Instrument delivery device with telescoping housing

Abstract

Provided herein is a medical device including: an instrument having a proximal end and a distal end; an outer housing configured to movably receive the instrument, the outer housing having proximal and distal ends and a sidewall defining an interior space therebetween; and an introducer having an inner housing having proximal and distal ends and a sidewall defining an interior space therebetween, the inner housing being slidably received within the outer housing, the distal end of the introducer configured to couple the introducer to an intravenous line. The inner housing is configured to move relative to the outer housing to move the instrument between a first position and a second position.

Description

[Technical Field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates generally to medical devices for use with intravenous (IV) catheters, and more particularly to medical devices having features for improving access to the vascular system. [Background technology]

[0002] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Patent Application No. 17 / 901,041, entitled "Instrument Delivery Device with Nested Housing," filed September 1, 2022, which is incorporated herein by reference in its entirety.

[0003] Description of Related Art When used with an indwelling IV catheter, an instrument delivery device, including an instrument used for blood collection, can include a displaceable instrument that is advanced beyond the tip of the indwelling catheter. Often, the displaceable instrument encounters obstacles as it advances, potentially resulting in deflection of the instrument. Examples of obstacles include friction of seals within the delivery device, tortuous paths within the integrated catheter, constriction of the catheter tube as it is inserted through the skin, thrombus, fibrin, and valves. Furthermore, instrument delivery can be complicated by instrument exchanges and the lengths required to deploy such instruments. Summary of the Invention [Problem to be solved by the invention]

[0004] Therefore, there is a need in the art for an instrument delivery device that allows for robust performance of the delivered instrument. [Means for solving the problem]

[0005] In this specification, an instrument having a proximal end and a distal end; an introducer configured to movably receive an instrument, the introducer having an outer housing having a proximal end, a distal end, and a sidewall defining an interior space therebetween, and an inner housing having a proximal end, a distal end, and a sidewall defining an interior space therebetween, the inner housing being slidably received within the outer housing; a distal end of the introducer configured to couple the introducer to an IV line, the inner housing configured to move relative to the outer housing to move the instrument between a first position and a second position, where in the first position the instrument is disposed within the outer housing and in the second position the distal end of the instrument is disposed beyond the distal end of the outer housing to place at least a first portion of the instrument within the IV line when the introducer is coupled to the IV line.

[0006] Also provided herein is a system including a catheter assembly, the catheter assembly including a catheter adapter having a distal end, a proximal end, a lumen extending between the distal and proximal ends, and a side port disposed between the distal and proximal ends, a catheter extending distally from the catheter adapter, and a fluid conduit having a proximal end coupled to the side port and a distal end, the side port in fluid communication with the lumen and the fluid conduit in fluid communication with the side port. [Brief explanation of the drawings]

[0007] [Figure 1A] FIG. 1 is a top view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 1B] FIG. 1 is a top view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 2] FIG. 1 is a top view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 3] FIG. 1 is a partial top view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 4]FIG. 1 is a partial top view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 5] 1 is a perspective view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 6] FIG. 1 is a partial top view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 7] 1 is a perspective view of an instrument delivery device and system according to non-limiting embodiments described herein. [Figure 8A] 1 is a partial view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 8B] 1 is a partial view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 8C] 1 is a partial view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 9A] 1 is a partial view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 9B] 1 is a partial view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 10] FIG. 1 is a perspective view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 11A] 1 is a cross-sectional view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 11B] 1 is a cross-sectional view of an instrument delivery device according to a non-limiting embodiment described herein. DETAILED DESCRIPTION OF THE INVENTION

[0008] The following description is provided to enable any person skilled in the art to make and use the described embodiments contemplated for practicing the invention. However, various modifications, equivalents, variations, and alternatives will remain readily apparent to those skilled in the art. All such modifications, equivalents, variations, and alternatives are intended to be within the spirit and scope of the present invention.

[0009] In the following description, the terms "upper," "lower," "right," "left," "vertical," "horizontal," "top," "bottom," "transverse," "longitudinal," and derivatives thereof, refer to the present invention as oriented in the drawings. However, it should be understood that the present invention contemplates various alternative modifications unless expressly specified to the contrary. It should also be understood that the specific devices illustrated in the accompanying drawings and described in the following specification are merely exemplary embodiments of the present invention. Accordingly, specific dimensions and other physical characteristics related to the embodiments disclosed herein are not to be considered limiting.

