An apparatus for transferring and mixing medical nutrition

Abstract

The invention relates to an apparatus for transferring and mixing medical nutrition in general. The invention is described by an apparatus for transferring and mixing medical nutrition, comprising: an adapter assembly comprising, a first mounting portion for mounting a first container and a second mounting portion for mounting a second container, wherein the first container stores a first liquid and the second container stores a second liquid; a merging space for receiving the first liquid and / or the second liquid; a first valve unit between the first mounting portion and the merging space and a second valve unit between the second mounting portion and the merging space, wherein the first valve unit and / or the second valve unit is / are operable to control a flow of the first liquid and / or the second liquid into the merging space; and a closure assembly mounted to the adapter assembly, the closure assembly comprising at least one first connector connectable to a conveying device for administering the first liquid and / or the second liquid from the merging space to a patient.

Description

[0001] Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0002] An apparatus for transferring and mixing medical nutrition

[0003] Field of Invention

[0004] The invention relates to an apparatus for transferring and mixing medical nutrition in general. In particular, the invention relates to an apparatus for transferring and mixing medical nutrition for administration to a patient.

[0005] Background of Invention

[0006] Medical and nutritional fluids are often manufactured and packaged separately prior to use to preserve their chemical and physical stability. The medical fluids may be combined during or shortly before administration, either by mixing the medical fluids immediately prior to administration or by administering the medical fluids concurrently or sequentially.

[0007] Typically, the mixing before administration or sequential administration is performed by a nurse / ca regiver or other medical professional, who may need to follow a specialized procedure before administering the medical fluids to a patient. In certain cases, the mixing and administration may be performed by the nurse or other medical professional multiple times for a predetermined dosage.

[0008] Furthermore, taking an example of parenteral nutrition which typically comprising fat, glucose and amino acids are manufactured and packaged separately. Later, the constituents are either mixed before administration or administered sequentially There are known compounders for mixing parenteral nutrition. Such compounders can mix individual compositions of parenteral nutrition. However, such devices can in particular be operated economically if large amounts of parenteral nutrition are needed at the location of the compounder.

[0009] Moreover, it is not possible to store a liquid comprising all these constituents already mixed for a longer period. Therefore, it is desired to store the constituents separately and they are mixed when the parenteral nutrition is required to be administered / infused to the patient. Patent application WO 2006 / 010411 Al (patent applicant: Fresenius Kabi Deutschland GmbH) describes a muti-chamber-concept in which the constituents are stored in one bag having several chambers or compartments and wherein the chambers are separated by peelable seals. Each constituent is stored in one separated chamber of the bag. In detail it is presented a 3-chamber-bag having parenteral nutrition constituents Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO of glucose solution, amino acid solution and lipid emulsion stored individually in separated chambers. Prior to patient administration, pressure is applied on the bag, for instance by rolling the bag, to open the peealeble seals and to enable mixing of the constituents. The mixed parenteral nutrition is administered to the patient. In this concept a fixed constituent ratio is provided.

[0010] Summary of the Invention

[0011] It is an object of the present invention to provide a portable and compact apparatus suitable for delivering medical nutrition fluids to a patient. It should be possible to enable sequential administration of medical nutrition to a patient.

[0012] In particular, it should be also possible to enable mixing of medical nutrition fluids before administration to a patient. Preferably also an individualization of the medical nutrition to the patient should be possible.

[0013] The aforesaid objects are achieved by the solution provided in claim 1 of the present invention. Various embodiments of the invention are subject of the dependent claims, of the description and of the drawings.

[0014] Accordingly, the present invention discloses an apparatus for transferring and mixing medical nutrition. The apparatus comprises an adapter assembly and a closure assembly mounted to the adapter assembly. The adapter assembly comprises a first mounting portion for mounting a first container and a second mounting portion for mounting a second container. The first container stores a first liquid and the second container stores a second liquid. The adapter assembly further comprises a merging space for receiving the first liquid and / or the second liquid. A first valve unit is provided between the first mounting portion and the merging space. A second valve unit is provided between the second mounting portion and the merging space. The first valve unit is operable to control a flow of the first liquid into the merging space and / or the second valve unit is operable to control a flow of the second liquid into the merging space. The closure assembly is mounted to the adapter assembly and comprises at least one first connector connectable to a conveying device for administering the first liquid and / or the second liquid from the merging space to a patient.

