Failure to Remove Expired Medications and Date Opened Vials
Penalty
Summary
Surveyors observed that the facility failed to properly manage medications and biologicals in the medication room. Specifically, an opened bottle of Tuberculin Purified Protein Derivative and an opened bottle of Afluria Influenza Vaccine were found in the vaccine refrigerator without any open date or open expiration date, despite both vials having been used. Additionally, three bags of IV Vancomycin and three bags of IV Zosyn, both antibiotics, were found in the medication room refrigerator with expiration dates that had already passed. These findings were confirmed by a registered nurse present during the observation. Further review of manufacturer instructions indicated that multi-dose vials of Afluria should be discarded within 28 days of being opened, and Tuberculin vials should be discarded after 30 days of use. The facility's own policy requires that outdated, contaminated, discontinued, or deteriorated medications be immediately removed from stock and disposed of according to established procedures. The failure to date opened vials and remove expired medications from stock led to the deficiency cited by surveyors.