Vascular access device with over-the-catheter introducer needle and near-patient access port - Patent Application 20070122997

Abstract

Provided herein is a vascular access device including a catheter insertion apparatus and a needleless access connector unit. The catheter insertion apparatus includes a catheter assembly having a housing defining a passageway, a needle slidably mounted within the passageway and defining a needle lumen, a frame, and a catheter coupled to the frame, the frame sliding within the housing to advance the catheter within the needle lumen. The catheter insertion apparatus is operable between an initial configuration in which the needle extends distally from the housing and the catheter is retracted proximally within the needle lumen, and an actuated configuration in which the needle is retracted back into the passageway of the housing and the catheter extends distally from the housing. The needleless access connector unit is positioned at the proximal end of the catheter assembly frame and provides an access port to the catheter.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Application No. 18 / 154,152, filed January 13, 2023, entitled "Vascular Access Device With Over-the-Catheter Introducer Needle and Near-Patient Access Port," the disclosure of which is incorporated herein by reference in its entirety. [Background technology]

[0002] Background of the Invention FIELD OF THE INVENTION Provided herein are devices and systems for use in vascular access, particularly catheter insertion devices configured to also provide vascular access for use with instrument delivery and blood suction devices.

[0003] 2. Description of Related Art Catheters are commonly used for administering fluids into and out of the body. In various settings, including hospitals and home care, patients receive fluids, medications, and blood products via vascular access devices (VADs), which include such catheters inserted into the patient's vascular system. A typical VAD includes a plastic catheter inserted into a patient's vein, and the length of the catheter can vary from a few centimeters, for example, if the VAD is a peripheral intravenous catheter (PIVC), to many centimeters, for example, if the VAD is a central venous catheter (CVC). A VAD may be left in place for short-term (days), medium-term (weeks), or long-term (months to years).

[0004] When a patient utilizes a VAD, a needle is used to access a vein or artery in the body for the purpose of introducing a catheter into the blood vessel. Common catheter insertion techniques include the "over-the-needle" technique and the "over-the-catheter" technique. In the "over-the-needle" technique, a catheter insertion device is used to insert a needle through the skin into the blood vessel until the needle tip is properly positioned within the vessel. After the needle is properly positioned, the catheter insertion device is manipulated to advance the catheter over the needle into the blood vessel, i.e., the catheter is "over-the-needle," and the needle is then withdrawn from the body, leaving the catheter indwelling with its distal end positioned within the blood vessel. In the "over-the-needle" technique, a catheter insertion device is used to insert a needle through the skin into the blood vessel and manipulated until the needle tip is properly positioned within the blood vessel. After the needle is properly positioned, the catheter insertion device is manipulated to advance the catheter through the needle and into the blood vessel, i.e., the needle is "over-the-catheter," and the needle is then withdrawn from the body, leaving the catheter indwelling with its distal end positioned within the blood vessel.

[0005] Each of the above-mentioned catheter insertion techniques has limitations associated with it regarding needle withdrawal and subsequent removal of the catheter insertion device from the insertion site. In the case of over-the-needle catheter insertion devices, the proximal portion of the catheter insertion device is typically completely detached from the catheter hub, which remains fixed to the patient at the insertion site. In over-the-catheter catheter insertion devices, the needle cannot be easily removed from the catheter and discarded due to interference with the catheter hub at its proximal end, which typically necessitates the use of a splittable needle. In either case, the design of existing catheter insertion devices leaves the entire catheter insertion device intact at the insertion site, preventing other associated devices (e.g., introducers) from being easily connected to it, thereby preventing guidewires, sensors, wires, fibers, obturators, or other instruments from being introduced through the catheter insertion device (and through the catheter) into the patient's vascular system.

[0006] Thus, there exists a need in the art for a VAD that provides vascular access for catheter insertion, instrument delivery, and blood aspiration. The VAD desirably includes an over-the-catheter introducer needle and a near-patient access port integral therewith or connectable thereto, through which such instrument delivery and / or blood aspiration is possible. Summary of the Invention

[0007] Provided herein is a vascular access device including a catheter insertion apparatus and a needleless access connector (NAC) unit. The catheter insertion apparatus includes a housing having a distal housing end and a proximal housing end and defining a longitudinal passage therein, a needle slidably mounted within the longitudinal passage and defining a needle lumen, and a catheter assembly having a frame and a catheter connected to the frame, the frame being slidably mounted within the housing for advancing the catheter within the needle lumen. The catheter insertion apparatus is operable in an initial configuration in which the needle extends distally from the distal housing end and the catheter is retracted proximally into the needle lumen, and in an actuated configuration in which the needle is retracted back within the longitudinal passage of the housing and the catheter extends distally from the distal housing end. The NAC unit is positioned at the proximal end of the frame of the catheter assembly, and the NAC unit provides an access port to the catheter.

