Abstract: An adhesive material for medical use comprising gelatin and a non-toxic cross-linking material such as transglutaminase. An optional embodiment of the invention includes dressings in which a layer of a transglutaminase is sandwiched between a first and second layer of gelatin. The hemostatic products are useful for the treatment of wounded tissue.

Abstract: Ionically cross-linked compositions containing carboxypolysaccharides, polyalkylene oxides, polyhydroxyl organic anions, optionally divalent cations, and aqueous media are provided. Methods for manufacturing ionically cross-linked compositions of carboxypolysaccharides, polyalkylene oxides, polyhydroxyl organic anions, optionally divalent cations, and aqueous media are also provided. Such compositions can be used by placing then in proximity to a tissue in need of lubrication or for prevention of adhesions and adhesion reformation.

Abstract: Methods for shaping tissue matrices are provided. The methods can be used to produce shaped tissue products that retain desired biologic properties without using chemical crosslinking agents.

Abstract: A bone repair composition including a cancellous bone matrix with cortical and/or cancellous bone particles loaded therein; and a kit comprising the cancellous bone matrix and the cortical and/or cancellous bone particles.

Abstract: A bioremodelable encasement structure comprising a pouch formed from at least one sheet of bioremodelable material, the pouch including an internal region that is configured to receive a device therein, the bioremodelable material comprising mesothelial tissue.

Abstract: The present invention relates to a temporary composite scaffold comprising discrete ECM particles formed as a fistula plug. We demonstrate that when using scaffolds containing ECM material, higher concentrations of ECM surprisingly do not give better cell morphology. Concentrations lower than 60% (w/w) are sufficient to obtain the best cell morphology and distribution.

Abstract: A method and device for the treatment of an aneurysm are provided. Different therapeutic agents are delivered to the aneurysmal site by a reservoir and delivery means in a localized, and, in some embodiments, time-released regimen, to treat, limit and reduce the severity of the aneurysm.

Abstract: A negative pressure wound therapy apparatus can include a wound dressing, a fluid collection container, a vacuum pump comprising a pump motor, and tubing. Additionally, the apparatus can include a pressure sensor that measures a pressure in the tubing. One or more tubes can channel a fluid between the wound dressing, the fluid collection canister, and the pump. In addition, first and second control circuits can be provided for controlling the pump motor without using a processor. The first control circuit can generate a difference signal between a desired pressure input and a pressure sensor input, and can further generate a motor control signal responsive to the difference signal. Moreover, a second control circuit can provide an override signal based at least in part on the difference signal and at least one reference signal. The override signal beneficially overrides the motor control signal to prevent the pump motor from stalling.

Abstract: Miniature axial flow pumps are implanted inside the heart or major arteries to provide hemodynamic support. These pumps commonly utilize tubular blood conduit tubes to transport blood across the aortic valve. The valve leaflets themselves are very thin and flexible, and will seal against the conduit if it is centered within the valve orifice. If the conduit is not centered, a leaflet can be pushed to the side of the aorta, preventing the leaflets from sealing and providing a path for backflow. If the blood flow conduit remains pushed against the side of the valve for a long period of time, thrombus may form in the crevice between the conduit and the aorta, causing serious thromboembolic events such as stroke, if the thrombus breaks free. The present invention provides a conduit support device that retains the conduit centered within the annulus of the natural heart valve.

Abstract: A pressure actuated single-lumen blood pumping device has a housing (4) having a wall (19) bounding a pressure transfer chamber (11; 411). The housing (4) bounds a pressure transfer port (9) for connection to a pressure source, the pressure transfer port (9) communicating with the pressure transfer chamber (11; 411) for alternatingly transferring over pressure and under pressure from the pressure source to the pressure transfer chamber (11; 411). A flexible tubular membrane (2; 102; 202; 302; 402) is arranged in the pressure transfer chamber (11; 411). A blood transfer conduit (3; 103; 203; 303; 403) passes through the wall (19) bounding the pressure transfer chamber (11; 411) and the blood transfer conduit (3; 103; 203; 303; 403) connects to opposite ends (5, 6; 105; 405, 406) of the flexible tubular membrane (2; 102; 202; 302; 402).

