LUER ACTIVATED DEVICE WITH VALVE ELEMENT UNDER TENSION

[0001] The present invention relates generally to luer activated devices or valves that allow for the bi-directional transfer of fluids to and from medical fluid flow systems.

[0002] Luer activated devices (LAD) or valves (LAV) are commonly used in association with medical fluid containers and medical fluid flow systems that are connected to patients or other subjects undergoing diagnostic, therapeutic or other medical procedures. A LAD can be attached to or part of a fluid container or a medical fluid flow system to simplify the addition of fluids to or withdrawal of fluids from the fluid flow system.

[0003] Within the medical field there are a wide variety of medical fluid flow systems, serving a variety of functions. One of the more common uses of LADs are in association with fluid flow systems that are used for the intravenous administration of fluids, such as saline, antibiotics, or any number of other medically-related fluids, to a patient. These flow systems are commonly referred to as intravenous or “IV” fluid administration sets, and use plastic tubing to connect a phlebotomized subject to one or more medical fluid sources, such as intravenous solution or medicament containers.

[0004] Typically, such intravenous administration sets include one or more LADs providing needless access to the fluid flow path to allow fluid to be added to or withdrawn from the IV tubing. The absence of a needle for injecting or withdrawing fluid has the important advantage of reducing the incidence of needle stick injuries to medical personnel. A LAD typically includes a tapered female luer component, such as the inlet into a valve housing, that accepts and mates with a tapered male luer of a medical infusion or aspiration device, such as a needleless syringe or a administration set tubing brand.

[0005] There are certain characteristics and qualities of LADs that are highly desirable. For example, the LAD should provide a sufficient microbial barrier for the full service life of the valve. It is desirable that the microbial barrier be conducive to the application of standard aseptic techniques preformed by clinicians during the use of the device. For example, the geometry of the LAD should be such that it is easily swabbable and reduces the potential of entrapping particulates or contaminants that cannot be cleanly swabbed clear prior to use. In addition, the LAD should not permit cross contamination between the male luer and the surfaces of the aseptic fluid path.

[0006] Furthermore, it is highly desirable that the LAD be substantially devoid of any interstitial space or any other “dead space” that cannot be flushed, or that such interstitial space be physically isolated from the fluid flow path. Such interstitial space has the potential of providing an environment for undesired microbial growth. In addition, the LAD should have a geometry that allows it to be sufficiently flushed so as to clear the dynamic fluid path and adjacent areas of residual blood or intravenous fluids to prevent undesired microbial growth.

[0007] LAD's are commonly used with intravenous catheters that provide access to a patient's vascular system. In such systems, another desirable feature of a LAD is minimal displacement of fluid during insertion and removal of the male luer. In certain situations, it is preferable that the LAD be a neutral/neutral device in that there is zero or only a very slight displacement of fluid during both insertion and removal of the male luer. In other situations it can be desirable for the LAD to produce a positive displacement of fluid from the valve housing during the insertion and removal of the male luer. The LAD also preferably prevents blood reflux into the catheter. Reflux is known to reduce the efficiency of the catheter, contribute to catheter clotting and also contribute to catheter related bloodstream infections.

[0008] In most situations it is preferred that the LAD be ergonomically dimensioned to be completely activated by a wide range of ISO compliant male luer lock adaptors. However, there may some instances when the LAD is specifically designed to be activated by a male luer lock that is not ISO complaint. Another desirable characteristic of a LAD is the ability of the LAD to seal against pressure contained within a fluid system to which the LAD is connected. For example, it is desirable to be leak resistance to positive pressures ranging from 10 to 45 psi and to negative pressures or vacuum from 1 to 5 psi. The LAD also preferably has a geometry that allows for easy priming and flushing that does not require any additional manipulations to remove residual air bubbles from the tubing system.

[0009] These and other desirable characteristics, which may be used separately or in combination, is preferably present over the full service life of the valve. When used in connection with an IV set or catheter, the LAD may go through many connections and disconnections. It is desirable that the life of an LAD last through upwards to about 100 connections and disconnections or 96 hours of dwell time.

