Patent Publication Number: US-10772800-B2

Title: Disposable cartridge for automatic drug compounder

Description:
TECHNICAL FIELD 
     The present disclosure generally relates to an apparatus that reconstitutes, mixes, and delivers a drug from a vial to a receiving container. Specifically, the present disclosure relates to a disposable cartridge with multiple flow paths to allow reconstitution of a drug, filling of a receiving container, delivery of diluents from hung diluent bags and diluent vials to medication vials, and removal of waste to a waste container. 
     BACKGROUND 
     Pharmaceutical compounding is the practice of creating a specific pharmaceutical product to fit the unique need of a patient. In practice, compounding is typically performed by a pharmacist, tech or a nurse who combines the appropriate ingredients using various tools. One common form of compounding comprises the combination of a powdered drug formulation with a specific diluent to create a suspended pharmaceutical composition. These types of compositions are commonly used in intravenous/parenteral medications. It is vital that the pharmaceuticals and diluents are maintained in a sterile state during the compounding process, and there exists a need for automating the process while maintaining the proper mixing characteristics (i.e., certain pharmaceuticals must be agitated in specific ways so that the pharmaceutical is properly mixed into solution but the solution is not frothed and air bubbles are not created). There exists a need for a compounding system that is easy to use, may be used frequently, efficiently, is reliable, and reduces user error. 
     SUMMARY 
     A disposable pump cartridge for a compounder system is provided. The cartridge may include a plurality of controllable fluid pathways and a piston for pumping fluid and/or vapors through selected ones of the fluid pathways. 
     In accordance with an embodiment, a pump cartridge for a compounder system is provided, the pump cartridge including at least one diluent port configured to receive a diluent in a diluent chamber; at least one waste port configured to provide vapor waste from a vapor waste chamber; a receiving container port configured to provide a fluid to a receiving container; a plurality of controllable fluid pathways fluidly coupled to the at least one diluent port, the at least one waste port, and the receiving container port; and a piston pump configured to pump the fluid and the vapor waste within the plurality of controllable fluid pathways. 
     In accordance with another embodiment, a compounder system is provided that includes a pump head assembly having a plurality of operational mechanisms; and a pump cartridge that includes a diluent port; an output port; a waste port; a plurality of valves; a needle assembly; and a piston, where the piston and the plurality of valves of the pump cartridge are configured to be operated by the plurality of operational mechanisms of the pump head assembly to (a) pump a fluid from a container through the diluent port and the needle assembly to a vial, (b) pump vapor waste through the needle assembly through the waste port to a waste container, and (c) pump a reconstituted drug from the vial through the needle assembly and the output port to a receiving container. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings, which are included to provide further understanding and are incorporated in and constitute a part of this specification, illustrate disclosed embodiments and together with the description serve to explain the principles of the disclosed embodiments. In the drawings: 
         FIG. 1  illustrates a front perspective view of an example of an exemplary embodiment of a compounding system in accordance with aspects of the present disclosure. 
         FIG. 2  illustrates a front perspective view of the compounding system of  FIG. 1  with a transparent housing in accordance with aspects of the present disclosure. 
         FIG. 3  illustrates a side view of the compounding system of  FIG. 1  with the housing removed in accordance with aspects of the present disclosure. 
         FIG. 4  illustrates a perspective view of an exemplary embodiment of a pump drive mechanism in accordance with aspects of the present disclosure. 
         FIG. 5  illustrates an exploded view of the pump drive mechanism of  FIG. 4  in accordance with aspects of the present disclosure. 
         FIG. 6  illustrates a perspective view of an example of an exemplary embodiment of a motor mount in accordance with aspects of the present disclosure, 
         FIG. 7  illustrates a rear perspective view of the motor mount of  FIG. 6  in accordance with aspects of the present disclosure. 
         FIG. 8  illustrates a perspective view of the motor mount of  FIG. 6  in accordance with aspects of the present disclosure. 
         FIG. 9  illustrates a perspective view of an exemplary embodiment of a cam housing in accordance with aspects of the present disclosure. 
         FIG. 10  illustrates a rear perspective view of the cam housing of  FIG. 9  in accordance with aspects of the present disclosure. 
         FIG. 11  illustrates a rear perspective view of the cam housing of  FIG. 9  with the gears removed in accordance with aspects of the present disclosure. 
         FIG. 12  illustrates a perspective view of an exemplary embodiment of a pump head assembly in accordance with aspects of the present disclosure. 
         FIG. 13  illustrates a perspective view of the pump head assembly of  FIG. 12  with an exemplary embodiment of a gripping system and vial puck in accordance with aspects of the present disclosure. 
         FIG. 14  illustrates a perspective view of the pump head assembly, gripping system and vial puck of  FIG. 13  in accordance with aspects of the present disclosure. 
         FIG. 15  illustrates a rear perspective view of the pump head assembly, gripping system and vial puck of  FIG. 13  in accordance with aspects of the present disclosure. 
         FIG. 16  illustrates a perspective view of an exemplary embodiment of a gripping system in accordance with aspects of the present disclosure. 
         FIG. 17  illustrates a rear perspective view of the gripping system of  FIG. 16  in accordance with aspects of the present disclosure. 
         FIG. 18  illustrates a side perspective view of the gripping system of  FIG. 16  in accordance with aspects of the present disclosure. 
         FIG. 19  illustrates a top plan view of the gripping system of  FIG. 16  in accordance with aspects of the present disclosure. 
         FIG. 20  illustrates a top plan view of the gripping system of  FIG. 16  in accordance with aspects of the present disclosure. 
         FIG. 21  is a flow chart illustrating an exemplary embodiment of the steps of a process in accordance with aspects of the present disclosure. 
         FIG. 22  illustrates a perspective view of an exemplary embodiment of a cartridge in accordance with aspects of the present disclosure. 
         FIG. 23  illustrates a perspective view of an exemplary embodiment of a carousel with a cover in accordance with aspects of the present disclosure. 
         FIG. 24  illustrates a front perspective view of another exemplary embodiment of a compounding system in accordance with aspects of the present disclosure. 
         FIG. 25  illustrates another front perspective view of the compounding system of  FIG. 24  in accordance with aspects of the present disclosure. 
         FIG. 26  illustrates a front perspective view of the compounding system of  FIG. 24  with portions of the housing removed in accordance with aspects of the present disclosure. 
         FIG. 27  illustrates a rear perspective view of the compounding system of  FIG. 24  with portions of the housing removed in accordance with aspects of the present disclosure. 
         FIG. 28  illustrates an exploded perspective view of the compounding system of  FIG. 24  in accordance with aspects of the present disclosure. 
         FIG. 29  illustrates a perspective view of the compounding system of  FIG. 24  with various components shown in enlarged views for clarity in accordance with aspects of the present disclosure. 
         FIG. 30  illustrates a perspective view of the cartridge of  FIG. 22  in accordance with aspects of the present disclosure. 
         FIG. 31  illustrates a perspective view of the cartridge of  FIG. 22  with a transparent bezel in accordance with aspects of the present disclosure. 
         FIG. 32  illustrates a bottom plan view of the cartridge of  FIG. 22  in accordance with aspects of the present disclosure. 
         FIG. 33A  illustrates a rear plan view of an exemplary embodiment of a cartridge with the bezel removed in accordance with aspects of the present disclosure. 
         FIG. 33B  illustrates a rear plan view of an exemplary embodiment of a cartridge with the bezel in place in accordance with aspects of the present disclosure. 
         FIG. 34  illustrates an exploded view of the cartridge of  FIG. 33A  in accordance with aspects of the present disclosure. 
         FIG. 35  illustrates a perspective view of an exemplary embodiment of a cartridge frame in accordance with aspects of the present disclosure. 
         FIG. 36  illustrates a rear perspective view of the cartridge frame of  FIG. 35  in accordance with aspects of the present disclosure. 
         FIG. 37  illustrates a rear perspective view of the cartridge frame of  FIG. 35  with an exemplary embodiment of a needle housing and an exemplary embodiment of an outlet port extension attached in accordance with aspects of the present disclosure. 
         FIG. 38  illustrates a cross sectional view of an exemplary embodiment of a needle system in accordance with aspects of the present disclosure. 
         FIG. 39  illustrates a rear perspective view of the cartridge frame of  FIG. 35  with an exemplary embodiment of a needle housing and an exemplary embodiment of a piston pump attached in accordance with aspects of the present disclosure. 
         FIG. 40  illustrates a front plan view of an exemplary embodiment of a sealing membrane in accordance with aspects of the present disclosure. 
         FIG. 41  illustrates a side perspective view of the sealing membrane of  FIG. 40  in accordance with aspects of the present disclosure. 
         FIG. 42  illustrates a rear perspective view of the sealing membrane of  FIG. 40  in accordance with aspects of the present disclosure. 
         FIG. 43  illustrates a close up cross sectional view of an exemplary embodiment of a valve and a valve chamber in accordance with aspects of the present disclosure. 
         FIG. 44  illustrates a close up cross sectional view of an exemplary embodiment of a fluid flow path in accordance with aspects of the present disclosure. 
         FIG. 45  illustrates a perspective view of an exemplary embodiment of a bezel in accordance with aspects of the present disclosure. 
         FIG. 46  illustrates a rear perspective view of the bezel of  FIG. 45  in accordance with aspects of the present disclosure. 
         FIG. 47  illustrates a perspective view of an exemplary embodiment of an assembled cartridge with a transparent bezel in accordance with aspects of the present disclosure. 
         FIG. 48  illustrates a perspective view of the cartridge of  FIG. 47  with an exemplary embodiment of a piston pump attached in accordance with aspects of the present disclosure, 
         FIG. 49  illustrates an exemplary embodiment of a cartridge frame showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 50  is a chart showing the positioning of certain valves in accordance with aspects of the present disclosure. 
         FIG. 51  is a flowchart illustrating the method steps of an exemplary embodiment in accordance with aspects of the present disclosure. 
         FIG. 52  is a flow chart illustrating the process of drawing diluent and pushing it into a vial in accordance with aspects of the present disclosure. 
         FIG. 53  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 54  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 55  is a flow chart illustrating the process of drawing a reconstituted drug from a vial and pushing into a receiving container in accordance with aspects of the present disclosure. 
         FIG. 56  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 57  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 58  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 59  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 60  is a flow chart illustrating the process of moving liquid from the receiving bag to the vapor waste bag in accordance with aspects of the present disclosure. 
         FIG. 61  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 62  illustrates the cartridge frame of  FIG. 49  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 63  illustrates a perspective view of an exemplary embodiment of a cartridge with a backpack attachment in accordance with aspects of the present disclosure. 
         FIG. 64  illustrates a perspective view of the cartridge of  FIG. 63  with a transparent backpack attachment in accordance with aspects of the present disclosure. 
         FIG. 65  illustrates a perspective view of a screw in accordance with aspects of the present disclosure. 
         FIG. 66  illustrates a perspective view of the screw of  FIG. 65  inside a screw chamber in accordance with aspects of the present disclosure. 
         FIG. 67  illustrates an exploded perspective view of another embodiment of a pump cartridge in accordance with aspects of the present disclosure. 
         FIG. 68A  illustrates a rear plan view of the cartridge of  FIG. 67  in accordance with aspects of the present disclosure. 
         FIG. 68B  illustrates a front plan view of the cartridge of  FIG. 67  in accordance with aspects of the present disclosure. 
         FIG. 69  illustrates a cross-sectional perspective view of the cartridge of  FIG. 67  with an attached backpack in accordance with aspects of the present disclosure. 
         FIG. 70  illustrates a finite element representation of a valve and valve actuator for a cartridge in accordance with aspects of the present disclosure. 
         FIG. 71  illustrates a cross-sectional side view of the cartridge of  FIG. 67  in accordance with aspects of the present disclosure. 
         FIG. 72  illustrates the cartridge of  FIG. 67  showing the valves and fluid flow paths in accordance with aspects of the present disclosure. 
         FIG. 73  illustrates the cartridge of  FIG. 67  showing a valve configuration for a diluent to receiving container fluid path in accordance with aspects of the present disclosure. 
         FIG. 74  illustrates the cartridge of  FIG. 67  showing a valve configuration for a reconstitution fluid path through in accordance with aspects of the present disclosure. 
         FIG. 75  illustrates the cartridge of  FIG. 67  showing a valve configuration for a compounding fluid path from in accordance with aspects of the present disclosure. 
         FIG. 76  illustrates the cartridge of  FIG. 67  showing a valve configuration for an air removal fluid path in accordance with aspects of the present disclosure. 
         FIG. 77  is a chart showing the positioning of certain valves in accordance with aspects of the present disclosure. 
         FIG. 78  illustrates a cross-sectional view of the cartridge of  FIG. 67  taken through an air filter in accordance with aspects of the present disclosure. 
         FIG. 79  illustrates a close up cross-sectional view of the cartridge of  FIG. 67  showing a portion of a fluid flow path in accordance with aspects of the present disclosure. 
         FIG. 80  illustrates a cross-sectional perspective view of a portion of the cartridge of  FIG. 67  taken through a needle housing in accordance with aspects of the present disclosure. 
         FIG. 81  illustrates a cross-sectional view of a portion of the cartridge of  FIG. 67  taken through an air-in-line fitment in accordance with aspects of the present disclosure. 
         FIG. 82A  illustrates a cross-sectional side view of the cartridge of  FIG. 67  showing a plurality of ports in accordance with aspects of the present disclosure. 
         FIG. 82B  illustrates a cross-sectional side view of a portion of a diluent manifold having a needle that may interface with one of the ports of  FIG. 82A  in accordance with aspects of the present disclosure. 
         FIG. 82C  illustrates a cross-sectional side view of a portion of the cartridge of  FIG. 67  showing port seals formed by a plurality of sealing members in accordance with aspects of the present disclosure. 
         FIG. 82D  illustrates a cross-sectional side view of the portion of the manifold of  FIG. 82B  compressed against the portion of the cartridge of  FIG. 82C  in accordance with aspects of the present disclosure. 
         FIG. 83  illustrates a cross-sectional perspective view of the cartridge of  FIG. 67  disposed adjacent a vial in accordance with aspects of the present disclosure. 
         FIG. 84  illustrates a cross-sectional side view of a portion of the cartridge of  FIG. 67  in the vicinity of a dual lumen needle in accordance with aspects of the present disclosure. 
