Patent Description:
Medical connectors are used to attach or interface between or among two or more medical components of patient fluid infusion systems, such as fluid lines or tubes (e.g., catheters), pumps, syringes, IV bags, drip chambers, infusion ports, injection sites, and/or shunts, etc..

Many different types of fluids are used in patient fluid infusion or transfer systems, including hydrating fluids (e.g., saline), nourishing fluids, pain-diminishing medications, antibiotics, antimicrobials, anti-inflammatories, sedatives, anticoagulants, chemotherapy drugs, bodily fluids (e.g., blood in dialysis procedures), and/or other types of medicinal fluids. In health clinics and hospitals, many different types of medicinal fluids need to be purchased, inventoried, stored, and made available to healthcare practitioners, which requires substantial storage space and is expensive, complex, and time-consuming.

In some situations, a fluid line is attached in fluid communication with a patient's vascular system, such as through an injection site into a blood vessel (e.g., an artery or vein). During an initial infusion phase, one or more medicinal fluids are infused through the fluid line into the patient's bloodstream. After the initial infusion phase is complete, the fluid line is sometimes left in place in a standby phase for an extended period until one or more subsequent infusions are performed. While the fluid line is in the standby phase, with the fluid stagnant, the risk of microbial invasion and colonization increases.

To diminish this risk, healthcare practitioners sometimes infuse a small amount of antimicrobial fluid into the end of a fluid line at the beginning of a standby phase to form a microbial block at the entrance of the fluid line. Before the next infusion phase, the antimicrobial fluid is generally removed by aspirating it from the fluid line into a syringe, and then discarding it, in order to avoid infusing the antimicrobial fluid into the patient. This antimicrobial block procedure is usually very effective, but sometimes it is not performed in clinical settings because it requires the purchase, inventory, retrieval, and infusion of an additional medicinal fluid and related disposables, which further adds to the burden of an otherwise onerous fluid supply system in the health clinic or hospital.

In some medical procedures, one or more additives are desired to be added to a particular medical fluid that is flowing through a fluid line for a variety of therapeutic purposes; however, the process for adding such additives requires obtaining and storing bulky liquid containers and utilizing some type of slow liquid-additive infusion procedure. <CIT> discusses a combination container/syringe with which it is possible to effectively eliminate air bubbles in a medicinal solution via a medicinal solution flow-through space. <CIT> discusses a drug delivery connector including a ball valve.

The invention is defined in the appended independent claims, to which attention is directed. Any feature mentioned in the following description that uses the term "embodiment" should be regarded as describing a mandatory feature if the feature in question is part of the independent claim. The other figures, aspects, and embodiments are provided for illustrative purposes and do not represent embodiments of the invention unless when combined with all of the features respectively defined in the independent claims. In some embodiments, a medical fluid connector is configured to receive an emitter of therapeutic agents to be emitted into a fluid pathway within the connector, the medical fluid connector comprising a proximal female end, an intermediate region, a distal male end, and a fluid pathway extending from the proximal female end, through the intermediate region, to the distal male end. A retaining structure is positioned within the intermediate region. In some embodiments, the retaining structure is configured to securely receive an emitter of one or more therapeutic agents in a position and orientation in which the fluid pathway is configured to convey fluid moving longitudinally through the fluid pathway directly into a proximal region of the emitter, around one or more outside lateral surfaces of the emitter, and toward the distal male end. In some embodiments, the retaining structure is configured to retain the emitter by way of only a friction fit or an interference fit between the retaining structure and the emitter, and not by way of other retaining methods (e.g., adhesive, sonic welding, entrapment between separable housing pieces, coating, molding, heat staking, solvent bonding, chemical bonding, etc.). In some embodiments, any retaining method can be used. In some embodiments, the medical fluid connector is open from end to end in that the connector is configured to allow at least a portion of the fluid to travel freely into and/or from the proximal female end, through the intermediate region, and to and/or out of the distal male end.

In some embodiments, a medical fluid connector comprises a housing with a proximal region and a distal region, with a fluid pathway extending between the proximal and distal regions. The fluid pathway is configured to receive and convey fluid through the housing. In some embodiments, the housing contains an emitter of one or more therapeutic agents that is securely positioned within the housing in a location in which the fluid pathway is configured to pass adjacent to and outside of at least a majority of the external surface area of the emitter. In some embodiments, the fluid pathway is at least partially open and configured to convey fluid freely through the housing about the emitter.

In some aspects, a method of manufacturing a medical fluid connector is provided. In some aspects, the method includes one or more of the following steps: (a) providing a housing comprising a proximal female end, an intermediate region, a distal male end, in which a fluid pathway extends from the proximal female end, through the intermediate region, to the distal male end; (b) providing a retaining structure positioned within the intermediate region, the retaining structure comprising a retaining space and a plurality of fluid flow spaces generally surrounding the retaining space; and (c) inserting an emitter of one or more therapeutic agents into the retaining space, such that the emitter is securely retained within the housing and the emitter is configured to remain secured within the connector when fluid moves longitudinally through the fluid pathway directly into a proximal region of the emitter, around one or more outside lateral surfaces of the emitter, and toward the distal male end.

Any of the embodiments described above, or described elsewhere herein, can include one or more of the following features.

In some embodiments, the medical fluid connector comprises an emitter. In some embodiments, the medical fluid connector comprises one or more additional emitters. In some embodiments, the emitter is configured to emit one or more antimicrobial agents into the fluid pathway when fluid passes through the connector. In some embodiments, the emitter is substantially cylindrical, substantially rectangular, substantially spherical, substantially conical, substantially pyramidal, or substantially cubical. In some embodiments, the retaining structure comprises a plurality of longitudinal struts. In some embodiments, the retaining structure comprises a plurality of base portions.

In some embodiments, the proximal female region near the proximal female end comprises a connection structure. In some embodiments, the connection structure comprises a screw thread. In some embodiments, at least a portion of the screw thread is oversized. In some embodiments, the screw thread comprises a disconnection-resistant feature.

In some embodiments, the distal region comprises a distal male protrusion. In some embodiments, the distal male protrusion is oversized.

Some aspects pertain to a method of providing an antimicrobial block for a standby patient fluid infusion line. In some aspects, the method comprises attaching a proximal portion of a medical connector to a syringe containing a liquid. In some aspects, the medical connector comprises an emitter of one or more antimicrobial agents. In some aspects, the medical connector is configured to securely position the emitter inside of a fluid pathway of the medical connector. In some aspects, the method comprises attaching a distal portion of the medical connector to a proximal end of a standby fluid line of a patient. In some aspcets, the method comprises infusing fluid from the syringe, through the proximal portion of the medical connector, into contact with at least upper and lateral external surfaces of the emitter, thereby emitting one or more therapeutic agents into the fluid pathway. In some aspects of the method, the emitter is positioned within an intermediate region of the connector.

