TECHNICAL FIELD

The current invention relates to an injection device that is configured for attachment to the skin of a patient using an adhesive layer, the injection device comprises a release liner covering the adhesive layer and the release liner is used to remove sterile barrier films located within the housing when the release liner is removed.

BACKGROUND OF THE INVENTION

Injection and infusion devices are used for the subcutaneous delivery of liquid medicaments to a patient. Such injection devices are often pen-shaped, having a long axis and are called injection pens. The injection pens comprise a housing, which can hold a dose setting and dose delivery mechanism. The medication is preferably present in a cartridge or in a prefilled syringe. A cartridge is normally attached to the housing of the injection pen using a cartridge holder. The user sets a dose of medication which is subsequently delivered from the cartridge. Such injection pens are used to deliver separate injections and not intended for continuous delivery of a medicament. The needle is attached to the injection pen each time before use and the needle penetrates a septum that is attached to the cartridge.

Infusion devices deliver the medication from the cartridge using a drive mechanism and a control mechanism that controls the advancement of a piston rod that abuts a moveable plunger present in the cartridge containing the medication. The medication is delivered to the patient via a fluid path and an external infusion set comprising a needle for subcutaneous delivery. With such infusion devices both continuous and temporary medicament delivery profiles can be programmed.

A patch device is an example of an infusion device that is attachable to the skin of the patient. Such patch devices do not need an external infusion set for delivery as the needle is directly contained in the patch device and may be inserted into the patient therefrom.

The injection and infusion devices comprise a dose setting mechanism, a delivery mechanism, a needle insertion and retraction mechanism or a needle shield protection system which is connected or connectable to a drive mechanism. The drive mechanism is driven by a power source which supplies energy to the injection or infusion device for executing tasks such as medication delivery, establishing a connection between the fluid path and the cartridge, needle insertion, needle retraction, advancing and/or retracting a piston rod, signaling to the user that the medication is in progress and/or complete, signaling to the user that the device can be removed, powering a processor unit in the device or establishing a wireless connection for data transmission to an external such as a smart phone. The power source used in such injection or infusion devices can be selected from a wide variety of options such as, but not limiting to, a spring (compression, torsional spring, and leaf spring), an electromotor, a battery, pressurized gas or liquid-hydraulic systems and the like. In the injection and infusion devices, several operations need to be arranged in a certain sequence for a correct operation and transmission of power from the energy source to final medicament delivery, for example, by advancing the plunger in the cartridge.

For a patch injection device, the needle must be inserted first, either using a steel needle (also called cannula) or a combination of a steel needle with a soft cannula; subsequently the steel needle must be retracted to leave the soft cannula in the subcutaneous tissue of the patient, followed by delivery of medication. Preferably, the needle, either a soft needle or a steel needle is retracted into the device before the patch device can be removed from the body. Alternatively, the needle is not retracted but a needle shield is extended from the body of the device to protect the needle tip and prevent needle stitching by the patient.

The liquid medicament is produced under sterile conditions and enclosed in a container to keep the medicament sterile. Such a container can be the above mentioned cartridge or an ampoule, both of which are preferably made of glass. As an alternative plastic containers may be used. The cartridge comprises a barrel having two openings, one opening at the end of a neck portion and a second opening opposite to the neck portion. The opening at the neck portion is normally closed by a penetrable septum that is attached to the neck portion using a crimp. The opposite opening is closed by a plunger and the medicament is enclosed by the barrel between the septum and the plunger. During medication delivery, the plunger in the cartridge is advanced in the cartridge by the drive mechanism. The cartridge is filled with the liquid medicament in a fill finish line, and either the plunger is inserted first into the barrel and the medicament is filled via the neck portion followed by closure using the septum crimped onto the neck portion, or the septum is attached first to the cartridge's neck and the medicament is filled from the opposite opening and finally closed by the plunger. The fill finish is done in a sterile environment. The filled cartridge is normally subjected to a visual inspection to ensure that no particulates are present in the liquid.

The filled cartridge is assembled with an injection or infusion device, preferably a patch device, having a fluid path unit that is used for establishing the connection between a fluid path and the liquid medicament. The fluid path unit comprises a housing or containment for housing a fluid path in the interior. The fluid path may comprise a needle or spike that can pierce through the septum of the cartridge, a tubing for fluid transfer connecting the needle or spike to a second needle (which is either a soft needle and/or a steel needle) intended for penetrating the skin of the patient. Preferably, during shelflife there is no connection between the cartridge and the fluid path and just prior to use the connection is established by penetrating the septum of the cartridge with the spike or needle. The interior of the housing or containment for the fluid path unit is sterilized during manufacturing and remains in a sterile condition during shelflife. The fluid path unit and the cartridge can be assembled in a sterile environment which may be cumbersome (for example in view of the visual inspection) and expensive or it is assembled in a non-sterile environment such as a clean room. The device comprising the assembly of the fluid path unit and cartridge can be in a sterile packaging during the shelflife which is removed just before use or it is in a non-sterile packaging. In either option, a sterile connection needs to be established between the content of the cartridge and the fluid path in the containment of the fluid path unit prior to use and this is usually done in a non-sterile environment. The US20160199568 discloses an infusion device with a peristaltic pump. The tubing of the pump is connected to a connector assembly comprising an ampoule with a liquid medicament and a connector for the tubing. Between the ampoule and the connector there are two strips to prevent the liquid passing from the ampoule to the tubing. The ampoule is directly closed by the film and not with a septum, and the connector for the tubing is always connected to the ampoule - there is no spike or needle for establishing the connection between the liquid medicament just prior to use. Removing the strip simultaneously establishes: a) a fluid connection between the cartridge and the tubing, and b) a sterile connection between the ampoule and the tubing. The fact that there is no separate closure for the ampoule reduces the reliability of the fixed connection and cannot be used for a modular assembly approach, moreover it will be cumbersome to use standard fill- finish procedures and standard components (such as a cartridge closed by a septum) for the device described in US20160199568.

In US4019512 a sterile connection between two connector ends of two tubings is established in a non- sterile environment by removing two strips from the two connector ends. The two strips keeping the ends of the tubings in a sterile environment during shelflife and the strips are removed after the two connector ends have been connected. A sterile connection is established between two tubings and not intended or suitable for establishing a connection between a cartridge and a fluid path of an infusion device.

In European Patent Application EP18161873.7 a cartridge is provided that is closed with a septum and therefore steps a) and b) that are mentioned above and occur simultaneously in the prior art are separated from each other. First a sterile connection is established between the fluid path and the standard cartridge and secondly the spike or needle of the fluid path penetrates the septum of the cartridge to establish the fluid connection. The advantage of having a standard cartridge closed by a septum and crimp is that standard production procedures can be used for fill-finish of the cartridge using standard components which increases the reliability of the assembly and the acceptance by pharmaceutical companies. A modular approach can be used, the cartridge may be filled at a different location then the assembly with the fluid path unit. Another advantage is that the cartridge with the sterile surface on the septum can be assembled with the sterile fluid path unit in a non-sterile environment. The connection shown in US20160199568 must be assembled in a sterile environment.

In European Patent application EP18161873.7, the septum of the cartridge is covered by a sterile barrier film and/or a passage inside of the injection device is covered by a sterile barrier film. The films are intended to keep the surface of the septum in a sterile condition and/or to keep a fluid path unit enclosed in a compartment having the passage in a sterile condition. The ends of the films go through a passage in the housing and through a passage in an adhesive layer configured for attaching the device to the skin of the patient. Prior to use, the adhesive layer is covered with a release liner protecting the skin adhesive layer. The ends of the sterile barrier films are connected to the release liner and the two sterile barrier films are removed simultaneously from the septum respectively the passage when removing the release liner from the adhesive layer. For a correct attachment of the ends of the sterile barrier films to the release liner, also a passage or aperture in the release liner is required. The sterile barrier films that are attached to the septum respectively to the passage of the fluid path, need to go through the passages in the housing, the adhesive layer and the release liner before the end of the sterile barrier can be attached to the surface of the release liner. No details for the passage are disclosed or means to further prevent liner fracture.

In WO 2018151890 a drug delivery device comprising a sterile fluid flow path is disclosed. Removable membranes are attached to sealing members which are part of the cartridge, and to an end of a fluid pathway. The membranes ensure that the sealing members remain in a sterile condition during shelflife and they are removed prior to moving the fluid pathway assembly towards the cartridge or the cartridge towards the fluid path assembly. The removable membranes may be connected to a membrane removal member to remove the membranes from the sealing members. The membrane removal member may be connected to a liner covering an adhesive layer attached to the device, and both removable membranes are attached to one side adjacent a passage in the liner, which may lead to increased mechanical stresses in the liner when removed and potentially lead to liner fracture. Additionally no details for the passage are disclosed or means to prevent liner fracture.

It is an object of the present invention to overcome the above mentioned drawbacks and provide an injection device comprising an improved housing and release liner for removing sterile barrier films using the release liner and improve the reliability and usability of the device. Additionally the improved housing and release liner facilitate the assembly of the device.

These objectives are solved by providing a notch in the housing, the skin adhesive layer and the release liner which form a passage for the films that are part of the removable sterile barrier and which allow for easy insertion of the films. Preferably the notch is U-shaped and the ends of the films that are connected to the release liner are attached to the release liner at different locations adjacent from the notch to reduce the mechanical stresses upon liner removal. The notch may be closed by a cover to guide the films and finally the release liner may be further strengthened using a strengthening sheet.

DEFI NITIONS

The term "medicament” or "medication” includes any flowable medical formulation suitable for controlled administration through a means such as, for example, a cannula or a hollow needle and comprises a liquid, a solution, a gel or a fine suspension containing one or more medical active ingredients. A medicament can be a composition comprising a single active ingredient or a pre-mixed or co-formulated composition with more than one active ingredient present in a single container. Medication includes drugs such as peptides (e.g., insulin, insulin-containing drugs, GLP-1 containing drugs or derived or analogous preparations), proteins and hormones, active ingredients derived from -or harvested by- biological sources, active ingredients based on hormones or genes, nutritional formulations, enzymes and other substances in both solid (suspended) or liquid form but also polysaccharides, vaccines, DNA, RNA, oligonucleotides, antibodies or parts of antibodies but also appropriate basic, auxiliary and carrier substances.

The distal end or distal direction is defined by the direction of the needle configured to penetrate the skin of the patient. For an injection pen this may be the injection needle and the end of the pen holding the needle or being configured to hold the needle is the distal end. For an infusion device the distal end and the distal direction is towards the needle configured to penetrate the skin of the patient, which may be along the axis of the device or tilted or perpendicular to the axis of the device. The distal direction in an infusion device represents the direction in which the medicament flows towards the insertion needle. The proximal direction or end is opposite to the distal direction or end.

In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "a" or "an" does not exclude a plurality. For example "a film” does not exclude the fact that there may be two films that functionally or structurally fulfill the purpose of "a film”. The mere fact that certain elements or steps are recited in distinct claims shall not preclude the existence of further meaningful combinations of these elements or steps.

GENERAL DESCRIPTION OF THE INVENTION

The injection device of the current invention comprises the following units:

A housing unit (HU) that the user holds for placing and attaching the injection device to the skin and which encloses the other subassemblies that will be described below. The housing unit may have a starting button accessible to the user for starting the injection and a sensing patch unit (SU) attached to an outside surface. The housing unit may have a viewing window for viewing a part of a cartridge unit (CU) enclosed within the housing that will be described below as well. Furthermore, the housing unit may have selected areas intended for providing visual signaling to the user. The selected areas may be transparent or semi-transparent to view an optical indicator. The housing unit may have an opening for receiving the cartridge unit and the opening may be closed using a cover.

A control unit or Printed Circuit Board Unit (PU) which controls the device based on signals received from the sensing patch unit, from a Drive Unit (DU) having a power source such as an electromotor or signals received from an external source via a wireless communication such as a Bluetooth connection. The control unit comprises a Printed Circuit Board (PCB) and the electrical power is preferably supplied by a battery present in the Drive Unit. The electronic circuitry of the injection device comprises the battery, the PCB and optionally the sensing patch unit (SU) comprising sensors that will be described below. The electronic circuitry may be open, i.e. switched off during shelflife and closed just prior to use in order to increase the lifetime of the battery or, alternatively, the electronic circuit is closed, i.e. switched on during shelflife. In the latter case, the control unit may have means for providing electric pulses applied at a certain frequency or duty cycle to the SU to check the status of the sensors (i.e. receive signals from the sensors) and therewith the status of the device and increase the battery lifetime while the electrical circuitry is always switched on. The PCB may have a push button switch which may be pressed upon by the starting button for starting the injection of the device. The push button switch may be in a disabled (or silent) mode during shelflife and enabled (activated mode) when the sensing patch unit provides a signal that, for example, the device is attached to the skin of the patient. The control unit may provide signals to the user of the device such as audible, tactile or visual status signals related to the start, progress, end of the injection or when there is a malfunctioning of the device. Examples of the malfunctioning are an occlusion in the medicament delivery system, low battery power, removing the device from the injection site prior to finalizing the injection or failure to insert or retract the needle from the patient's skin. The printed circuit board unit may also send the status signals to an external source such as a smart phone using a bluetooth connection.

