DETAILED ACTION
Notice of Pre-AIA or AIA Status
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Claim Objections
Claims 3, 8, and 10 are objected to because of the following informalities:
The phrase “comprises is based one” should be changed to –is based on—to correct the grammatical and typographical errors (Claim 3, Lines 3-4).
The phrase “based on” should be changed to –is based on—to correct the grammatical error (Claim 8, Line 3).
The phrase “based on” should be changed to –is based on—to correct the grammatical error (Claim 10, Line 3).
Appropriate correction is required.
Claim Rejections - 35 USC § 103
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
The factual inquiries for establishing a background for determining obviousness under 35 U.S.C. 103 are summarized as follows:
1. Determining the scope and contents of the prior art.
2. Ascertaining the differences between the prior art and the claims at issue.
3. Resolving the level of ordinary skill in the pertinent art.
4. Considering objective evidence present in the application indicating obviousness or nonobviousness.
Claims 1, 2, 4-6, 14, 16, 21, 23, 25, 29, and 62 are rejected under 35 U.S.C. 103 as being unpatentable over Payton et al. (US 2019/0150831 A1) alone.
Regarding Claim 1, Payton discloses a method of monitoring oxygen at a patient to determine patency with a patent airway (method for providing indication or establishment of airway patency of patient, monitoring of at least one targeted gas being expired or expelled from airway of patient, apnoeic or non-spontaneously breathing patient, based on measurements, determination of airway patency or location of blockage or obstruction of airway, Abstract; monitored gas may be O2, paragraph 0254; targeted gas is O2, paragraph 0301), the method comprising: providing a gas flow to a patient's airway (flow therapy or respiratory support provided or delivered to the patient may be from a source of gases providing for a fraction of oxygen at greater than ambient or air conditions or greater than about 20.95% (on a dry weight basis) of oxygen, optionally the source of gases being up to about 100% oxygen gas, paragraph 0041), the gas flow including a predetermined fraction of oxygen (flow therapy or respiratory support provided or delivered to the patient may be from a source of gases providing for a fraction of oxygen at greater than ambient or air conditions or greater than about 20.95% (on a dry weight basis) of oxygen, optionally the source of gases being up to about 100% oxygen gas, paragraph 0041), monitoring the fraction of oxygen at the patient's airway (monitored gas may be O2, paragraph 0254; targeted gas is O2, paragraph 0301; gas sensor (or sampling device) configured to monitor or detect at least one parameter (optionally concentration) of targeted gas as a monitored gas signal, paragraph 0268), generating a waveform representing the fraction of oxygen at the patient's airway (monitored gas signal is described as a waveform and is used to compare with the flow waveform, paragraphs 0057-0089; monitored gas may be O2, paragraph 0254; targeted gas is O2, paragraph 0301), and determining the patient’s patency with a patent airway based on the waveform (determine patient’s airway is unobstructed when delivered flow and monitored gas signal is above a threshold, determine patient’s airway is obstructed when delivered flow and monitored gas signal is below a threshold or the frequency of monitored gas signal is not similar to frequency of flow, monitored or targeted gas may be generated as a result of gas exchange in patient’s lungs, paragraphs 0090-0095). Payton also discloses the need of detecting respiratory gases reaching the lungs of the patient and measuring the gases being expired or expelled from the patient to determine whether or not the airway is blocked (paragraphs 0392-0393).
Payton does not explicitly disclose determining whether the patient is spontaneously breathing based on the waveform.
However, Payton teaches the method may be used when patient is being pre-oxygenated or at the time the patient is breathing spontaneously (paragraph 0443). Payton also teaches that an occlusion or blockage in trachea or vocal cords will interrupt action of the cardiogenic pump action preventing both flow therapy and respiratory support to patient as well as preventing clearance of gas being expired or expelled from patient (paragraph 0474).
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to determine whether a patient is spontaneously breathing based on the waveform, as taught by Payton, since an occlusion and blockage is an obvious sign or indication that patient that is being pre-oxygenated cannot spontaneously breathe and to raise an alarm or warning to a medical professional (Payton: paragraph 0127) for the safety of the patient (Payton: paragraph 0475). Since Payton teaches that this method can be used when a patient is being pre-oxygenated (when they’re fully conscious and spontaneously breathing), it is obvious that when there is an obstruction or blockage in the airway of the patient, the patient would be incapable of spontaneously breathing or breathing normally. Thus, a determination of the patient spontaneously breathing can obviously be made based on the waveform as there would be a difference between the waveform where the airway is not blocked versus the waveform where the airway is blocked. When the airway is not blocked, it is obvious that the gas sensor will be capable of detecting the oxygen being expelled from the patient’s lungs due to the airflow coming out of the patient’s lung. When the airway is blocked, it is obvious that the gas sensor will not detect any oxygen being expelled from the patient’s lungs due to the blockage.
