Abstract: A pen needle assembly is provided herein which includes: a hub having a body with a transverse wall; an arrangement for mounting the hub onto an injector; a first needle cannula extending distally from the transverse wall, the first needle cannula terminating at a distal end, formed for insertion into a patient, with a first lumen extending proximally from the distal end, the first needle cannula being of a first gauge; and, a second needle cannula extending proximally from the transverse wall, the second needle cannula extending from a distal end and terminating at a proximal end with a second lumen extending distally from the proximal end. The first and second lumens are in communication. Further, the second needle cannula is of a second gauge, the second gauge defining a larger external cross-section than the first gauge.

Abstract: A device and method for accessing a pericardial space of the heart includes a shaft having a cavity at a distal end, a suction lumen terminating in a distal port within the cavity and a hollow needle having a distal tip extending into the cavity. The cavity may be a recess in the shaft into which the distal tip of the needle fixedly protrudes. In other embodiments, the cavity is formed by an inflatable member positioned at the distal end of the shaft and the needle is slidable relative to the shaft. Suction is applied at the cavity to draw a pericardial bleb. The needle pierces the pericardial bleb for accessing the pericardial space and also facilitates delivery of payloads into the pericardial space.

Abstract: Devices and methods for gastrointestinal bypass are described. A gastrointestinal bypass device includes a gastrointestinal cuff and a gastrointestinal sleeve. The cuff may be configured to be attached in the esophagus, and may be sufficiently flexible to expand and collapse to conform with the inside of the esophagus to allow the esophagus to function substantially normally. The sleeve is configured to be coupled to the cuff, and may be made of a material that is floppy or flaccid but does not substantially expand radially.

Abstract: The present invention provides compositions and methods for treating a subject in need of treatment with testosterone, including introducing testosterone into the subject subcutaneously, intradermally, or intramuscularly, from a needle assisted jet injection device.

Abstract: Provided is a microneedle device which protects microneedle, has an easily portable shape, is free from such problems as breakage of small needles in the step of puncturing the skin with the microneedle, and ensures appropriate skin puncture for administering a drug. By studying the relationship between a device to be pressed to the skin and the height of an elevation on the skin surface under the pressing and thus producing a device equipped with microneedle that are embedded in a concave part having a definite depth, the microneedle can be surely and easily inserted and punctured into the skin while avoiding such problems as breakage of the small needles of the microneedle. Thus, a microneedle patch formulation, which is easily portable and ensures convenient drug administration to the skin, can be produced.

Abstract: A system for administering pain-free injections includes an electric current source having at least two electrodes attached adjacent an injection site, the electric current source producing a variable numbness pattern and providing a frame of reference for identifying a plurality of sub-areas of the injection site; and a probe applied to the plurality of sub-areas of the injection site for pain-response testing, wherein one or more areas of numbness in the variable numbness pattern are identifiable according to the plurality of sub-areas of the injection site. A fence may be removably applied to the injection site and provide a frame of reference for identifying a plurality of sub-areas of the injection site, and may aid in identifying one or more areas of numbness in the variable numbness pattern. The fence may be removably applied to the injection site via a belt or manual pressure.

Abstract: An injection device that comprises a chamber configured for containing a substance to be injected and a needle operatively associated with the chamber and having a length sufficient to deliver the substance to an intradermal injection site. A collar surrounds the needle, defining a collar cavity. The collar also has a peripheral forward skin-contacting surface that surrounds and is radially spaced from the needle and injection site by an area that is sufficiently large to allow a patient's skin to move into the collar cavity to properly position the needle for intradermal delivery of the substance to the injection site to allow spread of the injected substance under the skin while inhibiting or preventing backpressure within the skin from forcing the substance out through the injection site.

Abstract: The present invention relates to a compression device for stimulating the efflux of a body fluid from a body part. The device has a compression unit with a pressure-application region made of a deformable material, the region being formed to generate a repulsive force between the body part and the compression unit. The repulsive force passes through a force maximum then decreases to serve as an indication that the body part is guided sufficiently firmly and far enough onto the compression unit.