The injection device further comprises a drive unit (DU) comprising a drive housing supporting the components of the drive unit. Once the device and the drive unit is activated and advances a piston rod from a retracted position to an extended position for delivering a medicament from a cartridge unit (CU) via a needle unit (NU) to the patient. An example of such a power package is a battery powered electromotor that both may be part of the DU. Alternative power packages such as pneumatic, hydraulic or spring driven mechanisms may be used as well that are operated either pure mechanically or are supported by the battery powered electromotor. The housing of the of the drive unit supports and guides the piston rod either for a pure linear advancement, or the piston rod may be segmented and guided to perform a U-turn in order to reduce the dimensions (length) of the device. The segments of the piston rod may be connected to each other using hinges or they may be non-connecting elements that are guided by the housing of the drive unit into the cartridge unit. A gearing mechanism is part of the drive unit and the gearing mechanism transforms a rotation of the electromotor into piston rod advancement. The piston rod may rotate around its axis or slide during advancement. For rotational advancement, the piston rod is threadedly engaged with the housing of the drive unit, for non-rotational advancement the piston rod is splined to the housing of the drive unit. For example, the gear mechanism may rotate a threaded rod which is threadedly engaged with a piston rod that is splined to the housing such that the piston rod advances without rotation as the threaded rod is rotated. The gear mechanism may comprise a plurality of gear wheels including worm wheels and the gear mechanism may engage a gear wheel that is part of a cam shaft (CT) driving the needle insertion and retraction mechanism in the needle unit (NU). The control unit may control the rotation, the rotational speed and the rotational direction and therewith control and switch between the different operational states of the device, e.g. at rest, needle insertion into the patients skin, establishing a fluid communication between the cartridge unit and the needle unit, delivery of the medicament and retracting the skin needle into the needle unit upon completion of the injection. Preferably, the rotation of the electromotor is switched from non-rotating when the device is sleeping during shelflife, into rotation in a first rotation direction for activating the needle insertion mechanism of the needle unit comprising the skin needle and cartridge needle to establish the fluid connection between the patient and the cartridge unit. Subsequently the rotation direction is reversed in the second direction to advance the piston rod and expel medicament from the cartridge unit and finally the rotation direction may switch back to the first direction for retracting the skin needle from the patient. The rotation is transmitted from the electromotor to the drive unit (piston rod) and the needle insertion mechanism (needle unit) via the gearing mechanism to gear up or gear down the rotational speed of the electromotor. The electromotor thus may generate different rotational speeds for each rotation direction and for each operation status. The mechanism for advancing the piston rod, for example via the threaded rod described above, may be permanently coupled to the gearing mechanism or there may be a coupling mechanism between the gearing mechanism and the threaded rod such that piston rod advancement mechanism can be decoupled from the operation of the needle unit. The needle unit may be permanently coupled to the gearing mechanism or a second coupling mechanism may couple or decouple the rotation from the gear mechanism to the needle unit. The coupling mechanism may be a one-way coupling mechanism such that rotation in one rotation direction is transmitted either to the needle unit or to the threaded rod of the piston rod drive mechanism. Preferably, the one-way coupling is an axial or radial one-way ratchet system.

The drive unit housing may provide structural support to other components of the injection device and may hold the PCB unit, the needle unit or the cartridge unit. The drive unit housing may support and provide guidance to contacting elements that enable the transfer of signals from a sensor layer that is part of the sensing patch unit to the PCB unit. The drive unit is configured to be connected to the housing unit.

A sensing patch unit (SU) is attached to the outside surface of the housing and comprises a multilayered system having at least one adhesive layer for attachment to the housing, one skin adhesive layer for attachment to the skin of the patient, one release liner layer covering the skin adhesive layer, one sensor layer comprising sensors, preferably capacitive sensors, one layer having contacts for contacting the sensors in the sensor layer to the control circuit located at the printed circuit board. The sensors in the sensing patch are preferably capacitive sensors and the capacity of the sensors depends on the presence or absence of the release liner and whether the sensors are in close contact with the human skin. The release liner may have electrically conductive areas at least partially shielding the capacitive sensors in the sensor layer and therewith the release liner removal may be detected by the sensors as the dielectric and therewith capacitance is changed due to the removal.

Once the device is attached to the skin, the capacitance may change once again or reach a certain level which is measured by the sensors in the sensor layer and signaled to the PCB. The capacitive sensors are powered by the battery present in the drive unit via the contacting elements that are preferably guided through the drive unit. The sensor layer may have a plurality of sensors embedded therein or printed thereon. The capacitance is measured and transmitted to the control unit of the PCB and the data are used to, for example, enable the push button switch or even automatically start the injection procedure. The sensors in the sensor layer may be formed as electrically conductive areas in the sensor layer for example by printing or by galvanic or chemical deposition of metals (such as silver, gold, aluminum, copper or metal alloys) onto a base sheet forming the sensor layer. Alternatively an electrically conductive carbon layer is used as the sensor which is printed onto the base sheet or formed by local carbonization of the base sheet. Laser light that locally carbonizes a polymeric sheet of base material such as polycarbonate or polyethyleneterephthalate may be used for that purpose. The sensing patch unit SU may not have a sensor layer but the sensors may be embedded in the housing of the injection device. For example electrically conductive sensor areas may be injection molded directly onto or into the housing using two-component injection molding techniques wherein one component is non-conductive whereas the other component is electrically conductive. The other component may, for example be a carbon black filled plastic or a plastic filled with metal particles and the carbon black or the metal particles form a percolating network. Alternatively, the housing is treated with laser light to locally carbonize the surface and form the sensor areas. As another alternative, the surface may be flamed to form the conductive layer.

The multilayered system forming the sensing patch unit SU provides at least one passage for the skin insertion needle or for the films that are connected to the needle unit and/or cartridge unit within the housing. The films are guided via the passage in the housing and the passage in the sensing patch unit to the outside surface of the release liner.

The injection device further comprises the needle unit NU enclosed by a needle housing comprising a compartment enclosing a fluid path that can be sterilized, a receiving section for receiving the cartridge unit and a needle insertion and retraction mechanism. The needle insertion and retraction mechanism enables the movement of the skin needle from a retracted position inside the fluid path compartment through a passage to the outside of the compartment for skin insertion. The needle retraction mechanism moves the skin needle back into the compartment after delivery of the medicament. The needle retraction mechanism is optional as the skin insertion needle may not be retracted into the device but instead a needle shield may protect the needle after delivery and the shield may move axially or rotationally from the inside of the injection device to the outside thereby covering the tip of the skin needle and avoid undesired needle stitching. The needle insertion mechanism may further provide means for inserting the cartridge needle from a position within the fluid path compartment to a second position outside the compartment thereby penetrating a septum of the cartridge unit. The needle insertion for the cartridge needle and skin needle preferably occur simultaneously and the connecting conduit ensures that the medicament can flow to the patient. The cartridge needle and the skin needle are preferably oriented perpendicular to another. The cartridge needle and the skin needle are preferably hollow steel needles that are each engaged with a carrier. Alternatively, hollow plastic needles are used which may be rigid or flexible. In the latter case, the flexible needle is inserted together with a rigid needle into the skin of the patient and the rigid needle is subsequently retracted.

The needles may have the opening at the tip and/or may have separate opening on the side (pencil tip configuration). The carriers may be slideably engaged within the fluid path compartment and driven by at least one resilient member from a first to a second position thereby inserting the cartridge needle into the cartridge unit and the skin needle into the patient's skin. As a resilient member springs may be used such as compression springs, torsional springs, leg springs or belleville springs. Alternatively elastic elements, compressed gas or pyrogenic means may be used to insert the needles. The resilient member may directly engage with the carriers for the skin needle or the cartridge needle or the resilient element may engage an intermediate member that engages the carrier, having the advantage that tolerances may be compensated that arise when the carriers move towards the inserted position. Controlling the release of the resilient member for needle movement is done using a needle control element. The needle control element is part of the needle unit and moves from a first position to at least one intermediate position into an end position. In the initial position, the control element blocks the movement of the needle carriers that are biased to move towards the inserted position. In an intermediate position, the carriers for the cartridge needle or the skin needle may be released and the cartridge needle and/or the skin needle move to the inserted position. In the end position of the needle control element, the skin needle is retracted into the fluid path compartment or the needle shield is released to cover the non-retracted skin needle. The control element may be slideably engaged with the needle housing and preferably moves parallel to the bottom of the injection device from the starting to the end position or the control element may rotate through the several positions. The control element is driven by a cam shaft (CT) that is part of the needle unit and preferably engaged with the gearing mechanism of the drive unit. The cam shaft is therefore rotated by the electromotor via the gearing mechanism. The rotation of the cam shaft is preferably converted into an axial movement of the control element using a gear rack and the rotation of the cam shaft may be converted in a rotation of the control element using a link-motion or another gearing mechanism. The fluid path compartment of the needle housing may have an opening that facilitates the assembly of needle insertion and retraction mechanism and the opening is closed by a needle cover (NC) that is glued, welded (for example laser welded or ultrasonic welded) onto the housing to close the opening after assembly. The fluid path compartment has passages that allows the cam shaft to engage with the drive unit, or allows the cartridge needle to pierce the septum of the cartridge unit, or allows the skin needle to insert into the skin of the patient. For a safe operation of the device and to prevent contamination of the medicament, it may be required to sterilize the fluid path compartment and therefore the needle cover must form a sterile barrier for the opening in the fluid path compartment. Additionally, the passages for the cam shaft and the needles need to form a sterile barrier or are covered by a sterile barrier. The cam shaft is preferably engaged with the needle housing using an air tight seal such as an O-ring thus allowing for rotation of the cam shaft while preventing contamination of the fluid path compartment. The passages for the needle are covered by a sterile barrier film that is preferably removed prior to the needle movements as the needles may punch out a part of the film leading to needle blockage. The fluid path compartment may be sterilized via the passages as the films covering the passages are porous and enable chemical gas sterilization. Alternatively, the films are non-porous and radiation sterilization is used for sterilizing the fluid path compartment or, alternatively, a separate window is part of the needle housing which is covered by a porous film for chemical sterilization. The sterile barrier films have to be removed prior to use and therefore, the needle housing has an aperture which may be a closed or a half open aperture, for example a notch, for guiding the ends of the films to the outside of the needle housing. The sterile barrier films may be removed as the user pulls on the end of the film or the end of the films are attached to the release liner and removed together with the liner. The aperture is part of the fluid path compartment and/or the cartridge receiving section of the needle housing. Alternatively, the sterile barrier films are removed as the ends of the films are connected to a film removal mechanism that is engaged with, and driven by the gear mechanism of the drive unit. The injection device comprises a cartridge unit (CU) which may be inserted just prior to injection, or the injection device is ready to use and already contains the cartridge unit. The cartridge unit comprises a hollow barrel having two open ends. The barrel is preferably made from glass and optionally made from a plastic such as polypropylene. At the distal end, the barrel narrows into a neck section which is configured for attaching a pierceable septum to the barrel. The septum is attached to the neck using a crimp cap. Opposite to the septum, the barrel is closed by a plunger thereby enclosing the liquid medicament in a fluid tight manner. Advancement of the plunger by the piston rod of the drive unit expels the medicament from the cartridge once a fluid path connection has been established by piercing the septum with the cartridge needle. A cartridge adapter may be positioned between the plunger and the piston rod to compensate for an axial gap between the plunger and the distal end of the piston rod. The cartridge unit is receivable in a cartridge holder which is part of the needle housing or the housing unit. Once the cartridge is received in the cartridge holder, the septum is aligned with the cartridge needle. The barrel of the cartridge unit is preferably oriented parallel to the bottom of the housing unit intended for attachment to the patients skin. The surface of the septum that is not contacting the medicament is sterile and protected from contamination during shelflife. A sterile barrier film may cover the surface of the septum and the septum's surface is sterilized using chemical sterilization, steam sterilization or heat sterilization. Preferably a porous film is used as sterile barrier film in combination with chemical sterilization such as ETO sterilization. The sterile barrier film is preferably attached to the crimp of the cartridge unit and the sterile barrier film may be protected by a protective cap that may be removed prior to inserting the cartridge unit into the device. The sterile barrier film is removed before the cartridge needle pierces the septum. The sterile barrier film may therefore comprise a pull tab that the user removes before inserting the cartridge unit into the device or, preferably for a ready to use device, the pull tab is removed by the user once the CU is in the device or the pull tab is attached to the release liner. Alternatively, the sterile barrier is removed during production, just after the cartridge unit has been inserted. For removing the sterile barrier, the pull tab has to go through the apertures in the needle unit, the cartridge holder and the housing unit before being available to the user for direct removal or for attachment to the release liner for removal using the liner.