[0008] In a particular configuration, the NAC unit includes a connector portion having a proximal coupler, the proximal coupler comprising a split septum NAC.

[0009] In certain configurations, the NAC unit further includes a side port disposed in the connector portion, the side port being in fluid communication with the proximal coupler via a lumen defined in the connector portion, and the extension tube being coupled to the side port to provide a fluid path to the connector portion.

[0010] In certain configurations, the connector portion of the NAC unit includes cleaning enhancement features.

[0011] In certain configurations, the NAC unit further includes a stabilizing portion coupled to the connector portion, the stabilizing portion configured to be placed in contact with a skin surface of a patient.

[0012] In certain configurations, positioning the NAC unit at the proximal end of the frame of the catheter assembly provides a closed system VAD.

[0013] In a particular configuration, the frame has a distal frame end and a proximal frame end, the frame includes a pusher member positioned at the proximal frame end and a plurality of arms extending distally from the pusher member to the distal frame end, the plurality of arms engaging the housing to form a sliding engagement between the frame and the housing, and the pusher member is configured to be pushed distally to cause the plurality of arms to slide into the housing, thereby advancing the catheter within the needle lumen.

[0014] In certain configurations, the NAC unit is integrated into the push member of the frame.

[0015] In certain configurations, the NAC unit is separate from the catheter insertion device and can be connected to a pusher member.

[0016] In a particular configuration, the pusher member includes a luer connection formed thereon at the proximal frame end, and the connector portion of the NAC unit includes a terminal coupler configured to mate with the luer connection, the terminal coupler including a luer lock connection.

[0017] In certain configurations, the pusher member includes a side port formed therein adjacent the proximal end frame end.

[0018] In certain configurations, the NAC unit is connected to the side port of the pusher member via a length of intermediate tubing that extends between the side port and the end connector of the NAC unit.

[0019] In certain configurations, the NAC unit is coupled to the pusher member with the catheter insertion device in an initial or activated configuration.

[0020] In certain configurations, the access port and catheter form a fluid pathway compatible with the device.

[0021] In certain configurations, during transition from the initial configuration to the activated configuration, the pusher member is pushed distally into contact with the housing, with the arms sliding into the housing as the pusher member is pushed distally.

[0022] Also provided herein is a catheter system including a vascular access device, including a catheter insertion device and a NAC unit. The catheter insertion device includes a housing having a distal housing end and a proximal housing end and defining a longitudinal passage therein, a needle slidably mounted within the longitudinal passage and defining a needle lumen, and a catheter assembly having a frame and a catheter coupled to the frame, the frame slidably mounted within the housing for advancing the catheter within the needle lumen. The catheter insertion device is operable in an initial configuration in which the needle extends distally from the distal housing end and the catheter is retracted proximally within the needle lumen, and in an actuated configuration in which the needle is retracted back within the longitudinal passage of the housing and the catheter extends distally from the distal housing end through the needle lumen. The NAC unit is positioned at the proximal end of the catheter assembly frame, and provides an access port to the catheter. The catheter system also includes an instrument delivery device or blood aspiration device coupled to the access port of the NAC unit.

[0023] In certain configurations, the instrument delivery device is configured to advance the instrument through the NAC unit, into the catheter, and past the catheter to the distal end.

[0024] In certain configurations, the device is one of a guidewire, a sensor, a wire, a fiber, an obturator, or a tube.

