United States Patent 11
`Wunsch
`
`[11] Patent Number:
`
`[45) Date of Patent:
`
`4,559,036
`Dec. 17, 1985
`
`[54] APPARATUS FOR CONTROLLING
`ADMINISTRATION OF MULTIPLE
`INTRAVENOUS SOLUTIONS AND
`MEDICATIONS
`
`[76]
`
`Inventor: Richard E. Wunsch, 207 Circle Dr.,
`Traverse City, Mich. 49684
`
`[21] Appl. No.: 561,210
`
`[22] Filed:
`
`Dec. 14, 1983
`
`Tint, C14 oeeee cceceececesnenseestanersenes AG61M 5/14
`[51]
`[52] U.S. Ch. cece eeessescresessetsteteseens 604/81; 604/247;
`604/250; 604/259
`[58] Field of Search 00.0... ccs seeseeees 604/80-86,
`604/65-67, 245, 246, 247, 258, 259, 250;
`222/145
`
`[56]
`
`References Cited
`U.S. PATENT DOCUMENTS
`
`2,954,028
`8/1960 Smith ........cs scssssseeneeneseres 604/80
`
`3,043,303
`6/1962 Still vcr
`rcescccscnsetccssecereeenvens 604/66
`
`4,094,318
`6/1978 Burke 0...
`ccesconeesssersessoeers 604/81
`4,102,492 7/1978 Gold et al.
`-..cecsereeees 235/375
`
`7/1983 Shim ........cecsscsesessecesensneseneeees 604/67
`4,394,862
`1/1984 Bilstad et al.
`oo...
`sseeseeeeeee 604/6
`4,425,116
`
`....
`-- 604/247
`4,447,230 5/1984 Gula et al.
`4,512,764 4/1985 Wunsch ........cc ccsecessereseees 604/80
`
`Primary Examiner—C. Fred Rosenbaum
`Assistant Examiner—Karen Kaechele
`Attorney, Agent, or Firm—Cullen, Sloman, Cantor
`Grauer, Scott & Rutherford
`
`ABSTRACT
`[57]
`Apparatus for sequentially dispensing a plurality of
`solutions through an intravenous supply catheter in-
`cludes a disposable tubing manifold that is connected to
`each of the solutions to be administered. Flow ofsolu-
`tion through the branches of the tubing manifold is
`stopped by valves mounted upon a manifold plate
`which engage each branch. The quantity of solution
`dispensed is metered by a volumetric infusion pump and
`controlled by sequentially opening and closing the
`valves individually. Electronically operable motors or
`solenoids are connected to each valve for automatically
`opening and successively closing each valve. A se-
`quencer-timer in accordance with a predetermined pro-
`gram such as from a program card, controls the auto-
`matic energization and successive de-energization of
`each motor, one at a time and successively energizes
`additional motors for intermittent individual operation
`through a preselected cycle of machine operation.
`
`12 Claims, 4 Drawing Figures
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`
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`1
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`Sinclair Pharmaetal.
`EUNSUNG-1020
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`Sinclair Pharma et al.
`EUNSUNG-1020
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`1
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`U.S. Patent Dec.17, 1985
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`U.S. Patent Dec.17,1985 Sheet2of3
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`U.S. Patent Dec.17,1985
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`4,559,036
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`4,559,036
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`1
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`APPARATUS FOR CONTROLLING
`ADMINISTRATION OF MULTIPLE
`INTRAVENOUS SOLUTIONS AND
`MEDICATIONS
`
`BACKGROUND OF THE INVENTION
`
`1. Technical Field
`Thepresent invention relates to apparatus including a
`manifold for automatically administering intravenous
`solutions and medications. Moreparticularly, the inven-
`tion relates to apparatus for sequentially supplying a
`plurality of solutions to a single intravenous tube.
`2. Prior Art
`Medical treatment frequently requires the administra-
`tion of more than onesolution or medication by intrave-
`nous injection.
