Method and apparatus to account for transponder tagged objects used during medical procedures

• US 9,226,686 B2
• Filed: 11/22/2010
• Issued: 01/05/2016
• Est. Priority Date: 11/23/2009
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: RF Surgical Systems, Incorporated (Medtronic Plc)
• Inventors: Blair, William
• Primary Examiner(s): Nguyen, Nam V
• Application Number:
  US12/951,988
• Publication Number:
  US 20110181394A1
• Time in Patent Office: 1,870 Days
• Field of Search: 128/899, 340/505, 340/572.1, 340/10.34, 340/568.1, 705/28, 382/224
• US Class Current: 1/1
• CPC Class Codes: A61B 2050/155 Mayo stands
• CPC Class Codes: A61B 2090/0804 Counting number of instruments used; Instrument detectors
• CPC Class Codes: A61B 2562/17 Comprising radiolucent components
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/7495 using a reader or scanner device, e.g. barcode scanner
• CPC Class Codes: A61B 50/15 Mayo stands; Tables
• CPC Class Codes: A61B 50/33 Trays
• CPC Class Codes: A61B 90/98 using electromagnetic means, e.g. transponders
• CPC Class Codes: A61G 13/10 Parts, details or accessories surgical drape sheets A61B46/00
• CPC Class Codes: G06K 19/07773 Antenna details antennas for wireless devices, e.g. RFID tags, in general H01Q1/22

Abstract

Medical procedure related objects (e.g., instruments, supplies) tagged with transponders may be accounted for in a medical procedure environment via a medical object accounting system using a number of antennas, and optional readers. A first set of antennas may be configured to interrogate sterile fields and/or non-sterile fields which do not encompass a body of a patient to account for the objects proximate a start and an end of a medical procedure. Sterile fields may encompass working surfaces of tables and stands, typically used by nurses. Readers (e.g., symbol, RFID) may be employed. A database may be maintained with information including a current status of each instrument or supply, for instance as checked in or checked out. On notification of a discrepancy, a handheld antenna and/or second set of antennas may interrogate a volume encompassing a body of a patient for retained instruments or supplies. The system may be automatically configured (e.g., loading appropriate software) on communicative coupling of a device (e.g., antenna, reader, peripheral device).

Claims

1. A method of accounting for medical procedure objects, the method comprising:

at least proximate a start of a medical procedure on a patient, automatically detecting each of a number of medical procedure objects for performing the medical procedure within at least one sterile field using at least one sterile field antenna that is carried by at least a portion of a surface proximate the at least one sterile field, fixed with respect to the at least one sterile field, and having a detection range coextensive with the at least one sterile field, and which at least one sterile field is at least proximate to the patient but which at least one sterile field does not encompass any portion of a body of the patient;

each time one of the medical procedure objects is removed from the at least one sterile field, identifying the removed medical procedure object as checked out in a database; and

each time the medical procedure object is returned to the at least one sterile field or to a non-sterile field, identifying the returned medical procedure object as checked-in in the database;

automatically detecting a first medical procedure object of the number of medical procedure objects within the non-sterile field using at least one non-sterile field antenna that is carried proximate the non-sterile field and that has a detection range coextensive with the non-sterile field, wherein the non-sterile field does not encompass any portion of the body of the patient;

after detecting the first medical procedure object within the non-sterile field, automatically detecting the first medical procedure object within the at least one sterile field using the at least one sterile field antenna;

in response to detecting the first medical procedure object within the at least one sterile field after detecting the first medical procedure object within the non-sterile field, providing an indication that the first medical procedure object has been returned to the at least one sterile field after being present in the non-sterile field; and

at least proximate an end of the medical procedure on the patient, automatically determining whether each of the number of medical procedure objects detected within the at least one sterile field at least proximate the start of the medical procedure are present in at least one of either the at least one sterile field or at least one non-sterile field, neither of which the at least one sterile field and the at least one non-sterile field encompass any portion of the body of the patient.

