Dr Bill, just an update, well really there is no update. I faxed paperwork on 11-4-11 and have not received any news, just got off the phone with the second lab and they advised me that they just received my sample on 11-21-11. I still have not received my first results,I am going to call them right now.

When you have a chance please advise what state you reside in. I'll look up some possible resources to cut through these stalling techniques. There is no reasonable basis for this type of delay in re-testing...

Also, per previous advice, keep a record of each of these contacts.

I reside in California. I have been dealing with the post office they seem to have lost my certified signature package to ASAP drug solutions, which was for my first test results, on the other hand National Toxicology did receive my package for the secondary test. I called National toxicology and was advised that they just received my urine sample on 11-21-11 and I requested the retest from ASAP on 11-4-11 and I find it quite odd that I requested this retest on 11-4-11 and they just received my urine sample on 11-21-11, is this a normal time frame? Since this was for employment, I am losing thousands of dollars from loss of work. Dr Bill this has been such a bad experience but it would have been a whole lot worse if I didn't have your advise, THANK YOU..

OK I just received the initial results, it just says positive for Opiates screening cutoff 300 ng/ml, can you put this in layman's terms for me?

First of all it says nothing about Oxycontin. Hydrocodone, as noted previously, is well known to cross-react with Opiate panels (immunoassay).

Please clarify: Is there any identification of the test used? Any headings? Lab identification, date, time, numbers, someone should have certified the results.

Does it use the term screening?

300 is a standard cutoff so that is not unusual.

Verified Drug Results: Positive Panel: 9421048
Collection site: Date collected: 10/24/2011
Specimen ID: Date Lab reported: 10/26/2011
Accession No:G7478419 MRO verified: 11/03/2011
Laboratory: MRO:...

DRUG TEST POSITIVE FOR:
Screening Cutoff GC/MS Confirmation Cutoff Drug 300 ng/ml ng/ml
Opiates

OK well that didn't show up on the screen like I typed it but hopefuly you can get what you need off that information

If a GC/MS confirmation was performed this report should show a quantitative result: Ex: "507 ng/mg" (or something above 300)

The use of the term Positive Panel applies to initial screening.

There is no MRO name?


This response came from ASAP Drug Solutions?

ASAP has a website which indicates you can obtain results on line. Why don't you try that and see if it contains anymore info.

The bottom should read. Drug:Opiates. Screening cutoff:300ng/ml. GC/MS Confirmation Cutoff ng/ml

Attached Images

ASAP results.pdf (115.8 KB, 231 views)

Yes it came from ASAP drug solutions, the Dr's name is Dr Tang. There are no numbers for the GC/MS so I am assuming the GC/MS was not performed. I sent the PDF in my previous reply hope you can open it

Now we're getting somewhere. There was no confirmation performed. This "positive" was the result of an immunoassay, denoted "Panel", that is prone to false positive opiate readings in the presence of Hydrocodone. Furthermore, in all probability the "package insert" required by the FDA (Title 21, I, Part 809 et seq) contains advice of this cross reaction.

When you explained to the MRO that you were prescribed Hydrocodone he should have immediately called the testing laboratory and asked them to provide the cross-reactivities from that sheet. MROs receive frequent updates on all issues involving test interpretation (see advisory on this issue AAMRO). There is really no excuse for this, even though I still don't see why an MRO was involved in an IA review.

The re-test should clear this up definitely so long as they perform the test you requested.

It's puzzling that the initial test lab waited for 3 weeks to forward the sample. That should have been done within 24 hours.

Dr Bill, THANK YOU! I contacted ASAP today and they called me back with the MRO and they advised me that my results from the secondary lab came back negative. I find it kind of sad that the MRO tried to tell me that this is a rare occurrence. I requested a copy of the results for my file, once I receive a copy of the results I am going to discuss this with the MRO and explain my research and how this has cost me several thousand dollars all because of their inaccurate findings, any advise?

I'm so pleased that you prevailed. You must feel relieved. Does that mean that you get the job?

However, take no action until you have the new results in hand.

Then, send the MRO a certified letter advising him that you are willing to discuss the matter with him prior to taking further action and setting a deadline for him to call you. It is not advisable to call him. You are in charge now.

I have the MROs office address, medical license #, and Certifying Agency should you need it.

Don't forget the laboratory. They are the primary offender, made the initial error and they selected the MRO.

I would appreciate it if you would post the new results (like the other) when you get them. Those are very helpful in showing future victims how the two tests differ by report format. As before remove your personal identification first.

Once again I'm very happy for you.

Dr Bill, I have not forgot to post the secondary findings, I just have not received them from ASAP. I called them again! And requested the results again! Which they advised me they have aleady sent the results but they will copy them and resend them to me. I didn't get the job but hopefuly I will get in on the final part of the contract. You mentioned for me to send a letter and have the MRO contact me, what advise can you give me as far as what I can say to the MRO? Nothing I can say to him is going to get me back my loss of wages.I am relieved but at the same time It worries me that they can just say sorry and that is the end of it, when this has created such a hardship for me. I can't think of how many people may have lost a job or not got a job because of false positive results, I feel I need to somehow let people know, or report ASAP to the Better Business Bureau.

A complaint to the BBB will get no results. Sometime back I posted a list of the various agencies that have responsibility for drug testing, labs and MROs. That is available here:

https://www.askmehelpdesk.com/medica...st-393019.html

In addition, the MRO is a licensed physician. You can file a complaint with the medical licensing board for your state. He must also be a member of a MRO certifying group, AAMRO, or Medical Review Officer Certification Council (MROCC). You can check membership on-line and then file a complaint with the proper agency.

It is exceedingly important that an MRO is knowledgeable and attentive. They are the last line of defense in preventing these types of procedural errors.

By complaining to the appropriate agencies you will get action and the MRO will be called to account for his actions.

Of course it is also important to address the labs role in this matter.

By the way, the MROCC provided a monograph series on this subject for it's members. See Series. A little additional ammunition for you.

Did they say oxycontin or oxycodone? Oxycodone is Percocet and will often throw the same positive that hydrocodone (Vicodin) will. Hydrocodone and oxycodone are both opiate based partial synthetics and fall in the same class as codiene, heroine, morphine, etc. Oxycontin (often pronounced like oxycotton) is purely a synthetic opioid-like substance and produces different metabolytes and requires a different test. Hopefully this helps and you are just throwing an overall opiate positive, which is covered by your hydrocodone prescription. Good luck!