Drug delivery system and method of use

Abstract

The medical device includes a handle for carrying a drug having particles therein and a receiver having a first lumen defined by a first end and a second end. The receiver has an axis extending between the first end and the second end. The first end is configured to receive the particles from the handle, and the second end communicates with a second lumen having a cross-sectional dimension smaller than the cross-sectional dimension of the first lumen. Each of the cross-sectional dimensions of the first lumen and the second lumen is measured transverse to the axis. The second end is configured to receive the particles from the first end of the receiver. The second lumen is configured to control delivery of the drug to a delivery tube communicating with the second lumen based on the size of the particles.

Description

[Technical field]

[0001] Various aspects of the present disclosure relate generally to drug delivery systems, devices, and associated methods. In embodiments, the present disclosure relates to systems, devices, and associated methods for delivering therapeutic drugs, such as to a targeted treatment site. [Background technology]

[0002] In certain medical procedures, it may be necessary to stop or minimize bleeding within the body. For example, endoscopic medical procedures may require hemostasis of bleeding tissue within the gastrointestinal tract, such as the esophagus, stomach, or intestines.

[0003] During endoscopic surgery, a user inserts the shaft of the endoscope into a body lumen of a patient. The user uses the handle of the endoscope to control the endoscope during the procedure. Tools are passed through the working channel of the endoscope, for example, through ports in the handle, to deliver treatment at a surgical site near the distal end of the endoscope, which is distant from the operator.

[0004] To achieve hemostasis at a remote location, a hemostatic agent may be delivered. Delivery of the agent may be achieved, for example, by using a pressurized fluid system. However, such systems may make it difficult to control the delivery rate or particle size of the agent delivered to the target treatment site. Thus, the desired delivery rate or size of the delivered agent may not be achieved, the amount of agent delivered may be inconsistent, the agent may clog portions of the delivery device, and / or the agent may not reach the treatment site deep within the GI tract. Summary of the Invention

[0005] Aspects of the present disclosure relate, inter alia, to systems, devices, and methods for the delivery of various sized medicaments, etc. Each aspect disclosed herein may include one or more of the described features associated with some of the other disclosed aspects.

[0006] According to one example, a medical device may include a handle for carrying a drug having particles and a receiver having a first lumen defined by a first end and a second end. The receiver has an axis extending between the first end and the second end. The first end is configured to receive the particles from the handle and the second end communicates with a second lumen having a cross-sectional dimension smaller than a cross-sectional dimension of the first lumen. The cross-sectional dimensions of each of the first lumen and the second lumen are measured across the axis. The second end is configured to receive the particles from the first end of the receiver. The second lumen is configured to control delivery of the drug to a delivery tube communicating with the second lumen based on the size of the particles.

[0007] Some of the medical devices described herein may include any of the following features: The handle may include an enclosure for storing the agent and a filter mechanism disposed within the enclosure, the filter mechanism configured to inhibit at least a portion of the agent from being delivered to the receiver based on the size of the particle. The first end includes a third lumen having a cross-sectional dimension, measured across the axis, smaller than a cross-sectional lumen of the first lumen and larger than a cross-sectional lumen of the second lumen. The first lumen is disposed between the second lumen and the third lumen, the third lumen communicating with the second lumen via the first lumen. The second lumen is defined by and extends through the second end, and the third lumen is defined by and extends through the first end. The second end of the receiver includes an interface adjacent to the first lumen and configured to control delivery of the agent from the first lumen to the second lumen based on the size of the particle. The interface at the second end is a plane extending across the first lumen and defines an opening disposed along the plane in communication with the second lumen. The interface at the second end is a tapered surface defining an opening in communication with the second lumen. The length of the first lumen along the axis is greater than the length of each of the second lumen and the third lumen along the axis. The receiver is configured to mix the agent in the first lumen and separate the particles based on the size of the particles. The second end of the receiver is configured to receive any of the particles in the second lumen when the size of the particles is equal to or less than a predetermined size. The medical device further includes a plunger at least partially disposed within the enclosure, the plunger configured to move relative to the enclosure to move the agent within the enclosure. The plunger is configured to deliver a pressurized medium into the enclosure to move the agent toward the second end of the receiver.The medical device further includes a handle coupled to the plunger, the handle configured to control movement of the plunger relative to the enclosure to control delivery of the agent from the enclosure to the receiver.

[0008] According to another example, a medical device may include an enclosure for storing a drug having particles, a delivery tube, and a receiver disposed between and in communication with the enclosure and the delivery tube. The receiver has a longitudinal axis. The receiver includes a first lumen having a first cross-sectional dimension and a second lumen having a second cross-sectional dimension smaller than the first cross-sectional dimension. The cross-sectional dimensions of each of the first lumen and the second lumen are measured across the longitudinal axis. The first lumen is configured to capture particles of the drug having a first size received from the enclosure, and the second lumen is configured to deliver particles of the drug having a second size to the delivery tube. The second size is smaller than the first size.

[0009] Any of the medical devices described herein may include any of the following features: the second lumen is configured to inhibit delivery of particles of the agent having the first size to the delivery tube; the medical device further includes a ratchet configured to control an amount of the agent delivered from the enclosure to the receiver in response to actuation of a handle; the medical device further includes a plunger at least partially disposed within the enclosure, the plunger being movable relative to the enclosure, and the ratchet configured to control movement of the plunger into the enclosure; the plunger includes a nozzle tip that displaces a pressurized medium toward the agent stored in the enclosure to deliver the particles to the receiver.

[0010] According to another embodiment, a method for delivering a drug via a medical device including an enclosure, a receiver, and a delivery tube may include delivering the drug stored in the enclosure to a first lumen of the receiver. The drug is delivered in response to activation of a pressure source in communication with the enclosure. The method may include delivering particles of the drug having a size less than a predetermined size to a second lumen of the receiver, and delivering the particles of the drug having the size less than the predetermined size from the second lumen to the delivery tube.

[0011] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention as claimed. [Brief description of the drawings]

[0012] The accompanying drawings are incorporated in and constitute a part of this specification and together with the description illustrate exemplary aspects of the disclosure and serve to explain the principles of the disclosure.

[0013] [Figure 1] 1 is a side view of an exemplary medical device according to aspects of the present disclosure.

[0014] [Diagram 2] 2 is a perspective view of an exemplary receiver of the medical device of FIG. 1 including a recess interface according to an embodiment of the present disclosure.

