Violation Details: 00231377-AP-189270

Records Request Print
Date
11/9/2022
Report number
00231377-AP-189270
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to administer medication as ordered
Result
Substantiated
Rule(s) Violated
External site: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and (r)
Findings
Alleged Victim (AV) was prescribed a slow-acting insulin for a titrating period that begun on October 29, 2022. It was discovered that between October 29th through November 8, 2022, the wrong type of insulin was given to AV by Alleged Perpetrator 2 (AP2). AP2 did not check AV’s medical administration record (MAR) charter before giving AV the wrong dose of insulin. AP2 had been trained in medication management. AP2 failed to administer medication as ordered, which is neglect of care and constitutes abuse. The facility failed to assure AV’s medication was administer as ordered, which is a violation of Oregon Administrative Rules.