Patent Publication Number: US-2023141858-A1

Title: Automatic packager for medications

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to U.S. Provisional Patent Application No. 63/003,798, filed Apr. 1, 2020, the entire contents of which are incorporated by reference herein. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates to an automatic packager for medications. More particularly, the present invention relates to an automatic packager for pharmaceutical blister card packages. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    illustrates a blister card in accordance with some embodiments. 
         FIG.  2    is a perspective view of an automatic blister card packager in accordance with some embodiments. 
         FIG.  3    is a front perspective view of a universal feed cassette of the automatic blister card packager of  FIG.  2    in accordance with some embodiments. 
         FIG.  4    is a front perspective view of the universal feed cassette of  FIG.  3    with a part of a housing removed in accordance with some embodiments. 
         FIG.  5    is a plan view of the universal feed cassette of  FIG.  3    in accordance with some embodiments. 
         FIG.  6    is a perspective view of a cartridge of the universal feed cassette of  FIG.  3    in accordance with some embodiments. 
         FIG.  7    is a back perspective view of the cartridge of  FIG.  6    in accordance with some embodiments. 
         FIG.  8    is a back perspective view of the cartridge of  FIG.  6    in accordance with some embodiments. 
         FIG.  9    is a cross-sectional view of the cartridge of  FIG.  6    in accordance with some embodiments. 
         FIG.  10    is a perspective view of a cartridge mechanism of the universal feed cassette of  FIG.  3    in accordance with some embodiments. 
         FIG.  11    is a perspective view of a wheel of the cartridge of  FIG.  6    and a camera system and a shuttle system of the cartridge mechanism of  FIG.  10    in accordance with some embodiments. 
         FIG.  12    is a perspective view of the cartridge of  FIG.  6    and the cartridge mechanism of  FIG.  10    in accordance with some embodiments. 
         FIG.  13    is a perspective view of the cartridge of  FIG.  6    and the cartridge mechanism of  FIG.  10    in accordance with some embodiments. 
         FIG.  14    is a block diagram of the cartridge mechanism of  FIG.  10    in accordance with some embodiments. 
         FIG.  15    is a flowchart of a method of delivering medications to a platform of the cartridge mechanism of  FIG.  10    in accordance with some embodiments. 
         FIG.  16    is a flowchart of a method of dispensing medications from the cartridge of  FIG.  6    in accordance with some embodiments. 
         FIG.  17    is a perspective view of a packaging unit of the automatic blister card packager of  FIG.  2    in accordance with some embodiments. 
         FIGS.  18 A and  18 B  are perspective views of the packaging unit of  FIG.  17    in accordance with some embodiments. 
         FIG.  19    is a perspective view of a packaging equipment of the packaging unit of  FIG.  17    in accordance with some embodiments. 
         FIGS.  20 A and  20 B  are perspective views of a packaging base of the packaging equipment of  FIG.  19    in accordance with some embodiments. 
         FIG.  21    is a perspective view of a packaging plate of the packaging equipment of  FIG.  19    in accordance with some embodiments. 
         FIG.  22 A  is a perspective view of a packaging lid of the packaging equipment of  FIG.  19    in accordance with some embodiments. 
         FIG.  22 B  is a top plan view of the packaging lid of  FIG.  22 A  in accordance with some embodiments. 
         FIG.  22 C  is a bottom plan view of the packaging lid of  FIG.  22 A  in accordance with some embodiments. 
         FIG.  23    is a block diagram of the automatic blister card packager of  FIG.  2    in accordance with some embodiments. 
         FIG.  24    is a flowchart of a method for packaging a blister card using the automatic blister card packager of  FIG.  2    in accordance with some embodiments. 
         FIG.  25    is a perspective view of another automatic blister card packager in accordance with some embodiments. 
         FIG.  26    is an enlarged view of a portion of the automatic blister card packager of  FIG.  25   , illustrating a door in an open position and a blister card packaging unit in a first position. 
         FIG.  27    is an enlarged view of a portion of the automatic blister card packager of  FIG.  25   , illustrating the blister card packaging unit in a second position. 
         FIGS.  28 - 30    illustrate the blister card packaging unit of  FIG.  27    moved to various positions. 
         FIG.  31    is an enlarged view of a portion of the automatic blister card packager of  FIG.  25    including a manifold in accordance with some embodiments, where the manifold includes separate channels. 
         FIG.  32    is an enlarged view of a portion of the automatic blister card packager of  FIG.  25    including another manifold in accordance with some embodiments, where the manifold includes a shared channel. 
     
    
    
     DETAILED DESCRIPTION 
     Before any embodiments of the invention are explained in detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways. 
     Pharmacies use several types of packaging to provide pharmaceutical products or medications to consumers. The types of packaging may include strip packages, blister cards, pill vials, and the like. Pill vials and strip packages are most appropriate for individual customers of retail pharmacies. However, institutional customers, for example, nursing homes, palliative or hospice facilities, hospitals, and the like use blister cards extensively. 
       FIG.  1    illustrates an example of a blister card  100 . The blister card  100  includes a blister sheet  110  including thirty to thirty-two blister compartments  120 . Each blister compartment  120  may receive a single unit of medication or may receive more than a single unit of medication. When the blister compartments  120  are filled, a label sheet  130  is attached to the back of the blister sheet  110  to seal the blister compartments  120 . The label sheet  130  includes information regarding the blister card  100  including, for example, a facility name, a patient name, a medication name, a medication dose, and the like. The label sheet  130  includes seal portions  140  aligned with each blister compartment  120  such that a user may tear the seal portions  140  to retrieve the packaged medication. 
     In the example illustrated in  FIG.  1   , the blister card  100  is, for example, a standard 6″×9″ card. In other embodiments, the blister card  100  may be other sizes. The blister card  100  may be used for filling different amounts of pills for different periods of time. For example, the blister card  10  may be used for one week of pills (e.g.,  7  pills), for up to four weeks or a month of pills (e.g.,  28 - 31  pills), or more. In some embodiments, the blister card  100  is a “pre-pack” having only one medication in some or all the blister compartments  120 . In other embodiments, the blister card  100  may include more than one pill in the same blister compartment  120  or distributed among the different blister compartments  120 . In the example illustrated, the label sheet  130  is shown attached to the blister sheet  110 ; however, the label sheet  130  may be separately provided from the blister sheet  110 . The label sheet  130 , whether provided with the blister sheet  110  or separate from the blister sheet  110 , may be cold sealed or hot sealed with the blister sheet  110  after filling. In some embodiments, a bar code may printed on the label sheet  130  to provide identification information. The bar code may be scanned to retrieve information regarding the blister card  100  as provided above. The bar code may be pre-printed before filling or may be printed after filling to uniquely identify the blister card  100 . This bar code may be later used by a filling machine to identify that a correct blister card  100  is currently being filled. 
     Automatic strip packages are now used in retail pharmacies to quickly and accurately package medications into strip packages. Automatic strip packagers have allowed pharmacies to fulfill more customer orders in a relatively short time and with more accuracy than hand-filling vials. Accordingly, more and more pharmacies are now using automatic strip packagers to serve individual customers. On the other hand, a majority of blister cards are still filled by hand. Hand filling is performed by placing the blister sheet  110  on a table or on a hand-filling machine. A technician or pharmacist then hand fills each blister compartment  120  before sealing the blister card  100 . Hand-filling machines help verify accurate filling of the blister card  100  but do not themselves speed up the blister card  100  filling process. 
     Current blister card packagers available in the market are expensive, inefficient, and are generally not a good replacement for filling blister cards  100  by hand. Existing machines generally take up a large area and do not provide a cost benefit over hand filling the blister cards  100 . 
       FIG.  2    illustrates an example of an automatic blister card packager  200  that efficiently packages blister cards  100  in a quick and accurate manner. In the example illustrated, the automatic blister card packager  200  includes a universal feed cassette  205  and a packaging unit  210 . The universal feed cassette  205  receives medications from the bulk canisters and individually dispenses pills to the packaging unit  210 . Each universal feed cassette  205  may dispense eight separate pills at the same time. In the example illustrated in  FIG.  1   , the automatic blister card packager  200  includes one universal feed cassette  205 ; however, the automatic blister card packager  200  may include more than one universal feed cassette  205  to dispense more than eight pills at the same time. 
