Inline liquid drug medical devices with linear displaceable sliding flow control member

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INLINE LIQUID DRUG MEDICAL DEVICES WITH LINEAR DISPLACEABLE SLIDING FLOW CONTROL MEMBER WO 2011/058548 PCT/IL2010/000915

INLINE LIQUID DRUG MEDICAL DEVICES WITH LINEAR

DISPLACEABLE SLIDING FLOW CONTROL MEMBER

Field of the Invention

The invention relates to inline liquid drug medical devices for liquid drug reconstitution and administration purposes.

Background of the Invention

Commonly owned US Patent 6,238,372 entitled Fluid Control Device illustrates and describes a fluid control device for use with a syringe and at least one medicinal vessel. The fluid control device includes a first port, a second port for receiving the syringe, a third port including an adaptor having a fluid conduit member extending into the interior of the medicinal vessel when attached thereto and a flow control member selectively disposable from a first flow control position enabling a flow path between a first pair of two ports and second flow control position enabling a flow path between a second pair of two ports. The flow control member is coupled to one of the ports for manipulation between its flow control positions.

Commonly owned PCT International Application No. PCT/IL2005/000376 entitled Liquid Drug Medical Devices and published under PCT International Publication No. WO 2005/105014 illustrates and describes a liquid drug medical device for liquid drug reconstitution and administration purposes, a vial adapter with elastomer tubing and a needle shield removal device. The liquid drug medical device has a longitudinal axis and is intended for use with a source of physiological solution and a medicinal vessel. The liquid drug medical device includes a body member having a first port for fluid connection with the source of physiological solution and a flow control member rotatably mounted in the body member about an axis of rotation co-directional with the longitudinal axis. The flow control member has a first major flow duct and a second major flow duct substantially parallel to and non-coaxial with the axis of rotation and respectively terminating at a 1 WO 2011/058548 PCT/1L2010/000915 second port, and a third port for administering the liquid drug. The liquid drug medical device further includes a manually rotatable adapter having a fluid conduit member with a proximal end in flow communication with the second port and a distal end extending into the medicinal vessel on its attachment to the adapter, and coupled to the flow control member for rotating same between a first flow control position for connecting the first port with the second port, and a second flow control position for connecting the first port with the third port.

Commonly owned PCT International Application No. PCT/US2008/070024 entitled Medicament Mixing and Injection Apparatus and published under PCT International Publication No. WO 2009/038860 illustrates and describes a mixing and injection apparatus including a needle and a needle base, a syringe attachment element and a mixing chamber engagement assembly including a needle chamber surrounding the needle and a first liquid conduit portion, sealed from the needle chamber and a mixing chamber engagement portion including a second liquid conduit portion communicating with the first liquid conduit portion and configured for communication with a mixing chamber. The syringe attachment element and the needle base are configured to permit liquid communication between an interior of the syringe and the first liquid conduit portion when the syringe attachment element and the needle base are in the first relative engagement orientation and to permit liquid communication between an interior of the syringe and the needle when the syringe attachment element and the needle base are in the second relative engagement orientation, axially separated from the first relative orientation along the injection axis.

Summary of the Invention

The present invention is directed toward inline liquid drug medical devices for use with a source of physiological fluid and a medicinal vessel for liquid drug reconstitution and administration purposes. 2 WO 2011/058548 PCT/IL2010/000915

The inline liquid drug medical device includes a housing having a longitudinal device axis and a vial adapter removably attached on the housing and detachable therefrom along a line of detachment co-directional with the device axis. The housing has three ports, a first port onto which is connected the source of physiological fluid, a second port which leads to the medicinal vessel, and a third port which is fitted with a drug dispenser such as a needle, an atomizer, and the like.

The inline liquid drug medical device includes a manually operated actuating mechanism for applying a linear displacement force to a flow control member sealingly accommodated inside a bore in the housing for sliding the flow control member along the bore in a transverse direction to the device axis from an initial first flow control position for liquid drug reconstitution purposes to a subsequent second flow control position for liquid drug administration purposes. The first flow control position enables flow communication between the first port and the second port for liquid drug reconstitution purposes. The second flow control position enables flow communication between the first port and the third port fitted with a drug dispenser such as a needle, an atomizer, and the like, for liquid drug administration purposes. The first and third ports are preferably co-axial for facilitating more intuitive use of the device.

