Implementation Guidelines - Federal Transit Administration - U.S. ...

MRO is not required to direct the
analysis of the split specimen to be
performed.
• The MRO must maintain all
necessary records and protect the
employee’s privacy and testing
program confidentiality.
The MRO must confirm a positive test
result for marijuana, cocaine, amphetamines,
and/or phencyclidine unless the employee
presents a legitimate medical explanation for
the presence of the drug/metabolite in
his/her system. The burden of proof is on
the employee to provide necessary
documentation of the medical explanation.
This information must be presented at the
time of the verification interview with the
MRO. If a valid medical explanation is
provided, the MRO must verify and report
the test as negative. If not, the MRO must
verify and report the test result as positive.
If the laboratory reports a positive test
result for opiates, the MRO must review the
laboratory results to determine if 6acetylmorphine
(6-AM) was present in the
specimen: if so, the test must be verified
positive. If 6-AM is not present, but the
codeine or morphine levels are above 15,000
ng/mL, the burden of proof is on the
employee to provide documentation of a
legitimate medical explanation. If the
concentrations are less than 15,000 ng/mL,
the burden of proof is on the MRO to
determine if there is clinical evidence of
illegal drug use. To accomplish this task,
the MRO must conduct or require another
physician to conduct a face-to-face
examination of the employee. If no clinical
evidence is found, the MRO must verify the
test result as negative.
If a specimen is determined by the
laboratory to be adulterated or substituted,
the MRO will provide the employee with the
same opportunity to explain the test result as
if it were positive. Thus, the MRO should
explain the test results to the employee and
offer the employee the opportunity to
present a legitimate medical explanation for
the laboratory validity, or adulterant test
result. In the case of an adulterated
specimen, the employee has the burden of
proof to demonstrate that the adulterant
entered the specimen through physiological
means. In the case of a substituted
specimen, the employee must demonstrate
that he/she can produce a urine specimen
through physiological means that has
creatinine and specific gravity levels that fall
within the criteria of a substitute specimen.
If the explanation appears reasonable,
the employee will have up to 5 days to
undergo a medical examination by a
qualified medical physician, acceptable to
the MRO, to evaluate and consider any
evidence that the employee presents. The
evidence must be gathered using appropriate
methodology and controls to ensure its
accuracy and reliability. The employee
must demonstrate that the cited medical
condition actually results in the
physiological production of urine meeting
the creatinine and specific gravity criteria.
Chapter 7. Drug Testing Procedures 7-22 August 2002