     Referring to  FIGS.  3 - 5   , the universal feed cassette  205  includes a housing  215  having a plurality of cartridge slots  220  within the housing  215 . An opening  225  is provided on a front side (e.g., a first side) of the housing  215  and a cassette cover covers a back side (e.g., a second side) of the housing  215 . Dispensing openings  235  are provided on the bottom of the housing  215 . The dispensing openings  235  are in communication with a chute  230  of the automatic blister card packager  200 . 
     In the example illustrated in  FIGS.  3 - 5   , the universal feed cassette  205  includes up to sixteen cartridge slots  220 . In some embodiments, the cartridge slots  220  are arranged in a duplex-formation such that a second row of cartridge slots  220  are provided above a first row of cartridge slots  220  within the housing  215  to facilitate faster filling of blister cards  100 .  FIG.  5    illustrates a side-profile view of the duplex-formation of the cartridge slots  220 . A separating platform  234  is provided between the first row and the second row of cartridge slots  220 . In some embodiments, the universal feed cassette  205  may only include a single row of cartridge slots  220 , or may include more than two rows of cartridge slots  220 . The cartridge slots  220  receive cartridges  240  through the opening  225 . A plurality of cartridge mechanisms  245 , one for each cartridge slot  220  is fixed to the top of the housing  215 —for the second row of cartridge slots  220 —and the separating platform  234 —for the first row of cartridge slots  220 . When received in the cartridge slots  220 , the cartridges  240  are connected to the cartridge mechanism  245 . The cartridge mechanism  245  individually dispenses medications  180  from the cartridge  240  as described in detail below. The dispensing openings  235  transfer the medications  180  from the cartridges  240  to the packaging unit  210  for packaging. The cassette cover can be removed to access the cartridge mechanisms  245  from the back side of the housing  215 . The cartridge mechanisms  245  are removably fixed to the housing  215  such that a technician can remove a cartridge mechanism  245  for servicing. 
     Referring to  FIGS.  6 - 9   , the cartridge  240  includes a reservoir  250 , a reservoir cover  255 , a wheel  260 , and scooping members  265 . The reservoir  250  stores the medications  180  during the dispensing process. The wheel  260  is provided on one side of the cartridge  240  and extends into the bottom portion of the reservoir  250 . The bottom portion of the reservoir  250  has a curved shape starting from the side opposite that of the wheel  260 , the front side, and the back side and ending at the center of the bottom portion of the wheel  260  (see  FIG.  9   ). The curved shape of the reservoir  250  directs the medications  180  within the reservoir  250  towards the bottom of the wheel  260  and particularly into the scooping members  265  of the wheel  260 . 
     The reservoir cover  255  covers a portion (e.g., a spout portion  270 ) of the reservoir  250 . The reservoir cover  255  is pivotably attached to the spout portion  270  to pivot between an open position and a closed position. When a pharmacist is emptying the contents of the cartridge  240 , the reservoir cover  255  pivots to the open position to allow the medications  180  to flow out of the reservoir  250  into the bulk containers. During the dispensing process, the cartridge mechanism  245  includes a stopper  246  to inhibit the reservoir cover  255  from opening. As such, the medications  180  within the reservoir  250  are not accessible outside the machine during the dispending process. 
     Teeth  275  are provided on the outer circumferential surface of the wheel  260 . During the dispensing process, the teeth  275  interlock with teeth of a shaft driven by a motor assembly of the cartridge mechanism  245 . The wheel  260  is provided with three scooping members  265  to scoop individual medications  180  from the reservoir  250 . The scooping members  265  include an inward projection  266  extending into the wheel  260 . The curved surface of the reservoir  250  guides the medications  180  into the inward projections of the scooping members  265 . The scooping members  265  include a stopper  268  along a circumferential end of the inward projections that hold the medications  180  when the wheel  260  is being rotated. Scooping members  265  may be made in different sizes to accommodate the different sizes of medications  180 . The scooping members  265  can be swapped to configure the cartridges  240  to dispense medications  180  of different sizes. The scooping members  265  may also be removed for cleaning. In some embodiments, rather than being separate from the wheel  260 , the scooping members  265  may be formed integrally with the wheel  260 . In these embodiments, the wheels  260  or cartridges  240  may be swapped to dispense medications  180  of different sizes. 
     The wheel  260  includes holding pins  280  (see  FIG.  11   ) that extend and retract from the inside of the wheel  260  during rotation of the wheel  260 . The scooping members  265  include an opening to receive the holding pins  280 . The holding pins  280  along with the stopper and the circumferential surface of the inward projection  266  are used to hold a medication  180  when the wheel  260  is being rotated. During rotation of the wheel  260 , when the inward projections  266  of the scooping members  265  encounter the reservoir  250 , the medications  180  in the reservoir  250  move inward into the scooping members  265  due to the curved shape of the reservoir  250 . The holding pins  280  are retracted when the scooping members  265  are moving along the reservoir  250  at a bottom portion of the wheel  260 . As the scooping members  265  move out of the reservoir  250 , the holding pins  280  are advanced towards the circumferential end of the scooping members  265  to engage a medication  180 . The medications  180  are held between the circumferential end of the scooping member  265 , the holding pin  280 , and the stopper  268 . The scooping member  265  and the holding pin  280  can be used for any type of medication  180 . Typically, only a single medication  180  is pinched between the holding pin  280  and the scooping member  265 , while the other medications  180  fall back into the reservoir  250  during the rotation of the wheel  260 . As the scooping member  265  passes the top portion of the wheel  260 , the holding pin  280  is once again retracted to release the medication  180  into the cartridge mechanism  245 . The wheel  260  and the scooping member  265  may together be referred to as a singulating mechanism. 
       FIGS.  7  and  8    illustrate a cam and follower mechanism  285  that is used to advance and retract the holding pins  280 . The cam and follower mechanism  285  is provided in the wheel  260 . The cam and follower mechanism  285  includes a cam  290  and a plurality of followers  295 . In the example illustrated, the cartridge  240  includes three followers  295 , one for each of the holding pins  280 . The holding pins  280  are attached to the followers  295  to move with the followers  295 . The cam  290  is fixed to the cartridge  240  and remains stationary even when the wheel  260  is rotated. The cam  290  includes an arc portion  292  and a cut-off portion  294 . The arc portion  292  extends further from the center of the cam  290  than the cut-off portion  294 . The follower  295  includes a flat portion  296  that is coupled to a holding pin  280  and an outward projection  298  extending from the flat portion  296  to engage the circumferential surface of the cam  290 . A spring mechanism is connected to a radially inward end of the followers  295  to provide an inward biasing force to the followers  295 . The holding pin  280  is advanced when the corresponding follower  295  engages the arc portion  292  of the cam  290  and is retracted when the corresponding follower  295  engages the cut-off portion  294  of the cam  290 . The follower  295  is retracted due to the biasing force of the spring mechanism when the follower  295  engages the cut-off portion  294  of the cam  290 . 
     Referring to  FIGS.  10 - 14   , the cartridge mechanism  245  includes a shuttle system  300  (for example, a verification system), a camera system  305 , a motor assembly  310 , a printed circuit board  315 , and a lockout mechanism  316 . The shuttle system  300 , shown in  FIG.  12   , includes a platform  320 , a shuttle  325 , and a shuttle drive  330 . The platform  320  may be made from a clear or translucent plastic material. An LED lighting system  322 , as described above, may be provided over and/or under the platform  320  to illuminate the contents on the platform  320  when the camera system  305  is capturing an image of the contents. The LED lighting system  322  may emit visible or infrared light to illuminate the platform  320 . 
