Other causes of failed PEth test for alcohol abuse?

I just sense things are getting to a “critical mass” level....such that a young, hungry attorney will be willing to jump on this nonsense. I am looking around for one as we speak. This case could be career-making.

I had a thought today that I wanted to share with this group. When I recently had an ethanol blood test the lab tech has to use iodine to clean the draw site so as to now contaminate the blood sample. When they drew blood for PEth, the tech used an alcohol swab and the site and it wasn't fully dry before the needle was inserted. Could this feasibly cause a false positive test. If they are worried about it with an ethanol sample it seems reasonable that it could affect a test that directly involves blood and ethanol. Also, the tube used for collection was the same tube used for a previous ethanol sample that hemolyzed. When I asked the tech about this, he said that for some reason they have issues with this particular "grey top" vial, but they used the same grey top for the PEth sample.

It might be a long shot and I'm not 100% on how it is formed other than interaction of red blood cells and ethanol, could that reaction occur in a blood vial?

Yorkie-
We had this initial concern, but stopped allowing the alcohol swabbing and yet still had false positive results (affirmed by negative tests from another place with samples given just minutes after the first one). It was NOT the alcohol swab, in my opinion, validated by a toxicologist who reiterated that the test is NOT checking for alcohol, but for phosphatidyl ethanol, an alleged byproduct of the body’s processing of heavy alcohol consumption. The ONLY false positives I EVER received were from Forensic DNA & Testing in Dallas. To date, the three other test facilities have, rightly so since I don’t drink at all anymore, resulted in negative. My common denominator was FDNA.

Fair enough @fairlaneowner, I just wasn't sure if the red blood cells in the sample would react with the alcohol from the swab and create the PEth byproduct outside the body. Just a thought. I attached some information from the Substance Abuse and Mental Health Services Admin that has some interesting information on biomarkers including PEth test.

I still am waiting for my appointment with my provider who ordered the PEth test. The information in the SAMHSA brochure, which was directly referenced on my lab report, states that a single biomarker should not be damming and taken into context with other tests for a solid picture. This literature even says false positives are "unlikely but still unknown due to paucity of research".

And as alluded to in my other comments - the issues my family member had problems also ONLY at Forensic DNA & Testing in Dallas. I also do not believe it is based on wipe but we made them stop using it with the fingerprick tests. I am more concerned about the integrity of The FDNA testing protocol if not the collection facility as a whole... especially after finding Fairlane on here experiencing similar issues at the same place.

With regards to the grey top tube vs the tan top tubes (for the blood drawn tests)... I did some research into that as well. I do not remember all the specifics without going back through my notes but one of them is supposed to prevent the formation of alcohol in the tube itself after it is collected and waiting for testing. Some of the papers discuss this as a possible issue with PETH false positives for the blood drawn test. In our experience we received no false positives with the blood-drawn tests and were taking them same day as a failed fingerprick test. Our only failures were with the USDTL-based tests using the cards and drops used at FDNA despite passing blood-tests same day. We never had issues with the blood drawn tests at Request-a-Test using LabCorp as the backend. I do not believe Fairlane ever did the blood-draw method you are talking about - but he was getting in-consistent results with the USDTL tests given at a different facility same day.

My personal belief is the PETH as a whole - has false positives. If you can afford it and the results of the tests matter to you (which I am betting is the case for almost anyone taking this tests as they are being forced to for some reason) - I strongly recommend you take the test at two facilities the same day. Towards the end of our nightmare with these results we were doing 3 tests - one blood drawn, one at FDNA, and one at another lab using USDTL.

If you do the multiple tests (anywhere) and get in-consistent results please contact me and let me know your experiences. If you are having problems with the PETH tests at Forensic DNA in Dallas I would also been keenly interested in talking.

I am in Atlanta, Ga. I have had 3 false positive tests. I have had to do hair follicle and nail tests to prove that I haven't had any alcohol consumption.
In 2 of the 3 times, I had just finished working 4 days in a row. At my job site, we use hand sanitizer ALL the time.
The last result was 30ng/ml. I had used Orange essential oil on my wrists.
This test is not accurate. It's sensitivity is ridiculous.
I frankly detest the USDTL. I hate the finger stick test.

Here’s one for you....my program (Virginia HPMP) won’t accept nail or hair testing in place of or even as a supplement to blood PEth. Why?

