM> inches) or less. In some embodiments, the third distance may be <NUM> (<NUM> inches) or less.

In some embodiments, a difference between the first distance and the second distance may be <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inch), or another suitable distance. In some embodiments, a difference between the first distance and the second distance may be greater than <NUM> (<NUM> inches). In some embodiments, the first delivery device may be coupled to the catheter assembly on a first day, and the second delivery device may be coupled to the catheter assembly on a second day, which may be subsequent to the first day. In some embodiments, the second day may immediately follow the first day.

In some embodiments, a difference between the second distance and the third distance may be <NUM> (<NUM> inches), which facilitate extension through the thrombus that may be formed near the distal tip of the catheter and establishment of the fluid pathway through the catheter assembly. In further detail, in some embodiments, the size of the thrombus may increase over time, so the third distance may be greater than the second distance to increase a likelihood of passing through the thrombus when the third delivery device is coupled to the catheter assembly, which may occur after the second delivery device is coupled to the catheter assembly.

In some embodiments, a difference between the second distance and the third distance may be <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inch), or another suitable distance. In some embodiments, a difference between the second distance and the third distance may be greater than <NUM> (<NUM> inches). In some embodiments, the second delivery device may be coupled to the catheter assembly on the second day, and the third delivery device may be coupled to the catheter assembly on the third day, which may be subsequent to the second day. In some embodiments, the third day may immediately follow the second day.

In some embodiments, the first volume of blood may be transferred to the first blood collection container via the first tubular instrument on the first day. In some embodiments, the second volume of blood may be transferred to the second blood collection container via the second tubular instrument on the second day. In some embodiments, the third volume of blood may be transferred to the third blood collection container via the third tubular instrument on the third day. In some embodiments, one or more of the first volume of blood, the second volume of blood, and the third volume of blood may be equal to each other or different from each other.

In some embodiments, a distal end of one or more of the first tubular instrument, the second tubular instrument, and the third tubular instrument may include one or more side holes, which may facilitate blood flow into the catheter proximal to the thrombus. In some embodiments, the distal end of one or more of the first tubular instrument, the second tubular instrument, and the third tubular instrument may be closed and/or may include a slit. In some embodiments, one or more of the first tubular instrument, the second tubular instrument, and the third tubular instrument may be resistant to occlusion and thrombosis because the slit may be closed and blood may not be allowed to diffuse into the corresponding tubular instrument under normal physiological pres sures.

In some embodiments, the difference between the first distance and the second distance and the difference between the second distance and the third distance may increase a likelihood of extension through the thrombus and establishment of the fluid pathway through the catheter assembly. In some embodiments, one or more particular delivery devices in addition to the first delivery device, the second delivery device, and the third delivery device may be coupled to the catheter assembly without removing the catheter from the patient. In some embodiments, particular tubular instruments that are inserted through the dwelling catheter as time progresses may be increasingly longer, which may increase a likelihood of establishing the fluid pathway through the catheter assembly to allow blood draw and/or may reduce thrombosis.

In some embodiments, the first delivery device may include a first marking. In some embodiments, the second delivery device may include a second marking. In some embodiments, the third delivery device may include a third marking. In some embodiments, one or more of the first marking, the second marking, and the third marking may include a time to use the corresponding delivery device. For example, the first marking may include "Day <NUM>" or "First Blood Draw. " As another example, the second marking may include "Day <NUM>" or "Second Blood Draw. " As a further example, the third marking may include "Day <NUM>" or "Third Blood Draw. " In some embodiments, the first marking, the second marking, and/or the third marking may indicate a time to use the corresponding delivery devices with respect to each other.

In some embodiments, the first delivery device may include another marking. In some embodiments, the first delivery device may include a slider, which may be coupled to the first tubular instrument. In some embodiments, the slider may be aligned with the other marking in response to the distal surface of the first tubular instrument being flush with the distal tip of the catheter. Thus, in some embodiments, the other marking may indicate to a clinician that in response to further advancement of first tubular instrument in a distal direction, the first tubular instrument will extend distal to the distal tip.

In some embodiments, the second delivery device may include the other marking. In some embodiments, the second delivery device may include the slider that may be coupled to the second tubular instrument. In some embodiments, the slider may be aligned with the other marking in response to the distal surface of the second tubular instrument being flush with the distal tip of the catheter. Similarly, in some embodiments, the third delivery device may include the other marking. In some embodiments, the third delivery device may include the slider, which may be coupled to the third tubular instrument. In some embodiments, the slider may be aligned with the other marking in response to the distal surface of the third tubular instrument being flush with the distal tip of the catheter.

