Abstract: An apparatus and associated methods are provided to authenticate a patient based on a biometric identifier of the patient before a prescribed dose of medical therapeutic, such as analgesics or other medication, are dispensed to the patient. Authentication takes places by pressing a button and scanning the patient's fingerprint and recording data corresponding to the fingerprint into memory. To receive the medical therapeutic, the patient can have his or her fingerprint read and compared to the stored fingerprint. If there is a match and the programmed limitations are met (e.g., a time interval has elapsed since the last dose), then the medical therapeutic is automatically dispensed to the patient. The system may be integrated with a new patient-controlled medical therapeutic device or the system may be added to an already existing device. Other features and advantages of the example embodiments are described.

Abstract: An augmented, adaptive algorithm utilizing model predictive control (MPC) is developed for closed-loop glucose control in type 1 diabetes. A linear empirical input-output subject model is used with an MPC algorithm to regulate blood glucose online, where the subject model is recursively adapted, and the control signal for delivery of insulin and a counter-regulatory agent such as glucagon is based solely on online glucose concentration measurements. The MPC signal is synthesized by optimizing an augmented objective function that minimizes local insulin accumulation in the subcutaneous depot and control signal aggressiveness, while simultaneously regulating glucose concentration to a preset reference set point. The mathematical formulation governing the subcutaneous accumulation of administered insulin is derived based on nominal temporal values pertaining to the pharmacokinetics (timecourse of activity) of insulin in human, in terms of its absorption rate, peak absorption time, and overall time of action.

Abstract: A delivery device includes a durable housing portion and a separable disposable portion that selectively engage and disengage from each other. The disposable housing portion secures to the patient and may be disposed of after it has been in use for a prescribed period. Components that normally come into contact with a patient or with infusion media are supported by the disposable housing portion for disposal after the prescribed use, while the durable housing portion supports other components such as electronics for controlling delivery of infusion media from the reservoir and a drive device and drive linkage.

Abstract: A magnetically controlled pump is implanted into the brain of a patient and delivers a plurality of medicating agents at a controlled rate corresponding to the specific needs of the patient. The current invention comprises a flexible double walled pouch that is formed from two layers of polymer. The pouch is alternately expanded and contracting by magnetic solenoid. When contracted, a medicating agent is pushed out of the pouch through a plurality of needles. When the pouch is expanded, surrounding cerebral fluid is drawn into the space between the double walls of the pouch from which it is drawn through a catheter to an analyzer. Cerebral fluid drawn from the patient is analyzed. The operation of the apparatus and hence the treatment is remotely controlled based on these measurements and displayed through an external controller.

Abstract: Surgical fluid management systems and methods of operating surgical fluid management systems which may provide one or more functions associated with suction, irrigation, distention, deficit monitoring, infusion, fluid warming, and the like. Some example embodiments may include infra-red lamps arranged to heat fluid flowing through a disposable cartridge. Some example embodiments may provide a three-dimensional fluid path through the cartridge and/or multi-stage heating capabilities. Some example fluid management systems may be selectable between pressure control and flow control modes.

Abstract: A dialysis system includes: an enclosure; a dialysate pump carried by the enclosure and arranged to pump dialysate to a patient or dialyzer; at least one container connected fluidly to the dialysate pump; a load cell positioned to weigh dialysate located within the container; an accelerometer positioned and arranged to detect a force imparted on at least one of the enclosure and the container; and electronics configured to receive a first signal from the load cell and a second signal from the accelerometer and process the first and second signals so as to determine if an abnormality sensed by the load cell is a system error or a mechanical interference.

Abstract: A system, program product and method continuously optimize an ultrafiltration rate during an extracorporeal renal replacement process by modeling physiological and actual rate data. The system maps the sensed, physiological data to a mathematical model to assess the data in terms of the ultrafiltration rate. The model provides parameters used to predict where the treatment is headed based on current conditions. The system processes the parameters in terms of preset criteria to generate the optimized ultrafiltration rate. Where the system is networked, communication of the data may be accomplished using remote and online communication techniques.

Abstract: This invention provides an apparatus and method for controlling a fluid separation system, preferably a blood apheresis system, by sensing fluid pressure and comparing the sensed fluid pressure to a threshold value.