Some aspects pertain to a method of providing an antimicrobial block for a fluid infusion line. In some aspects, the method comprises providing a connector with an emitter of an antimicrobial agent, the emitter being securely positioned inside of a fluid pathway of the medical connector. In some aspects, the method comprises instructing a user to attach a proximal portion of the medical connector to a syringe containing a liquid. In some aspects, the method comprises instructing a user to infuse a fluid from the syringe, through the proximal portion of the medical connector, into contact with at least upper and lateral external surfaces of the emitter to thereby emit one or more therapeutic agents into the fluid pathway.

Nothing illustrated in these drawings or described in the associated text is indispensable or essential; rather, any feature, structure, material, component, or step illustrated or described in any embodiment can be used alone or omitted, or can be used with or instead of any feature, structure, material, component, or step illustrated or described in any other embodiment. For example, some embodiments do not include any emitter, but do include one or more other features illustrated or described in this specification. The features are illustrated and described in discrete embodiments merely for convenience of explanation, but not to limit the inventions or to segregate the inventions into isolated collections of features. The proportions and relative sizes of components and features illustrated in the drawings form part of this disclosure, but should only be interpreted to form part of a claim if recited in such claim, either now or in the future.

<FIG> illustrate an example of a medical connector <NUM>. Different embodiments of medical connectors are described in this specification, some of which include the features illustrated in <FIG>. A medical connector <NUM> comprises a housing comprising a proximal region <NUM> with a proximal end <NUM>, a distal region <NUM> with a distal end <NUM>, and a body <NUM> extending between the proximal and distal ends <NUM>, <NUM>. The distal region <NUM> can comprise a male protrusion <NUM>, such as a male luer protrusion. An internal fluid pathway <NUM> can extend between the proximal and distal regions <NUM>, <NUM> of the connector <NUM>, such as between the proximal and distal ends <NUM>, <NUM>. In some embodiments, either or both of the proximal or distal regions <NUM>, <NUM> can include a connection structure <NUM>, such as one or more threads (as shown), clasps, arms, latches, protrusions, and/or recesses, etc., that is configured to help guide, attach, and/or retain the medical connector to another device, such as another medical connector.

As shown in <FIG> and <FIG>, the proximal region <NUM> can comprise a threaded connection structure <NUM> configured to rotatably attach and detach from a corresponding threaded connection structure on another device, such as a male end of a syringe (not shown). A thread-stop or collar <NUM> can be positioned distally from the connection structure <NUM> to prevent or resist over-extending the threaded connection between the connector <NUM> and another medical device. As illustrated in <FIG> and <FIG>, the proximal region can include a female coupling <NUM> configured to slidably receive a corresponding male coupling of another device such as a syringe (not shown). In some embodiments, as shown, the female coupling <NUM> comprises a conduit <NUM> within the proximal region <NUM>. The conduit <NUM> can comprise a tapering wall structure that diminishes in diameter or horizontal cross-sectional width from the proximal end <NUM> toward the distal end <NUM>. In some embodiments, the taper can conform to a standard within the medical industry, such as any version of the ISO <NUM> standard (which includes a <NUM>% luer taper) or any other applicable standard (e.g., DIN and EN standard <NUM>:<NUM> and/or <NUM>-<NUM>:<NUM>). The conduit <NUM> can be configured to snugly and tightly receive a male coupling of another standard-compliant device with a corresponding taper or other shape, such as a corresponding luer taper, to produce resistance against fluid leakage after the male coupling is inserted fully into the female coupling <NUM>. In some embodiments, as shown, the connector <NUM> is separate from the syringe; and in some embodiments, the connector <NUM> is integrated into or bonded to the syringe.

In some embodiments, as illustrated, the connection structure <NUM> can comprise one or more disconnection-resisting features or structures configured to resist disconnection between the connector <NUM> and another medical implement (such as a syringe or other connector or other structure). The disconnection-resisting features(s) or structure(s) can have many different forms, such as one or more freely spinning positions or stages after connection is accomplished, one or more increased friction-inducing anti-rotation impediments, and/or one or more disconnection-resisting thread shapes. For example, in a threaded connection structure <NUM>, as shown in <FIG>, <FIG>, and <FIG>, a friction-inducing impediment can comprise one or more (e.g., at least two) protrusions <NUM> positioned between multiple thread turns, the one or more protrusions <NUM> extending radially outwardly from the inner surface <NUM> of the threading <NUM>, thereby providing a region of radial space between the radially outermost surface <NUM> of the protrusion <NUM> and the radially outermost surface <NUM> of the threading <NUM> that is smaller than the radial space between the inner surface <NUM> of the threading <NUM> and the outermost surface <NUM> of the threading <NUM>. In this example of an impediment, as the threading of another device (such as a syringe, not shown) is rotatably attached to the threading <NUM> of the connection structure <NUM>, the relative rotation of the two devices is slowed down or resisted through increased frictional contact between the impediment and the threading of the other device, thereby requiring greater torque to attach the two devices and/or requiring greater torque to detach the two devices, which diminishes the risk of accidental disconnection. The contact between the impediment and the threading of the other device may cause wedging, compaction, crushing, and/or compression of either or both structures. Many different types of impediments can be used to resist disconnection that are different from those described and/or illustrated.

