FIELD OF THE INVENTION
[0001] The invention relates to the manner of storing, dispensing and disposing of analyte
test strips.
BACKGROUND OF THE INVENTION
[0002] Analyte concentration determination in physiological samples is of ever increasing
importance to today's society. Such assays find use in a variety of application settings,
including clinical laboratory testing, home testing,
etc., where the results of such testing play a prominent role in the diagnosis and management
of a variety of disease conditions. Analytes of interest include glucose for diabetes
management, cholesterol for monitoring cardiovascular conditions, and the like. In
response to this growing importance of analyte concentration determination, a variety
of analyte concentration determination protocols and devices for both clinical and
home testing have been developed.
[0003] In determining the concentration of an analyte in a physiological sample, a physiological
sample must first be obtained. Obtaining the sample often involves cumbersome and
complicated devices which may not be easy to use or may be costly to manufacture.
The analyte concentration determination process may also involve a multitude of steps.
First, a sample is accessed by use of a skin-piercing mechanism,
e.g., a needle or lancet, which accessing may also involve the use of a sample collection
mechanism,
e.g., a capillary tube. Next, the sample must then be transferred to a testing device,
e.g., a test strip or the like, and then oftentimes the test strip is then transferred
to a measuring device such as a meter. Thus, the steps of accessing the sample, collecting
the sample, transferring the sample to a biosensor, and measuring the analyte concentration
in the sample are often performed as separate, consecutive steps with various device
and instrumentation.
[0004] Because of these disadvantages, it is not uncommon for patients who require frequent
monitoring of an analyte to simply become non-compliant in monitoring themselves.
With diabetics, for example, the failure to measure their glucose level on a prescribed
basis results in a lack of information necessary to properly control the level of
glucose. Uncontrolled glucose levels can be very dangerous and even life threatening.
[0005] Numerous approaches have been developed to facilitate test regiment compliance or
simplify testing for users. Certain devices combine a lancing-type device with various
other components involved in the analyte concentration determination procedure in
order to simplify the assay process. For example,
U.S. Patent No. 6,099,484 discloses a sampling device which includes a needle associated with a spring mechanism,
a capillary tube associated with a pusher, and a test strip.
U.S. Patent No. 5,820,570 discloses an apparatus which includes a base having a hollow needle and a cover having
a membrane, whereby the base and cover are connected together at a hinge point. Still
further, U.S. Patent Application Atty. Docket No. 054, entitled "Minimal Procedure
Analyte Test System," teaches a system and discusses other systems combining lancing
device, meter and test strip handling functionality.
[0006] Other systems, such as described in
U.S. Patent Nos. 5,510,266;
5,575,403 and
5, 863,800 offer test strip storage and dispensing system, but no integrally lancing features.
The devices described in the '403 patent does, however, include meter functionality.
[0007] With respect to each of these systems, provision is made for storing test strips
in an isolated manner and then conveniently dispensing them from their individual
packaging. Other systems in which test strips are individually sealed in an aluminum
laminate foil are known as well. To remove the test elements, the user tears open
the foil and takes out the test element.
[0008] Simply sealing test strip elements in foil has several drawbacks. Sealing test elements
in aluminum laminates produces a lot of waste material and requires a user to tear
or puncture the aluminum laminate, often causing problems in view of the dexterity
required, which ill people often face. In the '266, '403 and '800 patents, since test
elements are provided in a single container with multiple compartments, signification
waste packaging issues are avoided. Dexterity challenges are also addressed by providing
collateral hardware for extracting the test strips from their packaging. In each of
the references, the test strips provided are pushed out of the packages sensor-side
first In the '266 and '403 patents the face or front of the test strip itself punches
through a foil covering.
[0009] Similar containers comprising lancets and test ships are disclosed in document
US 6036924, which discloses a container for storing test ships including a lancet and comprising
a receptacle with an access aperture and a sheath portion.
[0010] Nether of these systems is amenable to use with test strips including integral (forward-facing)
lance features as are the storage containers of the present invention. The mode of
operation of the systems described in the '266 and '800 patents would destroy delicate
microneedle features.
[0011] Further, while the approach in the '403 patent could possibly be adapted for use
with a test element that integrally includes lance features, the planar storage orientation
of test strips contemplated therein is not space efficient and requires complex movement
of members (including the test strips held in covered wells) in use. Aspects of the
present invention offer a more elegant approach with a concomitant reduction in cost
of the storage devices or meter/lancing devices that may be used with the same.
[0012] Another aspect of the present invention is geared toward yet another consideration
in handling test strips,
i.
e., test strip disposal.
PCT publication WO 01/23885 provides for a test strip dispensing system with an integral waste disposal section.
However, no apparent provision is made for isolating used tester portions, contaminated
with biological fluid from unused members. Furthermore, individual test strip portions
are not isolated. Consequently, exposure of one portion results in exposure of others,
thereby introducing moisture or contaminates which can have a deleterious effect on
test strip reagent compounds and needle sterility, respectively.
[0013] EP 1 285 629 A1 which comprises prior art under Art.54(3) EPC for DE, FR, GB and IT only, discloses
a test strip container system as recited in claim 1 for all designated contracting
states except DE, FR, GB and IT.
[0014] EP 0 951 939 A2 discloses a test strip container system comprising: a plurality of test strips, each
including face or shoulder portions; a container body defining a plurality of test
strip receptacles, each receptacle having an access aperture at one end and at least
one ledge for supporting a test strip at its face or shoulder portions; a barrier
portion for closing off at least some of said access apertures at said one end such
that said test strips can be exposed for use one at a time; each receptacle having:
an inset portion extending from said at least one ledge to form a sheath portion at
another end, and an access path to the test strip from its rear via said access aperture.