`In many medical
`treatments several
`drugs are administered periodically.
`To minimize the numberofinjections given to a pa-
`tent it is commonpractice to inject medications through
`a single intravenous tubing by means of one or more
`Y-connectors. The normal procedureis for a member of
`a hospital staff to unsheath a needle and insert it in a
`Y-connectorat time periods and in quantities specified
`by the treating physician. When a given medication has
`been administered the needle is removed from the Y-
`connector, resheathed and stored next to the patient’s
`bed until the next treatment interval. This procedureis
`subject to contamination due to the repeated sheathing
`and unsheathing of the needle. While this procedure is
`acceptable when a limited number of medications are
`administered, as the frequency of administration in-
`creases the amountofstaff time expended,difficulty of
`keeping the needle and Y-connectorsterile, and chance
`of error in administering a medication likewise increase.
`This procedure for periodically administering medi-
`cations to patients is time consuming for hospital staff
`and requires detailed instructions because medicationis
`often prescribed around the clock. In medical treat-
`ments requiring a large numberofsolutions each having
`a loosely hanging tube, a memberofthe hospital staff
`could conceivably be confused and dispense the wrong
`solution.
`Frequently, tubesare left dangling loosely around the
`patient’s bed, instead of being tied out of the way, be-
`cause the tubes must be free for connection to the Y-
`connector. The tubes can be caughtin the side rails of
`the bed and damaged. During administration of a solu-
`tion one of the tubes may be pinched off inadvertently
`resulting in insufficient medication being dispensed.
`Various types of manifolding apparatus having been
`developed to meet the problems posed by supplying
`multiple medications
`to a patient. U.S. Pat. No.
`2,954,028 to Smith discloses such an apparatus for ad-
`ministering parenteral fluids through the use of a mani-
`fold. While the Smith manifold allows a large numberof
`medications to be administered simultaneously,
`it
`is
`bulky and time consumingtoset up. The different medi-
`cations in the various passages of the manifold may
`intermix and if not compatible could interact deleteri-
`ously with each other. Different branches of the mani-
`fold open into the central tube at directly opposite loca-
`tions which allows the fluids to flow from one branch
`into another.
`Reuse of the Smith manifold is subject to several
`drawbacks. It is well known that some medications,
`while theraputic for some, are toxic to otherpatients. If
`a patient receives medication through a manifold resid-
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`ual deposits of a previously administered medication
`maybe present in the manifold. If the residual deposit is
`a substancethat is toxic to the patient it is possible that
`the patient could be harmed. Therefore, unless the man-
`ifold is cleaned and sterilized between each patient,
`there is a danger that a patient may inadvertently re-
`ceive residue from a medication administered to a prior
`patient: Cleaning andsterilizing the manifold between
`uses is laborious and requires valuable staff time.
`In addition, prior art devices have failed to disclose
`an accurate method for sequentially metering several
`different medications through a common catheter that
`is both inexpensive and simple to use. While visual sight
`glass drop counters have been used with Y-connectors,
`as shownin U.S. Pat. No. 3,886,937 to Boboet al and in’
`the Smith manifold described above, such devices are
`time consuming to use and must be visually monitored
`for accuracy. Electronic drop counters as disclosed in
`U.S. Pat. No. 4,094,318 to Burke offer improved accu-
`racy but are extremely expensive, expecially if more
`than one or twosolutions are to be administered.
`RELATED PATENT APPLICATION
`Applicant’s copending U.S. patent application, Ser.
`No. 423,978 filed Sept. 27, 1982, now U.S. Pat. No.
`4,512,764 is entitled “Manifold For Controlling Admin-
`istration of Multiple Intravenous Solutions and Medica-
`tions”. The manifold includes manually operated valves
`for individually controlling the flow of each fluid
`through the manifold. The time intervals for opening
`and enclosing each valve are manually controlled.
