Abstract: A medicament delivery device for delivering a liquid medicament, the medicament delivery device comprising: a rigid casing containing a deformable medicament container, the deformable medicament container arranged to contain the liquid medicament; a pressurized gas cartridge connected to the rigid casing via a gas valve; wherein the gas valve is releasable to allow gas flow into the rigid casing to cause an increase in gas pressure in the rigid casing so as to compress the deformable medicament container to displace the liquid medicament.

Abstract: The present invention is related to a vaginal drug delivery device and to a vaginal diagnostic device that comprises a first and second rigid member, wherein the first and/or second rigid member comprises a reservoir holding a medicament to be delivered, an opening, and a pump for pumping said medicament out of said opening, and/or wherein the first rigid member and/or second rigid member comprises a diagnostic device for performing an intravaginal diagnosis or measurement therefor. The device further comprises a first flexible member and flexible part, wherein at least one of the first flexible member and the flexible part is at least partially elastic having an elasticity such that the device can be squeezed from an extended shape to a collapsed shape. The device is pre-biased to assume the extended shape when little to no external force is being applied thereto.

Abstract: A fluid reservoir for a fluid ejection head structure and a method for priming a fluid ejection head for a fluid dispensing device. The fluid reservoir includes an enclosed fluid cavity therein configured for containing fluid, a fluid outlet in fluid flow communication with the enclosed fluid cavity, and a flow inducing pump attached to the fluid reservoir opposite the fluid outlet.

Abstract: The present invention is related to the field of fluidic devices, and in particular, microfluidic cell culture systems. The present invention provides pumping, recirculation and sampling for a microfluidic device or devices. The present invention provides solutions to the control of microfluidics for both terrestrial and space applications, including the control over the movement of fluids in zero gravity or microgravity.

Abstract: Methods and devices for handling a fluid and delivering the fluid to the eye. The device has a vibrating element with a plurality of openings through which a fluid is ejected when the vibrated. An enclosure defines a chamber which holds a single application of the fluid. The enclosure may be biased against the vibrating element with a spring load developed in whole or part by the resilient structure of the enclosure. The chamber may be substantially empty after the single application.

Abstract: An optical decoding system including an optical sensor integral with or attachable to a housing of a drug delivery device and configured to be directed at first and second rotatable components of a dose setting and dispensing mechanism of the drug delivery device and a processor configured to: (i) cause the optical sensor to capture images of the first and second rotatable components at least at the beginning and end of a medicament dose dispensing process; (ii) determine a rotational position of both the first and second rotatable components in each of the captured images; and (iii) determine from the rotational positions of the first and second rotatable components an amount of medicament delivered by the dose setting and dispensing mechanism of the drug delivery device.

Abstract: A retrograde disposable intravenous (IV) set is disclosed. The IV set includes a diverter housing between upper and lower portions of a fluid line, the diverter housing including a lower end and an upper end extending away from the lower end and the fluid line to a syringe port located in the upper end, and a diverter member within the diverter housing and configured to move within the diverter housing from a first position, at which a first opening through the diverter member forms a first fluid pathway between the upper portion and the lower portion of the fluid line, to a second position, at which the first fluid pathway is blocked and a second fluid pathway is formed between the upper portion of the fluid line and a syringe port. Retrograde infusion may occur when the diverter member is in the second position.

Abstract: An electrohydraulic microjet drug delivery device includes: a discharge body provided with a power supply unit in which electric energy is stored; and a medicinal fluid delivery body detachably attached to the discharge body, the medicinal fluid delivery body including a pressure generation unit configured to store a pressure generation liquid, a medicinal fluid storage unit configured to store a medicinal fluid, an elastic separation membrane installed between the pressure generation unit and the medicinal fluid storage unit and configured to separate the pressure generation liquid and the medicinal fluid, a discharger installed inside the pressure generation unit so as to be submerged in the pressure generation liquid and configured to generate a spark using the electric energy stored in the power supply unit, and a nozzle kept in communication with the medicinal fluid storage unit.