The actuating mechanism has an initial liquid drug reconstitution position corresponding with the flow control member’s first flow control position and a subsequent liquid drug administration position corresponding with the flow control member’s second flow control position. One type of actuating mechanism employs a manual radial actuation force having a component for imparting a linear displacement force to the flow control member. Another type of actuating mechanism employs a manual linear actuation force for imparting a linear displacement force to a flow control member. Actuating mechanisms are preferably integrally formed with vial adapters for removal together with the vial adapters on detaching same from a housing after liquid drug reconstitution and prior to liquid drug administration. 3 WO 2011/058548 PCT/IL2010/000915

Alternatively, the actuating mechanisms can be integrally formed with the housings.

Brief Description of Drawings

In order to understand the invention and to see how it can be carried out in practice, preferred embodiments will now be described, by way of nonlimiting examples only, with reference to the accompanying drawings in which similar parts are likewise numbered, and in which:

Fig. 1 is a pictorial representation of a syringe, a vial and an inline liquid drug medical device having a rotary actuating mechanism and a linear displaceable sliding flow control member;

Fig. 2 is a bottom perspective view of Figure 1 ’s device;

Fig. 3A is a partially exploded view of Figure l's device;

Fig. 3B is a partially exploded view of another embodiment of Figure l's device with an integral vial adapter;

Fig. 4A is a top perspective view of Figure 1 *s device’s flow control member;

Fig. 4B is a bottom perspective view of Figure 1 ’s device’s flow control member;

Figs. 5A and 5B are longitudinal cross sections of Figure 1 ’s device along lines A-A and B-B, respectively, in Figure 1 showing its actuating mechanism in an initial liquid drug reconstitution position and its flow control member in a first flow control position for liquid drug reconstitution purposes;

Fig. 5C is similar to Figure 5A showing the separation distances SI and S2 between opposite internal surfaces of the actuating mechanism relative to its axis of rotation;

Fig. 5D is a transverse cross section of Figure l’s device along line C-C in Figure 5C showing the separation distances SI and S2 between opposite internal surfaces of the actuating mechanism relative to its axis of rotation;

Fig. 6A is a longitudinal cross section of Figure l’s device along line A-A in Figure 1 showing its actuating mechanism in a subsequent liquid drug 4 WO 2011/058548 PCT/IL2010/000915 administration position and its flow control member in a second flow control position for liquid drug administration purposes;

Figs. 6B is a transverse cross section of Figure l’s device along line C-C in Figure 6A showing its actuating mechanism in its subsequent liquid drug administration position and its flow control member in its second flow control position for liquid drug administration purposes;

Fig. 6C is a longitudinal cross section of Figure 1 ’s device along line B-B in Figure 1 showing its actuating mechanism in its liquid drug administration position and its flow control member in its second flow control position for liquid drug administration purposes;

Figs. 7A to 7G show the use of Figure l’s device for liquid drug reconstitution and administration purposes;

Fig. 8 is a pictorial representation of a syringe, a vial and an inline liquid drug medical device having an actuating mechanism with a spring leaf like actuator, and a linear displaceable sliding flow control member;

Fig. 9 is a bottom perspective view of Figure 8’s device;

Fig. 10 is a partially exploded view of Figure 8's device;

Fig. 11 is a top perspective view of Figure 8’s device’s flow control member;

Fig. 12 is a longitudinal cross section of Figure 8’s device along line D-D in Figure 8 showing its actuating mechanism in an initial liquid drug reconstitution position and its flow control member in a first flow control position for liquid drug reconstitution purposes;

Fig. 13 is a longitudinal cross sections of Figure 8’s device along line D-D in Figure 8 showing its flow control member in a second flow control position for liquid drug administration purposes subsequent to actuation of its actuating mechanism;

Figs. 14A to 14H show the use of Figure 8’s device for liquid drug reconstitution and administration purposes; 5

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WO 2011/058548 PCT/IL2010/000915

Fig. 15 is a pictorial representation of another embodiment of Figure 8’s device including a linear displaceable sliding flow control member in a first flow control position for liquid drug reconstitution purposes;

Fig. 16 is a longitudinal cross section of Figure 15's device along line E-E in Figure 15; and

Fig. 17 is a pictorial representation of yet another embodiment of Figure 8’s device with a vial adapter having an elliptically shaped stem and stem tip with a stem tip cavity.