In some embodiments, the catheter assembly may include a catheter adapter, which may include a distal end, a proximal end, and a lumen extending through the distal end of the catheter adapter and the proximal end of the catheter adapter. In some embodiments, the catheter assembly may include the catheter, which may be secured within the catheter adapter. In some embodiments, a distal end of the housing may include a connector, which may be configured to couple to a connector of the catheter adapter.

In some embodiments, another delivery device may include the housing, which may include one or more of the following: the first marking, the second marking, the third marking, and a slot. In some embodiments, the first marking is proximal to the second marking. In some embodiments, the delivery device may include a tubular instrument, which may include a distal end, a proximal end, and a lumen extending between the distal end of the tubular instrument and the proximal end of the tubular instrument. In some embodiments, the proximal end of the tubular instrument may be secured within the housing. In some embodiments, the slider may be coupled to the tubular instrument and slidable along the slot of the housing. In some embodiments, the slider may include an advancement tab, which may be gripped by the clinician to advance and/or retract the tubular instrument.

In some embodiments, in response to advancing the slider distally from a proximal position to the first marking, a distal surface of the distal end of the tubular instrument may be disposed at a first distance beyond the distal end of the housing. In some embodiments, in response to advancing the slider distally from the proximal position to the second marking, the distal surface of the distal end of the tubular instrument may be disposed at a second distance beyond the distal end of the housing. In some embodiments, the second distance beyond the distal end of the housing may be greater than the first distance beyond the distal end of the housing. In some embodiments, in response to advancing the slider distally from the proximal position to the third marking, the distal surface of the distal end of the tubular instrument may be disposed at a third distance beyond the distal end of the housing. In some embodiments, the third distance beyond the distal end of the housing may be greater than the second distance beyond the distal end of the housing.

It is to be understood that both the foregoing general description and the following detailed description are examples and explanatory and are not restrictive of the invention, as claimed. It should be understood that the various embodiments are not limited to the arrangements and tubular instrumentality shown in the drawings. Also, the drawings are not necessarily to scale. It should also be understood that the embodiments may be combined, or that other embodiments may be utilized and that structural changes, unless so claimed, may be made without departing from the scope of the various embodiments of the present invention. The following detailed description is, therefore, not to be taken in a limiting sense.

Referring now to <FIG>, in some embodiments, a delivery device <NUM> to deliver a tubular instrument <NUM> into the catheter <NUM> may facilitate an increased dwell period of the catheter <NUM>. In further detail, the delivery device <NUM> may be used to advance the tubular instrument <NUM> into the catheter <NUM> and/or beyond a distal tip <NUM> of the catheter <NUM> for fluid infusion or blood draw when the catheter <NUM> is compromised or nearing an end of its life.

In some embodiments, the delivery device <NUM> may include a housing <NUM> configured to couple to a catheter adapter <NUM>. In some embodiments, the delivery device <NUM> may include the tubular instrument <NUM>. In some embodiments, the delivery device <NUM> may include any suitable delivery device. Non-limiting examples of delivery devices that may be used with the tubular instrument <NUM> are described further in in <CIT>, entitled "EXTENSION HOUSING A PROBE OR INTRAVENOUS CATHETER," <CIT>, entitled "INSTRUMENT DELIVERY DEVICE HAVING A ROTARY ELEMENT," <CIT>, entitled "MULTI-DIAMETER CATHETER AND RELATED DEVICES AND METHODS," <CIT>, entitled "DELIVERY DEVICE FOR A VASCULAR ACCESS INSTRUMENT," <CIT>, entitled "SYRINGE-BASED DELIVERY DEVICE FOR A VASCULAR ACCESS INSTRUMENT," <CIT>, entitled "CATHETER DELIVERY DEVICE AND RELATED SYSTEMS AND METHODS," and <CIT>, entitled "VASCULAR ACCESS INSTRUMENT HAVING A FLUID PERMEABLE STRUCTURE AND RELATED DEVICES AND METHODS,".

In some embodiments, in response to the tubular instrument <NUM> being advanced distally with respect to the housing <NUM>, the delivery device <NUM> may be configured to introduce the tubular instrument <NUM> into the catheter assembly <NUM>, which may include the catheter adapter <NUM> and the catheter <NUM>. In some embodiments, in response to the tubular instrument <NUM> being introduced into the catheter assembly <NUM>, the tubular instrument <NUM> may access a fluid pathway of the catheter assembly <NUM> and/or the tubular instrument <NUM> may extend through the catheter assembly <NUM> to access the vasculature of the patient.

