[MCOH-EH] MCOH-EH Digest, Vol 247, Issue 12

Karl Auerbach kauerbach at aol.com
Sun Nov 9 07:06:24 PST 2014
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Claudine,  I¹ve signed you up for the MRO list

On 10/13/14, 8:17, "Holt, Claudine" <Claudine.Holt at tuhs.temple.edu> wrote:

>Yes, Dr. Auerbach.  I would appreciate it!  And can you send me the link
>to subscribe to the MRO list?
>
>And just to update the question, I received the anesthesiologist's record
>and she only received Propofol during the colonoscopy.  So it looks like
>I have to call this one positive.
>
>Sincerely,
>
>Claudine Holt, MD, MPH
>Staff Physician, Occupational Health Services
>Temple University Hospital
>Basement, Rock Pavilion
>215-707-8151 (phone)
>215-707-5751 (fax)
>Claudine.holt at tuhs.temple.edu
>
>
>
>-----Original Message-----
>From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of
>mcoh-eh-request at mylist.net
>Sent: Saturday, October 11, 2014 3:00 PM
>To: mcoh-eh at mylist.net
>Subject: MCOH-EH Digest, Vol 247, Issue 12
>
>Send MCOH-EH mailing list submissions to
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>
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>
>Today's Topics:
>
>   1. Re:  MRO question (Karl Auerbach)
>   2. Re:  MRO question (Jenkins, Maribeth)
>   3.  AUTO: Kim Mccracken is out of the office. (returning
>      10/13/2014) (KMccracken at mcleodhealth.org)
>
>
>----------------------------------------------------------------------
>
>Message: 1
>Date: Fri, 10 Oct 2014 16:03:01 -0400
>From: "Karl Auerbach" <KAuerbach at aol.com>
>To: "'MCOH/EH'" <mcoh-eh at mylist.net>
>Subject: Re: [MCOH-EH] MRO question
>Message-ID: <014a01cfe4c5$32c400b0$984c0210$@aol.com>
>Content-Type: text/plain; charset="iso-8859-1"
>
>It is a bit suspicious but don?t forget that drug tests are done at
>levels which may be well below the therapeutic ?half life? calculations.
>
> 
>
>I would be happy to send this on to the MRO list where you might get much
>more input.
>
> 
>
>Karl
>
> 
>
>From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Holt,
>Claudine
>Sent: Friday, October 10, 2014 1:29 PM
>To: 'mcoh-eh at mylist.net'
>Subject: [MCOH-EH] MRO question
>
> 
>
> Dear Colleagues,
>
> 
>
>I have an MRO question and would appreciate some feedback:
>
> 
>
>Someone came in for a pre-placement physical (in a patient care role) and
>the drug screen came back positive for phenobarbital.  She denies use of
>any barbiturate and none of the medications that she is on should cause a
>positive barbiturate screen.  However, she called me back a day later to
>say that she had a colonoscopy on 9/9 and her gastroenterologist told her
>that might have caused the positive test.  The drug test was done 20 days
>after the colonoscopy on 9/29 and as far as I know, you don?t typically
>get a barbiturate during a colonoscopy.
>
> 
>
>I asked her to have the anesthesiologist?s report sent to me so I could
>see what was administered.
>
> 
>
>The t ? of phenobarbital is 53-140 hours (per Up to Date).  Since it
>takes about 5 half-lives to eliminate something, it  could take from
>265-700 hours.  She had the procedure on 9/9 and the drug test on 9/29
>which is  480 hours.  So if she was given phenobarbital during the
>procedure, it actually might have been in her system.
>
> 
>
>Has anyone ever dealt with anything like this?  What are your thoughts?
>
> 
>
> 
>
>Sincerely,
>
> 
>
>Claudine Holt, MD, MPH
>
>Staff Physician, Occupational Health Services
>
>Temple University Hospital
>
>Basement, Rock Pavilion
>
>215-707-8151 (phone)
>
>215-707-5751 (fax)
>
> 
>
> 
>
> 
>
>  _____  
>
>
>This electronic message is intended to be for the use of the named
>recipient, and may contain information that is confidential or privileged.
>This communication may contain protected health information (PHI) that is
>legally protected from inappropriate disclosure by the Privacy Standards
>of the Health Insurance Portability and Accountability Act (HIPAA) and
>relevant Pennsylvania Laws. You can direct questions concerning PHI or
>HIPAA to the Corporate Compliance and Privacy Officer at (215) 707-5605.
>If you are not the intended recipient, please note that any
>dissemination, distribution or copying of this communication is strictly
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>the sender immediately by telephone or by return e-mail and delete and
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>------------------------------
>
>Message: 2
>Date: Fri, 10 Oct 2014 15:50:07 -0500
>From: "Jenkins, Maribeth" <mjenkins at hendrickhealth.org>
>To: "'Karl Auerbach'" <KAuerbach at aol.com>, "'MCOH/EH'"
>	<mcoh-eh at mylist.net>
>Subject: Re: [MCOH-EH] MRO question
>Message-ID:
>	<10B5ED9217444E41B0FF36663A9B79E90112174BFEAE at EMAIL.hhs.hendrickhealth.or
>g>
>	
>Content-Type: text/plain; charset="iso-8859-1"
>
>There is a MRO list?  I am looking for a new MRO now.
>
>Maribeth Jenkins, MSN, RN, LMT, CWC
>Employee Wellness Manager
>Hendrick Medical Center
>1900 Pine Street
>Abilene, TX 79601
>Phone: (325) 670-3010
>Fax: (325) 670-3051
>mjenkins at hendrickhealth.org<mailto:mbunn at hendrickhealth.org>
>www.ehendrick.org
>
>
>