[0015] [Diagram 3] 3 is a cross-sectional view of the receiver of FIG. 2 according to an embodiment of the present disclosure.

[0016] [Figure 4A] 10 is a perspective view of another exemplary receiver of the medical device of FIG. 1 including a protruding interface according to an embodiment of the present disclosure.

[0017] [Figure 4B]10 is a perspective view of another exemplary receiver of the medical device of FIG. 1 including a flat interface according to an embodiment of the present disclosure.

[0018] [Diagram 5] FIG. 4C is a side view of another exemplary medical system including the receiver of FIGS. 2-4B according to an embodiment of the present disclosure.

[0019] [Figure 6A] 6 is a partial perspective view of an exemplary plunger device of the medical system of FIG. 5 including a rounded tip, according to an embodiment of the present disclosure.

[0020] [Figure 6B] 6 is a partial perspective view of another exemplary plunger device of the medical system of FIG. 5 including a rounded nozzle, according to an embodiment of the present disclosure.

[0021] [Figure 6C] 6 is a partial perspective view of an exemplary plunger device of the medical system of FIG. 5 including a flat nozzle, according to an embodiment of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0022] The present disclosure relates, among other aspects, to systems, devices, and methods for endoscopic delivery of, for example, hemostatic agents. Reference will now be made in detail to aspects of the present disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numerals are used within the drawings to refer to the same or similar parts. The term "distal" refers to the part of the device that is furthest from the user when introduced into a patient. In contrast, the term "proximal" refers to the part of the device that is closest to the user when placed within a patient. As used herein, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, and a process, method, article, or device that comprises a list of elements does not necessarily include only those elements, but may include other elements not expressly described or inherent in such process, method, article, or device. The term "exemplary" is used to mean "example" rather than "ideal." As used herein, the terms "about," "substantially," and "approximately" indicate a range of values ​​within + / - 10% of a given numerical value.

[0023] Embodiments of the present disclosure may be used to deliver a substance to a bleeding target treatment site to achieve hemostasis or delivery of a therapeutic agent. For example, a hemostatic agent in the form of a powder may be delivered to treat gastrointestinal bleeding by a medical device including a receiver having a first lumen configured to receive particles of the powder. In some embodiments, the first lumen communicates with a second lumen having a cross-sectional dimension smaller than the cross-sectional dimension of the first lumen. In some embodiments, the second lumen is configured to control delivery of the powder to a delivery tube communicating with the second lumen based on the size of the particles. Embodiments of the present disclosure are not limited to such devices and methods, but may instead relate to devices and methods for performing various medical procedures and / or treating the large intestine (colon), small intestine, cecum, esophagus, any other portion of the gastrointestinal tract, and / or any other suitable patient anatomical structure (collectively referred to herein as a "target treatment site"). Various embodiments described herein include single-use or disposable medical devices.

[0024] In one example, a medical system for delivering a hemostatic substance / agent may include a receiver for receiving the agent and directing the agent to a catheter or other tube for delivery to a target treatment site within a subject. In an embodiment, the receiver may allow delivery of the agent to a subject with a desired particle size and inhibit delivery to a subject with an undesired particle size. The receiver may include a funnel having a configuration configured to facilitate movement of a portion of the agent at a desired particle size while retaining a portion of the agent within the receiver at an undesired particle size. The funnel configuration may include a flat surface, a concave surface, or a convex surface that impinges on the flow of the agent. Reference will now be made in detail to the examples of the present disclosure described above and illustrated in the accompanying drawings. Wherever possible, the same reference numbers are used throughout the drawings to indicate the same or similar parts.

[0025] 1 illustrates a side view of an exemplary medical device 100 according to an example of the present disclosure. The medical device 100 may include an insert portion 102, a proximal portion 110, and a receiver 120. In some embodiments, the insert portion 102 of the medical device 100 may include a catheter, an endoscope, a tube, or the like, for delivering a substance to a target treatment site within a patient. The proximal portion 110 may have a body 111 defined by a distal end 112 and a proximal end 114, and the distal end 112 of the proximal portion 110 may have a port 116 for coupling one or more components of the medical device 100, such as the receiver 120, to the proximal portion 110.

[0026] The proximal end 114 of the proximal portion 110 may include a handle 118 sized and shaped to be manually grasped by a user of the proximal portion 110, for example, during surgery. It should be understood that the sizes, shapes, contours and / or configurations of the insertion portion 102 and / or proximal portion 110 shown and described herein are merely illustrative and that they may include various other suitable arrangements without departing from the scope of the present disclosure.

[0027] With further reference to FIG. 1 , the proximal portion 110 of the medical device 100 may further include an enclosure 119 sized and shaped to store one or more components of the proximal portion 110 herein. In an embodiment, the enclosure 119 is disposed adjacent the distal end 112 of the body 111, although it should be understood that the enclosure 119 may be disposed at various other locations along the body 111. Additionally and / or alternatively, in other embodiments, the enclosure 119 may be disposed within the body 111, e.g., one or more components stored within the enclosure 119. By way of example, the enclosure 119 of the proximal portion 110 may include a container (not shown) for storing one or more substances, e.g., a drug. The drug may include, for example, a therapeutic agent capable of clotting blood, such as a hemostatic powder. In other embodiments, the drug may include various other materials and / or substances suitable for delivery.

[0028] As a further example, the body 111 of the proximal portion 110 may include a pressurized medium source (not shown) that stores a pressurized medium, e.g., a pressurized fluid. The pressurized fluid may be compressed air / gas, e.g., carbon dioxide (CO 2 ). The pressurized medium source may include a compressed air system, e.g., a pressurized cylinder. As described in more detail herein, the pressurized medium source may be configured to supply pressurized medium to a container in the enclosure 119 for mixing one or more substances (e.g., medicaments) stored in the container and / or for dispensing the substances to one or more other components of the medical device 100. Examples of one or more components included in the proximal portion 110 of the medical device 100 may follow at least some of the teachings of U.S. Patent Application No. 62 / 957,519, filed January 6, 2020, entitled "Devices and Methods for Delivering Powdered Medication," the disclosure of which is incorporated herein by reference.

[0029] 1 , the receiver 120 may be disposed at the distal end 112 of the proximal portion 110 and may be coupled to the body 111 via the port 116. In this case, the receiver 120 is in communication with one or more components of the proximal portion 110, such as a reservoir of the enclosure 119 and / or a source of pressurized medium. The insert 102 may be coupled to the receiver 120 at the opposite end of the port 116 and may be in communication with one or more components of the proximal portion 110 via the receiver 120 disposed therebetween.