2. The method of claim 1, further comprising:

in response to determining that a discrepancy exists between the number of medical procedure objects present in the at least one sterile field at least proximate the start of the medical procedure and the number of medical procedure objects present in the at least one sterile field or the at least one non-sterile field at least proximate the end of the medical procedure, providing an indication indicative of the existence of the discrepancy.

3. The method of claim 2 wherein providing an indication indicative of the existence of the discrepancy includes at least one of providing an aural indication, providing a visual indication or providing a tactile indication.

4. The method of claim 1 wherein automatically detecting each of a number of medical procedure objects within at least one sterile field includes at least one of wirelessly reading information from each of the medical procedure objects present in the at least one sterile field or wirelessly counting each of the medical procedure objects present in the at least one sterile field, and wherein wirelessly reading or wirelessly counting includes at least one of optically imaging, optically scanning, or wirelessly interrogating at least one of the medical procedure objects or a number of transponders associated with the medical procedure objects.

5. The method of claim 1 wherein the at least one sterile field is respectively coextensive with at least a portion of at least one of a back table, a supply table, or an instrument table, and wherein automatically detecting each of a number of medical procedure objects within at least one sterile field includes detecting any of the medical procedure objects present within respective portion of the back table, the supply table, or the instrument table.

6. The method of claim 1 wherein the at least one sterile field is respectively coextensive with an outer perimeter of an instrument tray, and wherein automatically detecting each of a number of medical procedure objects within at least one sterile field includes detecting any of the medical procedure objects present within the outer perimeter of the instrument tray.

7. The method of claim 1 wherein the at least one non-sterile field includes a waste receptacle and wherein automatically determining whether each of the number of medical procedure objects detected within the at least one sterile field at least proximate the start of the medical procedure are present in at least one of either the at least one sterile field or at least one non-sterile field includes determining whether any of the medical procedures objects are within a respective confines of the waste receptacle.

8. The method of claim 1, further comprising:

between the start and the end of the medical procedure on the patient, automatically tracking the presence or an absence of each of the number of medical procedure object within the at least one sterile field or the at least one non-sterile field.

9. The method of claim 1 wherein automatically detecting each of a number of medical procedure objects for performing the medical procedure within at least one sterile field using at least one antenna that is carried by at least a portion of a surface proximate the at least one field includes:

automatically detecting each of a number of medical procedure objects for performing the medical procedure within at least one sterile field using at least one antenna that is carried by at least a portion of a surface that includes at least one of;

at least a portion of a mat carrying the antenna placed beneath at least a portion of the one or more sterile fields;

at least a portion of a tray carrying the antenna, the tray beneath at least a portion of the one or more sterile fields;

or at least a portion of a surgical instrument support surface carrying the antenna, the surgical instrument support surface beneath at least a portion of the one or more sterile fields.

10. A system to account for medical procedure objects, the system comprising:

a plurality of sterile fields, each of the sterile fields encompassing an area that excludes any portion of a body of a patient on which a medical procedure is performed, each of the sterile fields including at least one sterile field antenna that is carried by at least a portion of a surface proximate the at least one sterile field, fixed with respect to the respective sterile field and having a detection range coextensive with the respective sterile field;

a non-sterile field that encompasses an area that excludes any portion of the body of the patient on which the medical procedure is performed, the non-sterile field including at least one non-sterile field antenna that is carried proximate the non-sterile field, fixed with respect to the non-sterile field, and having a detection range coextensive with the non-sterile filed;

a control subsystem including at least one processor and at least one processor-readable storage medium, the control subsystem configured to;

at least proximate a start of a medical procedure on a patient, use the respective sterile field antennas to automatically detect each of a number of medical procedure objects for performing the medical procedure within any of the plurality of sterile fields;

each time one of the medical procedure objects is removed from the at least one sterile field, identify the removed medical procedure object as checked out in a database; and

each time the medical procedure object is returned to the at least one sterile field or to the non-sterile field, identify the returned medical procedure object as checked-in in the database;

use the non-sterile field antenna to detect a first medical procedure object of the number of medical procedure objects within the non-sterile field;

after detection of the first medical procedure object within the non-sterile field, detect the first medical procedure object within at least one sterile field using the respective at least one sterile field antenna;

in response to detection of the first medical procedure object within the at least one sterile field after detection of the first medical procedure object within the non-sterile field, provide an indication that the first medical procedure object has been returned to the at least one sterile field after being present in the non-sterile field; and

at least proximate an end of the medical procedure on the patient, automatically determine whether each of the number of medical procedure objects detected within any of the sterile fields at least proximate the start of the medical procedure are present in at least one of either the sterile fields or at least one non-sterile field.

