US20090315702A1 - Medication Dispenser - Google Patents
Medication Dispenser Download PDFInfo
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- US20090315702A1 US20090315702A1 US12/307,574 US30757407A US2009315702A1 US 20090315702 A1 US20090315702 A1 US 20090315702A1 US 30757407 A US30757407 A US 30757407A US 2009315702 A1 US2009315702 A1 US 2009315702A1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
- A61J7/0427—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers with direct interaction with a dispensing or delivery system
- A61J7/0436—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers with direct interaction with a dispensing or delivery system resulting from removing a drug from, or opening, a container
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/0076—Medicament distribution means
- A61J7/0084—Medicament distribution means for multiple medicaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
- A61J7/0481—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers working on a schedule basis
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
- G16H20/13—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered from dispensers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J2200/00—General characteristics or adaptations
- A61J2200/30—Compliance analysis for taking medication
Definitions
- the present invention relates generally to the field of medication and health monitoring systems wirelessly connected to central data banks. More specifically, the present invention provides autonomous and automatic medication dispensing systems.
- Drug regimens for chronic diseases are often complex, long-term, and may require considerable behavior modification; for example restricting intake of wine, aged cheese or organ meats in the case of Mono-Amine Inhibitors.
- proper adherence to medication consumption schedules is not restricted to those of advanced years with the following problems being applicable to the US population in general:
- Noncompliance with medication consumption schedules is typically cited as occurring in from 50% to 75% of all patients and was responsible for up to 11% of hospital admissions in 2004.
- Nonadherence to medication consumption schedules in 2004 resulted in approximately 125,000 deaths, about twice the deaths from automobile accidents.
- a patient with advanced asthma may often be required to take a decongestant on an empty stomach before breakfast, one or more once-a-day medicines at breakfast, a plurality of inhalers, some once a day, some three times a day, an antibiotic taken with meals, and a one-a-day medicine at bedtime.
- Many medical doctors find that their patients forget one or more of these regimens and, as a result, do not receive the benefit that is available to them.
- Hypertension is a chronic condition that may result in stroke and heart failure.
- Noncompliance is a major factor in the increasing number of deaths related to cardiovascular disease.
- Diabetes affects 17 million people or 6.2 percent of the American population. Diabetes is a chronic illness, like hypertension, which involves a complex, long-term medical regimen.
- 95% of diabetes care is performed by the patient and includes, for example, timing medication to exercise and eating schedules. It is this particularly complex medication consumption regiment that results in high rates of noncompliance in diabetics.
- AIDS a worldwide epidemic effecting millions of people, is another disease with an extremely complex medical regimen.
- HAART highly active antiviral therapy
- the HAART treatment resulted in low or undetectable viral load levels in as much as 85% of the patients in the study.
- the real world only 50% of patients were positively affected by the HAART treatment; an alarming statistic that is closely tied to patient compliance.
- a medication consumer with a serious primary health problem for example AIDS, may succumb to symptoms related to the primary problem, for example fainting.
- the medication consumer state may not be detected until it is too late to provide even basic resuscitation action. In such cases, the entire basis for ensuring medication consumption becomes mute.
- U.S. Pat. No. 5,181,189 to Hafner teaches a device that receives information from a medicine container and provides storage and time-regulated dispensing of a single drug. Each medicine container is connected to a separate device, so that medication consumption is stymied by the consumer who has inadvertently separated the devices and cannot remember the location of one or more containers.
- U.S. Pat. No. 5,669,503 to Robin teaches a medication dose control system having a dispensing chamber connected to multiple dispensing hoppers. The user is required to rotate the dispensing chamber in response to an alarm, presenting difficulty to a frail, geriatric consumer.
- the user is not provided information, for example, pertaining to, time interval, drug name, or directions, for example “take with meals.”
- effective activation of pill dispensing alarms and/or reminders present significant barriers to setup, for example in a debilitated or geriatric user.
- E-Pill is a Boston area based company that has various solutions for medication compliance in the form of pill dispensers, reminders and software programs.
- the devices are in the price range between $25 for a birth control pill reminder, to a $750 home based pill dispenser with communication abilities. It also has a range of other related pill dispenser/medication reminders in the form of alarm and vibrating watches, pill dispensers and software programs that are configured for use with PDA's, cellular phones, and portable and home PC's.
- INRange Systems Inc. is a company founded in 2001 that manufactures and markets a Remote Medication Management System with the following business partners: University of Wisconsin, School of Pharmacy Penn State University, Erie Plastics Technology Center, and PSU Ben Franklin Technology Partners.
- the system comprises three elements: a medication dispenser unit, a software program, and a proprietary MEDisc, that holds medication—30 pills or capsules in a blisterized form, with bar-coded information, that is transmitted to the dispenser unit.
- the MEDisc moves with respect to the dispenser and the consumer is alerted to take the medication.
- Some embodiments of the present invention successfully address at least some of the shortcomings of the prior art by providing an autonomous and automatic personal medication dispensing system, some embodiments of which substantially ameliorate patient noncompliance.
- a medication dispensing system comprising a base, a box configured to connect to the base, the box comprising at least two compartments, a first compartment configured to contain at least one medication and a second compartment configured to contain at least one medication.
- the system further comprising at least two sensors connected to the base and configured to align with at least a portion of the at least two compartments when the box is connected to the base, the at least two sensors configured to each provide at least one state-indicating signal that indicates a state of the compartment.
- the system further comprising a housing connected to the base, the housing containing a wireless transponder connected to the at least two sensors and configured to wirelessly receive and transmit signals to a wireless remote health monitoring station, an audiovisual output connected to the at least two sensors, the audiovisual output configured to provide at least one audiovisual display responsive to the at least one state-indicating signal, and a power supply operatively associated with at least one of: the wireless transponder, the audiovisual output, and the at least two sensors.