[0030] 2, an exemplary schematic diagram of a receiver 120A is shown. The receiver 120A may include a sheath 130, a proximal end 133, and a distal end 134A defined by a wall 137. The wall 137 may be cylindrical or any other suitable shape. The sheath 130 defines a main lumen 132 extending between the proximal end 133 and the distal end 134A. In an example, at least a portion of the proximal end 133 and the distal end 134A may be at least partially disposed within the main lumen 132 of the sheath 130. The receiver 120A further includes an entry head 122 at the proximal end 133 of the sheath 130, the entry head 122 defining an opening 124. In an example, the entry head 122 extends proximally relative to the proximal end 133 of the receiver 120A, and the entry head 122 is disposed outside the main lumen 132 of the sheath 130.

[0031] The receiver 120A may further include a knob 126 at the proximal end 133. In examples, the knob 126 may be disposed between the entry head 122 and the proximal end 133. In some examples, the knob 126 may be integral with the entry head 122, where the knob 126 and the entry head 122 may form a unitary structure, while in other examples, the knob 126 may be a separate component from the entry head 122. The receiver 120A may further include one or more threads 128 disposed on an outer periphery of the entry head 122. In this case, the one or more threads 128 extend around the periphery of the opening 124.

[0032] 2, the knob 126 may include one or more grippable features (e.g., recesses, protrusions, etc.) thereon for manually manipulating the receiver 120A. When the knob 126 is secured to the inlet head 122, the knob 126 may be configured to rotate the inlet head 122 in response to actuation (e.g., rotation) of the knob 126 relative to one or more components of the medical device 110, such as the proximal portion 110. It should be appreciated that when the inlet head 122 is received within the port 116, the knob 126 may be connectable (and disconnectable) to the receiver 120A from the proximal portion 110 of the medical device 100 by pivotally engaging (and disengaging) one or more threads 128 with corresponding threads (not shown) of the body 111. In an example, the inlet head 122 of the receiver 120A may include a male luer connector for connecting with a corresponding female luer connector disposed in the port 116 of the proximal portion 110. In this case, with the inlet head 122 coupled to the port 116, the opening 124 may be in communication with one or more components of the proximal portion 110, such as a reservoir, a source of pressurized medium, etc.

[0033] 3, the receiver 120A may be coupled to the insertion section 102 of the medical device 100 at a distal end 134A. The main lumen 132 of the sheath 130 may be in communication with a proximal lumen 131 at the proximal end 133, an inlet lumen 135 of the inlet head 122, and a distal lumen 139 at the distal end 134A. In this case, the opening 124 of the inlet head 122 may be in communication with the inlet lumen 135, with the inlet lumen 135 in communication with the main lumen 132 of the sheath 130 via the proximal lumen 131 at the proximal end 133. The longitudinal length of the receiver 120A may define a longitudinal axis (not shown) extending between the proximal end 133 and the distal end 134A.

[0034] It should be understood that the proximal lumen 131 at the proximal end 133 may have a first cross-sectional dimension, the distal lumen 139 at the distal end 134A may have a second cross-sectional dimension, and the inlet lumen 135 at the inlet head 122 may have a third cross-sectional dimension. In an example, the cross-sectional dimensions of the proximal lumen 131, the distal lumen 139, and the inlet lumen 135 may be transverse to the longitudinal axis of the receiver 120A. In an example, the length along the longitudinal axis of the main lumen 132 is greater than the length along the longitudinal axis of each of the proximal lumen 131, the distal lumen 139, and / or the inlet lumen 135.

[0035] In examples, the first cross-sectional dimension of the proximal lumen 131 can be different than the second cross-sectional dimension of the distal lumen 139 and / or the third cross-sectional dimension of the inlet lumen 135. For example, the first cross-sectional dimension of the proximal lumen 131 can be relatively larger than the second cross-sectional dimension of the distal lumen 139 and / or the third cross-sectional dimension of the inlet lumen 135. Further, in some examples, the third cross-sectional dimension of the inlet lumen 135 can be relatively larger than the second cross-sectional dimension of the distal lumen 139.

[0036] As a further example, each of the first cross-sectional dimension of the proximal lumen 131, the second cross-sectional dimension of the distal lumen 139, and / or the third cross-sectional dimension of the inlet lumen 135 can be different from a cross-sectional dimension of the main lumen 132 of the sheath 130. In an example, the cross-sectional dimension of the main lumen 132 can be relatively larger than the first cross-sectional dimension of the proximal lumen 131, the second cross-sectional dimension of the distal lumen 139, and / or the third cross-sectional dimension of the inlet lumen 135, respectively. In some embodiments, the main lumen 132 can include a diameter in the range of about 0.4 inches (1.0 cm) to about 0.6 inches (1.5 cm), e.g., 0.5 inches (1.3 cm). Additionally, the main lumen 132 can include a longitudinal length in the range of about 0.9 inches (2.3 cm) to about 1.1 inches (2.8 cm), e.g., 1.0 inches (2.5 cm).

[0037] 3, the lumen 104 of the insert 102 may communicate with the main lumen 132 of the sheath 130 via a distal lumen 139 at the distal end 134A when the insert 102 is coupled to the receiver 120A at the distal end 134A. As described in further detail herein, the lumen 104 of the insert 102 may include a cross-sectional dimension sized and shaped to receive particles of a drug having a predetermined size stored in a reservoir in the enclosure 119. For example, in an embodiment in which the particles of the drug may be approximately 325 μm to approximately 425 μm in size, the lumen 104 of the insert 102 may be approximately 0.05 inches (0.13 cm) in diameter. As a further example, in an embodiment in which the particles of the drug may be approximately 500 μm to approximately 600 μm in size, the lumen 104 of the insert 102 may be approximately 0.08 inches (0.20 cm) in diameter. In some examples, the second cross-sectional dimension of the distal lumen 139 can be at least equal to or less than the cross-sectional dimension of the lumen 104 of the insert 102 .