`Thedifficulty is that an operator must attend to the
`manual operation for opening and closing the valves
`individually and one at a time and at the same time
`determine the period that each vaive is open. Also the
`attendant must make sure that the valve which controls
`the flow,or interruption of flow of the TKOor the keep
`open basic solution, must be so manually regulated, so
`that the valve is open whenall other valves are closed
`for continued intravenous feeding of a neutral or basic
`solution or medication to avoid clotting or clogging of
`the catheter or intravenous needle.It is further required’
`to intermittently open the TKO valve between the
`opening and closing of any two other valves to be sure
`that there is a flow of neutral solution between the flows
`of different solutions out through the manifold to elimi-
`nate any remnants of solution from one source mixing
`with a secondsolution.
`In the copending application, the multiple intrave-
`nous solution manifold comprises a three-piece mani-
`fold valve assembly having a disposable tubing mani-
`fold that assuressterility and purity in medications. The
`three part manifold apparatus is simple to disassemble
`for removing the disposable tubing manifold and replac-
`ing it with a newsterile tubing manifold. The remainder
`of the manifold valve assembly does not contact any
`medication and therefore maybe safely used repeatedly
`by different patients.
`In the copending application, the manifold plate has a
`plurality of manual valves with each valve being opera-
`tive to close off the flow of a solution through a branch
`of the tubing manifold to control the flow of the solu-
`tions to the patent.
`In the copending application, the dispensing tube of
`the valve manifold is preferably connected to an infu-
`sion pumpthatin turn pumpsthe intravenoussolution at
`a measureablerate into a patient by meansof an intrave-
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`3
`nous needle or catheter. At any one timeit is preferred
`that ony one valve will be open to allow the solution to
`be accurately measuredasit is dispensed. The infusion
`pump drawssolution at a known flow rate for a pre-
`scribed period of time, whereby the medication dose
`may be easily and accurately measured. A tube from a
`keep open solution, or base solution, is connected to one
`end of the valve manifold for use when no medication is
`being dispensed to prevent the formation ofclots in the
`catheter or in the patient’s vein at the injection point
`and is further used between the dispensing of different
`medication solutions to prevent mixing of the medica-
`tions.
`
`SUMMARY OF THE INVENTION
`
`An important feature of the present invention is to
`provide reversible electric motors or motor means in-
`cluding electronically controlled solenoids connected
`to the individual valves by which the valves mounted
`upon the valve plate may be automatically opened and
`closed intermittently energizing and successively de-
`energizing the electric motor means.
`Anotherfeature is to provide in connection with the
`manifold and its branches to which are directed various
`fluids to be injected intravenously, a valve for each
`branch of the manifold and for the inlet to the manifold
`for the purpose of squeezing closed adjacent portions of
`the manifold tubing preventing the flow of any of the
`fluids through the manifold. The valve includes a re-
`tractable element having a normal advanced position of
`maintaining the corresponding tube portion collapsed.
`Upon operation of an electric motor means, such as a
`reversible motor, or a solenoid is adapted to retract the
`valve element of the valve for a predetermined period
`to permit the passage ofintravenous fluid in one of the
`branches or through the inlet of the manifold for a
`predetermined period. Either reversal of the motor or
`the deactivation of the solenoid causes the valve ele-
`ment to re-engage and close off the corresponding tube
`portion of the manifold or manifold branch stopping
`further flow through that branch.
`Another feature includes an electronic controllable
`sequencer-timer having a plurality of electrical output
`leads connected to each motor means for individually
`and progressively activating one motor means opening
`said valve and after a predetermined time interval deac-
`tivating said motor means successively for closing said
`valve. Further progressively in accordance with a pre-
`determined time interval activating another motor
`means successively opening a valve for further progres-
`sively in accordance with a predetermined program
`successively activating and deactivating singly addi-
`tional motor means.
