Abstract: This document discusses, among other things, systems and methods for managing pain of a subject. A system includes a first sensor circuit to sense a first signal indicative of a functional state of the subject, a second sensor circuit to sense a second signal different from the first signal, and a controller circuit. The controller circuit may determine an operating mode of the second sensor circuit according to the sensed first signal, trigger the second senor circuit to sense the second signal under the determined operating mode, and generate a pain score using at least the second signal sensed under the determined operating mode. The pain score may be output to a patient or used for closed-loop control of a pain therapy.

Abstract: A transfer device designed to extract an amorphous or semi-solid structure, tissue, or construct from supporting media while maintaining the spatial integrity/organizational architecture thereof. The transfer device can include a controller, an actuator assembly, a plunger, and a needle. The controller can move the transfer device and the plunger independently.

Abstract: An automated blood glucose control system, including a processing and control unit capable of predicting, based on a mathematical model, the future trend of the patient's blood glucose G(t), wherein the model takes as inputs: a variable EE(t) representative of the time variation of the patient's energy expenditure; variable IOB(t) representative of the time variation of the patient's quantity of insulin on board; and a variable COB(t) representative of the time variation of the patient's quantity of glucose on board, and wherein the mathematical model is a model of black box type, that is, a non-physiological model only defined by the observation of the effects of input variables EE(t), IOB(t) and COB(t) on output variable G(t), without taking into account the different known physiological mechanisms operating in the patient's body.

Abstract: A bolus is inserted into the rumen of a bovine and includes sensors for collecting the temperature, activity level, and location of the animal over time and circuitry for communicating the collected data to a server that monitors the health, kinetic activity, and location of that animal and perhaps other animals in a herd. The battery of the bolus is continuously recharged in response to the peristaltic contractions of the rumen. The bolus communicates via a local network transmission technology such as Bluetooth to a radio transmitter mounted on the tail of the animal using a tail-mounted bracelet. This transmitter may then communicate the collected data and additional sensor data to the server. Thermal cameras mounted near water troughs, in corridors to milking rooms, or on drones may be used to supplement the data collected by the bolus to provide data indicative of the health condition of the animal.

Abstract: Systems and methods for wireless electronic communication between a medical apparatus and a remote electronic computing device comprise generating and outputting by the medical apparatus an output signal, including: encoding data in the output signal according to a predetermined characteristic of the output signal; receiving and decoding by the remote electronic computing device the encoded data in the output signal; and establishing a pairing between the medical apparatus and the remote electronic computing device.

Abstract: A therapeutic device for treating an acute medical condition of a patient such as cardiac arrest is provided. The device includes one or more sensors that monitor parameters such as heart rhythm that relate to the patient's medical condition. The device also includes a plurality of medication reservoirs, each reservoir including a conduit, wherein each reservoir holds a predetermined medication that may be used to treat the condition. A manifold is connected with the reservoirs via their respective conduits. A delivery line is connected with the manifold to deliver fluids from the manifold to the patient intravenously. One or more medication pumps are in fluid connection with respective ones of the reservoirs. A processor is connected with the sensors. The processor includes a memory that stores processing instructions to interpret the parameters and to determine a recommended medication to deliver to the patient based on the parameters, the recommended medication being one of the predetermined medications.

Abstract: Embodiments relate to a system comprising a drug dispenser; a user interface to receive a user information; a bio-feedback monitoring device to monitor at least one vital of a user as an input to the bio-feedback monitoring device; a communication module; a processor; a database; a memory; wherein the processor is communicatively coupled with the memory; and wherein the processor is configured to: receive a prescription; dispense a drug through the drug dispenser on authenticating the user information with at least one vital of the user and the prescription; update an inventory of the drug through the communication module; log record of dispensing of the drug; maintain a ledger of the record of dispensing of the drug, use blockchain technology. The output of the bio-feedback monitoring device controls a quantity of drug dispensed from the drug dispenser.

Abstract: An apparatus and method for employing the macro- and micro-structure of sleep and similar states of consciousness to optimize pain-treatment are disclosed wherein an objective biomarker of pain-related sleep disturbance guides pain treatment from a sleep perspective. Furthermore, this concept can be extended to states of reduced consciousness such as coma or sedation. Additionally, it could be applied on individuals who are non-communicative due to injury, disease, language issues and/or infancy.