- the at least two compartments include a hatch and the at least one state-indicating signal indicates whether the hatch has been opened.
- the at least one state-indicating signal indicates whether the at least one medication has been removed from at least one of the at least two compartments.
- the at least two sensors are sensitive to the weight of the at least one medication.
- the at least two sensors are sensitive to the presence of light and are positioned to be at least partially covered when at least one medication is contained within the compartment.
- the at least two compartments are at least partially, at least one of transparent, and translucent.
- the at least two compartments each contain at least one aperture configured to transmit light waves.
- the at least two sensors are wireless sensors providing radiant sensing beams from the group consisting of Ultrasound beams, laser beams, Split-light-beams, radar beams, infrared light beams and visible light beams.
- the radiant sensing beams comprise reflected radiant sensing beams.
- the box is configured to removably connect to the base.
- the box is configured to be disposed following consumption of the at least one medication contained in the at least two compartments.
- the housing includes a data reader and the box includes medication consumption data configured to be read by the data reader.
- the medication consumption data comprises a bar code and the data reader comprises a bar code reader.
- the medication consumption data includes at least one of the following: a name of user, a dosage a timing of dosage a medication appearance, and a medication reaction symptom requiring health provider notification.
- the at least two compartments are configured to be filled at a remote location.
- the at least two compartments are configured to packaged in a manner that facilitates shipment to a user via a postal service.
- the at least two compartments are designed to be substantially easily attached to the base.
- the at least two compartments are designed to be substantially easily removed from the base.
- the system includes a remote medication filling location where the at least one medication compartment is filled.
- the system includes at least two boxes, at least one first box and at least one second box, when the at least one first box is connected to the housing, the at least one second box is disconnected from the housing.
- the at least one first box contains the at least one medication and the at least one second box is empty of medication.
- the housing includes a clock display and clock set input
- the audiovisual output is configured to display at least one of: an audiovisual alert, confirming consumption of the at least one medication, an audiovisual alert to consume the at least one medication, an audiovisual alert to remove the at least one second box from the base, and an audiovisual alert to connect the at least one first box to the base.
- the at least two sensors are attached to at least one of: the at least two compartments, and the base.
- the housing includes a clock display and clock set input.
- the at least two sensors are operative to sense and transmit a signal indicating that a hatch associated with the compartment is in at least one state of: open, and opening.
- the at least two sensors are operative to sense and transmit a signal indicating that a hatch associated with the compartment is in at least one state of: open, and opening.
- the wireless transponder includes a user activated inactive mode.
- the transponder sends a wireless signal that the wireless transponder is in the inactive mode to the remote health monitoring station.
- the at least one audiovisual output on the housing comprises at least one of: an LED display, a liquid crystal display, a twisted crystal display, and a phosphor display.
- the system includes a remote health monitoring station is configured to wirelessly transmit the medication consumption data to the wireless transponder.
- the remote health monitoring station is configured to wirelessly update the medication consumption data.
- the audiovisual output is configured to provide at least one signal based upon at least one of: the medication consumption data and the state of the at least two compartments.
- the at least two sensors are operative to sense and transmit a signal indicating that the at least one medication has been accessed at an improper time, based upon the medication consumption data.
- the at least two sensors are configured to transmit a signal indicating that a wrong compartment has been accessed based upon the medication consumption data.
- the wireless transponder is configured to transmit wireless signals to the remote health monitoring station in the absence of a change in compartment state according to the consumption data within a programmed period of time.
- the remote health monitoring station is configured to communicate with the transponder in the absence of a change in compartment state within a programmed period of time.
- the communication includes providing at least one display transmitted by the remote health monitoring station via the audiovisual display.
- the remote health, monitoring station is configured to additionally transmit a message to a user through at least one of: a cellular telephone, and a hard-wired telephone.
- the remote health monitoring station is configured to issue a directive to contact a user, the directive being transmitted to at least one of: an acquaintance of the user, a medical person, and an emergency response system.
- the at least two compartments are configured to operate in conjunction with the audiovisual output on least one of: two or more times during a day, and two or more days.
- the power source includes at least one battery.
- the housing includes at least one battery.
- the at least one battery is rechargeable.
- the power source comprises a DC current, supplied by an AC/DC transformer.
- the housing is configured to contain at least one rechargeable battery configured to be recharged via the DC current.
- the housing is configured to contain the AC/DC transformer and further includes an AC input receptacle.
- the AC/DC transformer is located outside the housing and the housing further includes a DC input receptacle.
- the AC/DC transformer is part of a USB system and the housing further includes a USB input receptacle.
- the transponder is configured to receive an SMS messaging protocol and the at least one audiovisual output is configured to display the SMS protocol.
- the remote health monitoring station comprises an SMSC.
- the system includes a local wireless relay station configured to wirelessly receive the transponder signals and to receive and transmit signals to the wireless remote health monitoring station.
- the local wireless relay station includes a cellular telephone chip.
- the local wireless relay station communicates with the transponder using at least one of Bluetooth communication, RF and infrared communication.
- the remote health monitoring station further includes a Web server for communication through a Web-based function.
- the communication through the Web-based function includes an analysis by a medical professional.
- the system includes at least one integrated chip imprinted with at least two of: a circuit of the at least two sensors, a circuit of the at least one audiovisual output, and a circuit of the wireless transponder.
- At least one of the at least two compartments is about 25 millimeters on each of the X and Y axes.
- At least one of aid at least two compartments is about at least one of 10 millimeters, 15 millimeters, and 20 millimeters on the X and Y axes.
- At least one of the at least two compartments is no more than at least one of about 30 millimeters, 40 millimeters, and 50 millimeters on the X and Y axes.
