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1. 发明授权

US10369353B2 Seizure disorder evaluation based on intracranial pressure and patient motion 有权
公开(公告)号：US10369353B2
公开(公告)日：2019-08-06
申请号：US12359037
申请日：2009-01-23
申请人： Jonathon E. Giftakis , Nina M. Graves , Jonathan C. Werder , Eric J. Panken , Timothy J. Denison , Keith A. Miesel , Michele H. Herzog
发明人： Jonathon E. Giftakis , Nina M. Graves , Jonathan C. Werder , Eric J. Panken , Timothy J. Denison , Keith A. Miesel , Michele H. Herzog
IPC分类号： A61B5/03 , A61N1/05 , A61B5/00 , A61N1/36
摘要： Intracranial pressure of a patient may be monitored in order to evaluate a seizure disorder. In some examples, trends in the intracranial pressure over time may be monitored, e.g., to detect changes to the patient's condition. In addition, in some examples, a seizure metric may be generated for a detected seizure based on sensed intracranial pressures. The seizure metric may indicate, for example, an average, median, or highest relative intracranial pressure value observed during a seizure, a percent change from a baseline value during the seizure, or the time for the intracranial pressure to return to a baseline state after the occurrence of a seizure. In addition to or instead of intracranial pressure, patient motion or posture may be monitored in order to assess the patient's seizure disorder. For example, a seizure type or severity may be determined based on patient motion sensed during a seizure.

2. 发明授权

US09737660B2 Drug infusion device with controllable valve 有权
公开(公告)号：US09737660B2
公开(公告)日：2017-08-22
申请号：US13217981
申请日：2011-08-25
申请人： Reginald D. Robinson , Mary E. Robischon , Bernard Q. Li , Irfan Z. Ali , Steven R. Christenson , Keith A. Miesel
发明人： Reginald D. Robinson , Mary E. Robischon , Bernard Q. Li , Irfan Z. Ali , Steven R. Christenson , Keith A. Miesel
IPC分类号： A61M5/168 , A61M39/22 , A61M5/142
CPC分类号： A61M5/16827 , A61M5/14276 , A61M5/1684 , A61M39/223 , A61M2205/3523 , A61M2205/3569 , A61M2210/1003
摘要： A therapeutic fluid delivery device that includes at least one controllable valve is generally described. In one example, an implantable therapeutic fluid delivery system includes a first fluid pathway configured to convey a first therapeutic fluid and a second fluid pathway configured to convey a second therapeutic fluid, the second fluid pathway being separate from the first fluid pathway. The therapeutic fluid delivery system includes a valve connected to the first fluid pathway and the second fluid pathway, and a processor configured to control actuation of the valve to open and close the first fluid pathway and to open and close the second fluid pathway.

3. 发明授权

US09717846B2 Therapy system including multiple posture sensors 有权
公开(公告)号：US09717846B2
公开(公告)日：2017-08-01
申请号：US13561706
申请日：2012-07-30
申请人： Dennis M. Skelton , Jon P. Davis , Keith A. Miesel , Timothy J. Denison
发明人： Dennis M. Skelton , Jon P. Davis , Keith A. Miesel , Timothy J. Denison
IPC分类号： A61N1/372 , A61M5/142 , A61N1/36 , A61B5/11 , A61B5/00
CPC分类号： A61M5/14276 , A61B5/11 , A61B5/1116 , A61B5/4836 , A61B2562/0219 , A61M2005/14208 , A61M2205/17 , A61M2210/0693 , A61M2210/1053 , A61M2210/1078 , A61M2210/1089 , A61M2230/62 , A61N1/3605 , A61N1/37247
摘要： Posture-responsive therapy is delivered by the medical system based on posture state input from only one of multiple posture sensors at any given time. An example implantable medical system includes a first posture sensor and a second sensor. A processor controls therapy delivery to the patient based on at least one of a patient posture state or a patient activity level determined based on input from only one of the first or second posture sensors. In some examples, one of multiple posture sensors of an implantable posture-responsive medical system is used to automatically reorient another posture sensor (of the system), which has become disoriented. The disoriented posture sensor may be automatically reoriented for one or more posture states at a time.