Abstract: An injection device that comprises a chamber configured for containing a substance to be injected and a needle operatively associated with the chamber and having a length sufficient to deliver the substance to an intradermal injection site. A collar surrounds the needle, defining a collar cavity. The collar also has a peripheral forward skin-contacting surface that surrounds and is radially spaced from the needle and injection site by an area that is sufficiently large to allow a patient's skin to move into the collar cavity to properly position the needle for intradermal delivery of the substance to the injection site to allow spread of the injected substance under the skin while inhibiting or preventing backpressure within the skin from forcing the substance out through the injection site.

Abstract: Apparatuses and methods for performing and aiding venipuncture. The apparatuses of the present invention provide the medical practitioner with an improved tool for performing venipuncture methods. The apparatus preferably includes a handle that is connected to a plurality of tines that run roughly parallel to one another. During use, the tines of the apparatus are pressed against the skin of the patient such that they sit astride the vein to be accessed. The distance between the various tines of the present apparatuses varies so as to be able to accommodate a variety of vein widths. The apparatuses of the present invention may have tines at either one or both ends of the body of the apparatus. The apparatuses of the present invention may be used with a variety of vein accentuating devices, such as those that employ light to accentuate the vein to be punctured.

Abstract: A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes.

Abstract: A vascular catheter installer with a syringe holder adapted for use with a catheter syringe is provided for installing an indwelling catheter into a blood vessel. A syringe holder is slidably set on a rigid shaft, allowing a technician to maneuver an attached catheter syringe up and down the shaft. The technician presses down on a finger-hold platform while a stabilizer holds the device in place. The syringe holder can be locked in multiple locations along the shaft and the needle of the syringe can be immobilized within the protective walls of a needle shield for safety.

Abstract: An applicator (100) used to apply microneedle arrays (10) to a mammal. In particular, an application device for applying a microneedle device (120) to a skin surface comprising a flexible sheet (110) having a raised central area (115) attached to the microneedle device and a supporting member at or near the periphery of the flexible sheet, wherein the flexible sheet is configured such that it will undergo a stepwise motion in the direction orthogonal to the major plane of the sheet.

Abstract: A medication delivery device, particularly an intradermal delivery device, having a needle cannula, with a sharpened distal end having a forward tip, and a limiter disposed about the needle cannula. The limiter has a distal end defining a skin engaging surface which is disposed transversely to, and at least partially about, the needle cannula. The skin engaging surface is generally non-flat with generally coplanar portions, and a recess being defined in the skin engaging surface which defines a void in or adjacent to the coplanar portions into which portions of a patient's skin can be deformed into when the skin engaging surface is pressed against the patient's skin. The forward tip of the needle cannula is spaced apart from a plane defined by the coplanar portions a distance ranging from about 0.5 mm to 3.0 mm such that the skin engaging surface limits penetration of the forward tip of the needle cannula to the dermis layer of the patient's skin.

Abstract: A puncture device includes a first base plate; a second base plate; a base plate connection part having flexibility and connecting the first base plate and the second base plate in a horizontal direction; an adhesive means provided to surfaces in a same direction of the first base plate and the second base plate; and a puncture needle moving means provided in the first base plate and movably supporting a puncture needle. The puncture needle is supported away from a surface of the adhesive means a given distance and movable substantially in parallel to the surface of the adhesive means.

Abstract: An injection device that comprises a chamber configured for containing a substance to be injected and a needle operatively associated with the chamber and having a length sufficient to deliver the substance to an intradermal injection site. A collar surrounds the needle, defining a collar cavity. The collar also has a peripheral forward skin-contacting surface that surrounds and is radially spaced from the needle and injection site by an area that is sufficiently large to allow a patient's skin to move into the collar cavity to properly position the needle for intradermal delivery of the substance to the injection site to allow spread of the injected substance under the skin while inhibiting or preventing backpressure within the skin from forcing the substance out through the injection site.

Abstract: The present disclosure is directed to a device for locating a fistula. The device can include a first tine and a second tine each having a distal end and a proximal end with the first tine spaced a distance from the second tine sufficient for allowing a section of a fistula to fit therebetween. A compression member can be placed adjacent to the first tine and the second tine such that the compression member externally compresses and temporarily occludes a fistula thereby increasing blood pressure in a section of a fistula located between the first tine and the second tine.