Abstract: A system is provided for efficiently gelating and injecting a constant amount of biopolymer powder for effectively using biopolymer in sealing, stanching, and prevention of adhesion of a post-surgical site. Powder transfer line 320 for transferring biopolymer powder atomized with the pressure of noninflammable gas in powder agitating container 220, and transfer lines 310, 330 for separately transferring noninflammable gas and solution separately from the powder transfer line 320, are joined at the tip of nozzle attachment 400 for injecting a mixture of the biopolymer powder and the noninflammable gas, together with the noninflammable gas and the solution.

Abstract: An apparatus for pumping fluid through a flexible tubing is provided. The apparatus uses an electromagnet to activate upstream and downstream pinchers to control fluid flow. An armature is configured to compress the tubing, and in combination with the pinchers creates a fluid flow in the flexible tubing. Downstream occlusions in the tubing can be detected by monitoring for conditions wherein the armature does not close fully. Upstream occlusions in the tubing can be detected by monitoring for conditions wherein the armature does not open fully. A control module can be incorporated into the device for controlling the movement of the components and monitoring for occlusion conditions.

Abstract: A system architecture for closed loop control of infusion devices is described. The architecture provides means to control the flow from an infusion device as well as in some embodiments the pressure of the delivery. A variety of infusion systems are described that use the closed loop control architecture. In some embodiments the closed loop control may be adapted to current commonly used infusion means such as a gravity feed intravenous system. Other embodiments describe infusion pump system that use biasing or drive mechanisms of springs, elastomers, rotary and linear motors.

Abstract: A medical fluid pumping system includes a medical fluid pump; a first pressure chamber connected fluidly to the medical fluid pump; a second pressure chamber connected fluidly to the medical fluid pump; first and second pressure sensors connected operably to the first and second pressure chambers, respectively; and at least one processor operable with the pressure sensors to calculate a volume of gas in the medical fluid pump prior to a pump-out stroke using a reading from the first pressure sensor after exposing the pump to gas pressure from the first pressure chamber and to use the calculated volume of gas in combination with a known volume of the second pressure chamber and a pressure decay reading taken via the second pressure sensor during the pump-out stroke to calculate at least one volume of fluid pumped during the pump-out stroke.

Abstract: A fluid delivery system and method for measuring flow at a patient utilizing a differential force sensor in order to precisely control the flow of fluid at very low flow rates. The system includes a fluid line through which a fluid is conveyed to the patient, and a flow controller that selectively varies a rate of flow of the fluid through the fluid line. The differential force sensor can be mounted very close to a point of entry of the fluid into the patient's body. An onboard communications device is controllably coupled to the flow controller and to the force sensor, responds to an output signal, and provides a feedback to the flow controller in a closed-loop process. The system can pump the fluid at a higher frequency until the flow rate is actually reached at the patient and then adjust to the flow rate needed to ensure patient health.

Abstract: The present invention is directed to a system and method for providing care to a patient, comprising a patient care device having a number of configuration databases stored in a memory in the device. Each configuration database preferably includes protocols, operating limits, rule sets and/or operating features that collectively define an operating environment, or personality, of the device. Selection of a specific configuration database preferably is based at least in part upon patient-specific information obtained from any location in a distributed hospital network. Examples of such patient-specific information include patient age or size, patient medical characteristics, a location of the patient or a location of the care device. In a preferred embodiment, programming a patient care device to deliver a drug to a patient entails activating a configuration database and scanning a machine-readable drug label identifying a particular protocol stored in the activated database.

Abstract: A safety interlock for use in a medical device includes a central tubular portion defining a fluid passage for passing fluid through the safety interlock. An outer ring portion is adapted for mounting on the medical device. The outer ring portion is formed of a light transmitting material and includes at least one interposing surface. A connector portion connects the central tubular portion to the outer ring portion so that the outer ring portion is spaced radially outwardly from the central tubular portion in opposed relation with at least a portion of the central tubular portion. The safety interlock device is adapted for mounting in medical device in a path of electromagnetic radiation from a source of electromagnetic radiation for reflecting the electromagnetic radiation to a electromagnetic radiation detector when properly loaded on the medical device.