In some embodiments, the catheter assembly <NUM> may include or correspond to any suitable catheter assembly, such as, for example, the BD NEXIVATM Closed IV Catheter system, the BD CATHENATM Catheter system, the BD VENFLONTM Pro Safely Shielded IV Catheter system, the BD NEOFLONTM IV Cannula system, the BD INSYTETM AUTOGUARDTM BC Shielded IV Catheter system, or another suitable catheter assembly. In some embodiments, the catheter assembly <NUM> may be integrated with an integrated extension tube <NUM>. In other embodiments, the catheter assembly <NUM> may be non-integrated. In some embodiments, the catheter <NUM> may include a peripheral intravenous catheter (PIVC), a peripherally inserted central catheter (PICC), or a midline catheter.

In some embodiments, the catheter <NUM> may be secured within and extend distally from the catheter adapter <NUM>. In some embodiments, the catheter adapter <NUM> may include a distal end <NUM>, a proximal end <NUM>, and a lumen <NUM> extending between and/or through the distal end <NUM> and the proximal end <NUM>. In some embodiments, a septum may be disposed within the lumen of the catheter adapter <NUM>. In some embodiments, the tubular instrument <NUM> may be delivered to the vasculature through the septum or proximal to the septum.

In some embodiments, the delivery device <NUM> may include a connector <NUM>, which may be coupled to the proximal end <NUM> or another portion of the catheter assembly <NUM>, such as, for example, a Y-adapter. In some embodiments, the connector <NUM> may include a slip or thread or clip male luer adapter. In some embodiments, the connector <NUM> may include a slip or thread or clip female luer adapter. In some embodiments, the connector <NUM> may include an introducer or cannula that may be inserted into the proximal end <NUM> of the catheter adapter <NUM>. In some embodiments, the housing <NUM> may include a distal end <NUM> and a proximal end <NUM>. In some embodiments, the distal end <NUM> may include the connector <NUM>.

In some embodiments, the delivery device <NUM> may include a blood collection device <NUM>. In some embodiments, the blood collection device <NUM> may include or correspond to a blood collection container. In some embodiments, the blood collection container may include a syringe, an evacuated blood collection tube <NUM>, a small sample collection device, or any other container. In some embodiments, the blood collection device <NUM> may be coupled to the delivery device <NUM> after advancement of the tubular instrument <NUM> in the distal direction.

In some embodiments, the blood collection device may include a needle assembly, which may include a needle <NUM> configured to receive the blood collection container. In some embodiments, a proximal tip of the needle <NUM> may be disposed within an elastomeric sheath. In some embodiments, in response to the blood collection container pushing the elastomeric sheath distally, the needle <NUM> may pierce the elastomeric sheath and be inserted into the blood collection container. In these and other embodiments, the blood collection container may include the evacuated blood collection tube <NUM>.

In some embodiments, the blood collection device may include a holder <NUM>, which may be configured to receive the evacuated blood collection tube <NUM>. In some embodiments, the blood collection device may include the VACUTAINER® one-use holder, available from Becton, Dickinson and Company of Franklin Lakes, New Jersey. In some embodiments, the blood collection device <NUM> may be coupled to and in fluid communication with the proximal end <NUM> of the tubular instrument <NUM>. In some embodiments, the blood collection device <NUM> may be coupled to and in fluid communication with the proximal end <NUM> of the tubular instrument <NUM> via a fluid pathway extending through the needle <NUM> and the tubular instrument <NUM>. In some embodiments, the blood collection device <NUM> may be coupled to a proximal end <NUM> of the tubular instrument <NUM> in any number of suitable ways, such as via integration, a luer connection, etc..

In some embodiments, the delivery device <NUM> may include an advancement element. In some embodiments, the advancement element may include a tab or a grip, which may be moved by the clinician to advance the tubular instrument <NUM> in a distal direction and/or retract the tubular instrument <NUM> in a proximal direction. In some embodiments, the advancement element may be coupled to the tubular instrument <NUM>. In some embodiments, the advancement element may be rotated. In some embodiments, the advancement element may include a slider <NUM>, which may be slidable along a slot <NUM> disposed within the housing <NUM>, as illustrated in <FIG>. In some embodiments, the tubular instrument <NUM> may extend and move through the proximal end <NUM> of the housing <NUM>.

In some embodiments, in response to significant dwelling time within the vasculature, the catheter <NUM> of the catheter assembly <NUM> may be susceptible to narrowing, collapse, kinking, blockage by debris (e.g., fibrin or platelet clots), and adhering of the distal tip <NUM> of the catheter <NUM> to the vasculature. Thus, blood withdrawal using the catheter <NUM> may be difficult. In some embodiments, the tubular instrument <NUM> may include or act as another catheter that may provide access to the vasculature of the patient without any additional needle sticks without any additional needle sticks. Thus, in some embodiments, the tubular instrument <NUM> may be used for needle-free blood collection and/or fluid infusion.