[0025] In certain configurations, the instrument delivery device or the blood suction device includes a lock configured to secure the instrument delivery device or the blood suction device to the NAC unit. [Brief explanation of the drawings]

[0026] [Figure 1] FIG. 1 is a top view of a vascular access device according to an embodiment of the present disclosure, with the catheter insertion device in an initial configuration. [Figure 2] 2 is a top view of the vascular access device of FIG. 1 with the catheter insertion device in an activated configuration. [Figure 3] FIG. 3 is a top view of a vascular access device according to another embodiment of the present disclosure, with the catheter insertion device in an initial configuration. [Figure 4] 4 is a top view of the vascular access device of FIG. 3 with the catheter insertion device in an activated configuration. [Figure 5] FIG. 5 is a top view of a vascular access device according to another embodiment of the present disclosure, with the catheter insertion device in an initial configuration. [Figure 6] FIG. 6 is a top view of the vascular access device of FIG. 5 with the catheter insertion device in an activated configuration. [Figure 7] FIG. 7 is a top view of a vascular access device according to another embodiment of the present disclosure, with the catheter insertion device in an initial configuration. [Figure 8] 8 is a top view of the vascular access device of FIG. 7 with the catheter insertion device in an activated configuration. [Figure 9] FIG. 9 is a top view of a vascular access device according to another embodiment of the present disclosure, with the catheter insertion device in an initial configuration. [Figure 10] FIG. 10 is a top view of the vascular access device of FIG. 9 with the catheter insertion device in an activated configuration. [Figure 11] FIG. 11 is a top view of a vascular access device coupled to an instrument delivery device according to another embodiment of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0027] Description of the Invention 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, variations, equivalents, and alternatives are intended to be within the spirit and scope of the invention.

[0028] For purposes of the following description, the terms "upper," "lower," "right," "left," "vertical," "horizontal," "top," "bottom," "lateral," "longitudinal," and derivatives thereof, shall refer to the present invention as oriented in the drawing figures. 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] Provided herein are embodiments of a vascular access device for inserting a catheter, such as a peripheral intravenous catheter (PIVC), into a patient's vascular system, the vascular access device further configured to provide for introducing instruments through the catheter via a near-patient access port thereon.

[0030] 1 and 2, a non-limiting embodiment of a vascular access device (VAD) 10a according to one aspect of the present disclosure is shown. The VAD 10a includes a catheter insertion apparatus 12 and a needleless access connector (NAC) unit 14a, the VAD 10a configured to provide integration or connection between the NAC unit 14a and the catheter insertion apparatus 12. As described in further detail below, the NAC unit 14a provides a near-patient access port for the VAD 10a through which instrument delivery and / or blood aspiration can be achieved while the catheter insertion apparatus 12 remains in place at the catheter insertion site.

[0031] Referring initially to the catheter insertion device 12 of the VAD 10a, the catheter insertion device 12 generally includes a housing 16, a needle 18, and a catheter assembly 20 that includes a vascular access catheter 22 therein. The catheter insertion device 12 is operable in each of an initial configuration ( FIG. 1 ) and an actuated configuration ( FIG. 2 ). In the initial configuration of the catheter insertion device 12 (i.e., the configuration used for initial needle penetration into a patient's blood vessel), the needle 18 is positioned to extend distally from the housing 16, while the catheter 22 is fully retracted within the needle 18 and housing 16. In the actuated configuration of the catheter insertion device 12 (i.e., the configuration used for insertion of the catheter into a patient's blood vessel and needle withdrawal / retraction), the catheter 22 is advanced through the needle 18 and extends distally from the needle 18 and housing 16, while the needle 18 is fully retracted within the housing 16. Thus, the catheter insertion device 12 is configured as an "over-the-catheter" type insertion device, with the introducer needle 18 positioned over the catheter 22 as the catheter 22 is advanced into the patient's vascular system.

[0032] The housing 16 of the catheter insertion device 12 is configured as an elongated member having a distal housing end 24 and a proximal housing end 26, the distal housing end including a distal port 28 and the proximal housing end being open. The housing 16 defines a longitudinal passage 30 therein, within which the needle 18 and a portion of the catheter assembly 20 may be received. In some embodiments, the housing 16 may be provided with a flashback window 32 and a pair of taping wings 34. The flashback window 32 allows the user to detect blood flowing back into the device after the sharpened distal tip 36 of the needle 18 initially enters the blood vessel, confirming that access has been achieved. The taping wings 34 facilitate taping, wrapping, or otherwise securing the housing 16 to the patient after the catheter 22 is positioned within the target blood vessel.