     Typically, a single LED device may be used below the platform  320  to illuminate the translucent platform  320 . However, the single LED device may not provide uniform lighting through all of the surface area of the platform  320 . Particularly, each LED device includes a light signature such that the center of the platform  320  is brighter than the edges of the platform. This irregularity in brightness may result in misidentifying medications  180  during the image recognition process. In order to provide uniform brightness across the surface are of the platform, several LED devices may be placed around the bottom surface of the platform. In some embodiments, the light signature of the LED device is detected and a backing (not shown) may be applied to the platform to correct the light signature of the LED device. The backing, when applied to the platforms  320 , distributes the light from the LED device of the LED lighting system  322  such that every portion of the platform  320  is illuminated with similar brightness. 
     The shuttle  325  may be moved laterally between the platform  320 , over the reservoir  250 , and over a conduit  335 . The shuttle  325  transfers the medications from the platform  320  either to the reservoir  250  or to the conduit  335 . The shuttle  325  is driven by the shuttle drive  330 . The shuttle drive  330  may be a motor assembly, an actuator, or the like that moves the shuttle  325  between the platform  320 , over the reservoir  250 , and over the conduit  335 . In the example illustrated, the shuttle drive  330  includes a rotating screw  332  that moves the shuttle  325  laterally between the platform  320 , the reservoir  250 , and the conduit  335 . 
     The camera system  305  includes a camera  340  and a mirror  345 . The camera  340  is positioned at the back of the cartridge mechanism  245 . The camera  340  may be a still camera or a video camera that captures an image of the contents of the platform. The mirror  345  is placed directly above the platform  320  and is tilted at a 45-degree angle such that the camera  340  positioned at the back of the cartridge mechanism  245  can capture an image of the platform  320 . 
     The motor assembly  310  includes a motor  350  that drives a shaft  355  positioned in the middle of the cartridge mechanism  245 . The shaft  355  includes teeth  356  that interlock with the teeth  275  of the wheel  260  (see  FIG.  12   ). When the motor  350  is driven, the shaft  355  rotates the wheel  260  to individually dispense the medications  180 . 
     The PCB  315  includes the electrical components of the cartridge mechanism  245 . The PCB  315  is positioned on the side opposite that of the wheel  260 . In some embodiments, the PCB  315  includes an antenna  360  (see  FIG.  10   ) that detects an RFID tag  365  (see  FIG.  7 - 9   ) placed on the cartridge  240 . The RFID tag  365  may store information of the cartridge  240 . The information stored on the RFID tag  365  may include, for example, identification information of the cartridge  240 , medication restrictions (e.g., dedicated to allergenic medication or non-allergenic medication) of the cartridge  240 , and the like. 
     The lockout mechanism  316  is, for example, a lockout solenoid that prevents a cartridge  240  from being loaded onto the cartridge mechanism  245  when the lockout mechanism  316  is activated. During a dispensing process, not all cartridge mechanisms  245  are used to fill a prescription. In these situations, the lockout mechanism  316  is used to prevent cartridges  240  from being placed on inactive cartridge mechanism  245 . In addition, the lockout mechanism  316  may be used to prevent an incompatible or wrong cartridge  240  from being loaded to the cartridge mechanism  245 . For example, the cartridge mechanism  245  may read the RFID tag  365  to determine whether the correct and compatible cartridge  240  is being loaded to the cartridge mechanism  245 . The cartridge mechanism  245  may only deactivate the lockout mechanism  316  when the correct cartridge  240  is being loaded to the cartridge mechanism  245 . The lockout mechanism  316  may also be used to prevent the cartridge  240  from being removed from the cartridge mechanism  245 . Particularly, the lockout mechanism  316  locks the cartridge  240  in place when loaded on to the cartridge mechanism  245 . During the dispensing process, the lockout mechanism  316  is activated to prevent removal of the cartridge  240 . The lockout mechanism  316  may be deactivated when the dispensing process is complete and the cartridge  240  can be removed from the cartridge mechanism  245 . 
       FIG.  14    is a block diagram of one embodiment of the universal feed cassette  205 . In the example illustrated, the universal feed cassette  205  includes an electronic processor  370 , a memory  375 , a transceiver  380 , the camera systems  305 , the motor assemblies  310 , the lockout mechanisms  316 , the shuttle drives  330 , the antennas  360 , the pill sensors  362 , and indicator systems  384 . The electronic processor  370 , the memory  375 , the transceiver  380 , the camera system  305 , the motor assembly  310 , the lockout mechanism  316 , the shuttle drive  330 , and the pill sensor  362  communicate over one or more control and/or data buses (for example, a communication bus  382 ).  FIG.  14    illustrates only one example embodiment of the cartridge mechanism  245 . The cartridge mechanism  245  may include more or fewer components and may perform functions other than those explicitly described herein. 
     In some embodiments, the electronic processor  370  is implemented as a microprocessor with separate memory, such as the memory  375 . In other embodiments, the electronic processor  370  may be implemented as a microcontroller (with memory  375  on the same chip). In other embodiments, the electronic processor  370  may be implemented using multiple processors. In addition, the electronic processor  370  may be implemented partially or entirely as, for example, a field-programmable gate array (FPGA), an applications specific integrated circuit (ASIC), and the like, and the memory  375  may not be needed or be modified accordingly. In the example illustrated, the memory  375  includes non-transitory, computer-readable memory that stores instructions that are received and executed by the electronic processor  370  to carry out the functionality of the cartridge  240  described herein. The memory  375  may include, for example, a program storage area and a data storage area. The program storage area and the data storage area may include combinations of different types of memory, such as read-only memory and random-access memory.  FIG.  14    illustrates the universal feed cassette  205  as including a single electronic processor  370  and a single memory  375 . However, it should be noted that the universal feed cassette  205  may include separate electronic processor  370  and separate memories with one each for each of the cartridge mechanisms  245 . Accordingly, in some embodiments, a single processor performs the functions of the universal feed cassette  205  including all of the cartridge mechanisms  245  of the universal feed cassette  205 . In other embodiments, the functions of the universal feed cassette  205  and the cartridge mechanisms  245  may be divided between several processors. 
     The transceiver  380  enables wired or wireless communication between the electronic processor  370  and a control system of the automatic blister card packager  200  and/or a control system of the packaging unit  210 . In some embodiments, the transceiver  380  may include separate transmitting and receiving components, for example, a transmitter and a receiver. 
     The other components of the universal feed cassette  205  are described singularly with respect to a single cartridge mechanism  245 . However, it should be noted that the descriptions and functionality are equally applicable for each cartridge mechanism  245  of the universal feed cassette  205 . The camera system  305  receives control signals from the electronic processor  370 . Based on the control signals received from the electronic processor  370 , the camera system  305  controls the camera  340  and the lighting system that illuminates the platform  320 . The motor assembly  310  may send position sensor signals to the electronic processor  370  and receive control signals to operate a motor of the motor assembly  310  based on the position sensor signals. As described above, the shuttle drive  330  may be a motor assembly or an actuator. The shuttle drive  330  may also include a position sensor to determine the position of the shuttle  325 . The shuttle drive  330  may send the position sensor signals to the electronic processor  370 , which sends control signals to the shuttle drive  330  to move the shuttle  325  based on the position sensor signals. In some embodiments, the shuttle system  300  may also include a shuttle home sensor, which indicates whether the shuttle  325  is at a home position. Signals from the shuttle home sensor are provided to the electronic processor  370  to control the movement of the shuttle  325 . 
     The pill sensor  362  communicates with the electronic processor  370  to provide an indication of whether or not a pill is dispensed through the conduit  335 . The electronic processor  370  also controls the indicator system  364  to provide an indication of the status of each cartridge  240 . The indicator system  384  may include one or more LEDs provided behind a translucent plastic material. The electronic processor  370  may use the indicator system  384  to provide indications, for example, whether a cartridge  240  is correctly placed in the cartridge slot  220 . The electronic processor  370  may activate, for example, a blue LED to indicate that a next cartridge  240  should be placed in the corresponding cartridge slot  220  (that is, the cartridge slot  220  corresponding to the cartridge mechanism  245  with the blue LED activated). The electronic processor  370  may activate, for example, a green LED to indicate that the cartridge  240  was correctly placed in the cartridge slot  220 . The electronic processor  370  may activate, for example, a red LED to indicate that the cartridge  240  was not correctly placed in the cartridge slot  220 . Additionally, the electronic processor  370  may use the indicator system  384  to provide indications on where to place a cartridge  240  and when to remove a cartridge  240 . For example, the electronic processor  370  may activate a blue LED to indicate that a pharmacist can place a cartridge  240  in the cartridge slot  220  corresponding to the activated LED. The electronic processor  370  may activate a blue LED again to indicate that the dispensing process is complete and the cartridge  240  can be removed from the cartridge slot  220 . 