Regarding Claim 2, Payton teaches when the patient is breathing with the patent airway, the waveform indicates changes in the fraction of oxygen for each respiratory cycle as measured at the patient's airway (monitored gas signal is described as a waveform and is used to compare with the flow waveform, paragraphs 0057-0089; monitored gas may be O2, paragraph 0254; targeted gas is O2, paragraph 0301; O2 coming from the patient’s breathing will obviously change over time depending on inhalation and exhalation phases).
Regarding Claim 4, Payton teaches determining whether the patient is spontaneously breathing with the patent airway is based on determining that the patient has an obstructed airway when the waveform indicates insufficient change in the fraction of oxygen over a period of time as measured at the patient's airway (determine patient’s airway is obstructed when delivered flow and monitored gas signal is below a threshold or the frequency of monitored gas signal is not similar to frequency of flow, monitored or targeted gas may be generated as a result of gas exchange in patient’s lungs, paragraphs 0090-0095; a threshold and comparison of frequency are used to determine if the changes are sufficient or not).
Regarding Claim 5, Payton teaches automatically detecting that the patient has an obstructed airway based on the waveform (determine patient’s airway is obstructed when delivered flow and monitored gas signal is below a threshold or the frequency of monitored gas signal is not similar to frequency of flow, monitored or targeted gas may be generated as a result of gas exchange in patient’s lungs, paragraphs 0090-0095; warning or alarm or indication may be raised related to the patency of a patient's airway, such as for example if an airway occlusion or blockage or obstruction is detected or if the patency of a said patient's airway is compromised, paragraph 0128; controller (optionally comprising a processor) for determining a correlation between the delivered flow signal and said monitored gas signal, and characterizing a state of the patient's airway based on said correlation, paragraph 0269).
Regarding Claim 6, Payton teaches the gas flow to the patient’s airway includes providing the gas flow through a non-sealing user interface (patient interface is of the type comprising a sealing or non-sealing interface, and may further comprise a nasal mask, an oral mask, an oro-nasal mask, a full face mask, a nasal pillows mask, a nasal cannula, a combination of the above or some other gas conveying patient interface system, paragraph 0025).
Regarding Claim 14, Payton teaches providing the gas flow to the patient’s airway includes providing the gas flow at a high flow rate of greater than 15 litres per minute (LPM) (flow therapy or respiratory support may be delivered to the patient's airways is of a flow rate of: at least about 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, or 150 litres per min (LPM), or more; or may be selected between any of these values (for example, about 40 to about 80, about 50 to about 80, about 60 to about 80, about 70 to about 80 LPM), paragraph 0109).
Regarding Claim 16, Payton teaches providing the gas flow to the patient’s airway includes providing the gas flow at a high flow rate of between about 20LPM to 90LPM (flow therapy or respiratory support may be delivered to the patient's airways is of a flow rate of: at least about 20, 30, 40, 50, 60, 70, 80, 90 litres per min (LPM), or more; or may be selected between any of these values (for example, about 40 to about 80, about 50 to about 80, about 60 to about 80, about 70 to about 80 LPM), paragraph 0109).
Regarding Claim 21, Payton teaches including upon determining that the patient has an obstructed airway based on the waveform, providing an indication that the patient is has an obstructed airway (warning or alarm or indication may be raised related to the patency of a patient's airway, such as for example if an airway occlusion or blockage or obstruction is detected or if the patency of a said patient's airway is compromised, paragraph 0128).
Regarding Claim 23, Payton teaches the method is performed during a medical procedure when the patient has a diminished respiratory function or a risk of diminished respiratory function resulting from anaesthetic agents (varying gas flow with gas flow oscillations would be useful when a patients' respiratory drive is compromised or at least reduced, whether this is before, during or after a medical procedure or in any other situation, paragraph 0407; an assembled patient interface when pneumatically coupled to a circuit may be used to deliver gases to a patient during pre-oxygenation, when the patient is being anaesthetized and/or when the patient has been anaesthetized, paragraph 0441; method may additionally or alternatively be used when the patient is being pre-oxygenated prior to being anaesthetized. At that time, the patient is breathing spontaneously, paragraph 0443).
