Dilute and negative specimen

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mshamshad
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Joined: Mon Jul 06, 2020 4:01 pm

Dilute and negative specimen

Post by mshamshad » Mon Jul 06, 2020 4:10 pm

Hi,

I have a client who tested negative for a 5 panel drug screen with a creatinine of 13.2 mg/ml and a SG of 1.0020. Should I report this as 'negative Dilute". Is retesting recommended for him and if so it should be non-observed right? Thank you.



Robert Swotinsky MD
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Re: Dilute and negative specimen

Post by Robert Swotinsky MD » Tue Jul 07, 2020 9:38 pm

In many nonregulated testing programs, there is no rule or policy about what to do with a negative/dilute result. The standard practice is for MROs to report each negative/dilute result with the employer’s option or responsibility as described om the DOT Procedures, as follows:

 If creatinine between 2 and 5 mg/dL, immediate recollection under direct observation
 If creatinine greater than 5 mg/dL, may recollect (once) but not under direct observation. If the employer decides to recollect (or not) under these circumstances, it should do so across-the board, rather than recollecting certain employees and not recollecting others.

In the question as posted, the result is negative/dilute with a creatinine of 13.2 mg/dL. Following the model of the DOT Procedures, the MRO reports the result as negative/dilute and informs the employer that it may recollect but not under direct observation.

The HHS Mandatory Guidelines for Urine (UrMG) direct for a negative/dilute finding an immediate recollection (once) not under direct observation [§13.5(b)(1)].

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