[0038] 2 and 3, the distal end 134A of the receiver 120A can include an interface 136A and an opening 138A. In an example, the interface 136A defines a proximal surface of the distal end 134A that can be disposed within the main lumen 132 of the sheath 130. The opening 138A can be disposed along the interface 136A of the distal end 134A and can be in communication with a distal lumen 139 of the distal end 134A. In an example, the interface 136A, the opening 138A, and / or the distal lumen 139 of the distal end 134A can include a size, shape, and / or structure that can be configured to inhibit delivery of one or more substances (or portions thereof) from the sheath 130 to one or more components of the medical device 100, such as the insertion portion 102. Additionally and / or alternatively, the interface 136A, the opening 138A, and / or the distal lumen 139 may include a size, shape, and / or structure that may be configured to allow delivery of one or more other substances (or portions thereof) from the sheath 130 to one or more other components of the medical device 100, such as the insertion portion 102.

[0039] In an example, the interface 136A of the distal end 134A can be a concave surface that extends distally away from the proximal end 133 of the receiver 120A. For example, the distal end 134A can have a concave, recessed, dimpled, funneled, and / or concave structure that defines the interface 136A. In this case, when the opening 138A is located in the center of the interface 136A, a cross-sectional dimension (e.g., diameter) of the interface 136A adjacent the opening 138A can be smaller than a cross-sectional dimension (e.g., diameter) of the interface 136A relatively far from the opening 138A. As a result, it should be understood that the interface 136A of the distal end 134A is relatively wider along a portion proximate the proximal end 133 than an opposing portion proximate the opening 138A and / or the insert 102.

[0040] 2 and 3, the interface 136A of the distal end 134A may be configured to control the amount of a substance (e.g., a drug) that may be received in the sheath 130 and delivered to the insert 102 through the distal lumen 139 of the distal end 134A. In this case, the interface 136A may control the amount of the substance delivered based on the size of the drug-containing particles. The surface structure of the interface 136A may guide and / or move particles having a predetermined size from the main lumen 132 of the sheath 130 toward the opening 138A and into the lumen 104 of the insert 102. Additionally, the surface structure of the interface 136A may inhibit delivery into the lumen 104 of particles of a drug that do not have a predetermined size that are received in the sheath 130 and through the opening 138A into the lumen 104.

[0041] The opening 138A and / or the distal lumen 139 of the distal end 134A may be further configured to control the amount of the substance received by the sheath 130 and delivered to the insert 102 based on the size of the particles of the agent. For example, the cross-sectional dimension of the opening 138A and / or the distal lumen 139 may facilitate the delivery of particles of the agent having a predetermined size while inhibiting the delivery of particles of the agent not having the predetermined size from the main lumen 132 to the lumen 104 of the insert 102. In an example, the predetermined size of the particles may include a predetermined relationship between the cross-sectional dimension of the particles to the cross-sectional dimension of the lumen 104 of the insert 102. For example, the predetermined cross-sectional size of the particles may be approximately ⅓, ¼, ⅕, ⅙, ⅛, ⅛, ⅓, ⅛, ⅜, ⅜, ⅜, or less than the cross-sectional dimension of the lumen 104 of the insert 102, or may be smaller than the cross-sectional dimension of the lumen 104 of the insert 102. In other examples, the predetermined size may include various other suitable cross-sectional dimensions for the insert 102 .

[0042] According to an exemplary method of use of the medical device 100, a substance may initially be stored in a container of the enclosure 119, and the receiver 120A may be connected to the body 111 of the proximal portion 110 via the port 116. In this case, the inlet head 122 may be received in the port 116, and one or more threads 128 may mate with corresponding threads at the port 116. The threads 128 may be engaged with the body 111 of the proximal portion 110 in response to actuation (e.g., rotation) of the knob 126. Additionally, the insert 102 may be connected to the receiver 120A at a distal end 134A, and the lumen 104 of the insert 102 may be connected to the container of the enclosure 119 via the proximal lumen 131, the main lumen 132, and the distal lumen 139.

[0043] In this case, when the pressurized medium source of the proximal portion 110 is actuated, the pressurized medium can be delivered to the container of the enclosure 119. The pressurized medium can displace a substance stored in the container therein, thereby creating a mixture of substances. In an example, the substance can be a drug (e.g., a hemostatic powder) comprising a plurality of particles having various sizes and / or shapes. It should be understood that each of the plurality of particles can have a different structure from one another, including spherical, irregular, and / or asymmetrical contours. Actuation of the pressurized medium source of the medical device 110 can create a change in pressure within the container of the enclosure 119 that can displace the drug from the container to the receiver 120A via the port 116.

[0044] In an example, particles of drug are delivered through inlet head 122 into proximal lumen 131 at proximal end 133 and received within main lumen 132 of sheath 130. Once the particles of drug are received within sheath 130, receiver 120A may provide a further mixture of drug within main lumen 132. Upon entering sheath 130 of receiver 120A via proximal end 133, the particles of drug may travel within main lumen 132 and towards distal end 134A. In this case, the particles may encounter interface 136A at distal end 134A and, depending on the size of the particle, may be received through opening 138A or may deflect proximally (e.g., back) into main lumen 132 and back towards proximal end 133. In other words, the receiver 120A of the medical device 100 may be configured to mix, fractionate, and / or sort the agents within the sheath 130 based on the cross-sectional dimension, size, and / or shape of the particles.

[0045] As an example, the interface 136A of the distal end 134A can be configured to inhibit entry of one or more particles of the agent into the opening 138A and the distal end 139 when the particles have a size greater than a predetermined size. In an example, the predetermined size of the particles can include a predetermined cross-sectional dimension that is approximately ⅓, ¼, ⅕, ⅙, ⅛, ⅛, ⅜ ...

[0046] By facilitating delivery of a portion of the particles of the agent having a predetermined size through the opening 138A and the distal lumen 139, the receiver 120A may minimize clogging of the lumen 104 of the insert 102 during a procedure. In this case, the interface 136A, the opening 138A, and / or the distal lumen 139 of the distal end 134A may (e.g., individually and / or collectively) reduce delivery of excessive particles within the insert 102, thereby reducing instances of clogging of the lumen 104 and / or damage to the subject (e.g., patient). As a result, it should be appreciated that the receiver 120A in communication between the insert 102 and the proximal portion 110 may allow a predetermined portion of the substance (e.g., particles of the agent having a predetermined size) stored in the container of the enclosure 119 to be delivered by the medical device 100 to a target treatment site within the subject.