[0015] The containers of the present invention are preferably embodied as bottles, in particular bottles for medical nutrition. In one embodiment at least the first container, the second Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO container and / or the third container is / are embodied as a bottle, in particular as a bottle for medical nutrition.

[0016] Preferably the container is a container made of plastic. One example for a plastic material comprises polyolefin, as for instance polyethylene (PE), in particular low-density- polyethylene (LDPE) and / or polypropylene (PP).

[0017] Preferably the container is a blow-molded container. In one example the bottle is a BFS- bottle. This is a bottle which is produced by Blow-Fill-Seal method (BFS). In another example the bottle is a SBM-bottle. This is a bottle which is produced by Stretch-Blow- Molding method (SBM).

[0018] In one embodiment, the adapter assembly additionally comprises a third mounting portion for mounting a third container. A third valve unit is also provided between the third mounting portion and the merging space. A third container stores a third liquid. In this manner the required basic components for parenteral nutrition could be provided. Preferably, the first liquid comprises amino acids, the second liquid comprises glucose and / or the third liquid comprises fat. In another embodiment the containers are filled with an nutrition fluid for enteral nutrition.

[0019] According to an embodiment, the first valve unit is engaged with the first mounting portion, the second valve unit is engaged with the second mounting portion and the third valve unit is engaged with the third mounting portion. Each of the first valve unit, the second valve unit and the third valve unit can be embodied to comprise a movable plug member to open and close the first valve unit, the second valve unit and / or the third valve unit. This enables the sequential administration of medical nutrition components.

[0020] In one embodiment, each of the plug members is individually disposed in separate openings provided on a lateral side of the adapter assembly. Preferably, each of the plug members comprises a button and an elongate body to push and retract the plug member. This enables an easy handling of the apparatus. Each of the first valve unit, the second valve unit and the third valve unit can comprise a sleeve member as well.

[0021] Furthermore, the adapter assembly particularly comprises a duct in connection with the first mounting portion, the second mounting portion and / or the third mounting portion. The duct is preferably positioned between the valve unit and the merging space. This enables the mounting of containers of different sizes. Possible container sizes can range from 100 ml to 1000 ml. Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0022] The duct comprises a first inlet connected to the first mounting portion, a second inlet connected to the second mounting portion and / or a third inlet connected to the third mounting portion. More particularly, the sleeve member of the first valve unit is connected to the first inlet, the sleeve member of the second valve unit is connected to the second inlet and the sleeve member of the third valve unit is connected to the third inlet. In one specific embodiment each of the sleeve members comprises an aperture, for instance an annular aperture, preferably formed as a through hole.

[0023] In a further specific embodiment, the sleeve member is an elongated hollow tube, preferably with a rectangular cross-section. The annular aperture formed as a through hole encompassing the top and bottom surface of the sleeve member. At the outset, when mixing apparatus is not in use and / or the containers are not mounted to the adapter assembly, is hereinafter to be referred as an initial state or position. In the initial state, each of the plug members is in an initial first position and the elongate body of the plug member is at least partially positioned inside the sleeve member and seals the annular aperture.

[0024] When each of the plug members are in closed position, each of the plug members are able to be pushed towards the openings provided on the lateral side of the adapter assembly by pressing the button. In an embodiment, the elongate body is telescopically movable inside the sleeve member. Preferably, the elongated body has a rectangular cross-section similar to the cross-section of the sleeve member. The elongate body also can have an annular aperture in the form of a through hole similar to the annular aperture of the sleeve member. In the initial state, the annular aperture of the elongate body does not overlap with the through hole of the sleeve member. The button is configured to be pushed to uncover and / or open the annular aperture of the sleeve member in an open position of each of the plug members. The annular aperture is uncovered when the through hole of the elongate body of the plug member overlaps with the through hole of the sleeve member. A fluid connection between each of the mounting portions and the duct is opened in the open position or final position of the each of the plug members.