Detailed Description of Preferred Embodiments of the Invention

Inline Liquid Drug Medical Device including a Manually Operated Rotary

Actuating Mechanism and a Linear Displaceable Sliding Flow Control Member

Figure 1 shows a syringe 10 constituting a source of physiological fluid, a vial 20 constituting a medicinal vessel and an inline liquid drug medical device 100 for use with the syringe 10 and the vial 20. The syringe 10 includes a barrel 11 with a plunger 12 and a male Luer lock connector 13. The syringe 10 can be formed with other types of connectors. The vial 20 includes an open topped bottle 21 sealed by a vial stopper 22 capped by a metal band 23 or other suitable capping material. The vial 20 contains either a powdered or liquid drug 24. The syringe 10 typically contains diluent for reconstituting the vial contents 24.

Figures 2 to 6 show the inline liquid drug medical device 100 having a longitudinal device axis 101 and including a housing 102 and a vial adapter 103 removably coupled on the housing 102 and detachable therefrom along a line of detachment co-directional with the device axis 101. The housing 102 includes a generally cylindrical body 104 coaxial with the device axis 101 and having a syringe port 108 at one end and a port manifold 109 at its opposing end. The body 104 includes a throughgoing bore 106 having a bore axis 107 transversely directed to the device axis 101, a proximal bore end 106A and a distal bore end 106B. The body 104 includes a threaded intermediate section 6 WO 2011/058548 PCT/IL2010/000915 112 with circumferentially surrounding fastening threads 112A. An annular hand held sleeve 111 coaxially aligned with the device axis 101 is attached to the intermediate section 112 by two opposite attachment walls 118 for enabling a user to conformably grip the housing 102 during use. The sleeve 111 includes a sleeve opening 111 A for allowing access to the syringe port 108.

The syringe port 108 constitutes a first port in flow communication with the bore 106. The syringe port 108 is intended to the syringe’s connector 13 and is co-directional with the device axis 101 and preferably co-axial therewith. The syringe port 108 is typically in the form of a female Luer connector intended for receiving a syringe’s male Luer lock connector. The port manifold 109 is generally cylindrically shaped and is coaxially aligned with the device axis 101. The port manifold 109 includes a second port 113 and a third port 114 both in flow communication with the bore 106. The second port 113 and the third port 114 are co-directional with the device axis 101 and the third port 114 is preferably co-axial therewith. The third port 114 is preferably fitted with a needle 116 for liquid drug administration purposes. The second port 113 is preferably recessed with respect to the third port 114 thereby forming an annular cavity 117 for removably coupling the vial adapter 103 on the housing 102.

The device 100 includes a linear displaceable sliding flow control member (FCM) 120 sealingly accommodated in the bore 106 for establishing flow communication between the syringe port 108 and the second port 113 in a first flow control position for liquid drug reconstitution purposes, and between the syringe port 108 and the third port 114 in a second flow control position for liquid drug administration purposes. The flow control member 120 is of a generally cylindrical shape and has a peripheral cylindrical surface 121 with a semi-circular peripheral flow channel 122 and a longitudinally directed flow cutout 123, a blind bore 124, a proximal FCM end 126, and a distal FCM end 127. A proximal rounded protrusion 128 extends beyond the proximal FCM end 126, and serves as an abutment surface for applying a radial actuation force 7 WO 2011/058548 PCT/IL2010/000915 RAF thereagainst to impart a linear displacement force LDF to urge the flow control member 120 along the bore 106, In the first flow control position, the flow control member 120 is sealingly inserted in the bore 106 with the proximal rounded protrusion 128 substantially protruding out of the proximal bore end 106A (see Figures 5A-5D). In the second flow control position, the proximal rounded protrusion 128 is substantially wholly inserted in the proximal bore end 106A (see Figures 6A-6C).

The longitudinally directed flow cutout 123 is dimensioned so that it is in flow communication with the first port 108 when the flow control member 120 is in both its first flow control position and its second flow control position. The flow channel 122 is disposed towards the proximal FCM end 126 circumferentially extends from a proximal channel end 122A in flow communication with the flow cutout 123 to a distal channel end 122B. In the first flow control position, the distal channel end 122B is in flow communication with the second port 113 (see Figure 5A), and in the second flow control position, the distal channel end 122B is in flow communication with the third port 114 (see Figure 6A).

The vial adapter 103 includes a skirt 130 with a top surface 131 and downward depending flex members 132 for snap fitting onto the vial 20. The vial adapter 103 includes an elongated upright stem 133 and terminating in a circular stem end portion 134 having a stem cavity 135 shaped for accommodating onto the housing 102. The stem cavity 135 includes an upper body cavity section 135A for rotatably fitting onto the generally cylindrical body 104 and a cylindrically shaped lower manifold cavity section 135B for rotatably fitting onto the port manifold 109.