A disconnection-resisting thread shape can help resist or prevent disconnection between the connector <NUM> and another medical device, such as a syringe. For example, as illustrated in <FIG>, <FIG>, and <FIG>, a helical threading <NUM> with multiple thread turns can comprise a thread portion with an oversized region <NUM>, and/or an outwardly flaring or outwardly tapering region <NUM>. In some embodiments, as shown, the outermost diameter of a beginning thread portion <NUM> can be a first diameter that is a standard size or within a standard range of sizes, such as may be specified in any applicable medical device standard (e.g., any of those mentioned elsewhere in this specification), or slightly smaller than a standard size or range of sizes. As the thread progresses around the proximal region <NUM> in the distal direction, the outermost diameter of a portion of the thread can flare or taper outwardly to a non-standard second diameter than is larger than the first diameter and larger than the diameter or range of diameters specified in one or more applicable medical device standards. Since the other medical device to which the proximal region <NUM> of the connector <NUM> is configured to attach (e.g., a syringe) will typically have a standard diameter of threading, the outward taper or flare of the disconnection-resisting thread shape of the connector <NUM> can cause the space between the respective threads to decrease, or can cause the attachment region of the other medical device to stretch by a small amount, and/or can cause the threading <NUM> of the connector <NUM> to compress by a small amount. One or more of these effects can create opposing radial forces between the threading surface of the other medical device and the threading surface <NUM> of the connector <NUM>, which can increase the friction between the respective surfaces and thereby resist or prevent rotational movement and decrease the risk of accidental disconnection between the two devices. As shown in this example, the connector <NUM> can be configured to resist disconnection from a syringe. In some embodiments, the connection structure <NUM> is configured such that the resistance is sufficiently high that it is not possible under normal conditions of use to disconnect the connector <NUM> from the other medical device (e.g., disconnection is prevented). Many other different types of disconnection-resisting or disconnection-preventing features can be used instead of or in addition to those illustrated and/or described in this specification, including one or more structures not including thread shapes or impediments, or any type of threads at all.

In some uses, it may be desirable to temporarily attach the distal region <NUM> of the connector <NUM> to a standby fluid line that has at its proximal end a resealable needleless female connector, such as a Clave® connector sold by ICU Medical, Inc. or a SmartSite® connector sold by CareFusion Corporation. This type of configuration can allow a healthcare practitioner to infuse fluid from a fluid source (such as a syringe) into the proximal end <NUM> of connector <NUM>, through the distal end <NUM> of connector <NUM>, and into the resealable needleless female connector, the fluid line, and ultimately the patient. However, it may be undesirable, in some embodiments, to leave the connector <NUM> attached to a resealable female connector for a prolonged period, especially when unattended, since the connector <NUM> may not include a seal at its proximal end in some embodiments (as shown), and may therefore expose the fluid in the fluid line to the outside environment or even allow fluid in the fluid line to flow out of the fluid line. Thus, in some embodiments, there is no connection-securing structure (such as threads) in the distal region <NUM> of the connector <NUM> to discourage long-term connection. Rather, the illustrated connector <NUM>, without connection-securing structure, is configured to be rapidly and easily slidably inserted into and/or removed from a corresponding female connector without requiring any additional motion (e.g., twisting, rotating, clasping, etc.) in a non-secured connection. Also, the absence of connection-securing structure in the distal region <NUM> of the connector obviates the need to use a reverse twisting motion to remove the distal region <NUM> from the resealable needleless female connector, which would otherwise increase the risk that a threadably secured connection between a syringe and the proximal region <NUM> of the connector would be inadvertently partially or completely disconnected or backed out, potentially causing a leak.

In some embodiments (not shown), the distal region <NUM> can comprise any suitable connection structure, such as any connection structure that is illustrated and/or described in connection with the proximal region <NUM> of medical connector <NUM> or in connection with any other embodiment. If used, the connection structure can be included in an inner region <NUM> generally surrounding the male luer protrusion <NUM>. As illustrated, the inner region <NUM> can be generally surrounded by a shroud or skirt that is configured to pass over and around a corresponding female end of another fluid connector to which the male protrusion <NUM> of the connector <NUM> is configured to be attached. As illustrated in <FIG>, in some embodiments, the proximal end of the inner region <NUM> is positioned further in the distal direction than the distal end of the intermediate region <NUM>. In some embodiments, including those in which there is no gripping portion <NUM> in the distal region <NUM> of the connector <NUM> (or no gripping portion <NUM> at all), the shroud or skirt can be omitted, as with any other feature, structure, material, or step disclosed or illustrated in this specification. When the shroud or skirt is omitted, the male protrusion <NUM> can be fully exposed along its length from a proximal base region to a distal end region.

The male protrusion <NUM> can include one or more features to facilitate temporary attachment to a resealable needleless female connector. For example, the male protrusion <NUM> may not be a standard luer, in that it may have a non-standard size and/or shape (e.g., a size and/or shape that does not conform with one or more features or requirements of one or more medical industry standards, such as the ISO <NUM> medical luer standard and/or one or more other medical standards). In the illustrated embodiment, the male protrusion <NUM> has a taper that is about <NUM>%, which comports with one or more medical standards, but the male protrusion <NUM> is oversized in that it has a larger outer diameter on its distal end than is specified in one or more medical standards. For example, in some embodiments, the distal outer diameter of the male protrusion <NUM> can be at least about <NUM> micrometres (<NUM>/<NUM>,<NUM> of an inch) and or at least about <NUM> micrometres (<NUM>/<NUM>,<NUM> of an inch) larger than a standard distal outer diameter. Many other sizes can be used.

Since most resealable needleless female connectors have proximal openings with standard-size diameters, the oversized, non-standard male protrusion <NUM> will have a larger diameter at its distal end than the diameter at the distal end of the conduit of the female opening in a standard medical device to which the connector <NUM> is configured to attach. The larger diameter on the male protrusion <NUM> can enable it to fit more tightly or snugly at a lesser penetration depth into the female opening than would a male luer protrusion with a standard distal outer diameter. This can help to facilitate a non-secured, temporary attachment of the distal region <NUM> of the connector <NUM> to a resealable needleless female connector (not shown). Most, if not all, resealable needleless female connectors include a compressible elastomeric sealing element or other movable sealing element that can be advanced distally within such connector to temporarily open it to fluid flow, such as by inserting the male protrusion <NUM> into a proximal female opening on such a resealable needleless female connector. The sealing element is configured to rebound to a sealed position by pushing back against an inserted male protrusion. The amount of rebound or push-back force increases as the penetration depth of the inserted male protrusion increases. Since the male protrusion <NUM> is non-standard, having a larger distal outer diameter, it penetrates less distance into the needleless female connector when fully inserted, and therefore the sealing element exerts less proximally-directed rebound force against it, lowering the risk that the male protrusion <NUM> will be pushed back in the proximal direction by the sealing element and thereby dislodged from the resealable needleless female connector.

As shown, in some embodiments, the overall longitudinal length of the connector <NUM> can be relatively short. For example, either or both of the longitudinal length of the portion of the fluid pathway <NUM> within the threaded region (or the region on which the connection structure <NUM> is affixed, in some embodiments) and/or the longitudinal length of the portion of the fluid pathway <NUM> within the male protrusion <NUM> can be greater than the longitudinal length of the portion of the fluid pathway <NUM> that extends between the threaded region and the male protrusion <NUM>, as shown in <FIG>. As illustrated, a base portion <NUM> of the distal region <NUM> of the connector <NUM> can be relatively wide. For example, the external diameter and/or external horizontal cross sectional width of the base portion <NUM> can be larger than an external neck portion <NUM> located between the proximal region <NUM> and the base portion <NUM>. Many different sizes and proportions of the portions of the connector <NUM> can be used.