Abstract: Described are aspects and embodiments directed to systems for tapping into the breathing system to generate pressure in a sustained space with pulsating frequency to aid the pumping functions of cardiac muscle. In some embodiments, the generated energy can also be transferred to other forms of energy (e.g., electricity to power certain devices (e.g., pacemaker batteries). In further embodiments, the system utilizes air entrapment in a closed space to generate mechanical force with valves and timed release frequency to control power generation and mechanical movements that assist blood flow.

Abstract: Systems, methods, and devices for preparation of purified water and medicaments for various uses including blood treatment are described. Methods, devices, and systems for creating multiple-treatment batches are described. For example, a medicament fluid circuit can include a container with an interior chamber. The container can have a fluid filling port and a fluid extraction port. Both ports can be connected to the interior chamber. The filling port can have two sterilizing filters, each of which has a membrane. The sterilizing filters can be connected in series the membranes are separated by a distance of at least 0.5 cm. A first of the sterilizing filters can have a sealed inlet. The fluid extraction port can be sealed.

Abstract: An ambulatory ultrafiltration device includes a blood filter that has a blood side or fluid communication with the vascular system of the subject, an ultrafiltrate side, and a semipermeable membrane disposed between the blood side and the ultrafiltrate side. The ambulatory ultrafiltration also includes a buffer vessel in fluid communication with the blood side of the blood filter, and a blood pump. The blood pump is controlled to alternate between a withdrawal phase and a return phase. In the withdrawal phase, blood is withdrawn on a blood path from the subject via the blood filter to the buffer vessel. In the return phase, blood is returned from the buffer vessel to the subject on the blood path. The blood filter is arranged to remove ultrafiltrate from the blood during at least one of the withdrawal and return phases.

Abstract: The present invention relates to a system, apparatus, and method for separating components of a fluid, e.g. blood, which eliminates the need for expensive hardware and produces a stabilized waste product. The system comprises an apparatus or device (V) for separating components of a fluid (15?) comprising a container (5?) having at least one separation or filtration member (10?) capable of selectively separating or filtering at least one component from the fluid, and a superabsorbent material (20?) capable of absorbing the at least one component separated from the fluid, and thereby providing a processed fluid free or substantially free of said at least one component; and agitation means.

Abstract: A device removes first pulses in a pressure signal of a pressure sensor which is arranged in a fluid containing system to detect the first pulses, which originate from a first pulse generator, and second pulses, which originate from a second pulse generator. The first pulse generator operates in a sequence of pulse cycles, each pulse cycle resulting in at least one first pulse. The device repetitively obtains a current data sample, calculates a corresponding reference value and subtracts the reference value from the current data sample. The reference value is calculated as a function of other data sample(s) in the same pressure signal. The fluid containing system may include an extracorporeal blood flow circuit, e.g. as part of a dialysis machine, and a cardiovascular system of a human patient.

Abstract: A recirculation device of an extracorporeal blood treatment device is disclosed with a preferably universal medical fluid container to which an arterial line section of a fluid conducting system of the extracorporeal blood treatment device can be connected as an option. Furthermore, the recirculation device has a 3-way switch, preferably a 3-way valve, which is arranged directly downstream of the universal medical fluid container. A conduit of the 3-way switch is preferably coupled with a spike or a similar connecting device or is formed in one piece together with it.

Abstract: An assembly for dispensing fluid is described. In some implementations, an assembly can include a housing containing fluid, where the housing includes a conduit. The assembly can also include an actuator operably attached to the conduit of the housing. The actuator can include a body portion surrounding a cavity; a tip portion having a fluid path that is fluidly connected to the cavity, the cavity being fluidly connected to the conduit, and a channel support including a fluid passage space under pressure. The assembly can further include a collector having a collection zone configured to collect the fluid dispensed by the actuator.

Abstract: Methods and systems for providing modular components in an integrated infusion device and analyte monitoring system where the components are independently replaceable are provided.

Abstract: Fluid delivery and measurement systems and methods are disclosed.

Abstract: A syringe for use with an injector includes a body having a rear end and a front end, a plunger movably disposed within the body, an attachment member associated with the body and adapted to releasably engage a syringe retaining mechanism of the injector regardless of the orientation of the syringe with respect to the injector, and an encoding device operable to provide syringe information to the injector.