>From: MCOH-EH 
>[mailto:mcoh-eh-bounces+mjenkins=hendrickhealth.org at mylist.net] On Behalf
>Of Karl Auerbach via MCOH-EH
>Sent: Friday, October 10, 2014 3:03 PM
>To: 'MCOH/EH'
>Subject: Re: [MCOH-EH] MRO question
>
>It is a bit suspicious but don't forget that drug tests are done at
>levels which may be well below the therapeutic "half life" calculations.
>
>I would be happy to send this on to the MRO list where you might get much
>more input.
>
>Karl
>
>From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Holt,
>Claudine
>Sent: Friday, October 10, 2014 1:29 PM
>To: 'mcoh-eh at mylist.net'
>Subject: [MCOH-EH] MRO question
>
> Dear Colleagues,
>
>I have an MRO question and would appreciate some feedback:
>
>Someone came in for a pre-placement physical (in a patient care role) and
>the drug screen came back positive for phenobarbital.  She denies use of
>any barbiturate and none of the medications that she is on should cause a
>positive barbiturate screen.  However, she called me back a day later to
>say that she had a colonoscopy on 9/9 and her gastroenterologist told her
>that might have caused the positive test.  The drug test was done 20 days
>after the colonoscopy on 9/29 and as far as I know, you don't typically
>get a barbiturate during a colonoscopy.
>
>I asked her to have the anesthesiologist's report sent to me so I could
>see what was administered.
>
>The t ? of phenobarbital is 53-140 hours (per Up to Date).  Since it
>takes about 5 half-lives to eliminate something, it  could take from
>265-700 hours.  She had the procedure on 9/9 and the drug test on 9/29
>which is  480 hours.  So if she was given phenobarbital during the
>procedure, it actually might have been in her system.
>
>Has anyone ever dealt with anything like this?  What are your thoughts?
>
>
>Sincerely,
>
>Claudine Holt, MD, MPH
>Staff Physician, Occupational Health Services Temple University Hospital
>Basement, Rock Pavilion
>215-707-8151 (phone)
>215-707-5751 (fax)
>
>
>
>________________________________
>
>This electronic message is intended to be for the use of the named
>recipient, and may contain information that is confidential or
>privileged. This communication may contain protected health information
>(PHI) that is legally protected from inappropriate disclosure by the
>Privacy Standards of the Health Insurance Portability and Accountability
>Act (HIPAA) and relevant Pennsylvania Laws. You can direct questions
>concerning PHI or HIPAA to the Corporate Compliance and Privacy Officer
>at (215) 707-5605. If you are not the intended recipient, please note
>that any dissemination, distribution or copying of this communication is
>strictly prohibited. If you have received this message in error, you
>should notify the sender immediately by telephone or by return e-mail and
>delete and destroy all copies of this message.
>
>______________________________________________________________________
>PRIVILEGED AND CONFIDENTIAL NOTICE: The information contained in this
>e-mail may be confidential and/or privileged. This e-mail is intended to
>be reviewed initially by only the individual named above. If the reader
>of this e-mail is not the intended recipient or a representative of the
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>
>Thank you for your assistance.
>
>Hendrick Health System
>1900 Pine St.
>Abilene, TX 79601
>325-670-2000
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>------------------------------
>
>Message: 3
>Date: Fri, 10 Oct 2014 22:01:02 -0400
>From: KMccracken at mcleodhealth.org
>To: MCOH/EH <mcoh-eh at mylist.net>
>Subject: [MCOH-EH] AUTO: Kim Mccracken is out of the office.
>	(returning	10/13/2014)
>Message-ID:
>	<OF6158FE9A.6C278705-ON85257D6E.000B1513-85257D6E.000B1513 at mcleodhealth.o
>rg>
>	
>Content-Type: text/plain; charset=US-ASCII
>
>
>I am out of the office until 10/13/2014.
>
>I will respond to your message when I return.
>
>
>Note: This is an automated response to your message  "Re: [MCOH-EH] MRO
>question" sent on 10/10/2014 4:50:07 PM.
>
>This is the only notification you will receive while this person is away.
>
>NOTICE: This e-mail message and all attachments transmitted with it may
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>(postmaster at mcleodhealth.org), and delete this message and all copies and
>backups thereof. Thank You.
>
>
>
>
>------------------------------
>
>Subject: Digest Footer
>
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>------------------------------
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>End of MCOH-EH Digest, Vol 247, Issue 12
>****************************************
>
>
>
>---------------------------------------
>The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
>List membership is free, but only subscribers may post to the list.
>To post send messages to: mcoh-eh at mylist.net
>To become a subscriber, or to change your subscription options (turn off
>email while you're on vacation, etc):   http://www.mcoh-eh.net
>MediTrax / Occupational Health Systems, Inc. provides financial support
>to ensure the list remains a free resource for the occupational health
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