Thursday, July 17, 2014

Author Question: Drug Testing

My super good friend and author Mark Young is stopping by to challenge me with a medical question. Mark writes great novels and recently won the 2014 National Indie Excellence Awards panel in the Mystery category for his novel Broken Allegiance. Congratulations!

Welcome back to The Edge, Mark.

Mark asks:

I was hoping you could help with a little medical drug testing problem I have in my latest novel.

Here is the situation: My main character, Tom Kagan, is knocked out using the drug Ketamine. Later, when an internal affairs investigator orders blood and  urine samples taken, Kagan also has the hospital take a second sample for himself. 

When the drug test comes back for the cops, it shows nothing in his system. But when Kagan gets his sample back, it show Ketamine in his system.

Here is my question: Can someone provide a sample of a clean blood type that is the same as Kagan’s but is someone else's, destroy the test sample containing Ketamine, and make it appear that Kagan’s blood is clean? And urine tests, how specific are they tied to an individual? Can anyone provide a sample and make it appear as if it is Tom’s?

Jordyn Says:

It is not routine to "type" someone's blood unless they need blood. In general, when blood is sent to the lab, we have no idea what type it is. These days, there is a push at many hospitals to label specimens at the bedside to avoid patient ID errors. Many hospitals are also having the patient or family member initial the lab label (that has the patient's name, DOB, and medical record number) as a double check. The nurse (or collecting provider) then notes a collection time, the date and initials the specimen as well.

Most specimens are sent to the lab via a tube system. Specimens that are collected for legal reasons, I imagine, would also have to maintain the chain of custody.

So, it is possible for a blood specimen to be switched out for someone's who doesn't have the ketamine in their system but these are the problems you'll have to overcome. Switching out the tube but still having the label appear as it normally would. 

You could do a handwritten label. This would be rare but not unusual as long as it had all the identifying characteristics the lab would require. At a minimum, this would be the patient's name and DOB. Something like the computer system going down could cause something like this to happen. The lab may call to investigate why it was labeled in such a manner which could increase tension/conflict in your scene.

Also, in some situations, specimens are hand-carried to the lab on occasion to ensure delivery. This might well be the case here because there is legal concern and this is when a switch could take place as well.
Generally, what is tested for drugs is urine. Here is a post I did on the common, illicit (depending on the state) drugs we look for. You can test for Ketamine but it is going to be a "special order" test. Here is some great info on Ketamine drug testing.

You will have the same issue with a urine sample. Urine isn't "typed"-- it's not tied to a particular individual except by the label on the cup. Also, if it's a legal manner, the individual might have to be monitored as they pee to ensure the specimen wasn't altered or substituted out.

An intriguing scenario you have here. Good luck with your novel!


Mark Young is an award-winning author of three previous bestsellers, Revenge (A Travis Mays Novel) and two Gerrit O’Rourke novels, Off the Grid and Fatal eMpulse. Prior to his full-time writing career, Young served as a police officer with the Santa Rosa Police Department in California for twenty-six years. Additionally, he was an award-winning journalist and a Vietnam combat veteran. He served with several law enforcement task force operations, including the presidential Organized Crime and Drug Enforcement Task Force targeting major drug traffickers, and the federal Organized Crime Task Force charged with identifying and prosecuting prison gang leaders. He lives in the Pacific Northwest with his family. Visit to find out more about Young and his writing.

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