Storage device for health care facility

[0001] The present invention relates generally to a device for storing and dispensing medical items, and more specifically to a storage device providing controlled access to the medical items.

[0002] The present application claims priority from U.S. Pat. Ser. No. 60/377,027 filed Apr. 30, 2002; U.S. Pat. Ser. No. 60/376,625, filed Apr. 30, 2002; U.S. Pat. Ser. No. 60/376,655, filed Apr. 30, 2002; and U.S. Pat. Ser. No. 10/135,180 filed Apr. 30, 2002, which is a continuation-in-part of copending U.S. Pat. Ser. No. 10/059,929 filed Jan. 29, 2002, and incorporates such applications herein by reference.

[0003] Additionally, the present application is being filed concurrently with and incorporates by reference the following applications: “Automated Messaging Center System and Method For Use With A Healthcare System” (Attorney Docket No. EIS-5849 (1417G P 749)), Ser. No. ______; “System And Method For Obtaining Information From A Bar Code For Use With A Healthcare System” (Attorney Docket No. EIS-5897 (1417G P 754)), Ser. No. ______; “Infusion Therapy Bar Coding System and Method” (Attorney Docket No. EIS-5850 (01417GP0750)), Ser. No. ______; “System and Method for Providing Multiple Units of Measurement” (Attorney Docket No. EIS-5851 (1417GP0751)), Ser. No. ______; “Nursing Order Workflow System and Method” (Attorney Docket No. EIS-5899 (1417GP0756)), Ser. No. ______; “Healthcare Database Management Offline Backup and Synchronization System and Method” (Attorney Docket No. EIS-5895 (1417G-P752)), Ser. No. ______; “Biometric Security For Access To A Storage Device For A Healthcare Facility” (Attorney Docket No. EIS-5847 (1417G-P720)), Ser. No. ______; “System And Method For Supporting Clinical Decisions During Patient Care And Treatment” (Attorney Docket No. EIS-5896 (1417G-P753)), Ser. No. ______; “System And Method For Facilitating Patient Care And Treatment” (Attorney Docket No. EIS-5898 (1417G-P755)), Ser. No. ______; “System And Method For Facilitating Orders During Patient Care And Treatment” (Attorney Docket No. EIS-5900 (1417G-P757)), Ser. No. ______; and, “Pharmacy System And Method” (Attorney Docket No. EIS-5901 (1417G-P758)), Ser. No. ______.

[0004] Hospitals and other health care facilities commonly use locked cabinets to store and dispense medications and other medical items. Locked cabinets can provide efficient and accessible storage of medications and other medical items by using different shelves for storage of the different medical items. Additionally, locked drawers also prevent unauthorized access to the medications and other medical items. Such measures, while unfortunate, are typically provided in order to prevent theft of the medical items, particularly narcotics and other controlled substances. Sometimes, medication cabinets incorporate a computer or microprocessor to selectively provide access to a particular drawer in response to an input requesting a specific medication.

[0005] Nevertheless, narcotics and other controlled substances require even a greater degree of access control. One approach to providing this control involves incorporating individually lockable bins in drawers containing narcotics or other controlled substances. This solution, however, presents a choice between storing a unit dose in each individually lockable bin, incurring considerable cost, or storing multiple doses in an individually lockable bin, affording reduced security.

[0006] One approach to medication control is described in U.S. Pat. No. 6,065,819, (issued to William K. Holmes and David R. Williams). The '819 patent discloses a device wherein the unit includes an engine and dispensing drawer operably connected in end-to-end fashion with a lead screw type of mechanism. The engine comprises a motor for retracting the drawer and a complex engagement mechanism designed to engage crosspieces disposed at intervals beneath the drawer. This approach, however has several potential disadvantages. First, the engine uses a substantial portion of the drawer depth, thereby reducing storage density, increasing the number of drawers required for a given quantity of medication, and increasing cost. Second, the numerous mechanical and electrical components of the engine and engagement mechanism also provide increased cost. Finally, the engagement mechanism is normally disengaged so that a power failure during operation could enable access to the entire drawer.

