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    False negative UDT for fentanyl/Dr please respond
    An_252077 posted:
    I have been on fentanyl for years (100mcg) for chronic back pain due to degenerative disc disease and herniated discs. I'm also on klonopin 1 mg (2xday) for anxiety. I've been going to same doctor (internal medicine) so someone could not only treat my pain but my body as a whole. About 6-8 months ago I picked up my monthly RX for fentanyl and received a call from dr's office asking if I had any trouble getting my RX filled. I said no and they said that my drug screen had come back showing that I didn't have the medicine in my system (they asked if I had trouble filling it b/c they had called my pharmacy and told them not to fill). They apologized and stated that they had new associates that didn't know that if it didn't show up on UDT to send it to lab. I told them that I'd come back and take another test immediately because I use my patches as prescribed. They said it wasn't necessary and I asked them to please contact me when the lab results came back. They did and said everything was fine and apologized yet again. I've taken several more UDT's and all's been fine. Well, I went this past Friday to pick up my RX, took my UDT and was brought into a room where they told me my test showed nothing was in my system. I told them that was impossible as I wear my patches religiously, showed them the patch I had on and asked them to retest me. They said they did but it showed same results. I reminded them that this had happened before and to look in my chart. They came back and said that they, nor the on call dr could find anything and stated that they now used a different test. I asked for my dr and was told that he was on vacation until Tues. The on call dr would not release my RX. I asked what I could do and the nurse kept saying she didn't know, how sorry she was as she knew I'd been a good patient for years, if it were up to her she'd give me the RX but her hands were tied due to the dr. I stated that I was due to get the RX filled the next day as I would be out and what did the dr suggest I do if I got sick? He said go to the ER. I'm absolutely shocked that the test would show nothing in my system. I use them as prescribed (change them every 48 hrs). They have me changing it this often due to the fact that after this amt of time I start having increased pain. I've spent the last 24+ hours trying to figure out why this would happen. The only thing I can come up with is that I drink A LOT of water and did so the day of the test. I drank 3 16 oz bottles around mid day/early afternoon and didn't urinate so I could when I went. I was unsure as to when I was going to be able to break away from work as Friday is our busiest day at work and I only have 30 min for lunch. Please note that all I drink is water (bottled) with the exception of a sprite or two each week. I detest milk and juices. In any case, I'm wondering if anyone has ever experienced this before and if so, what happened? Does anyone have any good suggestions for me as to what to say if I do indeed end up in the ER? I'm praying that by some miracle I can make it to Tuesday (the office is closed for Memorial Day) before work in hopes of speaking with my physician. In regards to them "not finding" where this has happened before, I can contact the pharmacist who received the phone call from them that time. I truly don't know how I will be able to work (and it's a new job!) if I can't get this sorted out Tuesday morning. Any and all suggestions are welcome! Please respond ASAP as I need answers. Thank you!

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    blessedladyptl responded:
    I would call the pharmacist now. Try to tell him as little as possible in case what he was told is different than what you were told, Also be prepared to Not receive any meds at the er or be able to talk to your dr or get any meds Tues. Just seems to be the way this situation goes.

    If you aren't able to see your dr or get a rx Tues, you need to get a copy of your Medical Records in their entirety. First to see what they have written about this and the other time. Also to find out the name of the company that makes the urine drug test. The name should be at the bottom or top of the report. Then do a search on the company, that should tell you the problems other people may have had like yours.

    I do know from what I've read here that this problem is far more common than most people believe. And finding a new dr to treat your pain, especially is your previous one was not a pain management dr can take a very long time.
    An_252077 replied to blessedladyptl's response:
    I have to believe that once the test comes back from the lab it will show exactly what the previous one did - the medication was in my system at the time of the original test because it was!!. My doctor, unlike the oncall dr, is compassionate doctor who I believe will try to help me as I've never had a problem before (with the exception of that one time and it was not my fault). This was not my fault this time and I just have to pray that everything will turn out ok. Thank you for responding and by the way, are you in the medical field? Thanks again...
    ctbeth replied to An_252077's response:
    Hi An_252077,

    Today is Wednesday.
    Was the pharmacist able to help you?

    I'm concerned that this is an important situation regarding the first false-negative test.
    The entire thing should have been documented, for both legal and ethical reasons.

    Every lab test, result, phone conversation between a medical professional and patient must be documented.

    Getting your medical records from this office seems priority.

    You can then review them and see what the first false-neg test and subsequent apology. Your medical records are your property, although the office may charge you to make copies; they will keep the originals.

    With this info in hand, you can seek out a new pain management MD, even if you do get your Rx this week, it sounds as if you need to be proactive and find a new practice.

    As blessedladyptl said, a pain management specialist may be the best option.

    Please tell us how you're doing.

    annette030 responded:
    I recently saw a doctor speak on TV and he said up to 10% of ALL medical tests have either false negatives or false positives. He stated this was also specifically true of drug testing. He said most doctors use their experience and a good physical exam along with tests to come to a diagnosis.

    I am not surprised at all. Years ago, for my work as an RN, I had a random drug test that came back negative for hydrocodone, and klonopin, both of which I took everyday at that time. Fortunately, it was for work, so it was a good thing to get negative tests.

    My results at the doctor's office have always been okay.

    Best of luck to you, what a horrible predicament to be in.

    Take care, Annette
    ctbeth replied to annette030's response:
    What I find troubling is that An_252077 was actually wearing a fentanyl patch and showed this to a member of the staff.

    Remember back in our heyday when MDs and RNs treated the patient NOT the lab test.

    This woman clearly has been using her med as prescribed, as evidenced by her long history of success and the fact that she was actually wearing a fentanyl patch.

    I wish that we could return to the time when patients were treated as people, not lab tests.

    I had two false-negative pregnancy tests. Their names are Nathaniel and Jeremiah, LOL.



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