       FIG.  15    is a flowchart illustrating one example method  385  of delivering medications to the platform  320 . As illustrated in  FIG.  15   , the method  385  includes rotating, using the motor assembly  310 , a scooping member  265  past the bottom portion of the reservoir  250  (at block  390 ). Referring to  FIG.  9   , when the scooping member  265  is at the bottom portion of the reservoir  250 , the medications  180  move into the inward projection  266  of the scooping member  265  due to the curved shape of the reservoir  250 . As the medications  180  move into the inward projection  266 , the stopper  268  of the scooping member  265  carries at least one medication  180  past the bottom portion of the reservoir  250  as the scooping member  265  is rotated past the bottom portion of the reservoir  250 . The scooping members  265  are placed within the wheel  260  along circumferential ends of the wheel  260 . The wheel  260  is rotated to rotate the scooping members  265 . As described above, teeth  275  of the wheel  260  interlock with teeth of the shaft  355 , which is driven by the motor  350 . 
     The method  385  also includes advancing, using the cam and follower mechanism  285 , the holding pin  280  into the scooping member  265  (at block  395 ). Referring to  FIGS.  7    and  9 , as the scooping member  265  is rotated past the bottom portion of the reservoir  250 , the follower  295  corresponding to the scooping member  265  encounters the arc portion  292  of the cam  290 . The follower  295  is then advanced, which advances the holding pin  280  towards a circumference of the inward projection  266  of the scooping member  265 . 
     The method  385  further includes holding the medication between the holding pin  280  and the stopper  268  (at block  400 ). When the holding pin  280  is advanced, a medication  180  is held between the holding pin  280 , the circumferential end of the scooping member  265 , and the stopper  268 . The medication  180  is held in such a way until the scooping member  265  moves past the top portion of the wheel  260 . 
     The method  385  also includes rotating, using the motor assembly  310 , the scooping member  265  past the top portion of the wheel  260  (at block  405 ). As discussed above, the motor assembly  310  rotates the wheel  260  to rotate the scooping members  265 . The motor assembly  310  may also include a position sensor (not shown) to detect a position of the wheel  260 . For example, the motor assembly  310  may include a hall sensor to detect magnets placed at certain locations on the wheel  260  to determine the position of the wheel  260 . In other embodiments, the position sensor may be an optical sensor or the like. 
     The method  385  further includes retracting, using the cam and follower mechanism  285 , the holding pin  280  to drop the medication  180  on to the platform  320  (or for example, a verification system that verifies that an expected medication  180  (e.g., correct, single, and unbroken medication  180 ) is delivered) (at block  410 ). Referring to  FIGS.  7  and  9   , as the scooping member  265  is rotated past the top portion of the wheel  260 , the follower  295  corresponding to the scooping member  265  encounters the cut-off portion  294  of the cam  290 . The follower  295  is then retracted, which retracts the holding pin  280  away from the circumference of the inward projection  266  of the scooping member  265 . As the holding pin  280  is retracted, the medication  180  drops from the scooping member  265  on to the platform  320 . The scooping member  265  may be shaped to include a curved portion at a radially inward portion of the scooping member  265 . The curved portion pushes the medication  180  away from the wheel  260  and onto the platform  320  when the medication  180  is released by the holding pin  280 . Accordingly, the method  385  delivers a single medication  180  to the platform  320 . 
       FIG.  16    is a flowchart illustrating one example method  415  of dispensing medications from the cartridge  115 . As illustrated in  FIG.  16   , the method  415  includes rotating the wheel  260  to deliver a medication  180  to the shuttle system  300  (at block  420 ). For example, the electronic processor  370  executes the method  385  of  FIG.  15    to rotate the wheel and deliver the medication  180  to the shuttle system  300 . 
     The automatic blister card packager  200  may pack only a single medication of a kind in any one blister compartment  120 . Accordingly, the cartridge  240  may need to verify that an expected medication  180  (for example, a single unbroken medication  180 ) is dispensed to the packaging unit  210 . The method  415  further includes determining whether only a single unbroken medication  180  is delivered to the shuttle system  300  (at block  425 ). This may also be referred to as singulation verification. The electronic processor  370  controls the camera system  305  to acquire an image of contents of the platform  320 . The mirror  345  reflects the contents of platform  320  to the camera  340 , which captures the image. The camera  340  provides the captured image to the electronic processor  370  for verification. The electronic processor  370  may use image recognition techniques on the captured image to ensure that only a single unbroken medication  180  is delivered to the shuttle system. Example image recognition techniques are described in U.S. Patent Application Publication No. 2018/0091745, the entire contents of which are hereby incorporated by reference. 
     When the electronic processor  370  determines that more than one medication  180  has been delivered to the shuttle system  300  or that a broken medication  180  has been delivered to the shuttle system  300 , the method  415  includes returning the contents of the shuttle system  300  to the reservoir  125  (at block  430 ). The electronic processor  370  controls the shuttle drive  330  to move the shuttle  325  from the platform  320  to a first opening (e.g., the first position). The shuttle  325  returns the contents from the platform  320  to the reservoir  250  through the first opening. The method  415  returns to block  420  to deliver the next medication  180  to the shuttle system  300 . 
     When the electronic processor  370  determines that only one unbroken medication  180  has been delivered to the shuttle system  300 , the method  415  includes determining whether the correct medication  180  is delivered to the shuttle system  300  (at block  435 ). As described above, the electronic processor  370  may use the above incorporated image recognition techniques to determine whether the correct type of medication  180  has been delivered to the shuttle system  300 . 
     When the electronic processor  370  determines that the incorrect type of medication  180  is delivered to the shuttle system  300 , the method  415  moves to block  430  to return the contents of the shuttle system  300  to the reservoir  250 , as described above. Accordingly, in blocks  410  and  420 , the method  415  is determining whether an expected medication  180  is delivered to the shuttle system  300 . In some embodiments, determining whether an expected medication  180  is delivered may include only one of the blocks  425  or  435  or the blocks  425  and  435  may be performed in a different order. In other embodiments, rather than checking for whether a single unbroken medication  180  is delivered to the shuttle system  300 , determining whether an expected medication  180  may include determining whether a correct type of medication is delivered to the shuttle system  300  regardless of the number of medications delivered to the shuttle system  300 . In yet other embodiments, determining whether an expected medication  180  may include determining whether a correct number of medications is delivered to the shuttle system  300 . 
     When the electronic processor  370  determines that the correct type of medication  180  is delivered to the shuttle system  300 , the method  415  includes delivering the medication  180  to the packaging unit  210  (at block  440 ). The electronic processor  370  controls the shuttle drive  330  to move the shuttle  325  from the platform  320  to a second opening (e.g., the second position). The shuttle  325  delivers the medication  180  from the platform  320  to the packaging unit  210  through the second opening, the conduit  335 , and the dispensing opening. 
     The method  415  also includes verifying the delivery of the medication  180  to the packaging unit  210  (at block  445 ). The pill sensor  362  detects whether or not a pill was dispensed through the conduit  335  and provides indicating signals to the electronic processor  370 . When the electronic processor  370  determines that a medication  180  was delivered to the packaging unit  210 , the method returns to block  420  to deliver the next medication. When the electronic processor  370  determines that a medication  180  was not delivered to the packaging unit  210 , the electronic processor  370  sends an interrupt to the control system of the automatic blister card packager  200  and returns to block  420  to re-deliver the medication  180 . 
