You take for granted that when you pee in a cup and send it off to a lab for analysis that the human beings there give a fuck about if the results they send back are going to mess up your life or not.
Well.
Today’s moment of science… tales from the field.
Aah, the piss lab. I used to work at a lab that analyzed drugs in urine and oral fluid. If you were drug tested for a job test, that’s not the type of business the company did. If you were in long term managed pain care or if you’d gone through rehab and were on a medication based treatment plan, our company was making money off of yo- uh, helping you stay sober.
Apropos of absolutely nothing, check out the Last Week Tonight episode called Rehab. John Oliver mentions that certain drug testing labs refer to urine as ‘liquid gold.’ I’m absolutely not mentioning this because I think it reflects the attitude of my former employers, especially not the now-defunct urinalysis lab allegedly accused of medicaid fraud.
Nope. That’s not it at all.
(Allegedly).
The process of testing someone for drugs started in their doctor’s office. There were proprietary urine cups from the company that provided a relatively quick and accurate reading for several types of drugs. When they arrived at the office, the cup would be taken to our screening lab and tested for the presence of a dozen or so groups of drugs. Then the cup would be put in cold storage and an aliquot would be sent over to my side of the lab where we’d find out exactly what had come back in the sample. The results from the screening lab were a useful guide in telling us if our readings were within an expected range.
There were fail-safes in place to stop inaccurate results from getting out. The instruments were well maintained and managed as a team. Results went through several layers of verification before being sent to doctors. Samples had barcodes and labels everywhere so that it would be damn near impossible to mix up one aliquot with one from another cup.
There was this one time though.
I happened to run confirmation testing on one patient’s sample for two different substances. I only noticed it because in both cases, they didn’t match the screen. Then I looked at all their results and none of them matched the screen or their previous drug history. Not matching one of those, possible. Not matching anything, fucking weird.
I’d been at this lab for several years, and this was something new. There was absolutely no reason why someone couldn’t have mis-labeled an aliquot, it just hadn’t happened in all of my samples yet.
But then I walked into the certifying officer’s office, one of the fancy folks with a fancier degree who gave the final stamp of approval to all the results before they left the building. I showed them the problem, and the response? “Well this can happen.” I was surprised that they didn’t mean a mis-poured test tube. They meant that somehow, it was possible for six highly positive drug screens and all negative confirmation tests. Then came rationalization after rationalization why every single test result didn’t match the screen.
Because it was better to rationalize that than possibly accept that you have to delay releasing your results by four more days to re-test everything.
It’s true, some substances can trip a false positive screen for other drugs, which is a big reason why the confirmation tests are so important. More than one false positive would strain credulity. Six? Fuck you and the GC/MS you did this analysis on.
After a short deliberation, I got the cup out of the freezer. Of course the cup matched the screen and the patient records and not whatever bullshit I’d been handed at first.
I was able to get the patient re-tested for the two tests I’d personally overseen. The other four tests were not re-run.
The lab went out of business a few years ago. Couldn’t have happened to better people.
If you ever test positive for a drug that you absolutely, positively, beyond a shadow of a doubt know that you didn’t take and there’s no reason you should have tested positive for it? You might be in for a difficult conversation with your doctor. Request a re-test from the original cup. It can eliminate possible contamination or a sample switch.
And if that doesn’t work? You absolutely shouldn’t, but you can always keep calling the lab director with knock knock jokes until they reconsider their life decisions.
This has been your daily Moment of Science, not so fondly remembering the days of working nearly 70 hours a week with the promise of maybe a raise or a promotion next year.
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