Substituted, adulterated, and invalid specimens

Identification and handling of substituted, adulterated, and invalid specimens; refusals to test; required follow-up testing under direct observation.

A commercial driver provides a urine specimen for a pre-employment drug test. The laboratory reports the result as an invalid result because the pH is 9.4. During the verification interview, the driver denies tampering with the specimen and has no medical explanation or medications that would account for the pH. The MRO's investigation reveals that the specimen was stored in an unrefrigerated locker for four days during a summer heatwave before being shipped to the laboratory. What is the most appropriate action for the MRO?

A.Cancel the test and direct the employer to conduct an immediate recollection under direct observation.

B.Verify the test as a refusal to test because the specimen pH is outside the physiological range for human urine.

C.Cancel the test and report to the DER that no further action is required unless a negative result is required for this pre-employment test.

D.Direct the laboratory to send the primary specimen to another HHS-certified laboratory for additional testing to identify potential adulterants.