From the Guidelines
If a Medical Review Officer (MRO) discovers that a split specimen is requested but not available, they should immediately document that the split specimen is unavailable for testing and report this as a "failure to reconfirm: specimen not available for testing" to the employer and appropriate regulatory agencies. The MRO should then cancel both the primary and split specimen tests, as the integrity of the testing process has been compromised 1. The MRO should explain to the donor that their request cannot be fulfilled due to the unavailability of the split specimen and inform them that the original test result cannot be verified through split specimen testing. The employer should be directed to immediately collect another specimen from the employee under direct observation, without advance notice, as required by federal regulations. This situation represents a serious breach in the chain of custody procedures, as split specimens are mandated in federally regulated drug testing programs to ensure donors have the right to challenge positive results. The unavailability of a split specimen may indicate improper collection procedures, specimen tampering, or administrative errors that undermine the validity and defensibility of the testing process. Key considerations for the MRO include:
- Documenting the unavailability of the split specimen
- Reporting the issue to the employer and regulatory agencies
- Canceling the primary and split specimen tests
- Informing the donor of the situation and its implications
- Directing the employer to collect a new specimen under direct observation. It is essential to follow established procedures for handling such situations, as outlined in guidelines and regulations, to maintain the integrity of the testing process and protect the rights of donors 1.
From the Research
Actions for a Medical Review Officer (MRO) when a Split Specimen is Requested but Not Available
- If a split specimen is requested but not available, the MRO should follow established protocols for handling such situations, although specific guidance is not provided in the available studies 2, 3, 4, 5, 6.
- In general, the MRO's role involves reviewing and interpreting urine drug test results, and ensuring that the testing process is conducted fairly and accurately 6.
- When a split specimen is not available, the MRO may need to consider alternative options, such as:
- Notifying the relevant parties of the issue and seeking guidance on how to proceed.
- Reviewing the available documentation and test results to determine if there are any indications of tampering or other issues that may have affected the integrity of the specimen.
- Considering the use of other specimens or testing methods, if available.
- It is essential for the MRO to maintain accurate and detailed records of all actions taken in such situations, including any communications with relevant parties and any decisions made regarding the handling of the specimen 5.
- The MRO should also be aware of the potential consequences of not having a split specimen available, including the potential for disputes or challenges to the test results, and take steps to mitigate these risks whenever possible.