Referring now to <FIG> and <FIG>, in some embodiments, a first delivery device <NUM> may be coupled to the catheter assembly <NUM>. In some embodiments, the first delivery device <NUM> may be similar or identical to the delivery device <NUM> of <FIG>, respectively, in terms of one or more included features and/or operation. In some embodiments, the catheter <NUM> may be dwelling within the vasculature of the patient when the first delivery device <NUM> is coupled to the catheter assembly <NUM>. In further detail, the catheter <NUM> may be dwelling within the vasculature of the patient prior to coupling of the first delivery device <NUM> to the catheter assembly <NUM>.

In some embodiments, the first delivery device <NUM> may include a first housing <NUM> and a first tubular instrument <NUM>. In some embodiments, the first housing <NUM> and the first tubular instrument <NUM> may be similar or identical to the housing <NUM> and the tubular instrument <NUM> of <FIG> in terms of one or more included features and/or operation. In some embodiments, the first tubular instrument <NUM> may include a distal end <NUM>, the proximal end <NUM>, and a lumen extending between the distal end <NUM> of the first tubular instrument <NUM> and the proximal end <NUM> of the first tubular instrument <NUM>. In some embodiments, the lumen may extend through the distal end <NUM> and the proximal end <NUM>. In some embodiments, the proximal end <NUM> of the first tubular instrument <NUM> may be secured within the first housing <NUM>.

In some embodiments, the first tubular instrument <NUM> may be configured to advance distally from a proximal position to a distal position with respect to the first housing <NUM> and the catheter assembly <NUM>. In some embodiments, in response to the first tubular instrument <NUM> being in the proximal position, the first tubular instrument <NUM> may be proximal to the catheter assembly <NUM>. In further detail, the distal end <NUM> of the first tubular instrument <NUM> or a distal surface <NUM> of the first tubular instrument <NUM> may be proximal to the catheter assembly <NUM> and/or within the first housing <NUM>.

In some embodiments, in response to the first tubular instrument <NUM> being in the distal position, the distal surface <NUM> of the distal end <NUM> of first tubular instrument <NUM> may be disposed distal to a distal tip <NUM> of the catheter <NUM> and at a first distance beyond the distal tip <NUM> of the catheter <NUM>. In some embodiments, the distal surface <NUM> may include a distal-most surface of the distal end <NUM>. In some embodiments, the first tubular instrument <NUM> may be fully advanced with respect to the first housing <NUM> in response to the first tubular instrument <NUM> being in the distal position. For example, the slider <NUM> may contact a distal end of the slot <NUM>, which may act as a stop.

In some embodiments, after transferring a first volume of blood via the first tubular instrument <NUM> to a first blood collection container and moving the first tubular instrument <NUM> from the distal position toward the proximal position, the first delivery device <NUM> may be decoupled from the catheter assembly <NUM>.

Referring now to <FIG> and <FIG>, in some embodiments, after decoupling the first delivery device <NUM> from the catheter assembly <NUM>, a second delivery device <NUM> may be coupled to the catheter assembly <NUM>. In some embodiments, the second delivery device <NUM> may be similar or identical to the delivery device <NUM> of <FIG> in terms of one or more included features and/or operation. In some embodiments, the catheter <NUM> may be dwelling within the vasculature of the patient when the second delivery device <NUM> is coupled to the catheter assembly <NUM> and may not have been removed from the patient since insertion into the vasculature. In some embodiments, the catheter <NUM> may be dwelling within the vasculature of the patient prior to coupling of the second delivery device <NUM> to the catheter assembly <NUM>.

In some embodiments, the second delivery device <NUM> may include a second housing <NUM> and a second tubular instrument <NUM>. In some embodiments, the second housing <NUM> and the second tubular instrument <NUM> may be similar or identical to the housing <NUM> and the tubular instrument <NUM> of <FIG>, respectively, in terms of one or more included features and/or operation. In some embodiments, the second tubular instrument <NUM> may include the distal end <NUM>, the proximal end <NUM>, and the lumen extending between the distal end <NUM> of the second tubular instrument <NUM> and the proximal end <NUM> of the second tubular instrument <NUM>. In some embodiments, the lumen may extend through the distal end <NUM> and the proximal end <NUM>.