Abstract: Fluid infusion systems such as a portable fluid infusion device includes a housing configured to accommodate a removable fluid reservoir. The housing has a largest dimension and a smallest dimension. The portable fluid infusion device includes a drive system configured to be serially coupled to the removable fluid reservoir such that a combined dimension of the drive system and the removable fluid reservoir is less than or equal to the largest dimension. The portable fluid infusion device includes a planar battery configured to supply power to the drive system. The planar battery has a plurality of faces comprising one or more faces having a largest area, and the planar battery being situated such that the one or more faces are parallel to the largest dimension and the smallest dimension.

Abstract: The present invention relates to a therapeutically active compound for the treatment of a medical condition, wherein the therapeutically active compound is administered in liquid formulation via the vagina by using an intravaginal ring.

Abstract: An anesthesia vaporizer system includes a sump chamber, a variable volume reservoir within the sump chamber, and an anesthetic vaporizer. The variable volume reservoir is configured to contain anesthetic agent. A pressurized gas source is connected to the sump chamber and configured to maintain a constant pressure within the sump chamber to compress the variable volume reservoir to force the anesthetic agent through the anesthetic vaporizer, which vaporizes the liquid anesthetic agent for delivery to a patient.

Abstract: An administration system for delivery of a pharmaceutical composition to a patient has a delivery device configured to deliver a dose of the pharmaceutical composition to the patient and a notification device in communication with the delivery device. The notification device is configured to communicate information about a status of at least one property of the delivery device. The delivery device can be a wearable automatic injector configured to be worn on the patient's skin. The delivery device of the present disclosure may allow a user or the patient to view a status of a container. For example, the delivery device of the present disclosure may provide a simple and effective visual means of displaying fill confirmation and delivery confirmation.

Abstract: An apparatus includes a housing, a medicament container and a movable member. The medicament container is movable within the housing between a first position and a second position in response to a force produced by an energy storage member. A proximal end portion of the medicament container includes a flange and has a plunger disposed therein. A first shoulder of the movable member exerts the force on the flange to move the medicament container from the first position to the second position. A portion of the first shoulder deforms when the medicament container is in the second position such that at least a portion of the force is exerted upon the plunger. A second shoulder of the movable member exerts a retraction force on the flange to move the medicament container from the second position towards the first position.

Abstract: A drug delivery device has a housing with an adhesive pad associated with the lower surface of the housing and configured to removably attach to a human body surface. A drug reservoir is positioned within the housing and includes an outlet with a valve, with a needle fluidically connected to the reservoir and configured to define at least a portion of a fluid flow path between the reservoir and the human body surface. A controller is configured to control the components of the drug delivery device to execute a drug delivery routine. The drug delivery device also includes pressurized fluid positioned to apply a force to the reservoir. The controller moves the valve from a closed condition to an open condition during a drug delivery routine to allow the pressurized fluid to deform the reservoir or move a plunger to convey the drug out of the reservoir via the outlet.

Abstract: Disclosed herein are wearable drug delivery devices and methods for component positioning of a linear shuttle pump. In some approaches, a pump may include a pump chamber operably coupled with a piston, and a detent apparatus, wherein the detent apparatus comprises a detent body, a detent arm, and a detent engagement member. The detent engagement member may be retained in direct physical contact with first or second arrest locations of either the detent body or the detent arm. The pump may further include a piston grip coupled to the piston, the piston grip including a grip component engaged with an exterior of the piston. Movement of the piston grip may cause the piston to move axially relative to the pump chamber to control receipt and delivery of a liquid drug.

Abstract: A device for injecting contrast agent includes a supply line with a pressure regulator and leading to a soft injection bag in fluid communication with the supply line and with a catheter. The device also includes a pair of clamping plates acting on the injection bag and arranged on opposite sides of the injection bag. The clamping plates can be moves away from and close to each other. The device also includes a pair of inflatable compression bags. The compression bags are inflated with compressed air and act on corresponding clamping to plates to force the clamping plates to move close to each other and thus compress the injection bag. According to a method of the invention, the injection bag is filled from the source through the pressure regulator and a constant volume load container, and a contrast agent is supplied from the injection bag by gradually compressing the injection bag.

