Bladder control system with software

-

The present invention is directed toward a mattress system and a method to decrease pressure applied to a patient. The mattress system has an analyzer that receives the measurements regarding the geometry of the mattress and the pressure of the bladders within the mattress. With that data, the analyzer compares those measurements and transmits a pressure signal to a pressure provider device. In response to the pressure signal, the pressure provider device alters and/or maintains the pressure in the bladders to decrease the chance of bottoming out and/or decrease the pressure applied to the patient.

Skip to: Description  ·  Claims  · Patent History  ·  Patent History
Description
FIELD OF THE INVENTION

The present invention is directed to a bladder mattress system. The bladder mattress system is capable of undergoing a gatching process. A gatching process converts a mattress from a supine position to a cardiac chair position, from the cardiac chair position to the supine position, and positions in between the cardiac chair position and the supine position.

BACKGROUND OF THE INVENTION

Gaymar Industries, Inc. presently manufactures a mattress 100 that can be subjected to the gatching process as illustrated in FIG. 1 (the supine position) and in FIG. 2 (the cardiac chair position). The mattress 100 has a head section 110, a foot section 120, a gatch area 122 that distinguishes the head section 110 from the foot section 120, a longitudinal axis 130, a top surface 102 which a patient is designed to lay thereon and a bottom surface 104.

FIG. 3 is a cross-sectional view of mattress 100 illustrated in FIG. 1 taken along the lines 3-3. The mattress 100 contains a first set of plurality of inflatable cells 140 for supporting a patient in the head section 110 and a second set of plurality of inflatable cells 141 for supporting a patient in the foot section 120. The first set of plurality of inflatable cells 140 and the second set of plurality of inflatable cells 141 may be positioned longitudinally in relation to the longitudinal axis 130, horizontally in relation to the longitudinal axis, or combinations thereof.

The mattress 100 also has a first inflatable enclosure 112 (see FIGS. 3 and 4) and a second inflatable enclosure 114 (see FIG. 4) for laterally rotating a patient's head (and normally the upper torso) overlying the head section 110. The first and second inflatable enclosures 112, 114 can be positioned over the top surface of the first set of plurality of inflatable cells 140, under the bottom surface of the first set of plurality of inflatable cells 140, and/or combinations thereof.

The first inflatable enclosure 112 rotates the patient overlying the head section 110 in a first direction 113 relative to the longitudinal axis 130. The second inflatable enclosure 114 rotates the patient overlying the head section 110 in a second direction 115, relative to the longitudinal axis 130. The second direction 114 is opposite the first direction 113.

The mattress 100 also has an analyzer 150. The analyzer can be positioned within the mattress 100 (FIG. 3) or alternatively outside the mattress 100 (FIG. 5). The analyzer 150 is connected to a first pressure sensor 152, a second pressure sensor 154, a third pressure sensor 156, and a fourth pressure sensor 158. The first pressure sensor 152, the second pressure sensor 154, the third pressure sensor 156, and the fourth pressure sensor 158 are pressure transducers or light sensors. There are no magnetic field strength sensors or electrically conductive baffle sheet(s) in the mattress 100 to determine the rotation of the patient's head on the mattress. The light sensor embodiment is described in greater detail in commonly assigned U.S. Pat. No. 6,145,142. The preferred embodiment for the pressure sensors, however, is the pressure transducers.

The third pressure sensor 156 measures the pressure within the first set of plurality of inflatable cells 140. The third pressure sensor 156 transmits a third measured pressure value 301 to the analyzer 150. The fourth pressure sensor measures the pressure within the second set of plurality of inflatable cells 141. The fourth pressure sensor 158 transmits a fourth measured pressure value 303 to the analyzer 150.

The first pressure sensor 152 measures the pressure within the first inflatable enclosure 112. The first pressure sensor 152 measures the pressure in (a) the enclosure as illustrated in FIG. 5, (b) an inlet conduit 116 that provides the fluid to the enclosure as generically illustrated in FIG. 6a for all bladders, and/or the outlet conduit 118 that release the fluid from the enclosure as illustrated in the broken line format as illustrated in FIG. 6a as an alternative embodiment. The input conduit and the output conduit can, in some embodiments, be the same as illustrated in FIG. 6b. The first pressure sensor 152 transmits the first measured pressure 153 to the analyzer 150.

