Search found 921 matches

by Robert Swotinsky MD
Thu Sep 10, 2020 8:49 pm
Forum: Drug and Alcohol Testing
Topic: 6th Edition Update
Replies: 3
Views: 110

Re: 6th Edition Update

The MROCC recertification examination has been updated as new regulations, science, and practices evolve. The MROCC exam has been updated since I wrote the 5th ed in 2014 -2015. I help write the MROCC exam. But, I'm just one of a team who do that, and the others are experts in MRO related topics but...
by Robert Swotinsky MD
Wed Sep 09, 2020 10:00 pm
Forum: Drug and Alcohol Testing
Topic: 6th Edition Update
Replies: 3
Views: 110

Re: 6th Edition Update

The 6th ed and CME program should be available by the end of the year. It's in copyediting right now.
by Robert Swotinsky MD
Tue Sep 01, 2020 8:05 pm
Forum: Drug and Alcohol Testing
Topic: CBD:THCA Ratios
Replies: 1
Views: 441

Re: CBD:THCA ratios

I think the question is, How reliable is it so use the THCA-to-CBD ratio to determine if the THC came from CBD?

A positive test result for CBD can demonstrate that the person ingested CBD. There is no consensus on the use of THCA-to-CBD ratios to rule in, or rule out, the use of THC.
by Robert Swotinsky MD
Sat Aug 29, 2020 11:53 am
Forum: Fitness-for-duty (e.g., preplacement) exams, non-DOT
Topic: Police officer on warfarin
Replies: 2
Views: 510

Re: Police officer on warfarin

The American College of Occupational and Environmental Medicine publishes medical evaluation guidelines for law enforcement officers, available by subscription. With respect to warfarin, the guideline is, "approved only if assigned to restricted duty; medication may cause significant bleeding (parti...
by Robert Swotinsky MD
Tue Aug 25, 2020 3:04 pm
Forum: Drug and Alcohol Testing
Topic: Morphine positive at 600 ng/mL
Replies: 2
Views: 359

Re: Morphine positive at 600 ng/mL

The result is negative because the morphine level is attributable to consumption of poppy seeds, even if the donor does not recall having consumed them. The information as posted does not indicate a likely safety or medical qualification concern that would require an alert to the employer.
by Robert Swotinsky MD
Sat Aug 15, 2020 2:12 pm
Forum: Drug and Alcohol Testing
Topic: Drug testing reference
Replies: 1
Views: 344

Re: Drug testing reference

The American Society of Addiction Medicine's 2017 consensus document on the use of drug testing in clinical medicine discusses the value of monitoring by drug testing. I am not aware of studies that have assessed the effectiveness of drug testing in reducing relapse. See: https://www.asam.org/docs/d...
by Robert Swotinsky MD
Wed Aug 12, 2020 3:14 pm
Forum: DOT Physicals
Topic: DOT Physical and Drug Testing
Replies: 1
Views: 538

Re: DOT Physical and Drug Testing

1. Do we as the ME have the right/authority to order a drug test on the driver, since a drug test is not standard procedure for the usual DOT physical. Yes. The dipstick UA, visual acuity, blood pressure, pulse, and whisper test are minimal requirements for testing. The medical examiner can include...
by Robert Swotinsky MD
Wed Jul 29, 2020 9:54 pm
Forum: Drug and Alcohol Testing
Topic: Donor now deceased
Replies: 2
Views: 499

Re: Donor now deceased

I would report it as positive. If the donor resurfaces and contacts you, reopen the MRO review. But, based on what you've posted, I wouldn't bother the wife/family about the test.
by Robert Swotinsky MD
Thu Jul 23, 2020 2:05 pm
Forum: Drug and Alcohol Testing
Topic: Subpoena for MRO notes
Replies: 2
Views: 981

Re: Subpoena for MRO notes

First, if you have reasonable access to an attorney, ask the attorney to check if the subpoena is valid. You may also ask the attorney for advice about releasing the records. In general, donors DO have access to MRO notes upon request, as they would also have access to medical records. That means th...
by Robert Swotinsky MD
Wed Jul 15, 2020 7:58 pm
Forum: Fitness-for-duty (e.g., preplacement) exams, non-DOT
Topic: Respiratory mask fit test
Replies: 3
Views: 6433

Re: Respiratory mask fit test

You can use 99080. If your billing system attaches a price to a CPT code, and if there's already some other price in there for 99080, then hopefully the system will allow you to use a made-up code like 99080F (for "fit test:).