When Anthony Bing called his doctor's office, it wasn't for a new symptom or a prescription refill. Instead, the 64-year-old man was worried about going to jail.
As part of his probation requirements, he was subject to urine testing twice a week at a Philadelphia probation office. Those tests had come back positive for alcohol five times in a row, according to Bing's physician. Now his probation and his freedom were in jeopardy.
There was just one problem: The Navy veteran had not had a drop of alcohol in almost a year. But the test said otherwise. How could he find out what went wrong in time to stop the court from sending him behind bars?
Before we answer this puzzle, it's important to understand Bing's history and how he came into the legal system. Bing served in the U.S. Navy from 1981 to 1986 -- first until he hurt his shoulder, and then as a cook -- getting sent out to sea for months at a time.
After his service, he worked a series of odd jobs as a truck driver, warehouse worker, and glass cutter. He admits he developed a drug problem in his post-service years, and was arrested for the first time in his life in 2017 for assault.
Given his clean record and Navy service, he was transferred to Veterans' Treatment Court, which helps those with addiction or mental illness use Department of Veterans Affairs (VA) services. Similar programs across the country let nonviolent offenders enter treatment programs, helping them . But typically have wide discretion to "violate" a participant and can send anyone to prison without proof beyond a reasonable doubt.
Bing's false-positive urine tests threatened to do just that, upending all the progress he has made since his arrest. He married "a great lady" named Priscilla, a licensed practical nurse with 31 years' experience. Returning to jail would also complicate his substantial health problems. Besides high blood pressure and sleep apnea, he is partially paralyzed on one side and lost vision in his right eye last year, making him legally blind.
So what went wrong? The culprit was the testing procedure. Bing was taking a common diabetes medication which produces high levels of sugar in the urine. Because the sample was kept at room temperature for hours before it was tested, that sugar fermented into alcohol, resulting in his positive tests. This case was so significant that in the New England Journal of Medicine in February.
We wish we could say Bing's case has a happy ending, but we can't. Months after the initial false tests, we were made aware of another flurry of false positives, requiring a second letter reminding the court of the careful tests we performed at the VA that we believe proved Bing's innocence.
That should have ended it. But then we were told of a third handful of false positives, requiring a third letter to the court on May 6, again detailing Bing's innocence. Bing now has hired a lawyer to fix this broken bureaucracy that just can't seem to get it right.
It is shameful that anyone -- especially a disabled Navy veteran -- has had to endure this treatment. Sadly, it appears that it is not that unusual. Substances as ordinary as can trigger a positive test result for alcohol. can also trigger false-positive results for drug or alcohol tests. Even if the test works well, analysts need to interpret the result carefully to ensure accuracy. But it appears that the people administering these tests in the criminal system sometimes have , and there seems to be little standardization across agencies, labs, or contractors.
Furthermore, it's crucial to note that Bing's predicament may be more common than one would suspect. The diabetes medication he was taking, , is a widely prescribed drug that in total spending by Medicare Part D. It's part of a class of drugs that treats not only diabetes, but also heart and kidney disease. If the urine samples from patients on these drugs aren't handled quickly, the same kind of false positives may occur.
How many cases like Bing's have happened without anyone taking note? We don't know. But without better procedures for drug testing, more cases like his will crop up.
Let's not do this to our veterans or to any Americans. No one should lose their freedom because of inadequate scientific standards.
is a senior fellow at the Leonard Davis Institute of Health Economics and an assistant professor in the Department of Medical Ethics and Health Policy at the University of Pennsylvania. He is also a staff physician at the Philadelphia Crescenz VA Medical Center. is the Deputy Public Defender of the Forensic Science Unit at the New Jersey Office of the Public Defender, where she has been an attorney since 2014.