Blood Tests: Potential Problems

October 11th, 2006 Allen Trapp Posted in Blood Test, Chemical Test No Comments »

When the police arrest an individual for DUI and arrange for blood to be drawn by a nurse, phlebotomist or other qualified individual, it should in all cases in Georgia be taken from the suspect via a vacutainer.  Two vacutainers (vials with a seal or septum at the top) are included in each blood alcohol testing kit provided to police agencies in Georgia.  Each of these vials should contain two substances -sodium flouride, the  preservative, and potassium oxalate, an anticoagulent.  Each of these tubes will be  vacuum sealed, which explains why they are called vacutainers .

The vacutainers also have an expiration date, after which the vacuum seal is no longer warrantied.  The expiration date will be printed on the outside of the blood testing kit, which is basically a small cardboard box.  The truth is that only a very small handful of  phlebotomists or police officers ever pay any attention to the expiration date, because they are rarely challenged on the issue.  In addition, state crime lab personnel don’t confirm the the expiration date.

The manufacturer’s quality control procedures only require that one out of every four thousand vials be checked.  The bottome line is that there are at least three possible defects in the state’s blood test:

1. A failed septum (or seal) on one or both of the vials, which cannot be detected after the blood in a tube has been tested, because that vial has been opened.

2. Improper amount of sodium flouride in one or both of the tubes.  Since the vacutainers are rarely if ever refrigerated before being dropped off at the the Division of Forensic Sciences, the proper amount of preservative is critical. Either too much or too little can lead to a false high test result. 

3. Improper amount of potassium oxalate in either of the tubes. 

In the case of a defective seal organisms from the environment, such as candida albicans, can get in.  Unless there is enough sodium flouride in the vial, the organisms that may be in your client’s blood will grow. The most common of these is candida albicans, a yeastlike organism that has proven to be highly resistant to sodium floride. When candida albicans is in close proximity to glucose and a source of heat, it will create ethyl alcohol via fermentation.

Too much sodium flouride may cause “salting out”, which will also lead to a false high test result with headspace gas chromatography. This can occur even if there is no problem with the vacutainer, but the phlebotomist draws too little blood.

If there is not enough potassium oxalate, the blood can coagulate or “micro-coagulate” which is almost completly undectable. Because this changes the ratio of liquid to solid in the substance that is tested, and ethanol is water soluble, it can lead to a false high test result.

It can be virtually guaranteed that in any case involving a blood test the lab did not test for the presence of Candida Albicans, the lab did not check the vial seal, and the lab did not check the amount of sodium flouride or potassium oxalate in the tube.

If any of these occurred, you will in all likelihood have a false high blood alcohol concentration reported by the lab.

Written by Allen Trapp who is board certified by the National College for DUI Defense and the author of Georgia DUI Survival Guide Visit Website
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Urine Tests: False Positive Results for Drugs

August 14th, 2006 Allen Trapp Posted in Urine Test No Comments »

Substances that cause False Positive Drug Test Results

THC – Substances or Conditions which can cause false positives
Dronabinol (Marinol)
Ibuprofen; (Advil, Nuprin, Motrin, Excedrin IB etc)
Ketoprofen (Orudis KT)
Kidney infection (Kidney disease, diabetes) Liver Disease
Naproxen (Aleve)
Promethazine (Phenergan, Promethegan)
Riboflavin (B2, Hempseed Oil)

Amphetamines – Substances or Conditions which can cause false positives
Ephedrine, pseudoephedrine, propylephedrine, phenylephrine, or desoxyephedrine
(Nyquil, Contact, Sudafed, Allerest, Tavist-D, Dimetapp, etc)
Phenegan-D, Robitussin Cold and Flu, Vicks Nyquil
Over-the-counter diet aids with phenylpropanolamine (Dexatrim, Accutrim)
Over-the-counter nasal sprays (Vicks inhaler, Afrin)
Asthma medications (Marax, Bronkaid tablets, Primatine Tablets)
Prescription medications (Amfepramone, Cathne, Etafediabe, Morazone,phendimetrazine, phenmetrazine, benzphetamine, fenfluramine, dexfenfluramine,dexdenfluramine,Redux, mephentermine, Mesocarb, methoxyphenamine, phentermine,amineptine, Pholedrine, hydroymethamphetamine, Dexedrine, amifepramone, clobenzorex,fenproyorex, mefenorex, fenelylline, Didrex, dextroamphetamine, methphenidate, Ritalin,pemoline, Cylert, selegiline, Deprenyl, Eldepryl, Famprofazone) Kidney infection, kidney disease, Liver disease, diabetes

