Pat Pizzo has been in toxicology for a long time. The director of toxicology, substance abuse testing for Kroll Laboratories, Gretna, La, has spent part of her long and varied career with the FBI. In 1980 she joined Kroll—one of the largest urine drug screen testing labs in the country. Today, her lab processes an average of 8,000 samples per day (about 64,000 tests per day with reagents) and employs almost 100 techs, from specimen processors to certifying scientists.

Obtaining the solid, reliable results her clients have come to depend on has been a challenge for the lab. At the heart of this challenge has been finding the most efficient screening tests for processing the thousands of patient samples that stream into the lab each day.

When Pizzo started working at Kroll, the lab was using chromatography for its drug abuse results. Pizzo remembers it being both labor intensive and slow, but most of all she remembers it being subjective. “A person’s looking at a color of a spot on a plate … and they’re making a determination,” Pizzo says, “so it’s subjective for the person who’s screening it.”

The need to keep up with the lab’s rapid pace made the determination to experiment with a number of different systems throughout the 1980s and early ’90s, from an early automated system, which lacked a good linear curve, to the laborious florescent polarization immunoassay procedure. Finally, in the mid 1990s, the lab was approached by Microgenics, a brand now manufactured by Thermo Fisher Scientific, East Providence, RI, to try out its drugs of abuse immunoassay screening tests.

Figuring she had worked with everything else on the market, Pizzo was keen to give it a try. First, however, she insisted certain criteria be met to ensure none of the time-saving features or reliability the lab currently enjoyed would be compromised in the switch.

Pizzo required that the new immunoassays had to be reliable and robust, and must have the option to run multiple drug cutoff levels for a drug on one single analyzer channel. Microgenics brought in its products, which were an instant hit at the lab. When the techs looked at the linear range of the calibration curves for each of the drugs, the Microgenics range far exceeded the range of the system they were using—a big plus for Pizzo and her team.

“They proved to me beyond a question of a doubt that it worked,” she says. “My staff fell in love with the products, I was truly impressed, and we’ve been using Microgenics and DRI products ever since.”

Performance Is Key

While in the past Pizzo’s lab had tended to take “a grass is always greener” approach when new technology became available, there’s one big reason why she says she’s stuck with Microgenics: performance.

“It performs extremely well,” she says. “The correlation for a suspect positive with the Microgenics reagents and the rate of confirmation with GC Mass-Spec is extremely good. The accuracy of the quantitation with Microgenics as compared to GC Mass-Spec is excellent. The curves are stable for very long times, so we don’t have to calibrate.”

One Step Ahead Means Timely Results

Flexibility and organization are the keys to success at Pizzo’s lab, which is responsible for providing results of the tests performed on a variety of state, federal, and commercial employees, as well as for keeping track of the ever-expanding and changing panels employed by each one.

In her effort to stay one step ahead, Pizzo has been in frequent contact with Thermo Fisher since the beginning. And she does so without spending hours on hold or navigating tedious automated customer service voice prompts. “The company has a very proactive service department that calls every 3 months to find out if there are any issues. It’s really nice when there is someone you know you can call, or if when you don’t have the time, someone to call you, check up on things, and ask if there are there any new areas that need to be addressed,” she says.

The friendly and responsive attitude is a huge help to Pizzo, who’s always battling to keep abreast of both substance abuse trends on the streets and government and state regulations. “For us the biggest challenge is to stay on top of what’s out there in the market. What are they using on the street that we’re not testing for routinely in the lab? And how do we have to adjust to what they’re doing?”

Pizzo realized early on that the key to staying ahead was to provide her reagent manufacturer with constant and useful feedback. “For years I, as well as other chemists, told them that we needed an immunoassay kit for meperidine [Demerol], since it’s widely abused in the health care profession, and because it’s very difficult to screen for without an immunoassay procedure.” Pizzo broached the subject to Thermo Fisher, and a kit was released a few short years later.

“That’s what’s important,” Pizzo says, “having a company who listens to the people out in the fields when they say, ‘This is a drug we think is going to be a problem in the future.’ “

Pizzo sees challenges ahead, especially with regard to changes in federal drug testing regulations, but she’s confident in Thermo Fisher’s ability to keep up.

And while she’s constantly busy working to keep up with regulators and drug abuse trends, Pizzo believes there’s still plenty of room for Kroll Laboratories to continue to grow. “We’d like to become a sole source provider. We’d like to be able to help with your collections, do your drug screen tests, and do background checks for you if you need it.”

The future also holds continued collaboration with Thermo Fisher. “They’re very important in helping us stay current in the field,” Pizzo says.

Stephen Noonoo is associate editor of CLP.