Abstract: Infusion systems, infusion devices, and related operating methods are provided. An exemplary method of operating an infusion device to deliver fluid to a user in accordance with an operating mode involves obtaining operational information pertaining to one or more prior instances of the operating mode, obtaining status information pertaining to the infusion device, and determining a diagnosis time based at least in part on the operational information. The diagnosis time is prior to a subsequent instance of the operating mode. At the diagnosis time, the method automatically determines the viability of the subsequent instance of the operating mode based at least in part on the status information and automatically generates a notification indicative of a recommended action for the user based at least in part on the viability.

Abstract: Systems, methods, and devices can detect a dangerous or adverse condition or anticipated condition that indicates an undesirable amount of electric current in a patient-connected tube providing fluid to a patient. The fluid flow to the patient is stopped responsive to the detection. Stoppage of fluid flow to the patient can reduce or prevent electric current in the fluid from reaching a patient, flowing through the patient to ground, and/or continuing to flow through the patient.

Abstract: A pump, related system, and related method are provided. The pump includes a reservoir, a port, and a plunger. The reservoir delivers a liquid by discharging the liquid through the port coupled to the reservoir. The plunger has a piston coupled to a shaft and is disposed within the reservoir in sliding engagement with an inner surface of the reservoir. The piston defines a liquid side of the reservoir and a non-liquid side of the reservoir whereby movement of the plunger towards the liquid side of the reservoir discharges liquid through the port. The pump also includes a reference-volume assembly and/or a linear position sensor. The reference-volume assembly is coupled to the reservoir at an opposite end of the reservoir relative to the port and includes a reference-volume chamber in acoustic communication with the non-liquid side of the reservoir, a speaker disposed within the reference-volume chamber, and a reference microphone disposed within the reference-volume chamber.

Abstract: An infusion system includes an infusion device and a sensing device. The infusion system may further include a characteristic determining device. The infusion device also includes a communication system for transmitting to and receiving communications from the sensing device or a computer. The sensing device may sense an analyte of a bodily fluid of the user. The analyte may be calibrated using data from the infusion device and from a characteristic determining device. The system may be set up to automatically call for assistance when analytes reach a certain level.

Abstract: An integrated drug delivery and biosensor (IDDB) system is implemented on a patch or arm band. The drug delivery system includes needles adapted to pierce the skin and direct injection of a predetermined dosage of medication through the needles into the epidermis of the skin of a patient. The integrated biosensor monitors absorption of the medication into the epidermis of the skin of the patient and may also monitor concentration of the medication or other relevant substances in arterial blood flow of the patient. The integrated biosensor may also monitor a patient's vitals in response to the medication. The integrated biosensor may then alter dosage or frequency of administration of dosages or even halt a dosage of medication in response to the patient's vitals or absorption of the medication.

Abstract: An injection device for injecting a medicant into a plurality of tissue sites in a patient for a selected treatment is constructed and arranged such that the number of tissue sites is the total number for the selected treatment thereby requiring a single positioning step. The injection device includes a body having a syringe and a control linkage, the syringe including a plurality of barrels, and a cooperating plunger array including a plurality of plungers. Each barrel receives a corresponding plunger. The injection device further includes a plurality of injection needles connected to the syringe wherein one injection needle is connected to each barrel, a multi-lumen tip, a shaft connected to the multi-lumen tip and extending between said multi-lumen tip and said body. The control linkage is connected to each needle so as to move each needle between a deployed injection position and a retracted position.

Abstract: An auto-injector for administering a dose of a liquid medicament (M) is presented having a tubular chassis telescopable in an elongate chassis, a carrier subassembly comprising a tubular carrier slidably arranged partially inside the chassis and inside the case, where the carrier is adapted to contain a syringe with a hollow injection needle, a drive spring and a plunger for forwarding load of the drive spring to a stopper of the syringe, wherein the syringe is lockable for joint axial translation with the carrier.

Abstract: A pneumatic autoinjector that, once activated, automatically mixes at least two components in a pre-filled chamber and then ejects the mixture in a manner suitable for medicament injection. The mixable components may be a dry/wet combination (e.g., powder and solvent), wet/wet combination (e.g., two pre-diluted medicaments), wet/gas combination (e.g., chemical A and gas B), or gas/gas combination. In some embodiments, autoinjectors made in accordance with the teachings of the present disclosure may automatically perform a sequence comprising thorough medicament mixing (e.g., reconstitution of a dried medicament with solvent), an optional pause to enhance medicament dissolution or suspension, optional needle insertion into the patient (not required in needle-free embodiments), medicament injection into the patient, and optional needle retraction for safe storage.

