Kelly and colleagues (2008) found a PCNFI device failed to prevent contamination. After administering injections to hepatitis B patients, researchers found hepatitis B had penetrated the protective cap and contaminated the internal components of the jet injector, showing that the internal fluid pathway and patient contacting parts cannot safely be reused. Researchers developed a new jet injection design by combining the drug reservoir, plunger and nozzle into a single-use disposable cartridge. The cartridge is placed onto the tip of the jet injector and when activated a rod pushes the plunger forward. This device is known as a disposable-cartridge jet injectors (DCJI). The International Standards Organization recommended abandoning the use of the name "jet injector", which is associated with a risk of cross-contamination and rather refer to newer devices as "needle-free injectors". Modern needle-free injector brands Diabetics have been using jet injectors in the United States for at least 20 years. These devices have all been spring-loaded. At their peak, jet injectors accounted for only 7% of the injector market. Currently, the only model available in the United States is the Injex 23. In the United Kingdom, the Insujet has recently entered the market. As of June 2015, the Insujet is available in the UK and a few select countries. Researchers from the University of Twente in the Netherlands patented a Jet Injection System, comprising a microfluidic device for jet ejection and a laser-based heating system. A continuous laser beam – also called a continuous-wave laser – heats the liquid to be administered, which is then launched in a droplet form across the epidermis and then slows down into the tissue below. Concerns Since the jet injector breaks the barrier of the skin, there is a risk of blood and biological material being transferred from one user to the next. Research on the risks of cross-contamination arose immediately after the invention of jet injection technology. There are three inherent problems with jet injectors: Splash-back Splash-back refers to the jet stream penetrating the outer skin at a high velocity causing the jet stream to ricochet backwards and contaminate the nozzle. Instances of splash-back have been published by several researchers. Samir Mitragrotri visually captured splash-back after discharging a multi-use nozzle jet injector using high-speed microcinematography. Hoffman and colleagues (2001) also observed the nozzle and internal fluid pathway of the jet injector becoming contaminated. Fluid suck-back Fluid suck-back occurs when blood left on the