[0007] Further, U.S. Pat. Nos. 5,961,036, 5,957,372 and 6,073,834, commonly assigned to Diebold, Inc., disclose an apparatus and method for accepting return of unused medical items. The apparatus includes a return drawer and a retrieve drawer which are opened responsive to signals received from a display terminal networked with a computer. The return drawer includes a pocket that is accessible from outside of the housing when the return drawer is moved to an open position. The pocket includes an opening and is closed by a trap door when the return drawer is in the open position. Medical items to be returned are placed in the pocket and the return drawer is closed. Upon the closing of the return drawer the trap door is moved to an open position by an actuator. The return medical item passes from the pocket to a retrieve area in the retrieve drawer. Medical items are stored in the retrieve area until the retrieve drawer is controlled responsive to the input of data at the display terminal. Such a device, however, is expensive to manufacture and complicated to operate.

[0008] Accordingly, an inexpensive and reliable drawer operating system that provides graduated access to a drawer so that items stored in the drawer may be extracted from the front of the drawer and access given to more rearward portions of the drawer only after inventories have been depleted is desired. Additionally, an inexpensive and reliable return system that allows users to deposit unused medical items, including medications such as narcotics, for safe return to authorized personnel, such as a pharmacist, is desired. Thus, the present invention is provided.

[0009] The present invention provides a device for controlling access to medications and other medical items in various compartments of the drawer. The device comprises a ratcheting drawer and a latching mechanism. Generally, one or more ratcheting drawers are provided in modules which are placed in a cabinet. One type of cabinet is a moveable medication depot. The ratcheting drawer, or one or more modules containing a plurality of ratcheting drawers, is fitted within the cabinet.

[0010] According to one aspect of the present invention, the ratcheting drawer has a ratcheting member that is connected to the drawer. The ratcheting member may include a series of one-directional teeth affixed to the ratcheting drawer. The ratcheting member is engaged by the latching mechanism for controlled access to the ratcheting drawer.

[0011] According to another aspect of the present invention, the latching mechanism is removably connected to the cabinet, or to the module connected to the cabinet. Additionally, the latching mechanism may also be a component of the drawer. The latching mechanism is configured to engage the ratcheting drawer at any of a plurality of positions to prevent the drawer from being opened beyond a specific position, while still allowing the drawer to be closed at any time. The latching mechanism may include a solenoid that receives a signal from a controller for engagement/disengagement with the ratcheting member. In one embodiment, the latching mechanism is adapted to engage one of the one-directional teeth to resist opening of the ratcheting drawer, while still allow closing of the drawer when engaged.

[0012] According to another aspect of the present invention, a controller is provided. The controller is operatively connected to the latching mechanism. The controller controls engagement of the ratcheting member by the latching mechanism. Additionally, the controller may receive signals from a computer as to which drawer to open, as well as how far to open each drawer to access a specific bin.

[0013] According to another aspect of the present invention, a sensor is provided. The sensor is operatively connected to the latching mechanism. The sensor senses the position of the drawer and sends a signal to the controller of the position of the ratcheting drawer. In one embodiment, the ratcheting drawer has markings thereon which are sensed by the sensor as the drawer moved in and out. The sensors may be fixedly mounted to the framework of the depot, to read the markings and to determine the absolute position of the ratcheting drawer.

[0014] According to another aspect of the present invention, the ratcheting drawer is divided into a plurality of bins adapted to hold the medical items. Generally, the bins are disposed to become exposed sequentially as the drawer is opened. In one embodiment, the controller receives authorization for access to the medical items in the depot. The controller may determine which drawer and which bin to access. The controller also tracks which bins have been accessed and the position of the ratcheting drawer. Based on certain information, the controller typically allows access to the first bin of the ratcheting drawer containing one of the medical items, as opposed to the empty bins in front of that bin.

[0015] According to another embodiment of the present invention, the latching mechanism is normally engaged with one of the series of one-directional teeth to prevent the ratcheting drawer from opening beyond its current position. Upon receipt of a signal, the controller disengages the latching mechanism until the ratcheting drawer is positioned to expose the bin authorized for access. When the sensor reads the marking that indicates that the ratcheting drawer is appropriately positioned (i.e., the authorized bin is exposed), the controller allows the latching mechanism to re-engage to prevent further withdrawal of the ratcheting drawer.

[0016] According to another aspect of the present invention, the particular bin authorized for access may be determined by a processing unit included in a cabinet or depot. Alternatively, a processing unit may be configured to authorize opening of a particular ratcheting drawer, and the ratcheting drawer assembly may comprise a controller which tracks the bins that were previously accessed and allows access to the next sequential bin.

[0017] According to another aspect of the present invention, the ratcheting drawer is mounted in a module that is removably secured in the cabinet. Further a plurality of ratcheting drawers may be mounted in the module. The module is adapted to be removably inserted within a cabinet so that a variety of modules having various drawer configurations may be inserted in the cabinet.