Abstract: Disclosed herein are wearable drug delivery devices and methods for component positioning of a linear shuttle pump. In some approaches, a pump may include a pump chamber operably coupled with a piston, and a detent apparatus, wherein the detent apparatus comprises a detent body, a detent arm, and a detent engagement member. The detent engagement member may be retained in direct physical contact with first or second arrest locations of either the detent body or the detent arm. The pump may further include a piston grip coupled to the piston, the piston grip including a grip component engaged with an exterior of the piston. Movement of the piston grip may cause the piston to move axially relative to the pump chamber to control receipt and delivery of a liquid drug.

Abstract: A repeater system may control a pump by using a repeater and a user interface. An adhesive patch system may be used for affixing a pump or other object to a human body. Such an adhesive patch system may include two sets of adhesive members, each member including an adhesive material on at least one side so as to attach to the body. The members of the first set are spaced to allow the members of the second set to attach to the body in spaces provided between the members of the first set, and the members of the second set are spaced to allow members of the first set to detach from the body without detaching the members of the second set. Also, fill stations and base stations are provided for personal pump systems.

Abstract: Systems and methods of micro-infusion of medical fluids are disclosed. Micro-infusion systems may include a pump, a patient interface, tubing between the pump and the interface, and a micro-infusion device along the tubing. A first portion of the tubing above the micro-infusion device is longer than a second portion of the tubing below the device. The micro-infusion device may include a chamber in-line with the tubing, a first valve between the chamber and the first portion of the tubing, a second valve between the chamber and the second portion of the tubing and a third valve between the chamber and a dump chamber. The second valve may be slidably disposed within the chamber. A medical fluid may be provided into the chamber that slides the second valve displacing another fluid in the chamber through the third valve into the dump chamber.

Abstract: The present invention is related to a vaginal drug delivery device and to a vaginal diagnostic device that comprises a first and second rigid member, wherein the first and/or second rigid member comprises a reservoir holding a medicament to be delivered, an opening, and a pump for pumping said medicament out of said opening, and/or wherein the first rigid member and/or second rigid member comprises a diagnostic device for performing an intravaginal diagnosis or measurement therefor. The device further comprises a first flexible member and flexible part, wherein at least one of the first flexible member and the flexible part is at least partially elastic having an elasticity such that the device can be squeezed from an extended shape to a collapsed shape. The device is pre-biased to assume the extended shape when little to no external force is being applied thereto.

Abstract: The invention relates to an ablation catheter which controls the temperature and reduces the coagulation of biological fluids on an electrode of a catheter, prevents the impedance rise of tissue in contact with the electrode, and maximizes the potential energy transfer to the tissue, thereby allowing an increase in the lesion size produced by the ablation. The electrode includes passages positioned to allow saline flow out of an inner cavity of the electrode. This fluid flow is pulsatile to increase turbulence, reducing areas of stagnant flow, and produces a desired cooling effect.

Abstract: Gas-powered fluid injection systems and methods are disclosed, e.g., for delivering fluids into a patient's body. An injection device comprises a driver housing which forms and/or encloses a gas pressure source, an actuation piston driven by the gas pressure source and a hydraulic fluid pressurized by movement of the actuation piston. The hydraulic fluid flows through an adjustable valve into a plunger lumen which pushes a plunger of a fluid dispensing device, such as a syringe, to dispense an injection fluid, such as a medicament. The injection device has a movable plunger sleeve which receives the plunger of the fluid dispensing device. The plunger sleeve is moved during the activation and de-activation of the injection device such that it relieves residual pressure in the fluid dispensing device thereby preventing the fluid dispensing device from continuing to dispense injection fluid after the injection device has been de-actuated.

Abstract: Disclosed herein is an apparatus for cooling a sterile liquid for use in cryotherapy, the apparatus comprising: a first chamber (202) adapted to receive a removable container (201) of sterile liquid and a fluid port for receiving a fluid for applying, in use, pressure to a received removable container (201); and a second chamber (203) comprising a cooler; wherein the first chamber (202) is arranged to be in thermal conductivity with the second chamber (203) such that, in use, the contents of the first chamber (202) are cooled by the cooler of the second chamber (203). Advantageously, embodiments provide a system, heat exchanger unit within the system and method for supplying a sterilised working fluid to a catheter system for cryotherapy, the working fluid being supplied at a desired and easily controllable temperature and flow rate.