The second pressure sensor 154 measures the pressure within the second inflatable enclosure 114. The second pressure sensor 154 can be the same or different type of sensor as the first pressure sensor 152, and can be positioned in the same or similar locations as the first pressure sensor. The second pressure sensor 154 transmits the second measured pressure 155 to the analyzer 150.

The analyzer 150 receives a predetermined angle value 160. The predetermined angle value 160 is the desired angle in which the entity on the mattress is to be rotated in the head section 110 at that particular time. The predetermined angle value 160 is either a programmed value over a certain time frame and/or a value that is provided by an entity that controls the mattress 100 positioning.

The analyzer 150 reviews the first measured pressure 153, the second measured pressure 155, and the predetermined angle value 160. If the analyzer 150 determines the first measured pressure 153 and the second measured pressure 155 are not interpreted to be at the predetermined angle value 160, the analyzer 150 transmits a signal 162 to a pressure provider device 170.

The analyzer 150 also reviews the third measured pressure 301 and the fourth measured pressure 303, and transmits the signal 162 to alter the pressure in the first set of plurality of inflatable cells 140 and/or the second set of plurality of inflatable cells 141.

The pressure provider device 170 provides a desired quantity of fluid into the first inflatable enclosure 112, the second inflatable enclosure 114, and the plurality of inflatable air cells 140, 141 as illustrated in FIG. 5, and magnified in FIGS. 6a and 6b. The fluid is preferably air, but it could be an aqueous fluid. The fluid is directed into the respective enclosures 112, 114, and cells 140, 141 through each enclosures and cells respective inlet and/or outlet conduits 116, 118. The pressure provider device 170 is normally positioned exterior to the mattress 100. The pressure provider device 170 is positioned exterior of the mattress 100 to avoid unnecessary kinking in the conduits 116, 118 in the gatch area 122. The gatch area 122 is notorious for kinking hoses that adversely alter the pressure provided to the respective bladders 112, 114, 141, 140.

If the fluid is air, the first inflatable enclosure 112, the second inflatable enclosure 114 and/or the plurality of inflatable cells 140, 141 can be air-loss devices or not. An air-loss device allows air to escape through a plurality of apertures. Those apertures are supposed to be directed toward the patient lying on the mattress 10.

The pressure provider device 170 alters the fluid quantity in the first inflatable enclosure 112 and the second inflatable enclosure 114 in response to the signal 162. By adjusting the fluid quantity, the pressure provider device 170 controls the pressure within the first inflatable enclosure 112, the second inflatable enclosure 114, and the plurality of inflatable cells 140, 141.

Depending on the information transmitted within the pressure signal 162, the pressure provider device 170 alters and/or maintains the pressure within the first inflatable enclosure 112 and the second inflatable enclosure 114. If the pressure is altered, the pressure is altered so the first inflatable enclosure 112 and the second inflatable enclosure 114 are adjusted toward the desired angle value 162. The pressure provider device 170 also alters the pressure within the inflatable cells 141, 140 to obtain the desired air pressure therein.

Even though the head section 110 rotates, the foot section 120 does not rotate at all. That makes it impossible for the mattress 100 to rotate about its longitudinal axis 130. However, the head section 110 is able to rotate about a part of the longitudinal axis 130.

In addition, the mattress 100 can be converted between a supine configuration (as shown in FIG. 1) and a cardiac chair configuration (as shown in FIG. 2), which includes the numerous positions in between. The gatch area 122 allows the mattress to easily convert into these distinct positions and positions in-between. This mattress conversion can be accomplished by positioning the mattress 100 onto a conventional mattress support apparatus 101. The mattress support apparatus has numerous components that can alter the mattress 100 position and those components are known to those of ordinary skill in the art. Those components can be a manual apparatuses, electronic apparatuses, pneumatic apparatuses, mechanical components and/or combinations thereof.

The mattress 100 is a very good mattress, but there are some issues that can be improved to decrease the chances of the formation of bed sores. The present invention provides such improvements.

SUMMARY OF THE INVENTION

The present invention is directed toward a mattress system and a method to decrease pressure applied to a patient. The mattress system has an analyzer that receives the measurements regarding the geometry of the mattress and the pressure of the bladders within the mattress. With that data, the analyzer compares those measurements and transmits a pressure signal to a pressure provider device. In response to the pressure signal, the pressure provider device alters and/or maintains the pressure in the bladders to decrease the chance of bottoming out and/or decrease the pressure applied to the patient.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 illustrates a prior art mattress in a supine configuration.