4. 发明授权

US09327117B2 Bladder sensing using impedance and posture 有权
标题翻译：膀胱感应使用阻抗和姿势
公开(公告)号：US09327117B2
公开(公告)日：2016-05-03
申请号：US13264023
申请日：2010-04-20
申请人： Timothy J. Denison , Keith A. Miesel
发明人： Timothy J. Denison , Keith A. Miesel
IPC分类号： A61B5/04 , A61B5/05 , A61B5/00 , A61N1/36 , A61B5/053 , A61B5/11 , A61B5/20
CPC分类号： A61N1/36007 , A61B5/053 , A61B5/1116 , A61B5/204 , A61B5/686 , A61B5/6883 , A61B5/7203 , A61B2560/0462 , A61B2562/0219
摘要： This disclosure provides techniques for bladder sensing. In accordance with the techniques described in this disclosure, a device may measure the impedance of a bladder, determine the posture of a patient, and determine a status of the bladder based on the impedance and posture.
摘要翻译：本公开提供了用于膀胱感测的技术。根据本公开中描述的技术，装置可以测量膀胱的阻抗，确定患者的姿势，并且基于阻抗和姿势来确定膀胱的状态。

5. 发明授权

US09044537B2 Devices and methods for detecting catheter complications 有权
标题翻译：用于检测导管并发症的装置和方法
公开(公告)号：US09044537B2
公开(公告)日：2015-06-02
申请号：US13169092
申请日：2011-06-27
申请人： Scott L. Kalpin , Lucien Bell Solefack , Keith A. Miesel
发明人： Scott L. Kalpin , Lucien Bell Solefack , Keith A. Miesel
IPC分类号： A61M25/00 , A61M5/142 , A61M5/168 , A61M5/172 , A61M27/00
CPC分类号： A61M5/14276 , A61M5/16854 , A61M5/16859 , A61M5/1723 , A61M27/006 , A61M2005/1726 , A61M2025/0003 , A61M2202/0464 , A61M2205/3331 , A61M2205/3344 , A61M2205/3355 , A61M2210/0693 , A61M2230/005 , A61M2230/04 , A61M2230/06 , A61M2230/40 , A61M2230/42 , A61M2230/63
摘要： A method for determining status of an implanted catheter includes acquiring raw pressure data from a pressure sensor of in an implantable infusion device. The pressure sensor is in communication with a lumen of the catheter operably coupled to the infusion device. The catheter has a delivery region, in communication with the lumen, intended to be positioned in a fluid-filled target location of a patient. The method further includes filtering the raw pressure data to remove the DC component, leaving the AC component within a relevant physiological frequency range; rectifying the AC component to produce a rectified pressure signal; calculating a mean magnitude of the rectified signal; and determining whether the mean magnitude is below a predetermined threshold. If the mean magnitude is below the threshold, the catheter is determined to be in a state other than a normal state.
摘要翻译：用于确定植入导管的状态的方法包括从可植入输注装置中的压力传感器获取原始压力数据。压力传感器与可操作地连接到输注装置的导管的内腔连通。导管具有与内腔连通的输送区域，用于定位在患者的流体填充的目标位置。该方法还包括过滤原始压力数据以去除DC分量，将AC分量留在相关的生理频率范围内; 整流交流分量以产生整流压力信号; 计算整流信号的平均幅度; 以及确定平均幅度是否低于预定阈值。如果平均值低于阈值，则确定导管处于正常状态以外的状态。

6. 发明申请

US20130253447A1 NEEDLE PLACEMENT SYSTEM 审中-公开
标题翻译：针头放置系统
公开(公告)号：US20130253447A1
公开(公告)日：2013-09-26
申请号：US13426045
申请日：2012-03-21
申请人： Brian W. Ball , Keith A. Miesel , Mary M. Morris , Luis E. Fesser , Jonathan P. Bogott
发明人： Brian W. Ball , Keith A. Miesel , Mary M. Morris , Luis E. Fesser , Jonathan P. Bogott
IPC分类号： A61M5/00
CPC分类号： A61M5/427 , A61M5/14276 , A61M5/46 , A61M2005/1588
摘要： A needle and needle system that aids in determining needle position with respect to an implanted device. The system determines needle position by detecting changes in electrical characteristics and the system further may generate a cue to indicate proper needle placement within an implanted device. Methods for detecting needle position with respect to an implanted infusion device are also disclosed.
摘要翻译：针和针系统，其有助于相对于植入装置确定针位置。该系统通过检测电特性的变化来确定针位置，并且该系统还可以产生一个提示，以指示植入装置内适当的针位置。还公开了相对于植入的输注装置检测针位置的方法。

