What action should a Collector take if a Department of Transportation (DOT) donor refuses to sign the Chain of Custody Form (CCF)?

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From the Research

If a DOT donor refuses to sign the Chain of Custody Form (CCF), the collector should note "Refusal to Sign" in the designated area and document the refusal in the "Remarks" section, then complete the collection process and notify the Designated Employer Representative (DER) immediately. This action is crucial as the refusal to sign is considered a refusal to test under DOT regulations, which can have significant consequences, including removal from safety-sensitive duties 1. The collector should prioritize completing the collection process and ensuring the specimen is sent to the laboratory for testing, despite the missing donor signature.

Key Steps for the Collector

  • Note "Refusal to Sign" in the designated area of the CCF
  • Document the refusal in the "Remarks" section, including details about the circumstances
  • Complete the collection process as normal, including signing the form themselves
  • Immediately notify the DER of the situation
  • Ensure the test is processed by the laboratory despite the missing donor signature

The signature on the CCF is a critical component of the testing process, as it confirms the donor's understanding of the specimen collection procedure and the chain of custody 2. However, the collector's primary responsibility is to ensure the integrity of the testing process and comply with DOT regulations. By following the outlined steps, the collector can maintain the integrity of the process while also addressing the donor's refusal to sign.

Considerations for the Collector

  • The refusal to sign should be treated as a refusal to test, with the same consequences as a positive test result
  • The collector should prioritize clear and detailed documentation of the refusal
  • The DER should be notified immediately to ensure prompt action is taken in accordance with DOT regulations
  • The laboratory should process the test as normal, despite the missing donor signature, to ensure compliance with regulations and maintain the integrity of the testing process.

References

Research

The family physician as medical review officer.

The Journal of the American Board of Family Practice, 1995

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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