- At least one of the at least two compartments have different measurements along the X axis than along the Y axis.
- At least one of the at least two compartments have polygonal shapes on the X and Y axes.
- At least one of the at least two compartments has at least one shape of: triangular, rectangular, and hexagonal, on the X and Y axes.
- At least one of the at least two compartments have a curved shape on the X and Y axes.
- At least one of the at least two compartments is about 25 millimeters deep on the Z axis.
- At least one of the at least two compartments is at least one of about 10 millimeters, 15 millimeters, and 20 millimeters deep on the Z axis.
- At least one of the at least two compartments is no more than about 30 millimeters, 40 millimeters, or even 50 millimeters deep on Z axis.
- At least one of the box and the base comprise a material selected from the group consisting of: polyethylene, polyvinyl chloride, polyurethane, nylon and a biocompatible polymer fiber.
- At least one of the box and the base comprise a material selected from the group consisting of: metals, synthetic biostable polymer, a natural polymer, and an inorganic material.
- the biostable polymer comprises a material from the group consisting of: a polyolefin, a polyurethane, a fluorinated polyolefin, a chlorinated polyolefin, a polyamide, an acrylate polymer, an acrylamide polymer, a vinyl polymer, a polyacetal, a polycarbonate, a polyether, a polyester, an aromatic polyester, a polysulfone, and a silicone rubber.
- the natural polymer comprises a material from the group consisting of: a polyolefin, a polyurethane, a Mylar, a silicone, and a fluorinated polyolefin.
- a method for monitoring consumption of medication from a medication box comprising: filling at least two medication compartments on a first medication box with medication, sending the first medication box to a user connecting the at least two medication compartments to at least two medication sensor transponders receiving signals from the at least two medication sensor transponders at a central station, and communicating with the user based upon the signals received from the at least two medication sensor transponders.
- the method wherein the medication box is disposable and the method further includes: disposing of the first medication box upon consumption of the medication, filling at least two medication compartments on a first medication box with medication, sending the first medication box to a user, an connecting the at least two medication compartments to at least two medication sensor transponders.
- an autonomous and automatic medication dispensing system that works in conjunction with a remote health monitoring station, the system comprising a box comprising at least two compartments having a compartment-securing hatch, the at least two compartments configured to contain at least one medication, at least two sensors operatively associated with the at least two compartments and configured to provide at least one state-indicating signal that indicates a state of the compartment, a housing configured to connect to the at least one medication compartment, the housing containing several items, including a CPU connected to the at least two sensors and configured to provide at least one CPU audiovisual output signal responsive to the at least one state-indicating signal a wireless transponder connected to the CPU and configured to wirelessly receive and transmit signals to a wireless remote health monitoring station an audiovisual output connected to the CPU and to the wireless transponder, the output configured to provide at least one audiovisual display responsive to at least one of: the CPU audiovisual output signal, and the wireless transponder, a power source operatively associated with at least one of the items contained in the housing a
- the at least two sensors are attached to at least one of: the at least two compartments, and the housing.
- the housing includes a clock display and clock set input.
- the at least two sensors are operative to sense and transmit a signal indicating that a hatch associated with the compartment is in at least one state of: open, and opening.
- the at least two sensors are operative to sense and transmit a signal indicating that a hatch associated with the compartment is in at least one state of: open, and opening.
- the CPU includes a user activated inactive mode.
- the transponder sends a wireless signal that the CPU is in the inactive mode to the remote health monitoring station.
- the at least one audiovisual output on the housing comprises at least one of: an LED display, a liquid crystal display, a twisted crystal display, and a phosphor display.
- the CPU includes medication consumption data, the data including at least one of the following a name of user, a dosage, a timing of dosage, a medication appearance, and a medication reaction symptom requiring health provider notification.
- the audiovisual output provides a display until the hatch state is opened according to the consumption data.
- the remote health monitoring station is configured to wirelessly transmit the medication consumption data to the wireless transponder.
- the remote health monitoring station is configured to wirelessly update the medication consumption data.
- the audiovisual output is configured to provide at least one signal based upon at least one of: the medication consumption data, and the state of the compartment-securing hatch.
- the at least two sensors are operative to sense and transmit a signal indicating that the medication has been accessed at an improper time, based upon the medication consumption data.
- the at least one medication compartment comprises at least two medication compartments, each compartment operatively associated with at least two sensors.
- the at least two sensors are configured to transmit a signal indicating that a wrong compartment has been accessed based upon the medication consumption data.
- the wireless transponder is configured to transmit wireless signals to the remote health monitoring station in the absence of a change in compartment state according to the consumption data within a programmed period of time.
- the remote health monitoring station is configured to communicate with the transponder in the absence of a change in compartment state within a programmed period of time.
- the communication includes providing at least one display transmitted by the remote health monitoring station via the audiovisual display.
- the remote health monitoring station is configured to additionally transmit a message to a user through at least one of: a cellular telephone, and a hard-wired telephone.
- the remote health monitoring station is configured to issue a directive to contact a user, the directive being transmitted to at least one of: an acquaintance of the user, a medical person, and an emergency response system.
- the at least two compartments are configured to operate in conjunction with the audiovisual output on least one of: two or more times during a day, and two or more days.
- the power source includes at least one battery.
- the housing includes at least one battery.
- the at least one battery is rechargeable.
- the power source comprises a DC current, supplied by an AC/DC transformer.
- the housing is configured to contain at least one rechargeable battery configured to be recharged via the DC current.
- the housing is configured to contain the AC/DC transformer and further includes an AC input receptacle.
- the AC/DC transformer is located outside the housing and the housing further includes a DC input receptacle.