The connector <NUM> can comprise a grasping portion <NUM>, such as one or more tabs (as shown), recesses, protrusions, stripes, bumps, and/or friction-inducing gripping surfaces, etc. In the embodiment illustrated in <FIG>, the grasping portion <NUM> enables a user to securely retain the connector <NUM> during connection and disconnection with another device, such as when another device is twisted, or swayed or rocked back and forth, onto or away from the threaded proximal region <NUM>, or when the threaded proximal region <NUM> is twisted, or swayed or rocked back and forth, into or out of another device.

The grasping portion <NUM> can be relatively large in comparison to the size of the overall connector <NUM>. For example, as shown in <FIG> and <FIG>, the horizontal cross-sectional width (e.g., extending between respective lateral edges) of the grasping portion <NUM> can be larger than the external diameter or horizontal cross-sectional width of the base portion <NUM>, in some embodiments. As illustrated, the longitudinal length (in the proximal-to-distal dimension) of the grasping portion <NUM> can be larger than the longitudinal length of the connection structure <NUM> in the proximal region <NUM> of the connector <NUM>. In some embodiments, as shown, the longitudinal length of the grasping portion <NUM> can extend over more than half of the overall longitudinal length of the connector <NUM>. The grasping portion <NUM> can comprise one or more curved lateral edges or sides, as illustrated.

As illustrated in <FIG>, in some embodiments the grasping portion <NUM> can comprise one or more upper edges <NUM> and/or one or more lower edges <NUM>. As shown, one or both of the upper edges <NUM> can be slanted, such as with a downwardly sloped slant; and/or one or both of the lower edges <NUM> can be slanted, such as with an upwardly sloped slant. In an intermediate region of the connector <NUM> (e.g., below the thread-stop or collar <NUM> and above the distal region <NUM>), the connector body can comprise a first region having a first cross-sectional width or diameter, a second region positioned distal from the first region and having a second cross-sectional width or diameter, and a third region positioned distal from the second region and having a third cross-section width or diameter. As shown in <FIG>, the second cross-sectional width or diameter can be smaller than either or both of the first cross-sectional width or diameter and/or the third cross-sectional width or diameter. As shown, in a region of the connector body below the second region, the connector body can comprise a continuously increasing outer cross-section or diameter that produces an outward flare from the second region in a distal direction toward the distal region <NUM> of the connector <NUM>.

As shown in <FIG>, in some embodiments one or more friction-inducing impediments <NUM> can be positioned circumferentially along the connection structure <NUM> in a region that is generally about midway between the grasping portions <NUM>. In some embodiments, such as shown in <FIG>, the friction-inducing impediment <NUM> can be positioned circumferentially along the connection structure <NUM> in general alignment with one or more longitudinal edges of one or more grasping portions <NUM> (see <FIG>).

In some embodiments (not shown), the horizontal cross-sectional width of the grasping portion <NUM> is no larger than the external diameter or horizontal cross-sectional width of the base portion <NUM>, and/or may comprise one or more small friction-inducing structures, such as one or more protrusions, grooves, and/or other slide-resistant structures or materials. In some embodiments, the grasping portion <NUM> can be omitted, as with any other feature, structure, material, or step disclosed or illustrated in this specification.

In some embodiments, all or a portion of the fluid pathway <NUM> inside of the connector <NUM> can be straight, as illustrated in <FIG> (either before or after insertion of an emitter <NUM>, as shown in <FIG> and <FIG>), from the proximal region <NUM> or proximal end <NUM> to the distal region <NUM> or end <NUM> of the connector <NUM>, such that a single straight line can be drawn within the fluid pathway <NUM> from the beginning to the end of the fluid pathway <NUM>. In some embodiments, the fluid pathway <NUM> can extend along a generally straight path without one or multiple sharp, angular, perpendicular, and/or obtuse changes in direction in the fluid pathway <NUM>. In some embodiments, the fluid pathway <NUM> is straight or generally straight at least along a majority of the longitudinal length of the fluid pathway <NUM>. The fluid pathway <NUM> can be straight or generally straight along any particular segment of the fluid pathway, such as along the distance between all or a majority of the proximal end <NUM> of the connector <NUM> and the proximal end of the intermediate region <NUM>, between all or a majority of the proximal end of the intermediate region <NUM> and the distal end of the intermediate region <NUM>, and/or between all or a majority of the proximal end of the portion of the fluid pathway <NUM> within the male protrusion <NUM> and the distal end of the portion of the fluid pathway <NUM> within the male protrusion. A straight path or a generally straight path can diminish turbulence and/or stagnation in one or more portions of the fluid pathway <NUM> and/or can provide a high flow rate and low fluid resistance.

As shown in <FIG>, the diameter or horizontal cross sectional width of the fluid pathway <NUM> can vary along the longitudinal length of the fluid pathway <NUM>. For example, as illustrated in <FIG>, the diameter or cross sectional width of the fluid pathway <NUM> in at least a portion of the proximal region <NUM> can be larger than the diameter or cross sectional width of the fluid pathway <NUM> in at least a portion of an intermediate region <NUM>, which in turn can be larger than the diameter or cross sectional width of the fluid pathway <NUM> in at least a portion of the distal region <NUM>, such as the portion of the fluid pathway <NUM> inside of the male protrusion <NUM>.

In some embodiments, as shown, the connector <NUM> can comprise a stationary structure without any moving external and/or internal parts during use. For example, the external and/or internal shape, orientation, position, and/or size of the connector <NUM> and its internal components before attachment to or engagement with another medical device can be the same as it is after attachment to or engagement with another medical device. In some embodiments, the connector <NUM> can comprise moving parts to facilitate connection and disconnection, opening and closing of the connector to form a valve, and/or regulation of pressure or volume.

The connector <NUM> can comprise one or more additional features that are not shown in <FIG>, such as proximal and/or distal ends <NUM>, <NUM> that include resealably openable and closeable apertures with one or more resilient or rigid sealing elements to enable selective fluid flow; a rigid internal cannula or support member or spike that is configured to assist in supporting or opening a sealing element; a body <NUM> that is clear or transparent or includes a clear or transparent portion and/or one or more other internal structures that are clear or transparent or include a clear or transparent portion that is or are configured to enable viewing of fluid within the internal fluid pathway <NUM> during use; a cap for selectively closing the fluid pathway; and/or a pressure-regulating or volume-regulating feature inside of the connector <NUM> to enable neutral flow, etc..