         FIG. 85  illustrates a perspective view of a needle housing member of the cartridge of  FIG. 67  in accordance with aspects of the present disclosure. 
         FIG. 86  illustrates a perspective view of a portion of the cartridge of  FIG. 67  in the vicinity of the needle housing in accordance with aspects of the present disclosure. 
         FIG. 87  illustrates a cross-sectional top view of the cartridge of  FIG. 67  taken through a bayonet opening in accordance with aspects of the present disclosure. 
         FIG. 88  illustrates a cross-sectional perspective view of the cartridge of  FIG. 67  taken through the bayonet opening in accordance with aspects of the present disclosure. 
         FIG. 89  illustrates a cross-sectional perspective view of a portion of the cartridge of  FIG. 67  showing enlarged views of backpack engagement structures in accordance with aspects of the present disclosure. 
         FIG. 90  illustrates a cross-sectional view of an embodiment of a carousel having cartridges disposed thereon in accordance with aspects of the present disclosure. 
         FIG. 91  illustrates a perspective view of the carousel of  FIG. 90  in accordance with aspects of the present disclosure. 
         FIG. 92  illustrates a cross-sectional perspective view of a portion of the carousel of  FIG. 90  showing backpack engagement features of the carousel in accordance with aspects of the present disclosure. 
         FIG. 93  illustrates a perspective view of a mounting member for a cartridge and backpack assembly in accordance with aspects of the present disclosure. 
         FIG. 94  illustrates a cross-sectional perspective view of the carousel and backpack of  FIG. 93  showing tube management features of the backpack in accordance with aspects of the present disclosure. 
         FIG. 95  illustrates a cross-sectional perspective view a cartridge and backpack showing tube management features of the backpack in accordance with aspects of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     The detailed description set forth below describes various configurations of the subject technology and is not intended to represent the only configurations in which the subject technology may be practiced. The detailed description includes specific details for the purpose of providing a thorough understanding of the subject technology. Accordingly, dimensions may be provided in regard to certain aspects as non-limiting examples. However, it will be apparent to those skilled in the art that the subject technology may be practiced without these specific details. In some instances, well-known structures and components are shown in block diagram form in order to avoid obscuring the concepts of the subject technology. 
     It is to be understood that the present disclosure includes examples of the subject technology and does not limit the scope of the appended claims. Various aspects of the subject technology will now be disclosed according to particular but non-limiting examples. Various embodiments described in the present disclosure may be carried out in different ways and variations, and in accordance with a desired application or implementation. 
     The present system comprises multiple features and technologies that in conjunction form a compounding system that can efficiently reconstitute pharmaceuticals in a sterile environment and deliver the compounded pharmaceutical to a delivery bag for use on a patient. 
       FIG. 1  illustrates a compounder system  10  according to an embodiment.  FIG. 2  illustrates the system  10  with a transparent outer housing  12  and  FIG. 3  illustrates the system with the housing removed. The system comprises a carousel assembly  14  that contains up to 10 individual cartridges  16 . The carousel  14  can hold more or less cartridges  16  if desired. The cartridges  15  are disposable and provide unique fluid paths between a vial  18  containing a powdered drug (or concentrated liquid drug), multiple diluents, and a receiving container. The cartridges  16  may, if desired, also provide a fluid path to a vapor waste container. However, in other embodiments, filtered or unfiltered non-toxic waste may be vented from the compounder to the environment reducing or eliminating the need for a waste port. Each cartridge contains a piston pump and valves that control the fluid intake, outtake, and fluid path selection during the steps of the compounding process as the fluid moves through the cartridge and into a receiving container. 
     The carousel assembly  14  is mounted on the apparatus such that it can rotate to bring different cartridges  16  into alignment with the pump drive mechanism  20 . The carousel  14  is typically enclosed within a housing  12  that can be opened in order to replace the carousel  14  with a new carousel  14  after removing a used one. As illustrated, the carousel  14  can contain up to 10 cartridges  16 , allowing a particular carousel to be used up to 10 times. In this configuration, each carousel assembly can support, for example, 10 to 100 receiving containers, depending on the type of compounding to be performed. For example, for hazardous drug compounding, a carousel assembly can support compounding to ten receiving containers. In another example, for non-hazardous drug compounding such as antibiotic or pain medication compounding, a carousel assembly can support compounding to 100 receiving containers. The housing  12  also includes a star wheel  22  positioned underneath the carousel  14 . The star wheel rotates vials  18  of pharmaceuticals into position either in concert with, or separate from, the specific cartridges  16  on the carousel  14 . The housing  12  may also include an opening  24  for loading the vials  18  into position on the star wheel  22 . 
     Each one of the cartridges  16  in the carousel  14  is a disposable unit that includes multiple pathways for the diluent and vapor waste. These pathways will be described in detail with reference to, for example,  FIGS. 39-63 and 68A-77  later in the application. Each cartridge  16  is a small, single disposable unit that may also include a “backpack” in which a tube for connection to the receiving container (e.g., an IV bag, a syringe, or an elastomeric bag) may be maintained. Each cartridge  16  also may include a pumping mechanism such as a piston pump for moving fluid and vapor through the cartridge  16  as well as a dual lumen needle in a housing that can pierce a vial puck  26  on top of a vial  18  once the vial  18  has been moved into position by the pump drive mechanism  20 . For example, the needle may pierce the vial puck  26  via the compressive action of the vial puck  26 , which is moved towards the needle. Each cartridge  16  also includes a plurality of ports designed to match up with the needles of a plurality of diluent manifolds. Each cartridge  16  also includes openings to receive mounting posts and a locking bayonet from the pump head assembly  28 . Although a locking bayonet is described herein as an example, other locking mechanisms may be used to retrieve and lock a cartridge to the pump head (e.g., grippers, clamps, or the like may extend from the pump head). Each cartridge  16  also includes openings allowing valve actuators from the pump motor mechanism to interact with the valves on each cartridge  16 . 
     Adjacent the housing  12  that holds the vials  18  and the carousel  14  is an apparatus  30  for holding at least one container  32 , such as an IV bag  32  as shown in the figures. The IV bag  32  typically has two ports such as ports  34  and  36 . For example, in one implementation, port  34  is an intake port  34  and port  36  is an outlet port  36 . Although this implementation is sometimes discussed herein as an example, either of ports  34  and  36  may be implemented as an input and/or outlet port for container  32 . For example, in another implementation, an inlet  34  for receiving a connector at the end of tubing  38  may be provided on the outlet port  36 . In the embodiment shown, the IV bag  32  hangs from the holding apparatus  30 , which, in one embodiment is a post with a hook as illustrated in  FIGS. 1-3 . As discussed in further detail hereinafter, one or more of the hooks for hanging containers such as diluent containers, receiving containers, or waste containers may be provided with a weight sensor such as a load cell that detects and monitors the weight of a hung container. The holding apparatus  30  can take any other form necessary to position the IV bag  32  or other pharmaceutical container. Once the IV bag  32  is positioned on the holding apparatus  30 , a first tube  38  (a portion of which is shown in  FIG. 1 ) is connected from a cartridge  16  on the carousel  14  to the inlet  34  of the IV bag  32 . For example, the first tube may be housed in a backpack attached to the cartridge and extended from within the backpack (e.g., by an operator or automatically) to reach the IV bag  32 . A connector  37  such as a Texium® connector may be provided on the end of tube  38  for connecting to inlet  34  of receiving container  32 . 
     On the opposite side of the compounder  10  is an array of holding apparatuses  40  for holding multiple IV bags  32  or other containers. In the illustrated version of the compounder  10 , five IV bags  42 ,  44  are pictured. Three of these bags  42  may contain diluents, such as saline, D5W or sterile water, although any diluent known in the art may be utilized. An additional bag in the array may be an empty vapor waste bag  44  for collecting waste such as potentially hazardous or toxic vapor waste from the mixing process. An additional bag  44  may be a liquid waste bag. The liquid waste hag may be configured to receive non-toxic liquid waste such as saline from a receiving container. As discussed in further detail hereinafter, liquid waste may be pumped to the waste hag via dedicated tubing using a mechanical pump. In operation, diluent lines and a vapor waste line from the corresponding containers  42  and  44  may each be connected to a cartridge  16  through a disposable manifold. 
     The compounding system  10  also includes a specialized vial puck  26  designed to attach to multiple types of vials  18 . In operation, the vial puck  26  is placed on top of the vial  18  containing the drug in need of reconstitution. Once the vial puck  26  is in place, the vial  18  is loaded into the star wheel  22  of the compounder  10 . Mating features on the vial puck  26  provide proper alignment both while the vial puck  26  is in the star wheel  22  and when the vial puck  26  is later rotated into position so that the compounder  10  can remove it from the star wheel  22  for further processing. 
     The pump drive mechanism  20  is illustrated in  FIG. 4 , and in an exploded view in  FIG. 5 , according to an embodiment. In the embodiment shown in  FIGS. 4 and 5 , the pump drive mechanism  20  comprises a multitude of sections. At one end of the pump drive mechanism  20  is the rotation housing  46 , which holds the drive electronics and includes locking flanges  94  on its housing  96  for flexible tubing  50  which may run from one or more diluent containers and/or waste containers to one or more corresponding manifolds. The rotation housing  46  is capable of rotating around its axis to rotate the rest of the pump drive mechanism  20 . The rotation housing  46  includes bearing ribs  52  on its ends which allow it to rotate. For example, the pump drive mechanism may be configured to rotate through any suitable angle such as up to and including 180°, or more than 180°. 
     Next to the rotation housing  46  is the motor mount  54 , which is shown alone from various angles in  FIGS. 6-8 , according to an embodiment. In the embodiment shown in  FIGS. 4-8 , the cam housing  56 , shown in further details from various angles  FIGS. 9-11 , is connected to the motor mount  54 , which includes cams and gears that control the rotary motion of the motors and the axial motion of the pump drive mechanism  20  as it moves into position to pick up a cartridge  16  and a vial  18 . 
     The compounder system also includes a diluent magazine (not shown) that mounts in a slot  60  located on the side of the pump drive mechanism. The diluent magazine may be a disposable piece configured to receive any number of individual diluent manifolds operable as diluent ports. The diluent manifolds (not shown) may be modular so they can easily and removably connect to each other, the magazine, and/or connect to the pump drive mechanism  20 . 
     The final portion of the pump drive mechanism  20  is the pump head assembly  28 . The pump head assembly  28  includes the vial grasping arms  76 , the vial lift  78 , the pump cartridge grasp  80 , the pump piston eccentric drive shaft  82  with drive pin  222 , the valve actuation mechanisms  84 , as well as the motors that allow the pump drive mechanism  20  to move forward and back and to rotate in order to mix the pharmaceutical in the vial  18  once the diluent has been added to it. The compounder  10  may also include an input screen  86  such as a touch screen  86  as shown in the figures to provide data entry by the user and notifications, instructions, and feedback to the user. 
     The operation of the compounder system  10  will now be generally described in the flowchart illustrated at  FIG. 21 , according to an embodiment. In the first step  88 , a user inserts a new diluent manifold magazine having a plurality of manifolds (e.g., diluent manifolds and waste manifolds) into the slot  60  on the side of the pump head assembly  28 . Manifolds may be loaded into the magazine before or after installing the magazine in the slot  60 . The manifolds maintain needles inside the housing of the manifold until the cartridge  16  is later locked in place. The magazine may contain any number of diluent manifolds and vapor waste manifolds. In one illustrative system, there may be three diluent manifolds and one vapor waste manifold. In the next step  92 , diluent tubing is connected to corresponding diluent bags. The tubes may be routed through locking flanges on a surface (e.g., the front surface) of the compounder frame to hold them in place. For example, in the illustrated embodiment of  FIG. 24 , the tubes are held in place with locking flanges  2402  on the frame of the compounder. Alternatively, other types of clips or locking mechanisms known in the art may be used to hold the tubes securely in place. In the illustrated embodiment of  FIG. 4 , the additional flanges  94  positioned on the outside housing  96  of the pump drive mechanism  20  are provided for securing internal wiring of the compounder. In the next step  98 , waste tubing may be connected to the vapor waste bag  44 . In other embodiments, tubing may be pre-coupled between the manifolds and associated containers such as diluent containers and/or waste containers and the operations of steps  92  and  98  may be omitted. 
     If desired, in the next step  100 , a new carousel  14  may be loaded into a carousel mounting station such as a carousel hub of the compounder system. The carousel  14  may contain any number of disposable cartridges  16  arranged in a generally circular array. In the next step  110 , a vial puck  26  is attached to the top of a vial  18  of a powdered or liquid pharmaceutical for reconstitution and the vial  18  is loaded into the star wheel  22  under the carousel  14  in the next step  112 . Step  110  may include loading multiple vials  18  into multiple vial puck recesses in star wheel  22 . After one or more vials are loaded into the star wheel, the vials are rotated into position to enable and initiate scanning of the vial label of each vial. In one embodiment, the user will be allowed to load vials into the star wheel until all vial slots are occupied with vials before the scanning is initiated. A sensor may be provided that detects the loading of each vial after which a next vial puck recess is rotated into the loading position for the user. Allowing the user to load all vials into the star wheel prior to scanning of the vial labels helps increase the efficiency of compounding. However, in other implementations, scanning of vial labels may be performed after each vial is loaded or after a subset of vials is loaded. Following these setup steps, the next step  114  is for a user to select the appropriate dosage on the input screen. 
     After the selection on the input screen  86 , the compounder  10  begins operation  116 . The star wheel  22  rotates the vial into alignment  118  with the vial grasping calipers  76  of the pump head assembly  28 . The vial puck  26  includes, for example, gears that interface with gears coupled to a rotational motor that allow the vial  18  to rotate  120  so that a scanner (e.g., a bar code scanner or one or more cameras) can scan  122  a label on the vial  18 . The scanner or camera (and associated processing circuitry) may determine a lot number and an expiration date for the vial. The lot number and expiration date may be compared with other information such as the current date and/or recall or other instructions associated with the lot number. Once the vial  18  is scanned and aligned, in the next step  124  the pump drive mechanism  20  moves forward into position to grip the vial  18  with the calipers  76 . The forward movement also brings the mounting posts  130  and locking bayonet  128  on the front of the pump head assembly  28  into matching alignment with corresponding openings on a cartridge  16 . In the next step  126  the cartridge  16  is locked in place on the pump head assembly  28  with the locking bayonet  128  and the calipers  76  grip  132  the vial puck  25  on the top of the vial  18 . The calipers  76  then remove  132  the vial  18  from the star wheel  22  by moving backward, while at the same time pulling  134  the cartridge  15  off of the carousel  14 . 
