A robotic intravenous automation system, including a robotically controlled holder configured to manipulate an intravenous (IV) bag and a closed system transfer device (CSTD). The controller includes a processor configured to control the holder. The IV bag includes a first fluid port and a second fluid port, and the CSTD includes a CSTD port, a spike adapter that is fluidically separated from the CSTD port, and a flexible member connecting the CSTD port to the spike adapter.