In some embodiments, as shown, the connector <NUM> can be configured to receive or include one or more components that are configured to provide one or more therapeutic agents into the medicinal fluid that is inside and/or moving through the fluid pathway <NUM>. For example, as illustrated in <FIG>, <FIG>, and <FIG>, an emitter <NUM> of one or more therapeutic agents can be inserted into the connector <NUM> in an internal region, such as in the intermediate region <NUM>, of the fluid pathway <NUM>. As illustrated, in some embodiments, the emitter <NUM> is positioned entirely within the connector <NUM> and not partially or entirely positioned within another medical device, such as a syringe. The connector <NUM> can be temporarily or permanently attached to a syringe or any other medical device. The connector <NUM> with the emitter <NUM> can be configured to provide infusion of one or more therapeutic agents in a low-profile, non-bulky, inexpensive manner, without requiring large or complex storage or logistical requirements.

The emitter <NUM> can comprise any material and/or structure that is configured to provide, leach out, release, diffuse, infuse, dissolve, erode into, or otherwise emit a therapeutic agent into the fluid pathway <NUM>, alone or in combination with fluid flowing through the fluid pathway <NUM>. In some embodiments, the emitter <NUM> can comprise a non-dissolving substrate or storage material or matrix or other base material in which a therapeutic agent is temporarily held or captured or bound until the therapeutic agent is emitted within the fluid pathway <NUM>. The emitter <NUM> can have any suitable shape. For example, the emitter <NUM> can be cylindrical (as shown) or rectangular. In some embodiments, as shown, the emitter <NUM> can be elongate (e.g., its longitudinal length, from its proximal end <NUM> or face to its distal end <NUM> or face is larger than its diameter or cross sectional area). As illustrated, some emitters <NUM> are solid or substantially solid or resistive to fluid flow from a proximal end or face <NUM> to a distal end or face <NUM>. For example, as shown, in some embodiments there are no internal, discrete, and/or generally longitudinally oriented fluid pathways within or through the emitter <NUM>; rather, fluid may be permitted to soak into or be absorbed by or pass through the emitter <NUM> only in essentially random or highly tortious directions (e.g., not a direct or discrete pathway), and/or fluid may not be permitted to soak into or pass through the emitter <NUM> at all. In some embodiments (not shown), an emitter <NUM> for use with the connector <NUM>, or with any other embodiment of a connector, can include one or more apertures, channels, tunnels, passages, and/or fluid pathways that are configured to carry or convey fluid through or within the emitter (e.g., from a proximal end or face <NUM> to a distal end or face <NUM>) without substantial resistance to fluid flow.

In some embodiments, all or at least a portion of the outer housing of the connector <NUM> where all or at least a portion of the emitter <NUM> is contained can be clear or transparent to permit viewing of the emitter <NUM> from outside of the connector <NUM>. In some embodiments, as shown, the emitter <NUM> is very small. For example, as shown in <FIG>, the longitudinal length of the emitter <NUM>, from its proximal face to its distal face can be less than or equal to about the longitudinal length of the conduit <NUM> within the proximal region <NUM> and/or less than or equal to about the longitudinal length of the male protrusion <NUM>; and/or the diameter or cross-sectional area of the emitter <NUM> can be less than or equal to about the outer diameter of the male protrusion <NUM>. In some embodiments, the longitudinal length of the emitter <NUM> and/or the diameter of the emitter can be a few millimeters (e.g., at least about <NUM> millimeters or at least about <NUM> millimeters). Many other sizes and shapes and configurations can be used for the emitter <NUM>.

As illustrated, in some applications, the emitter <NUM> can comprise a compressible and/or fibrous matrix material on which a therapeutic agent has been coated or into which a therapeutic agent has been infused, impregnated, soaked, absorbed, and/or bonded. In some embodiments, the emitter <NUM> can include any suitable biocompatible binder to facilitate a temporary water-soluble or other liquid-soluble bond between the base material and the therapeutic agent, or the emitter <NUM> may not include any binder. In some embodiments, the emitter <NUM> does not include a substrate but is instead formed of a consumable material that gradually erodes away or dissolves into the fluid pathway <NUM> during infusion until it is used up. Any type of therapeutic agent can be used, including but not limited to one or more nourishing agents (e.g., vitamins, minerals, etc.), pain-diminishing medications, antibiotics, antimicrobials (e.g., any chlorhexidine-based compound), anti-inflammatories, sedatives, anticoagulants (e.g., heparin), chemotherapy drugs, and/or other types of therapeutic agent. The size and shape of the emitter <NUM> and/or of the overall connector <NUM> can be very different depending upon the amount or type of therapeutic agent that is intended to be infused. For example, a very large connector can be used when a large amount of therapeutic agent needs to be infused. Many other different types of emitters can be used instead of or in addition to the emitter <NUM> as illustrated. For example, an emitter can be provided in the form of a coating on an interior surface of the connector <NUM> or a material integrated into a portion of the base of the body <NUM> of the connector <NUM>, or any other suitable material or structure that provides a therapeutic agent at a desired time, in a desired dosage, and/or at a desired infusion rate. Among many other embodiments, an emitter for use with the connector <NUM> can be provided in the form of any of the cartridges or other emitters that are illustrated or described in International <CIT>). Many other types of emitters can be used instead of or in addition to those illustrated or described.

In some embodiments in which an emitter <NUM> is provided in the form of an inserted material, such as is shown in the example of <FIG>, the interior region of the connector <NUM> can comprise a retaining structure <NUM> for the emitter <NUM>, as illustrated in <FIG>. Although the retaining structure <NUM> is illustrated with particular dimensions and features, the retaining structure <NUM> can comprise any suitable material or structure that retains the emitter <NUM> in such a way that the emitter <NUM> can be configured to emit one or more therapeutic agents as desired for a particular medical therapy.