[0018] According to another aspect of the present invention, a motorless device for controlling access to one or more medical items is provided. The motorless device comprises at least one ratcheting drawer with a plurality of bins adapted to hold medical items and disposed to become exposed sequentially as the drawer is opened, a sensor for determining a current position of the ratcheting drawer relative to the plurality bins, and a latching mechanism configured to engage the ratcheting drawer at any of a plurality of positions to prevent the drawer from opening beyond the current position while allowing the drawer to be closed. Further, a ratcheting mechanism is operatively connected to the drawer, and the ratcheting mechanism is selectively engaged by the latching mechanism.

[0019] According to another embodiment, one of the drawers is a return drawer. The controller obtains a signal that a medical item is to be returned, the controller provides a signal to the latching mechanism to disengage the ratcheting member to expose the next empty bin in the series of bins for placement of a medical item to be returned therein. After the medical item to be returned is placed in the next empty bin, the bin is returned to an unexposed position. Further, the controller does not allow exposure of the contents of that bin until the controller receives a signal by an authorized user.

[0020] According to another embodiment, a storage device for controlling access to returned medical items in a medical facility is provided. The storage device comprises a housing having a return bin secured in the interior of the housing. The return bin has a cavity with an opening, and the return bin is movable to a plurality of positions. The housing has a first aperture that mates with the opening in the return bin when the return bin is positioned in a first position. The housing also has a cover which overlays the first aperture in the housing to provide controlled access to the cavity of the return bin inside the housing. An actuator is provided and connected to the return bin. The actuator manipulates movement of the return bin. A controller electrically connected to the actuator provides the actuator with a signal for manipulating the return bin between the first and second positions. Additionally, the housing has a second aperture providing access to the interior of the housing. A locking door covers the second aperture to control access to the interior of the housing through the second aperture.

[0021] According to another aspect of the present invention, a method for securing access to medical items in a container is provided. The method comprises the steps of providing a drawer having a unidirectional ratcheting member, providing a latching mechanism, providing a controller operatively connected to the latching mechanism, and sending a signal from the controller to the latching mechanism to manipulate the latching mechanism for controlling engagement of the latching mechanism with the ratcheting member. Additionally, a sensor may be provided and be operatively connected to the controller. The sensor senses a position of the drawer, and sends a signal from the sensor to the controller of the position of the drawer.

[0022] According to yet another aspect of the present invention, a method of returning a medical item to the storage device is provided. The method comprises providing a housing having an interior and a return bin in the housing. The housing has a cover which is opened. When the cover is opened, the a cavity in the return bin is accessible through a first aperture in the housing. The medical items to be returned are then deposited within the cavity of the return bin, and the cover is closed. When the cover is closed an actuator manipulates the return bin from a first position to a second position when the cover is closed, to expel the contents of the items from the cavity into the interior of the housing. The contents in the interior of the housing can then be removed through a locking door.

[0023] Other features and advantages of the invention will be apparent from the following specification taken in conjunction with the following drawings.

[0024] To understand the present invention, it will now be described by way of example, with reference to the accompanying drawings in which:

[0025]FIG. 1 is a perspective view of a medication depot having a ratcheting drawer and a return storage system of the present invention;

[0026]FIG. 2 is a perspective view of a module of ratcheting drawers of the present invention;

[0027]FIG. 3 is a front perspective view of one ratcheting drawer of the present invention;

[0028]FIG. 4 is a bottom perspective view of one ratcheting drawer of the present invention;

[0029]FIG. 5 is a partial top view of the framework of the ratcheting drawer assembly of FIG. 1, with one ratcheting drawer removed;

[0030]FIG. 6A is a partial cut-away side elevation view of FIG. 5;

[0031]FIG. 6B is top plan view of FIG. 6a;

[0032]FIG. 7 is another embodiment of the latch mechanism of FIG. 5;

[0033]FIG. 8A is a partial cut-away side elevation view of the return storage system of FIG. 1; and, FIG. 8B is a partial cut-away side elevation view of the return storage system of FIG. 1.

[0034] While this invention is susceptible of embodiments in many different forms, there are shown in the drawings and will herein be described in detail, preferred embodiments of the invention with the understanding that the present disclosures are to be considered as exemplifications of the principles of the invention and are not intended to limit the broad aspects of the invention to the embodiments illustrated.