     In some embodiments, the cartridge  16  includes a backpack that includes a coiled tube. In this embodiment, in step  136  the pump drive mechanism  20  tilts the cartridge  16  toward the user to expose the end of the tube and prompts  138  the user to pull the tube out of the backpack and connect it to the receiving bag  32 . In an alternative embodiment, the tube  38  is exposed on the side of the carousel  14  once the cartridge  15  is pulled away from the carousel  14 . In another alternative embodiment, the tube  38  is automatically pushed out (e.g., out of the backpack) thus allowing the user to grab onto the connector located at the end of the tube and connect to the receiving container. The system prompts  138  the user to pull the tube out from the carousel  14  and connect it to the input  34  of the IV bag  32 . Once the tube  38  is connected, in step  140  the user may notify the compounder  10  to continue the compounding process by interacting with the input screen  86 . 
     At step  142 , the vial  18  is pulled up towards the cartridge  16  so that one or more needles such as a coaxial dual lumen needle of the cartridge  16  pierce the top of the vial puck  26  and enter the interior of the vial  18 . Although the example of  FIG. 21  shows engagement of the needle with the vial puck after the user attaches the tube from the cartridge to the receiving container, this is merely illustrative. In another embodiment, steps  138  and  140  may be performed after step  142  such that engagement of the needle with the vial puck occurs before the user attaches the tube from the cartridge to the receiving container. 
     Diluent is pumped at step  144  into the vial  18  through the cartridge  16  and a first needle in the proper dosage. If necessary, a second or third diluent may be added to the vial  18  via a second or third diluent manifold attached to the cartridge  16 . Simultaneously, vapor waste is pumped  144  out of the vial  18 , through a second needle, through the cartridge  16  and the vapor waste manifold, and into the vapor waste bag  44 . The valve actuators  84  on the pump head assembly  28  open and close the valves of the cartridge  16  in order to change the fluid flow paths as necessary during the process. Once the diluent is pumped into the vial  18 , the pump drive mechanism  20  agitates the vial  18  in the next step  146  by rotating the vial lift  78  up to, for example 180 degrees such that the vial  18  is rotated between right-side-up and upside-down positions. The agitation process may be repeated for as long as necessary, depending on the type of pharmaceutical that is being reconstituted. Moreover, different agitation patterns may be used depending on the type of drugs being reconstituted. For example, for some drugs, rather than rotating by 180 degrees, a combination of forward-backward, and left-right motion of the pump head may be performed to generate a swirling agitation of the vial. A plurality of default agitation patterns for specific drugs or other medical fluids may be included in the drug library stored in (and/or accessible by) the compounder control circuitry. Once the agitation step is complete, the pump drive mechanism rotates the vial to an upside down position or other suitable position and holds it in place. In some embodiments, a fluid such as a diluent already in the receiving container  32  may be pumped (e.g., through the cartridge or via a separate path) into a liquid waste container to allow room in the receiving container for receiving the reconstituted medicine. 
     In the next step  148 , the valve actuators  84  reorient the valves of the cartridge and the pumping mechanism of the cartridge  16  is activated to pump  150  the reconstituted drug into the receiving bag  32  through the attached tube. Once the drug is pumped into the receiving bag  32 , in the next step  152  the pump drive mechanism  20  clears the tube  38  by either pumping filtered air or more diluent through the tube  38  into the receiving bag  32  after another valve adjustment to ensure that all of the reconstituted drug is provided to the receiving bag  32 . In some scenarios, a syringe may be used as a receiving container  32 . In scenarios in which a syringe is used as the receiving container  32 , following delivery of the reconstituted drug to the syringe, a vacuum may be generated in tube  38  by pump drive mechanism  20  to remove any air or other vapors that may have been pushed into the syringe so that, when the syringe is removed from tube  38 , the reconstituted drug is ready for delivery to a patient and no air or other unwanted gasses are present in the syringe. 
     The system then prompts  154  the user to remove the tube  38  from the receiving container  32 . The user may then insert the connector (e.g., a Texium® or SmartSite® connector) into its slot in the backpack or carousel and an optical sensor in the pump head may sense the presence of the connector and automatically retract the tube into either the carousel or the backpack. The tube is pulled back into either the carousel  14  or the backpack, depending on which type of system is in use. In the next step  156 , the compounder  10  rotates the vial  18  back into alignment with the star wheel  22  and releases it. The used cartridge  16  may also be replaced on the carousel  14 . The used cartridge may be released when a sensor in the pump drive determines that the tube has been replaced in the cartridge (e.g., by sensing the presence of a connector such as a Texium® connector at the end of the tube in the backpack of the cartridge through a window of the cartridge). The carousel  14  and/or star wheel  22  then may rotate  158  to a new unused cartridge  16  and/or a new unused vial  18  and the process may be replicated for a new drug. In some circumstances (e.g., multiple reconstitutions of the same drug), a single cartridge may be used more than once with more than one vial. 
     The cartridges  16  are designed to be disposable, allowing a user to utilize all the cartridges  16  in a given carousel  14  before replacing the carousel  14 . After a cartridge  16  is used, the carousel  14  rotates to the next cartridge  16  and the system software updates to note that the cartridge  16  has been used, thus preventing cross-contamination from other reconstituted drugs. Each cartridge  16  is designed to contain all the necessary flow paths, valves, filters and pumps to reconstitute a drug with multiple diluents if necessary, pump the reconstituted drug into the receiving container, pump vapor waste out of the system into a waste container, and perform a final QS step in order to make sure that the proper amount of drug and diluent is present in the receiving container. This complete package is made possible by the specific and unique construction of the cartridge  16 , its flow paths, and its valve construction. 
     An embodiment of a cartridge  16  is illustrated in  FIG. 22 . As shown in  FIG. 22 , cartridge  16  may include a cartridge frame  160 , a cartridge bezel  164 , as well as a piston pump  166 , a needle housing  168  and a needle assembly  170 . The cartridge frame  160  provides the main support for each cartridge  16  and includes diluent chambers, a vapor waste chamber, a pumping chamber, a hydrophobic vent, an exit port, and/or other features as described hereinafter that can be connected to a tube that connects to the receiving container  32 . 
     The frame  160  of the cartridge  16  also includes locating features that allow each cartridge  16  to be removably mounted to the pump head assembly  28 . These features include, for example, three openings  198  to receive mounting posts  130  from the pump head assembly  28 , and a keyhole  210  that allows a locking bayonet  128  to be inserted therein and turned to lock the cartridge  16  to the pump head assembly  28  for removal from the carousel  14 . An outlet port extension  220  may be present in some embodiments. The piston pump  166  is mounted within a chamber with a rod  194  positioned within a silicone piston boot. Furthermore, the bezel  164  includes openings  228  in which the valves  190  of the sealing membrane are located and be accessed by the valve actuators  84 . Moreover, the bezel  164  includes openings  230  that allow a fluid manifold to be connected to the diluent and vapor waste chambers in the cartridge  16 . As discussed in further detail hereinafter, bezel  164  may also include an opening that facilitates the detection of a connector (e.g., a. Texium® or SmartSite® connector) when the user inserts the connector into the provided slot when compounding is complete. In operation, the needles of the fluid manifold enter through the openings  230  in the bezel  164  and pierce the sealing membrane to gain fluidic access to the diluent and vapor waste chambers defined in the cartridge  16  between the sealing membrane and the cartridge frame  160 . Further details of various embodiments of the cartridge  16  will be discussed hereinafter. 
     Referring to  FIG. 23 , an exemplary embodiment of a carousel  14  removed from the compounder  10  is illustrated, according to an embodiment. The carousel  14  of  FIG. 23  includes an array of ten cartridges  16  in this embodiment, but it should be understood that more or fewer cartridges  16  can be present on the carousel  14 , leaving some of the carousel  14  pockets  500  empty, or the frame  510  of the carousel can be designed to have more or fewer cartridge pockets  500 . In some implementations, the carousel  14  may also, optionally, include a cover  511  that prevents a user from accessing the tubes coupled to each of the cartridges  16  directly. In these implementations, the cover  511  may be removed if necessary to access the backs of the cartridges  16 . In the example implementation of  FIG. 23 , a connector such as a Texium® attachment  548  is disposed adjacent each cartridge  16 , the attachment  548  being attached to the tube  38  that runs from the extension  220  on each cartridge  16 . 
       FIGS. 24-29  show the compounder  10  according to another embodiment. As shown in  FIG. 24 , holding apparatus  40  may be implemented as an extended arm providing support for mounting devices for each of containers  42  and  44 . Holding apparatus  40  and holding apparatus  30  may each include one or more sensors such as weight sensors configured to provide weight measurements for determining whether an appropriate amount of fluid has been added to or removed from a container or to confirm that fluid is being transferred to and/or from the appropriate container (e.g., that the appropriate diluent is being dispensed). A scanner  2404  may be provided with which each diluent container and/or the receiving container can be scanned before and/or after attachment to compounder  10 . As shown in  FIG. 24 , a carousel cover  2400  and tube management structures  2402  may also be provided on compounder  10  in various embodiments. For example, tubes connected between containers  42  and/or  44  and corresponding manifolds can each be mounted in a groove of tube management structure  2402  to prevent tangling or catching of the tubes during operation of compounder  10 . 
     As shown in  FIG. 25 , an opening  2502  may be provided by which vials  18  can be installed in the star wheel. Additionally, an exterior pump  2500  may be provided for pumping non-toxic liquid waste from, for example, receiving container  32  to a waste container  44  (e.g., for pumping a desired amount of saline out of receiving container  32  quickly and without passing the liquid waste through a cartridge and/or other portions of the compounder). 
     A fluidics module  2504  may be provided that includes several container mounts  2506 . Container mounts  2506  may be used for hanging diluent and waste containers and may include sensor circuitry for sensing when a container has been hung and/or sensing the weight of the container. In this way, the operation of compounder  10  can be monitored to ensure that the correct diluent contain has been scanned and hung in the correct location and that the waste is being provided in an expected amount to the appropriate waste container. 
     As shown in  FIG. 26 , pump  2500  and display  86  may be mounted to a chassis  2600 . Pump drive  20  may be mounted partially within the chassis  2600  with pump head assembly  28  extending from the chassis to a position which allows the pump head assembly to rotate (e.g., to turn over or agitate a vial). Carousel  14  is also shown in  FIG. 26  without any cartridges mounted therein so that cartridge mounting recesses  500  can be seen. 
     Star wheel  22  (sometimes referred to herein as a vial tray) is shown in  FIG. 26  with several empty vial puck recesses  2604 . Vial tray  22  may be rotated and an actuating door  2608  may be opened to facilitate loading of vials  18  into the vial puck recesses  2604  in vial tray  22 . In some embodiments, door  2608  may be closed before rotation of vial tray  22  to ensure that the operator&#39;s fingers are not in danger of injury from the rotating tray. However, this is merely illustrative. In other embodiments a sensor such as sensor  2650  (e.g., a light curtain) may be provided instead of (or in addition to) door  2608  to sense the presence of an operator in the vicinity of tray  22  and prevent rotation of the tray if the operator or any other obstruction is detected. 
     Similarly, a lid may be provided for carousel  14  to prevent contamination of cartridges  16  loaded therein, and to prevent injury to an operator due to rotation of the carousel. A lid sensor (not shown) may also be provided to detect the position (e.g., an open position or a closed position) of the lid. Rotation of carousel  14  may be prevented if the lid is not detected in a closed position by the lid sensor. 
     Each vial  18  that is inserted may be detected using a sensor such as sensor  2652  (e.g., a load sensor or an optical sensor) when placed in a vial puck recess  2604 . When detected, the inserted vial may be moved to a scanning position by rotating vial tray  22  and then the inserted vial  18  may be rotated within its position in vial tray  22  using a vial rotation motor  2602  to allow the vial label to be scanned. 
     A reverse perspective view of compounder  10  is shown in  FIG. 27  in which scanning components can be seen. In particular, a camera  2700  is mounted in an opening in chassis  2600  and configured to view a vial  18  in a scanning position. Motor  2602  may rotate vial  18  through one or more full rotations so that camera  2700  can capture images of the vial label. In some embodiments, an illumination device  2702  (e.g., a light-emitting diode or other light source) may be provided that illuminates vial  18  for imaging with camera  2700 . 
     As shown in  FIG. 27  one or more gears  2704  coupled to motor  2602  may be provided that engage corresponding gears on a vial puck  26  to which a vial  18  is attached at the scanning position. The vial tray  22  may be rotated so that the vial puck gears engage the rotation motor gears so that when the motor  2602  is operated the vial  18  is rotated. 
       FIG. 27  also shows how a magazine  2706  containing one or more manifolds may be mounted in a recess in pump head assembly  28 . A magazine slot in magazine  2706  for the vapor waste manifold may be keyed to prevent accidental connection of a diluent manifold in that slot (or a waste manifold in a diluent slot in the magazine). Other diluent slots in magazine  2706  may have a common geometry and thus any diluent manifold can fit in the magazine diluent slots. One or more manifold sensors such as manifold sensor  2750  (e.g., an optical sensor) may be provided in the manifold recess in pump head assembly  28 . Manifold sensor  2750  may be configured to detect the presence (or absence) of a manifold in a manifold recess (slot) in magazine  2706  to ensure that an appropriate manifold (e.g., a diluent manifold or waste manifold) is loaded at the expected position for compounding operations. In this way, the pump head may detect a manifold presence. The pump head and/or manifold sensors may communicate with the diluent load sensors to ensure proper positioning of the diluent manifolds. Various operational components  2708  such as valve actuators, needle actuators, mounting posts, a locking bayonet, and a drive pin can also be seen extended from pump head assembly  28  which are configured to secure and operate a pump cartridge  16 . 
