Failure to Date Multi-Use Medication Vial Upon Opening
Penalty
Summary
Surveyors observed that a multi-use vial of Tuberculin, Purified Protein Derivative diluted/Aplisol, was found open and undated in the medication storage room, with approximately three-quarters of the vial remaining. The vial had been dispensed from the pharmacy several weeks prior and had an imprinted expiration date, but there was no indication of when it was first accessed. The Director of Nursing confirmed during the observation that the vial was open and undated, and acknowledged that it should have been dated upon opening. Review of facility policy and pharmacy documentation confirmed that multi-use vials are required to be dated when first accessed and that this specific medication should be discarded 30 days after opening. This failure to properly date the multi-use vial had the potential to affect all 56 residents in the facility.