Unexpected Results

Understanding screening variables and their operational impacts.

Choose your Tests Wisely
Topaz Orange Atom

Designed to Reduce Unexpected Results

“Initial drug screens frequently produce what we call a ‘false positive’ because the antibodies in these tests can be fooled by chemicals that look similar to the target drug.”
— National Institute on Drug Abuse (NIDA)
Stat 1 icon
$300-$1,500+
Confirmatory lab fees, staff time, retesting, and administrative overhead can exceed $300–$1,500 per unexpected result (not including downstream costs).
Stat 2 icon
$50,000+
Disputes, appeals, and compliance reporting can lead to significant fines & liability exposure often exceeds $50K in clinical or employment settings.
Stat 3 icon
2-6+ Hours
Investigations, documentation, follow-ups, patient/provider callbacks, and repeat screenings can add 2–6+ hours of labor per result, tying up clinical resources.

*Rapid tests are screening tools. Clinical or legal decisions should be supported by confirmatory testing where appropriate.*

What Best Describes Your Situation?

Presumptive Positive

Why this can occur

• Cross-reactivity with prescription or over-the-counter medications.

• Dietary supplements or common substances.

• Screening cutoff thresholds near detection limits.

• Sample handling or integrity issues.

Recommended next steps

• Confirm proper collection conditions.

• Review recent medications or exposures.

• Verify analytes included in the panel.

• Consider confirmatory testing when appropriate.

Escalate when

• Results conflict with clinical presentation.

• Employment, legal, or treatment decisions depend on outcome.

Conflicting Confirmation Results

Why this can occur

• Immunoassay sensitivity vs laboratory specificity.

• Differences in metabolite detection.

• Timing between screening and confirmation.

• Laboratory cutoff thresholds.

Recommended next steps

• Confirm analyte and metabolite alignment.

• Review laboratory reporting thresholds.

• Document timing between screen and confirmation.

• Request technical review if discrepancies persist.

Escalate when

• Patterns repeat across samples.

• Program policy requires documented reconciliation.

Unexpected Negative

Why this can occur

• Sample dilution or tampering.

• Collection outside the detection window.

• Target analyte not included in panel configuration.

• Concentration below cutoff.

Recommended next steps

• Review collection protocol.

• Confirm panel configuration.

• Assess detection window relevance.

• Retest if clinically or operationally indicated.

Program Workflow Question

Common scenarios

• Documentation requirements.

• Retesting protocols.

• Confirmation thresholds.

• Internal policy alignment.

Next steps

• Review program guidelines.

• Establish escalation criteria.

• Contact Topaz support for workflow guidance.

Common Contributors to Presumptive (False) Positives

When screening results show a substance you weren't expecting to see.

The Operational Impacts of Unexpected Results

Unexpected results don’t just affect outcomes, they impact time, trust, and cost.

If you're experiencing unexpected results, connect with us to understand their potential operational impacts, estimate downstream costs and explore next steps.

Explore the Impacts

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Review potential contributors and discuss screening options designed for dependable results.
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