Regarding Claim 25, Payton teaches setting the gas flow at a continuous flow rate independent of the patient’s breathing (flow therapy or a respiratory support may be provided at a constant flow rate, paragraph 0053; the patient may be spontaneously breathing both an oscillating or otherwise varying flow and a constant flow rate may be used, and the concentration of CO2 or another targeted gas used to determine airway patency, paragraph 0526; since the flow is a constant flow rate that does not change over time, the flow rate would be independent from the patient’s breathing), and wherein providing the gas flow to the patient’s airway includes providing the gas flow at the continuous flow rate (flow therapy or a respiratory support may be provided at a constant flow rate, paragraph 0053; the patient may be spontaneously breathing both an oscillating or otherwise varying flow and a constant flow rate may be used, and the concentration of CO2 or another targeted gas used to determine airway patency, paragraph 0526).
Regarding Claim 29, Payton teaches providing the gas flow to the patient’s airway includes continuously providing the gas flow to the patient’s airway (flow therapy or a respiratory support may be provided at a constant flow rate, paragraph 0053; the patient may be spontaneously breathing both an oscillating or otherwise varying flow and a constant flow rate may be used, and the concentration of CO2 or another targeted gas used to determine airway patency, paragraph 0526) and monitoring includes continuously monitoring the fraction of oxygen at the patient’s airway (signal processing unit continuously monitors the targeted gas concentration level from the sensor, paragraph 0587).
Regarding Claim 62, Payton teaches humidifying the gas flow (the gases supplied may be delivered in a fully saturated or humidified condition, paragraph 0147).
Claims 3, 10, 12, 13, and 18 are rejected under 35 U.S.C. 103 as being unpatentable over Payton et al. (US 2019/0150831 A1) in view of Peter et al. (US 2021/0338950 A1).
Regarding Claim 3, Payton teaches the claimed invention of Claim 1. Payton fails to explicitly teach determining whether the patient is spontaneously breathing with the patent airway is based on the waveform indicating a decrease in the fraction of oxygen with respect to a baseline fraction of oxygen delivered to the patient corresponding to an assumed respiratory cycle of the patient.
However, Peter, of the same field of endeavor, teaches a process for monitoring a measuring system for mechanical ventilation of a patient (Abstract) including determining whether the patient is spontaneously breathing with the patent airway is based on the waveform indicating a decrease in the fraction of oxygen with respect to a baseline fraction of oxygen delivered to the patient corresponding to an assumed respiratory cycle of the patient (level of O2 shown to decrease greatly during exhalation and also decreases a bit during inspiration, Fig 2; inhalation has a higher O2 concentration, exhalation has a higher CO2 concentration, the drawing shows the O2 concentration over time across a single breath, paragraph 0093) since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize a decrease in oxygen fraction or concentration to determine spontaneous breathing, as taught by Peter, since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing. It is clear that the O2 concentration would change and decrease periodically throughout breaths of a patient. It is obvious that any deviation from this behavior would indicate something that is not spontaneous breathing.
Regarding Claim 10, Payton teaches the claimed invention of Claim 1. Payton fails to explicitly teach determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least two dips during a period of assumed respiratory cycle when an inspiratory demand of the patient is not met.
However, Peter, of the same field of endeavor, teaches a process for monitoring a measuring system for mechanical ventilation of a patient (Abstract) including determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least two dips during a period of assumed respiratory cycle when an inspiratory demand of the patient is not met (level of O2 shown to decrease greatly during exhalation and also decreases a bit during inspiration, Fig 2; inhalation has a higher O2 concentration, exhalation has a higher CO2 concentration, the drawing shows the O2 concentration over time across a single breath, paragraph 0093; inspiratory demand is not met since it is shown that the O2 concentration decreases a bit during inspiration) since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize two dips in the O2 concentration waveform to determine spontaneous breathing, as taught by Peter, since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing. It is clear that the O2 concentration would change and decrease periodically throughout breaths of a patient. It is obvious that any deviation from this behavior would indicate something that is not spontaneous breathing.
Regarding Claim 12, Payton teaches the claimed invention of Claim 1. Payton also teaches providing the gas flow to the patient's airway includes providing the gas flow at a high flow rate (flow therapy or respiratory support may be delivered to the patient's airways is of a flow rate of: at least about 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, or 150 litres per min (LPM), or more; or may be selected between any of these values (for example, about 40 to about 80, about 50 to about 80, about 60 to about 80, about 70 to about 80 LPM), paragraph 0109). Payton fails to teach determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least one dip during a period of assumed respiratory cycle.
