Device delivery apparatus, systems and methods for extending through a thrombus - Patents.com

Abstract

The method may include coupling a first delivery device to a catheter assembly, which may include a catheter present within a patient's vasculature. The first delivery device may include a first tubular device. In response to the first tubular device being present at a distal location, a distal surface of the first tubular device may be positioned a first distance beyond a distal tip of the catheter. The method may include coupling a second delivery device to the catheter assembly after disconnecting the first delivery device from the catheter assembly. The second delivery device may include a second tubular device. In response to the second tubular device being present at a distal location, a distal surface of the second tubular device may be positioned a second distance beyond the distal tip of the catheter. The second distance may be greater than the first distance.

Description

[Technical Field]

[0001] Catheters are commonly used to infuse fluids into a patient's vascular system. For example, catheters may be used to infuse normal saline solution, various medications, or total parenteral nutrition. Catheters may also be used to withdraw blood from a patient. [Background technology]

[0002] The catheter may comprise an over-the-needle peripheral intravenous ("IV") catheter. In this case, the catheter may be mounted over an introducer needle having a sharp distal tip. The catheter and introducer needle may be assembled so that the bevel of the needle extends beyond the distal tip of the catheter, facing away from the patient's skin. The catheter and introducer needle are typically inserted at a shallow angle through the skin into the patient's vascular system.

[0003] To verify proper placement of the introducer needle and / or catheter within the vasculature, the physician will typically confirm the presence of a "flashback" of blood in the flashback chamber of the catheter assembly. Once placement of the introducer needle within the vasculature is confirmed, the physician may temporarily occlude flow through the vasculature and then remove the introducer needle, leaving the catheter in place for future blood withdrawal and / or fluid injection.

[0004] Drawing blood using a catheter can be difficult for several reasons, especially when the catheter remains in the vascular system for a day or more. When a catheter is inserted and left in a patient for an extended period of time, the catheter or blood vessel becomes thin and prone to collapse, kinking, blockage by deposits (e.g., fibrin or platelet clumps), and adhesion of the catheter tip to the vascular system. For this reason, although catheters are used to obtain blood samples at the time of catheter placement, catheters are not frequently used to obtain blood samples during the catheter's lifetime. Thus, when a blood sample is needed, an additional needle stick is often required to provide vascular access for blood collection, which can be painful for the patient and can result in high material costs.

[0005] In some cases, to avoid additional needle sticks, a tubular device may be used to access a patient's vascular system via a catheter. The tubular device is inserted through the catheter and into the vascular system, extending the life of the catheter and allowing blood draws through the catheter without additional needle sticks.

[0006] The subject matter claimed herein is not limited to embodiments that solve any disadvantages or that operate only in environments such as those described above. Rather, this background is merely provided to illustrate one example technology area in which some implementations described herein may be practiced. [Prior art documents] [Patent documents]

[0007] [Patent Document 1] U.S. Patent Application Serial No. 16 / 037,246 [Patent Document 2] U.S. Patent Application Serial No. 16 / 388,650 [Patent Document 3] U.S. Patent Application Serial No. 16 / 037,319 [Patent Document 4] U.S. Patent Application Serial No. 16 / 502,541 [Patent Document 5] U.S. Patent Application Serial No. 16 / 691,217 [Patent Document 6] U.S. Patent Application Serial No. 16 / 742,013 [Patent Document 7] U.S. Patent Application Serial No. 16 / 838,831 Summary of the Invention

[0008] The present invention generally relates to one or more delivery devices and related systems and methods for providing access to a patient's vasculature. In some embodiments, the delivery devices may each deliver a tubular device through a catheter. In some embodiments, the tubular device may facilitate an increased dwell time for the catheter within the patient's vasculature. In some embodiments, the delivery device may be used to advance the tubular device into and / or beyond the distal end of the catheter when the catheter becomes compromised or nears the end of its life, overcoming obstacles such as thrombi, valves, and / or fibrin sheaths in or around the catheter that might otherwise impede blood withdrawal.

[0009] In some embodiments, the delivery device may provide needle-free delivery of tubular devices into a patient's vasculature for blood withdrawal, fluid delivery, patient or device monitoring, or another physician need by using an existing catheter present in the vasculature. In some embodiments, the tubular devices of the delivery device may be of different lengths, and a delivery device with a longer tubular device may be used after a delivery device with a shorter tubular device to increase the likelihood of the tubular device passing through a thrombus that may increase in size over time.

[0010] In some embodiments, the method may include coupling a first delivery device to a catheter assembly. In some embodiments, the catheter assembly may comprise a catheter residing within the patient's vasculature. In some embodiments, the first delivery device may comprise a first housing and a first tubular device. In some embodiments, the first tubular device may comprise a distal end, a proximal end, and a lumen extending between the distal end of the first tubular device and the proximal end of the first tubular device. In some embodiments, the proximal end of the first tubular device may be secured within the first housing.

[0011] In some embodiments, the first tubular device may be positioned to advance distally from a proximal position to a distal position relative to the first housing and catheter assembly. In some embodiments, in response to the first tubular device being in the proximal position, the first tubular device may be proximal to the catheter assembly. In some embodiments, in response to the first tubular device being in the distal position, a distal surface of the distal end of the first tubular device may be positioned distal to and a first distance beyond the distal tip of the catheter. In some embodiments, in response to the first tubular device being in the distal position, the first tubular device may be fully advanced relative to the first housing.

[0012] In some embodiments, after transport of the first quantity of blood through the first tubular device and into the first blood collection container and movement of the first tubular device from the distal position to the proximal position, the method may include decoupling the first delivery device from the catheter assembly. In some embodiments, after decoupling the first delivery device from the catheter assembly, the method may include coupling a second delivery device to the catheter assembly.

