Failure to Date Opened Insulin Vials in Medication Cart
Penalty
Summary
Surveyors found that the facility failed to ensure all drugs and biologicals were labeled in accordance with professional standards, specifically by not recording the opened-on date on two multidose insulin vials stored in a medication cart. During an observation, two opened vials of insulin—one Lantus vial for a female resident with Type 2 Diabetes Mellitus and one Lispro vial for another female resident with the same diagnosis—were found in the 100-hall nurse cart without the required opened-on date written on either the vial or its box. Both residents had received multiple insulin injections in the past week, and the facility's policy required the date of opening to be recorded on multidose containers. Interviews with nursing staff and clinical supervisors confirmed that the standard practice was to write the opened-on date on insulin vials and check expiration dates before administration. However, the staff were unable to locate any opened-on dates on the vials in question. The facility's policy, as reviewed by surveyors, also specified that the date of opening must be recorded on multidose containers, and this was not followed in these instances.