Medical Review Officer (MRO) Process

Non-DOT:

• When the laboratory receives a Specimen, they will screen for the drugs indicated by the Panel ID at a specific cut off level
  • If there is any presumptive positive detected in the initial screening phase, the lab will run confirmation/secondary test
  • The confirmation tests are run at a lower cut-off levels to further break the drug class and ensure accuracy and prevent a “false non-negative”.
• If lab confirmed as non-Negative, the report will be sent to the Medical Review Officer for review
  • non-Negatives can include, but not limited to:
    • Positive for one or more of the drugs screened and confirmed
    • Adulteration/Substitution detected
• Just because the sample was determined to be non-negative, it doesn’t mean the donor is using illicit drugs or was attempting to adulterate the specimen. 
  • The MRO will determine this in an ‘Interview’ process
• The Donor would have provided a contact number on a Chain of Custody form while at the clinic when initially providing their sample. 
  • The MRO will attempt to contact the Donor with the number provided.

MRO Reporting:

NonContact Positive

• If the MRO is unable to reach Donor after two call attempts and waits 24 hours till after the initial call, they can close it as a nonContact Positive.
• If the donor calls back in, the report could be amended. 

Positive

• If MRO is able to speak with donor and the Donor is unable or does not have a valid prescription or medical explanation for the lab reported Positive, the MRO will complete as Positive

Negative

• Donor has a valid prescription/medical explanation verified by the MRO for the non-negative result.

Cancelled

• Cancelled per MRO (Invalid Result from Lab - has abnormal physical characteristics, or has an endogenous substance at an abnormal concentration that prevents the laboratory from completing or obtaining a valid drug test result)
  • Abnormal pH (≥ 4 and < 4.5, ≥ 9 and < 11)
  • Possible Oxidant Activity
  • Immunoassay Interference
  • GC/MS Interference or LCMS Interference
  • Abnormal Physical Characteristic
  • Bottle A & Bottle B - Different Physical Characteristic
  • Adulterated/Substituted 

DOT:

• Every DOT Drug Screen will be sent to an MRO, regardless of Positive or Negative results at the Laboratory. 
• If lab confirmed non-Negative, same steps as above with 1 exception

If the Medical Review Officer was unable to contact the donor within 24 hours, they will notify the DER and keep the report open for up to 10 days per DOT Guidelines

If you have any further questions, or need a product enabled on your account, 
please contact Verified First Client Services for assistance.

Call 844-709-2708 or email ClientServices@VerifiedFirst.com