[0010] As described more fully below, the fluid access devices of the present invention provides important advances in the safe and efficient administration or withdrawal of medical fluids to or from a fluid flow system.

[0011] In accordance with one aspect of the present invention, a medical valve for the bi-directional transfer of fluid is provided with a valve housing having an inlet adapted for receiving a male luer, an outlet and a passageway therethrough. A fluid flow controller is received within the valve housing and has a valve element fixedly attached to the inlet. The valve element has a resealable aperture for receiving a male luer and sealing the inlet. An extending portion extends away from the valve element and is fixedly attached to the outlet to define a fluid flow path in communication with the aperture and the outlet. The fluid flow controller is maintained in a tensioned state within the valve housing, such that insertion of a male luer into the inlet decreases the tension in at least a portion of the fluid flow controller.

[0012] According to another aspect of the present invention, a medical valve for the bi-directional transfer of fluid is provided with a valve housing having an inlet adapted for receiving a male luer. A fluid flow controller associated with the valve housing has a valve element fixedly attached to the inlet in a tensioned state. The valve element has a first sealing layer defining a first resealable aperture, a second sealing layer defining a second resealable aperture, and a channel therebetween and in communication with both apertures. The channel is substantially closed in the tensioned state and open in an untensioned state.

[0013] According to yet another aspect of the present invention, a method of manufacturing a medical valve involves providing a fluid flow controller having a valve element and an extending portion defining a fluid flow path. The valve element is fixedly attached to an upper portion of a valve housing so as to seal an inlet of the upper housing portion. The fluid flow controller is stretched away from the inlet and a lower housing portion is placed over the extending portion of the fluid flow controller so that the extending portion extends into an outlet of the lower housing portion. The lower housing portion is fixedly attached to the lower housing portion and a section of the extending portion is fixedly attached to the outlet, thereby maintaining the fluid flow controller in a tensioned state.

[0032] As required, detailed embodiments of the present invention are disclosed herein; however, it is to be understood that the disclosed embodiments are merely exemplary of the invention, which may be embodied in various forms. Therefore, specific details disclosed herein are not to be interpreted as limiting, but merely as a basis for teaching one skilled in the art to variously employ the present invention in virtually any appropriate manner.

[0033] FIG. 1 generally illustrates a first embodiment of a luer activated device (LAD) or valve of the present invention, generally designated as 10. The LAD 10 includes a generally tubular valve housing 12 preferably comprised of a rigid material, such as plastic or other suitable material. The LAD 10 is provided as a combination of a joined upper housing portion 14 and a lower housing portion 16. The LAD 10 also includes an inlet 18, an outlet 20, and a passageway 22 defined therebetween. The terms “inlet” and “outlet” are not to be interpreted as limiting the LAD 10 to applications involving fluid flow in a particular direction, e.g., from the inlet 18 to the outlet 20, because LAD's according to the present invention may be used in applications involving fluid flow from the inlet 18 to the outlet 20 or from the outlet 20 to the inlet 18.

[0034] The outlet 20 is adapted to be connected to any of a number of fluid flow systems, so the exact configuration of the outlet 20 will vary according to the nature of the fluid flow system to which it is to be connected. For example, the illustrated outlet 20 is suitable for use in connecting the valve 10 to an IV administrative tubing set (not illustrated). In the embodiment of FIG. 1, the outlet 20 includes a skirt 24 defining an internal thread 26, which may be adapted to engage an external thread of the associated fluid flow system (not illustrated). Of course, the outlet 20 may be provided with a different configuration, a different locking system, or without a locking system, depending on the anticipated usage of the valve 10.

[0035] The inlet 18 includes an opening 28 adapted to receive a male luer 30 (FIGS. 2 and 3) according to known structure and operation. The inlet 18 and male luer 30 preferably conform functionally to ISO and/or ANSI standards. In general the inlet 18 is unable to conform dimensionally to ISO luer standards as there would be insufficient volume to house the septum displacement upon insertion of a luer tip.