As illustrated, in some examples, the retaining structure <NUM> can comprise one or more retaining components <NUM> that extend from an internal wall of the connector <NUM> into an internal space of the connector (such as radially inwardly). For example, as shown, the retaining components <NUM> can be retaining struts that extend generally longitudinally along the fluid pathway <NUM>. The retaining components <NUM> can be positioned in the intermediate region <NUM>, as shown. In some embodiments, the retaining structure <NUM> can comprise at least two or at least three or at least four (as shown in <FIG>) retaining components <NUM> such as retaining struts. As shown in <FIG>, one or more of the retaining components <NUM> can comprise a first portion or component that extends a first distance from an internal wall of the connector <NUM> into an internal space of the connector and a second portion or component that extends a second distance from an internal wall of the connector <NUM> into an internal space of the connect. The second distance can be greater than the first distance. For example, one or more of the retaining struts can comprise a retaining protrusion, such as an elongate longitudinal portion, and a base portion <NUM>. The longitudinal portion can be formed as a protrusion extending radially inwardly from the interior wall of the intermediate region <NUM> of the fluid pathway <NUM> of the connector <NUM>. As shown, in some embodiments, one or more of the base portions <NUM> can be radially aligned with one or more of the longitudinal portions <NUM>. One or more of the base portions <NUM> can extend radially inwardly from the interior wall of the fluid pathway <NUM> further than one or more of the longitudinal portions <NUM>, as illustrated in <FIG>, <FIG>, <FIG>, for example.

In some embodiments, as shown, the retaining structure <NUM> can provide a retaining space within which the emitter <NUM> can be retained. For example, the retaining space can correspond to the outer width or thickness of the emitter <NUM>, such as by being about the same size as or slightly smaller than the outer width or thickness of the emitter <NUM>. When an emitter <NUM> is inserted into a retaining space, such as by pushing the retainer into the proximal end <NUM> of the connector <NUM>, through the proximal portion of the fluid pathway <NUM>, and into the intermediate portion <NUM>, the emitter <NUM> can radially compress or contract by a small amount such that the retaining structure <NUM> can exert a radially inwardly directed retaining force against the emitter <NUM> that is sufficient to produce an increase in friction that resists dislodgment of the emitter <NUM> from the retaining space (for example, as shown in <FIG>). In some embodiments, as illustrated, the emitter <NUM> can be securely retained within the connector <NUM> in a manner that resists or prevents either or both of longitudinal or lateral movement of the emitter <NUM> within the retaining space. In some embodiments (not shown), the retaining space is configured to be somewhat larger than the emitter <NUM> to permit the emitter <NUM> to move or float within the retaining space, either before or during infusion.

As shown, a plurality of longitudinal portions <NUM> can be positioned radially around the retaining space such that the plurality of longitudinal portions <NUM> are configured to contact the outer surface of the emitter <NUM> when inserted. In some embodiments, as illustrated, the longitudinal portions <NUM> are provided generally equally spaced circumferentially from each other. As illustrated, one or more of the longitudinal portions can comprise longitudinal faces (e.g., facing radially inwardly) that are slightly inwardly tapered along the longitudinal dimension in the proximal-to-distal direction, such that the distance between respective longitudinal portions is slightly less on the distal side of the longitudinal portions than on the proximal side of the longitudinal portions. This inward tapering can help to securely retain the emitter <NUM> when inserted into the retaining space. As shown in <FIG>, one or more of the longitudinal portions <NUM> can include a proximal face or region <NUM> that is tapered or beveled or slanted to facilitate insertion of an emitter <NUM> into the retaining space by providing an initially wide but gradually narrowing region for the emitter <NUM> upon insertion of the emitter <NUM> into the retaining space.

As shown in <FIG> and <FIG>, a flow space <NUM> can be provided between two or more retaining components (e.g., longitudinal portions <NUM>) sequentially positioned circumferentially around the fluid pathway <NUM> (and/or generally surrounding or positioned generally around the retaining space). As shown in <FIG> and <FIG>, the one or more flow spaces <NUM> can be configured to permit fluid flowing through the fluid pathway <NUM> within the connector <NUM> to flow around the longitudinal portions <NUM> and through the flow spaces <NUM>, along one or more lateral sides or lateral surfaces of the emitter <NUM>, such as between the one or more lateral sides or lateral surfaces of the emitter <NUM> and the internal wall of the fluid pathway <NUM>. In some embodiments, there is at least one flow space <NUM>, or at least two flow spaces <NUM>, or at least four flow spaces <NUM> (as shown). In some embodiments, as illustrated in <FIG>, at least a majority of the external surface area of the emitter <NUM> is spaced from the internal surface of the fluid pathway <NUM> so that the fluid pathway <NUM> can pass adjacent to and around the outside of the emitter <NUM> to permit some or all of the fluid to flow around the outside of the emitter <NUM> (e.g., at least a majority of the external lateral surface area of the emitter <NUM> does not contact one or more retaining components or other surfaces inside of the connector <NUM>). In some embodiments of connector <NUM>, there are no flow spaces or only very small and/or very constricted flow spaces, such that all or a majority of the fluid pathway and the fluid flowing through the connector is configured to pass within or through the emitter <NUM> (e.g., by passing through a proximal portion or face <NUM> of the emitter <NUM> and exiting out of a distal portion or face <NUM> of the emitter <NUM>). Such an emitter <NUM> can have many forms; for example, it can be solid and/or porous and/or include one or more apertures, channels, tunnels, passages, and/or fluid pathways for conveying or carrying fluid.

A base retainer can be formed in any suitable manner, such as by a plurality of base portions <NUM> (as illustrated), that can provide a lower flow space <NUM> between a distal end of the intermediate region <NUM> and a distal end of the emitter <NUM>, as shown in <FIG> and <FIG>. The distal end of the retaining space, as shown, can include an aperture <NUM> that is smaller in diameter than another portion of the flow pathway <NUM> in the intermediate region <NUM> and/or that is smaller in diameter than the retaining space. Within the flow pathway <NUM>, the aperture <NUM> can lead from the intermediate region <NUM> to the interior of the male protrusion <NUM>, as illustrated. The base retainer can assist in retaining the emitter <NUM> apart or spaced away from the distal end of the intermediate region and/or from the aperture <NUM>, so as to enable fluid flowing through the fluid pathway <NUM> to flow around the distal end of the emitter <NUM> and out of the aperture <NUM> (without causing the emitter <NUM> to plug up or block the aperture <NUM>).