[0047] When the cross-sectional dimension of the proximal lumen 131 is relatively smaller in size than the cross-sectional dimension of the main lumen 132, particles of drug that are received by the sheath 130 and do not fit a predetermined size limit may be retained and / or stagnated within the main lumen 132 between the proximal end 133 and the distal end 134. In other words, the portion of the particles of drug that do not have a predetermined size and that stray from the distal end 134A towards the proximal end 133 are inhibited from being delivered through the proximal end 133 by the flow of incoming fluid moving through the inlet lumen 135 towards the main lumen 132.

[0048] In some instances, at least a portion of the particles that do not fit the predetermined size constraints may be deposited along the bottom (or other surface) of the sheath 130. In this case, the particles deposited within the main lumen 132 of the sheath 130 may form a fixed and / or stationary layer of material within the receiver 120A. It should be understood that the cross-sectional dimension of the proximal lumen 131 at the proximal end 133 may be larger than all or substantially all of the particles received within the main lumen 132 of the sheath 130.

[0049] 4A, another exemplary receiver 120B is shown in accordance with an example of the present disclosure. Except as otherwise specified below, the receiver 120B may be substantially similar to the receiver 120A described above, and similar reference numbers are used to identify similar components. It should be understood that the receiver 120B may be configurable and operable similarly to the receiver 120A, and that the receiver 120B may be readily incorporated into the medical device 100 described above.

[0050] For example, the receiver 120B can include a distal end 134B disposed along an end opposite the proximal end 133 of the sheath 130. The distal end 134B can be at least partially disposed within the main lumen 132 of the sheath 130 and can include an interface 136B and an opening 138B. The interface 136B can define a proximal surface of the distal end 134B, and the opening 138B can be disposed along the interface 136B. The opening 138B can be in communication with a distal lumen (similar to distal lumen 139) of the distal end 134B. In examples, the interface 136B, the opening 138B, and / or the distal lumen of the distal end 134B can include a size (e.g., cross-sectional size), shape, and / or configuration that can be configured to inhibit delivery of one or more substances (or portions thereof) from the sheath 130 to the insertion portion 102. Additionally and / or alternatively, the interface 136B, the opening 138B, and / or the distal lumen of the distal end 134B may include a size (e.g., cross-sectional size), shape, and / or structure that may be configured to allow delivery of one or more other substances (or portions thereof) from the sheath 130 to the insertion portion 102.

[0051] In an example, the interface 136B of the distal end 134B may have a protruding surface that tapers proximally toward the proximal end 133 of the receiver 120B. In other words, the distal end 134B may be elongated, cone-shaped, and / or have an expanded structure to define the interface 136B. In some examples, the interface 136B may be configured to control the amount of a substance (e.g., a drug) received in the sheath 130 through the distal lumen of the distal end 134B and delivered to the insertion portion 102. In this case, the interface 136B may control the amount of the substance delivered based on the size of the particles including the drug. The structure of the interface 136B may guide and / or move particles having a predetermined size from the main lumen 132 of the sheath 130 toward the opening 138B and into the lumen 104 of the insertion portion 102. Additionally, the structure of interface 136B may inhibit delivery of particles of drug that are received by sheath 130 and do not have a predetermined size from being received into lumen 104 through opening 138B.

[0052] 4B, another exemplary receiver 120C is shown in accordance with an example of the present disclosure. Except as otherwise specified below, receiver 120C can be substantially similar to receiver 120A described above, and similar reference numbers are used to identify similar components. It should be understood that receiver 120C can be configured and operable similarly to receiver 120A, and that receiver 120C can be readily incorporated into medical device 100 described above.

[0053] For example, the receiver 120C can include a distal end 134C disposed along an end opposite the proximal end 133 of the sheath 130. The distal end 134C can be at least partially disposed within the main lumen 132 of the sheath 130 and can include an interface 136C and an opening 138C. The interface 136C can define a proximal surface of the distal end 134C, and the opening 138C can be disposed along the interface 136C. The opening 138C can be in communication with a distal lumen (similar to the distal lumen 139) of the distal end 134C. In examples, the interface 136C, the opening 138C, and / or the distal lumen of the distal end 134C can include a size (e.g., cross-sectional size), shape, and / or configuration that can be configured to inhibit delivery of one or more substances (or portions thereof) from the sheath 130 to the insertion portion 102. Additionally and / or alternatively, the interface 136C, the opening 138C, and / or the distal lumen of the distal end 134C may include a size (e.g., cross-sectional size), shape, and / or structure that may be configured to allow delivery of one or more other substances (or portions thereof) from the sheath 130 to the insertion portion 102.

[0054] In an example, the interface 136C of the distal end 134C can be a plane extending across the longitudinal axis of the receiver 120C. For example, the distal end 134C can have a planar and / or flat structure defining the interface 136C. In some examples, the interface 136C can be configured to control the amount of a substance (e.g., a drug) received in the sheath 130 and delivered to the insertion portion 102 through the distal lumen of the distal end 134C. In this case, the interface 136C can control the amount of the substance delivered based on the size of the particles including the drug. The structure of the interface 136C can guide and / or move particles having a predetermined size from the main lumen 132 of the sheath 130 toward the opening 138C and into the lumen 104 of the insertion portion 102. Additionally, the structure of the interface 136C can inhibit delivery of particles of a drug received in the sheath 130 and not having a predetermined size from being received through the opening 138C into the lumen 104.

[0055] FIG. 5 shows a side view of an exemplary medical device 200 according to an example of the present disclosure. The medical device 200 may include an insert 102, a proximal portion 210, and a receiver 120. It should be understood that the medical device 200 may include any of the exemplary receivers 120A, 120B, 120C and insert 102 described above without departing from the scope of the present disclosure. The proximal portion 210 may have a first body 211 and a second body 216, with the first body 211 disposed at a distal end 212 of the proximal portion 210 and the second body 216 disposed at a proximal end 214 of the proximal portion 210. The first body 211 of the proximal portion 210 may be coupled to the second body 216 by a rod 217 extending between the first body 211 and the second body 216. In an example, the rod 217 may be secured to the second body 216 and may extend through the first body 211. As described in further detail herein, the second body 216 and rod 217 may be configured to move relative to the first body 211 in response to actuation of one or more other components of the medical device 200, such as one or more handles 218.

[0056] The proximal portion 210 of the medical device 200 may further include a switch 220, a plunger 230, and a syringe 240. The switch 220 of the proximal portion 210 may be in communication with a source of pressurized medium (not shown) by one or more tubes 222 coupled to the switch 220 and the source of pressurized medium, respectively. Additionally, the switch 220 of the proximal portion 210 may be in communication with the plunger 230 by one or more tubes 222 coupled thereto. As described further herein, the switch 220 is configured to selectively establish communication between the source of pressurized medium and the plunger 230 in response to actuation of the switch 220.

