Problematic collections

While most donors will cooperate fully if treated with dignity and courtesy, there may be instances when unusual events may occur. While it is not possible to anticipate every type of unusual event, some of the more frequent are:

Specimen Temperature Outside Limits: If the specimen temperature is outside normal parameters, i.e., less than 90°F or greater than 100°F then:

Inform the donor that the temperature of the specimen is outside normal limits (too low or too high) and that the specimen needs to be recollected. If the specimen cannot be recollected or the donor refuses, inform the donor that specimen temperature will be noted on the final report.

NOTE: This is important because if the donor has drug in his/her system at the time of collection, collection at a later time may allow the drug to clear. Therefore, if at all possible, make every effort to resolve the situation at the time of the incident.

Specimen Contains Visible Blood: Urine specimens may not contain visible blood for drug testing because:

Blood may  interfere with the testing process (which could result in false negative tests). Urines containing visible blood are considered biohazardous and require special packing procedures in order to be shipped.

Instructions to client to obtain a clean catch urine specimen:

  1. Wipe area until free of blood.
  2. Start urinating into the toilet. After a few seconds, place the urine container under the stream of urine until  the cup is at least half-full.

Uncooperative or Belligerent Donor: Presumably, the donor has agreed to the drug test prior to appearing at the collection site. However, attitudes may change just before, or during the collection process. Remain courteous and do not argue with a donor. It remains the right of the donor to refuse collection at any time, of course at his/her own risk. Remind the donor that you will call the requesting clinician/provider with a summary of what occurred.

Suspicion Donor is Adulterating Sample (Adding water or other substance): Remain courteous and do not argue with the donor. The following statement may be appropriate:

“We are instructed to tell everyone that the lab tests for water and other materials that may have been added. It will show up on the test report.”

Donor Cannot Urinate or Produces Insufficient Volume: Upon receipt of the specimen, the collector must first determine if there is sufficient urine for testing. Minimum sample volume is thirty (30) mL, approximately a third of a cup, and is sufficient for retest and confirmatory procedures if required.

If there is not a sufficient urine volume, the collector shall take possession of the partial specimen and instruct the donor to drink fluids (no more than 8 oz.) and try again in a reasonable amount of time. If possible, the donor should remain on the premises and preferably within visual contact of the collection site person until a complete specimen is provided.

In the event a donor cannot provide a specimen of adequate volume, the requesting facility should be notified for further instruction. In some cases, it may be acceptable to reschedule the collection. However, it may be necessary to determine whether a valid medical reason exists for the donor’s scarce urine output or if the donor is refusing to provide a specimen.