[0025] Though the abovementioned mechanism is disclosed for the operation of each of the valve units, the invention is not limited by the mechanism of the valve unit. Any other suitable valve mechanism known in the art can be used for opening and closing of the fluid connection according to present invention. Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0026] In an embodiment, each of the first valve unit, the second valve unit and / or the third valve unit is independently operable to open and / or close the fluid connection between the corresponding mounting portions and the duct. In other words, each of the valve unit is independently operable to control the flow of medical nutrition fluid between the containers and the adapter assembly. The enables the sequential administration of medical nutrition components in a specific sequence. In addition, this enables adaptation of a possible mixing sequence.

[0027] According to a further embodiment, the merging space forms a neck portion, and the closure assembly is mounted on the neck portion of the adapter assembly forming a head portion. Furthermore, the first mounting portion, the second mounting portion and / or the third mounting portion are positioned inline and form a shoulder portion. The neck portion protrudes from the shoulder portion of the adapter assembly. This enables an improved handling of the apparatus.

[0028] In an embodiment, the closure assembly comprises at least one second connector for injecting an additive in the merging space. Preferably the closure assembly is embodied as a cap. The first connector and the second connector are arranged on the cap. Further, the first connector and the second connector are each covered by a break-off part in an initial state before use. In other words, the break-off part is initially intact and is broken- off or removed to uncover the first connector and / or the second connector when medical nutrition is required to be transferred for administration to a patient. A possible embodiment of the closure device is described in patent application WO 2018 / 060333 Al (patent applicant: Fresenius Kabi Deutschland GmbH). The content of this patent application concerning the construction and function of the cap is incorporated herein by reference.

[0029] The apparatus is preferably supported by a hanger while administering a mixed medical nutrition to the patient. The hanger is preferably positioned on the side of the apparatus opposite of the closure assembly.

[0030] According to another embodiment, the first container, the second container and / or the third container are pre-assembled with the adapter assembly. The first container comprises a first liquid, the second container comprises a second liquid and the third container comprises a third liquid. In this way a specific nutrition composition can be provided to the patient. Preferably the apparatus is ready to be used. Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0031] The present invention thus provides an apparatus for transferring and possibly mixing the medical nutrition for administration to a patient in a simple and efficient manner. The apparatus disclosed hereinabove is simple in construction and compact which allows for less storage space. The adapter assembly is modular and can be configured to accommodate medical nutrition container of various sizes and volumes. Furthermore, since each of the valve unit is independently controlled, the apparatus can be utilized for sequential administration of nutrition to a patient. In other words, medical nutrition from one of the containers can be chosen to be administered at a time. In another scenario, a mixture of medical nutrition can be simply prepared at least in the merging space which can be subsequently administered to the patient.

[0032] Brief description of drawings

[0033] The idea underlying the invention shall be explained in greater detail below with reference to the illustrative embodiments represented in the figures, wherein:

[0034] Figure la illustrates a side view of an apparatus for transferring and mixing medical nutrition with medical containers preassembled.

[0035] Figure lb illustrates a sectional view of the apparatus as shown in Figures la.

[0036] Figure 2a illustrates a perspective view of an adapter assembly and a closure assembly mounted to the adapter assembly.

[0037] Figure 2b illustrates a side view of the adapter assembly and the closure assembly without valve unit components.

[0038] Figure 2c illustrates a perspective sectional view of the interior of the adapter assembly and the closure assembly.

[0039] Figured 2d illustrates a side-sectional view of the adapter assembly and the closure assembly shown in figure 2c.

