Expired and Unlabeled Medications Found in Medication Cart
Penalty
Summary
Surveyors identified that the facility failed to ensure proper labeling and storage of medications in medication cart 1. During observation and interview, an opened bottle of vitamin B1 was found in the cart with an expiration date that had already passed. The bottle was labeled with an opened date, but the expiration date printed on the bottle had lapsed. The nurse present acknowledged that it was the responsibility of licensed nursing staff to check expiration dates and stated that administering expired medication could cause adverse effects. Additionally, an opened foil pack of Ipratropium with Albuterol Solution for a resident with respiratory failure, dysphagia, and a gastrostomy tube was found in the medication cart without a label indicating the date it was opened. The pharmacy fill date was several months prior, and the nurse could not determine when the pack was opened. The manufacturer's instructions require that opened foil packs be used or discarded within two weeks of opening, and the lack of labeling made it impossible to ensure compliance with this requirement. A similar issue was found for another resident with COPD, hypertension, obstructive sleep apnea, and muscle weakness. An opened and expired foil pack of Ipratropium with Albuterol Solution was found in the medication cart, with the nurse confirming it had been opened beyond the recommended period. Facility policies reviewed by surveyors required all medications to be properly labeled and expired or deteriorated drugs to be returned or destroyed, but these procedures were not followed in these instances.