It is necessary in hospitals and other medical environments to organize medical implants and surgical instrumentation in surgical cases. The implants and instruments are typically held in various brackets and trays within the case, so as to be presented in a convenient, organized fashion upon their use in a medical procedure, such as a surgical procedure. These surgical cases are typically provided with a lid to protect the contents.
The demands on medical personnel involved in surgical procedures are often very great. For example, many procedures may be performed in the context of trauma treatment, requiring prompt treatment of an injured patient. Even in the context of the scheduled treatment of a patient, unexpected developments during the course of the procedure can create great urgency. Accordingly, medical personnel are often operating under substantial time constraints and a great deal of resultant psychological pressure, based on the stakes involved in the proper performance of their duties (the health, or possibly even the life, of the patient). It is not an exaggeration to state that the delay of even a few seconds can cost a life in emergency treatment. Therefore, it is critical that the apparatus and methods used by such personnel are designed to work as efficiently and safely as possible, in order to allow the personnel to perform their work quickly, as well as to accommodate minor mistakes and mishaps which may occur in the course of such high-pressure work.
In the context of surgical cases, a case must offer a convenient hand-hold so that it can be quickly grasped and lifted. The hand-hold may be a handle protruding from the case body, an opening in the case walls for the fingertips to be inserted, a protrusion on the case walls for fingertip gripping, or in some cases may simply be the flat outer side walls of the case itself.
Ideally, the hand-hold will allow the case to be grasped and lifted by one hand. This will allow medical personnel who are already using one hand to carry something else, to grasp and lift the case. Also, a case which is designed to be carried by one hand should accommodate the situation where it is grasped and lifted by both hands, and then one hand loses its grip. It is also preferable that at least when not in use, the hand-hold will not protrude too far from the walls of the case.
It is also common for surgical trays to be presented in situations where physical access to the tray is limited. For example, trays may often be stored in such a way that lateral access to the ends or side of the tray is not available. Furthermore, surgical trays may be disposed in use in sterilization enclosures which also limit lateral access to the tray. In such situations, grasping and lifting of prior art trays, in which the handles are projections on the end walls of the base or around the edges of the top of the lid, will be difficult if not impossible. Accordingly, there is a need in the art for a system which provides a handle system allowing convenient grasping and lifting of the surgical tray when the tray can only be accessed from above.
Prior art hand-hold systems for surgical cases do not typically meet all of these design criteria. For example, U.S. Pat. No. 4,728,504 to Nichols, entitled "Stackable Medical Instrument Sterilizer Container" discloses a container 10 including a housing 12 having handles 28 provided on opposite ends of the container to facilitate handling of the container. The handles 28 are arched protrusions which allow only a fingertip grip, which is weaker than a full hand grip. Also, these handles 28 do not permit the case to be securely carried by one hand. U.S. Pat. No. 5,415,846 to Berry, Jr., entitled "Plastic Autoclave Tray and Lid Combination" discloses an autoclave tray 21 having an outwardly extending flange 25 and is typical of prior art systems which have a simple rim around the edge of the case. The rim can be used for a fingertip hold, and has the same problems as discussed above with reference to the Nichols '504 patent. Handle systems such as those of the Berry and Nichols patents do not allow the tray to be lifted from above when the tray system is in a confined space such that only the top surface of system is accessible. Specifically, if those trays were in an enclosure open at the top and closely matching the outer periphery of the tray, they could not be grasped and lifted, as it would not be possible for the user's hands to grip the handles.
The lid of a surgical case must also be designed with both safety and ease of use in mind. A lid which is unduly cumbersome to remove will cause an unacceptable delay in accessing the products inside the case. On the other hand, if the lid comes off too easily, it may come off accidentally or prematurely, for example during transport. A loose lid that accidentally becomes separated from the case may allow the case contents to become disarranged or result in the spillage of the case contents, delaying the surgery and possibly resulting in damage to the case contents. Also, a loose lid may in itself present a hazard if it falls to the floor in a busy area.
Underlying all of the constraints discussed above are fundamental ergonomic design concepts which apply to any product which people use. A product should be a simple as possible while accomplishing the required function, with a minimum of moving parts, and its method of use should be simple and easily understood from the product itself. Furthermore, the product should be simple and inexpensive to manufacture. Thus, it is preferable that the hand-hold and lid-securing functions be combined, such that they are performed at least in part by the same structural elements of the case system. The simplicity of the mechanical design is particularly important in the surgical tray field, as complex designs having many mating parts will be more difficult to properly sterilize.
Systems combining the hand-hold and lid-securing functions are known in the art. For example, U.S. Pat. No. 4,915,913 to Williams et al., entitled "Medical Sterilizer Device with Improved Latch Mechanism" discloses a medical sterilization case 4 and a cover C which is latched to the body of case by a pair of latch mechanisms 20. Each latch mechanism includes a handle 22 and a complicated latch mechanism 20 which includes, among other components, a hinge plate 106, an elongated retention member 110, a second retention member 116, a latch plate 130, and coil springs 142. These components are arranged so as to provide a pivoting, double-action latching system for the cover C. The Williams system is unduly complex for the simple functions being performed. Also the handle 22 is provided as a means to accomplish the unlatching of the latch mechanism, and is not well adapted to be used to pick up the case. If used to pick up the case, the force applied to the handle 22 would tend to result in the inadvertent unlatching of the latch mechanism, undesirably allowing the cover to come free prematurely.
The Berry '846 patent, discussed above, also discloses a relatively complex latching mechanism. In Berry, a frame 50, a spring clip 51, a slide 52, collar 53, and cooperating screw stud 53a are assembled to form a slide latch assembly which allows the lid 22 to be releasably secured to the tray 21. Similarly, U.S. Pat. No. 5,384,103 to Miller, entitled "Instrument Tray," also discloses a complex locking mechanism 16 which is disposed on the outer surface of each of the tray end walls (see, for example, FIG. 4 of Miller and associated text at 6:54-7:42). Also, the handles of the Miller tray may be accessed through openings in the cover, but the system is not designed to take advantage of any mechanical association of the handles with the lid to contribute to securement of the lid. Although Miller is directed to the problem of providing a releasable locking system for a tray lid, as in the Williams and Berry patents, the locking mechanism 16 provided by Miller is an inordinately complex design solution for the problem addressed.
Accordingly, there is a need in the art for a combined surgical case handling and lid securing system having improved ergonomics and allowing a firm, secure full-hand grasp, and which permits one-handed grasping, lifting, and carrying of the case as well as positively engaging the lid to the case until its removal is desired. The handle of the lid is accessible even when the system is approachable only from the top. The lid should remain positively secured to the case even when the case is held sideways, for example when one hand is used to grasp, lift and carry the case. The hand-holding and lid-securing functions should be combined in a single system, such that parts serving one function also contribute to the other function. There is also a need in the art for a surgical case lid-securing system meeting these specifications that is simple and inexpensive to manufacture and is simple to use.