[0010] It should be understood that numerical ranges recited herein are intended to include all values ​​and subranges subsumed therein. For example, a range of "1 to 10" is intended to include all subranges between (and including) the stated minimum value of 1 and the stated maximum value of 10, i.e., subranges having a minimum value of 1 or greater and a maximum value of 10 or less.

[0011] Provided herein are devices and systems for delivering certain devices through an indwelling catheter, such as a peripheral intravenous catheter (PIVC). Certain devices (e.g., blood collection devices) are described below and illustrated in the accompanying drawings in terms of devices that may be used with a PIVC. However, those skilled in the art will understand that any number of different types of devices for introducing devices may be used within the scope of this disclosure, including devices ranging from tubing, probes, sensors (e.g., pressure sensors, pH sensors, lactate sensors, glucose sensors, etc.), wiring, fiber optics, guidewires, etc.

[0012] 1A and 1B, a non-limiting embodiment of a system including a catheter assembly 10 and an instrument delivery device 110 is shown. Catheter assemblies suitable for use with the instrument delivery devices described herein are commercially available, for example, from Becton, Dickinson and Company under the trade name Nexiva. The catheter assembly 10 may include a catheter adapter 12, which may include a distal end 14 and a proximal end 16. In some embodiments, the catheter adapter 12 may include one or more additional ports 18. In some embodiments, the port 18 may be located between the distal end 14 and the proximal end 16. In some embodiments, two or more ports 18 may be located between the distal end 14 and the proximal end 16. In some embodiments, the port 18 may be located at the proximal end 16. In some embodiments, the first catheter adapter 12 may include a first lumen 20 extending through the distal end 14 and the proximal end 16. The first lumen 20 may be sealed at the proximal end 16 of the catheter adapter 12.

[0013] In some non-limiting embodiments or aspects, the catheter assembly 10 may include a catheter 22 extending from the distal end 14. In some embodiments, the first catheter 22 may include a peripheral intravenous catheter, a midline catheter, or a peripherally inserted central catheter. As known to those skilled in the art, the catheter 22 may be formed of any suitable material and may have any useful length. In some non-limiting embodiments or aspects, the catheter assembly 10 may include a first fluid conduit 24 extending from the port 18. The first fluid conduit 24 may be formed of any suitable material known to those skilled in the art and may have a distal end 26 and a proximal end 28. The first fluid conduit 24 may be coupled to the port 18 at its distal end 26. In some non-limiting embodiments or aspects, a connector 30 may be coupled to the proximal end 28 of the first fluid conduit 24. Connector 30 may be a T-connector (e.g., one side port disposed at a 90 degree angle relative to the longitudinal axis of connector 30), a Y-connector (e.g., one side port disposed at an angle between 15 and 165 degrees relative to the longitudinal axis of connector 30), or any other type of connector known in the art. Connector 30 may include a second lumen extending therethrough with any number of branches appropriate for the type of connector.

[0014] In some non-limiting embodiments or aspects, the catheter assembly 10 may include an extension set (integrated with or detachably connectable to the catheter adapter 12, connector 30, and / or needleless access connector 32) that includes a second fluid conduit (such as the second fluid conduit 34). Extension sets are known to those skilled in the art and are commercially available, for example, from Becton, Dickinson and Company. In some non-limiting embodiments or aspects, the second fluid conduit 34 may include a Luer connection 36 at its end. In some non-limiting embodiments or aspects, the extension set may include a clamp 40 to enable occlusion of the second fluid conduit 34. The clamp 40 and the second fluid conduit 34 may be formed of any suitable material known to those skilled in the art. In non-limiting embodiments, the second lumen (e.g., within the connector 30) has an inner diameter substantially equal to the inner diameter of the first fluid conduit 24 and / or the second fluid conduit 34.

[0015] The catheter assembly 10 may include a needleless access connector 32 and / or a second fluid conduit 34. Suitable needleless access connectors 32 can include any split septum connector and / or a connector with direct fluid line access. Needleless access connectors 32 are known to those skilled in the art and are commercially available, for example, from Becton, Dickinson and Company under the trade names MAXPLUS, MAXZERO, Q-SYTE, and SMARTSITE. The non-limiting embodiment of FIGS. 1A and 1B shows a needleless access connector disposed on a connector 30. However, one skilled in the art will understand that a suitable needleless access connector may also be disposed on a luer 36. In a non-limiting embodiment, the needleless access connector 32 includes a septum (not shown), such as a self-healing septum. In a non-limiting embodiment, the septum is a slit-type septum. As described below, the instrument delivery device 110 may be reversibly connectable to the needleless access connector 32, and one or more portions of the instrument delivery device may pierce the septum to access the patient's vascular system through the catheter 22.

