Abstract: A bi-lateral endobronchial suctioning device includes actuating and articulating components that allow a provider to accurately suction both right and left bronchi as well as the trachea in a controlled and safe manner. A control mechanism is used to manipulate the actuating components in tubes forming a suction catheter to flex the tip of the bi-lateral endobronchial suctioning device to the left and to the right when the device is inserted through an endotracheal tube or other similar device, to enable directional control of a catheter for suctioning the lungs or trachea. The device further includes a bronchoalveolar lavage (BAL) port allowing sterile saline or other liquids or fluids to travel down the catheter lumen to assist with breaking up thick secretions which collect in the airways.

Abstract: A fenestrated tracheostomy tube has a shaft (1) made of a silicone or other soft material. The fenestrated region (10) located in the trachea (20) has two rows of several openings (11) along the center line of the tube. The openings (12) are formed in a separate plate (12) of a stiffer material bonded or moulded in an aperture (13) in the shaft (1) of the tube to give the shaft extra stiffness in this region.

Abstract: A suction device has an upper section with an upper end formed as a handle and a lower end shaped as a torus. A lateral component is integrally formed with the suction device and extends from adjacent to the upper end and adjacent to the lower end. The lateral component has a passageway there through. The suction device and the lateral component are fabricated of a generally rigid plastic material. An intubation guide stylet is slidably positioned in the passageway of the lateral component. The top of the intubation guide stylet is positionable above the lateral component and the bottom is positionable below the lateral component.

Abstract: A system for aiding in the proper placement of an endotracheal tube in the trachea of a patent includes an endotracheal tube having a proximal region and a distal region. At least one electrode is included on the distal region to provide an electrical stimulation signal to patient tissue. The system includes a control unit coupled to the electrode and configured to differentiate proper placement of the endotracheal tube in the patient's trachea from improper placement of the endotracheal tube in the patient's esophagus based on a sensed response to the electrical stimulation provided by the electrode.

Abstract: A device for display of medical vision images and video may include a portable display screen and housing. The device may also include a mounting mechanism located on the back of the housing. The mounting mechanism may be configured to removably engage a complementary mounting mechanism on a structure for removably mounting the portable display screen and housing to the structure. The device may also include means for communicatively coupling the portable display screen to one or more optoelectronic vision and illumination modules for control and processing of information.

Abstract: A steerable guidewire. The steerable guidewire is fabricated includes an outer tube, an inner tube, a hub, and a distal articulating region. The steerable guidewire hub can be removed to permit advancement of catheters over its proximal end followed by re-attachment of the hub to permit deflection of the distal end of the steerable guidewire.

Abstract: A mandibular subluxation device (MSD) is provided. The device includes an upper MSD component and a lower MSD component. The upper MSD component includes and upper tooth guide connected to an upper plate having a pair of depending legs. The upper MSD component further includes an upper force receiving plate. The MSD also includes a lower MSD component. The lower MSD component includes a lower tooth guide connected to a lower plate. The lower MSD component further includes a lower force receiving plate. The upper and lower MSD components are connected in a way that allows relative longitudinal movement between the two components between a neutral position and a plurality of extended positions. A ratchet mechanism inhibits movement of the lower plate from any extended position toward the neutral position. The ratchet mechanism may be manually disengaged to allow the lower MSD component to return to the neutral position.

Abstract: Apparatus for providing breathing assistance, the apparatus including a body including a recess for receiving teeth of a user to thereby position the body within an oral cavity of the user, a first opening extending beyond lips of a user to allow air from outside the oral cavity to be drawn in through the opening, a second opening provided in the oral cavity to allow air to be directed into a posterior region of the oral cavity and a channel connecting the first and second openings, the channel extending through at least part of a buccal sulcus of the user.

Abstract: Disclosed herein is a guide wire insertion device for a catheter procedure. The guide wire insertion device for a catheter procedure includes an injection unit (100) including an injection needle, and a guide wire transfer unit (200) which transfers a guide wire so as to insert the guide wire through the injection needle, and the injection unit and the guide wire transfer unit are integrated with each other so as to continuously perform injection of the injection needle and transfer of the guide wire. According to such a configuration, the injection of the injection needle and the insertion of the guide wire may be accurately and easily performed so that a catheter procedure is convenient.

