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1. (WO2019032934) RECONSTITUTION DEVICE, SYSTEM, AND METHOD TO ADMINISTER A DRUG IN A MODERATE BOLUS
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TITLE

RECONSTITUTION DEVICE, SYSTEM, AND METHOD TO ADMINISTER

A DRUG IN A MODERATE BOLUS

CROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims priority to U.S. Patent Application No. 15/673,813, filed August 10, 2017, and entitled RECONSTITUTION DEVICE, SYSTEM, AND METHOD TO ADMINISTER A DRUG IN A MODERATE BOLUS, the contents of which is hereby incorporated into this specification in its entirety.

BACKGROUND

[0002] Medical therapy often requires the intravenous administration of, for example, fluids to correct electrolyte imbalance, medicated solutions to deliver medication, and/or nutrients to provide nutrition to patients unable to receive oral or enteral nutrition. Intravenous ("IV") fluids are generally available in aseptic single- or multi-chamber flexible containers that include an administration port and a medication port. An IV administration set is typically inserted into a flexible container (e.g., an IV bag) via the administration port to allow administration of the fluids from the flexible container to the patient. Likewise, medications and/or nutrients can be injected, into the flexible container, via the medication port.

[0003] Certain active agents, such as medications and nutrients, which are unstable in liquid form, are stored in dry form. For example, active agents may be unstable at the pH of the IV fluid, susceptible to light, etc., thus requiring dry form storage. Typically, dry form active agents may be stored in glass vials, sealed with rubber stoppers, or other containers such as plastic containers, ampoules, or small bags that may be closed with standard screw caps. Prior to being administered to a patient, these dry form active agents are reconstituted. Reconstitution typically includes removing a protective cover to expose the rubber stopper, wiping the stopper with an antiseptic wipe, adding diluent to the vial by inserting a needle of a syringe through the rubber stopper and depositing the contents of the syringe, such as diluent, into the vial, and shaking the vial to fully dissolve or suspend the active agents. Subsequently, the resulting reconstituted solution or suspension is withdrawn from the vial by inserting a needle of a syringe through the rubber stopper, aspirating the solution or suspension into the syringe, and injecting the contents of the syringe into the flexible

container via the medication port. Some medications and nutrients, however, begin to degrade as soon as they are mixed into the flexible container. Ascorbic acid, vitamin B 1 , and vitamin C, for example, degrade in total parenteral nutrition mixtures, while vitamins A and E degrade in parenteral nutrition mixtures upon exposure to light.

[0004] An improved system and method for using a reconstitution device to administer medications, especially quickly degrading medications, is needed accordingly.

SUMMARY

[0005] To improve the administration of medications, especially those that degrade quickly, a new patient medication delivery paradigm must be implemented. Implementing a new and alternate way of medication administration requires, for example, a new and alternate reconstitution device, system, and method. More specifically, a reconstitution device can be configured to establish a fluid pathway between a source (e.g., an IV bag) and a location (e.g., a patient). Along this fluid pathway, a drug (e.g., a powdered drug, a lyophilized drug, or a liquid drug) may be introduced, via reconstitution device connectivity with a drug container, such as a drug vial.

[0006] In light of the disclosure herein, and without limiting the scope of the invention in any way, in a first aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, a reconstitution device includes a piercing member, a delivery member, a collar, and a cap. The piercing member has a first end and a second end. The first end of the piercing member is configured to engage an administration port. The delivery member has a first end and a second end. The first end of the delivery member is configured to engage a delivery site. The collar is configured to engage a vial. The cap extends from the collar and holds the piercing member and the delivery member, such that the second end of the piercing member and the second end of the delivery member are disposed within the collar.

[0007] In a second aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the cap is formed integrally with the collar.

[0008] In a third aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the collar is cylindrical and is configured to concentrically engage the vial.

[0009] In a fourth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the collar engages with the vial, such that the piercing member is in fluid communication with the vial and the delivery member is in fluid communication with the vial.

[0010] In a fifth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the administration port is an IV bag port, and the first end of the piercing member is configured to pierce the IV bag port.

[0011] In a sixth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the delivery site is an IV line, connectable to a patient, and the first end of the delivery member is configured to connect to the IV line.

[0012] In an seventh aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, when placed in an operating position, each of the piercing member and the delivery member are oriented vertically.