[0016] 1A and 1B, the device delivery device 110 includes an outer housing 116 having a proximal end and a distal end, and an inner housing 118 slidably received within the outer housing 116. In a non-limiting embodiment, the inner housing 118 and the outer housing 116 are in a telescoping relationship, such that the entire inner housing 116, or nearly the entire inner housing 116, is slidably received within the outer housing 116. The inner housing 118 also includes a proximal end and a distal end, and in a non-limiting embodiment, the inner housing may have a diameter that varies along its length, e.g., the distal end of the inner housing 118 has a larger diameter than the remainder of the inner housing 118. The device delivery device 110 further includes a device, which is illustrated in the drawings as a catheter or fluid conduit 150 having a proximal end and a distal end 152. However, as discussed above and as will be understood by one of ordinary skill in the art, the device may be any medical device that can be delivered to a patient's vascular system through the catheter assembly 10. The fluid conduit 150 is slidably received within the outer housing 116. The fluid conduit 150 can be advanced and / or retracted relative to the outer housing 116 by relative displacement of the inner housing 118 with respect to the outer housing 116. In a non-limiting embodiment, the fluid conduit 150 can be advanced from a first position and a second position. In the first position, the distal end 152 of the fluid conduit 150 is disposed within the instrument delivery device 110, e.g., the outer housing 116 and / or the lock. In the second position, the distal end 152 of the fluid conduit 150 is located distal to the lock 132 and, in embodiments in which the instrument delivery device 110 is coupled to the catheter assembly 10, optionally distal to the catheter 22. In FIGS. 1A and 1B, the lock 130 is illustrated as a proboscis 132 and arms. However, those skilled in the art will appreciate that any type of suitable connection may be used to secure the device delivery device to an indwelling catheter (such as catheter assembly 10).The connections may include luer connections, clips, blunt plastic cannula, blunt metal cannula, hybrid luer (eg, cannulated), friction fit, and the like.

[0017] The devices that can be used with the device delivery device 110 described herein may be formed from any useful material. In a non-limiting embodiment, the device is a fluid conduit, which is formed from a polymer, such as a polyimide-containing material, nylon, polyurethane, and other suitable polymeric materials. Additionally, the inner housing 118 may be formed from any suitable material, including polyethylene, polypropylene, nylon, polyurethane, and the like. Those skilled in the art will appreciate that various materials are suitable, so long as they minimize possible buckling of the inner housing 118. In a non-limiting embodiment, the inner housing 118 is formed from a material that provides resistance to buckling, such as polyethylene, polypropylene, nylon, polyurethane, and the like.

[0018] 1A shows the instrument delivery device in a first state, with the instrument (here, fluid conduit 150) in a first position received within outer housing 116 and inner housing 118 in the first position extending proximally from the outer housing. In a non-limiting embodiment, inner housing 118 couples or otherwise interacts with fluid conduit 150 such that when the inner housing is advanced to the second position (e.g., by a user grasping grip 182 and applying a distal force to inner housing 118), fluid conduit 150 moves to the second position such that distal end 152 of fluid conduit 150 extends beyond outer housing 116, lock 130 (if present), and / or catheter 22. Grip 182 may be located at the proximal end of inner housing 118 and may be located at or near clamp 180 suitable for occluding fluid flow through inner housing 118 and / or fluid conduit 150, as described in more detail below. Grip 182 may be formed from an ergonomic material to provide comfort to a user while gripping instrument delivery device 110 and may include features, for example, to increase grip strength and prevent slippage during advancement / retraction of inner housing 118. Clamp 180 may be, for example, a slide clamp as shown in Figures 1A and 1B or a pinch clamp as shown in Figure 10.

[0019] As mentioned above, the distal end of the inner housing 118 may have a larger diameter than the rest of the inner housing 118 so that as the inner housing 118 is retracted, one or more features on the outer housing 116 interact with the enlarged portion of the inner housing 118 to prevent the inner housing 118 from being completely withdrawn from the outer housing 116. The enlarged distal portion of the inner housing 118 may include a vent to allow air to pass therethrough, reducing the force required to advance / pull the inner housing 118. Also, as described below, a lubricant 190 may be applied to the enlarged portion of the inner housing 118 to reduce friction between the inner housing 118 and the outer housing 116.

