Reciprocating Medical Devices - a Study of a New Safety Device
| Status: | Completed |
|---|---|
| Conditions: | Arthritis, Cancer, Cancer, Osteoarthritis (OA), Rheumatoid Arthritis, Hospital, Endocrine |
| Therapuetic Areas: | Endocrinology, Oncology, Rheumatology, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | November 2004 |
| End Date: | August 2010 |
Randomized Controlled Trial of the Reciprocating Procedure Device Versus the Conventional Syringe in Syringe-and-Needle Procedures
The study design is a randomized study to directly compare the performance and the outcome
of syringe and needle procedures with a standard syringe or the new reciprocating procedure
device (RDP), which is a type of safety syringe. Over a 5 year period, 820 subjects who
require and assent to a syringe and needle procedure for their usual and customary care will
be randomized to either a conventional syringe or the RPD with one arm with and without
ultrasound guidance. The RPD is designed to be safer, faster, less painful, and more
effective for the patient, and the mechanics of the RPD are intended to provide the
physician with better needle control, resulting in less needle trauma to patient tissues,
and thus, reduced bleeding and pain for the patient. This clinical trial will address
whether the RPD is indeed superior to the conventional syringe for shots, injections, and
needle procedures, and whether it is a safer, less painful syringe.
of syringe and needle procedures with a standard syringe or the new reciprocating procedure
device (RDP), which is a type of safety syringe. Over a 5 year period, 820 subjects who
require and assent to a syringe and needle procedure for their usual and customary care will
be randomized to either a conventional syringe or the RPD with one arm with and without
ultrasound guidance. The RPD is designed to be safer, faster, less painful, and more
effective for the patient, and the mechanics of the RPD are intended to provide the
physician with better needle control, resulting in less needle trauma to patient tissues,
and thus, reduced bleeding and pain for the patient. This clinical trial will address
whether the RPD is indeed superior to the conventional syringe for shots, injections, and
needle procedures, and whether it is a safer, less painful syringe.
* BACKGROUND
The syringe is an ancient device designed principally to inject medications. However,
because of the inherent biomechanics of the human hand and the interaction of the hand with
the piston, the syringe is very stable and easily controlled the injection phase, but is
extremely unstable and difficult to control in the aspiration phase. New reciprocating
technology that accommodates the biomechanics of hand function has great promise of
improving the stability and safety of hand-held devices, including procedure syringes.
* EXPERIMENTAL DESIGN AND METHODS
The study design is a randomized study to directly compare the performance and the outcome
of syringe and needle procedures accomplished either with a standard syringe or the new
reciprocating procedure device (RDP). Over a 5 year period, 820 subjects who require and
assent to a syringe procedure for their usual and customary care will be randomized to
either a conventional syringe or the reciprocating syringe. The following syringe procedures
will be studied: 1) local anesthesia, 2) centesis (arthrocentesis, paracentesis,
thoracentesis, amniocentesis, pericardiocentesis), 3) aspiration and puncture (aspiration of
bursa, cyst, abscess, shunt, bone marrow, and other syringe aspiration procedures), 4)
injection of a therapeutic or diagnostic substance into a joint, bursa, vessel, or other
body structure, 5) fine needle biopsy with syringe vacuum of a mass or tissue, 6) irrigation
procedures (wound, bladder, and other irrigation procedures), and 7) vascular access
(introduction of a wire, catheter, or sheath into a blood vessel), and 8) with and without
ultrasound guidance.
In a subject with multiple individual procedure sites, or requires multiple separate
biopsies, each will be randomized between the two syringes, and each biopsy or fluid sample
will be analyzed separately (as is medically appropriate). The physicians who will perform
the syringe procedures will be those physicians who usually perform the syringe procedures
and are credentialed to do so. Outcome data collection will occur first by one of the
investigators observing the procedure and collecting the data by real time interview and by
chart review including cost analysis. Outcome data will include effectiveness (preprocedural
pain, pain at 2 weeks post procedure, and pain at 6 months postprocedure), procedure time,
patient pain, operator satisfaction, trauma to tissues, complications, diagnostic yield,
overall medical care costs and hospital stay. Retrospective review of 30 charts of the
device used clinically has also been approved (2006). Analysis of data will be performed by
a statistician blinded to treatment group.
*SIGNIFICANCE: The proposed study will be the first to study the clinical performance
characteristics of a medical device that incorporates the new reciprocating technology
designed to take advantage of the inherent biomechanical stability characteristics of the
human hand. The preclinical studies presented in the preliminary data demonstrate markedly
enhanced device performance characteristics, and much greater control and stability,
strongly suggesting that reciprocating devices will be safer, more effective, more
economical, and provide better patient outcomes.
The syringe is an ancient device designed principally to inject medications. However,
because of the inherent biomechanics of the human hand and the interaction of the hand with
the piston, the syringe is very stable and easily controlled the injection phase, but is
extremely unstable and difficult to control in the aspiration phase. New reciprocating
technology that accommodates the biomechanics of hand function has great promise of
improving the stability and safety of hand-held devices, including procedure syringes.
* EXPERIMENTAL DESIGN AND METHODS
The study design is a randomized study to directly compare the performance and the outcome
of syringe and needle procedures accomplished either with a standard syringe or the new
reciprocating procedure device (RDP). Over a 5 year period, 820 subjects who require and
assent to a syringe procedure for their usual and customary care will be randomized to
either a conventional syringe or the reciprocating syringe. The following syringe procedures
will be studied: 1) local anesthesia, 2) centesis (arthrocentesis, paracentesis,
thoracentesis, amniocentesis, pericardiocentesis), 3) aspiration and puncture (aspiration of
bursa, cyst, abscess, shunt, bone marrow, and other syringe aspiration procedures), 4)
injection of a therapeutic or diagnostic substance into a joint, bursa, vessel, or other
body structure, 5) fine needle biopsy with syringe vacuum of a mass or tissue, 6) irrigation
procedures (wound, bladder, and other irrigation procedures), and 7) vascular access
(introduction of a wire, catheter, or sheath into a blood vessel), and 8) with and without
ultrasound guidance.
In a subject with multiple individual procedure sites, or requires multiple separate
biopsies, each will be randomized between the two syringes, and each biopsy or fluid sample
will be analyzed separately (as is medically appropriate). The physicians who will perform
the syringe procedures will be those physicians who usually perform the syringe procedures
and are credentialed to do so. Outcome data collection will occur first by one of the
investigators observing the procedure and collecting the data by real time interview and by
chart review including cost analysis. Outcome data will include effectiveness (preprocedural
pain, pain at 2 weeks post procedure, and pain at 6 months postprocedure), procedure time,
patient pain, operator satisfaction, trauma to tissues, complications, diagnostic yield,
overall medical care costs and hospital stay. Retrospective review of 30 charts of the
device used clinically has also been approved (2006). Analysis of data will be performed by
a statistician blinded to treatment group.
*SIGNIFICANCE: The proposed study will be the first to study the clinical performance
characteristics of a medical device that incorporates the new reciprocating technology
designed to take advantage of the inherent biomechanical stability characteristics of the
human hand. The preclinical studies presented in the preliminary data demonstrate markedly
enhanced device performance characteristics, and much greater control and stability,
strongly suggesting that reciprocating devices will be safer, more effective, more
economical, and provide better patient outcomes.
Inclusion Criteria:
- A syringe and needle procedure is required for the normal customary care of the
patient
Exclusion Criteria:
- hemorrhagic diathesis,
- use of anticoagulants and antiplatelet agents child or susceptible population
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