[MCOH-EH] For-Cause Invalid Result

[Sampson, Deborah]

Thank you both for your questions and answer. I am having some interesting issues with this very topic in our facility and it is so good to know I am not alone in this challenge. The MROs have been very helpful to me in these situations.
Deborah A. Sampson, PhD, APRN, COHN-S, FAANP
Director
Employee Health and Wellness Services
Southern New Hampshire Health   P.O.Box 2014   8 Prospect Street   Nashua, NH 03060
p(603) 281-8583  f (603) 577-5665
deborah.sampson at snhhealth.org<mailto:deborah.sampson at snhhealth.org>

[cid:image002.png at 01D12056.31ABE440]



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Falcone, Melissa
Sent: Monday, January 18, 2016 11:32 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] For-Cause Invalid Result

I would confirm with whomever did the collection that it was truly a direct observation.  Some people think that if someone is in or near the washroom or collection area, it is an observed collection.  DOT regulations would allow repeat testing with same sex collector having the donor drop his/her pants to the knees, observing for any straps or other paraphernalia that could contain artificial or other urine, then have them witness the donor void into the container.  I used to do our own collections and sadly caught many people with some very creative ways of hiding artificial urine.  If you have an invalid result it may have been a PH issue which is a huge red flag for a "fake" sample.  Antibiotics typically do not interfere with urine drug tests.  Have you also consulted with the MRO or the testing lab?  Most labs have a scientist that will talk through the results with you and give you recommendations as well.

Melissa Falcone, RN

Melissa Falcone, RN  |  Manager  |  Employee Health
PeaceHealth<http://www.peacehealth.org/>  |  2901 Squalicum Parkway  |  Bellingham, WA 98225
[peace-logo-lockup copy_480px]office 360-788-6300 ext. 4571  |  mobile 360-383-8626  |  fax 360-715-4129


From: MCOH-EH [mailto:mcoh-eh-bounces+mfalcone=peacehealth.org at mylist.net] On Behalf Of Linda Clark, MD
Sent: Friday, January 15, 2016 10:05 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [MCOH-EH] For-Cause Invalid Result

I need an opinion from the list.

I had a non-DOT for-cause drug test that came back invalid - interfering substance.  However, they also reported it was positive for amphetamines. I'd never had an invalid specimen also report (officially) an identified substance.

MRO interview - the guy was on antibiotics (doesn't know which one) at the time of the collection and was prescribed Adderall.  I was thinking of repeating the test under observation.  He tells me that the original collection was done observed - this is the company's protocol.  It was indicated on the CCD, and I confirmed that it was the case (done standardly for for-cause tests). I verified the amphetamine prescription as being valid.

Am I all done? Can I report this if the test was invalid?  I want to report as negative and be finished. I'm not sure what I would gain by repeat under observation unless I wait until antibiotics are out of his system (just finished yesterday).  Especially since this was for suspicion. The time has passed.

Opinion? Thanks.

Linda L. Clark, MD, MS
Occupational and Preventive Medicine
(585) 227-0072 P
(585) 227-9585 F
lclark at doctorclark.org<mailto:lclark at doctorclark.org>

[065_clark_occ_logo_long_color]


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