[0020] As described below and illustrated in the accompanying drawings, instrument delivery device 110 may include any number of features to provide a more robust system for accessing a patient's vasculature. With continued reference to FIGS. 1A and 1B and 2 and 3 , in a non-limiting embodiment, a joint 113 is included at the distal end of outer housing 116, for example, between outer housing 116 and lock 130. Suitable joints 113 may include pivotal joints, spherical joints, pin joints, cylindrical joints, hinge joints, and rotary joints. Such joints 113 may improve the usability of instrument delivery device 110, for example, by allowing greater access in terms of distance from the patient's skin, and may also improve securement of the indwelling catheter by avoiding over-manipulation of catheter assembly 10 during instrument delivery and associated medical procedures. In a non-limiting embodiment, proboscis 132 is formed of a flexible material that allows similar pivotal and / or rotational degrees of freedom to avoid over-manipulation of catheter assembly 10.

[0021] Inner housing 118 may include a connector at its proximal end to allow various medical devices to be attached to inner housing 118 to provide devices that can be advanced into a patient's vasculature, to inject compositions into the vasculature, and / or to receive fluids that can be withdrawn from the vasculature. Suitable connectors 170 include luer connectors, luer lock access devices, needleless access connectors, and the like, known to those skilled in the art.

[0022] 1A and 2, in a non-limiting embodiment, the inner housing 118 and / or the device may include one or more indicators 184, 186 disposed on its exterior surface. Suitable indicators may be visual and / or tactile and may be provided to provide, for example, the length of the device, the positioning of the device relative to an indwelling catheter, etc. In a non-limiting embodiment, the one or more indicators 186 may be provided on the inner housing 118, and the outer housing 116 may be formed at least partially of a transparent material to allow viewing of the indicators 186 through the outer housing 116 throughout the movement of the inner housing 118 from the first position to the second position. In a non-limiting embodiment, separate indicators in the form of tactile stops 182 may be included at one or more locations along the inner housing 118 to provide a tactile indication to the user of a particular threshold. For example, the tactile stop 182 may indicate that the device (e.g., the fluid conduit 150) has nearly reached its fully extended state and / or may indicate that the device cannot be extended any further (e.g., as shown in FIG. 1B).

[0023] 1A and 1B and 2, 4, and 5, in a non-limiting embodiment, a lubricant 190 may be applied to one or more locations on the instrument delivery device 110 or within one or more components within the instrument delivery device 110. For example, the lubricant 190 may be applied to the exterior surface of the distal portion (e.g., proboscis 132) of the outer housing of the instrument delivery device 110 (such as the catheter assembly 10) that is inserted into an indwelling catheter to reduce the force required to couple the devices. The lubricant 190 may be applied to one or more locations within the outer housing 116 (e.g., on one or more exterior surfaces of the inner housing 118 or on one or more exterior surfaces of an instrument (e.g., fluid conduit 150)). As also shown in FIGS. 5 and 10, one or more septa 200 (disposed within the outer housing 116) and one or more seals 205, 207 disposed around a portion of the instrument (e.g., the fluid conduit 150) and may be movable with the instrument through the outer housing 116. The seals 205, 207 may be positioned at the proximal end of the instrument (e.g., fluid conduit 150) or at any suitable location along the instrument. A lubricant 190 may be applied to the outer surface of one or more of the seals 205 and / or 207. Similarly or alternatively, the lubricant 190 may be provided around an opening through the septum 200 through which an instrument (e.g., fluid conduit 150) may pass. Suitable lubricants are known to those skilled in the art and may include silicone-based lubricants. One or more of the septum 200 and seals 205, 207 may include a venting mechanism to facilitate advancement and withdrawal of the instrument (e.g., fluid conduit 150). In a non-limiting embodiment, the proboscis 132 may be configured to provide a fluid-tight seal with the catheter assembly, for example, by having a diameter of the proboscis 132 that closely matches the diameter of the catheter adapter 12 and / or needleless access connector 32, thereby limiting the possibility of fluid leakage between the outer wall of the proboscis 132 and the inner wall of the catheter adapter 12 and / or needleless access connector 32.The addition of lubricant 190 to the proboscis can facilitate the introduction of the instrument delivery device 110 into the catheter assembly 10 despite their close diameters.

