Failure to Monitor for Side Effects of Cymbalta in a Resident
Penalty
Summary
The facility failed to monitor for side effects in a resident who was prescribed Cymbalta, a medication used to treat depression and chronic pain. The resident had multiple diagnoses, including end stage renal disease, type 2 diabetes mellitus with diabetic polyneuropathy, and chronic obstructive pulmonary disease. The resident's Minimum Data Set indicated moderate cognitive impairment and dependence on staff for daily activities. Despite an active order for Cymbalta, there was no documentation or order for monitoring the resident for potential side effects associated with the medication. During interviews, both a registered nurse and the Director of Nursing confirmed that monitoring for side effects of Cymbalta was necessary and should be performed by licensed nurses, with any observed side effects to be reported to the physician. The facility's policy required monitoring for side effects of psychotropic medications, but this was not implemented for the resident in question. The lack of monitoring was identified through record review and staff interviews, with the Director of Nursing acknowledging the importance of such monitoring to assess the resident's tolerance to the medication.