(12) United States Patent
`Woehr et al.
`
`(10) Patent No.:
`(45) Date of Patent:
`
`US 7,736,339 B2
`Jun. 15, 2010
`
`USOO7736339B2
`
`DE
`
`(56)
`
`References Cited
`3,562,097 s PEN in Nis
`- W4-
`aZmburg
`(Continued)
`FOREIGN PATENT DOCUMENTS
`30 OO 903 A1
`1, 1980
`(Continued)
`OTHER PUBLICATIONS
`Patent Abstracts of Japan; entitled “Indwelling Puncture Needle With
`Wing Having Branching Part”. Application No. 11-021665, Publica
`tion No. 2000-2 17925; Date of Publication Aug. 8, 2000, Applicant
`Hanako Medical KK, 3 pgs.
`(Continued)
`Primary Examiner Kevin C Sirmons
`Assistant Examiner Michael J Anderson
`(74) Attorney, Agent, or Firm—Klein, O'Neill & Singh, LLP
`
`(54) CATHETER INSERTION DEVICE
`(75) Inventors: Kevin Woehr, Felsberg (DE); Kenneth
`C. Raines, Bethlehem, PA (US)
`
`(73) Assignee: B.Braun Melsungen AG, Melsungen
`(DE)
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 663 days.
`
`(*) Notice:
`
`(21) Appl. No.:
`
`10/520,325
`
`(22) PCT Filed:
`
`Jul. 2, 2003
`
`(86). PCT No.:
`
`PCT/EPO3/07073
`
`S371 (c)(1),
`(2), (4) Date:
`
`Sep. 12, 2005
`
`(87) PCT Pub. No.: WO2004/004819
`
`PCT Pub. Date: Jan. 15, 2004
`
`(65)
`
`Prior Publication Data
`US 2006/O155245A1
`Jul. 13, 2006
`
`(30)
`Jul. 4, 2002
`
`(51) Int. Cl.
`(2006.01)
`A6M 5/00
`(52) U.S. Cl. .................................. 604/164.08; 604/110
`(58) Field of Classification Search ................. 604/110,
`604/167,263,533, 164
`See application file for complete search history.
`
`ABSTRACT
`(57)
`The invention relates to a catheter insertion device compris
`ing: an approximately hollow cylindrical catheter sleeve (2),
`at whose distal end a catheter (4) is attached; a needle sleeve
`(8) with a hollow needle (9), which is attached thereto and
`which, when ready for use, extends through the catheter
`sleeve (2) and the catheter (4), and; a needle protective ele
`ment (13) that is arranged inside the catheter sleeve (2) while
`being able to move on the needle (9). Said needle protective
`element has an engaging section (13c) that engages with an
`Foreign Application Priority Data
`engaging device (9b), which is formed in the vicinity of the
`(DE) ............................ 2021 O 394 U needle tip, when the hollow needle is withdrawn from the
`catheter sleeve (2). A check valve (7, 17) is placed inside the
`catheter sleeve (2) between the catheter (4) and the needle
`protective element (13). The hollow needle (9), when ready
`for use, extends through said check valve, and the check valve
`automatically closes once the needle is withdrawn.
`
`25 Claims, 3 Drawing Sheets
`
`
`
`
`
`
`
`5
`5b
`NSNSNSNN
`CSS
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`1
`
`B. Braun 2018
`
`

`

`US 7,736,339 B2
`Page 2
`
`U.S. PATENT DOCUMENTS
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`6.245,048 B1
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`6,287.278 B1* 9/2001 Woehr et al. ................ 604/110
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`6,379,333 B1
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`6,379,372 B1
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`6,652,490 B2 11/2003 Howell
`6,692.471 B2
`2/2004 Boudreaux
`6,699.221 B2
`3/2004 Vaillancourt
`6,709,419 B2
`3/2004 Woehr
`6,719,726 B2
`4/2004 Meng et al.
`6,749,588 B1
`6/2004 Howell et al.
`
`2
`
`

`

`US 7,736,339 B2
`Page 3
`
`12/1998
`WO 98.53875
`WO
`6, 1999
`WO99,26682
`WO
`WOO3O 11381 A1 * 2/2003
`WO
`WO WO 2004/004819 A1
`1/2004
`
`2002.0128604 A1 ck
`
`9, 2002 Nakajima - - - - - - - - - - - - - - 604,164.01
`
`lication Sep. 25, 2001, Applicant Medikit KK, 7 pg.S.