[0024] 1A and 1B, as well as 2, 6, and 7, in a non-limiting embodiment, the instrument delivery device 110 may include one or more supports 210 disposed within the outer housing 116 to limit and / or prevent buckling of the inner housing 118 and / or the instrument (e.g., the fluid conduit 150) upon distal advancement of the inner housing 118 and / or the instrument (e.g., the fluid conduit 150) through the outer housing 116. The supports 210 may include, for example, a constriction in the outer housing 116, one or more washers disposed around the inner housing 118 and / or the instrument, etc., to reduce the effective buckling length and / or buckling mode shape of the inner housing 118 and / or the instrument. Suitable supports are also described in U.S. Provisional Patent Application No. 63 / 273,226, filed October 29, 2021, which is incorporated herein by reference in its entirety.

[0025] 1A and 1B and 8A-8C, for example, in a non-limiting embodiment where the device is fluid conduit 150, a catheter (such as catheter 22) may be placed to transfer fluid (such as blood) into or out of the vascular system of a patient. In a non-limiting embodiment as shown in FIGS. 1A and 8B, fluid conduit 150 may be coupled at junction 163 to a separate fluid tube 166 that passes through inner housing 118. Separate fluid tube 166 may extend beyond the proximal end of inner housing 118, as shown in FIG. 8B, for example, and may be coupled to connector 170, optionally via adapter 172. In a non-limiting embodiment, fluid conduit 150 has a length sufficient to pass through inner housing 118 and couple to connector 170, optionally via adapter 172. For example, as shown in FIGS. 8A and 8C, in a non-limiting embodiment, inner housing 118 itself forms a fluid conduit in fluid communication with fluid conduit 150. 8C, a separate fluid tube 173 may be provided at the proximal end of inner housing 118 and may optionally be in fluid communication with connector 170 via adapter 172. In any of the described embodiments, an adapter may be provided to fluidly connect fluid tube 166, inner housing 118, and / or fluid conduit 150 to connector 170, such as those previously described herein.

[0026] 9A and 9B, various non-limiting configurations of connector 170 are shown, in addition to the connector 170 previously described. As shown in FIG. 9A, connector 170 may be coupled to a fluid conduit (e.g., fluid conduit 150 or 166) by a clamp 180 and grip 182 disposed distally of connector 170. As previously described, connector 170 may be a luer connector, a luer lock access device, a needleless access connector, or the like, as known to those skilled in the art. As shown in FIG. 9B, outer housing 118 may include a beveled portion, for example, at its proximal end, to position connector 170 non-parallel to the longitudinal axis of outer housing 116. In either embodiment, the connector may be coupled to inner housing 118 and / or a fluid conduit (e.g., fluid conduit 150 or 166) via an adapter 172.

[0027] 11A-11B, in a non-limiting embodiment, inner housing 118 and / or outer housing 116 may be configured with clamp 180 to provide for the withdrawal of blood through fluid conduit 150 when the fluid conduit is in a second position (with its distal end 152 located within the patient's vasculature). In a non-limiting embodiment, blood can be withdrawn into fluid conduit 150 (e.g., by vacuum provided by vacuum blood draw device 215) while clamp 180 is in a first configuration, preventing fluid flow to connector 170, as shown, for example, in FIG. 11A. With the fluid path occluded, blood can pass through one or more openings 212 in fluid conduit 150 and fill a space within inner housing 118, e.g., between fluid conduit 150 and inner housing 118. In a non-limiting embodiment, one or more plugs 213 and / or seals 214 can be positioned within inner housing 118 to confine the drawn blood to the space inside inner housing 118 and / or prevent waste blood (the initial blood drawn while clamp 180 is in the configuration shown in FIG. 11A ) from flowing to blood collection device 215. After that space is filled, clamp 180 can be reoriented to a second configuration ( FIG. 11B ) that does not impede fluid flow through conduit 150 to connector 170 and collector 215. With the space between the outer surface of conduit 150 and the inner surface of inner housing 118 already filled, a fresh blood sample can be drawn into connector 170 and into any medical device (e.g., collector 215) coupled to connector 170.

[0028] The present disclosure has been described in detail for purposes of illustration, based on what are presently considered to be the most practical and preferred embodiments or aspects. It should be understood, however, that these details are for illustrative purposes only, and that the present disclosure is not limited to the disclosed embodiments or aspects, but on the contrary, is intended to cover modifications and equivalent arrangements within the spirit and scope of the appended claims. For example, it should be understood that the present disclosure contemplates that, to the extent possible, one or more features of any embodiment can be combined with one or more features of any other embodiment.

