Instrument transport device with one-handed forward capability

Abstract

Provided herein is an instrument delivery device for advancing an instrument into a vascular access device. The instrument delivery device includes an outer housing, an introducer portion positioned at a distal end of the outer housing and configured to mate with the vascular access device, and an inner housing positioned within the interior volume of the outer housing and having a distal end for engaging a proximal end of an instrument, the inner housing being movable relative to the outer housing. A wheel member is positioned on the outer housing and rotatable relative thereto and operably coupled to the inner housing, such that when the wheel member is rotated in a first direction, it moves the inner housing distally within the outer housing, thereby also moving the instrument distally to a position where the distal end of the instrument is disposed beyond the distal end of the outer housing.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Application No. 17 / 900,995, filed September 1, 2022, entitled "Instrument Delivery Device with One-Handed Advancement Capability," the entire disclosure of which is incorporated herein by reference in its entirety. [Background technology]

[0002] Background of the Invention FIELD OF THE INVENTION FIELD OF THE DISCLOSURE The present disclosure relates generally to instrument delivery devices for use with intravenous (IV) catheters, and more particularly to instrument delivery devices having features for advancing instruments within the vascular system.

[0003] 2. Description of Related Art Vascular access devices (VADs) are used in medicine to access a patient's peripheral vasculature for the purposes of infusion therapy and / or blood withdrawal. Common types of VADs include over-the-needle peripheral intravenous catheters (PIVCs), peripherally inserted central catheters (PICCs), central venous catheters (CVCs), and midline catheters. VADs may be left in place for short-term (days), medium-term (weeks), or long-term (months to years).

[0004] Instrument delivery devices are often used with indwelling venous catheters to deliver instruments, such as fluid pathway tubing, guidewires, obturators, wires, electrical wiring, probes, or sensors, into the indwelling venous catheter, and the instrument delivery device advances the instrument beyond the tip of the indwelling venous catheter. Some instrument delivery devices use a telescoping housing arrangement (i.e., telescoping outer and inner housings) to advance the instrument to a proximal or distal position relative to the tip of the indwelling catheter. The outer housing of the device is positioned distally adjacent the VAD, and the inner housing extends proximally from the outer housing. The inner housing may include a gripping feature thereon that allows an operator to grasp the inner housing and push it into the outer housing, thereby advancing the instrument distally and into the indwelling catheter. One drawback of this configuration of instrument delivery device and the method used to advance the inner housing into the outer housing is that it requires the operator to use two hands to actuate the instrument delivery device. That is, one hand of the operator is positioned distally at the end of the outer housing adjacent the VAD to stabilize the instrument delivery device, and the other hand is positioned proximally at the end of the inner housing to grasp the inner housing and push it into the outer housing. The operator's hands are therefore positioned far apart, requiring large relative movements to one another in order to manipulate the instrument, and neither hand can be used to stabilize the VAD and indwelling catheter through which the instrument is advanced.

[0005] Therefore, there is a need in the art for an instrument delivery device that allows for an ergonomic one-handed advancement option and allows the advancing hand to remain in a reference position without requiring significant axial movement to follow the movement of the inner housing. Summary of the Invention

[0006] Provided herein is an instrument delivery device for advancing an instrument into a vascular access device. The instrument delivery device includes an outer housing defining an interior volume and having proximal and distal ends, an introducer portion positioned at the distal end of the outer housing and configured to mate with an access connector of the vascular access device, and an inner housing having proximal and distal ends, the distal end positioned within the interior volume to engage the proximal end of an instrument, and configured for movement relative to the outer housing. The instrument delivery device also includes a wheel member positioned on the outer housing and rotatable relative to the outer housing, the wheel member operably coupled to the inner housing and displacing the inner housing distally within the outer housing upon rotation of the wheel member. Distal movement of the inner housing displaces the instrument from a first position in which the distal end of the instrument is disposed within the outer housing to a second position in which the distal end of the instrument is disposed beyond the distal end of the outer housing.

[0007] In some embodiments, the wheel member is mounted to the outer housing adjacent the distal end of the outer housing.

[0008] In some embodiments, gripping features are formed on the outer housing at a distal end of the outer housing adjacent the wheel member.

[0009] In some embodiments, the wheel member includes an advance wheel engageable by a user to cause its rotation, and a spool operably coupled to the advance wheel such that the spool rotates in response to rotation of the advance wheel.

[0010] In some embodiments, a tether cord is provided having a first end coupled to the distal end of the inner housing and a second end engaged to the spool.

[0011] In some embodiments, rotation of the wheel member in a first direction causes the tether cord to wrap around the spool and pull the inner housing toward the distal end of the outer housing, thereby moving the device from the first position to the second position.

[0012] In some embodiments, the tether cord is a semi-rigid cord, and rotation of the wheel member in the second direction causes the semi-rigid cord to unwind from the spool and push the inner housing back toward the proximal end of the outer housing, thereby moving the device from the second position to the first position.

[0013] In some embodiments, the spool is mounted adjacent to the advancement member and includes a gear mounted thereon, the advancement member and gear each including intermeshing teeth thereon such that rotation of the advancement member causes rotation of the gear which is transmitted to the spool.

[0014] In some embodiments, the advancement member and gear have different diameters to provide a force or displacement mechanical advantage in tensioning the tether cord when the advancement member is rotated.

[0015] In some embodiments, the instrument is advanced from the proximal end to the distal end of the outer housing, and one of the instrument and the tether cord is looped one or more times around the spool, effectively coupling the instrument or tether cord to the wheel member.

[0016] In some embodiments, rotation of the wheel member in a first direction causes the instrument and inner housing to advance toward the distal end of the outer housing, thereby moving the instrument from the first position to the second position, and rotation of the wheel member in a second direction causes the instrument and inner housing to retract toward the proximal end of the outer housing, thereby moving the instrument from the second position to the first position.

[0017] In some embodiments, a first portion of the instrument is pulled by the wheel member and a second portion of the instrument is pushed by the wheel member during rotation of the wheel member in the first direction and the second direction.

[0018] In some embodiments, the wheel member is mounted on the outer housing adjacent the proximal end of the outer housing, with a bottom side of the wheel member engaging an upper surface of the inner housing, and rotation of the wheel member in a second direction toward the proximal end of the outer housing causes the bottom side of the wheel member to urge the inner housing toward the distal end of the outer housing, thereby causing the instrument to move from the first position to the second position.

[0019] In some embodiments, the wheel member is a toothed wheel and the top surface of the inner housing includes a grooved track, and when the toothed wheel rotates in the second direction, the toothed wheel engages the grooved track in a rack and pinion type engagement to urge the inner housing toward the distal end of the outer housing.