[0036] The male luer 30 has a hollow channel 32 defined by a generally tubular wall 34. The wall 34 preferably has a substantially smooth outer surface 36 which is typically cylindrical or conical. The inlet 18 may include external threads 38, in which case a portion of the luer wall 34 may be surrounded by a collar member 40 (FIGS. 2 and 3) having internal threads 42 adapted to removably lock the male luer 30 to the inlet 18. Other locking mechanisms may also be incorporated into LAD's according to the present invention.

[0037] By way of example, the collar member 40 and luer wall 34 may be configured to provide a tactile feel when the male luer 30 has been fully engaged to the LAD 10. As shown in shadow in FIG. 3 the luer wall may include some detents 13 which are placed so as to register with one of cavities or openings 11 formed in the collar member 40. To allow the LAD to connect with standard male luers, the detents 13 may be placed lower on the luer wall 34 and the collar member 40 extended to provide the registration.

[0038] The inlet 18 fixedly receives a fluid flow controller 44 having a resealable slit or aperture 46 therethrough. The flow controller 44 acts as a microbial barrier between the internal passageway 22 of the LAD 10 and the atmosphere. The flow controller 44 may include a substantially concave upper surface 48 (FIG. 1), which provides a relatively tight seal of the aperture 46. Alternatively, the upper surface 48a may be substantially flat (FIG. 7), such that it can be easily wiped with antiseptic, which aids in preventing contamination during use.

[0039] The flow controller 44 is comprised of a first portion or valve element 50, which includes the upper surface 48 and the aperture 46, and a second portion or extending portion 52 (FIG. 1) that extends away from the valve element 50. The extending portion 52 is generally tubular and defines a fluid flow path 54 in communication with the aperture 46 of the valve element 50. The valve element 50 is fixedly attached to the LAD inlet 18, while the extending portion 52 is fixedly attached to the LAD outlet 20, preferably by mechanical means, such as a bushing member 56. The operation of the flow controller 44 is illustrated in FIGS. 2 and 3, and will be described in greater detail herein.

[0040] Preferably, the flow controller 44 is molded as a unitary piece, typically from a deformable elastomeric material, such as silicone or rubber or santoprene. The “as-molded” configuration of the flow controller 44 is shown in FIG. 4, with a substantially convex upper surface 48b and an extending portion 52 comprised of a wall 58 having a bulb or bulge 60. The illustrated wall 58 has a generally uniform outer radius, except for the bulge 60, which has an increased outer radius. The bulge 60 affects the flow dynamics of the LAD 10, as will be described in greater detail herein.

[0041] It will be seen that the flow controller 44 is significantly shorter in the “as-molded” configuration of FIG. 4, as compared to the condition illustrated in FIG. 1. According to a preferred method of manufacturing the flow controller 44, the flow controller 44 is initially provided in the relatively short “as-molded” condition of FIG. 4, along with a separate upper valve housing portion 14. The valve element 50 is fixedly attached to the LAD inlet 18 to close the opening 28 thereof. This may be done by any of a number of means, which vary according to the materials selected for the flow controller 44 and the upper housing portion 14. These means include, but are not limited to, adhesion or mechanical attachment (e.g., crimping), although the flow controller 44 is preferably overmolded onto the upper housing portion 14. The aperture 46 may be formed in the valve element 50 prior to or after the valve element 50 is secured to the LAD inlet 18. Referring briefly to FIG. 2, the overmolded section attaching the controller 44 and the upper housing portion 14, may be dimensioned to engage the threads of the male luer to provide the desired torque resistance to disengagement per ISO standards.

[0042] When the valve element 50 has been secured to the inlet 18, an elongated mandrel or vacuum member 62 is inserted through the aperture 46 and the fluid flow path 54 (FIG. 5). A suction source (not illustrated) is associated with the mandrel 62 and creates a vacuum force that pulls the extending portion 52 inwardly against the mandrel 62. The mandrel 62 is then moved downwardly (in the orientation of FIG. 5) to push the convex upper surface 48b into the LAD inlet 18 and stretch the extending portion 52. In the “fully stretched” condition of FIG. 5, the bulge 60 substantially flattens out against the mandrel 62 and the wall 58 of the extending portion 52 has a generally uniform outer radius. It will be appreciated that the flow controller 44, and in particular the extending portion 52 is in a state of tension in the “fully stretched” condition of FIG. 5.