[0015] EP 0 901 634 B1 discloses a test strip container system comprising: a container body, said container
body defining a plurality of test strip receptacles at one end, and a barrier portion
for closing off at least some of said test strip receptacles.
[0016] The present invention offers further improvement in test strip handling and use.
Each aspect of the invention addresses certain concerns, thus providing a system better
able to meet the public's needs.
SUMMARY OF THE INVENTION
[0017] The present invention provides test strip container systems as recited in the claims.
[0018] Each variation of the invention includes a test strip container adapted to individually
receive a plurality of test strips in a sealed fashion. The type of seal used affords
the ability to expose test strips for use one at a time. Preferred seals for such
purpose include foil (such as an aluminum foil laminate) and a rotatable lid or cap
including a single port to be moved from one test strip receptacle portion to the
next.
[0019] The test strip receptacle is configured to receive and protect a lance member including
at least one forward-facing microneedle. This adaptation or configuration includes
an inset portion to house the needle and an access path to the test strip from its
rear.
[0020] The inventive container may also include a waste receptacle that can be closed-off
for safe storage of spent test strips apart from unused members. Since protecting
used text strips held in the waste receptacle from exposure is not critical, any sort
of cap or closure mechanism may be employed in this regard. In preferred variations
of the invention, however, where a cylindrical container body is employed the waste
receptacle is situated across from or on the opposite side from where unused test
strips are accessed. Various optional safety features may be provided in connection
with the waste receptacle.
[0021] In use, the container preferably interfaces with a meter/lancing device to select
and/or retrieve a test strip. A user may intermittently position the container to
facilitate such action or load the container into the meter/lancing device.
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] Each of the following figures diagrammatically illustrates aspects of the present
invention. Variation of the invention from that shown in the figures is contemplated.
[0023] Figure 1 is a perspective view of a representative meter and test strip as may be
used in connection with variations of the present invention.
[0024] Figures 2A and 2B are perspective views of variations of the inventive container.
[0025] Figure 3 is a perspective view of a section of a receptacle portion of the container,
located as depicted in FIG 2B, together with a test strip indicating how it is placed
in the same.
[0026] Figures 4A-4C are perspective views of a variation of the inventive container incorporating
a waste receptacle.
DETAILED DESCRIPTiON OF THE INVENTION
[0027] In describing the invention in greater detail than provided in the Summary above,
colorimetric and electrochemical test strips sensors are first described, followed
by discussion of features and the use of exemplary combination test strip meter and
lancing device of the present invention. After this background discussion, features
of the invention containers are described in detail. Finally, kits advantageously
incorporating components of the present invention are described.
[0028] Before the present invention is described in such detail, however, it is to be understood
that this invention is not limited to particular variations set forth and may, of
course, vary. Various changes may be made to the invention described and equivalents
may be substituted without departing from the true spirit and scope of the invention.
In addition, many modifications may be made to adapt a particular situation, material,
composition of matter, process, process act(s) or step(s), to the objective(s), spirit
or scope of the present invention. All such modifications are intended to be within
the scope of the claims made herein. For example, description of the use of electrochemical
and photometric sensor type test strips is not intended to be limiting; those skilled
in the art will appreciate that the subject devices, systems and methods are useful
in the measurement of other physical and chemical characteristics of biological substances,
e.g., blood coagulation time, blood cholesterol level,
etc.
[0029] Methods recited herein may be carried out in any order of the recited events which
is logically possible, as well as the recited order of events. Furthermore, where
a range of values is provided, it is understood that every intervening value, between
the upper and lower limit of that range and any other stated or intervening value
in that stated range is encompassed within the invention. Also, it is contemplated
that any optional feature of the inventive variations described may be set forth and
claimed independently, or in combination with any one or more of the features described
herein.
[0030] The referenced items are provided solely for their disclosure prior to the filing
date of the present application. Nothing herein is to be construed as an admission
that the present invention is not entitled to antedate such material by virtue of
prior invention.
[0031] Reference to a singular item, includes the possibility that there are plural of the
same items present. More specifically, as used herein and in the appended claims,
the singular forms "a," "and," "said" and "the" include plural referents unless the
context clearly dictates otherwise. It is further noted that the claims may be drafted
to exclude any optional element. As such, this statement is intended to serve as antecedent
basis for use of such exclusive terminology as "solely," "only" and the like in connection
with the recitation of claim elements, or use of a "negative" limitation. Finally,
it is noted that unless defined otherwise herein, all technical and scientific terms
used herein have the same meaning as commonly understood by one of ordinary skill
in the art to which this invention belongs.
Colorimetric/Photometric Sensor Variations
[0032] In testers including colorimetric or photometric (herein used interchangeably) biosensor,
the same is provided by at least a matrix and/or a membrane for receiving a sample
and a reagent composition (set within the matrix or membrane) set upon a support structure.
Where a membrane as well as a matrix is provided, the membrane will generally be placed
opposite of the support structure upon the matrix. A membrane advantageously includes
apertures or pores for sample access.
[0033] In some embodiments, the sensor comprises a membrane containing a reagent composition
impregnated therein while a matrix may or may not contain reagent composition. Often
the matrix preferably provides a deposition area for the various members of the signal
producing system, described
infra, as well as for the light absorbing or chromogenic product produced by the signal
producing system,
i.e., the indicator, as well as provides a location for the detection of the light-absorbing
product produced by the indicator of the signal producing system .
[0034] A membrane provided may comprise a membrane that exhibits aqueous fluid flow properties
and is sufficiently porous (
i.e., provides sufficient void space) for chemical reactions of a signal producing system
to take place. Ideally, the membrane pore structure would not support red blood cell
flow to the surface of the membrane being interrogated (
i.e., the color intensity of which is a subject of the measurement correlated to analyte
concentration). Any matrix provided may or may not have pores and/or a porosity gradient,
e.g. with larger pores near or at the sample application region and smaller pores at the
detection region.