11. The system of claim 10, further comprising:

at least one receiver communicatively coupled to the at least one antenna in at least some of the plurality of sterile fields, the antennas and receiver providing a range that is about coextensive with the sterile fields and which range does not extend into any portion of the body of the patient when the patient is supported by a patient support structure during the medical procedure.

12. The system of claim 11, further comprising:

at least one transmitter communicatively coupled to the antennas to transmit an interrogation signal to any transponders in the sterile fields.

13. The system of claim 11 wherein the sterile fields are coextensive with at least a portion of a back table, a supply table, and an instrument table, respectively.

14. The system of claim 13 wherein one of the sterile fields is coextensive with a portable instrument tray and at least one of the antennas is physically coupled to the portable instrument tray.

15. The system of claim 11, further comprising:

a plurality of substrates, each of the substrates carrying at least a respective one of the antennas, the substrates positionable with respect to a respective one of each of the sterile fields such that a range of the at least respective one of the antennas covers the respective sterile field.

16. The system of claim 11 wherein the at least one receiver includes a plurality of receivers, each of at least some of the receivers physically coupled to a respective one of the substrates.

17. The system of claim 11 wherein the at least one receiver includes a plurality of receivers, each of at least some of the receivers physically housed in a controller console, at least some of the antennas remotely located from the control console and communicatively coupled to respective ones of the receivers via a respective wired connection.

18. The system of claim 10, further comprising:

at least one transmitter and receiver; and

at least one antenna that is a part of a handheld wand, the at least one antenna communicatively coupleable to the at least one transmitter and receiver to transmitting interrogation signals and receive response signals in a random orientation.

19. The system of claim 18 wherein the control subsystem is further configured to cause interrogations signals to be transmitted and to read identifiers encoded in response signals received from transponders in response to the interrogation signals.

20. The system of claim 10, further comprising:

a plurality of antennas communicatively coupled via at least one universal serial bus communications link to the control subsystem, at least some of the antennas located at least proximate respective ones of the sterile fields.

21. The system of claim 10 wherein the control subsystem is resident in a console and is configured by an application program loaded in response to communicative coupling of a reader to the console.

22. The system of claim 10, further comprising:

a plurality of readers communicatively coupled to the console and positioned at least proximate respective ones of the sterile fields and the non-sterile field, the readers including at least one of radio frequency identification readers or machine-readable symbol readers.

23. The system of claim 10, further comprising:

at least one cover sized to completely cover at least one of the antennas, the cover comprising a material that is capable of withstanding sterilization.

24. The system of claim 11 wherein the non-sterile field is coextensive with a waste receptacle.

25. A system to account for medical procedure objects, the system comprising:

a computer system including at least one processor and at least one computer-readable storage medium;

a number of readers to monitor a number of sterile fields in which at least one of medical implements or medical supplies are kept for use during medical procedures, and which any single one of the sterile fields does not encompass a patient support surface that supports a patient during a medical procedure, the readers selectively communicatively coupleable to the computer system;

a non-sterile field reader to monitor a non-sterile field in which at least one of the medical implements or the medical supplies are placed or disposed after use during medical procedures and which non-sterile field does not encompass a patient support surface that supports the patient during the medical procedure, that non-sterile field reader selectively communicatively coupleable to the computer system; and

a set of instructions executed by the at least one processor responsive to an initial communicative coupling of one of the readers to the computer system, the set of instructions to cause the computer system to;

autonomously identify the medical implements and medical supplies present in the number of sterile fields based at least in part on communication received from the number of readers;

each time one of the medical procedure objects is removed from the at least one sterile field, autonomously identify the removed medical procedure object as checked out in a database;

