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Based on interview, review of documents and review of 1 of 2 clinical records the accuracy of the record could not be determined in that progress notes were not congruent with the medication administration record (MAR) and pharmacy records.
Findings:

Citing patient #1, a 12 year old male presenting to the emergency room at 0734 hours on 1 /17/2001 with extreme pain due to kidney stones.

Review of the MAR reflected the patient received Morphine 2 mg IV 5 times (10 mg in 12 hours) as follows:
0850
0925
1238
1355
1911

1630 Morphine via PCA pump using a 50 mg per 50 milliliter bag was started to run at no more than 0.7mg every 10 minutes on demand. with Morphine 4 mg loading dose

Per personnel #26, (pharmacist ) on 5/24/2011 at 11;10am, when the PCA was discontinued and returned to the pharmacy 40 cc was left in the bag which was wasted.
The patient received a total of 10 mg from the PCA

However, progress notes reflected the following:

1/17/11 1939 "Patient received 12 mg morphine in 90 minutes"
1/17/11 2130 "Patient receives 20 mg since start of PCA"
1/18/11 1206 "Patient received 19 mg Morphine in 1.5 hours