Failure to Properly Store and Dispose of Insulin Medications
Penalty
Summary
Facility staff failed to ensure the safe and secure storage of medications, specifically insulin, as required by professional standards and manufacturer guidelines. Surveyors observed multiple opened and undated vials of insulin, as well as expired insulin vials, stored in medication refrigerators on two separate floors. In one instance, an opened and expired vial of Humalog Mix 75/25 insulin was found in the medication room refrigerator, with documentation showing it had been opened over a month prior and administered to a resident beyond the recommended 28-day usage period. The medication administration record confirmed that expired insulin was given to the resident for at least two days. Additional observations revealed further deficiencies in medication storage practices. On another floor, surveyors found an opened vial of Aspart insulin with no expiration date, two opened vials of Lantus insulin with no dates, and an opened Lantus insulin pen belonging to a discharged resident, all stored in the medication refrigerator. Review of medication records indicated that some of these insulins had not been administered for weeks or months, and in one case, a discharged resident's insulin pen remained in storage for nearly two months after discharge. Manufacturer guidelines for all insulins observed require disposal 28 days after opening, regardless of remaining volume or storage conditions. Interviews with nursing staff and unit managers confirmed that responsibility for checking and removing expired or undated medications from storage was not consistently followed. Staff acknowledged that they had not noticed expiration dates or failed to remove medications for discharged residents. The lack of proper dating, timely removal, and disposal of expired or unused insulin vials and pens directly led to the deficiencies cited in the report.