A donor recently came in and gave a specimen my collector would not accept. I am not sure of the exact reason, but the most common reasons are that the specimen’s temperature is out of range or suspected substitution (we get lots of synthetic urine around here.) The collector explained to the donor that we could not accept the specimen because we did not believe it came from his body, and he was welcome to provide another specimen, but, if he left the clinic, it would be a “refusal”. The donor became a little belligerent and wanted to argue that he was not refusing to take the test – he gave us a specimen and we were the ones refusing to accept it. We tried to explain what a “refusal” meant as it relates to drug testing. In the drug testing arena (as in most industries) we have a unique vocabulary that has definitions that differ from society in general. Here are a few of those terms and how they are defined by our industry:

Refusal – when a donor refuses to give a specimen that the collector will accept. The collector has the right to refuse any specimen for any reason. We most commonly refuse specimens for those issues listed above: the temperature is out of range and/or suspected substitution. We will also refuse if we think the specimen has been adulterated. As collectors, we also have the right to end the collection and call it a refusal if the donor becomes unruly. However, we have never had to go that far.

Adulterated – the collector believes something was added to the donor’s urine specimen to thwart the test; bleach or ammonia are the most common substances.

Fatal Flaw – an error the collector makes that “breaks” the chain of custody and cannot be rectified. i.e., collector fails to print or sign their name on the CCF (custody & control form), there is insufficient quantity of a urine specimen in the containers sent to the lab, the specimen container leaked in transit, or the specimen label on the urine containers do not match those on the CCF.

Direct Observation – the observer must witness the urine directly leaving the body as being voided into the collection cup. When a federal (DOT) test is conducted and the donor gives the collector a specimen they will not accept, the 2nd specimen must be directly observed by a person of the same gender. The donor must drop their pants to their knees, raise their shirt above the navel and turn 360 degrees in front of the observer prior to voiding. This regulation is to prevent the use on a strap on prosthetic design to mimic human genitalia. (Google the whizzinator – yes, they really sell these things!)

You can find some of these terms further defined along with some others I did not mention on our website under Resources.

Not understanding the terminology is no reason to argue. Even after we explain the meaning of refusal, many donors still want to stand their ground. They usually leave the clinic without providing a specimen we will accept because we never concede our position. How well does the collection site your company use stand their ground?