IJSOO8577431B2
`
`(12) Unlted States Patent
`(10) Patent No.:
`US 8,577,431 B2
`
`Lamego et al.
`(45) Date of Patent:
`Nov. 5, 2013
`
`(54) NOISE SHIELDING FORA NONINVASIVE
`DEVICE
`
`(52) US. Cl.
`USPC ............ 600/310; 600/316; 600/322; 600/323
`
`(75)
`
`Inventors: Marcelo Lamego, Coto De Caza, CA
`(US); Sean Merritt, Lake Forest, CA
`(US); Cristiano Dalvi, Mission Viejo,
`CA (US); Hung Vo, Garden Grove, CA
`(US); Johannes Bruinsma, Mission
`Viejo, CA (US); Jeroen Poeze, Mission
`Viejo, CA (US); Ferdyan Lesmana,
`Irvine, CA (US); Greg Olsen, Trabuco
`Canyon, CA (US); Massi Joe E. Kiani,
`Laguna Niguel, CA (US)
`
`(73) Assignee: Cercacor Laboratories, Inc., Irvine, CA
`(US)
`
`( * ) Notice:
`
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 918 days.
`
`EP
`WO
`W0
`
`(58) Field Of Classification Search
`USPC ......... 600/310, 316, 322, 323, 344, 473, 476,
`600/326; 356/41
`See application file for complete search history.
`
`(56)
`
`References Cited
`U.S. PATENT DOCUMENTS
`
`4,114,604 A
`4,258,719 A
`
`9/1978 Shaw et a1.
`3/1981 Lewyn
`
`(Continued)
`
`FOREIGN PATENT DOCUMENTS
`
`3/1991
`419223
`7/1993
`WO93/12712
`5/2000
`WO 00/25112
`OTHER PUBLICATIONS
`
`(21) Appl.No.: 12/497,528
`
`(22)
`
`(65)
`
`Filed:
`
`Jul. 2, 2009
`
`Prior Publication Data
`
`US 2010/0004519 A1
`
`Jan. 7, 2010
`
`Related US. Application Data
`
`(63) Continuation-in-part of application No. 29/323,409,
`filed on Aug. 25, 2008, now Pat. No. Des. 621,516,
`which is a continuation-in—part of application No.
`29/323,408, filed on Aug. 25, 2008, now Pat. No. Des.
`606,659.
`
`(60) Provisional application No. 61/086,060, filed on Aug.
`4, 2008, provisional application No. 61/086,108, filed
`on Aug.
`4, 2008, provisional
`application No.
`61/086,063,
`filed on Aug. 4, 2008, provisional
`application No. 61/086,057, filed on Aug. 4, 2008,
`provisional application No. 61/078,228, filed on Jul. 3,
`2008, provisional application No. 61/078,207, filed on
`Jul. 3, 2008, provisional application No. 61/091,732,
`filed on Aug. 25, 2008.
`
`(51)
`
`Int. Cl.
`A6IB 5/1455
`
`(2006.01)
`
`International Search Report issued in Application No. PCT/US2009/
`052756, mailed Feb. 10, 2009 in 14 pages.
`
`(Continued)
`
`Primary Examiner 7 Eric Winakur
`Assistant Examiner 7 Chu Chuan (JJ) Liu
`(74) Attorney, Agent, or Firm 7 Knobbe Martens Olson &
`Bear LLP
`
`ABSTRACT
`(57)
`A noninvasive physiological sensor for measuring one or
`more physiological parameters of a medical patient can
`include a bump interposed between a light source and a pho-
`todetector. The bump can be placed in contact with body
`tissue of a patient and thereby reduce a thickness of the body
`tissue. As a result, an optical pathlength between the light
`source and the photodetector can be reduced. In addition, the
`sensor can include a heat sink that can direct heat away from
`the light source. Moreover, the sensor can include shielding in
`the optical path between the light source and the photodetec-
`tor. The shielding can reduce noise received by the photode-
`tector.
`
`21 Claims, 43 Drawing Sheets
`
`/71 450
`
`
`
`APPLE 1038
`
`1
`
`APPLE 1038
`
`