[0033] The catheter assembly 20 of the catheter insertion device 12 includes a vascular access catheter 22 and a frame 38 that holds the catheter, the frame 38 having a distal end 40 including a plurality of arms 42 receivable within the housing 16 and a proximal end 44 including a pusher member 46 and having an integrated NAC unit 14a, as described in more detail below. In the initial configuration of the catheter insertion device 12, the pusher member 46 of the frame 38 is slidably attached to the housing 16 by the arms 42 of the frame 38 and is spaced from the proximal housing end 26. The arms 42 slidably engage the housing 16 to advance the catheter assembly 20 into the internal passageway 30 of the housing 16 when the pusher member 46 is pushed distally by a user.

[0034] In operation of the catheter insertion device 12, the needle 18 is first introduced into the blood vessel with the catheter insertion device 12 in its initial configuration, for example, by manual placement in a conventional manner. After introduction of the needle 18 into the blood vessel, flashback will be observed through the window 32, and the catheter 22 can be advanced distally off the needle 18 (and distally out past the housing 16) by distally advancing the pusher member 46, as shown in FIG. 2 . That is, the pusher member 46 may be actuated distally until it contacts the proximal end 26 of the housing 16.

[0035] According to some embodiments, once the catheter 22 has been advanced (but with the needle 18 still in an initial state extending distally from the housing 16), the pusher member 46 may be rotated or further biased relative to the housing 16 to retract the needle 18 and lock the catheter 22 in place. In one embodiment, gripping features 48a and 48b may be provided on the housing 16 and the pusher member 46, respectively, such that the gripping features 48a and 48b are axially aligned with one another, thereby retracting the needle 18 and locking the catheter 22. Rotation of the pusher member 46 relative to the housing 16 places the catheter insertion device 12 in an activated configuration, positioning the catheter 22 distally from the needle 18 and housing 16 and retracting the needle 18 back into the housing 16.

[0036] It will be appreciated that the catheter insertion device 12 may include various internal components that provide for retraction of the needle 18 and locking of the catheter 22 in place when the catheter insertion device 12 is in the activated configuration. By way of example, the catheter insertion device 12 may include a coil spring 50 and a plurality of locking features (not shown) provided on the needle 18 (i.e., on its hub) or also provided within the housing 16 and on the frame 38 that interact with each other to provide such retraction and locking functions. The coil spring 50 may be positioned concentrically around the needle 18 between the distal housing end 24 and the needle hub (provided at its proximal end), with the coil spring 50 initially held in a compressed state and then allowed to expand to a relaxed state as the catheter insertion device 12 transitions from the initial configuration to the activated configuration, causing the needle 18 to retract back into the housing 16. A first group of locking features (on the needle 18 and housing 16) may be utilized to allow the coil spring 50 to release from a compressed state and expand to a relaxed state, thereby retracting the needle 18 back into the housing 16, while a second group of locking features (on the needle 18 and frame 38) may be utilized to lock the catheter 22 in place after the needle 18 is retracted.

[0037] As described above, the VAD 10a includes a NAC unit 14a that is integrated with or connected to the catheter insertion device 12. In the illustrated embodiment, the NAC unit 14a is integrated with the catheter insertion device 12 such that the catheter insertion device 12 and the NAC unit 14a are provided as a single device. In the illustrated non-limiting embodiment, the NAC unit 14a has a connector portion 72 and a stabilizing portion 74, where the connector portion 72 is integrated with the catheter insertion device 12 and the stabilizing portion 74 is coupled to the connector portion 72 and is configured to be placed against the patient's skin surface at or near the insertion site of the catheter 22.

[0038] The connector portion 72 has a distal end 76 that is integral with the catheter insertion device 12, e.g., integrally formed with and / or permanently coupled to the pusher member 46, such that a lumen (not shown) defined by the connector portion 72 is configured to at least selectively be in fluid communication with the catheter 22 of the catheter insertion device 12. A proximal end 78 of the connector portion 72 has a coupler 80 that provides a proximal port for the NAC unit 14a. The proximal coupler 80 may be configured to physically and fluidly couple, for example, as a split-septum NAC configured to receive the blunt introducer of a peripheral device such as a blood aspiration device (e.g., PIVO™ manufactured by Becton, Dickinson and Company) or a vascular access probe (VAP) for intravascular digital measurement of patient data such as temperature, pH, lactate, and / or other blood-based measurements.