Abstract: A capsule medical apparatus includes a living tissue drawing portion in which a space for drawing the living tissue into a body of the capsule medical apparatus is formed; a movable unit that includes an engaging unit, which can be engaged with the living tissue of the subject, and that moves on a surface of the body of the capsule medical apparatus and in the living tissue drawing portion; an injection needle that has an ejection port for a drug and that protrudes such that the ejection port is positioned in the living tissue drawing portion; and an injection needle driver that drives the injection needle such that the injection needle protrudes.

Abstract: A skin gripping means for use with an injector (200) is disclosed. In one embodiment the skin gripping means is a needle guard (100). An exterior surface (7) of the skin gripping means (100) is provided with a plurality of fingers (6) adapted to engage a subject's skin (9) when in use. A method of performing a subcutaneous injection is also disclosed with includes the steps of bringing a skin gripping means (100) of an injector (200) into contact with the skin (9) of a subject, moving the skin gripping means (100) substantially parallel to the skin (9) to thereby form a fold (10) in the skin, moving a needle (11) of the injector (200) into the fold (10) to a suitable position for a subcutaneous injection and injecting a substance through the needle (11).

Abstract: An injection device that comprises a chamber configured for containing a substance to be injected and a needle operatively associated with the chamber and having a length sufficient to deliver the substance to an intradermal injection site. A collar surrounds the needle, defining a collar cavity. The collar also has a peripheral forward skin-contacting surface that surrounds and is radially spaced from the needle and injection site by an area that is sufficiently large to allow a patient's skin to move into the collar cavity to properly position the needle for intradermal delivery of the substance to the injection site to allow spread of the injected substance under the skin while inhibiting or preventing backpressure within the skin from forcing the substance out through the injection site.

Abstract: The present invention provides a puncture device and an administration device in which a puncture needle can be stuck certainly to a predetermined region of a skin. The puncture device and the administration device of the present invention are provided with a puncture needle moving means for retaining aforesaid puncture needle to be movable and a skin deforming means for deforming the skin, wherein it is constituted such that the puncture needle is moved by aforesaid puncture needle moving means and punctures the skin deformed by aforesaid skin deforming means.

Abstract: An injection catheter for infusing therapeutic and diagnostic agents into the heart is provided. The injection catheter comprises a catheter body comprising a flexible tubing having proximal and distal ends and at least one lumen therethrough. A tip section comprising a flexible tubing having proximal and distal ends is mounted at the distal end of the catheter body. A needle control handle is provided at the proximal end of the catheter body. An injection needle extends through the tip section, catheter body, and needle control handle and has a proximal end attached to the needle control handle and a distal end within the tip section. The injection needle is longitudinally slidable within the tip section so that its distal end can extend beyond the distal end of the tip section upon suitable manipulation of the needle control handle.

Abstract: The present invention is a Miniature Vein Enhancer that includes a Miniature Projection Head. The Miniature Projection Head may be operated in one of three modes, AFM, DBM, and RTM. The Miniature Projection Head of the present invention projects an image of the veins of a patient, which aids the practitioner in pinpointing a vein for an intravenous drip, blood test, and the like. The Miniature projection head may have a cavity for a power source or it may have a power source located in a body portion of the Miniature Vein Enhancer. The Miniature Vein Enhancer may be attached to one of several improved needle protectors, or the Miniature Vein Enhancer may be attached to a body similar to a flashlight for hand held use. The Miniature Vein Enhancer of the present invention may also be attached to a magnifying glass, a flat panel display, and the like.

Abstract: A pen needle assembly (111) includes an outer shell (151) having a first end adapted to contact a patient's skin at an injection site. A hub (131) is movably disposed within the outer shell. A needle (121) is fixed to the movable hub and has a patient end for piercing the skin at the injection site. An inner shell (171) is disposed within the outer shell and adapted to engage the pen needle assembly with a drug delivery pen (100). A first spring (141) has a first end connected to the outer shell and a second end connected to the inner shell. A second spring (161) has a first end connected to the inner shell and a second end connected to the hub. An adhesive layer (191) is disposed on the movable hub for contacting and raising the skin at the injection site.

Abstract: Apparatuses and methods for performing and aiding venipuncture. The apparatuses of the present invention provide the medical practitioner with an improved tool for performing venipuncture methods. The apparatus preferably includes a handle that is connected to a plurality of tines that run roughly parallel to one another. During use, the tines of the apparatus are pressed against the skin of the patient such that they sit astride the vein to be accessed. The distance between the various tines of the present apparatuses varies so as to be able to accommodate a variety of vein widths. The apparatuses of the present invention may have tines at either one or both ends of the body of the apparatus. The apparatuses of the present invention may be used with a variety of vein accentuating devices, such as those that employ light to accentuate the vein to be punctured.