[0020] In some embodiments, one or more support wheels are positioned within the outer housing, within the interior volume, adjacent to the bottom surface of the inner housing and opposite the wheel members, and the wheel members and the one or more support wheels are pressed together against the inner housing to provide frictional engagement between the wheel members and the top surface of the inner housing, which frictional engagement between the wheel members and the top surface of the inner housing urges the inner housing toward the terminal end of the outer housing as the wheel members are rotated in the second direction.

[0021] In some embodiments, the wheel member is a compliant advancement wheel configured to provide frictional engagement between the wheel member and the top surface of the inner housing.

[0022] In some embodiments, 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.

[0023] In some embodiments, the device is a catheter and the inner housing is in fluid communication with the catheter such that fluid flowing proximally from the catheter is received within the inner housing, or fluid flowing distally from the inner housing is received within the catheter.

[0024] In some embodiments, one or more supports are provided that are disposed within the outer housing and configured to limit buckling of an instrument advanced through the outer housing.

[0025] Also provided herein is a system including a catheter assembly having a catheter adapter having a lumen extending between a distal end and a proximal end of the catheter adapter and a side port disposed between the distal and proximal ends, the side port being in fluid communication with the lumen. The catheter assembly also includes a catheter secured to the distal end of the catheter adapter and extending distally from the catheter adapter, and a fluid conduit having a proximal end coupled to the side port and a distal end connected to the needleless access connector. An instrument delivery device advances instruments through the needleless access connector, the fluid conduit, and the catheter adapter and into the catheter. [Brief explanation of the drawings]

[0026] [Figure 1A] FIG. 1A is a side view of a catheter assembly and an associated instrument delivery device usable therewith, according to a non-limiting embodiment described herein, with the instrument delivery device in a first configuration. [Figure 1B] FIG. 1B is a side view of the catheter assembly and associated instrument delivery device of FIG. 1A, with the instrument delivery device in a second configuration. [Figure 2] FIG. 2 is a perspective view of the instrument delivery device of FIGS. 1A and 1B. [Figure 3] 3 is a partial cross-sectional view of the instrument carrier of FIG. 2 taken along line aa, showing a wheel member according to an embodiment described herein. [Figure 4]FIG. 4 is an exploded end view of the wheel member of FIG. [Figure 5] FIG. 5 is a partial cross-sectional view of an instrument carrier taken along line aa showing a wheel member according to another embodiment described herein. [Figure 6] FIG. 6 is an exploded end view of the wheel member of FIG. [Figure 7] FIG. 7 is a perspective view of an instrument delivery device according to a non-limiting embodiment described herein. [Figure 8] 8 is a partial cross-sectional view of the instrument carrier device of FIG. 7 taken along line bb showing a wheel member according to an embodiment described herein. [Figure 9] FIG. 9 is an exploded end view of the wheel member of FIG. [Figure 10] FIG. 10 is a partial cross-sectional view of an instrument carrier taken along line bb showing a wheel member according to another embodiment described herein. [Figure 11] FIG. 11 is an exploded end view of the wheel member of FIG. [Figure 12A] FIG. 12A is a side view of a catheter assembly and an associated instrument delivery device usable therewith, according to a non-limiting embodiment described herein, the instrument delivery device being in a first configuration. [Figure 12B] FIG. 12B is a side view of the catheter assembly and associated instrument delivery device of FIG. 12A, with the instrument delivery device in a second configuration. [Figure 13] FIG. 13 is a perspective view of the instrument delivery device of FIGS. 12A and 12B. [Figure 14] 14 is a partial cross-sectional view of the instrument delivery device of FIG. 13 taken along line cc according to embodiments described herein. [Figure 15] 15 is a partial cross-sectional view of the instrument delivery device of FIG. 13 taken along line cc according to another embodiment described herein. [Figure 16] FIG. 16 is a partial cross-sectional view of an instrument transport device showing a wheel member according to another embodiment described herein. [Figure 17] FIG. 17 is a partial cross-sectional view of an instrument transport device showing a wheel member according to another embodiment described herein. [Figure 18] 18 is an exploded end view of the wheel member of FIG. 17. FIG. DETAILED DESCRIPTION OF THE INVENTION

[0027] Description of the Invention The following description is provided to enable those 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.

[0028] In the following description, the terms "upper," "lower," "right," "left," "vertical," "horizontal," "top," "bottom," "lateral," "longitudinal," and derivatives thereof, refer to the present invention as oriented in the drawings. However, it should be understood that the present invention may contemplate 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 relating to the embodiments disclosed herein are not to be considered limiting.

[0029] As used herein, the terms "proximal" and "distal" refer to directions closer to and further from a user who brings the device into contact with a patient, respectively. Thus, for example, the end of a device that first contacts a patient's body is the distal end, while the opposite end of the device that is manipulated by the user is the proximal end of the device.

[0030] Terms such as "first," "second," etc. are not intended to refer to a particular order or chronology, but rather to different conditions, characteristics, or elements.

[0031] As used herein, "at least one" is synonymous with "one or more." For example, the phrase "at least one of A, B, and C" means any one of A, B, and C, or any two or more combinations of A, B, and C. For example, "at least one of A, B, and C" includes one or more of A alone, or one or more of B alone, or one or more of C alone, or one or more of A and B, or one or more of A and C, or one or more of B and C, or one or more of all of A, B, and C.

[0032] It should be understood that the 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 recited minimum value of 1 and the recited maximum value of 10, i.e., subranges having a minimum value equal to or greater than 1 and a maximum value equal to or less than 10.

[0033] Provided herein are devices and systems for delivering instruments through an indwelling catheter, such as a peripheral intravenous catheter (PIVC). While particular devices (e.g., blood suction devices) are described below and illustrated in the accompanying drawings in terms of devices that may be used with a PIVC, one skilled in the art will understand that any number of different devices for introducing instruments 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.

[0034] 1A and 1B, shown are non-limiting embodiments of a system including a catheter assembly 10 and an instrument delivery device 110. 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. The ports 18 may be located between the distal end 14 and the proximal end 16, or more than one port 18 may be located between the distal end 14 and the proximal end 16. The ports 18 may instead 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.

[0035] In some non-limiting embodiments or aspects, the catheter assembly 10 may include a catheter 22 extending from the distal end 14. The first catheter 22 may include a peripheral intravenous catheter, a midline catheter, or a peripherally inserted central catheter. The catheter 22 may be formed of any suitable material and may be of any useful length, as known to those of skill in the art. 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 of skill in the art and may have a distal end 26 and a proximal end 28, and 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 positioned at a 90 degree angle relative to the longitudinal axis of connector 30), a y-connector (e.g., one side port positioned at an angle of 15 to 165 degrees relative to the longitudinal axis of connector 30), or any other type of connector known in the art, and may include a second lumen therein with any number of branches appropriate for that type of connector.