[0039] Connector portion 72 also includes and / or defines one or more additional ports, such as a side port 82. Side port 82 can be included in connector portion 72 such that it is located between proximal end 78 and distal end 76. In some embodiments, side port 82 can be positioned such that connector portion 72 forms, for example, a Y-connector or a T-connector. More specifically, side port 82 can be positioned near or adjacent proximal coupler 80, substantially perpendicular (e.g., about 90 degrees) to the lumen of connector portion 72. In non-limiting embodiments, side port 82 extends from connector portion 72 at an angle other than 90 degrees relative to the lumen (e.g., side port 82 extends at an angle between 15 and 165 degrees, for example, but not by way of limitation, including all values ​​and subranges therebetween).

[0040] 1 and 2, an extension tube 84 is integral with the NAC unit 14a and is joined thereto via a side port 82. The extension tube 84 is in fluid communication with the lumen of the side port 82. In some embodiments, the side port 82 and / or the extension tube 84 can be at least a portion of and / or form a fluid line, which may be used for fluid delivery, fluid removal, fluid flushing, etc. In such embodiments, for example, an arrangement in which the side port 82 is disposed adjacent the proximal coupler 80 may enable flushing of the proximal coupler 80, any valve(s) contained therein, and / or the space between the any valve(s) and the inner surface of the connector portion 72 (e.g., defining at least a portion of the lumen).

[0041] 1 and 2, a proximal access port 86 is coupled to the proximal end portion of extension tube 84, which is in fluid communication with side port 82 of catheter connector 46. A connector 88 of a desired type (e.g., NAC) may be coupled to access port 86 to allow for fluid connection of a component (e.g., a syringe, IV bag, etc.) to extension tube 84. In some embodiments, a clamp 90 is provided on extension tube 84 to selectively restrict flow through extension tube 84.

[0042] Advantageously, integrating the NAC unit 14a with the catheter insertion device 12 provides a closed catheter system with a near-patient access port for the VAD 10a through which instrument delivery and / or blood aspiration is possible. The near-patient access port provided by the NAC unit 14a allows guidewires, sensors, wires, fibers, obturators, or other instruments to be advanced linearly into the fluid path of the VAD 10a or beyond the tip of the catheter.

[0043] 3 and 4, a VAD 10b according to another aspect of the present disclosure is shown. The VAD 10b of FIGS. 3 and 4 differs from the VAD 10a of FIGS. 1 and 2 in that the NAC unit 14b is provided as a detachable unit separate from but connectable to the catheter insertion device 12. In such an embodiment, the pusher member 46 of the catheter insertion device 12 includes a connector 92 at its proximal end that provides for connection of the NAC unit 14b. The proximal connector 92 of the pusher member 46 may therefore, in one embodiment, be configured as a female Luer connection having threads 94 on its outer surface.

[0044] In the embodiment of Figures 3 and 4, the NAC unit 14b is structured as described above in the embodiment of Figures 1 and 2, in that the NAC unit 14b includes a connector portion 72 and a stabilizing portion 74, with the connector portion 72 including a proximal coupler 80 and a side port 82. As described above, the proximal coupler 80 is configured as a NAC that provides a proximal port for the NAC unit 14b and may be configured as a split-septum NAC configured to receive a blunt introducer of a peripheral device, while the side port 82 provides for an extension tube 84 (or extension set) to be coupled thereto or integrally formed therewith. The NAC unit 14b further includes a distal coupler 96 (positioned at the distal end 76) thereon that is configured to mate with the connector 92 of the pusher member 46. According to one embodiment, the distal coupler 96 is configured as a male luer connection that mates with the female luer connection of the connector 92. Coupling of the NAC unit 14b to the catheter insertion device 12 (via mating of the end coupler 96 and connector 92) thus provides a closed catheter system for the VAD 10b with a near-patient access port through which instrument delivery and / or blood aspiration can be performed. The near-patient access port provided by the NAC unit 14b allows guidewires, sensors, wires, fibers, obturators, or other instruments to be advanced linearly into the fluid pathway of the VAD 10b or beyond the tip of the catheter 22.

[0045] According to embodiments, the NAC unit 14b may be attached to the catheter insertion device 12 while the catheter insertion device 12 is in an initial or activated configuration, i.e., before or after catheter insertion and advancement. Selective connection of the NAC unit 14b in this manner provides flexibility to the practitioner regarding the timing of connection of the NAC unit 14b to the catheter insertion device 12, provides ease of use of the catheter insertion device 12, and allows for easy introduction / advancement of instruments into and through the VAD 10b.

