***[Case report #1]{.underline}***

A 45- year-old T/W was called in for a random drug test. The specimen
was reported as an Invalid result, with the presence of Oxidants
detected. The MRO contacted the lab and was informed that possibly
Halides were detected. As per DOT regulations, the specimen was then
sent to another SAMHSA/NIDA approved lab (NWT) for further testing. That
lab elucidated the offending substance and reported the specimen as
***"Adulterated, presence of Halides found".***

The client was interviewed according to approved protocol and offered no
explanation of how the result was found. He had no medical conditions
and was not taking any medication. He denied tampering with the
specimen. He was then given 5 days to seek a medical explanation from
his physician. After 5 days, he returned without an acceptable
explanation, and was declared ***"A Refusal To Test, Specimen
Adulterated".*** As per DOT regulations, he availed himself of the
Confirmation Testing. As expected, the confirming lab was not able to
report the specimen as ***"Adulterated".*** The previous specimen was
cancelled and a report was filed with ODAPC.

***[Case report #2]{.underline}***

An applicant for a safety-sensitive position provided an "out of range"
specimen. As per regulations, he then provided an observed specimen. The
results were as follows: the first specimen was positive for THC
metabolite, and the second specimen (which was collected approximately 1
hour later) was positive for Cocaine metabolite, but no THC was
detected. The client was interviewed and denied using drugs or tampering
with the tests. After being confronted with the results, the donor
admitted to using Cocaine. The MRO then asked, "so who gave you the
first sample?" Upon hearing this, the client, with a sly smile, admitted
that his "friend" donated the first sample, which he attempted to pass
off as his own. He was declared a ***"Positive for Cocaine***
***Metabolite".*** The first specimen was ***"Cancelled".***

***[Case report #3]{.underline}***

A 53- year-old client who previously tested positive for Cocaine
metabolite was unable to leave a required specimen in 3 hours. All
during the process he was complaining of a feeling of fullness in his
bladder and being unable to void properly and empty his bladder. He made
several attempts, but was unable to give 45 cc of urine. At the end of
the 3-hour time frame he was sent to the DER, who in turn referred him
to the MRO. The history obtained was that the client had been
complaining of nocturia 8-10 nightly, worsening over the past several
weeks, with urinary frequency and inability to express a stream of
urine. He denied using drugs. He had seen his Doctor prior to the test
with these complaints but the Doctor did not begin therapy and referred
him to a Urologist. He was referred to our consultant who found a
massively enlarged prostate. His Urologist performed a sonogram that
showed a very enlarged prostate and marked residual volume in his
bladder. His Urologist instituted medical therapy, which resolved the
condition. The MRO's decision was that there was a medical condition
that existed, which was likely to interfere with the client's ability to
leave a valid urine test. He was then sent to our Psychological
consultant to determine if any substance abuse issues were active. He
was interviewed and no current active substance abuse issues were
detected. After treatment, he left another specimen, which was negative.