`

`US 8,577,431 B2
`
`Page 2
`
`(56)
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`4,267,844 A
`4,444,471 A
`4,655,225 A
`4,755,676 A
`4,781,195 A
`4,805,623 A
`4,880,304 A
`4,960,128 A
`4,964,408 A
`5028 787 A
`5:035:243 A
`5,041,187 A
`5,069,213 A
`5,069,214 A
`5,077,476 A
`D326 715 s
`5,131:391 A
`5,137,023 A
`5,159,929 A
`5,163,438 A
`5,222,496 A
`5,249,576 A
`5,278,627 A
`5,297,548 A
`5,319,355 A
`5,337,744 A
`5,337,745 A
`5,341,805 A
`5,362,966 A
`D353,195 S
`D353,196 5
`5,377,676 A
`D356 870 s
`D359:546 S
`5,431,170 A
`D36l,840 s
`5,437,275 A
`5,441,054 A
`D362,063 s
`5,452,717 A
`D363,120 S
`5,456,252 A
`5,479,934 A
`5,482,034 A
`5,482,036 A
`5,490,505 A
`5,494,043 A
`5,511,546 A
`5,533,511 A
`5,534,851 A
`5,553,615 A
`5,553,616 A
`5,561,275 A
`5,562,002 A
`5,590,649 A
`5,602,924 A
`D378,414 S
`5,632,272 A
`5,638,816 A
`5,638,818 A
`5,645,440 A
`5,676,143 A
`5,685,299 A
`D390,666 s
`D393,830 S
`5,743,262 A
`5,750,927 A
`5,752,914 A
`5,758,644 A
`5,760,910 A
`5,769,785 A
`5,782,757 A
`5,785,659 A
`5,791,347 A
`5,792,052 A
`
`5/1981 Yamanishi
`4/1984 Ford JLet 31.
`4/1987 Déihneetal.
`7/1988 Gaalenra etal.
`11/1988 Martin
`2/1989 Jébsis
`....................... 356/41
`11/1989 Jaeb etal.
`10/1990 Gordon etal.
`10/1990 Hink etal.
`7/1991 Rosenthalet 31.
`7/1991 MuZ
`8/1991 Hinketal.
`12/1991 Polczynski
`12/1991 Samarasetal.
`12/1991 Rosenthal
`6/1992 Schmidt
`7/1992 Sakai etal.
`8/1992 Mendelson etal.
`11/1992 Morris et al.
`11/1992 Gordon etal.
`6/1993 Clarke etal.
`10/1993 Goldbergeretal.
`1/1994 Aoyagietal.
`3/1994 Pologe .......................... 600/310
`6/1994 Russek
`8/1994 Branigan
`8/1994 Benaron
`8/1994 Stavridietal.
`11/1994 Rosenthaletal.
`12/1994 Savage etal.
`12/1994 Savage et 31.
`1/1995 Varietal.
`3/1995 Ivers et 31.
`6/1995 Savage etal.
`7/1995 Mathews
`8/1995 Savage etal.
`8/1995 Amundsen etal.
`8/1995 Tsuchiya
`9/1995 Savage etal.
`9/1995 Branigan et 31.
`10/1995 Savage etal.
`10/1995 Varietal.
`l/l996 Imran
`1/1996 Lewis et al.
`1/1996 Diab etal.
`2/1996 Diabetal.
`2/1996 O’Sullivan etal.
`4/1996 Hon
`7/1996 Kasparietal.
`7/1996 Russek
`9/1996 Carirn etal.
`9/1996 Hametal.
`10/1996 Savage etal.
`10/1996 Lalin
`1/1997 Caro etal.
`2/1997 Durandetal.
`3/1997 Allen etal.
`5/1997 Diab etal.
`6/1997 Kiani-Azarbayjanyetal.
`6/1997 Diabetal.
`7/1997 Tobleretal.
`10/1997 Simonsen etal.
`11/1997 Diab etal.
`2/1998 Lagerlof
`4/1998 Tobleretal.
`4/1998 Lepper, Jr. et al.
`5/1998 Baltazar
`5/1998 Delonzoret al.
`6/1998 Diab etal.
`6/1998 Lepper, Jr. et al.
`6/1998 Diab etal.
`7/1998 Diab etal.
`7/1998 Caro etal.
`8/1998 Flaherty etal.
`8/1998 Isaacson et al.
`
`............. 600/310
`
`5,810,734 A
`5,823,950 A
`5,826,885 A
`5,830,131 A
`5,833,618 A
`D403,070 S
`5,860,919 A
`5,890,929 A
`5,902,235 A
`5,904,654 A
`5,919,134 A
`5934925 A
`5,940,182 A
`D414,870 S
`5,995,855 A
`5,997,343 A
`6,002,952 A
`6,011,986 A
`6,027,452 A
`6,036,642 A
`6,045,509 A
`6049727 A
`61067462 A
`6,081,735 A
`6,088,607 A
`6,110,522 A
`6,124,597 A
`6,128,521 A
`6,129,675 A
`6,144,866 A
`6,144,868 A
`6,151,516 A
`6,152,754 A
`6,157,850 A
`6,165,005 A
`6,172,743 B1
`6,181,958 B1
`6,184,521 B1
`6,206,830 B1
`6,223,063 B1
`6,229,856 Bl
`6,232,609 B1
`6,236,872 B1
`6,241,683 B1
`6,253,097 Bl
`6,256,523 B1
`6,263,222 B1
`6,278,522 B1
`6,278,889 B1
`6,280,213 B1
`6,285,896 Bl
`6,301,493 B1
`6,317,627 B1
`6,321,100 B1
`D452,012 S
`6,334,065 B1
`6,343,224 Bl
`6,345,194 B1
`6,349,228 B1
`6,353,750 B1
`6,360,113 B1
`6,360,114 B1
`6,360,115 B1
`D455,834 S
`6,368,283 Bl
`6371921 Bl
`6,377,829 Bl
`6,388,240 B2
`6,397,091 132
`6,430,437 Bl
`6,430,525 B1
`D463,56l S
`6,463,311 B1
`6,470,199 B1
`6,501,975 B2
`6,505,059 B1
`6,515,273 B2
`6,519,487 B1
`6,525,386 B1
`
`9/1998 Caro et a1.
`10/1998 Diab etal.
`10/1998 Helgeland
`11/1998 Caro etal.
`11/1998 Caro etal.
`12/1998 Maeda et al.
`1/1999 Kiani-Azarbayjanyetal.
`4/1999 M111? et al~
`5/1999 LeW1S etal.
`5/1999 Wohltmann et al.
`7/1999 Dlab
`8/1999 Tobleretal.
`8/1999 Lepper,Jr.eta1.
`10/1999 Saltzstein et al.
`11/1999 Kianietal.
`12/1999 Mills et al.
`12/1999 Dlab etal~
`10000 Dlab etal.
`2/2000 Flaherty etal.
`3/2000 Diab et al.
`4/2000 Caro etal.
`40000 Cr_0thall
`50000 Dlab etal~
`60000 Dlab etal~
`70000 Dlab etal.
`8/2000 Lepper,Jr.eta1.
`90000 Shehada
`10/2000 Marro etal.
`10/2000 Jay
`11/2000 Mleseletal.
`11/2000 Parker
`11/2000 Kiani-Azarbayjanyetal.
`11/2000 G9rhardtetal~
`12/2000 Dl_ab etal~
`12/2000 MlllS et al.
`1/2001 Kleyetal.
`l/2001 Steuer et al.
`2/2001 Coffin, IV etal.
`3/2001 Diab etal.
`4/2001 Chaiken etal.
`5/2001 Dlab etal.
`5/2001
`SI_1yder et al~
`5/2001 Dlab etal.
`6/2001 Macklemetal.
`6/2001 Aronowetal.
`7/2001 Dlab etal.
`7/2001 Diab etal.
`8/2001 Lepper,Jr.eta1.
`8/2001 Robinson
`8/2001 Tobleretal.
`9/2001 Tobleretal.
`10/2001 Marro etal.
`11/2001 Ennenetal.
`ll/2001 Parker
`12/2001 Phillips
`12/2001 Al-Alietal.
`“2002 Parker
`2/2002 Nelsonet al.
`2/2002 Kianietal.
`3/2002 Kimuraetal.
`3/2002 Dettling
`3/2002 Diab et a1.
`3/2002 Greenwaldetal.
`4/2002 Oonarsetal.
`4/2002 Xu etal.
`4/2002 Caro 9tal.
`4/2002 Al-All
`5/2002 Sehulz et al.
`50002 Dlab etal.
`8/2002 Marro
`8/2002 Weberetal.
`9/2002 Fukatsu et al.
`10/2002 Diab
`10/2002 Kopotic et 31.
`12/2002 Diab etal.
`1/2003 Kolliasetal.
`2/2003 A1-Ali
`2/2003 Parker
`2/2003 Mills et al.
`
`2
`
`