- the AC/DC transformer is part of a USB system and the housing further includes a USB input receptacle.
- the transponder is configured to receive an SMS messaging protocol and the at least one audiovisual output is configured to display the SMS protocol.
- the remote health monitoring station comprises an SMSC.
- the system includes a local wireless relay station configured to wirelessly receive the transponder signals and to receive and transmit signals to the wireless remote health monitoring station.
- the local wireless relay station includes a cellular telephone chip.
- the local wireless relay station communicates with the transponder using at least one of Bluetooth communication, RF and infra-red communication.
- the remote health monitoring station further includes a Web server for communication through a Web-based function.
- the communication through the Web-based function includes an analysis by a medical professional.
- the system includes at least one integrated chip imprinted with at least two of: a circuit of the at least two sensors, a circuit of the at least one audiovisual output, and a circuit of the wireless transponder.
- a method for providing medication according to a preset schedule in conjunction with a user monitoring device comprising: providing a medication dispenser to a user, the dispenser having at least two compartments, connecting compartment monitors to the at least two compartments, the monitor configured to monitor a state of the at least two compartments and provide digital signals with respect to the state of the at least two compartments providing the digital signals to a wireless transponder configuring the transponder to wirelessly communicate the signals to a wireless remote health monitoring station,
- the method further comprising locating proximate to the medication dispenser a wireless user monitoring device that monitors and provides digital signals on a condition of the user, and configuring the user monitoring device to wirelessly communicate the user monitoring signals with the wireless remote health monitoring station.
- the method further including providing alerts pertaining to a user condition communicated by the user monitor, and a state of aid at least two compartments.
- the method further including integrating an audiovisual output with the dispenser and providing an audiovisual signal responsive to a state of the at least two compartments.
- the method further including providing an audiovisual signal via the audiovisual output, the signal being responsive to the wireless remote health monitoring station.
- FIG. 1 shows a schematic view of a medication dispensing system in conjunction with a consumer health sensor, according to embodiments of the invention
- FIGS. 2-6B show alternative embodiments of the medication dispensing system shown in FIG. 1 , according to embodiments of the invention.
- FIG. 7 shows a Flowchart of a medication dispensing, according to embodiments of the invention.
- the present invention relates to an autonomous and automatic personal medication dispensing system in conjunction with at least one consumer health sensor, some embodiments of which substantially ameliorate patient noncompliance while providing assurance of appropriate health monitoring and attention.
- method refers to manners, means, techniques and procedures for accomplishing a given task including, but not limited to, those manners, means, techniques and procedures either known to, or readily developed from known manners, means, techniques and procedures by practitioners of the chemical, pharmacological, biological, biochemical and medical arts.
- Implementation of the methods of the present invention involves performing or completing selected tasks or steps manually, automatically, or a combination thereof.
- FIG. 1 shows a schematic view of a medication reminder and dispensing system 100 .
- System 100 includes an electronic monitoring unit 184 having clips 166 that removably connect to a medication compartment 132 .
- Compartment 132 includes medication berths 134 A- 134 G containing medication 174 B- 174 G. Hatches 136 B- 136 G are in the closed positions.
- monitoring unit 184 includes a Computerized Processing Unit (CPU) 138 that includes a medication consumption data module.
- CPU 138 typically contains medication data related to, inter alia:
- CPU 138 is connected to an audiovisual display 172 , powered by a power system 194 , configured to visually demonstrate an image 178 of one or more medications.
- CPU 138 provides an audiovisual indication 168 that indicates which berth 134 to open and, optionally, a message 174 regarding consumption conditions, for example to consume “with milk”.
- condition refers to general directions for taking medication, including but not limited to, “take with food,” and/or is optionally based upon consumer medical history, for example, warning a diabetic to check blood sugar prior to taking a dose of insulin.
- display 172 includes a clock 142 that is synchronized with CPU 138 and optionally flashes a set period of time prior to consumption of medication 174 .
- compartment 132 connects to electronic unit 184 with clips 166 , thereby aligning hatches 136 A- 136 G with sensors 170 A- 170 G.
- a hatch sensor 170 A registers the opening and transmits a signal to CPU 138 .
- audiovisual display 172 provides one or more of a variety of demonstrations including, inter alia, sounds, vibrations, visual flashes and moving images.
- hatch sensor 170 A senses when hatch 136 A is opened partially, for example, in a manner that does not allow a user access to medication 174 A. In such cases, hatch sensor 170 A does not provide a hatch “open” signal, but either a null signal or a signal that hatch 136 A has been improperly opened.
- CPU 138 signals audiovisual display 172 to provide a display that indicates that medication hatch 136 A must be reopened and medication 174 A removed.
- hatch sensor 170 B registers opening and audiovisual display 172 immediately provides one or more of a variety of demonstrations noted above to direct the user to close wrong hatch 170 B and, instead, open correct hatch 170 A.
- medication as used herein is intended to include any vitamin, mineral, substance or medicine, including tablets, capsules, powders and liquids of prescription and non-prescription items.
- aerosols, powders and liquids are packaged in easily opened discrete packages and dispensed from system 100 .
- system 100 includes detachment sensor 122 that senses when compartment 132 has been detached from unit 184 for example when the user wishes to take a walk without the necessity of carrying unit 172 .
- Detachment sensor is programmed to communicate the detachment of clips 166 and to communicate to CPU 138 that a lack of movement of hatches 136 does not indicate non-compliance.
- detachment sensor 122 Upon the return of the user and the hook up of unit 172 with compartment 132 , detachment sensor 122 updates CPU 138 on the state of dispenser, for example, that in a certain period of time, hatch 134 E should be opened by the user.
