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BD Pyxis Anesthesia ES System (PAS ES), REF: 327 recallZ-1207-2023 · CareFusion 303, Inc. · initiated Feb 14, 2023

Open, Classified

Is my device affected?

  1. Compare the model, catalog and lot or serial numbers on your device or its packaging with the code information below. A recall usually covers only specific models or lots.
  2. If yours is listed, follow the instructions from CareFusion 303, Inc. or your healthcare provider. The company's action is summarized under what the company is doing.
  3. Do not stop using a prescribed or implanted device on your own — talk to your healthcare provider first.

Where to find your model and lot numbers · What recall classes and statuses mean

Why it was recalled

Automated dispensing cabinet drawer firmware may have inadvertently been downgraded to an earlier version of drawer firmware during new device installations or device replacement upgrades, which may lead to an increased frequency of drawer failures, which could increase the likelihood of patients experiencing delays in receiving medications.

FDA root cause category: Software change control

What the company is doing

On 01/14/23, correction notices were mailed to directors of pharmacy informing them to take the following actions: 1) Ensure this letter and contents are forwarded and/or discussed with all appropriate personnel to ensure proper awareness of the issue. 2) If you are experiencing any issues, such as drawer failures, call BD technical support and refer to user guides for additional information and troubleshooting procedures. a. BD Pyxis MedStation ES user guide, refer to sections "Recover storage space" (Chapter 9, pg. 76) and "Emergency medication removal" (Appendix 11, pg. 119). See references 1 and 2 below for additional details. b. BD Pyxis PAS ES user guide, refer to sections "Emergency access procedures" (Appendix A, pg. 77) and "Storage spaces are not responsive" (Appendix B, pg. 81). See references 3 and 4 below for additional details. 3) Complete and return the Customer Response Form. The firm will take the following actions: 1) All customers who may have affected devices will be notified. 2) Upon receipt of completed response forms, the firm will coordinate the firmware upgrade with customers. Technical Support: 1-800-727-6102, Phone hours: 24 hours, 7 days a week

Recall details

Recall number
Z-1207-2023
Status
Open, Classified
Initiated by the company
Feb 14, 2023
Posted by the FDA
Mar 17, 2023
Recalling firm
CareFusion 303, Inc.
Quantity
7914
Product code
BRY
Distribution
Worldwide - US Nationwide distribution including in the states of NY, PA, OH, TX, FL, KY, IL, DE, AK, WI, KS, LA, WA, AZ, CO, MI, IN, TN, SD, AR, MO, CA, NV, MA, SC, VA, WV, CT, ME, NE, RI, GA, NC, IA, MN, AL, OK, MS, NM, NH, VT, WY, OR, ID, NJ, UT, DC, HI, MD, MT, ND and the country of Canada.

Product description

BD Pyxis Anesthesia ES System (PAS ES), REF: 327; BP Pyxis MedStation ES (Med ES Main), REF: 323; BD Pyxis MedStation ES Tower (Med ES Tower), REF: 352; all with BD Pyxis ES version 1.6.1 drawer firmware (version 1.10.2.5). Pyxis MedStation Enterprise Server (ES) System is an automated medication dispensing system supporting decentralized medication management in a pharmaceutical environment.

Code information (models, lots, serial numbers)

REF/UDI-DI: 327/10885403477836, 323/10885403512667, 352/10885403512674

Devices named in this recall

3 devices in the FDA device registry whose identifier appears in the recall's code information.

Product lines

Sources and updates

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