[0057] 5, the plunger 230 of the proximal portion 210 may include a longitudinal length defined by and extending between a distal end 232 and a proximal end 234. It should be understood that the plunger 230 may define an internal lumen between the distal end 232 and the proximal end 234 and may be configured to supply a pressurized medium from a pressurized medium source. The proximal end 234 of the plunger 230 may include a port 235 that may be configured and operable to place the plunger 230 in communication with at least one of the one or more tubes 222. In this case, the plunger 230 communicates with the switch 220 via the tube 222 received in the port 235. It should be understood that in other examples, the port 235 may be located along various other portions of the plunger 230 than described herein without departing from the scope of the present disclosure.

[0058] The proximal end 234 of the plunger 230 can be received within the slot 215 of the second body 216, thereby removably securing the plunger 230 to the second body 216. With the proximal end 234 of the plunger 230 coupled to the second body 216 via the slot 215, the plunger 230 is configured to move relative to the first body 211 in response to movement of the second body 216 relative to the first body 211, as described in further detail herein. The syringe 240 of the proximal portion 210 can include a longitudinal length defined by and extending between a distal port 242 and a proximal flange 244. The syringe 240 can define a lumen 246 between the distal port 242 and the proximal flange 244, configured to store a substance therein, such as, for example, a medicament (e.g., a hemostatic powder), and to receive the plunger 230.

[0059] In some embodiments, the syringe 240 may include one or more filter mechanisms 248 disposed within the lumen 246, for example, at various suitable locations between the distal port 242 and the proximal flange 244. FIG. 5 illustrates one such filter mechanism 248. The filter mechanism 248 may include a mesh or screen having a porous structure. The pores of the filter mechanism 248 may be sized and / or shaped to inhibit a portion of the matter (e.g., particulates of hemostatic powder) from passing through the filter mechanism 248 (e.g., in a distal direction from a portion of the lumen 246 adjacent the proximal flange 244 to a portion of the lumen 246 adjacent the distal port 242) based at least in part on the size of the particles of the matter. In other words, the filter mechanism 248 may be configured to allow a portion of the matter disposed within the lumen 246 to pass through the filter mechanism 248 (toward the distal port 242) based on the size of the particles of the matter that are smaller than the size of the pores (e.g., openings) of the filter mechanism 248. The filter mechanism 248 may reduce the instance of material clogging one or more components of the medical device 200 (e.g., the distal port 242, the receiver 120, the insert 102) by retaining portions of material larger than the pores of the filter mechanism 248 within the lumen 246.

[0060] 5, the proximal flange 244 of the syringe 240 may be configured and operable to releasably engage the slot 213 of the first body 211, thereby securing the syringe 240 to the first body 211 of the proximal portion 210. In some examples, the first body 211 may further include one or more retention features 219 along an exterior of the first body 211 to secure the syringe 240 thereon. It should be understood that in other examples, the slot 213 and / or the one or more retention features 219 may be disposed along various other portions of the first body 211 as described herein without departing from the scope of the present disclosure. The distal end 232 of the plunger 230 may be disposed within the lumen 246 of the syringe 240 and may be movable relative to the distal port 242. The distal end 232 of the plunger 230 may provide a seal against an interior surface of a wall of the syringe 246.

[0061] As described in further detail herein, the plunger 230 is configured to move relative to the syringe 240 within the lumen 246 in response to movement of the second body 216 relative to the first body 211. In an example, the distal port 242 of the syringe 240 may be configured and operable to couple the syringe 240 to one or more components of the medical device 200, such as the receiver 120. In this case, the inlet head 122 of the receiver 120 may be received and secured within the distal port 242 of the syringe 240, such that the sheath 130 of the receiver 120 is in communication with the lumen 246 of the syringe 240.

[0062] The first body 211 of the proximal portion 210 may further include one or more handles 218A, 218B. The handle 218A may be movable and configured to pivot relative to the remainder of the first body 211, including the handle 218B. In an example, the handles 218A, 218B of the first body 211 may be coupled to a ratchet mechanism (not shown) of the proximal portion 210. For example, the ratchet mechanism may be disposed within the first body 211 and configured to control a speed of movement of the second body 216 relative to the first body 211. When the handles 218A, 218B are pulled proximally, the ratchet mechanism is engaged to move the second body 216 relative to the first body 211.

[0063] 5, with the plunger 230 secured to the second body 216 and the syringe 240 secured to the first body 211, the ratchet mechanism of the proximal portion 210 may further control the movement of the plunger 230 into the lumen 246 of the syringe 240 in response to actuation of the handles 218A, 218B. The ratchet mechanism may be operable to facilitate progressive actuation of the second body 216 and the plunger 230 along a plurality of incremental states relative to the first body 211 and the syringe 240, respectively, in response to mechanical actuation of the handles 218A, 218B. As described in further detail herein, the ratchet mechanism of the proximal portion 210 may be configured to control the progression of the plunger 230 relative to the syringe 240, thereby controlling the delivery flow rate of a substance disposed within the lumen 246 of the syringe 240.

[0064] 6A-6C show partial perspective views of the distal end 234 of exemplary plungers 230A, 230B, 230C according to examples of the present disclosure. Except as otherwise noted below, plungers 230A, 230B, 230C are substantially similar to plunger 230 described above, and like reference numerals are used to identify like components. It should be understood that plungers 230A, 230B, 230C can be configured and operable like plunger 230, and that plungers 230A, 230B, 230C can be readily incorporated into medical device 200 described above.

[0065] 6A, for example, the exemplary plunger 230A can include a rounded head 236 at the distal end 232, which forms a non-planar surface that can extend outwardly from the distal end 232. In some examples, the rounded head 236 includes a spherical, bulbous, and / or curved structure that forms a profile transverse to the longitudinal axis of the plunger 230A. As described in further detail herein, the rounded head 236 of the plunger 230A can be configured to move and / or guide one or more substances disposed within the lumen 246 of the syringe 240 toward the distal port 242 as the plunger 230A advances therethrough.