     An exploded view of various components of compounder  10  is shown in  FIG. 28 . Components discussed above such as display  86 , pump  2500 , dose hanger  30 , fluidics module  2504 , pump drive  20  with pump head assembly  28 , camera  2700 , and lighting device  2702  are shown. Additional components such as a chassis base  2810  and chassis housing  2812  of chassis  2600  are also shown in  FIG. 28 . A rear panel  2802  having an electronics assembly  2803  can be mounted to chassis housing  12  and pump drive  20  may be seated in an opening  2808  in chassis housing  2812  that allows pump head assembly  28  to protrude from chassis housing  2812 . Processing circuitry for managing operations of compounder system  10  may be included in electronics assembly  2803 . 
     A vial tray and carousel drive assembly  2800  is also shown in which actuating door  2608  and a carousel hub  2814  can be seen. Carousel  14  may be placed onto carousel hub and rotated by vial tray and carousel drive assembly  2800  operating to rotate hub  2814  to move a selected cartridge in the carousel into position to be retrieved and operated by pump drive  20 . Vial tray and carousel drive assembly  2800  may include separate drive assemblies for the vial tray and for the carousel such that vial tray  22  and carousel  14  may be rotated independently. 
       FIG. 29  shows another perspective view of compounder  10  highlighting the locations of various particular components such as the carousel  14  with cartridges  16  mounted therein, a cartridge  16  having a backpack  2900 , a vial puck  26  for mounting vials  18 , and pump head assembly  28  with a diluent magazine  2706  containing a plurality of manifolds  2906  in accordance with an embodiment. Further features of the pump cartridge  16  will be described hereinafter in connection with  FIGS. 30-95  in accordance with various embodiments. 
     The cartridges  16  are designed to be disposable, allowing a user to utilize all the cartridges  16  in a given carousel  14  before replacing the carousel  14 . After a cartridge  16  is used, the carousel  14  rotates to the next cartridge  16 , and the system software updates to note that the cartridge  16  has been used, thus preventing cross-contamination from other reconstituted drugs. Each cartridge  16  is designed to contain all the necessary flow paths, valves, filters, pistons, and pumps to reconstitute a drug with multiple diluents if necessary, pump the reconstituted drug into the receiving container, pump vapor waste out of the system into a waste container, and perform a final QS step in order to make sure that the proper amount of drug and diluent is present in the receiving container. The amount of diluent pumped into vials for reconstitution and the amount of medication pumped out of vials to the receiving container are controlled by the volumetric piston pump in the cartridge which can be compared against weights obtained by the gravimetric scales (e.g., one or more diluent load cells and a receiving container load cell) of the compounder for quality control. This complete package is made possible by the specific and unique construction of the cartridge  16 , its flow paths, and its valve construction. 
     The construction of an embodiment of a cartridge  16  is illustrated in  FIGS. 30-34 . A fully constructed cartridge  16  is shown in  FIGS. 30-32, 33A and 33B . An exploded version of a cartridge  16  is illustrated in  FIG. 34  and shows the three main portions of the cartridge  16 : the cartridge frame  160 , the cartridge sealing membrane  162 , the cartridge bezel  164 , as well as the piston pump  166 , the needle housing  168  and the needle assembly  170  according to an embodiment. 
     Referring to  FIG. 35 , a front view of the cartridge frame  160  is illustrated. The cartridge frame  160  provides the main support for each cartridge  16  and includes diluent chambers  172 , a vapor waste chamber  174 , a pumping chamber  176 , a hydrophobic vent  178 , an exit port  180  that can be connected to a tube  38  that connects to the receiving container  32 , a mount  182  for a piston boot  184 , a piston pump  166  and a cartridge needle housing  168  to hold the needles  316 ,  318  that are used to move liquids and waste vapor to and from the vial  18  during reconstitution and filling of the receiving container  32 , numerous flow paths  186  for diluents, vapor waste, filtered air, and reconstituted drugs, and chambers  188  in which valves  190  are positioned in order to modify the flow paths  186  when necessary. 
       FIG. 35  illustrates a cartridge frame  160  with the other portions of the cartridge  16  removed. In this embodiment, three chambers  172  are defined in the surface  192  of the frame  160 , one for each type of diluent. Adjacent the three diluent chambers  172  is a vapor waste chamber  174  for connection to a vapor waste container  44 . A chamber  176  is included for positioning a piston pump  166 , as shown, for example, in  FIGS. 22, 30-32 and 39 . The piston pump  166  is mounted within this chamber  176  with a rod  194  positioned within an elastomeric (e.g., silicone) piston boot  184 , which is shown in  FIG. 34  before insertion into the pumping chamber  176 . A pump chamber opening  196  allows fluidic access to the pump chamber  176 . 
     The frame  160  of the cartridge  16  also includes locating features that allow each cartridge  16  to be removably mounted to the pump head assembly  28 . These features include three openings  198  to receive mounting posts  130  from the pump head assembly  28 , and a keyhole  210  that allows a locking bayonet  128  to be inserted therein and turned to lock the cartridge  16  to the pump head assembly  28  for removal from the carousel  14 . 
     The cartridge needle housing  168  is shown in, for example,  FIG. 37  and extends from the bottom  212  of the cartridge frame  160  and may be designed to be removable by snapping a pair of locking flanges  214  on the needle housing  168  into flange openings  216  in the cartridge frame  160  (see, e.g.,  FIG. 30 ). The cartridge needle housing  168  is designed to prevent accidental user contact with the needle assembly  170  and to maintain the sterility of the needles  316 ,  318 . The needle housing  168  also receives the vial puck  26  in a position to allow the needles  316 ,  318  to pierce the vial puck  26 .  FIG. 38  illustrates a cross sectional view of a portion of cartridge  16  with the needles  316 ,  318  in place. A dual lumen needle is typically used. For example, a dual lumen needle may include a 22 gauge or 24 gauge (g) needle  316  positioned within a 18 gauge needle  318  in one embodiment. In various embodiments, the needle size can be any suitable size, as long as the vapor needle is sufficiently smaller than the liquid needle. In particular, the needle size may be determined based on the desired flow rate. In one particular implementation, the dual lumen needle may include a 18 g fluid needle and a 24 g vapor needle. However, in other implementations, a larger fluid needle (e.g., a 16 g or 17 g needle) may be used. This dual lumen design allows the needles  316 ,  318  of the cartridge  16  to add and remove diluent and reconstituted drug as well as remove vapor waste from the vial  18  as the vial  18  is filled with diluent during the reconstitution process. The needles  316 ,  318  are held in place in the needle housing with respective needle housing members  317 A,  317 B (e.g., overmolded needle housing members) and in operation, can be extended into the vial  18  by, for example, pressing the vial against the needle housing to compress a spring within the needle housing and allow the portion of the needle housing to be push up to expose needles  316 ,  318 . 
     The illustrated embodiment of the cartridge frame  160  in  FIGS. 35-37 and 39  also includes eight valve chambers  188 . These chambers  188 , in combination with portions of sealing membrane  162  in spaced opposition to the chambers form valves  190 , which will be discussed in detail later in the application. The valve chambers  188  in conjunction with the valves  190  allow opening and closing of various fluid flow paths  186  defined on the surface  192  of the cartridge frame  160 . The frame  160  also includes a hydrophobic vent  178  for air intake. If desired, a filter can be present within this vent  178 . The frame  160  includes an outlet port  180  (sometimes referred to herein as a receiving container port) for connection to a tube  38  that runs to a receiving bag  32 . The outlet port  180  is also shown in  FIGS. 36 and 37 , which show the back  200  of the frame  160 .  FIG. 37  illustrates an extension  220  that may be provided in some embodiments. Extension  220  may be provided as a tube management structure and may include an opening  1801  through which a tube a tube from outlet port  180 ) can be fed to prevent tangling or other interference between tubes of various cartridges. 
       FIG. 39  illustrates the piston pump  166  positioned in the frame  160 . The piston pump  166  is utilized in conjunction with the adjustable flow paths  186  in the cartridge  16  to move diluent, vapor waste to and from the vial  18  and the receiving bag  32 , and air through the fluid pathways  186  during the reconstitution process. When the cartridge  16  is removed from the carousel  14  and locked to the pump head assembly  28  through the operation of the mounting posts  130  and locking bayonet  128 , the piston pump  166  may be driven by a motor that rotates an eccentric drive shaft  82  as with a drive pin  222  shown in  FIGS. 13 and 14 . The drive pin  222  is parallel but offset from the rotational axis of the drive shaft, which creates a sinusoidal motion and drives the piston pump  166  in an up and down motion to perform its pumping operations. The operation of the piston pump  166  and the valving system in the cartridge  16  will be explained in detail below after the description of the other elements of the cartridge  16 . 
     The next element of the cartridge  16  is the sealing membrane  162  which is illustrated apart from the other elements of the cartridge  15  in  FIGS. 40-42 . The sealing membrane  162  is preferably constructed from silicone or another flexible or compliant material that can provide an air and liquid tight seal between the cartridge frame  160 , the sealing membrane  162 , and the cartridge bezel  164 . The sealing membrane  162  includes openings  224  for the mounting posts  130  of the pump head assembly  28  as well as an opening  226  for the locking bayonet  128 . These openings allow the mounting posts  138  and locking bayonet  128  to pass through the sealing membrane  162  into position on the cartridge frame  160  while also providing an air and liquid tight seal to maintain the various fluid flow paths  186  of the cartridge  16 . 
     The sealing membrane  162  also includes eight portions that from valves  190  in the illustrated embodiment. The valves  190  are defined in part by upward extending hollow portions of the sealing membrane  162 . From the back of the membrane  162 , the valves  190  are indentations in the surface. More or fewer valves  190  may be utilized depending on the design of the cartridge  16  and the number of diluents and fluid flow paths  186  necessary for the cartridge  16  operation. The functions of these valves  190  will be explained in conjunction with the operation of the fluid flow paths  186  of the cartridge  16 . The valves  190  themselves are shown in close up in  FIG. 43 . 
     When the sealing membrane  162  is mounted on the cartridge frame  160  and the bezel  164  is mounted on the sealing membrane  162 , a liquid and vapor sealed area is formed between the cartridge frame  160  and the sealing membrane  162  which forms the fluid flow channels  186 . A cross section of an exemplary channel is shown in  FIG. 44 . The fluid flow channels  186  will be described in relation to the operation of the cartridge  16  itself. When the sealing membrane  162  is positioned on the cartridge frame  160 , the valves  190  are seated in the valve chambers  188  defined on the cartridge frame  160  to create chambers that may be opened m and closed by the valves  190  to adjust the fluid flow paths  186  during operation. 
     The third portion of the cartridge  16  is a bezel  154  that may, for example, constructed of polycarbonate. Various views of an exemplary bezel  167  are shown in  FIGS. 45 and 46 . The bezel  164  is mounted on top of the sealing membrane  162  to sandwich the sealing membrane  162  between the bezel  164  and the cartridge frame  160 . The bezel  164  includes openings  229  for the posts  130  of the pump head assembly  28 , the locking bayonet  128  and the valve actuators  84 . Furthermore, the bezel  164  includes openings  228  in which the valves  190  of the sealing membrane  162  can sit and be accessed by the valve actuators  84 . Moreover, the bezel  164  includes openings  230  that allow a fluid manifold to be connected to the diluent  172  and vapor waste chambers  174  in the cartridge  16 . In operation, the needles of the fluid manifold enter through the openings  230  in the bezel  164  and pierce the sealing membrane  162  to gain fluidic access to the diluent  172  and vapor waste chambers  174  defined in the cartridge  16  between the sealing membrane  162  and the cartridge frame  160 . The bezel  164  also includes upstanding extensions  232  on its inner side  234  that press down on the sealing membrane  162  to maintain a tight seal.  FIG. 47  illustrates a transparent version of the bezel  164  positioned on the sealing membrane  162 .  FIG. 48  illustrates the clear bezel  164  on the sealing membrane  162  with the piston pump  166  in place. 
     Before describing the various fluid flow paths in the cartridge  16 , the operation of the pumping and valve mechanisms will be described with reference to  FIGS. 3, 4, 13 and 14 . The piston pump  166  acts as a positive displacement pump that has significant advantages over a traditional peristaltic pump mechanism. First, it has the best rate accuracy and flow continuity regardless of the pump&#39;s orientation or environmental conditions. Second, it is able to push an excess of 50 psi into elastomeric pumps. As previously described, the piston pump  166  is positioned within the cartridge  16  in a silicone piston pump boot  184 . The pump mechanism is driven by a motor in the pump motor mechanism  20  which rotates an eccentric drive shaft  82  and drive pin  222  on the pump head assembly  28  which controls the movement of the piston  166  as well as the valve actuators  84 . In operation, the cartridge  16  is placed on the cartridge grasp  80  on the locating posts  130  and locked in place by the locking bayonet  128 . This aligns the valves  190  with the valve actuators  84  and the eccentric drive shaft  82  and pin  222  with the piston pump  166 . The piston  166  is driven by the eccentric drive pin  222 . The pin  222  is parallel to but offset from the rotational axis of the drive shaft, which produces sinusoidal motion that is converted to an axial movement of the piston  166 . 
     The valve actuators  84  are illustrated in  FIGS. 13 and 14 , which show the pump head assembly  28  removed from the rest of the pump motor mechanism  20 . Each one of the valves  190  has a corresponding valve actuator  84  that is controlled by a geared cam to cause axial movement of the valve actuator  84  into contact with the valve  190  to close the valve  190  and away from the valve  190  to open the valve  190 . In one embodiment, eight valve actuators  84  are provided, one for each valve  190 , and they are aligned with the positions of the valves  190  so they can extend through the openings  228  in the bezel  154  of the cartridge  16  and contact the valves  190 . The valve actuators  84  are software controlled so that they can automatically cause the valves  190  to open and close depending on which flow paths  186  need to be opened and closed. 
     The valve actuators  84  are operated at different times in the pumping cycle depending on the required fluid flow path. The fill portion of the piston  166  starts as the piston rod  194  moves, and the inlet valve is opened and the outlet valve is closed. Other valves  190  will be opened and closed depending on the necessary fluid flow paths. At the end of the fill portion of the cycle when the piston  166  is at the bottom dead center position, the valve actuation changes to close the inlet and open the outlet valves. At this point, the delivery portion of the cycle starts and the piston  166  moves in the opposite direction. The delivery portion of the cycle ends when the piston  166  reaches the top dead center location, which is the home location. When the piston  166  reaches this position, a new cycle is started. 