- unit 184 includes sensors that sense when clips 166 are properly aligned with compartment 132 upon connection of compartment 132 . Should clips 166 be, for example, in partial connection with compartment 174 that misaligns hatch sensors 170 , CPU 138 provides an appropriate alert on audiovisual display 172 to remind the user to realign compartment 132 with unit 184 .
- system 100 includes a unit transponder 176 that communicates wirelessly 146 with a local wireless relay 120 , which, for example, is located within several to several tens of meters of unit 184 and communicates with system 100 via wireless signals 146 .
- Local wireless relay 120 communicates wirelessly 156 with a central processing data bank 188 .
- central data bank 188 is operatively associated with a health data bank 162 that is in wireless communication with at least one user monitor device 220 , as defined below.
- central processing data bank 188 communicates directly with unit transponder 176 , thereby bypassing wireless relay 120 ; a user option provided, for example, to a user who is active and periodically takes unit 184 and compartment 132 out of range of wireless relay 120 .
- data bank 188 is programmed by an operator and, thereafter, system 100 functions to ensure that the user has, in fact, complied with a given medication consumption schedule without intervention of the operator.
- system 100 and data bank 188 function in an autonomic and autonomous fashion, and initiate actions with respect to user non-compliance. Additionally or alternatively, system 100 and data bank 188 function under the observation of an operator as explained below.
- transponder 176 communicates wirelessly 248 with a cell phone 160 in a closed loop system so that phone 160 provides additional back-up to remind the user to take medication 174 .
- communication between transponder 176 and cell phone 160 and reminding a user to consume medication 174 occurs automatically and autonomically in a closed loop.
- CPU 138 additionally provides messages to the consumer via cell phone 160 using least one of a SMS (Short Message Service) or MMS (Multi Media Service), or via Internet based messaging (such as in cellular telephones operating in GPRS networks).
- SMS Short Message Service
- MMS Multi Media Service
- Internet based messaging such as in cellular telephones operating in GPRS networks.
- CPU 138 optionally provides messages to the consumer via WiMax, WiFi, Zigbee, USB wireless communication; the many wireless systems for communication being well known to those familiar with the art.
- hoppers 134 are loaded with medication 174 by a person familiar to the consumer at the consumer location, for example, in a private home.
- filling of system 100 with medication is in conjunction with central processing data bank 188 .
- hoppers 134 are loaded with medication 174 in proximity to data bank 188 and shipped to the user.
- system 100 communicates to locations outside of system 100 , for example, to a telephone located at a local pharmacy where hoppers 134 are loaded with medication 174 .
- hoppers 134 are loaded with medication 174 .
- the pharmacy is updated via a telephone. In this fashion, reminders to take medication 174 , programming of CPU 138 and filling of compartment 132 are automatic and autonomic.
- computer chips are optionally provided to the user or the pharmacist and inserted into system 100 to interact with CPU 138 , thereby updating system 100 on, inter alia, the medical state of the user, medication scheduling and/or changes in dosage.
- central data bank 188 includes a screen 162 that provides a supervisor with a visual alert 192 that notifies the supervisor that medication 174 has not been consumed within a certain period of time.
- the operator after waiting a period of time for the user to respond to indicator 168 , the operator initiates an inquiry to the user telephonically through cell phone 160 and/or a designated caretaker. With personal contact, visual inspection ensures that the user has not suffered an untoward health condition, for example a heart attack.
- unit 184 communicates wirelessly 248 with a cellular phone 160 that is carried by the user. If the user fails to take medication 174 , a signal is transmitted wirelessly 148 so that phone 160 provides indicator 168 and or messages 192 to reinforce audiovisual display 172 .
- a wireless signal 158 or 146 is transmitted to central data bank 188 and an inquiry is made of the user as noted above.
- system 100 optionally includes at least one user monitor device 220 that is operatively associated with wireless relay 120 , for example, through a wireless signal 222 .
- User monitor device 220 typically receives a user parameter, for example, whether the user is in distress, has a high pulse rate, or has fainted. User monitor device 220 then communicates the parameter to local wireless relay 120 via wireless signal 222 . The sensed parameter is then passed on to a central data bank 188 where the parameter is analyzed and appropriate action is initiated, either by central data bank 188 or via a supervisor associated with a health monitoring agency as noted below.
- a user parameter for example, whether the user is in distress, has a high pulse rate, or has fainted.
- User monitor device 220 then communicates the parameter to local wireless relay 120 via wireless signal 222 .
- the sensed parameter is then passed on to a central data bank 188 where the parameter is analyzed and appropriate action is initiated, either by central data bank 188 or via a supervisor associated with a health monitoring agency as noted below.
- central processing data bank 188 refers to any data bank including medication consumption information and/or user parameters with respect to user monitoring device 220 .
- the human operator is part of a health alert system, known in the art, for example “Lifeline”, a subsidiary of Philips Corporation.
- the devices offered by Lifeline include a personal health alert button that is worn around the neck, wrist, or another body part. In embodiments, the use presses the alert button when faced with symptoms of an apparent looming medical emergency. All information regarding the operation of “Lifeline” is hereby included in its entirety as if fully written herein.
- the human operator optionally assesses the user's current medical condition from the received information based upon user medical history, which is stored in remote central data bank 188 .
- central data bank 188 acts as gateway, only alerting the operator when a parameter passes normal limits as indicated in the patient history.
- a monitor 130 continually provides an ECG signal for observation by the operator.
- user monitor device 220 comprises a wrist-mounted sensor that, for example, senses pulse rate.
- user monitor device 220 is mounted, worn, carried or otherwise in contact with substantially any part of the body or in close proximity to the user body.
- user monitor device 220 is optionally in the form of a necklace for being worn at the neck of the subject.
- User monitor device 220 optionally includes a panic input that is activated by a user, alternatively or in addition, to sensor 220 .
