Unnecessary Medication Administered to Resident with Type I Diabetes
Penalty
Summary
The facility failed to ensure that a resident's drug regimen was free from unnecessary medications. A resident with a diagnosis of Type I diabetes mellitus (T1DM) was prescribed and administered Trulicity, a medication only approved for use in Type II diabetes mellitus (T2DM). Medical record review showed the resident was cognitively intact, required insulin injections, and had multiple diagnoses related to T1DM. Despite this, physician orders and the Medication Administration Record confirmed that Trulicity was administered on several occasions during the resident's stay. Interviews with facility staff, including a pharmacist, nurse practitioner, physician, LPN, and RN, revealed a lack of awareness regarding the appropriateness of Trulicity for T1DM. Both pharmacists and the physician confirmed that Trulicity is not approved or effective for T1DM due to its mechanism of action, which requires endogenous insulin production. The nurse practitioner who prescribed the medication admitted to treating T1DM and T2DM similarly and was unaware of the resident's specific needs. The facility's policy required that residents' medication regimens be managed to avoid unnecessary drugs, but this was not followed in this case.