`

`US 8,577,431 B2
`
`Page 3
`
`(56)
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`6,526,300 B1
`6,541,756 B2
`6,542,764 B1
`6,580,086 B1
`6,584,336 B1
`6,595,316 B2
`6,597,932 B2
`6,597,933 B2
`6,606,509 B2
`6,606,511 B1
`D481,459 5
`6,632,181 B2
`6,636,759 B2
`6,639,668 B1
`6,640,116 B2
`6,643,530 B2
`6,650,917 B2
`6,654,624 B2
`6,658,276 B2
`6,661,161 B1
`6,671,531 B2
`6,678,543 B2
`6 684 090 B2
`6:684’091 B2
`6,697:656 B1
`6,697,657 B1
`6,697,658 B2
`RE38 476 E
`6,699:194 B1
`6 714 804 B2
`R3338:492 E
`6,721,582 B2
`6 721 585 B1
`6:725:075 B2
`6,728,560 B2
`6 735 459 B2
`6:745’060 B2
`6,760:607 B2
`6,770,028 B1
`6 771 994 B2
`6:792:300 B1
`6,813,511 B2
`6,816,241 B2
`6,816,741 B2
`6,822,564 B2
`6,826,419 B2
`6,830,711 B2
`6,850,787 B2
`6,850 788 B2
`6 852,083 B2
`15502:“ 5 s
`6,861,639 B2
`6,898,452 B2
`6,920,345 B2
`D508,862 s
`6,931,268 B1
`6,934,570 B2
`6,939,305 B2
`6,943,348 B1
`6,950,687 B2
`D510,625 s
`6,961,598 B2
`6 970 792 B1
`6:979:812 B2
`6,985,764 B2
`6,993,371 B2
`D514,461 s
`6,996,427 B2
`6,999,904 B2
`7,003,338 B2
`7,003,339 B2
`7,015,451 B2
`7,024,233 B2
`7,027,849 B2
`7,030,749 B2
`
`2/2003 Kiani et 31.
`4/2003 $011111Z et a1.
`4/2003 Al-Ali et 31.
`6/2003 Schulz et al.
`6/2003 Ali et al.
`7/2003 Cybulski et al.
`7/2003 Tian et al.
`7/2003 Kiani et 31.
`8/2003 Schmitt
`8/2003 Ali et al.
`10/2003 Nahm
`10/2003 Flaherty et 31.
`10/2003 Robinson ...................... 600/310
`10/2003 Trepagnier
`10/2003 Diab
`11/2003 Diab et al.
`11/2003 Diab et al.
`11/2003 Diab et al.
`12/2003 Gruhl
`12/2003 Lanzo et 31.
`12/2003 Al-Ali et 31.
`1/2004 Diab et a1.
`1/2004 Ali et 31.
`1/2004 Parker
`2/2004 Al-Ali
`2/2004 Shehada et al.
`2/2004 Al-Ali
`3/2004 Diab et al.
`3/2004 Diab et 31.
`3/2004 Al-Ali et 31.
`4/2004 Diab e131.
`4/2004 Trepagnier et al.
`4/2004 Parker
`4/2004 Al-Ali
`4/2004 Kollias et 31.
`5/2004 Parker
`6/2004 Diab e131.
`7/2004 Al-All
`8/2004 Ali et 31.
`8/2004 Kiani et 31.
`9/2004 Diab et a1.
`11/2004 Diab et al.
`11/2004 Grubisic
`11/2004 Diab
`11/2004 Al-Ali
`11/2004 Diab et 31.
`12/2004 Mills et a1.
`2/2005 Weber et 31.
`2/2005 Al-Ali
`2/2005 Caro et 31.
`3/2005 Huang
`3/2005 Al-Ali
`5/2005 Al-Ali et 31.
`7/2005 141741113131.
`8/2005 Behar et a1.
`8/2005 Kiani-Azarbayjany et al.
`8/2005 Kiani et 31.
`9/2005 Flaherty et 31.
`9/2005 Coffin, IV
`9/2005 Al-Ali
`10/2005 Widener et al.
`11/2005 Diab
`11/2005 Diab
`12/2005 Al-Ali
`1/2006 Mason et a1.
`1/2006 Kiani et 31.
`2/2006 Harju
`2/2006 Ali et 31.
`2/2006 Weber et 31.
`2/2006 Weber et 31.
`2/2006 Diab et 31.
`3/2006 Dalke et 31.
`4/2006 Ali et 31.
`4/2006 Al-Ali
`4/2006 Al-Ali
`
`7,039,449 B2
`7,041,060 B2
`7,044,918 BZ
`7,067,893 B2
`7,096,052 B2
`7,096,054 B2
`7,132,641 B2
`7,142,901 32
`7,149,561 32
`D535a031 S
`D537,164 S
`7,186,966 132
`7,190,261 132
`7115984 132
`7,215,986 B2
`7,221,971 132
`7,225,006 132
`7,225,007 132
`RE39,672 E
`D547454 S
`7,239,905 B2
`7,245,953 Bl
`D549,830 S
`7,254,429 B2
`7,254,431 132
`7,254,433 B2
`7,254,434 B2
`D550,364 s
`D551,350 S
`7,272,425 132
`7,274,955 B2
`D553,248 S
`D554,263 S
`7,280,858 B2
`7,289,835 B2
`7,292,883 B2
`7,295,866 B2
`D562,985 S
`7,328,053 Bl
`7,332,784 B2
`7,340,287 B2
`7,341,559 B2
`7,343,186 B2
`D566,282 S
`D567,125 S
`7355512 Bl
`7,356,365 132
`D569a001 S
`13569521 S
`7,371,981 B2
`7,373,193 B2
`7,373,194 B2
`7,376,453 B1
`7,377,794 B2
`7,377,899 B2
`7,383,070 B2
`7,415,297 B2
`7,428,432 B2
`7,438,683 B2
`7440787 32
`7,454,240 B2
`7,467,002 B2
`7,469,157 B2
`7,471,969 B2
`7,471,971 32
`7,483,729 B2
`7,483,730 B2
`7,489,958 B2
`7,496,391 B2
`7,496,393 B2
`D587,657 S
`7,499,741 B2
`7,499,835 B2
`7,500,950 B2
`7,509,154 B2
`7,509,494 B2
`7,510,849 B2
`7,526,328 B2
`7,530,942 B1
`
`5/2006 Al-Ali
`5/2006 Flaherty et al.
`5/2006 Diab
`6/2006 Mills et 31.
`8/2006 Mason et al.
`8/2006 Abdul-Hafiz et a1.
`11/2006 Schulz et 31.
`11/2006 K9111 et 31.
`12/2006 Dlab
`“2007 Barrett etf11~
`2/2007 Sh1gem0r1 et al.
`30007 Al-AI}
`30007 Al-All
`50007 D131)
`5/2007 Dlab
`50007 Dlab _
`50007 Al-Al} 6t al~
`50007 Al-All
`6/2007 Shehada et al.
`_
`70007 H9161} 6t al~
`7/2007 K1an1-Azarbayjany et al.
`7/2007 Parker
`8/2007 Behar et 31.
`8/2007 Schurman et 31.
`80007 Al-Ali
`8/2007 Diab et a1.
`8/2007 Schulz et al.
`9/2007 Glover et al.
`9/2007 Lorimer et 31.
`90007 A1411
`9/2007 K1an1etal.
`10/2007 Nguyen et al.
`10/2007 Al-Ali et al.
`10/2007 Al-Ali et al.
`10/2007 Mansfield et 31.
`11/2007 De Felice et al.
`11/2007 Al-Ali
`2/2008 Brefl<a et al.
`2/2008 Dlab et al~
`2/2008 Mllls et al.
`3/2008 Mason et al.
`3/2008 Schulz et al.
`3/2008 Lamego et al.
`4/2008 Al-Ali et al.
`4/2008 Okabe et a1.
`4/2008 Al-All
`40008 Schmman
`50008 0111319
`50008 Omakl
`5/2008 Abdul-Hafiz
`5/2008 Al-All et a1.
`5/2008 Weber et al.
`5/2008 Diab et a1.
`5/2008 Al-Ali et al.
`5/2008 Weber et 31.
`6/2008 Diab et a1.
`8/2008 Al-Ali et 31.
`9/2008 A11 et-al.
`10/2008 Al-All et a1.
`10/2008 D131)
`11/2008 Dlab et a1.
`12/2008 Weber et 31.
`12/2008 Diab et a1.
`12/2008 Diab et al.
`12/2008 Dlab 9t al~
`1/2009 Al-All et a1.
`1/2009 Diab et al.
`2/2009 Diab et a1.
`2/2009 Dlab et a1.
`2/2009 Diab et al.
`3/2009 Al-Ali et al.
`3/2009 Diab et 31.
`3/2009 Weber et 31.
`3/2009 Al-Ali et 31.
`3/2009 Diab et 31.
`3/2009 Al-Ali
`3/2009 Schurman et 31.
`4/2009 Diab et 31.
`5/2009 Diab
`
`3
`
`