[0013] In a eighth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the first end of the piercing member is formed integrally with the administration port.

[0014] In a ninth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the administration port is connected to an IV solution container.

[0015] In an tenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, at least one of the first end of the piercing member, the second end of the piercing member, and the second end of the delivery member includes a syringe needle.

[0016] In an eleventh aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, a reconstitution system includes a drug vial, a fluid container, and a reconstitution device. The reconstitution device includes a piercing member, a delivery member, a collar, and a cap. The piercing member has a first end and a second end. The first end of the piercing member is configured to engage the fluid container. The delivery member has a first end and a second end. The first end of the delivery member is configured to engage a delivery site. The cap extends from the collar and holds the piercing member and the delivery member, such that the second end of the piercing member and the second end of the delivery member are disposed within the collar.

[0017] In a twelfth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the collar engages the vial, such that the piercing member is in fluid communication with the vial and the delivery member is in fluid communication with the vial.

[0018] In a thirteenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the fluid container holds a fluid, such that the fluid may travel from the fluid container into the first end of the piercing member, through the piercing member, from the second end of the piercing member into the vial, from the vial into the second end of the delivery member, through the delivery member, and from the first end of the delivery member to the delivery site.

[0019] In a fourteenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the vial contains an active agent.

[0020] In a fifteenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the active agent is a pharmaceutical agent or a nutritional supplement.

[0021] In a sixteenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the fluid container is an IV bag and the delivery site is an IV line connectable to a patient.

[0022] In a seventeenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, an infusion pump is in operable communication with the IV line.

[0023] In a eighteenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, the fluid container is formed integrally with the reconstitution device.

[0024] In a nineteenth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, a method of using a reconstitution system includes enabling a piercing member and a delivery member to be

placed in simultaneous communication with an inside of a vial. The method further includes enabling fluid from a container to be introduced, via the piercing member, into the vial to mix with an agent located within the vial to form a mixed drug. The method further includes enabling the mixed drug to be delivered from the vial together with fluid from the IV bag, via the delivery member.

[0025] In a twentieth aspect of the present disclosure, which may be combined with any other aspect listed herein unless specified otherwise, enabling the mixed drug to be delivered from the vial, via the delivery member, includes enabling a distal end of the delivery member to be connected to a tube that is connectable to a patient.

[0026] In light of the disclosure and aspects set forth herein, it is accordingly an advantage of the present disclosure to provide a reconstitution system ensuring that administration is performed as a moderate bolus by delivering the reconstituted drug directly to the IV administration set.

[0027] It is another advantage of the present disclosure to provide a reconstitution system reducing drug degradation by reconstituting the drug and immediately delivering it to the IV administration set.

[0028] It is a further advantage of the present disclosure to provide a reconstitution system ensuring that it is a ready-to-use application by being configured to accept vials directly.

[0029] It is yet another advantage of the present disclosure to provide a reconstitution system avoiding the tedious preparation steps involved with typical dried drug reconstitution by accepting vials directly.

[0030] It is yet a further advantage of the present disclosure to provide a reconstitution system ensuring that drug prescriptions and deliveries are not inadvertently missed by medical professionals by pre-plugging the vial.

[0031] It is still another advantage of the present disclosure to provide a reconstitution system ensuring passive reconstitution by connecting the drug vial in series with a delivery site, such that, in one embodiment, no additional action is required for reconstitution to take place.

[0032] It is still a further advantage of the present disclosure to provide a reconstitution system ensuring that microbiological contamination risk is minimized by accepting pre-plugged vials in a sterile manner.

[0033] Additional features and advantages of the disclosed devices, systems, and methods are described in, and will be apparent from, the following Detailed Description and the Figures. The features and advantages described herein are not all-inclusive and, in particular, many additional features and advantages will be apparent to one of ordinary skill in the art in view of the figures and description. Also, any particular embodiment does not necessarily have to have all of the advantages listed herein. Moreover, it should be noted that the language used in the specification has been principally selected for readability and instructional purposes, and not to limit the scope of the inventive subject matter.

BRIEF DESCRIPTION OF THE FIGURES

[0034] Understanding that figures depict only typical embodiments of the invention and are not to be considered to be limiting the scope of the present disclosure, the present disclosure is described and explained with additional specificity and detail through the use of the accompanying figures. The figures are listed below.

