Frequently Asked Questions

FAQ. 1   Our current lab’s lab director isn’t a board certified toxicologist.  Should this matter?

Answer:  Absolutely – much like you expect the most from your specialists when you look for a provider and want someone board certified in the specialty,  you should expect no less from your toxicology laboratory.  Unfortunately, many labs utilize a loophole that allows a pathlogist to use his license to allow up to five facilities to get their CLIA license and COLA certifications.   While not always true, most pathologists do not have any background in the newest methods for liquid chromatography, mass spectroscopy, the updates in software and method development for toxicology, etc…  This limits a laboratory’s ability to develop and trouble shoot their own testing methods and causes them to rely on “consultants” and vendors who have a vested interested in selling consumables rather than patient care.  At US Medical Scientific we employ some of the top toxicological talent in the country.  Our facilities are staffed and overseen by board certified PhDs – toxicologists.  When you have questions about the chemistry or the processes within the body once medications or testing – or simply would like to discuss a result – our highly qualified scientists are always available to take your call and consult.

FAQ. 2   Our current lab is CLIA and COLA certified.  Does this mean they are held to the highest standard?

Answer:  Not necessarily.  While having these certifications is a minimum standard – please do your due diligence.  Ask for proficiencies between your lab and independent reference labs to be sure they’re testing within range.  The only way to make sure your laboratory is testing at the highest level is to benchmark them against other facilities.  If you’d like us to help set one of these studies up, please contact us.

FAQ. 3  My lab did proficiency testing with CAP but I’m sure the quantification of drugs of interest is not accurate on some drugs.  Is this possible?

Answser:  Yes.  CAP does proficiency testing using synthetic urine that has been spiked with the drug being tested.  This means the body chemistry or metabolism doesn’t take place and we don’t see many of the metabolites.  The body naturally attached a sugar, or glucose, to many hydrophobic compounds in order to make them more water soluble and able to pass through the blood stream and to your kidneys then be eliminated through urine.  When we test we are looking for the molecular weight of the parent drug.  Once a drug has been glucuronidated, its molecular weight increases and it will not be seen.  In order to separate the glucose from the target of interest, we have to use and enzyme that acts as a molecular scissors of sorts – beta glucuronidase.   When this step is done properly and we get separate of all glucose from target drug molecules, then we are able to get an accurate count.  However, beta glucuronidase is a very expensive enzyme and therefore many labs do not build quality controls for this enzyme into each run.  If too little is being used – then your counts will be artificially low – or give false negatives.  This is just one of the many reasons why you want board certified toxicologist in your lab all the time – setting up your methods correctly.  If you would like our team to audit your methods for accuracy, please contact us at info@usmedsci.com