Search found 930 matches

by Robert Swotinsky MD
Tue May 25, 2021 1:06 pm
Forum: DOT Physicals
Topic: Checking the EMR
Replies: 4
Views: 8188

Re: Checking the EMR

"We are having a debate in our department about this very topic. Some in our dept want each driver to sign a release before there DOT exam so we can review their chart. If they do not sign, they are considering not performing the exam due to suspicion of an underlying condition." I'm unaware of dat...
by Robert Swotinsky MD
Mon May 10, 2021 9:18 pm
Forum: Drug and Alcohol Testing
Topic: Safety Sensitive
Replies: 2
Views: 3449

Re: Safety sensitive

We have been debating internally as to whether they should be verbal via telephone, or written. Even a phone call needs to be documented in writing. So, I just pass along the concern in writing, as a comment on the drug test report. For example: "During the review of this test, a likely safety conc...
by Robert Swotinsky MD
Thu Feb 11, 2021 3:30 pm
Forum: Drug and Alcohol Testing
Topic: Donor requesting additional reconfirmation
Replies: 2
Views: 3935

Re: Donor requesting additional reconfirmation

Generally, donors do not have an option for multiple reconfirmation analyses. The attorney can seek additional testing and, if he/she is granted that right by the courts or by the employer, the attorney or you can contact the laboratory directly to arrange it. I understand the distinction between ha...
by Robert Swotinsky MD
Wed Jan 20, 2021 10:06 pm
Forum: Drug and Alcohol Testing
Topic: DOT random not yet driving and no CDL/CLP
Replies: 2
Views: 3693

Re: DOT random not yet driving and no CDL/CLP

Review it like a DOT test. You could reach out to the employer re: DOT v. non DOT, but it sounds like they've already decided they want this to be a DOT test, and it's their decision.
by Robert Swotinsky MD
Thu Jan 14, 2021 9:15 pm
Forum: Drug and Alcohol Testing
Topic: Give quantitative laboratory results to the employer?
Replies: 1
Views: 4669

Re: Give quantitative laboratory results to the employer?

There is no regulation or guidance saying NOT to release such information on a case by case basis. (You may recall that the feds don't want routine reporting of concentrations.) I'd go ahead and release the concentration. Usually, having it in black and white helps settle any questions.
by Robert Swotinsky MD
Thu Jan 14, 2021 9:10 pm
Forum: Drug and Alcohol Testing
Topic: Foreign Rx
Replies: 1
Views: 3626

Re: Foreign Rx

If there is some degree of ongoing relationship w/the doctor in Brazil, then the foreign prescription is acceptable (assuming that it matches up w/the test result). Some old federal guidance noted that customs officials limit the amount of controlled substances that a person can bring into this coun...
by Robert Swotinsky MD
Fri Nov 20, 2020 8:15 am
Forum: Fitness-for-duty (e.g., preplacement) exams, non-DOT
Topic: Pre employment & Methadone
Replies: 1
Views: 6370

Re: Pre employment & Methadone

If the electrician job involves high voltage, working unprotected at heights, or other particularly hazardous environments, you may want to inquire in more detail. Ask for a couple of office notes and the most recent two or three compliance monitoring drug tests. While you mention a negative drug te...
by Robert Swotinsky MD
Wed Nov 11, 2020 6:22 pm
Forum: Drug and Alcohol Testing
Topic: Buprenorphine positive oral fluid test with interesting reason provided by donor
Replies: 1
Views: 3885

Re: Buprenorphine positive oral fluid test with interesting reason provided by donor

The medical literature does not describe positive buprenorphine results from inadvertent exposure. The medical literature does describe buprenorphine, including street (nonprescribed) buprenorphine, as a drug taken by opioid-dependent people to help ward off withdrawal symptoms. A SAP could offer su...
by Robert Swotinsky MD
Mon Oct 26, 2020 2:29 pm
Forum: Drug and Alcohol Testing
Topic: Amphetamine, methamphetamine, medical marijuana
Replies: 1
Views: 4102

Re: Amphetamine, methamphetamine, medical marijuana

Yes, ask for d & l isomers if they have not already been performed. The methamphetamine is not explainable by the use of Adderall (amphetamine). Methamphetamine is metabolized to amphetamine. But, amphetamine is not metabolized to methamphetamine. That's why you need to get d & l isomers - to help f...
by Robert Swotinsky MD
Thu Sep 10, 2020 8:49 pm
Forum: Drug and Alcohol Testing
Topic: 6th Edition Update
Replies: 3
Views: 5924

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...