[0035] Fig. 1 is a perspective view of one embodiment of a reconstitution device, according to an example embodiment of the present disclosure.

[0036] Fig. 2 is an elevation sectioned view of the reconstitution device of Fig. 1, further illustrating its fluid flow paths, according to an example embodiment of the present disclosure.

[0037] Fig. 3 is a perspective view of one alternative embodiment of a reconstitution device of the present disclosure, which includes an integrated fluid container.

[0038] Fig. 4 is a plot of the absorbance of a reconstituted solution as a function of administered volume, as performed by a reconstitution device of the present disclosure.

[0039] Fig. 5 is a schematic view of one embodiment of a system employing any of the reconstitution devices described herein.

[0040] Fig. 6 is an elevation sectioned view of an alternate embodiment of the reconstitution device, illustrating an alternate configuration of flow paths, according to an example embodiment of the present disclosure.

DETAILED DESCRIPTION

[0041] Certain embodiments described herein relate generally to the field of IV administration of an active agent. More particularly, some embodiments described herein relate to reconstitution of an active agent in a vial, followed by IV administration of the active agent as a moderate bolus using an IV administration set directly connected to the vial.

[0042] As discussed herein, adding a dried drug to an IV bag typically includes several tedious steps. For example, a medical professional may be required to remove a protective cover of a vial, wipe a stopper of the vial, add diluent to the vial, and shake the vial. The drug then has to be withdrawn from the vial and injected into, for example, an IV line, an IV bag, etc. Additionally, as discussed above, once a drug is reconstituted, the drug begins to degrade immediately; thus, timing is all the more critical.

[0043] Typical commercially available vial reconstitution systems (e.g., the Baxter Vial-Mate™ system) are configured such that the drug contained in the vial is added into the IV bag directly, via a port. In such systems, the drug from the vial is mixed with the entire IV bag prior to being administered to the patient. For example, the drug is delivered into the IV bag, via a medication port, mixes within the IV bag, and is then administered to the patient via an administration port (e.g., by an IV set connected to the IV bag at the administration port). In this delivery paradigm, the drug is not fully delivered until the entire contents of the IV bag have been delivered. In other words, there is no moderate bolus effect with respect to drug delivery. Moreover, the longer the drug sits in the IV bag in a reconstituted state, while waiting to be delivered, the more likely it becomes that the drug will degrade.

[0044] By comparison, the reconstitution system disclosed herein is configured so that the vial containing the drug is connected directly with the delivery site. The connection allows the reconstituted drug to travel directly to the delivery site, such as an IV set. Direct drug delivery avoids the requirement of having to mix the drug in the IV bag. In this manner, a reconstituted active agent may flow directly into the IV administration set, delivering the active agent as a bolus during the initial period of the IV therapy. Delivering the drug as a bolus reduces the likelihood that the drug will degrade prior to delivery.

[0045] Referring now to the drawings and in particular to Fig. 1, one embodiment of the reconstitution device of the present disclosure is illustrated by reconstitution device 10.

Reconstitution device 10 may be constructed of any suitable plastic or rubber material, such as PVC, non DEHP PVC, Krayton polypropylene mixture, or other similar materials.

[0046] Reconstitution device 10 includes a cylindrical collar 20. In alternate embodiments, the collar 20 may be other cross sections (e.g., hexagonal, square, triangular, etc.). Cylindrical collar 20 is configured to engage a vial 25 (e.g., via concentric engagement). In the illustrated embodiment, the top of the vial 25 is received within cylindrical collar 20, such that the cylindrical collar 20 is disposed around the outside of the top of vial 25. Vial 25 typically contains an active agent such as a pharmaceutical agent or a nutritional supplement. The active agent may be present as a dried powder, such as a powder obtained by lyophilization. Alternatively, the active agent is present in an aqueous solution or suspension, or more typical liquid form. As discussed herein, reconstitution device 10 is particularly useful for connecting to an IV line to deliver a moderate bolus to a patient.

