Pre-OP Urine test?

A friend just called, freaking out, asking me about how to beat a drug test. She’s having surgery on a tendon in her hand, and the nurse called and told her to be ready to give a urine sample when she gets there. It will be outpatient surgery, with general anesthesia.

This worries her because she occasionally uses marijuana. For reasons I’d rather not get into, it is very important to her to keep this a secret. I think it’s a really bad idea to fake the test, but I need to be able to reassure her that it’s not a drug screen, or that the results wont come back to bite her later.

Anyway onto the questions:

  1. What is the urine test for?

  2. Can she request the results not go into her medical record?

  3. How accurate is a hospital drug screen? Could she later deny the accuracy of said test?

I seriously doubt they are going to screen for illegal drug use. It is surely just to do a health screen for details relevant to the surgery. Even if they did screen for MJ, that information is strictly protected under HIPAA laws (assuming this is in the U.S.). It wouldn’t ever be released to anyone without her consent. Doctors don’t try to bust anyone for illegal drug use. HIPPA laws would prevent them from doing so even if they wanted to. This is non-issue for her and she should allow the screen.

I suspect they want to make sure she’s not pregnant before they do surgery.

Shag is right, the results of the test are protected by federal law and the hospital cannot share them, even with family members, without her signed waiver. Even if they did test for marijuana, which they very probably don’t.

That’s the only thing we ever tested for in the urines that came down from the OR.

Also, she can *ask *the hospital what the test is for, if she’s worried. It’s *her *medical care, she needs to grow up and be a responsible adult and ask questions about it.

Then why do they collect pre-op urine from men? I’m guessing they’re just doing a quick “dipstick” screen to see that nothing is horribly off like passing sugar or whatever else those sticks test for. Sound about right?

Is she treating with a pain management doctor in the same practice? It might be a narcotics screen unrelated to the surgery.

IANAD, but my guess is that they look for anything that could affect the course of the operation and healing thereafter. For example, isn’t diabetes diagnosed at least in part via a urine test? Protein in urine can (but doesn’t always) indicate a kidney problem. And so on.

I’d be real surprised if there wasn’t also a blood sample taken for similar reasons. That’s been my experience with my various surgeries and general anesthesia.

It is probably to check for pregnancy, and to make sure that her organs are functioning ok. So they would check for sugars or proteins in urine. Not for drugs.

I did have a minor freakout myself, in a similar way. My husband and I went in for a scheduled inducement with my son. We were supposed to go the the hospital at 10pm (to start one medication to soften my cervix), and then to be induced with pitocin the next morning.

I thought it would be a really bright idea to go out for a big steak dinner that night. This was a terrible idea on multiple levels. But I had half a glass of wine with dinner. And proceeded to freak right the fuck out about having a +BAC, and child protective services, etc…

If they are drug testing, I’d bet it’s so the anesthesiologist has a full awareness of anything in the patient’s system that might have an effect on the anesthesia. it’s certainly not to rat her out to anyone, the results are protected by HIPAA.

The only time I’ve seen pre-op urines from male patients was as part as a pre-op screening, usually done long before the surgery date, and in those cases it would be used to check for infection, diabetes, and kidney and liver problems, in tandem with the blood tests that are done at the same time.

Urines coming down from the ambulatory surgery center were pretty much always to check HCG (pregnancy) in female patients of childbearing age.

That’s just my experience in the one hospital where I rotated through the urinalysis bench on a regular basis.

Well, if they guy IS pregnant, that’s probably something they really need to know about first…

Believe it or not, we’ve seen positive pregnancy tests on men - it’s super rare to see in the lab, but the presence of HCG in a male patient’s serum can be a sign of certain malignancies. Or, much more often, a mis-labeled specimen!

Thanks for all the replies. I’ve passed along the advice, she seemed placated.

To everyone who said the results are protected by HIPPA: HIPPA doesn’t help you if you’ve given releases of your medical records.

That’s HIPAA, dammit!

:wink:

There isn’t a blanket “release” that says anyone who asks about it can know. There are certain entities within the medical field that have a medical need for the information who can obtain it, but you provide releases so the information can be sent to entities you specify.

Hmm. Sorry for the off-topic, but when I saw the thread title, with “OP” in caps, my first thought was, “Wow – a urine test before starting a thread (original post)? Harsh.”

In addition to what lff pointed out, she’d have to fill out an additional form (under HIPAA) for the provider to release protected health information relating to drug/alcohol screening, HIV/AIDS screening or sickle cell conditions. Your state is likely to have similar laws, which may also cover psychiatric/psychological health information.

I would have guessed they were looking for anything that would interfere with the anesthesia, before operating, like crack or booze, etc. I don’t think MJ qualifies for that.