HospitalInspections.org

Based on observation, +interview and record review, the facility failed to monitor and remove expired or outdated emergency medications from patient care areas in the Emergency Department (ED). This had the potential to affect all patients who are treated in the facility's ED. The hospital census was one when the survey began.

Record review of policy titled, "Emergency Room Services Cleaning and Inventory", dated 10/12/10 showed that medication and supply outdates are to be checked twice a month (page 1, #2.g).

1. Observation on 03/03/11 at 11:55 AM, showed that ED Patient Bay #2 contained the following outdated emergency medications:
-three Lidocaine 2% (for treatment cardiac emergencies) injections, Lot #75-407-DK, expired 03/01/11;
-two Phenytoin Sodium (for treatment of seizures) injections, Lot #81-0349-EV, expired 03/01/11.

2. Observation on 03/03/11 at 12:10 PM, showed that ED Patient Bay #3 contained the following outdated emergency medications:
-four Lidocaine 2% injections, Lot #75-407-DK, expired 03/01/11;
-two Phenytoin Sodium injections, Lot #81-0349-EV, expired 03/01/11.

3. Observation on 03/03/11 at 12:25 PM, showed that ED Patient Bay #1 contained the following outdated emergency medications:
-two Lidocaine 2% injections, Lot #75-407-DK, expired 03/01/11;
-two Phenytoin Sodium injections, Lot #81-0349-EV, expired 03/01/11.

During an interview on 03/03/11 at 12:35, Staff A, ED RN (Registered Nurse) confirmed the outdated medications and stated that the night nurse scheduled in the ED is responsible for removing outdated medications from the medication drawers every two weeks. Staff A stated that the medications in the drawers are considered crash cart drugs (medications that would be used during a medical emergency).

During an interview on 03/03/11 at 1:00 PM, Staff B, Director of Patient Care confirmed the medications were expired in the ED.