`A further feature includes in conjunction with an
`electronic controllable sequencer
`a
`timing cycle
`wherein over a period of time corresponding valves are
`independently and successively opened for a predeter-
`mined time interval and thereafter closed wherein suc-
`cessively an additional valve is separately opened for a
`period and successively wherein throughout the com-
`plete cycle each of the individual valves are progres-
`sively and oneat a time opened for a period maintained
`open and successively closed. As a result the adminis-
`tration of the respective different
`intravenous fluids
`continues one at a time automatically throughout the
`cycle or repeats thereof during the overall time cycle
`for the machine.
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`invention contem-
`Another feature of the present
`plates that each valve will include a movable elementin
`one position normally squeezing together an adjacent
`portion of the tubing of the manifold preventing the
`flow of any particular intravenous fluid through a cor-
`responding branch of the manifold and wherein auto-
`matic control mechanism is provided whereby only one
`valve will be opened for a period, maintained open and
`successively closed before a second valve is opened for
`a predetermined period and successively closed, etc.
`A further feature contemplates the use of a program
`card impressed with a predetermined program orinput
`data which is removably projected into the sequencer-
`timer for the progressive energization and successive
`de-energization of the multiple channel output from the
`sequencer-timer individually connected to the corre-
`sponding motor means.
`A further feature includes a miniaturized reversible
`electric motor mounted upon each valve which in-
`cludes a drive shaft wherein the movable element is
`actuated by a valve stem threadly connected thereto
`and wherein intermeshing gears are interposed between
`the drive shaft and the valve stem whereby in an auto-
`matic manner the valve may be openedfor a predeter-
`mined period,
`thereafter progressively closed. Upon
`deactivation of a first electric motor, a second electric
`motor is activated, etc., opening another valve for a
`predetermined period of time and thereafter rotating in
`the opposite direction for closing the valve.
`A further feature includes in conjunction with each
`of the valve elements a spring biased piston attached
`thereto and a solenoid having a reciprocal armature
`connected to the piston whereby onselective energiza-
`tion of the solenoid, the elementis retracted for a prede-
`termined period of time opening the passage of one fluid
`through a branch or portion of the manifold. Upon
`deactivation of the solenoid the elementis biased in the
`opposite direction for closing off the flow through said
`branch or manifold.
`A further feature contemplates the use of a hinge
`interconnecting the one side edges of the manifold and
`valve plates, and with a screw means interconnecting
`the other side edges of said plates for facilitating open-
`ing of the manifold plate and for replacement of the
`tubing manifold.
`An importantfeature includes in conjunction with an
`electric controllable sequencer-timer, a program card
`having thereon a plurality of markable parallel spaced
`tracks corresponding to the numberof controlled chan-
`nels to the respective electric motors. The tracks have a
`length corresponding to a preselected time cycle with
`preselected data applied to each track. The sequencer-
`timer includes a solid state random access memoryacti-
`vated by the incoming data upon the program card
`together with a plurality of output switches correspond-
`ing and connected to each channel respectively for
`selectively and progressively activating one at a time,
`each motor means in compliance with data pro-
`grammed upon the input program card.
`These and other features and objects will be seen
`from the following Specification and claims in conjunc-
`tion with the appended drawings.
`THE DRAWINGS
`
`FIG. 1 is a front perspective view of the present
`apparatus for controlling administration of multiple
`intermediate solutions.
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`4,559,036
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`FIG. 2 is an exploded perspective view of the ele-
`ments of the solution manifold selector and tubing mani-
`fold shown in FIG.1 and on an increasedscale.
`FIG. 3 is a fragmentary longitudinal section of a
`reversible motor operated valve of which a plurality are
`shown in FIG. 1, mounted upon the manifold selector
`on an increased scale.
`FIG. 4 is a similar fragmentary section, showing a
`solenoid controlled valve corresponding to the valves
`shown in FIG.1.
`It will be understood that the above drawingsillus-
`trate merely preferred embodiments of the invention
`and that other embodiments are contemplated within
`the scope of the claims hereafter set forth.
