Failure to Label and Remove Expired Medications
Penalty
Summary
Surveyors identified that the facility failed to properly label and remove expired medications in accordance with facility policy and manufacturer guidelines. Specifically, an open bottle of artificial tears eye drops for one resident was found in a medication cart without a date indicating when use began. The responsible LVN confirmed that the eye drops were not labeled with an open date, making it impossible to determine if the medication was still within its effective period. Facility policy and the manufacturer's instructions require multi-dose eye drops to be dated upon opening to ensure timely disposal. Additionally, an open Lispro Kwikpen insulin pen for another resident was found stored at room temperature and labeled with an expiration date that had already passed. The LVN acknowledged that the insulin pen had been opened and used beyond the 28-day period recommended by the manufacturer for potency and safety. The medication administration record (MAR) confirmed that four doses of expired insulin were administered to the resident after the expiration date had passed. The Director of Nursing (DON) reviewed the findings and confirmed that the expired insulin had not been removed from the medication cart as required, and that multiple LVNs had failed to identify and discard the expired medication. The DON also confirmed that the artificial tears eye drop bottle was not labeled with an open date, which is necessary to determine expiration. Facility policies reviewed by surveyors require that outdated or expired medications be immediately removed from stock and that multi-dose containers be dated when opened.