`

`US 8,577,431 B2
`
`Page 4
`
`(56)
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`5/2009
`5/2009
`7/2009
`9/2009
`10/2009
`11/2009
`ll/2009
`12/2009
`l/2010
`2/2010
`2/2010
`2/2010
`2/2010
`4/2010
`5/2010
`6/2010
`6/2010
`7/2010
`7/2010
`7/2010
`8/2010
`9/2010
`9/2010
`10/2010
`ll/2010
`ll/2010
`ll/2010
`ll/2010
`l/2011
`l/2011
`2/2011
`2/2011
`2/2011
`2/2011
`3/2011
`3/2011
`3/2011
`3/2011
`3/2011
`4/2011
`5/2011
`5/2011
`5/2011
`5/2011
`5/2011
`6/2011
`6/2011
`6/2011
`7/2011
`8/2011
`8/2011
`8/2011
`8/2011
`8/2011
`9/2011
`9/2011
`10/2011
`10/2011
`10/2011
`10/2011
`10/2011
`10/2011
`ll/2011
`ll/2011
`2/2012
`2/2012
`2/2012
`3/2012
`3/2012
`3/2012
`4/2012
`5/2012
`5/2012
`5/2012
`5/2012
`
`Al Ali et al.
`Diab et al.
`Al-Ali et al.
`Al-Ali et al.
`Laakkonen
`Jones et al.
`Flaherty
`Kiani et al.
`Al-Ali et al.
`Al-Ali et al.
`Eghbal et al.
`Coakley et al.
`Raridan et al.
`Al-Ali et al.
`Parker
`Al-Ali et al.
`Al-Ali
`Al-Ali et al.
`Al-Ali et al.
`Dalke et al.
`Kiani et al.
`Diab
`Diab
`Schurman et al.
`Parker
`Kiani et al.
`Al-Ali
`Al-Ali
`Weber et al.
`Weber et al.
`Al-Ali
`Al-Ali et al.
`Al-Ali et al.
`Al-Ali et al.
`Al-Ali et al.
`Trepagnier et al.
`Weber et al.
`Popov et al.
`Al-Ali
`Al-Ali et al.
`Al-Ali
`Mason et al.
`Diab et al.
`Kiani
`Flaherty et al.
`Lamego et al.
`Kiani et al.
`Diab et al.
`Kiani
`Diab
`Kiani
`Ali et al.
`Al-Ali
`Bellott et al.
`Kiani-Azarbayjany et al.
`Diab et al.
`Al-Ali et al.
`Bellott et al.
`Diab et al.
`Ali et al.
`Diab et al.
`Diab et al.
`Kiani
`Al-Ali et al.
`Parker
`Al-Ali et al.
`Diab et al.
`Diab et al.
`Al-Ali et al.
`Diab et al.
`Diab et al.
`Parker
`Diab et al.
`Kiani
`Diab et al.
`
`5/2012 Al-Ali et al.
`8,190,223 B2
`5/2012 Diab et al.
`8,190,227 B2
`6/2012 Kiani et al.
`8,203,438 B2
`6/2012 Merritt et al.
`8,203,704 B2
`7/2012 Al-Ali et al.
`8,224,411 B2
`7/2012 Al-Ali
`8,228,181 B2
`7/2012 Diab et al.
`8,229,533 B2
`2/2002 Benni
`........................... 600/323
`2002/0016536 A1*
`5/2002 Toida
`2002/0052547 A1
`7/2002 Chaiken et al.
`2002/0091322 A1
`2002/0115918 A1
`8/2002 Crowley
`2/2004 Abdul-Hafiz et a1.
`2004/0039272 A1*
`3/2004 Larson et al.
`2004/0049237 A1
`3/2004 Rantala et al.
`2004/0054269 A1
`3/2004 Schulz et al.
`2004/0054291 A1
`2005/0162761 A1
`7/2005 Hargis et al.
`7/2006 Xu et al.
`2006/0167347 A1
`8/2006 Kiani et al.
`2006/0189859 A1
`9/2006 Kessler et al.
`2006/0208191 A1
`9/2006 Dalke et al.
`2006/0211924 A1
`2006/0258922 A1* 11/2006 Mason et a1.
`2007/0165218 A1
`7/2007 Qing et a1.
`2007/0197886 A1
`8/2007 Naganuma et al.
`2007/0293792 A1
`12/2007 Sliwa et a1.
`2008/0036855 A1
`2/2008 Heenan
`2008/0071154 A1
`3/2008 Hausmann et al.
`2008/0130232 A1
`6/2008 Yamamoto et a1.
`2008/0139908 A1
`6/2008 Kurth
`2008/0208006 A1
`8/2008 Farr
`2009/0043180 A1
`2/2009 Tschautscher et al.
`2009/0105565 A1
`4/2009 Xu
`2009/0163775 A1
`6/2009 Barrett et al.
`2009/0259114 A1
`10/2009 Johnson et al.
`2010/0004518 A1
`l/2010 Vo et al.
`2010/0049018 A1*
`2/2010 Duffy et a1.
`2010/0090118 A1
`4/2010 Rozenfeld
`
`........ 600/322
`
`................. 600/323
`
`................... 600/323
`
`OTHER PUBLICATIONS
`
`International Preliminary Report on Patentability and Written Opin-
`ion of the International Searching Authority issued in Application
`No. PCT/US2009/052756, mailed Feb. 8, 2011 in 8 pages.
`International Search Report and Written Opinion for PCT/US2009/
`049638, mailed Jan. 7, 2010.
`Burritt, Mary F.; Current Analytical Approaches to Measuring Blood
`Analytes; vol. 36; No. 8(B); 1990.
`Hall, et al., Jeffrey W.; Near-Infrared Spectrophotometry: A New
`Dimension in Clinical Chemistry; vol. 38; No. 9; 1992.
