Medicine dosage system
United States Patent 11 1 Colver 1 MEDICINE DOSAGE SYSTEM Robert W. Culver, 4601 N. College Ave.. Indianapolis. Ind. 46205 [22] Filed: Nov. 9. 1973 [21] Appl. No.1 414,312  
 [76] Inventor:  
 [56] References Cited UNITED STATES PATENTS 1.931.224 10/1933 Herz ..3l2/234.5  
 2.336.572 12/1943 Schuessler 312/2342 2.530.220 11/1950 Belcher l 312/234 X 2.964.370 l2/l960 Butler 312/234 X 3.149.892 9/1964 Barrow 312/2345 3.262.747 7/1966 Kotzek et a1... 312/2345 3.460.899 8/1969 Miller 312/209 X 3.512.858 5/1970 Relyea 312/2345 3.708.709 1/1973 Morrison et a1. 312/209 3.715.148 2/1973 Beals 312/209 FOREIGN PATENTS OR APPLICATIONS 1.384.034 11/1964 France 312/2341 Primary E.ruminerPaul R. Gilliam Attorney. Agent. or Firm-William R. Coffey 1 1 Apr. 8, 1975 [57] ABSTRACT An apparatus for distributing predetermined dosage units of pharmaceutical materials comprising a housing movable from room to room in a hospital or nursing home as well as between a pharmacy and a hospital or nursing home. a plurality of patient trays removably mounted in the housing. dosage time indicators disposed along and on one side edge portion of each tray and prescription number indicators disposed along and on the&#39;opposite side edge portion of each tray. Each tray is elongated and formed to provide a plurality of longitudinally spaced apart. longitudinally relatively narrow cavities extending transversely between the side edge portions of the tray with the ends of the cavities being adjacent. respectively. the side edge portions. Each cavity is formed to receive a dosage unit which is packaged in a generally flat. rectangularly-shaped package which will conforrningly fit into a cavity in the tray. The patient trays may be molded from relatively thin plastic material in order to be inexpensive and. in some cases. disposable. In order to give such trays handling strength. a support tray may be provided for receiving each patient tray. the support tray being rigid and easy to handle. Clips may be used to fasten the patient trays to their support trays. and such clips may be color coded. lettered or numbered to provide the time indicators and prescription number indicators.  
 6 Claims, 9 Drawing Figures MEDICINE DOSAGE SYSTEM The present invention relates generally to apparatus for the preparation and distribution of predetermined dosage units of pharmaceutical materials, and more particularly to the provision of novel trays for use in preparing and distributing such dosage units.  
  It is now very common for a pharmacy to serve the pharmaceutical needs of a nursing home by delivering to the home each day one or more cases containing exactly the pharmaceutical requirements for each patient in the home for a 24-hour period. Medication is administered four times a day in most nursing homes, i.e., breakfast, lunch, supper and bedtime. Nurses take the cases which are delivered to the nursing home and make their rounds each administration period.  
  U.S. Pat. No. 3,512,858 issued May 19, 1970 in U.S. Class 312, 234.5 discloses an apparatus and method for preparing and distributing individual dosage units of pharmaceutical materials particularly to patients in nursing homes. Reference is made to the U.S. Pat. No. 3,512,858 and the patent references cited therein as being the pertinent prior art known to me.  
  I have found that the apparatus and system disclosed and claimed in U.S. Pat. No. 3,512,858 is inordinately expensive for a pharmacist to use and not very efficient for the pharmacist or the administering nurse to use. One of the basic problems with the system disclosed in US. Pat. No. 3,512,858 is that each tray is rather large and must, therefore, include dosage units for several different patients. Because of the size of the trays and the way the trays are organized in the carrying case, a patient&#39;s dosage requirements may appear on several different trays within the case.  
  It is my concept to provide one tray for each patient. If any patient&#39;s dosage requirements exceed the capacity of one of my trays, I shall simply use two trays for that one patient. That is, my system contemplates the use of one tray per patient per day, the tray preferably being of a capacity sufficient to accommodate approximately 30 doses, i.e., fractions of tablets or multiples of tablets and capsules. Statistically, I believe, 1 percent or less of the patients in a nursing home will ever require more than 30 doses a day.  
  Each of my patient trays will, therefore, include first indicia means to indicate the times when such dosage units on the tray are to be administered each day and second indicia means to indicate the patients prescription numbers for the various dosage units contained in the tray. Such prescription numbers are required by state laws and regulations. That is, a pharmacy must be able to identify, by prescription number, each dosage unit being administered to a patient. I may, for instance, assign each patient a base number which will identify the patient and then, by adding letters or numbers to the base number, identify each dosage unit. For instance, John Doe&#39;s base number may be 87652- One pharmaceutical material administered to John Doe may, for instance, have the prescription number 87652-A.  