In some embodiments, the proximal end <NUM> of the second tubular instrument <NUM> may be secured within the second housing <NUM>. In some embodiments, the second tubular instrument <NUM> may be configured to advance distally from the proximal position to the distal position with respect to the second housing <NUM> and the catheter assembly <NUM>. In some embodiments, the second tubular instrument <NUM> may be fully advanced with respect to the second housing <NUM> in response to the second tubular instrument <NUM> being in the distal position. For example, the slider <NUM> may contact a distal end of the slot <NUM>, which may act as a stop.

In some embodiments, in response to the second tubular instrument <NUM> being in the proximal position, the second tubular instrument <NUM> may be proximal to the catheter assembly <NUM>. In further detail, the distal end <NUM> of the second tubular instrument <NUM> or the distal surface <NUM> of the second tubular instrument <NUM> may be proximal to the catheter assembly <NUM> and/or within the second housing <NUM>. In some embodiments, in response to the second tubular instrument <NUM> being in the distal position, the distal surface <NUM> of the distal end <NUM> of the second tubular instrument <NUM> may be disposed distal to the distal tip <NUM> of the catheter <NUM> and at a second distance beyond the distal tip <NUM> of the catheter <NUM>. In some embodiments, the distal surface <NUM> may include a distal-most surface of the distal end <NUM>. In some embodiments, the second distance may be greater than the first distance.

In some embodiments, after transferring a second volume of blood via the second tubular instrument <NUM> to a second blood collection container and moving the second tubular instrument <NUM> from the distal position toward the proximal position, the second delivery device <NUM> may be decoupled from the catheter assembly <NUM>.

In some embodiments, a difference between the first distance and the second distance may be <NUM> (<NUM> inches), which may facilitate extension through a thrombus that may be formed near the distal tip <NUM> of the catheter <NUM> and establishment of a fluid pathway through the catheter assembly <NUM>. In further detail, in some embodiments, a size of the thrombus may increase over time, so the second distance may be greater than the first distance to increase a likelihood of the second tubular instrument <NUM> passing through the thrombus when the second delivery device is coupled to the catheter assembly <NUM>, which after the first delivery device is coupled to the catheter assembly <NUM>. In some embodiments, the first distance may be <NUM> (<NUM> inch) or less. In some embodiments, the second distance may be <NUM> (<NUM> inches) or less.

In some embodiments, a difference between the first distance and the second distance may be <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inch), or another suitable distance. In some embodiments, a difference between the first distance and the second distance may be greater than <NUM> (<NUM> inches). In some embodiments, the first delivery device may be coupled to the catheter assembly <NUM> on a first day, and the second delivery device may be coupled to the catheter assembly <NUM> on a second day, which may be subsequent to the first day. In some embodiments, the second day may immediately follow the first day.

Referring now to <FIG> and <FIG>, in some embodiments, after decoupling the second delivery device <NUM> from the catheter assembly <NUM>, a third delivery device <NUM> may be coupled to the catheter assembly <NUM>. In some embodiments, the third delivery device <NUM> may be similar or identical to the delivery device <NUM> of <FIG> in terms of one or more included features and/or operation. In some embodiments, the catheter <NUM> may be dwelling within the vasculature of the patient when the third delivery device <NUM> is coupled to the catheter assembly <NUM> and may not have been removed from the patient since insertion into the vasculature. In some embodiments, the catheter <NUM> may be dwelling within the vasculature of the patient prior to coupling of the second delivery device <NUM> to the catheter assembly <NUM>.

In some embodiments, the third delivery device <NUM> may include a third housing <NUM> and a third tubular instrument <NUM>. In some embodiments, the third housing <NUM> and the third tubular instrument <NUM> may be similar or identical to the housing <NUM> and the tubular instrument <NUM> of <FIG>, respectively, in terms of one or more included features and/or operation. In some embodiments, the third tubular instrument <NUM> may include the distal end <NUM>, the proximal end <NUM>, and the lumen extending between the distal end <NUM> and the proximal end <NUM>. In some embodiments, the lumen may extend through the distal end <NUM> and the proximal end <NUM>.

In some embodiments, the proximal end <NUM> of the third tubular instrument <NUM> may be secured within the third housing <NUM>. In some embodiments, the third tubular instrument <NUM> may be configured to advance distally from the proximal position to the distal position with respect to the third housing <NUM> and the catheter assembly <NUM>. In some embodiments, the third tubular instrument <NUM> may be fully advanced with respect to the third housing <NUM> in response to the third tubular instrument <NUM> being in the distal position. For example, the slider <NUM> may contact a distal end of the slot <NUM>, which may act as a stop.

