Split Specimen Testing Procedures
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Questions and Answers

What is the time limit for an employee to request a test of a split specimen after being notified of a verified positive drug test?

  • 24 hours
  • 72 hours (correct)
  • 5 days
  • 48 hours

    • Which of the following is NOT a valid reason for an employee to miss the 72-hour deadline for requesting a split specimen test?

  • Illness
  • Busy work schedule (correct)
  • Inability to contact the MRO
  • Serious injury

    • What must the MRO do upon receiving a timely request from an employee for a split specimen test?

  • Notify the employee's supervisor immediately
  • Document the request and notify the primary laboratory (correct)
  • Conduct the test on-site
  • Dismiss the request if the drug test result is positive

    • Who is responsible for covering the costs of a split specimen test?

    <p>The employer (B)</p> Signup and view all the answers

    What must an employee provide if they miss the 72-hour deadline to request a split specimen test?

    <p>Documentation of valid reasons for the delay (B)</p> Signup and view all the answers

    What does the MRO do if they determine that an employee's delay was due to a legitimate reason?

    <p>They schedule the split specimen test (C)</p> Signup and view all the answers

    Which statement is true regarding split specimen testing?

    <p>Only employees can initiate the split specimen request (D)</p> Signup and view all the answers

    What must the employer do if the employee is unable to pay for the split specimen testing?

    <p>The employer must ensure the test is conducted in a timely manner. (B)</p> Signup and view all the answers

    What is one action the laboratory must take if the split specimen is unavailable?

    <p>Report the results for the primary specimen. (D)</p> Signup and view all the answers

    What items must be forwarded to the second laboratory when sending the split specimen?

    <p>The split specimen, the MRO's request, and Copy 1 of the CCF. (C)</p> Signup and view all the answers

    Which of the following must the second laboratory conduct when testing the split specimen?

    <p>Conduct tests regardless of cutoff concentrations. (C)</p> Signup and view all the answers

    What should a laboratory do if the split specimen fails to reconfirm the drug presence?

    <p>Conduct validity tests to find the reason. (D)</p> Signup and view all the answers

    When can the laboratory that tested the primary specimen open the split specimen?

    <p>Under no circumstances. (A)</p> Signup and view all the answers

    What must the laboratory do when reporting split specimen results to the MRO?

    <p>Check the appropriate boxes on Copy 1 of the CCF. (B)</p> Signup and view all the answers

    What method should a laboratory use to report results of split specimen tests?

    <p>Directly and only to the MRO's business address. (A)</p> Signup and view all the answers

    What is the purpose of conducting validity tests on a split specimen?

    <p>To investigate failure to reconfirm presence of drugs. (C)</p> Signup and view all the answers

    How should the laboratory handle inadvertent disclosure of the employee's identity during testing?

    <p>It does not cause a fatal flaw. (D)</p> Signup and view all the answers

    If an adulterant is detected in the primary specimen, what must the second laboratory do?

    <p>Use the confirmatory test criteria specified. (B)</p> Signup and view all the answers

    If the laboratory reconfirms a positive test result for drug(s) or drug metabolite(s) in a split specimen, what is the final result?

    <p>The result is a positive test. (A)</p> Signup and view all the answers

    What is the MRO's responsibility when a split specimen is reported as invalid, adulterated, and/or substituted, and the original test results are also invalid?

    <p>Direct the DER to collect another specimen under direct observation. (B)</p> Signup and view all the answers

    When a split specimen fails to reconfirm the primary specimen results due to substitution criteria not being met, and the creatinine concentration is between 2mg/dL and 5mg/dL, what additional action must the MRO take?

    <p>Direct the DER to collect another specimen under direct observation, with no notice given to the employee. (D)</p> Signup and view all the answers

    If the laboratory reports a split specimen as adulterated and/or substituted, and the MRO determines that there is no legitimate medical explanation for the finding, what action must the MRO take?

    <p>Report the test to the DER and employee as a verified refusal to test. (A)</p> Signup and view all the answers

    What is the final result if a laboratory reconfirms an adulterated or substituted result in a split specimen?

    <p>The result is a refusal to test. (A)</p> Signup and view all the answers

    If the primary specimen result is also invalid when the split specimen fails to reconfirm, what is the correct course of action?

