Abstract: Systems and methods are provided for moving fluids from a patient to a canister and lowering or eliminating the bio-burden of the canister. In one instance, a method for removing fluids from a patient includes using reduced pressure to remove fluids from a patient, delivering the fluids into a reduced-pressure conduit and into a fluid reservoir, exposing the fluids removed from the patient to a UV light source to kill pathogens to create disposable fluids, and disposing of the disposable fluids. Other systems, devices, and methods are presented.

Abstract: A system and method for increasing the speed of blood and wall shear stress (WSS) in a peripheral vein for a sufficient period of time to result in a persistent increase in the overall diameter and lumen diameter of the vein is provided. The method includes pumping blood at a desired rate and pulsatility. The pumping is monitored and adjusted, as necessary, to maintain the desired blood speed, WSS and pulsatility in the peripheral vein in order to optimize the rate and extent of dilation of the peripheral vein.

Abstract: The present invention provides a minimally-invasive percutaneous device that can be positioned within the body of a subject to aid in the movement or pumping of a bodily fluid. In one embodiment, the device comprises a plurality of pump units configured to transform from a first compressed configuration where the pump units are organized in a serial arrangement into a second expanded configuration where the pump units are reorganized into a parallel arrangement.

Abstract: A dialysis system including a disposable fluid pumping cassette including at least one flexible membrane attached to a housing and at least one port extending from the housing, the at least one port including a spike; at least one dialysis fluid supply in fluid communication with at least one tubing and tubing connector; an autoconnection device including a shuttle for moving the at least one tubing and tubing connector towards the spike of the at least one port, the autoconnection device including at least one lead screw in mechanical communication with the shuttle, a motor and power transmission equipment to transmit power from the motor to the at least one lead screw; and a controller programmed to operate the motor to move the at least one tubing and tubing connector towards the spike of the at least one port of the disposable fluid pumping cassette.

Abstract: Methods include monitoring indicators of blood pH or blood electrolyte levels during a blood fluid removal session and adjusting concentrations of pH buffers or electrolytes in dialysate or replacement fluid used during the session based on the monitored indicators. Blood fluid removal systems may employ sensors that monitor blood pH or electrolyte levels to adjust the fluid parameters during a blood fluid removal session.

Abstract: Extracorporeal life support (ECLS) systems, devices and methods wherein a portable ECLS device is used to deliver cardiovascular support to a humans or animal patient (or harvested organ(s)) during pre-hospital or inter-hospital transport.

Abstract: The present invention relates to systems, methods and uses for recycling at least a part of water lost during various renal replacement therapy processes, e.g. in the preparation of a fresh dialysate solution or fresh reconstitution fluid for kidney disease dialysis and hemofiltration by utilizing water from the spent fluids. The system of the invention is useful in hemodialysis and in peritoneal dialysis as well as in hemofiltration for reuse of water from filtrates and spent fluids. In addition, the system of the invention is useful in the development of a renal assist device or artificial kidney.

Abstract: The described invention is a hyperthermia and hyperoxygenation medical apparatus for treating diseases of the blood and purification of stored blood supplies. The invention comprises a hollow chamber through which blood is made to flow. Within the hollow chamber are a heating element and a gas diffuser. As blood flows through the chamber, blood is heated to a preset limit while ozone or other beneficial gas is diffused into the blood by a diffuser with pores to a preset concentration. After heating and gasification, blood exits the hollow chamber and is either returned to the patient or returned to storage. The hollow chamber, heating element and gas diffuser are designed to maintain efficient, linear blood flow through the invention, in part by taking advantage of die radial symmetry of the hollow chamber and diffuser designs. Linear flow ensures uniform and controlled heating and gasification of the blood with negligible undesirable turbulence to the blood components.

Abstract: A hemodialysis system includes a blood treatment machine, a blood pump housed by the blood treatment machine, a first dialysate pump housed by the blood treatment machine, a second dialysate pump housed by the blood treatment machine; and a fluid cassette including an upper portion and a lower portion. The fluid cassette further includes a blood pumping tube extending from the upper portion to the lower portion of the fluid cassette, a first dialysate pumping tube extending from the upper portion to the lower portion of the fluid cassette, and a second dialysate pumping tube extending from the upper portion to the lower portion of the fluid cassette.