[0035] Materials from which a membrane may be fabricated vary, include polymers,
e.g. polysulfone, polyamides, cellulose or absorbent paper, and the like, where the material
may or may not be functionalized to provide for covalent or non-covalent attachment
of the various members of the signal producing system. In a tester made a thin membrane
material, the tester may require less than 1/2 µl of sample to wet a sufficiently
large area of the membrane to obtain a good optical measurement.
[0036] Regarding suitable matrices, a number of different types have been developed for
use in various analyte detection assays, which matrices may differ in terms of materials,
dimensions and the like, where representative matrices include, but are not limited
to, those described in
U.S. Patent Nos.: 4,734,360;
4,900,666;
4,935,346;
5,059,394;
5,304,468;
5,306,623; 5,418,142;
5,426,032;
5,515,170;
5,526,120;
5,563,042;
5,620,863;
5,753,429;
5,573,452;
5,780,304;
5,789,255;
5,843,691;
5,846,486;
5,968,836 and
5,972,294.
[0037] However configured, one or more members of a signal producing system of the biosensor
produce a detectable product in response to the presence of analyte, which detectable
product can be used to derive the amount of analyte present in the assayed sample.
In the subject test strips, the one or more members of the signal producing system
are preferably associated with (
e.g., covalently or non-covalently attached to) at least a portion of (
i.e., the detection region) the matrix or membrane, and in many embodiments to substantially
all of the same.
[0038] The signal producing system may comprise an analyte oxidation signal producing system.
By analyte oxidation signal producing system, it is meant that in generating the detectable
signal from which the analyte concentration in the sample is derived, the analyte
is oxidized by a suitable enzyme to produce an oxidized form of the analyte and a
corresponding or proportional amount of hydrogen peroxide. The hydrogen peroxide is
then employed, in turn, to generate the detectable product from one or more indicator
compounds, where the amount of detectable product generated by the signal measuring
system,
i.e. the signal, is then related to the amount of analyte in the initial sample. As such,
the analyte oxidation signal producing systems present in the subject test strips
are also correctly characterized as hydrogen peroxide based signal producing systems.
[0039] Hydrogen peroxide based signal producing systems include an enzyme that oxidizes
the analyte and produces a corresponding amount of hydrogen peroxide, where by corresponding
amount is meant that the amount of hydrogen peroxide that is produced is proportional
to the amount of analyte present in the sample. The specific nature of this first
enzyme necessarily depends on the nature of the analyte being assayed but is generally
an oxidase or dehydrogenase. As such, the first enzyme may be: glucose oxidase (where
the analyte is glucose), or glucose dehydrogenase either using NAD or PQQ as cofactor;
cholesterol oxidase (where the analyte is cholesterol); alcohol oxidase (where the
analyte is alcohol); lactate oxidase (where the analyte is lactate) and the like.
Other oxidizing enzymes for use with these and other analytes of interest are known
to those skilled in the art and may also be employed. In those preferred embodiments
where the reagent test strip is designed for the detection of glucose concentration,
the first enzyme is glucose oxidase. The glucose oxidase may be obtained from any
convenient source (
e.g. a naturally occurring source such as Aspergillus niger or Penicillum, or recombinantly
produced).
[0040] The second enzyme of such a signal producing system is an enzyme that catalyzes the
conversion of one or more indicator compounds into a detectable product in the presence
of hydrogen peroxide, where the amount of detectable product that is produced by this
reaction is proportional to the amount of hydrogen peroxide that is present. This
second enzyme is generally a peroxidase, where suitable peroxidases include: horseradish
peroxidase (HRP), soy peroxidase, recombinantly produced peroxidase and synthetic
analogs having peroxidative activity and the like. See,
e.g.,
Y. Ci, F. Wang; Analytica Chimica Acta, 233 (1990), 299-302.
[0041] Indicator compound or compounds provided are preferably ones that are either formed
or decomposed by the hydrogen peroxide in the presence of the peroxidase to produce
an indicator dye that absorbs light in a predetermined wavelength range. Preferably
the indicator dye absorbs strongly at a wavelength different from that at which the
sample or the testing reagent absorbs strongly. The oxidized form of the indicator
may be a colored, faintly-colored, or colorless final product that evidences a change
in color of the testing side of the membrane. That is to say, the testing reagent
can indicate the presence of glucose in a sample by a colored area being bleached
or, alternatively, by a colorless area developing color.
[0042] Indicator compounds that are useful in the present invention include both one-and
two-component chromogenic substrates. One-component systems include aromatic amines,
aromatic alcohols, azines, and benzidines, such as tetramethyl benzidine-HCl. Suitable
two-component systems include those in which one component is MBTH, an MBTH derivative
(see
e.g., those disclosed in
EP-A-0 781 350), or 4-aminoantipyrine and the other component is an aromatic amine, aromatic alcohol,
conjugated amine, conjugated alcohol or aromatic or aliphatic aldehyde. Exemplary
two-component systems are 3-methyl-2-benzothiazolinone hydrazone hydrochloride (MBTH)
combined with 3-dimethylaminobenzoic acid (DMAB); MBTH combined with 3,5-dichloro-2-hydroxybenzene-sulfonic
acid (DCHBS); and 3-methyl-2-benzothiazolinone hydrazone N-sulfonyl benzenesulfonate
monosodium (MBTHSB) combined with 8-anilino-1 naphthalene sulfonic acid ammonium (ANS).
In certain embodiments, the dye couple MBTHSB-ANS is preferred.