[0047] Reconstitution device 10 also includes a hollow, fluid carrying piercing member 30 connected to a cap 22 extending from collar 20. Cap 22 may be formed integrally with or be attached to collar 20. Piercing member 30 as illustrated has a first end 32 and a second end 34. The first end 32 of the piercing member 30 is configured to engage an administration port of an IV bag, so that vial 25 may be placed in fluid communication with the IV bag. For example, the first end 32 of the piercing member 30 may be configured to pierce the administration port (e.g., an IV bag port). The administration port may be connected to an IV solution container. In an embodiment, the first end 32 of the piercing member 30 is formed integrally with the administration port of the IV bag. For example, in an embodiment, the IV bag (e.g., the administration port and the IV solution container) may be permanently fixed to the reconstitution device 10, such that the reconstitution device 10 is manufactured and configured with the IV bag. Alternatively, for example, the reconstitution device 10 may be configured to engage with the administration port of any typical IV bag. Piercing member 30 may be made of metal (e.g., stainless steel), medical grade plastic, or any other suitable material.

[0048] Reconstitution device 10 also includes a hollow, fluid carrying delivery member 40, which extends from cap 22 connected to collar 20. Delivery member 40 may be formed with (same material as) or be attached to cap 22. Delivery member 40 as illustrated has a first end 42 and a second end 44. The first end 42 of the delivery member 40 is

configured to engage a delivery site. For example, the delivery site is an IV line, connectable to a patient. In an embodiment, delivery member 40 is configured for connecting the vial 25 to a delivery port of an IV line (e.g., at the first end 42 of the delivery member 40). In an embodiment, the first end 42 of the delivery member 40 includes a luer connector. Each of the first end 32 of the piercing member 30, the second end 34 of the piercing member 30 and the second end 44 of the delivery member 40 may be or may include a syringe needle.

[0049] In the illustrated embodiment, each of the second end 34 of piercing member 30 and second end 44 of the delivery member 40 are disposed within cylindrical collar 20 of reconstitution device 10. As noted previously, cylindrical collar 20 is configured to concentrically engage the vial 25 (e.g., the top of the vial 25). In an embodiment, by concentrically engaging cylindrical collar 20 with the vial 25, each of the second end 34 of piercing member 30 and the second end 44 of delivery member 40 extend into the vial 25 when device 10 is mated to the vial. For example, the piercing member 30 is in fluid communication with the vial 25. Likewise, for example, the delivery member 40 is in fluid communication with the vial 25. In an embodiment, the second end 34 of piercing member 30 and the second end 44 of delivery member 40 extend through a rubber stopper on the top of the vial 25, such that both the second end 34 of the piercing member 30 and the second end 44 of the delivery member 40 are in sealed fluid communication with the inside of vial 25.

[0050] Fig. 2 illustrates an expanded view of reconstitution device 10, highlighting its fluid flow pathways. For example, piercing member 30 provides a first fluid pathway 36 extending between its first end 32 and its second end 34. Likewise, delivery member 40 provides a second fluid pathway 46 extending between its first end 42 and its second end 44. First fluid pathway 36 at the second end 34 of the piercing member 30 and second fluid pathway 46 at the second end 44 of the delivery member 40 are accordingly disposed within the vial 25 (not pictured) when device 10 is mated to the vial 25 as described above.

[0051] A complete fluid pathway is provided accordingly: fluid may flow from the first end 32 of piercing member 30, through the piercing member 30, from the second end 34 of piercing member 30 into the vial 25, from the vial 25 into the second end 44 of delivery member 40, through the delivery member 40, and from the first end 42 of the delivery member 40 to and/or into a delivery site, e.g., an IV line, connected to a patient.

[0052] First end 32 of piercing member 30 is sharpened to pierce and engage an administration port, such as an IV bag port. First end 42 of the delivery member 40 in the illustrated embodiment is provided with a connector, e.g., a luer connector, to fluidly sealingly engage a delivery site, such as a mating luer connector of an IV line, which is in turn connected to a patient. Other types of connections, besides luer connections, may be used, such as hose barbs or a compression fitting to connect the first end 42 of delivery member 40 to the delivery site, e.g., an IV line tube.

[0053] Thus, in an example, fluid, such as saline or glucose from an IV bag, may travel into the first end 32 of the piercing member 30 and subsequently into vial 25. The fluid mixes with the dry, e.g., granulated, drug in vial 25 to form a drug solution. The drug solution may then flow from vial 25, through delivery member 40, out the first end 42 of the delivery member 40 into a delivery site, such as an IV line.