The specific details for the removal of the sterile barrier films from the cartridge unit and the needle unit are described in the following. It is an objective of the present invention to provide an injection device which is configured for attachment to the skin of a patient using an adhesive layer. The injection device comprises a housing, for example the housing unit (HU) described above, and the skin adhesive layer attached to an outside surface of the housing for attaching the injection device to the skin of a patient which is covered by a release liner thereby preventing skin attachment of the injection device. The skin adhesive layer and the release liner are part of the sensing patch unit (SU). Furthermore the injection device comprises a film having two ends, one end is connected to a surface inside of the housing and forming a removable sterile barrier, the other end is connected to an outside surface of the release liner that is not contacting the skin adhesive layer. The injection device is characterized by a notch in the housing, in the skin adhesive layer and in the release liner defining a passage for the film from the inside to the outside of the housing. The notches in the housing, in the skin adhesive layer and in the release liner are aligned with respect to each other to form the passage. A notch implies that the open end of the notch is located at a rim or border of the housing, the skin adhesive layer and the release liner respectively. The notch in the housing serves as the aperture described above that may be housing unit, the cartridge holder or the needle unit. The film having two ends where one end is connected to the release liner and the other end inside the housing forming a sterile barrier ensures that the film, and therewith the sterile barrier can be removed simultaneously with the release liner in a single step, therewith improving the usability of the device as the sterile barriers do not have to be removed separately. The notch in the housing and the alignment with the notches in the adhesive layer and the release liner enhances easy assembly of the device as the films can be inserted into the notch, and do not have to be passed through a closed aperture in the housing which would be cumbersome.

Preferably, the notch in the housing, the skin adhesive layer and the release liner comprises a U- shaped aperture ending in a notch opening configured for receiving the film. The notch opening facilitates the insertion of the film into the U-shaped aperture as it allow sideways insertion. A closed aperture requires insertion in a plane perpendicular to the plane of the U-shaped aperture which would be difficult in view of the amount of space available in the device. The U-shaped aperture has two legs that are preferably oriented parallel to another and may facilitate the guidance of the film upon release liner removal when the films are attached to the release liner or even when the films are directly removed by the user.

Preferably, the injection device comprises two films, each film having two ends wherein one end of each film is connected each to one of two surfaces inside of the housing forming two removable barrier films and the other end of each film is connected each to the outside surface of the release liner that is not contacting the skin adhesive layer. One of the two films is attached to the needle unit (NU) and the other film is connected to the cartridge unit (CU). The two surfaces inside the housing are kept in a sterile condition during shelflife thereby preventing contamination of the surfaces during shelflife and therewith prevent contamination of the medicament during the injection upon use. Additionally the fact that two films are used has the advantage that the two subassemblies (CU and NU) can be produced separately, and if required at different locations and each can be sterilized using an appropriate sterilization technique. For example the needle unit can be sterilized using radiation sterilization whereas the cartridge unit comprising the medicament may be damaged by radiation and is sterilized using chemical surface sterilization.

The injection device wherein one of the two other ends is connected to the release liner adjacent to one leg of the U-shaped aperture whereas the other of the two other ends is connected to the release liner adjacent to the other leg of the U-shaped aperture in the release liner. Each of the two other ends is each connected to one side of the U-shaped aperture and are therefore opposite to another. This has the advantage that the force that is required to remove the two films is distributed to two locations upon release liner removal thereby reducing the stress concentrations in the release liner and the potential for tear and damage of the release liner leading to partial liner removal. Additionally, the release liner is unrolled from the skin adhesive layer and by connecting the ends of the films to two locations surrounding the U-shaped aperture, the two ends that are removably connected to the inside of the housing and forming the sterile barrier can be removed one after another which again reduces the initial stress in the release liner when the sterile barriers are removed. If the two ends of the films are connected to the same location, or on one side of the U-shaped aperture then this may lead to undesired stress concentrations as the two films are simultaneously removed and the forces are directed to a single location only.

The notch opening of the injection device is closed by a cover. When the notch opening is closed by the cover, a closed aperture is formed surrounding the two films, thereby the play for the films is reduced and the films cannot leave the notch when the release liner is removed leading to a better control of the removal of the sterile barriers within the housing. The cover may be part of the housing unit (HU) and preferably closes the opening that is available for receiving the cartridge unit (CU) as well. The cover preferably slides along the rim having the notch opening when the cover closes the housing

The cover may be a separate housing cover that can be splined to the housing unit such that the separate housing cover can be guided when closing the housing and notch opening after receipt of the film. The film is preferably received in the notch opening during insertion of the cartridge unit (CU) into the housing unit. The cover is engaged with the housing, preferably the cover is already guided while the notch opening is still open and available for receiving one or two films, and subsequently the cover is slided to the end position and thereby closing the notch opening forming a closed passage for the one or two films.

The notch in the housing preferably has rounded edges. During release liner removal the films may slide along the surface of the notch, preferably along the surfaces forming the legs of the U-shaped notch, and rounded edges facilitate the smooth removal and prevent fracture of the films when the release liner is removed.

The one end of the film forming a removable sterile barrier is connected to a surface of, and covering a passage in a fluid path compartment located in the housing, preferably in the needle housing. The needle housing comprises a cartridge needle configured to be moved within the fluid path compartment through the passage and the one end of the film forming a removable sterile barrier keeps the fluid path compartment in a sterile condition when covering the passage. The fluid path compartment located in the housing comprises a fluid path consisting of a conduit connecting the cartridge needle to a skin needle. The fluid path should be protected from contamination during shelflife and upon use the skin needle and cartridge needle connect to the skin and cartridge respectively to provide a safe fluid connection between the medicament and the patient. The fluid path compartment encloses the fluid path and passages are available for the skin needle and the cartridge needle which need to be closed by protective films preventing contamination during shelflife and which are free for passage of the needles during use. Therefore the films are removable films as otherwise the needles have to go through the protective films first which may lead to needle blockage as the (hollow) needles may punch out a part of the film.

One end of the film forming a removable sterile barrier is connected to the end of a cartridge or cartridge unit (CU) that is located within the housing and closed by a pierceable septum, the one end of the film forming a removable sterile barrier covers the surface of the septum and keeps the surface of the septum in a sterile condition while covering the septum. The medicament is preferably enclosed in a cartridge and needs to be sterile during shelflife. The cartridge is closed by a septum and the outside surface preferably remains in a sterile condition too during shelflife and cannot be contaminated. The cartridge with attached film is preferably sterilized prior to filling the medicament into the cartridge such that the film and the surface of the septum are sterile. This is achieved by the end of the film forming a sterile barrier and covering the septum. The film is removed such that the cartridge needle that is driven by the insertion mechanism is driven through the passage into the pierceable septum that is not covered.

The one end of the film forming a removable sterile barrier is connected to an end surface of the crimp (or crimp cap) holding the septum to the cartridge. The end of the film is preferably attached (for example by heat sealing, glueing or ultrasonic sealing) to the end surface of the crimp prior to attaching the septum to the cartridge using the crimp. In a subsequent step the surface of the septum behind the end of the film is sterilized and remains sterile.

The cartridge needle present in the needle unit (NU) is configured to be moved through the passage of the fluid path compartment into the pierceable septum of the cartridge unit when the one end of the film forming a removable sterile barrier that is covering the passage of the fluid path compartment and the one end of the film forming a removable sterile barrier connected to the end of the cartridge have been removed. When both ends of the films have been removed the passage of the fluid path compartment and the surface of the septum are free and the cartridge needle can pierce the septum without the risk of needle blockage due to punching of one or both of the ends of the films forming a sterile barrier.

Both films may be removed prior to use of the device such that the two sterile barrier films on the needle unit and the cartridge unit cover the passage of the fluid path compartment and the septum during shelflife. Alternatively, the films are removed during production, after insertion of the cartridge and closure of the housing unit using the cover such that there are no sterile barrier films present during shelflife. In the latter option it is preferred to package the device in a suitable packaging, for example a peel pouch or blister to prevent contamination of the surface of the septum during shelflife. As another alternative, only one of the two film is removed and the cartridge needle pierces one of the two films that has not been removed. As yet another alternative, the two films are not removed and the needle pierces both films before penetrating the septum.

The film comprising both ends and the sterile barrier film may be a monolithic film, i.e. made of a single sheet of material, or the film comprises a pull-tab attached to the one end of the film forming a sterile barrier whereas the pull tab comprises the other end of the film connected to the outside layer of the release liner. The pull tab is made from a different material then the one end of the film forming a sterile barrier. The use of a separate pull tab ensures that different films for different purposes may be used. For the sterile barrier, preferably porous membranes such as Tyvek may be used which allow for chemical sterilization techniques (using ETO, Gas plasma (ozone), Hydrogen Peroxide or Nitrogen Oxide gases that may flow through the porous membrane) or that can be easily attached to the end of the cartridge, preferably to the end of the crimp. For the pull tab, films may be used that can be properly attached to the release liner or which have a higher tear strength. By using two different films using two different materials the versatility and flexibility during manufacturing and use can be enhanced.

The release liner for the sensing patch unit may be covered by a strengthening sheet that is adhesively connected to the outside surface of the release liner and covering the notch in the release liner and the other end of the film, e.g. the end of the film that is not forming the sterile barrier film within the housing. The release liner may be subjected to stresses when removing the sterile barriers from the inside of the housing as the forces required to release the removable connections are above the forces to remove the liner from the skin adhesive. These stresses may be concentrated around the notch as the ends of the films are attached adjacent to the notch. The strengthening sheet strengthens the release liner, particularly around the notch to prevent tearing or fracture of the release liner. Additionally, the bonding between the ends of the films connected to the liner may be strengthened as well. The strengthening sheet may be a polymeric sheet that is adhesively attached or welded / heat, or ultrasonic) to the release liner. Alternatively a woven or non-woven fiber material, for example cotton or paper (cellulose) may be used to strengthen the release liner.

The release liner further comprises an aperture for the skin needle wherein the end of the skin needle is configured to be moved from a first position inside the housing to a second position outside the housing, the aperture for the skin needle is covered by a removable second sterile barrier film that is adhesively attached to the strengthening sheet. The skin needle needs to move into the skin of the patient and is inserted from the inside of the fluid path compartment into the skin. The fluid path compartment is kept in a sterile condition using the removable second sterile barrier film which is attached or bonded to a second aperture of the fluid path compartment. The needle insertion mechanism is capable of moving and inserting the cartridge needle as well as the skin needle before expelling the medicament whereas preferably the skin needle can be retracted into the housing after the medicament has been expelled. The second sterile barrier film is connected to the strengthening sheet and the strengthening sheet is attached to the release line such that liner removal also removes the second sterile barrier film. The skin needle is enclosed by the fluid path compartment of the needle unit and connected to the cartridge needle by a conduit.

The films preferably have at least one fold (U-turn for example) between the two ends of the film. The at least one fold is preferably close to the sterile barrier film covering the passage of the fluid path compartment or the end of the cartridge. This has the advantage that the film can peel off, or unroll from the passage or the end of the cartridge which reduces the forces required for film removal. If the film is unrolled, then the adhesive strength at a specific location needs to be overcome only and the film is removed step by step. If the film needs to be removed at once, for example if there is no fold and the force required to remove the film at once is significantly higher

A flip-off cap may cover the film that is attached to the end of the cartridge, preferably to the end of the crimp. The flip off cap protects the film during attachment to the cartridge, transport and handling for the sterilization and fill finish steps. The flip off cap is at least partially removed from the crimp prior to insertion of the cartridge into a cartridge holder that is part of the housing and making the film available for insertion into the notch. The flip off cap may have perforated sections forming predetermined breaking points such that the cap or a part of the cap can be removed easily. Optionally a part of the cap remains attached to the end of the cartridge and may be used for correct alignment and positioning of the cartridge.

The injection device may comprise a sensor layer that is part of the housing or attached to the housing. For example the sensor layer may be part of the skin adhesive layer or may be part of a layer positioned between the skin adhesive layer and the housing. The sensor layer may comprise capacitive sensors that are connected to the control unit within the housing using resilient connecting members. The sensor layer may be at least partially covered by a shielding layer, for example an electrically conducting layer that is part of the release liner or the strengthening sheet attached to the release liner. For example, the release liner comprises a conductive layer such as a silver ink layer or carbon black layer that is printed or vapor deposited onto the liner. The sensor layer is capable of detecting the release liner removal as the capacitance (dielectric) for, or adjacent to, the sensors changes. Furthermore skin attachment may be detected as the capacitance of the sensors changes once again. The sensor signals are forwarded to the control unit using the connecting members and may be used for notifying optically and/or acoustically the status of the device ( "ready for attachment” or "ready to press the start button”) or enable or activate the start button.

