Three Common Breath Alcohol Confirmation Test Issues.
Very rarely does a Breath Alcohol Technician (BAT) perform a confirmation test, but when they do they may encounter some common breath alcohol confirmation test issues that if addressed incorrectly may result in audit nightmares or even a cancelled test.
A DOT confirmation test is performed on a subject following a positive screening test result of .020 or greater followed by a required :15 wait period. But a lot can happen during that :15 wait period that requires you as the Breath Alcohol Technician, to respond and document information correctly in order for the test result to be “defensible”. In other words, if you don’t want a test result to be cancelled under the DOT guidelines or become subject to legal scrutiny, you must recognize, respond and document the confirmation test issues correctly.
What if the employee leaves the testing facility during the :15 wait period?
In the DOT Regulations, Section 40.261, subpart N, an employee is considered to have refused to take an alcohol test if they fail to remain at the testing site until the testing process is complete. This is considered by the DOT as “prohibited conduct”, and is treated the same as a positive test. The resulting consequences of a positive test slightly vary depending upon the DOT agency. However, many employers choose to terminate the employee’s employment rather than have the employee complete treatment and/or education under the direction of a SAP, pass a return-to-duty test and submit to follow-up tests which are the minimum consequences for returning an employee to work.
If the employee leaves the testing facility during the :15 wait period, you, as the BAT, must make a note in the Remarks section of the Alcohol Testing Form, “employee left the testing facility” and notify the DER immediately. If you fail to properly document this event, you will be required to correct the flaw by issuing a Memorandum for Record in order for the test result to be valid.
What if the employee refuses to sign Step 4 of the ATF?
An employees is require to sign Step 4 if the result of their Confirmation Test is .020 or greater. However, an employee’s refusal to sign Step 4 of the Alcohol Test Form is not considered a refusal to test. The breath sample was successfully submitted and a test result obtained. However, you must make a note in the Remarks section of the form stating, “employee refused to sign Step 4”. If you fail to make a note of the subject’s refusal to sign Step 4 the test will be cancelled unless the BAT corrects the omission with a signed Memorandum for Record.
What if the employee drinks something or puts something in their mouth during the :15 wait period?
Given the tenseness of the situation the :15 wait period can feel a lot longer than :15 for both the BAT and the employee. It would not be uncommon for the employee to take a drink of water or put something in their mouth such as gum during this time to relieve the tension.
If this occurs, you must remind the employee of the wait period instructions…”please do not put anything in your mouth during this wait period”, and then document in the Remarks section, “employee took a drink of water”…or “employee put gum in their mouth”. Being specific is important.
More importantly, you must not start the wait period all over, but must begin the confirmation test at the end of the :15 wait period. Because alcohol is eliminated from the body at a steady rate, delaying the confirmation test by starting the wait period all over may result in a lower confirmation test result, and may potentially lower it below the .020 cut-off level, resulting in a negative test.
Routine training is key
Because most BATs rarely administer confirmation tests it is important for you to routinely practice confirmation test scenarios such as these so you can respond correctly and with confidence to these testing challenges.
Darlene Limburg says
None of the above have been concerns thus far in the clinic (knock on wood).
Jennifer Bellantese says
No I cannot say that I have been doing it long enough to run into these issues. However, I will print out these training guidelines and have them on hand if they ever do come up!! Thank you so much!
Have a wonderful and restful Thanksgiving!
Beatriz Ortiz says
I have never encountered ant of these scenarios as of yet but I do think it is important to practice them in order to be better prepared.
Carolyn Mourad says
I have not had a problem with any of the issues above. I believe the issue with the employee leaving the test area, or putting something in their mouths can be resolved by calling for someone to sit with the employee while waiting. Having a very limited space so they are in almost constant view is also helpful. This is my usual protocol in this situation. (My Safety Officer makes himself available if I should need him to sit with someone.)
As far as dealing with employees who refuse to sign step 4, prior to all testing our employees sign a consent form that states that refusal to submit to any testing can result in immediate termination.
We have a robust assistance program for persons who test positive on substance testing. The refusal to sign/submit results in termination. If an absolute test results as positive, then they are given an opportunity to get help through our EAP.
I believe this helps in increasing compliance as well as being the right thing to do from the medical standpoint.
Ben Cheek says
1. I would document a refusal to test that donor left the testing facility then fax the copy of the ATF. I would then call the DER to inform them of the situation. I have only had this situation happen once.
2. I document in the remarks donor declined to sign step 4 so the DER doesn’t get confused if they don’t know step 4 isn’t a requirement for the employee to sign. I then contact the DER because there was a positive confirmation test. I have never had this situation happen.
3. I would reinstruct the donor not to put anything in their mouth and document in the remarks that they put something in their mouth. I would not start the wait period over. I have never had the happen.
James Lemus says
True Story: Emergency room doctor was drinking on a Sunday afternoon in Palm Springs prior to returning to Los Angeles. Doctor was driving alone in a Porsche and gets pulled over by CHP officer. CHP officer claims to have smelled alcohol, performs sobriety check that includes a Breath Alcohol Test and test is >.08
ER doctor is Cuban and white complexion with sandy brown hair and hyper guy. CHP officer is black. ER doctor is polite and tells officer that “we are minority brothers”, gets in front of officer and claims to be nauseated from a bad lunch, and burps and belches literally in officers face. Obviously, doctor is arrested and taken to police station and blood test is taken after much delay and blood test is < .08.
Court proceedings and officer is asked about doctors behavior. Was the doctor obnoxious and in your face? Officer confirms that doctor was belching in his face. Attorney for doctor immediately requests a dismissal of drunk driving charge. Gastric content is not deep alvelolar air. Judge grants the motion.
Doctor and attorney go to lunch with a glass of wine.
Jennie Lee-Pace says
That’s very odd indeed. Never heard of anything like that. The belching action involves air from the deep lung area.
Ruth Kusterer says
In our facility, we, as the BAT testers, stay with the employee during the 15 minute wait period in the testing room. This enables us to keep an eye on what the employee is doing during the wait period. As per protocol, we instruct the employee to not place anything in their mouths, try not to burp, and we sit there with them. We have never had an employee leave or refuse to sign the step 4 on the form. During the 15 minute wait, we are there to answer any questions about the testing procedure and confirmation testing. I hope this helps other testing facilities.
Shawn A. Fulk says
Ken, I have had to do a few confirmation testing but have not run into any of these issues at this time. Thank you for the info though!!
Joanne Hall-Hellen says
I have not been exposed to the above situations however the review has been very helpful!
Belinda says
I have not encountered this problem, I have had to do conformation testing on a subject , and have had no issues.
They have signed step 4 on the form with no problem and have followed the instructions for the 15 min. wait.
Gwen Warshaw says
I have not been exposed to the above situations however the review has been very helpful!