The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

Based on manufacturer's label guidelines, observations, and interviews, the facility failed to store medications according to manufacturer's recommendations.

The findings included:

Review of manufacturer's label on a 100 milliliter (ml) bag of Normal Saline (NA/liquid administered to patient via a vein) intravenous (IV) fluid revealed, " only in moisture barrier overwrap..."

Observation of the Cardiac Catheter Lab #1 (a procedure room where a flexible tube/catheter is placed inside a patient's heart) on 11/9/16 at 9:45 AM, revealed one 100 ml bag of normal saline IV solution, unwrapped from the outer moisture barrier overwrap, and stored in the drawer of the crash cart. Further observation of the crash cart revealed one 250 mg multi-dose bottle of Nitroglycerine 25 mg (milligrams)/250 ml with the top dust cover removed and an access port/device inserted in the top, with no date documented of when the bottle was opened.

Interview with the Nurse Manager (NM) of the Cardiac Catheter Lab, on 11/9/16 at 9:45 AM, in the Cath Lab, confirmed the 100 ml bag of IV Normal Saline was unwrapped, and confirmed the bag should not have been stored with the protective overwrap removed. Further interview confirmed the 250 ml bottle of Nitroglyerine was opened, undated, and had an access device inserted in the top. Further interview with the NM confirmed the bottle of nitroglyerine solution should have been discarded after being opened.
Based on policy review, observations, and interviews, the facility failed to store drugs in a secure area.

The findings included:

Review of facility policy Medication Storage, Disposition, and Security policy, effective date 2/11, revealed, "...medications are stored securely...A secure medication area is defined as...An area in which staff is actively providing patient care...Area is restricted..."

Observations of an anesthesia cart on 11/9/16 at 10:00 AM, located in an isolated corridor behind the cardiac catheter labs (a procedure room where a flexible tube is inserted into the patient's heart), revealed the corridor was isolated and was accessable through an unlocked door on one end. Further observation of the anesthesia cart revealed the bottom drawer was unlocked and had two 1000 milliliter (ml) bags of Lactated Ringers (a liquid solution given to patients through the vein) intravenous (IV) solution, three 1000 ml bags of Normal Saline IV Solution, two 250 ml bottles of Ultane (inhaled anesthesia), two 100 ml bottles of Isoflurane (inhaled ansethesia), and two 240 ml bottles of Suprane (inhaled anesthesia).

Interview with the Certified Nurse Anesthetist #1 and the Cardiac Catheter Lab Manager on 11/9/16 at 10:05, in the corridor behind the cardiac catheter lab, confirmed there were IV solutions and bottles of inhaled anesthesia stored in the unlocked drawers and the corridor was isolated and accessible through an unlocked door.