Refusal to test with negative result

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nehabadheka

Refusal to test with negative result

Post by nehabadheka » Tue Oct 01, 2019 1:00 pm

Hello all,

I have a result where the sample was inadequate, and the shy bladder was initiated. But the donor walked out before submitting another sample as she had to drop off her sister to work. Donor was told that this would amount to refusal to test. The inadequate sample was sent for testing and result is negative. Do I determine the final result to be “negative” or “refusal”?? This was non DOT.

Thanks in advance for your input.



Robert Swotinsky MD
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Re: Refusal to test with negative result

Post by Robert Swotinsky MD » Tue Oct 01, 2019 5:05 pm

The collector should have discarded the 1st specimen. At this point, the test outcome is a refusal to test as this "trumps" the negative result from the suspect specimen.
directly observed collection procedure.jpg
directly observed collection procedure.jpg (67.88 KiB) Viewed 491 times

nehabadheka

Re: Refusal to test with negative result

Post by nehabadheka » Wed Oct 02, 2019 10:05 am

Thank you, Dr Swotinsky for your response. I wanted to clarify about the 2nd specimen if adequate, both specimens are sent for testing...but they are on the same COC. So these are sent as bottle A, bottle B, in which case it would be two voids. Or the 2nd specimen is split in two bottles? And so there will be two bottle A..from 1st and 2nd collection? I want to make sure the collector understands what to do.

Robert Swotinsky MD
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Posts: 880
Joined: Sun May 23, 2010 3:42 pm
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Re: Refusal to test with negative result

Post by Robert Swotinsky MD » Wed Oct 02, 2019 5:46 pm

The collector uses a CCF for the 1st specimen. The collector uses a different CCF for the 2nd specimen. If the 2nd specimen is adequate, the collector sends the 1st specimen (or, if split, the 1st Bottle A and Bottle B) with its CCF and the second specimen (or, if split, the 2nd Bottle A and Bottle B) with its different CCF.

DrCRZ

Re: Refusal to test with negative result

Post by DrCRZ » Fri Oct 04, 2019 11:18 am

The donor left the collection site before the second collection is completed. Is the decision maker in this case the MRO or the DER?

nehabadheka

Re: Refusal to test with negative result

Post by nehabadheka » Fri Oct 04, 2019 11:48 am

Thank you very much Dr Swotinsky for clarifying that part. Makes sense.

Dr CRZ, I have not been able to get in touch with the DER. Tried calls and emails. So I suppose I am in the lead here as the decision maker. And it is tricky since some MROs have suggested that the test be cancelled due to collector error and some have suggested calling it negative. And others call it refusal. So there is no majority response to guide the decision. I do feel that following Federal guidelines is always a best policy and the gold standard that we go by.

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