The stem 133 includes an annular manifold support 136 at a distal end of the lower manifold cavity section 135B for circumferentially coupling with the annular cavity 117. A fluid conduit 137 which is co-axial with the device axis 101 has a proximal end 137A in the annular manifold support 136 for sealed flow communication with the second port 113 on coupling the vial adapter 103 to the housing 102. The fluid conduit 137 fluidly connects at a 8 WO 2011/058548 PCT/IL2010/000915 distal end 137B to a co-axial puncturing cannula 141 through a fluid interconnect conduit 137C. The puncturing cannula 141 serves to puncture the vial stopper 22 on its positive insertion into the vial adapter 103, and extends slightly therebeyond so that on inverting the vial 20 its nearly entire contents 24 can be aspirated therefrom through the puncturing cannula 141 to syringe 10. The stem 133 also includes a blind needle bore 138 for receiving the needle 116 on coupling the vial adapter 103 on the housing 102.

In a first embodiment, as shown in Figure 3A, the stem 133 has a circumferential rim 139 along a bottom section for engaging a coupler 142 which secures the stem 133 to the top surface 131. In another embodiment, as shown in Figure 3B, a device 100A similar to device 100 includes an integrally built vial adapter 103A which is removably coupled to the housing 102.

The vial adapter 103 is screw threaded onto the housing 102 by means of a pair of opposite fastening members 143 extending upright from the stem end portion 134 co-directional and on opposing sides of the device axis 101. The fastening members 143 each have a perpendicularly projecting tooth 144 for engaging the fastening threads 112A. As the vial adapter 103 is rotated relative to the housing 102 about an axis of rotation 146 co-axial with the device axis 101, the vial adapter 103 unscrews from the housing 102 and is detachable therefrom along a line of detachment co-directional with the device axis 101.

The vial adapter 103 is integrally formed with a manually operated rotary actuating mechanism 150 for applying a radial actuation force RAF for imparting a linear displacement force LDF for sliding the flow control member 120 along the bore 106 from its first flow control position to its second flow control position. The actuating mechanism 150 is implemented by employing a semi-circular internal cam surface 151 of the stem end portion 134 for bearing against the proximal rounded protrusion 128 as the vial adapter 103 is rotationally detached from the housing 102. The actuating mechanism 150 has an initial liquid drug reconstitution position corresponding to the flow control member 120’s first flow control position when the vial adapter 103 is screw 9 WO 2011/058548 PCT/IL2010/000915 threaded attached on the housing 102 and a subsequent liquid drug administration position corresponding with the flow control member 120’s second flow control position when the vial adapter 103 is detachable from the housing 102. The internal cam surface'151 defines a separation (S) relative to the axis of rotation 146. The internal cam surface 151 has a maximum separation SI at the actuating mechanism 150’s liquid drug reconstitution position and a minimum separation S2 in actuating mechanism 150’s liquid drug administration position. The separation S2 is smaller than the separation SI such that as the vial adapter 103 is screw unthreaded from the housing 102, the internal cam surface 151 applies a radial actuation force RAF against the protrusion 128 having a component for imparting a linear displacement force (LDF) to the flow control member 120 for sliding same along the bore 106 from its first flow control position to its second flow control position. The stem end portion 134 has an external surface 134A with a uniform radius relative to the axis of rotation 146 such that its wall thickness increases from its thinnest where the internal cam surface 151 abuts the flow control member 120 at the actuating mechanism’s liquid drug reconstitution position to its thickest where the internal cam surface 151 abuts the flow control member 120 at the actuating mechanism’s liquid drug administration position.

Operation of the device 100 may best be explained by referring to Figures 5A - 5D and Figures 6A - 6C.

Figures 5A - 5D show the actuating mechanism 150 in its initial liquid drug reconstitution position and the flow control member 120 in its first flow control position. The vial adapter 103 is screw threaded onto the housing 102 and the flow control member 120 protrudes from the proximal bore end 106A with the proximal rounded protrusion 128 abutting the internal cam surface 151.