Abstract: A controller for operating a pumping apparatus to supply fluid to a patient through a pump set includes a processor programmed to instruct a first source of electromagnetic radiation to emit electromagnetic radiation in a direction for striking a safety interlock of the pump set. The processor activates a first electromagnetic radiation detector to detect the electromagnetic radiation emitted from the first source. The processor instructs a second source of electromagnetic radiation to emit electromagnetic radiation in a direction for striking the safety interlock. The processor activates a second electromagnetic radiation detector to detect the electromagnetic radiation emitted from the second source. The processor controls the pumping apparatus to operate for pumping fluid in the pump set only when electromagnetic radiation emitted from the first source is detected by the first detector and when the electromagnetic radiation emitted from the second source is not detect by the second detector.

Abstract: An infusion pump which includes a fingerprint reader to verify that a patient or a user is authorized to activate a patient-controlled analgesic button. The fingerprint reader can be integrated into the patient-controlled analgesic button. The infusion pump delivers a dose of medication to the patient if the fingerprint of the patient or user matches a pre-loaded fingerprint.

Abstract: A micro fluid delivery device is particularly useful in medical applications. The device may be worn or carried by the user and may deliver drugs or other medicaments to the user or patient. The device has a control system that accepts input from the user and controls all aspects of operation of the device. The control system measures the output of the pump and adjusts the output of the pump to achieve the desired dosage rate and size. This eliminates differences from pump to pump that result from inevitable variations in the manufacturing of such small scale affordable devices.

Abstract: Systems and methods are disclosed for detecting or diagnosing diseases by sampling and testing intra-oral fluids.

Abstract: A medical-solution administration device includes a medical-solution reservoir that is filled with at least a medical solution and that feeds the medical solution to a medical solution administration side; a pump that discharges to the medical-solution reservoir a driving liquid that is used in pushing the medical solution filled in the medical-solution reservoir; and a driving liquid reservoir that is filled with the driving liquid, wherein the medical-solution reservoir forms a pipe in which the driving liquid discharged by the pump enters from an opening on one end so that the medical solution is pushed to the medical solution administration side from an opening on other end of the pipe, and a marker is placed between the driving liquid and the medical solution, the marker being used in detecting a pushed quantity of the medical solution pushed by the driving liquid.

Abstract: An ophthalmic injection device has a dispensing chamber housing, a plunger, an actuator for driving the plunger, a temperature control device, and a temperature release mechanism. The dispensing chamber housing has an inner surface and an outer surface. The inner surface partially defines a dispensing chamber for holding a quantity of a substance. The plunger is engaged with the inner surface of the dispensing chamber housing, is capable of sliding in the dispensing chamber housing, and is fluidly sealed to the inner surface of the dispensing chamber housing. The temperature control device at least partially surrounds the dispensing chamber housing and is capable of altering the temperature of the substance in the dispensing chamber. The temperature release mechanism is in a locked position when the substance is outside the proper temperature range and an unlocked position when the substance is in the proper temperature range.

Abstract: The medical device for distributing fluid comprises: a syringe (12) for distributing a contrast product; an actuator (28) which is suitable for acting on the syringe in order to ensure that the contrast product flows at a pressure greater than 30 bar; an injection outlet (14) for injecting the contrast product towards the body of a patient, and being connected to the syringe (12); it further comprises: an inflation outlet (16) for a balloon; a distributor (32) which is connected at the outlet of the syringe (12) and which is suitable for selectively connecting the same syringe (12) to the injection outlet (14) or to the inflation outlet (16); and means (20; 22) for controlling the distributor (32) between a first state which connects the syringe to the injection outlet (14) and a second state which connects the syringe (12) to the inflation outlet (16).

Abstract: An apparatus for extracorporeal oxygenation of a patient's blood during cardiopulmonary bypass surgery. The apparatus comprises a bubble sensor, arranged at or connected to a venous line, for detecting bubbles in the venous blood received from the patient. When air bubbles are detected, a second pump is activated to draw air from an air chamber provided in an air filter connected to the venous line and arranged downstream of the bubble sensor. A first pump draws the blood from the air filter and supplies the blood to an oxygenator and to the patient via an arterial line.

Abstract: A system for use with a drug delivery device includes a sensor unit and a deactivation unit operatively coupled to an output of the sensor unit and to a drug-retaining region of the drug delivery device, wherein the drug-retaining region contains a drug. The sensor unit is configured to detect a characteristic of a local environment and generate an output corresponding to a value of the detected characteristic. The deactivation unit is configured to render the drug ineffective when the output of the sensor unit satisfies a predetermined condition.