`DETAILED DESCRIPTION OF AN
`EMBODIMENTOF THE INVENTION
`
`6
`Needle 19 is adapted for application to the vein of a
`patient, human or otherwise, for the controlled delivery
`of a plurality ofdifferent intravenous solutions or medi-
`cations, one at a time. This is determined by the solution
`manifold selector 17, which may be automatically con-
`trolied by the sequencer-timer 13.
`In the illustrative embodiment, and to assist in the
`uniform delivery of preselected different intravenous
`fluids to the patient, there is employed an infusion pump
`20, readily available on the market, which is interposed
`in the dispensing tube 18 for pumping solutions, one at
`a time, into the patient at a predetermined flow rate as
`set by the pump 20. The manifold selector includes
`manifold plate 21, replacable manifold 22 and a valve
`plate 23 sandwiched together, as shown in FIG.1, and
`is shown further in FIG. 2 corresponding to the draw-
`ing in copending application Ser. No. 423,978.
`Thevalve plate 23 of my copending application cor-
`respondsto valve plate 23 forming a part of the present
`solution manifold selector 17, FIG. 1. The only differ-
`ence is that the valves 40 in the copending application
`are manually operable while the valves 40 of the present
`embodiment, FIG. 1 are controlled by electric motor
`means. These are either reversible electric motors 48,
`FIG. 3, or solenoids 59, FIG. 4, for individually con-
`trolling the operation of the respective valves 40.
`Where in the copending application, the manifold
`plate 21 is connected to the valve plate 23 with the
`tubing manifold 22 interposed in a sandwich,as by fas-
`teners extending through the corresponding plates, in
`the illustrative embodiment, FIG. 1, the assembly of the
`manifold plate 21 to the valve plate 23 includes upon
`their one upright sides a hinge 24 and upon their other
`upright sides, the hand operated screw fastener 25. By
`this construction, manifold plate 21 may be swung open
`upon release and disengagementof fastener 25 to permit
`the removal and replacement of tubing manifold 22,
`FIG.2.
`In operation, the intravenous solutions contained in
`the plurality of bottles 15, including the bottle marked
`TKO,are connected to the manifold 22 by means of
`supply tubes 16. The solutions passing through the man-
`ifold 22 are sequentially administered by means of the
`dispensing tube 18 which is powered and controlled by
`infusion pump 20. The medication is injected into a
`patient by meansofa catheteror intravenous needie 19.
`It is contemplated that an intravenous needle is consid-
`ered equivalent to the use of a catheter.
`Manifold plate 21 which receives the tubing manifold
`22 is covered by the valve plate 23. Manifold plate 21 as
`described in said copending application is a rigid mem-
`ber having a vertical slot 26 running the length of the
`manifold plate from the top 27 to the bottom 28. The
`vertical slot is a U-shaped channel opening on the face
`of the manifold plate. Branch slots 29 are formed in the
`manifold plate 21 to extend from the vertical slot 26 to
`the lateral sides 30 of the manifold plate. The branch
`slots are U-shaped channels that open into the face of
`the manifold plate. The branch slots 29 extend up-
`wardly from thevertical slot 26 at a slightly acute angle.
`The tubing manifold 22 is made up of the trunk tube
`32 that extends from the top 27 to the bottom 28 of the
`manifold plate. The trunk tube 32 includes a female
`connector 33 onits top end and a male connector 34 on
`its bottom end. A plurality of branch tubes 37 extend
`from opposite sides of the trunk tube 32 from longitudi-
`nally spaced openings 38 formed in the trunk tube. The
`branch tubes‘ open into the trunk tube 32 to permit fluid
`
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`Refering to FIG. 1, apparatus for controlling the
`administration of multiple intravenous solutions and
`medications is generally indicated at 10 for intrave-
`nously dispensing a plurality of medications and solu-
`tions to a patient. An upright vertically adjustable tube
`support 11 is mounted upon a standard post 12, frag-
`mentarily shown.