[0043] In yet other embodiments of colorimetric sensors that may be used in the present
invention, signal producing systems that form a fluorescent detectable product (or
detectable non- fluorescent substance,
e.g. in a fluorescent background) may be employed, such as those described in
Kiyoshi Zaitsu, Yosuke Ohkura, "New fluorogenic substrates for Horseradish Peroxidase:
rapid and sensitive assay for hydrogen peroxide and the Peroxidase", Analytical Biochemistry
(1980) 109, 109-113. Examples of such colorimetric reagent test strips suitable for use with the subject
invention include those described in
U.S. Patent Nos. 5,563,042;
5,753,452;
5,789,255.
Electrochemical Sensor Variations
[0044] Instead of using a colorimetric sensor as described above, test strips used in connection
with the present invention may employ an electrochemical sensor. . Typically, an electrochemical
sensor comprises at least a pair of opposing electrodes, although electrochemical
test strips with planar electrodes may be used in the prevent invention.
[0045] Where opposing-electrode type strips are employed, at least the surfaces of electrodes
facing each other are comprised of a conductive layer such as a metal, where metals
of interest include palladium, gold, platinum, silver, iridium, stainless steel and
the like as well as carbon (conductive carbon ink) and indium doped tin oxide.
[0046] One conductive layer is preferably formed by sputtering a thin layer of gold (Au),
the other by sputtering a thin layer of palladium (Pd). Alternately, the electrodes
may be formed by screen printing a selected conductive pattern, including conductive
leads, with a carbon or metal ink on the backing surfaces. An additional insulating
layer may be printed on top of this conductive layer which exposes a precisely defined
pattern of electrodes. However formed, after deposition of conductive layers, the
surface may be subsequently treated with a hydrophilic agent to facilitate transport
of a fluid sample into the reaction zone there between. Depending on the voltage sequence
applied to the cell, one electrode may serve as a counter/reference electrode and
the other as the working electrode of the electrochemical cell. However, where a double
pulse voltage waveform is employed, each electrode acts as a counter/reference and
working electrode once during analyte concentration measurement.
[0047] Regardless of reaction zone or electrode configuration, a reagent coating is typically
provided therein. Reagent systems of interest typically include an enzyme and a redox
active component (mediator). The redox component of the reagent composition, when
present, is made up of one or more redox agents. A variety of different redox agents
(
i.e., mediators) are known in the art and include: ferricyanide, phenazine ethosulphate,
phenazine methosulfate, pheylenediamine, 1-methoxyphenazine methosulfate, 2,6-dimethyl-1,4-benzoquinone,
2,5-dichloro-1,4-benzoquinone, ferrocene derivatives, osmium bipyridyl complexes,
ruthenium complexes, and the like. In many embodiments, the redox active component
of particular interest is ferricyanide, and the like. The enzyme of choice may vary
depending on the analyte concentration which is to be measured. For example, suitable
enzymes for the assay of glucose in whole blood include glucose oxidase or dehydrogenase
(NAD or PQQ based). Suitable enzymes for the assay of cholesterol in whole blood include
cholesterol oxidase and esterase.
[0048] Other reagents that may be present in the reaction area include buffering agents
(
e.g., citraconate, citrate, malic, maleic, phosphate, "Good" buffers and the like); divalent
cations (
e.g., calcium chloride, and magnesium chloride); surfactants (
e.g., Triton, Macol, Tetronic, Silwet, Zonyl, Aerosol, Geropon, Chaps, and Pluronic);
and stabilizing agents (
e.g., albumin, sucrose, trehalose, mannitol and lactose).
Test Strip Systems and Use
[0050] As mentioned above, the test strips housed in the container as described further
below is preferably used an automated lancing and meter device. FIG 1 shows one such
device.
[0051] A test strip
2, including a skin-piercing element
4 is set within a meter
6. The test strip includes a biosensor (hidden from view) adjacent to a flow path of
the needle
4. Preferably, the sensor is of the sort described above. Referring to FIG 3, test
strip device
2 has a first end
8 and a second end
10, wherein the skin-piercing or lancing blade or needle
4 is associated with first end
8 and at least the second end
10 is configured for insertion into meter
6. Further constructional details or options for test strip 2 may be as described in
EP-A-1 281 352,
EP 1360931 and
EP 1360933.
[0052] Regarding meter
6, it preferably has an ergonomically-designed housing
12 having dimensions which allow it to be comfortably held and manipulated with one
hand. Housing
12 may be made of a metal, plastic or other suitable material, preferably one that is
light weight but sufficiently durable. The distal portion
14 of the housing provides an aperture
16 through which test strip device
2 is advanced from a retracted position within meter
6 to an extended position wherein at least a portion of the test strip microneedle/lancet
4 extends a distance outside aperture
16.
[0053] Distal portion
14 further defines a chamber in which test strip device
2 is received within a test strip receiving mechanism
18. Test strip device
2 may be inserted into meter
6 by removing distal housing portion
14 from housing
12 and inserting test strip device
2 into test strip receiving mechanism
18. Alternatively, test strip device
2 may be inserted into meter
6 and received into mechanism
18 via aperture
14.
[0054] Preferably, distal housing portion
14 is transparent or semi-transparent to allow the user to visually confirm proper engagement
between test strip device
2 and receiving area
18 prior to conducting the analyte concentration assay, as well as to visualize the
test site and to visually confirm the filling of strip
2 with body fluid during the assay (especially if electronic sensing is not provided
to discern the same) . When test strip device
2 is properly seated within receiving mechanism
18, the biosensor with test strip device
2 operatively engages with the meter's testing components. In the case of electrochemical
test strip embodiments, the electrodes of the biosensor operatively engage with the
meter's electronics; with colorimetric test strip embodiments, the matrix or membrane
area having a signal producing system is operatively aligned with the meter's optical
components. The meter's electronics or optical componentry, upon sensing when the
reaction zone or matrix area, respectively, within test strip device
2 is filled with the sampled fluid, supplies an input signal to the test strip biosensor
and receives an output signal therefrom which is representative of the sample fluid
characteristic being measured.