Abstract: A continuous flow centrifuge bowl includes a rotatable outer body, and a top and bottom core that are rotatable with the outer body. The bottom core has a wall extending proximally from a bottom wall. The proximally extending wall is radially outward from at least a portion of the top core and, together with the top core, defines a primary separation region in which initial separation of the whole blood occurs. The bowl may also have a secondary separation region located between the top core and the outer body, and a rotary seal that couples an inlet port and two outlet ports to the outer body. The inlet port may be connected to an inlet tube that extends distally into a whole blood introduction region. Additionally, one of the outlet ports may be connected to an extraction tube that extends into a region below the bottom core.

Abstract: A system for removing undesirable elements from blood. The system includes a centrifuge bowl to separate the blood into components according to relative densities of the components, a pump to provide wash solution that washes the blood in the centrifuge bowl, and a controller to wash the blood in the centrifuge bowl in a first wash and remove first undesirable elements and to wash the blood in the centrifuge bowl in a second wash and remove trapped undesirable elements. The controller to further mix the blood and the wash solution in the centrifuge bowl and provide diluted blood, separate the diluted blood into concentrated blood and the wash solution, fill the centrifuge bowl with previously concentrated blood to build a buffy coat, and empty the centrifuge bowl of the concentrated blood and the previously concentrated blood after the buffy coat is reached.

Abstract: A pump with a controller for adjusting head pressure using a pressure boost is provided. The pressure boost may be dynamically adjusted during a surgical procedure based on the device being used and inflow and/or outflow settings.

Abstract: An end effector for use with a surgical instrument includes a plurality of staples, an agent reservoir comprising a medical agent, a dispensing passage configured to convey the medical agent from the agent reservoir to tissue, and a firing system which includes a cutting member, a movable member, and a firing member, wherein the firing system is configured to cooperatively move the movable member and the firing member to simultaneously fire the plurality of staples and dispense at least a portion of the medical agent near the cutting member owing to the advancement of the firing member.

Abstract: A variety of location-based and/or proximity-based features related to diabetes management systems can be used to improve maintenance compliance and/or to provide important information to PWD designated assistance entities (e.g., family, friends, givers, HCPs, emergency medicine providers) under certain conditions. In some cases, a user's location can be tracked or determined to trigger and/or time alerts about upcoming maintenance tasks in a way that will increase the likelihood that the PWD will immediately perform the designated maintenance task. In some cases, methods, devices, and systems provided herein can use proximity to non-paired mobile computing devices to deliver data to PWD designated assistance entities.

Abstract: Pump cassettes, infusion systems, and methods are described. An example pump cassette may include a rigid body comprising a frame portion, a base portion, a compliant membrane disposed substantially therebetween, and two opposing longitudinal edge sections. The rigid body may include a controllable fluid pathway defined in part by the compliant membrane and extending from an inlet port to an outlet port. The pump cassette may include a piston disposed at least partially within the rigid body such that movement of the piston varies a volume of a pump chamber defined within the controllable fluid pathway.

Abstract: An infusion pump includes a pumping mechanism having at least one sensor and a pump motor and a pump control subsystem configured to control operation of the pumping mechanism, the pump control subsystem including a processor, a memory, and a startup module configured to drive the pump motor at a first rate, receive input from the at least one sensor, and drive the pump motor at a second rate based on the input received from the at least one sensor. Startup algorithms command an infusion pump to reach a targeted delivery rate or steady state in minimal time without requiring priming of the pump line or otherwise engaging in known methods of pump startup analysis.

Abstract: A method of infusing and aspirating fluid from the body is provided. The method includes providing a catheter system which includes an inner lumen, the proximal end of which is connected to an infusion mechanism configured to control infusion of a fluid, and an outer lumen, the proximal end of which is connected to an aspiration mechanism configured to control aspiration of fluid from the body. The method also includes activating the infusion mechanism to infuse fluid into the body for a first infusion time period and at a first infusion pressure, disabling the infusion mechanism to stop infusion, and activating the aspiration mechanism to aspirate fluid for a first aspiration time period and at a first aspiration pressure.

Abstract: An intravenous tubing set is provided having a coupling component for accessing a source of flush solution; a flush chamber; a first IV tubing for delivering saline solution from the source of flush solution to the flush chamber; a first flow control device disposed in the tubing between the source of flush solution and the flush chamber to control the flow of flush solution into the flush chamber; a second IV tubing for delivering flush solution to a patient catheter; and a second flow control device disposed in the second tubing between the flush chamber and the patient catheter.