Claims

1. an instrument having a proximal end and a distal end; an introducer configured to movably receive an instrument, the introducer having an outer housing having a proximal end, a distal end, and a sidewall defining an interior space therebetween, and an inner housing having a proximal end, a distal end, and a sidewall defining an interior space therebetween, the inner housing being slidably received within the outer housing; A medical device comprising: a distal end of the introducer configured to connect the introducer to an venous line; The inner housing is configured to move relative to the outer housing to move the device between a first position and a second position, where in the first position the device is disposed within the outer housing and in the second position the distal end of the device is disposed beyond the distal end of the outer housing to position at least a first portion of the device within the IV line when the introducer is connected to the IV line. A medical device characterized by:

2. 10. The medical device of claim 1, wherein the outer housing includes a lock at a distal end thereof, the lock configured to couple the introducer to an intravenous line.

3. 10. The medical device of claim 1, wherein a coupling is disposed at the distal end of the outer housing, optionally between the distal end of the outer housing and the lock.

4. 4. The medical device of claim 3, wherein the joint is a revolute joint, a spherical joint, a pin joint, a cylindrical joint, a hinge joint, or a pivot joint.

5. The medical device of claim 1 , further comprising a septum disposed at the distal end of the outer housing.

6. The medical device of claim 1 , further comprising a seal disposed at the proximal end of the instrument.

7. 10. The medical device of claim 1, further comprising a lubricant disposed at one or more locations within the inner housing.

8. The medical device of claim 1 , wherein the inner housing includes a grip disposed at a proximal end thereof.

9. 10. The medical device of claim 1, wherein the instrument is one or more of a catheter, a guidewire, an obturator, a wire, an electrical wiring, a probe, a light pipe, and a sensor.

10. The medical device of claim 1 , wherein the instrument is a catheter.

11. 11. The medical device of claim 10, wherein the inner housing includes a clamp at a proximal end thereof configured to selectively block fluid flow through the inner housing.

12. 12. The medical device of claim 11, wherein when the clamp is positioned to block fluid flow through the inner housing, blood withdrawn from the intravenous catheter flows through the catheter into the space in the inner housing and / or the space in the outer housing.

13. 13. The medical device of claim 12, wherein when the clamp is positioned to allow fluid flow through the inner housing, blood drawn through the intravenous catheter flows through the catheter to the proximal end of the inner housing.

14. 11. The medical device of claim 10, wherein the inner housing is in fluid communication with the catheter, and fluid flowing proximally from the catheter is received within the inner housing.

15. 11. The medical device of claim 10, wherein the inner housing further comprises a fluid conduit in fluid communication with the catheter.

16. 16. The medical device of claim 15, wherein the fluid conduit extends proximally beyond the proximal end of the inner housing.

17. 10. The medical device of claim 1, further comprising a fluid conduit coupled to the proximal end of the inner housing.

18. The medical device of claim 1 , further comprising one or more supports disposed within the outer housing and configured to limit buckling of an instrument advanced through the outer housing.

19. 10. The medical device of claim 1, wherein the inner housing is formed from a material having sufficient rigidity to limit and / or prevent buckling of the inner housing as the inner housing is advanced through the outer housing.

20. 10. The medical device of claim 1, wherein the inner diameter of the outer housing is configured to limit and / or prevent buckling of the inner housing and / or the instrument as the inner housing is advanced through the outer housing.

21. The medical device of claim 1 , further comprising a seal disposed around the periphery of the instrument and capable of sliding with the instrument through the outer housing.

22. 10. The medical device of claim 1, further comprising one or more indicia disposed on the inner housing and / or the device corresponding to the length and / or position of the device relative to the intravenous catheter.

23. 23. The medical device of claim 22, wherein the one or more indicators are visual and / or tactile indicators.

24. 10. The medical device of claim 1, wherein the inner housing includes a connector at its proximal end.

25. 10. A system comprising a catheter assembly and the medical device of claim 1, The catheter assembly comprises: a catheter adapter having a distal end, a proximal end, a lumen extending between the distal end and the proximal end, and a side port disposed between the distal end and the proximal end, the side port being in fluid communication with the lumen; a catheter extending distally from the catheter adapter; a fluid conduit having a proximal end coupled to the side port and a distal end in fluid communication with the side port; A system comprising:

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