In some embodiments, in response to the third tubular instrument <NUM> being in the proximal position, the third tubular instrument <NUM> may be proximal to the catheter assembly <NUM>. In further detail, the distal end <NUM> of the third tubular instrument <NUM> or the distal surface <NUM> of the third tubular instrument <NUM> may be proximal to the catheter assembly <NUM> and/or within the third housing <NUM>. In some embodiments, in response to the third tubular instrument <NUM> being in the distal position, the distal surface <NUM> of the distal end of the third tubular instrument <NUM> may be disposed distal to the distal tip <NUM> of the catheter <NUM> and at a third distance beyond the distal tip <NUM> of the catheter <NUM>. In some embodiments, the distal surface <NUM> may include a distal-most surface of the distal end <NUM>. In some embodiments, the third distance may be greater than the second distance.

In some embodiments, after transferring a third volume of blood via the third tubular instrument <NUM> to a third blood collection container and moving the third tubular instrument <NUM> from the distal position toward the proximal position, the third delivery device <NUM> may be decoupled from the catheter assembly <NUM>.

In some embodiments, the third distance may be <NUM> (<NUM> inches) or less. In some embodiments, a difference between the second distance and the third distance may be <NUM> (<NUM> inches), which facilitate extension through the thrombus that may be formed near the distal tip of the catheter and establishment of the fluid pathway through the catheter assembly <NUM>. In further detail, in some embodiments, the size of the thrombus may increase over time, so the third distance may be greater than the second distance to increase a likelihood of the third tubular instrument <NUM> passing through the thrombus when the third delivery device is coupled to the catheter assembly <NUM>, which may occur after the second delivery device is coupled to the catheter assembly <NUM>.

In some embodiments, a difference between the second distance and the third distance may be <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inches), <NUM> (<NUM> inch), or another suitable distance. In some embodiments, a difference between the second distance and the third distance may be greater than <NUM> (<NUM> inches). In some embodiments, the second delivery device <NUM> may be coupled to the catheter assembly <NUM> on the second day, and the third delivery device <NUM> may be coupled to the catheter assembly <NUM> on the third day, which may be subsequent to the second day. In some embodiments, the third day may immediately follow the second day.

Referring now to <FIG>, in some embodiments, the first volume of blood may be transferred to the first blood collection container 70a via the first tubular instrument <NUM> on the first day. In some embodiments, the second volume of blood may be transferred to the second blood collection container 70b via the second tubular instrument <NUM> on the second day. In some embodiments, the third volume of blood may be transferred to the third blood collection container 70c via the third tubular instrument <NUM> on the third day.

In some embodiments, one or more of the first volume of blood, the second volume of blood, and the third volume of blood may be equal to each other or different from each other. In some embodiments, one or more of the first blood collection container 70a, the second blood collection container 70b, and the third blood collection container 70c may be a same blood collection container or different blood collection containers. In some embodiments, the first volume of blood may be collected in the first blood collection container 70a and/or one or more other blood collection containers. In some embodiments, the second volume of blood may be collected in the second blood collection container 70b and/or one or more other blood collection containers. In some embodiments, the third volume of blood may be collected in the third blood collection container 70c and/or one or more other blood collection containers.

In some embodiments, the distal end <NUM> of one or more of the first tubular instrument <NUM>, the second tubular instrument <NUM>, and the third tubular instrument <NUM> may include one or more side holes <NUM>, which may facilitate blood flow into the catheter <NUM> proximal to the thrombus. In some embodiments, the distal end <NUM> of one or more of the first tubular instrument <NUM>, the second tubular instrument <NUM>, and the third tubular instrument <NUM> may be closed and/or may include a slit.

In some embodiments, the side holes <NUM> in the first tubular instrument <NUM> may be within the first distance or a particular distance the distal tip <NUM> extends beyond the catheter <NUM>. In some embodiments, the side holes <NUM> in the second tubular instrument <NUM> may be within the second distance or a particular distance the distal tip <NUM> extends beyond the catheter <NUM>. In some embodiments, the side holes <NUM> in the third tubular instrument <NUM> may be within the second distance or a particular distance the distal tip <NUM> extends beyond the catheter <NUM>.

In some embodiments, one or more of the first tubular instrument <NUM>, the second tubular instrument <NUM>, and the third tubular instrument <NUM> may be resistant to occlusion and thrombosis because the slit may be closed, and blood may not be allowed to diffuse into the corresponding tubular instrument under normal physiological pressures. In some embodiments, the distal end <NUM> may include a distal opening.

