Failure to Properly Label, Date, and Remove Expired Insulin
Penalty
Summary
Surveyors observed that insulin pens and vials on two medication carts were not properly labeled or dated in accordance with manufacturer recommendations and professional standards. Specifically, several insulin pens and vials lacked pharmacy labels, were not dated when opened, and some were found to be used past their expiration dates. The manufacturer's guidelines for various types of insulin, including glargine, Humalog, Lispro, Novolog, Aspart, and Toujeo Solostar, require that these medications be used within 28 days of being removed from refrigeration. Despite these requirements, multiple insulin products on both the 100-hall and 200-hall carts were either missing open dates, missing expiration dates, or had expired but were still present on the carts. During interviews, an LPN acknowledged that the insulins should have been discarded when expired or labeled when opened, but was unsure who was responsible for ensuring compliance. The DON stated that her expectation was for the nurse who removed the insulin from refrigeration to label it with the opened and expiration dates, and that nurses should always check expiration dates before administration. The failure to properly label, date, and remove expired insulin was directly observed and confirmed by staff interviews.