     The movement of the eccentric drive shaft  82  can be in a clockwise direction under normal conditions when delivering fluid and counter clockwise when pulling fluid. The pump mechanism can be made to pump backwards depending on the required flow path. The drive shall not be inadvertently back driven in either direction by the effects of pressure in the disposable line up to 50 psi. 
     The operation of the cartridge  16  and the adjustment of the fluid flow paths  186  will now be described with reference to  FIGS. 49-62  according to an embodiment.  FIG. 49  shows a view of a cartridge  16  with both the bezel  164  and the sealing membrane  162  removed for clarity. It is to be understood that in normal operation, the bezel  164  seals the sealing membrane  162  against the cartridge frame  160  to form the various air and liquid tight flow paths  186 .  FIG. 49  illustrates a cartridge  16  with three diluent chambers  172  and one vapor waste chamber  174 . An opening  196  allows access to the piston pump chamber  176  and allows the piston pump  166  to move fluid and/or vapor waste into and out of the pump chamber  176 . The illustration also shows a port  180  to the receiving container  32 , which in operation, will have a flexible tube attached to it. This opening  180  can also be seen in  FIG. 37 . Also shown are the vent port  178  for allowing filtered air to enter the system as well as a needle vent port  236  for allowing air to vent from the needle assembly  170  and a needle liquid port  320  to allow liquid to enter the needle assembly  170 . 
     In the embodiment shown in  FIGS. 49-62 , the eight valves  190  are designated as  1 A,  1 B,  2 A,  2 B,  3 A,  3 B,  4 A and  4 B. It should be noted that in these figures, the valves  190  themselves are not shown. Valves  190  are formed as are part of the sealing membrane  162  as illustrated in  FIGS. 40-42  and project into the chambers  188  that are designated with the valve numbers in  FIGS. 49, 50, 53, 54, 56, 57, 58, 59, and 61-62 . Also shown are the diluent chambers  172 , the diluent lines  322 , the vapor waste chamber  174 , and the vapor waste line  324 . All of these lines and chambers are formed in the surface  192  of the cartridge frame  160  and the sealing membrane  162  seals them once it is placed on top of the cartridge frame  160  and locked in place with the bezel  164 . 
       FIG. 50  is a chart showing the position and operation of the valves  190  during various portions of a reconstitution process. Certain valves  190  are associated with each other and/or with other parts of the system. For example, valves  1 A and  1 B are tied to the pumping mechanism and valves  3 A,  3 B,  4 A and  4 B are tied to each other and are timed 180° apart.  FIG. 51  is a flow chart illustrating the steps of the process according to an embodiment. 
     Before the process begins, setup steps  238  and  240  may be performed to attach a flexible line  50  between each manifold and the diluent bag or vapor waste bag, and to position each detachable manifold  90  on the pump head assembly  28 . Next, the cartridge  16  and vial  18  are moved  242  into place by the pump head assembly  28  and a flexible tube  38  with a connector is attached to the receiving container&#39;s port. In an embodiment, the movement of the cartridge  16  into place on the mounting posts  130  and locking bayonet  128  pushes back the sleeves on a manifold, exposing  244  the needles, which are inserted into the diluent chambers  172  and vapor waste chamber  174  by piercing the sealing membrane  162  above the chambers  172 ,  174 . Each manifold has flexible tubes attached to it that run to the diluent bags  42  and the vapor waste bag  44 . 
       FIG. 52  is a flow chart illustrating the process of drawing diluent from the diluent containers  42  and pushing the diluent into the vial  18 . At step  278 , the hardware references are opened. Next  280  the valves  190  are reset. Next  282  the waste line is opened. The pump is then reset  284  and the valves  190  are checked  286  to see if they are ready. If they are not, they are initialized  288  to their proper positions. The amount of diluent to deliver is calculated at step  290  and the proper number of revolutions of the drive shaft for the pump is calculated  292 . The pump then runs  294  to perform the process and the hardware references are released  296 . The detailed steps of this process will now be described. 
     Referring back to  FIG. 51 , the first step  246  of the process is pulling diluent into the piston  166 , as shown in  FIG. 53 . Valve  2 A is open and valve  2 B is closed. The piston  1166  is actuated to draw diluent from a diluent bag  42  into the fluid line along the pathway illustrated by the arrows in  FIG. 53 . Valve  1 B is open and valve  1 A is closed, thus allowing the piston  166  to draw the fluid along the fluid pathway  186  into the pump chamber opening  196 . 
     Next, the valves are reoriented  248 . In the next step  250 , as illustrated in  FIG. 54 , the diluent that has been pulled into the piston pump  166  is pushed into the vial  18  through one needle  316 , while the air from the vial  18  exits the vial  18  through the other needle  318 . Valve  2 A remains open and valve  2 B remains closed. Valve  1 B is closed and valve  1 A is opened to form a new fluid pathway  186  from the piston pump  166  to the needle liquid port  320 , into the needle assembly  170  and into the vial  18 . The piston pump  166  is actuated, thus pumping the diluent from the piston pump  166  along the flow path  186  illustrated by the arrows and into the vial  18 . At the same time, valve  4 B remains closed and valve  4 A remains open. This allows the air from the vial  18  that is pushed out by the insertion of the diluent to exit the vial  18  through the needle assembly  170 , our through the needle vent port  236 , and into a separate flow path  186 . This flow path  186  leads to the vapor waste port  174  and the air exits the cartridge  16  and flows to the vapor waste container  44 . 
     After this step, the vial is agitated  252  (e.g., using an agitation pattern specific to the drug being reconstituted) by the pump motor mechanism  20  to reconstitute the drug. After reconstitution, the vial is presented at an orientation that is easy to visual verify whether there is powder in the solution. If the operator indicates, upon visual inspection, that the reconstitution is complete, the process continues in the cartridge. First, the valves are reoriented  254 .  FIG. 55  is a flow chart illustrating the step  256  of drawing the reconstituted drug from the vial  18  and pushing it into the receiving bag  32 . At step  278 , the hardware references are opened. Next  280  the valves  190  are reset. Next  282  the waste line is opened. The pump is then reset  284  and the valves  190  are checked  286  to see if they are ready. If they are not, they are initialized  288  to their proper positions. The amount of diluent to deliver is calculated at step  290  and the proper number of revolutions of the drive shaft for the pump is calculated  292 . The pump then runs  294  to perform the process and the hardware references are released  296 . The detailed steps of this process will now be described. 
     As shown in  FIG. 561 , valve  1 A is opened and valve  1 B is closed. The piston pump  166  is actuated and draws the reconstituted drug from the vial  18  through the needle assembly  170 , through the needle liquid port  320  and into the fluid pathway  186  shown by the arrows. The reconstituted drug is drawn into the piston pump  166 . During this time, the diluent is locked out of the system by closing valve  2 A. The vapor waste pathway is also locked out of the system by closing valve  4 A. Valve  4 B is opened to allow filtered air to enter the system and flow into the vial  18  through the needle assembly  170  as the reconstituted drug flows out of the vial  18  through another fluid pathway  186 , thus preventing a vacuum in the system. 
     Next, the valves are reoriented  258 . The next step  260  in the process is to push the reconstituted drug from the piston pump  166  into the receiving container  32  as shown in  FIG. 57 . Valve  1 A is closed and valve  1 B is opened. Valve  2 A remains closed in order to lock the diluent out of the system. Valve  2 B remains open as well as valve  3 B. Valve  3 A remains closed. The piston pump  166  is actuated and pushes the reconstituted drug out of the piston pump  166  and along the fluid pathway  186  as shown by the arrows to the exit port  180  that leads to the receiving container  32 . 
     Next, the valves are reoriented  262 . The next step is to add extra diluent to the receiving container  32  if necessary. Referring to  FIG. 58 , valve  2 A is opened and valve  2 B is closed to allow diluent to enter the system. Valve  1 B is opened and valve  1 A is closed, allowing the piston pump  166  to draw  264  diluent into the piston pump chamber  166  along the fluid pathway  186  designated by arrows. The vial  18  is locked out of the system by the closure of valve  1 A. Once the diluent is in the piston pump  166 , the next step commences as shown in  FIG. 59 . The valves  190  are reoriented  266 . The vial  18  remains locked out of the system by the closure of valve  1 A. Valve  1 B remains open and valve  2 A is closed to lock the diluent containers out of the system. Valve  2 B is open allowing access to the fluid pathway  186  to the port  180  that leads to the receiving container  32 . The pump  166  is actuated and pushes  268  the diluent along the fluid flow path  186  designated by the arrows and out the port  180  into the flexible tube  50  and into the receiving container  32 . 
     Steps  270 - 276  may be performed as a QS process to remove extra fluid and/or vapor from the receiving container if necessary.  FIG. 60  is a flow chart illustrating operations that may be performed as part of this QS process. As shown in  FIG. 60 , at step  278 , the hardware references are opened. Next  280  the valves  190  are reset. Next  282  the waste line is opened. The pump is then reset  284  and the valves  190  are checked  286  to see if they are ready. If they are not, they are initialized  288  to their proper positions. The amount of diluent to deliver, if relevant, is calculated at step  290  and the proper number of revolutions of the drive shaft for the pump is calculated  292 . The pump then runs  294  to perform the process and the hardware references are released  296 . 
     Returning now to  FIG. 51 , at step  270 , the valves are reoriented. For example, referring to  FIG. 61 , the diluent is locked out of the system by closure of valve  2 A. Valve  3 B is opened while valve  3 A remains closed. Valve  1 B is opened and the vial  18  is locked out of the system by the closure of valve  1 A. The piston pump  166  is actuated and draws (step  272 ,  FIG. 51 ) liquid from the receiving bag  32  into the pump chamber  176 . The valves are reoriented  274 . For example, as shown in  FIG. 52 , valve  2 A remains closed to lock out the diluent. Valve  1 B remains open and valve  1 A remains closed. Valve  3 B is closed and valve  3 A is opened, allowing fluidic access to the vapor waste port  174  through the fluid flow path  186  designated by the arrow. Valve  1 A is closed to keep the vial  18  locked out of the system. The piston pump  166  is actuated and the fluid is pumped  276  out of the piston pump chamber  176 , through the flow paths  186  designated by the arrows, out of the cartridge  15  through the vapor waste port  174  and into the vapor waste container  44 . 
     An alternative embodiment of the cartridge  16  utilizing a “backpack” to coil the flexible tubing  38  is illustrated in  FIGS. 63-66 . The backpack  298  is attached to the back  200  of the cartridge frame  16  and one end of the flexible tube  38  is attached to the outlet port  180  on the back  200  of the cartridge frame  16 . The backpack  298  comprises a housing  310  with a screw  312  (as shown outside of the screw chamber  314  in  FIG. 65  and inside the screw chamber  314  in  FIG. 66 ) defined in a chamber  314  that can rotate to coil the flexible tubing  38 . At the opposite end of the tubing is a connector  300  (e.g., an ISO Luer connector such as a Texium® attachment) that a user can pull out of the backpack  298  and attach to the receiving bag  32 . In some embodiments, the tubing attached to the connector  300  may be automatically extended from within backpack  298  to facilitate attachment by the user. Upon completion of the filling of the bag  32 , the screw mechanism  312  can draw the flexible tubing  38  back into the backpack  298  and out of the way so that the next cartridge  16  in the carousel  14  can be utilized. Retraction of the flexible tubing may be automatic once the ISO Luer is placed into the opening in the backpack. 
     Turning now to  FIG. 67 , an exploded perspective view of another embodiment of cartridge  16  shows the three main portions of the cartridge  16 : the cartridge frame  160 , the cartridge sealing membrane  162 , the cartridge bezel  164 , as well as the piston pump  166 , the needle housing  168  and the needle assembly  170 . In the example of  FIG. 67 , cartridge bezel  164  includes an additional opening  3022  to provide access to a pressure dome formed on membrane  152  to allow sensing of pressure in the fluid pathways of cartridge  16 . An air-in-line sensor fitment  3000  is also provided that is configured to mate with an air-in-line (AIL) sensor in the compounder. 
     In order to control the flow of gasses such as vapor waste and sterile air within the cartridge, cartridge  16  may be provided with gas flow control structures such as an air filter  3005  and one or more check valve discs  3004  that mount to frame  160  with a check valve cover  3002 . Air filter  3006 , check valve discs  3004 , and check valve cover  3002  may cooperate to allow vapor waste to flow in only one direction from the vial to the waste port and to allow sterile (filtered) air to flow in only one direction into the cartridge from a vent adjacent the air filter to the vial. In this way, unwanted vapor waste may be prevented from flowing out of the pump cartridge and may be instead guided to a vapor waste container. 
     As shown in  FIG. 67 , piston  165  may include a piston boot  3007  that, for example, provides one or more moveable seals (e.g., two moveable seals) for controlling the volume of a pump chamber when piston  166  is actuated,  FIG. 67  also shows various structures for control of another embodiment of needle housing  168  in which needle assembly  170  includes a dual lumen needle with a first needle overmold  317 A, a second needle overmold  317 B, a needle spring  3014 , and a needle membrane  3008 . An opening  3020  in bezel  154  may be provided that aligns with a corresponding opening  3021  in frame  160  to allow a view through cartridge  16  (e.g., by a sensor of the pump drive mechanism) into a backpack that is mounted to cartridge  16  as will be described in further detail hereinafter. A protrusion  3016  formed on a top side of cartridge frame  160  may be provided as a mounting structure for the backpack. 
       FIGS. 68A and 68B  show assembled views of the cartridge embodiment shown in  FIG. 67  from the bezel side and frame side respectively in which an opening  3120  (formed by openings  3020  and  3021  of  FIG. 67 ) that allows a view completely through cartridge  16  can be seen. As shown in  FIG. 68A , in some embodiments, cartridge  16  may include four diluent and waste ports  3100  and a pressure dome  3101 . For example, three of the ports  3100  may be configured as diluent ports and one of the ports  3100  may be configured as a waste port. A pressure sensor in the pump head assembly  28  may determine pressure within the fluid pathways in cartridge  16  by contacting pressure dome  3101 . Each of the ports  3100  may be formed from an opening in bezel  154  and a chamber located behind a portion of membrane  162  in frame  160 . 
