Chain of Custody and the Medical Review Officer

A critical component of all drug testing protocols (sports and workplace) is chain of custody, which refers to the policy whereby the collected sample (usually urine) never leaves the direct observation of a member of the drug testing team until it arrives at the laboratory. Once collected, the processed sample remains under the direct observation of the testing team until it is hand-

delivered to the shipping company, which also maintains direct observation until the sample is hand-delivered to the certified laboratory. The goal is to eliminate any potential tampering with the specimen. The MRO (medical review officer) is responsible for reviewing the chain of custody form to ensure no potential tampering. If chain of custody cannot be verified, the test result is considered invalid. The overarching goal and philosophy of the Drug-Free Workplace (DFW) program is to deter, not merely detect, drug use in the workplace. The role of the MRO physician is to advocate for the employee-athlete donor and ensure the ongoing integrity of the testing program.

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