[0036] In some non-limiting embodiments or aspects, the catheter assembly 10 may include an extension set (integral to or removably 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 & Co. In some non-limiting embodiments or aspects, the second fluid conduit 34 may include a luer connection 36 at its end. The extension set may also 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.

[0037] 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 those with direct fluid pathway 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 Q-SYTE and SMARTSITE. While the non-limiting embodiment of FIGS. 1A and 1B shows a needleless access connector disposed on a connector 30, those 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 slit-type self-healing septum. As described below, an instrument delivery device 110 may be reversibly connectable to the needleless access connector 32, such that one or more portions of the instrument delivery device may puncture the septum to access the patient's vascular system through the catheter 22.

[0038] 1A and 1B, and now also referring to FIG. 2, instrument delivery device 110 includes an outer housing 116 having a proximal end 120 and a distal end 122, and an inner housing 118 slidably received within outer housing 116. In a non-limiting embodiment, inner housing 118 and outer housing 116 are in a nested relationship such that inner housing 118 may be slidably received entirely or nearly entirely within outer housing 116. Inner housing 118 also includes a proximal end 124 and a distal end 126, and in a non-limiting embodiment, the inner housing may have a variable diameter along its length. By way of example, distal end 126 of inner housing 118 may have a larger diameter than other portions of inner housing 118 to provide more localized stiffness or sliding feature(s) and limit friction or binding. As another example, the distal end 126 of the inner housing 118 has a smaller diameter than the remainder of the inner housing 118 and is positioned to maintain the inner housing 118 in a fixed position in the blood-drawing advanced state, allowing the operator's hands to be freed until additional components (e.g., a vacutainer tube) are manipulated. The device delivery device 110 further includes a device, illustrated in the drawings as a catheter or fluid conduit 150 (but understood to alternatively be a probe, guidewire, or other device) having a proximal end 152 and a distal end 154, but which may be any medical device capable of being delivered through the catheter assembly 10 to the patient's vascular system, as previously described and as will be understood by those skilled in the art. The fluid conduit 150 is received within the outer housing 116 and may be advanced and / or retracted relative to the outer housing 116 by displacement of the inner housing 118 relative to the outer housing 116.1A , where the distal end 154 of the fluid conduit 150 is located within the instrument delivery device 110, e.g., within the outer housing 116 and / or within a lock 130 (e.g., securing the instrument delivery device 110 to the needleless access connector 32), to a second position, as shown in FIG. 1B , where the distal end 154 of the fluid conduit 150 is located at the distal end of the lock 130 and, in embodiments where the instrument delivery device 110 is coupled to the catheter assembly 10, optionally at the distal end of the catheter 22. While the lock 130 is illustrated as a blunt cannula 132 and an arm 134, one skilled in the art will understand that any type of suitable connection may be used to secure the instrument delivery device 110 to an indwelling catheter such as the catheter assembly 10, including a luer connection, a clip, a blunt plastic cannula, a blunt metal cannula, a hybrid luer (e.g., with a cannula), a friction fit, or the like.

[0039] The instruments useful with the instrument delivery device 110 described herein may be formed of any useful material. In a non-limiting embodiment, the instrument is a fluid conduit formed of a polymer, such as a polyimide-containing material. Furthermore, the inner housing 118 may be formed of any suitable material, including a material that provides the inner housing with a flexible, rigid, or semi-rigid structure. In a non-limiting embodiment, the inner housing 118 is formed of a material that provides resistance to buckling.

[0040] As can be appreciated, Figure 1A shows the instrument delivery device in a first condition, where the instrument (here, fluid conduit 150) is in a first position and is received within outer housing 116, and inner housing 118 is in a first position and extends proximally from the outer housing. In a non-limiting embodiment, inner housing 118 is coupled to or otherwise interacts with fluid conduit 150 such that, when inner housing 118 is advanced distally to a second position, as shown in Figure 1B, fluid conduit 150 is moved to the second position and a distal end 154 of fluid conduit 150 extends beyond outer housing 116, lock 130 (if present), and / or catheter 22.

[0041] As mentioned above, the distal end of the inner housing 118 may be larger in diameter than the remainder of the inner housing 118, such 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 fully withdrawn from the outer housing 116. The enlarged distal portion of the inner housing 118 may include vents to allow air to pass therethrough to reduce the force required to advance / retract the inner housing 118, and 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.

[0042] Inner housing 118 may include a connector 170 at its proximal end 124 to allow various medical devices to be attached to inner housing 118, for example, to provide a device that can be advanced into a patient's vascular system, to inject compositions into the vascular system, and / or to receive fluids withdrawn from the vascular system. Suitable connectors 170 include luer connectors, luer lock access devices, needleless access connectors, and the like, known to those skilled in the art.

[0043] In a non-limiting embodiment, the inner housing 118 may include one or more indicia 186 disposed on its outer surface. Suitable indicia may be visual and / or tactile and may be provided to indicate, for example, the length of the device, the position of the device relative to the indwelling catheter, etc. In a non-limiting embodiment, the one or more indicia 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 visualization of the indicia 186 throughout the transition from the first position of the inner housing 118 to the second position of the outer housing 118. In a non-limiting embodiment, the indicia 186 in the form of a tactile stop may be included at one or more locations along the inner housing 118 to provide a tactile indication to the user of a certain threshold. For example, the tactile stop may indicate that the device (e.g., the fluid conduit 150) has nearly reached its full extension and / or that the device cannot be extended any further (e.g., as shown in FIG. 1B ).

[0044] In a non-limiting embodiment, lubricant 190 may be applied to one or more locations on or within one or more components of instrument delivery device 110. For example, lubricant 190 may be applied to the outer surface of a distal portion (e.g., blunt cannula 132) of outer housing 116 of instrument delivery device 110 that is inserted into an indwelling catheter, such as catheter assembly 10, to reduce the force required to couple the device. Lubricant 190 may be applied to one or more locations within outer housing 116, such as on one or more outer surfaces of inner housing 118 and / or on one or more outer surfaces of an instrument (e.g., fluid conduit 150).

[0045] In a non-limiting embodiment, the instrument delivery device 110 includes one or more supports 216 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) as the inner housing 118 and / or the instrument are advanced distally through the outer housing 116. The supports 216 may include a narrowed portion of the outer housing 116, one or more washers disposed about the inner housing 118 and / or the instrument, and / or the like, for example, 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, the contents of which are incorporated herein by reference in their entirety.

