MEDICATION NAME: Cocaine 4% Topical Solution 4ml
VOLUME: 4mL BATCH SIZE: 31
Item – Strength – Size
Cocaine Powder 5gm 1 vial Mallinkrodt
Sterile Water for Injection 125ml Baxter

QS cocaine 5gm vial to 125ml with sterile water (4% final conc.) Draw up solution into # 2 60ml syringes. Filter 4ml through 0.22micron filter into 30ml tamper evident oral cup x 31 and seal. Draw up excess and document waste with cosignature into CII safe. Attach IVA tamper-proof seal.

Name of Facility: Sacred Heart Medical center

City, State: Eugene, OR

Years as a Buyer: 14