[0043] With the mandrel 62 still in place and providing a suction force, the lower valve housing portion 16 is slid over the extending portion 52 and affixed to the upper housing portion 14 (FIG. 6). A portion of the mandrel 62 and the extending portion 52 remains outside of the lower housing portion 16. A bushing member 56 is affixed to this portion of the extending portion 52, and the mandrel 62 is removed (FIG. 7). When the mandrel 62 has been removed, the flow controller 44 is free to move into an “assembled” condition (FIGS. 1 and 7). The flow controller 44 as a whole shifts upwardly and the upper surface 48 assumes either a concave condition (FIG. 1) or a flat condition (FIG. 7) depending on the magnitude of the original convex curvature (FIG. 4) and the degree of stretching. Forcing the upper surface 48 to fit within the inlet opening 28 forces the valve element into a state of radial compression, which promotes an improved seal of the resealable aperture 46, thereby preventing fluid leakage through the inlet 18. The bushing member 56 constrains the extending portion 52, thereby maintaining it in a state of tension, and preventing it from returning to the “as-molded” condition of FIG. 4. From FIG. 7, it will be seen that the fluid flow path 54 is isolated from the surrounding LAD passageway 22 to define the sole path for fluid moving through the LAD 10.

[0044] In an alternate embodiment, the extending portion 52 may be directly attached to the lower valve housing portion 52 by over-molding.

[0045] Turning now to the operation of the LAD 10, a male luer 30 is inserted into the inlet 18 and through the aperture 46 (FIG. 2). If desired, the aperture 46 or the male luer 30 may be lubricated for ease of insertion and removal. The male luer 30 deforms the flow controller 44 and relieves some of the tension in the extending portion 52. On account of the shape memory of the elastomeric material, this reduction in tension allows the bulge 60 to reemerge and expand outwardly into the surrounding passageway 22, thereby defining a first volume V of the fluid flow path 54.

[0046] The male luer 30 is further inserted into the aperture 46 until the aperture 46 completely opens and allows a portion of the male luer 30 to move into the extending portion 52. The outer radius of the male luer 30 is larger than the inner radius of the fluid flow path 54, which causes the portion of the wall 58 between the bulge 60 and the male luer 30 to bend outward into a generally frusto-conical shape defining a fluid reservoir 64 (FIG. 3). When the fluid reservoir 64 has been established and the male luer 30 is fully inserted, a second volume V′ is defined.

[0047] The difference between the first volume V (FIGS. 1 and 2) and the second volume V′ (FIG. 3) determines the magnitude of the fluid displacement when the male luer 30 is inserted and removed, and that difference is determined by the configuration of the bulge 60. Reflux of fluid into the male luer 30 can lead to a number of problems, such as contamination, so it may be preferred for the bulge 60 to be adapted such that the difference between the first volume V and the second volume V′ is minimized. In one embodiment, the bulge 60 is adapted such that the first volume V is substantially equal to the second volume V′, which ideally creates a neutral fluid displacement, thereby substantially eliminating fluid reflux when the male luer 30 is inserted or removed. If the volumes V and V′ cannot be practicably equated, then preferably the bulge 60 is adapted such that the second volume V′ is only slightly smaller than the first volume V, which results in a minor positive fluid displacement as the male luer 30 is inserted into the LAD 10 and a minor negative fluid displacement as the male luer 30 is removed from the LAD 10.

[0048] FIG. 8 illustrates another LAD 10a according to the present invention. The LAD 10a of FIG. 8 generally conforms to the foregoing description of the embodiment of FIG. 1, except it includes a restrictor member 66 mounted within the valve housing 12. The restrictor member 66 acts as a second or auxiliary resealable aperture, as will be described in greater detail herein.