`Electronic controllable sequencer-timer 13 overlies
`tube support 11 and is suitably bracketed thereto. The
`sequencer-timer 13 has a plurality of electrical output
`leads 49 connected to each motor or motor means,
`hereafter described, to individually and progressively
`activate one motor means opening a valve and after a
`predetermined time interval, deactivating or reversing
`the motor meansfor successively closing said valve and
`for further progressively and in accordance with a pre-
`determined program successively activate and deacti-
`vate similarly or reverse additional motor means.
`In the illustrative embodiment,
`the controller se-
`quencer-timer is a unit available on the market. For
`example, one such timer is known as the XANADU
`Controls-Solid State Programmer Sequencer. XAN-
`ADU Controls, of Springfield, N.J.,
`is a division of 40
`Valcor Engineering Corporation.
`Thestructure, function and operation of the control-
`ler sequencer-timer
`is set
`forth in U.S. Pat. No.
`4,102,492 dated July 25, 1978 entitled Universal Pro-
`grammable Process Control Apparatus. To the extent
`that the function and operation of the controller se-
`quencer-timer is not shown in detail in the drawings
`herein, such portions thereof as directed to the, function
`and operation set forth in said patent are incorporated
`herein be reference.
`In the illustrative embodiment employing the present
`disclosed controller sequencer-timer 13, there is incor-
`porated a program card 14, FIG. 1, which is mountable
`upona retractable tray 68. The tray 68 projects from the
`sequencer-timer 13 to receive the program card 14.
`A plurality of intravenousfluid bottles 15, sometimes
`hereafter referred to as I.V. bottles, each contain differ-
`ent medications or solutions adapted to be delivered
`through corresponding supply tube 16 to the present
`solution manifold selector 17 mounted upon support
`post 11 in FIG. 1. One of the IV bottles has a further
`designation TKOthereon, representative of Keep Open
`Base Solution, which in accordance with a predeter-
`mined sequence hereafter described and through its
`supply tube 16 is directed to the present solution mani-
`fold selector 17. Depending from the solution manifold
`selector 17 at 34 is a flexible dispensing tube 18 which
`has on one end a catheter or intravenous needle 19.
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`flow from the branch tubes 37 to the trunk tube 32. The
`branchtubesintersect the trunk tube at spaced locations
`to that fluid flow is directed into the trunk tube and not
`into another branch tube. An upper portion of trunk
`tube 32 is sometimes referred to as a branch.
`When the tubing manifold 22 is placed in the mani-
`fold plate 21, the branch tubes 37 arefit into the branch
`slots 29 while the trunk tube 32fits into the vertical slot
`26. The branch tubes 37 in their free state extend per-
`pendicularly from trunk tube 32. However, when the
`tubing manifold 22 is placed in the manifold plate 21,
`the branch tubes 37 are bent into the inclination of the
`branch slots 29. By doing so, fluid flow in the branch
`tubes from the lateral sides 30 to the trunk tube 32 is
`encouraged by gravity while fluid flow in the opposite
`direction is resisted by gravity.
`The valve plate 23 includes a plurality of valves 40
`which are used to selectively permit fluid flow through
`the branch tubes 37 and the trunk tube 32. The valves 40
`includes a reciprocal element 41, FIG. 3, whichis posi-
`tioned to bear upon one of the branch tubes 37 or the
`trunk tube 32. The element, sometimes referred to as a
`wedge, is connected to internally threaded valve stem
`42 thatis retained in the valve plate by mountplate 46.
`The valve stem receives valve shaft 43 for moving the
`element
`longitudinally relative
`to the
`internally
`threaded valve stem 42. Element41is slidably and non-
`rotatively movable in flat slot 44.