[0046] In a non-limiting embodiment in which the device is a fluid conduit 150, fluid (e.g., blood) may be transferred to or from a patient's vascular system in which a catheter, such as catheter 22, may be placed. As shown in FIGS. 1A and 1B and 2 , the fluid conduit 150 may be joined to the inner housing 118 at a fitting 164. According to a non-limiting embodiment, the fluid conduit 150 may be joined at the fitting 164 to a separate fluid tube 166 that passes through the inner housing 118 and is connected to a connector 170. In other non-limiting embodiments, the fluid conduit 150 may be joined to the inner housing 118 at the fitting 164, with the inner housing 118 itself forming a fluid conduit in fluid communication with the connector 170. In any of the above-described embodiments, a clamp 180 suitable for occluding fluid flow through the inner housing 118 and / or the fluid conduit 166 may be provided at the proximal end 124 of the inner housing 118. According to embodiments, the clamp 180 may be a slide clamp or a pinch clamp.

[0047] According to an embodiment, movement of the inner housing 118 and fluid conduit 150 relative to the outer housing 116, including distal and optionally proximal movement thereof, is effected by wheel members 200 mounted on the outer housing 116. In operation of the instrument delivery device 110, an operator actuates (e.g., rotates) the wheel members 200, thereby causing linear movement of the inner housing 118 and fluid conduit 150, such as advancing or retracting the inner housing 118 and fluid conduit 150. By providing the wheel members 200 on the outer housing 116, an operator may use one hand to both stabilize the instrument delivery device 110 (with respect to the catheter assembly 10 / catheter adapter 12) and to manipulate the wheel members 200 to translate the inner housing 118 and fluid conduit 150 between the first and second positions described above. Thus, the wheel member 200 allows for an ergonomic one-handed advancement option that allows the advancement hand to remain in a reference position without having to move axially significantly to follow the movement of the inner housing 118.

[0048] In one embodiment, a grip 201 is formed on the outer surface of the outer housing 116 adjacent the wheel member 200. While the operator's thumb or fingers engage the wheel member 200, the remainder of the operator's hand is grasped onto the grip 201 so that the instrument carrier 110 may be held firmly by the operator.

[0049] 3 and 4 illustrate an exemplary embodiment of a wheel member 200—wheel member 200a—that may be included in the instrument carrier 110. The wheel member 200a is positioned at its distal end 122 on the outer housing 116. The outer housing 116 includes a compartment 202 formed therein and configured to house the wheel member 200a. The wheel member 200a includes a spool 204 and an advancement wheel 206 formed or coupled together to form a single component. The spool 204 includes an axle 204a that maintains the spool 204 within the compartment 202 and enables rotation of the spool 204. The spool 204 also includes a spool drum 204b about which the tether cord 212 is wound, as described in more detail below. The advancement wheel 206, which is directly coupled to or integrally formed with the spool 204, extends upwardly from the compartment 202 and is engageable by an operator. An operator can directly rotate the advancement wheel 206 by applying force, and the advancement wheel 206 is rotatable in a first direction 208 and a second direction 210 .

[0050] Actuation of the wheel member 200a causes corresponding linear movement of the inner housing 118 and the fluid conduit 150 via a tether cord 212 connecting the inner housing 118 to the wheel member 200a. A first end of the tether cord 212 is connected to the distal end 126 of the inner housing, such as at an anchor point 213, and a second end of the tether cord 212 is wound around a spool drum. The tether cord 212 extends into a volume 214 defined by the outer housing 116 and, in one embodiment, may be positioned above the fluid conduit 150 to avoid contact with the fluid conduit 150. The support 216 and / or other components (e.g., seals) included in the outer housing 116 may be configured to accommodate the routing of the tether cord 212.

[0051] According to non-limiting embodiments, the tether cord 212 may be formed from any of a number of suitable materials capable of withstanding forces exerted thereon by movement of the associated wheel member 200a. In some embodiments, the tether cord 212 may be configured to withstand only a tensile force exerted thereon by a tensile force exerted thereon in response to rotation of the advancement wheel 206 in the first direction 208. In such embodiments, the tether cord 212 may be formed from, for example, a flexible polymeric material. In other embodiments, the tether cord 212 may be configured to withstand both a tensile force exerted thereon in response to rotation of the advancement wheel 206 in the first direction 208 and a compressive / compressive force exerted thereon in response to rotation of the advancement wheel 206 in the second direction 210. In such embodiments, the tether cord 212 may be formed from a semi-rigid metallic or polymeric material (e.g., a metal wire or guide wire) capable of withstanding both tensile and compressive / compressive forces.

[0052] In operation of the instrument delivery device 110, rotation of the wheel member 200a (i.e., rotation of the advancement wheel 206 and corresponding rotation of the spool 204) in a first direction 208 (i.e., toward the distal end 122 of the outer housing 116) causes the tether cord 212 to wrap around the spool drum 204b, thereby applying a pulling force to the inner housing 118. In response to the application of this pulling force, the inner housing 118 is moved / slid toward the distal end 122 of the outer housing 116, which causes the fluid conduit 150 to advance distally such that the distal end 154 of the fluid conduit 150 may be extended from the outer housing 116 and blunt cannula 132 into the catheter assembly 10.

[0053] In some embodiments, the inner housing 118 and fluid conduit 150 may be retracted toward the proximal end 120 of the outer housing 116 by an operator manually pulling the proximal end 124 of the inner housing 118 back from the outer housing 116. In other embodiments, rotation of the wheel member 200a in the second direction 210 (i.e., toward the proximal end 120 of the outer housing 116) causes the tether cord 212 to be released from the spool drum 204b, thereby applying a pushing force to the inner housing 118. In response to the application of this pushing force, the inner housing 118 is moved / slid toward the proximal end 120 of the outer housing 116, such that the fluid conduit 150 may be retracted proximally and the distal end 154 of the fluid conduit 150 may be retracted into the outer housing 116.

[0054] 5 and 6, another exemplary embodiment of a wheel member 200 (wheel member 200b) that may be included in the instrument transport device 110 is shown. Similar to wheel member 200a, wheel member 200b is positioned on the outer housing 116 at its distal end 122 within a compartment 202 of the outer housing 116. Wheel member 200b includes an advancement wheel 218 and a spool 220, both of which are configured to rotate within the compartment 202. Advancement wheel 218 is positioned to extend partially from compartment 202, allowing an operator to rotate advancement wheel 218 using a thumb or finger. Advancement wheel 218 includes teeth 222 thereon and functions as a gear, as described in more detail below. Spool 220 is positioned adjacent to advancement wheel 218 and is horizontally offset therefrom. The spool 220 includes a spool drum 220a around which the tether cord 212 may be wound, and a gear 220b having teeth 224 that interface with teeth 222 on the advance wheel 218, such that rotation of the advance wheel 218 rotates the spool 220. In the depicted embodiment, the teeth 222 are formed along the outermost edge of the advance wheel 218. In other embodiments, however, the teeth 222 may be formed along a portion of the advance wheel 218 that is inset against the outermost edge.