Abstract: The present invention, in some embodiments thereof, relates to a pharmaceutical dispensing system with dynamic and automatic pharmaceutical dispensing regimes and methods thereof.

Abstract: A method may include collecting sensor data related to a quality of health of a patient. The method may include receiving patient input in response to a minimum number of questions for high statistical measurement of three health dimensions of the patient. The method may include generating a health score for each of three health dimensions of the patient. The method may include categorizing the health score for each of the three health dimensions. The method may include determining a minimum category of questions for high statistical measurement of each category of the three health dimensions. The method may include quantifying each of the three health dimensions of the patient per a VAS health score. The method may include generating a health risk score that is based on the health score for each of the three health dimensions. The method may include providing a health risk result to a care-provider.

Abstract: Disclosed are systems and methods for secure and seamless set up and modification of bolus calculator parameters for a bolus calculator tool by a health care provider (HCP). In one aspect, a method for enabling HCP set up of a bolus calculator includes providing a server accessible by both an HCP and a patient; upon login by the HCP, displaying, or transmitting for display, a fillable form, the fillable form including one or more fields for entry of one or more bolus calculator parameters; receiving data from the fillable form, the data corresponding to one or more bolus calculator parameters; and upon login by the patient, transmitting data to a device associated with the patient, the transmitted data based on the received data, where the transmitted data corresponds to one or more of the bolus calculator parameters in a format suitable for entry to a bolus calculator.

Abstract: Gesture-informed patient management systems and related medical devices and operating methods are provided. A method of assisting operation of a medical device using a sensing arrangement capable of detecting physical movement by a user involves detecting a configuration procedure performed by the user in response to output of the sensing arrangement indicative of one or more gestures with respect to the medical device by the user, determining a current state of the user within the configuration procedure based at least in part on the one or more gestures with respect to the medical device relative to a sequence of gestures corresponding to a defined sequence of tasks for the configuration procedure, and providing a graphical user interface display on a client device comprising guidance information influenced by the current state within the configuration procedure.

Abstract: A system includes a catheter, a display system, and a control system in communication with the catheter and the display system. The control system includes one or more processors configured for receiving a set of model points of a model of one or more passageways of a patient and receiving a first set of measured points collected from within the patient passageways. Each point includes coordinates within a surgical environment occupied by the patient. The one or more processors are also configured for generating a first registration between the set of measured points and the set of model points, generating a second registration between a second set of measured points and the set of model points, and determining, after generating the first and second registrations, whether to implement the second registration in place of the first registration.

Abstract: A method may include collecting sensor data and patient data. The method may include receiving input from a patient that provides a quantification of a present health risk assessment of the patient using minimum clicks in minimum categories using a VAS. The method may include receiving patient input including both manual input and sensor output in response to one or more questions directed to a quality of health of the patient. The method may include generating a CCB score with a pre-defined risk stratification. The CCB score may be based on at least two of the patient data, the sensor data, and the patient input. The method may include generating a CCB result. The CCB result may include the CCB score and a risk stratification of the patient based on the pre-defined risk stratification and the CCB score. The method may include providing a CCB result to a care-provider.

Abstract: Infusion systems, infusion devices, and related operating methods are provided. An exemplary method of operating an infusion device capable of delivering fluid to a user involves determining a current amount of active fluid in the body of the user, determining a threshold amount of active fluid in the body of the user, and automatically altering operation of the infusion device to modify delivery of the fluid to the user based on a relationship between the current amount and the threshold amount.

Abstract: A video feed of one or more pupils of a patient can be received and processed to determine a raw measure of pupil size of the one or more pupils over time. Based on this raw measure, at least one of a) a depth of anesthesia for the patient, b) an index of cognitive activity for the patient, and c) a degree of perfusion of an anesthetic being administered to the patient to one or both hemispheres of a brain of the patient can be determined such that one or more actions can be caused to be performed. Related systems, methods, and article of manufacture are described.

Abstract: Methods and apparatus including determining a rate of occurrence of a glycemic excursion event, determining a frequency of an alarm activation associated with the glycemic excursion event, determining an analyte level associated with the alarm activation, and setting an alarm parameter based on one or more of the determined rate of occurrence of the glycemic excursion event, the frequency of the alarm activation associated with the glycemic excursion event or the determined analyte level are provided.