LEGENDS TO THE FIGURES

While the invention has been described in detail in the drawings below and foregoing general description, such description is to be considered illustrative or exemplary and not restrictive. Variations to the disclosed embodiments can be understood and effected by those skilled in the art and practicing the claimed invention, from a study of the drawings, the disclosure, and the appended claims.

Figures 1 a,b: Injection device Figure 2: Injection device showing the subassemblies

Figures 3 a, b,c: PCB unit

Figure 3d: PCB unit assembled with drive unit DU

Figure 4: Exploded view showing all components of drive unit DU

Figure 5a-k: Individual components drive unit DU

Figure 6: Threaded rod, piston rod within drive carrier of the DU

Figure 7: Needle unit NU

Figure 8: Exploded view showing all components of the needle unit NU

Figure 8a-r: Individual component needle unit NU

Figure 9: Fluid path, not shown are the skin needle and the cartridge needle

Figure 10: Cartridge needle slider spring

Figure 11 : Detailed view of cartridge needle slider in mechanic holder

Figure 12: Needle insertion assembly, cartridge needle and skin needle in retracted position Figure 13: Detail of skin needle holder abutting the slider, keeping the holder in the retracted position

Figure 14: Cam shaft of the needle unit NU

Figure 15: Cam shaft in passage of the needle unit NU

Figure 16 a,b: Needle cover for needle unit

Figure 17: Sterile barrier film

Figure 18: Sterile barrier film covering aperture skin needle in needle cover

Figure 19: Cartridge unit CU

Figure 20: Exploded view showing components of the cartridge unit CU

Figure 21 : Details of the sterile barrier film, flip-off cap and crimp

Figure 22: Components sensing patch unit SU

Figure 23: Sensing patch unit assembled with release liner

Figure 24: Sensor layer in sensing patch

Figure 25: Release liner, bottom view on surface not attached to skin adhesive layer Figure 26: Exploded view housing unit HU

Figure 27: Detailed view of push button in HU

Figure 28 a,b: Cover for housing unit HU

Figure 29: Cartridge unit CU inserted in needle unit NU

Figure 30: Detail of cover HU fixating the cartridge of CU in the needle unit NU

Figure 31 : Detail of cover HU closing the notch in the housing unit

Figure 32: Cross section of assembled injection device showing CU and NU

Figure 33: Cross section of assembled injection device showing battery, electromotor and gear mechanism of the drive unit

Figure 34: Release liner removed from the injection device Figure 35: Detail of the gear mechanism

Figure 36: Detail of the gear mechanism and the electromotor of the DU engaging the cam shaft and slider of the NU

Figure 37 a, b: Cartridge needle slider driven by the cartridge needle slider spring (all NU) to pierce the septum of the CU

Figure 38: Skin needle slider abutting the slider for keeping the skin needle in the retracted position

Figure 39: Upper leg of torsional spring biasing the skin needle holder towards the inserted position via the upper spring slider

Figure 40: Cross section of the needle unit with the slider in the starting position

Figure 41 : Cross section of the needle unit with the slider in an intermediate position

Figure 42: Leg of torsional has moved the skin needle holder to the inserted position via upper spring slider

Figure 43: Gear mechanism driving the threaded rod for piston rod advancement

Figure 44: Drive unit and needle unit, piston rod in retracted position with a full cartridge Figure 45: Drive unit and needle unit, piston rod in extended position, cartridge empty Figure 46: Gear mechanism and slider in an intermediate position

Figure 47: Lower leg of spring biasing the lower spring slider towards the retracted position, locking member prevents movement of the lower spring slider towards the retracted position

Figure 48: Upper spring slider released from the skin needle holder

Figure 49: Cross section of needle unit with slider in final position and skin needle holder in retracted position

Figure 50: Injection device with retracted needle

DETAILED DESCRIPTION OF THE FIGURES

In Figure 1a, the injection device (1) is shown which comprises a housing unit HU (2) having an indicator (4) and a push button (5). The housing unit HU (2) is closed by a cover (8) having a viewing window (3) for viewing a not shown cartridge. The injection device can be attached to the skin of the patient by a skin adhesive layer which is part of a sensing patch unit that is attached to a bottom surface of the housing unit (2). The skin adhesive layer is covered by a release liner (6) which prevents undesired attachment of the injection device such that the patient can first select a suitable location for skin attachment. The release liner is a sheet of material that comprises a gripping area (7) facilitating the removal of the release liner by the user. The gripping area may be roughened or having an elevated area that may be structured. Alternatively, the gripping area may be an aperture in the sheet of material. The gripping area may have visual indicators such as arrows or symbols printed thereon to instruct the user. A 3-dimensional perspective view of the injection device is presented in Figure 1b.

An exploded view of the injection device showing the subassemblies and components forming the device is shown in Figure 2. The injection device comprises a printed circuit board unit PCB (9) for controlling the injection of the device, a drive unit DU (10) for driving a piston rod (of the DU) and a needle insertion mechanism (of a NU), a needle insertion unit NU (11), the housing unit HU (2), a cartridge unit CU (12) and a sensing patch unit SU (13).

The PCB unit (9) is shown in Figure 3a,b,c and comprises a printed circuit board with conductive leads, integrated circuits, contacts for power supply, contacts for receiving signals from the sensing patch unit (13), contacts for sending signals to the electromotor, a switch and preferably a wireless transmitter/receiver unit. The top surface (14) of the PCB unit comprises a push button switch (16), positioning apertures (18), LED light indicators (17) and through holes forming contacts (20) for a stepper motor. The bottom surface (15) comprises contacts (21) for contacting the battery and separate contacts (19) for contacting contact springs. The PCB unit (9) is positioned on top of the drive unit (10) using protrusions (22) of the drive unit that engage the apertures (18) of the PCB unit, see Figure 3d. The PCB unit may be fixated by plastic deformation and/or melting the protrusions (22) after positioning the PCB unit on top of the drive unit (10). Alternatively, the PCB unit (9) is fixated using a snap-fit connection.

An exploded view of the parts forming the drive unit DU (10) is depicted in Figure 4. A drive cover (23) engages a drive carrier (24) thereby forming the housing for the drive unit. An elongated threaded rod TR (25) is received by bearings in the drive carrier (24). The threaded rod (25) is driven by an electromotor via a gearing mechanism and rotation of the threaded rod (25) is transformed in axial movement of a piston rod. The gearing mechanism comprises a gear shaft (27) and the gear mechanism is driven by a stepper motor (28). The gear shaft (27) is received by bearings in the drive carrier (24) and the stepper motor (28) is received in a preformed compartment of the drive carrier. The stepper motor (28) is powered by a battery (30) which is also enclosed in, and preferably attached to the drive carrier (24). For example the battery may be glued or adhesively attached to the drive carrier to prevent battery loosening upon mechanical impact. Alternatively, a press-fit connection is used to fixate the battery using clips or a resilient foam material. A plurality of contact springs (29) are guided through the drive unit (10) establishing contacts between the sensing patch unit and the PCB unit. The contact springs (29) are made from an electrically conductive material and are preferably spiral springs and may directly contact the sensing patch unit or the PCB unit or via contacting pins that are biased by the spring. The diameter of the contact springs (29) may vary to facilitate the positioning in one of the drive cover (23) or the drive carrier (24). The drive unit has a piston rod (31) which is preferably guided by the drive carrier (24) to form a U-shaped piston rod that is configured to advance a plunger in a cartridge for expelling the medicament from the device.

A detailed view of the components forming the drive unit is shown in Figures 5a to 5k. The drive cover DC (23) comprises the protrusions (22) for positioning and fixation of the PCB unit (9) and a snapper (33) or snap fit connector for connecting the drive cover to the drive carrier (24). The drive cover comprises cylindrically shaped apertures (32) that are aligned with complementary apertures of the drive carrier to form a passage for the contacting springs (Figure 5a). The threaded rod (25) comprises a threaded rod driver (34), shaped as a gear wheel that is rotationally and axially fixed to the threaded rod (25) and comprises gear teeth (35) on the outside circumferential surface of the driver (34) and which are oriented parallel to the axis of the threaded rod. Adjacent to the gear teeth (35) there is at least one flexible arm (38) having at least one ratchet member (37) pointing towards the central axis of the threaded rod (25). The at least one flexible arm (38) surrounds a hollow space within the driver (34) that is available for the ratchet wheel (26). The threaded rod (25) has a shaft end (36) that is received in a bearing formed in the drive carrier (24). The shaft of the threaded rod (25) may engage a central opening of the ratchet wheel (26). The gear shaft (27) is shown in Figure 5c and comprises a gear wheel (39) that is configured to engage a worm wheel of the stepper motor. Adjacent to the gear wheel (39), the gear shaft comprises a worm wheel (40) that is configured to engage the gear teeth (35) of the threaded rod driver (34). The gear shaft (27) has shaft ends (41 ) that are received by bearings in the drive carrier (24). A detailed view of the stepper motor (28) is presented in Figure 5d, the stepper motor comprises a motor (42) an end plate (44), contacts (45) and worm wheel (46) of the stepper motor. The end plate (44) has edges (43) to rotationally and axially fixate the stepper motor (28) in the drive carrier. The end plate (44) may have a handle

(47) facilitating the gripping and automated positioning of the stepper motor (28) in the drive carrier (24). The worm wheel of the stepper motor (46) engages the gear wheel (39) of the gear shaft and the worm wheel (40) of the gear shaft (27) engages the gear teeth (35) of the driver (34) for the threaded rod. The worm wheel (46), the gear wheel (39), the worm wheel (40) and the gear teeth (35) form a gearing mechanism (46,39,40,35) to gear down the rotation of the motor (42) into a rotation of the threaded rod.

Details of the piston rod (31 ) are shown in Figures 5e, 5f and 5g. The piston rod comprises segments

(48) that are connected to each other via hinges (52) such that the individual segments can rotate with respect to each other. The segments (48) have a segment guidance (55) that protrudes from each segment in a direction perpendicular to the direction for advancing the piston rod (31 ). The last segment (49) of the piston rod comprises a protrusion (50) configured for engaging a spacer that is part of the cartridge unit to form a pivot bearing between the spacer and the last segment (49). The last segment may comprise a guiding fin (51 ) that is configured to engage the barrel of the cartridge such that the last segment, and preferably therewith the segmented piston rod, correctly enters the cartridge. The first segment (53) of the segmented piston rod comprises an internal threading (54) that engages an external threading of the threaded rod (25).

The drive carrier (24) comprises cylindrical apertures (56) that are aligned with the apertures (32) of the drive cover after assembly to guide the contact springs (29) through the drive unit (Figure 5h). The carrier furthermore comprises a holder (58) for the battery (30) and the stepper motor (28), and protrusions or snappers (57) that may connect, preferably irreversibly, to the snappers (33) of the drive cover. A guidance (59) guides the segments of the piston rod such that the piston rod may go from a straight or stacked configuration of the individual segments to a curved configuration and back to a straight configuration, thereby rotating the individual hinges between the segments. The piston rod may have a U-shape due to the guidance (59) of the drive carrier. A detail of the segmented piston rod (31 ) engaging the guidance (59) is shown in Figure 5j. The segment guidance (55) of each segment (48) engages a keyway (59a) of the drive carrier thereby further guiding the piston rod (31 ) and preventing rotation of the piston rod around its own axis. The threaded engagement of the first segment of the piston rod with the threaded rod is therefore transferred in axial advancement (or retraction) of the piston rod once the threaded rod is rotated via the gear mechanism (46,39,40,35).

A coupling mechanism between the driver (34) of the threaded rod (25) and the ratchet wheel (26) is shown in Figure 5k. The ratchet wheel (26) is inserted in the hollow space of the driver (34) onto the shaft and ratchet teeth (26a) on the outer surface of the ratchet wheel (26) engage the ratchet member (37) of the driver (34). The interaction between the shaft of the threaded rod and the ratchet wheel (26) is such that the ratchet wheel may rotate in both directions with respect to the shaft. However the ratchet teeth (26a) are asymmetrically shaped, preferably saw tooth shaped that extend radially outwards, and the engagement with the ratchet member (37) mounted on a flexible arm (38) is such that the ratchet wheel may rotate in one direction only due to the one way ratchet (37, 26a). Or, as the driver (34) is rotationally fixed to the threaded rod (25), rotation of the driver in one direction is always transmitted to the ratchet wheel due to the form fit between the teeth (37, 26a), whereas the ratchet member (37) ratchets over the teeth (26a) in the opposite direction thereby generating audible clicks. In the latter case the ratchet wheel may not rotate or only rotates once a certain frictional resistance has been overcome.

