Expired Tuberculin Solution Not Discarded as Required
Penalty
Summary
The facility failed to provide proper pharmaceutical services by not removing an expired vial of tuberculin skin testing (TST) solution from the vaccine/medication refrigerator. During an observation, a vial of TST solution was found with an open date of 4/24, lacking staff initials, and had not been discarded after the required 30-day period as indicated by both facility policy and the manufacturer's instructions. The ADON confirmed that the TST was administered to residents and staff as needed, and acknowledged that the vial should have been discarded after 30 days, but the lack of initials and a clear open date made it impossible to verify compliance. Interviews with the ADON, DON, and Administrator revealed that responsibility for labeling and discarding multi-dose vials rested with the ADON and DON. The DON stated that failure to discard expired medications could result in ineffective vaccinations or false test results. The facility's policy required nurses to label multi-dose vials with the date opened and discard them after 30 days unless otherwise specified. The TST package insert and FDA guidance also specified disposal after 30 days of opening, which was not followed in this instance.