- Date
- 5/29/2024
- Report number
- 00333798-AP-284840
- Type
- Licensing Violation
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide a safe medication administration system
- Result
- Substantiated
- Findings
- Alleged Victim (AV) was prescribed antibiotics for his/her medical condition. AV did not receive the last three doses of antibiotics as ordered by AV's doctor. Based on facility documentation and interviews, the facility staff misread AV's medication order which caused the error. AV did not have an adverse reaction as result of the medication error. However, the facility failed to ensure adequate professional oversight to ensure AV's medication is carried out as prescribed which is a violation of Oregon Administrative Rules.