In some embodiments, the difference between the first distance and the second distance and the difference between the second distance and the third distance may increase a likelihood of extension through the thrombus and establishment of the fluid pathway through the catheter assembly <NUM>. In some embodiments, one or more particular delivery devices in addition to the first delivery device <NUM>, the second delivery device <NUM>, and the third delivery device <NUM> may be coupled to the catheter assembly <NUM> without removing the catheter <NUM> from the patient. In some embodiments, particular tubular instruments that are inserted through the dwelling catheter <NUM> as time progresses may be increasingly longer, which may increase a likelihood of establishing the fluid pathway through the catheter assembly <NUM> to allow blood draw and/or may reduce thrombosis.

In some embodiments, the first delivery device <NUM> may include a first marking 74a, which may be disposed on an outer surface of the first housing <NUM>. In some embodiments, the second delivery device may include a second marking 74b, which may be disposed on an outer surface of the second housing <NUM>. In some embodiments, the third delivery device <NUM> may include a third marking 74c, which may be disposed on an outer surface of the third housing <NUM>. In some embodiments, the first marking 74a, the second marking 74b, and the third marking 74c may include one or more of a line, indent, groove, text, color, or another suitable marking.

In some embodiments, one or more of the first marking 74a, the second marking 74b, and the third marking 74c may include a time to use the corresponding delivery device. For example, the first marking 74a may include "Day <NUM>" or "First Blood Draw. " As another example, the second marking 74b may include "Day <NUM>" or "Second Blood Draw. " As a further example, the third marking 74c may include "Day <NUM>" or "Third Blood Draw. " In some embodiments, the first marking 74a, the second marking 74b, and/or the third marking 74c may indicate a time to use the corresponding delivery devices with respect to each other.

In some embodiments, the first housing <NUM> may include another marking 76a. In some embodiments, the first delivery device <NUM> may include the slider <NUM>, which may be coupled to the first tubular instrument <NUM>. In some embodiments, the slider <NUM> may be aligned with the other marking 76a in response to the distal surface <NUM> of the first tubular instrument <NUM> being flush with the distal tip <NUM> of the catheter <NUM>. Thus, in some embodiments, the other marking 76a may indicate to the clinician that in response to further advancement of first tubular instrument <NUM> in a distal direction, the first tubular instrument <NUM> will extend distal to the distal tip <NUM> of the catheter <NUM>.

In some embodiments, the second housing <NUM> may include the other marking 76b. In some embodiments, the second delivery device <NUM> may include the slider <NUM> that may be coupled to the second tubular instrument <NUM>. In some embodiments, the slider <NUM> may be aligned with the other marking 76b in response to the distal surface <NUM> of the second tubular instrument <NUM> being flush with the distal tip <NUM> of the catheter <NUM>. Similarly, in some embodiments, the third delivery device <NUM> may include the other marking 76c. In some embodiments, the third delivery device may include the slider <NUM>, which may be coupled to the third tubular instrument <NUM>. In some embodiments, the slider <NUM> may be aligned with the other marking 76c in response to the distal surface <NUM> of the third tubular instrument <NUM> being flush with the distal tip <NUM> of the catheter <NUM>.

In some embodiments, the third housing <NUM> may be longer than the second housing <NUM>, which may be longer than the first housing <NUM>. Thus, the third tubular instrument <NUM>, which may be longer than the second tubular instrument <NUM> and the first tubular instrument <NUM> may be contained within the third housing <NUM> prior to advancement in the distal direction. Similarly, in some embodiments, the second tubular instrument <NUM> may be contained within the second housing <NUM> prior to advancement in the distal direction, and the first tubular instrument <NUM> may be contained within the first housing <NUM> prior to advancement in the distal direction.

Referring now to <FIG>, in some embodiments, a delivery device <NUM> may include a housing <NUM> and a tubular instrument <NUM>. In some embodiments, the housing <NUM> may include one or more of the following: a first marking <NUM>, a second marking <NUM>, a third marking <NUM>, and the slot <NUM>. In some embodiments, the first marking <NUM>, the second marking <NUM>, and the third marking <NUM> may include one or more of a line, indent, groove, text, color, or another suitable marking.

In some embodiments, the first marking <NUM> may be proximal to the second marking <NUM>. In some embodiments, the delivery device <NUM> may include the tubular instrument <NUM>, which may include the distal end <NUM>, the proximal end <NUM>, and the lumen. In some embodiments, the proximal end of the tubular instrument may be secured within the housing <NUM>. In some embodiments, the slider <NUM> may be coupled to the tubular instrument <NUM> and slidable along the slot <NUM> of the housing <NUM>. In some embodiments, the slider <NUM> may include an advancement tab, which may be gripped by a clinician to advance and/or retract the tubular instrument.

