County District Court File No. 27-CR-15-22145
Swanson, Attorney General, St. Paul, Minnesota; and Michael
O. Freeman, Hennepin County Attorney, Jonathan P. Schmidt,
Assistant County Attorney, Minneapolis, Minnesota (for
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.
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
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.
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
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
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.
Nystrom offered Brown four options to remove the suspected
narcotics: (1) Brown could remove the bag himself, (2) Dr.
Nystrom could administer an enema, (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
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,
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 ...