FIG. 2 illustrates a prior art mattress in a cardiac chair configuration.

FIG. 3 illustrates a cross-sectional view of FIG. 1 taken along lines 3-3.

FIG. 4 is a top view of FIG. 1 without a cover.

FIG. 5 is an electrical schematic of the prior art.

FIGS. 6a and 6b illustrate fluid conduit patterns from the pressure provider device to the bladders as used in the prior art.

FIG. 7 illustrates a representative sample of bottoming out.

FIG. 8 illustrates an embodiment of the present invention.

FIG. 9 illustrates a flow chart of the present invention's electrical circuit system.

FIG. 10 illustrates an alternative embodiment of the present invention.

FIG. 11 illustrates a flow chart of the present invention's alternative electrical circuit system.

FIGS. 12a and 12b illustrate an alternative embodiment of the present invention regarding the additional bladder.

FIG. 13 illustrates a self-contained mattress system.

FIG. 14 illustrates an alternative embodiment of the present invention having a second gatch area.

DETAILED DESCRIPTION OF THE INVENTION

The mattress 100 and all the components described above are used in the present invention. The present invention is a modification of the prior art mattress 100.

Prior Art Problems:

A potential problem with the prior art mattress 100 described above is that the vertical patient load increases to a point where the patient bottoms out. “Bottoms out” means a portion 88 of a mattress 100 has little to no air at the location where a portion of the patient's body 20 is positioned, as illustrated in FIG. 7.

Bottoming out is undesirable because the patient's skin is subject to pressure from the mattress support apparatus 101 and possibly other undesirable forces. The support apparatus 101 is designed to support a mattress 100 and a patient, not provide the desired pressure to the patient. Bottoming out increases the pressure applied to the patient's skin. That undesired pressure can cause unwanted bed sores or equivalents thereof.

Another potential problem with the prior art mattress is that during the gatching process from a supine configuration toward the cardiac chair configuration, the tissue interface pressure distribution experienced by the patient shifts. The tissue interface pressure distribution shifts, typically (but not exclusively) from the shoulders, back and sacrum areas to almost exclusively the sacrum area. As the sacrum typically represents a lower proportion of the patient's surface area, the tissue interface pressure experienced by the patient on the mattress 100 increases to the point that pressure relief cannot be sustained, or pressure reduction cannot be achieved.

Solutions to the Problems:

The present invention is directed to controlling the pressure within the mattress' bladders as the mattress is in the gatching process and/or not in the supine position. That control is designed to decrease the chance of bottoming out and/or obtaining desired pressure reduction.

First Method:

The first method to decrease those problems is to modifying the analyzer 150, the sensors, and the pressure provider device 170.

The pressure sensors 152, 154 measure the pressure within, entering and/or exiting the bladders 112, 114, 140, 141. It has been determined that to decrease the chance of the cited problems that the bladder pressure must be measured and the mattress geometry must be determined. The mattress geometry is determined by a geometry sensor system 200. An example of the geometry sensor system 200 is illustrated in FIG. 8.

By measuring the pressure and determining the mattress geometry, the present invention is able to dynamically alter the support surface pressure in response to different gatch positions of the surgical bed. This is important since using pressure transducers alone to sense the pressure and react accordingly has been determined to be insufficient. It is insufficient because the pressure transducers have no way of knowing what the geometrical patient position is. In order to achieve this dynamic control, it is necessary to use geometry sensor(s) (for the positioning of the mattress) in conjunction with the pressure sensors. The angle (geometry) sensors could be, by way of example but without limitation, accelerometers of mechanical ball-in-bowl type magnetic devices. Types of such devices are giant magento-resistive devices and Hall effect field sensors.

Hall effect field sensors detect change in the characteristics of a magnetic field generated by the repositioning of the mattress. A magnet 210 is positioned apart from a distance measuring sensor 212. For example the magnet 210 can be positioned on the support surface's extension 108 while the geometry sensor can be positioned on the bottom side 104 of the head section 110; vice versa or equivalents thereof. Sensor 212 detects the change in position of the magnet 210 during movement of the respective mattress 100 by detecting the change in magnetic field. Based on this change in magnetic field, sensor 212 sends a signal 330 indicative of the up, down, or neutral positions of the respective mattress 100 to analyzer 150 as illustrated in FIG. 9.

