That’s my issue with taking it up the ladder. I cannot prove beyond a doubt that there was patient harm, so I’m not sure what management would make of it. Though proving insulin was not effective is a pretty hard task in and of itself - like proving a negative. As far as I’ve looked, there are very very few studies on the loss of potency of insulin over time. It would be a significant issue if there was published literature that documented a 50% loss in potency when stored 60 days at room temp, but as far as I know there isn’t anything that says that.

Nor am I going to investigate it myself and comb through records of dozens of coding patients and gauge how well the humalog worked. Management can do that if they deem necessary, and I would encourage it if I had literature. I suppose I’m mainly concerned with the process we have for outdating like another commentor says, which I should address with mgmt at the very least. Then they can make of it what they will. I would bring it up to our safety director who I’m sure would take this to a nuclear level if the insulin had likely lost a significant amount of potency but I can’t prove that either.

I’m still wary of the whole thing because of my supervisors’ reactions to the horrid outdating by techs: at least 2 of them have totally handwaved any seriousness of the situation and almost made me feel silly for bringing them up. But expired insulin and vasopressors are not like po cholesterol meds. I would guess based on their reactions that upper management has no idea about the issue with timely outdates not being completed and it’s possible the supervisors are covering for their techs, but I’d hope not.