The drive carrier supporting the threaded rod (25) engaging the segmented piston rod (31 ) is shown in Figure 6. The threaded rod (25) comprises an external threading (60) which engages the internal threading (54) of the first segment. The segmented piston rod is guided by two guidances (59) that direct the segmented piston rod in a U-shape. Rotation of the threaded rod driver (34) via the gear mechanism will advance the piston rod, e.g. slide the piston rod, due to the threaded engagement with the first segment.

The needle unit (11 ) has a cartridge holder (61 ) adapted to receive the cartridge unit (12) whereby a neck of the cartridge engages the abutment surface (62) of the cartridge holder to axially position the cartridge unit in the cartridge holder (61). A distal end of the cartridge unit is receivable in the receiving section (63) of the cartridge holder. The housing (67) is closed by a sterile barrier film (64) that is attached to the housing and covering a passage for a cartridge needle. The sterile barrier film (64) has a pull tab (70) that is guided through an aperture (13) located between the needle housing and the cartridge holder to an outside surface, for example a surface of the release liner, of the injection device. A rotatable cam shaft (68) having a gear wheel (69) located outside of the needle unit is available for driving the components located inside the needle unit. The passage of the cam- shaft (68) is sealed to form a tight barrier (for example using an O-ring) that prevents contamination from outside the needle unit via the cam-shaft surface to the inside of the needle unit. The needle unit (1 1 ) is attacheable, to the drive unit (10) using keys (65) that match corresponding keyways on the drive unit and the connection is preferably fixed, e.g., non-reversible, using locking aperture (66) of the needle unit that is engageable with a corresponding sloped protrusion on the drive unit.

An exploded view with the components forming the needle unit is displayed in Figure 8 and comprises a needle housing (67) enclosing a fluid path and the components for the needle insertion and retraction mechanism. The needle housing is part of the enclosure forming a sterile barrier preventing contamination of the fluid path and passages (102, 104, 98) in the needle housing need to be sealed or covered accordingly. The passage (104) for a cartridge needle is covered by a sterile barrier film (64) that may be removed from the needle housing using a pull tab (70) guided to the outside or an outside surface of the injection device.

The needle housing (67) comprises a mechanic holder (94) which provides structural support to a slider (71 ), a skin needle holder (85), a cartridge needle slider (92) and the cam shaft (68). The mechanic holder (94) is a separate part of the needle housing (67) but functionally behaves as an integrated part of the needle housing (67).

The slider (71 ) may move parallel to the bottom surface of the housing unit between discrete lateral positions and the movement is controlled by the PCB unit and driven by the drive unit. The lateral movement is guided by linear keys (73) that engage linear guidances (105) of the mechanic holder (94). The slider (71 ) comprises a gear rack (75) for driving the slider in the latter direction by a cam shaft that is coupled to the gear mechanism (46,39,40,35) of the drive unit. The slider (71 ) comprises linear guidances (74) that engage spring sliders (83, 84), the linear guidances are oriented perpendicular to the movement direction of the slider, or, in other words, parallel to the skin needle insertion direction. Furthermore, the slider has an extension comprising a locking fork (72) which holds a cartridge needle slider in a retracted position.

The slider (71 ) comprises a spring holder (1 12, see Figure 8k) for holding a torsional spring (79), thus the torsional spring (79) follows the lateral movements of the slider. The torsional spring (79) is fixated after insertion into the spring holder using a spring fixator (76). The torsional spring (79) has an upper leg (81 ) and a lower leg (80) connected by a coil (82). The coil (82) biases the two legs towards each other when the torsional spring is assembled in the needle unit. The coil (82) has a connecting bar (1 17) connecting two parts of the coil spring that ensure that the two legs are biases towards each other when tensioned (Figure 8m). The upper leg (81 ) biases an upper spring slider (83) and the lower leg (80) biases a lower spring slider (84) as will be described in detail below. The connecting bar (1 17) is configured to be inserted into a receiving pocket (1 13) of the spring holder (1 12) and the coil (79) surrounds the spring holder.

The mechanic holder (94) supports a skin needle holder (85) and has linear guidances (106) to guide the skin needle holder (85) for moving perpendicular to the bottom surface of the housing unit of the injection device. The skin needle holder (85) has a plurality of keys (86) that engage the linear guidances (106) of the mechanic holder for guiding the skin needle holder from a needle retracted to an inserted position and from the inserted position back to the retracted position. The skin needle holder (85) is driven by the torsional spring between those two positions using the two legs. The skin needle holder (85) holds the skin needle (87) which is a hollow steel needle that is fluid tight sealed into the holder, for example using a rigid or flexible glue. The skin needle holder comprises a passage connecting the needle to an outlet in the holder adapted to receive a tube (89).

The tube (89) provides a fluid conduit between the skin needle (87) and a cartridge needle (90). The cartridge needle is inserted and attached (for example using an adhesive connection) to a cartridge needle holder (91 ) which provides mechanical support to the cartridge needle (91 ) and connects the needle to the tubing (89). The cartridge needle holder (91 ) may be an integrated part of, or inserted into a cartridge needle slider (92). The cartridge needle slider (92) has guidances (93) which engage keyways (95) of the mechanic holder (94) that allow for axial movement of the cartridge needle slider (92) parallel to the bottom of the injection device. Preferably, the lateral movement of the slider (71 ) is perpendicular to the movement of the cartridge needle slider (92). The cartridge needle (90) can be moved from a retracted position inside the needle unit to an extended position outside the needle unit thereby passing through the passage (104), preferably after removing the sterile barrier (64). The cartridge needle (90) is preferably a hollow steel needle with a sharp tip that is open, or alternatively the steel needle is a pencil tip needle with a closed tip and a lateral opening. Optionally, plastic needles or spikes may be used.

The needle unit (1 1 ) further comprises a cam shaft (68) comprising a gear wheel (100) for the gear rack (75) that is located on the slider (71 ) inside the needle housing (67), and a gear wheel (69) located outside the needle unit and configured for engaging the gear mechanism of the drive unit (10). The cam-shaft (68) is rotatably received by the passage (102) of the needle housing and a corresponding passage (102b) in the mechanic holder. A sealing is present between the cam shaft (68) and the needle housing (67) and/or the mechanic holder, to prevent contamination of the fluid path enclosed by the needle housing. Such a sealing may comprise an elastic element such as an O-ring surrounding the cam shaft and being in a press-fit engagement with a housing part.

The needle housing has an opening or fluid path compartment (101 , Figure 8b) that is closed by a needle cover (96) which encloses the fluid path after insertion and mounting of all components into the fluid path compartment (101 ). The needle cover (96) has a sealing rim (96) which may be fixated in a corresponding recess of the needle housing (67) to form a tight seal preventing contamination of the fluid path compartment. The needle cover is preferably made from a plastic material that is welded, for example laser welded or ultrasonic welded onto the needle housing. The needle cover (67) comprises an aperture (98) for the skin needle (87) which is closed by a sterile barrier film (99). The sterile barrier films (99, 64) are preferably made from a porous membrane allowing for chemical sterilization techniques such as gas plasma or ETO sterilization. An example is a non-woven polyethylene fiber membrane, such as the Tyvek membrane.

Details of the components forming the needle unit will be described in Figures 8a to 8r. A detail of the key (65) and the locking aperture (66) of the needle unit (67) is shown in Figure 8a. The key (65) may engage a connecting ridge (189) that is part of the drive unit (Figure 5h) and once the locking aperture (66) engages the locking protrusion (190), then the drive unit (10) and needle unit (1 1 ) are irreversibly attached to another. The fluid path compartment (101 ) that provides part of the sterile enclosure for the fluid path is shown in Figure 8b. The apertures (102, 104) for the cam shaft and cartridge needle are part of wall sections oriented perpendicular to the bottom surface of the fluid path compartment. The passage for the cam shaft (68) on the outside surface of the wall section has a protruding rim for mechanical support and/or fixation of the sealing element as can be seen in Figure 8a. The mechanic holder (94) fits into the fluid path compartment, preferably by press-fit or by another locking means such as a snapper or by an adhesive connection. See Figure 8c, which represent a view from the below of the device showing the aperture for the skin needle (130). The passage for the cam shaft (102b) in the mechanic holder is aligned with the passage (102) of the needle housing (67) and a compartment (103) is available for the slider to move laterally as the slider is guided by the guidances (105) of the mechanic holder (94), see also Figure 8d (representing a view from the side of the mechanic holder). The linear guidances (106) for engaging the skin needle holder (85) is shown from the top of the mechanic holder in Figure 8e whereas details for the keyways (95) guiding the cartridge needle slider and details of the passage for the cam shaft (102b) can be seen in cross sections in Figures 8f and 8g, respectively.

The skin needle holder (85) comprises next to the linear keys (86) receiving sections (107, 108) for the upper spring slider (83) and the lower spring slider (84). The key-keyway engagement (86, 106) guides the skin needle holder in the mechanic holder such that the skin needle holder can only move in the needle insertion direction. The receiving sections (107, 108) have an engagement surface for the spring sliders such that forces from the legs of the torsional spring may be transferred to the skin needle holder while the spring sliders can move on the engagement surface in a direction that is perpendicular to the skin needle insertion direction. The assembly of the mechanic holder (94) and the skin needle holder (85) is shown in Figure 8i, with the skin needle holder in the needle retracted position.

The slider (71 ) comprises the linear keys (73) for engaging the mechanic holder, and two linear guidances (74) for engaging the spring sliders (83,84). The slider further comprises a stop surface (1 1 1 ) that is adapted to abut a surface, preferably a bottom surface, of the skin needle holder (85) for keeping the skin needle holder in a retracted position. The slider (71 ) comprises a gear rack (75) having gear teeth (1 10) that may engage the gear wheel (110) of the cam shaft. The linear guidances together with the gear rack - gear wheel interaction (75, 1 10) ensure that the slider can move in the lateral direction (Figure 8j). A top view of a section of the slider (71 ) showing the two linear guidances (74) that may engage the spring sliders (83, 84) is presented in Figure 8I. The spring sliders (83,84) are keyed to the slider such that they can move up and down in the guidance (74) while they have to follow the lateral movement of the slider (71 ). A spring holder (1 12) is attached to, and protrudes from a base (1 16) of the slider (71 ). The spring holder (1 12) has a circular outer shape that is split apart by a receiving pocket (1 13) and further comprises a cut-out (1 15) that is configured for attaching the spring fixator (76) thereto. The receiving pocket receives and rotationally fixates the bridging bar (1 17) of the torsional spring (79) to the slider. Furthermore the receiving pocket together with the connecting bar provides the counterbalance for the two legs of the spring when tensioned. Thus the lateral movement of the slider (71 ) will be followed by the torsional spring (79) with the upper and lower spring legs (84, 85), by the upper and lower spring sliders (83, 84) and by the locking fork (72).

The assembly of the torsional spring (79) onto the spring holder (1 12) is shown in Figures 8n and 8o. First the coil spring (79) is mounted onto the spring holder (112) whereby the bridging bar (1 17) is inserted into the receiving pocket. The bridging bar (1 17) abuts a surface (1 18) of the slider and the spring fixator (76) is mounted onto the end section (1 14) of the spring holder (112) whereby a wing (78) of the fixator fits into the receiving pocket and pushes the bridging bar (1 17) towards the abutment surface (118) of the slider (71 ). The fixator has a flexible arm with a protrusion that snap fits into the cut-out (1 15) of the spring holder and locks the spring to the slider.

The upper spring slider (83) and the lower spring slider (84) are shown in Figures 8p and 8q, respectively. The upper spring slider (83) comprises a key (120) that engages the linear guidance (74) of the slider (71 ). Furthermore the slider has an opening (123) for receiving the upper leg (81 ) of the torsional spring into a receiving section (122) of the upper slider. The lower spring slider (84) is preferably identical to the upper spring slider but oriented upside down and showing a holding surface (124) which is intended to engage a locking member (109) that is present on the mechanic holder (94). The assembly of the upper and lower spring sliders engaging the linear guidances (74) of the slider (71 ) is presented in Figure 8r.

