Identification and handling of substituted, adulterated, and invalid specimens; refusals to test; required follow-up testing under direct observation.
A safety-sensitive employee's drug test result is reported as substituted by the laboratory. During the verification interview, the employee explains that her low creatinine and specific gravity are due to her long-term adherence to a strict vegan diet, high daily water intake, and low body mass index. She provides a letter from her primary care physician confirming these lifestyle factors. How should the MRO proceed?
A.Accept the explanation and cancel the test because the employee provided a written statement from a licensed physician confirming her personal characteristics and dietary habits.
B.Inform the employee that her personal characteristics do not by themselves constitute an explanation and that she must demonstrate they result in the physiological production of urine meeting the substitution criteria.
C.Cancel the test and order an immediate recollection under direct observation because the employee's explanation makes the specimen result an invalid test rather than a refusal.
D.Immediately verify the result as a refusal to test because federal regulations explicitly prohibit the consideration of an employee's diet or body weight in the verification of a substituted specimen.