- panic button monitor device 220 is mounted on and/or connected to electronic monitoring unit 184 .
- Examples of parameters that are sensed by user monitor device 220 and or interpreted by central data bank 188 based upon information supplied by user monitor device optionally include, inter alia: heart rate; heart rate variability; breathing rate; arrhythmia of the heart, general rhythm and functioning of the heart; blood pressure; presence of abnormal body movements such as convulsions for example; body position; general body movements; body temperature; presence and level of sweat; oxygen pressure in the blood.
- central data bank 188 supports manual and/or automatic collection of the one parameter; and is able to execute one or more instructions for extracting medical information about the user when such measurements relate, for example, to a physiologic parameter.
- a human operator optionally a trained medical person sees this information on central data bank monitor 130 and talks to the patient using cellular telephone 160 that communicates with the user either directly or through audiovisual display 172 .
- the operator receives and/or communicates with the user or other locations via a LAN (local area network) connection or an Internet connection.
- the operator communicates with the user via cell phone 160 using least one of a SMS or MMS, or electronic mail such as an e-mail message or facsimile, or Internet based messaging (such as in cellular telephones operating in GPRS (General Packet Radio Service) networks.
- cell phone 160 includes an add-on video camera, such as in the case of 3G (third generation) cellular telephones, that enables a visual and audio conversation is made between the call center operator and the user.
- 3G third generation
- communication with system 100 comprises an add-on to cell phone 160 with standard access, for example Bluetooth, IEEE 802.11 protocol or IRDA (Infrared Data Association).
- standard access for example Bluetooth, IEEE 802.11 protocol or IRDA (Infrared Data Association).
- an alarm signal that communicates user distress is transmitted to family members, and/or caregiver, for example, by sending an SMS message to their cellular telephone or by a voice message.
- wireless link 248 between system 100 and cell phone 160 uses Home RF protocol or alternatively any other proprietary protocol using a RF link, any type of wireless infrared, or any other radio frequency protocol communication link.
- local wireless relay 120 is located in proximity to unit 100 , is connected to a standard power supply and has a broadcast range sufficient to communicate with data bank 188 .
- local transponder performs additional duties in addition to monitoring system 100 , for example providing monitoring of oxygen consumption in sleep apnea, and/or monitoring blood pressure.
- FIG. 2 shows an alternative embodiment for medication reminder and dispensing, comprising system 200 in which a disposable box comprising multiple compartments 132 slides onto a transverse support 266 including sensors 170 .
- FIG. 3 shows an alternative embodiment for medication reminder and dispensing, comprising system 300 that includes a base 320 to which multiple compartments 332 attach. Compartments 332 interconnect via transverse supports 266 . In an exemplary embodiment, sensors 170 on base 320 are operatively associated with compartments 332 .
- FIG. 4 shows an alternative embodiment of the medication reminder and dispensing system of FIG. 3 , comprising system 400 that includes a disposable box 412 with hatches 410 on medication compartments 432 .
- Disposable box 412 is typically filled at a central facility and shipped to a user.
- the user loads disposable box 412 on base unit 420 and base unit reads a bar code 414 on an identification label 416 which optionally includes user readable information 418 , for example the name of the user.
- Bar code 414 contains medication dispensing information, a first portion of which is displayed on a display 424 and a second portion of which directs box 400 to communicate with the central station regarding patient compliance. Additionally, base unit 420 includes a base board 426 having an array of sensors 422 .
- identification label 416 includes a radio frequency (RF) identification tag and base unit 420 includes an RF reader which is displayed on display 424 and at the central station.
- RF radio frequency
- system 400 is shown with 28 compartments 432 , system 400 optionally has at least about five, 10 or 12 compartments 432 . Alternatively, system 400 has no more than about 30, 50, 100 or even 300 compartments 432 , each compartment 432 having one or more sensors 422 on baseboard 426 .
- FIG. 5A shows one embodiment of system 400 in which compartment 432 includes a curved floor 434 that directs medication 450 to sit over a sensor 422 .
- Sensor 422 emits wireless reflecting radiant waves 421 that reflect off a medication 450 , with a short reflection time indicating the presence of pill 450 .
- FIG. 5B shows radiant waves 421 reflecting off hatch 410 in the absence of medication 450 , with the longer reflection time indicating that compartment 432 has been emptied of medication 450 .
- sensors 422 are optionally configured to determine the position of hatch 410 , as explained above.
- Sensor 422 is optionally any variety of radiant wave transceivers that determine distance from any one of several reflected wireless waves 421 , as described in the following patents, the entirety of which are incorporated herein by reference:
- sensor 422 is light sensor and the presence of medication 450 over sensor 422 , light is blocked, thereby indicating the presence of medication 450 .
- the presence of ambient light signifies that medication 450 has been removed from compartment 432 .
- sensor 420 senses the ambient light after hatch 410 has been closed and hatch 410 is optionally, transparent or translucent; or contains one or more apertures that allow the transmission of light to sensor 422 .
- medication is weighed in each compartment 432 as is taught in U.S. Pat. No. 5,042,685 (Moulding, Jr., et al), the entirety of which is hereby incorporated by reference; an embodiment of which is seen in FIG. 6A which shows sensor 422 comprising a weighing platform 440 that is sensitive to the weight of medication 450 .
- weighing platform 440 moves upward in a direction 426 , indicating that compartment 432 has been emptied.
- compartments 432 are about 25 millimeters on each of the X and Y axes. In alternative embodiments, compartments 432 are at least about 10 millimeters, 15 millimeters, or at least about 20 millimeters on the X and Y axes. In further embodiments, compartments are no more than about 30 millimeters, 40 millimeters, or even 50 millimeters on the X and Y axes. Additionally, compartments 432 may have different measurements along the X axis than along the Y axis, forming a substantially rectangular shape.
