Violation Details: 00239674-AP-197187

Records Request Print
Date
1/2/2023
Report number
00239674-AP-197187
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Rule(s) Violated
External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(f)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and (f)
Findings
Alleged Perpetrator 2 (AP2) failed to ensure the Alleged Victim’s (AV) medications were administered as ordered. On or about January 2, 2023, AP2 administered an incorrect dose of blood pressure medication to the AV causing AV’s blood pressure to drop, resulting in AV feeling dizzy, shaky, and weak. AP2’s actions caused AV unreasonable discomfort, are a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to provide a safe medication administration system which is a violation of Oregon Administrative Rules.