`
`FOREIGN PATENT DOCUMENTS
`
`7/2004 East
`6,764,468 B1
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`6,883,778 B1
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`6,902,546 B2
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`6,916,311 B2
`OTHER PUBLICATIONS
`6,972,002 B2 * 12/2005 Thorne .................. 604,164.08
`Patent Abstracts of Japan; entitled “Safe Indwelling Needle'. Appli
`7,125,396 2. 10, 2006 Leinsing et al.
`771 B
`52's Menziet al. .......... 600 cation No. 2000-078335, Publication No. 2001-259029, Date of Pub
`2003/01998.27 A1* 10 2003 Thorne .................. 600 Patent Abstracts of Japan; entitled “Safety Indwelling Needle",
`2004-0044313 Al
`3, 2004 Nakajima
`Application No. 2000-182911, Publication No. 2002-000727, Date
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`2006/0155245 A1
`7/2006 Woehr ................... 604,164.08
`Patent Abstracts of Japan; entitled “Indwelling Needle Structure'.
`Application No. 2001-363865, Publication No. 2003-1751 12, Date
`of Publication Jun. 24, 2003, Applicant Mitsubishi Pencil Co LTD, 5
`pg.S.
`Patent Abstracts of Japan; entitled “Indwelling Needle Structure and
`Seal Material Used Therefor”, Application No. 2005-0351 12, Publi
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`Committee ISO/TC 84, Switzerland.
`* cited by examiner
`
`31 OO 622 A1
`32 10 148 A1
`44 34569 A1
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`O 414997 A1
`O 554841 A1
`0 747 084 A2
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`1 101 508 A2
`1 101 508 A3
`1 180381 A1
`1240 916 B1
`1374 942 A1
`1374942 B1
`2 118 440 A
`WO97, 45151
`
`DE
`DE
`DE
`DE
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`EP
`GB
`WO
`
`4f1980
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`1, 2004
`1, 2004
`11, 1983
`12/1997
`
`3
`
`

`

`U.S. Patent
`
`Jun. 15, 2010
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`U.S. Patent
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`Jun. 15, 2010
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`1.
`CATHETER INSERTON DEVICE
`
`US 7,736,339 B2
`
`The invention relates to a catheter insertion device accord
`ing to the preamble of claim 1.
`
`CROSS-REFERENCE TO RELATED
`APPLICATION
`
`This is a U.S. national phase application of PCT applica
`tion No. PCTJEP2003/007073, filed Jul. 2, 2003, which
`claims priority to German application Ser. No. 202 10394.3,
`filed Jul. 4, 2002, the contents of these applications are
`expressly incorporated herein by reference.
`
`BACKGROUND
`
`A device of this kind is known from EP 352 928, wherein
`in a hollow catheter hub a needle guard element is arranged.
`On withdrawal of the hollow needle from the catheter overan
`engaging means near the tip of the hollow needle, the needle
`guard element engages with the engaging means and covers
`the tip when the hollow needle is separated from the catheter.
`In this design, after withdrawal of the hollow needle from the
`catheter, through this catheter blood can issue with which the
`operating personnel can come into contact.
`The invention is based on the object of designing a catheter
`insertion device of the type described above such that an
`outflow of blood from the catheter is prevented after removal
`of the hollow needle with the needle guard element.
`SUMMARY
`
`This object is solved according to the invention by the
`features in the characterizing part of claim 1. In the ready
`position, a check valve is arranged in the catheter hub
`between the catheter and the needle guard element. Through
`this valve the hollow needle extends, so that after withdrawal
`of the hollow needle from the catheter the latter can be reli
`ably closed such that an outflow of blood is prevented, while
`simultaneously the tip of the hollow needle is securely cov
`ered by the needle guard element so that the operating per
`Sonnel cannot injure themselves on the needle tip.
`
`10
`
`15
`
`25
`
`30
`
`35
`
`40
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`Exemplary embodiments of the invention are explained in
`more detail below with reference to the drawing, in which:
`FIG. 1 shows a longitudinal section through a catheter
`insertion device in the ready position,
`FIG. 2 shows the catheter insertion device with the hollow
`needle removed,
`FIG.3 shows the device with an attached syringe,
`FIG. 4 shows a sectional view along the line A-A in FIG. 1,
`FIG. 5 shows a longitudinal section through another
`embodiment,
`FIG. 6 shows a view of the valve disc,
`FIG. 7 shows different views of a valve actuating element,
`FIG. 8 shows a longitudinal section through a further
`embodiment,
`FIG.9 shows front views of the valve actuating element of
`FIG. 8, and
`FIG. 10 shows a longitudinal section through a further
`embodiment.
