- Date
- 4/5/2025
- Report number
- 00393778-AP-344464
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide a safe medication administration system
- Result
- Substantiated
- Findings
- On or about April 5, 2025, the Alleged Victim (AV) received medication of another resident. Alleged Perpetrator #2 (AP2) became distracted while passing medication and pulled incorrect medication and administered it to AV. AV had a reaction to the incorrect medication, including chest pain and trouble breathing, was sent to the emergency room and was diagnosed with an overdose. AP2's actions caused physical and emotional distress to AV, which is a violation of resident rights, is considered neglect of care and constitutes abuse. Respondent failed to ensure staff were properly trained prior to providing medication administration to residents. This constitutes abuse by neglect, as outlined in OAR 411-020-0002(1)(b)(A)(i).
- Sanction
- RCFCP26-00167 $188.00 fine assessed