Abstract: A system and method for delivering fluid into a flexible biological barrier employs a microneedle structure wherein a final position of microneedles (12) inserted into the biological barrier (14) is generally sideways projecting from the delivery configuration instead of the conventional downwards projecting arrangement. The microneedles (12) project from a relief surface (16) which is distinct from a primary biological-barrier contact region (18, 26) of the delivery configuration, and is typically angled upwards away from the biological barrier. During insertion, the contact region (18, 26) is brought into contact with the biological barrier (14) and moved parallel to the surface of the flexible biological barrier so as to generate a boundary (20) between a stretched portion (22) and a non-stretched portion (24) of the barrier.

Abstract: A piercing tool (1) can safely and reliably pierce a piercing needle (411) into a skin layer. The piercing tool (1) comprises a belt-like flexible fixing member (2) having an opening (3) formed for raising skin, and a piercing needle moving means (4) mounted on the belt-like fixing member (2) for movably holding the piercing needle (411). By moving the piercing needle moving means (4), the piercing needle (411) is moved so as to be pierced into the skin raised from the opening (3).

Abstract: An injection apparatus for making an injection at a predetermined depth in skin comprises: a skin positioning member, an injection needle (610), and means guiding the injection needle for movement from a parking position above the skin beside said skin positioning member to slide beneath said skin positioning member to an injection position; wherein: the tip (620) of the injection needle is closer to the longitudinal axis of the shaft portion (650) than is the outside of the shaft portion (650) and/or the length of the lumen opening (625) of the needle is in a range from 5 to 15 times the diameter of the shaft (650) of the needle. An injection needle wherein the length of the lumen opening (625) of the needle is in a range from 5 to 15 times the diameter of the shaft (650) of the needle.

Abstract: The present invention relates to a compression device for stimulating the efflux of a body fluid from a body part. The device has a compression unit with a pressure-application region made of a deformable material, the region being formed to generate a repulsive force between the body part and the compression unit. The repulsive force passes through a force maximum then decreases to serve as an indication that the body part is guided sufficiently firmly and far enough onto the compression unit.

Abstract: Apparatus for use with tissue (22) of a subject, including a substance (24) configured to be injected into the tissue, and first and second tissue-squeezing surfaces (20) configured to be placed on first and second sides of the tissue, to exert pressure on the tissue by being moved toward each other in response to a squeezing force (F), and to facilitate injection of the substance into the tissue by releasing the substance in response to application of the squeezing force.

Abstract: The present invention is a Miniature Vein Enhancer that includes a Miniature Projection Head. The Miniature Projection Head may be operated in one of three modes, AFM, DBM, and RTM. The Miniature Projection Head of the present invention projects an image of the veins of a patient, which aids the practitioner in pinpointing a vein for an intravenous drip, blood test, and the like. The Miniature projection head may have a cavity for a power source or it may have a power source located in a body portion of the Miniature Vein Enhancer. The Miniature Vein Enhancer may be attached to one of several improved needle protectors, or the Miniature Vein Enhancer may be attached to a body similar to a flashlight for hand held use. The Miniature Vein Enhancer of the present invention may also be attached to a magnifying glass, a flat panel display, and the like.

Abstract: A system and method is provided for an injectable substance delivery device comprising a limiter, shoulder or post, that controls how deep the needle is inserted into the tissue. The limiter is sized in proportions that control the maximum insertion depth of the needle into the tissue without excessively restricting the complete insertion of the needle. The system and method further comprises an normalization or stabilizer ring that prevents distortion of the tissue in the vicinity of the infusion, so that the needle length is the major determining factor as to how deep the infusion is delivered.