`Kuenstner, et al., J. Todd; Measurement of Hemoglobin in Unlysed
`Blood by Near-Infrared Spectroscopy; vol. 48; No. 4, 1994.
`Manzke, et al ., B., Multi Wavelength Pulse Oximetry in the Measure-
`ment of Hemoglobin Fractions; vol. 2676.
`Naumenko, E. K.; Choice of Wavelengths for Stable Determination
`ofConcentrations ofHemoglobin Derivatives from Absorption Spec-
`tra ofErythrocytes; vol. 63; No. 1; pp. 60-66 Jan-Feb. 1996; Original
`article submitted Nov. 3, 1994.
`Schmitt, Joseph M.; Simple Photon Diffusion Anaylsis of the Effects
`of Multiple Scattering on Pulse Oximetry; Mar. 14, 1991; revised
`Aug. 30, 1991.
`Schmitt, et al., Joseph M.; Measurement of Blood Hematocrit by
`Dual-Wavelength near-IR Photoplethysmography; vol. 1641; 1992.
`Schnapp, et al., L.M.; Pulse Oximetry. Uses andAbuses.; Chest 1990;
`98; 1244-1250 DOI 10.1378/Chest.98.5.1244.
`PCT International Search Report, App. No. PCT/US2010/047899,
`Date of Actual Completion of Search: Jan. 26, 2011, 4 pages.
`International Preliminary Report on Patentability and Written Opin-
`ion of the International Searching Authority issued in Application
`No. PCT US2009/049638, mailed Jan. 5, 2011 in 9 pages.
`http://www.masimo .com/rainbow/pronto .htrn Noninvasive & Imme-
`diate Hemoglobin Testing, printed on Aug. 20, 2009.
`http://www.masimo.com/pulserimeter/Rad5.htrn; Signal Extrac-
`tion Pulse Oximeter, printed on Aug. 20, 2009.
`http://blogderoliveira.blogspot.com/2008i02i0liarchivehtml;
`Ricardo Oliveira, printed on Aug. 20, 2009.
`
`B2
`B2
`B2
`B2
`B2
`
`SB
`
`SB
`
`SB
`
`2
`
`2
`
`2
`B2
`B2
`
`SEB
`
`2
`B2
`B2
`B2
`B2
`
`SB
`
`2
`B2
`B2
`
`EB
`
`2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B1
`B2
`B2
`B2
`B2
`B2
`B2
`
`EB
`
`2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`
`EB
`
`2
`B2
`B2
`B2
`B2
`B2
`B2
`B2
`B1
`B2
`
`7,530,949
`7,530,955
`7,563,110
`7,596,398
`7,606,606
`D603,966
`7,618,375
`D606,659
`7,647,083
`D609,193
`7,657,294
`7,657,295
`7,657,296
`D614,305
`RE41,317
`7,729,733
`7,734,320
`7,761,127
`7,761,128
`7,764,982
`D621,5 16
`7,791,155
`7,801,581
`7,822,452
`RE4l,9l2
`7,844,313
`7,844,314
`7,844,315
`7,865,222
`7,873,497
`7,880,606
`7,880,626
`7,891,355
`7,894,868
`7,899,507
`7,899,518
`7,904,132
`7,909,772
`7,910,875
`7,919,713
`7,937,128
`7,937,129
`7,937,130
`7,941,199
`7,951,086
`7,957,780
`7,962,188
`7,962,190
`7,976,472
`7,988,637
`7,990,382
`7,991,446
`8,000,761
`8,008,088
`RE42,753
`8,019,400
`8,028,701
`8,029,765
`8,036,728
`8,046,040
`8,046,041
`8,046,042
`8,048,040
`8,050,728
`RE43,169
`8,118,620
`8,126,528
`8,128,572
`8,130,105
`8,145,287
`8,150,487
`8,175,672
`8,180,420
`8,182,443
`8,185,180
`
`4
`
`

`

`US 8,577,431 B2
`Page 5
`
`(56)
`
`References Cited
`OTHER PUBLICATIONS
`
`http://www.masimo.com/rad-57/; Noninvasive Measurement of
`Methemoglobin, Carboxyhemoglobin and Oxyhemoglobin in the
`blood. Printed on Aug. 20, 2009.
`http://amivital.ugr.es/blog/?tag+spo2; Monitorizacion
`hemoglobina .
`.
`. y mucho mas, printed on Aug. 20, 2009.
`http://www.masimo.com/spco/; Carboxyhemoglobin Noninvasive >
`Continuous > Immediate, printed on Aug. 20, 2009.
`
`de
`
`la
`
`http://www.masimo .com/PARTNERS/WELCHALLYN.htm; Welch
`Allyn Expands Patient Monitor Capabilities with Masimo Pulse
`Oximetry Technology, printed on Aug. 20, 2009.
`http://www.masimo.com/pulserimeter/PPO.htm; Masimo Per-
`sonal Pulse Oximeter, printed on Aug. 20, 2009.
`http://www.masimo.com/generalFloor/system.htm; Masimo Patient
`SafetyNet System at a Glance, printed on Aug. 20, 2009.
`European Office Action issued in application No. 107639015 on Jan.
`1 1, 2013.
`
`* cited by examiner
`
`5
`
`