Abstract: A system for optimizing a patient's basal insulin dosage regimen over time, adapted to determine from blood glucose values whether and by how much to vary a patient's present recommended amount of the insulin-containing drug in order to maintain the patient's future blood glucose level measurements within a predefined range, and wherein a given blood glucose value is disregarded if no patient-actuated operation being indicative of the administration of a dose of an insulin containing drug has been detected in a pre-defined amount of time prior to the determination of the given blood glucose value.

Abstract: A drug delivery device comprises a shield (30) moveably mounted to a main portion and being displaceable by a user between a shielding and a non-shielding position, wherein a needle assembly (50) can be mounted on a reservoir, the shield covering the needle assembly in the shielding position. The needle assembly is moveable between a dis-connected and connected position in fluid communication with the reservoir. In such an arrangement a mounted needle assembly is moved from the dis-connected to the connected position when the shield is moved from the shielding to the non-shielding position, and moved from the connected to the dis-connected position when the shield is moved from the non-shielding to the shielding position.

Abstract: A combination container/syringe (1) provided with an outer cylinder (10) that forms a cylindrical shape centered on an axial line (O); a front stopper that is inserted into a distal end side of the outer cylinder (10); and a cylindrical tip (50) that is fitted to an outer periphery of the distal end of the outer cylinder via a fitting hole (61) at a base end side, and that has a bypass chamber (71) that houses the front stopper at a front side of the fitting hole, in which an inner diameter of the bypass chamber is formed larger than an outer diameter of the front stopper, and a plurality of ribs (74) that protrude toward an inside in a radial direction and extend in the direction of the axial line to make close contact with the outer peripheral surface of the front stopper that has moved to the inside of the bypass chamber are provided spaced apart in a circumferential direction on the inner peripheral surface (73) of the bypass chamber.

Abstract: A drug delivery device which includes a first housing part, a second housing part, a button, a drug expelling mechanism, a graduated plate, a circuit board and a pressing rod. The button is connected to the first housing part. The drug expelling mechanism is disposed inside the second housing part, and includes a dose setting member which is rotatable and configured to set a drug dose to be expelled. The graduated plate is disposed inside the first housing part and connected to the button, and includes a first conductive element and a plurality of second conductive element disposed on a surface thereof. The plurality of second conductive elements are arranged in interval and the first conductive element is electrically connected to the plurality of second conductive elements. The circuit board is disposed inside the first housing part and connected to the dose setting member.

Abstract: A safety syringe includes a barrel having a positioning groove, a needle holder mounted in the barrel and having a first internal flange engaged in the positioning groove of the barrel and a first positioning flange, an interlocking seat mounted in the needle holder and having an elastic flap and a first external flange, and a plunger mounted in the barrel and having a second external flange. By means of engagement between the elastic flap of the interlocking seat and the second external flange of the plunger, the interlocking seat can be pulled by the plunger to let the first external flange to be forced into engagement with the first internal flange of the needle holder for allowing the needle holder with an attached needlestick to be pulled backwardly into the inside of the barrel to assure the safety of the syringe after the injection.

Abstract: A retractable syringe, plunger and releasable needle assembly including a retractable needle, a needle seal, a retaining member and an ejector member. The retaining member has a mating surface for mounting to a complementary mating surface of an interior wall of a syringe barrel. The plunger comprises a plunger outer, a plunger rod frangibly connected to a controlling member, a spring and a unitary plunger seal capable of engaging the retractable needle, wherein the plunger rod, plunger outer and the controlling member co-operate to releasably maintain the spring in an initially compressed state. After delivery of fluid contents of the syringe, the plunger forces the ejector member to release the retractable needle from the retaining member. Decompression of the spring at the end of depression of the plunger facilitates retraction of the retractable needle when engaged with the unitary plunger seal.

Abstract: An auto-injector for administering a dose of a liquid medicament includes an elongate housing that contains a syringe with a hollow needle and a bung for sealing the syringe and displacing the medicament. The housing has distal and proximal ends with an orifice to be applied to an injection site. A spring mechanism, upon activation, pushes the needle from a covered position inside the housing into an advanced position through the orifice. The spring mechanism also operates the syringe to supply the dose of medicament. An activating mechanism is arranged to lock the spring mechanism in a pressurized state prior and to release the spring mechanism upon manual operation. The spring mechanism includes a torsion spring ground at one end in the housing and in a gear member on the other end. The gear member is rotatable to move another gear member to push the bung towards the proximal end.

