Responding to a Second Dilute Negative Result

(Summer 2017) Real Life Incidents: Working Partners® Consortium members receive phone support and consultation about drug-free workplace (DFWP) issues — a benefit we term “troubleshooting.” Here is a brief description of a troubleshoot call and our response/suggestions.

Situation:

A long-time, drug-free workplace (DFWP) Program Administrator (P.A.) called with questions about an employee who tested “dilute negative” on a random test. This long-time P.A. knew her drug-free policy well and was aware she was supposed to send the employee for another test (aka recollection) – which she did. She also remembered it was best practice to give that employee the minimum possible advance notice that a recollection was required, and she adhered to that, as well.

While her policy cites the recollection could be under direct observation, she decided not to go that route. (When asked by the Working Partners® how she made that decision, she really didn’t have a solid answer – said she “just didn’t think it was necessary.”)

The P.A. was stumped when the result of the recollection was also dilute negative — which prompted her call to Working Partners®. The employee in question has been with the company for 10 years and he has shared with coworkers (though not the P.A.) that he has various health problems. The P.A. said she called Working Partners® called to see if it was OK to do a second recollection — this time under direct observation.

Response:

As with many other drug testing issues, Working Partners® often suggests that businesses mirror some of the testing specifications mandated by the Department of Transportation (DOT), even if the test they are conducting is not officially mandated by DOT (aka DOT look-alike testing). Such is the case with responding to a dilute negative test.

This particular P.A. started down that path but took a few detours along the way. First, the issue of observed collection: mirroring DOT specifications, this company’s policy states that a recollection due to a negative dilute result “may be administered under direct observation … as directed by the MRO.”  According to DOT, the MRO will use objective measures (i.e., the measured creatinine concentration of the urine) to decide whether the employee should be directly observed giving his/her second specimen.  Instead of relying on her gut (“just didn’t think it was necessary”), it would have been more prudent for the P.A. to have consulted with her MRO to determine whether the employee should have been watched when he gave his second specimen.

The second detour that the P.A. was about to take (but thankfully called before taking that path) was to do another recollection after she received a second dilute negative result. According to DOT, “if the result of the test you directed the employee to take … is also negative and dilute, you are not permitted to make the employee take an additional test because the result was dilute.”

In short, when the second test was reported as dilute negative, she should have treated it as a negative and moved on.

But what does a negative dilute really mean? Isn’t that result indicative of the employee’s attempt to “mess with” the test? NO! There are three main things that can cause the test to be dilute:

1. The donor has a medical problem involving his/her kidneys.
2. The donor legitimately drinks a lot of water – possibly to beat the heat, lose weight or avoid kidney stones.
3. The donor is attempting to alter the test by flooding his/her system with water.

In essence, the majority of the causes are legitimate and not tied with any employee misconduct.

At the end of the call, the P.A. determined she would not ask the employee to go for another test and was appreciative of the learning that occurred during the call.

When making action-decisions, always think comprehensively about the situation you are involved in and are creating by your actions.  Also, consider the what-if scenarios to aid in determining direction.  Most importantly, you could do what the employer with this situation did if you are part of our consortium:

Call Working Partners® Consortium at (614) 337-8200 or 866-354-3397.

As a member of Working Partners® Consortium, don’t forget your access to this troubleshooting service.  Be safe, not sorry!