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NORTHEASTERN VERMONT REGIONAL HOSPITAL 1315 HOSPITAL DRIVE SAINT JOHNSBURY, VT 05819 June 11, 2014
VIOLATION: POLICIES - DRUG MANAGEMENT Tag No: C0276
Based on observation and confirmed through staff interviews the facility failed to assure that all drugs and biologicals were stored in a secured manner and that outdated drugs and biologicals were not available for patient use. Findings include:

During tour of the Emergency Department (ED) with the ED Nurse Manager, at 10:45 AM on 6/10/14, the following observations were made:

a. There was a vial of Verapamil (used to treat high blood pressure and control chest pain) 5mg/2 ml stored in the emergency Adult Code Cart, with an expiration date of 3/1/14.
b. There were 2 (1) Liter bags of Lactated Ringers intravenous solution stored in a refrigerator in Exam Room #2, each with an expiration date of February 2014.
c. A container of Hurricane Spray (topical anesthetic) was stored, unsecured and unmonitored in an unlocked cabinet in Exam Room #2.

These findings were confirmed by the ED Nurse Manager at the time of tour. On 6/11/14 at 2:35PM, the ED Nurse Manager stated that storing refrigerated lactated ringers solution was fairly new to the department and that a procedure for checking for outdates had not been established. The Director of Pharmacy confirmed, during interview on the afternoon of 6/11/14, that all drugs and biologicals should be stored in a secure manner and stated that s/he had not been aware the topical anesthetic spray had been stored in an unsecured area.