[0013] In some embodiments, the second delivery device may comprise a second housing and a second tubular device. In some embodiments, the second tubular device may comprise a distal end, a proximal end, and a lumen extending between the distal end of the second tubular device and the proximal end of the second tubular device. In some embodiments, the proximal end of the second tubular device may be secured within the second housing. In some embodiments, the second tubular device may be configured to advance distally from a proximal position to a distal position relative to the second housing and catheter assembly. In some embodiments, the second tubular device may be fully advanced relative to the second housing in response to the second tubular device being in the distal position.

[0014] In some embodiments, in response to the second tubular device being in the proximal position, the second tubular device may be proximal to the catheter assembly. In some embodiments, in response to the second tubular device being in the distal position, a distal surface of the distal end of the second tubular device may be disposed distal to and a second distance beyond the distal tip of the catheter. In some embodiments, the second distance may be greater than the first distance.

[0015] In some embodiments, after transport of the second quantity of blood through the second tubular device and into the second blood collection container and movement of the second tubular device from the distal position to the proximal position, the method may include disconnecting the second delivery device from the catheter assembly. In some embodiments, after disconnecting the second delivery device from the catheter assembly, the method may include connecting a third delivery device to the catheter assembly.

[0016] In some embodiments, the third delivery device may comprise a third housing and a third tubular device. In some embodiments, the third tubular device may comprise a distal end, a proximal end, and a lumen extending between the distal end of the third tubular device and the proximal end of the third tubular device. In some embodiments, the proximal end of the third tubular device may be secured within the third housing. In some embodiments, the third tubular device may be configured to advance distally from a proximal position to a distal position relative to the third housing and catheter assembly. In some embodiments, the third tubular device may be fully advanced relative to the third housing in response to the third tubular device being in the distal end position.

[0017] In some embodiments, in response to the third tubular device being in the proximal position, the third tubular device may be proximal to the catheter assembly. In some embodiments, in response to the third tubular device being in the distal position, a distal surface of the distal end of the third tubular device may be disposed distal to and a third distance beyond the distal tip of the catheter. In some embodiments, the third distance may be greater than the second distance. In some embodiments, after transport of the third quantity of blood through the third tubular device and into the third blood collection container, and movement of the third tubular device from the distal position to the proximal position, the method may comprise disconnecting the third delivery device from the catheter assembly.

[0018] In some embodiments, the difference between the first distance and the second distance may be 0.5 inches, which may facilitate elongation through a thrombus that may form near the distal tip of the catheter and establishment of a fluid pathway through the catheter assembly. In further detail, in some embodiments, the second distance may be greater than the first distance, such that a thrombus increases in size over time, increasing the likelihood that a thrombus will pass through when the second delivery device is coupled to the catheter assembly after the first delivery device is coupled to the catheter assembly. In some embodiments, the first distance may be 1 inch or less. In some embodiments, the second distance may be 1.5 inches or less. In some embodiments, the third distance may be 2 inches or less.

[0019] In some embodiments, the difference between the first distance and the second distance may be 0.25 inches, 0.33 inches, 0.75 inches, 1 inch, or another suitable distance. In some embodiments, the difference between the first distance and the second distance may be greater than 0.25 inches. In some embodiments, a first delivery device may be coupled to the catheter assembly on a first day, and a second delivery device may be coupled to the catheter assembly on a second day, which may follow the first day. In some embodiments, the second day may be immediately after the first day.

[0020] In some embodiments, the difference between the second distance and the third distance may be 0.5 inches, which facilitates elongation through a thrombus that may form near the distal tip of the catheter and establishment of a fluid pathway through the catheter assembly. In further detail, in some embodiments, the third distance may be greater than the second distance so as to increase the likelihood of passing through a thrombus that may increase in size over time when the third delivery device is coupled to the catheter assembly, which may occur after the second delivery device is coupled to the catheter assembly.

[0021] In some embodiments, the difference between the second distance and the third distance may be 0.25 inches, 0.33 inches, 0.75 inches, 1 inch, or another suitable distance. In some embodiments, the difference between the second distance and the third distance may be greater than 0.25 inches. In some embodiments, a second delivery device may be coupled to the catheter assembly on a second day, and a third delivery device may be coupled to the catheter assembly on a third day, which may follow the second day. In some embodiments, the third day may be immediately after the second day.

[0022] In some embodiments, a first amount of blood may be transported to a first blood collection container via a first tubular device on a first day. In some embodiments, a second amount of blood may be transported to a second blood collection container via a second tubular device on a second day. In some embodiments, a third amount of blood may be transported to a third blood collection container via a third tubular device on a third day. In some embodiments, one or more of the first amount of blood, the second amount of blood, and the third amount of blood may be the same as or different from one another.

[0023] In some embodiments, the distal ends of one or more of the first, second, and third tubular devices may include one or more side holes, which may facilitate blood flow into the catheter proximal to a thrombus. In some embodiments, the distal ends of one or more of the first, second, and third tubular devices may be closed and / or include a slit. In some embodiments, the slit may be closed, and blood may not diffuse into the corresponding tubular device under normal physiological pressure, thereby making one or more of the first, second, and third tubular devices resistant to occlusion and thrombosis.

[0024] In some embodiments, the difference between the first distance and the second distance and the difference between the second distance and the third distance may increase the likelihood of elongation through a thrombus and establishment of a fluid pathway through the catheter assembly. In some embodiments, one or more specific delivery devices in addition to the first delivery device, the second delivery device, and the third delivery device may be coupled to the catheter assembly without removing the catheter from the patient. In some embodiments, the specific delivery device inserted through an existing catheter may become increasingly longer over time, which may increase the likelihood of establishing a fluid pathway through the catheter assembly, allowing for blood collection and / or reducing thrombosis.