    <p>Direct the DER to collect another specimen under direct observation. (A)</p> Signup and view all the answers

    If the primary specimen fails to reconfirm the adulteration or substitution of the split specimen, what action must the MRO take?

    <p>Cancel the test and inform ODAPC. (D)</p> Signup and view all the answers

    When a split specimen is reported as being invalid, adulterated, and/or substituted, but the laboratory reconfirmed one or more of the primary specimen results, what should the MRO do?

    <p>Follow the procedures for reconfirmed results in paragraph (a) of the section and report the additional information about the split specimen. (B)</p> Signup and view all the answers

    If the split specimen is not available for testing or there is no split laboratory available, what should the MRO do?

    <p>There is no specific action the MRO needs to take in this case. (B)</p> Signup and view all the answers

    When a split specimen fails to reconfirm the primary specimen results, what information must the MRO report to ODAPC?

    <p>The reason for the failure to reconfirm. (A)</p> Signup and view all the answers

    Flashcards

    MRO Responsibilities

    The responsibilities of the Medical Review Officer in drug testing processes.

    Specimen Collection

    The process of obtaining a urine sample from an employee for testing.

    Test Cancellation

    The act of nullifying a drug test due to specific reasons.

    Split Specimen Results

    Results from a two-part urine drug test, requiring specific reporting steps.

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    Notification to ODAPC

    Obligation to notify the Office of Drug and Alcohol Policy Compliance regarding test outcomes.

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    Split specimen test request

    An employee must request this test within 72 hours of being notified about a verified positive drug test.

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    MRO notification

    The Medical Review Officer informs the employee of a positive test result or refusal.

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    Timely request conditions

    If the employee misses the 72-hour window, they can present reasons for the delay.

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    Documentation requirement

    The MRO must document the date and time of the employee's split specimen test request.

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    Employer's responsibility

    Employers must ensure split specimen tests are conducted timely following a request.

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    Payment for split specimen test

    Employers cannot require employees to pay directly for split specimen tests.

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    Reasons for late request

    Injuries, illnesses, or lack of notice can be acceptable reasons for requesting a test late.

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    Second laboratory testing

    The split specimen must be sent to a second HHS-certified lab upon request.

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    Split Specimen Testing

    A testing procedure involving two samples for confirmation of drug tests.

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    Employer Payment Responsibility

    Employers often are responsible for the cost of split specimen tests.

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    Laboratory's First Step

    Laboratories must check for the availability of the split specimen first.

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    Primary Specimen Testing

    If the split specimen is unavailable, tests proceed with the primary specimen.

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    Authorization to Open Specimen

    Labs cannot open split specimens except in specific circumstances.

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    MRO's Written Notice

    When instructed, labs must forward the split specimen per the MRO's request.

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    Confidentiality in Reporting

    Labs must not disclose employee identities when sending specimens.

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    Testing for Drug Presence

    Second labs test split specimens for drugs/metabolites present in primary tests.

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    Validity Testing

    If unable to reconfirm, labs conduct validity tests to explain results.

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    Confirming Adulterants

    Labs test for specific adulterants if detected in the primary specimen.

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    Testing for Substituted Results

    Labs conduct confirmatory tests on creatinine and specific gravity for substitutions.

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    Reporting Protocols

    Labs report results directly to the MRO, not through other agents.

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    Logging Split Specimen Results

    MROs receive and log confirmed or failed reconfirmation results.

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    Confidentiality in Results

    Inadvertent disclosure of identity doesn’t invalidate tests.

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    Laboratory Best Practices

    Labs must adhere to HHS protocols for accuracy and reliability.

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    Category 1 Split Specimen Result

    The laboratory reconfirmed one or more of the primary specimen results.

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    Reconfirmed Positive Test

    A reconfirmed positive test is considered the final result.

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    Reconfirmed Refusal to Test

    If reconfirmed as adulterated or substituted, refusal to test is final.

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    Combination Result

    When there are both positive and refusal results, report both.

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    Category 2 Split Specimen Result

    Laboratory fails to reconfirm all primary results, test must be cancelled.

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    Report to DER

    MRO must report the cancellation to DER and the employee.

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    Immediate Collection Requirement

    Direct observation collection required if substitution criteria are not met.