  My preferred patient trays are elongated and formed to provide opposite longitudinally extending side edge portions with a plurality of spaced apart, longitudinally relatively narrow cavities extending transversely between the side edge portions with the ends of the cavities being adjacent, respectively, the said side edge portions. Each cavity is formed to have a bottom, front side and back side, and each cavity is proportioned to receive one dosage unit package. I prefer to use dosage unit packages which are generally flat rectangularlyshaped packages having opposite sides and top and bot tom edges. Many pharmaceutical houses are now able and very willing to deliver pills and capsules in such packages or strips of such packages with one tablet or one capsule in each such package. Such packages are received in the tray cavities with the bottom edge of the package adjacent .or resting on the bottom of the cavity and the side edges of the package adjacent, respectively, the ends of the cavity. Adjacent each such cavity which is filled with such a package, I place indicia means on the side edge portion of the tray to indicate the patients prescription number corresponding to the package. That is, I place a letter or a number adjacent the filled cavity to go along with the patient&#39;s base number which may be preferably placed at another location on the tray. Then, on the other side edge portion of the tray, I place indicia means to indicate the four administering periods sequentially or any other times if used. For instance, I may place a red indicator on one side edge portion of the tray near the front so that every thing up to the red indicator will be administered first thing in the morning or at breakfast. Then, I may place a blue indicator along the side edge portion so that everything up to the blue indicator will be administered at noon, and so on. I may also use indicators which have times printed thereon.  
  While my basic tray is referred to as a patient tray. I may use the same tray in the pharmacy to stock shortterm supplies of dosages for each patient. That is, while I will have two trays for John Doe, one in the carrying case at the nursing home and another in a carrying case at the pharmacy, I can set up one or more trays for John Doe in the stocking shelves of the pharmacy to serve as transfer trays. I may then load these transfer trays with several days supply ofdrugs for John Doe so that, when it is necessary to load a tray to put it in a case going to the nursing home, I can simply go to the transfer trays for John Doe and quickly load the tray going to the nursing home. By using such transfer trays, it will not be necessary for me to go to the general supply of dosage units to find what is needed for John Doe each time I load his tray. I may load the transfer trays for John Doe with amounts sufficient to handle his needs for 3 or 4 days. Preferably, such transfer trays will have dividers adhesively or otherwise secured thereto to divide the trays and to identify, by patients prescription number, the drugs to be administered as well as the times when they are to be administered.  
  My patient trays may be made from relatively thin plastic sheet material so that they will be inexpensive and, in some cases, disposable after they have been used for a period of time. For handling purposes, therefore, I may use a support tray for each patient tray, which support tray is formed conformingly to receive the patient tray. The two trays may be fastened together, for instance, by clip means, and the clip means may, in some embodiments, provide the necessary indicia such as the time indicators and the last digit or number of the patients prescription number.  
  Other objects and features of my present invention will become apparent as this description progresses.  
  To the accomplishment of the above and related objects, this invention may be embodied in the forms illustrated in the accompanying drawings, attention being called to the fact, however, that the drawings are illustrative only, and that changes may be made in the specific constructions illustrated and described, so long as the scope of the appended claims is not violated.  
 In the drawings:  
  FIG. I is a perspective view ofmy preferred basic patient trays;  
  FIG. 2 is a fragmentary plan view ofa portion of the side flange of the patient tray showing a clip-on indicia means;  
  FIG. 3 is a fragmentary sectional view taken from FIG. 2 generally along the line 3-3;  
  FIG. 4 is a sectional view of such a patient tray showing the tray disposed in a support tray;  
  FIG. 5 is a sectional view taken along the line 5-5 in FIG. 4&#39;,  
  FIG. 6 is a sectional view taken along the line 6-6 in FIG. 4;  
  FIG. 7 is a perspective view of a dosage package particularly suited for use in my patient trays;  
  FIG. 8 is a perspective view of a clip used to secure the patient tray to the support tray; and  
  FIG. 9 is a perspective view of a carrying case or housing for the patients trays and a push cart for the carrying cases.  