[0035] Referring now in detail to the Figures, and initially to FIG. 1, there is shown a storage device in the form of a medical item/medication cabinet or depot 100 for storing and dispensing medical items, such as medications, and for controlling and monitoring access to the medical items in the depot 100. The medication depot 100 may have wheels 101, and thus be moveable by a nurse or other clinician. The medication depot 100 has a frame that includes one or more apertures configured to accommodate drawer assemblies 102. The drawer assemblies 102 include a drawer 104 for storing and dispensing medical items. The drawer assemblies 102 may also include a framework 134. The drawers 104 may be provided as individual drawers of varying sizes. Additionally, as shown in FIG. 2, the drawers 104 may be provided as interchangeable modular units 108, having a plurality of drawers 104, that are inserted into the cabinet 100. The drawers 104 may be lockable. As described herein, any of the drawers 104 may also be of the ratcheting type to control access to the individual drawers 104, and to control access to various portions of each drawer.

[0036] As shown in FIG. 2, one embodiment of the medication depot 100 has an interchangeable modular unit 108. The interchangeable modular unit 108 comprises an array of ratcheting drawers 104 (i.e., five drawers wide and four drawers high, however, it is understood that the module 108 can be of a variety of sizes to hold a variety of drawers 104). The modular unit 108 is a retrofittable unit that may be inserted into a modular opening in the cabinet 100. Drawers 104 of varying sizes may be provided in the modules 108, and different module units 108 may be interchangeably installed in the same opening of the cabinet 100. Thus, by combining drawer modules 108 with different types of drawers 104, a medication depot 100 may be assembled to provide a desired quantity of various size and various access-controllable drawers. For example, in the medication depot 100 of FIG. 1, one module 108 of ratcheting drawers 104 is combined with standard locking drawers 104 located below the module unit 108.

[0037] As shown in FIG. 2, the modular unit 108 is illustrated in a retracted position (i.e., prior to insertion or during removal of the modular unit 108), however, in FIG. 1 the modular unit 108 is shown in its fully seated position in the cabinet 100. The modular unit 108 has slides 110, which are on the side of the modular unit in the embodiment illustrated. The slides 110 engage a mating member 112 of the cabinet 100. As such, the modular unit 108 is easily insertable and removable from the cabinet 100.

[0038]FIGS. 3 and 4 illustrate one of the ratcheting drawers 104 of the present invention. Specifically, FIG. 3 illustrates a front perspective view of one embodiment of the ratcheting drawer 104, and FIG. 4 illustrates a bottom perspective view of one embodiment of the ratcheting drawer 104. As shown in these figures, the ratcheting drawer 104 has a height (H), width (W) and depth (D). The ratcheting drawer 104 may further have a plurality of dividers 114 which divide the drawers 104 into separate bins 116 for storage of the medical items, including medications and controlled medications such as narcotics. The dividers 114 allow the bins 116 to become exposed sequentially as the drawer 104 is opened. Each bin 116 is preferably configured to hold an individual item, and with respect to medication, each bin 116 is preferably configured to hold a unit dose of the medication. The size of bins 116 can be adjusted by repositioning the dividers 114 which are adapted to be adjustably positioned in the drawer 104.

[0039] The ratcheting drawer 104 has a ratcheting member 118. As shown in FIGS. 3 and 4, in one embodiment the ratcheting member 118 is a unidirectional member having a plurality of teeth 120. The term unidirectional identifies that in one direction the ratcheting member 118 does not prevent movement (i.e., the drawer 104 may be pushed back into the cabinet 100 at any time), while in a second direction the ratcheting member 118 may prevent movement if so engaged (i.e., the latching mechanism 122 may engage the ratcheting member 118 to stop the drawer 104 from further outward movement).

[0040] As shown in FIG. 4, the ratcheting member 118 is a linear ratcheting gear, however, it is understood that other mechanical and electrical configurations are interchangeable for the linear ratcheting gear 118. The linear ratcheting gear 118 comprises a series of one-directional or one-way teeth 120. The linear ratcheting gear 118 having the one-directional teeth 120 is disposed on the drawer 104 such that the assembly resists extension of the drawer 104 (movement from back to front) when engaged, but yet still allows retraction of the drawer 104 (movement of the drawer from front to back) when engaged.

[0041] The ratcheting member 118 may be formed in a “U” shape as shown in FIG. 3. In the embodiment illustrated, the ratcheting member 118 is disposed on the bottom surface of ratcheting drawer 104, and is affixed to ratcheting drawer 104 with the use of screws, rivets, welding, brazing, or other attachment means known in the art.

