Healthcare Inspection – Medication Management Concerns, South Texas Veterans Health Care System, San Antonio, Texas

OIG conducted an inspection to assess the merit of allegations made by a complainant regarding the intravenous compounded sterile product (CSP) medication error rate, improper aseptic technique while mixing CSPs, and excessive CSP wastage at the South Texas Veterans Health Care System (system), San Antonio, TX. A CSP is a pharmaceutical preparation that has been made or modified using manufacturer labeled instructions in a controlled sterile environment. We did not substantiate the allegation that the system’s pharmacy compounding error rate was high. We also did not substantiate that pharmacy personnel did not observe aseptic technique while compounding sterile products. However, we did substantiate excessive waste of CSPs. Because the stability of most compounded sterile products increases with refrigerated storage, we recommended that the System Director ensure that processes be developed to improve storage conditions of CSPs on patient units in an effort to reduce unnecessary waste.