Abstract: A system for at least partial closed-loop control of a medical condition is disclosed. The system includes at least one medical fluid pump. The medical fluid pump including a sensor for determining the volume of fluid pumped by the pump. Also, at least one continuous analyte monitor, and a controller. The controller is in communication with the medical fluid pump and the at least one continuous analyte monitor. The controller includes a processor. The processor includes instructions for delivery of medical fluid based at least on data received from the at least one continuous analyte monitor.

Abstract: A patient hydration system with an infusion subsystem responsive to a source of hydration fluid for infusing the patient with hydration fluid. A urine output measurement subsystem determines the amount of urine output by the patient. A setting is received corresponding to an amount of urine to be output by the patient. When or after the urine output measurement subsystem indicates the set amount of urine has been output by the patient, the infusion subsystem is controlled to administer hydration fluid to the patient based on the patient's further urine output.

Abstract: A patient hydration system including an infusion device for administering hydration fluid to a patient, and a hydration fluid measurement device responsive to a source of hydration fluid, a patient urine output measurement device. A controller is responsive to the hydration fluid measurement device and the patient urine output measurement device. The controller operates the infusion device, in response to the patient urine output measurement device and the hydration fluid measurement device, to hydrate the patient based on the patient's urine output. The controller also monitors the operation history of the infusion device thereby providing redundancy in the measurement of the amount of hydration fluid administered to the patient.

Abstract: A breast pump system is disclosed for cyclically applying and simultaneously monitoring the negative pressure imposed while expressing milk from a breast. Structurally, the system includes a breast shield formed with a recess for receiving a breast. Further, a collection reservoir is connected to the recess of the breast shield for receiving milk therefrom. A pump is connected in fluid communication to the recess of the breast shield for applying the negative pressure to the breast. Also, a one-way valve is positioned between the recess and the collection reservoir to permit flow of milk into the collection reservoir while preserving ambient pressure in the collection reservoir. Importantly, a pressure gauge is connected between the pump and the breast shield for monitoring the operational pressure on the breast in real time. Further, a regulator manages the negative pressure applied by the pump in response to the monitored operational pressure.

Abstract: A tool system for operating an irrigation pump. The pump includes a fixed pump head driven by a pump motor and a removable tube set. A readable memory such as a RFID is integral with the tube set. The tube set memory contains data describing the physical characteristics of the tube set. A control console reads the data in the tube set memory. Based on these data, the control console then regulates the operation of the pump motor so that fluid, when required, is delivered at those flow rates. These data are also used by the control console to regulate priming of the pump so that when the system is initially set up a head of irrigation fluid can be pumped close to the end of the handpiece from which the fluid is to be discharged.

Abstract: A micro fluid delivery device is particularly useful in medical applications. The device may be worn or carried by the user and may deliver drugs or other medicaments to the user or patient. The device has a control system that accepts input from the user and controls all aspects of operation of the device. The control system measures the output of the pump and adjusts the output of the pump to achieve the desired dosage rate and size. This eliminates differences from pump to pump that result from inevitable variations in the manufacturing of such small scale affordable devices.

Abstract: An angiographic injector system includes a manifold and valve which selectively connects either a syringe pump or a low pressure system to a catheter which is inserted into a patient. The valve is normally biased to a state which connects the low pressure system to the catheter for pressure monitoring, saline flushing, or aspirating functions. When an injection is to be made, the valve automatically switches so that the low pressure system is disconnected and not exposed to high pressure, while the syringe pump is connected through the manifold to the catheter.

Abstract: A micro fluid delivery device is particularly useful in medical applications. The device may be worn or carried by the user and may deliver drugs or other medicaments to the user or patient. The device has a control system that accepts input from the user and controls all aspects of operation of the device. The control system measures the output of the pump and adjusts the output of the pump to achieve the desired dosage rate and size. This eliminates differences from pump to pump that result from inevitable variations in the manufacturing of such small scale affordable devices.

Abstract: A method is provided of controlling a pump including a electrical motor coupled to a rotor which carries first and second impellers at opposite ends thereof. The method includes: (a) driving the rotor using the motor, so as to circulate fluid from the first impeller through a first fluid circuit, the second impeller, a second fluid circuit, and back to the first impeller; (b) determining a resistance of the first fluid circuit, based on a first motor parameter; (c) determining a flow rate through the first fluid circuit based on a second motor parameter; and (d) varying at least one operational parameter of the pump so as to maintain a predetermined relationship between the flow rate and the resistance of the first fluid circuit.