Abstract: A precision triggering mechanism for engaging a portion of a device and a method of using the same are provided. The mechanism comprises an electric linear motor, a force limiter, a force sensor, an engagement slide, and a controller. The electric linear motor includes a drive rod, a driver that applies a force to the drive rod to move the drive rod linearly, and a sensor for detecting a linear position of the drive rod. The force limiter is connected to the drive rod and is configured to absorb an amount of axial force asserted by the drive rod above a maximum amount. The force sensor is connected to the force limiter and is configured to detect an amount of force applied by the force limiter on the force sensor. The engagement slide includes an end extending from the force sensor for engaging the portion of the device.

Abstract: To provide a liquid leakage detection device in which restriction of of a patient is alleviated as compared with the related art while receiving an injection. A liquid leakage detection device 2 detects that an injection solution to be injected into a blood vessel 4 leaks to the outside of the blood vessel 4. The liquid leakage detection device 2 includes a plurality of thermocouples 18 attached to a body surface around a puncture site 16 of an injection needle 12 for injecting the injection solution, an acquisition device 34 which acquires a value indicating a body surface temperature at an attachment point of each of the thermocouples 18 based on an output of each of the thermocouples 18, and a determination device 14 which determines that the injection solution leaks to the outside of the blood vessel when the acquired value deviates from a normal temperature of the body surface temperature at the attachment point.

Abstract: The invention relates to a control device for controlling the administration of propofol to a patient according to the preamble of claim 1 and to a method for controlling the administration of propofol to a patient according to the preamble of claim 4. With a method of this kind a bispectral index (BIS) target value is set which shall be, at least approximately, reached within a patient. A controller then computes a recommended infusion rate of propofol based on the target BIS value and further based on a measured propofol level of the patient for administering propofol to the patient.

Abstract: A distributed system can include a server outside of a clinical environment and a connectivity adapter and a plurality of infusion pumps within the clinical environment. The connectivity adapter can receive from the server a location of an update, such as a drug library update or an operational software update, to be delivered to the infusion pumps. The location can be received over a first messaging communication channel of a network, and the update data can be received over a second, data communication channel of the network. The update data can be stored at the connectivity adapter such that it can be sent to the infusion pumps.

Abstract: A wearable thermometer patch for monitoring healing of a wound on a user's skin includes a circuit substrate comprising an electric circuit and a plurality of temperature probe units distributed in a two-dimensional array. Each of the plurality of temperature probe units can include a temperature sensor in electric connection with the electric circuit in the circuit substrate. The plurality of temperature probe units can measure temperature values on a user's skin at different positions defined by the two-dimensional array.

Abstract: A closed-loop control for a medical therapeutic system is disclosed that includes one or more processes or components for/in the medical therapeutic system, a controller configured to determine whether one or more operations of the process(es) or component(s) are within a corresponding safety envelope, and one or more sensors. The process(es)/component(s) are configured to deliver a controlled amount of a substance, energy or force to a patient. The sensor(s) are configured to measure or determine a value of a measurable parameter of the process(es)/component(s) and/or effected by the operation(s), and provide the value(s) of the measurable parameter(s) to the controller. The controller determines whether each of the operation(s) are within the corresponding safety envelope according to a corresponding function that mathematically describes the operation. The safety envelope corresponds to known safe values of the measurable parameter, or an unmeasured parameter based on the measurable parameter.

Abstract: A method may include collecting sensor data related to health of a patient and receiving input that provides quantification of health of the patient. The method may include generating a first marker based on the sensor data and/or the quantification of the health of the patient including a first dimension indicative of additional examination to be performed. The method may include generating a second marker based on one or more risk algorithms including a second dimension indicative of an acute assessment of issues related to the health of the patient. The method may include comparing the first and/or second markers to a first or second marker baseline. The method may include generating a health result based on the comparison of the first and/or second marker to the first or second marker baseline and providing an alert to a care-provider that includes the health result.

Abstract: A medical fluid delivery system including remote machine updating and control is disclosed. An example medical fluid delivery system includes a first fluid delivery device for a first patient and a second fluid delivery device for a second patient. The medical fluid delivery system also includes a server in communication with the first and second fluid delivery devices and a software application for a mobile device. The software application causes a first icon to be displayed representing the first fluid delivery device and a second icon to be simultaneously displayed representing the second fluid delivery device. The medical fluid delivery system further includes a first communication link between the first and second fluid delivery devices and the server, and a second communication link between the server and the software application. The software application receives status updates from the fluid delivery devices via the server and the first and second links.

