Ask X3What does 49 CFR 40.159 (What does the MRO do when a drug test result is invalid?) require?
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As a motor-carrier owner, here is what the Medical Review Officer (MRO) is required to do when a drug test result is invalid, according to 49 CFR 40.159:
1. Review and Consult: The MRO must discuss the laboratory results with a certifying scientist to decide if the primary specimen needs testing at another HHS-certified laboratory. If the test is invalid due to a pH between 9.0 and 9.5 with no other medical explanation, the MRO may investigate whether transit time and temperature caused the reading.
2. Contact the Employee: If no further lab testing is needed, the MRO must contact the employee to explain the situation, discuss the limits of disclosure, and ask if they have a medical explanation or take any medications that caused the result.
3. Handle Acceptable Medical Explanations: If the employee provides an acceptable medical explanation:
* The MRO cancels the test and informs your Designated Employer Representative (DER).
* No further action is required unless a negative test is needed (such as for pre-employment, return-to-duty, or follow-up). If a permanent medical condition prevents a valid specimen, the MRO follows specific clinical evaluation procedures.
4. Handle Unexplained/Denied Invalid Results: If the employee cannot provide a valid explanation or prescription but denies adulterating the specimen:
* The MRO cancels the test and notifies your DER that a second collection must happen immediately under direct observation.
* The MRO will recommend collecting an alternate specimen (like oral fluid instead of urine, if practicable) and instruct you to give the driver the minimum possible advance notice.
5. Handle Admissions:
* If the employee admits to adulterating or substituting the specimen, the MRO must write and sign a statement that day and report a refusal to test.
* If the employee admits to drug use, the MRO writes and signs a statement that day, reports the admission to your DER, and reports the test as cancelled.
6. Handle Recollections: If a direct-observation recollection results in another invalid result, the MRO will follow specific procedures depending on whether the second invalid result is for the same or a different reason (such as directing further direct-observation collections or clinical evaluations).
7. Prerequisite for Reporting: The MRO can only report an invalid result after receiving a legible Copy 1 of the Custody and Control Form (CCF) along with Copy 2 (or a legible copy, or any copy containing the employee's signature).