The analyzer 150 continuously monitors and adjusts the surface fluid pressure in each bladder 114, 112, 141, 140 in response to the patient and mattress geometry through signal 162 to the pressure provider device 170. Obviously, signal 162 can be numerous types of signals that allow the pressure provider device 170 to determine how much fluid should be directed and/or pulled to the respective bladder 114, 141, 140, 112. The analyzer 150, preferentially and independently, adjusts the pressure of different regions of the mattress surface in response to mattress position during the gatch process and any other time with the patient on and/or off the mattress 100.

The mattress 100 through the analyzer 150 and the pressure provider device 170 cradles the patient in the foot section 120 when the bed frame 101 is being re-positioned toward the cardiac chair position. The cradle position is similar to the bottoming out illustrated in FIG. 7 in that the bladder surrounds the patient but it differs in that the bladder does not bottom out. As previously stated, the pressure applied to a patient's back in the cardiac chair position is diminished with respect to those applied to the foot section. To accommodate these pressure changes in the mattress, the analyzer transmits signal 162 to alter the pressure in the respective bladders 112, 114, 140, 141 as set forth in the representative sample bladder pressure protocol:

    • The default firmness setting in the bladders 112, 114, 140, 141 of the mattress 100 is 18 mmHg. That pressure is sufficient to support most patients in the supine position, however as the head of the bed is elevated, the surface area supporting the patient becomes less. As a result there is more weight per square inch of surface area. To prevent the patient from bottoming in this situation the following protocol, which is an example, is used:
    • If head section 110 is >15° and <30° relative to the extension 108, the bladder pressure is adjusted to a firmness of 22 mmHg (if the firmness is currently at 22 mmHg or greater, the pressure is not altered);
    • If head section 110 is >30° and <45° relative to the extension 108, the bladder pressure is adjusted to a firmness of 26 mmHg (if the firmness is currently at 26 or greater, the pressure is not altered);
    • If head section 110 is >45° and <65° relative to the extension 108, the bladder pressure is adjusted to a firmness of 30 mmHg and if the pressure is currently at 30, the pressure is adjusted to 35 mmHg;
    • If head section 110 is >65° or greater relative to the extension 108, the bladder pressure is adjusted to a firmness of 35 mmHg.

The bladder pressure protocol 164 can obviously be modified to obtain the desired pressure. This bladder protocol is programmed into the analyzer 150, and/or can be modified in the analyzer 150 in a similar manner that the desired angle value 162 is programmed into the analyzer 150.

The bladder pressure protocol reverts to the original firmness settings when the head of bed is reduced to <15°. This protocol could be discontinued when the patient is being rotated.

If the mattress 100 provides percussion and/or vibration modes, this protocol should be disabled when the percussion and/or vibration modes are operating. The percussion and/or vibration modes can be performed by the bladders 112, 114 if the pressure provider device 170 is programmed to direct and pull the fluid in and out of the bladders 112, 114 at specific rates to obtain the desired operational mode of vibration and/or percussion.

Second Method:

The present invention can have an additional bladder 250 positioned in the foot section 120 as illustrated in FIG. 10. In particular, it is desired that the additional bladder 250 is positioned below the area that the patient's sacrum area would normally be located. The additional bladder 250 is interconnected to the pressure provider device 170 in the same way that the other bladders 112, 114, 140, 141 are connected to the pressure provider device as schematically illustrated in FIG. 11. Moreover, the analyzer 150 is interconnected to a pressure sensor 255 that monitors the pressure within the additional bladder 250 in the same manner in which the other bladders 112, 114, 140, 141 are measured as schematically illustrated in FIG. 11.

It is possible that the additional bladder 250 may be incorporated into the bladders 141. The bladder 250 could have an inlet 260 that allows the fluid to enter directly from the interior of the bladders 141 as illustrated in FIG. 12a. The inlet 260 could also be positioned on the exterior surface of the bladder unit 250, 141 as illustrated in FIG. 12b.

Conversely, if the foot section 120 is raised in relation to the support section 101, the additional bladder 250 can positioned in the head section 110 to provide additional support to the patient's back area. That alternative embodiment is illustrated generically in FIGS. 12a and 12b.