  Referring now particularly to the drawings, it will be seen that my illustrative patient tray 10 is elongated and formed to provide opposite longitudinally extending side edge portions 12, 14 and end edge portions l6, l8. For purposes of this description, it will be assumed that the end edge portion 18 is the front end of the tray I while the end edge portion 16 is the rear end of the tray. I may place a patient identifier on the end flange 18. The identifier may be a paper or plastic card adhesively or otherwise secured to the flange 18. For reasons which shall be discussed hereinafter, the side edge portions I2, 14 are preferably formed to provide outwardly and longitudinally extending flanges which are relatively thin in cross section as best viewed in FIGS. and 6. The tray is formed to provide a plurality of longitudinally spaced apart, longitudinally relatively narrow cavities 24 extending transversely between the side edge portions I2, 14 with the ends of the cavities being adjacent. respectively, the side edge portion. The illustrativetray I0 is formed with a large cavity or space 26 extending the entire length of the tray and bounded by side walls 28, 30 and end walls 32, 34. Then, the individual cavities 24 are defined primarily by integrally formed, longitudinally spaced apart protrusions 40, 42 extending laterally inwardly, respec tively, from the side edge portions 12, 14 or, more particularly, from the side walls 28, 30 forming such side edge portions. Each protrusion 40, 42 on one side of the tray 10 is transversely aligned with one of the pro trusions on the opposite side of the tray such that the space between adjacent protrusions define the cavities 24. Each protrusion has an upper portion 44 terminating a first distance from its respective side edge portion and a lower portion 46 terminating a second and greater distance from its respective side edge portion. Then, the illustrative tray has a bottom formed with ribs extending upwardly and transversely between the aligned lower portions 46 such that it is the ribs 50 which define the bottoms of the cavities 24. As best seen in FIG. 4, each illustrative protrusion 40, 42 is tapered to be longitudinally wider at its lower portion than at its upper portion such that the cavities 24 are longitudinally wider at their upper portions than at their lower portions. Further, it will be seen that the upper surfaces 52 of the upper portions 44 are lying in the same generally horizontal plane and that the upper surfaces 54 of the lower portion 46 are lying in the same generally horizontal plane. The illustrative cross sectional shapes of the cavities 24 as best seen in FIGS. 4, 5 and 6 have been worked out to accommodate the various pill package configurations or unit dosage packages sold by the various pharmaceutical houses. One such pill package 58 is illustrated in the drawings and includes a paper cover 60 over a plastic sheet 62 which is formed with a blister cavity 64 in which a tablet 66 is carried. A capsule package 70 is also illustrated. Such packages are commonly referred to as blister packs. Of course, the blisters for the capsules will generally be somewhat transversely longer than the blisters for the round tablets such as indicated at 66.  
  In FIG. 1, I show time indicators 72, 74, 76, 78, respectively, for breakfast, lunch, dinner and bedtime. These are the four usual drug administering periods. The indicators, which may be adhesively backed tabs, may be selectively placed along the right-hand side of the tray, i.e., the flange portion 14, to indicate when the dosage units placed in the cavities in front of or behind the tabs should be taken. For instance, the dosage units in the cavities in front of and parallel with the indicator 72 should be taken around breakfast time, everything in the cavities in front of and parallel with the indicator 74 should be taken around lunch time, and so forth. As indicated previously, I may provide four different colors to signify the four different administering periods.  
  On the other side of the flange portion 12, I show patient prescription number indicators which, in the illustrative embodiment, are capital letters. It is my intention that these capital letters serve as the last letter of the prescription base number shown on the patient identifier 20 on the end flange 18. While I show only four prescription number indicators 80, it will be appreciated that one such indicator may be placed beside each cavity containing a dosage unit. Since a patient may take several doses each day of a particular material, there may be, for instance, several indicators having the same letter or number placed along the flange 12. For instance, if a patient is to take one particular pill four times a day, then the last letter or number for that pill will appear four times on the flange portion 12 adjacent the cavities containing the pill. Of course, the pills will be placed in registry with the time period indicator markers shown on the flange portion 14.  
  While both the time indicators and the prescription number indicators may be adhesively-backed tabs, it will be appreciated that I may use clip-on indicators such as illustrated in FIGS. 2 and 3. In FIGS. 2 and 3, I show a time indicator 72 which may be a simple plastic lip proportioned and designed snugly to clip on the flange portion 14. Such clips may be colored to indicate time periods and they may bear letters or numbers to indicate the last number of the prescription number. Further, the flange portions l2, 14 may be formed with indentations or protrusions which will engage, for instance, protrusions or indentations on the clips 72&#39; to facilitate the securement of the clips to the flange portions. One such technique for securing a clip is illustrated in conjunction with FIGS. 5, 6 and 8.  