[0055] Circumferentially positioned about aperture
16 is a pressure ring
20, the distal surface of which is applied to the skin and encircles the piercing site
within the skin during a testing procedure. The compressive pressure exerted on the
skin by pressure ring
20 facilitates the extraction of body fluids from the surrounding tissue and the transfer
of such fluid into test strip device
2.
[0056] Distal housing portion
14 is preferably itself in movable engagement with meter
6 wherein distal housing portion
14 is slightly translatable or depressible along a longitudinal axis of the meter. Between
distal housing portion
14 and the a proximal portion of housing
12, is a pressure sensor
22 which senses and gauges the amount of pressure exerted on distal housing portion
14 when compressing pressure ring
20 against the skin. Pressure sensor
22 is preferably an electrical type sensor which may be of the kind commonly known in
the field of electronics. Pressure sensor indicators
24, in electrical communication with pressure sensor
22, are Provided to indicate the level of pressure being applied to distal housing portion
14 so that the user may adjust the amount of pressure being applied, if necessary, in
order to apply an optimal pressure.
[0057] In many embodiments, meter
6 has a display
26, such as an LCD display, for displaying data, such as input parameters and test results.
Additionally, meter
6 has various controls and buttons for inputting data to the meter's processing components
and for controlling the piercing action of test strip device
2. For example, lever
28 is used to retract test strip device
2 to a loaded position within meter
6 and thereby preload a spring mechanism (not shown) for later, on-demand extension
or ejection of test strip device
2 from aperture
16 by depressing button
30. When distal housing portion
14 is properly positioned on the skin, such ejection of test strip device
2 causes microneedle
4 to instantaneously pierce the skin for accessing the body fluid therein. Buttons
32 and
34, when depressed, input signals to the meter's processing components indicating whether
the measurement to be made is for testing/information purposes (and for recovering
the test results from a memory means within the meter's electronics) or for calibration
purposes, respectively.
[0058] Meter
6 may further be configured to receive and retain a replaceable cartridge containing
a plurality of the subject test strip devices. After using a test strip device, the
meter may either eject the used test strip from the meter or store them for disposal
at a later time. Such a configuration eliminates the necessary handling of test strips,
thereby minimizing the likelihood of damage to the strip and inadvertent injury to
the patient. Furthermore, because manual handling of the test strips is eliminated,
the test strips may be made much smaller thereby reducing the amount of materials
required, providing a cost savings. The meter disclosed in
EP 1 362 551 is of particular relevance in regard to these considerations.
[0059] Additionally, certain aspects of the functionality of meters suitable for use with
the subject systems are disclosed in
U.S. Patent No. 6,193,873, as well as in
EP-A-1 252 514,
EP-A-1 252 365,
WO 02/48707,
WO02/50609 and
EP-A-1 284 121. Of course, in those embodiments using a colorimetric assay system, a spectrophotometer
or optical meter will be employed, where certain aspects of the functionality of such
meters suitable for use are described in, for example,
U.S. Patent Nos. 4,734,360, 4;900,666, 4,935,346; 5,059,394, 5,304,468, 5,306,623, 5,418,142, 5,426,032, 5,515,170,
5,526,120, 5,563,042, 5,620,863, 5,753,429, 5,773,452, 5,780,304, 5,789,255, 5,843,691,
5,846,486, 5,968,836 and 5,972,294.
[0060] In use, the subject invention provides methods for determining a characteristic of
the sample,
e.g., the concentration of an analyte in a sample. The subject methods find use in the
determination of a variety of different analyte concentrations, where representative
analytes include glucose, cholesterol, lactate, alcohol, and the like. In many embodiments,
the subject methods are employed to determine the glucose concentration in a physiological
sample. Test strip devices
2 used in connection with the present invention are particularly suited for use in
determining the concentration of an analyte in blood or blood fractions, and more
particularly in whole blood or interstitial fluid.
[0061] In using test strip
2, meter
6 is actuated so microneedle
4 is inserted into a target area of skin. Typically, the skin-piercing element is inserted
into the skin of a finger or forearm for about 1 to 60 seconds, usually for about
1 to 15 seconds and more usually for about 1 to 5 seconds. Depending on the type of
physiological sample to be obtained, the subject skin-piercing element
4 may be penetrated to various skin layers, including the dermis, epidermis and the
stratum corneum, but in many embodiments will penetrate no farther than the subcutaneous
layer of the skin.
[0062] The test strips is preferably loaded into the meter automatically by way of the meter
interfacing with a cartridge or container as described further below. Interface member
18 may simply be a device that captures and holds test strip or it may include electrode
elements (particularly for use in interfacing with electrochemical test strips).
[0063] Once test strip device
2 is properly received within mechanism
18, it may then be spring loaded or cocked by means of lever
28, thereby retracting the test strip device
2 and preparing it for firing Meter
6 is then positioned substantially perpendicular to the targeted skin surface wherein
distal housing portion
14, and more specifically pressure ring
20, is caused to contact the target skin area Some compressive pressure may be manually
applied to the target skin area,
i.e., by pressing the distal end of meter
14 against the target skin area, to ensure that skin-piercing element
4 is properly inserted into the skin. By applying such pressure, a counter force causes
distal housing portion
14 to press back upon pressure sensor
22.