Abstract: Systems and methods for processing sensor data and self-calibration are provided. In some embodiments, systems and methods are provided which are capable of calibrating a continuous analyte sensor based on an initial sensitivity, and then continuously performing self-calibration without using, or with reduced use of, reference measurements. In certain embodiments, a sensitivity of the analyte sensor is determined by applying an estimative algorithm that is a function of certain parameters. Also described herein are systems and methods for determining a property of an analyte sensor using a stimulus signal. The sensor property can be used to compensate sensor data for sensitivity drift, or determine another property associated with the sensor, such as temperature, sensor membrane damage, moisture ingress in sensor electronics, and scaling factors.

Abstract: Systems and methods for identifying and treating patients with high frequency electrical signals. A representative method for identifying a patient as a candidate for pain treatment includes identifying a first sensory threshold, delivering an electrical signal to a neural population of the patient at a frequency in a frequency range of 1.5 kHz to 100 kHz and, while and/or after delivering the electrical signal to the patient, identifying a second sensory threshold of the patient. If the second sensory threshold is less than the first, the method can include identifying the patient as a candidate for receiving an electrical signal at a frequency in the foregoing range for pain treatment.

Abstract: A deep brain stimulation device includes a probe having a transparent distal portion, crossed by a channel open at a proximal end of the probe, and also includes electrodes affixed to the distal portion of the probe and electrode terminals affixed to a proximal portion of the probe. Further, the device includes an electrical housing including a channel open at its two ends and housing electrical terminals in contact with the terminals of the probe, and an electrical extension lead affixed to the housing and connected to the terminals of the housing. The channel of the housing is open at the other one of its ends and the device further includes a waveguide at least partly housed in the central channel of the probe, all the way to the distal portion of the probe, and a transmitter housing capable of being connected to the waveguide for the injection of a predetermined wavelength.

Abstract: An example of a system for providing a patient with pain management includes a pain monitoring circuit. The pain monitoring circuit may include parameter analyzer circuitry and pain score generator circuitry. The parameter analyzer circuitry may be configured to receive and analyze one or more timing parameters and one or more baroreflex parameters allowing for determination of baroreflex sensitivity (BRS) of the patient. The one or more timing parameters are indicative of time intervals during which values of the one or more baroreflex parameters are used to determine the BRS. The pain score generator circuitry may be configured to compute a pain score using an outcome of the analysis. The pain score is a function of the BRS during the time intervals and indicative of a degree of pain of the patient.

Abstract: Systems and methods for processing sensor data and self-calibration are provided. In some embodiments, systems and methods are provided which are capable of calibrating a continuous analyte sensor based on an initial sensitivity, and then continuously performing self-calibration without using, or with reduced use of, reference measurements. In certain embodiments, a sensitivity of the analyte sensor is determined by applying an estimative algorithm that is a function of certain parameters. Also described herein are systems and methods for determining a property of an analyte sensor using a stimulus signal. The sensor property can be used to compensate sensor data for sensitivity drift, or determine another property associated with the sensor, such as temperature, sensor membrane damage, moisture ingress in sensor electronics, and scaling factors.

Abstract: In various example embodiments, a system and method for determining an ideal customized beverage for a particular user and generating user-specific instructions to create the beverage. In example embodiments, a beverage request may be received by the system from a network. The system may further receive and store information about a dispenser responsible for creating the beverage and information about the user. The received information may be used by the system to determine a user-specific ideal beverage formulation. The system may further use the determined formulation to generate user-specific composition instructions and export the instructions over a network to the dispensing device.

Abstract: An example system includes a flexible substrate configured to be mounted to a skin surface. The system includes a sensor probe that has a first end attached to the flexible substrate and a second end configured to extend beneath the skin surface to contact interstitial fluid. A sensor is configured to measure a physiological property and is disposed at the second end of the sensor probe. A transmitter is attached to the flexible substrate and is configured to provide information related to sensor measurements to a controller. The controller is configured to a drug delivery rate based on the information.

Abstract: A system and method for patient-adaptive hemodynamic management is described. One embodiment includes a system for hemodynamic management including transfusion, volume resuscitation with intravenous fluids, and medications, utilizing monitored hemodynamic parameters including the described dynamic predictors of fluid responsiveness, and including an intelligent algorithm capable of adaptation of the function of the device to specific patients.