The tube or conduit (89) connecting the skin needle holder (85) to the cartridge needle holder (91 ) is presented in Figure 9. The ends of the tube are inserted into the holders and fluid tight connected by a press- fit of the elastic tubing material, or the ends are adhesively connected to the holders. The cartridge needle holder (91 ) has a locking feature (125), for example a locking arm or a snapper that may engage the cartridge needle slider (92). A detail of the cartridge needle slider (92) is shown in cross sectional view of Figure 1 1. The cartridge needle slider (92) is engaged with the mechanic holder (94) through the key-keyway engagement (95, 93, Figures 8, 8f) and can move from a retracted position to an extended position parallel to the bottom surface of the device. The cartridge needle slider spring (88) is positioned and compressed between the mechanic holder (94) and the cartridge needle slider (92) thereby biasing the slider to move towards the inserted position. The cartridge needle slider is retained in the retracted position by knob (126) that is part of the cartridge needle slider (92) which engages the locking fork (72) of the slider (71 ). Once the slider (71 ) is moved in a lateral direction, preferably from a starting position to an intermediate position, then the engagement between the fork (72) and the knob (126) is released and the cartridge needle slider (92) moves together with the cartridge needle (90), the cartridge needle holder (91 ) and the end of the flexible tube (89) towards the passage (104) of the fluid path compartment. The cartridge needle (90) will at least partially go through the passage for penetrating a septum of the cartridge unit. A detailed view of the cartridge needle slider spring (88) is shown in Figure 10. The spring is preferably a tapered coil spring having the advantage of a space saving arrangement when the spring is compressed as the coil sections do not abut each other when compressed.

The assembled needle insertion and retraction mechanism and the fluid path is shown in Figure 12. The slider (71 ) is in the starting position and can move due to rotation of the cam shaft (68) in the lateral direction as the slider (71 ) is guided by the mechanic holder (94). The upper leg (81 ) of the torsional spring (79) presses onto the upper spring slider (83) which itself presses onto the receiving section (107) of the skin needle holder (85). The skin needle holder is kept in the retracted position against the bias of the spring force as will be explained in Figure 13. The torsional spring (79) is locked to the slider (71 ) by the spring fixator (76) and the locking fork (72) engages the knob (126) of the cartridge needle slider. The skin needle holder (85) is kept in the retracted position when the slider (71 ) is in the starting position due to the stop surface (1 1 1 ) of the slider (71 ) abutting the lower surface of the skin needle holder (85), Figure 13.

Details of the cam shaft (68) with the two gear wheels (69, 100) at each end is shown in Figure 14, and a cross section of the cam shaft going through the passages (102, 102b) of the needle housing and the mechanic holder in Figure 15. The gear wheel (69) at one end of the cam shaft (68) is located on the inside of the (sterile) fluid path compartment whereas the gear wheel (100) at the other end is located outside of the needle housing (non-sterile). An O-ring forms a seal between the housing and the cam shaft preventing contamination of a sterile fluid path compartment and providing a frictional resistance for rotating the cam shaft (68). The needle cover (96) comprising the aperture (98) for the skin needle is shown in Figure 16b. The outside surface of the needle cover (Figure 16a) has a sealing surface (128) and a circumferential rim (129) that surrounds the aperture (98) and sealing surface. The barrier film (99) is preferably attached to the sealing surface (128) only and not to the rim (129). The rim acts as a support for attaching the surface of the barrier film (99) to an adhesive layer, for example a strengthening film or to the release liner itself. During removal of the sterile film (99), either using the release liner or via the strengthening film, then preferably the film (99) is not attached to the circumferential rim (129) as this will facilitate the roll-off or peel-off of the sterile film (99) from the sealing surface (128).

The assembled cartridge unit (12) is shown in Figure 19 and a detailed view of the individual parts in Figure 20. The cartridge unit (12) comprises a barrel (132) which is a hollow cylinder having a distal opening (133) and a proximal opening (134). At the distal end, the barrel has a neck (135) area with a lower diameter compared to the proximal barrel section. The distal opening (133) is closed by a pierceable septum (141) which is attached to the neck using a crimp cap (139). The crimp cap has an opening that is available for a needle or spike for penetrating the septum (141). A sterile barrier film (136) is preferably connected to an end wall of the crimp cap thereby covering the opening of the crimp cap and the septum's surface underneath. The sterile barrier film (136) is glued, welded, heat welded or otherwise sealed to the surface of the crimp cap thereby forming a protective layer for the surface of the septum. The connection between the crimp cap and the sterile barrier film (136) is such that the film may be removed easily while still providing a tight seal between the film and the cap. The sterile barrier film (136) is preferably a film made from porous non-woven fibres and the porosity allows for chemical sterilization agents to pass through. The sterile barrier film (136) has a pull tap (137) which is an integral part of the porous film or a separate film connected to the sterile barrier film (136). The pull-tab (137) is preferably guided to the outside or an outside surface of the injection device such that the barrier film may be removed by pulling the tab. The sterile barrier film (136) and/or the pull tab (137) may be folded to promote the peel-off, or roll-off, of the sterile barrier film (136) from the crimp cap. The sterile barrier film and/or pull tab may be guided around pins or wheels within the housing unit to facilitate film removal, for example using a pulley system.

The cartridge unit (12) may comprise a flip-off cap (138) covering the sterile barrier film (136). The flip- off cap (136) is preferably attached to the crimp (139). The flip-off cap (138) protects the sterile barrier film during handling of the cartridge unit and the cap may be removed just prior to inserting the cartridge unit (12) into the housing unit of the injection device. The flip-off cap (138) may have openings to enable sterilization of the sterile barrier film (136) and the septum's surface and/or penetration of a needle. The flip-off-cap (138) is preferably made from a plastic material and attached to the crimp cap using heat welding, laser welding or ultrasonic welding. The crimp cap (139) is preferably made from a metal such as aluminum. Furthermore, the flip-off cap (138) may have perforated sections forming predetermined breaking points for easy flip-off cap removal. The parts of the flip-off cap remaining on the crimp cap may be used to position the correctly cartridge unit in the housing unit, for example the angular position. A plunger (140) is moveably positioned within the proximal opening (134) of the barrel (132) thereby forming a sealing for the medicament that is enclosed in the cartridge. The plunger may be moved by the piston rod (31 ) of the drive unit (10) during medicament delivery. The plunger may be placed at different axial positions in the barrel for cartridges having different fill volumes of the medicament. It may be beneficial to have the piston rod (31 ) at a fixed starting position (or retracted position) and compensate the gap between the end of the piston rod (31 ) and the proximal end of the plunger (140) using a spacer (142). The spacer (142) compensates for the gap and is beneficial for a homogeneous distribution of the forces from the piston rod to the plunger (140). Optionally, a pivot bearing (143,50) is formed between the protrusion (50) on the distal end of the last segment of the piston rod and a bearing surface (143) present on a proximal surface of the spacer (142). The bearing surface (143) may be a recessed section matching a ball shaped protrusion on the end of the piston rod to form a ball in a socket bearing. Alternatively one of the two surfaces is flat and abutting a ball shaped protrusion for a ball on plate bearing.

Figure 21 shows a detailed view of the flip-off cap (138), the crimp cap (139) and the sterile barrier film (136). The crimp cap has an end surface (148) with an aperture (149) for the cartridge needle. The end surface (148) is used for attaching the sterile barrier film (136) to the crimp cap. The surface may be heat treated, etched, roughened or coated with an adhesion promotor to enhance the connection between the sterile barrier film and the crimp cap. The flip-off cap (138) comprises connectors (146) for connecting to the crimp cap (139) and predetermined breaking points (147) facilitate the controlled release of the flip-off cap from the cartridge unit. The sterile barrier film (136) may have an internal fold (145) that is located inside the housing and the pull tab (137) may have an external fold (144) located outside the housing when the device is assembled.

A detailed view of the sensing patch unit (13) is given in Figures 22 to 25. The sensing patch unit (13) comprises an aperture fully enclosed by the film-shaped unit, for example a circular aperture (156) in the film, that is available for the skin needle. Furthermore the sensing patch unit (13) has an opening, or at least semi open aperture, preferably a notch shaped opening (155) located at a rim of the film-shaped unit, that is available for inserting the sterile barrier films from the needle unit and/or the cartridge unit. The sensing patch unit (13) further comprises contact points (157) located in the top surface that may contact the contact springs (29) for connecting the sensing patch unit to the printed circuit board unit. The release liner (6) for the sensing patch unit may comprise a conductive layer (154) that at least partially covers one or both of the surfaces of the release liner. The conductive layer (154) is preferably a coated or a printed metal layer on top of a polymeric sheet of material forming the base for the release liner. Examples are a silver ink layer or an aluminum or gold layer deposited onto the surface. Alternatively a non-metallic coating may be used, for example a carbon black coating. The release liner has an aperture (153) for the skin needle that is aligned with the aperture (156) of the sensing patch unit (13). The release liner has a notch (150) that is located at a rim of the release liner and aligned with the notch (155) of the sensing patch unit such that the sterile barrier films may pass through the sensing patch unit (13) and the release liner (6). The notch (150) has an opening (152) located at an edge of the release liner and the notch preferably has two legs that start at the opening (152) to form a U-shaped notch. The assembly of the sensing patch unit (13) and the release liner is shown in Figure 23, the top layer (159) facing the housing unit comprises an adhesive for attachment to the device. The sensing patch unit (13) comprises at least one sensor layer (160) that is located between the adhesive layer (159) connecting the patch to the housing and the release liner (6). The sensor layer (160) comprises a sensor area (161 ) that is connected to contact (164) using electrically conductive leads (163). The contact (164) is connected to one of the contacts (157) present in the top layer (see Figure 22) such that signals can be transmitted from -and to- the sensor (161 ) via the contact springs (29). The sensor layer (160) may have at least one second sensor area (162) that is connected via a separate lead that is not shown to the contact springs. The sensor area (161 ) and second sensor area (162) each form a capacitive sensor where each capacitance depends on the dielectric present adjacent to the sensors (skin or air) and/or the presence of an electrical shielding that may be present in the release liner. The latter enables the detection of the release liner removal. The sensing patch unit may further comprise additional sensor areas and/or sensor layers and grounding layers present between the several layers to reduce the signal to noise ratio and improve the accuracy of the capacitive measurements. Furthermore isolation layers may be present between two layers having conductive leads.

The sensor layer may have one sensor area (161 ) only.

The sensing patch unit further comprises a skin adhesive layer (191 ) that is adjacent to the release liner. The skin adhesive layer (191 ) is the outermost layer of the sensing patch unit when the sensing patch unit is attached to the housing using the adhesive top layer (159).

A bottom view of the release liner (6) is shown in Figure 25. The backside surface (165) that is not in contact with the skin adhesive layer (191 ) comprises adhesive or connecting spots (166, 167) that are each located adjacent from the notch (150) in the release liner. The adhesive spots are arranged to allow for attaching one or both of the sterile barrier films (64, 136) from the needle unit and/or the cartridge unit to the release liner's backside surface. Preferably the spots are opposite to another to ensure that both ends of the sterile barrier films (for example the ends of the pull tabs) are each connected to one side facing the notch for an even stress distribution upon release liner removal. The adhesive spots may comprise double sided adhesive tape, a hot melt or a spot that is prepared for glueing the ends of the films (or pull tabs) to the backside surface (165) of the release liner. The surface of the release liner may be treated (roughened, etched, heat treated or coated with an adhesion promotor) to enhance the attachment between the release liner and the sterile barrier films,

The housing unit (2) is presented in Figure 26 and comprises a housing cover (168) forming the top surface of the injection device. The housing cover (168) comprises the indicator (4) which may be an elevated and semi-transparent section of the housing cover (16) such that underlying LED lights can shine through the indicator for showing a status of the device or of the injection procedure. The housing cover (168) has an aperture (177) shaped to receive and hold the push button (5). The housing cover further comprises a guiding rib (169) for guiding the cover (8) of the housing unit during device assembly. The housing cover (168) is attached to a housing base (171 ) via a closure rim (170) engaging a matching rim (172) on the housing base. The connection may be an adhesive connection or the two parts may be welded (heat, laser, ultrasonic) together after assembly of the needle unit and drive unit into the housing unit. The housing base (171) comprises support flanges or snappers (175) to engage the drive unit and or the needle unit, and an aperture (173) for the skin needle. Housing base (171) has guiding rib (178) which forms together with the guiding rib (169) of the housing cover (168) guiding means to guide the cover (8) when closing the housing unit and fixating the cartridge unit in the cartridge holder. The cover (8) has markings (176) printed onto or embossed in the cover (8) such that the user can monitor the fluid level in the cartridge through the viewing window (3). The housing base (171) comprises a notch (174) that is aligned in the assembled device with the notches in the release liner, the sensing patch unit and the needle housing (150, 155, 131) to form a passage for the sterile barrier film from the inside of the housing unit to the outside of the injection device or to an outside surface of the release liner.

