Print Violation: 00164912-AP-130824

Provider Information

Pelican Pointe

615 WASHBURN WAY
Klamath Falls, OR 97603

Date: 3/10/2021
Report number: 00164912-AP-130824
Type: Licensing Violation
Level: 3 - Moderate harm or potential for serious 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) and (r)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and (j)
Findings: On or about March 9, 2021, the Alleged Victim (AV) was administered a vaccine without his/her medical decision representatives consent. Alleged Perpetrator #2 (AP2) was to get consent of all residents decision representatives approval prior to administering vaccines. AV's representative did not give consent, however, AV did sign the document, however, AV does not have capacity to understand the document. AV received the vaccine and had an adverse reaction and was sent to the hospital for treatment. AV was placed at risk for serious harm and suffered unreasonable discomfort. AP2's actions are a violation of resident rights, are considered neglect of care and constitute abuse. The facility failed to provide a safe medication administration system, which is a violation of Oregon Administrative Rules.