[0025] In some embodiments, the first delivery device may include a first marking. In some embodiments, the second delivery device may include a second marking. In some embodiments, the third delivery device may include a third marking. In some embodiments, one or more of the first marking, second marking, and third marking may include a time for using the corresponding delivery device. For example, the first marking may include "first day" or "first blood draw." In another example, the second marking may include "second day" or "second blood draw." In a further example, the third marking may include "third day" or "third blood draw." In some embodiments, the first marking, second marking, and / or third marking may indicate a time for using the corresponding delivery device relative to one another.

[0026] In some embodiments, the first delivery device may include additional markings. In some embodiments, the first delivery device may include a slider, which may be coupled to the first tubular instrument. In some embodiments, the slider may cooperate with additional markings in response to the distal surface of the first tubular instrument flushing with the distal end of the catheter. Thus, in some embodiments, the additional markings may indicate to the physician that in response to further distal advancement of the first tubular instrument, the first tubular instrument will extend distally to a distal tip.

[0027] In some embodiments, the second delivery device may include additional markings. In some embodiments, the second delivery device may include a slider that may be coupled to the second tubular device. In some embodiments, the slider may be aligned with additional markings in response to a distal surface of the second tubular device flushing with the distal end of the catheter. Similarly, in some embodiments, the third delivery device may include additional markings. In some embodiments, the third delivery device may include a slider that may be coupled to the third tubular device. In some embodiments, the slider may be aligned with additional markings in response to a distal surface of the third tubular device flushing with the distal end of the catheter.

[0028] In some embodiments, the catheter assembly may include a catheter adapter, which may have a distal end, a proximal end, and a lumen extending between the distal end of the catheter adapter and the proximal end of the catheter adapter. In some embodiments, the catheter assembly may include a catheter, which may be secured within the catheter adapter. In some embodiments, the distal end of the housing may include a connector, which may be configured to couple to the connector of the catheter adapter.

[0029] In some embodiments, the separate delivery device may include a housing, which includes one or more of the following: a first marking, a second marking, a third marking, and a slot. In some embodiments, the first marking is proximal to the second marking. In some embodiments, the delivery device may include a tubular instrument, which may include a distal end, a proximal end, and a lumen extending between the distal end of the tubular instrument and the proximal end of the tubular instrument. In some embodiments, the proximal end of the tubular instrument may be secured within the housing. In some embodiments, a slider may be coupled to the tubular instrument and may be slidable along the slot in the housing. In some embodiments, the slider may include an advancement tab that may be grasped by a physician to advance and / or retract the tubular instrument.

[0030] In some embodiments, in response to distally advancing the slider from the proximal position to the first marking, the distal surface of the distal end of the tubular instrument may be positioned a first distance beyond the distal end of the housing. In some embodiments, in response to distally advancing the slider from the proximal position to the second marking, the distal surface of the distal end of the tubular instrument may be positioned a second distance beyond the distal end of the housing. In some embodiments, the second distance beyond the distal end of the housing may be greater than the first distance beyond the distal end of the housing. In some embodiments, in response to distally advancing the slider from the proximal position to the third marking, the distal surface of the distal end of the tubular instrument may be positioned a third distance beyond the distal end of the housing. In some embodiments, the third distance beyond the distal end of the housing may be greater than the second distance beyond the distal end of the housing.

[0031] It is to be understood that both the following general description and the detailed description are exemplary and explanatory and are not restrictive of the present invention, as defined in the claims. It is to be understood that the various embodiments are not limited in the arrangements or instrumentality as shown in the drawings. Moreover, the drawings are not necessarily to scale. It is to be understood that the embodiments may be combined or utilized in different ways, and structural changes may be made, unless otherwise stated in the claims, without departing from the scope of the various embodiments of the present invention. Therefore, the following detailed description is not to be construed as limiting. [Brief explanation of the drawings]

[0032] Exemplary embodiments will be described and explained in detail with additional particularity and through the use of the accompanying drawings.

[0033] [Figure 1A] FIG. 1A is a top perspective view of an exemplary delivery device coupled to an exemplary catheter assembly, showing an exemplary tubular instrument in a proximal position, according to some embodiments. [Figure 1B] FIG. 1B is a top perspective view of the delivery device of FIG. 1A coupled to a catheter assembly, showing the tubular device in a distal position, according to some embodiments. [Figure 2A] FIG. 2A is a top perspective view of a first delivery device showing an exemplary first tubular instrument in a proximal position, according to some embodiments. [Figure 2B] FIG. 2B is a top perspective view of the second delivery device showing the exemplary second tubular instrument in a proximal position, according to some embodiments. [Figure 2C] FIG. 2C is a top perspective view of a third delivery device showing an exemplary third tubular instrument in a proximal position, according to some embodiments. [Figure 3A] FIG. 3A is a top perspective view of the first delivery device of FIG. 2A showing the first tubular instrument in a distal position, according to some embodiments. [Figure 3B] FIG. 3B is a top perspective view of the second delivery device of FIG. 2B showing the second tubular instrument in a distal position, according to some embodiments. [Figure 3C] FIG. 3C is a top perspective view of the third delivery device of FIG. 2C showing the third tubular instrument in a distal position, according to some embodiments. [Figure 4] FIG. 4 is a top perspective view of an elongate delivery device, according to some embodiments.

[0034] [Detailed Description of the Invention] 1A-1B, in some embodiments, a delivery device 10 for delivering a tubular device 12 into a catheter 14 may facilitate an increased dwell time for the catheter 14. In further detail, when the catheter 14 is worn out or nearing the end of its life, the delivery device 10 may be used to advance the tubular device 12 into the catheter 14 and / or beyond the distal end 16 of the catheter 14 for fluid injection or blood withdrawal.