Abstract: An optical assembly is configured for use with an endotracheal tube insertion device and includes a flexible member with an elongated body having a substantially cylindrical shape, a distal end, and a proximal end. An endotracheal tube is carried by the flexible member, and an endotracheal tube retention tab extends outwardly from the flexible member and is configured to allow the endotracheal tube to be positioned and retained therein. The endotracheal tube retention tab has a substantially circular cross-sectional shape, defines a longitudinally extending channel, and includes an elongated slot formed therein. The elongated slot is configured to provide access to the channel and to facilitate removal of the endotracheal tube.

Abstract: The present invention provides improved medical devices equipped with a visualization device for intubation, ventilation, drug delivery, feeding and continuous remote monitoring of a patient. The present invention also provides methods for rapid and accurate placement of a medical device in a patient and continuous real time monitoring, including a remote monitoring, of the patient after the placement.

Abstract: This disclosure describes systems, methods, and apparatus for intubation where indicators of a bougie's axial orientation and insertion depth into the trachea are not visible. In particular, a bougie having one or more tactile indicators of axial orientation and/or depth of insertion are disclosed. The tactile indicators can include finger grooves and/or a ridge to name two examples.

Abstract: A sheath for an endotracheal intubation device includes an elongate flexible portion defining a closed conduit and an adjacent open channel defined by opposing lips for releasably retaining an endotracheal tube, and a rigid portion extending from a distal end of the flexible portion, the flexible portion including a gap in one of the lips adjacent the rigid portion to expose an edge of the rigid portion, the gap allowing the endotracheal tube to be pinched between the edge of the rigid portion and a lip of the flexible portion to enhance retention of the tube when an articulated arm disposed in the closed conduit is curved, and facilitate release of the tube when the arm is not curved.

Abstract: The invention is related to a medical device (1) for conducting a medical examination and/or intervention within a human or animal body, the medical device (1) comprising a handle (2) and a curved guiding bar (3) connected to the handle (2), the guiding bar (3) comprising a guiding duct (4) adapted for guiding a medical instrument (5) from the handle area to a distal end (7) of the guiding bar (3) which is distant from the handle (2), the guiding bar (3) comprising on its distal end (7) a first camera (6) which is integrated within the guiding bar (3) or attached to the guiding bar (3), whereby the first camera (6) is arranged and adjusted for capturing an area (8) in front of the distal end (7) of the guiding bar (3).

Abstract: An improved oscillating positive expiratory pressure (“OPEP”) device, for respiratory therapy having a self sterilizing flow valve capable of insertion into the curved OPEP body without tools or aids. The flow valve is also tear resistant and incorporates a flared reinforced proximal end. To maximize the benefit to patients, the adjustable therapy selector is constrained from withdrawal and is dimensioned to accept commercially available, standardized respiratory fittings adaptors, mouthpieces and “Tees” that are capable of connection to multiple respiratory therapy devices or medicated aerosol delivery units. The aesthetics have been altered by the addition of an arced handle.

Abstract: There is provided herein, a bite block (100) comprising an insertion channel (134) and an airway channel (132) wherein the airway channel is adapted to receive exhaled breath and wherein the first insert channel is adapted to pass a medical instrument. There is provided herein, a bite block comprising an oral insert channel, wherein a portion of said channel opens into a cavity (142) adapted to slidably receive an oral prong (270) the oral insert channel is adapted to receive exhaled breath.

Abstract: A device for holding a tracheostoma device over a tracheostoma of a patient including a passage having a distal and a proximal opening for receiving the tracheostoma device at the distal opening thereof. A flange may extend laterally, caudially, and cranially from the passage. The flange may have a proximal side facing the tracheostoma of the patient and a distal side facing outwardly from the patient. At least a part of said proximal side may include skin adhesive. The flange may have a higher moment of resistance in the caudal/cranial direction than in the lateral/medial direction for said device by having a higher moment of resistance in the caudal/cranial direction than in the lateral/medial direction for at least a part of said flange.

Abstract: A balloon catheter (60) includes an elongated catheter member (63) and an inflatable balloon (65) located adjacent a distal end (5) of the catheter member (63). Band type measuring electrodes (7) located on the catheter member (63) within the balloon (65) include a pair of outer stimulating electrodes (8) and sensing electrodes (9) for measuring the cross-sectional area and volume of the balloon (65) by impedance planimetry measuring. A light emitting diode (20) is located on each measuring electrode (7) for emitting light so that the location of the balloon catheter, and in particular, the measuring electrodes (7) can be detected in a vessel (91) with a translucent wall within the body of a human subject.

