Print Violation: 00041822-AP-029388

Provider Information

Middlefield Oaks Assisted Living Community

1500 VILLAGE DRIVE
Cottage Grove, OR 97424

Date: 7/25/2019
Report number: 00041822-AP-029388
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: 411-054-0055(1)(a) and (f)
Findings: The Alleged Victim (AV) experienced side effects from being given 2 times the amount of morphine as ordered. On or about July 25, 2019, Alleged Perpetrator #2 (AP2) gave AV 2 times the amount of morphine as ordered, as he/she had popped the medication, left the medication room to attend to something else and when returned, popped two more morphine for the resident and administered the medication. AP2 failed to administer medication as ordered, which is 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.