`
`45
`
`50
`
`55
`
`60
`
`DETAILED DESCRIPTION
`
`FIG. 1 shows a catheter insertion device 1 having a catheter
`hub 2 which has a two-part form in the embodiment. A distal
`hub element 3 of the catheter hub has a holding section 3a in
`which a catheter 4 is press-fitted. The proximal end of the hub
`
`65
`
`2
`element 3 has an enlarged diameter with regard to the distal
`end and forms a connecting section with a hub element 5
`whose distal end overlaps the proximal end of the hub ele
`ment 3 and which is provided at its proximal end with a Luer
`thread 6. Between the two hub elements 3 and5, a check valve
`in the form of a valve disc 7 is inserted and is fixed in place by
`the two hub elements 3 and 5.
`In the ready position according to FIG. 1, there is inserted
`in the catheter hub 2 a needle hub 8 to which a hollow needle
`9 is fixed which extends through the valve disc 7 and the
`catheter 4 so that the needle tip 9a is exposed. Between needle
`hub 8 and valve disc 7 there is displaceably arranged in the
`proximal hub element 5 a valve actuating element 10 which
`has a truncated cone-shaped locating section 10a which
`serves to open the valve disc 7, as FIG. 3 shows. On the
`proximal side, a plunger section 10b adjoins the locating
`section 10a and has a hollow space for receiving a needle
`guard element 13. In the embodiment shown, the plunger
`section 10b is formed by two spaced plungers between which
`the needle guard element in the form of a spring clip 13 is
`inserted, as shown in the cross-sectional view in FIG. 4.
`On withdrawal of the hollow needle 9 from the catheter hub
`2, an engaging means 9b (FIG. 2), provided near the needle tip
`9a and having the form of a radial projection on the hollow
`needle which can be formed by light crimping, engages with
`the outer circumference of a bore in the rear wall 13c of the
`spring clip 13, so that the spring clip 13 is removed from the
`catheter hub with the needle 9, while simultaneously the
`spring arms 13a and 13.b of the spring clip cover the needle
`tip, completely protecting and blocking it. In this separated
`position shown in FIG. 2, the valve disc 7, due to its elasticity,
`closes the through-hole for the hollow needle 9 so that no
`blood can flow out through the catheter 4. As FIG. 6 shows,
`the valve disc is provided for example with three slits 7a
`starting from the middle and extending radially over a short
`sectionX, forming elastic flaps 7b therebetween which can be
`expanded by the hollow needle.
`FIG. 3 shows the insertion of a syringe 14 in the catheter
`hub 2, wherein the neck portion 14a of the Syringe comes to
`abut on the plunger section 10b of the valve actuating element
`10 and presses it against the valve disc 7, so that the truncated
`cone-shaped locating section 10a outwardly displaces the
`flaps 7b of the valve disc and thereby opens the valve, so that
`a liquid can be inserted from the Syringe 14 into the catheter
`4.
`The incline of the truncated cone on the locating section
`10a and the displacement path of the actuating element 10
`relative to the valve disc 7 are designed such that due to the
`elasticity of the material of the valve disc 7, the flaps 7b
`displace the locating section 10a to the right in FIG. 3 when
`the syringe 14 is removed from the catheter hub 2. Hereby, the
`valve disc 7 is automatically closed, as the position in FIG.2
`shows.
`In the hub element 5, there is formed by a shoulder 5a a stop
`for the actuating element 10, to define the position of the
`actuating element in the separated position in FIG. 2. Hereby,
`the truncated cone-shaped locating section 10a lies near the
`stop 5a, while its distal end abuts on the valve disc 7 as shown
`in FIG. 2. The radial slits 7a of the valve disc 7 are designed
`such that in the ready position in FIG. 1, the flaps 7b are bent
`radially upwards less than in the open position by the locating
`Section 10a in FIG. 3.
`As the cross-sectional view in FIG. 4 shows, the two plung
`erSlob of the valve actuating element 10 are guided in longi
`tudinal grooves 5e of the hub element 5 and they project
`radially inwards into the bore 5c of the hub element 5, so that
`they form an abutting surface for the neckportion 14a of the
`syringe 14. The bore 5c in the hub element 5 is formed slightly
`conically corresponding to the conical neck portion 14a of a
`Syringe.