Abstract: Systems and methods for controlling fluid delivery via a manually administrable medication container to a patient through a fluid delivery pathway are provided. The systems and methods described herein incorporate rules-based clinical decision support logic to drive a flow control valve within a flow pathway to determine whether the IV fluid connected to the input port is consistent with medical orders, accepted delivery protocols, and/or specific patient and patient histories. Related apparatus, systems, methods and articles are also described.

Abstract: Infusion systems, infusion devices, and related operating methods are provided. An exemplary method of operating an infusion device to deliver a bolus amount of fluid influencing a physiological condition in a body of a user involves identifying, based on measurement values for the physiological condition, a residual value for the physiological condition resulting from the bolus amount of the fluid and determining an updated ratio for a subsequent bolus by adjusting an initial ratio influencing the bolus amount to compensate for the residual value. The updated ratio may be stored in a data storage element for use in determining a subsequent bolus amount in lieu of the initial ratio value.

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: Certain embodiments of the present invention relate to a pharmaceutical injection device, and it is an object thereof to optimize the mixing of pharmaceutical in a pharmaceutical cartridge. To achieve this object, a pharmaceutical injection device may comprise a main case, a piston, a drive motor, a buzzer, and a controller. The main case has a cartridge holder. The piston is inserted into a pharmaceutical cartridge mounted to the cartridge holder. The drive motor drives the piston. The buzzer emits a sound that tells the user to shake the pharmaceutical cartridge to mix or dissolve its contents. Before activating the drive motor and injecting the pharmaceutical, the control unit controls the buzzer so that a sound is emitted at specific intervals to prompt shaking.

Abstract: The present invention concerns a drive mechanism (3) for a drug delivery device (1), which comprises a piston rod (40) comprising a first piston rod member (7) and a second piston rod member (8). The drive mechanism (3) further comprises an adjustment member (9). The drive mechanism (3) has a first state in which the first and the second piston rod member (7, 8) are moveable with respect to each other by operating the adjustment member (9), thereby adjusting the length of the piston rod (40), and wherein the adjustment member (9) is arranged at least partially inside the second piston rod member (8). Moreover, the present invention concerns a method for assembling the drug delivery device (1).

Abstract: The invention relates to a disposable drug delivery device for selecting and dispensing a number of user variable doses of a medicament. The device comprises a housing, a cartridge holder for retaining a cartridge containing the medicament, a piston rod displaceable relative to the cartridge holder, a driver coupled to the piston rod, a display member for indicating a set dose and being coupled to the housing and to the driver, and a button coupled to the display member and to the driver.

Abstract: The present disclosure relates to a drive mechanism for an injection device for setting and dispensing of a dose of a medicament, the drive mechanism comprising: an inner body fixable inside a housing of the injection device, the inner body comprising an elongated shaft extending in an axial direction (z) and having an outer thread, a tubular-shaped display member having an inner thread engaged with the outer thread of the inner body, and a dose member axially displaceable between a dose setting position (S) and a dose dispensing position (D) relative to the display member, wherein the display member comprises at least one blocking member movable in axial direction (z) between a blocking position (B) and a release position (R) and engageable with a blocking structure on the outer circumference of the inner body, wherein when in blocking position (B) the blocking member axially engages with the dose member and with the blocking structure to block an axial displacement of the dose member from the dose settin

Abstract: The invention relates to a drug delivery device comprising: a syringe with a body from which a needle extends and an inner sheath; a piston rod comprising a piston and an actuation head, a support sheath for holding the body. It is envisaged that the support sheath and the actuation head comprise corresponding indicators.

Abstract: An injector for administering a first and a second liquid or pasty substance, in particular a drug, comprises an outer injector body in which an inner injector body is longitudinally displaceably guided in which a plunger is longitudinally displaceably guided. To improve such an injector, the inner injector body has a cuff which sealingly contacts the inner wall of the outer injector body and which can be flowed around by the second liquid or pasty substance when it is in the end position in the outer injector body.

