If a specimen shows signs of adulteration, which action is appropriate per typical policy?

If a specimen shows signs of adulteration, which action is appropriate per typical policy?

• A. Document adulteration, consider confirmatory testing or recollection per policy, and notify the client; follow specimen rejection or retention procedures
• B. Do nothing
• C. Notify only the donor
• D. Immediately report to regulatory authorities

Answer: (A)

When a specimen shows signs of adulteration, the priority is to protect the test’s integrity and the chain of custody. The appropriate action is to document the adulteration carefully, consider confirmatory testing or recollection according to policy, and notify the client, while following established specimen rejection or retention procedures. Documenting adulteration creates an auditable record of what was observed and when, which is essential if results are challenged or reviewed. Considering confirmatory testing or recollection gives the lab a path to determine whether valid results can still be obtained: a second method can verify results in the presence of adulteration, or recollecting a new specimen under proper collection conditions can provide a valid sample. Notifying the client ensures they’re aware of the issue and can decide on the next steps, such as retesting or replacing the specimen, while holding to the lab’s confidentiality and reporting requirements. Rejection or retention procedures are part of the policy to manage the specimen appropriately—either discarding an invalid specimen or holding onto it for potential retesting or documentation.

Choosing to do nothing fails to protect result validity and violates standard procedures for specimen integrity. Notifying only the donor is inappropriate because results and decisions typically flow to the client or employer who ordered the test, not just the donor. Immediate reporting to regulatory authorities is not the standard response for routine adulteration and should only occur if a policy or law requires it.