[0066] The distal head 232 of the plunger 230A may further include an opening 239A disposed on the rounded head 236. In an example, the opening 239A may be disposed along a central portion of the rounded head 236 and communicate with an inner lumen of the plunger 230A. It should be understood that in other examples, the opening 239A may be disposed along various other portions of the rounded head 236. The opening 239A of the rounded head 236 may be sized, shaped, and configured to deliver a substance (e.g., a pressurized medium) disposed within the inner lumen of the plunger 230A outwardly from the distal end 232, e.g., into the lumen 246 of the syringe 240 when the plunger 230A is received within the lumen 246.

[0067] 6B, the exemplary plunger 230B may include a rounded nozzle 238B extending outwardly from the rounded head 236 at the distal end 232. In this case, the rounded nozzle 238B extends distally relative to the rounded head 236 and includes a longitudinal length aligned parallel to the longitudinal axis of the plunger 230B. The distal head 232 of the plunger 230B further includes an opening 239B defined by the distal end of the rounded nozzle 238B. In an example, the opening 239B may be located at the end of the rounded nozzle 238B and communicate with the inner lumen of the plunger 230B. It should be understood that in other examples, the opening 239B may be located along various other portions of the rounded nozzle 238B and / or the rounded head 236.

[0068] The opening 239B of the rounded head 238B may be sized, shaped, and configured to deliver a substance disposed within the inner lumen of the plunger 230B outwardly from the distal end 232, for example, into the lumen 246 of the syringe 240 when the plunger 230B is received therein. The rounded nozzle 238B may be sized, shaped, and configured to control a flow rate of the substance delivered from the opening 239B into the lumen 246 of the syringe 240. Additionally, the structure of the rounded nozzle 238B may be operable to facilitate moving and / or guiding a substance stored within the lumen 246 of the syringe 240 toward the distal port 232 while minimizing compression of the substance within the lumen 246 by the rounded head 236.

[0069] 6B, with the rounded nozzle 238B having an elongated profile relative to the distal end 232 of the plunger 230B, the plunger 230B may enable delivery of pressurized medium to the medicament within the syringe 240 while reducing the range of movement (e.g., translation) of the distal end 232 into the lumen 246 and toward the distal port 232. As a result, it should be appreciated that the rounded nozzle 238B may be configured to reduce compression of the material within the lumen 246 and clogging of the distal port 242 in response to the rounded head 236 compressing the material upon movement of the plunger 230B relative to the syringe 240.

[0070] 6C, the exemplary plunger 230C may include a flat nozzle 238C extending outwardly from the rounded head 236 at the distal end 232. In this case, the flat nozzle 238C extends distally from the rounded head 236 and includes a longitudinal length aligned parallel to the longitudinal axis of the plunger 230C. The distal head 232 of the plunger 230C may further include an opening 239C defined by the distal end of the flat nozzle 238C. In this example, the opening 239C may be located at the end of the flat nozzle 238C and communicate with the inner lumen of the plunger 230C. It should be understood that in other examples, the opening 239C may be located along various other portions of the flat nozzle 238C and / or the rounded head 236.

[0071] The opening 239C of the flat nozzle 238C may be sized, shaped, and configured to deliver a substance disposed within the inner lumen of the plunger 230C outwardly from the distal end 232. The flat nozzle 238C may be sized, shaped, and configured to control a flow rate of the substance delivered from the opening 239C. Additionally, the expanded contour and / or structure of the flat nozzle 238C may be operable to facilitate moving and / or guiding the substance stored in the syringe 240 toward the distal port 232 while minimizing compression of the substance within the lumen 246 by the rounded head 236. As a result, it should be appreciated that the flat nozzle 238C may be configured to reduce compression of the substance within the lumen 246 and clogging of the distal port 242 in response to the rounded head 236 compressing the substance by movement of the plunger 230C relative to the syringe 240.

[0072] According to an exemplary method of using the medical device 200, a substance can first be stored in the lumen 246 of the syringe 240, and at least the distal end 232 of the plunger 230 can be disposed within the lumen 246. It should be understood that the medical device 200 can include any of the exemplary plungers 230A, 230B, 230C described above without departing from the scope of the present disclosure. The syringe 240 can be secured to the first body 211 by disposing the proximal flange 244 within the slot 213, which engages the syringe 240 with one or more retention features 219. With the second body 216 moved to its most proximal (e.g., left) extent relative to the first body 211, the plunger 230 can be secured to the second body 216 by disposing the proximal end 234 within the slot 215. The switch 220 of the proximal portion 210 can be in communication with the port 235 of the plunger 230 via the tube 222.

[0073] The switch 220 can be further coupled to a source of pressurized media (not shown) via another tube 222, such that the inner lumen of the plunger 230 communicates with the source of pressurized media via the switch 220. The receiver 120 can be connected to a syringe 240 via a distal port 242 by inserting the inlet head 122 into the distal port 242, and actuating the knob 126 to rotatably engage the threads 128 with corresponding threads at the distal port 242. Additionally, the insert 102 can be connected to the receiver 120 at its distal end 134, such that the lumen 104 of the insert 102 can communicate with the lumen 246 of the syringe 240 via the receiver 120.

[0074] In this case, when the switch 220 is actuated, pressurized medium from the pressurized medium source can be delivered to the plunger 230 and out from the distal end 232. The pressurized medium can displace a substance stored in the lumen 246 therein, thereby creating a mixture of substances. In an example, the substance can be a drug (e.g., a hemostatic powder) that includes multiple particles of various sizes and / or shapes. Actuation of the switch 220 of the medical device 200 can create a pressure change within the lumen 246 of the syringe 240 that can displace the drug from the lumen 246 to the receiver 120 via the distal port 242.

[0075] In an example, particles of a drug are delivered through the inlet head 122 and received within the sheath 130 of the receiver 120. Once the particles of a drug are received within the sheath 130, the receiver 120 may provide a further mixture of the drug therein. The particles of a drug may be moved into the sheath 130 and delivered to the insert 102 through the distal end 134 according to the methods described above. As a result, it should be understood that the receiver 120 may be configured to inhibit entry of one or more particles of a drug into the insert 102 when the particles have a size greater than a predetermined size. In this case, the remainder of the particles not having a predetermined size may be retained within the sheath 130 of the receiver 120.

