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From: Robert Swotinsky MD
Date: 23 Jun 2004
Time: 17:40:36 -0700
Remote Name: 68.166.234.84
This is a specimen that is positive for marijuana and adulterated with nitrite (>500). The MRO is supposed to check for alternative medical explanations for each result and report each verified determination. (The next paragraph describes an exception allowed for pre-employment tests.) If the MRO verifies one result (e.g., marijuana) but is still working on the other result (e.g., evaluation of the donor's explanation for physiologically producing nitrite >500), the MRO may report the verified marijuana result immediately and the other result (if ultimately verified as adulterated) later. The verification of the first result would be reason enough to remove the donor from safety sensitive functions.
DOT has advised MROs that, for a preemployment test with the employer's concurrence, the MRO may report a verified positive result for one drug without continuing to seek verification for other positive results from the same specimen. (The same concept probably applies to positive/adulterated and positive/substituted results.) The MRO should use his or her judgement to decide if verification of the other non-negative result(s) can be completed quickly. If the MRO does not complete verification of the other non-negative result(s), the report to the employer should not identify those results. The MRO instead documents these nonverified results in his or her own records as nonverified and nonreported.