     An example cartridge  240  and cartridge mechanism  245  are described in U.S. Pat. No. 10,583,941, filed on Oct. 15, 2018, entitled “UNIVERSAL FEED MECHANISM FOR AUTOMATIC PACKAGER,” the entire contents of which are hereby incorporated by reference 
     Referring to  FIG.  2   , the automatic blister card packager  200  also includes a chute or manifold  230  and a blister card packaging unit  210 . The universal feed cassette  205  is placed on top of the chute  230 . The chute  230  includes a plurality of discrete tracks corresponding to each of the cartridges  240  (particularly, a conduit of each cartridge  240 ) mounted on the chute  230 . The illustrated tracks are independent channels that together form the chute  230 . The tracks direct pharmaceuticals from the universal feed cassette  205  toward packaging equipment  510  of the blister card packaging unit  210 . Conduits of the cartridges  240  align with holes in the chute  230  such that medications slide down the chute  230  toward the packaging equipment  510 . The tracks  450  isolate the medications from each other as the medications slide down the chute  230  toward the packaging equipment  510 . In the illustrated embodiment, the chute  230  includes eight tracks  450 . In other embodiments, the chute  230  may include fewer or more tracks  450 . The number of tracks corresponds to the number of rows or columns (depending on the orientation) of a blister card that is desired to be filled. The automatic blister card packager  200  (and, thereby, the universal feed cassette  205  and the chute  230 ) may be designed with different numbers of cassettes and tracks to fill blister cards of different sizes. 
     Cameras are mounted at or near the junction of the conduits and the chute  230 . Each camera is associated with one of the cartridge  240  supported in the universal feed cassette  205 . The cameras are operable to determine whether the correct number and/or type of pharmaceuticals are being dispensed from the cartridges  240 . In some embodiments, the cameras only look for the presence or absence of an object in the conduit. The cameras capture images of pharmaceuticals exiting the universal feed cassette  205  and compare features (e.g., color, contour, size, shape, inscription, etc.) of the pharmaceuticals to stored images of known pharmaceuticals. In some embodiments, recognition software may be employed to automatically compare the images captured by the cameras to stored images. In other embodiments, the captured images may be transmitted to a remotely-located pharmacist or technician who analyzes the images and verifies that the correct number and type of pharmaceuticals were dispensed. In further embodiments, the cameras may be infrared sensors that only detect whether an object (e.g., a pill) drops through the universal feed cassette  205 , rather than identifying the particular type of pharmaceutical. 
     Referring to  FIGS.  17 - 18 B , the packaging unit  210  includes a rail system  505 , and packaging equipment  510  (also referred to as a platen). The rail system  505  includes a rail base  515 , rails  520 , and a rail drive  525 . The rail base  515  is fixed to a frame of the automatic blister card packager  200 , for example, using fasteners. In some embodiments, the rail base  515  is removably secured to the frame such that a technician may remove the packaging unit  210  for servicing. The rails  520  are provided on the rail base  515 . 
     In the example illustrated in  FIGS.  17 - 18 B , the rails  520  include fixed rails  530 , first moveable rails  535 , and second moveable rails  540 . The fixed rails  530  are fastened to the rail base  515  using fasteners such that the fixed rails  530  are stationary with respect to the rail base  515 . The fixed rails  530  start at a rear of the rail base  515  and extend, for example, up to a third of the length of the rail base  515 . The first moveable rails  535  slide along the fixed rails  530  and extend the rails  520  up to two thirds of the length of the rail base  515 . The second moveable rails  540  slide along the first moveable rails  535  and extend the rails  520  up to the entire length of the rail base  515 . The packaging equipment  510  is attached to the second moveable rails  540  to move with the second moveable rails  540 . The rails  520  telescope the packaging equipment  510  along the length of the rail base  515 . 
     The rail drive  525  may be a motor assembly, an actuator, or the like that moves the packaging equipment  510  between the rear of the rail base  515  and the front of the rail base  515  along the length of the rail base  515 . In the example illustrated, the rail drive  525  includes a rotating screw  545  that moves the packaging equipment  510  laterally between the rear of the rail base  515  and the front of the rail base  515  along the length of the rail base  515 . The rotating screw  545  includes a magnetic end  550  at the end of the rotating screw  545 . The magnetic end  550  attaches to a corresponding end  555  of the packaging equipment  510 . The magnetic end  550  may include a magnet that attaches to magnetic material of the corresponding end  555 . In some embodiments, the magnetic end  550  includes magnetic material that attaches to magnets  556  on or in the corresponding end  555 . The rotating screw  545  moves the packaging equipment  510  between a first position (as shown in  FIG.  18 A ) and a second position (as shown in  FIG.  18 B ). 
     Referring to  FIG.  18 A , when in the first position, the packaging equipment  510  is within the automatic blister card packager  200  and is inaccessible by a pharmacist and/or technician. The rail drive  525  moves the packaging equipment  510  under the chute  230  within the automatic blister card packager  200  to fill a blister card  100  placed in the packaging equipment  510 . The first position may correspond to a first third (⅓ rd ) of the rail base  515  such that the packaging equipment  510  is entirely over the fixed rails  530  and can be moved by the rail drive  525  to align medication receiving openings  630  of the packaging equipment  510  with the chute  230 . 
     Referring to  FIG.  18 B , when in the second position, the packaging equipment  510  may still be within the automatic blister card packager  200 . However, at least a portion of the packaging equipment  510  is accessible by a user to pull the packaging equipment. The second position may correspond to a second third (⅓ rd ) of the rail base  515  such that the first moveable rails  535  have travelled and reached an end of the fixed rails  530 . When the rail drive  525  drives the rotating screw  545 , the first moveable rails  535  move along the fixed rails  530  to move the packaging equipment  510  between the first position and the second position. When in the second position, a user may pull the packaging equipment  510  towards the user to disengage the packaging equipment  510  from the magnetic end  550 . As such, a user may pull the packaging equipment from the second position to a third position (as shown in  FIG.  17   ). 
     Referring to  FIG.  17   , when in the third position, the packaging equipment  510  is outside the automatic blister card packager  200 . The third position may correspond to a final third (⅓ rd ) of the rail base  515  such that the second moveable rails  540  have travelled and reached an end of the first moveable rails  535 . When the user pulls the packaging equipment  510 , the second moveable rails  540  slide along the first moveable rails  535  to move the packaging equipment  510  between the second position and the third position. When in the third position, the user may open the packaging equipment  510  to replace a filled blister card  100  from the packaging equipment. 
     Referring to  FIG.  19   , the packaging equipment  510  includes a packaging base  560 , a packaging plate  565 , and a packaging lid  570 . Referring to  FIGS.  20 A and  20 B , the packaging base  560  includes a base portion  575 , a first leg portion  580  extending downwards on a left side (e.g., a first side) of the base portion  575 , a second leg portion  585  extending downwards on a right side (e.g., a second side) of the base portion  575 , and a third leg portion  590  extending downwards on a front side (e.g., a third side) of the base portion  575 . The rear side (e.g., a fourth side) of the base portion  575  is left open to accommodate the rail drive  525  under the packaging base  560 . The first leg portion  580  is fastened to the second moveable rails  540  on the left side (e.g., the first side) and the second leg portion  585  is fastened to the second moveable rails  540  on the right side (e.g., the second side). The end  555  is provided on the third leg portion  590  and may include magnets  556  or magnetic material that correspondingly attaches to the magnetic end  550 . The base portion  575  may also include a guard  595  provided on the second leg portion  585 . The guard  595  may be provided at a front end of the packaging equipment and extends right of the second leg portion  585 . The guard  595  inhibits a user&#39;s limbs or other objects from entering the inside of the blister card packager  200  during operation. 
     The packaging plate  565  is attached to the base portion  575  of the packaging base  560  such that the packaging plate  565  is above the packaging base  560 . Referring to  FIG.  21   , the packaging plate  565  includes blister openings  600  provided in a blister card receiving portion  605 . The blister card receiving portion  605  is slightly depressed in the packaging plate  565  to accommodate the blister sheet  110  when the packaging lid  570  is closed on the packaging plate  565 . The blister openings  600  accommodate blister compartments  120  of the blister sheet  110 . In the example illustrated, the blister openings  600  are through-holes that extend through the packaging plate  565 . In some embodiments, the blister openings  600  do not extend through the packaging plate  565  and may include a base portion at the bottom of the opening. There are a limited number of manufacturers of blister cards  100 . The variability in dimensions between different manufacturers of blister cards  100  is minimal with only up to 0.5 mm in variability in the height/width/depth of the blister compartments  120 . Accordingly, the blister openings  600  may be designed to accommodate blister cards  100  from any manufacturer by dimensioning the blister openings  600  to fit a bigger of the blister cards  100  from different manufacturers. In some embodiments, different packaging plates  565  may be used for different facilities based on the blister cards  100  used by the facility that packages the blister cards  100 . 
