Failure to Date and Remove Expired Insulin Pens from Medication Carts
Penalty
Summary
Surveyors found that the facility failed to properly date opened multi-dose insulin pen injectors and failed to remove expired insulin pens from medication carts in two of five medication administration carts. Specifically, on the 100 hall medication cart, an opened and undated Lantus insulin pen was observed. Manufacturer instructions require that Lantus insulin multi-dose vials be discarded 28 days after opening. On the 200 hall medication cart, an opened and undated Glargine insulin pen and an Admelog Solostar insulin pen, which had been opened on 3/2/25 and expired on 3/30/25, were found. These deficiencies were identified during observations with two nurses, both of whom acknowledged that nurses are responsible for dating and discarding multi-dose vials per facility training and competency requirements. Interviews with the nurses revealed that they had not checked the dates of opening on insulin vials in their medication carts at the beginning of their shifts, although they stated they had not administered expired medication during those shifts. The Director of Nursing and the Administrator both confirmed that it is the responsibility of all nurses to check for and remove expired medications from the carts every shift, and that no expired items should remain in the medication carts.