[0055] 5 and 6, the spool 220 and advancement wheel 218 include axles 220c and 218a, respectively, by which these components are positioned within the compartment 202 and about which they rotate. When the spool 220 is rotated, the rotation causes the tether cord 212 to be wound or released from the spool drum 220a depending on the direction the advancement wheel 218 is rotated (i.e., the tether cord 212 is wound onto the spool drum 220a when the advancement wheel 218 is rotated in the second direction 210 and released from the spool drum 220a when the advancement wheel 218 is rotated in the first direction 208), thereby causing displacement of the corresponding distal or proximal ends of the inner housing 118 and fluid conduit 150 relative to the outer housing 116. That is, rotation of the advancement wheel 218 in the second direction 210 causes the tether cord 212 to wrap around the spool drum 220a, thereby exerting a pulling force on the inner housing 118, causing the inner housing 118 to move / slide toward the distal end 122 of the outer housing 116 and also advancing the fluid conduit 150 distally. Additionally, in some embodiments, rotation of the advancement wheel 218 in the first direction 208 causes the tether cord 212 to release from the spool drum 220a, thereby exerting a pushing force on the inner housing 118, causing the inner housing 118 to move / slide toward the proximal end 120 of the outer housing 116 and also retracting the fluid conduit 150 proximally.

[0056] According to the depicted embodiment, the gear formed by advancement wheel 218 has a larger diameter than gear 220b, thereby causing tether cord 212—and the coupled inner housing 118 (and fluid conduit 150)—to be advanced or retracted a greater distance per rotation of advancement wheel 218. That is, the larger diameter of advancement wheel 218 provides a displacement-type mechanical advantage to instrument delivery device 110 when advancing or retracting inner housing 118 and fluid conduit 150. In contrast, in other embodiments, the gear formed by advancement wheel 218 may have a diameter equal to or smaller than gear 220b. In such embodiments, inner housing 118 (and fluid conduit 150) may be advanced or retracted a smaller distance per rotation of advancement wheel 218, and such advancement or retraction may be achieved with a smaller amount of force on advancement wheel 218.

[0057] 7-11, an additional embodiment of an instrument carrier 230 is shown. The structure of the instrument carrier 230 is substantially similar to that of the instrument carrier 110 shown in FIGS. 1-6, and therefore, like parts are labeled identically to the instrument carrier 230. Furthermore, the structure of the wheel members 200 included in the instrument carrier 230—either wheel member 200a (FIGS. 8 and 9) or wheel member 200b (FIGS. 10 and 11)—is identical to that of the wheel members 200a, 200b shown in FIGS. 3 and 4 and 5 and 6, respectively. As provided in detail herein below, the wheel members 200 included in the instrument carrier 230 interact with the inner housing 118 and fluid conduit 150 of the instrument carrier 230 in a manner different from that of the instrument carrier 110 of FIGS. 1-6 when advancing and retracting the inner housing 118 and fluid conduit 150 relative to the outer housing 116.

[0058] 8 and 9, the wheel member 200a includes a spool 204 and an advancement wheel formed or coupled together to form a single component. The spool includes an axle 204a that maintains the spool 204 within the compartment 202 and allows the spool 204 to rotate, and a spool drum 204b around which the fluid conduit 150 is looped, as described in more detail below. The advancement wheel 206 extends upwardly from the compartment 202, and an operator can apply force to directly rotate the advancement wheel 206, which is rotatable in a first direction 208 and a second direction 210.

[0059] 7 and 8 and 9, the fluid conduit 150 (or, alternatively, an instrument such as a probe or guidewire) is looped around the spool drum 204b at a location on the fluid conduit 150 between its proximal end 152 and distal end 154, such that the fluid conduit 150 operably connects or couples the wheel member 200a to the inner housing 118 (when the proximal end 152 of the fluid conduit 150 is connected to the fitting 164 on the inner housing 118). According to an embodiment, the fluid conduit 150 is looped around the spool drum 204b one or more times (e.g., two, three, or more times) as needed to create traction / friction and a “locking” effect that prevents the fluid conduit 150 from slipping relative to the spool 204 when the wheel member 200a is rotated. Thus, actuation of the wheel member 200a causes corresponding linear movement of the fluid conduit 150, and thus the inner housing 118.

[0060] In operation of the instrument transport device 230, rotation of the wheel member 200a (i.e., rotation of the advance wheel 206 and corresponding rotation of the spool 204) in the first direction 208 (i.e., toward the terminal end 122 of the outer housing 116) applies a pulling force to the portion 150a of the fluid conduit 150 extending between the spool drum 204b and the inner housing 118, thereby also applying a pulling force to the inner housing 118, causing the inner housing 118 to move / slide toward the terminal end 122 of the outer housing 116. When this portion 150a of the fluid conduit 150 is pulled toward the distal end 122 of the outer housing 116, the remaining portion 150b of the fluid conduit 150 (between the spool drum 204b and the distal end 154 of the fluid conduit 150) may be pushed and advanced in the distal direction, causing the distal end 154 of the fluid conduit 150 to extend from the outer housing 116 and the blunt cannula 132 into the catheter assembly 10.

[0061] Upon further operation of the instrument delivery device 230, rotation of the wheel member 200a in the second direction 210 (i.e., toward the proximal end 120 of the outer housing 116) applies a pulling force to the portion 150b of the fluid conduit 150. As this portion 150b of the fluid conduit 150 is pulled back and retracted toward the proximal end 122 of the outer housing 116, the portion 150a of the fluid conduit 150 (extending between the spool drum 204b and the inner housing 118) is caused to push back proximally, thereby also applying a pushing force to the inner housing 118, causing the inner housing 118 to move / slide back toward the proximal end 120 of the outer housing 116. In other embodiments, the inner housing 118 and fluid conduit 150 may be retracted toward the proximal end 120 of the outer housing 116 by the operator manually pulling the proximal end 124 of the inner housing 118 away from the outer housing 116.