`
`7
`
`

`

`US 7,736,339 B2
`
`3
`On the inner circumference of the bore 5c of the hub
`element 5, a further shoulder 5b having a smaller diameter is
`formed, on which the radially outer areas of the spring arms
`13a and 13b abut in the ready position in FIG.1. Hereby, the
`spring clip 13 is fixed in its position in the hub element 5.
`When the needle hub 8 with the hollow needle 9 is removed
`from the catheter hub 2, first the spring clip 13 is held on the
`shoulder 5bby abutting until the radial projection.9b comes to
`abut on the rear wall 13c of the spring clip. In this position, the
`two spring arms 13a, 13b can be released from the shoulder
`5b and spring back inwards to cover the needle tip, as FIG. 2
`shows, whereupon the spring clip 13 with the hollow needle 9
`can be removed from the catheter hub.
`In the embodiment according to FIGS. 1 to 3, the distal end
`section of the hub element 5 is shrunk, welded or bonded onto
`the proximal end section of the hub element 3 after the valve
`actuating element 10 and the valve disc 7 are inserted in the
`hub element 5. It is also possible to join the two hub elements
`3 and 5 to one another, for example by a thread which is
`secured against loosening after assembly. The spring clip 13
`is inserted together with the hollow needle 9 in the bore 5c of
`the hub element 5 during assembly, wherein the radially outer
`areas of the spring arms 13a, 13b Snap in at the shoulder 5b
`under elastic deformation.
`Preferably, in front of the shoulder 5b a projection 5b' can
`beformed in the bore 5c of the hub element, as shown in FIG.
`2. Hereby the snap-in and holding effect of the spring clip 13
`is increased.
`FIG. 5 shows a modified embodiment of the connection of
`the two hub elements 3 and 5, in which two cylindrical sec
`tions 3b and 5d engage in one another. A thread can be
`provided between these two cylindrical sections. However, it
`is also possible to bond or weld these two sections.
`In this embodiment, the valve actuating element 10 is also
`modified in relation to the embodiment of FIGS. 1 to 3. FIG.
`7a shows a side view of the approximately U-shaped actuat
`ing element 10 with the spring clip 13 inserted therein. As the
`side view rotated by 90° in FIG.7b shows, the locating section
`10a is partly flattened on opposite sides so that the width of
`the plunger sections 10b extends into the locating section 10a.
`FIG. 7c is a front view from the left in FIG.7b and shows the
`flattened structure of the locating section 10a. FIG. 7d is a
`sectional view along the central line in FIG.7b. FIG. 7e shows
`a section through the valve actuating element 10 along the
`line B-B in FIG. 7d.
`FIG. 5 shows the lower half of the valve actuating element
`10 corresponding to the view in FIG.7a, and the upper halfin
`a sectional view rotated by 90° corresponding to FIG.7b. The
`shoulder 5a for positioning the valve actuating element 10 in
`the hub element 5 is hereby formed on the ends of the dia
`metrically opposite grooves 5e (FIG. 4), so that the proximal
`ends of the plunger sections 10b abut on the shoulders 5a.
`Corresponding to the shoulder 5b in FIGS. 1 to 3 in the
`embodiment in FIG. 5, there is formed on the hub element 5
`a projection 5f which projects inwards at diametrically oppo
`site positions on the bore 5c of the hub element 5 and fixes the
`spring clip 13 in the hub element 5 until the spring arms 13a,
`13.b spring inwards over the needle tip and the spring clip with
`the hollow needle 9 is removed from the catheter hub.
`FIG. 8 shows a modified embodiment having a hollow
`cylindrical valve actuating element 10 on whose inner cir
`cumference a projection 10f is formed for positioning the
`spring clip 13 inside the valve actuating element 10. FIG. 9a
`shows a front view of the valve actuating element 10 from the
`right and FIG.9b shows a front view from the left in FIG. 8,
`wherein for locating the neck portion 14a of a Syringe 14, in
`this embodiment radially inwardly projecting ribs 10e are
`formed which protrude radially into the bore 5c of the hub
`element 5, as the upper half of the valve actuating element in
`
`40
`
`45
`
`4
`FIG.8 shows, in which the sectional view of the lower half of
`the valve actuating element 10 is shown rotated by 90° in
`relation to the upper half.