`Eachofthe valves 40 has an open position, FIG.3, in
`which fluid flow is permitted through the tube or
`branch 37, and a closed position in which the element 41
`is pressed against tube 37 to prevent fluid flow there-
`through. A valve 40 is also provided adjacent the trunk
`tube 32 for shutting off the keep open solution from the
`bottle marked TKO, FIG. 1. The valve 40, FIG. 2,
`marked TKO, engaging the trunk tube 32 operates in
`the same manneras each ofthe valves 40 engaging the
`branch tubes 37.
`In operation, the solution bottles 15 are hung above
`the manifold selector 17, such as from sequencer-timer
`13, so that solutions flow from the bottles 15 to the
`selector 17 through the supply tubes 16. One supply
`tube is received within the female connector 33, FIGS.
`1 and 3, that extends from the top 27 of the manifold
`plate 21 in fluid flow connection with the trunk tube 32.
`Other supply tubes 16 are received within female con-
`nectors 33 that are attached to each of the branch tubes
`37 and extend from thelateral sides 30 of the manifold
`plate 21. Each I.V.solution flows from the bottles 15 to
`the manifold selector 17. The flow ofthe I.V. solution
`into the dispensing tube 18 is controlled by meansof the
`valves 40. Each of the valves 40 has an open position in
`which fluid is permitted to flow from the supply tubes
`16 into the dispensing tube 18 and a closed position in
`which the branch tube 37 or trunk 32 is pinched off to
`prevent fluid flow therethrough.
`As disclosed in my pending patent application Ser.
`No. 423,978, fluid volume through the dispensing tube
`18 is controlled by volumetric infusion pump 20. The
`pump 20 accurately meters and maintains constant flow
`through the dispensing tube and can regulate the
`amount of fluid administered. By controlling the
`amount of fluid administered while the appropriate
`valve 40 is open the volume of solution dispensed is
`automatically controlled.
`Accurate control of fluid administration may be as-
`sured by sequentially opening and closing the valves 40
`so that a single volumetric infusion pump may be used
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`to draw fluids from each ofthe solution bottles sequen-
`tially. When none of the medications are required the
`valve 40 controlling the trunk tube 32 is opened to
`permit the keep open solution TKOorbasesolution to
`flow, thereby keeping the intravenous needle open and
`free of clots. The valve 40 for the keep open solution is
`preferably opened for a short period between changes
`in medication to flush out the manifold, thereby pre-
`venting intermixing of solutions.
`According to the present invention the tubing mani-
`fold 22 is disposable. The manifold plate 21 is easily
`opened from the valve plate 23 and the tubing manifold
`may be simply disconnected from the supply tubes 16
`and removed from the manifold selector 17. The tubing
`manifold 22, FIG. 2, is then replaced when a new pa-
`tient is to be hooked up to the manifold selector 17.
`As disclosed in my copending application, up to eight
`solutions may be accomodated by a single manifold
`selector 17. It should be understood that the numberof
`branches and valves provided can be changed. Each of
`the fluids is introduced into the trunk tubeat a location
`spaced from the other openings 38 in the trunk tube32.
`In this way thefluids are introduced into the trunk tube
`32 and begin flowing toward the bottom 28 of the mani-
`fold plate 21 before encountering the next opening 38 in
`the trunk tube 32.
`Referring to FIG. 3, internally threaded valve stem
`42 includes an axial shank 45 which extends through
`mountplate 46 and into gear housing 47 forming a part
`of valve assembly 40. The miniature, reversible electric
`motor 48 having a powerlead 49 at one endis projected
`into and secured within gear housing 47 and includes
`drive shaft 50. The channellead is one ofa plurality of
`channel leads designated at 49 in FIG. 1, which extends
`from the sequencer-timer 13. In the illustrative embodi-
`ment, there are eight channel leads which extend from
`the sequencer-timer 13 and which are individually con-
`nected to the electric motor means 40, 53 FIGS. 3 and
`4.