`

`U.S. Patent
`
`S
`
`US 8,577,431 B2
`
`
`
` _a<55"EmzwmawfizmSE30.1........._z:_
`
`_KE:
`
`
`
`wEésazmmopommo\.8mg
`
`moimmczmmm22%92529:.WW—””—fig.,,,,,Hrm;N
`
`memmmoomm
`
`OS
`
`
`
`me”5:20:x:memzmm
`
`%Em:_
`,m"E3fizmo
`moimflz":zoEoézoEo
`
`SwimmmnzxmEmgozmam:
`
`_____
`
`N:we
`
`
`
`moEmEzmoéos
`
`or?VF?.
`
`rOEm:
`
`
`
`
`
`xmoimz.........E052
`
`6
`
`
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 2 of 43
`
`US 8,577,431 B2
`
`SENSORZUQ
`
`
`
`EMHTERSHELL
`204
`
`MONWOR
`2093
`
`DETECTOR
`SHELL
`206
`
`BUTTONS
`
`CONTROL / ©
`208a \
`
`
`
`DISPLAY 2108
`
`FIG. 2A
`
`7
`
`

`

`U.S. Patent
`
`V
`
`3102
`
`34f03
`
`US 8,577,431 B2
`
`0ImamN‘/2:20
`
`Doom
`
`mjm<o
`
`NEmeow
`
`motzOE4/
`
`MOmem
`
`EON
`
`mm.0.“—
`
`%mzotbm%Jomkzoo
`
`
`8
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 4 of 43
`
`US 8,577,431 B2
`
`200C
`\\‘
`
`SENSOR
`
`CABLE
`212
`
`STRAP
`214
`
`l~
`
` DBPLAY
`
`DBPLAY
`2100
`
`BUTTONS
`flBc
`
`MONHOR
`2090
`
`FIG. 2C
`
`9
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 5 of 43
`
`US 8,577,431 B2
`
`\
`
`DISPLAY
`
`210d
`
`
`
`ETHERNETPORT
`
`(OPHONAU
`
`Z8
`
`//
`
`USB INTERFACE
`
`(OPTIONAL)
`216
`
`
`
`10
`
`10
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 6 of 43
`
`US 8,577,431 B2
`
`mmom
`
`
`48.0.”—
`
`11
`
`11
`
`

`

`
`
`FIG. 3B
`
`12
`
`

`

`U.S. Patent
`
`US 8,577
`
`
`
`FIG. 3c
`
`13
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 9 of 43
`
`US 8,577,431 B2
`
`
`
`FIG. 30
`
`14
`
`14
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 10 of 43
`
`US 8,577,431 B2
`
`
`
`FIG. 3E
`
`15
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 11 of 43
`
`US 8,577,431 B2
`
`
`
`
`
`
`
`FIG.3F
`
`3061‘
`
`16
`
`16
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 12 of 43
`
`US 8,577,431 B2
`
`
`
`17
`
`17
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 13 of 43
`
`US 8,577,431 B2
`
`510
`
`305
`
`(3 +20nm+16nm
`
`FIG.5
`
`WAVELENGTH
`
`1600nm
`
`900nm
`
`500
`
`A‘I‘5
`
`
`
`
`
`~1.5xdifference
`
`TRANSMITTANCE
`
`18
`
`18
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 14 0f 43
`
`US 8,577,431 B2
`
`608
`
`610
`
`605
`/
`
`FIG. 6A
`
`605
`/
`
`608
`
`610 .
`
`605
`\‘
`
`FIG. 68
`
`608
`
`i
`
`T
`
`T b i
`
`FIG. 6C “0
`
`FIG. GB
`
`19
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 15 of 43
`
`US 8,577,431 B2
`
`
`
`FIG.6E
`
`20
`
`20
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 16 of 43
`
`US 8,577,431 B2
`
`701A
`\
`
`EMITTER
`HOUSING
`704a
`
`LEDS
`104
`
`5 !
`
`FINGER 102
`
`TISSUE BED
`
`OPENING
`
`733
`
`/ 710a
`703a [\I
`
`
`_m COE‘EXEQVE
`
`PHOTODIODES I
`
`r- -
`SHIELDING790a
`106
`
`h|_
`DETECTOR
`
`— HOUSING/SHELL
`
`
`SUBMOUNT
`707a
`
`7303
`
`706a
`
`DETECTOR
`SIGNAL
`107
`
`FIG. 7A
`
`21
`
`21
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 17 of 43
`
`US 8,577,431 B2
`
`7018
`\
`
`EMITTERS
`
`104
`
`EMITTER
`HOUSING
`704a
`
`I ~
`
`
`
`FINGER 102
`
`
`
`TISSUE BED
`OPENING(S)
`710b
`
`
`703b
`BUMP
`
`CONTACT AREA
`770b
`705b
`
`
`CONDUCTIVE
`PHOTODIODES
`GLASS 730b
`106
`
`
`
`
`DETECTOR
`HOUSING/SHELL
`
`706b
`
`SUBMOUNT
`
`707b
`
`DETECTOR
`SIGNAL
`107
`
`FIG. 7B
`
`22
`
`22
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 18 of 43
`
`US 8,577,431 B2
`
`730
`
`733
`
`731 FIG. 8A
`
`731
`
`uIInIaIaIalaIalaIanaIuInIlnlminimum-alnlulnlulnlnla:
`
`733
`
`FIG. BB
`
`S330“
`
`835
`
`—_
`
`FIG. SC
`
`839
`
`23
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 19 of 43
`
`USSfi7I43lB2
`
`ii.
`
`
`
`/./.!/./i.
`
`
`
`mw<40mm/EO
`
`£5828\0%76mm08
`
`Amzzaoomv,OE
`
`
`mg
`
`//
`
`
`
`
`
`i.ow£5828/////ANZESNViii1/1.:E830
`
`
`
`
`
`
`.£5828iii/i.TE08/l\\
`
`
`
`
`Amzzaomv___sr8830
`
`
`
`
`
`
`
`
`
`
`
`
`oowrcomeoomrcow?com?com?
`
`a.GE
`
`AEE£m:o.o>m>>
`
`
`
`°/o Transmission
`of Light
`
`24
`
`24
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 20 of 43
`
`US 8,577,431 B2
`
`
`
`
`
`
`mm_oza\omormm_oz439Noz_zmaomo;moofi voz_2m_n_omo;moodmm_ozxNmoemoz_Zm_n_omo;mood
`522onm8moo:502o3.:M552B3818I
`
`82<0?.OE
`
`comcomcowcomcomcor
`
` _
`
`
`
`82\\Aodimmw_02oz_m_>>0E0nomoz<§moufimm
`
`
`
`
`
`Noise Floor
`
`25
`
`
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 21 0f 43
`
`US 8,577,431 B2
`
`
`
`
`
`82\Ao._m=_._mmm_02m>_._.o:n_zoomomoz<2m0mmmm
`
` voz_zmn_omo“.moodmm_oZxmoz_zmmomodmoodmm_oZ4Noz_zmmomo”.mood
`
`
`
`
`
`
`mm_oZnroz_zmn_omo...moodmm_oZo
`
`3.:362do5:03.02“. comcomoovcomcomcor
`
`
`
`82m3..QE
`
`Noise Floor (dB)
`
`26
`
`26
`
`
`
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 22 of 43
`
`US 8,577,431 B2
`
`
`
`EMHTER1104
`
`TOPEMWHNG
`LEDS
`1102
`
`
`
`
`THERMSTOR
`1120
`
`
` DRWER
`$DEEMWWNG
`LEDS
`1104
`
`1105
`
` ‘7
`
`CONTROL
`QGNAL
`
`SUBMOUNT
`1106
`
`FIG. 11
`
`27
`
`27
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 23 of 43
`
`US 8,577,431 B2
`
`DETECTOR1
`
`
`
`DETECTOR2
`
`
`
`
`
`DETECTOR
`
`4
`
`
`DETECTOR SUBMOUNT
`
`
`1200
`DETECTOR3
`
`FIG. 12
`
`28
`
`28
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 24 of 43
`
`US 8,577,431 B2
`
`1300
`
`/
`
`1305
`
`EMITTER (POINT SOURCE)
`_____________________________.
`1304 I
`.
`V1 EMITTER SET1
`:
`,
`.
`.,____ DRIVER
`; DE]
`I
`:
`E
`
`EIVIITTER SETn
`EU
`/
`
`.
`
`.
`
`.
`
`PULSEn 3C5:
`m
`
`CONTROL
`SIGNAL
`
`(FROM
`PROCESSOR
`1010)
`
`
`
`
`
`
`\.,
`-0;
`’1
`0
`
`PULSE
`SEQUENCE
`1303
`
`\:/
`PULSE1 7Q?
`
`1302
`
`DETECTED LIGHT
`
`1306
`
`SPACING
`
`PULSE
`
`PULSE
`
`1
`
`I
`
`loool
`
`n
`
`MULTI—
`STREAM
`SIGNAL
`
`FIG. 13
`
`INTERFACE
`
`
`
`
`
`
`
`
`
`
`
`TO SIGNAL
`PROCESSOR
`I310
`
`29
`
`29
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 25 of 43
`
`US 8,577,431 B2
`
`
`
`FIG. 14A
`
`30
`
`30
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 26 of 43
`
`US 8,577,431 B2
`
`FROM EMHTERS
`
`1420
`
`005
`
`1400b
`
`1410b
`
`FIG. 14B
`
`31
`
`31
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 27 of 43
`
`US 8,577,431 B2
`
`
`
`FIG. 14C
`
`32
`
`32
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 28 of 43
`
`US 8,577,431 B2
`
`605b
`
`FIG. 14D
`
`33
`
`33
`
`
`