     The packaging plate  565  also includes pickup portions  610  that extend from the blister card receiving portion  605 , for example, on opposite sides of the blister card receiving portion  605 . When a blister card  100  is filled, a user may pick the blister card  100  from the packaging plate  565  by placing the user&#39;s fingers in the pickup portion  610 . In some embodiments, only a single pickup portion  610  may be provided or the pickup portions  610  may be provided on the same side or adjacent sides of the blister card receiving portion  605 . The pickup portions  610  may be depressed to similar depth or different depth than the blister card receiving portion  605  to facilitate picking up of a filled blister card  100 . 
     Referring to  FIG.  19   , the packaging lid  570  is hingedly connected to the packaging plate  565  using hinges  615 . The hinges  615  are provided at a rear of the packaging equipment  510  such that the packaging lid  570  can be placed in a closed position and an open position. Referring to  FIGS.  22 A- 22 C , the packaging lid  570  includes a top side  620  and a bottom side  625  opposite the top side  620 . Medication receiving openings  630  extend from the top side  620  to the bottom side  625  of the packaging lid  570 . At the bottom side  625 , the medication receiving openings  630  include a shape that corresponds to the blister openings  600  of the packaging plate  565 . In the example illustrated, at the bottom side  625 , the medication receiving openings  630  include a shape that has two straight sides and two curved sides. At the top side  620 , the medication receiving openings  630  include a shape that corresponds to or accommodates medication dispensing openings in the chute  230 . In the example illustrated, at the top side  620 , the medication receiving openings  630  include a shape that is square or rectangular. The medication receiving openings  630  may have a larger area on the top side  620  compared to the area on the bottom side  625 . Walls of the medication receiving openings  630  curve and/or converge between the shape on the top side  620  and the shape on the bottom side  625  to direct the medications from the chute  230  to the blister compartments  120  of the blister card  100  placed in the packaging plate  565 . The medication receiving openings  630  are sized to inhibit medications from bouncing out of the packaging equipment  510 . Particularly, the medication receiving openings  630  have a height to inhibit the medications from bouncing upwards and out of the top side  620  when dispensed from the chute  230 . In some embodiments, the height of the medication receiving openings  630  is approximately 1 inch. In other embodiments, the height of the medication receiving openings  630  is between 1 inch and 2 inches. In further embodiments, the height of the medication receiving openings is between 2 inches and 3 inches. The added height of the medication receiving openings  630  also inhibits the medications from being sheared when the packaging equipment  510  moves into and out of the blister card packager  200 . 
     In some embodiments, the packaging plate  565  and the packaging lid  570  are detachably attached to the packaging base  560 . The packaging plates  565  and the packaging lids  570  may be provided in different sizes to accommodate blister cards  100  of different kinds, for example, from different manufacturers and/or having different sizes. In some embodiments, the packaging plates  565  and the packaging lids  570  may be provided in different sizes to accommodate manifolds or chutes having different sizes of medication dispensing openings. The packaging plate  565  and the packaging lid  570  can be detached from the base portion  560  to exchange with a packaging plate  565  and a packaging lid  570  of a different size. 
     The rail drive  525  moves the packaging equipment  510  to align the medication receiving openings  630  with the medication dispensing openings of the chute  230 . When a new blister sheet  110  is placed in the packaging equipment  510 , the rail drive  525  retracts the packaging equipment such that a first row of the medication receiving openings  630  (e.g., a front-most row of medication receiving openings  630 ) is aligned with the medication dispensing openings of the chute  230 . When medication is dispensed from the chute to the blister compartments  120  of the first row, the rail drive  525  is actuated to move the packaging equipment  510  such that a second row of the medication receiving openings  630  is aligned with the medication dispensing openings of the chute  230 . The rail drive  525  moves the packaging equipment  510  to successively align the rows of the medication receiving openings  630  with the medication dispensing openings of the chute  230 . When the blister card  100  is filled, the rail drive  525  moves the packaging equipment  510  to the second position such that a user may replace the filled blister card  100  with an unfilled blister card  100 . 
     In some embodiments, the blister card  100  may receive multiple medications in a single blister compartment  120 . In these embodiments, a universal feed cassette  205  having multiple rows of cartridges  240  may be used. The universal feed cassette  205  may be stocked such that cartridges  240  including all the medications that are to be packaged in a single blister compartment  120  are provided in the same column. Cartridges  240  provided in the same column share the same track of the chute  230 . Accordingly, when the universal feed cassette  205  is operated, the multiple medications that are to be received in the same blister compartment  120  are dropped together into the blister compartment  120  through the shared column. In some embodiments, the cartridges  240  including all the medications that are to be packaged in a single blister compartment  120  may be provided in different columns. In these embodiments, the rail drive  525  is operated to move the packaging equipment  510  around such that the blister compartments  120  are placed under different columns to receive the multiple medications. 
     As discussed above, when the packaging equipment  510  is in the second position, the user may pull the packaging equipment  510  to the third position to replace the blister card  100 . When in the third position, the user may perform a first check or verification and observes the medication receiving openings  630  to ensure that no medications are stuck in the medication receiving openings  630  and that all the medications have transferred from the medication receiving openings  630  to the blister compartments  120  of the blister card  100  currently being filled. After the first check or verification, the user may open the packaging lid  570 . When the packaging lid  570  is opened, the user may perform a second check or verification and observe the blister compartments  120  to ensure that the desired number of blister compartments  120  are correctly filled. The user may then place the label sheet  130  on the blister sheet  110  and press down to stick the label sheet  130  to the blister sheet  110 . The label sheet  130  includes an adhesive to stick the label sheet  130  to the blister sheet  110 . The user may then pick up the blister card  100  from the packaging plate  565  using the pickup portions  610 . A new blister sheet  110  is then placed in the packaging plate  565  to fill the next blister card  100 . 
     In some embodiments, a heating element  572  (shown in  FIG.  22 C ) is provided on the packaging plate  565  and/or the packaging lid  570 . A switch or push button  574  (shown in  FIG.  22 B ) may be provided on the packaging lid  570  to activate the heating element  572 . Once the user verifies that the blister compartments  120  are correctly are correctly filled, the user places the label sheet  130  on the blister sheet  110  and activates the heating element  572  by pushing the switch  574 . The heating elements  572  provides the heat to heat seal the label sheet  130  to the blister sheet  110 . 
       FIG.  23    schematically illustrates one embodiment of the automatic blister card packager  200 . The automatic blister card packager  200  controls operations of the rail drive  525  to align the packaging equipment  510  with the chute  230  as set forth above, and controls when the active cartridges  240  positioned on the chute  230  are operated. 
     In the example illustrated, the automatic blister card packager  200  includes a packager electronic processor  650 , a packager memory  655 , a packager transceiver  660 , a packager input/output interface  665 , and the rail drive  525 . The packager electronic processor  650 , the packager memory  655 , the packager transceiver  660 , the packager input/output interface  665 , and the rail drive  525  communicate over one or more control and/or data buses (e.g., a communication bus  670 ).  FIG.  23    illustrates only one exemplary embodiment of the automatic blister card packager  200 . The automatic blister card packager  200  may include more or fewer components and may perform functions other than those explicitly described herein. 
     The packager electronic processor  650  and the packager memory  655  may be implemented similar to the electronic processor  370  and the memory  375  respectively, as described above. The packager transceiver  660  enables communication from the automatic blister card packager  200  to the communication network  675 . In other embodiments, the packager transceiver  660  may include separate transmitting and receiving components, for example, a transmitter and a receiver. The automatic blister card packager  200 , through the communication network  675 , may communicate with the cartridge mechanism  245 . 
