NMR Standards of Validity
(good reference: MRO ALERT, VOL.VI, No.1 Jan/Feb 1995 p.15) VALID SPECIMEN MEANS: NOT UNSUITABLE AND NOT ADULTERATED!
CATEGORY I: Straightforward!
Specimen is DILUTE! Sp.Gr. < 1.003 AND Creatinine < 20. M.R.O. reports lab findings (including negative or canceled test) to employer. A dilute specimen is NOT a reasonable suspicion or cause to require donor to submit to another specimen collection…….. HOWEVER…. Employer MAY require one additional “observed collection” if it’s written in their policy.
CATEGORY II: The “gray zone!
Specimen is UNSUITABLE! This applies when a valid immunoassay result is not achieved (abnormal high or low readings) or pH out of normal range, but the presence of adulterants is not substantiated. MRO actions: Discuss with lab’s chief scientist. Contact donor and inform that specimen was unsuitable. Ask especially about NSAID’s or other explanations. If no explanation, inform donor and employer that another specimen will be collected under direct observation. If there is an acceptable explanation for the unsuitability, the MRO should report “canceled test.”
CATEGORY III: Straightforward! (Adulterated = Refusal to test)
Specimen is ADULTERATED! Specific adulterant(s) identified by the laboratory through procedures that can be forensically validated! MRO reports “adulterated” to employer & informs employer that this constitutes “refusal to test.” This has the impact of a positive test requiring removal from safety-sensitive function.