They say, “because those tests aren’t positive enough.” Allow me to translate....”positive tests keep us in bidness.”

Follow the $$$, folks.

Ok. I am really fed up. I am just going to put out here my history. I am an RN. I am alcoholic. No trouble with my nursing license, nor my driver's license.
I went to an outpatient treatment center. I self reported to the board of Ga. Nursing.
I now have a consent order. In this consent order, due the diagnosis of severe alcoholic, (treatment center got $45000 for that code) the board of Nursing ordered me to do monthly PEth testing for 1 year. I was ordered to do FINGER STICK testing. Who knows why.
I have had 4 false positive tests. The last two were January 15 and February 13.
On January 29th I did a nail test came back Negative and a urine test came back Negative.
The treatment center is again wanting me to do another nail test on February 27.. $177 to $181.
After the 2nd positive PEth test in July 2018, I had been doing duplicating with Lab Corp but in December, my money was just too tight. I stopped. Any Lab Tests charges $176; Lab Corp $139.
I know it's about the money. The handling lab: Choice Labs makes money every time I test, Any Lab charges $32 for collecting.
There are other nurses in my treatment center aftercare group who have been ordered to do this test. They are terrified. Can't blame them. They don't have to have FINGER STICK testing. I am puzzled by that too. I told them to insist on not going to the lab location that I was assigned.
I believe the cause of my false positive tests lie with the lab location, the technician ( been the same one all 12 tests).
I am exhausted, frustrated and angry over this "infallible test".
The money I have thrown out to this.
The treatment center would not send a letter to the board of nursing to suggest to drop this test. It's a money maker.

I 100% agree it is all about the money. They get a test that mostly works - except when it gets a false positive. Then they don’t worry about the poor people that get the false positives.

And the people in the business that monitor compliance. Well... why would they care if you are getting false positives either. That just means they get paid more too. It you that is just SOL not them...

Never mind it ruins people’s lives. I truly hope it ends up bitting some of them in the rear... or someone they love with the same results.

I do have a question though. You say you had to do “finger stick”. I assume this is with some place doing the backend testing with USDTL? Our experience with LabCorp was they only did the blood-drawn PETH using what was the MedTox backend tests (now owned by LabCorp).

For the USDTL ones, I strongly believe you can mess that test up in collection based on the experiences of my wife and Fairlane.

A couple hints that “may” help but I cannot say will fix the problems. Just things we made them change over time but did not have enough good tests with the USDTL test to feel good about these being responsible for the changes. I still just think the test is just flawed.

1) Make them use a factory fresh test kit that has not been setting around too long. Have them open it in front of you. You would think this would be obvious... but not all collection facilities do this...

2) Do not let them use the alcohol wipe. The USDTL instructions tell them not to use an ethanol based wipe. The ones they were using were not but we made them stop using them totally.

3) Do not let them squeeze or milk the finger. The USDTL instructions tell them not to... because it stops the bleeding. I found some research papers showing how this can negatively effect other finger prick tests. Can’t say that is the case here but it is something we changed.

4) do not let them wipe your finger on the card. Make the blood drop and fall. They will complain about this unless you are a bleeder. But again it is in the USDTL instructions but more subtly than I stated here.

5) make the seal the kit in front of you after testing.

Hi.
Any Lab Tests is the collector. The specimen does go to the USDTL via FedEx.
I have inspected the kit to if it's been tampered with, I haven't seen an expiration date; I have wondered about that. They pull the kit out from behind a counter, I have never seen the box.
It has been a long year. This was my last one.
It has been the same collector every time. Every time there is positive test , I have done 2 hair follicle tests, both were negative. Then my treatment center said after the 2nd positive tests said now we are going to make you do the nail tests. The 27th with be my 3rd nail tests. The last 2 were negative.
I am sober. I am wondering and am honestly fearful that they will do something to my nails.
I am seriously thinking about either doing a PEth test with Lab Corp on the same day as the nail. As a just in case they do something.
I won't be surprised if when I do my daily call on the 27th, that I will have to do a urine test as well. They made me do that in January.
I haven't done a urine in the month of February yet.
So now it turn to diluted urine tests. Those are $84. They gotta recoup losing that monthly PEth test. I am serious. I have started "holding it" giving them my first morning urine now.
I do not trust any of the lab companies.