[0040] Detailed description of drawings

[0041] Figure la shows an apparatus 100 for transferring and mixing medical nutrition. The apparatus 100 comprises an adapter assembly 101 and a closure assembly 102. A plurality of containers 104, 106, 108 are assembled with the adapter assembly 101. Said plurality of containers 104, 106, 108 store respective different liquid constituents of medical Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO nutrition. The apparatus 100 comprises here a sleeve 112 encasing the plurality of containers 104, 106, 108. This improves the mounting and fixing of the containers 104, 106, 108. In the shown embodiment, the containers 104, 106, 108 store, as an example, a first liquid, a second liquid and a third liquid respectively. The first liquid, the second liquid and the third liquid are liquids for medical nutrition, preferably for parenteral nutrition. Preferably, the first liquid comprises amino acids, the second liquid comprises glucose and the third liquid comprises fat.

[0042] Figure lb illustrates a sectional view of the apparatus 100 as shown in Figures la. The adapter assembly 101 comprises a plurality of mounting portions 114, 116, 118 for mounting the plurality of containers 104, 106, 108 respectively. As shown in the figure, each of the mounting portions 114, 116, 118 are formed in the shape of a type of an inverted mushroom. Each of the mounting portions 114, 116, 118 includes a preferably conical shaped top portion 120 attached onto an elongate member 122. The elongate member 122 is preferably formed as a hollow pipe or cap. The elongate members 122 of each of the mounting portions 114, 116, 118 are configured to receive neck and / or head portions of each of the containers 104, 106, 108 respectively. Each of the mounting portions 114, 116, 118 or of the elongate members 122 is formed as a receiving area to receive the neck and / or head of the container 104, 106, 108 respectively. For instance, the containers 104, 106, 108 are fixed to the mounting portions 114, 116, 118 or to the elongate members 122 by a clamping connection or by a snap-fit connection. Preferably the connection is a non-detachable connection, for instance by form-fit joining of the components, i.e. the necks and / or heads of the containers 104, 106, 108 and the elongate members 122. Each of the connections is a fluid-tight connection.

[0043] The adapter assembly 101 further comprises a merging space 119 for receiving one or more fluids from the plurality of containers 104, 106, 108. One of more valve units 124, 126, 128 are connected with the plurality of mounting portions 114, 116, 118 to control the flow of liquids from the plurality of containers 104, 106, 108. The first valve unit 124 is provided between, for example, the first mounting portion 114 and the merging space 119. Similarly, according to the embodiment shown in Figure lb, the second valve unit 126 is provided between the second mounting portion 116 and the merging space 119 and the third valve unit 128 is provided between the third mounting portion 118 and the merging space 119. Each of the valve units 124, 126, 128 is operable to control a flow of the liquid from each of the plurality of containers 104, 106, 108 into the merging space 119. Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0044] Figure 2a and 2b illustrates the adapter assembly 101 and the closure assembly 102. The closure assembly 102 is mounted to the adapter assembly 101 and comprises a cap 200. In the illustrated embodiment, the cap 200 comprises a cap body which, on a top surface, comprises two connectors 204, 206 for connecting various conveying devices (not shown) f.i. during an infusion. In other words, the connectors 204, 206 are connectable to a conveying device for administering the medical nutrition / liquid from the merging 119 space to a patient. In an embodiment, one of the connectors 204 is utilized for infusion (infusion connector) and the other connector 206 (injection connector) is used for injecting an additive in the merging space 119 (injection connector). Thus, the cap 200 further facilitates effective infusion process to a patient.

[0045] The apparatus 100 thus provides for transferring and / or mixing medical nutrition for administration to a patient in a simple and efficient manner. The apparatus 100 disclosed hereinabove is simple in construction and compact which allows for less storage space. The adapter assembly 101 is modular and can be configured to accommodate medical nutrition containers 104, 106, 108 of various sizes and volumes.

[0046] In construction, the connectors 204, 206 of the cap 200 each comprises a sealing element which is received and held in a clamping manner on a holding device. The sealing elements are preferably resealable and / or elastomeric components to serve the purpose of closing openings on the top surface of the cap body to the outside. The connectors 204, 206 are connectable to the corresponding conveying devices which are able to be positioned against an outside surface of the sealing element. For instance, a needle syringe can be used to inject an additive to the nutrition liquid and / or a spike of a giving set can be used to extract liquid for infusion to a patient.