Abstract: An injection device including at least one sensor for detecting an operating process of the injection device, an electronic circuit connected to the sensor for establishing the beginning and elapsed time of a service life, based on one or more sensor signals, and an output device connected to the circuit for providing a signal indicating the end of the service life. The invention encompasses a method for determining a service life of an injection device, wherein the beginning of the service life is established by one or more sensors for detecting an operating process of the device, a signal is generated which signals the end of the service life, and at least one of an optical, acoustic or tactile output device is associated with the injection device for providing a signal which indicates the end of the service life.

Abstract: The invention is directed to techniques for monitoring the condition of a patient, such as a patient having congestive heart failure, and appropriately modifying the patient's drug therapy as a function of a pressure in the patient's heart, such as the estimated pulmonary artery diastolic pressure. The drugs may be administered by an implanted drug delivery device. The drug selection, the drug dosage or both may be controlled as a function of the pressure and/or the activity level of the patient.

Abstract: A fluid delivery system and method for measuring flow at a patient utilizing a differential force sensor in order to precisely control the flow of fluid at very low flow rates. The system includes a fluid line through which a fluid is conveyed to the patient, and a flow controller that selectively varies a rate of flow of the fluid through the fluid line. The differential force sensor can be mounted very close to a point of entry of the fluid into the patient's body. An onboard communications device is controllably coupled to the flow controller and to the force sensor, responds to an output signal, and provides a feedback to the flow controller in a closed-loop process. The system can pump the fluid at a higher frequency until the flow rate is actually reached at the patient and then adjust to the flow rate needed to ensure patient health.

Abstract: A portable drug administration device includes a pump and a controller configured to control operation of the pump according to a standard administration mode and a suspend mode in which drug administration is temporarily suspended. The device is configured to generate an event trigger on the occurrence of at least one of an error condition and/or the beginning of a maintenance action by the user. The controller is configured to detect the occurrence of the event trigger, and to store, in response to the event trigger, administration data, the administration data comprising all information that characterizes the current administration according at the time of occurrence of the event trigger automatically in a memory and to switch the device from the standard administration mode to the suspend mode.

Abstract: Self-injection system allows a user to inject a drug from a cartridge carrying unique identification information, into any one of a plurality of injection sites. Tissue at each injection site is associated with at least one injection parameter, such as flow-rate, that is different for each site. A scanner reads the identification information of the cartridge and cooperates with a central processing unit to determine the validity of the drug in order to permit an injection procedure to commence. The central processing unit has a memory for storing the different injection parameters and controls a drive unit for driving fluid from the cartridge and through a needle into the selected tissue, at the injection parameter that is associated with the user selected tissue for the injection.

Abstract: A method of adjusting infusion parameters that provide coverage of a selected target volume for direct infusions of a fluid includes using an algorithm for calculation of optimal packing of spheres or cylinders in a selected volume to determine the coverage of the selected target volume.

Abstract: Systems, devices and methods for delivery of a chemical substance to the body of the patient are provided. Such embodiments may include an infusion catheter configured to be inserted into tissue, a catheter securing element configured to be adhered to the skin of the patient and further configured to secure the infusion catheter to the skin, a drug delivery pump configured to infuse a drug into the infusion catheter for delivery to a drug infused region on the body of the patient, and a treatment element configured to apply a treatment to the drug infused region to improve pharmacodynamics of the drug during a period of delivery of the drug to the patient.

Abstract: A pump for rapidly discharging irrigation fluid to a surgical site. The pump includes a cabinet with an opening. Inside the pump there is a static plate and a dynamic plate that extends towards/retracts from the static plate. The space between the plates is a bag well in which a bag containing irrigation fluid can be inserted/replaced through the cabinet opening. A lid covers the opening. A sensor monitors the open/closed state of the lid. A drive motor actuates the dynamic plate. A control unit regulates the actuation of the motor. Only when the lid sensor determines that the lid is closed does the control unit actuate the motor. The dynamic plate can be placed in various open positions relative to the static plate so bags containing different volumes of fluid can be used with the pump.

Abstract: A patient hydration system with a patient urine output measurement device, a hydration fluid administration subsystem, and a controller, responsive to the patient urine output measurement device. The controller is configured to control the hydration fluid administration subsystem to administer hydration fluid to the patient to prevent dehydration of the patient. A hydration sensor is also included to detect at least one patient parameter indicative of the patient's hydration state.

