Lower riskMedical device recall · FDA · Published March 11, 2025
BD Pyxis MedBank Mini/Tower and MedFlex: Software bug may cause extra medication doses
BD Pyxis automated dispensing cabinets with software version 2.4 have a bug that can cause incorrect medication counts and extra doses. Affected units include MedBank Mini, Tower, MedFlex, and MedPass models.
Due to a software bug, automated dispensing cabinet is unable to calculate countback discrepancies during the issue process, which causes incorrect transaction quantity to be recorded. This bug can also result in the CUBIE opening more times than needed for the transaction to be completed, which may result in a patient receiving more than the intended dose of medication.
Take action
Contact the company
📍Recalling firmCareFusion 303, Inc.10020 Pacific Mesa Blvd · San Diego, CA 92121-4386
✎ GovInfoNow plain-language explainer
BD Pyxis automated dispensing cabinets (MedBank Mini, Tower, MedFlex, MedPass) with software version 2.4 have a software bug that can cause incorrect medication counts and potentially give patients more medication than intended. This is a software issue that could lead to over-dosing. Read more at govinfonow.com/recall/52645-bd-pyxis-medbank-mini-tower-and-medflex-software-bug-may.
“BD Pyxis MedBank Mini/Tower and MedFlex: Software bug may cause extra medication doses.” GovInfoNow, updated August 17, 2026. https://govinfonow.com/recall/52645-bd-pyxis-medbank-mini-tower-and-medflex-software-bug-may. Based on FDA recall #Z-1545-2025 (https://api.fda.gov/device/enforcement.json?search=recall_number:%22Z-1545-2025%22&limit=1).
CareFusion 303, Inc. recalled BD Pyxis automated dispensing cabinets due to a software bug that may cause patients to receive incorrect medication doses, the FDA said on March 11, 2025.
How to tell if you have it
BD Pyxis MedBank Mini
BD Pyxis MedBank Tower
BD Pyxis MedFlex
BD Pyxis MedBank MedPass
The hazard
A software bug prevents the automated dispensing cabinet from calculating countback discrepancies during the issue process, resulting in incorrect transaction quantities being recorded. The bug can also cause the CUBIE to open more times than needed, potentially leading a patient to receive more than the intended dose of medication.
Context
GovInfoNow's records show CareFusion 303, Inc. has 64 other recalls on record since June 12, 2017. Other recent recalls of similar products include Medtronic SynchroMed Flex Infusion Software Issue: Steps May Not Program Correctly (April 8, 2026), Boston Scientific TheraSphere 360 Y-90 Software Anomaly Recall (June 19, 2026) and Baxter Novum IQ Syringe Pump Recall: Software Issue May Cause Infusion Errors (Aug. 11, 2026).
How to tell if you have this one
Check for BD Pyxis MedBank Mini, Tower, MedFlex, or MedPass cabinets with software version 2.4. The software version is listed in the product's reference and unique identification codes.
Brand
BD Pyxis
Category
Medical device
Based on the official FDA remedy
What to do — step by step
Check Software Version
Look for the software version in the product's reference and unique identification codes (e.g., 169-143/10885403512568/2.4).
Where it went and when
Where it was distributed
Distributed nationwide; the notice names 48 states.
Named in the notice
Covered by “nationwide”
Not listed
FDA distribution: “US Nationwide distribution: CA, TX, WI, CO, AK, VA, TN, WA, NC, NY, MS, FL, KS, MI, IN, MN, MT, KY, MO, UT, NJ, OH, PA, ND, OR, NE, SD, NV, OK, GA, MA, IA, HI, ME, AZ, IL, SC, LA, WV, AL, ID, NM, DC, NH, VT, CT, MD, AR, WY.” States read from FDA’s own wording; “not listed” means the notice does not name it.
Named in the notice: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming.
Recall timeline
FDA published this recall 36 days after the firm started it.
1Firm started the recall
2FDA classified it Class II
3Published in FDA’s Enforcement Report
Dates from the agency record only; steps without a date are left out.
The facts (hazard, remedy, dates, manufacturer) are pulled from the official FDA recall record. The plain-language summary and step-by-step checklist are written by GovInfoNow to make the official notice easier to act on — they don’t replace it.
Official source: FDA Recall #Z-1545-2025 (March 11, 2025) — FDA publishes no per-recall page; this is the official machine-readable enforcement record. Search FDA recalls for Z-1545-2025 to see it in context.
Plain-language summary written by qwen3:4b on August 17, 2026, from the official record above. Not reviewed by a person — if it conflicts with the FDA notice, the notice is correct. Report an error on this page.
GovInfoNow is an independent service and is not a government agency. We republish official FDA recall data; we don’t issue, amend or administer recalls.