[0049] As with the embodiment of FIG. 1, the flow controller 44a is preferably molded as a unitary piece, typically from a deformable elastomeric material, such as silicone or rubber or santoprene. With the flow controller 44a in an “as-molded” configuration, the valve element 50 is secured to the LAD inlet 18 (FIG. 10) to close the opening 28 thereof. This may be done by any of a number of means, which vary according to the materials selected for the flow controller 44a and the upper housing portion 14. These means include, but are not limited to, adhesion or mechanical attachment (e.g., crimping), although the flow controller 44a is preferably overmolded onto the upper housing portion 14. In FIG. 10, the extending portion 52 of the flow controller 44a is illustrated without a bulge, but a bulge may also be provided without departing from the scope of the present invention.

[0050] When the valve element 50 has been secured to the inlet 18, an elongated mandrel or vacuum member 62 is inserted through the aperture 46 and the fluid flow path 54 (FIG. 11). A suction source (not illustrated) is associated with the mandrel 62 and creates a vacuum force that pulls the extending portion 52 inwardly against the mandrel 62. The mandrel 62 is then moved downwardly (in the orientation of FIG. 11) to push the convex upper surface 48b into the LAD inlet 18, stretch the extending portion 52, and maintain the flow controller 44a in a state of tension.

[0051] With the mandrel 62 still in place and providing a suction force, the restrictor member 66 is slid over the extending portion 52 and into the position of FIG. 11. In the illustrated embodiment, the restrictor member 66 has an annular rim 68 adapted to abut a shoulder 70 of the upper housing portion 14. A generally tubular portion 72 extends upwardly from the rim 68 and terminates in an inwardly extending upper flange 74. In a relaxed condition (FIG. 8), the flange 74 defines an opening 76 smaller than the diameter of the extending portion 52 to compress and close the fluid flow path 54, but the presence of the mandrel 62 widens the opening 76 into an open condition (FIG. 11). The profile of the opening 76 may vary, provided that it is adapted to close the fluid flow path 54 in the relaxed condition of FIG. 8 and to allow passage of the fluid flow path 54 in the open condition of FIG. 11.

[0052] As described in greater detail herein, the flange 74 has the tendency to resiliently return to the relaxed condition when the mandrel 62 is removed from the LAD 10a. Accordingly, the flange 74 is preferably comprised of a material more rigid than the elastomeric material of the flow controller 44a (to pinch the fluid flow path 54 closed), but sufficiently pliable to move between the relaxed condition of FIG. 8 and the open condition of FIGS. 9B and 11. Suitable materials for the flange 74, and preferably the entire restrictor member 66, include rubber, silicone, polyisoprene, HDPE and polyurethane It will be seen from the following description that the restrictor member 66 may be provided in virtually any configuration, provided that it includes means for holding it in place within the LAD 10a and means for resiliently compressing a section of the fluid flow path 54 into a closed position (FIGS. 8 and 9A).

[0053] When the restrictor member 66 has been properly positioned within the upper housing portion 14, the lower valve housing portion 16 is slid over the extending portion 52 and affixed to the upper housing portion 52 (FIG. 12). Preferably, the lower housing portion 16 includes an element, illustrated in FIG. 12 as an upwardly extending annular lip 78, which abuts the restrictor member rim 68 and maintains the restrictor member 66 in place. However, other means for maintaining the restrictor member 66 in place within the housing 12 may be used without departing from the scope of the present invention.

[0054] A portion of the mandrel 62 and the extending portion 52 remains outside of the lower housing portion 16. A bushing member 56 is affixed to this portion of the extending portion 52 (FIG. 13), and the mandrel 62 is removed (FIG. 8). When the mandrel 62 has been removed, the flow controller 44a is free to move into an “assembled” condition (FIG. 8), according to the foregoing description of the embodiment of FIG. 1. Additionally, the flange 74 of the restrictor member 66 resiliently returns to its relaxed condition, thereby decreasing the size of the opening 76 and pinching closed a section of the fluid flow path 54.