       FIG. 69  is a cross-sectional perspective side view of an assembled cartridge  16  having a backpack  3202  (e.g., an implementation of backpack  2900  of  FIG. 29 ) attached thereto to form a cartridge and backpack assembly  3203 . As shown in  FIG. 69 , protrusion  3016  may extend into an opening  3201  in the backpack  3202  to latch the backpack to cartridge  16  at the top side. Additional latching structures at the bottom side will be described in further detail hereinafter. An additional structure  3200  may be disposed between backpack  3202  and cartridge  16 . Structure  3200  may be substantially planar and may be shaped and positioned to latch cartridge and backpack assembly  3203  to carousel  14 . For example, protrusions  3206  that extend from the top of the backpack  3202  may be actuatable to facilitate installation and removal of the cartridge and backpack assembly into and out of the carousel. For example, ramp structures on the carousel may compress protrusions  3206  when cartridge and backpack assembly  3203  is pushed into the carousel until protrusions  3206  snap up into a locked position to secure the cartridge and backpack assembly in the carousel. To remove cartridge and backpack assembly  3203  from the carousel for compounding operations, a bayonet  128  that extends into opening  210  may be turned to lower protrusions  3206  to release the cartridge and backpack assembly from the carousel. Further features of the coupling of cartridge and backpack assembly  3203  to the carousel will be described hereinafter. 
     Tubing (e.g., flexible tubing  38 ) for fluidly coupling cartridge  16  to a receiving container  32  may be housed within backpack  3202 . For example, the tubing may be coupled at an output port  180  (e.g., a receiving container port—see, e.g.,  FIG. 58B ) to cartridge  16 , coiled within an internal cavity of backpack  3202 , and extend through opening  3210  so that an end of the tubing can be pulled by an operator to extend the tubing for coupling to the receiving container. An additional opening  3204  may be provided within which a connector such as a Texium® connector coupled to the end of the tubing can be stored when the cartridge and backpack assembly is not in use. When instructed (e.g., by onscreen instructions on display  86 ) an operator may remove the connector from opening  3204 , pull the tubing from within backpack  3202 , and connect to the connector to a receiving container. For example, processing circuitry of the compounder system may provide instructions, using the display, to (a) remove a connector that is coupled to the tubing from an additional opening in the backpack, (b) pull the tubing from the backpack, and (c) connect the connector to the receiving container. In another embodiment, extension of the flexible tubing is automatic (e.g., software determines the precise moment the flexible tube should be extended, the pump head operates screw mechanism to extend the tubing, and a signal to the user to pull the ISO Luer out of the backpack opening is provided). Compounder  10  may include a sensor such as an optical sensor that determines whether the connector is present within opening  3204  (e.g., by viewing the connector through opening  3120 ). 
     Compounder  10  may determine, based on whether the connector is within opening  3204 , whether and when to release the cartridge and backpack assembly from the pump head assembly. For example, following compounding operations, an operator may be instructed to remove the connector from the receiving container and return the connector into opening  3204 . Backpack  3202  may include features and components for facilitating the storage and extraction of the tubing from within the internal cavity. When the connector is detected in opening  3204 , the pump drive mechanism  20  may operate one or more coiling mechanisms within backpack  3202  to pull the extended tubing back into the backpack and may turn the bayonet to lower protrusions  3206  so that the cartridge and backpack assembly can be returned to the carousel. 
       FIG. 69  also shows an enlarged view of a portion of cartridge  16  with the cross-section taken through two of valves  190 . As shown in the enlarged view, each valve  190  may be formed from a raised portion  6908  of sealing membrane  162  that extends from a planar portion  6906  of sealing membrane  162  into a corresponding opening  228  in cartridge bezel  164 . In the example shown in, for example,  FIGS. 67-69 , raised portion  6908  is a pyramid-shaped dome formed in opening  228 . In a portion of the fluid path  6900  formed between sealing membrane  162  and frame  160  adjacent each valve  190 , frame  160  may include a rib  6902  in spaced opposition to the raised portion  6908  of the sealing membrane for that valve. When raised portion  6908  is in a raised position as illustrated in  FIG. 69 , fluid and/or vapor can flow over rib  6902  through the open valve. In operation, a valve actuator  84  that extends from and is operable by pump head assembly  28  can extend through opening  228  to compress raised portion  6908  against rib  6902  to close the valve and prevent fluid from flowing therethrough. 
       FIG. 70  shows a finite element representation of a cross-sectional view of a portion of a valve  190  in which sealing membrane  162  is compressed against cartridge frame  160  by valve actuator  7000  (e.g., one of valve actuators  84 ) to close the valve. Finite-element analysis indicates that providing a valve having a raised portion  6908  in, for example, the form of a pyramid-shaped dome may allow valves  190  to be operated with relatively less stress in comparison with a flat membrane valve and may therefore provide longer lasting valves. The reduced stresses may allow membrane  162  to be formed from relatively less expensive or easier to work with materials such as polyisoprene or thermoplastic elastomeric (TPE) materials. 
       FIG. 71  is a cross-sectional side view of the cartridge of  FIG. 67  showing piston pump  166 . As shown in  FIG. 71 , piston pump  166  may include a silicon boot  7100  having first and second seals  7102  and  7104 . Forward seal  7104  may form a moving boundary of a pump chamber  6106 . Rearward seal  7102  may prevent dust or other contaminants from contacting forward seal  7104 . Pump chamber  7106  may be formed adjacent one or more valves  190  (e.g., a pair of valves may be disposed on opposing sides of the pump chamber to control fluid flow into and out of the pump chamber). The operation of valves  190  in cooperation with piston pump  166  are described in further detail hereinafter in connection with, for example,  FIGS. 72-77 . 
     In  FIG. 72 , for purposes of discussion herein, valves  190  are labeled in three valve groups V 1 , V 2 , and V 3 . Valve group V 1  may be a diluent valve group having three valves P 1 , P 2 , and P 3 . Valve group V 2  may be a reconstitution valve group having three valves P 1 , P 2 , and P 3 . Piston pump valves P 1  and P 2  of valve group V 3  (e.g., a piston pump valve group) may be operated alternately in cooperation with piston pump  166 . For example, during a forward stroke of piston pump  166 , valve V 1 /P 1  may be closed and valve V 3 /P 2  may be open and during a backward stroke of piston pump  166 , valve V 1 /P 1  may be open and valve V 3 /P 2  may be closed to pump fluid in a first direction within the fluid pathways of cartridge  16 . In another example, to pump fluid in an opposite, second direction within the fluid pathways of cartridge  16 , during a forward stroke of piston pump  166 , valve V 3 /P 1  may be Open and valve V 3 /P 2  may be closed and during a backward stroke of piston pump  166 , valve V 3 /P 1  may be closed and valve V 3 /P 2  may be open. 
       FIGS. 73-76  show various examples of valve configurations for pumping fluids through cartridge  16  for various portions of a compounding operation using the valve labels shown in  FIG. 72  for reference. In the example of  FIG. 73 , the valves of valve groups V 1  and V 2  are configured for pumping diluent from a diluent container directly to a receiving container (e.g., valves P 1  and P 3  of group V 1  are closed, valve P 2  of group V 1  is open, valves P 1  and P 2  of group V 2  are closed, and valve P 3  of group V 2  is open to form a fluid path  7300  from one of diluent ports  3100  to receiving container port  7302 ). 
     In the example of  FIG. 74 , the valves of valve groups V 1  and V 2  are configured for pumping diluent from a diluent container to a vial for reconstitution operations (e.g., valves P 1  and P 3  of group V 1  are closed, valve P 2  of group V 1  is open, valves P 2  and P 3  of group V 2  are closed, and valve P 1  of group V 2  is open to form a fluid path  7400  from one of diluent ports  3100  to vial port  7402 ). As shown, during reconstitution operations, a hazardous vapor path  7404  may be formed from a vial waste port  7406  to waste port  3100  to be provided to waste container  44 . In some embodiments, a non-hazardous waste path  7408  may be provided from a non-hazardous vial waste port  7405  to air filter port  7410 . However, this is merely illustrative. In some embodiments, air filter port  7410  may be associated with air filter check valve structures  3004 ,  3004 , and  3006  that prevent flow of any vapor waste along path  7408  and ensure that all vapor waste from vial  18  is moved along path  7404  through waste port  3100 . 
     In the example of  FIG. 75 , the valves of valve groups V 1  and V 2  are configured for pumping a reconstituted drug from a vial to a receiving container for compounding operations (e.g., valves P 1  and P 2  of group V 1  are closed, valve P 3  of group V 1  is open, valves P 1  and P 1  of group V 2  are closed, and valve P 3  of group V 2  is open to form a fluid path  7500  from vial port  7402  to receiving container port  7302 ). As shown, during compounding operations, a path  7502  may be formed from air filter port  7410  to non-hazardous vapor vial port  7405  to provide filtered, sterile air from outside cartridge  16  into the vial to prevent a vacuum from being generated when the drug is pumped from the vial. 
     Although the receiving container  32  is shown in, for example,  FIGS. 1, 3, 24, and 25  as an IV bag, in some scenarios, the receiving container  32  may be implemented as a syringe. For example, a Texium® connector coupled by tubing to an output port such as receiving container port  7302  may be connected to a needle free valve connector such as a SmartSite® connector, the SmartSite® connector being coupled by additional tubing to another needle free valve connector (e.g., another SmartSite® connector) that is connected to a syringe for receiving a reconstituted drug. In scenarios in which the receiving container is a syringe, it may be desirable, after pumping the drug from the vial into the syringe, to remove air or other vapors from the syringe. 
     In the example of  FIG. 76 , the valves of valve groups V 1  and V 2  are configured for pumping air from a receiving container such as a syringe (e.g., valves P 1  and P 3  of group V 1  are closed, valve P 2  of group V 1  is open, valves P 2  and P 3  of group V 2  are closed, and valve P 1  of group V 2  is open to form a fluid path  7600  from receiving container port  4302  to waste port  3100 ). In each of the configurations of  FIGS. 73-76 , the valves P 1  and P 2  of group V 3  may be alternately opened and closed in cooperation with the motion of piston pump  166  to move the desired fluid or vapor along the fluid pathways defined by valves  190 . 
       FIG. 77  is a chart showing the position and operation of the valves  190  as labeled in  FIG. 72  during various portions of a reconstitution/compounding process as described above in connection with  FIGS. 73-76 . 
       FIG. 78  is a cross-sectional top view of cartridge  16  taken through air filter housing  3002  along a line that passes through both check valve discs  3004 . As shown in  FIG. 78 , a first one of check valve discs  3004  may be aligned with air filter  3006  and may have a concave side facing the air filter. In this way, that disc  3004  may form a check valve that allows filtered air to flow through filter  3006  along a path  7800  into cartridge  16  and prevents flow of air or other (e.g., hazardous) vapors out of cartridge  16 . The other of check valve discs  3004  may have an opposite orientation and may have a concave side that receives vapor flow from within cartridge  16  (e.g., along path  7802  from vial  18 ) and allows flow of the vapor along a path  7804  to a waste container while preventing flow of the vapor to air filter  7800 . Air filter  3006  may be configured to provide, for example, 0.2 micron filtration and may be formed from a polytetrafluoroethylene (PTFE) or polypropylene (PP) material (as examples). Check valve cover  3002  may be configured to hold check valve discs  3004  in place and may be secured in cartridge housing using, for example, ultrasonic welding. 
       FIG. 79  illustrates a cross-sectional side view of cartridge  16  along with an enlarged view of a portion of the cartridge in the vicinity of sealing member engagement features that secure and seal the sealing membrane  162  to cartridge frame  160 . As shown in  FIG. 79 , sealing membrane  162  may include one or more compression ribs  7900  that extend perpendicularly from the overall planar structure of the membrane. Ribs  7900  may be compressed into valve pockets  7902  and/or fluidic paths  7904  to seal the valve pockets and/or fluidic paths. When pressed into pockets  7902  and/or fluidic paths  7904 , ribs  7900  may be compressed by, for example, 8%-10% radially (e.g., compressed a distance of approximately 0.1 mm for a rib having a width of 1.2 mm) to form a compression seal. Each rib may be provided with a relief channel  7906  to ease the initial compression of the rib as it is pressed into the relevant opening in frame  160 . 
       FIG. 80  is an enlarged cross sectional perspective side view of a portion of the cartridge and backpack assembly in which the internal cavity  3300  and bottom side latching features  3302  of backpack  3202  can be seen. As shown, a protruding portion  3304  of cartridge frame  160  can extend perpendicularly from the frame and between latching features  3302  of backpack  3202  (e.g., through an opening in backpack  3202 ) to secure the backpack to cartridge  16  at the bottom side. Needle housing members  317 A and  317 B are also shown disposed in a needle cavity  3331  in cartridge frame  160  respectively securing needles  316  and  318  therein. 
       FIG. 81  is an enlarged cross-sectional side view of air-in-line sensor fitment  3000  showing how a flow path  8100  may be provided in the fitment that can be viewed and/or monitored by an air-in-line sensor in pump head assembly  28 .  FIG. 82A  is a cross-sectional side view of cartridge  16  with the cross section take through diluent ports  3100 D, waste port  3100 W, and receiving container port  7302 . As shown in the example of  FIG. 82A , each diluent port  3100 D may be formed by a portion of membrane  162  that is formed within an opening in bezel  164  and adjacent to a diluent, chamber  8200 D. Waste port  3100 W may be formed by a portion of membrane  162  that is formed within an opening in bezel  164  and adjacent to a vapor waste chamber  8200 W. Receiving container port  7302  may be formed from an opening that leads to a receiving container chamber  8202  in which tubing that extends into backpack  3202  may be disposed to form a fluid path to the receiving container from cartridge  16 . 
     When compressed by a sealing manifold membrane such as sealing manifold membrane  8252  of manifold  8250  of  FIG. 82B , the portion of sealing membrane  162  that forms diluent and/or waste ports  3100  creates a drip-free connection between the manifold  8250  and the cartridge. A manifold needle  8254  of a selected diluent manifold  8250  and a manifold needle of a waste manifold can extend through the corresponding manifold membrane  8252  and the sealing membrane  162  in the respective diluent and waste port to form fluid paths through sealing membrane  162  (e.g., through opening  8256 , central bore  8257 , and opening  8258  of needle  8254 ) for diluents and waste vapors for reconstitution and compounding operations. 