[0042] The ratcheting drawer 104 further has a first mating member 124 to physically support the ratcheting drawer 104 and to assist the ratcheting drawer 104 to be slidingly opened and closed. The first mating member engages a second mating member 126 for guiding and supporting the drawer 104 as the drawer 104 is extended and retracted. Typically, the second mating member 126 is fixedly mounted within the medication depot 100 by being affixed to either the framework 134 of the drawer assembly 102, the framework of the modular unit 108, or the medication cabinet 100 itself. In the embodiment illustrated, the second mating member 126 is affixed to the framework 134 of the drawer assembly 102, however, it may also be affixed to either the cabinet 102 or the modular unit 108. Additionally, in the embodiment illustrated, the first mating member 124 is centrally disposed on the bottom surface of the ratcheting drawer 104 adjacent the ratcheting member 118. Further, in the embodiment illustrated the first mating member 124 comprises a channel or rail and the second mating member 124 comprises a slide member (it is understood that these components may be reversed). The first mating member 124 freely and slidingly engages the second mating member 126 for providing sliding movement of the drawer 104. It should be understood that while the first and second mating members are illustrated and described as a rail and slide engagement mechanism in the figures, other mating configurations known in the art are contemplated and are within the scope of the present invention.

[0043] As best shown in FIG. 4, the ratcheting drawer 104 also has markings 128 thereon. Typically, the markings 128 are located on the bottom of the drawer 104 opposing the ratcheting member 118, however the markings 128 may also be placed at other locations. The markings 128 are configured to provide data to a sensor 130 for determining the position of the drawer 104. Further, the markings 128 may indicate the currently accessible bin 116. In the disclosed embodiment, the markings 128 comprise binary marking stickers (i.e., stickers where each of a series of positions is either light or dark to provide a binary data word), however, other markings or types of indicators are understood by those in the art. The markings 128 extend about the entire depth (D) of the drawer 104 to provide positioning information about the entire depth (D) of the drawer 104.

[0044] As shown in FIGS. 5 and 6, the sensor 130 is provided for determining the position of the drawer 104. The sensor 130 may be an optical sensor, such as a binary optical sensor, or it may be any other type of sensor know in the art. The sensor 130 is positioned to read the markings 128 disposed on the ratcheting drawer 104. As the ratcheting drawer 104 is extended and retracted, the markings 128 are sensed and sequentially read by sensor 130. The sensor 130 then transmits data or other signals to a controller 132, or to a central processing unit that controls the controller 132, corresponding to the sensed information from the markings 128, and indicative of the position of the drawer 104. Typically, the sensor 130 is affixed to either the framework 134 of the drawer assembly 102, the framework of the modular unit 108, or the medication cabinet 100 itself. In the specific embodiment illustrated, the sensor 130 is affixed to the framework 134 of the drawer assembly 102. The sensor 130 remains stationary as the ratcheting drawer 104 is extended and retracted. Affixing the electronic components in a stationary position enhances the reliability of the system.

[0045] The markings 128 for the drawer 104 are calibrated to allow controller 132 to properly control access to the ratcheting drawer 104. Typically, calibration is conducted by calibrating the markings 128 to the one-directional ratcheting member 118 and to the bins 116. This calibration may be consummated by physical alignment of the markings 128 with the one-directional ratcheting member 118 and the bins 116, by software embedded in controller 132, or by a combination thereof.

[0046] As shown in FIGS. 5 and 6, the drawer assembly 102 for the ratcheting drawers 104 also includes a latching mechanism 122. The latching mechanism 122 controllably engages the ratcheting member 118. Typically, the latching mechanism 122 is affixed to either the framework 134 of the drawer assembly 102, the framework of the modular unit 108, or the medication cabinet 100 itself. In the specific embodiment illustrated, the latching mechanism 122 is affixed to the framework 134 of the drawer assembly 102. As such, the latching mechanism 122 remains stationary as the ratcheting drawer 104 is extended and retracted. Generally, when the ratcheting drawers 104 are separate from a modular unit 108, the latching mechanism 122 is a component of the assembly of the ratcheting drawers 104. Additionally, when the ratcheting drawers 104 are part of the modular unit 108, the latching mechanism 122 is also a component of the assembly 102 of the ratcheting drawers 104, however, in this configuration the latching assembly 122 is also a component of the module unit 108.