In some embodiments, as shown in <FIG>, the circumference of a circle transcribed by the longitudinal portions <NUM> and/or the base portions <NUM> of the retaining structures <NUM> around the fluid path can be greater than the circumference of the internal fluid pathway <NUM> of the distal end <NUM> (and/or greater than the circumference of the aperture <NUM> of the fluid pathway of the distal end <NUM>). In some embodiments, as shown in <FIG>, the distance across the intermediate region <NUM> between generally opposite facing longitudinal portions <NUM> and/or base portions <NUM> can be greater than a minimum diameter of the internal fluid pathway <NUM> of the distal end <NUM> and/or greater than the diameter of the aperture <NUM> of the fluid pathway of the distal end <NUM>. For instance, as shown in <FIG>, in some embodiments, where two retaining structures are positioned generally opposite one another about a circumference formed by the retaining structures <NUM> around the fluid path, the transverse distance between the oppositely positioned retaining structures <NUM> and/or base portions <NUM> is greater than the diameter of the internal fluid pathway <NUM> of the distal end <NUM> (and/or greater than a diameter of the aperture <NUM>). As shown in <FIG> and <FIG>, respectively, in some embodiments, the circumference formed by the retaining structures <NUM> around the fluid pathway is about the same size or just smaller than the circumference of an emitter <NUM>. In some embodiments, when the circumference formed by the retaining structures <NUM> around fluid pathway is just smaller than the circumference of an emitter <NUM>, the longitudinal portions <NUM> of the retaining structures <NUM> can engage (e.g., hold or restrain) the emitter <NUM> (e.g., by friction). In some embodiments, as shown in <FIG>, when the internal fluid pathway <NUM> is smaller than the portion of the intermediate region <NUM> between the longitudinal portions <NUM>, then a distal shelf or support region or fluid diverting region can be formed in the internal region <NUM> between the longitudinal portions and the internal fluid pathway <NUM> of the distal end <NUM>. As shown in <FIG>, the shelf or support region or fluid diverting region can be generally horizontal or generally transverse in some embodiments.

In some embodiments, as shown in <FIG> and <FIG>, a circumference formed by the base portions <NUM> about the fluid path within the intermediate region <NUM> can be greater than the circumference of the internal fluid pathway <NUM> of the distal end <NUM> (and/or greater than the circumference of the aperture <NUM> of the fluid pathway of the distal end <NUM>). For instance, as shown in <FIG>, in some embodiments, where two base portion <NUM> structures are positioned generally opposite from one another about a circumference formed by the base structures <NUM> around the fluid path, the transverse distance between the oppositely positioned retaining structures <NUM> is greater than the diameter of the internal fluid pathway <NUM> of the distal end <NUM> (and/or greater than a diameter of the aperture <NUM>). As shown in <FIG>, in some embodiments, the internal-most circumference formed by the base portions <NUM> terminates circumferentially outwardly of the circumference of the aperture <NUM>. In some embodiments, as shown in <FIG>, the portion of the intermediate region <NUM> within the longitudinal portions <NUM> is smaller in transverse width or diameter or circumference than the conduit <NUM> within the proximal region <NUM>.

As illustrated in <FIG> and <FIG>, the connector <NUM> can be configured so that the position and orientation of the retaining structure and the emitter <NUM> permits fluid flowing through the fluid pathway <NUM> to flow mostly or entirely around and/or outside of the emitter <NUM>. In its initial state, the emitter <NUM> can be dry or not saturated with fluid. As fluid flows around and/or outside of the emitter <NUM>, the emitter <NUM> is wetted or the level of wetness of the emitter <NUM> is increased and therapeutic agent is emitted from the emitter <NUM> into the flowing fluid, first from the periphery of the emitter <NUM> (which is closest to the flowing fluid) and then from the core or interior of the emitter <NUM>. As the fluid flowing around the emitter <NUM> soaks into and/or eventually saturates the emitter <NUM>, therapeutic agent contained within the interior of the emitter <NUM> migrates toward the periphery of the emitter <NUM> and is eventually emitted into the fluid pathway <NUM>. By directing the fluid flow predominantly around and/or outside, rather than predominantly through, the emitter <NUM>, the connector <NUM> does not become plugged up or require excessive force on the syringe to accomplish fluid infusion. In some embodiments (not shown), most or all of the fluid flow can be directed through the emitter <NUM>, for example in embodiments in which there are no flow spaces <NUM>, <NUM>. Also, by directing the fluid flow predominantly around and/or outside, rather than predominantly through the emitter <NUM>, the connector <NUM> allows at least a portion of fluid to flow freely through the connector.

As shown in the example of <FIG>, in some embodiments, the proximal face of the emitter <NUM> can be unobstructed by the retaining structure <NUM> within the fluid pathway <NUM>. For example, as shown, the retaining structure <NUM> can be positioned only on or along or in contact with one or more outer lateral or longitudinal sides of the emitter <NUM> and/or not on or along or in contact with or in blocking relationship with a proximal face of the emitter <NUM>. In some embodiments, the proximal face of the emitter <NUM> is exposed to the full diameter or cross-sectional width of the fluid pathway <NUM> of the conduit <NUM> within the proximal region <NUM>, such that the fluid flowing through the fluid pathway is configured to initially contact the full proximal face of the emitter <NUM> when flowing in a distally directed longitudinal direction, without being required to twist or turn to contact the proximal face of the emitter <NUM>. In some embodiments, as illustrated in <FIG>, there is no constriction or blockage of the fluid pathway <NUM> within the proximal region <NUM> between the conduit <NUM> and the proximal face of the emitter <NUM>.

The emitter <NUM>, in some implementations, can be positioned within the fluid pathway <NUM> a sufficient distance from the proximal end <NUM> of the connector <NUM> that when a male protrusion (such as from a syringe) is inserted into the proximal region <NUM> of the connector, the distal end of the male protrusion does not contact the emitter <NUM>.

In some embodiments, as illustrated, the portion of the fluid pathway <NUM> located within the male protrusion <NUM> can be generally or completely unobstructed and/or unimpeded. For example, as shown, the emitter <NUM> can be located entirely outside of the fluid pathway <NUM> located within the male protrusion <NUM>. For example, the emitter <NUM> can be configured to be positioned within the intermediate portion <NUM> of the connector <NUM>, as shown. In some embodiments, as illustrated, the emitter <NUM> can be positioned entirely inside of the connector <NUM>, with no portion of the emitter protruding outside of the connector <NUM>. As shown in <FIG> and <FIG>, the connector can be shaped, structured, and/or contoured such that the fluid pathway <NUM> of the connector <NUM> can be configured to convey liquid along a first portion of the fluid pathway <NUM> around the outside of the emitter <NUM>, the first portion having an outer perimeter that is wider than the diameter of the emitter <NUM>, and along a second portion of the fluid pathway <NUM> in a distal direction from the emitter <NUM> into a region having an outer perimeter that is narrower than the diameter of the emitter <NUM> (e.g., inside of the male protrusion <NUM>).

