Failure to Remove Expired Medications and Date Opened Insulin and Eye Drops
Penalty
Summary
Surveyors identified a failure to follow the facility’s medication storage and labeling policy, specifically related to opened and expired medications on medication carts. During a medication cart inspection with a nurse, one resident’s lispro insulin vial was observed to be open, in use, and not dated, despite the facility policy requiring that the date opened be written on the container when the manufacturer’s seal is broken. Another resident’s Brimonidine ophthalmic solution was found on the cart with a date indicating it had exceeded the 28‑day usability period identified by the nurse, who acknowledged that the eye drops were expired and that expired medications should not remain on the cart. In a separate medication cart inspection with another nurse, two residents’ insulin pen injectors (Fiasp FlexTouch and Lyumjev KwikPen) were observed with dates indicating they had been open beyond the 30‑day period the nurse stated insulin remains usable, and the nurse confirmed both insulins were expired and should not be on the cart. The DON stated that only non‑expired medications should be on the medication cart, that insulin is good for 28–30 days after opening, and that eye drops are good for 30 days, and also confirmed that opened insulin and eye drops should be dated on the package when first opened. The facility’s Storage of Medication policy states that outdated medications must be immediately removed from inventory and that containers must be dated when first opened, with undated vials defaulting to the dispensed date for expiration calculation, and that all expired medications must be removed from active supply and destroyed.
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