Abstract: An artery stabilizer device, which is held in place by a technician over a targeted artery using just one or two fingertips of the technician's hand, is provided for stabilizing the artery while the user inserts the needle of a syringe into the artery. A pair of stabilizer fingers, which protrude from the bottom surface of a finger-hold platform, hold the artery in place while the needle is inserted into the artery distal the tips of the stabilizer fingers. In one embodiment, a gauze pad is attached beneath the finger-hold platform, allowing the user to quickly apply a dressing over the wound created by the needle puncture. Another embodiment provides a needle guide between extended stabilizer fingers for stabilizing the needle during the arterial puncture. Each embodiment creates an augmented pulse at the targeted needle insertion site, making it easier for the technician to palpate the pulse there. Arterial line insertions can also be facilitated using this invention.

Abstract: A surgical apparatus is provided including a disposable loading unit selectively operatively engagable within a distal end of a first half-section; and a wound treatment material applicator assembly for delivering wound treatment material to the target surgical site. The disposable loading unit includes a cartridge; a plurality of deployable needles supported within the cartridge, wherein each needle includes a lumen extending therethrough and at least one hole formed in an outer periphery thereof; and an actuation member translatably disposed within the cartridge for delivering a driving force to each needle to deploy the needles from the cartridge. The applicator assembly includes a first and second reservoir supported on the distal end of a respective first and second half-section; and a source of wound treatment material in fluid communication with each reservoir.

Abstract: A piercing tool (1) can safely and reliably pierce a piercing needle (411) into a skin layer. The piercing tool (1) comprises a belt-like flexible fixing member (2) having an opening (3) formed for raising skin, and a piercing needle moving means (4) mounted on the belt-like fixing member (2) for movably holding the piercing needle (411). By moving the piercing needle moving means (4), the piercing needle (411) is moved so as to be pierced into the skin raised from the opening (3).

Abstract: An automatic vaccinator of eggs, consisting of a system for applying vaccine with a vaccine chamber in which vaccine bags are hung and with an air bag that, when expanded, forces the vaccine from the bags and through tubing to a distribution manifold and the injectors, so that the vaccine is delivered to the eggs, is disclosed. A pressure sensor is installed in the distribution manifold and connected to a regulator, measuring the pressure in the distribution manifold at the point farthest from the vaccine chamber and controlling the pressure in the air bag to maintain a uniform quantity of vaccine being injected into the eggs and turning off the vaccinator if the pressure falls below a critical level, signaling that the vaccine bags are empty. The mechanical unit includes a system to support, align and secure the injectors over the egg tray, composed of two plates that work independently, a support plate and an alignment plate.

Abstract: An apparatus for delivering or withdrawing a fluid through at least one layer of the skin is provided. The device may include a body having a top face, a bottom face, a side edge and at least one channel. The bottom face includes a first surface area and a second surface area adjacent to and recessed at a first distance from the first surface area. The bottom face further includes at least one raised protrusion disposed on the second surface area. The protrusion has a height from the first surface greater than the first distance. At least one dermal-access member is provided in the protrusion and is in fluid communication with the channel to deliver or withdraw the fluid.

Abstract: An apparatus for guiding the placement of a subcutaneous device that includes a strap having an indentation configured for a fold of skin and fat layer to be positioned within the indentation as the subcutaneous device is advanced to a desired implantation site.

Abstract: A blood vessel locating and stabilizing device including a transparent planar device that may be used to locate and stabilize a blood vessel so that the blood vessel is less likely to roll when it is punctured with a needle. The device is planar and includes a transparent region and a recess formed in a distal side surface that is configured to locate and stabilize a blood vessel. In a method of using the present device, the planar member is gripped along a first and second major surfaces of the device, the recess is positioned over the targeted blood vessel, and a force is applied to the device so that the blood vessel is located and stabilized.

Abstract: The invention is directed to a method of bonding a hermetically sealed electronics package to an electrode or a flexible circuit and the resulting electronics package that is suitable for implantation in living tissue, such as for a retinal or cortical electrode array to enable restoration of sight to certain non-sighted individuals. The hermetically sealed electronics package is directly bonded to the flex circuit or electrode by electroplating a biocompatible material, such as platinum or gold, effectively forming a plated rivet-shaped connection, which bonds the flex circuit to the electronics package. The resulting electronic device is biocompatible and is suitable for long-term implantation in living tissue.

Abstract: A system and method of treating urinary incontinence including a catheter and injection guide operatively disposed together. At least one needle is operatively disposed within at least one lumen and at least one channel extending through the catheter and injection guide respectively. The injection guide is transformable from a pre-injection configuration for placement in the bladder to an injection configuration for injection of a pharmaceutical such as botulinum toxin into the bladder tissue. Upon introduction of the pharmaceutical to the bladder tissue, symptoms of incontinence are alleviated.

