Patent Publication Number: US-2003222548-A1

Title: Storage device for health care facility

Description:
TECHNICAL FIELD  
       [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.  
       RELATED APPLICATIONS  
       [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. ______.  
       BACKGROUND PRIOR ART  
       [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 &#39;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.  
       SUMMARY OF THE INVENTION  
       [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.  
     
    
    
     BRIEF DESCRIPTION OF THE DRAWING  
     [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. 6 a;    
     [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. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
     [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 8 a - 8   b , 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. 8 a  and  8   b ). 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. 8 a  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. 8 b , 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.