[0047] The connectors 204, 206 are each covered by break-off parts 216, 218 in an initial state, and are closed to the outside in such a manner that the openings with the sealing elements arranged therein are not accessible from the outside and are protected against contamination. The interior formed by the break-off parts 216, 218 is preferably sterile. The break-off parts 216, 218 are connected to the cap body at a predetermined breaking point such that the break-off part detaches from the cap body along the predetermined breaking point. A possible embodiment of the closure device 102 or the cap 200 is described in patent application WO 2018 / 060333 Al. The content of this patent application concerning the construction and function of the cap 200 is incorporated herein by reference. Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0048] According to the embodiment as illustrated in Figures 2a to 2d, each of the valve units 124, 126, 126 comprises a movable plug member 220 to open and close the respective valve unit 124, 126, 128. Each of the plug members 220 is individually disposed in separate openings 222 provided on a lateral side of the adapter assembly 101. Each of the plug members 220 comprises a button 226 and an elongate body 228 to push and / or retract the plug member 220. Furthermore, each of the valve units 124, 126, 128 can comprise a sleeve member 230 for accommodating the elongate body 228 of the plug member 220. The sleeve member 230 comprises preferably an annular aperture 232 formed as a through hole. According to the embodiment shown in Figure 2c, the sleeve member 230 is an elongated hollow tube with a rectangular cross-section. The annular aperture 232 formed as a through hole encompassing the top and bottom surface of the sleeve member 230.

[0049] At the outset, the apparatus 100 is not in use and / or the plurality of containers 104, 106, 108 are not mounted to the adapter assembly 101, hereinafter to be referred as an initial state / position. In such initial state, each of the plug members 220 is in an initial first position, here the closed position, and the elongate body 228 of the plug member 220 is at least partially positioned inside the sleeve member 230 and seals the annular aperture 232.

[0050] When in closed position, each of the plug members 220 is able to be pushed towards the opening 222 provided on the lateral side of the adapter assembly 102 by pressing the button 226. In an embodiment, the elongate body 228 is telescopically movable inside the sleeve member 230 (not shown in the figures). The shown embodiment of the elongate body 228 has a rectangular cross-section similar to the cross-section of the sleeve member 230. The elongate body 228 also has an annular aperture (not shown) in the form of a through hole similar to the annular aperture 232 of the sleeve member 230. In the initial state, the annular aperture of the elongate body 228 does not overlap with the annular aperture 232 of the sleeve member 230. The button 226 is configured to be pushed to uncover / open the annular aperture 232 of the sleeve member in an open position of each of the plug members 220. The annular aperture 232 is uncovered when the through hole / annular aperture 232 of the elongate body 228 of the plug member 220 overlaps with the through hole / annular aperture of the sleeve member 230. A fluid connection between each of the mounting portions 114, 116, 118 and the duct is opened in the final position, here the open position of the each of the plug members 220. The aforementioned mechanism provides a simple and easy way of activation / deactivation of the valve units 124, 126, 128. Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0051] Though the abovementioned mechanism is disclosed for the operation of each of the valve units, the invention is not limited by the mechanism of the shown valve units 124, 126, 128. Any other suitable valve mechanism known in the art can be used for opening and closing of the fluid connection according to present invention. Similarly, the shape and / or construction of the elongate body 222 and / or of the sleeve member 230 may be different from the embodiments described hereinabove. For example, the elongate body 222 and / or the sleeve member 230 may have a circular cross-section.

[0052] As shown in Figures 2c and 2d, the adapter assembly 101 comprises a duct 233 in connection with the plurality of mounting portions 114, 116, 118. The duct 233 is positioned between the valve units 124, 126, 128 and the merging space 119. The duct 233 comprises a first inlet 234 connected to the first mounting portion 114, a second inlet 236 connected to the second mounting portion 116 and / or a third inlet 238 connected to the third mounting portion 118. More particularly, the sleeve members 230 of each of the valve unit 124, 126, 128 is affixed to the first inlet 234, the second inlet 236 and the third inlet 238 such that the duct 233 is in fluid connection with the sleeve members 230 of each of the valve units 124, 126, 128.