[0054] Reconstitution device 10, in an embodiment, provides for vertical loading of the vial 25 into the cylindrical collar 20, wherein each of vial 25, piercing member 30 and at least a portion of delivery member 40 are oriented vertically. For example, when reconstitution device 10 is placed in an operating position, each of the piercing member 30 and the delivery member 40 are oriented vertically. In an embodiment, cylindrical collar 20 is oriented vertically such that, responsive to concentric engagement with the vial 25, the vial 25 is held vertically. By ensuring that the vial 25 is engaged with the reconstitution device 10 vertically (e.g., in a top-up configuration), reconstituted material will not inadvertently drip out of the vial 25. By comparison, if the vial 25 were oriented in a different manner (e.g., in a top-down configuration, sideways configuration, etc.), gravity may cause liquid within the vial 25 to leak out of the vial 25. The vertical orientation of the vial 25, in top-up orientation, minimizes leakage.

[0055] Referring now to Fig. 3, an alternative reconstitution device 60 of the present disclosure is illustrated. Reconstitution device 60 in the illustrated embodiment integrates fluid container 70, which may be a rigid fluid container or a flexible fluid container. In one embodiment, fluid container 70 is an IV bag. Fluid container 70 may, for example, be provided pre-loaded with a saline or glucose solution. The rigid portions of reconstitution device 60 may be made of any of the materials listed above for device 10.

Fluid container 70, if flexible, may be made of any suitable material known to those of skill in the art.

[0056] Reconstitution device 60, like device 10, includes cylindrical collar 20, which is configured to concentrically engage the top of vial 25, and a cap 22 holding piercing member 30 and delivery member 40. Piercing member 30 includes the second end 34 as before and the first end 32 formed with or connected to the administration port of fluid container 70. Thus reconstitution device 60, in one embodiment, is provided as an integrated unit with cylindrical collar 20, cap 22, piercing member 30, delivery member 40 and fluid container 70.

[0057] Delivery member 40 of reconstitution device 60 has the first end 42 and the second end 44 as described above. First end 42 of the delivery member 40 is configured to engage the delivery site as described above. Second end 34 of the piercing member 30 and second end 44 of delivery member 40 are located, again, within cylindrical collar 20 of the reconstitution device 60 and extend into vial 25, as described above for system 10 (e.g., the top of the vial 25). In the illustrated embodiment, piercing member 30 is in fluid communication with both fluid container 70 and the vial 25. Likewise, in the illustrated embodiment, the delivery member 40 is in fluid communication with both the vial 25 and the delivery site (e.g., an IV tube).

[0058] In an embodiment, fluid container 70 holds a fluid, such as saline or glucose, which travels from fluid container 70, into the first end 32 of piercing member 30, through the piercing member 30, from the second end 34 of piercing member 30, into the vial 25 to mix with a dry, e.g., a granulated, powdered agent, to form a drug solution, wherein the drug solution travels from vial 25 into the second end 44 of the delivery member 40, through the delivery member 40, and from the first end 42 of delivery member 40 into the delivery site, e.g., an IV fluid line connected to a patient.

[0059] Fig. 4 illustrates an example of the absorbance of a reconstituted solution as a function of administered volume, when performed by a reconstitution device according to an example embodiment of the present disclosure. This example provides an illustration of the performance capability of an embodiment, and is not intended to limit the foregoing disclosure in any respect.

[0060] More particularly, the chart depicted in Fig. 4 includes the absorbance of a reconstituted solution of a multivitamin composition comprising fat soluble and water soluble vitamins for infusion, as a function of administered volume using either reconstitution device 10 or reconstitution system 60 as depicted respectively in Figs. 1 and 3 described above. For example, the multivitamin composition, in a lyophilized or sterile powder, may contain the following vitamins:


[0061] The chart depicted in Fig. 4 illustrates absorbance from a bolus administration of the multivitamin solution as a function of administered volume using a 30% glucose solution bag (e.g., 500 mL format size) obtained from an IV bag (e.g., fluid container 70). The reconstituted solution was dyed, in yellow color, so that absorbance of the reconstituted solution could be measured during administration of 200 mL of nutrition fluid. In this example, absorbance was measured at an optical wavelength of 446 nm.