Opiates – Substances or Conditions which can cause false positives
Poppy Seeds
Tylenol with codeine
Most prescription pain medications
Cough suppressants with Dextromethorphan (DXM)
Nyquil
Kidney infection, Kidney Disease
Diabetes, Liver Disease

Ecstacy – Substances or Conditions which can cause false positives
Ephedrine, pseudoephedrine, propylephedrine, phenylephrine, or desoxyephedrine
(Nyquil, Contact, Sudafed, Allerest, Tavist-D, Dimetapp, etc)
Phenegan-D, Robitussin Cold and Flu, Vicks Nyquil
Over-the-counter diet aids with phenylpropanolamine (Dexatrim, Accutrim)
Over-the-counter nasal sprays (Vicks inhaler, Afrin)
Asthma medications (Marax, Bronkaid tablets, Primatine Tablets)
Prescription medications (Amfepramone, Cathne, Etafediabe, Morazone,phendimetrazine, phenmetrazine, benzphetamine, fenfluramine, dexfenfluramine, dexdenfluramine,Redux, mephentermine, Mesocarb, methoxyphenamine, phentermine, amineptine, Pholedrine, hydroymethamphetamine, Dexedrine, amifepramone, clobenzorex, fenproyorex, mefenorex, fenelylline, Didrex, dextroamphetamine, methphenidate, Ritalin, pemoline, Cylert, selegiline, Deprenyl, Eldepryl, Famprofazone) Kidney infection, kidney disease
Liver disease, diabetes

Cocaine – Substances or Conditions which can cause false positives
Kidney infection (kidney disease)
Liver infection (liver disease)
Amoxicillin, tonic water

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Blood and Urine tests for Methamphetamine

August 11th, 2006 Allen Trapp Posted in Blood Test, Chemical Test, Urine Test No Comments »

     If a person has taken methamphetamine, that individual should also have its metabolite amphetamine in his or her system. In other words, levels of both methamphetamine and amphetamine should be detected in both the blood and urine. Some GC/MS assays can falsely yield positive methamphetamine levels when high concentrations of ephedrine or pseudoephedrine are present in the specimen. Depending on the temperature of the injection port, the ephedrine or pseudoephedrine can be converted (or cooked) to methamphetamine. Therefore, sound scientific practice requires a negative report for methamphetamine if only methamphetamine is found in blood or urine. The absence of amphetamine means that the person had not consumed methamphetamine, which would in the ordinary course of metabolism would produce amphetamine. Therefore, in a case where only methamphetamine is found in the blood or urine the person probably had a cold and taken cold medicine containing ephedrine or pseudoephedrine.

Written by Allen Trapp who is board certified by the National College for DUI Defense and the author of Georgia DUI Survival Guide Visit Website
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Blood Tests: Why a Hospital Test is Suspect.

August 4th, 2006 Allen Trapp Posted in Blood Test, Chemical Test No Comments »

Hospital laboratory testing of serum alcohol involves use of the enzymatic method. The enzyme kits do not measure alcohol directly. They oxidize alcohol to acetaldehyde by the reduction of NAD+ to NADH. The amount of NADH produced
is therefore a function of the amount of alcohol present in the sample, and the amount of NADH produced is measured via a color reaction. However, if the blood also contains high levels of lactate (lactic acid) from either the administration of Ringer’s Lactate or the release of lactate from damaged tissues and also high levels of LDH (lactate dehydrogenase) enzyme from damaged tissues, then it is possible that the NAD+ from the enzyme kits will also oxidize lactate to pyruvate, thereby also producing NADH which would appear as “alcohol” in the test results. Therefore, it may be possible to have falsely high alcohol test results from serum alcohol tests using these hospital enzyme kits if both lactate and LDH are in high concentrations in the blood.

Most cases with only a hospital blood test are homicide by vehicle or serious injury by vehicle cases, and either of these charges carries up to fifteen years in prison.  Therefore, someone in this situation needs to understand that an expert such as a professor of toxicology must be on your team.  Otherwise, the State will introduce unrefuted evidence that your blood alcohol concentration was at a certain level, and you will be on your way to prison.  Don’t cut corners when your life and liberty are endangered; make the investment. 

Written by Allen Trapp who is board certified by the National College for DUI Defense and the author of Georgia DUI Survival Guide Visit Website
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