Figures 6A - 6C show the actuating mechanism 150 in its subsequent liquid drug administration position and the flow control member 120 in its second flow control position after a half turn unthreading the vial adapter 103 from the housing 102. The radial actuation force RAF is continuously applied 10 WO 2011/058548 PCT/IL2010/000915 to the flow control member 120 by the internal cam surface 151 having a continuously decreasing separation S from the axis of rotation 146 for imparting the linear displacement force LDF to slidingly displace the flow control member 120 to its second flow control position. The teeth 144 fully disengage from the fastening threads 112A at the actuating mechanism’s liquid drug administration position when the flow control member 120 is in the second flow control position at which time the vial adapter 103 is detachable from the housing 102.

The use of the inline liquid drug medical device 100 for liquid drug reconstitution and administration is shown in Figures 7A to 7G as follows:

Figure 7A shows the device 100 is in its initial first flow control position for liquid drug reconstitution and a user mounting the device 100 on a vial 20, as indicated by arrow M.

Figure 7B shows the user approximating the syringe 10 towards the device 100, as indicated by arrow N, and screw threading the syringe 10 onto the device 100, as indicated by arrow O.

Figure 7C shows the user injecting the syringe’s contents into the vial 20, as indicated by arrow P. The user agitates the assemblage for reconstituting the liquid drug.

Figure 7D shows the user inverting the assemblage and aspirating the reconstituted liquid drug contents into the syringe 10, as indicated by arrow Q.

Figure 7E shows the user rotating the vial adapter 103 to the subsequent liquid drug administration position for slidingly displacing the flow control member 120 to its subsequent second flow control position, as indicated by arrow R. Optionally, for this step and the following steps, the user inverts the assemblage so that the syringe 10 is above the vial 20.

Figure 7F shows the user screw threading the vial adapter 103 from the housing 102, as indicated by arrow S for exposing the needle 116, thereby enabling administration of the liquid drug (see Figure 7G). The user disposes of the vial adapter 103 with the spent vial 20. 11 WO 2011/058548 PCT/IL2010/000915

Inline Liquid Drug Medical Devices including a Manually Operated Actuating

Mechanism with a Spring Leaf-like Actuator and a Linear Displaceable Sliding

Flow Control Member

Figure 8 shows the syringe 10, the vial 20 and an inline liquid drug medical device 200 for use with the syringe 10 and the vial 20.

Figures 9 to 13 show the inline liquid drug medical device 200 has a longitudinal device axis 201 and includes a housing 202 and a vial adapter 203 removably coupled on the housing 202 and detachable therefrom along a line of detachment co-directional with the device axis 201. The housing 202 includes a generally cylindrical central body 204 with a throughgoing bore 206 having a bore axis 207 transversely directed to the device axis 201 and having a proximal end 206A and a distal end 206B.

The housing 202 includes a syringe port 208 constituting a first port in flow communication with the bore 206 and a port manifold 209 on opposite sides of the central body 204. The syringe port 208 is co-directional with the device axis 201 and preferably co-axial therewith. The port manifold 209 includes a pair of opposite and parallel major surfaces 211 co-directional with the bore axis 207 arid a pair of opposite minor end surfaces 212 for securing the vial adapter 203 onto the housing 202. The port manifold 209 includes the second port 213 and the third port 214 both in flow communication with the bore 206. The second port 213 and the third port 214 are co-directional with the device axis 201 and the third port 214 is preferably co-axial therewith, A center of the second port 213 is offset from the device axis 201 by a length L. The third port 214 is preferably fitted with a needle 216. The second port 213 is preferably recessed with respect to the third port 214 thereby forming a cavity 217 for sealingly coupling the vial adapter 203 to the housing 202.

The housing 202 includes a flow control member 218 for sliding linear movement along the bore 206 from an initial first flow control position for establishing flow communication between the first port 208 and the second port 213 to a subsequent second flow control position for establishing flow communication between the first port 208 and the third port 214. The bore 206 12 WO 2011/058548 PCT/IL2010/000915 has a uniform cross section therealong except its distal end 206B which is formed with a platform 219 on the side of the port manifold 209 for acting as a stopper for stopping the sliding linear movement of the flow control member 218 at its second flow control position. The platform may be formed on the side of the syringe port 208.

The flow control member 218 has a proximal end 218A and a distal end 218B and a peripheral cylindrical surface 221. The flow control member 218 is shaped and dimensioned for sealing insertion in the throughgoing bore 206 and is longer than same such that its proximal end 218A protrudes from the proximal end 206A in its first flow control position (see Figure 12) and its distal end 218B protrudes from the distal end 206B in its second flow control position (see Figure 13).

