Expired Insulin Vial Found in Medication Cart
Penalty
Summary
A deficiency was identified when a nurse medication cart was inspected and found to contain an opened insulin vial that had exceeded its allowable usage period. The insulin vial was labeled with an open date, and upon review, it was determined that the vial had expired based on the facility's policy and manufacturer instructions, which state that opened insulin vials are only good for 28 to 31 days. The nurse present during the inspection acknowledged that she had not noticed the vial had expired and stated that it was each nurse's responsibility to monitor for expired medications. The Director of Nursing (DON) and the Administrator both confirmed that nursing staff are expected to remove expired insulins from medication carts. Facility policy documents reviewed indicated that outdated or expired medications are to be immediately removed from stock and disposed of according to procedures. Manufacturer instructions for insulin also specify that opened vials should be discarded after 31 days. The failure to remove the expired insulin from the medication cart was observed during the survey, and staff interviews confirmed that the expired medication had not been identified or removed as required by policy.