Abstract: A venipuncture assist device includes a main body having a first surface configured to confront a target venipuncture site. The device further includes a vein capture channel disposed within the first surface configured to urge a portion of a patient's tissue and subcutaneous vein therein when the vein capture channel is evacuated by vacuum, wherein the urging creates a bend in the vein for piercing by a venipuncture needle. The device further includes one or more needle channels extending from a front main body surface configured to receive and guide the needle into the bend in the vein.

Abstract: Embodiments of a retractable syringe assembly are provided that include a single syringe barrel configuration and dual syringe barrel configuration. In one or more embodiments, the assemblies include a barrel having a dividing wall to divide the chamber to define a fluid chamber having a first cross-sectional width for retaining fluid and a needle chamber for housing a needle hub assembly. The assemblies include a projection extending radially outwardly from the plunger rod to interact with a ramped portion of the dividing wall to cause the needle cannula to retract and be housed within the needle chamber.

Abstract: The invention relates to a device (1) for dosing and dry nebulization of nebulizable material, comprising a nebulization channel (3), which has a first attachment piece and a second attachment piece, and a source of compressed carrier gas connected to the first attachment piece via a valve for the purpose of sending a carrier gas pressure pulse into the nebulization channel. The device is characterized in that between the first attachment piece and second attachment piece, and above the nebulization channel, a reservoir open only towards the nebulization channel, and used for receiving the nebulizable material, is connected to the nebulization channel such that it is gas-tight with respect to the environment, and that, when the valve is closed, a pressure compensation takes place in the nebulization channel and in the reservoir.

Abstract: There is provided a medicament dispenser for use with plural elongate form medicament carriers, each having multiple distinct medicament dose portions carried thereby, the dispenser having a dispensing mechanism for dispensing the distinct medicament dose portions carried by each of the plural medicament carriers. The mechanism comprises a receiving station for receiving each of the plural medicament carriers; a release for releasing a distinct medicament dose portion from each of the plural medicament carriers on receipt thereof by the receiving station; an outlet, positioned to be in communication with the distinct medicament dose portions releasable by said a release; and an indexer for individually indexing the distinct medicament dose portions of each of the plural medicament carriers.

Abstract: The present invention relates to a method for the ventilation of a living being (3), the respiration airflow (v) flowing into the living being (3) and out of the living being (3) being detected, it being ascertained from the detected respiration airflow (v) whether an inhalation phase or an exhalation phase is present, and the air pressure (p) in a respiratory organ of the living being (3) being regulated, characterized in that, upon recognition of an inhalation phase, the air pressure (p) in the respiratory organ is raised at the beginning of the inhalation phase and lowered again with progressing respiration cycle.

Abstract: An oscillating positive respiratory pressure apparatus and a method of performing oscillating positive respiratory pressure therapy. The apparatus includes a housing having an interior chamber, a chamber inlet, a chamber outlet, an exhalation flow path defined between the inlet and the outlet, and a restrictor member rotatably mounted within the interior chamber. The restrictor member has an axis of rotation that is substantially perpendicular to the flow path at the inlet, and includes at least one blocking segment. Rotation of the restrictor member moves the at least one blocking segment between an open position and a closed position. Respiratory pressure at the chamber inlet oscillates between a minimum when the at least one blocking segment is in the open position and a maximum when the at least one blocking segment is in the closed position. By exhaling into the apparatus, oscillating positive expiratory pressure therapy is administered.

Abstract: A controller or processor (s) implements detection of respiratory related conditions that may serve as control logic to synchronize pressure treatment delivery with a patient's respiratory cycle. Based on data derived from sensor signals associated with the respiratory treatment, a monitoring device, detector or respiratory treatment apparatus may evaluate flow measures from a flow sensor and distinguish flow attributable to the respiratory treatment apparatus and flow attributable to patient respiratory muscles. The determination may serve as a basis of synchronization criteria that controls pressure levels from a pressure treatment apparatus, such as by evaluating the determined patient generated flow or a relationship between total flow and apparatus flow. In some embodiments, data for the cycling conditions is determined in preliminary treatment cycles during which synchronized pressure changes are controlled according to other cycling criteria.