Abstract: A device (10) is provided for facilitating insertion of a needle or a cannula into a vein of a patient. The device comprises a fluid chamber (23) adapted to be held in operable engagement with a surface of the patient's skin by a fastener (30/34/35) that extends about a limb of the patient. The device is adapted to create a volume of reduced pressure within the fluid chamber, so as to facilitate expansion of an underlying part of the vein. The device enables insertion of a needle or cannula into the expanded part of the vein, whilst the fluid chamber remains operably engaged with the surface of a patient's skin.

Abstract: A patch-sized fluid delivery device may include a reusable portion and a disposable portion. The disposable portion may include components that come into contact with the fluid, while the reusable portion may include only components that do not come into contact with the fluid. Redundant systems, such as redundant controllers, power sources, motor actuators, and alarms, may be provided. Alternatively or additionally, certain components can be multi-functional, such a microphones and loudspeakers that may be used for both acoustic volume sensing and for other functions and a coil that may be used as both an inductive coupler for a battery recharger and an antenna for a wireless transceiver. Various types of network interfaces may be provided in order to allow for remote control and monitoring of the device.

Abstract: In one aspect, an apparatus for measuring peripheral venous pressure includes a tubing having two ends with one end connectable to a fluid source and the other end connectable to a vein, a fluid controlling device configured to have an on position and an off position, and at least one pressure sensor configured to measure fluid pressures therein. When the fluid controlling device is in the on position, fluid flow in the tubing is allowed to pass through the fluid controlling device, such that the at least one pressure sensor measures both a fluid pressure from the fluid source and a distal venous pressure from the vein. When the fluid controlling device is in the off position, no fluid flow in the tubing is allowed to pass through the fluid controlling device, such that the at least one pressure sensor measures the distal venous pressure from the vein only.

Abstract: The technical problem of the present invention to provide a medical device, which exhibits an increased safety of the device and facilitates a safe use is solved by medical device for delivering at least one drug agent, comprising a sensor, a control unit and an attachable dispense assembly, wherein the sensor is configured to detect attachment of the dispense assembly to the medical device, wherein the control unit is configured to determine at least based on a signal from the sensor whether the end of life of the dispense assembly is reached and wherein the medical device is configured to indicate the end of life of the dispense assembly. The technical problem is further solved by a method according to the invention.

Abstract: A method and system for a drug delivery device with multiple status indicators is disclosed. For example the device may include an operator indicator and/or second indicator. The indicators may be seen in one location. For example they may be viewed through one optical path. Optionally the operator indicator may attract attention. The operator indicator may give information that is pertinent to operation of the device to an operator of the system. The operator indicator may have an encoded output signal. Optionally a second indicator may convey information that is not conveyed by the user operator by the operator indicator, for example information that is not pertinent to the regular operation of the machine. Alternatively or additional, the second indicator may function at times when operator indicator is not functioning.

Abstract: This invention relates to apparatus used to alter the temperature and humidity of gases. The apparatus of the present invention comprises an insufflator, humidifier and transportation means connected to delivery means to deliver humidified and heated gases to a body cavity prior to and during a medical procedure. In one form of the present invention the insufflator and humidifier are contained in the one housing, while in another form the humidifier is located proximal and external to the insufflator. The transportation means that delivers the humidified gases to the body cavity comprises a flexible tubing having located within, throughout or around it heating means. The heating means may be a heat conductive wire, a ribbon of PTC material, or a conducting wire extruded into the walls of tubing, where the tubing may be made from a PTC material or flexible plastics.

Abstract: Described herein are introducer devices and methods for using an introducer device to facilitate passing an endoluminal instrument to a target region of a body cavity. An introducer device may include a tubular member having an inner wall that defines a channel configured to receive the endoluminal instrument and a plurality of projections disposed in the channel at perimetrically spaced apart locations around the inner wall, where the projections extend inward and are configured to offset the endoluminal instrument from the inner wall, thereby creating a space between the endoluminal instrument and the inner wall. A method for using an introducer device may include passing the endoluminal instrument to a first instrument insertion depth within the introducer device, advancing the introducer device in the body cavity, and advancing the endoluminal instrument to a second instrument insertion depth within the introducer device.