[0047] As shown in FIGS. 6A and 6B, one embodiment the latching mechanism 122 comprises a solenoid 136 having an engaging member 138. The solenoid 136 is operatively connected to the controller 132. The engaging member 138 operatively engages the ratcheting member 118 to prevent outward movement of the drawer 104. The latching mechanism 122 is normally engaged with linear ratcheting gear 118. Accordingly, when engaging member 138 of the latching mechanism 122 is engaged with linear ratcheting gear 118, the ratcheting drawer 104 is prevented from being further extended. When the engaging member 138 of the latching mechanism 122 is released from the linear ratcheting gear 118, however, an authorized operator, such as a nurse, may extend the ratcheting drawer 104 until the authorized one of the bins 116 is exposed. Typically, when the latching mechanism 122 releases a drawer 104, the drawer can be extended only one bin 116 length. At that point, the sensor 130 senses the position of the drawer 104 and the controller 132 transmits a signal to the latching mechanism 122 to engage the linear ratcheting gear 118 so that the drawer 104 cannot be extended further to prevent access to additional bins 116, if so required. The ratcheting drawer 104, however, may be closed while the latching mechanism 122 is engaged with the ratcheting mechanism 118. As such, the controller 132 controls engagement of the ratcheting member 118 by the latching mechanism 122. And, the present invention provides access to a first full one of the bins upon each successive authorization, whereupon the medical item in the one of the bins is withdrawn by the medication depot operator, and the next one of the bins becomes the first full one of the bins.

[0048] As shown in FIGS. 6A and 6B, an ejection mechanism 140 is provided in the ratcheting drawer assembly 102. In the embodiment illustrated, the ejection mechanism 140 is affixed to the framework 134, however it may also be affixed to other stationary items such as the modular unit 108 or the cabinet 100. The ejection mechanism 140 may comprise, for example, a spring 142 and a pusher 146, whereby the spring 142 applies a force to the pusher 146 relative to a fixed point of the medication depot 100 structural framework. As such, when the drawer 104 is in the fully closed position and the controller 132 sends a signal to the latching mechanism 122 to disengage the ratcheting member 118 to open the drawer, the ejection mechanism 140 provides an initial force to slide the drawer 104 to a slightly open position, providing a visual indication of the correct drawer to be accessed for authorized removal of the medical item.

[0049] The controller 132 is configured to receive an authorization signal from either a central computer or processor (not shown) or a local computer or processor 148. The signal may be, for example, a data signal corresponding to a specific one of the bins (210 in FIG. 2) that a user, such as a nurse, is authorized to access. Typically, the controller 132 includes a printed circuit board and has software or controls which receives data, interprets data and performs routines with the data to develop output, and it also transmits the output. Further, the controller 132 may store data and/or output. The signal may also correspond to a particular ratcheting drawer 104, all of whose bins hold unit doses of one particular medication, or a particular medication stored in one or more ratcheting drawers. The controller 132 may be hardwired to the central computer and/or local processor 148. In one embodiment the controller 132 receives a remote signal, typically via a radio frequency (RF) signal from the central processor. With remote use, the cabinet 100 generally has a transmitter/receiver (not shown) which can receive and transmit RF and other type signals with the central processor. In one embodiment the controller 132 is a separate unit from the local processor 148. In another embodiment, the controller 132 and the local processor 148 are integral as in FIG. 1.

[0050] When the authorization signal corresponds to a particular drawer or medication, the controller 132 may be configured to track which bins 116 of the ratcheting drawer 104 or ratcheting drawers 104 have been accessed. As explained above, the authorization signal may be provided, for example, by the central processor. Additionally, the authorization signal may be provided by a local computer or processor 148. Typically, the central processor controls both the local processor 148 and the controller 132. Both the central processor unit and the local processor unit 148 interfaces with data files of the medical center and pharmacy. Patient or medication data can be entered into the system at any location, including at the local processing unit 148 via an interface, such as a scanner 150 (e.g., by scanning a patient identification strap) or a keyboard 152 (e.g., by entering a patient identification code or a medication code). The local processing unit 148 receives the patient or medication data, verifies access authorization (e.g., by matching a prescription file with patient identification data, and matching a personnel identification with a medication control level) and provides a control signal that unlocks a particular one of drawers 104 for which access has been authorized.