     However, the example of  FIG. 82A , in which the seal of ports  3100 D and  3100 W are formed solely by a portion of membrane  162  that extends into an opening in bezel  164  is merely illustrative. In some embodiments, in order to provide an improved drip-free seal, the seal of each of ports  3100 D and port  3100 W may be formed by a plurality of sealing members. In one example, three sealing members may be provided to form a port seal for cartridge  16 . 
       FIG. 82C  shows a cross-sectional view of a port of cartridge  16  in an implementation with three sealing members. As shown in  FIG. 82C , a port  3100  (e.g., one of diluent portion  3100 D or waste port  3100 W) may be formed from a portion of membrane  162  that is disposed between an outer sealing member  8252  (formed in an opening  8260  in bezel  164 ) and an inner sealing member  8264 . Inner sealing member  8264  may be disposed between membrane  152  and chamber  8200 . 
     As shown in  FIG. 82C , outer sealing member  8260  may include a portion that extends through opening  8260  and may also include a recess  8268  on an interior surface adjacent to membrane  152 . Membrane  162  may also include a recess  8266  on an interior surface adjacent to inner sealing member  8264 . Providing a portion  3100  with multiple sealing members such as the three sealing members (i.e., member  8262 , member  8264 , and the portion of membrane  162  formed between members  8262  and  8264 ) may provide an enhanced wiping of needle  8254  to provide an improved dry disconnect in comparison with implementations with a single sealing member. However, this is merely illustrative. In various embodiments, one, two, three, or more than three sealing members for each port may be provided. Similarly, interstitial spaces formed from recesses  8266  and  8268  may further increase the efficiency of the wiping of needle  8254 , however, in various embodiments, sealing members may be provided with or without recesses  8266  and/or  8268 . 
       FIG. 82D  shows the manifold  8250  of  FIG. 82B  with manifold sealing member  8252  compressed against outer sealing member  8262  of port  3100  of  FIG. 82C . As shown in  FIG. 82D , needle  8254  is extended from manifold  8250  through sealing members  8252  and  8262 , through interstitial space  8268 , through membrane  152 , through interstitial space  8266 , and through inner sealing member  8264  such that openings  8256  and  8258  and central bore  8257  form a fluid pathway between cartridge  16  and manifold  8250 . 
     In the example of  FIG. 82A , the portion of membrane  162  that extends into the openings in bezel  164  in ports  3100  may be compressed (e.g., compressed by 10% radially) to cause a wiping effect on the diluent needles that are extended therethrough and withdrawn therefrom so that when the diluent needles are retracted into the manifold, no liquid is left on the diluent needle or one the outer surfaces of the cartridge or the membrane. 
     In the example of  FIGS. 82C and 82D , the portion of sealing member  8262  that extends into the openings in bezel  164  in ports  3100  may be compressed (e.g., compressed by 10% radially) to cause a wiping effect on the diluent needles that are extended therethrough and withdrawn therefrom so that when the diluent needles are retracted into the manifold, no liquid is left on the diluent needle or one the outer surfaces of the cartridge or the membrane. The multiple sealing members of  FIGS. 82C and 82D  may be arranged to each provide a wiping effect on needle  8254  that complements the wiping effect of the other sealing members (e.g., by providing, with each member, a peak wiping force on the needle at locations angularly spaced with respect to the peak wiping force of other members). 
       FIG. 83  is cross-sectional perspective side view of cartridge and backpack assembly  3203  in which protrusion  3016  and protrusion  3304  of cartridge frame  160  can be seen cooperating to couple cartridge  16  to backpack  3202  to form cartridge and backpack assembly  3203 . To install backpack  3202  onto cartridge  16 , opening  3201  of backpack  3202  can be positioned over protrusion  3016  and backpack  3202  can be rotated (e.g., in a direction  3401 ) to push latching features  3302  of backpack  3202  against latching protrusion  3304  until latching protrusion  3304  snaps into position between latching features  3302 . As shown, protrusion  3016  may be formed on an additional latching structure of cartridge  16  such as a flexible arm  3400 . Flexible arm  3400  may allow backpack  3202  to be pulled downward by a small distance when backpack  3202  is rotated to press latching feature  3302  onto protrusion  3304 . Flexible arm  3400  may be resilient to maintain an upward force the holds latching features  3302  in a latched position against protrusion  3304 . 
     In the example of  FIG. 83 , a vial  18  and vial puck  26  are positioned adjacent to cartridge and backpack assembly  3203  with needle assembly  170  extended into the vial through sealing member  3402  of cartridge  15  and sealing member  3404  of vial puck  26  which may provide a drip free seal and allow fluid to be provided into and/or removed from vial  18 . Sealing member  3402  may be, for example, an implementation of sealing member  3008 . As shown, when the needle assembly  170  is extended into the vial, portions of the vial puck  26  may be located adjacent to latching features  3302  of backpack  3202 . 
       FIG. 84  shows a cross-sectional view of a portion of cartridge  16  along with an enlarged view of a portion of needle assembly  170 . As shown in  FIG. 84 , needle housing  168  may include a sealing membrane  3402  formed within an annular housing member  8404  that is attached to cartridge frame  160  via one or more housing arms  8408 . A spring  8410  may be provided that extends from needle housing member  317 B into needle housing  168  such that compression of spring  8410  is necessary to extend needles  316  and  318  through sealing membrane  3402 . In this way, a user handling cartridge  16  is prevented from being injured by access to needle assembly  170 . In operation, a vial puck may be pressed against annular housing member  8404  to compress spring  8410  such that needle assembly  170  extends through sealing membrane  3402  and through a sealing membrane of the vial puck into the vial. 
     Dual lumen needles  316  and  318  may be respectively provided with openings  8400  and  8402  that provide fluid access to central bores of the needles. Needle  316  may, for example, be a 24 gauge needle held in cartridge frame  160  by a high density polyethylene (HDPE) overmold  317 A, the needle having an opening  8400  for venting the drug vial. Opening  8400  may be formed using a slot cut as shown to reduce coring of the sealing membranes as the needle is inserted and retracted. Needle  318  may, for example, be an 18 gauge needle held in cartridge frame by a high density polyethylene (HDPE) overmold  317 B with one or more openings  8402  for fluid flow into and/or out of the vial. Openings  8402  may include two drilled holes configured to reduce coring and to allow up to, for example, 60 mL/min of fluid flow. 
     In this way, during reconstitution operations, diluent may be provided into the vial via openings  8402  of needle  318  and vapor waste may be simultaneously extracted from the vial via opening  8400  in needle  316 . During compounding operations, a reconstituted drug may be pulled from the vial via openings  8402  of needle  318  and sterile air may be provided into the vial via opening  8400  of needle  316 . 
       FIG. 85  shows an inverted perspective view of annular housing member  8404  and housing arms  8408  showing how housing members  8404  and  8408  may be formed from an integral structure that houses sealing membrane  3402 . A needle guide structure  8500  may extend from annular housing member  8404  between arms  8408 . Engagement features such as compressible snap features  8502  may be provided on arms  8408  for securing arms  8408  within cartridge frame  160 . 
       FIG. 86  shows arms  8408  disposed partially within and extending from cartridge frame  160 . As shown, snap features  8502  are engaged with a ledge  8600  on cartridge housing  160  with spring  8410  fully extended such that needle assembly  170  is contained completely within the needle housing assembly. 
       FIG. 87  is a cross sectional top view of cartridge  16  showing how a ramp structure such as bayonet capture ramp  3500  may be provided within opening  210 . As shown, bayonet capture ramp may include a hard stop rib  3502  that prevents over travel of the bayonet, and a ramp  3504  that, when the bayonet  128  is rotated, bears against the bayonet so that the bayonet captures the cartridge and pulls the cartridge up to the compounder arm. A portion of the bayonet may extend through opening  210  into an opening in structure  3200  (see, e.g.,  FIG. 83 ) such that, when the bayonet is rotated, the bayonet also bears against portions of structure  3200  to move, rotate, and/or deform structure  3200  to release the cartridge and backpack assembly  3203  from the carousel.  FIG. 88  shows a cross-sectional perspective view of a portion of cartridge  16  showing ramp structure  3500  formed on a sidewall of opening  210 . 
       FIG. 89  shows a cross-sectional perspective view of cartridge and backpack assembly  3203  with further enlarged portions of the cartridge and backpack assembly  3203  showing various aspects of the interface between cartridge  16  and backpack  3202 . As shown in  FIG. 89 , opening  3120  may extend through cartridge frame  160  to a position within backpack  3202  adjacent to and beneath opening  3204 . In this way, when a connector is inserted into opening  3204 , a sensor in the pump head assembly can view the connector through opening  3120 . 
       FIG. 89  also shows an enlarged view of an exemplary engagement between a latching structure such as as protrusion  3304  of cartridge frame  160  and latching features  3302  of backpack  3202 . As shown, latching features  3302  may be formed from an opening  3801  in backpack  3202  that forms an upper protrusion  3800  and lower protrusion  3802 . When backpack  3202  is attached to cartridge  16 , a portion of bottom protrusion  3802  may bear against an additional latching structure such as ramped surface  3804  of protrusion  3304  to push protrusion  3304  upwards as backpack  3202  is rotated into position. When backpack  3202  has been rotated into a latched position, protrusion  3304  of cartridge frame  160  overlaps with protrusion  3800  of backpack  3202  and extends through opening  3801  to secure backpack  3202  to cartridge  16  at the bottom end. 
       FIG. 90  shows a cross sectional view of a carousel  14  having a plurality of cartridge and backpack assemblies  3203  mounted in corresponding cartridge pockets  500 . As shown in  FIG. 90  a connector  4002  such as a Texium® connector may be disposed in an opening in each backpack  3202  of each cartridge and backpack assembly  3203 . The connector  4002  may be disposed at an end of tubing  4000  (e.g., an implementation of tubing  38  of  FIG. 1  disconnected from receiving container  32 ) that extends from the connector into the internal cavity of each backpack  3202  and connects to an output port of the cartridge  16  attached to that backpack. A central opening  4005  can also be seen in the cross-sectional view of  FIG. 90 . As shown, central opening  4005  may be a substantially cylindrical opening with a portion having slatted planar walls that together form a polygonal pattern  4007  that corresponds to the polygonal shape of carousel huh  2814  ( FIG. 28 ). However, other patters for central opening (and carousel hub  2814 ) such as a “D” shape are contemplated. 
     A perspective view of carousel  14  is shown in  FIG. 91 . As shown in  FIG. 91 , cartridge and backpack assemblies  3203  may be disposed around the circumference of carousel  14  and carousel  14  may include recesses  4009  in an upper surface  4013  for accommodating tubing  4000  and connector  4002  of each cartridge and backpack assembly  3203 . Carousel  14  may also include a bottom surface  4015  having a plurality of extensions  4017  that extends downward therefrom and each have a recess  4011  that accommodate needle housing  168  of a corresponding cartridge and backpack assembly  3203 . Extensions  4017  may have a protective bottom surface  4019  that runs underneath a needle housing  168  of an installed cartridge and prevents actuation of the needle housing that could expose an operator to the needle assembly therein. Protective bottom surface  4019  may also serve as a surface for collecting any small amount of drug that may inadvertently drip from the needle (or needle housing) of the cartridge  16 ). A handle  4026  may be provided that facilitates user installation of a new carousel of cartridges onto carousel hub  2814  ( FIG. 28 ) and removal of a carousel with used cartridges from the carousel hub. 
       FIG. 92  is a cross-sectional perspective view of a portion of a cartridge and backpack assembly  3203  that is mounted to carousel  14 . As shown in  FIG. 92 , carousel  14  may include a an extended portion  4102  of top surface  4013  that extends over cartridge and backpack assembly  3203  in cartridge pocket  500  and includes a recess  4100  on an inner surface that is configured to receive protrusion  3206  of structure  3200  of cartridge and backpack assembly  3203  to secure cartridge and backpack assembly  3203  within pocket  500 . Carousel  14  may also include structural members in pocket  500  such as a bumper member  4103  configured to help hold cartridge and backpack assembly  3203  in place when cartridge and backpack assembly  3203  is mounted in pocket  500 . When it is desired to remove cartridge and backpack assembly  3203  from pocket  500  of carousel  14 , protrusions  3206  may be lowered and thereby removed from recesses  4100  to allow cartridge and backpack assembly  3203  to move out of pocket  500 . Protrusions  3206  may be lowered by pressing, moving, rotating, and/or deforming structure  3200  using, for example, bayonet  128 . 
       FIG. 93  shows a perspective view of structure  3200 . As shown in  FIG. 93 , structure  3200  may be a patterned structure (e.g., a molded resiliently deformable plastic structure) having various features for facilitating mounting and removal of cartridge and backpack assembly  3203  to and from carousel  14 . For example, structure  3200  may include a central opening  4202  configured to receive a portion of the bayonet that extends from the pump head assembly of the pump drive mechanism through cartridge  16 . When the bayonet is turned, portions of the bayonet may simultaneously bear against an upper structure  4204  and a lower structure  4210  of structure  3200 . When the bayonet bears downward against lower structure  4210 , lower structure  4210  may be moved downward and/or rotated by the bayonet such that lower structure  4210  pulls correspondingly downward on protrusions  3206  in order to lower protrusions  3206  (e.g., in direction  4220  of  FIG. 93 ). When the bayonet simultaneously bears upward on upper structure  4204 , upper structure  4204  may pull, via arms  4206  and  4212 , correspondingly upward on latch structure  4216  (e.g., to raise the latch structure in direction  4218  of  FIG. 93 . 
     In this way, protrusions  3206  and latch structure  4216  may be simultaneously retracted toward the center of structure  3200  (e.g., out of recess  4100  of carousel  14 ) in order to release cartridge and backpack assembly  3203  from carousel  14 . Latch structure  4216  may, for example, extend through an opening in backpack  3202  to engage a corresponding recess in cartridge pocket  500  when the cartridge and backpack assembly  3203  is mounted in the pocket. 