Abstract: A respiratory mask is provided having an outer shell coupled to a cushion for the delivery of a gas to a user. The cushion of the respiratory mask has at least one pleat disposed in the cushion in order to provide varying degrees of flexibility and support about the cushion.

Abstract: A mask assembly suitable for the treatment of sleep disordered breathing, comprising: a mask to provide pressurized air to a patient; upper and lower slot features located on each side of the mask; a headgear assembly, comprising: a back portion; a pair of upper straps provided to the back portion, each upper strap having a loop portion and a hook portion at a free end thereof for releasably attaching to the loop portion; a pair of lower straps extending away from the back portion, each lower strap having a loop portion and a hook portion at a free end thereof for releasably attaching to the loop portion; and a connection region of each loop portion of each strap, the connection region being adapted to receive a respective hook portion, the connection region being wider than each respective hook portion along each respective hook portion's entire length.

Abstract: Catheters and methods for supporting a guidewire or delivering a radiopaque, diagnostic or therapeutic agent through a vessel stenosis or other tortuous anatomy are disclosed. A catheter can comprise an elongate shaft body and a tip member disposed at a distal end of the shaft body. The shaft body can extend from a proximal end to the distal end and can define an inner lumen. The shaft body can include a liner, a braid member surrounding the liner, a multi-layer coil surrounding the braid member, and a polymer cover surrounding the multi-layer coil. The multi-layer coil can include first and second coil layers wound in opposing directions. An outer surface portion of the polymer cover can include one or more helical threads. In an example, the one or more helical threads are positioned around a distal end portion of the shaft body. The tip member can be made from a metal or a polymer and can also include one or more helical threads around its outer surface.

Abstract: A medical tube, which is inserted into a tubular organ and discharges and suctions fluid, is provided with a tube-shape main body which extends a prescribed length and with a valve which is disposed in a portion of the main body that is inserted into the tubular organ and can discharge or suction a fluid, wherein the valve includes multiple slits which are formed so as to extend axially of the body a prescribed length, reaching from the outer periphery to the inner periphery of the main body, and which are provided spaced in the circumferential direction of the main body. Each slit is formed tilted in the same direction with respect to a radially-extending line which passes through the axial center of the main body.

Abstract: The invention concerns a medical robot for guiding elongate flexible medical parts, comprising: a fixed base having an outer peripheral wall; a container which is movable relative to the fixed base by a degree of freedom of rotation, the container comprising an inner peripheral wall defining with the outer peripheral wall a first compartment; and the outer peripheral wall having an aperture which opens into the interior of the first compartment and via which the first elongate flexible part can be moved.

Abstract: Embodiments of steerable catheters are disclosed. The catheters may include a plurality of generally arcuate-shaped struts connected at proximal and distal ends of a handle. The handle is connected to a tubular portion at a distal end of the handle. The tubular portion includes a resilient component positioned near a distal tip of the tubular portion. The catheter includes a pull wire fixed to a point at or near the distal tip of the tubular portion. Upon manual compression of the handle, the struts are squeezed together, lengthening the handle, and extending the pull wire proximally. The proximal extension of the pull wire can cause the distal tip of the catheter to deflect. The catheter can be rotated greater than 360° around a longitudinal axis. The compressible handle can allow a user of the catheter tactile feedback and control over navigation of the catheter.

Abstract: A catheter includes a handle and an elongate member extending from the handle. The catheter may also include steering system coupled to the handle. The steering system may be configured to deflect at least a portion of the elongate member in at least one direction. The catheter may also include a locking mechanism configured to lock the portion of the elongate member in a deflected configuration, and a lever coupled to the handle. The lever may be configured to move from a first position to a second position to engage the locking mechanism. The lever may also be configured to be separably retained at least at one of the first position or the second position to prevent movement therebetween.

Abstract: A deflectable device, such as a catheter, is provided that includes a hinge that enhances the ability of the device to deflect or bend within a predetermined plane. The catheter comprises an elongated tubular catheter body having proximal and distal ends and at least one lumen extending therethrough. A distal segment is provided distal to the distal end of the catheter body. A tubular hinge is provided between the distal end of the catheter body and the proximal end of the distal segment. The hinge has an axis and at least one lumen extending therethrough. The tube includes at least one slot, and preferably a plurality of slots, extending part of the way through the hinge generally transverse to the axis of the hinge.