Medical Review Officer (MRO) Assistant Training-2020 Tab 7 MRO-A Combined

2020 Tab 7 MRO-A Combined

Pdf Summary

The document discusses the topic of laboratory urine testing, specifically focused on forensic drug testing and the considerations involved in conducting such tests. The main goal of a forensic drug testing laboratory is to accurately differentiate between specimens that contain drugs or their metabolites at or above the cut-off level, and those that do not. The laboratory must also determine the validity of the specimen and identify any cases of substitution or adulteration.<br /><br />The document explains the process of drug testing, which involves an initial screening test using an immunoassay to eliminate negative specimens from further consideration. It highlights that a negative specimen does not necessarily mean the absence of drugs or metabolites, but rather indicates a concentration below the cut-off level. On the other hand, a positive specimen has a concentration equal to or higher than the cut-off level.<br /><br />The document also provides information about the different types of drug tests, such as immunoassays, confirmatory tests, and reconfirmation tests. Immunoassays use various methods, such as EIA, KIMS, and FPIA, to detect the presence of drugs or metabolites. Confirmatory tests combine chromatographic separation and mass spectrometric identification to confirm the presence of specific drugs or metabolites. Reconfirmation tests are performed at a second certified lab to validate the initial findings.<br /><br />The document further explains the concept of specimen validity testing (SVT), which is the evaluation of urine specimens to determine if they are consistent with normal human urine. SVT includes testing for adulterants, such as substances added to the urine, dilution, or substitution. The criteria for determining a substituted, dilute, or invalid specimen are provided.<br /><br />The document also mentions the requirements set forth by the Department of Transportation (DOT) for SVT and the reporting of negative-dilute results. It includes information on testing split specimens and the reporting requirements for primary and split specimens.<br /><br />The document concludes with a discussion on the contents of a typical litigation package, which includes chains of custody, immunoassay and GC/MS data, and reports on substituted and adulterated specimens.

Keywords

laboratory urine testing

forensic drug testing

cut-off level

specimen validity testing

immunoassay

confirmatory tests

reconfirmation tests

adulterants

Department of Transportation

litigation package