     Structure  3200  may also include a recess  4200  that forms a portion of opening  3120  to facilitate viewing of a connector stored within backpack  3202  as discussed herein. An opening  4208  may be formed in structure  3200  between arm  4206  and upper structure  4204 . An opening  4214  may be formed in structure  3200  that extends from arm  4212  along lower structure  4210 . Openings  4208  and  4214  may be a connected single opening that is patterned to form structures  4210 ,  4204 ,  4206  and  4212  that actuate protrusions  3206  and latch structure  4216  when structure  3200  is deformed (e.g., to rotate a portion of the structure to pull on protrusions  3206 ). 
       FIG. 94  is a cross-sectional perspective view of another portion of a cartridge and backpack assembly  3203  that is mounted to carousel  14 . As shown in  FIG. 94 , backpack  3202  may include a roller assembly  4300  that can be turned to actively drive tubing  4000  into or out of backpack  3202 . For example, roller assembly  4300  may be turned in a first direction to extend tubing  4000  from within cavity  3300  or turned in an opposite second direction to retract tubing  4000  into cavity  3300 . Roller assembly  4300  may be turned by an operator or automatically by a spring drive within backpack  3202  or by a drive mechanism that extends from the pump drive assembly through cartridge  16  to backpack  3202 . 
     As shown in  FIG. 94 , backpack  3202  may also include internal structures for managing the insertion and removal of tubing  4000 . For example, a strain relief structure  4304  may be provided that at least partially covers a bottom portion of tubing  4000  so that a pull against tubing  4000  from outside of backpack  3202  will result in tubing  4000  bearing against strain relief structure  4304  rather than resulting in a pull along the length of the tubing that could undesirably detach the tubing from cartridge  16 . Strain relief structure  4304  may, for example, be an integrally formed internal extension that extends from a sidewall of interior compartment  3300  in a direction substantially perpendicular to the direction in which tubing  4000  exits backpack  3202 . Backpack  3202  may also include a guide structure  4302  having a curved internal surface  4306  that forms a curved surface against which tubing  4000  can be coiled. 
       FIG. 95  is a cross-sectional top perspective view of cartridge and backpack assembly  3203  showing how a plurality of coil ramp extensions  4400  can be formed on a bottom surface of internal cavity  3300  to form a ramp that encourages coiling of tubing  4000  when tubing  4000  is inserted into cavity  3300 . As shown, each ramp extension  4400  may each have a height. The height of each ramp extension may increase with distance from strain relief structure  4304  to form the desired coil ramp. 
     The subject technology is illustrated, for example, according to various aspects described above. Various examples of these aspects are described as numbered concepts or clauses (1, 2, 3, etc.) for convenience. These concepts or clauses are provided as examples and do not limit the subject technology. It is noted that any of the dependent concepts may be combined in any combination with each other or one or more other independent concepts, to form an independent concept. The following is a non-limiting summary of some concepts presented herein: 
     Concept 1. A pump cartridge for a compounder system, the pump cartridge comprising: 
     at least one diluent port configured to receive a diluent in a diluent chamber; 
     a receiving container port configured to provide a fluid to a receiving container; 
     a plurality of controllable fluid pathways fluidly coupled to the at least one diluent port and the receiving container port; and 
     a pump configured to pump the fluid within the plurality of controllable fluid pathways. 
     Concept 2. The pump cartridge of Concept 1 or any other Concept, further comprising a plurality of valves in the fluid pathways, wherein the valves are operable to select a particular fluid pathway from the plurality of fluid pathways. 
     Concept 3. The pump cartridge of Concept 2, further comprising: 
     a cartridge frame; 
     a cartridge bezel; and 
     a sealing membrane disposed between the cartridge frame and the cartridge bezel, wherein the at least one diluent port and the plurality of valves are each formed, in part, from a portion of the sealing membrane that extends into a corresponding opening in the cartridge bezel, and wherein the cartridge frame and the sealing membrane form the plurality of fluid pathways. 
     Concept 4. The pump cartridge of Concept 3 or any other Concept, further comprising at least one waste port configured to provide vapor waste from a vapor waste chamber, wherein the at least one diluent port comprises three diluent ports aligned in a row with the at least one waste port.
 
Concept 5. The pump cartridge of Concept 4 or any other Concept, wherein the portion of the sealing membrane of each diluent port that extends into the corresponding opening in the cartridge bezel is radially compressed by the cartridge bezel such that when a diluent needle is extracted from that diluent port, the needle is wiped by the portion of sealing membrane.
 
Concept 6. The pump cartridge of Concept 3 or any other Concept, wherein the portion of the sealing membrane that extends into the corresponding opening for each valve comprises a pyramid-shaped dome that extends into the opening.
 
Concept 7. The pump cartridge of Concept 6 or any other Concept, wherein the cartridge frame comprises a rib in spaced opposition to the pyramid-shaped dome of each valve and wherein the pyramid-shaped dome is configured to be compressed against the corresponding rib of the cartridge frame to close the valve.
 
Concept 8. The pump cartridge of c1 Concept 7 or any other Concept, wherein the plurality of valves comprises a diluent valve group, a reconstitution valve group, and a pump valve group.
 
Concept 9. The pump cartridge of Concept 8 or any other Concept, wherein the diluent valve group comprises three valves, the reconstitution valve group comprises three valves, and the pump valve group comprises two valves disposed on opposing sides of a pump chamber for a piston pump.
 
Concept 10. The pump cartridge of Concept 9 or any other Concept, wherein the diluent valve group and the reconstitution valve group are operable to form a diluent to receiving container fluid path, a reconstitution fluid path, a compounding fluid path, and an air removal fluid path from the plurality of fluid pathways.
 
Concept 11. The pump cartridge of Concept 3 or any other Concept, further comprising a pressure dome formed from an additional portion of the sealing membrane that is located adjacent an additional opening in the cartridge bezel.
 
Concept 12. The pump cartridge of Concept 3 or any other Concept, further comprising:
 
     a needle housing assembly; and 
     a needle assembly disposed within the needle housing assembly. 
     Concept 13. The pump cartridge of Concept 12 or any other Concept, wherein the needle assembly comprises a dual lumen needle. 
     Concept 14. The pump cartridge of Concept 13 or any other Concept, wherein the needle assembly further comprises a spring configured to be compressed by a pressure on the needle housing assembly to expose the needle assembly. 
     Concept 15. The pump cartridge of Concept 14 or any other Concept, further comprising a sealing member disposed in the needle assembly housing, wherein the needle assembly is configured to extend through the sealing member when the spring is compressed. 
     Concept 16. The pump cartridge of Concept 3 or any other Concept, wherein the cartridge frame comprises latching structures for mounting a tube management backpack to the cartridge. 
     Concept 17. The pump cartridge of Concept 16 or any other Concept, further comprising an opening that extends through the cartridge frame and the cartridge bezel, wherein the opening is configured to align with a connector disposed in an opening in the backpack.
 
Concept 18. The pump cartridge of Concept 3 or any other Concept, further comprising a bayonet opening having a ramp structure configured to engage a bayonet of a pump head assembly of the compounder system for lifting and pulling of the cartridge from a carousel of cartridges.
 
Concept 19. The pump cartridge of Concept 3 or any other Concept, further comprising:
 
     an air filter; and 
     a pair of check valves configured to allow filtered air from the air filter to pass into the pump cartridge and to prevent unwanted vapors from flowing out of the pump cartridge. 
     Concept 20. A compounder system, comprising: 
     a pump head assembly having a plurality of operational mechanisms; and 
     a pump cartridge comprising, a diluent port, an output port, a waste port, a plurality of valves, a needle assembly, and a piston, 
     wherein the piston and the plurality of valves of the pump cartridge are configured to be operated by the plurality of operational mechanisms of the pump head assembly to (a) pump a fluid from a container through the diluent port and the needle assembly to a vial, (b) pump vapor waste through the needle assembly through the waste port to a waste container, and (c) pump a reconstituted drug from the vial through the needle assembly and the output port to a receiving container. 
     Concept 21. The compounder system of Concept 20 or any other Concept, wherein the diluent port comprises: 
     an opening in a bezel of the pump cartridge; and 
     a portion of a sealing membrane of the cartridge that extends into the opening. 
     Concept 22. The compounder system of Concept 20 or any other Concept, wherein the diluent port comprises: 
     an opening in a bezel of the pump cartridge; 
     an outer sealing member that extends into the opening; 
     a portion of a sealing membrane of the cartridge; and 
     an inner sealing member, wherein the portion of the sealing membrane is disposed between the outer sealing member and the inner sealing member. 
     Concept 24. The compounder system of Concept 22 or any other Concept, further comprising a recess in the outer sealing member adjacent to the portion of the sealing membrane. 
     Concept 25. The compounder system of Concept 24 or any other Concept, further comprising an additional recess in the sealing membrane adjacent to the inner sealing member. 
     Concept 26. The compounder system of Concept 20 or any other Concept, wherein the pump cartridge further comprises an opening configured to allow communication with an optical sensor of the pump head assembly, wherein the optical sensor is configure to cause automatic retraction of a receiving container tube coupled to the output port in response to detection of a connector attached to the receiving container tube. 
     The present disclosure is provided to enable any person skilled in the art to practice the various aspects described herein. The disclosure provides various examples of the subject technology, and the subject technology is not limited to these examples. Various modifications to these aspects will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other aspects. 
     One or more aspects or features of the subject matter described herein may be realized in digital electronic circuitry, integrated circuitry, specially designed ASICs (application specific integrated circuits), computer hardware, firmware, software, and/or combinations thereof. For example, infusion pump systems disclosed herein may include an electronic system with one or more processors embedded therein or coupled thereto. Such an electronic system may include various types of computer readable media and interfaces for various other types of computer readable media. Electronic system may include a bus, processing unit(s), a system memory, a read-only memory (ROM), a permanent storage device, an input device interface, an output device interface, and a network interface, for example. 
     Bus may collectively represent all system, peripheral, and chipset buses that communicatively connect the numerous internal devices of electronic system of an infusion pump system. For instance, bus may communicatively connect processing unit(s) with ROM, system memory, and permanent storage device. From these various memory units, processing unit(s) may retrieve instructions to execute and data to process in order to execute various processes. The processing unit(s) can be a single processor or a multi-core processor in different implementations. 
     A reference to an element in the singular is not intended to mean “one and only one” unless specifically so stated, but rather “one or more.” Unless specifically stated otherwise, the term “some” refers to one or more. Pronouns in the masculine (e.g., his) include the feminine and neuter gender (e.g., her and its) and vice versa. Headings and subheadings, if any, are used for convenience only and do not limit the invention. 
     The word “exemplary” is used herein to mean “serving as an example or illustration.” Any aspect or design described herein as “exemplary” is not necessarily to be construed as preferred or advantageous over other aspects or designs. In one aspect, various alternative configurations and operations described herein may be considered to be at least equivalent. 
     As used herein, the phrase “at least one of” preceding a series of items, with the term “or” to separate any of the items, modifies the list as a whole, rather than each item of the list. The phrase “at least one of” does not require selection of at least one item rather, the phrase allows a meaning that includes at least one of any one of the items, and/or at least one of any combination of the items, and/or at least one of each of the items. By way of example, the phrase “at least one of A, B, or C” may refer to: only A, only B, or only C; or any combination of A, B, and C. 
     A phrase such as an “aspect” does not imply that such aspect is essential to the subject technology or that such aspect applies to all configurations of the subject technology. A disclosure relating to an aspect may apply to all configurations, or one or more configurations. An aspect may provide one or more examples. A phrase such as an aspect may refer to one or more aspects and vice versa. A phrase such as an “embodiment” does not imply that such embodiment is essential to the subject technology or that such embodiment applies to all configurations of the subject technology. A disclosure relating to an embodiment may apply to all embodiments, or one or more embodiments. An embodiment may provide one or more examples. A phrase such an embodiment may refer to one or more embodiments and vice versa. A phrase such as a “configuration” does not imply that such configuration is essential to the subject technology or that such configuration applies to all configurations of the subject technology. A disclosure relating to a configuration may apply to all configurations, or one or more configurations. A configuration may provide one or more examples. A phrase such a configuration may refer to one or more configurations and vice versa. 
     In one aspect, unless otherwise stated, all measurements, values, ratings, positions, magnitudes, sizes, and other specifications that are set forth in this specification, including in the claims that follow, are approximate, not exact. In one aspect, they are intended to have a reasonable range that is consistent with the functions to which they relate and with what is customary in the art to which they pertain. 
     It is understood that the specific order or hierarchy of steps, or operations in the processes or methods disclosed are illustrations of exemplary approaches. Based upon implementation preferences or scenarios, it is understood that the specific order or hierarchy of steps, operations or processes may be rearranged. Some of the steps, operations or processes may be performed simultaneously. In some implementation preferences or scenarios, certain operations may or may not be performed. Some or all of the steps, operations, or processes may be performed automatically, without the intervention of a user. The accompanying method claims present elements of the various steps, operations or processes in a sample order, and are not meant to be limited to the specific order or hierarchy presented. 
     All structural and functional equivalents to the elements of the various aspects described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be encompassed by the claims. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the claims. No claim element is to be construed under the provisions of 35 U.S.C. § 112 (f) unless the element is expressly recited using the phrase “means for” or, in the case of a method claim, the element is recited using the phrase “step for.” Furthermore, to the extent that the term “include,” “have,” or the like is used, such term is intended to be inclusive in a manner similar to the term “comprise” as “comprise” is interpreted when employed as a transitional word in a claim. 
     The Title, Background, Summary, Brief Description of the Drawings and Abstract of the disclosure are hereby incorporated into the disclosure and are provided as illustrative examples of the disclosure, not as restrictive descriptions. It is submitted with the understanding that they will not be used to limit the scope or meaning of the claims. In addition, in the Detailed Description, it can be seen that the description provides illustrative examples and the various features are grouped together in various embodiments for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the claimed subject matter requires more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive subject matter lies in less than all features of a single disclosed configuration or operation. The following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separately claimed subject matter. 
     The claims are not intended to be limited to the aspects described herein, but are to be accorded the full scope consistent with the language claims and to encompass all legal equivalents. Notwithstanding, none of the claims are intended to embrace subject matter that fails to satisfy the requirement of 35 U.S.C. § 101, 102, or 103, nor should they be interpreted in such a way.