Abstract: A training device and related method designed to provide a user or trainee with a realistic tactile sensation or feel for inserting a penetrating device, such as a tracheotomy tube, into the stoma of a subject. The device and method provides a means for providing the user with a high level of initial resistance followed by a relatively quick transition to a lower level of resistance. The resistance will change after the user has pushed the penetrating device past a certain threshold of force or displacement. The resulting transition to a lower level of force, or “pop”, provides the user with a realistic feel to prepare them for procedures on the stoma of an actual subject. A user may then become acclimated to the feel of proper insertion technique. The training device may also be used to train care, cleaning, maintenance, suction, and ventilation of a subject as necessary.

Abstract: A tracheostomy tube assembly includes a flexible tube (1, 1?) and a flexible introducer (2, 2?) within the tube, the introducer having a passage (22) along its length for receiving a guidewire (9) inserted into the trachea (7) through a tracheostomy (6). The tube (1) has an inwardly-projecting collar (17, 17?) at its patient end (11), which engages an outwardly-projecting shoulder (24, 24?) on the introducer (2, 2?) so that the tube does not ride rearwardly along the introducer during insertion. The flexibility of the assembly is such that it can be inserted through the tracheostomy (6) while straight and then curves to follow the guidewire (9) as its patient end enters the trachea (7).

Abstract: An intubation device is provided. An intubation device comprises a movable guide configured to guide an insertion of an endotracheal tube into a trachea of a patient, the guide having a guide extension and a guide tip; an external trachea identifier source external to the trachea and disposed on the patient during an intubation, wherein the trachea identifier source generates and transmits a signal; at least one trachea condition sensor disposed on the guide tip to detect the signal generated by the trachea identifier source; and a guide control device operatively coupled to the guide, the guide control device configured to move the guide into the trachea in response to the detected signal.

Abstract: A medical article, such as a connector fitting, is stabilized on a patient with a retainer having a base and moveable walls. Actuation surfaces configured to move the walls in at least a lateral direction towards each other are suspended above the base by a pair of supports. When pressed together, inner surfaces of the walls form a channel configured to encircle the medical article. The medical article may be pressed down against the actuation surfaces by a medical provider to cause the walls to encircle the medical article. Thereafter, the medical provider may snap the walls together using a latching mechanism to stabilize the medical article on the patient.

Abstract: Tracheal assembly devices include: (a) a mouthpiece sized and configured to allow an endotracheal tube to extend outwardly therefrom; and (b) a cutting blade in communication with an outwardly facing portion of the mouthpiece. The mouthpiece can include at least one outwardly projecting substantially rigid short tube defining an open channel. The short tube can be configured to allow the endotracheal tube to slidably move therethrough. The cutting blade may be held in a handle releasably attached to the short tube.

Abstract: Methods and devices are provided for performing various procedures using interchangeable end effectors. In general, the methods and devices allow a surgeon to remotely and selectively attach various interchangeable surgical end effectors to a shaft located within a patient's body, thus allowing the surgeon to perform various procedures without the need to remove the shaft from the patient's body. In an exemplary embodiment, multiple end effectors can be introduced into a body cavity. The end effectors can be disassociated or separate from one another such that they float within the body cavity. A distal end of a shaft can be positioned within the body cavity and it can be used to selectively engage one of the end effectors. In particular, the device can be configured to allow each end effector to be remotely attached and detached from the distal end of the shaft.

Abstract: An oral device for temporary placement in a patient's oral cavity includes upper and lower jaw braces and a tongue-engaging member. The upper and lower jaw braces are connected so that the lower jaw brace is advanced in an anterior direction relative to the upper jaw brace when the upper and lower jaw braces are closed together. A partial vacuum is drawn in the oral cavity and the vacuum and lower jaw displacement together control the position of the tongue in order to clear the patient's airway to reduce sleep apnea or treat other conditions.