The flow control member 218 includes a flow channel 222 co-directional with the device axis 201 and disposed toward the proximal end 218A. The flow channel 222 has a proximal end 223 and a distal end 224. The peripheral surface 221 is formed with a longitudinally directed flow cutout 226 and a second longitudinally directed cutout 227 on the opposite side to the flow cutout 226. The cutout 227 faces the port manifold 209 and is located towards the distal end 218B and defines an abutment surface 228 for abutting against the stopper 219 for stopping the flow control member 218 at its second flow control position.

The vial adapter 203 includes a skirt 230 with a top surface 231 and downward depending flex members 232 for snap fitting onto a vial 20. The vial adapter 203 includes an elongated upright stem 233 terminating in a bifurcated tip 234 with a pair of opposite and parallel spaced apart inside surfaces 236 for friction fitting onto the port manifold 209’s major surfaces 211. The stem 233 includes a fluid conduit 237 with a proximal end 237A for sealing insertion in the cavity 217 for sealed flow communication with the second port 213 on coupling the vial adapter 203 on the housing 202. The fluid conduit 237 terminates at the distal end 237B fluidly connecting with a pointed 13 WO 2011/058548 PCT/1L2010/000915 cannula 241. The stem 233 also includes a blind needle bore 238 for receiving the needle 216 on coupling the vial adapter 203 to the housing 202.

The vial adapter 203 is integrally formed with a manually operated actuating mechanism 250 for applying a linear actuation force LAF for imparting a linear displacement force LDF for sliding the flow control member 218 along the bore 206 from its first flow control position to its second flow control position. The actuating mechanism 250 is in the form of a hand operated upright spring leaf like actuator 251 attached towards the stem 233’s base and having a free end 252 disposed opposite the flow control member’s proximal end 218A. The actuator 251 has a pin 253 for sliding insertion into a recess 254 formed in the flow control member’s proximal end 218A. The actuator 251 is preferably resiliently flexed from an initial position juxtaposed against the flow control member 218. The actuating mechanism 250 is preferably designed such that the pin 253 slides freely from the recess 254 on being released after being used to urge the flow control member 218 to its second flow control position to revert to its initial vertical position.

The use of the inline liquid drug medical device 200 for liquid drug reconstitution and administration as shown in Figures 14A to 14H is as follows:

Figure 14A shows the device 200 is in its initial first flow control position for liquid drug reconstitution and a user mounting the device 200 on a vial 20, as indicated by arrow M.

Figure 14B shows the user approximating the syringe 10 towards the device 200, as indicated by arrow N, and screw threading the syringe 10 onto the device 200, as indicated by arrow O.

Figure 14C shows the user injecting the syringe’s contents into the vial 20, as indicated by arrow P. The user agitates the assemblage for reconstituting the liquid drug.

Figure 14D shows the user inverting the assemblage and aspirating the reconstituted liquid drug contents into the syringe 10, as indicated by arrow Q.

Figure 14E shows the user depressing the hand operated actuator 239 to urge the flow control member 218 to its subsequent second flow control 14 WO 2011/058548 PCT/IL2010/000915 position in which the syringe port 208 is in flow communication with the third port 214, as indicated by arrow R.

Figure 14F shows the user releasing the hand operated actuator 251 which reverts to its pre-depressed position, as indicated by arrow S. Optionally, for this step and the following steps, the user inverts the assemblage so that the syringe 10 is up and the vial 20 is down.

Figure 14G shows the user pulling the vial adapter 203 with the spent vial 20 from the housing 202 for exposing the needle 216, as indicated by arrow T, thereby enabling administration of the liquid drug (see Figure 14H).

Figures 15 and 16 show an inline liquid drug medical device 200A similar in construction to the device 200 and therefore similar parts are likewise numbered. The device 200A differs from the device 200 insofar the former 200A includes an engagement mechanism 256 in which the free end 252 is formed with an annular flange 257 for engaging the proximal end 218A.

Figure 17 show an inline liquid drug medical device 200B similar in construction and operation to the device 200 and therefore similar parts are likewise numbered. The device 200B differs from the device 200 insofar the former 200B includes an elliptically shaped stem 258 and stem tip 259 with a stem cavity 261, and a bore 206 which is cylindrically shaped and includes a keyed protrusion 262 extending therealong for fitting into a groove 263 in the flow control member 218. The keyed protrusion 262 and the groove 263 are configured for preventing rotation of the flow control member 218 inside the bore 206.

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