  As discussed briefly above, the patient trays I0 may also be used as transfer trays within the pharmacy to stock a few days supply of dosage units for each patient. For such a usage, I may place divider cards such as indicated at 82 in the cavities and adhesively or otherwise secured to the protrusions defining the cavities, the divider cards carrying the patient information such as the patients prescription number, or the last letter or digit of the number, and the time when the prescribed materials are to be taken. For convenience. the names and strength of the drugs should be on the cards. For instance, John Doe, with the base prescription number 87652- may have one or more transfer trays within the pharmacy to hold as many as 3 or 4 days supply of the drugs which will be taken by John Doe. Assuming that John Doe is taking only three different pills, then his transfer tray or trays will have three such dividers 82 therein identifying the cavities containing his three different prescriptions.  
  As discussed previously. it may be advisable to form the tray from a very thin sheet of plastic material so that the tray can be inexpensive and, in fact, disposable after it has been used for a considerable period of time. For instance, after a tray 10 is set up with a set of prescriptions for a patient, it may be advisable to start off with a new tray if the patients prescription situation drastically changes. Particularly, if adhesive tabs are used for the time indicators and patient number indicators, it may be easier to set up a new tray than to remove all of the old stickers and apply new ones to the old tray if a patients prescription situation changes signiflcantly.  
  Thus, since the trays 10 may be made from relatively thin material and therefore somewhat flimsy or flexible, I may provide support trays 88 which are proportioned and designed conformingly to receive and support the patient trays H]. The illustrative support tray 88 includes longitudinally extending side flanges 90, 92 and end flanges 94, 96. The flange portions l2, 14 rest, respectively. on the support flanges 90, 92 and the end flange portions l6, 18 rest, respectively, on the end support flanges 94, 96. The cross sectional shape of the support tray 88 as best seen in FIGS. 4, 5 and 6 is such that the support tray conformingly receives the patient tray 10.  
  In the illustrative embodiment, the support tray 88 is provided with a plurality oflongitudinally spaced apart small protrusions 100 extending downwardly from the bottom surfaces of the side support flanges 90, 92. There is one such protrusion 100 on each support flange in a position to register with the center of each cavity 24 of the patient tray. Then, in order to fasten the patient tray It) to the support tray 88, I may use a plurality of clips 104 of the type shown in FIGS. 5, 6 and 8. Each illustrative clip 104 is a generally U-shaped cross section clip providing an upper leg portion 106 engaging the flange l2, 14 of the tray 10, a lower leg portion 108 engaging the support flange 90, 92 and a central portion 110 extending about the adjacent edges of the flange and support flange. The lower leg portion 108 may include, in its upwardly facing surface, an indentation or socket 112 for receivably engaging a protrusion 100 to hold the clip 104 securely in position. Further, the clips 104 may carry indicia means thereon such as the last letter or number of the patients prescription number as well as colors or letters or numbers for time period indicators. In other words, the clips 104 may serve as information-bearing elements as well as fastening elements.  
  While the clips 104 are illustrative, it will be appreciated that I may use several different techniques for holding the patient trays 10 in the support trays 88. For instance, I may use only a single clip which is effective to secure the end flange 16 of the patient tray to the end support flange 94 of the support tray. A simple plastic clip which is generally U-shaped in cross section will work quite satisfactorily to connect the two flanges 16, 94. With such a connection at the end flange 16, I could also use a patient identifier 20 which is adhesively backed and which engages both the end flange 18 as well as the end flange 96 of the support tray.  
  My preferred patient tray, which I have already constructed and found to be satisfactory for the purpose intended, is 1 foot long, 2% inches wide and &#34;/9 inch deep, all outside dimensions. That tray has 30 dosage cavities throughout its length. The flanges l2, 14 are approximately V4 inch wide while the end flanges l6, 18 are approximately A inch and inch wide, respectively. l have constructed such trays from a sheet of plastic material only l/32 inch thick to have the trays quite rigid and self-supporting such that it is possible to use them without a support tray 88. Further, the described tray will accommodate most. if not all, blister pack packages provided by pharmaceutical houses, the maximum size of which are generally 2 X 1 inch or perhaps as much as 2 X 1% inches. Most packages will be in the size neighborhood of 1% X inch.  