Abstract: In a bilateral bite block, a broad upper component extends bilaterally between a front end and a back end for overlying a person's tongue and at least some of the person's lower molars and for underlying at least some of the person's upper molars. Molar blocks extend downward from both sides of the broad upper component and are disposed for contacting the person's lower molars. A groove is disposed within a top surface of a handle and the broad upper component for receiving an endotracheal tube. An aperture is disposed within the groove in the broad upper component for grasping a received endotracheal tube that can extend within the groove from the handle to beyond the back end of the upper component so that a received endotracheal tube that extends within the groove can contact the person's tongue and thereby enhance the grasp of the endotracheal tube.

Abstract: An oral device for improving airway patency includes a tongue constraint and a negative pressure source. The tongue constraint engages the patient's tongue to maintain a clear region below the palate in an oral cavity and allow an anterior portion of the tongue to rise. By applying a negative pressure in the clear region, an airway behind the soft palate or tongue of the patient can be maintained. The tongue constraint is usually connected to an anchor. The anchor may be held between the patient's teeth or may engage the inferior surface of the palate. Another oral device for improving airway patency includes a lateral tongue structure and a negative pressure source.

Abstract: A system selectively delivers either breath-synchronized, flow-targeted ventilation (BSFTV) or closed-system positive pressure ventilation (CSPPV) to augment respiration of a patient with a standard tracheal tube. A removable adaptor has a cap that can be removably attached to the proximal connector of the tracheal tube in BSFTV mode, and an inner cannula that extends within the tracheal tube to effectively divide it into two lumens. The adaptor includes a ventilator connector for removably engaging a ventilator hose to deliver air/oxygen through the adaptor and one lumen of the tracheal tube with a flow rate varying over each respiratory cycle in a predetermined waveform synchronized with the patient's respiratory cycle to augment the patient's spontaneous respiration. The adaptor also includes a port allowing the spontaneously-breathing patient to freely inhale and exhale in open exchange with the atmosphere through the other lumen.

Abstract: An introducer 40 for guiding an endotracheal tube into a patient's trachea and method for use is provided. The introducer used independently of the endotracheal tube is a malleable elongated tubular body 42 having a proximal end 44 and a distal end 46 and includes an extendible malleable guide member 50 disposed in the bore 48 of the tubular body. Ports 52 are provided in the wall of the tubular body at a point where an operator will normally support the introducer 40 during intubation for contact of the guide member 50 with a finger or fingers of the hand supporting the introducer so that the guide member 50 can be extended without the operator changing the position of the supporting hand while leaving the other hand free for use of a viewing device.

Abstract: A device for removing secretions from an artificial tube is provided. The device may include a clearing catheter and a driving mechanism that may apply repetitive motion to the clearing catheter. In another version of the device, the clearing catheter may dispense irrigation fluid and aspirate the irrigation fluid. The clearing catheter may have an irrigation and an aspiration lumen that may both reciprocate with the clearing catheter. In another version a compliant member into which irrigation fluid is located may be present.

Abstract: The invention relates to a laryngeal mask airway device (1) for insertion into patient to provide an airway passage to the patient's glottic opening, the device (1) including an airway tube (2), a mask (3) attached to the airway tube (2), the mask (3) including a body (4) having a distal end (5) and a proximal end (6), a peripheral inflatable cuff (7), and an outlet (8), the mask (3) being attached to the airway tube (2) for gaseous communication between the tube (2) and the outlet (8), the device (1) further including a structure to prevent occlusion of the outlet (8) by the patient's anatomy, the structure including a support (11), and a conduit (28a) to allow gas to flow out of the outlet (8), past the support.

Abstract: A guidance system for assisting with the insertion of a needle or other medical component into the body of a patient is disclosed. The guidance system utilizes ultrasound imaging or other suitable imaging technology. In one embodiment, the guidance system comprises an imaging device including a probe for producing an image of an internal body portion target, such as a vessel. One or more sensors are included with the probe. The sensors sense a detectable characteristic related to the needle, such as a magnetic field of a magnet included with the needle. The system includes a processor that uses data relating to the detectable characteristic sensed by the sensors to determine a position and/or orientation of the needle in three spatial dimensions. In yet another embodiment, systems and methods for determining the length of the needle to be guided by the guidance system are disclosed.

Abstract: An intubation guide for guiding, positioning and/or insertion of e.g. an endotracheal tube in a patients trachea, and where the intubation guide comprises a relatively flexible guide extending from the distal end of a relatively stiff positioning handle having a curved section between its distal and proximal end, wherein the guide element forms a scoop shaped guide in extension of the positioning handle, and in that the positioning handle comprises an intubation channel extending along the positioning handle, and having a first end near the proximal end of the positioning handle, and the other end at the distal end near the guide scoop.