each time the medical procedure object is returned to the at least one sterile field or to the at least one non-sterile field, autonomously identify the returned medical procedure object as checked-in in the database;

autonomously detect a first medical implement or medical supply of the identified medical implements and medical supplies within the non-sterile field based at least in part on communications received from the non-sterile field reader;

after autonomous detection of the first medical procedure object within the non-sterile field, autonomously detect the first medical implement or medical supply within one of the number of sterile fields based at least in part on communications received from the respective reader; and

in response to autonomous detection of the first medical implement or medical supply within one of the number of sterile fields after autonomous detection of first medical implement or medical supply within the non-sterile field, provide an indication that the first medical implement or medical supply has been returned to the one of the number of sterile fields after being present in the non-sterile field.

26. The system of claim 25 wherein the readers each include a substrate that is positioned at least proximate at least one of a back table, a supply table, or an instrument table.

27. The system of claim 25 wherein the readers each include an antenna operable to transmit an interrogation signal to a respective one of the sterile fields and to receive a response signal from any transponders in the respective one of the sterile fields.

28. The system of claim 25 wherein the readers are communicatively coupled to the computer system by at least one wired or wireless universal serial bus.

29. A method of operating a medical procedure object accounting system, the method comprising:

detecting by a computer system an initial communicative coupling of an initial reader;

loading a first set of instructions to at least one computer-readable storage medium in response to the detection of an initial communicative coupling of the initial reader to the computer system, the instructions executable by at least one processor of the computer system to cause the computer system to;

autonomously identify medical implements and medical supplies present in a number of sterile fields that do not encompass any portion of a body of a patient;

each time one of the medical procedure objects is removed from the at least one sterile field, autonomously identifying the removed medical procedure object as checked out in a database;

each time the medical procedure object is returned to the at least one sterile field or to at least one non-sterile field, autonomously identifying the returned medical procedure object as checked-in in the database;

autonomously detect a first medical procedure object within a non-sterile field that dose not encompass any portion of the body of the patient;

after autonomous detection of the first medical procedure object within the non-sterile field, autonomously detect the first medical procedure object within one of the number of sterile fields; and

in response to autonomous detection of the first medical procedure object within one of the number of sterile fields after autonomous detection of the first medical procedure object within the non-sterile field, provide an indication that the first medical procedure object has been returned to the one of the number of sterile fields after being present in the non-sterile field; and

executing the first set of instructions by the at least one processor.

30. The method of claim 29 wherein executing the first set of instructions by the at least one processor causes the at least one processor to autonomously check the identified medical implements and medical supplies into and out of the sterile fields, by:

limiting a detection range of at least one antenna to be coextensive with at least one sterile field proximate a patient, but not encompass any portion of a body of the patient by directionally shielding via a radio frequency (“

RF”

) shield, at least a portion of an electromagnetic emission from the at least one antenna, the at least one antenna carried by at least a portion of a surface proximate the at least one sterile field and fixed with respect to the at least one sterile field;

at least proximate a start of a medical procedure on a patient, automatically detecting any of the medical implements and medical supplies within the at least one sterile field; and

at least proximate an end of the medical procedure on the patient, automatically determining whether each of the number of medical implements and medical supplies detected within the at least one sterile field at least proximate the start of the medical procedure are present in at least one of either the at least one sterile field or at least one non-sterile field, neither of which the at least one sterile field or the at least one non-sterile field encompass any portion of the body of the patient.

31. The method of claim 29 wherein executing the first set of instructions by the at least one processor causes the at least one processor to check the medical implements and medical supplies into and out of the sterile fields, by:

updating a database stored in the at least one computer-readable medium to reflect a status of a medical procedure object.

32. The method of claim 30, further comprising:

detecting by a computer system an initial communicative coupling of a non-reader;

loading a second set of instructions to at least one computer-readable storage medium in response to the detection of an initial communicative coupling of the non-reader to the computer system, the instructions executable by at least one processor of the computer system to cause the computer system to process information collected by the non-reader; and

executing the second set of instructions by the at least one processor.