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

Abstract: A device (1) for dispensing a fluid, in particular to a patient, comprising a container (15), in particular an at least partly collapsible container, with an interior (17) for receiving the fluid. The container (15) comprises a closure piece (20) which is rigidly arranged in the container (15) in particular and on which a dispensing opening (24) is formed, wherein the fluid can be dispensed out of the interior (17) through the dispensing opening. The device (1) comprises a pump device (40) driven by a pump drive (50) in order to pump the fluid out of the interior (17) of the container (15). The pump device (40) is fluidically arranged between the interior (17) and the dispensing opening (24) so that the fluid can be pumped out of the interior (17) to the dispensing opening (24) by the pump device (40).

Abstract: The invention relates to a needleless injection device, containing at least one membrane, or a corresponding device for needleless injection of a substance, having at least one membrane, with which a powdered, gel-like or liquid agent, in particular an active agent, can be injected in a needleless manner into a tissue or a body by means of high impact speed. The invention also relates to a method for such a needleless injection device containing a membrane, and use thereof.

Abstract: An electronic drug compliance monitoring system and associated methods utilize a pill having an electronic transmission capability and external means for receiving that transmission to sense the presence of the pill in the patient's body or digestive tract.

Abstract: Disclosed is a medicine ingestion state management method capable of objectively managing medicine ingestion states of patients. The medicine ingestion state management method involves an operation of prescribing medicine (10) encapsulating, together with a medicament, a medicine information transmitting unit (20) having a function of transmitting medicine information capable of specifying a type and a quantity of the medicament to each individual patient, and an operation of grasping the medicine ingestion state of each patient by collecting the medicine information from each medicine information transmitting unit (20) in each patient.

Abstract: A device introduced small volumes of fluid for delivery to a patient through a fluid line. The device includes a first arm adapted to receive a syringe and a second arm fluidly connected to an upstream reservoir that defines an internal volume adapted to receive a volume of fluid. The device includes a fluid obstruction mechanism configured to selectably block flow of fluid from the reservoir toward the patient, wherein the fluid obstruction mechanism transitions between a first state that permits fluid flow from the reservoir toward the patient and a second state that directs fluid flow from the syringe into the reservoir while blocking fluid flow from the reservoir toward the patient.

Abstract: Systems and methods of micro-infusion of medical fluids are disclosed. Micro-infusion systems may include a pump, a patient interface, tubing between the pump and the interface, and a micro-infusion device along the tubing. A first portion of the tubing above the micro-infusion device is longer than a second portion of the tubing below the device. The micro-infusion device may include a chamber in-line with the tubing, a first valve between the chamber and the first portion of the tubing, a second valve between the chamber and the second portion of the tubing and a third valve between the chamber and a dump chamber. The second valve may be slidably disposed within the chamber. A medical fluid may be provided into the chamber that slides the second valve displacing another fluid in the chamber through the third valve into the dump chamber.

Abstract: Apparatus and methods to treat skin defects include a pump with reservoirs for a pressurization gas and a fluid. Upon activation, the pump generates a gas introduced into the gas reservoir, a movable wall of which displaces a movable wall of a fluid source, thus dispensing the fluid into the dressing to spread throughout irrespective of orientation of the dressing, maintaining a transport fluid (e.g. carrier) in the dressing and in contact with a skin defect being treated. The dressing may have a distribution network, and multiple members, dispensing the fluid into the dressing and in contact with a skin defect being treated.

Abstract: Some embodiments of an infusion pump system may be configured to detect when at least one component of the pump system is exposed to an impact above a threshold level. In particular embodiments, the infusion pump system can be equipped with a drive system detection system configured to detect when one or more components of the drive system are damaged or inoperable.

Abstract: A medical pump provides programming to assist a patient in complying with treatment schedules involving varying dosages of medicament(s). The pump includes stored treatment schedules and protocols that describe control of flow control device(s) for delivering different medicines according to the protocols and which may provide reminders and instructions to the patient.

Abstract: Apparatus and methods may be provided to monitor performance of an intraosseous device, including a system comprising an intraosseous device, a sensor contained within a tip of the intraosseous device, a monitor configured to record a signal from the sensor, and an electrical conductor coupled to the sensor and configured to transmit the signal from the sensor to the monitor. The tip of the intraosseous device may be configured to penetrate bone and bone marrow such that the tip is disposed in the bone marrow. In certain embodiments, the tip may also include a side port for delivering fluids into the bone marrow.

