Failure to Properly Label and Remove Expired Medications
Penalty
Summary
Surveyors identified multiple deficiencies related to the labeling and storage of medications and biologicals. In one instance, an open vial of Humulin R insulin for a resident was found stored at room temperature without a date indicating when storage or use at room temperature began. The nurse responsible was unaware of when the insulin was opened or when it would expire, and acknowledged that the vial should have been labeled and replaced to prevent the administration of expired medication. The facility's policy and the manufacturer's instructions both require opened insulin vials to be dated and discarded within a specified period, which was not followed in this case. Another deficiency involved an open Humulin N Kwikpen insulin for a different resident, which was labeled with an open date and a discard date, but was not removed from use after the discard date had passed. The expired insulin pen continued to be stored and administered to the resident beyond the recommended 14-day period, as confirmed by the nurse. The nurse acknowledged that several doses of expired insulin were given to the resident, constituting a significant medication error. Facility policy and manufacturer guidelines both require the removal and disposal of expired insulin pens, which was not done. Additionally, an open bottle of Timolol eye drops for another resident was found stored at room temperature without a label indicating the date of opening. The nurse interviewed stated that eye drops are typically good for 28 days after opening, but without a date, it was impossible to determine if the medication was expired. The Director of Nursing confirmed that the failure to label the medication with an open date was contrary to facility policy and could result in the use of expired medication. The facility's policies and the manufacturer's instructions both require multi-dose medications to be labeled with the date of opening to ensure timely disposal.