the American College of Medical Genetics. Laboratory performance Newborn screening programs participate in quality control programs as in any other laboratory, with some notable exceptions. Much of the success of newborn screening programs is dependent on the filter paper used for the collection of the samples. Initial studies using Robert Guthrie's test for PKU reported high false positive rates that were attributed to a poorly selected type of filter paper. This source of variation has been eliminated in most newborn screening programs through standardization of approved sources of filter paper for use in newborn screening programs. In most regions, the newborn screening card (which contains demographic information as well as attached filter paper for blood collection) is supplied by the organization carrying out the testing, to remove variations from this source. Society and culture Controversy Newborn screening tests have become a subject of political controversy in the last decade. Lawsuits, media attention, and advocacy groups have surfaced a number of different, and possibly countervailing, positions on the use of screening tests. Some have asked for government mandates to widen the extent of the screening to find detectable and treatable birth defects. Others have opposed mandatory screening concerned that effective follow-up and treatment may not be available, or that false positive screening tests may cause harm to infants and their families. Others have learned that government agencies were often secretly storing the results in databases for future genetic research, often without consent of the parents nor limits on how the data could be used in the future. Increasing mandatory tests in California Many rare diseases have not historically been tested for or testing that has been available has not been mandatory. One such disease is glutaric acidemia type I, a neurometabolic disease present in approximately 1 out of every 100,000 live births. A short-term California testing pilot project in 2003 and 2004 demonstrated the cost of forgoing rare disease testing on newborns. While both Zachary Wyvill and Zachary Black were both born with the same disease during the pilot program, Wyvill's birth hospital tested only for four state-mandated diseases while Black was born at a hospital participating in the pilot program. Wyvill's disease went undetected for over six months during which irreversible damage occurred but Black's disease was treated with diet and vitamin supplements. Both sets of parents became advocates for expanded neonatal testing and testified in favor of expanding tandem