`FIG. 10 shows a modified embodiment wherein between
`the two hub elements 3 and 5 a check valve 17 is inserted,
`which has a hollow cylindrical section 17b starting from a
`flange section 17a and abutting on the inner circumference of
`the hub element 3. From the inner circumference near the
`flange section 17a there start two opposite flaps 17c, which
`abut on the outer circumference of the hollow needle 9 in the
`ready position in FIG. 10. When the needle 9 is removed from
`the catheter hub 2, the elastically deformed flaps 17c move
`inwards and close the valve. In this embodiment, an actuating
`element for opening the valve 17 is not necessary, because the
`pressure of the fluid from the syringe 14 displaces the flaps
`17c radially outwards so that the liquid can flow out through
`the valve17. In this embodiment of a check valve, a so-called
`duck-bill valve is concerned, whose construction is in itself
`known.
`In FIG. 10, in order to allow the spring clip 13 to be held in
`the catheter hub during withdrawal of the hollow needle 9
`from the catheter hub 2 until the radial projection 9b on the
`hollow needle engages with the rear wall 13c to cover the
`needle tip, in this embodiment there is formed on the inner
`circumference of the proximal hub element 5 a projection 5f
`which extends radially inwards and on which the radially
`outer areas of the spring arms 13a and 13b come to abut and
`hold the spring clip until the spring arms spring back radially
`inwards to cover the needle tip. The inner diameter of the
`projection 5f is designed only slightly smaller than the maxi
`mum radial dimension at the spring arms 13a and 13b, so that
`during assembly the spring clip 13 can be inserted by slight
`pressure into the position in the catheter hub as shown in FIG.
`10.
`In the embodiment of a catheter insertion device according
`to FIGS. 1 to 9, in the position of the valve actuating element
`10 in FIG. 2 the valve disc 7 can be opened by low pressure
`produced by the syringe 4 for drawing off liquid from the
`catheter, wherein the elastic flaps 7b are bent upward by the
`low pressure. In the embodiment of FIG. 10, a drawing-off of
`liquid from the catheter is not possible, because the duck-bill
`valve does not open when there is low pressure on the proxi
`mal side.
`It is convenient to fabricate the check valve in the form of
`a valve disc 7 or of the flap valve 17 from elastic silicon, while
`a correspondingly rigid plastic material is used for the hub
`elements 3 and 5 and for the valve actuating element 10.
`What is claimed is:
`1. A catheter insertion device comprising
`a hollow catheter hub having a catheter tube attached at a
`distal end thereof,
`a needle hub having a hollow needle attached thereto and
`extending through the catheter hub and the catheter tube
`when in a ready position,
`a needle guard element arranged displaceably on the
`needle in the catheter hub and having an engaging sec
`tion which engages with an engaging means formed near
`the needle tip when the hollow needle is removed from
`the catheter hub,
`wherein a check valve comprising a valve disc having
`radial slits starting from a middle section of the valve
`disc is disposed between the catheter tube and the needle
`guard element in the catheter hub through which the
`hollow needle extends in the ready position and which
`automatically closes after the removal of the needle, and
`wherein the check valve remains in the catheter hub
`when the hollow needle is removed from the catheter
`hub and the catheter tube; and
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`5
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`10
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`25
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`30
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`35
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`50
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`55
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`60
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`65
`
`8
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`

`

`US 7,736,339 B2
`
`5
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`10
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`15
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`25
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`30
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`35
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`5
`wherein a valve actuating element is displaceably guided in
`the catheter hub and has a hollow space for receiving the
`needle guard element.
`2. The device according to claim 1, wherein the catheter
`hub comprises a distal hub element and a proximal hub ele
`ment, and the check valve is held between the distal hub
`element and the proximal hub element, which are joined to
`one another.
`3. The device according to claim 1, wherein the check valve
`has a plurality of radially elastically expandable valve flaps
`configured to be moved into an open position by fluid pres
`Sure generated from a syringe.
`4. The device according to claim 1, wherein the catheter
`hub comprises an inner circumference and a radial projection
`projecting radially from the inner circumference, which is
`configured to engage with the needle guard element in the
`ready position.
`5. The device according to claim 1, wherein the valve
`actuating element is formed as a hollow cylinder with a trun
`cated cone-shaped distal end section and comprising two
`proximally extending legs defining the hollow space for
`receiving the needle guard therebetween.
`6. The device according to claim 5, wherein the hollow
`cylindrical valve actuating element comprises an inner cir
`cumference and a radial projection.
`7. The device according to claim 1, wherein the valve
`actuating element has a truncated cone-shaped abutting sec
`tion.