Abstract: A system for accessing a sinus cavity of a subject includes an access tool configured to penetrate into the sinus cavity from a location external the subject. The system further includes an access sheath having a distal tubular portion, a lumen extending through the access sheath and the distal tubular portion and dimensioned to receive the access tool, the distal tubular portion comprising one or more cutting surfaces disposed about an external surface thereof. The one or more cutting surfaces may include a plurality of longitudinally oriented grooves for flutes disposed about the periphery of the distal tubular member.

Abstract: An imaging system having an imaging assembly having an imaging device for generating imaging signals corresponding to images of anatomy of a patient disclosed. The imaging assembly, which may be a component of a feeding tube assembly, transmits the imaging signals generated to a console, which presents images generated corresponding to the imaging signals on a display. A reference menu is presented on the display including menu items, which correspond to reference materials including photographs, video recordings, audio recordings, diagrams, animations, and/or text. Each of the materials provides information about anatomy, patient preparation, imaging catheter preparation, imaging catheter placement, imaging catheter operation, imaging catheter features, console preparation, console operation, console features, system operation, system features, and/or contact information.

Abstract: A switchable adapter for a suction tube has a manifold, a switching base rotatably connected to a pivot portion of the manifold, an air-tight component mounted between the pivot portion of the manifold and the switching base, and a cover mounted on an end of the pivot portion. The switching base has two connecting tubes. When the switching base pivots relative to the pivot portion of the manifold, the connecting tubes alternatively communicate with the manifold by rotation of the switching base. Thus, the switchable adapter is switched to allow the suction tube to suck sputa out of a trachea of a patient.

Abstract: A medical device is provided for insertion into a cavity of a patient to visual the internal membranes of the patient. The medical device can be an endotracheal tube, a suction tube, a bronchoscope, a tube changer, an esophageal tube, an intubating tube, an esophageal tube in combination with a separate intubating tube, a device for manipulating the position of the epiglottis of the patient, a stylet, or a tube insertable into the vagina of the patient. The medical device has a camera lumen having a sealed window at one end thereof attached thereto, and a separate camera which is insertable into the camera lumen and is removable from the camera lumen. The camera is used to monitor the internal membranes of the patient during the medical procedure.

Abstract: Systems, devices, and methods are disclosed for the cleaning of an endotracheal tube while a patient is being supported by a ventilator connected to the endotracheal tube for the purpose of increasing the available space for airflow or to prevent the build up of materials that may constrict airflow or be a potential nidus for infection. In one embodiment, a mechanically-actuated endotracheal tube cleaning device is configured to removably receive a visualization member to provide cleaning of the endotracheal tube under direct visualization.

Abstract: This invention provides a device for delivering substances such as medical implants and tissues. The device comprises a mandrel and a mandrel guide whereby substances are delivered by retracting the mandrel guide relative to the mandrel. Included among the various embodiments are devices specialized for delivering retinal pigment epithelial (RPE) cells or nanoplates containing RPE cells to the retina, devices with precise control of delivery, devices with specialized mandrels and/or nozzles, and multifunctional devices adapted to provide additional functions such as infusion and/or suction, illumination, and diathermy.

Abstract: Provided is a curvature-adjustable endotracheal tube. The curvature-adjustable endotracheal tube includes: a hollow cylindrical tube body configured to maintain a patient's airway; and a curvature-adjusting wire configured to allow an operator to freely adjust the curvature of the tube body to correspond to the curvature of the patient's airway into which the tube body is inserted. Both ends of the curvature-adjusting wire are respectively fixed to a distal portion and a proximal portion of the tube body such that the distal portion is pulled and bent when the proximal portion is bent by the operator.

Abstract: A collar for a tracheostomy tube, a method of securing a tracheostomy tube to the neck of a patient, and a medical device including a collar for the tracheostomy tube. In one exemplary embodiment, the collar includes a securing portion, a protection portion, and an attachment portion. The securing portion secures the tracheostomy tube to the neck of the patient. The protection portion extends from the securing portion and covers a portion of a flange of the tracheostomy tube. The protection portion is also positioned between the tracheostomy tube flange and the neck skin of the patient when the securing portion is attached to the tracheostomy tube. The attachment portion attaches the securing portion to the tracheostomy tube.