- compartments 432 have varied shaped, for example circular, triangular and/or polygonal, wherein the polygons have more than four sides, for example hexagonal shapes.
- compartments are approximately 25 millimeters deep, on the Z axis.
- compartments 432 are at least about 10 millimeters, 15 millimeters, or at least about 20 millimeters deep on the Z axis.
- compartments are no more than about 30 millimeters, 40 millimeters, or even 50 millimeters deep on Z axis.
- compartments 432 in terms of amount, size, and shape are readily understood by those familiar with the art.
- box 412 , and/or base unit 420 comprise a material selected from the group consisting of: polyethylene, polyvinyl chloride, polyurethane, nylon and a biocompatible polymer fiber.
- At least a portion of box 412 , and/or base unit 420 comprise a material selected from the group consisting of: metals, synthetic biostable polymer, a natural polymer, and an inorganic material.
- the biostable polymer comprises a material from the group consisting of: a polyolefin, a polyurethane, a fluorinated polyolefin, a chlorinated polyolefin, a polyamide, an acrylate polymer, an acrylamide polymer, a vinyl polymer, a polyacetal, a polycarbonate, a polyether, a polyester, an aromatic polyester, a polysulfone, and a silicone rubber.
- the natural polymer comprises a material from the group consisting of: a polyolefin, a polyurethane, a Mylar, a silicone, and a fluorinated polyolefin.
- box 412 and/or base unit 420 may be constructed are readily understood by those familiar with the art.
- FIG. 7 shows a flowchart of a system 500 for use of disposable medication dispensing system 400 ( FIGS. 4-6B ).
- a caregiver for example a doctor, writes prescriptions for an end user and sends the prescription to a central dispensing station.
- the central station record the prescription in a data bank and, at a confirm and bill stage 614 , the central station confirms that end user is eligible for receiving the medication, an example of which is taught in U.S. Pat. No. 6,088,429 (Garcia), the entirety of which is hereby incorporated by reference.
- a 3 rd party payer is billed for the medications, such 3 rd party payers including, inter alia, an insurance company and/or a welfare agency, for example Medicare in the United States.
- 3 rd party payers including, inter alia, an insurance company and/or a welfare agency, for example Medicare in the United States.
- An example of an embodiment of an electronic billing system that bills directly for dispensed medications is taught in U.S. Pat. No. 6,757,898 (risen, et al), the entirety of which is hereby incorporated by reference.
- the central station then sends the prescription to a loading stage 616 where the medication is loaded into a disposable medication box, for example box 420 seen in FIG. 4 .
- loading stage 616 includes electronically mechanized loading systems, for example pill loading robots, that load and package medication, and example of which is taught in U.S. Pat. No. 5,522,525 (McLaughlin, et al), the entirety of which is hereby incorporated by reference.
- the central station encodes medication dispensing information is on bar code 414 to be displayed on display 424 .
- the central dispensing station sends the medication box to the end user.
- the end user or a caregiver for example a visiting nurse, loads disposable medication box 412 ( FIG. 4 ) on base unit 420 and base unit reads bar code 414 .
- the end user is notified of proper times to take medication and, upon taking medication, a user monitoring stage 624 provides an update to the central station.
- Communication provided at monitoring stage 624 optionally uses a wireless transponder noted above.
- communication is transmitted through a hardwire hookup to a telephone line.
- communication occurs through a hardwire hookup to a computer that transmits via the internet; the many ways of communicating medication updates being well known to those familiar with the art.
- the central station proceeds to a monitoring alert stage 626 wherein the end user is contact verbally, for example telephonically.
- the central station proceeds to a contact user stage 628 wherein physical contact, via a monitoring counselor, is made with the end user.
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| Application Number | Priority Date | Filing Date | Title |
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| IL176712A IL176712A0 (en) | 2006-07-05 | 2006-07-05 | Medication dispenser |
| IL176712 | 2006-07-05 | ||
| PCT/IL2007/000776 WO2008004212A2 (fr) | 2006-07-05 | 2007-06-26 | Distributeur de médicament |
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| US13/330,792 Active 2028-01-26 US8878654B2 (en) | 2006-07-05 | 2011-12-20 | Medication dispenser |
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| US13/330,792 Active 2028-01-26 US8878654B2 (en) | 2006-07-05 | 2011-12-20 | Medication dispenser |
Country Status (7)
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|---|---|
| US (3) | US20090315702A1 (fr) |
| EP (1) | EP2037990B1 (fr) |
| CN (1) | CN101512514B (fr) |
| CA (1) | CA2691965A1 (fr) |
| GB (1) | GB2453483B (fr) |
| IL (1) | IL176712A0 (fr) |
| WO (1) | WO2008004212A2 (fr) |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US20090301925A1 (en) * | 2006-07-05 | 2009-12-10 | Alloro Michael Cohen | Medication Dispenser |