[0064] The relative amount (
i.e., high, normal and low) of counter pressure is then measured and displayed by optional
pressure sensor indicators
24. Preferably, the amount of pressure applied should generally be in the "normal" range.
Indicators
24 inform the user as to when too much or too little pressure is being applied. When
the indicators show that the applied pressure is "normal", the user may then depress
the spring-release button
30. Due to the spring force released, receiving/carrying mechanism
18 and test strip device
2 are caused to thrust forward thereby causing skin-piercing element
4 to extend from aperture
16 and puncture the targeted skin area.
[0065] The penetration of skin-piercing element
4 into the skin preferably create a fluid sample pooling area (defined by the recess
or opening within skin-piercing element shown in FIG 3). In which case, sample fluid
enters the pooling area by the open-space configuration (
e.g., recess or opening, within skin piercing element
4), and possibly also from the opposite side of the skin-piercing element. The pooled
sample fluid is then transferred directly to the reaction zone of a test strip or
thereto by a fluid pathway by at least a capillary force exerted on the pooled fluid.
Where no enlarged pooling area is provided, a simple capillary channel may prove effective
in certain situations as well, though such a set-up may not be most preferred.
[0066] In any case, the transfer of fluid from the wound site to the biosensor may be further
facilitated by exerting physical positive pressure circumferentially around the penetration
site by means of a pressure ring
20 or by applying a source of negative pressure through the fluid channel thereby vacuuming
the body fluid exposed to the distal end of the channel. Fluid passing into the biosensor
reaction zone may simply fill the area or alternately be distributed by subchannels
or another similar distribution feature.
[0067] Once meter
6 senses that the reaction zone or matrix area is completely filled with the sample
of body fluid, the meter electronics or optics are activated to perform analysis of
the extracted sample. At this point, the meter may be removed by the patient from
the penetration site or kept on the skin surface until the test results are shown
on the display. Meter
6 may alternatively or additionally include means for automatically retracting the
microneedle strip from the skin once the reaction cell is filled with the body fluid
sample.
[0068] With an electrochemical-based analyte concentration determination assay, an electrochemical
measurement is made using the counter/reference and working electrodes. The electrochemical
measurement that is made may vary depending on the particular nature of the assay
and the meter with which the electrochemical test strip is employed, (
e.g., depending on whether the assay is coulometric, amperometric or potentiometric).
Generally, the electrochemical measurement will measure charge (coulometric), current
(amperometric) or potential (potentiometric), usually over a given period of time
following sample introduction into the reaction area. Methods for making the above
described electrochemical measurement are further described in
U.S. Patent Nos: 4,224,125;
4,545,382; and
5,266,179; as well as in
International Patent Publications WO 97/18465 and
WO 99/49307.
[0069] Following detection of the electrochemical signal generated in the reaction zone,
the amount of the analyte present in the sample is typically determined by relating
the electrochemical signal generated from a series of previously obtained control
or standard values. In many embodiments, the electrochemical signal measurement steps
and analyte concentration derivation steps, are performed automatically by a device
designed to work with the test strip to produce a value of analyte concentration in
a sample applied to the test strip. A representative reading device for automatically
practicing these steps, such that user need only apply sample to the reaction zone
and then read the final analyte concentration result from the device, is further described
in
EP-A-1 067 384.
[0070] For a colorimetric or photometric analyte concentration determination assay, sample
applied to a subject test strip, more specifically to a reaction area of a test strip,
is allowed to react with members of a signal producing system present in the reaction
zone to produce a detectable product that is representative of the analyte of interest
in an amount proportional to the initial amount of analyte present in the sample.
The amount of detectable product (
i.e., signal produced by the signal producing system) is then determined and related to
the amount of analyte in the initial sample. With such colorimetric assays, optical-type
meters are used to perform the above mentioned detection and relation steps. The above
described reaction, detection and relating steps, as well as instruments for performing
the same, are further described in U.S. PatentNos. 4,734,360; 4,900,666; 4,935,346;
5,059,394; 5,304,468; 5,306,623; 5,418,142; 5,426,032; 5,515,170; 5,526,120; 5,563,042;
5,620,863; 5,753,429; 5,773,452; 5,780,304; 5,789,255; 5,843,691; 5,846,486; 5,968,836
and 5,972,294. Examples of such colorimetric or photometric reagent test strips suitable
for use with the subject invention include those described in
U.S. Patent Nos.: 5,563,042;
5,753,452;
5,789,255.
Container and Test Strip Devices/Combinations
[0071] FIG. 3 shows a test strip as introduced above in. A strip or substrate portion
36 carries the biosensor
38, usually adjacent needle
4. Each test strip preferably includes at least one lancet/needle or skin piercing element
4, typically having a pointed tip
40. In addition the body of lance
4 may incorporate various features to collect and/or convey a biological sample to
a given test strip sensor.
[0072] Actually, any suitable shape of skin-piercing element
4 may be employed with the subject test strip devices, as long as the shape enables
the skin to be pierced with minimal pain to the patient. For example, the skin-piercing
element may have a substantially flat or planar configuration, or may be substantially
cylindrical-like, wedge-like or triangular in shape such as a substantially flattened
triangle-like configuration, blade-shaped, or have any other suitable shape. The cross-sectional
shape of the skin-piercing element, or at least the portion of skin-piercing element
that is penetrable into the skin, may be any suitable shape, including, but not limited
to, substantially rectangular, oblong, square, oval, circular, diamond, triangular,
star,
etc. Additionally, the skin-piercing element may be tapered or may otherwise define a
point or apex at its distal end. Such a configuration may take the form of an oblique
angle at the tip or a pyramid or triangular shape or the like.