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    Category 3 Split Specimen Result

    Fails to reconfirm and reports split as invalid, adulterated, or substituted.

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    Legitimate Medical Explanation

    MRO checks for a valid medical reason behind adulteration/substitution.

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    Verified Refusal to Test

    If no legitimate explanation, report as refusal to test.

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    72-Hour Request Window

    Employee has 72 hours to request a primary specimen test.

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    Laboratory Procedures

    Follow specific procedures when processing primary specimens.

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    Category 4 Split Result

    Partial reconfirmation with split reported as invalid/adulterated.

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    Category 5 Split Specimen Result

    The split specimen was unavailable or no lab available for testing.

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    Inform ODAPC

    MRO must inform ODAPC of failures to reconfirm results.

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    Study Notes

    Employee Split Specimen Test Request

    • Employees have 72 hours from notification of a positive drug test or refusal to test due to adulteration/substitution to request a split specimen test.
    • Request can be verbal or written.
    • Failure to request within 72 hours allows employees to present documented reasons like injury, illness, or lack of notice.
    • MROs must consider these reasons—legitimate reasons trigger split specimen testing.

    MRO Responsibilities in Split Specimen Testing

    • MROs provide immediate written notification to the testing laboratory.
    • MROs document the date and time of the employee's request.

    Employer Responsibility for Split Specimen Costs

    • Employers are responsible for timely split specimen testing.
    • Employers must not require employee payment for the cost of testing.
    • Employers may seek reimbursement from employees, but testing must occur regardless.

    First Laboratory Procedures for Split Specimens

    • Laboratories check for specimen availability.
    • If unavailable/insufficient, normal testing for primary specimen continues.
    • Laboratories inform MRO of unavailability, providing information on the cause.
    • Laboratories are not authorized to open or otherwise handle split specimens without MRO authorization (except special cases in §40.83).
    • Forwarding materials include the sealed split specimen, MRO instruction copy, and copy of the CCF.
    • Laboratories must not include employee identity information in forwarding materials.

    Second Laboratory Reconfirmation Procedures

    • Laboratories test split specimens for drugs/metabolites confirmed in primary specimen.
    • Tests are conducted regardless of concentration cutoffs.
    • Laboratories perform validity tests if reconfirmation fails.
    • Additional testing at another HHS-certified lab is possible if reconfirmation fails.

    Second Laboratory Procedures for Adulterated Samples

    • Laboratories test split specimens for detected adulterants, per relevant section and applicable guidelines.
    • Validity testing and additional HHS-certified lab testing options exist if adulteration reconfirmation fails.

    Second Laboratory Procedures for Substituted Samples

    • Laboratories test split specimens for creatinine and specific gravity based on criteria in §40.88.

    Split Specimen Report Information

    • Laboratories provide results indicating reconfirmation or failure in Copy 1 of the CCF, using guideline specifics.
    • Laboratories document the confirming scientist's name, signature, and date on the CCF.

    Laboratory Reporting Methods

    • Laboratories report results directly to the MRO at their place of business.
    • This does not include the DER or service agents.
    • Results are transmitted via fax, courier, mail, or electronic methods preferably within the same day/next business day. The fully signed CCF is transmitted.

    MRO Actions Based on Split Specimen Results

    • MROs categorize and act on split specimen results:
      • Category 1 (Reconfirmed): Report confirmed positive, refusal, or both results to the DER and employee.
      • Category 2 (Failed, no invalid): Cancel the test, notify ODAPC with the details. In certain circumstances (low creatinine concentrations) additional testing is required.
      • Category 3 (Failed, invalid): Cancel the test, notify ODAPC, may direct the collection of another specimen under direct observation.
      • Category 4 (Partially reconfirmed, invalid) : Follow the reconfirmation procedures for the successfully reconfirmed results, and the cancellation procedures for the invalid results.
      • Category 5 (Unavailable): Cancel Test, inform the DER, additional collecting is required under direct observation and inform ODAPC.
    • MROs document the action taken on Copy 2 of the CCF and provide copies to the employee/employer.

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    Description

    This quiz covers the essential procedures and responsibilities related to split specimen testing in drug testing scenarios. It highlights employee rights and the responsibilities of Medical Review Officers (MROs) and employers. Understanding these guidelines is crucial for compliance and proper testing protocol.

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