10 ms·
> To guard against false positives, the Mandatory Guidelines for Federal Workplace Drug Testing Programs, published in 2017, require a codeine cutoff of 2,000 n
by PragmaticPulp 4y ago
> To guard against false positives, the Mandatory Guidelines for Federal Workplace Drug Testing Programs, published in 2017, require a codeine cutoff of 2,000 nanograms per milliliter of urine. But the Hackensack University Medical Center's lab, according to Kate's complaint, used a cutoff of 300 ng/ml, less than one-sixth the federal standard. Virtua Voorhees Hospital's lab, according to Kaitlin's complaint, used a cutoff of just 10 ng/ml, 99.5 percent lower than the recommended level.
Using a cutoff that is 200 times more strict than standard drug testing practices without giving the patient any warning that they’ll be tested (and guidance to avoid poppy seed foods) is asking for false positives.
Given that the other cases resulted in six-figure settlements, it’s surprising that this practice continues.
- nullc 4y ago> Given that the other cases resulted in six-figure settlements, it’s surprising that this practice continues. a six figure settlement is a rounding error for these institutions. Given their inefficiency it could easily cost many times that just to change their practices and train doctors to not do the wrong thing. Funding incentives for child welfare agencies also encourage them to cast a wide net (and miseducated mandatory reporters).
- MikeDelta 4y agoI seriously hope they sue and get an 8 figure settlement, or even more. And legal consequences for those involved.
- giantg2 4y agoMandatory reporters might be reporting everything, not out of miseducation, but rather out of fear of overzealous prosecutors.
- dahdum 4y ago> a six figure settlement is a rounding error for these institutions. Given their inefficiency it could easily cost many times that just to change their practices and train doctors to not do the wrong thing. They refused to discharge the mother for days and kept the baby in the NICU for an extra week. Average cost per day for the NICU is ~$3k/day. Six-figure settlements aren't enough if they get away with it frequently.
- giantg2 4y agoSounds like the hospital is subjecting mothers to damages through their negligence.
- behringer 4y agoAlso sounds like a phi violation.
- candiodari 4y agoNo, Youth Services is doing that. The hospital is just referring them, as they are legally obliged to do, and making extra money in the process ...
- giantg2 4y agoCPS is generally required to investigate any complaint and follow a protocol. The hospital doesn't have a failed drug test since it doesn't meet the guidelines. They're only required to report if they reasonably believe the mother is using drugs. Tests below the guideline level don't provide that basis. It's an unnecessary/false report. It's the same way that courts grant protection orders or red flag orders - they're supposed to use the basis of something being more likely than not. Yet they consistently "err on the side of caution" and simply grant the order even though it's not actually likely to occur in most cases. Thus we see some lawyers advising their clients to file orders without basis during divorce to gain leverage. I'd love to see the numbers, but I would guess the process is abused or misruled on more often than it's used correctly.
- candiodari 4y agoI find this to be very typical of CPS. As they report themselves, they miss the large majority of actual child abuse (and one reason often cited, that children and parents agree actual child abuse is less of a problem ... than CPS. So everyone lies to CPS, and they're essentially only used as a means to hurt others, for example in divorce). You'd think the reaction to this problem would be to seriously downsize CPS, and raise the threshold for involvement. The opposite is happening.
- dahdum 4y agoIn the complaint we can see she tested at just 18 nanograms. Utterly negligent. > No one explained the details of the test results to Kaitlin at the time, but Kaitlin later learned that the second test conducted on her urine sample reported a finding of 18 nanograms of codeine per milliliter of the sample (18 ng/mL). The laboratory testing Kaitlin’s sample employed a cutoff of 10 ng/mL to determine whether a sample was positive for codeine, a testing cutoff level that is dramatically lower than recommended in Federal guidelines. https://www.aclu-nj.org/sites/default/files/field_documents/kaitlin_k_complaint_redacted.pdf https://www.aclu-nj.org/sites/default/files/field_documents/...
- coffeebeqn 4y agoThe hospital we had our last birth at have fentanyl through the epidural or some kind of opiate orally. I really wonder how they can even run these tests unless they don’t use any opiates
- Centigonal 4y agoDespite agonizing the same receptors, fentanyl is chemically very different from poppy alkaloids like codeine.