Abstract: An autoinjector includes a main body having a container, the container having a drug therein, a hollow needle coupled to the container through which the drug can be delivered. The autoinjector also has a power source having a liquefied gas therein as a driver, a flow regulator, and at least one outlet through which some of the driver can exit the power pack in a gaseous state. The power source and container are coupled together for operation such that, when an injection is initiated, the flow regulator will control an exit rate of the driver such that the liquefied gas in the power source is maintained at substantially its vapor pressure and the power source will adjustably apply a force to deliver the drug via the hollow needle at a delivery rate that is a constant delivery rate.

Abstract: The invention relates to an ablation catheter which controls the temperature and reduces the coagulation of biological fluids on an electrode of a catheter, prevents the impedance rise of tissue in contact with the electrode, and maximizes the potential energy transfer to the tissue, thereby allowing an increase in the lesion size produced by the ablation. The electrode includes passages positioned to allow saline flow out of an inner cavity of the electrode. This fluid flow is pulsatile to increase turbulence, reducing areas of stagnant flow, and produces a desired cooling effect.

Abstract: A medical device includes a first housing portion (FHP) and a second housing portion (SHP) configured to be to be movable relative to each other from a first position to operatively engage at a second position to couple at least one of a drive device and a needle-inserting device supported by one of the FHP and the SHP to a reservoir supported by the other of the FHP and the SHP. Electronic circuitry configured to detect at least one of a first magnetic interaction between a magnet and at least one of a first magnetically attractive material and a first magnet-responsive device and a second magnetic interaction between the magnet and at least one of a second magnetically attractive material and a second magnet-responsive device, and to provide a signal or a change in state in response to detecting at least one of the interactions.

Abstract: An apparatus includes a container, a needle, and an actuation assembly. The container contains a dose of a naloxone composition having a delivered volume of at least about 0.34 mL. The actuation assembly includes an energy storage member that produces a force on a movable member to move the needle and to deliver the dose of the naloxone composition. The 90% confidence interval of at least one of the relative mean maximum naloxone plasma concentration after dose delivery into the body (Cmax), time to reach the maximum naloxone plasma concentration (Tmax), area under the plasma concentration-time curve from pre-dose (time 0) extrapolated to infinity (AUC0-?), or area under the plasma concentration-time curve from pre-dose (time 0) to the time of the last quantifiable concentration (Tlast) (AUC0-t) of the delivered dose to a delivered dose of a corresponding naloxone composition delivered via a manually-actuated syringe is within 80% to 125%.

Abstract: Embodiments of the invention include an implant having an energy converter, wherein the converter is designed to convert applied energy to heat. In embodiments of the invention, the energy converter is situated in such a way that heat generated from the energy conversion is active at an outer surface of the implant.

Abstract: An apparatus for cleansing wounds, in which wound exudate is removed from a wound bed and selectively cleansed and returned to the wound. The cleansing means removes materials deleterious to wound healing, and the cleansed fluid, still containing materials that are beneficial in promoting wound healing, is returned to the wound bed. The associated wound dressing and cleansing means are conformable to the wound, and may have irrigant fluid circulated from a reservoir by a device for moving fluid through a flow path which passes through the dressing and a means for fluid cleansing and back to the dressing.

Abstract: Various types of supporting structures, supporting devices, attachment mechanisms and attachment techniques may be provided to support and/or stabilize an intraosseous device installed at a target site in a patient. Various methods and procedures may also be provided to releasably engage a supporting structure or supporting device proximate a target site. Apparatus and methods may be provided to monitor performance of an intraosseous device during communication of drugs, medications and/or fluids with an intraosseous space.

Abstract: An irrigation system for providing a continuous and controlled flow of a fluid. The system includes (a) a reservoir system having a main longitudinal axis and a plurality of containers of fluid; (b) a fluid transfer system in fluid connection with said reservoir system and includes at least one fluid transfer head, adapted to transfer fluid from one of said plurality of containers to an external tubing system; and (c) at least one connector between said container and said fluid transfer head. Each fluid transfer head has a mechanism adapted to linearly move each of said fluid transfer heads along said main longitudinal axis. Each container comprises a neck and a nipple. Each connector is reversibly coupled to said irrigation system and comprises: a lower section comprising two arcs, the distance between the centers of said arcs substantially equal to the distance between the centers of said neck and said nipple.