[0035] In some embodiments, delivery device 10 may comprise a housing 18 disposed in connection with a catheter adapter 19. In some embodiments, delivery device 10 may comprise a tubular device 12. In some embodiments, delivery device 10 may comprise any suitable delivery device. Non-limiting examples of delivery devices are U.S. patent application Ser. No. 16 / 037,246 (Patent Document 1), filed July 17, 2018, entitled "EXTENSION HOUSING A PROBE OR INTRAVENOUS CATHETER," U.S. patent application Ser. No. 16 / 388,650 (Patent Document 2), filed April 18, 2019, entitled "INSTRUMENT DELIVERY DEVICE HAVING A ROTARY ELEMENT," U.S. patent application Ser. No. 16 / 037,319 (Patent Document 3), filed July 17, 2018, entitled "MULTI-DIAMETER CATHETER AND RELATED DEVICES AND METHODS," and U.S. patent application Ser. No. 16 / 037,319 (Patent Document 3), filed July 3, 2019, entitled "DELIVERY DEVICE FOR A VASCULAR ACCESS" No. 16 / 502,541 (Patent Document 4), filed on November 21, 2019, entitled "SYRINGE-BASED DELIVERY DEVICE FOR A VASCULAR ACCESS INSTRUMENT," U.S. Patent Application No. 16 / 691,217 (Patent Document 5), filed on January 14, 2020, entitled "CATHETER DELIVERY DEVICE AND RELATED SYSTEMS AND METHODS," U.S. Patent Application No. 16 / 742,013 (Patent Document 6), filed on April 2, 2020, entitled "VASCULAR ACCESS INSTRUMENT HAVING A FLUID PERMEABLE STRUCTURE AND RELATED DEVICES AND No. 16 / 838,831, filed under the title "METHODS," which are incorporated herein by reference.

[0036] In some embodiments, in response to the tubular device 12 being advanced distally relative to the housing 18, the delivery device 10 may be configured to allow the tubular device 12 to be introduced into a catheter assembly 20, which may include a catheter adapter 19 and a catheter 14. In some embodiments, in response to the tubular device 12 being introduced into the catheter assembly 20, the tubular device 12 may access a fluid pathway of the catheter assembly 20 and / or the tubular device 12 may extend through the catheter assembly 20 to access the patient's vascular system.

[0037] In some embodiments, the catheter assembly 20 may comprise or correspond to any catheter assembly, such as, for example, the BD NEXIVA™ Closed IV Catheter System, the BD CATHENA™ Catheter System, the BD VENFLON™ Pro Safely Shielded IV Catheter System, the BD NEOFLON™ IV Cannula System, the BD INSYTE™ AUTOGUARD™ BC Shielded IV Catheter System, or another suitable catheter assembly. In some embodiments, the catheter assembly 20 may be integrated with an integrated extension tube 22. In other embodiments, the catheter assembly 20 may not be integrated. In some embodiments, the catheter 14 may comprise a peripheral intravenous catheter (PIVC), a peripherally inserted central catheter (PICC), or a midline catheter.

[0038] In some embodiments, the catheter 14 may be secured within and extend distally from the catheter adapter 19. In some embodiments, the catheter adapter 19 may include a distal end 24, a proximal end 26, and a lumen extending between and / or through the distal end 24 and the proximal end 26. In some embodiments, a septum may be disposed within the lumen of the catheter adapter 19. In some embodiments, the tubular device 12 may be delivered through the septum or into the vasculature proximal to the septum.

[0039] In some embodiments, the delivery device 10 may include a connector 30, which may be coupled to the proximal end 26 of the catheter assembly 20 or to another portion, such as, for example, a Y-adapter. In some embodiments, the connector 30 may include a slip, thread, or clip male luer adapter. In some embodiments, the connector 30 may include a slip, thread, or clip female luer adapter. In some embodiments, the connector 30 may include an introducer or cannula that may be inserted into the proximal end 26 of the catheter adapter 19. In some embodiments, the housing 18 may include a distal end 32 and a proximal end 34. In some embodiments, the distal end 32 may include the connector 30.

[0040] In some embodiments, delivery device 10 may include a blood collection device 36. In some embodiments, blood collection device 36 may include or correspond to a blood collection container. In some embodiments, the blood collection container may include a syringe, a vacuum blood collection tube 38, a small sample collection device, or other container. In some embodiments, blood collection device 36 may be coupled to delivery device 10 after distal advancement of tubular device 12.

[0041] In some embodiments, the blood collection device may include a needle assembly, which may include a needle 40 positioned to receive a blood collection container. In some embodiments, the proximal tip of the needle 40 may be positioned within an elastomeric sheath. In some embodiments, in response to the blood collection container pushing the elastomeric sheath distally, the needle 40 may pierce the elastomeric sheath and enter the blood collection container. In these and other embodiments, the blood collection container may include a vacuum blood collection tube 38.

[0042] In some embodiments, the blood collection device may include a holder, which may be configured to receive the vacuum blood collection tube 38. In some embodiments, the blood collection device may include a disposable holder, VACUTAINER®, available from Becton & Dickinson Company (Franklin Lakes, NJ). In some embodiments, the blood collection device 36 may be coupled to and in fluid communication with the proximal end 43 of the tubular device 12. In some embodiments, the blood collection device 36 may be coupled to and in fluid communication with the proximal end 43 of the tubular device 12 via a fluid path extending through the needle 40 or the tubular device 12. In some embodiments, the blood collection device 36 may be coupled to and in fluid communication with the proximal end 43 of the tubular device 12 in any number of suitable ways, such as integrally, with a luer connector, or the like.