Abstract: [Subject] A test substance application system for animal experiment capable of administering a required amount of a test substance uniformly and reliably from a nose or a mouth into a nasal cavity or into a lung of an experimental animal is provided. [Means for Solution] The system includes a respiration monitoring device 2 that monitors a respiration state of an experimental animal detected by a respiration pick-up device 1 to thereby measure a timing upon switching from an expiratory phase to an inhalatory phase and outputs a trigger signal T at that timing, and an application device 3 that sprays a predetermined amount of a test substance into a nasal cavity or an oral cavity of the experimental animal when the trigger signal T is outputted from the device 2.

Abstract: The present invention relates to methods for operating a respiration apparatus and a respiration system, and also a respiration apparatus and a respiration system. The respiration system comprises a respiration apparatus and a computer software program for an external computer to operate the respiration apparatus. The respiration apparatus comprises a processor device and an apparatus software program and an apparatus configuration. The validities of the computer software, the apparatus software and the apparatus configuration are in each case characterized by a version. The versions are compared with one another to detect a version conflict. If invalid versions are present, the computer software is provided with a program component with a limit value and a plausibility rule, or the setting parameters are sorted into a first group and a second group. The setting parameters of the first group are retained.

Abstract: A flow generator and humidifier construction is described, including a flow generator construction adapted to reduce noise output compared to known flow generators of comparable size. The flow generator includes a chassis forming first and second muffler volumes and a venturi-shaped connection portion, and a metal/polymer composite material blower enclosure which suppresses noise from the blower. The flow generator may be programmed to include a reminder system including a menu from which the user may request a reminder to take specific action, e.g., replace a component, call a physician, and/or enter patient data card, etc.

Abstract: The present disclosure pertains to a mechanical ventilator system configured to deliver a pressurized flow of breathable gas to the airway of a subject. The system is configured to generate the pressurized flow of breathable gas according to a volume control mode therapy regime that delivers a target tidal volume to the subject during inhalation. During an individual inhalation, the system is configured to determine and/or adjust an inspiratory pressure level of the pressurized flow of breathable gas of the volume control mode therapy regime. The inspiratory pressure level is adjusted such that during the inhalation the inspiratory pressure level is not reduced to impede respiratory effort by the subject responsive to the target tidal volume being exceeded during the inhalation. The system comprises one or more of a pressure generator, a subject interface, one or more sensors, one or more processors, a user interface, electronic storage, and/or other components.

Abstract: A low-cost CPAP apparatus in which, upon detection of the transition from inhalation to exhalation, the blower motor is de-energized to allow it to freewheel. When the pressure in the patient mask (or whatever interface is utilized) reaches a minimum pressure level during exhalation, the motor is re-energized and its speed is controlled so to maintain the pressure at a level suitable for exhalation. Upon detection of the transition from exhalation to inhalation, the motor speed is increased to provide higher pressures in the patient mask suitable for inhalation.

Abstract: Techniques for emergency apneic oxygenation include a cannula having a longitudinal inner passage with an inner diameter. A distal portion has a first outer diameter greater than the inner diameter, and is made of shape memory material shaped to bend in a first direction along the inner passage. A cannula base has a second outer diameter greater than the first outer diameter. A distance from a distal end of the cannula to a proximal end of the distal portion of the cannula is less than a distance from a surface of a throat of a subject to a distal surface of an airway of the subject. The inner passage is configured to pass a catheter connected at a proximal end to an oxygen source. In various embodiments, the cannula is used with a trocar and, optionally, a system base, or supplied in a kit with a catheter.

Abstract: A surgical instrument system for use in a surgical procedure is disclosed. The surgical instrument system may include an instrument configured to puncture the tissue of a patient and detect when the instrument has entered a lumen of the patient's body. Liquid may be present in the lumen or the lumen may be devoid of liquid or tissue. The instrument is configured to determine when the needle tip is engaged with a portion of patient's tissue and determine when the needle tip has exited that portion of the patient's tissue by detecting changes in properties of the tissue, specifically, electrical resistance.

Abstract: Disclosed is a transtracheal ventilation device including at least one base plate with an opening and comprising a tubular connecting part with a channel and a central axis. The base plate and the connecting part are connected to each other such that a lumen, when inserted into the device, extends into the channel through the opening along the central axis to a fixing element (a fastening). The fixing element can be pivoted relative to the central axis. The fixing element is arranged at a distance of at least 5 millimeters along the central axis from a base plate face which faces away from the fixing element, and the opening has an inner diameter which is at least 20% larger than an outer diameter of the lumen at least on a first plane perpendicular to the central axis.