However, Peter, of the same field of endeavor, teaches a process for monitoring a measuring system for mechanical ventilation of a patient (Abstract) including determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least one dip during a period of assumed respiratory cycle (level of O2 shown to decrease greatly during exhalation and also decreases a bit during inspiration, Fig 2; inhalation has a higher O2 concentration, exhalation has a higher CO2 concentration, the drawing shows the O2 concentration over time across a single breath, paragraph 0093) since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize at least one dip in the O2 concentration waveform to determine spontaneous breathing, as taught by Peter, since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing. It is clear that the O2 concentration would change and decrease periodically throughout breaths of a patient. It is obvious that any deviation from this behavior would indicate something that is not spontaneous breathing.
Regarding Claim 13, Payton-Peter combination teaches each dip in the waveform represents a decrease in the fraction of oxygen with respect to a baseline fraction of oxygen delivered to the patient (Payton: flow therapy or respiratory support provided or delivered to the patient may be from a source of gases providing for a fraction of oxygen at greater than ambient or air conditions or greater than about 20.95% (on a dry weight basis) of oxygen, optionally the source of gases being up to about 100% oxygen gas, paragraph 0041; Peter: dips in the O2 concentration is shown as a decrease with respect to the oxygen provided to the patient, Fig 2).
Regarding Claim 18, Payton teaches the claimed invention of Claim 1. Payton also teaches providing the gas flow to the patient’s airway includes providing the gas flow at a low flow rate of less than 20 LPM (flow therapy or respiratory support may be delivered to the patient's airways is of a flow rate of: at least about 5,10, 20 litres per min (LPM), paragraph 0109). Payton fails to teach determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least two dips during a period of assumed respiratory cycle.
However, Peter, of the same field of endeavor, teaches a process for monitoring a measuring system for mechanical ventilation of a patient (Abstract) including determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least two dips during a period of assumed respiratory cycle (level of O2 shown to decrease greatly during exhalation and also decreases a bit during inspiration, Fig 2; inhalation has a higher O2 concentration, exhalation has a higher CO2 concentration, the drawing shows the O2 concentration over time across a single breath, paragraph 0093) since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize two dips in the O2 concentration waveform to determine spontaneous breathing, as taught by Peter, since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing. It is clear that the O2 concentration would change and decrease periodically throughout breaths of a patient. It is obvious that any deviation from this behavior would indicate something that is not spontaneous breathing.
Claims 8 and 9 are rejected under 35 U.S.C. 103 as being unpatentable over Payton et al. (US 2019/0150831 A1) in view of Kline (US 2004/0210154 A1).
Regarding Claim 8, Payton teaches the claimed invention of Claim 1. Payton fails to teach determining whether the patient is spontaneously breathing with the patent airway based on the waveform indicating a change in oxygen fraction with respect to a baseline oxygen fraction delivered to the patient of more than about 10%.
However, Kline, of the same field of endeavor, teaches a device and method for ascertaining the functioning of the respiratory system (Abstract) including determining whether the patient is spontaneously breathing with the patent airway based on a change in oxygen fraction with respect to a baseline oxygen fraction delivered to the patient of more than about 10% (Fig 1 shows respiratory system during inhalation, paragraph 0027; Fig 2 shows respiratory system during exhalation, paragraph 0028; Fig 1 starts off with O2 at 100 Torr and CO2 at 0 Torr which equals to 100% O2; Fig 2 results with O2 at 80 Torr and CO2 at 40 Torr which equals to 80/(40+80)= 67% O2; 100%-67% = 33% change or decrease of O2 which is greater than 10%) since this is an expected O2 concentration change during the respiration of a patient.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize a change in O2 concentration of more than 10% to determine spontaneous breathing, as taught by Kline, since this is an expected O2 concentration change during the respiration of a patient. It is clear that during a breath, a patient would produce a decrease in O2 concentration that can be up to a 33% change in O2. Thus, one of ordinary skill in the art would utilize these values to determine if the patient is spontaneously breathing.
Regarding Claim 9, Payton teaches the claimed invention of Claim 1. Payton fails to teach determining whether the patient is spontaneously breathing with the patent airway based on the waveform indicating a change in oxygen fraction with respect to a baseline oxygen fraction delivered to the patient of more than about 30%.
However, Kline, of the same field of endeavor, teaches a device and method for ascertaining the functioning of the respiratory system (Abstract) including determining whether the patient is spontaneously breathing with the patent airway based on a change in oxygen fraction with respect to a baseline oxygen fraction delivered to the patient of more than about 30% (Fig 1 shows respiratory system during inhalation, paragraph 0027; Fig 2 shows respiratory system during exhalation, paragraph 0028; Fig 1 starts off with O2 at 100 Torr and CO2 at 0 Torr which equals to 100% O2; Fig 2 results with O2 at 80 Torr and CO2 at 40 Torr which equals to 80/(40+80)= 67% O2; 100%-67% = 33% change or decrease of O2 which is greater than 30%) since this is an expected O2 concentration change during the respiration of a patient.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize a change in O2 concentration of more than 30% to determine spontaneous breathing, as taught by Kline, since this is an expected O2 concentration change during the respiration of a patient. It is clear that during a breath, a patient would produce a decrease in O2 concentration that can be up to a 33% change in O2. Thus, one of ordinary skill in the art would utilize these values to determine if the patient is spontaneously breathing.