[0076] Actuation of the handles 218A, 218B can provide control over the advancement of the plunger 230 relative to the syringe 240, such as advancement of the distal end 232 toward the distal port 242. In this case, movement of the distal end 232 relative to the lumen 246 can displace a drug stored in the syringe 240 toward the distal port 242 in response to the rounded head 236 abutting the drug and urging the drug distally. It should be appreciated that the rounded head 236 of the distal end 232 can be configured to disturb accumulated material disposed within the lumen 246 of the syringe 240 to facilitate delivery of the particles through the distal port 242.

[0077] The control of the movement of the plunger 230 relative to the syringe 240 provided by the ratchet mechanism of the proximal portion 210 may allow the rounded head 236 to agitate the medicament within the syringe 240 by disturbing the arrangement and / or condition of the particles stored along the bottom (or other) surface of the lumen 246. It should be appreciated that movement of particles of the medicament may be improved for delivery by a pressurized medium through the distal port 242 in response to the rounded head 236 of the plunger 230 moving the particles.

[0078] In some examples, movement of the plunger 230 toward the distal port 242 may cause the medicament (disposed along the bottom surface of the lumen 246) to accumulate relatively upwards as the space between the distal end 232 and the distal port 242 in the syringe decreases. In this case, the top surface of the accumulated medicament may rise (e.g., increase) as the space between the distal end 232 and the distal port 242 narrows, thereby adjusting the level (e.g., height) of the top surface of the medicament using the openings 239A, 239B, 239C of the plunger 230. As a result, movement of the plunger 230 relative to the syringe 240 may facilitate directing the pressurized medium from the openings 239A, 239B, 239C to the medicament for delivery into the receiver 120 by disposing particles of the medicament in the flow passages of the openings 239A, 239B, 239C.

[0079] With switch 220 actuated to permit delivery of the pressurized medium within plunger 230, openings 239A, 239B, 239C at distal end 232 can deliver the pressurized medium therethrough and direct particles of medicament to distal port 242. Additionally, in the example of plungers 230B, 230C including nozzles 238B, 238C, respectively, the extensions of nozzles 238B, 238C can facilitate delivery of the pressurized medium to the medicament while minimizing abutment head 236 compressing the medicament within lumen 246, thereby requiring less movement of plungers 230B, 230C.

[0080] It should be appreciated that in some instances, at least a portion of the agent stored in the syringe 240 may remain within the lumen 246 to minimize clogging of the insert 102 and may not be received by the receiver 120. Additionally, the portion of the agent received within the receiver 120 may be disposed along a bottom surface of the sheath 130, such that the agent forms its top surface. In this case, the pressurized medium delivered from the plunger 230 into the receiver 120 may agitate particles disposed along the top surface of the agent for delivery into the insert 102.

[0081] Each of the above-mentioned devices, assemblies, and methods may be used, for example, to provide controlled delivery of hemostatic agents to a target treatment site. Any of the medical devices 100, 200, for example, the receivers 120A, 120B, 120C of the above-mentioned medical devices 100, 200 may be inserted using imaging systems, illumination systems, etc., that aid in locating the medical devices 100, 200 within an endoscope or similar device. By providing a device that allows a user to treat a subject's bleeding tissue using receivers 120A, 120B, 120C that control the delivery rate of hemostatic agents during surgery while minimizing instances of clogging, the user may reduce the overall time of surgery, increase the efficiency and efficacy of surgery, and avoid unnecessary damage to the subject's body due to clogging of the medical devices 100, 200 and / or ineffective blood clotting.

[0082] It will be apparent to those skilled in the art that various modifications and variations can be made in the disclosed devices and methods without departing from the scope of the disclosure. Other aspects of the disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the features disclosed herein. It is intended that the specification and examples be considered as illustrative only.

Claims

1. a handle for carrying the medicament having particles; a receiver having a first lumen defined by a first end and a second end; the receiver has an axis extending between the first end and the second end, the first end configured to receive the particles from the handle, and the second end communicating with a second lumen having a cross-sectional dimension smaller than a cross-sectional dimension of the first lumen; the first end includes a third lumen having a cross-sectional dimension smaller than a cross-sectional dimension of the first lumen and larger than a cross-sectional dimension of the second lumen; a cross-sectional dimension of each of the first lumen, the second lumen, and the third lumen is measured across the axis; the second end is configured to receive the particles from the first end of the receiver; A medical device, wherein the second lumen is configured to control delivery of the agent to a delivery tube communicating with the second lumen based on a size of the particles.

2. 10. The medical device of claim 1, wherein the handle includes an enclosure for storing the medication and a filter mechanism disposed within the enclosure, the filter mechanism configured to inhibit at least a portion of the medication from being delivered to the receiver based on the size of the particles.

3. The medical device of claim 1 , wherein the first lumen is disposed between the second lumen and the third lumen, and the third lumen communicates with the second lumen via the first lumen.

4. 4. The medical device of claim 1, wherein the second lumen is defined by and extends through the second end and the third lumen is defined by and extends through the first end.

5. 5. The medical device of claim 1 , wherein the second end of the receiver is adjacent to the first lumen and includes an interface configured to control delivery of the agent from the first lumen to the second lumen based on the size of the particle.

6. 6. The medical device of claim 5, wherein the interface at the second end is a plane extending across the first lumen and defines an opening disposed along the plane, the opening communicating with the second lumen.

7. 7. The medical device of claim 5 or claim 6, wherein the interface at the second end is a tapered surface defining an opening in communication with the second lumen.

8. 8. The medical device of claim 1, wherein the first lumen has a length along the axis that is greater than a length along the axis of each of the second lumen and the third lumen.

9. 9. The medical device of claim 1, wherein the receiver is configured to mix the agent in the first lumen and to fractionate the particles based on the size of the particles.

10. 10. The medical device of claim 9, wherein the second end of the receiver is configured to accept the one or more particles in the second lumen via fluid communication between the second end and the first end if the size of the one or more particles is equal to or less than a predefined size.

11. 3. The medical device of claim 2, further comprising a plunger disposed at least partially within the enclosure, the plunger configured to move relative to the enclosure to move the agent within the enclosure.

12. The medical device of claim 11 , wherein the plunger is configured to deliver a pressurized medium into the enclosure to move the agent toward the second end of the receiver.

13. 13. The medical device of claim 11 or claim 12, further comprising a handle coupled to the plunger, the handle configured to control movement of the plunger relative to the enclosure to control delivery of the agent from the enclosure to the receiver.

14. 13. The medical device of claim 12, comprising a nozzle tip that moves the pressurized medium toward the agent stored within the enclosure to deliver the particles to the receiver.

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