Abstract: Systems, devices, and methods are disclosed for the cleaning of an endotracheal tube while a patient is being supported by a ventilator connected to the endotracheal tube for the purpose of increasing the available space for airflow or to prevent the build up of materials that may constrict airflow or be a potential nidus for infection. In one embodiment, a mechanically-actuated endotracheal tube cleaning device is configured to removably receive a visualization member to provide cleaning of the endotracheal tube under direct visualization.

Abstract: Airway devices are provided for introducing an endoscope into a patient's gastrointestinal system that include a tubular proximal portion sized for placement in an oral cavity and including a passage for receiving an endoscope therethrough, and a curved distal portion. The distal portion may have a “C” shaped wall defining a channel extending from the passage to a distal tip of the distal portion. The proximal portion may include a flange for placement adjacent the patient's teeth when the airway device is inserted into the oral cavity, and the airway device may include sampling and fluid delivery lumens including ports on the face of the flange. The sampling lumen may include an inlet port within the passage, and the fluid delivery lumen may include an outlet port communicating with the channel such that the outlet port is offset distally relative to the inlet port.

Abstract: The present disclosure describes systems and methods that utilize a tracheal tube with an integral visualization device, such as a camera. The tracheal tube system may include a camera apparatus or other visualization device that is associated with a lumen formed in the wall of the tube. In addition, the camera apparatus may be positioned within a holder associated with a distal end of the tracheal tube that functions to hold and position the optical components of the camera relative to the tube and provides an acceptable profile for comfortable intubation. Further, the camera apparatus and its associated holder may include additional components, such as integral light sources and flushing or cleaning devices to remove any buildup from the camera or optical components.

Abstract: The present invention concerns a tracheostomy cannula comprising a cannula tube, wherein the cannula tube has a bend with a radially inward and a radially outward side of the cannula tube and a tube lumen and a tube wall and an axis extending parallel to the tube wall in the tube lumen and a distal and a proximal end and on the radially outward side of the bend a first window region having one or more openings in the tube wall. To provide a tracheostomy cannula having a cannula tube, with which talking is made possible and the entry of air into the tissue is prevented even when the position of the tracheostomy cannula in the trachea or the anatomical conditions change, it is proposed in accordance with the invention that the cannula tube has in axially displaced relationship with the first window region at least one further window region having one or more openings in the tube wall.

Abstract: A device for use with an endotracheal tube. The device includes a shaft having a wall with a flexible region proximate a tip of the shaft. The shaft both distally and proximally of the flexible region is of a higher durometer than the durometer of the flexible region.

Abstract: A surgical instrument includes a hollow cylindrical member having a flexible region along at least a part of the hollow cylindrical member and a malleable tubing disposed over at least an outer surface of the flexible region of the hollow cylindrical member. The flexible region and the malleable tubing disposed over the flexible region can bend multiple times. The malleable tubing can maintain a bent orientation until the malleable tubing is re-bent by a user. The surgical instrument also includes connections that prevent the malleable tubing from moving longitudinally relative to the hollow cylindrical member. The malleable tubing may be made of various materials, one example of which is anodized, annealed aluminum.

Abstract: An introducer guide (19) for an intubation device (21) having an open channel adapted to releasably secure an introducer, and shaped such that advancement of an intubation tube (21) through which the introducer extends causes the introducer to be removed from the introducer guide (19).

Abstract: A device for locating an operational unit within a patient's body within the framework of a minimally-invasive surgery intervention includes a shaft having a distal end carrying an operational unit. The device includes an illuminator located at the distal end of the shaft. The illuminator is selectively adjustable to provide a selectively variable lighting field in correspondence with the operational unit. The device may be, for example, a delivery system for a heart valve or a balloon device for post-dilation of such a heart valve once implanted.

Abstract: A respiratory access assembly includes a distal plate having a port, the port adapted to be positioned in operable communication with an artificial airway of a patient. The assembly also includes a proximal plate including a first port and a second port and, when the distal plate is positioned against the proximal plate in a stacked configuration, each plate is configured to move relative to the other. There is a clutch positioned between the plates, the clutch cooperating with both plates to substantially prevent movement of the plates when the port of the distal plate is positioned in an alignment with at least one port of the proximal plate and an object is positioned through the aligned ports of the plates.