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What is the proper way to “waste and witness” the unused amount of an open narcotic vial?

Monday October 15, 2012
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Question:

Dear Nancy,

What is the proper way to “waste and witness” the unused amount of an open narcotic vial? It is my understanding that the drug needs to be drawn up in a syringe and the contents then emptied into a sink or specialized area. I have been refusing to co-sign for a physician who insists on throwing the half-full vial into a Sharps container that has a large opening to which anyone can retrieve the vial.

Donna



Nancy Brent replies:

Dear Donna,

The correct method for wasting narcotics is an important edict to follow, since federal law and the federal Drug Enforcement Agency set these requirements. It is assumed your hospital policy follows the federal edicts currently in effect and therefore your hospital policy should be your guide and followed to the letter.

There is no doubt that when wasting a narcotic, there must be two individuals who witness and attest to the wasting. If the wasting is not done according to applicable federal law and hospital policy, then no co-signing of the waste should take place.

You might want to raise this issue with risk management, the pharmacy and your CNO. Start with a confidential meeting with the CNO, who can then take appropriate action by sharing the information with pharmacy, risk management, and others in administration, including the CMO.

The issue of non-compliance with the adopted wasting policy not only potentially affects you, but the facility as well, since it must comply with DEA policies and file periodic reports concerning this issue with the DEA.

Even though you are not co-signing an unacceptable waste procedure, the physician might try and turn the attention from his or her non-compliance with appropriate wasting procedures to you — by saying, for example, “if you were so concerned about the vial(s) in the Sharps container, why didn't you report it sooner?” Interestingly, could it be that the physician throws the half empty vial into the sharps box for his or her, or another staff member's, later use?

Acting on this issue as soon as possible is not only in your best interest, but others' best interest as well.

Cordially,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.