`

`US. Patent
`
`Nov. 5 2013
`
`Sheet 29 of 43
`
`a“ @w
`
`FIG. 14E
`
`34
`
`

`

`US. Patent
`
`Nov. 5 2013
`
`Sheet 30 of 43
`
`
`
`FIG. 14F
`
`35
`
`

`

`US. Patent
`
`Nov. 5 2013
`
`Sheet 31 of 43
`
`
`
`FIG. 14G
`
`36
`
`

`

`US. Patent
`
`Nov. 5 2013
`
`Sheet 32 of 43
`
`
`
`FIG. 14H
`
`37
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 33 of 43
`
`US 8,577,431 B2
`
`3501‘
`
`357f
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`FIG. MI
`
`38
`
`38
`
`

`

`U.S. Patent
`
`NOV.5,2013
`
`Sheet 34 of 43
`
`US 8,577,431 B2
`
`mom”
`
`ommr
`
`mOH<43mZ_
`
`HZDOEme
`
`wom4
`
`wow?
`
`
`
`<2..0.“—
`
`<oomv
`
`39
`
`39
`
`
`

`

`U.S. Patent
`
`N
`
`m
`
`34f053mhS
`
`US 8,577,431 B2
`
`5,ommwmm><._xzaham:Wwok/33m;
`
`3..1H
`
`mom?
`
`HZDOEmDm
`
`0mm;
`
`moon?
`
`40
`
`mom:
`
`vow?
`
`
`
`mmv.9".
`
`40
`
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 36 of 43
`
`US 8,577,431 B2
`
`1506
`
`1580
`
`FIG.15C
`
`41
`
`41
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 37 of 43
`
`US 8,577,431 B2
`
`
`
`
`
`Mimimom”Anom—
`
`omw.OE mom;
`
`owe
`
`42
`
`42
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 38 of 43
`
`US 8,577,431 B2
`
`1530
`
`1565
`
`\
`
`1506
`
`1500E
`
`FIG.15E
`
`43
`
`43
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`e
`
`09
`
`%
`
`US 8,577,431 B2
`
`won?
`
`mm4cm:
`
`f0mm_
`
`
`
`"Br.07..
`
`
`
`mi..imwwlflw.i‘H.HHH.§H!S£53.an-
`
`44
`
`44
`
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 40 of 43
`
`US 8,577,431 B2
`
`1575
`
`1587
`
`1514
`
`FIG.156
`
`45
`
`45
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 41 of 43
`
`US 8,577,431 B2
`
`1587
`
`1514
`
`1575
`
`FIG.15H
`
`46
`
`46
`
`

`

`US. Patent
`
`Nov. 5, 2013
`
`Sheet 42 of 43
`
`US 8,577,431 B2
`
`
`
`
`FIG.16A
`
`Ox"-
`CD‘—
`
`47
`
`47
`
`

`

`U.S. Patent
`
`NOV. 5, 2013
`
`Sheet 43 of 43
`
`US 8,577,431 B2
`
`1787
`
`O67
`
`FIG. 17
`
`48
`
`48
`
`

