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Occurrence Summary Reports for:
COLORADO MENTAL HEALTH INSTITUTE AT PUEBLO-PSYCH
Thursday, November 23, 2017 4:07 AM

Facility: COLORADO MENTAL HEALTH INSTITUTE AT PUEBLO-PSYCH
Date of Occurrence: 6/7/2015
Report Timely: No
Type of Occurrence: Abuse/Physical

DESCRIPTION OF OCCURRENCE:
On 06/07/15 a male patient, in his 20s, was administered medication against his wishes.

FACILITY ACTION:
The facility conducted an internal investigation. The facility notified the police department and appropriate facility administration and personnel. The patient was exhibiting symptoms of an impending seizure which progressed into a seizure. When the seizure was over, a staff member asked the patient if he wanted to take his medication and the patient declined several times. The staff member kept asking him if he wanted the medication and the patient finally quit answering the staff member. The staff member then drew up an intramuscular dose of the medication and administered the medication against the patient's wishes. The patient developed a red nodule that was warm and firm to the touch where staff had injected the medication. The medication administration appeared to have been outside of the intramuscular injection parameters. The staff member stated the patient often refused medication and then would agree to take it later. She said she thought the patient was being his usual self and refusing his medication. The staff member further explained that while attempting to give the patient his medication, the patient was in an awkward position making it difficult to see the appropriate area. The patient suddenly moved while the injection was administered. The staff member was placed on administrative leave pending the investigation. The patient's roommate confirmed the patient had refused the medication and the medication was administered anyway. The staff member resigned.

DEPARTMENT FINDINGS:
The Department reviewed the facility's report and supplemental documentation and found that the facility acted appropriately by reporting the occurrence, notifying the appropriate persons and agencies, assessing the patient, suspending the staff member and conducting an investigation.

The facility is subject to a deficiency for failing to report the occurrence timely. The Department will review this occurrence prior to any survey or upon receipt of any complaint that may be filed against this facility.


Sent to Facility: 7/10/2015

FACILITY COMMENT: Following receipt of the above summary, no additional comments were submitted by the facility.


Released to Public: 7/24/2015

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