7. 发明授权

US08444578B2 Wearable ambulatory data recorder 有权
标题翻译：可佩戴的卧床数据记录仪
公开(公告)号：US08444578B2
公开(公告)日：2013-05-21
申请号：US13217011
申请日：2011-08-24
申请人： Duane L. Bourget , Keith A. Miesel , Gregory F. Molnar
发明人： Duane L. Bourget , Keith A. Miesel , Gregory F. Molnar
IPC分类号： A61B5/103
CPC分类号： A61N1/08 , A61B5/0002 , A61B5/0031 , A61B5/0402 , A61B5/0476 , A61B5/0488 , A61B5/08 , A61B5/1116 , A61B5/1118 , A61B5/112 , A61B5/145 , A61B5/4082 , A61B5/4809 , A61B5/4815 , A61B5/4839 , A61B5/6831 , A61B5/6833 , A61B2560/0223 , A61B2560/0412 , A61B2560/0431 , A61B2562/0219 , A61N1/36021 , A61N1/36071 , A61N1/3702 , G06F19/00 , G06F19/3456 , G06F19/3481 , G16H10/60 , G16H40/63
摘要： A wearable ambulatory data recorder that senses physiological parameters of a patient, and stores physiological parameter data for later retrieval, as well as techniques for using such a wearable ambulatory data recorder, are described. The data recorder includes one or more sensors located on or within a housing. The data recorder may include an adhesive layer for attachment to a patient. In some embodiments, the housing may be within a patch, e.g., bandage, which includes the adhesive layer. The housing may be waterproof. Features of the data recorder such as size, waterproofness, and inclusion of an adhesive may allow the data recorder to be unobtrusively worn by a patient during a variety of daily activities. The data recorder may be for single use and thereafter disposable.
摘要翻译：描述了感测患者的生理参数并存储用于稍后检索的生理参数数据的可穿戴式步行数据记录器，以及使用这种可穿戴式可动态数据记录器的技术。数据记录器包括位于壳体上或壳体内的一个或多个传感器。数据记录器可以包括用于附接到患者的粘合剂层。在一些实施例中，壳体可以在包括粘合剂层的贴片（例如绷带）内。外壳可能是防水的。诸如尺寸，防水性和包含粘合剂的数据记录器的特征可允许数据记录器在各种日常活动期间被患者不佩服地佩戴。数据记录器可以是单次使用的，然后是一次性的。

8. 发明授权

US08401666B2 Modification profiles for posture-responsive therapy 有权
标题翻译：用于姿势反应疗法的修改方案
公开(公告)号：US08401666B2
公开(公告)日：2013-03-19
申请号：US12433856
申请日：2009-04-30
申请人： Dennis M. Skelton , Jon P. Davis , Rajeev Sahasrabudhe , Shyam Gokaldas , Joseph J. Nolan , Dennis Bourget , Duane Bourget , Keith A. Miesel , James Zimmerman
发明人： Dennis M. Skelton , Jon P. Davis , Rajeev Sahasrabudhe , Shyam Gokaldas , Joseph J. Nolan , Dennis Bourget , Duane Bourget , Keith A. Miesel , James Zimmerman
IPC分类号： A61N1/365
CPC分类号： A61N1/37247 , A61B5/1116 , A61B5/1118 , A61B2562/0219 , A61N1/36071 , A61N1/36132 , A61N1/36135 , A61N1/36542 , G06F19/00 , G06F19/3418 , G06F19/3481 , G16H20/10 , G16H40/63 , G16H50/20 , G16H80/00
摘要： In general, the disclosure describes techniques for modifying therapy provided to a patient by a medical device. The techniques may be applicable to electrical stimulation therapy or other therapies. Modification of therapy may include adjustment of one or more therapy parameter values that define one or more characteristics of stimulation therapy delivered to a patient. The therapy modification may be based on activity of a patient that is detected by an IMD, such as a change in a detected posture state occupied by the patient. Different therapy modifications may be applied for different changes in detected posture state. An IMD may modify therapy based on a transition from one posture state to another posture state, and apply different modifications for different transitions. In some aspects, the modification may include a profile, such as a ramp up or ramp down in a parameter value over a period of time. The profile may be different for different posture transitions. A ramp slope may be steeper for one transition than for another transition. When a patient transitions from an upright to a lying posture state, for example, the profile may be especially abrupt. In some examples, a modification profile may define a dwell time.
摘要翻译：通常，本公开描述了用于修改由医疗装置提供给患者的治疗的技术。这些技术可能适用于电刺激治疗或其他疗法。治疗的修改可以包括调整一个或多个治疗参数值，其定义递送给患者的刺激疗法的一个或多个特征。治疗修改可以基于由IMD检测到的患者的活动，例如患者所占据的检测到的姿势状态的变化。可以对检测到的姿势状态的不同变化应用不同的治疗修改。 IMD可以基于从一个姿势状态到另一个姿势状态的转变来修改治疗，并对不同的转变应用不同的修改。在一些方面，修改可以包括轮廓，例如在一段时间内在参数值中的斜坡上升或下降。对于不同的姿势转换，轮廓可能不同。坡度斜坡对于一个过渡而言可能比另一个过渡更陡峭。当患者从直立状态转变到躺卧状态时，例如，轮廓可能特别突然。在一些示例中，修改简档可以定义驻留时间。