| US8055380B1 (en) * | 2009-12-01 | 2011-11-08 | Vandana Verma | Daily pill dispensing apparatus |
| US20120035760A1 (en) * | 2010-08-06 | 2012-02-09 | Nathaniel Gerald Portney | Digital dispenser system |
| US20120065776A1 (en) * | 2010-09-13 | 2012-03-15 | Ipcomm Llc | Method and Apparatus for Remote Monitoring of Daily Dispensing of Medication |
| US20130088328A1 (en) * | 2011-09-12 | 2013-04-11 | Christopher J. DiMartino | Biometric electronic communicating drug dispenser |
| US8752728B2 (en) | 2012-03-26 | 2014-06-17 | Orbital Innovations, Llc | Portable, time-release dosage form dispensing assembly |
| US20140207278A1 (en) * | 2010-09-13 | 2014-07-24 | Ipcomm Llc | Medication Dispensing System |
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| US20090301925A1 (en) * | 2006-07-05 | 2009-12-10 | Alloro Michael Cohen | Medication Dispenser |
| US8085135B2 (en) | 2006-07-05 | 2011-12-27 | Michael Cohen Alloro | Medication dispenser |
| US8878654B2 (en) | 2006-07-05 | 2014-11-04 | Michael Cohen-Alloro | Medication dispenser |
| US8055380B1 (en) * | 2009-12-01 | 2011-11-08 | Vandana Verma | Daily pill dispensing apparatus |
| US20120035760A1 (en) * | 2010-08-06 | 2012-02-09 | Nathaniel Gerald Portney | Digital dispenser system |
| US9965594B2 (en) * | 2010-08-06 | 2018-05-08 | Nathaniel Gerald Portney | Digital dispenser system |
| US20140207278A1 (en) * | 2010-09-13 | 2014-07-24 | Ipcomm Llc | Medication Dispensing System |
| US8725291B2 (en) * | 2010-09-13 | 2014-05-13 | Ipcomm | Method and apparatus for remote monitoring of daily dispensing of medication |
| US20120065776A1 (en) * | 2010-09-13 | 2012-03-15 | Ipcomm Llc | Method and Apparatus for Remote Monitoring of Daily Dispensing of Medication |
| US9600635B2 (en) * | 2010-09-13 | 2017-03-21 | Anelto | Medication dispensing system |
| US10347377B1 (en) | 2011-06-17 | 2019-07-09 | Omcare LLC. | Web enabled audiovisual medication dispensing |
| US10078732B2 (en) | 2011-06-17 | 2018-09-18 | Omcare Llc | Web enabled audiovisual medication dispensing |
| US9202011B2 (en) * | 2011-06-17 | 2015-12-01 | Lisa M. Lavin | Web enabled audiovisual medication dispensing |
| US20130088328A1 (en) * | 2011-09-12 | 2013-04-11 | Christopher J. DiMartino | Biometric electronic communicating drug dispenser |
| US9439835B2 (en) * | 2011-09-12 | 2016-09-13 | Medication Control Systems, Llc | Biometric electronic communicating drug dispenser |
| US8752728B2 (en) | 2012-03-26 | 2014-06-17 | Orbital Innovations, Llc | Portable, time-release dosage form dispensing assembly |
| US9907730B2 (en) | 2013-02-22 | 2018-03-06 | Remedev, Inc. | Remotely-executed medical therapy device |
| EP2958537A4 (fr) * | 2013-02-22 | 2016-01-20 | Remedev Inc | Dispositif pour thérapie médicale conduite à distance |
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| US11188873B2 (en) | 2013-02-22 | 2021-11-30 | Whenmed Vc Llc | Remotely-executed medical therapy device |
| US20140277705A1 (en) * | 2013-03-14 | 2014-09-18 | Ipcomm Llc | Medication Compliance Monitor - Method and Apparatus |
| US10945917B2 (en) | 2016-04-15 | 2021-03-16 | Nippon Frontier Medicine Laboratories Inc. | Detection apparatus for detecting taking-out of contained object from blister pack, detection method therefor, and medication management system |
| WO2018053627A1 (fr) * | 2016-09-21 | 2018-03-29 | Smart Wave Technologies Corp. | Moniteur de distributeur universel |
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| US20200085694A1 (en) * | 2018-09-15 | 2020-03-19 | Miteshkumar Ishwarbhai Patel | System and method for storing medication and alerting users and caregivers for timely intake |
| US10610457B1 (en) * | 2018-09-15 | 2020-04-07 | Miteshkumar Ishwarbhai Patel | System and method for storing medication and alerting users and caregivers for timely intake |
| USD904007S1 (en) | 2019-01-16 | 2020-12-08 | Omcare Llc | Web enabled audiovisual medication dispenser |
| US11743424B1 (en) | 2019-01-16 | 2023-08-29 | Omcare Inc. | Web enabled audiovisual medication dispensing with enhanced compliance verification |
| US12356113B1 (en) | 2019-01-16 | 2025-07-08 | Omcare Inc. | Web enabled audiovisual medication dispensing with enhanced compliance verification |
| US10653583B1 (en) * | 2019-02-13 | 2020-05-19 | Gary Walker | Programmable pill box assembly |
| US11485568B2 (en) | 2019-12-11 | 2022-11-01 | TW3 Properties LLC | Portable, reusable medication dispensing assembly which has communication capability to improve medication adherence |
| US11357705B2 (en) | 2019-12-11 | 2022-06-14 | TW3 Properties LLC | Portable, reusable dispensing assembly having multiple operating modes |
Also Published As
| Publication number | Publication date |
|---|---|
| US20120154120A1 (en) | 2012-06-21 |
| GB2453483A (en) | 2009-04-08 |
| EP2037990B1 (fr) | 2012-06-06 |
| GB0901306D0 (en) | 2009-03-11 |
| CN101512514A (zh) | 2009-08-19 |
| WO2008004212A3 (fr) | 2009-04-30 |
| EP2037990A4 (fr) | 2010-02-03 |
| WO2008004212A2 (fr) | 2008-01-10 |
| US20090301925A1 (en) | 2009-12-10 |
| CN101512514B (zh) | 2012-10-03 |
| IL176712A0 (en) | 2007-10-31 |
| GB2453483B (en) | 2011-02-16 |
| US8878654B2 (en) | 2014-11-04 |
| US8085135B2 (en) | 2011-12-27 |
| EP2037990A2 (fr) | 2009-03-25 |
| CA2691965A1 (fr) | 2008-01-10 |
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