  The system just described has several advantages over presently available systems, not the least of which is a very significant reduction in cost of supplies to the pharmacist. lpresently believe that my system will permit the pharmacist a reduction in cost of over 50 percent. Further, the system provides a reduction in size of the trays and the carrying cases for easier transportation in that the carrying cases may be moved in the trunk or back seat of an automobile. Presently available carrying cases and particularly those shown in the Relyea US. Pat. No. 3,512,858 are extremely large and difficult to carry, primarily because the individual trays are quite large. My system is extremely advantageous because it makes use of the unit dosage packages provided by the pharmaceutical houses when they are available, thereby obtaining a saving in the pharmacists time and the cost of packages. The Relyea system is designed to accept only one type of blister package requiring the pharmacist, himself, to package each dosage unit in the required type of package. I believe it is easier to train new nurses to use my patient tray system wherein each tray is assigned to a particular patient. My system is advantageous because it is easy to see a patients full day of medicine set up in one tray in one glance.  
  Further, my trays are large enough to permit a few liquid close containers to be placed in the trays. Small plastic cups are conventionally provided for unit liquid dosages. Such cups can be placed in my trays l0 and. if necessary, the cups can be steadied within the tray by small pieces of adhesive tape or the like. I may provide V clip-on brackets (not shown) for steadying the cups dose, may be placed in the tray 10 to rest upon either the bottom ribs 50 or the upper surfaces 54.  
  Further, and importantly, the cavities in my tray 10 are proportioned such that the packages 58 will be slanted rearwardly on an angle and spaced apart as shown such that the name of the drug can be easily read without pulling the packages out of the tray.  
  The cross sectional shapes of the cavities 26, as shown in FIGS. 5 and 6, are designed to accommodate the off-setting or staggering of blisters by the pharma ceutical houses. Such offsetting or staggering is to accommodate stacking within shipping packages. In one sequence, the blisters will be to the left on the packages and in the next sequence, the blisters will be to the right. Further, the cross sectional shape of the cavities, their longitudinal spacing, and the depth of the protrusions defining the cavities facilitate the gripping of individual packages within the cavities.  
  Turning now to FIG. 9, it will be seen that l have shown a carrying case 150 having an open front 152, handle [54 and ten vertically spaced shelves 156 for supporting the trays [0, three trays on each shelf. The open front is closed by a door (not shown) which may slide vertically downwardly from the top of the case and which may be locked in its closing position. The case 150 and a companion case (not shown) may be supported on pull-out platforms M0 on a push cart 162 which will stay in the nursing home. The carrying cases 162 will be transported between the pharmacy and the nursing home. For drug protection reasons, the push cart may preferably be provided with sliding doors 164 4 only one of which is shown) equipped with lock means 166 such that the filled carrying cases 150 may be locked inside the cart 162.  
 l claim:  
  1. An apparatus for distributing predetermined dosage units of pharmaceutical materials, each dosage unit being provided in generally flat rectangularly-shaped packages having opposite side edges and top and bottom edges, said apparatus comprising housing means, a plurality of patient trays removably mounted in said housing means, each tray being elongated and formed to provide opposite longitudinally extending side edge portions with a plurality of longitudinally spaced apart, longitudinally relatively narrow cavities extending transversely between said side edge portions with the ends of said cavities being adjacent, respectively, said side edge portions, each cavity being formed to have a bottom, front side and back side, each cavity being proportioned to receive one of the packages with the bottom edge of the package adjacent the bottom of said cavity and the side edges of the package adjacent, respectively, the ends of said cavity, said cavities in said tray being defined primarily by integrally formed, longitudinally spaced apart protrusions extending laterally inwardly, respectively, from said side edge portions toward the longitudinal center of said tray, each said protrusion having an upper portion terminating a first distance from its respective side edge portion and a lower portion terminating a second and greater distance from its respective side edge portion, each protrusion on one side of said tray being transversely aligned with one of said protrusions on the opposite side of said tray.  
  2. The apparatus of claim 1 in which each said protrusion is tapered to be longitudinally wider at its lower portion than its upper portion such that said cavities are longitudinally wider at their upper portions than at their lower portions.  
  3. The apparatus of claim 2 in which said tray is formed to have a bottom with ribs extending upwardly and transversely between aligned lower portions of said protrusions to define said bottoms of said cavities.  
  4. The apparatus of claim 1 in which said tray is formed to have a bottom with ribs extending upwardly and transversely between aligned lower portions of said protrusions to define said bottoms of said cavities.  
  5. The apparatus of claim 1 including first indicia means disposed along and on one side edge portion of said tray to indicate the times when such dosage units are to be administered and second indicia means disposed along and on the other side edge portion of said tray to indicate the patients prescription numbers for the various dosage units contained in the tray.  
  6. The apparatus of claim 5 in which the side edge portions of said tray provide, respectively, longitudinally and outwardly extending, upwardly facing flanges, said indicia means being disposed on said