[0062] The chart depicts absorbance peaking near the beginning of the administration and subsequently decreasing, in an exponential fashion, as nutrition fluid is administered. The administration was stopped after yellow color was no longer observed in the reconstituted solution vial. The chart illustrates two improvements provided by the reconstitution device 10 (or reconstitution system 60). First, the chart illustrates that that absorbance is highest at the initial stages of fluid delivery; absorbance decreases exponentially. This suggests that a significant portion of a reconstituted solution is delivered at the beginning of the administration process. In other words, the reconstituted solution is delivered as a moderate bolus. Moreover, by delivering the drug at the beginning of administration, harmful effects associated with drug degradation are reduced. Second, the chart illustrates that most of the reconstituted solution is delivered within the first several hundred milliliters of fluid. For example, by 200 mL, almost no absorbance was measurable. This suggests that the administration process disclosed herein is more efficient, requiring less fluid (e.g., saline, glucose, etc.) to deliver the drug effectively.

[0063] The above described reconstitution device, system, and method may be used, for example, during parenteral nutrition therapy. In this case, reconstitution may be used to enhance the administration of a multivitamin product that would otherwise be added to a total parenteral nutrition ("TPN") bag through the medication port. Examples for known parenteral nutrition products, which could be used with the present device, system, and method, include Olimel, Oliclinomel, Clinomel, Clinimix, Numeta, ClinOleic, Smof abiven, Kabiven, PeriKabiven, StructoKabiven, Aminomix, Nutriflex, Nutriflex Lipid, Pediaven etc. In various examples, the reconstitution device may be permanently connected to a TPN bag, or may be added to the TPN bag prior to use. Likewise, either a multi-chamber bag or a single-chamber bag may be used with the present device, system, and method.

[0064] Fig. 5 illustrates one embodiment of a system 100 employing either reconstitution device 10 or reconstitution device 60 described above, configured to engage with drug vial 25. System 100 includes an IV bag 110, hanging from a stand 120. The IV bag 110 may include a fluid, such as saline, glucose, etc., for delivery to a patient 130. As illustrated, the IV bag 110 is positioned on the stand 120 to ensure that the IV bag 110 is vertically above the patient 130. This may ensure, for example, that fluid in the IV bag 110 may flow to the patient 130 via a gravity flow.

[0065] System 100 includes reconstitution device 10. Reconstitution device 10 engages with the IV bag 110 as previously described (e.g., via piercing member 30). In an

embodiment, the IV bag 110 is formed integrally with the reconstitution device 10. System 100 also includes delivery tube 140. In an example embodiment, delivery tube 140 is an IV tube. Delivery tube 140 engages with the reconstitution device 10 as previously described (e.g., via the first end 42 of delivery member 40). Delivery tube 140 also engages with a patient 130 at an IV location 150. For example, delivery tube 140 may include an intravenous needle inserted into the patient 130 at the IV location 150.

[0066] Delivery tube 140 is configured to convey the fluid in the IV bag 110 from the reconstitution device 10 to the patient 130 at the IV location 150. While flow conveyance may be facilitated by gravity, as described above with respect to the IV bag 110 positioning on the stand 120, additional or alternative modes of fluid conveyance may be implemented. For example, system 100 may further include an infusion pump 160, which may for example be a Sigma™ Large Volume Pump ("LVP") provided by the assignee of the present disclosure. Infusion pump 160 may control fluid conveyance along delivery tube 140 (e.g., from the reconstitution device 10 to the patient 130 at the IV location 150).

[0067] In an embodiment, a method of using the reconstitution system 100 includes enabling the piercing member 30 and the delivery member 40 of the reconstitution device 10 to be placed in simultaneous communication with an inside of the vial 25. The method further includes enabling fluid from the IV bag 110 to be introduced, via the piercing member 30, into the vial 25 to mix with an agent located within the vial 25 to form a mixed drug. The method further includes enabling the mixed drug to be delivered from the vial 25 together with fluid from the IV bag 110, via the delivery member 40. In a related embodiment, enabling the mixed drug to be delivered from the vial 25, via the delivery member 40, includes enabling a distal end of the delivery member 40 to be connected to the delivery tube 140 that is connectable to the patient 130.

[0068] For example, with reference to Figs. 1 and 5, the fluid in the IV bag 110 may travel into the first end 32 of the piercing member 30, and subsequently travel into the vial 25. The fluid mixes with the dried drug to form a reconstituted drug solution. The reconstituted drug solution may then flow from the vial 25 , through delivery member 40 and out the first end 42 of the delivery member 40, into delivery tube 140. The reconstituted drug solution may then flow to IV location 150, and subsequently be administered to the patient 130.

