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Cold temperature and unable to obtain 2nd specimen

Posted: Wed Apr 05, 2017 8:49 am
by Bfit
We had non-DOT urine drug screen. Donor gave a cold specimen with sufficient urine volume and agreed to have one direct observation. Collector waited 3 hours and still no urine specimen produced. Donor remarked that he is unable to give a urine at the 3 hour mark. Employer did not give direction to collector so donor went home after 3 hours. Employer called in am telling collector that donor should have stayed until he produced a specimen regardless of time. Collector discarded the cold urine from first specimen.

Is this a refusal to test? What do we advise the company? Can you have donor come this morning and collect under direct observation?
He is not considered shy bladder because he gave a cold specimen so the 3 hour mark is not applicable in this case?

Bfit

Re: Cold temperature and unable to obtain 2nd specimen

Posted: Wed Apr 05, 2017 2:40 pm
by Robert Swotinsky MD
This is a shy bladder event because he did not provide a required urine specimen within 3 hrs. The employer is mistaken in believing the collection site can and should keep the donor indefinitely until he/she provides a specimen.

Send the collection site documentation to the MRO and let the employer know that it can confer w/the MRO to identify a shy bladder examining physician. The employer should ask the donor if the reason for not providing a specimen is psych or physical. If the donor says neither, then the evaluation to validate a medical explanation would seem moot.
shy bladder evaluation flow chart.jpg
shy bladder evaluation flow chart.jpg (65.55 KiB) Viewed 2140 times

Re: Cold temperature and unable to obtain 2nd specimen

Posted: Fri Apr 07, 2017 11:53 am
by Bfit
Thank you for your input. But what about the first specimen clearly being out of temperature range and had sufficient volume? Do you disregard this completely and do a shy bladder evaluation?

Bfit

Re: Cold temperature and unable to obtain 2nd specimen

Posted: Fri Apr 07, 2017 7:25 pm
by Robert Swotinsky MD
Where the donor fails to provide a sufficient specimen for a second test, (a) the collector discards the first specimen, and (b) the failure to provide a sufficient specimen for the second test triggers a shy bladder assessment.

Re: Cold temperature and unable to obtain 2nd specimen

Posted: Wed Sep 25, 2019 12:06 pm
by Kdantin
In this situation, where the donor agreed to comply with the second collection under DO but was unable to produce a specimen, shouldn't the first specimen have been processed and sent to the lab while the shy bladder evaluation was ongoing? Refer to page 77 of the fifth edition of the manual.