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State v. Brown

Court of Appeals of Minnesota

May 29, 2018

State of Minnesota, Respondent,
v.
Guntallwon Karloyea Brown, Appellant.

         Hennepin County District Court File No. 27-CR-15-22145

          Lori Swanson, Attorney General, St. Paul, Minnesota; and Michael O. Freeman, Hennepin County Attorney, Jonathan P. Schmidt, Assistant County Attorney, Minneapolis, Minnesota (for respondent)

          Cathryn Middlebrook, Chief Appellate Public Defender, Jennifer Workman Jesness, Assistant Public Defender, St. Paul, Minnesota (for appellant)

          Considered and decided by Reilly, Presiding Judge; Halbrooks, Judge; and Connolly, Judge.

         SYLLABUS

         Applying the three-factor balancing test in Winston v. Lee, 470 U.S. 753, 105 S.Ct. 1611 (1985), a procedure to remove suspected narcotics from appellant's rectum, which was authorized by a valid search warrant and performed by a medical doctor in a hospital setting after appellant declined less-intrusive options, did not violate federal and state constitutional protections against unreasonable searches and seizures.

          OPINION

          HALBROOKS, Judge

         On appeal from his conviction of fifth-degree possession of a controlled substance, appellant argues that the district court erred by denying his motion to suppress evidence removed from appellant's rectum by a medical doctor. Appellant argues that the medical procedure was unreasonable under Winston. We affirm.

         FACTS

         In the course of a narcotics investigation focused on crack cocaine, Minneapolis police set up a controlled buy from appellant Guntallwon Karloyea Brown. After a successful purchase by a confidential informant, officers observed Brown make two hand-to-hand transactions with third parties. During a subsequent investigative stop, an officer saw Brown "shoving his hands down his pants, " which suggested that he might be concealing something. Brown was arrested.

         At the police station, police observed Brown "grinding his buttocks" against his chair in a back and forth motion. Brown then stood up, straddled the chair rail, and ground his butt cheeks into it. An officer told Brown to stop, believing that he was "attempting to jam narcotics up his rectum." After moving Brown into an interview room, the officer observed Brown "taking his hands and shoving . . . kind of between his legs, shoving upwards." Based on his training and experience, the officer believed that Brown was trying to insert something into his rectum. A strip search revealed clear plastic sticking out of Brown's anus. Based on all of the above information, police applied for and obtained a warrant authorizing a search of Brown's person and transported him to North Memorial Hospital to execute it. In the emergency department, Christopher Palmer, M.D., performed an external body search and did not see anything protruding from Brown's anus. Dr. Palmer offered Brown a liquid laxative, but he refused it. After consulting the hospital's legal counsel, Dr. Palmer declined to administer a laxative or perform any procedure to remove the suspected narcotics without Brown's consent.

         Police then applied for and obtained a more specific search warrant from the same district court judge who had granted the first warrant. The second warrant expressly authorized hospital staff to "use any medical/physical means necessary to have Brown vomit or defecate the contents of his stomach or physically by any means necessary remove the narcotics from the anal cavity so Officers can retrieve the narcotics." Police transported Brown to the emergency department at Hennepin County Medical Center (HCMC), where Paul Nystrom, M.D., reviewed the warrant and consulted the hospital's legal counsel about his rights and obligations. Dr. Nystrom understood the warrant to authorize the removal of the narcotics through any medically reasonable means but not to compel him to act if he was ethically opposed. His assessment was that leaving cocaine in the rectum had the potential to cause serious complications or death, but that no medical emergency existed at the time.

          Dr. Nystrom offered Brown four options to remove the suspected narcotics: (1) Brown could remove the bag himself, (2) Dr. Nystrom could administer an enema, [1](3) Dr. Nystrom could sedate Brown and perform an anoscopy, or (4) Dr. Nystrom could put Brown on a ventilator and insert a nasogastric tube to deliver a laxative that would "eventually clear his bowels." After explaining the different procedures and associated risks, Dr. Nystrom recommended options one or two. Dr. Nystrom told Brown that if he did not select an option, they would proceed with a sedated anoscopy. Brown remained silent.

         After giving Brown time to consider his options, and because the first two options required Brown's participation, which was not forthcoming, Dr. Nystrom elected to proceed with the third option-sedation and anoscopy. Dr. Nystrom concluded that, absent Brown's cooperation, anoscopy was the safest and most conservative means of removal. He described the procedure as the insertion of a speculum in the rectum to allow inspection of the four quadrants. The procedure is typically done to look for internal bleeding or hemorrhoids, but can also be used to remove a foreign body. Dr. Nystrom explained that the speculum is "like the size of a large bowel movement, so it's not comfortable, " but it allows visualization of "whatever it is you're worried about." The procedure takes "a couple of minutes, " and then the speculum is removed. He testified that although sedation is not always required for anoscopy, relaxation makes the procedure, "less painful, less uncomfortable."

          After another medical doctor sedated Brown intravenously with Propofol, Dr. Nystrom inserted the anoscope and conducted a visual inspection, but he did not immediately see anything. Taking a second look, he saw the edge of a plastic bag. Using Magill forceps, Dr. Nystrom removed the bag and handed it ...


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