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MRO Services
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The Medical Review Officer (MRO) process
was first developed by the U.S. Department
of
Transportation to provide a level of safety
and confidentiality between the employer
who required a urine drug screen test and the
employee who was required to submit to the
test. Although established originally for the
federally regulated testing programs, the
MRO process has been widely embraced by
the private sector and is now considered
essential to all quality drug testing programs. |
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In the MRO
process, an MRO receives drug test results from the laboratory, reviews the
results and evaluates the validity of the
result. If the result is positive, the MRO
determines whether there is a legitimate
medical reason for the test to be positive. An
example is the appropriate use of
prescription medication that can legitimately result in
a positive drug test. Based on the
review, the results are verified and reported as
"Positive", "Negative", "Adulterated",
"Substituted", or "Canceled/Invalid/No-Test". The
employer then takes action according to
internal company policy, federal requirements
or both.
Medical Review Officer services are provided by a licensed physician
specializing in
addiction medicine. Services include the interpretation
and evaluation of test results
from confirmed positive, adulterated and substituted
specimens in addition to the
employee's medical history or other
relevant biomedical information necessary to
determine if there is a legitimate
explanation for a confirmed positive test.
Howard M. Strickler, M.D.
President and Medical Review Officer
 Dr.
Strickler received a M.D. Degree from the University of Louisville in 1979.
Following a Residency at Anniston Family Practice in Alabama and a Fellowship in
Addiction Medicine at Willingway Hospital in Georgia, he became certified in
Addiction Medicine by the American Society of Addiction Medicine in 1986.
He was trained as a Medical Review Officer in 1990 and was one of the first to
be certified by the American Association of Medical Review Officers in 1992 when
certification became available. Dr. Strickler
has practiced medicine for more than 20
years.
MRO Term Definitions
Adulterated Specimen:
A specimen that contains a substance that is not expected
to be present in human urine, or contains a
substance expected to be present but is at
a concentration so high that it is not
consistent with human urine.
Dilute Specimen:
A specimen with creatinine and specific gravity values lower than
expected for human urine. Is considered a negative test.
Substituted Specimen:
A specimen with creatinine and specific gravity
values that are
so diminished that they are not consistent with
human urine. The latest DOT ruling on
SVT is summarized below:
Split Specimen:
In drug testing, a part of the urine specimen that is sent to a first
laboratory and retained unopened, and which
is transported to a second laboratory in
the event that the employee requests that it
be tested following a verified positive test of
the primary specimen or a verified
adulterated or substituted test result.
 Verified test:
A drug test result or validity testing result from an HHS-certified
laboratory that has undergone review and
final determination by the MRO.
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