     As noted above, the automatic blister card packager  200  may include the packager input/output interface  665  (or more commonly referred to as a user interface). The packager input/output interface  665  may include one or more input mechanisms (e.g., a touch screen, a keypad, a button, a knob, and the like), one or more output mechanisms (e.g., a display, a printer, a speaker, and the like), or a combination thereof. The packager input/output interface  665  receives input from the input devices actuated by a user, and provides output to the output devices with which a user interacts. In some embodiments, as an alternative or in addition to managing inputs and outputs through the packager input/output interface  665 , the automatic blister card packager  200  may receive user inputs, provide user outputs, or both by communicating with an external device, such as a console computer, over a wired or wireless connection. 
       FIG.  24    is a flowchart illustrating one example method  700  of packaging blister cards  100 . As illustrated in  FIG.  24   , the method  700  includes moving, using the rail drive  525 , the packaging equipment  510  from the second position to the first position (at block  705 ). The packager electronic processor  650  controls the rail drive  525  to move the packaging equipment  510  from the second position to the first position as set forth above. A user places an unfilled blister sheet  110  in the packaging equipment and pushes the packaging equipment  510  from the third position to the second position such that the end  555  attaches to the magnetic end  550 . In some embodiments, the packager electronic processor  650  may determine that the end  555  is attached to the magnetic end  550  and in response controls the rail drive  525  to move the packaging equipment from the second position to the first position. 
     The method  700  also includes aligning, using the rail drive  525 , a first row of the medication receiving openings  630  with the medication dispensing openings of the chute  230  (at block  710 ). The packager electronic processor  650  controls the rail drive  525  to align the first row, for example, the front-most row of the medication receiving openings  630  with the medication dispensing openings of the chute  230 . The method  700  further includes instructing the universal feed cassette  205  to dispense medications (at block  715 ). The universal feed cassette  205  controls the individual cartridge mechanism  245  to dispense medications to the packaging equipment  510  through the chute  230 . 
     The method  700  also includes determining, using the packager electronic processor  650 , that medications are dispensed (at block  720 ). The packager electronic processor  650  may determine that the medications are dispensed based on receiving an acknowledgement from the universal feed cassette  205 . In some embodiments, the packager electronic processor  650  may implement a timer and determine that the medications are dispensed when the timer expires. In some embodiments, the packager electronic processor  650  uses the cameras or sensors placed near the conduits of the chute  230  to determine that a medication passed through the chute  230 . The method  700  further includes determining, using the packager electronic processor  650 , whether a blister card  100  in the packaging equipment  510  is filled (at block  725 ). The packager electronic processor  650  may determine that the blister card  100  is filled when the medications are dispensed to the last row of the medication receiving openings  630 . 
     When the packager electronic processor  650  determines that the blister card  100  has not yet been filled, the method  700  includes aligning, using the rail drive  525 , a next row of the medication receiving openings  630  with the medication dispensing openings of the chute  230  (at block  730 ). The packager electronic processor  650  controls the rail drive  525  to align the next row, for example, the second, the third, or the fourth row of the medication receiving openings  630  with the medication dispensing openings of the chute  230 . In some embodiments, the electronic processor  650  implements a delay before aligning the next row. The delay may be selected to account for settling of the medication (e.g., after bouncing) in the blaster card  100 . The method repeats blocks  715 ,  720 ,  725 , and  730  until the blister card  100  is filled. When the packager electronic processor  650  determines that the blister card  100  has not yet been filled, the method  700  includes moving, using the rail drive  525 , the packaging equipment  510  from the first position to the second position (at block  735 ). The packager electronic processor  650  controls the rail drive  525  to move the packaging equipment  510  from the first position to the second position as set forth above. The user then replaces filled blister card  100  with the next blister card  100  to be filled. 
     In some embodiments, the chute  230  may include two or more rows of medication dispensing openings such that more than one row of the blister compartments  120  can be simultaneously filled. In one embodiment having two rows of medication dispensing openings, a first row of medication dispensing openings draws medications from a first row of cartridges  240 , and a second row of medication dispensing openings draws medications from a second row of cartridges  240 . In this embodiments, the first row of medications dispensing openings may be used to fill the blister cards  100  while the second row of cartridges  240  is being refilled, and the second row of medications dispending openings may be used to fill the blister cards  100  while the first row of cartridges  240  are being refilled. Additionally, the first row of cartridges  240  may be used for a first medication and the second row of cartridges  240  may be used for a second medication, and so on, when the blister card  100  is being packaged with multiple medications. In one embodiment having four rows of medication dispensing openings drawing medications from four rows of cartridges  240 , all four rows of medication dispensing openings may be used to quickly fill the blister card  100  in one go. 
     Although the illustrated packaging equipment  510  is moved linearly between positions by the rail drive  525 , in other embodiments, the packaging equipment  510  may be moved in other manners and/or by other suitable means. For example, the packaging equipment  510  may be mounted on a plate (e.g., a turn-style plate) that is rotatable between positions. Alternatively, the packaging equipment  510  may be connected to a conveyor- or chain-style system that moves the packaging equipment  510  in a loop (e.g., forward and backward, and up and down). In such embodiments, the automatic blister card packager  200  may include more than one packaging equipment. For example, the automatic blister card packager  200  may include two packaging equipments, such that as one packaging equipment on one side of the turn-style plate or the conveyor-style system is being filled by the automatic blister card packager  200 , the other packaging equipment on an opposite side of the turn-style plate or the conveyor-style system can be manipulated (e.g., inspected, opened/closed, refilled, etc.) by a user. 
       FIGS.  25 - 31    illustrate another example of an automatic blister card packager  800 . The automatic blister card packager  800  is similar to the automatic blister card packager  200  described above with reference to  FIGS.  1 - 24   . Reference is made to the description of the automatic blister card packager  200  for description of features, operations, and alternatives of the automatic blister card packager  800  not explicitly described below. It should be noted that features of the automatic blister card packager  200  may be used with the automatic blister card packager  800  and vice versa. 
     The illustrated automatic blister card packager  800  includes a universal feed cassette  805 , a blister card packaging unit  810  ( FIGS.  26 - 30   ), and a manifold  815  that connects the universal feed cassette  805  and the packaging unit  810 . The universal feed cassette  805  and the packaging unit  810  are supported by a frame  820 . The frame  820  also supports a screen  825 . The screen  825  provides a user interface for interacting with the automatic blister card packager  800 . In some embodiments, the screen  825  may be a touch screen. In other embodiments, the automatic blister card packager  800  may include other devices for the user interface, such as a mouse, trackball or trackpad, keyboard, camera, speaker, microphone, and the like. The frame  820  further includes shelves  830  for supporting other devices associated with the automatic blister card packager  800 , such as a printer  835 . As such, the automatic blister card packager  800  may be a standalone unit. 
     In the illustrated embodiment, the universal feed cassette  805  includes sixteen cartridge slots  840 . The cartridge slots  840  are configured to receive cartridges, such as the cartridges  240  shown in  FIG.  6   . The illustrated cartridge slots  840  are arranged in two vertically-stacked rows of eight. In other embodiments, the universal feed cassette  805  may include fewer or more cartridge slots  840 , as noted above. In one example, the universal feed cassette  805  may include twenty cartridge slots  840 . The cartridge slots  840  are arranged in two vertically-stacked rows of ten. In another example, the universal feed cassette  805  includes a single row of 10 cartridge slots  840 . These universal feed cassettes  805  with ten or twenty cartridge slots  840  can be used to fill blister cards  120  having a 10×6 blister compartment  120  configuration. 
     As shown in  FIG.  26   , the automatic blister card packager  800  includes a door  845  that provides selective access to the packaging unit  810 . The door  845  is movable between a closed position ( FIG.  25   ) and an open position ( FIG.  26   ). In the illustrated embodiment, the door  845  pivots between the closed and open positions. When in the open position, the door  845  may also provide a shelf to help support the packaging unit  810 . 
