Lab Overwork 

“In the last 10 years, Utah’s population has increased by 24 percent, but the volume of testing has increased 228 percent,” says Patrick Luedtke, director of the Utah Health Department’s public-health laboratories. Delayed tests complicate criminal DUI prosecutions and can also delay family members of a deceased person being able to collect life insurance for up to two months.

“Put all those numbers together, and it doesn’t take a rocket scientist to understand that there is a collision course of misery on the horizon,” says Luedtke.

Legislators, however, say the issue did not rise to their attention in the 2011 session, especially with Medicaid consuming much of the Health & Human Services budget. In the 2011 session, legislators did allocate $350,000 for equipment to aid in testing samples, although that appropriation was geared more toward testing for spice, the synthetic marijuana product banned during the session.

Still, lab officials say such measures are stop-gap at best when it comes to a workload they split between tests they process for the state Office of the Medical Examiner and the DUI-related tests they process for approximately 200 of the state’s law-enforcement agencies.

In late February, Teresa Garrett, deputy director of the Utah Department of Health’s Public Health Practice, was looking for help on the Hill after Sen. John Valentine, R-Orem, presented Senate Bill 314, a liquor bill that included an enforcement provision tying the number of DUI-enforcement officers in the Utah Highway Patrol to the number of liquor licenses in the state. In the hallway outside Valentine’s senate committee room, Garrett told Valentine about the problem state labs were facing that would only be exacerbated by the new emphasis on DUI arrests his bill encouraged.

“The pace of growth of DUI arrests in our state is on a pretty steep uphill curve, and our staff can’t keep up with the number of tests we’re required to get done in a certain period of time,” Garrett told City Weekly in a separate interview. “When someone shows up in court, [if] test results aren’t there, there is a risk that person could not be charged with a DUI.”

Valentine doesn’t recall the brief meeting with Garrett, and says he heard no formal presentation about the issue. “This didn’t rise to the level of anything I had any awareness of,” Valentine says of the hectic session.

“I knew about problems we had in the Medical Examiner’s office,” Valentine says, referring to problems the Office of the Medical Examiner has in getting timely death certificates out to individuals. “We went to work for that and got them two additional physicians.”

“We came out kind of pretty this last legislative session,” says Chief Medical Examiner Todd Grey, acknowledging the added personnel. “Our life has gotten easier, but it doesn’t address, or solve, the toxicology-lab issue.” His office, a subset of the Department of Health, is tasked with investigating sudden and suspicious types of death and is equally reliant on the lab and its six overworked scientists, as are all of the state’s law-enforcement agencies.

“If four doctors are giving samples to the lab, or six doctors, it’s still a huge number of samples,” Grey says. He says if his office needs to run drug tests, it means issuing certificates that says the cause of death is pending, while the family waits between eight and 10 weeks for toxicology to process the request.

The family, in the meantime, can’t claim insurance policies on their departed loved one until those results come back—an often dire situation if the deceased was the primary breadwinner in the family.

“It’s not uncommon for me to get two to three calls a month from family members who are desperate and in tears because they can’t do anything with a death certificate that says ‘pending’ on it,” Grey says.

Grey argues the nature of his work has changed in the past decade.

“Currently, we’re looking at 450 to 500 deaths a year that are due to drug toxicity, either prescription drugs or street drugs,” Grey says, adding that three times more of those deaths are from prescription drugs as from illicit drugs. Deaths from prescription drugs are also more difficult to test properly.

The state lab has streamlined its procedures this year by adopting new protocols, like not testing urine for drugs if the blood sample is negative for drugs, combining different testing methods and exploring whether their scientists can give expert testimony in courts through video so they spend less time testifying at trial and more time in the lab.

“In the last three to four months, we’ve made some improvements,” says Gambrelli Layco, director of the Bureau of Forensic Toxicology for the state labs. “But those [improvements] are sort of a Band-Aid.”

Rep. Dave Clark, R-Santa Clara, chair of the Social Services Appropriations committee, says he never received a formal presentation as to the scope of the problem but believes the Legislature ought to consider relieving testing strains by outsourcing some of the workload.

“It might be more cost-effective to leverage with existing labs [in the private sector],” Clark says.
Valentine also says that it’s something he’s ready to study to see if it’s a serious issue that needs to be addressed.

“We can play the blame game, but I don’t think that going to be of any use,” Valentine says. “Now that we’ve got a problem, let’s see what we can do to fix it.”