Claim 11 is rejected under 35 U.S.C. 103 as being unpatentable over Payton et al. (US 2019/0150831 A1) in view of Peter et al. (US 2021/0338950 A1) and Kline (US 2004/0210154 A1).
Regarding Claim 11, Payton teaches the claimed invention of Claim 1. Payton fails to teach determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least two dips during a period of assumed respiratory cycle when an inspiratory demand of the patient is not met, and the waveform indicating a change in oxygen fraction with respect to a baseline oxygen fraction delivered to the patient is about 10% to 30%.
However, Peter, of the same field of endeavor, teaches a process for monitoring a measuring system for mechanical ventilation of a patient (Abstract) including determining that the patient is spontaneously breathing with the patent airway based on the waveform indicating at least two dips during a period of assumed respiratory cycle when an inspiratory demand of the patient is not met (level of O2 shown to decrease greatly during exhalation and also decreases a bit during inspiration, Fig 2; inhalation has a higher O2 concentration, exhalation has a higher CO2 concentration, the drawing shows the O2 concentration over time across a single breath, paragraph 0093; inspiratory demand is not met since it is shown that the O2 concentration decreases a bit during inspiration) since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize two dips in the O2 concentration waveform to determine spontaneous breathing, as taught by Peter, since this is an expected behavior of the O2 concentration when a patient is spontaneously breathing. It is clear that the O2 concentration would change and decrease periodically throughout breaths of a patient. It is obvious that any deviation from this behavior would indicate something that is not spontaneous breathing.
Payton-Peter combination fails to teach the waveform indicating a change in oxygen fraction with respect to a baseline oxygen fraction delivered to the patient is about 10% to 30%.
However, Kline, of the same field of endeavor, teaches a device and method for ascertaining the functioning of the respiratory system (Abstract) including indicating a change in oxygen fraction with respect to a baseline oxygen fraction delivered to the patient is about 10% to 30% (Fig 1 shows respiratory system during inhalation, paragraph 0027; Fig 3 shows a respiratory system afflicted with a pulmonary vascular occlusion during exhalation, paragraph 0029; Fig 1 starts off with O2 at 100 Torr and CO2 at 0 Torr which equals to 100% O2; Fig 3 results with O2 at 85 Torr and CO2 at 20 Torr which equals to 85/(20+85)= 81% O2; 100%-81% = 19% change or decrease of O2 which is between 10% to 30%) since this is an expected O2 concentration change during the respiration of a patient, particularly a patient afflicted with a disease.
Therefore, it would have been obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to utilize a change in O2 concentration of between 10% to 30% to determine spontaneous breathing, as taught by Kline, since this is an expected O2 concentration change during the respiration of a patient, particularly a patient afflicted with a disease. It is clear that during a breath, a patient would produce a decrease in O2 concentration that can be up to a 33% change in O2. Any decrease in O2 concentration that is less than a 33% change in O2 would obviously be caused by a disease within the patient’s respiratory system. Thus, one of ordinary skill in the art would utilize these values to determine if the patient is spontaneously breathing as these values would be expected for both healthy and diseased patients.
Conclusion
The prior art made of record and not relied upon is considered pertinent to applicant's disclosure. See PTO-892 for art cited of interest including:
US 20080127977 A1 shows the behavior of O2% throughout the breath of the patient (Fig 8).
US 20110302992 A1 shows the gas percentage of O2 over time (Fig 6).
US 20090050148 A1 shows the O2% over breaths (Fig 2).
US 20040249301 A1 shows O2 concentration over time including during an apnea period (Fig 2a).
US 6884222 B1 shows the O2% over a breath (Fig 1).
US 20080300500 A1 discusses the partial pressure of CO2 remaining low due to the airway being closed during obstructive apnea (paragraph 0029).
Any inquiry concerning this communication or earlier communications from the examiner should be directed to BRIAN THAI-BINH KHONG whose telephone number is (571)272-1857. The examiner can normally be reached Monday to Thursday 9:00 am-6:00 pm.
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If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Kendra Carter can be reached at (571) 272-9034. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300.
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/BRIAN T KHONG/ Examiner, Art Unit 3785
/PAIGE KATHLEEN BUGG/ Primary Examiner, Art Unit 3785
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