[0062] 10 and 11, the interaction between the fluid conduit 150 and the wheel member 200b will be described according to the illustrated embodiment. As previously described, the wheel member 200b includes a forward wheel 218 and a spool 220, both of which are configured to rotate within the compartment 202. The forward wheel 218 is positioned to extend partially from the compartment 202 and includes teeth 222 thereon, and may therefore function as a gear. The spool 220 includes a spool drum 220a, about which the fluid conduit 150 may be wound in one or more loops, as described above, and a gear 220b having teeth 224 that interact with the teeth 222 on the forward wheel 218, such that rotation of the forward wheel 218 rotates the spool 220.

[0063] The fluid conduit 150 is looped around the spool drum 220a one or more times (e.g., two, three, or more times) as needed to create traction / friction and a "locking" effect so that the fluid conduit 150 does not slip relative to the spool 220 when the wheel member 200b is rotated. Rotation of the wheel member 200b in the second direction 210 exerts a pulling force on the portion 150a of the fluid conduit 150 extending between the spool drum 220a and the inner housing 118, which in turn exerts a pulling force on the inner housing 118, causing the inner housing 118 to move / slide toward the distal end 122 of the outer housing 116. As this portion 150a of the fluid conduit 150 is pulled toward the distal end 122 of the outer housing 116, the remaining portion 150b of the fluid conduit 150 (between the spool drum 220a and the distal end 154 of the fluid conduit 150) may be pushed distally and caused the distal end 154 of the fluid conduit 150 to extend from the outer housing 116 and blunt cannula 132 into the catheter assembly 10. Conversely, rotation of the wheel member 200b in the first direction 208 applies a pulling force to the portion 150b of the fluid conduit 150. When this portion 150b of the fluid conduit 150 is pulled back and retracted toward the proximal end 122 of the outer housing 116, it causes the portion 150a of the fluid conduit 150 (extending between the spool drum 220a and the inner housing 118) to be pushed back proximally, thereby also applying a pushing force to the inner housing 118, causing the inner housing 118 to move / slide back toward the proximal end 120 of the outer housing 116. In other embodiments, the inner housing 118 and fluid conduit 150 may be retracted toward the proximal end 120 of the outer housing 116 by an operator manually pulling the proximal end 124 of the inner housing 118 away from the outer housing 116.

[0064] As previously mentioned, the size of the advancement wheel 218 (i.e., its diameter) relative to the gear 220b can determine the mechanical advantage provided by the wheel member 200b. When the gear formed by the advancement wheel 218 has a larger diameter than the gear 220b, the fluid conduit 150 is advanced or retracted a greater distance per amount of rotation of the advancement wheel 218. Conversely, when the gear formed by the advancement wheel 218 has a smaller diameter than the gear 220b, the fluid conduit 150 is advanced or retracted a smaller distance per amount of rotation of the advancement wheel 218, but such advancement or retraction may be achieved with a reduced amount of force on the advancement wheel 218.

[0065] While Figures 7-11 show and describe the fluid conduit 150 (or another device) looped around the spool drum 220a to provide for advancement of the inner housing 118 and fluid conduit 150, it will be appreciated that the tether cord 212 (Figures 1-6) may alternatively be looped around the spool drum 220a to provide for advancement of the inner housing 118 and fluid conduit 150. That is, similar to the instrument delivery device 110 of Figures 1-6, the tether cord 212 may extend between the inner housing 118 and the wheel members 200a, 200b, but instead of being wrapped around a spool drum that is part of the wheel members 200a, 200b (i.e., spool drum 220a), the tether cord 212 is looped around the spool drum 220a a sufficient number of times (e.g., one, two, or three times) to create traction / friction and a "locking" effect, and then continues distally to another drum around which the tether cord 212 is wrapped. Through operation of the wheel members 200a, 200b as described above, the advancement or retraction of the tether cord 212 will in turn cause a corresponding advancement or retraction of the fluid conduit 150 (or alternative device) and inner housing 118, however, the looped wrapping of the tether cord 212 about the spool drum 220a has the advantage of allowing the tether cord 212 to better withstand the pushing and pulling forces applied to it and allowing the advancement and retraction of the fluid conduit 150 and inner housing 118.

[0066] 12A and 12B and 13, another embodiment of an instrument carrier 240 is shown. Again, components common to instrument carrier 240 and instrument carriers 110, 230 are labeled identically.

[0067] In instrument delivery device 240, wheel members 242 are provided for advancing and retracting inner housing 118 and fluid conduit 150. In operation of instrument delivery device 110, an operator actuates (e.g., rotates) wheel members 242, thereby causing linear movement of inner housing 118 and fluid conduit 150, such as advancing or retracting inner housing 118 and fluid conduit 150. Wheel members 242 are positioned on outer housing 116 at its proximal end 120. While different from the positioning of wheel members 242 at distal end 122 of outer housing 116 as provided in the embodiment of FIGS. 1-11 , positioning wheel members 242 at proximal end 120 on outer housing 116 still allows for an ergonomic, one-handed advancement option for the operator when translating inner housing 118 and fluid conduit 150 of instrument delivery device 240 between a first position and a second position.

[0068] 14 shows an exemplary embodiment of a wheel member 242, i.e., wheel member 242a, that may be included in instrument carrier 240. Wheel member 242a is positioned at its proximal end 120 on outer housing 116. Outer housing 116 includes a compartment 244 formed therein and configured to receive wheel member 242a. Wheel member 242a includes an advancement wheel 246 mounted on an axle 248, which maintains advancement wheel 246 within compartment 244 and allows advancement wheel 246 to rotate in first direction 208 and second direction 210. An upper portion 246a of advancement wheel 246 extends upwardly from compartment 244 and is external to outer housing 116 for engagement by an operator, while a bottom portion 246b of advancement wheel 246 is positioned to engage inner housing 118, as described in more detail below.

[0069] 14, the advancement wheel 246 includes teeth 249 thereon that are configured to engage a grooved track 250 formed along the top surface of the inner housing 118. Due to the engagement of the teeth 249 with the grooved track 250, the advancement wheel 246 and the inner housing 118 thus form a rack and pinion type engagement that functions to urge the inner housing 118 (and fluid conduit 150) toward the distal end 122 of the outer housing 116 or back toward the proximal end 120 of the outer housing 116, depending on the direction the advancement wheel 246 is rotated.

[0070] In operation of the instrument delivery device 240, rotation of the advancement wheel 246 in the second direction 210 (i.e., toward the proximal end 120 of the outer housing 116) causes rack-and-pinion engagement between the advancement wheel 246 and the inner housing 118, advancing the inner housing 118 distally forward. The inner housing 118 therefore moves / slides toward the distal end 122 of the outer housing 116, thereby causing the fluid conduit 150 to distally advance such that the distal end 154 of the fluid conduit 150 may extend from the outer housing 116 and blunt cannula 132 into the catheter assembly 10. Conversely, rotation of the wheel member 242 in the first direction 208 (i.e., toward the distal end 122 of the outer housing 116) causes rack-and-pinion engagement between the advancement wheel 246 and the inner housing 118, retracting the inner housing 118 proximally rearward. Accordingly, the inner housing 118 thus moves / slides toward the proximal end 120 of the outer housing 116, which causes the fluid conduit 150 to retract proximally, such that the distal end 154 of the fluid conduit 150 may be retracted within the outer housing 116.