[0051] As explained above, the controller 132 is electrically connected to and configured to receive a signal from the sensor 130 indicating the position of the ratcheting drawer 104. Further, the controller 132 tracks which bins have been accessed and the position of the ratcheting drawer 104. As such, the controller 132 typically only allows access to the first bin 116 of the ratcheting drawer 104 containing one of the medical items. When the controller 132 receives a certain authorization signal, it energizes the solenoid 136, releasing the engaging member 138 of the latching mechanism 122. The latching mechanism 122 is normally engaged with linear ratcheting gear 118 attached to the drawer 104. Accordingly, when latching mechanism 122 is engaged with linear ratcheting gear 118, it prevents the ratcheting drawer 104 from being further extended. When latching mechanism 122 releases the ratcheting gear 118, however, an authorized operator, such as a nurse, pulling on the drawer 104 may extend the ratcheting drawer 104 from the cabinet 100. Further, when the latching mechanism 122 releases the ratcheting gear 118 in the fully closed position the spring mechanism above provides an initial force to at least partially open the drawer 104. Then, when the ratcheting drawer 104 approaches a position exposing the authorized bin 116, as indicated by sensor 130 reading the markings 128, controller 132 de-energizes solenoid 136, and latching mechanism 122 re-engages the ratcheting mechanism 118 to prevent the drawer 104 from being opened further.

[0052] In the embodiment illustrated, all electronic components of the ratcheting drawer assembly 102 (i.e., sensor 130, controller 132, and solenoid 136) are affixed to some framework and remain stationary as the ratcheting drawer 104 is extended and retracted. Affixing the electronic components in a stationary position will enhance the reliability of the system in comparison to devices that incorporate moving electronic components. As shown in FIG. 6, the latching mechanism 122 and the sensor 130 are positioned generally below the top of second mating member 126. The sensor 130 and the components of the latching mechanism 122 have a height such that they can be positioned below the ratcheting drawer 104 and still leave sufficient height for the bins 116 of the ratcheting drawer 104 to contain medical items. Therefore, essentially the full depth D of the drawer may comprise storage bins 116. Using the full depth of the drawer 104 for storage increases the number of bins 116 that are provided in a drawer 104 of a given depth, and increases storage density which is an important attribute of medication depots.

[0053]FIGS. 5 and 7 show alternative latching mechanisms 122, respectively accommodating different orientations of solenoid 136. In FIG. 5, the solenoid 136 is oriented to provide displacement of the engaging member 138. The solenoid 136 is positioned parallel to linear ratcheting gear 118 (i.e., parallel to the direction of sliding motion of the ratcheting drawer). The engaging member 138 in FIG. 5 is connected to the solenoid 136 through a pivoting linkage 154 which translates the motion approximately 90°. A biasing member (not shown) in the form of a spring may also be provided to maintain the engaging member 138 in contact with the ratcheting member 118 when the solenoid 136 is not energized. As such, the ratcheting member is normally engaged by the latching mechanism to resist opening of the ratcheting drawer beyond the current position. Then, when the controller obtains authorization for access to the one or more medical items stored in a particular bin 116 the controller 132 provides a signal to the latching mechanism 122 to disengage the ratcheting member 118 to expose the particular bin 116 of the particular drawer 104.

[0054] In FIG. 7, solenoid 136 is oriented to provide displacement of an engaging member 138 directly away from linear ratcheting gear 118 when the solenoid 136 is positioned perpendicular to the direction of sliding motion of ratcheting drawer (i.e., perpendicular to the linear ratcheting gear 118). The one-directional teeth 120 of linear ratcheting gear 118 have an engaging face 119 perpendicular to the direction of sliding motion of ratcheting drawer 104 and a sliding face 121 at a small angle to the to the direction of sliding motion of ratcheting drawer 104 to provide a mechanical advantage that allows the ratcheting drawer to be easily retracted. In the latching mechanisms illustrated in FIGS. 5 and 7, the engaging member 138 is disposed to engage the engaging face 119 of one of the one-directional teeth 120 when the solenoid 136 is de-energized. When solenoid 136 is energized the plunger 137 of the solenoid 136 withdrawals the engaging member 138 from linear ratcheting gear 118, allowing the ratcheting drawer 104 to slide open. The engaging member 138 may be a rotating wheel to provide minimal resistance to closing the ratcheting drawer by rolling on the sliding face 121.

[0055] Further, one of the drawers 104 may be a return drawer. A return drawer is an empty drawer where medical items may be returned to the system, as opposed to containing a medical item for disbursement thereof. Typically, the control of return drawer system operates in the reverse manner as the standard distribution drawer. As such, when the controller 132 obtains a signal that a medical item is to be returned, the controller 132 provides a signal to the latching mechanism 122 to disengage the ratcheting member 118 to expose the next empty bin 116 in series adjacent the front of the drawer 104 for placement of a medical item to be returned therein. After the medical item to be returned is placed in the next empty bin 116, the bin is returned to an unexposed position, i.e. the bin and/or the drawer is closed, and the controller 132 does not allow exposure of the contents of that bin 116 until the controller receives a signal by an authorized user. The user may then provide a command to the system indicating that the specific medical item has been returned.

