I have started providing MRO services for an employer. They use point-of-care-testing (POCT) for pre-employment, non-regulated, split testing. They screen urine with the POCT:
- If negative, MRO-A assists the MRO to verify negative and no further action.
- If positive for any drug, sample is split and sent off to lab. Any lab-confirmed positive gets sent to the MRO.
Issue: On document review of the cases I have received to review, I have noticed that on the POCT form that the collector originally used to screen the sample, that the validity question on the POCT form is scratched out -- (i.e., not completed). I asked for an MOU, and was told that the cup they are using does not have a built-in validity strip and they are in the process of researching a different cup, or purchasing the stand-alone validity cassettes.
This means that the POCT cup only tests for temperature and drugs but has no validity tests, hence it is potentially missing adulterated or substituted samples. The handbook helped me confirm this logic. Mind you I have only seen samples that were sent to the lab, and there is a vast majority of POCT ‘negatives’ that never get to the lab, nor the MRO. I am going to advise the employer and discourage using a POCT screening process that bypasses validity testing.
I wanted to check in this group whether anyone has encountered this and if there’s any other advice.
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