[0043] In some embodiments, the delivery device 10 may include an advancement element. In some embodiments, the advancement element may include a tab or grip that may be moved by a physician to advance the tubular instrument 12 distally and / or retract the tubular instrument 12 proximally. In some embodiments, the advancement element may be coupled to the tubular instrument 12. In some embodiments, the advancement element may rotate. In some embodiments, the advancement element may include a slider 41, which may be slidable along a slot 45 disposed within the housing 18, as shown in FIGS. 1A-1B. In some embodiments, the tubular instrument 12 may extend and move through the proximal end 26 of the housing 18.

[0044] In some embodiments, in response to significant residence time within the vasculature, the catheter 14 of the catheter assembly 20 may be prone to thinning, collapse, kinking, occlusion by debris (e.g., fibrin, platelet clumps), and adhesion of the distal tip of the catheter 14 to the vasculature. Thus, drawing blood using the catheter 14 may be difficult. In some embodiments, the tubular device 12 may comprise or serve as another catheter that can provide access to a patient's vasculature without any additional needle stick. Thus, in some embodiments, the tubular device 12 may be used for needleless blood collection and / or fluid injection.

[0045] 2A and 3A, in some embodiments, a first delivery device 44 may be coupled to the catheter assembly 20. In some embodiments, the first delivery device 44 may be similar to or identical to the delivery device 10 of FIGS. 1A-1B, respectively, with respect to one or more included features and / or operation. In some embodiments, the catheter 14 may be present within the patient's vasculature when the first delivery device 44 is coupled to the catheter assembly 20. In further detail, the catheter 14 may be present within the patient's vasculature before the first delivery device 44 is coupled to the catheter assembly 20.

[0046] In some embodiments, the first delivery device 44 may comprise a first housing 46 and a first tubular device 48. In some embodiments, the first housing 46 and the first tubular device 42 may be similar to or identical to the housing 18 and the tubular device 12 of FIGS. 1A-1B, respectively, with respect to one or more included features and / or operation. In some embodiments, the first tubular device 48 may comprise a distal end 50, a proximal end 43, and a lumen extending between the distal end 50 of the first tubular device 48 and the proximal end 43 of the first tubular device 48. In some embodiments, the lumen may extend through the distal end 50 and the proximal end 43. In some embodiments, the proximal end 43 of the first tubular device 48 may be secured within the first housing 46.

[0047] In some embodiments, the first tubular device 48 may be positioned to advance distally from a proximal position to a distal position relative to the first housing 46 and the catheter assembly 20. In some embodiments, in response to the first tubular device 48 being in a proximal position, the first tubular device 48 may be proximal to the catheter assembly 20. In further detail, the distal end 50 of the first tubular device 48 or the distal surface 56 of the first tubular device 48 may be proximal to the catheter assembly 20 and / or within the first housing 46.

[0048] In some embodiments, in response to the first tubular instrument 48 being in the distal position, the distal surface 56 of the distal end 50 of the first tubular instrument 48 may be disposed distal to the distal tip 16 of the catheter 14 and a first distance beyond the distal end 16 of the catheter 14. In some embodiments, the distal surface 56 may comprise the distal-most surface of the distal end 50. In some embodiments, in response to the first tubular instrument 48 being in the distal position, the first tubular instrument 48 may be fully advanced relative to the first housing 46. For example, the slider 41 may contact the distal end of the slot 45, which may act as a stop.

[0049] In some embodiments, after transport of the first quantity of blood through the first tubular device to the first blood collection container and movement of the first tubular device from a distal position to a proximal position, the first delivery device 44 may be disconnected from the catheter assembly 20.

[0050] 2B and 3B, in some embodiments, after disconnecting the first delivery device 44 from the catheter assembly 20, a second delivery device 58 may be coupled to the catheter assembly 20. In some embodiments, the second delivery device 58 may be similar to or identical to the delivery device 10 of FIGS. 1A-1B, respectively, with respect to one or more included features and / or operation. In some embodiments, the catheter 14 may reside within the patient's vasculature when the second delivery device 58 is coupled to the catheter assembly 20 and has not been removed from the patient for insertion into a blood vessel. In some embodiments, the catheter 14 may reside within the patient's vasculature before the second delivery device 58 is coupled to the catheter assembly 20.

[0051] In some embodiments, the second delivery device 58 may comprise a second housing 60 and a second tubular device 62. In some embodiments, the second housing 60 and the first tubular device 62 may be similar to or identical to the housing 18 and the tubular device 12 of FIGS. 1A-1B, respectively, with respect to one or more included features and / or operation. In some embodiments, the second tubular device 62 may comprise a distal end 50, a proximal end 43, and a lumen extending between the distal end 50 of the second tubular device 62 and the proximal end 43 of the second tubular device 62. In some embodiments, the lumen may extend through the distal end 50 and the proximal end 43.

[0052] In some embodiments, the proximal end 43 of the second tubular device 62 may be secured within the second housing 60. In some embodiments, the second tubular device 62 may be positioned to advance distally from a proximal position to a distal position relative to the second housing 60 and catheter assembly 20. In some embodiments, in response to the second tubular device 62 being in the distal position, the second tubular device 62 may be fully advanced relative to the second housing 60. For example, the slider 41 may contact the distal end of the slot 45, which may act as a stop.

[0053] In some embodiments, in response to the second tubular device 62 being in a proximal position, the second tubular device 62 may be proximal to the catheter assembly 20. In further detail, the distal end 50 of the second tubular device 62 or the distal surface 56 of the second tubular device 62 may be proximal to the catheter assembly 20 and / or within the second housing 60. In some embodiments, in response to the second tubular device 62 being in a distal position, the distal surface 56 of the distal end 50 of the second tubular device 62 may be disposed distal to the distal tip 16 of the catheter 14 and a second distance beyond the distal end 16 of the catheter 14. In some embodiments, the distal surface 56 may comprise the distal-most surface of the distal end 50. In some embodiments, the second distance may be greater than the first distance.