[0053] In an embodiment, each valve unit 124, 126, 128 is independently operable or independently can be controlled to open and / or close the fluid connection between the respective mounting portions 114, 116, 118 and the duct 233. In other words, each of the valve unit 124, 126, 128 is independently operable to control the flow of medical nutrition / fluid from the containers 104, 106, 108 to the adapter assembly 101. For example, the valve unit 124 associated with the mounting portion 114 can be opened to transfer medical nutrition from container 106 to the merging space 119.

[0054] Via opening the valve units 124, 126, 128, the medical liquids flow into the merging space 119 and via the infusion port 204 of the cap 200 and an inserted spike and connected giving set to a patient. Further, since each of the valve unit 124, 126, 128 is independently controlled, the apparatus 100 can be utilized for sequential administration of nutrition to a patient. In other words, medical nutrition from one of the containers 104, 106, 108 can be chosen to be administered at a time. Furthermore, in another scenario, a mixture of medical nutrition can be simply prepared in the merging space 119 which can be subsequently administered to the patient. All valve units 124, 126, 128 are opened at the same time. In this application the merging space 119 acts as a mixing space or mixing chamber. Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0055] The merging space 119 forms a neck portion 244 and the closure assembly 102 is mounted on the neck portion 244 of the adapter assembly 101 forming a head portion. Furthermore, the plurality of mounting portions 114, 116, 118 are positioned inline and form a shoulder portion 242. The neck portion 244 protrudes from the shoulder portion 242 of the adapter assembly 102.

[0056] According to the embodiment shown in figures la and lb, the plurality of containers 104, 106, 108 filled with medical nutrition are pre-assembled with the adapter assembly 101. The medical nutrition preferably comprises fat, glucose and amino acids respectively. Further, the apparatus 100 is supported by a hanger (not shown) while administering a mixed medical nutrition to the patient.

[0057] It will be understood that the invention may be embodied in other specific forms without departing from the spirit or central characteristics thereof. The present examples and embodiments, therefore, are to be considered in all respects as illustrative and not restrictive, and the invention is not to be limited to the details given herein. Accordingly, features of the above-described specific embodiments can be combined with one another. Further, features described in the summary of the invention can be combined with one another. Furthermore, features of the above-described specific embodiments and features described in the summary of the invention can be combined with one another.

[0058] Reference list:

[0059] 100 Apparatus for transferring and mixing medical nutrition

[0060] 101 Adapter assembly (forming a neck and shoulder portion)

[0061] 102 Closure assembly (forming a head portion)

[0062] 104 First container

[0063] 106 Second container

[0064] 108 Third container

[0065] 112 Sleeve

[0066] 114 Frist mounting portion

[0067] 116 Second mounting portion

[0068] 118 Third mounting portion Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO

[0069] 119 Merging space or mixing space or mixing chamber

[0070] 120 Top portion

[0071] 122 Elongate member

[0072] 124 First valve unit

[0073] 126 Second valve unit

[0074] 128 Third valve unit

[0075] 200 Cap

[0076] 204 First connector or infusion port

[0077] 206 Second connector or injection port

[0078] 216 Break-off part

[0079] 218 Break-off part

[0080] 220 Movable plug member

[0081] 222 Separate opening

[0082] 226 Button (of the plug members 220)

[0083] 228 Elongate body (of the plug members 220)

[0084] 230 Sleeve member

[0085] 232 Annular aperture

[0086] 233 Duct

[0087] 234 First inlet (of the duct 233)

[0088] 236 Second inlet (of the duct 233)

[0089] 238 Third inlet (of the duct 233)

[0090] 242 Shoulder portion (of the adapter assembly 102)

[0091] 244 Neck portion (of the adapter assembly 102)