Abstract: A pumping device that can be used with currently-available pressure bag infusers is disclosed. The pumping device is hand-held and lightweight. The device is controlled by a microprocessor. Thus constant pressure to the bag is maintained through automatic adjustment of pumping and venting functions. In addition, a novel, new pressure bag infuser and a modified Luer Lock fitting for use with the pumping device are described.

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: Systems and related methods are provided for measuring a ketone in the fluid of a patient or other user. The systems include a portable measurement device for analyzing a plurality of fluid samples and for generating a corresponding plurality of ketone measurement results. The systems also include an electronic or communications device, for example, such as a cell phone or smartphone, configured to communicate with the measurement device. The system further includes a software application. The systems and related methods according to one aspect provide reminders, preferably interactive reminders that facilitate user compliance with a weight management or diabetic ketoacidosis (DKA) monitoring or prevention program. The systems and related methods according to another aspect incorporate ketone tags and/or trigger points to improve accuracy of results and to advance user compliance.

Abstract: A drug delivery system has a fluid store that has a first tubing having an outlet fitted with a connector of a given configuration that prevents the connector from being coupled to a conventional counterpart connector. The system further has a tube retaining device that has a catheter extending out of one of its ends and an inlet connector at its other end that has a configuration complementary to the configuration of the outlet connector of the first tubing, so that the first tubing may be matingly connected to the tube retaining device to establish a through fluid path from the first tubing to the catheter. A one-way valve may be provided to the tubing to prevent fluid from flowing backwards into the tubing. The tubing can be selectively occluded and opened to regulate the flow of fluid from the tubing to the catheter.

Abstract: An infusion pump assembly is disclosed. The infusion pump assembly includes a locking tab and a pump barrel inside a pump barrel housing, where the pump barrel accommodates a reservoir assembly. The reservoir assembly includes a reservoir and a plunger rod. The infusion pump assembly also includes a locking disc at a terminus of the pump barrel. The locking disc includes a clearance hole for the plunger rod. The locking disc also includes at least one locking tab notch in close proximity with the locking tab. The locking tab is in moveable engagement with the locking tab notch, and the reservoir moves the locking tab from a locked position to an unlocked position when the plunger rod is inserted through clearance hole. The locking disc rotates upon torque being applied to the reservoir assembly, the locking disc rotating from a non-loaded position to a loaded position with respect to the plunger rod and a drive screw.

Abstract: An intravenous medication delivery safety assembly insures proper medication is delivered to a patient. The assembly includes an IV bag holding a medication. A tube has a first end coupled to the bag. A microchip is coupled to the tube proximate a second end of the tube. The microchip provides identifying data corresponding to the medication in the bag. A conduit is selectively coupled to the second end of the tube. The conduit is configured for coupling to a cannula. A security mechanism is coupled to the conduit to prevent coupling the tube to the conduit. A processor is coupled to the conduit and includes confirmation data corresponding to the patient to receive the medication. The processor reads the microchip and is operationally coupled to the security mechanism to permit coupling of the tube to the conduit only when the confirmation data properly corresponds to the identifying data.

Abstract: A micropump device. The micropump device includes a first layer forming a first chamber configured to store a working material, a second chamber defined by a deflectable membrane in fluid communication with the first chamber and configured to deflect in response to a pressure increase in the first chamber in response to a volume increase in the first chamber, the second chamber configured to store a drug compound to be delivered to a subject's vascular system, and at least one needle in fluid communication with the second chamber and configured to penetrate a subject's skin to pump the drug compound in response to the deflection of the deflectable membrane.

Abstract: A drug delivery device having a housing containing a gas generator controlled by an electronic controller. The gas generator generates gas into a reciprocable chamber, whereby reciprocation of the chamber causes a lever to reciprocate a pawl, and this action causes a ratchet to undergo incremental advancement. The device may also be provided with manual control for delivering a bolus dose of drug when necessary.