[0054] In some embodiments, after transport of the second quantity of blood through the second tubular device 62 to the second blood collection container and movement of the second tubular device 62 from the distal position to the proximal position, the second delivery device 58 may be disconnected from the catheter assembly 20.

[0055] In some embodiments, the difference between the first distance and the second distance may be 0.5 inches, which facilitates elongation through a thrombus that may form near the distal tip 16 of the catheter 14 and establishment of a fluid pathway through the catheter assembly 20. In further detail, in some embodiments, the second distance may be greater than the first distance, such that thrombus size increases over time, increasing the likelihood that the second tubular device 62 will pass through a thrombus when the second delivery device is coupled to the catheter assembly 20 after the first delivery device is coupled to the catheter assembly 20. In some embodiments, the first distance may be 1 inch or less. In some embodiments, the second distance may be 1.5 inches or less.

[0056] In some embodiments, the difference between the first distance and the second distance may be 0.25 inches, 0.33 inches, 0.75 inches, 1 inch, or another suitable distance. In some embodiments, the difference between the first distance and the second distance may be greater than 0.25 inches. In some embodiments, a first delivery device may be coupled to the catheter assembly 20 on a first day, and a second delivery device may be coupled to the catheter assembly 20 on a second day, which may follow the first day. In some embodiments, the second day may be immediately after the first day.

[0057] 2C and 3C, in some embodiments, after disconnecting the second delivery device 58 from the catheter assembly 20, a third delivery device 64 may be coupled to the catheter assembly 20. In some embodiments, the third delivery device 64 may be similar to or identical to the delivery device 10 of FIGS. 1A-1B, respectively, with respect to one or more included features and / or operations. In some embodiments, the catheter 14 may reside within the patient's vasculature when the third delivery device 64 is coupled to the catheter assembly 20 and may not be removed from the patient for insertion into the vasculature. In some embodiments, the catheter 14 may reside within the patient's vasculature before the second delivery device 58 is coupled to the catheter assembly 20.

[0058] In some embodiments, the third delivery device 64 may comprise a third housing 66 and a third tubular device 68. In some embodiments, the third housing 66 and the first tubular device 62 may be similar to or identical to the housing 18 and the tubular device 12 of FIGS. 1A-1B, respectively, with respect to one or more included features and / or operation. In some embodiments, the third tubular device 68 may comprise a distal end 50, a proximal end 43, and a lumen extending between the distal end 50 and the proximal end 43. In some embodiments, the lumen may extend through the distal end 50 and the proximal end 43.

[0059] In some embodiments, the proximal end 43 of the third tubular device 68 may be secured within the third housing 66. In some embodiments, the third tubular device 68 may be positioned to advance distally from a proximal position to a distal position relative to the third housing 66 and catheter assembly 20. In some embodiments, in response to the third tubular device 68 being in the distal position, the third tubular device 68 may be fully advanced relative to the second housing 66. For example, the slider 41 may contact the distal end of the slot 45, which may act as a stop.

[0060] In some embodiments, in response to the third tubular device 68 being in a proximal position, the third tubular device 68 may be proximal to the catheter assembly 20. In further detail, the distal end 50 of the third tubular device 68 or the distal surface 56 of the third tubular device 68 may be proximal to the catheter assembly 20 and / or within the third housing 66. In some embodiments, in response to the third tubular device 68 being in a distal position, the distal surface 56 of the distal end of the third tubular device 68 may be disposed distal to the distal tip 16 of the catheter 14 and a third distance beyond the distal end 16 of the catheter 14. In some embodiments, the distal surface 56 may comprise the distal-most surface of the distal end 50. In some embodiments, the third distance may be greater than the second distance.

[0061] In some embodiments, after transport of the third amount of blood through the third tubular device 68 to the third blood collection container and movement of the third tubular device 68 from the distal position to the proximal position, the second delivery device 64 may be disconnected from the catheter assembly 20.

[0062] In some embodiments, the third distance may be 2 inches or less. In some embodiments, the difference between the second distance and the third distance may be 0.5 inches, which facilitates elongation through a thrombus that may form near the distal tip of the catheter and establishment of a fluid pathway through the catheter assembly 20. In further detail, in some embodiments, the third distance may be greater than the second distance so as to increase the likelihood that the third tubular device 68 will pass through a thrombus as the thrombus size increases over time, which may occur after the second delivery device is coupled to the catheter assembly 20.

[0063] In some embodiments, the difference between the second distance and the third distance may be 0.25 inches, 0.33 inches, 0.75 inches, 1 inch, or another suitable distance. In some embodiments, the difference between the second distance and the third distance may be greater than 0.25 inches. In some embodiments, the second delivery device 58 may be coupled to the catheter assembly 20 on the second day, and the third delivery device 64 may be coupled to the catheter assembly 20 on the third day, which may follow the second day. In some embodiments, the third day may be immediately after the second day.

[0064] 2A-3C, in some embodiments, a first amount of blood may be transferred on a first day via first tubular device 48 to first blood collection container 70a. In some embodiments, a second amount of blood may be transferred on a second day via second tubular device 62 to second blood collection container 70b. In some embodiments, a third amount of blood may be transferred on a third day via third tubular device 68 to third blood collection container 70c.

