What Should Employers Know About Split Specimen Drug Test?

Written By Lucas Kibby

The common and DOT-required process of having a donor’s specimen be split is to help protect the donor if a false positive occurs or if the donor just wants a second opinion. A false positive can occur if there is a breach in the specimen testing process, faulty equipment, or some other unforeseen error.

Split specimen testing is simply having the donor’s sample split into two vials and sent to the lab where one of vial is tested. There are four results likely to be reported back on this first test: Negative, Negative-Dilute, Positive, and Positive-Dilute.

When negative, there is no need for the split specimen to be tested. However, for every lab-positive result for federally mandated test, a Medical Review Officer (MRO) must reach out to every donor in order to determine if there is an alternative (legal) explanation for the urine test results, like prescriptions or medications. For non-federally regulated tests, it is best practice to have an MRO review the results with the donor and should be included in your drug testing policy.

In this donor interview, if a legitimate explanation for the “lab positive” result is found, the donor is informed the test will be reported “Negative” to the employer and the employer should not be aware that a “lab positive” result was reported to the MRO.

If the donor proves difficult or “impossible” to find or the donor does not contact the MRO back after being contacted, the MRO may issue the report of “non-contact positive” after 10 days.

Split specimen testing does not happen unless the positive result is disputed by the donor. The MRO will informed the donor that the split specimen (Bottle B) was collected and can be sent to another lab for confirmation.

The split specimen testing process and expected timeline

For all positive results, the MRO reports the initial positive to the employer, because the employer still has to take the driver (if FMCSA, for example) off the road and wait for the results of split. If the donor agrees to have the split specimen to be tested, the split specimen process may take an additional week to receive the final result.

The employer must allow the split test to take place regardless of who is paying for the split drug test, which labs charge for, up to $150.

After the split specimen is tested at a second lab site, there are five different scenarios that can take place, the first two being the most common, and the following actions required, according to DOT Rule 49 CFR Part 40 Section 40.187:

1. The laboratory reconfirmed one or more of the primary specimen results.

The MRO must report to the DER and the employee the result(s) that was/were reconfirmed.

• In the case of a reconfirmed positive test(s) for drug(s) or drug metabolite(s), the positive is the final result.
• In the case of a reconfirmed adulterated or substituted result, the refusal to test is the final result.
• In the case of a combination positive and refusal to test results, the final result is both positive and refusal to test.

2. The laboratory failed to reconfirm all of the primary specimen results because, as appropriate, drug(s)/drug metabolite(s) were not detected; adulteration criteria were not met; and/or substitution criteria were not met.

The MRO must report to the DER and the employee that the test must be cancelled.

• The MRO must inform ODAPC of the failure to reconfirm using the format in Appendix D to this part.
• In a case where the split failed to reconfirm because the substitution criteria were not met and the split specimen creatinine concentration was equal to or greater than 2mg/dL but less than or equal to 5mg/dL, the MRO must, in addition to step in (b)(1) of this paragraph, direct the DER to ensure the immediate collection of another specimen from the employee under direct observation, with no notice given to the employee of this collection requirement until immediately before the collection.
• In a case where the split failed to reconfirm and the primary specimen’s result was also invalid, direct the DER to ensure the immediate collection of another specimen from the employee under direct observation, with no notice given to the employee of this collection requirement until immediately before the collection.

To see full MRO responsibilities in DOT Rule 49 CFR Part 40 Section 40.187, click here.

For re-testing of a split specimen, employers should expect an additional week to receive results, after the initial 2+ days it took to receive the first lab results. If there are other unforeseen delays, there are times when one donor’s final drug testing result may not be completed for 2 weeks after going into the collection site.

Don’t have split specimen as an option in your company’s drug testing program? Show your employees that you care, provide them a safety net, and ensure you are making a decision on accurate information in your drug testing program.  Let CleanFleet review your drug testing policy to make sure best practices are established. Give us a call at 503-479-6082.