[0069] The fluid conveyance process described above may, in certain embodiments, include additional steps. For example, the reconstitution device 10 may initially engage the drug vial 25 at the cylindrical collar 20; however, prior to this engagement, the delivery tube 140 may be clamped (e.g., via a typical medical line clamp). The medical professional may do this to initially ensure that any in-line air (e.g., in delivery tube 140, in reconstitution device 10, etc.) is removed from the system 100. More particularly, once the reconstitution device 10 is affixed to both the IV bag 110 and the delivery tube 140, any in-line air may flow upwards to the IV bag. Upward air flow may be facilitated by the IV bag 110 being positioned on the stand 120 so that it is vertically above the reconstitution device 10 and the patient 130. The medical professional may further ensure that no in-line air remains through additional techniques (e.g., tapping the reconstitution device 10). Once all in-line air has been removed, the delivery tube 140 is undamped and the fluid conveyance process described above occurs.

[0070] Fig. 6 illustrates an expanded view of an alternate embodiment of the reconstitution device 210, highlighting its alternate configuration of fluid flow pathways. In this alternate configuration, there are three fluid flow pathways: a first fluid pathway 236, a second fluid pathway 246, and a third fluid pathway 248.

[0071] More particularly, for example, piercing member 230 provides the first fluid pathway 236 extending between its first end 232 and its second end 234. Likewise, delivery member 240 provides the second fluid pathway 246 extending between its first end 242 and its second end 244. Reconstitution device 210 also includes the third fluid pathway 248 extending between the first end 232 of the piercing member 230 and the first end 242 of the delivery member 242. In this example, each of the first fluid pathway 236 and the third fluid pathway 248 share a same end (e.g., first end 232). Likewise, in this example, each of the second fluid pathway 246 and the third fluid pathway 248 share a same end (e.g., first end 242). First fluid pathway 236 at the second end 234 of the piercing member 230 and second fluid pathway 246 at the second end 244 of the delivery member 240 are accordingly disposed within the vial 25 (not pictured) when device 210 is mated to the vial 25 as described above.

[0072] Several complete fluid pathways are provided accordingly. Fluid may flow from the first end 232 of piercing member 230, through the piercing member 230, from the

second end 234 of piercing member 230 into the vial 25, from the vial 25 into the second end 244 of delivery member 240, through the delivery member 240 via the second fluid pathway 246, and from the first end 242 of the delivery member 240 to and/or into a delivery site, e.g., an IV line, connected to a patient. Alternatively, fluid may flow from the first end 232 of piercing member 230, through the delivery member 240 via the third fluid pathway 248, and from the first end 242 of the delivery member 240 to and/or into a delivery site, e.g., an IV line, connected to a patient.

[0073] Providing for multiple fluid pathways from the piercing member 230 may be beneficial, for example, to regulate the dosing of vitamins. For example, if a multivitamin composition is administered too quickly, some of the vitamins may, likewise, be excreted too quickly, without having had the chance to be fully absorbed by the body. In other words, there may be circumstances where a delivered bolus may be too concentrated. Accordingly, by providing multiple fluid pathways, some of which do not interact with the vial 25 (e.g., third fluid pathway 248), reconstitution device 210 may provide a more moderate bolus, thus extending or prolonging the administration of a composition.

[0074] As used in this specification, including the claims, the term "and/or" is a conjunction that is either inclusive or exclusive. Accordingly, the term "and/or" either signifies the presence of two or more things in a group or signifies that one selection may be made from a group of alternatives.

[0075] Without further elaboration, it is believed that one skilled in the art can use the preceding description to utilize the claimed inventions to their fullest extent. The examples and embodiments disclosed herein are to be construed as merely illustrative and not a limitation of the scope of the present disclosure in any way. It will be apparent to those having skill in the art that changes may be made to the details of the above-described embodiments without departing from the underlying principles discussed. In other words, various modifications and improvements of the embodiments specifically disclosed in the description above are within the scope of the appended claims. For example, any suitable combination of features of the various embodiments described is contemplated. Note that elements recited in means-plus-function format are intended to be construed in accordance with 35 U.S.C. § 112 ψ). The scope of the invention is therefore defined by the following claims.