Multi-mode cannulating apparatus
United States Patent [1 1 Mellor I 1 MULTI-MODE CANNULATING APPARATUS [76] Inventor: Eli K. Mellor, 305 Andover Dr.,  
 Burbank, Calif. 91504 [22] Filed: Aug. 22, 1973 [21] Appl. No.2 390,542  
 [52] US. Cl l28/2l4.4; 128/DIG. 16  
 [51] Int. Cl A6Im 05/14 [58] Field of Search l28/2l4.4, 221, DIG. 16, 128/348 [56] References Cited UNITED STATES PATENTS 3,463,152 8/1969 Sorenson 128/214.4  
 3,599,637 8/1971 Schwartz l28/2l4.4  
 3,670,727 6/1972 Reiterman 128/221 1 Apr. 8, 1975 3,739,778 6/1973 Monestere et a1 128/2 14.4 3,757,771 1/1972 Ruegg et a1 128/214.4 X 3,766,916 10/1973 Moorehead et a1 128/214.4  
 FOREIGN PATENTS OR APPLICATIONS 689,131 3/1953 United Kingdom 128/221 Primary Examiner-Dalton L. Truluck Attorney, Agent, or Firm-William W. Haefliger [57] ABSTRACT Multiple mode cannulating apparatus wherein a blood vessel puncturing rod is removable from a tubular body having a forward stem penetrating the vessel, the  
 body having a rearward extension allowing pinch-off between the time that the rod is removed and auxiliary tubing is coupled to the extension.  
 6 Claims, 5 Drawing Figures 1 MULTI-MODE CANNULATING APPARATUS BACKGROUND OF THE INVENTION This invention relates generally to apparatus for use with extra-corporeal blood passing equipment, and more particularly concerns the control of blood flow in both withdrawal and return directions between a single blood vessel cannula and the equipment.  
  There is need for rapidly installable and efficiently operable apparatus controlling the flow of blood between a single cannula at a patients vessel such as a vein and the extra-corporeal means such as dialysis equipment. In this regard, it is highly desirable that cannulation and dialysis be carried out with minimum disturbance to the patient, which requires that vein puncturing be construction. at only one point. Prior apparatus of which I am aware does not incorporate the unusually advantageous features of constructon, modes of operation and surprisingly favorable results afforded by the invention, as will appear.  
 SUMMARY OF THE INVENTION Basically, the invention concerns multiple mode, cannulating apparatus wherein a blood vessel puncturing rod is removable from a tubular body having a forward stem penetrating the vessel, and wherein the body has a rearward extension allowing pinch-off between the time that the rod is removed and auxiliary tubing is coupled to the extension. Accordingly, blood may then be circulated from and to the body via that tubing and auxiliary tubing connected with a body side port, as will be seen. This assures that during such blood flow treatment, the puncture rod is removed from the body so as not to inadvertently re-puncture the vessel if the equipment is caused to be moved on or relative to the patient.  
  Other objects include the provision of a removable elastomer plug on the insert, which seals off between the insert and puncture rod; the provision of an adapter duct to couple the auxiliary tubing to the flexible extension; and the provision of tabs or wings on the body to facilitate its use and connection to the skin of a patient, as will be seen.  
  These and other objects and advantages of the invention, as well as the details of an illustrative embodiment, will be more fully understood from the following description and drawings, in which:  
 DRAWING DESCRIPTION FIG. 1 is an enlarged vertical section taken through a multiple mode needle embodying the invention;  
  FIG. 2 is a view like FIG. 1 showing one mode of needle operation;  
  FIG. 3 is a view like FIG. 1 showing another mode of needle operation;  
  FIG. 4 is a fragmentary view showing a pinch-off configuration, and  
  FIG. 5 is a view in vertical section through a body of the type shown in FIG. 1.  
 DETAILED DESCRIPTION The cannulating needle apparatus of FIG. I includes an axially extending tubular body 11 defining a blood flow passage 10a. The body includes telescopically interfitting and bonded plastic portions 11a, 11b and He, portion 11a comprising a forward flexible stem or cannula insertible into a blood vessel seen at 12 in FIGS. 2 and 3. Portions llb and 110 are typically relatively inflexible.  
  Stem portion lla contains porting to pass blood flow to and from the vessel, and is illustrated for example by a terminal port 13 at the stem forwardly tapered end 14, and lateral side ports 15 in rearwardly closely spaced relation to port 13. Four such ports 15 may be provided at about intervals about axis 16, whereby at least one or more ports will remain in blood passing open communication with the vessel interior, despite possible blanking of another port or ports by the vessel wall.  
  A rearward tubular extension 17 is provided on the body to extend axially rearwardly from a body rear port 18. Extension 17 may consist of laterally flexible plastic tubing, allowing pinch-off as shown in FIG. 4, and for purposes as will appear. Typically, the forward portion 17a of the extension is telescopically fitted over the rearward extent of the body portion 110, as shown.  
  The body portion also has one side port for conducting blood flowing between passage 10a and first auxiliary tubing such as is indicated at 20. For such purpose, that body portion llc has a rearwardly and sidewardly angled stub duct 21 defining a side port 22, the tubing 20 telescopically fitted over the stub duct at 23.  