A detail of the push button (5) in the assembled device is presented in Figure 27, showing the aperture (177) in the housing cover and the part of the PCB unit (9) below the aperture having the push button switch

(16) contacted by a stem that protrudes from the push button. Once the sensing patch unit detects removal of the release liner or device attachment to the skin, the push button switch is activated such that the injection may be started by pushing the button. Details showing the inside surface of the cover 8 are shown in Figures 28a and Figure 28b. A rib or keyway (179) of the cover may engage the guiding rib (169) of the housing cover and another rib or keyway (180) of the cover may engage the guiding rib (178) of the housing base, such that the cover (8) may be shifted over the opening (192) in the housing cover. A detail of the needle unit (11) with the cartridge unit (12) inserted into the cartridge holder is shown in Figure 29. The cover (8) comprises deformable ribs or arresters (181) that engage a rim of the barrel (132) of the cartridge that is located at the proximal opening (134) and thereby fixating the cartridge in the device (Figure 30).

During assembly, the cartridge unit (12) is inserted in the cartridge holder of the needle unit (11). The sterile membrane (136) and/or the pull tab (137) is inserted into the notch in the needle housing, preferably from the side, and guided through the notch in the housing base, the sensing patch unit and the release liner such that the end of the sterile barrier or the pull tab may be attached to the outside surface of the release liner or is available for the user. The cartridge unit comprising the sterile barrier film (136) is preferably sideways inserted into the housing. Subsequently, the cover (8) is engaged with the ribs (169, 178) of the housing unit and moved to close the notch and prevent the sterile barriers from leaving the notch (Figure 31). During closure of the cover (8) the deformable ribs are plastically deformed to axially or rotationally fixate the cartridge unit (12). The cover (8) may have a locking feature such as a protrusion or flexible arm engaging a counter locking feature on the housing cover or housing base to irreversibly lock the cover (8) to the housing unit.

The assembled injection device including the cartridge unit (12) is shown in two cross sections taken in a plane through the cartridge unit (Figure 32) and through the battery/stepper motor (Figure 33). The cartridge unit (12) is oriented parallel to the bottom surface of the injection device and the septum is aligned with the passage in the needle housing such that the cartridge needle may move through the septum. The LED indicators

(17) of the PCB unit are located below the indicator section (4) of the housing cover. The lower surface of the PCB unit (9) is contacted with the contacts (157) of the sensor layer in the sensing patch unit via the contact springs (29). The springs (29) are guided through the apertures (32, 56) in the drive unit. The battery (30) and the stepper motor (28) are fixated by form fit or an adhesive to the holder (58) of the drive unit. The functioning of the injection device will be described in the following. The electronic circuitry of the PCB unit (9) is powered by the battery (30) in the drive unit (10) throughout the lifecycle of the injection device, i.e., there is no separate switch closing the electronic circuit after shelflife and just prior to using the device. The status of the device is monitored by measuring the signals from the sensor patch unit, preferably at a low tact frequency to save battery power during shelflife. The user removes the injection device (1) from a packaging and selects a suitable injection location on the body while the release liner (6) is still attached to the skin adhesive layer of the sensing patch unit (13). The user grasps the gripping area (7) of the release liner and peels the release liner (6) from the skin adhesive layer as indicated by the arrow (191) in Figure 34. As the liner is removed, the sterile barrier film (64) on the needle unit and /or the sterile barrier film (136) on the cartridge unit are peeled-off from the housing of the needle unit, respectively from the crimp cap of the cartridge unit. Both pull tabs (70, 137) are preferably each connected to the outside surface (165) of the release liner on opposite sides of the notch (150) thereby ensuring that the sterile barrier films (64, 136) are removed one after another, and the forces are directed to different areas on the release liner thereby reducing the risk of liner fracture. The notch (150) in the release liner may be reinforced by a strengthening sheet (182) that is attached to the release liner and covering the notch (150) thereby further reducing the fracture risk. The strengthening sheet (182) is applied onto the surface of the release liner not contacting the skin adhesive layer and the strengthening sheet may cover one or both ends of the pull tabs (70, 137) for fixating the pull tabs to the release liner in case the pull tabs are not contacted using the adhesive spots (166, 167) on the backside of the liner. Alternatively, the strengthening sheet may further enhance the connection between the release liner and the pull tabs (70,137) if the pull tabs are adhered to the liner using the first and second adhesive spots (166, 167). The strengthening sheet (182) preferably attaches to the barrier film (99) covering the passage (98) in the needle housing such that the release liner removal simultaneously removes the sterile barrier for the skin needle. Thus during release liner removal at least one sterile barrier film is removed either from the needle unit, and/or from the cartridge unit and/or from the passage for the skin needle. Optionally, two strengthening sheets are used, one covering both pull tabs and the other the sterile barrier for the needle housing. As another option three strengthening sheets are used for each pull tab and the sterile barrier for the needle housing.

Preferably, during release liner removal all three sterile barrier films that cover the passage for the skin needle, the passage for the cartridge needle and the sterile barrier film covering the septum are removed from the device and both passages of the needle unit and the one passage for the cartridge unit are free.

The release liner (6) and/or the strengthening sheets (182) may be coated with a conductive layer (154) which at least partially shields the sensor areas (161, 162) in the sensor layer (160) of the sensing patch unit (13). Upon removal, the dielectric adjacent and/or between the at least two sensor areas (161 , 162) changes as the release liner with the shielding layer is removed and the skin adhesive layer or sensors are exposed to the ambient. The change is measured by the capacitive sensors (161, 162) in the sensor layer (160) and signaled to the PCB unit (9) via the contacting springs (29). In principle the change can be measured with one of the two sensors (161,162) only. The tact frequency for the electronic circuit preferably has been low to save energy and once the change is capacity is processed, the tact frequency may be increased. Furthermore, the push button switch (16) may be released after the liner removal has been detected by the capacitive sensor. Alternatively, the push button switch (16) is released after attaching the injection device to the skin of the patient. Once attached, the dielectric medium for the sensors (161, 162) in the sensor layer changes again, indicating proper skin attachment of the device. The release liner removal and/or the skin attachment may be notified to the user by the visual LED indicators and / or by audible signals generated by a buzzer, and/or signaled by an external device receiving the information via wireless transmittance.

After the liner removal and the skin attachment, the push button switch (16) of the PCB unit is active and the user may push the button (5) to start the injection sequence. As an alternative, the device does not have a push button (5) and push button switch (16), but starts automatically the injection procedure, preferably after a delay time after the sensor patch unit detects that the device is attached to the skin. Safety loops may be included to ensure that the injection is not started too early, for example when the user is still manipulating the device at the injection location. Such as a safety loop may require a stable sensor signal for a minimum amount of time before the injection sequence is started automatically. Alternatively, the injection sequence is started based on an audible signal from the user that is detected by a microphone which is connected to the PCB unit. As yet another alternative, the injection device does not have a mechanical push button on the device but a virtual release button is available on a separate device that is wireless connected to the injection device, for example a smart phone. The virtual release button is pressed on the external device and transmitted to the device which starts the injection sequence.

Cartridge needle insertion: When the user pushes the push button, the injection sequence is started or the injection sequence is automatically started if there is no mechanical push button in the device. The stepper motor (28) in the drive unit is controlled by the PCB unit (9) to rotate in a first rotation direction that may be at a first rotational speed optimized for the needle insertion. The rotation of the stepper motor is transferred by gearing (46,39,40,35) into a rotation of the ratchet wheel (26) as the one-way ratchet (37, 26a) between the driver (34) and the ratchet wheel (26) forces the latter to co-rotate with the driver (34). The cam shaft (68) rotates as well as the drive teeth (26b) of the ratchet wheel (26) engage the gear wheel (69) of the cam shaft, see Figure 35. The rotation of the cam shaft (68) is transferred from the gear wheel (100) of the cam shaft to the gear rack (75) of the slider (71) located in the needle unit. The slider (71) will move from a starting position to a first intermediate position due to the gear teeth (110) of the gear rack (75) engaging the gear wheel (100) of the cam shaft (68), Figure 36. The slider is guided by the mechanic holder (94) due to the linear guidance formed by the linear keys (73) on the slider and the guidance (105) on the mechanic holder. As the slider (71) moves to the first intermediate position, the engagement between the locking fork (72) of the slider and the knob (126) of the cartridge needle slider (92) is released and the cartridge needle slider (92) is moved by the decompressing spring (88) and the cartridge needle (90) pierces the septum (141) of the cartridge unit (Figures 37 a, b). The movement of the assembly of cartridge needle holder (91) and cartridge needle slider (92) may be accompanied by an acoustic signal and/or visual signal (LED light) and/or tactile feedback to the user.

Skin needle insertion: When the slider (71) is in the starting position (Figures 39 and 40), then the stop surface (111) of the slider abuts the skin needle holder (85), (Figure 40) and keeps the skin needle holder in a needle retracted position against the bias of the upper leg (81 ) of the torsional spring (79) pushing on the skin needle holder (85) via the upper spring slider (83) and the receiving section (107) of the skin needle holder. The upper leg (81 ) abuts an abutment surface (184) of the upper spring slider which may be a sloped surface. Upon rotation of the cam shaft, the slider (71 ) moves towards the first intermediate position (Figure 41 ) and the engagement between the slider (71 ) having stop surface (1 1 1) to the skin needle holder is released (see Figure 38). The skin needle holder (85) will move together with the skin needle (87) towards the inserted position and the tip of the skin needle moves through the aperture (98) in the housing unit as the upper leg (81 ) of the torsional spring (79) pushes on the upper spring slider (83). The skin needle holder (85) is guided with its keys (86) through guidances (106) of the mechanic holder (94) to insert the needle (87) perpendicular to the bottom surface of the injection device. In Figure 42, the skin needle holder is in the needle inserted position and the conduit (89) can be observed in the cross sectional view. The cartridge needle has been inserted first in this example followed by the insertion of the skin needle thereby establishing a fluid contact between the patient and the medicament present in the cartridge unit. The situation may also be reversed, e.g. that first the skin needle (87) is inserted followed by the insertion of the cartridge needle (90). The insertion step may also comprise two intermediate positions for the slider (7) a first intermediate position where the cartridge needle is inserted and a second intermediate position where the kin needle is inserted. Alternatively there may be a continuous movement from the starting position to the first intermediate position while to two needles are inserted subsequently.

When the skin needle (87) is in the inserted position then there is an anti-shift back feature for the skin needle holder (85). In the needle inserted position, the end of the upper leg (81 ) contacts a sloped surface (185) of the upper spring slider (83). When the upper spring slider (83) contacts the skin needle holder (85) via the receiving section (107) then a return movement of the holder will be stopped as the end of the upper leg (81 ) will abut end surface (186) of the upper skin slider (83). During a return movement, the sloped surface (185) will guide the end of the upper leg into abutment with the end surface (186) of the upper skin slider thereby blocking the upward movement of the skin needle holder (85).

The movement of the skin needle holder (85) in the needle inserted direction is stopped when the skin needle holder (85) abuts a wall or stop surface that is present on the housing of the needle unit. Preferably, the skin needle holder (85) engages, for example abuts in the inserted position the lower spring slider (84). The lower spring slider (84) may but the receiving section (108) on the skin needle holder (85), see Figure 47. The lower spring slider (84) is kept in the needle inserted position under the bias of the lower leg (80) of the torsional spring (79) which intends to move the lower spring slider from the inserted position to the retracted position. The lower spring slider (84) is kept in the inserted position (Figure 47) as the holding surface (124) of the lower spring slider engages the locking member (109) on the mechanic holder. The engagement between the holding surface (124) and the locking member (109) is such that the lower skin slider (84) may axially move together with the slider (71 ).

During assembly of the device, the upper spring slider (83) is in the needle retracted position and biased by the upper leg (81 ) towards the needle inserted position and this movement is blocked by the skin needle holder (85) engaging the slider (71). When the upper spring slider is in the needle retracted position, then the lower spring slider (84) is in the needle inserted position and not in abutment with the skin needle holder (85) yet. The lower spring needle slider (84) is kept in the inserted position due the engagement (109, 124) of the slider with the mechanic holder.

Dose delivery: The slider (71) is moved to an intermediate position for needle insertion and that position is defined by the number of revolutions (or steps) of the stepper motor in the first rotation direction and therewith the number of revolutions of the cam shaft (68) for sliding the slider (71). After a certain number of revolutions in one rotation direction the rotation in that direction is stopped. Alternatively a separate sensor that is not shown measures the position of the slider and forwards the information to the PCB unit. After the insertion of both needles, the rotation direction of the stepper motor (28) is reversed. The threaded rod (25) comprising the driver (34) will be rotated in the opposite direction and the rotation of the driver (34) is not transmitted to the ratchet wheel (25) as the torque that is transmitted from the ratchet arms (37) of the driver (34) to the asymmetric ratchet teeth (26a) of the ratchet wheel (26) is below the friction between of the cam-shaft (68) and the housing as, for example, generated by the O-ring (102a). Alternatively, there may be a tight press-fit between the cam shaft and the housing forming a sterile barrier. The ratchet wheel (26) will not rotate and the ratchet member (37) at the end of the flexible arms (38) will ratchet over the ratchet teeth (26a) of the ratchet wheel thereby generating audible clicks during dose delivery (Figure 43).