9. 发明授权

US08397578B2 Capacitive pressure sensor assembly 有权
标题翻译：电容式压力传感器组件
公开(公告)号：US08397578B2
公开(公告)日：2013-03-19
申请号：US12793459
申请日：2010-06-03
申请人： Keith A. Miesel , James M. Haase , Chris J. Paidosh , Darren A. Janzig , Timothy J. Denison
发明人： Keith A. Miesel , James M. Haase , Chris J. Paidosh , Darren A. Janzig , Timothy J. Denison
IPC分类号： G01L9/12 , A61M5/14
CPC分类号： G01L9/0072 , G01L19/142 , G01L19/143 , G01L19/147 , H01L2224/48472 , Y10T29/49002 , Y10T29/53265
摘要： The disclosure is directed to a capacitive pressure sensor, and the assembly of a capacitive pressure sensor, that may be used within an implantable medical pump. In one example, a housing ferrule that encloses one capacitive plate and includes at least one protrusion for attaching a support structure of the capacitive plate. The at least one protrusion defines a smaller inner diameter as a reference point for securing the support structure while the ferrule provides a larger inner diameter to allow the support structure to tilt inside the ferrule to orient the capacitive plate into a desired plane. Despite manufacturing irregularities, the capacitive plate can be mounted in the desired plane parallel to another capacitive plate, a diaphragm, mounted to an edge of the ferrule. In another example, an assembly tool provides a stage to orient the capacitive plate and support structure within the ferrule at a desired depth.
摘要翻译：本公开涉及电容式压力传感器以及可在可植入医疗泵内使用的电容式压力传感器的组件。在一个示例中，壳体套圈包围一个电容板并且包括用于附接电容板的支撑结构的至少一个突起。所述至少一个突出部限定较小的内径作为用于固定支撑结构的参考点，同时套圈提供更大的内径以允许支撑结构在套圈内部倾斜以将电容板定向到期望的平面。尽管制造不规则，但是电容板可以安装在平行于另一个电容板的所需平面中，该电容板安装在套圈的边缘上。在另一示例中，组装工具提供了将电容板和支撑结构定位在套圈内的阶段，以期望的深度。

10. 发明授权

US08323244B2 Catheter malfunction determinations using physiologic pressure 有权
标题翻译：使用生理压力的导管故障测定
公开(公告)号：US08323244B2
公开(公告)日：2012-12-04
申请号：US11731356
申请日：2007-03-30
申请人： Keith A. Miesel , Robert J. Coffey
发明人： Keith A. Miesel , Robert J. Coffey
IPC分类号： A61M5/00 , A61B5/08 , A61B5/02 , A61M31/00
CPC分类号： A61M5/14276 , A61M5/16859 , A61M2005/1726 , A61M2202/0464
摘要： Methods and systems for determining whether an implanted catheter used to deliver fluids to a selected internal delivery site is malfunctioning. The malfunctions may include that the infusion section of the catheter is not located at or has migrated away from the selected internal delivery site, is leaking, is blocked, etc. The determination is made by analyzing the pressure modulation of fluid within the catheter and determining whether the pressure of the fluid in the catheter is modulated by physiologic pressure changes experienced at the selected internal delivery site. The physiologic pressure modulations at the selected internal delivery site may be caused by, e.g., cardiac activity, respiration, changes in patient's posture, etc.
摘要翻译：用于确定用于将流体输送到选择的内部递送部位的植入导管是否发生故障的方法和系统。故障可能包括导管的输液部分不位于或已经偏离所选择的内部输送部位，正在泄漏，被阻塞等。通过分析导管内的流体的压力调节并确定导管中液体的压力是否受选择的内部递送部位所经历的生理压力变化的调节。选择的内部递送部位的生理压力调节可以由例如心脏活动，呼吸，患者姿势变化等引起。

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