[0065] In some embodiments, one or more of the first volume of blood, the second volume of blood, and the third volume of blood may be the same or different from one another. In some embodiments, one or more of the first blood collection container 70a, the second blood collection container 70b, and the third blood collection container 70c may be the same or different blood collection containers. In some embodiments, the first volume of blood may be collected in the first blood collection container 70a and / or one or more other blood collection containers. In some embodiments, the second volume of blood may be collected in the second blood collection container 70b and / or one or more other blood collection containers. In some embodiments, the third volume of blood may be collected in the third blood collection container 70c and / or one or more other blood collection containers.

[0066] In some embodiments, the distal ends 50 of one or more of the first tubular device 48, the second tubular device 62, and the third tubular device 68 may include one or more side holes 72, which may facilitate blood flow through the catheter 14 proximal to the thrombus. In some embodiments, the distal ends of one or more of the first tubular device 48, the second tubular device 62, and the third tubular device 68 may be closed and / or include a slit.

[0067] In some embodiments, the side holes 72 in the first tubular device 48 may be within a first distance or within a particular distance that the distal tip 16 extends beyond the catheter 14. In some embodiments, the side holes 72 in the second tubular device 62 may be within a second distance or within a particular distance that the distal tip 16 extends beyond the catheter 14. In some embodiments, the side holes 72 in the third tubular device 68 may be within a second distance or within a particular distance that the distal tip 16 extends beyond the catheter 14.

[0068] In some embodiments, one or more of first tubular device 48, second tubular device 62, and third tubular device 68 may be resistant to occlusion or thrombosis because the slits may be closed and blood may not be allowed to diffuse into the corresponding tubular device under normal physiological pressure. In some embodiments, distal end 50 may comprise a distal opening.

[0069] In some embodiments, the difference between the first distance and the second distance and the difference between the second distance and the third distance may increase the likelihood of elongation through a thrombus and establishment of a fluid pathway through the catheter assembly. In some embodiments, one or more particular delivery devices in addition to the first delivery device 44, the second delivery device 58, and the third delivery device 64 may be coupled to the catheter assembly 20 without removing the catheter 14 from the patient. In some embodiments, the particular delivery device inserted through the indwelling catheter 14 becomes increasingly longer over time, which may increase the likelihood of establishing a fluid pathway through the catheter assembly 20, allowing for blood collection and / or reducing thrombosis.

[0070] In some embodiments, the first delivery device 44 may include a first marking 74a, which may be disposed on the outer surface of the first housing 46. In some embodiments, the second delivery device may include a second marking 74b, which may be disposed on the outer surface of the second housing 60. In some embodiments, the third delivery device may include a third marking 74c, which may be disposed on the outer surface of the third housing 66. In some embodiments, the first marking 74a, the second marking 74b, and the third marking 74c may comprise one or more lines, indentations, grooves, text, colors, or other suitable markings.

[0071] In some embodiments, one or more of the first marking 74a, the second marking 74b, and the third marking 74c may comprise a time for using the corresponding delivery device. For example, the first marking 74a may comprise "first day" or "first blood draw." In another example, the second marking 74b may comprise "second day" or "second blood draw." In a further example, the third marking 74c may comprise "third day" or "third blood draw." In some embodiments, the first marking 74a, the second marking 74b, and / or the third marking 74c may indicate a time for using the corresponding delivery device relative to one another.

[0072] In some embodiments, the first housing 46 may include another marking 76a. In some embodiments, the first delivery device 44 may include a slider 41, which may be coupled to the first tubular instrument 48. In some embodiments, the slider may be associated with another marking 76a in response to the distal surface 56 of the first tubular instrument 48 flushing with the distal tip 16 of the catheter 14. Thus, in some embodiments, the another marking 76a may indicate to the physician that in response to further distal advancement of the first tubular instrument 48, the first tubular instrument 48 will extend distally to the distal tip 16 of the catheter 14.

[0073] In some embodiments, the second housing 60 may include another marking 76b. In some embodiments, the second delivery device 58 may include a slider 41 that may be coupled to the second tubular device 62. In some embodiments, the slider 41 may be associated with another marking 76b in response to the distal surface 56 of the second tubular device 62 flushing with the distal tip 16 of the catheter 14. Similarly, in some embodiments, the third housing 64 may include another marking 76c. In some embodiments, the third delivery device may include a slider 41 that may be coupled to the third tubular device 68. In some embodiments, the slider 41 may be associated with another marking 76c in response to the distal surface 56 of the third tubular device 68 flushing with the distal tip 16 of the catheter 14.

[0074] In some embodiments, the third housing 66 may be longer than the second housing 60, which may be longer than the first housing. Thus, the third tubular instrument 68 may be longer than the second tubular instrument 62 and the first tubular instrument 48 and may be contained within the third housing 66 prior to distal advancement. Similarly, in some embodiments, the second tubular instrument 62 may be contained within the second housing 60 prior to distal advancement, and the first tubular instrument 48 may be contained within the first housing 46 prior to distal advancement.

[0075] 4, in some embodiments, delivery device 80 may comprise a housing 82 and a tubular implement 84. In some embodiments, housing 82 may comprise one or more of the following: a first marking 86, a second marking 88, a third marking 90, and a slot 45. In some embodiments, first marking 86, second marking 88, and third marking 90 may comprise one or more lines, indentations, grooves, text, color, or another suitable marking.

[0076] In some embodiments, the first marking 86 may be proximal to the second marking 88. In some embodiments, the delivery device 80 may include a tubular device 84, which may include a distal end 50, a proximal end 43, and a lumen. In some embodiments, the proximal end of the tubular device may be secured within the housing 82. In some embodiments, the slider 41 may be coupled to the tubular device 82 and may be slidable along the slot 45 in the housing 82. In some embodiments, the slider 41 may include an advancement tab that may be grasped by the physician to advance and / or retract the tubular device.

