AAMRO Certified MRO – Dr. Greg Elam

Greg Elam, M.D. is certified by the American Association of Medical Review Officers. He has clinical experience in dealing with controlled substance disorders and has supervised the review of over two million drug tests. He brings a very professional and personable approach to the review of drug tests. The first interaction with someone knowledgeable about substance abuse disorders is likely with the MRO. Therefore, the MRO interview sets the tone for future interactions, giving the MRO the opportunity to provide a positive approach to a shame based condition. Dr. Elam epitomizes the professional but compassionate physician in dealing with drug test issues. MRO Review of Negative Tests:

As required under the Federal regulations for Negative test results, staff under Dr. Elam’s direct, personal supervision will perform the administrative functions of reviewing the MRO copy of the CCF and laboratory test data for accuracy and completeness. Dr. Elam will personally review and audit 5% of the negative tests and CCFs on a quarterly basis, including all results that require a corrective action. Samples that are reported from the laboratory as negative and dilute will be reported to the DER as “Negative and Dilute. You may recollect a sample NOT under direct observation.”

MRO Review of Positive, Adulterated, Substituted, or Invalid Test Results:
Prior to making a final decision on a specimen that was reported positive, adulterated, substituted, or an invalid test result by the laboratory, Dr. Elam shall give the donor an opportunity to explain the test result. In carrying out this responsibility, Dr. Elam shall evaluate alternative medical explanations for the positive, adulterated, substituted, or invalid test result. This action will include conducting an interview with the donor, review of the donor's medical history, and review of any other biomedical factors. Dr. Elam shall review medical records made available by the donor when a result could have resulted from taking legally prescribed medication. Following verification of the laboratory test result, he will report the verified result to the agency's designated representative. Verified positive tests will be reported verbally with the name of drug(s). If a positive test is also dilute it will simply be noted on the report since no additional action is required. Verified adulterated specimens will be reported verbally with the name of the adulterant, and the DER will be informed that this represents a refusal to test. Verified substituted samples will be reported verbally which represents a refusal to test. All verbally reported results will be followed by a written electronic report.

When a laboratory reports an invalid result due to the possible presence of an unidentified interfering substance/adulterant, Dr. Elam will discuss the results with the certifying scientist at the laboratory to obtain more specific information. He will conduct an interview with the donor and then:

(i) May direct the laboratory to send the specimen to another SAMHSA certified laboratory to possibly identify the interfering substance/adulterant;

(ii) Shall report the result as ``Test Cancelled'' and an immediate direct observed collection is not required if the explanation provided by the donor is acceptable; or

(iii) Shall report the result as ``Test Cancelled'' and indicates that an immediate direct observed collection is required if the explanation provided by the donor is not acceptable.