[0071] 15 shows another exemplary embodiment of a wheel member 242, namely, wheel member 242b, that may be included in instrument transport device 240. Wheel member 242b is positioned at its proximal end 120 on outer housing 116. Wheel member 242b includes an advancement wheel 252 mounted on an axle 248, which maintains advancement wheel 252 within compartment 244 and enables advancement wheel 252 to rotate in first direction 208 and second direction 210. An upper portion 252a of advancement wheel 252 extends upward from compartment 244 and is outside of outer housing 116 for operator engagement, while a bottom portion 252b of advancement wheel 246 is positioned to engage and apply pressure against inner housing 118, as described in more detail below.

[0072] According to the illustrated embodiment, wheel member 242b of instrument carrier 240 is configured to interact with inner housing 118 through a friction-type engagement for the purposes of urging inner housing 118 toward distal end 122 of outer housing 116 or pushing inner housing 118 back toward proximal end 120 of outer housing 116. To provide the friction-type engagement between wheel member 242b and inner housing 118, advancement wheel 252 may be formed of rubber or other compliant material that assists in applying pressure against the top surface of inner housing 118. Additionally, one or more support wheels 254 are included in instrument carrier 240 and are positioned opposite advancement wheel 252, i.e., adjacent the bottom surface of inner housing 118, and are secured within outer housing 116. The vertical alignment of the support wheel 254 and the advancement wheel 252 on opposite sides of the inner housing 118 creates a pressing force that is applied perpendicularly against the inner housing 118 with a desired spacing therebetween that is slightly less than the diameter / height of the inner housing 118. A frictional engagement is thus provided between the advancement wheel 252 and the top surface of the inner housing 118, which allows the inner housing 118 to move.

[0073] In operation of the instrument delivery device 240, rotation of the advancement wheel 252 in the second direction 210 (i.e., toward the proximal end 120 of the outer housing 116) causes the frictional engagement between the advancement wheel 252 and the inner housing 118 to advance the inner housing 118 distally forward. The inner housing 118 therefore moves / slides toward the distal end 122 of the outer housing 116, which causes the fluid conduit 150 to advance distally such that the distal end 154 of the fluid conduit 150 may extend from the outer housing 116 and blunt cannula 132 into the catheter assembly 10. Conversely, rotation of the advancement wheel 252 in the first direction 208 (i.e., toward the distal end 122 of the outer housing 116) causes the frictional engagement between the advancement wheel 252 and the inner housing 118 to retract the inner housing 118 proximally rearward. The inner housing 118 thus moves / slides toward the proximal end 120 of the outer housing 116, which in turn causes the fluid conduit 150 to retract proximally so that the distal end 154 of the fluid conduit 150 may be retracted within the outer housing 116.

[0074] 15 and support wheel(s) 254 may be repositioned on / within the outer housing 116 toward its distal end 122 and act against one another to directly translate the fluid conduit 150, as shown in FIG. 16. That is, the advancement wheel 252 is positioned such that an upper portion 252a of the advancement wheel 252 extends upward from the compartment 244 and is outside the outer housing 116, and a bottom portion 252b of the advancement wheel 246 engages the fluid conduit 150, while the support wheel(s) 254 are positioned opposite the advancement wheel 252 and fixed within the outer housing 116. The vertical alignment of the support wheel 254 and advancement wheel 252 on opposite sides of the fluid conduit 150 results in a compressive force being applied perpendicular to the fluid conduit 150 with a desired spacing therebetween that is slightly less than the diameter / height of the fluid conduit 150. A frictional engagement is thus provided between the advancement wheel 252 and the top surface of the fluid conduit 150, which may cause the fluid conduit 150 to move. In operation of the instrument delivery device 240, rotation of the advancement wheel 252 in the second direction 210 (i.e., toward the proximal end 120 of the outer housing 116) causes frictional engagement between the advancement wheel 252 and the fluid conduit 150, advancing the fluid conduit 150 (and thus the inner housing 118) distally forward. Conversely, rotation of the advancement wheel 252 in the first direction 208 (i.e., toward the distal end 122 of the outer housing 116) causes frictional engagement between the advancement wheel 252 and the fluid conduit 150, retracting the fluid conduit 150 (and thus the inner housing 118) proximally rearward.

[0075] As described above with respect to the embodiment of Figures 12-16, rotation of the advancement wheels 246, 252 in the second direction 210 (i.e., toward the proximal end 120 of the outer housing 116) causes the inner housing 118 to advance distally forward, while rotation of the advancement wheels 246, 252 in the first direction 208 (i.e., toward the distal end 122 of the outer housing 116) causes the inner housing 118 to retract proximally rearward. It will be appreciated that, according to additional embodiments, the structure of the advancement wheels 246, 252 and the positioning of the inner housing 118 (within the outer housing 116) can be modified to reverse the direction of movement of the inner housing 118 relative to the direction of rotation of the advancement wheels 246, 252. Referring to Figures 17 and 18, a wheel member 242c is provided on the instrument transport device 240, which includes a two-stage advancement wheel 256, which includes an actuation portion 256a and an engagement portion 256b. Portions 256a, 256b are integrally formed, with actuation portion 256a having a larger diameter than engagement portion 256b. Actuation portion 256a extends upward from compartment 244 and is external to outer housing 116 so as to be engageable by an operator, while engagement portion 256b is positioned to engage and apply pressure to fluid conduit 150, as will be described in more detail below. As best shown in FIG. 17 , inner housing 118 and fluid conduit 150 are positioned within outer housing 116, against wheel member 242c, and against support wheel 254, so that the bottom surface of fluid conduit 150 rests on top of engagement portion 256b and the top surface of fluid conduit 150 is engaged by support wheel 254. This structure of wheel member 242c and the arrangement of support wheel 254 relative to 254, together with the positioning of fluid conduit 150, results in rotation of advancement wheel 256 in a first direction 208 (i.e., toward distal end 122 of outer housing 116) causing fluid conduit 150 to advance distally forward, and rotation of advancement wheel 256 in a second direction 210 (i.e., toward proximal end 120 of outer housing 116) causing fluid conduit 150 to retract proximally rearward.