[0046] 5 and 6 and 7 and 8, VADs 10c and 10d according to further aspects of the present disclosure are shown. The VAD 10c of FIGS. 5 and 6 is identical to the VAD 10a of FIGS. 1 and 2, including the NAC unit 14a of the VAD 10a, except that the NAC unit 14c integrated with the catheter insertion device 12 does not include a side port and associated extension tubing / set integrated therewith. Similarly, the VAD 10d of FIGS. 7 and 8 is identical to the VAD 10b of FIGS. 3 and 4, including the NAC unit 14b of the VAD 10b, except that its separate / attachable NAC unit 14d (attachable to the catheter insertion device 12) does not include a side port and associated extension tubing / set integrated therewith. In either embodiment, the integration or connection of the NAC unit 14c and 14d to the catheter insertion device 12 provides a closed-system VAD 10c and 10d with a near-patient access port for instrument delivery and blood aspiration.

[0047] 9 and 10, a VAD 10e according to another embodiment of the present disclosure is shown. The VAD 10e of FIGS. 9 and 10 differs from the VADs 10a, 10b, 10c, and 10d of FIGS. 1-8 in that its NAC unit 14e is provided as part of an extension set 97 separate from the catheter insertion device 12 and connected thereto via an intermediate tube 98. To accommodate connection of the extension set 97 (including the NAC unit 14e) to the catheter insertion device 12, the pusher member 46 of the catheter insertion device 12 includes a side port 100 adjacent its proximal end into which the intermediate tube 98 is received, the intermediate tube 98 extending between the side port 100 and the extension set 97 and NAC unit 14e.

[0048] 9 and 10, the NAC unit 14e is configured similarly to the NAC units 14a, 14b previously described in the embodiment of FIGS. 1-4 in that it includes a connector portion 72 including a proximal coupler 80 configured as a NAC and a side port 82 to which an extension tube is connected (or integrally formed). However, the NAC unit 14e includes a distal coupler 102 configured to receive the intermediate tube 98 therein, thereby fluidly connecting the lumen of the connector portion 72 (not shown) to the side port 100 of the catheter insertion device 12 and, therefore, the catheter 22 of the catheter insertion device 12. In some embodiments, a stabilizing portion (not shown) may be provided in the NAC unit 14e.

[0049] Connecting the NAC unit 14e (as part of the extension set 97) to the catheter insertion device 12 via the side port 100 on the pusher member 46 and the intermediate tube 98 provides a closed catheter system with a near-patient access port for the VAD 10e, through which instrument delivery and / or blood aspiration can be performed. The near-patient access port provided by the NAC unit 14e allows guidewires, sensors, wires, fibers, obturators, or other instruments to be advanced into the fluid path of the VAD 10e or beyond the tip of the catheter 22.

[0050] Referring now to FIG. 11 , the VADs 10a, 10b of FIGS. 1-2 or 3-4 are shown with an instrument advancement device 104 coupled thereto to illustrate the connection of a device to its near-patient access port, made possible by the inclusion of a NAC unit 14a, 14b in the VADs 10a, 10b. The instrument advancement device 104 may be of any suitable shape, size, or configuration and may be coupled to the VADs 10a, 10b via the NAC unit 14a, 14b. As shown in FIG. 11 , the instrument advancement device 104 includes an introducer 106, a lock 108, an instrument 110 (e.g., a catheter, guidewire, probe, etc.), and an actuator 112. A portion of the actuator 112 is configured to be advanced along the top surface of the introducer 106, which facilitates advancement of the instrument 110 through the introducer 106, the lock 108, the VADs 10a, 10b, and the distal catheter 22. In some embodiments, a luer adapter, luer lock access device (LEAD), or other connection device 114 may be provided at the proximal end of the introducer 106 to allow connection of another component to the device, such as a syringe or vacutainer, to facilitate blood aspiration.