[0073] The dimensions of the skin-piercing element may vary depending on a variety of factors
such as the type of physiological sample to be obtained, the desired penetration depth
and the thickness of the skin layers of the particular patient being tested. Generally,
the skin-piercing element is constructed to provide skin-piercing and fluid extraction
functions and, thus, is designed to be sufficiently robust to withstand insertion
into and withdrawal from the skin. Typically, to accomplish these goals, the ratio
of the penetration length (defined by the distance between the base of the skin-piercing
element and its distal tip) to diameter (where such diameter is measured at the base
of the skin-piercing element) is from about 1 to 1, usually about 2 to 1, more usually
about 5 to 1 or 10 to 1 and oftentimes 50 to 1.
[0074] The total length of the skin-piercing elements generally ranges from about 1 to 30,000
microns, usually from about 100 to 10,000 microns and more usually from about 1,000
to 3,000 microns. The penetration length of the skin-piercing elements generally ranges
from about 1 to 5000 microns, usually about 100 to 3000 microns and more usually about
1000 to 2000 microns. The height or thickness of skin-piercing elements, at least
the thickness of the distal portion 4, typically ranges from about 1 to 1000 microns,
usually from about 10 to 500 microns and more usually from about 50 to 250 microns.
The outer diameter at the base generally ranges from about 1 to 2000 microns, usually
about 300 to 1000 microns and more usually from about 500 to 1000 microns. In many
embodiments, the outer diameter of the distal tip generally does not exceed about
100 microns and is generally less than about 20 microns and more typically less than
about 1 micron. However, it will be appreciated by one of skill in the art that the
outer diameter of the skin-piercing element may vary along its length or may be substantially
constant.
[0075] Regarding the fluid-conveying features noted that be incorporated in lance element
4, a channel
42, preferably of capillary dimensions may be provided. In addition (or alternately),
a recessed pooling area or section
44 may be provided. Such a recessed or space-defining area is used to create a space
or volume within the pierced tissue. This space serves as a reservoir within which
bodily fluid is caused to pool
in situ prior to being transferred to the biosensor portion of the subject test strip devices.
As such, the availability of a greater volume of body fluid can be provided with a
tip that is smaller and/or sharper than conventional microneedles, thereby reducing
pain. The greater availability of body fluid also results in a faster collection rate
of sampling.
[0076] Generally, space-defining lancet configurations in the present invention create or
define a space within the pierced tissue having a volume at least as great as the
available fluid volume in the reaction zone of the biosensor. Such space or volume
ranges from about 10 to 1,000 nL, and more usually from about 50 to 250 nL. Such volume
occupies a substantial portion of the entire volume occupied by the structure of the
skin-piercing element, and ranges from about 50% to 99% and more usually from about
50% to 75% of the entire volume occupied by the skin piercing element.
[0077] While not shown, the test strip may include secondary fluid transfer pathways set
in fluid communication with channel
42 to convey sample outwardly, dispersing the same across the sensor employed in an
opposing, attached test strip. Like channel
42, secondary pathways or channels are preferably dimensioned so as to exert a capillary
force on fluid within the pooling area defined by the open space portion of the microneedle,
and draws or wicks physiological sample to within the reaction zone or matrix area
of the biosensor. As such, the diameter or width of a single fluid channel or pathway
does not exceed 1000 microns and will usually be about 100 to 200 microns in diameter.
This diameter may be constant along its length or may vary. It may be preferred that
any sub-channels have cross-sectional diameters in the range from about 1 to 200 microns
and more usually from about 20 to 50 microns in that they are not required to convey
the same volume of fluid as a primary channel.
[0078] In certain embodiments of the invention, the fluid pathway may further include one
or more agents to facilitate sample collection. For example, one or more hydrophilic
agents may be present in the fluid pathway, where such agents include, but are not
limited to types of surface modifiers or surfactants such as mercaptoethane sulfonic
acid (MESA), Triton, Macol, Tetronic, Silwet, Zonyl, Aerosol, Geropon, Chaps, and
Pluronic. In any event, many of the techniques described in
U.S. 2002 168 290 and
U.S. 2003 212 344 referenced above are applicable to fabricating test strip devices as described herein
- especially those details regarding needle/lance production Details as to electrochemical
test strip production may also be appreciated in view of
EP-A-1 324 038 and
EP-A-1 316 367.
[0079] However constructed, as commented on above, test strips used in the present invention
advantageously include at least one forward-facing lancing member. In which case,
receptacle portions
46 of containers
48 according to the present invention are adapted to receive the same.
[0080] More specifically, as illustrated in FIG 3, a given receptacle
46 within a container
48 includes a socket or sheath portion
50 to accept and protect microneedle
4. Shoulder or ledge sections
52 are provided adjacent socket
50 to support a test strip at its face or shoulder portions
54. The main body of the test strip is preferably received in a upper sheath or jacket
portion
56.
[0081] A transition section
58 is preferably provided above the main body sheath portion. As shown, angled faces
60 define the transition section. Optional transition section
58 may serve as an aid in loading a test strip into a given receptacle and/or as a guide
for a meter interface member / electrode pair
18 to capture and extract a test strip from the receptacle. Above the transition section,
walls
62 may extend further upwards to an aperture
64. The walls may further serve to guide a test strip extraction (or insertion) element.
To facilitate this, the end
10 of a given test strip opposite needle(s)
4 to be handled (
e.g., by a meter extraction element) preferably terminates in a widened portion of receptacle
46, adjacent faces
60, or more preferably adjacent the region of walls
62.
[0082] Of course the ultimate shape/configuration of receptacle members within a container
48 according to the invention may vary, especially in a manner complimentary to the
form of test strips to be housed within the same. Likewise, the external configuration
and closure features of test strip canisters according to the present invention may
vary. FIGs 2A and 2B show two variations of closure features usable in the present
invention.