Abstract: A device for the deposition of adipose tissue, comprising: a) a syringe for grafting the tissue, b) a system for controlling the advance of the plunger of the syringe, which receives information about the movement of the syringe in the direction of withdrawal from an external system for detecting the movement of the syringe, and c) an external system for detecting the movement of the syringe. The control system determines the advance of the plunger of the syringe on the basis of the movement of the syringe in the direction of withdrawal and on the basis of the quantity of adipose tissue per unit of length of deposition. The advantages deriving from the use of this device in lipomodelling (or fat grafting) are in an automatic control of deposition of the adipose tissue and a correct uniformity of the graft.

Abstract: A medication delivery system for delivering medicament to a body of a user. The medication delivery system may include a housing having a plurality of medicament reservoirs therein, a first sensor configured to continuously monitor a parameter of the body, and a pump mechanism configured to pump medicament from each of the plurality of medicament reservoirs to a delivery mechanism having a portion disposed within the body of the user.

Abstract: A needle-point pen apparatus and methods for administering a medication. The needle-point pen apparatus can include a barrel, a needle movably disposed within an inner channel of the barrel, the needle having a tip and an elongate shaft. A driving unit is coupled to the needle and provides a driving actuation to the needle. The driving actuation causes the needle to reciprocate within the barrel between one or more extended and retracted positions. The needle being designed to at least partially insert the medication into living tissue. A medication reservoir supplies the medication to the needle for at least partial insertion into the tissue. A computing device controls the needle actuation and the supply of the medication to the needle for controlling administration of the medication at multiple different computer-controlled depths and/or locations of the tissue.

Abstract: Methods and systems are presented for monitoring a clinical procedure using regional blood oxygen saturation (rSO2) of a subject. The rSO2 of a subject is monitored, and clinical information is received, indicating that the subject is undergoing a clinical procedure (e.g., an infusion pump procedure for sodium nitroprusside administration). A change in the rSO2 of the subject is detected, which may be indicative of a circulatory system impairment (e.g., elevated venous oxygen saturation) caused by the clinical procedure. Status information, which may be indicative of an increased risk of a physiological event (e.g., cyanide toxicity) is determined for the subject based on the clinical information and the detected change in the rSO2 of the subject. Corrective actions may be triggered based on the status information in order to reduce the increased risk. The corrective actions may be implemented as smart prompt or closed loop systems.

Abstract: A device that can be placed within or near the cranial vault that fluctuates in size in response to changes in CSF pressure is disclosed. The device diminishes in size when CSF pressures rise and increases in size as CSF pressures diminish. The device has the effect of reducing the flow of CSF occurring in the foramen magnum and provides an alternative to craniovertebral decompression in Chiari I patients. The device may have applications in other neurologic illnesses associated with abnormal CSF flow, such as Idiopathic Syringomyelia, Normal Pressure Hydrocephalus, and CSF dural leaks.

Abstract: A medical fluid infusion system includes a pump system configured to deliver a fluid drug to a patient. The system includes a pump, such as a piston pump, for driving fluid to a patient. One or more pressure sensors are configured to measure and detect changes in fluid pressure in a fluid flow line of the infusion system. The changes in fluid pressure, when detected, can be an indication of proper or improper functioning of a valve system of the pump system of the fluid infusion system.

Abstract: Provided herein are computer-based systems, software, and methods of using the same including a daily patient questionnaire, the questionnaire comprising: a question for determining whether the patient avoided solid food; a question for determining whether the patient had difficulty swallowing solid food; a question for determining what action the patient took to correct or relieve difficulty swallowing food; a question for determining the amount of pain the patient experienced while swallowing food; and a software module configured to apply an algorithm to answers to one or more of said questions to determine a score, wherein said score illustrates one or more selected from the group consisting of: (1) severity, intensity, or frequency of patient dysphagia; (2) suitability of a patient for a particular diagnostic tool, diagnostic method, or therapy for dysphagia; and (3) efficacy of a particular therapy for dysphagia.