Claims

Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WOClaims1. An apparatus (100) for transferring and mixing medical nutrition, comprising : an adapter assembly (101) comprising, a first mounting portion (114) for mounting a first container (104), in particular a first bottle (104), and a second mounting portion (116) for mounting a second container (106), in particular a second bottle (106), wherein the first container (104) stores a first liquid and the second container (106) stores a second liquid; a merging space (119) for receiving the first liquid and / or the second liquid; a first valve unit (124) between the first mounting portion (114) and the merging space (119) and a second valve unit (126) between the second mounting portion (116) and the merging space (119), wherein the first valve unit (124) and / or the second valve unit (126) is / are operable to control a flow of the first liquid and / or the second liquid into the merging space (119); and a closure assembly (102) mounted to the adapter assembly (101), the closure assembly (102) comprising at least one first connector (204) connectable to a conveying device for administering the first liquid and / or the second liquid from the merging space (119) to a patient wherein the closure assembly (102) is configured as a cap (200).

2. The apparatus (100) as claimed in claim 1, wherein the adapter assembly (101) comprises a third mounting portion (118) for mounting a third container (108), preferably a third bottle (108), and a third valve unit (128) between the third mounting portion (118) and the merging space (119), the third container (108) stores a third liquid.

3. The apparatus (100) as claimed in claim 1 and / or claim 2, wherein the first liquid comprises amino acids, the second liquid comprises glucose and / or the third liquid comprises fat.

4. The apparatus (100) as claimed in one of the preceding claims, wherein each of the first valve unit (124), the second valve unit (126) and / or the third valve unit (128) comprises a movable plug member (220) to open and close the first valve unit (124), the second valve unit (126) and / or the third valve unit (128).

5. The apparatus (100) as claimed in claim 4, wherein each of the plug members (220) is individually disposed in a separate opening (222) provided on a lateral side of the adapter assembly (101).Fresenius Kabi Deutschland GmbH FK19094-03-PAT-WO6. The apparatus (100) as claimed in claims 4 to 5, wherein each of the plug members (220) comprises a button (226) and an elongate body (228) to push and retract the plug member (220).

7. The apparatus (100) as claimed in one of the preceding claims, wherein the adapter assembly (101) comprises a duct (233) in connection with the first mounting portion (114), the second mounting portion (116) and / or the third mounting portion (118), wherein the duct (233) is positioned between the first valve unit (124), the second valve unit (126) and / or the third valve unit (128) and the merging space (119).

8. The apparatus (100) as claimed in claim 7, wherein the duct (233) comprises a first inlet (234) connected to the first mounting portion (114), a second inlet (236) connected to the second mounting portion (116) and / or a third inlet (238) connected to the third mounting portion (118).

9. The apparatus (100) as claimed in one of the preceding claims, wherein each of the first valve unit (124), the second valve unit (126) and / or the third valve unit (128) is independently operable to open and / or close the fluid connection between the respective mounting portions (114, 116, 118) and the duct (233) and / or the mixing chamber (119).

10. The apparatus (100) as claimed in one of the preceding claims, wherein the merging space (119) forms a neck portion (244) of the adapter assembly (101) and the closure assembly (102), forming a head portion, is mounted on the neck portion (244) of the adapter assembly (101).

11. The apparatus (100) as claimed in claim 10, wherein the first mounting portion (114), the second mounting portion (116) and / or the third mounting portion (116) are positioned inline and forming a shoulder portion (242) and wherein the neck portion (244) protrudes from the shoulder portion (242) of the adapter assembly (101).

12. The apparatus (100) as claimed in one of the preceding claims, wherein the closure assembly (102) comprises at least one second connector (206) for injecting an additive, preferably to the merging space (119), in particular wherein the first connector (204) an / or the second connector (206) is / are covered by a break-off part (216, 218) in an initial state before use.

13. The apparatus (100) as claimed in one of the preceding claims, wherein at least the first container (104), the second container (106) and / or the third container (108) is a blow-molded container, preferably a BFS-container or a SBM-container.

14. The apparatus (100) as claimed in one of the preceding claims, wherein a hanger is provided for supporting the apparatus (100) while administering the medical nutrition to a patient.

15. A multi-chamber container cluster comprising an apparatus (100) according to one of the preceding claims, wherein a first container (104), a second container (106) and / or a third container (108) are pre-assembled to the apparatus (100).

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