Violation Details: 00332527-AP-283712

Date
5/21/2024
Report number
00332527-AP-283712
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Findings
The Alleged Victim (AV) had a kidney stone that was causing him/her pain. AV was scheduled for surgery in February 2024, however, the facility was not made aware to hold AV's medications prior to surgery, so the surgery was re-scheduled for May 2024. On the day of AV's surgery, the hospital noticed that AV bruised during placing an IV. The hospital called the facility and learned that AV had been receiving medication that was to be held to complete the surgery. AV's surgery had to be cancelled again, placing AV in unreasonable discomfort. Respondent failed to ensure AV's medications were held to ensure AV could have surgery. This constitutes abuse by neglect, as outlined in OAR 411-020-0002(1)(b)(A)(i).