[0076] It will be appreciated that a similar type of structure for wheel member 242c may be positioned at the proximal end 120 of outer housing 116 rather than in the location shown in Figure 17, with inner housing 118 engaged by engagement portion 256b and support wheel 254 instead of fluid conduit 150. It will further be appreciated that with wheel member 242c positioned at the proximal end 120 of outer housing 116, engagement portion 256b of advancement wheel 256 may be configured to engage inner housing 118 via a rack and pinion type engagement, as previously described for the embodiment of Figure 14, rather than a friction type engagement.

[0077] Advantageously, the embodiments of the instrument delivery device described herein provide the operator with an ergonomic, one-handed advancement option. Locating the wheel members on the distal outer housing of the instrument delivery device allows the operator to use one hand to stabilize the instrument delivery device relative to the catheter assembly 10 and manipulate the wheel members to advance and / or retract the instrument. This allows the operator's advancing hand to remain in a reference position without requiring significant axial movement to follow the movement of the inner housing, thus simplifying use of the instrument delivery device.

[0078] While 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 that such details are for that purpose 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. 1. An instrument delivery device for advancing an instrument into a vascular access device, the instrument delivery device comprising: an outer housing defining an interior volume and having a proximal end and a distal end; an introducer portion positioned at the distal end of the outer housing and configured to mate with an access connector of the vascular access device; an inner housing having a proximal end and a distal end, the distal end positioned within the interior volume to engage the proximal end of the instrument, the inner housing configured to move relative to the outer housing; and a wheel member positioned on the outer housing and rotatable relative to the outer housing, the wheel member operably coupled to the inner housing to distally move the inner housing within the outer housing when the wheel member is rotated; Equipped with an instrument delivery device, wherein distal movement of the inner housing moves the instrument from a first position where the distal end of the instrument is disposed within the outer housing, to a second position where the distal end of the instrument is disposed beyond the distal end of the outer housing.

2. The instrument delivery device of claim 1 , wherein the wheel member is mounted to the outer housing adjacent the distal end of the outer housing.

3. The instrument delivery device of claim 2 , further comprising a gripping feature formed on the outer housing at the distal end of the outer housing adjacent the wheel member.

4. The wheel member is an advancement wheel engageable by an operator to cause rotation; and a spool operatively connected to the advancement wheel, said spool rotating in response to rotation of the advancement wheel; The instrument delivery device of claim 2 , comprising:

5. 5. The instrument delivery device of claim 4, further comprising a tether cord having a first end connected to the distal end of the inner housing and a second end engaged with the spool.

6. 5. The instrument delivery device of claim 4, wherein rotation of the wheel member in a first direction causes the tether cord to wrap around the spool and pull the inner housing toward the distal end of the outer housing, thereby moving the instrument from the first position to the second position.

7. 6. The instrument delivery device of claim 5, wherein the tether cord comprises a semi-rigid cord, and rotation of the wheel member in a second direction causes the semi-rigid cord to be released from the spool and push the inner housing back toward the proximal end of the outer housing, thereby moving the instrument from the second position to the first position.

8. 5. The instrument delivery device of claim 4, wherein the spool includes a gear mounted adjacent to and mounted on the advancement member, the advancement member and the gear each including intermeshing teeth thereon, such that rotation of the advancement member causes rotation of the gear which is transmitted to the spool.

9. 9. The instrument delivery device of claim 8, wherein the advancement member and the gear have different diameters to provide a force or displacement mechanical advantage when the advancement member is rotated to pull on the tether cord.

10. 5. The instrument delivery device of claim 4, wherein the instrument advances forward from the proximal end toward the distal end of the outer housing, and one of the instrument and the tether cord is looped one or more times around the spool to effectively couple the instrument or the tether cord to the wheel member.

11. rotation of the wheel member in a first direction causes the instrument and the inner housing to advance toward the distal end of the outer housing, thereby moving the instrument from the first position to the second position; and 11. The instrument delivery device of claim 10, wherein rotation of the wheel member in a second direction causes the instrument and the inner housing to move back toward the proximal end of the outer housing, thereby moving the instrument from the second position to the first position.

12. 2. The instrument transport device of claim 1, wherein a first portion of the instrument is pulled by the wheel member and a second portion of the instrument is pushed by the wheel member during rotation of the wheel member in the first direction and the second direction.

13. the wheel member is mounted on the outer housing adjacent the proximal end of the outer housing, with a bottom side of the wheel member engaging an upper surface of the inner housing; and 2. The instrument delivery device of claim 1, wherein rotation of the wheel member in a second direction, toward the proximal end of the outer housing, causes the bottom side of the wheel member to urge the inner housing toward the distal end of the outer housing, thereby moving the instrument from the first position to the second position.

14. 14. The instrument transport device of claim 13, wherein the wheel member comprises a toothed wheel, the top surface of the inner housing having a grooved track, the toothed wheel engaging the grooved track in a rack and pinion type engagement to urge the inner housing toward the distal end of the outer housing when the toothed wheel is rotated in the second direction.

15. the outer housing further comprising one or more support wheels positioned within the interior volume and adjacent a bottom surface of the inner housing opposite the wheel members, the wheel members and the one or more support wheels being pressed together against the inner housing to provide frictional engagement between the wheel members and the top surface of the inner housing; and 14. The instrument delivery device of claim 13, wherein the frictional engagement between the wheel member and the top surface of the inner housing urges the inner housing toward the distal end of the outer housing when the wheel member is rotated in the second direction.

16. The instrument transport device of claim 15 , wherein the wheel members comprise conformable advancement wheels configured to provide frictional engagement between the wheel members and the top surface of the inner housing.

17. The instrument delivery 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.

18. 2. The instrument delivery device of claim 1, wherein the instrument is a catheter and the inner housing is in fluid communication with the catheter such that fluid flowing proximally from the catheter is received within the inner housing or fluid flowing distally from the inner housing is received within the catheter.

19. 10. The instrument delivery device of claim 1, further comprising one or more supports disposed within the outer housing configured to limit buckling of the instrument as it is advanced through the outer housing.

20. The system, A catheter assembly comprising: A catheter adapter, a lumen extending between the distal and proximal ends of the catheter adapter; and a side port disposed between the distal end and the proximal end, the side port in fluid communication with the lumen; a catheter adapter, a catheter secured to the distal end of the catheter adapter and extending distally from the catheter adapter; and a fluid conduit having a proximal end connected to the side port and a distal end connected to a needleless access connector; a catheter assembly comprising:

10. The instrument delivery device of claim 1, wherein the instrument delivery device advances an instrument through the needleless access connector, the fluid conduit, and the catheter adapter and into the catheter. A system comprising:

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