What does 49 CFR 40.187 (What does the MRO do with split specimen laboratory results?) require?

According to 49 CFR 40.187, as a motor-carrier owner, you will receive split specimen laboratory results from the Medical Review Officer (MRO) that fall into five categories, and the MRO must take specific actions based on those results:

* Category 1 (Reconfirmed Results): The laboratory reconfirmed one or more primary specimen results. The MRO must report the reconfirmed result(s) to the designated employer representative (DER) and the employee. A reconfirmed drug positive is final, a reconfirmed adulterated or substituted result is a final refusal to test, and a combination result is both.

* Category 2 (Failure to Reconfirm): The laboratory failed to reconfirm all primary results (drugs/metabolites not detected, or adulteration/substitution criteria not met). The MRO must report to the DER and employee that the test must be cancelled, inform ODAPC using the format in Appendix F, and in specific substitution or invalid primary test cases, direct the DER to immediately collect another specimen under direct observation without prior notice to the employee.

* Category 3 (Failure to Reconfirm + Invalid/Adulterated/Substituted Split):

* *If invalid:* The MRO must report the cancellation and reason to the DER and employee, direct an immediate direct-observation collection with no advance notice, and inform ODAPC.

* *If adulterated and/or substituted:* The MRO must contact the employee, follow § 40.145 procedures for a legitimate medical explanation, and either cancel the test (if a medical explanation exists) or report a verified refusal to test (if no medical explanation exists), giving the employee 72 hours to request a test of the primary specimen.

* Category 4 (Partial Reconfirmation + Invalid/Adulterated/Substituted Split): The MRO must follow the Category 1 procedures for the reconfirmed results, report that the split was also reported as invalid, adulterated, and/or substituted, and instruct the DER to take action only on the reconfirmed result(s).

* Category 5 (Split Unavailable or No Lab Available): The MRO must report the test cancellation and reason to the DER and employee, direct the DER to immediately recollect another specimen under direct observation with no prior notice, and notify ODAPC using Appendix F.

* Documentation: For all split specimen results, the MRO must complete Step 7 of Copy 2 of the CCF (checking the appropriate "Reconfirmed," "Failed to Reconfirm," or "Test Cancelled" box, signing, dating, and entering their name), and send a legible copy to the employer while keeping a copy for their records.