`
`A pinion 51 on shaft 50 is in mesh with gear 52
`mounted upon shaft 45 of valve stem 42. With positive
`voltage delivered through channel lead 49 to motor 48,
`drive shaft 50 will rotate in one direction for effecting a
`retraction of valve element 41 releasing branch 37 from
`its collapsed condition and permitting the flow offluid
`therethrough. The branch 37, FIG. 3, corresponds to
`the branches 32, 37 of FIG.2.
`In FIG. 3, motor 48 has been activated by a positive
`voltage retracting valve element 41 to permit flow of
`fluid through branch 37. After a predetermined time
`interval, negative voltage is delivered through lead 49
`to motor 48 for rotating the drive shaft 50 in the oppo-
`site direction. This causes a longitudinal advanceof the
`valve element 41 to operatively engage and collapse an
`adjacent section of the branch tube 37 closing off flow
`therethrough. This will be the normal condition of the
`valve assembly 40 with flow through tube 37 closed.
`With respect to the electric motor means associated
`with the valve assemblies 40, instead of using a revers-
`ible motor 48, there may be employed solenoid valve
`actuator 53, FIG. 4. In this embodiment, valve element
`41 is shownin a retracted open position and wherein the
`solenoid 59 of the actuator 53 has been energized
`through a corresponding lead 49, FIG.3.
`Piston 54 is axially connected to element 41 and is
`positioned within a cylindrical bore 55 within mount
`plate 23,
`fragmentarily shown. Coiled spring 56 is
`nested within the bore 55 andis retained by stop ring 57.
`
`8
`
`

`

`9
`Thespring 56 is adapted to normally bias the element 41
`to an advance position wherein the element 41 crush-
`ingly engages and collapses the corresponding branch
`32, FIG.2 for illustration, or any of the branches 37 for
`interrupting the flow of intravenousfluid therethrough.
`The solenoid valve actuator 53 also includes armature
`58 shownin a retracted position, FIG. 4, with solenoid
`59 activated.
`Forwardly facing tube guide 63 located upon the
`front face of valve plate 23 extends around portions of
`tube support 11 in cooperation with the manually ad-
`justable tube clamp 64 on the valve plate 23 for adjust-
`ably securing the solution manifold selector 17 in a
`predetermined position.
`A pair of vertically spaced hand clamps 65 project
`laterally from the infusion plump 20 and are adjustably
`received upon support tube 11 for clamping infusion
`pump 20 in a preselected adjusted position thereon.
`Depending from the controller sequencer-time 13is a
`suitable support bracket 66 which includes a clamp
`means, not shown,centrally thereof which overlies and
`is secured to the upper end of tube support 11. Each of
`the bottle 15 includes a swivel type of bottle holder 67
`which is removably connected to the corresponding
`opposed support brackets 66, by which the bottles 15
`are removably suspended from sequencer-timer 13. The
`support standard post 12 has a base ofsufficient lateral
`extent so as to stabilize and maintain the entire assem-
`bly, in FIG. 1 adjustably secured upon tube 11.
`As shownin FIG.1, there is provided upon sequenc-
`er-timer 13 upon the front thereof the retractable tray
`68 upon whichis positioned the program card 14, The
`card 14 has thereon a plurality of data receiving parallel
`spaced tracks 69.
`to the programmer timer 13 whose
`With respect
`structure, function and operation are disclosed in U.S.
`Pat. No. 4,102,492, specific details of the construction
`thereof are omitted, except to the extent that operative
`elementsare disclosed in the patent and incorporated by
`reference herein to the extent necessary to support the
`present disclosure.
`The present sequencer-timer 13 is a controlled se-
`quencerthat allows users to program arbitrary on-off
`sequences on eight
`to ten independent channels by
`means of pencil marks applied to tracks 69 upon the
`program card 14, FIG.1. As is conventional, the pres-
`ent programmer-timer 13 has a four position front panel
`control