Alternative Embodiment for a Self-Contained System

The pressure provider device 170 can be positioned within the mattress 100. In this embodiment, the pressure provider device 170 may be two components. The first component 170a is positioned in the head section 110 and the second component 170b is positioned in the foot section 120. Preferably the first component 170a and the second component 170b are positioned to provide the least amount of pressure to the patient, normally the terminal ends of the head and foot sections. The first component 170a provides the desired fluid to the bladders 112, 114, 140 in the head section while the second component 170b provides the desired fluid to the bladders 141, (possibly) 250 in the foot section. Preferably, each component 170a,b is electrically interconnected 99 to (a) the other component 170a,b directly and/or (b) the analyzer 150, as illustrated in FIG. 13.

By using an electrical connection to connect the two pressure provider devices 170a,b, the mattress 100 can be self-contained. Self-contained mattresses are desired because it decreases the kinking that occurs if fluid conduits had to traverse through the gatch area 122. If fluid conduits are kinked, the fluid conduits 118, 116 do not always provide the desired pressure to the bladders. In contrast, an electrical connection can be kinked and the kinking does not normally inhibit the transmission of the electrical signal through the kinked area. Accordingly, dividing the pressure provider device and placing each device 170a,b in two distinct sections when the mattress 100 is a self-contained mattress to decrease the adverse effects of kinking is desired.

By separating the pressure provider devices 170a,b for the respective head section 110 and foot section 120, the pressure provider devices 170a,b will provide the desired fluid to the desired bladder. When the mattress 100 is a self-contained mattress the fluid is normally air because it can be easily obtained and does not render the mattress 100 too heavy. The pressure provider device 170 is normally positioned toward an exterior side surface of the mattress as illustrated in FIG. 13.

Each pressure provider device has an air aperture that allows air to be drawn into or expelled out of the pressure provider device. Each pressure provider device, in this embodiment, has a fan (not shown) positioned near the air aperture to draw the air into the pressure provider device. The pressure provider device has a conventional manifold system that opens and closes the numerous conduits that direct the fluid toward or away from the bladders 112, 114, 141, 140, 250 as directed by the analyzer 150.

Alternative Embodiment for the Foot Section

The mattress 100 can also have a second gatch area 340 as illustrated in FIG. 14. The second gatch area 340 is positioned where the patient's knee would normally overlie. The second gatch area divides the foot section 120 into a seat section 342 and a calf section 344. For a self-contained embodiment, there could be a third pressure provider device 170c positioned in the seat section 342.

The seat section 342 and the calf section 344 can be raised and/or lowered to obtain the desired shape. The seat section 342 and the calf section 344 can also have geometry sensors 200 (which include the magnet 210 and the distance measuring sensor 212) positioned thereon. For example, the geometry sensor system 200 can be positioned on the underside of the seat section, the calf section, the corresponding support structure 101, and/or the base 109 of the support structure under the foot section 120.

Alternative Embodiment for the Geometry Sensor

The geometry sensor can also be a transmission from a computer interface system of the support surface 101. If the computer interface system can determine the exact angle of the head section, the calf section and the seat section in relation to the corresponding sections, the computer interface system transmits the angle values to the analyzer 150. The computer interface system can determine the precise angle of the mattress' sections in relation to the mattress being in the supine configuration.

While the preferred embodiment of the invention has been illustrated and described, it will be clear that the invention is not so limited. Numerous modifications, changes, variations, substitutions and equivalents will occur to those skilled in the art without departing from the spirit and scope of the present invention as defined by the appended claims.

Claims

1. A mattress system comprising:

a mattress having a head section having a first set of support bladders that receive a fluid and a set of rotation bladders that receive the fluid; a foot section having a second set of support bladders that receive the fluid; a gatch area positioned between the foot section and the head section; and a pressure sensor associated with each bladder that measures the pressure associated with each bladder;
a support structure positioned below the mattress and allows the head section to be positioned any where between a supine configuration and a cardiac chair configuration;
a geometry sensor that measures the angle of the head section in relation to the mattress being in a supine configuration;
an analyzer that receives the measurement from the pressure sensor and the measurement from the geometry sensor, and analyzes the measurements to transmit a pressure signal; and
a pressure provider device (a) receives the pressure signal and (b) alters and/or maintains the fluid pressure within the bladders to reduce the chance of (i) bottoming out of the bladders and/or (ii) forming bed sores on a patient positioned on the mattress.

