Palomar Health, a California public healthcare district located in San Diego County, has paid $250,000 to resolve allegations of diversion of fentanyl from one of its facilities and failure to keep accurate records for fentanyl. Palomar Health is California’s largest healthcare district, with campuses in Escondido and Poway. This settlement arises from a self-disclosure Palomar Health made to the US Drug Enforcement Administration (DEA) that one of its employees may have diverted controlled substances. The government investigated Palomar Health and concluded that vials of fentanyl were diverted from Pyxis machines—automated medication dispensing machines often used in hospital settings—located at Palomar Health’s Cardiac Catheterization Lab in Escondido. Specifically, the government concluded that over a five‑month period, numerous vials of fentanyl were diverted from the Pyxis machines and unused fentanyl was not properly disposed of. In addition to paying $250,000 to resolve the government’s claims, Palomar Health entered into a Memorandum of Agreement with the DEA requiring Palomar Health to undertake additional measures to increase security, implement specialized training, and to handle controlled substances properly and safely.