MRO Results Validation Procedure

The role of the Medical Review Officer is to review and validate drug test results. In the case of a positive test, the MRO must also determine if the test result is due to a medically legitimate reason. The following is the basic summary of the MRO results verification process:

Donor Name:__________________ ID #______________________
Check: Are there any significant packaging or Chain of Custody errors? Y / N

If “Yes”, the test is “Invalid”.

Provide the donor with an opportunity to discuss positive test results. Document all attempts to reach donor. If unable to reach donor within 24 hours, ask the employer representative to assist in locating the donor.

• Maintain a call log regarding donor contact:
  Date;  Time;  Phone # ; Contacted  (y/n?);  Comments

• Identify yourself as the physician and MRO
• Confirm the individual’s identity, (eg read first 5 digits of their ss# and ask them for the last 4 digits.)
• Explain to the donor that medical information that affects fitness for duty may be shared with the employer
• Inform the donor of the test results

• Seek potential sources of the drugs, such as legitimate prescribed medications, invasive medical procedures, poppy seed ingestion, etc.
  In the case of prescribed medications, seek the donor’s assistance in confirming that prescriptions are legitimate.
• If test result is positive for opiates, consider test for heroin, and look for evidence of clinical abuse.
• If positive for methamphetamine, determine isomeric composition (d=RX, 1=OTC)
• Consult with laboratory officials and/or other experts as needed

If collected under SAMSHA (DOT test), request as needed:

• Quantitative results
• Re-analysis of the specimen, per donors request
• Analysis of the split specimen (if collected)

• Based upon the above review, make the following MRO determination:
  Negative; Verified Positive; Invalid; Test Cancelled; Sample Adulterated

• Report results to the appropriate client representative