2. The mattress system of claim 1 wherein the foot section further comprises a sacrum area bladder.

3. The mattress system of claim 2 wherein the sacrum area bladder is within the second set of support bladders.

4. The mattress system of claim 2 wherein the sacrum area bladder is over at least a portion of the second set of support bladders.

5. The mattress system of claim 1 wherein the pressure provider device and the analyzer are in the mattress.

6. The mattress system of claim 1 wherein pressure provider device is divided into a first device positioned in the head section and a second device positioned in the foot section.

7. The mattress system of claim 6 wherein the first device receives the pressure signal and the second device receives the pressure signal.

8. The mattress system of claim 1 wherein the foot section has a seat section positioned near the gatch area and calf section, and positioned between the calf section and the seat section is a second gatch area.

9. The mattress system of claim 1 wherein the support structure has the geometry sensor.

10. The mattress system of claim 9 wherein the geometry sensor is incorporated into a computer interface that measures the angle of the head section in relation to the mattress being in the supine configuration.

11. The mattress system of claim 1 wherein the geometry sensor is selected from the group consisting of giant magneto-resistive devices and a Hall effect field sensors.

12. The mattress system of claim 1 wherein the mattress has at least a portion of the geometry sensor.

13. The mattress system of claim 1 wherein the support structure has at least a portion of the geometry sensor.

14. The mattress system of claim 1 wherein the fluid is air.

15. The mattress system of claim 1 wherein the fluid is an aqueous liquid.

16. The mattress system of claim 1 wherein some of the bladders are low air-loss bladders.

17. The mattress system of claim 1 wherein the pressure in at least one of the bladders within the foot section and/or a seat sub-section positioned (a) within the foot section and (b) near the gatch area is increased when the head section is at a predetermined angle in relation to the support section.

18. A mattress system comprising:

a mattress having a head section having a first set of support bladders that receive a fluid and a set of rotation bladders that receive the fluid; a foot section having a second set of support bladders that receive the fluid; a gatch area positioned between the foot section and the head section; and a pressure sensor associated with each bladder that measures the pressure associated with each bladder;
a support structure positioned below the mattress and allows the head section to be positioned any where between a supine configuration and a cardiac chair configuration;
a geometry sensor that measures the angle of the foot section in relation to the mattress being in a supine configuration;
an analyzer that receives the measurement from the pressure sensor and the measurement from the geometry sensor, and analyzes the measurements to transmit a pressure signal; and
a pressure provider device (a) receives the pressure signal and (b) alters and/or maintains the fluid pressure within the bladders to reduce the chance of (i) bottoming out of the bladders and/or (ii) forming bed sores on a patient positioned on the mattress.

19. The mattress system of claim 18 wherein the head section further comprises a back area bladder.

20. A method of adjusting a mattress system comprising: the mattress is positioned over a support structure that allows the head section to be positioned any where between a supine configuration and a cardiac chair configuration;

positioning a patient on a mattress having a head section having a first set of support bladders that receive a fluid and a set of rotation bladders that receive the fluid; a foot section having a second set of support bladders that receive the fluid; a gatch area positioned between the foot section and the head section; and a pressure sensor associated with each bladder that measures the pressure associated with each bladder;
measuring with a geometry sensor the angle of the head section in relation to the mattress being in a supine configuration;
transmitting a pressure signal based on an analysis of the measurement from the pressure sensor and the measurement from the geometry sensor; and
altering and/or maintaining, based on the pressure signal, the fluid pressure within the bladders to reduce the chance of (i) bottoming out of the bladders and/or (ii) forming bed sores on a patient positioned on the mattress.

21. The mattress system of claim 1 wherein the pressure in at least one of the bladders within the foot section and/or a seat sub-section positioned (a) within the foot section and (b) near the gatch area is decreased when the head section is at a predetermined angle in relation to the support section.

Patent History
Publication number: 20070289067
Type: Application
Filed: Jun 14, 2006
Publication Date: Dec 20, 2007
Applicant:
Inventors: Richard Buchanan (Hamburg, NY), Roland E. Flick (Elma, NY)
Application Number: 11/452,512