[MCOH-EH] MCOH-EH Digest, Vol 247, Issue 12
Holt, Claudine
Claudine.Holt at tuhs.temple.edu
Mon Oct 13 05:17:37 PDT 2014
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-----
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Sent: Saturday, October 11, 2014 3:00 PM
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Subject: MCOH-EH Digest, Vol 247, Issue 12
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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 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.
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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.org>
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 intended recipient, you are hereby notified that any review, dissemination or copying of this e-mail, or the information contained herein, is prohibited. If you have received this e-mail in error, notify the above sender, send the message back and then delete it.
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.org>
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 contain legally PRIVILEGED and CONFIDENTIAL information intended solely for the use of the addressee. If the reader of this message is not the intended recipient, you are hereby notified that any reading, dissemination, distribution, copying, or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender immediately and/or notify the postmaster (postmaster at mcleodhealth.org), and delete this message and all copies and backups thereof. Thank You.
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End of MCOH-EH Digest, Vol 247, Issue 12
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