- messe 4y agoOk, but how do they rule out codeine usage while pregnant? I’m not sure about the US, but in Ireland, small doses of codeine + ibuprofen or paracetamol (acetaminophen) are readily available from pharmacies without a prescription, and as far as I’m aware they’re not strictly recommended against during pregnancy.
- kevviiinn 4y agoTylenol 3 is not available in the US without a prescription, no formulation of codeine is. Besides poppy seed bagels, that is
- messe 4y agoInteresting. As far as I know only the combinations with a higher strength codeine are prescription only in Ireland. It’s the same in the UK, as far as I know (presumably because it would be nigh impossible to prevent small amounts of cross-border smuggling with the North)z Most opiates on the other hand, would be rarely prescribed by doctors
- Gibbon1 4y agoMy experience is women hoard Tylenol 3 to use for period pain.
- 4y ago
- LeoPanthera 4y ago> Using a cutoff that is 200 times more strict than standard drug testing practices without giving the patient any warning that they’ll be tested (and guidance to avoid poppy seed foods) is asking for false positives. Occam's razor must apply here. They know what they're doing, and doing it intentionally.
- bmmayer1 4y agoShouldn't Hanlon's razor apply here instead? "Never attribute to malice that which is adequately explained by stupidity"
- hattar 4y agoInterestingly, both could apply here.
- watwut 4y agoAt some point, one must stop playing perpetually naïve Pollyanna and start making realistic guesses.
- LeoPanthera 4y agoThe past few years have convinced me quite strongly that malice is sometimes, even often, the correct explanation.
- doctor_eval 4y agoSufficiently advanced stupidity is indistinguishable from malice… and vice versa.
- kzrdude 4y agoI think we're too slow to call it malice sometimes, aren't we? If it doesn't look cartoonishly evil we ascribe it to other intentions, I mean. While it would be more bold to just call it evil, such as: evil by neglience, evil by greed, etc.
- StrangeATractor 4y ago> Given that the other cases resulted in six-figure settlements, it’s surprising that this practice continues. Honestly that sounds pretty low.
- encryptluks2 4y ago[dead]
- EVa5I7bHFq9mnYK 4y agoMaybe the thinking was, what bad can happen from being extra cautious, an extra visit from a kind child safety inspector?
- sowbug 4y agoThat's dangerously close to the thinking that if you've done nothing wrong, you have nothing to hide. The US Fourth Amendment right against unreasonable search and seizure means that we, as a society, are OK not detecting all crime. But this doesn't feel like a commonly held value these days. "If we can save just one life..." is considered a valid argument for excessive safety protocols. Not far from "If we can detect just one crime..." (Not necessarily disagreeing with your point; indeed, maybe that was the thinking.)
- iudqnolq 4y agoFor one, you could temporarily lose your child/parents. Whenever something bad happens to a child and there was an investigation in progress the investigators are criticized. So they've set things up in many states to bias strongly towards briefly taking the child away and placing them with strangers. But that has long-lasting negative impacts on childhood development.
- candiodari 4y agoYes, what could possibly go wrong if you keep mother and child separate ... oh wait. That's actually well studied: https://en.wikipedia.org/wiki/Reactive_attachment_disorder https://en.wikipedia.org/wiki/Reactive_attachment_disorder That this can happen, of course, to any sane person would be a very strong argument not to interfere, and place the threshold for taking children forcibly away almost at the point they would die without aid, because the vast majority of problems neglect causes are much less bad than the problems CPS causes. Neglect causes "parentification" [1], where sometimes very young children take responsibility for themselves and sometimes also for others. The one psychological problem children can develop that can actually improve outcomes for them. Essentially if children "succeed" at parentification, it results in good outcomes. So you'd think we would alter society to make it easier for children to take care of themselves (e.g. guarantee medical access for children by themselves WITHOUT referring them to CPS, in abstract a clear, workable, understandable set of rules. Do X, Y and Z (e.g. school) and you get to do what you want, which must of course include telling social services to get the fuck out) The problem CPS has is that in general, very, very bad parents deliver better results with children than CPS interference. This is partly due to the state of CPS institutions and just how incredibly bad they are, but is also the result of how the human mind works. A constant relationship with even an abusive parent/caregiver is a lot better than many short caregiver relationships, even if those are pretty good ones. [1] https://en.wikipedia.org/wiki/Parentification https://en.wikipedia.org/wiki/Parentification
- LinAGKar 4y agoBut if they were given warning they could avoid opiates before the tests, so it wouldn't work anyway.