[0055] Turning now to the operation of the LAD 10a, a male luer 30 is partially inserted into the inlet 18 and through the aperture 46 (FIG. 9A). The male luer 30 opens the aperture 46, but not the opening 76 of the restrictor member 66, so flow through the LAD inlet 18 remains closed (FIG. 9A). Hence, it will be seen that the restrictor member 66 acts as a secondary or auxiliary sealing element that prevents fluid flow through the inlet 18 when the male luer 30 is only partially inserted. As the male luer 30 is further inserted into the inlet 18, it engages the section of the fluid flow path 54 closed by the restrictor member 66 and forces the restrictor member 66 into the open condition of FIG. 9B. In the condition of FIG. 9B, fluid flow through the LAD 10a may begin. If the extending portion 52 includes a bulge (not illustrated), the fluid displacement upon inserting and removing the male luer 30 will be governed according to the foregoing description of the embodiment of FIG. 1.

[0056] Similarly upon withdrawal of the male luer 30, as the male luer is withdrawn the male luer no longer engages the section of the fluid flow path 54 adjacent the restrictor member 66 and the restrictor member then closes the flow path. Further withdrawal of the male luer will create a vacuum condition in the flow path 54 which pulls fluid from within the male luer. This reduces aersolization of fluid from the male luer tip.

[0057] FIG. 14 illustrates yet another LAD 10b according to the present invention. The LAD 10b of FIG. 14 generally conforms to the foregoing description of the embodiment of FIG. 1, except it includes a modified valve element 80. The modified valve element 80 provides a second or auxiliary resealable aperture 82, similar to the embodiment of FIG. 8, but it may be preferred for some applications because it eliminates the potential non-flushable “dead space” between the upper and lower sealing elements, as described in greater detail herein.

[0058] As with the embodiment of FIG. 1, the flow controller 44b is preferably molded as a unitary piece (FIG. 17), typically from a deformable elastomeric material, such as silicone or rubber or santoprene. The modified valve element 80 includes an upper surface or first sealing layer 48 defining a first resealable aperture 46 adapted to receive a male luer 30 (FIG. 15). In the illustrated embodiment, a skirt 84 extends downwardly from the outer perimeter of the first sealing layer 48. A second sealing layer 86 is spaced from the first sealing layer 48 and includes a rim 88 comparable in structure and operation to the restrictor member rim 68 of the embodiment of FIG. 8. The rim 88 defines a second resealable aperture 82 adapted to receive a male luer 30 (FIG. 16) and preferably coaxial with the first aperture 46. The first and second apertures 46 and 82 are joined by a channel 90. As shown in FIG. 17, the channel 90 is preferably at least partially open in the “as-molded” configuration. The flow controller 44b is illustrated in FIG. 17 with a flat upper surface 48 and a bulge 60, but it will be appreciated from the following description that the upper surface 48 may be substantially convex in the “as-molded” configuration and/or the extending portion 52 may be provided without the bulge 60.

[0059] With the flow controller 44b in an “as-molded” configuration, the modified valve element 80 is secured to the LAD inlet 18 (FIG. 18) to close the opening 28 thereof. This may be done by any of a number of means, but is preferably achieved by pushing the upper surface 48 upward through the inlet 18 until the skirt 84 seats within a ledge or shelf 92 of the inlet 18 by a friction fit. Preferably, the upper surface 48 is slightly larger than the inlet 18, such that the upper surface 48 is seated with an interference fit that results in a radial compression that aids in more tightly sealing the first aperture 46.

[0060] When the first sealing layer 48 is securely seated, the rim 88 is positioned to abut a shoulder 70 of the upper housing portion 14. The rim 88 may be affixed to the shoulder 70 by a variety of means, depending on the material selected for the housing upper portion 14 and the flow controller 44b. Suitable means may include welding, adhesion, and a press fit with the lower housing portion 16, as described in greater detail herein.

[0061] Preferably, the distance between the top of the upper surface 48 and the rim 88 is less than the height of the inlet 18, such that the channel 90 must be stretched to properly position the first and second sealing layers 48 and 86. FIG. 18 shows that a channel 90 in such a state of tension will deform to be substantially closed, along with the first aperture 46 and the second aperture 82. Stretching the channel 90 may cause the first and/or second sealing layers to assume a generally concave configuration (not illustrated) that imparts a radial compression on the associated apertures and aids in maintaining the inlet 18 in a sealed condition.