Abstract: An implantable pump (10) is provided for pumping a drug in a patient's body (100). The pump includes a drug delivery chamber (22) configured to be filled with the drug and a drug delivery catheter (50) having a catheter lumen (58) and a distal end (56), the drug delivery catheter in fluid communication with the drug delivery chamber and configured to deliver the drug to a delivery site (102). It also includes a pushing element (44) coupled to the distal end of the catheter, and configured to push away from the catheter lumen fibrotic matter that has developed in response to the drug delivery catheter. Other embodiments are also described.

Abstract: A movement and control mechanism for operating a syringe is disclosed. The movement mechanism comprises a rotatable shaft, at least one rod disposed coaxially to the shaft and a plunger associated unit, accommodating the plunger of the syringe and axially translated upon the rotation of the shaft. An electrical sensor system implemented with the movement mechanism for detecting the plunger of the syringe, during the operation of the mechanism, is further disclosed. A control system for the movement mechanism, controlling the operation the thereof is disclosed as well.

Abstract: A portable therapeutic apparatus and a method for controlling the apparatus are provided. In one aspect the apparatus and the method can be implemented using a patch unit (100, 200) removably attachable to a cradle unit (20), said cradle unit removably attachable to the body of the patient; a position detector (1000) comprising a patch portion (900) and a cradle portion (800), said patch portion coupled to the patch unit, said cradle portion coupled to the cradle unit; a processor adapted for receiving a position indication signal from the at least one position detector, said position indication signal corresponding to a physical proximity of the patch portion to the cradle portion, —and, wherein the portable therapeutic apparatus is adapted for at least one therapeutic function selected from the group consisting of delivering a therapeutic fluid into the body of the patient and sensing a bodily analyte.

Abstract: Techniques for control of fluid delivery from a fluid reservoir by a medical infusion pump are described. Setting of at least one electronically-controllable pumping parameter is determined by the use of one or more mechanical keys. The mechanical key actuates one or more electronic switches of a mechanical key receptacle coupled to the medical infusion pump. The electronic switches are coupled to the medical infusion pump to control the at least one electronically-controllable pumping parameter. Keys can be differently configured to actuate different switches corresponding to particular settings and can include display indicia showing the particular parameter value set by the key.

Abstract: A micro fluid delivery device is particularly useful in medical applications. The device may be worn or carried by the user and may deliver drugs or other medicaments to the user or patient. The device has a control system that accepts input from the user and controls all aspects of operation of the device. The control system measures the output of the pump and adjusts the output of the pump to achieve the desired dosage rate and size. This eliminates differences from pump to pump that result from inevitable variations in the manufacturing of such small scale affordable devices.

Abstract: A patient hydration system with an infusion subsystem which infuses fluid into a patient and a urine output measurement subsystem for measuring the amount of urine output by the patient. A controller is configured to control the infusion subsystem and is responsive to the urine output measurement subsystem. The controller includes a balancing function which controls the infusion subsystem to administer fluid infused into the patient to balance the urine output with the fluid infusion. The controller also includes a taper down function which controls the infusion subsystem to administer fluid infused into the patient at a rate less than the rate of urine output by the patient.

Abstract: A pump set for use with a pump to deliver a supply of liquid to a patient. The feeding set has a conduit for the nutrient liquid and a safety interlock device associated with the conduit. The pumping apparatus has a pumping device and a control system for controlling operation of the pump. An electromagnetic radiation source is operatively connected to the control system of the pump for emitting an electromagnetic radiation signal in a direction for striking the safety interlock device of the feeding set. The safety interlock device is adapted to affect the direction of the electromagnetic radiation. An electromagnetic radiation detector is operatively connected to the control system for receiving the electromagnetic radiation signal when the direction is affected by the safety interlock device, and providing an indication to the control system that the feeding set conduit is properly positioned in the feeding pump.

Abstract: A pump to deliver bone-growth factors to a carrier matrix within a patient. Pump can be internal or external. With external pumps, additional amounts of the same growth factor may be added, or the bioactive agent may be changed during the course of treatment. An external pump permits the use of cells to promote bone growth. The pump can have several reservoirs and the pump can itself be received in the carrier matrix with an outlet tube or other structure to defuse the growth factors into the carrier matrix. The pump protocol can be used for slow-to-heal fractures, such as closed fractures, and can be used for slow-to-heal patients.