     As shown in  FIGS.  26  and  27   , the blister card packaging unit  810  is movable toward and away from the automatic blister card packager  800 , similar to the blister card packaging unit  210  described above. This movement is generally in a forward-backward direction along a first axis. The first axis may also be referred to as a z-axis. In the illustrated embodiment, however, the packaging unit  210  is also movable side-to-side within the automatic blister card packager  800 , as shown in  FIGS.  28 - 30   . This movement is along a second axis that is perpendicular to the first axis. The second axis may also be referred to as an x-axis. Movement along the first axis is controlled by a first rail system  850  including first rails  855  and a first rail drive  860  (similar to the rail system  505 ). Movement along the second axis is controlled by a second rail system  865  including second rails  870  and a second rail drive  875 . The packaging unit  810  moves forward-backward along the first axis and side-to-side along the second axis to position different openings  865  beneath the manifold  815 , as further described below. This is especially useful when filling multiple medications in a single blister compartment  120  as described above. 
       FIG.  31    illustrates one example of the manifold  815  for use with the automatic blister card packager  800 . The manifold  815  helps direct pharmaceuticals (e.g., pills, vitamins, etc.) from the universal feed cassette  805  to the blister card packaging unit  810 . In the illustrated embodiment, the manifold  815  includes eight separate tracks or channels  870 . The number of channels  870  correspond to the number of cartridge slots  840  (and thereby cartridges) in each row of the universal feed cassette  805 . As such, in some embodiments, the manifold  815  may include fewer or more channels  870 . Each channel  870  has a separate outlet that corresponds to one of the openings  865  ( FIG.  28   ) in the packaging unit  810 . When pharmaceuticals are delivered from the universal feed cassette  805 , the pharmaceuticals travel through the channels  870  of the manifold  815 , through the outlets, and into one of the openings  865  in the packaging unit  810 . Because the packaging unit  810  can also move side-to-side, the outlets of the manifold  815  do not always necessarily match up with the same openings  865  in the packaging unit  810 . In some embodiments, one or more cameras  872  (or sensors) are provided by the channels  870  of the manifold  815  to verify that a pharmaceutical passed through the channels  870 . As discussed above, the one or more cameras  872  may be used to detect the presence or absence of an object and/or to detect that a correct number and/or type of pharmaceutical is passing to the channels  870 . 
       FIG.  32    illustrates another example of a manifold  815 A for use with the automatic blister card packager  800 . In the illustrated embodiment, the manifold  815 A includes two shared tracks or channels  870 A that dispense pharmaceuticals through shared outlets to the packing unit  810 . For example, four cartridge slots  840  (and thereby cartridges) share one half of the manifold  815 A to dispense pharmaceuticals through a first outlet, while four other cartridge slots  840  (and thereby cartridges) share the other half of the manifold  815 A to dispense pharmaceuticals through a second outlet. In other embodiments, the manifold  815 A may include a single shared track or channel that dispenses pharmaceuticals through a single outlet. The illustrated manifold  815 , therefore, can only direct pharmaceuticals to two openings  865  ( FIG.  28   ) of the packaging unit  810  at a time. The packaging unit  810 , however, can move side-to-side to align with different openings  865  in a row of openings  865  with the shared outlets of the manifold  815 A. 
     In operation, the different manifolds  815 ,  815 A and side-to-side movement of the blister card packaging unit  810  provide additional benefits for filling a blister card (e.g., the blister card  100  shown in  FIG.  1   ). In particular, the outlets of the manifolds  815 ,  815 A are able to be aligned with any compartment  120  in the blister card  100  to deliver a pill to that compartment  120 . As such, pills for a prescription order may be loaded into essentially any cartridge in the universal feed cassette  805 . The automatic blister card packager  800  can determine and optimize a travel path for the packaging unit  810  to fill the compartments  120 , as needed. 
     Using the first manifold  815 , the cartridges may simultaneously (or relatively simultaneously) release pills to fill a row of compartments  120 , the packaging unit  810  may index to the next row of compartments  120  along the first axis (i.e., the z-axis), and the process may repeat until all of the rows of compartments  120  are filled. In some embodiments, the cartridges may release a single pill into each compartment. In other embodiments, the cartridges may release multiple pills into each compartment (e.g., between two and eight pills, depending on the size of the compartment). While one row of cartridges (e.g., the bottom row) is being used to fill the blister card  100 , the other row of cartridges (e.g., the top row) may be refilled by a user with the next desired type of pills, or vice versa. Such an arrangement may be particularly useful when the same type of pill is being filled in each compartment  120  of the blister card  100 . 
     Alternatively, only some of the channels  870  may be used to fill the blister card  100 . For example, only two of the cartridge slots  840  may include cartridges that contain the desired pills for a particular blister card. In such embodiments, only the channels  870  and outlets associated with those cartridges may be used to direct pills into the blister card  100 . After particular compartments  120  in a row are filled, the packaging unit  810  may then move along the second axis (i.e., the x-axis) to fill additional compartments in the row. Once a complete row of compartments  120  is full, the packaging unit  810  may index to the next row of compartments  120  along the first axis (i.e., the z-axis), and the process may repeat. In some embodiments, a complete row of compartments  120  may not be filled before the packaging unit  810  moves on to the next row. Rather, the packaging unit  810  may “zig-zag” along the first and second axes to fill the compartments  120 . During this time, the cartridges associated with the other cartridge slots  840  may be refilled, filled with pills for another order, or go unused. This process may be carried out using any number of cartridges and associated channels  870  of the manifold  815 , such as one, two, three, four, five, six, or seven. 
     Using the second manifold  815 A, only two of the cartridges (e.g., one of the cartridges associated with each shared channel  870 A) may release pills. The pills are then delivered by the shared outlets into the associated compartments  120  of the blister card  100 . After particular compartments  120  in a row are filled, the packaging unit  810  may then move along the second axis (i.e., the x-axis) to fill additional compartments  120  in the row. Once a complete row of compartments  120  is full, the packaging unit  810  may index to the next row of compartments  120  along the first axis (i.e., the z-axis), and the process may repeat. Such a process may be used to deliver a single pill to each compartment  120  of the blister card  100 . Alternatively, multiple pills may be delivered to each compartment  120  of the blister card  100 . For example, more than one cartridge associated with each shared channel  870 A may simultaneously (or relatively simultaneously) release a pill into the shared channel  870 A to deliver multiple pills to a single compartment  120 . Alternatively, each cartridge may release more than one pill into the shared channel  870 A. In some embodiments, a complete row of compartments  120  may not be filled before the packaging unit  810  moves on to the next row. Rather, the packaging unit  810  may “zig-zag” along the first and second axes to fill the compartments  120 . While the desired cartridges are being used, the other cartridges may be refilled, filled with pills for another order, or go unused. 
     The cartridges in the cartridge slots  840  of the universal feed cassette  805  may be filled with the same type of pills or may be filled with different types of pills, as needed. As such, the compartments  120  of the blister card  100  may be filled with different pills and/or combinations of pills. For example, a first compartment  120  may be filled one pill of a first type, while a second compartment  120  may be filled one pill of the first type and one pill of a second type. Additionally, another compartment may include two pills of the second type, a pill of a third type, and a pill of a fourth type. As should be readily understood, any combination of number and types of pills per compartment  120  is possible, depending on the size of the compartment  120 . 
     Since the blister card packaging unit  810  is movable side-to-side along the second axis (i.e., the x-axis), the processor of the automatic blister card packager  800  can identify which pills are located within which cartridge and generate an optimal path of travel for the blister card packaging unit  810 . The processor can determine which type(s) of pills and how many pills are needed for each compartment, based on the prescription order. The processor can also optimize the path using a cost function based on, for example, how many pills are able to be dropped at a time, and the shortest travel distance to the next set of compartments  120 . The processor can then send instructions to the rail drives  860 ,  875  to move the packaging unit  810 . The processor can also send instructions to the universal feed cassette  805  to release pills from the cassettes at particular times. Using either manifold  815 ,  815 A, different pills may be dropped into adjacent or non-adjacent compartments  120  of the blister card  100  at the same time to decrease the fill time of the blister card  100 . 
     Thus, the invention provides, among other things, an automatic blister card packager. Various features and advantages of the invention are set forth in the following claims.