IV Compounding Robot History and Where ABB Fits

Every chemotherapy bag that reaches a cancer ward was mixed by someone, or something, in a hospital pharmacy. For decades that meant a pharmacist or technician working with syringes and vials inside a ventilated cabinet. Today an IV compounding robot can weigh the drug, reconstitute the powder and withdraw the dose inside a sealed cell. This post follows that change from hand mixing to the first automated compounders, looks at a Florida cancer center that put a robot to work this autumn, and asks where ABB's collaborative arms could fit in hospital pharmacies over the next few years.

A chemotherapy infusion running from an IV bag and pump at the Royal Liverpool Hospital chemotherapy unit, 2011. Photo: robbelaw / Wikimedia Commons (CC BY-SA 2.0)

How pharmacists mixed IV and chemo doses by hand

Compounding is the old pharmacy trade of making a medicine to fit one patient's prescription when no factory product does. A 1934 photo from the University of Alberta's pharmacy lab shows what that looked like: shelves of stock bottles and a pharmacist at an open bench. Injectable drugs are harder. A tablet can survive a dusty room, but anything that goes straight into a vein has to be sterile and dosed exactly. Children add another layer, because most products are packaged for adults and have to be diluted down to a small patient's dose.

A pharmacist at work in the University of Alberta pharmacy lab, March 1934. Photo: University of Alberta Archives via Wikimedia Commons (public domain)

Cancer drugs made the job harder. The US National Cancer Institute began its chemotherapy testing program around 1950, and as more cytotoxic drugs reached clinics, pharmacy staff were handling compounds built to kill dividing cells, so the work moved into ventilated cabinets. Biological safety cabinets were sold commercially from 1950, and the laminar flow hood, which blows HEPA filtered air across the work surface in a smooth curtain, became the standard place to draw up a dose. The pharmacist still did every step by hand: swab the vial, reconstitute the powder, pull the volume, inject it into the bag and label it.

J. Hartwell (right) and an assistant at the start of the National Cancer Institute chemotherapy testing program, about 1950. Photo: National Cancer Institute via Wikimedia Commons (public domain)

Robots arrived in the 2000s. Intelligent Hospital Systems was formed in Winnipeg in 2004 to build RIVA, a robotic IV automation system that fills syringes and bags in a closed cell, and RIVA units went to hospitals in Canada, the United States, Australia and Asia. In Italy, the University Hospital of Ancona began automating oncology compounding with the Loccioni APOTECAchemo in 2007 and added a second robot when clinical validation ended in 2009. In 2014 the Monroe Carell Jr. Children's Hospital at Vanderbilt installed two i.v.STATION robots to prepare IV and syringe doses for its young patients.

CDC scientists working through air tight glove ports in a maximum containment cabinet lab, 1978. Photo: CDC / Betty Partin via Wikimedia Commons (public domain)

A chemo robot named Cathey and the case for automation

The newest example comes from Florida. On 2 October 2026, Cleveland Clinic Weston Hospital said its Maroone Cancer Center pharmacy had become the first in the state to use an APOTECAchemo. Staff named the robot Cathey, after a donor who helped fund the infusion area. It weighs drugs and diluents, handles vials, reconstitutes powders, withdraws doses, fills the final containers and records each step electronically. The hospital says gravimetric checks, where the system weighs ingredients throughout the job, add a safety layer beyond visual inspection, and that patient wait times have already dropped.

A robot for preparing patient specific cytostatic drugs, an APOTECAchemo unit in a hospital pharmacy. Photo: Dr. Jochen Schnurrer / Wikimedia Commons (CC BY-SA 4.0)

You can see why in a pharmacy like the one aboard the hospital ship USNS Mercy, where a technician works with his arms through the glove ports of an isolator. Every manual transfer is a chance to contaminate the bag or expose the operator. A 2023 meta-analysis of robotic cytotoxic drug preparation found robots more accurate than manual compounding and linked to less contamination of infusion bags, though results on speed were mixed. A 2023 review of 33 studies reached a similar view and said labor savings remain unclear. Tablet automation such as robotic pill dispensing is a different problem, because there the product already exists.

Hospitalman Hunter Larson prepares medical compounds in an isolator aboard the hospital ship USNS Mercy, January 2024. Photo: U.S. Navy / Gavin Arnoldhendershot via Wikimedia Commons (public domain)

ABB does not sell a compounding robot, and no source we found puts ABB arms inside one. Its healthcare work is close, though. In 2019 ABB announced a healthcare research hub at the TMC Innovation Institute in Houston to work on robots for hospital laboratories, and it has shown a mobile YuMi concept for hospital labs. A GoFa CRB 15000 cobot could, in principle, load vials and bags into a compounding cell, while a single arm YuMi IRB 14050 could sort and label finished doses. Cells like that are usually built and tested first in RobotStudio before anyone touches a drug.

A GoFa cobot at ABB's healthcare research hub. Photo: ABB

Where hospital compounding automation goes next

Over the next few years most of the growth will be in hospital pharmacies. Loccioni already sells separate APOTECA systems for batch filling of non hazardous syringes and IV bags, which it says reach up to ten times the output of patient specific preparation, plus software that links the robots to the electronic health record. Expect more of those links: an order placed in the record, a dose prepared, weighed, labeled and logged without anyone retyping a number. Patients receiving infusions at home will feel this indirectly, through ready to administer bags made in central pharmacies.

ABB's mobile YuMi concept, a dual arm robot on a wheeled base, in a hospital lab corridor. Photo: ABB

Cost is the first open problem. A compounding robot sits in a cleanroom, needs validation and competes with skilled technicians who can switch between drugs quickly. The 2023 meta-analysis found failure rates between 0.9 and 16.75 percent across studies, so a pharmacist still has to deal with the doses a robot rejects. Vials come in many sizes and closure types, and every new drug has to be set up and checked. The same analysis found slightly more contamination of the work area with robots, though the difference was not statistically significant, so cleaning routines still matter.

Glass vials and ampoules of chemotherapy drugs, 1986. Photo: Bill Branson / National Cancer Institute via Wikimedia Commons (public domain)

The people stay in the room, doing different work. Cleveland Clinic Weston says its robot frees pharmacists and technicians for clinical oversight, quality checks and patient care. For ABB, the opening sits around the cell. GoFa cobots already run automated lab workstations at the drug discovery company XtalPi, which uses more than 100 of them. Bringing that kind of arm into sterile compounding would need cleanroom surfaces, validated software and hospital approval, so for now it is a possibility to watch, with no ABB product on the market for it.

Automated lab workstations at XtalPi, built with ABB GoFa cobots. Photo: ABB

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