In some embodiments, in response to advancing the slider <NUM> distally from a proximal position to the first marking <NUM>, the distal surface <NUM> of the distal end <NUM> of the tubular instrument <NUM> may be disposed at a first distance beyond the distal end <NUM> of the housing <NUM> or the first distance beyond the distal tip <NUM> of the catheter <NUM>. In some embodiments, in response to advancing the slider <NUM> distally from the proximal position to the second marking <NUM>, the distal surface <NUM> of the distal end <NUM> of the tubular instrument may be disposed at a second distance beyond the distal end of the housing or the second distance beyond the distal tip <NUM> of the catheter <NUM>.

In some embodiments, the second distance beyond the distal end <NUM> of the housing <NUM> may be greater than the first distance beyond the distal end <NUM> of the housing <NUM>. As mentioned previously, in some embodiments, the second distance beyond the distal tip <NUM> of the catheter <NUM> may be greater than the first distance beyond the distal tip <NUM> of the catheter <NUM>.

In some embodiments, in response to advancing the slider <NUM> distally from the proximal position to the third marking <NUM>, the distal surface <NUM> of the distal end of the tubular instrument <NUM> may be disposed at a third distance beyond the distal end <NUM> of the housing <NUM>. In some embodiments, the third distance may be greater than the second distance. In some embodiments, the third distance beyond the distal end <NUM> of the housing <NUM> may be greater than the second distance beyond the distal end <NUM> of the housing <NUM>. As mentioned previously, in some embodiments, the third distance beyond the distal tip <NUM> of the catheter <NUM> may be greater than the second distance beyond the distal tip <NUM> of the catheter <NUM>.

In some embodiments, different blood collection containers or a same blood collection container may be used to collect blood via the delivery device <NUM> or any of the other delivery devices of the present disclosure. In some embodiments, the slider <NUM> may be advanced distally from the proximal position to the first marking <NUM> at a first duration of time for a first blood draw. In some embodiments, the slider <NUM> may be advanced distally from the first marking <NUM> to the second marking <NUM> at a second duration of time later than the first duration of time. In some embodiments, the slider <NUM> may be advanced distally from the second marking <NUM> to the third marking <NUM> at a third duration of time later than the second duration of time. In some embodiments, the first duration of time may correspond to about one day. In some embodiments, the second duration of time and the third duration of time may correspond to about two days and about three days, respectively. In some embodiments, the first duration of time, the second duration of time, and the third duration of time may correspond to any suitable duration of time from insertion of the catheter <NUM> into the vasculature.

Claim 1:
A blood draw kit, comprising:
a first delivery device (<NUM>), comprising: a first housing (<NUM>), wherein a distal end of the first housing (<NUM>) comprises a first adapter (<NUM>) configured to couple to a catheter assembly (<NUM>); and
a first tubular instrument (<NUM>), comprising a distal end (<NUM>), a proximal end (<NUM>), and a lumen extending between the distal end (<NUM>) of the first tubular instrument (<NUM>) and the proximal end (<NUM>) of the first tubular instrument (<NUM>), wherein the proximal end (<NUM>) of the first tubular instrument (<NUM>) is secured within the first housing (<NUM>), wherein the first tubular instrument (<NUM>) is configured to advance distally from a proximal position to a distal position with respect to the first housing (<NUM>) and the catheter assembly (<NUM>), wherein in response to the first tubular instrument (<NUM>) advancing distally from the proximal position to the distal position with respect to the first housing (<NUM>), a distal surface (<NUM>) of the distal end (<NUM>) of the first tubular instrument (<NUM>) is disposed at a first distance beyond the distal end of the first housing (<NUM>);
a second delivery device (<NUM>), comprising:
a second housing (<NUM>), wherein a distal end of the second housing comprises a second adapter configured to couple to a catheter assembly (<NUM>); and
a second tubular instrument (<NUM>), comprising a distal end (<NUM>), a proximal end (<NUM>), and a lumen extending between the distal end (<NUM>) of the second tubular instrument (<NUM>) and the proximal end (<NUM>) of the second tubular instrument (<NUM>), wherein the proximal end (<NUM>) of the second tubular instrument (<NUM>) is secured within the second housing (<NUM>), wherein the second tubular instrument (<NUM>) is configured to advance distally from a proximal position to a distal position with respect to the second housing (<NUM>) and the catheter assembly, wherein in response to the second tubular instrument (<NUM>) advancing distally from the proximal position to the distal position with respect to the second housing (<NUM>), a distal surface (<NUM>) of the distal end (<NUM>) of the second tubular instrument (<NUM>) is disposed at a second distance beyond the distal end of the second housing (<NUM>), wherein the second distance is greater than the first distance.