[0077] In some embodiments, in response to advancing the slider 41 distally from the proximal position to the first marking 86, the distal surface 56 of the distal end 50 of the tubular instrument 84 may be positioned a first distance beyond the distal end 32 of the housing 82 or a first distance beyond the distal tip 16 of the catheter 14. In some embodiments, in response to advancing the slider 41 distally from the proximal position to the second marking 88, the distal surface 56 of the distal end 50 of the tubular instrument may be positioned a second distance beyond the distal end of the housing or a second distance beyond the distal tip 16 of the catheter 14.

[0078] In some embodiments, the second distance beyond the distal end 50 of the housing 82 may be greater than the first distance beyond the distal end 32 of the housing 82. As noted above, in some embodiments, the second distance beyond the distal tip 16 of the catheter 14 may be greater than the first distance beyond the distal tip 16 of the catheter 14.

[0079] In some embodiments, in response to advancing the slider 41 distally from the proximal position to the third marking 90, the distal surface 56 of the distal end of the tubular instrument 84 may be positioned a third distance beyond the distal end 32 of the housing 82. In some embodiments, the third distance may be greater than the second distance. In some embodiments, the third distance beyond the distal end 32 of the housing 82 may be greater than the second distance beyond the distal end 32 of the housing 82. As noted above, in some embodiments, the third distance beyond the distal tip 16 of the catheter 14 may be greater than the second distance beyond the distal tip 16 of the catheter 14.

[0080] In some embodiments, different blood collection containers or the same blood collection container may be used to draw blood via delivery device 80 or any other delivery device of the present disclosure. In some embodiments, slider 41 may advance distally from a proximal position to first marking 86 at a first time interval for a first blood collection. In some embodiments, slider 41 may advance distally from first marking 86 to second marking 88 at a second time interval after the first time interval. In some embodiments, slider 41 may advance distally from second marking 88 to third marking 90 at a third time interval after the second time interval. In some embodiments, the first time interval may correspond to approximately one day. In some embodiments, the second and third time intervals may correspond to approximately two and three days, respectively. In some embodiments, the first, second, and third time intervals may correspond to any suitable time intervals from insertion of catheter 14 into the vasculature.

[0081] All examples and conditional language used herein are intended for educational purposes to aid the reader in understanding the present invention and the concepts of the inventor's contributions beyond the prior art, and should be construed without being limited to such specific examples and conditions. Although embodiments of the present invention have been described in detail, it should be understood that various changes, substitutions, and alterations can be made without departing from the spirit and scope of the present invention.

Claims

1. A blood collection kit comprising a first delivery device and a second delivery device, The first delivery device a first housing and a first tubular device; a distal end of the first housing comprising a first adapter configured to couple to a catheter assembly; the first tubular device having a distal end, a proximal end, and a lumen extending between the distal end of the first tubular device and the proximal end of the first tubular device, the proximal end of the first tubular device being secured within the first housing, the first tubular device being disposed to be distally advanced from a proximal position to a distal position relative to the first housing and the catheter assembly; in response to the first tubular instrument being advanced distally from a proximal position to a distal position relative to the first housing, a distal surface of a distal end of the first tubular instrument is disposed a first distance beyond the distal end of the first housing; The second delivery device a second housing and a second tubular device; a distal end of the second housing comprising a second adapter configured to couple to a catheter assembly; the second tubular instrument has a distal end, a proximal end, and a lumen extending between the distal end of the second tubular instrument and the proximal end of the second tubular instrument, the proximal end of the second tubular instrument being secured within the second housing, the second tubular instrument being disposed to be distally advanced relative to the second housing and the catheter assembly from a proximal position to a distal position; in response to the second tubular instrument being advanced distally from a proximal position to a distal position relative to the second housing, a distal surface of a distal end of the second tubular instrument is disposed a second distance beyond the distal end of the second housing; The second distance is greater than the first distance.

2. 2. The blood collection kit of claim 1, wherein the distal ends of the first tubular device and the second tubular device are closed.

3. The blood collection kit of claim 1 , wherein the distal end of the first tubular device and the distal end of the second tubular device are provided with a plurality of side holes.

4. Further comprising a third delivery device; the third delivery device comprises a third housing and a third tubular device; a distal end of the third housing comprising a third adapter configured to couple to a catheter assembly; the third tubular instrument has a distal end, a proximal end, and a lumen extending between the distal end of the third tubular instrument and the proximal end of the third tubular instrument, the proximal end of the third tubular instrument being secured within the third housing, the third tubular instrument being disposed to be distally advanced relative to the third housing and the catheter assembly from a proximal position to a distal position; in response to the third tubular instrument being advanced distally from a proximal position to a distal position relative to the third housing, a distal surface of a distal end of the third tubular instrument is disposed a third distance beyond the distal end of the third housing; The blood collection kit of claim 1 , wherein the third distance is greater than the second distance.

5. The first housing has a first marking, a second marking, and a slot, the first marking being proximal to the second marking; the first delivery device further comprises a slider; 2. The blood collection kit of claim 1, wherein the slider is coupled to the tubular device and is slidable along the slot of the first housing, such that advancing the slider moves a distal end of the first tubular device.

6. A blood collection kit as described in claim 5, wherein the difference between the first marking and the second marking is 0.5 inches.

7. 2. The blood collection kit of claim 1, wherein the first distance is one inch or less.

8. 8. The blood collection kit of claim 7, wherein the second distance is 1.5 inches or less.

9. A blood collection kit as described in claim 5, wherein the first housing has a third marking distal to the second marking.

10. 10. The blood collection kit of claim 9, wherein the distal end of the tubular device is flush with the distal tip of the catheter in response to the slider engaging with the first marking, the second marking, the third marking or another marking on the housing.

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