Abstract: Disclosed is a device for providing resuscitation or suspended state through redistribution of cardiac output to increase supply to the brain and heart for a patient. The device includes an electrically controllable redistribution component attachable to the patient to provide redistribution of the cardiac output to increase supply to the brain and heart. The redistribution component, following a predefined reaction pattern based on an electrical signal, and computer means configured to: receive a patient data which identifies physiological and/or anatomical characteristics of the patent; and provide the electrical signal for the redistribution component based on the patient data or a standard response. The device may provide mechanisms to protect the aorta and the remaining anatomy of the patient from inadvertent damage caused by the disclosed device in any usage scenario of either correct intended usage or unintended usage. Also disclosed is a method for providing resuscitation or suspended state.

Abstract: A method may include delivering autonomic neural stimulation (ANS) therapy, including delivering stimulation pulses to evoke physiological responses. The method may further include recording physiological parameter values, including recording first population data, the first population data including evoked response (ER) values corresponding to the evoked physiological responses, and recording second population data, the second population data including reference values that include no effect (NE) values corresponding to times without an evoked physiological response. The method may further include quantifying a relationship between the first population data and the second population data, and analyzing the quantified relationship for a signature to indicate if the stimulation pulses are evoking desired physiological responses.

Abstract: An example system includes a flexible substrate configured to be mounted to a skin surface. The system includes a sensor probe that has a first end attached to the flexible substrate and a second end configured to extend beneath the skin surface to contact interstitial fluid. A sensor is configured to measure a physiological property and is disposed at the second end of the sensor probe. A transmitter is attached to the flexible substrate and is configured to provide information related to sensor measurements to a controller. The controller is configured to a drug delivery rate based on the information.

Abstract: The disclosure describes a method and system or controlling symptoms of patients suffering from Parkinson's Disease. In some examples, one or more biomarkers indicative of a patient's present symptoms are determined. The biomarkers may be used to control therapy delivered to the patient in a closed-loop manner. In addition, biomarkers may be used as an indication of therapy effectiveness.

Abstract: A device for delivering fluid to a user includes a housing, a drive motor assembly in the housing, a force sensor, and an electronics module. The drive motor assembly regulates delivery of fluid by actuating a piston of a fluid reservoir, and the force sensor generates output levels in response to force imparted thereto during, for example, fluid delivery operations. The electronics module processes the output levels of the force sensor to assess the operating health of the force sensor, to check for occlusions in the fluid delivery path, and to monitor the seating status of the fluid reservoir.

Abstract: Systems and methods described herein include those for the continual modification of intestinal microbes. Described herein are systems including sampling devices, analysis devices, computational devices and user interface devices as well as methods for the use of such devices in combination.

Abstract: Some embodiments of an infusion pump system can include a controller in which one or more features sets to be provided by the controller are enabled or disabled based upon the particular pump device that is connected to the controller. For example, in some embodiments, one or more advanced features of the controller are available to the user only when a first type of pump device (e.g., having predefined settings stored therein) is connected to the controller, and those advanced features of the controller are disabled when a second type of pump device is connected to the controller.

Abstract: Some embodiments of a portable infusion pump system can be configured to can be configured to adjust the sensitivity of particular detectors or alert systems based (at least in part) on information received from a monitoring device. For example, a glucose monitoring device can communication with an infusion pump assembly used to supply insulin or another medication to a user. In such circumstances, the data received from the monitoring device can be used to adjust the sensitivity of an occlusion detection system.

Abstract: Generally, methods of analyte monitoring management, and articles of manufacturing related thereto, are provided. The methods include receiving analyte measurement data and analyzing the analyte measurement data for health related parameters. Recommendations are determined for creating or modifying a treatment program based on the analysis, and provided within a user-interface that enables a user to create or modify the treatment program. Further, generally, methods of for managing analyte measurement data, and articles of manufacturing related thereto, are provided. The methods include receiving analyte measurement data that represent data collected over a time period, and analyzing the analyte measurement data for analyte episodes within that time period. Threshold based episodes and/or rate-of-change based episodes may be determined.

Abstract: A system for delivery of a volume of infusible fluid. The system includes a controller configured to calculate a trajectory for delivering infusible fluid, the trajectory comprising at least one volume of fluid, and determine a schedule for delivering the at least one volume of fluid according to the trajectory, wherein the schedule comprising an interval and a volume of infusible fluid for delivery. The system also includes a volume sensor assembly for determining the at least one volume of fluid delivered, wherein the controller recalculates the trajectory based on the volume of fluid delivered.