`8. The device according to claim 1, wherein the needle
`guard element is formed as a spring clip which has diametri
`cally opposite spring arms starting from a rear wall provided
`with a bore, wherein bent end sections of the spring arms
`overlap and block the needle tip when the engaging means of
`the needle comes to abut on the rear wall.
`9. A catheter insertion device comprising:
`a catheter tube attached to an end of a catheter hub, the
`catheter tube comprising a lumen and the catheter hub
`comprising an interior cavity;
`a needle defining a needle axis attached to an end of a
`needle hub, said needle projecting through the lumen of
`40
`the catheter tube:
`a valve for regulating fluid flow positioned inside the inte
`rior cavity of the catheter hub and in mechanical com
`munication with a movable valve actuating element for
`opening the valve, and wherein the valve remains inside
`the interior cavity of the catheter hub when the needle is
`removed from the catheter tube and the catheter hub; and
`a needle guard element comprising two needle guard arms
`crossing the needle axis of the needle positioned inside
`the catheter hub adjacent the valve in a ready position.
`10. A catheter insertion device comprising:
`a catheter tube attached to an end of a catheter hub, the
`catheter tube comprising a lumen and the catheter hub
`comprising an interior cavity;
`a needle defining a needle axis attached to an end of a
`needle hub, said needle projecting through the lumen of
`the catheter tube and comprising an engaging section
`near a needle tip;
`a valve for regulating fluid flow positioned inside the inte
`rior cavity of the catheter hub, said valve comprising an
`opening and the needle projecting through the opening,
`and wherein the valve remains inside the interior cavity
`of the catheter hub when the needle is removed from the
`catheter tube and the catheter hub;
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`45
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`50
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`55
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`60
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`6
`a needle guard element comprising an opening adapted to
`contact the engaging section of the needle positioned
`between the valve and the needle hub; and
`wherein a valve actuating element is slidably displaced in
`the interior cavity of the catheter hub for opening the
`valve.
`11. The catheter insertion device of claim 9, wherein the
`two needle guard arms cross one another.
`12. The catheter insertion device of claim 9, wherein the
`needle guard element comprises a proximal wall comprising
`an opening having the needle passing therethrough.
`13. The catheter insertion device of claim 9, wherein the
`valve is a disc having at least one slit formed therein.
`14. The catheter insertion device of claim 9, wherein the
`movable valve actuating element comprises two leg sections
`comprising a space therebetween for accommodating the
`needle guard.
`15. The catheter insertion device of claim 10, wherein the
`engaging section is crimp.
`16. The catheter insertion device of claim 10, wherein the
`needle guard further comprises at least one arm comprising
`an apex abutting a shoulder located on the interior Surface of
`the catheter hub.
`17. The catheter insertion device of claim 10, wherein the
`needle guard comprises two arms that intersect one another.
`18. The catheter insertion device of claim 10, wherein the
`valve actuating element comprises two leg sections compris
`ing a space therebetween for accommodating the needle
`guard.
`19. The catheter insertion device of claim 10, wherein the
`needle guard is made from a metal material.
`20. The device according to claim 1, further comprising a
`valve actuating element formed as a hollow cylinder with a
`truncated cone-shaped distal end section, with two legs
`extending proximally therefrom, the two proximally extend
`ing legs defining a space therebetween configured for receiv
`ing the needle guard element.
`21. The device according to claim 20, wherein the catheter
`hub comprises a diameter variation on an inner circumference
`of the catheter hub located between a distal end and a proxi
`mal end of the valve actuating element.
`22. The catheter insertion device according to claim 9.
`wherein the movable valve actuating element is formed as a
`hollow cylinder with a truncated cone-shaped distal end sec
`tion, comprising two proximally extending legs defining a
`space therebetween configured to receive the needle guard
`element.
`23. The catheter insertion device according to claim 9.
`wherein the catheter hub comprises a diameter variation on an
`inner circumference of the catheter hub located between a
`distal end and a proximal end of the valve actuating element
`when in the ready position.
`24. The catheter insertion device according to claim 10,
`wherein the valve actuating element is formed as a hollow
`cylinder with a truncated cone-shaped distal end section,
`comprising two proximally extending legs defining a space
`therebetween configured for receiving the needle guard ele
`ment therebetween.
`25. The catheter insertion device according to claim 10,
`wherein the catheter hub comprises a diameter variation on an
`inner circumference of the catheter hub located between a
`distal end and a proximal end of the valve actuating element
`when