The connector <NUM> can be used in many different ways and/or in many different systems for providing one or more therapeutic medical effects. An example of using the connector <NUM> in a method of providing an anti-microbial block in a patient standby fluid line or providing an emitted therapeutic agent (such as any agent disclosed elsewhere in this specification) in any fluid line can include one or more of the following steps, and/or one or more instructions can be provided to the user (e.g., healthcare practitioner or patient) to perform one or more of the following steps, in any suitable order:.

(<NUM>) The connector <NUM> with an antimicrobial emitter <NUM> or another type of emitter <NUM> of one or more therapeutic agents can be attached to the proximal end of a fluid line at the end of an infusion stage to initiate the beginning of a standby stage. In some embodiments, the emitter <NUM> can comprise a dry or unsaturated, biocompatible, clinically safe dosage of an anti-microbial material, such as a chlorhexidine compound, or an antithrombotic material, or any other therapeutic material, that is configured to be infused into the fluid pathway <NUM>. A standard liquid, such as water or saline, or any other suitable liquid, can be forced into or infused into the proximal end <NUM> of the connector <NUM> from another medical device, such as a syringe or a pump or a vial or a fluid line or an IV bag, and brought into fluid communication with the emitter <NUM> (e.g. by passing around or through, and/or within it).

(<NUM>) An antimicrobial or other therapeutic agent can be automatically emitted from the emitter <NUM> and infused into the fluid line to form an antimicrobial block downstream of the emitter <NUM> and/or to provide any other therapeutic effect in the fluid line. In some embodiments, only a small amount of standard or other liquid is passed from the syringe into the connector <NUM> (e.g., less than or equal to about <NUM> cc or less than or equal to about <NUM> cc or less than or equal to about <NUM> cc of water or saline), such that the antimicrobial or other agent remains in the fluid line during the standby stage and does not migrate in any appreciable amount into the patient's bloodstream.

In some embodiments, by utilizing connectors <NUM> with antimicrobial-infused emitters <NUM> or other therapeutic-agent-infused emitters <NUM>, a health clinic or hospital can conveniently diminish the space, expense, and logistics associated with providing and infusing antimicrobial liquid or other therapeutic liquid into fluid lines to perform antimicrobial blocks. The connector <NUM> can be used in many different types of methods.

In some embodiments, as shown, the medical connector <NUM> is not a valve. In some embodiments, the medical connector <NUM> does not have a dynamic sealing mechanism. In some embodiments, for example, the medical connector <NUM> does not have both a closed mode (a position where fluids do not pass and/or are restricted through the medical connector <NUM>) and an open mode (a position where fluids pass through the medical connector <NUM> freely). In some embodiments, the medical connector <NUM> is not configured to stop the flow of fluid through the medical connector <NUM>. In some embodiments, the medical connector is not configured to provide a low pressure seal. In some embodiments, the medical connector lacks a closable aperture. In some embodiments, the medical connector <NUM> is open. In some embodiments, fluid can flow freely (and/or in unrestricted fashion) through the proximal end <NUM>, to the intermediate region <NUM>, and through the distal region <NUM> via the internal fluid pathway <NUM> (e.g., when the medical connector <NUM> lacks or has an emitter <NUM>). In some embodiments, the medical connector <NUM> lacks a ring seal around the fluid path and in the intermediate region.

In some embodiments, the internal fluid pathway <NUM> of the medical connector <NUM> does not have a stretchable and/or compressible gland or resilient seal. In some embodiments, the internal fluid pathway <NUM> of the medical connector <NUM> is not configured to receive a stretchable and/or compressible gland or resilient seal. In some embodiments, the medical connector <NUM> is not configured to allow the compression of a stretchable and/or compressible gland or resilient seal within the internal fluid pathway <NUM>. In some embodiments, the medical connector <NUM> lacks an actuator configured to open and close. In some embodiments, the medical connector <NUM> lacks a rigid supporting or centering or piercing member (e.g., a cannula, needle, spike, etc.). In some embodiments, the internal fluid pathway <NUM> lacks a rigid member. In some embodiments, the medical the intermediate portion <NUM> is not configured to allow a rigid member to pass into the intermediate portion <NUM>. In some embodiments, the base portions <NUM> do not extend into the internal fluid pathway <NUM> of the distal end <NUM>. In some embodiments, the fluid pathway <NUM> in the distal region <NUM> is of insufficient diameter to accommodate a rigid member.

Claim 1:
An antimicrobial medical fluid connector (<NUM>) separate from a syringe, the medical fluid connector (<NUM>) configured to receive an antimicrobial emitter (<NUM>) of one or more therapeutic agents to be emitted into a fluid pathway (<NUM>) within the medical fluid connector (<NUM>), the medical fluid connector (<NUM>) comprising:
an outer housing comprising a proximal female end (<NUM>), an intermediate region (<NUM>), a distal male end (<NUM>), an internal wall, and a fluid pathway (<NUM>) surrounded by the internal wall, wherein the fluid pathway (<NUM>) extends from the proximal female end (<NUM>), through the intermediate region (<NUM>), to the distal male end (<NUM>), and the proximal female end (<NUM>) is configured to attach to a syringe;
a retaining structure comprising a plurality of longitudinal struts (<NUM>) and a plurality of base portions (<NUM>)
wherein the retaining structure (<NUM>) is positioned within the intermediate region (<NUM>) and extends radially inward from the internal wall and into the fluid pathway (<NUM>) such that the retaining structure (<NUM>) is configured to securely receive the emitter (<NUM>) within a receiving region prior to attachment to the syringe such that movement of the emitter (<NUM>) is restricted, the emitter (<NUM>) is prevented from blocking an aperture (<NUM>) of the distal male end (<NUM>) by the plurality of base portions (<NUM>), wherein the retaining structure (<NUM>) is configured to receive the emitter (<NUM>) in a position and orientation such that a flow space (<NUM>) is between one or more outside lateral surfaces of the emitter (<NUM>) and the internal wall, and wherein the fluid pathway (<NUM>) is configured to convey fluid without the one or more therapeutic agents moving longitudinally through the fluid pathway (<NUM>) directly into a proximal region of the emitter (<NUM>), through the flow space (<NUM>) such that fluid flows around the one or more outside lateral surfaces of the emitter (<NUM>), and toward the distal male end (<NUM>) with the one or more therapeutic agents.