The rotation of the driver (34) will rotate the threaded rod (25) and the piston rod (31) will advance due to the threaded engagement (54, 60) between the threaded rod (25) and the first segment (53) of the piston rod (31). The segmented piston rod is prevented from rotation around its own axis and will slide through the guidances (59) during advancement thereby going through a U-shaped configuration. The last segment of the piston rod (49) either abuts the plunger (140) in the cartridge or abuts the spacer (142) abutting the plunger to expel medication through the cartridge needle, the conduit and the skin needle into the patient. The driver (34) is permanently rotationally coupled to the threaded rod (25) independent from the rotation direction that is transmitted from the stepper motor via the gear mechanism. This implies that during the needle insertion step the segmented piston rod may retract as the slider is moved from the first position to the intermediate position. The spacer may comprise a resilient element for keeping the pivot bearing between the last segment and the spacer in engagement during the piston rod retraction.

The piston rod advancement is shown in Figures 44 and 45, where the piston rod (31) advances the plunger (140) in the barrel (132) of the cartridge unit. The last segment (49) of the piston rod comprises the protrusion (50) that engages a bearing surface (143) of the spacer (142). The pivot bearing that is established may be a ball-in-a-socket, or a ball-on-plate bearing ensuring that any off-axis loading by the piston rod entering the cartridge is compensated and that the plunger is not subjected to any tilting moment. When the plunger (140) has reached the end of the barrel and enters the neck section (Figure 45) then the piston rod advancement is stopped. As an alternative and not desired option, the plunger may stop in a position that is between the positions shown in Figures 44 and 45, due to an occlusion in the fluid path preventing further advancement of the plunger. The PCB unit may have several options for detecting that the cartridge has been emptied or that there is an occlusion. The electromotor may have an encoder measuring the rotation or steps of the electromotor and a separate sensor (for example a photo sensor, or a sliding contact) following the rotation of the gear mechanism and a control module in the PCB unit measures any differences in rotation between the two for detecting an empty cartridge or an occlusion. This set-up requires separate sensor units. Alternatively, the current is measured to energize the electromotor and used as a signal for the load delivered by the motor. The current signal needs to be processed by the control module for detecting a blocking of the piston rod advancement, which requires additional features in the PCB unit. In another arrangement, the Back Electro Motive Force (BEMF) is measured where the electromotor is operated as a generator for a limited period of time during a cycle and the resultant voltage is measured before the electromotor is switched back to motor operation. This option has the advantage that it does not require any additional components. Finally, the extra load on the electromotor due to blockage of the piston rod advancement can be measured as a phase shift or step-loss due to an axial displacement of the rotor versus the stator in the electromotor and this may be used for detecting an empty cartridge or an occlusion.

The control system in the PCB unit may activate optical (LED) or acoustic (buzzer) or tactile (vibrating signals to the user when the cartridge has been emptied or when the there is an occlusion in the fluid path preventing further piston rod advancement.

Retraction of the skin needle: When the plunger has advanced to the end of the cartridge, a signal from a sensor, an encoder or the electromotor is received signaling blockage of the piston rod. The PCB unit controlling the electromotor will reverse the rotation direction from the second rotation (for delivery) back to the first rotation direction that was also used for the needle insertion step. The gear mechanism will rotate the driver (34) and the ratchet wheel (26) as the one way ratchet system is rotationally locked. As a result, the slider (71) will move from the first intermediate position to a next position (Figure 46). The next position may be the final position or a subsequent intermediate position before moving to the final position. Preferably, the slider moves from a first intermediate position without any additional stops to the final position. The movement of the slider (71) results in a lateral movement of the upper spring slider (83) and the lower spring slider (84) as the two spring sliders are engaged via the linear guidances (74) to the slider (71), see Figure 8I. The skin needle holder (85) is engaged with the mechanic holder (94) resulting in a relative axial movement between the skin needle sliders (83,84) and the skin needle holder (85) as the slider (71) moves towards the final position. Preferably, the engagement between the upper spring slider (83) and the engagement section (107) of the skin needle holder (85) is released first (Figure 48). The biasing force of the upper leg (81) may move the upper spring slider in a final position, for example in abutment with the mechanic holder and simultaneously the skin needle holder (85) is free to move back into the retracted position. In a subsequent step, while the slider is moving towards the final position, the engagement between the lower spring slider (84) and the mechanic holder (109, 84) is released and the lower spring slider (84) moves towards the retracted position as the slider is guided by linear guidances (74) of the slider due to the torque that is released from the torsional spring and applied to the lower spring slider via the lower leg (80). The lower spring slider (84) engages receiving section (108) of the skin needle holder and therefore the skin needle holder (85) including the needle (87) is moved back to the retracted position as the skin needle holder is guided in the mechanic holder (Figure 49, Figure 50). The lower skin slider has an end surface preventing movement back to the inserted position as the end of the lower leg (80) will abut the end surface of the lower skin slider. This mechanism equals the mechanism for preventing the movement the skin needle holder from the inserted to the retracted position using end surface (188) for the upper spring slider, see above.

As an alternative, first the lower spring slider is released from the mechanic holder followed by the release of the upper spring slider from the skin needle holder.

As the slider (71) has reached the final position (Figure 49), the sensor system described above will signal blocking of the gearing mechanism and this signal may be used by the PCB unit to provide and acoustic, visual or tactile signal to the user that the skin needle has been retracted. The PCB unit may apply a holding time, for example 60 seconds, more preferably 30 seconds, even more preferably between 5 and 10 seconds during (or after) which a signal is provided to the user before the user may remove the device from the skin. The holding time enhances the diffusion of the medicament into the (subcutaneous) tissue before removing the device from the skin. The end of injection signal may be directly sent to the user by the device and/or may be sent via a wireless connection (such as Bluetooth) to an external device which provides the end of injection signal.

The signals provided by the sensors and/or the electromotor related to the needle insertion, piston rod advancement to the final position, occlusion in the fluid path unit or needle retraction may be used for the visual, tactile or audible signaling directly to the user. Optionally, the signals are sent to an external device, for example a smart phone and the smart phone provides for the visual, tactile or audible signals. Thus there may be a system were the injection device provide signals to the user, or that one of the device or the external device (smart phone) provides for the signals. The PCB unit may signal an alarm to the user upon malfunctioning of the device such as the occurrence of partial removal of the device as measured by the sensor unit, an occlusion in the fluid path, motor failure, low battery power, failure of the push button switch, failure to insert the cartridge needle into the cartridge unit, failure to insert the skin needle or failure to retract the skin needle. Such a signal may be followed by additional steps in the injection sequence, for example when the sensors in the sensor layer of the sensor patch unit measure partial removal of the device or when an occlusion occurs, then the processor may activate the needle retraction step (by reversing the rotation direction of the motor) before the cartridge has been emptied.

Signals may also be received from an external device to the PCB unit via a wireless communication such that the start of the injection may be triggered by an external device.

The PCB unit may be capable of receiving vocal instructions from the user, for example using a voice recognition tool. Alternatively, the PCB unit may provide vocal instructions using a speaker for giving instructions to the user.

The injection device is intended to be used in combination with a wide variety of medicaments each having a specific dosing volume and/or viscosity of the liquid and which require a certain injection time. Preferably, the injection device is configured to receive glass cartridges with a nominal volume between 2 mL and 10 mL. Smaller cartridges may use the cartridge holder that is designed for the larger cartridges using a volume adapter that compensates for the space between the smaller cartridge and the cartridge holder. The injection time is preferably below 30 minutes, more preferably below 10 minutes and most preferably less than 1 minute. The gear ratios of the gearing mechanism between the electromotor and the cam shaft may be adapted to accommodate different viscosities of the medicament in the cartridge unit and/or different needle gauges for the skin needle, respectively the cartridge needle used which may increase the force required to advance the piston rod.

PART ANNOTATION

1 Injection device 25 Threaded rod TR

2 Housing unit HU 26 Ratchet wheel RW

3 Viewing window cover 26a Ratchet teeth ratchet wheel

4 Indicator 26b Drive teeth ratchet wheel

5 Push button 27 Gear shaft GS

6 Release liner sensing patch unit 28 Stepper motor SR

7 Gripping area 29 Contact springs CS

8 Cover HU 30 Battery BY

9 Printed circuit board unit PCB 31 Piston rod PR

10 Drive unit DU 32 Cylindrical aperture

11 Needle unit NU 33 Snapper

12 Cartridge unit CU 34 Threaded rod driver

13 Sensing patch unit SU 35 Gear teeth threaded rod driver

14 Top surface PCB 36 Shaft end

15 Bottom surface PCB 37 Ratchet member

16 Push button switch 38 Flexible arm

17 LED indicators 39 Gear wheel gear shaft

18 Positioning apertures PCB 40 Worm wheel gear shaft

19 Contacts for contact springs 41 Shaft ends

20 Contacts to stepper motor 42 Motor

21 Contacts to battery 43 Edge end plate

22 Protrusions drive unit 44 End plate

23 Drive cover DC 45 Contacts

24 Drive carrier DR 46 Worm wheel stepper motor Handle end plate 83 Upper spring slider

Segment piston rod 84 Lower spring slider

Last segment piston rod 85 Skin needle holder

Protrusion last segment 86 Linear keys

Guiding fin 87 Skin needle

Hinge piston rod 88 Tapered cartridge needle slider First segment piston rod spring

Internal threading 89 Tube, conduit

Segment guidance 90 Cartridge needle

Cylindrical aperture drive carrier 91 Cartridge needle holder Protrusion, snapper 92 Cartridge needle slider CNS Holder for battery, motor 93 Guidance

Guidance piston rod 94 Mechanic holder

; Keyway 95 Keyways to guidance CNS

Outside threading piston rod 96 Needle cover

Cartridge holder 97 Sealing rim

Abutment surface 98 Aperture skin needle

Receiving section 99 Barrier film

Sterile barrier needle unit 100 Gear wheel CT for gear rack Key 101 Fluid path compartment

Locking aperture 102 Passage cam shaft

Housing needle unit 102a O-ring cam shaft

Cam shaft 102b Passage cam shaft

Gear wheel cam shaft 103 Slider compartment

Pull tab 104 Passage fluid path

Slider compartment

Locking fork slider 105 Guidance mechanic holder to

Linear keys slider slider

Linear guidances to spring slider 106 Guidance mechanic holder to

Gear rack slider skin needle holder

Spring fixator 107 Receiving section upper spring

Aperture slider

Wing 108 Receiving section for lower

Torsional spring spring slider on skin needle Lower leg holder

Upper leg

Coil Locking member for lower 142 Spacer

spring slider on mechanic 143 Bearing surface

holder 144 External fold

Teeth gear rack 145 Internal fold

Stop surface to SNH 146 Connector

Spring holder 147 Predetermined breaking point Receiving pocket 148 End surface

End section 149 Aperture for cartridge needle Cut out 150 Notch RL

Base slider 151 Legs U-shaped notch Bridging bar 152 Opening notch

Abutment surface slider 153 Aperture RL skin needle Flexible arm spring holder 154 Conductive layer

Key upper spring slider 155 Notch sensing patch unit Key lower spring slider 156 Aperture sensing patch unit Receiving section 157 Contact points

Opening for upper leg 158 Assembly

Holding surface lower spring 159 Adhesive top layer to HU slider 160 Sensor layer

Locking feature 161 Sensor area

Knob 162 Second sensor area

Aperture MH 163 Lead

Sealing surface 164 Contact

Circumferential rim 165 Backside surface RL Aperture skin needle in MH 166 Adhesive spot

Aperture needle housing for 167 Second adhesive spot sterile barrier film 168 Housing cover HC

Barrel 169 Guiding rib

Distal opening 170 Closure rim

Proximal opening 171 Housing base HB

Neck 172 Closing rim

Sterile barrier film 173 Aperture skin needle

Pull tab 174 Notch HB

Flip off cap 175 Support flange, snapper

Crimp 176 Marks

Plunger 177 Aperture HC push button

Septum 178 Guiding rib Rib engager HC 187 Sloped surface lower slider Rib engager HB 188 End surface lower slider Deformable ribs, arresters 189 Connector

Strengthening sheet 190 Lock protrusion

Contact surface spring slider to 191 Skin adhesive layer receiving section 192 Opening housing cover Contact surface spring to slider 46,39,40,35 Gearing mechanism Sloped surface upper slider 37,26a One-way ratchet

End surface upper slider