[0062] When the modified valve element 80 has been secured to the inlet 18, an elongated mandrel or vacuum member 62 is inserted through the apertures 46 and 82, the channel 90, and the fluid flow path 54 (FIG. 19). A suction source (not illustrated) is associated with the mandrel 62 and creates a vacuum force that pulls the extending portion 52 and bulge 60 inwardly against the mandrel 62. The mandrel 62 is then moved downwardly (in the orientation of FIG. 20) to stretch the extending portion 52 and maintain the flow controller 44b in a state of tension.

[0063] With the mandrel 62 still in place and providing a suction force, the lower housing portion 16 is slid over the extending portion 52 and affixed to the upper housing portion 14 (FIG. 21). Preferably, the lower housing portion 16 includes an element, illustrated in FIG. 21 as an upwardly extending annular lip 78, which compresses the second sealing layer rim 88 and maintains the second sealing layer 86 in place. This may be done instead of or in addition to welding or otherwise securing the rim 88 to the shoulder 70 in the condition of FIG. 18. However, in comparison to the restrictor member rim 68 of FIG. 8, the second sealing layer 86 is relatively flexible, so it may be preferred to use two joinder means (e.g., welding and a compression relationship) to ensure that the second sealing layer 86 is securely maintained within the LAD housing 12.

[0064] A portion of the mandrel 62 and the extending portion 52 remains outside of the lower housing portion 16. A bushing member 56 is affixed to this portion of the extending portion 52 (FIG. 21), and the mandrel 62 is removed (FIG. 14). When the mandrel 62 has been removed, the flow controller 44b is free to move into an “assembled” condition (FIG. 14), according to the foregoing description of the embodiment of FIG. 1. Additionally, the channel 90 and the second aperture 82 will resiliently close to seal the inlet 18, along with the first aperture 46.

[0065] Turning now to the operation of the LAD 44b, a male luer 30 is partially inserted into the inlet 18 and through the first aperture 46 (FIG. 15). The male luer 30 opens the aperture 46 and at least a portion of the channel 90, but not the second aperture 82, so flow through the LAD inlet 18 remains closed. Hence, it will be seen that the second sealing layer 86 acts as a secondary or auxiliary sealing element that prevents fluid flow through the inlet 18 when the male luer 30 is only partially inserted.

[0066] As the male luer 30 is further inserted into the inlet 18, it continues to deform the flow controller 44b, which causes the bulge 60 to reemerge, and opens the second aperture 82 (FIG. 16). In the condition of FIG. 16, fluid flow through the LAD 10b may begin. Depending on the nature of the bulge 60 and the resulting fluid reservoir 64, insertion or removal of the male luer 30 will result in a positive, negative, or neutral fluid displacement, according to the foregoing description of the embodiment of FIG. 1.

[0067] It will be appreciated that the embodiment of FIG. 8 similarly provides a second sealing element (the restrictor member opening 76). However, the embodiment of FIG. 14, which provides a substantially closed channel 90 between the upper and lower sealing layers 48 and 86, may be preferred for certain applications.

[0068] The flow controller 44b of FIG. 14 may be modified by removing the extending portion 52 and leaving only the valve element 80, as shown in FIGS. 22-26. The resulting flow controller 44c may be incorporated as a valve of any of a number of devices, including LAD's as described herein (FIGS. 22 and 23) and T-sites (FIGS. 24-26). Such a flow controller 44c may be preferred to known single or double slit septum-type valves, because there are two separate sealing layers 48 and 86, along with a channel 90 therebetween that is substantially closed in a relaxed condition (FIGS. 22, 24, and 26) to prevent the creation of a “dead space.”

[0069] Referring in particular to FIG. 26, flow flows through the channel formed by the housing in a path which causes any air present in the injection site to be displaced out of the housing. This provides a self flushing feature to the valve.

[0070] While the present invention has been described in terms of certain preferred and alternative embodiments for purposes of illustration, it is not limited to the precise embodiments shown or to the particular features, shapes or sizes illustrated. A variety of changes may be made without departing from the present invention as defined by the appended claims.