[0056] As shown in FIGS. 1 and 8a-8b, a return storage device 160 is provided for controlling access to returned medical items in a medical facility. The return storage device 160 may be connected to the medical cart or some other fixture, or it may be a separate, stand-alone component. The return storage device 160 generally includes a housing 162 and a return bin 164. The housing 162 has an interior 166, a first aperture 168, and a second aperture 170. Typically, the first aperture 168 is located on a top or upper portion of the housing 162, and the second aperture 170 is located toward a bottom or lower portion of the housing 162, well below the first aperture 168. The first aperture 168 has a cover 172 which is operated by a solenoid (not shown) to provide controlled access to the interior of the housing 162. The second aperture 170 has a locking door 171 covering it to control access to the interior 166 of the housing 162. In one embodiment, access to unlock the locking door 171 is prevented by the cover 172 overlaying the lock of the locking door 171.

[0057] The return bin 164 is secured in the interior of the housing 162, and the return bin 164 has a cavity 174 with an opening 176. In one embodiment, the return bin 164 is a drum. The return bin is movable in the interior 166 of the housing 162 to a plurality of positions. Two such positions include the first position 178 and the second position 180 (shown in FIGS. 8a and 8b). The return bin 164 is movable through an actuator 182, which may be mechanically driven or may be weight driven. Additionally, the return bin 164 may be moveable through a weight (not shown). Finally, the return bin 164 may be moveable through a combination of an actuator 164 and a separate weight. In one embodiment, the actuator 182 is a linkage controlled with a solenoid (not shown). The actuator 182 and/or the weight (not shown) manipulate movement of the return bin 164. Typically, all movement of the return bin 164, including the actuator 182, and the cover 172 of the housing is controlled by the controller, which may be the same controller 132 for the ratcheting drawer 104.

[0058] As shown in FIG. 8a the return bin 164 is shown in the second position 180. In the second position 180, and typically in any position other than the first position 178, an exterior 184 of the return bin 164 mates with the first aperture 168 in the housing 162 to operatively close the interior of the housing 162. Further, in the second position 180, with the opening 176 of the return bin 164 facing downward, gravity acts on the contents in the cavity 174 to all the contents of the cavity to be expelled into the interior 166 of the housing 162. The return bin 164 may have a weight (not shown) to assist or provide movement of the return bin 164 from the second position 180 to the first position 178 such that motors, solenoids, springs, etc... are not required. The actuator 182, however, maintains the return bin 164 in the second position 180 when the cover 172 of the housing 162 is closed. Further, the actuator 182 assists in moving the return bin 164 from the first position 178 to the second position 180 after the cover 172 has been closed. In the second position 180 the cover 172 remains locked in the closed position by the solenoid (not shown).

[0059] As shown in FIG. 8b, the return bin 164 is shown in the first position 178. In the first position 178 the opening 176 of the return bin 164 is positioned in-line or mating with the first aperture 168 in the housing 162. Typically, the cover 172 of the housing only opens with the opening 176 of the return bin 168 mates with the first opening 176. In this position medical items can be deposited in the cavity 174 of the return bin 164 through the opening 176. To position the return bin 164 in the first position 178, the weight manipulates movement of the return bin 164 from the second position 180, or any other position, to the first position 178. As explained above, in one embodiment the movement is conducted through rotation of the return bin 164. Alternatively, the actuator 182 may assist or provide movement of the return bin 164 to the first position 178. The actuator 182 may be operatively connected to the cover 172 such that when the cover 172 opens, the weight and/or the actuator 182 has manipulated, or is manipulating, the return bin 164 to have the opening 176 in the cavity 174 mate with the first aperture 178 in the housing 162, and such that when the cover 174 is closed, the actuator 182 manipulates the return bin 164 to have the exterior 184 covering the first aperture 178 to prevent access to the interior 166 of the housing 162.

[0060] Additionally, a keyed lock (not shown) may be provided to override the controller for opening and closing the cover, especially during malfunction of the system or during a power failure.

[0061] It will be understood that the invention may be embodied in other specific forms without departing from the spirit or central characteristics thereof. The present embodiments, therefore, are to be considered in all respects as illustrative and not restrictive, and the invention is not to be limited to the details given herein.