Abstract: A skin retention device 10 for a medical jet-injection unit 20 comprises a contact face provided with adhesive 12 in the area surrounding and close to the injection opening(s) 11 of the nozzle 21 which ensures god contact between the nozzle 21 and the skin 30 of a subject in the area chosen for an injection. Consequently the injection force can be lowered dramatically. In case of two-stage jet-injections, the initial injection force can be lowered because the skin retention close to the injection point significantly reduces the energy consuming elastic expansion of the skin 30 in the injection area, and the second injection force can be lowered because of the high degree of fixed positioning of the injection opening of the nozzle 21 relative to the injection channel in the skin 30 made during the initial injection stage. Thus a high degree of injection safety is achieved, minimizing the risk of whet shots, while skin lift and lower injection force decreases the risk of damage of the underlying tissue.

Abstract: A tissue perforation device and method. The device preferably includes a housing having a housing pass-through, a penetrator securely and sealably positioned so that the penetrator device passes through the housing pass-through, and a vacuum system comprising a vacuum source securely and sealably attached through the housing for advancing a patient's tissue onto the penetrator device.

Abstract: A device (10, 110) for facilitating insertion of a needle or a cannula into a vein of a patient, the device (10, 110) comprising means (20, 120,220) for creating a localised area of reduced pressure at a surface of the patient's skin, so as to facilitate expansion of an underlying part of the vein, and means (26,226) for enabling insertion of a needle or cannula into the expanded part of the vein.

Abstract: A tissue perforation device and method. The device preferably includes a housing having a housing pass-through, a penetrator device securely and sealably positioned so that the penetrator device passes through the housing pass-through, and a vacuum system comprising a vacuum source securely and sealably attached through the housing for advancing a patient's tissue onto the penetrator device.

Abstract: A needle delivery system for electrodes includes a needle and a handle. The needle is configured to be inserted into the human body and to deliver and place an electrode therewithin. The needle is inserted along a direction substantially parallel to the surface of the skin. The handle draws a line of skin upward in a direction substantially normal to the direction of insertion of the needle. The handle includes a guide hole to guide the placement of the needle into the line of the skin.

Abstract: An apparatus for grasping the fundal mucosa and method for delivery of and safe placement of a tissue bulking agent adjacent to the right and left vagus nerve trunk in the lesser curvature of the of the stomach or at the gastroesophageal junction to compress the vagus nerve trunks that control both electrical stimulation of the gastric ghrelin cells, and the parastolic muscular tone of the smooth muscles of the stomach to effect appetite and effect weight loss.

Abstract: Disclosed is a closure catheter, for closing a body cavity such as a vessel, or the left atrial appendage of the heart. The closure catheter includes a plurality of deployable tissue anchors, which may be laterally deployed into surrounding tissue. The anchors may thereafter be used to draw the tissue radially inwardly, to close the body cavity. Methods are also disclosed.

Abstract: Apparatus and method for assisting in choosing a suitable site for a skin invasive action, such as drug injection, e.g. insulin for persons with diabetes, or collecting blood or tissue samples. Measures and processes parameters relating to a specific area part of the skin or subcutis and determines whether the area part is suitable for the skin invasive action based on the processed parameters. Suitable for assisting a person in choosing a site during an injection/sampling procedure, ensuring that skin invasive actions are performed at suitable sites only. Very useful for repetitive skin invasive actions, such as BG measurements and insulin injections. Helps in varying sites for the skin invasive action without the need for keeping a record of used sites manually. Helps in avoiding tissue infiltrations and lipodystrophy.

Abstract: A vein holder to prevent vein roll during vein puncture procedures while also preventing the caregiver from accidentally sticking themselves. The legs of the vein holder are to be adjusted as needed to straddel the size of vein being used. Once placed on the caregiver's thumb and the legs adjusted to the proper width apart, the vein holder is placed on the patient's skin, just over the chosen vein, and pressed down lightly into the patient's skin to hold the vein from rolling left or right. The caregiver's other hand holds the needle and then punctures the vein between the legs of the vein holder. If the needle misses it's mark, for any reason, the caregiver will not stick their own thumb by accident.