[0083] In FIG 2A, canister
48 includes a lid
66 rotably attached to the canister by way of an arm
68, rotably secured at a lower pivot
70. An inset interface in which a portion of the lid rides within a recess of
72 of the container body
74 may provide an upper rotation interface. An access port
76 is provide in lid
66 which, when aligned with a corresponding aperture
64 of a receptacle portion
46 provides access to a test strip
2. Otherwise, lid 66 closes-off the various receptacle portions included in canister
48. Meter 6 is preferably configured to automatically actuate the lid, whether by means
of rotating bar
68 or another feature, for example, if lid
66 is alternately secured body
74 by way of a pin and cap/shoulder bolt type arrangement
78 (shown in broken line and with dashed leader to indicate use alternate to the connection
approach described above).
[0084] Another approach to closing off receptacle portions containing unused test strips
is illustrated in FIG 2B. Here, container body
74 is covered by a conventional foil laminate cover
76. Generally, such a laminate includes aluminum foil. Alternately, cover
76 comprises a water barrier polymer film material alone or in combination with a thin
foil material wherein the two are laminated together. Suitable materials include those
which are commonly used for pharmaceutical and food packaging applications, such as
those disclosed in
U.S. Patent Nos. 4,769,261,
6287,612 and
4,678,092. The cover can be laminated to the container body by hot melt adhesive or other energy
means, such as, ultrasonic welding, heat sealing, RF,
etc.
[0085] Such a cover is preferably adhered to a face portions
92 of the canister
48. FIGs 4A and 4B clearly illustrate the face portions between aperture sections
64 at which the connection can be made. FIG 4B shows a foil cover
76 as may be used to cover the plurality of receptacles
46 in canister devices according to the present invention from the underside. When a
foil cover is employed, access to each receptacle portion is achieved by puncturing
the same at the desired access site by an access member such as interface portion
18 provided in meter
6.
[0086] In some cases, it may be desired, even necessary to provide a canister as configured
in FIG 2A with a lin
66 with a supplemental seal or cover
76 as shown in other variations of the invention. In which case, it may provided substantially
as described above as well. In any case, such a seal would be located beneath lid
66.
[0087] However access/closure of receptacles
46 is to be provided, it may be preferred to include desiccant in each or one or more
adjacent chambers. Suitable desiccants include silica gel beads, molecular sieve,
etc. Desiccant
90 may simply be deposited and fixed in the end of each receptacle portion or physically
entrapped in a separate compartment The desiccant can also be blended into the material
that is used to fabricate the receptacles, for instance, in the form of a composite.
[0088] Additional optional aspects of the present invention shown in FIGs 4A-4C concern
a waste receptacle portion
80 that may integrally be provided in the container
48. A hollow provided in canister body
48 may be covered by a waste cap or lid
82 to securely house used test strips.
[0089] Such strips will generally be ejected from meter 6 into the waste receptacle upon
completion of testing. To access the waste section of the container, a user may pop
open the lid using extension
84 to provide adequate purchase. A hinge section
86 is preferably provided to maintain association between the canister and its lid.
While a simple press-fit or friction fit between the lid interior periphery
86 and container upper, outer periphery
88 is contemplated in the variations shown in FIGs 4A-4C, to form a seal, detent features
may be provided. Furthermore, other variations including a latching interface, a threaded
interface or the like may be employed to allow opening and closing-off waste receptacle
80.
[0090] The waste container may contain an absorbent material (
e.g., a sponge) to soak up any access blood. Waste receptacle
80 may be designed to easily accept the test strip, but make removal of a test strip
therefrom difficult. This result can be achieved through geometry of receptacle. For
example, a funnel-shaped entry section
94 may be provided. Alternately, a tacky material may be set inside the receptacle,
preferably along its internal wall(s)
96 or base
98, to capture and hold spent test strips. Other means may be employed as well. Providing
one-way access to the receptacle for test strips or simply making inadvertent removal/loss
of test strips from its confines offers a desirably safety feature.
[0091] Each of the containers
48 shown has a generally cylindrical body. Such a configuration is preferred since it
facilitates circular disposition of a plurality of receptacles and corresponding number
of strip
2 as shown in FIG 4C. The configuration is also highly advantageous from the perspective
of automated manipulation of container
48 in indexing (for example in a meter adapted to receive the container/canister) from
one receptacle to another containing an unused test strip. However, it is to be appreciated
that, just as receptacle and test strip configuration may very, so may that of the
container and waste receptacle (when provided). Still, regular shapes, including polygons
of up to about 100 sides may be preferred in this regard. The number sides provided
may match-up to the number of receptacles/test strips included in a given package.
[0092] As to the number of strips and receptacles, it will generally be preferred to include
at least 10 pair. However, up to about 100 may be provided. Most preferably between
about 20 and 50 receptacles
46, each containing a single test strip
2 will be provided.
[0093] However many are provided, aspects of the present invention require loading and removal
of tests strips from the container in a reciprocal fashion. Preferably, they are inserted
and removed along the same axis of each test strip. Where a preferred waste receptacle
80 is provided, loading and removing a test strip from the same access port is advantageous
because it allows placing the opening of the waste receptacle opposite that of the
test strip(s). In instances where forward-facing lance member(s) are provided in the
test strip(s), two-way access from the same port
64 allows for the lancet/microneedle protection features described above, referring
to sheath or recess section
50.
[0094] In all, the present invention offers numerous potential advantages and configurations.
Some variations may enjoy each of these advantages by its various features while others
may be more application specific and be best suited to a particular situation.
[0095] Though the invention has been described in reference to certain examples, optionally
incorporating various features, the invention is not to be limited to the those described.
The invention is not limited to the uses noted or by way of the exemplary description
provided herein. It is to be understood that the breadth of the present invention
is to be limited only by the literal or equitable scope of the following claims.