`

`US 8,577,431 B2
`
`1
`NOISE SHIELDING FORA NONINVASIVE
`DEVICE
`
`RELATED APPLICATIONS
`
`This application claims the benefit of priority under 35
`U.S.C. §ll9(e) of the following US. Provisional Patent
`Applications:
`
`2
`
`light detector. For example, noninvasive sensors often include
`a clothespin—shaped housing that includes a contoured bed
`conforming generally to the shape of a finger. The contoured
`bed positions the finger for measurement and attempts to
`stabilize it.
`
`Unfortunately, this type of contour cannot be ideal, espe-
`cially for measuring blood constituents like glucose.
`
`Attorney Docket
`)
`M
`JM.002 {
`
`A3p. No.
`
`Filing
`Date
`
`Title
`
`6 /086,060
`
`6 /086,108
`
`6 /086,063
`
`6 /086,057
`
`6 /078,228
`
`6 /078,207
`
`6 /091,732
`
`
`
`Aug. 4, 2008
`
`Aug. 4, 2008
`
`Aug. 4, 2008
`
`Aug. 4, 2008
`
`Jul. 3, 2008
`
`Jul. 3, 2008
`
`Aug. 25, 2008
`
`Multi-Strearn Data Collection System For
`Non-Invasive Measurement of Glucose
`and Other Analytes
`Multi-Strearn Sensor Front Ends for
`Noninvasive Measurement of Glucose
`and Other Analytes
`Multi-Strearn Detector For Noninvasive
`Measurement Of Glucose And Other
`Analytes
`Multi-Strearn Emitter For Noninvasive
`Measurement Of Glucose And Other
`Analytes
`Noise Shielding ForA Non-Invasive
`Device
`Contoured Protrusion for Improving
`Spectroscopic Measurement ofBlood
`Constituents
`Sensor For Improving Measurement Of
`Blood Constituents
`
`This application also claims the benefit ofpriority under 35
`U.S.C. §l20 as a continuation-in-part of the following US.
`Design Patent Applications:
`
`App. No.
`
`Filing
`Date
`
`Title
`
`Attorney Docket
`
`29/323,409
`
`Aug. 25, 2008
`
`29/323,408
`
`Aug. 25, 2008
`
`Patient Monitoring MLHUM.009DA
`Sensor
`Patient Monitor
`
`MLHUM.010DA
`
`
`
`
`
`
`
`30
`
`35
`
`40
`
`
`
`JM.003
`
`JM.004
`
`JM.005
`
`JM.006
`
`JM.007
`
`JM.011
`
`)
`
`)
`
`)
`
`)
`
`)
`
`)
`
`
`
`SUMMARY
`
`This disclosure describes embodiments of noninvasive
`
`methods, devices, and systems for measuring a blood analyte,
`such as oxygen, carbon monoxide, methemoglobin,
`total
`hemoglobin, glucose, proteins, glucose, lipids, a percentage
`thereof (e.g., saturation) or for measuring many other physi-
`ologically relevant patient characteristics. These characteris-
`tics can relate, for example, to pulse rate, hydration, trending
`information and analysis, and the like. In certain embodi-
`ments, a noninvasive sensor interfaces with tissue at a mea-
`surement site and deforms the tissue in a way that increases
`signal gain in certain desired wavelengths. In an embodiment,
`a protrusion can be provided in a finger bed of a noninvasive
`sensor for a patient’ s finger. The protrusion can reduce tissue
`thickness, thereby sometimes increasing signal gain by tens
`of times or even more. This protrusion can include different
`sizes and shapes depending on the tissue site and the desired
`blood analyte to be measured.
`In disclosed embodiments, the protrusion is employed in
`noninvasive sensors to assist in measuring and detecting vari-
`ous analytes. The disclosed noninvasive sensor can also
`include, among other things, emitters and detectors posi-
`tioned to produce multi-stream sensor information. The non-
`invasive sensor can have different architectures and can
`
`include or be coupled to other components, such as a display
`device, a network interface, and the like. The protrusion can
`be employed in any type of noninvasive sensor.
`In certain embodiments, a noninvasive physiological sen-
`sor for measuring one or more physiological parameters of a
`medical patient can include a bump interposed between a
`light source and a photodetector. The bump can be placed in
`contact with body tissue of a patient and thereby reduce a
`thickness ofthe body tissue. As a result, an optical pathlength
`between the light source and the photodetector can be
`reduced. In addition, the sensor can include a heat sink that
`
`49
`
`The foregoing applications are hereby incorporated by ref-
`erence in their entirety.
`
`45
`
`BACKGROUND
`
`The standard of care in caregiver environments includes
`patient monitoring through spectroscopic analysis using, for
`example, a pulse oximeter. Devices capable of spectroscopic
`analysis generally include a light source(s) transmitting opti-
`cal radiation into or reflecting offa measurement site, such as,
`body tissue carrying pulsing blood. After attenuation by tis-
`sue and fluids of the measurement site, a photodetection
`device(s) detects the attenuated light and outputs a detector
`signal(s) responsive to the detected attenuated light. A signal
`processing device(s) process the detector(s) signal(s) and out-
`puts a measurement indicative of a blood constituent of inter-
`est, such as glucose, oxygen, met hemoglobin, total hemo-
`globin, other physiological parameters, or other data or
`combinations of data useful in determining a state or trend of
`wellness of a patient.
`In noninvasive devices and methods, a sensor is often
`adapted to position a finger proximate the light source and
`
`50
`
`55
`
`60
`
`65
`
`49
`
`

`

`US 8,577,431 B2
`
`3
`can direct heat away from the light source. Moreover, the
`sensor can include shielding in the optical path between the
`light source and the photodetector. The shielding can reduce
`noise received by the photodetector.
`For purposes of summarizing the disclosure, certain 5
`aspects, advantages and novel features of the inventions have
`been described herein. It is to be understood that not neces-
`
`sarily all such advantages can be achieved in accordance with
`any particular embodiment ofthe inventions disclosed herein.
`Thus, the inventions disclosed herein can be embodied or
`carried out in a manner that achieves or optimizes one advan-
`tage or group of advantages as taught herein without neces-
`sarily achieving other advantages as can be taught or sug-
`gested herein.
`
`10
`
`15
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`Throughout the drawings, reference numbers can be re-
`used to indicate correspondence between referenced ele- 20
`ments. The drawings are provided to illustrate embodiments
`of the inventions described herein and not to limit the scope
`thereof.
`
`4
`
`FIG. 11 illustrates a block diagram of some of the compo-
`nents that may include an embodiment of a sensor, according
`to an embodiment of the disclosure;
`FIG. 12 illustrates an example detector portion that may be
`employed in an embodiment of a sensor, according to an
`embodiment of the disclosure;
`FIG. 13 illustrates an example multi-stream operation of
`the system of FIG. 1, according to an embodiment of the
`disclosure;
`FIG. 14A illustrates another example detector portion hav-
`ing a partially cylindrical protrusi