  In order to insert the stem lla into the blood vessel 12, it is first necessary to puncture same. For thispurpose a rearwardly removable rod 24 is provided to extend axially within the passage Na, and to have a sharp tip 24a. The portion 11a may be flexible, or inflexible. An enlargement 25 functioning as a handle is attached to the rear end of the rod and exposed rearwardly of extension 17, so as to be manually rearwardly retracted. A sealing elastomer plug 27 serves to transmit force from the pusher to the extension 17.  
  The plug 27 comprises one form of means for sealing off between the rod and extension 17. Further, it is constructed so as to be manually removable off the extension when the rod is rearwardly removed from the body, in order to accommodate subsequent coupling of other auxiliary flexible, blood flow tubing 28 with extension 17, as for example is illustrated in FIG. 3. For this purpose, the plug 27 may have an annular lip 29 fitting telescopically over the extension end 30, and an insert 31 fitting into the extension bore 32. The insert 31 has a tight, sliding and sealing fit with rod 24, to pre vent leakage of blood rearwardly from extension 17, when the vessel is punctured.  
  Subsequent to such puncturing, the rod 24 is retracted rearwardly. During or immediately following such removal, the extension is clamped to pinch-off, as seen in FIG. 4, clamp elements 32 representing manual or mechanical clamping means. Also the plug 27 is then removed. This makes possible the operative attachment of tubing 28 to the extension rear end portion 30, without undue leakage of blood. In this regard, such attachment is facilitated by use of an adpater duct part 34 having a flanged rear end 35 to which tubing 28 may be attached. Such attachment may be carried out prior to insertion of the tapered forward end 36 of the duct 34 into the bore 32 of the extension 17, to have a tight sealing fit therewith. FIG. 4 shows the approach of the duct end 36 toward the rear end 30 of the extension, for simultaneous insertion of the duct end and release of the clamp elements 32. The adapter duct 34 may initially be removably carried by the pusher 25, as by penetration of the tapered end 36 into tight fitting relation with bore 38 to provide antiseptic protection for end 36.  
  The numeral 39 in FIG. 3 indicates the provision of extra corporeal means connected with auxiliary tubing 20 and 28 for circulating blood to and from the vessel 12 via the passage a. Such means may for example comprise dialysis equipment as described in my copending U.S. Pat. application Ser. No. 244,399, filed Apr. 17, 1972, now abandoned. Numeral 40 in FIG. 1 indicates a protective length of tubing initially fitting on the body 11, and about stem 11a.  
  FIG. 5 is a vertical section through a body 50 of the type seen in FIG. 1, the axis indicated at 50a. Plastic tabs or wings 51 are integrally formed with the body to be placed upon the skin of a patient at the time cannulation is to commence. The wings are then elevated as shown by the broken lines 51a, and retained between the technicians thumb and first finger 53 and 54, to provide a grip on the apparatus allowing it to be advanced with the rod or needle tip 24a extended, to achieve cannulation. Thereafter, the wings 51 are allowed to drop back to the full line positions shown, for suitable attachment to the patients skin, holding the equipment in place during blood treatment.  
 I claim:  
  1. in multiple mode, cannulating apparatus, the combination comprising a. an axially extending tubular body defining a blood flow passage and having a forward stem portion insertible into a blood vessel, the body having a side port for conducting blood flowing between said passage and first auxiliary tubing, the body also having a rear port in alignment with said axis,  
 b. a rearward tubular extension on the body and extending axially rearwardly from said rear port, said extension characterized as having pinch-off flexibility,  
 c. a rearwardly removable rod extending axially within said passage and generally coaxially completely through said extension, the rod having a vessel puncturing tip,  
 d. sealing means sealing off between the rod and extension and removable off the extension when the rod is removed from said body, thereby to accommodate coupling of other auxiliary, flexible, blood flow tubing with said extension, and  
 e. a pusher carrying the rod at the rear of said tubular extension, the pusher being rearwardly elongated and having a rearwardly extending bore, and a tubular adapter part removably received into said bore and extending rearwardly therefrom.  
  2. The combination of claim 1 wherein said sealing means comprises an elastomer plug at least partially inserted into the tubular extension at the rear thereof, the rod extending through the plug.  
  3. The combination of claim 1 wherein said adapter part is sized for telescopic connection with the tubular extension after removal of the rod therefrom.  
  4. The combination of claim 1 wherein said forward stem portion is flexible, and contains a terminal port at the stem forward end and lateral side ports in closely rearwardly spaced relation to said terminal port.  
  5. The combination of claim 1 including flexible wings connected with and projecting sidwardly from said body.  
  6. ln multiple mode, cannulating apparatus, the combination comprising:  
 a. an axially extending tubular body defining a blood flow passage and having a forward stem portion insertible into a blood vessel, the body having a side port connected with first auxiliary tubing for conducting blood flowing between said passage and said first auxiliary tubing, the body also having a rear port in alignment with said axis,  
 b. a rearward tubular extension on the body and extending axially rearwardly from said rear port, said extension characterized as having pinch-off flexibility,  
 c. an adapter duct having removable telescopic connection with said rearward tubular extension, and other auxiliary, flexible, blood flow tubing coupled with said adapter duct,  
 d. means for circulating blood to and from said passage via said side and rear ports and said first and other auxiliary tubing, and  
 e. flexible wings integral with the bottom surface of said body and projecting sidewardly therefrom for seating on the skin of a patient, the wings being capable of being flexed into side-by-side relation so as to be gripped for advancing or retracting the body endwise.