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From: Robert Swotinsky MD
Date: 17 Nov 2004
Time: 19:35:49 -0800
Remote Name: 68.166.236.185
As of late 2003, Northwest Toxicology was the only lab testing for iodate adulterated urine specimens. Perhaps because this test was new and there were no other labs testing for iodate, Northwest Tox (now owned by LabOne) made a decision then that it would report iodate-adulteration only when it found another adulterant (e.g., nitrite, fluoride, etc.) in the specimen, too. This is what a representative of Northwest Tox told me last year when I researched the issue for an article I was working on for MRO Update, the October 2003 issue. If your specimen has another adulterant other than iodate, then have the split reconfirmed for that other adulterant; the iodate in this case is an incidental finding and the result will depend on the presence of that other adulterant. If this is truly a case where there is a single adulterant (iodate) and no other lab can analyze for iodate in the split, then you're in a situation that is not specifically addressed by regulation or guideline. There is no requirement under Part 40 for cancellation of the split, since the split IS available and the problem isn't failure of the reconfirmation test to identify the adulterant. I suggest you tell the donor that he/she has the right to a split analysis, and if the donor asks for the split tell him/her that the same lab will do the split analysis. If the donor insists that the split be analyzed elsewhere -- an unlikely scenario -- then explain that there is no other lab to run the split, document what the donor has directed you (i.e., that he or she wants the split analyzed elsewhere), and let the initial adulterated determination stand.