[0051] 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. The vascular access device A catheter insertion device, comprising: a housing having a distal housing end and a proximal housing end and defining a longitudinal passage therein; a needle slidably mounted within the longitudinal passage and defining a needle lumen; and a catheter assembly comprising a frame and a catheter held by the frame, the frame slidably mounted within the housing for advancing the catheter within the needle lumen; the catheter insertion device is operable in an initial configuration in which the needle extends distally from the distal housing end and the catheter is retracted proximally into the needle lumen, and in an actuated configuration in which the needle is retracted back into the longitudinal passage of the housing and the catheter extends distally from the distal housing end through the needle lumen; a catheter insertion device, a needleless access connector (NAC) unit positioned at a proximal end of the frame of the catheter assembly, the NAC unit providing an access port to the catheter; A vascular access device comprising:

2. The vascular access device of claim 1 , wherein the NAC unit comprises a connector portion including a proximal coupler, the proximal coupler comprising a split septum NAC.

3. The NAC unit a side port in the connector portion, the side port in fluid communication with the proximal coupler via a lumen defined in the connector portion; and an extension tube coupled to the side port to provide a fluid path to the connector portion; The vascular access device of claim 2 , further comprising:

4. The vascular access device of claim 3 , wherein the connector portion of the NAC unit comprises a cleaning-enhancing feature.

5. 3. The vascular access device of claim 2, wherein the NAC unit further comprises a stabilizing portion coupled to the connector portion, the stabilizing portion configured to be placed in contact with a skin surface of a patient.

6. The vascular access device of claim 1 , wherein positioning the NAC unit at the proximal end of the frame of the catheter assembly provides a closed system VAD.

7. The frame has a distal frame end and a proximal frame end, the frame comprising: a pusher member positioned at the proximal frame end; and a plurality of arms extending distally from the pusher member to the distal frame end, the plurality of arms engaging the housing to form a sliding engagement between the frame and the housing; The vascular access device of claim 2 , wherein the pusher member is configured to be pushed distally to slide the arms into the housing, thereby advancing the catheter within the needle lumen.

8. The vascular access device of claim 7 , wherein the NAC unit is integrated with the pusher member of the frame.

9. The vascular access device of claim 7 , wherein the NAC unit is separate from the catheter insertion apparatus and connectable to the pusher member.

10. 10. The vascular access device of claim 9, wherein the pusher member includes a luer connection formed thereon at the proximal frame end, and the connector portion of the NAC unit comprises an end coupler configured to mate with the luer connection, the end coupler comprising a luer lock connection.

11. The vascular access device of claim 9 , wherein the pusher member includes a side port formed therein adjacent the proximal end frame end.

12. 12. The vascular access device of claim 11, wherein the NAC unit is connected to a side port of the pusher member via a length of intermediate tubing extending between the side port and an end connector of the NAC unit.

13. The vascular access device of claim 9 , wherein the NAC unit is coupled to the pusher member with the catheter insertion apparatus in the initial configuration or in the actuated configuration.

14. The vascular access device of claim 1 , wherein the access port and the catheter form a fluid pathway compatible with an instrument.

15. 2. The vascular access device of claim 1, wherein when transitioning from the initial configuration to the actuated configuration, the pusher member is pushed distally into contact with the housing, and the plurality of arms slide within the housing as the pusher member is pushed distally.

16. The catheter system A catheter insertion device, comprising: a housing having a distal housing end and a proximal housing end and defining a longitudinal passage therein; a needle slidably mounted within the longitudinal passage and defining a needle lumen; and a catheter assembly comprising a frame and a catheter carried by the frame, the frame slidably mounted within the housing for advancing the catheter within the needle lumen; the catheter insertion device is operable in an initial configuration in which the needle extends distally from the distal housing end and the catheter is retracted proximally into the needle lumen, and in an actuated configuration in which the needle is retracted back into the longitudinal passage of the housing and the catheter extends distally from the distal housing end through the needle lumen; and a needleless access connector (NAC) unit positioned at a proximal end of the frame of the catheter assembly, the NAC unit providing an access port to the catheter; a catheter insertion device, an instrument delivery device or blood suction device coupled to the access port of the NAC unit; A catheter system comprising:

17. 17. The catheter system of claim 16, wherein the instrument delivery device or the blood suction device is configured to advance an instrument through the NAC unit into the catheter and past the catheter to a distal end.

18. 18. The catheter system of claim 17, wherein the device comprises one of a guidewire, a sensor, a wire, a fiber, an obturator, or a tube.

19. The catheter system of claim 16 , wherein the instrument delivery device or the blood suction device comprises a lock configured to secure the instrument delivery device or the blood suction device to the NAC unit.

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