Abstract: A patient interface, including a mask assembly and a headgear assembly, provides improved facial sealing and improved ease of use. The mask assembly includes an inflating or ballooning seal. The seal can be secured between two portions of a snap-fit exoskeleton. The headgear assembly connects to the mask assembly with flexible straps during course fitting and with more rigid straps following course fitting. The straps include holes that fit over a tapering post on the mask assembly.

Abstract: The invention concerns a nasal cannula assembly (10) adapted to deliver gases to a patient comprising a first compartment (1) and a second compartment (2) separated by a separation wall (6); a pair of nasal prongs (5) in fluid communication with the first compartment (1); the first compartment (1) comprising a first inlet (11) for introducing a first gas into said first compartment (1); the second compartment (2) comprising a second inlet (2) for introducing a second gas into said second compartment (2); and the separation wall (6) comprising at least one flow restriction element (35) for controlling the passage of gas from the second compartment (2) to the first compartment (1).

Abstract: A system for generating nitric oxide can include an apparatus positioned in a trachea of a mammal, the apparatus including a respiration sensor for collecting information related to one or more triggering events associated with the trachea, an oxygen sensor for collecting information related to a concentration of oxygen in a gas, and one or more pairs of electrodes for initiating a series of electric arcs to generate nitric oxide, and the system for generating nitric oxide can also include a controller for determining one or more control parameters based on the information collected by the respiration sensor and the oxygen sensor, wherein the series of electric arcs is initiated based on the control parameters determined by the controller.

Abstract: A humidifier includes a water receiving chamber enclosed by a main body and a bottom plate, the water receiving chamber is divided into a gastight liquid reservoir chamber and a heating chamber communicated with exterior environment by a vertically disposed partition plate. A passage for communicating the liquid reservoir chamber and the heating chamber is disposed adjacent to the bottom plate. A baffle extending toward the bottom plate from a top wall of the main body is disposed in the heating chamber, there is a gap between the baffle and each of a circumferential sidewall of the heating chamber and a level of liquid in the heating chamber. A circumferential sidewall of the baffle, the partition plate and the top wall collectively form a backflow tank. When the humidifier and a respirator including the humidifier are tilted, the water inside the humidifier does not flow out.

Abstract: Systems and methods for treating a lung of a lung of a patient. One embodiment of a method comprises positioning a leadless marker in the lung of the patient relative to the target, and collecting position data of the marker. This method further comprises determining the location of the marker in an external reference frame outside the patient based on the collected position data, and providing an objective output in the external reference frame that is responsive to movement of the marker. The objective output is provided at a frequency (i.e., periodicity) that results in a clinically acceptable tracking error. In addition, the objective output can also be provided at least substantially contemporaneously with collecting the position data used to determine the location of the marker.

Abstract: An efficiently packaged ready to use intermittent urinary catheter. The catheter is retained within a retention chamber having a profile that mimics the profile of the catheter by sealing the upper and a lower films together along a peripheral seal line. The retention chamber includes an enlarged compartment intermediate axial ends of the catheter in which lubricant is stored.

Abstract: An introducer (10) with a steerable distal tip section (17) is disclosed. The steerable distal tip section may comprise an articulation support member comprising a laser-cut pattern of symmetrical elongated apertures in which the shape of each aperture is defined by at least three radii, a central radii being the largest and two end radii being smaller. This pattern of apertures can minimize ovaling of the cross-sectional shape of introducer shaft over the length of the deflectable section. The introducer can articulate in multiple planes. A tension pull wire can allow the introducer to resist directional bias.

Abstract: A medical device control handle has a first actuation assembly and a second actuation assembly, wherein each assembly has a shaft that is axially aligned but not rotationally coupled with the other shaft. The first actuation assembly includes a first actuation member and a clutch mechanism having a friction disk for generating frictional torque in rendering the first actuation member self-holding. The first actuation member has a cam portion adapted to impart translational motion and rotational motion for disengaging the clutch mechanism upon pivotation of the first actuation member, thus allowing rotation of the first shaft to manipulate a feature of the medical device, for example, deflection. The second actuation assembly includes a second actuation member and a translating member that is responsive to rotation of the second shaft so as to manipulate another feature of the medical device. The second actuation member is also self holding.