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Searching for Drugs and Crossing Ethical Lines | Guest Blog

After multiple exams, imaging, enemas, and a colonoscopy in search for drugs—against the prisoner's consent and outside the limitations of the search warrant—the hospital billed the man for its services.

Back in September, I blogged about a case of a man in Tennessee who was sedated, intubated, and placed on a ventilator without his consent so that an emergency physician could perform a rectal exam looking for drugs. The court ruled that the man’s Fourth Amendment rights against an unreasonable search were violated.

It gets worse. In New Mexico, a man is suing several law enforcement agencies and officers and doctors because of what some might consider an excessive search. See what you think.

When the man was pulled over for running a stop sign, officers say he was clenching his buttocks, which led them to suspect he was hiding drugs in his rectum.

They obtained a search warrant, but a doctor at the first hospital they took the prisoner to refused to do the search saying he believed it was not ethical.

A second hospital was much more accommodating.

At that institution, he allegedly underwent two digital rectal exams, two abdominal x-rays, and three enemas—all without his consent. He was forced to defecate in front of the police. After those procedures yielded nothing, he was sedated, and a colonoscopy was performed, also without consent and also negative for drugs.

According to the report, the search warrant was not valid for the county in which the second hospital was located and had expired well before the colonoscopy was done.

Here’s the punch line. At the end of the video in the link to the story, the reporter mentions that the hospital has billed the man for its services and is considering sending the bill to a collection agency if he doesn’t pay.

And the television station investigating the case found another man who says he had a similar but somewhat less aggressive experience.

But wait, there’s more.

A 54-year-old woman is suing the El Paso County Texas Board of Managers, a hospital, two doctors, and several Customs and Border Protection (CBP) officers.

After a dog indicated she might be carrying drugs, she alleges she was strip searched and underwent anal and vaginal probing, was given a laxative followed by observed defecation, an x-ray, and a CT scan—all without her consent or a warrant.

From the article: “The lawsuit said after the CT scan one of the officers told the woman she could sign the medical consent form, and CBP would pay for the exams, but if she did not sign, she would be charged. The woman refused to sign and eventually she was billed more than $5,000 for the examinations.”

The CBP and the hospital would  not comment on the specifics of the lawsuit, but I will.

What is going on here?

Can you imagine the humiliation and suffering these people went through? This didn’t happen in Turkmenistan or North Korea. This was right here in the USA.

Have any of these people ever heard of the Constitution?

What concerns me the most is the involved physicians. If the allegations are true, how can they justify their actions?

ADDENDUM January 16, 2014

The man who received the three enemas, the colonoscopy and more has settled with the involved county and city governments for $1.6 million. According to this report, the case against the hospital and the doctors is still ongoing.

Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last three years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 1300 page views per day, and he has over 7,900 followers on Twitter.

  • Evan Thomas says:

    I became aware of these stories a while back, and I agree that aside from the egregious behavior of the cops the complicit physicians in these instances are just as much to blame.

    The attending physician unquestionably has a duty to verify the authenticity of a warrant, or at least refer it to the hospital’s risk management department.

    The idea of sending a bill to a patient for consent-denied procedures (as opposed to the unconsented ones that might occur with an unconscious patient) is ridiculous.

  • KAC RN says:

    Clenching his buttocks? Seriously. The really troubling part of these stories is how quickly and with complete abandon everyone (one sane physician, excepted) bought into the vigilante mentatlity. They were going to find drugs if they had to bend, fold, spindle or mutilate.

  • WMS says:

    This thread stirred my interest. Let’s say the warrant was in all ways legal. Since judges are often in a position to order people to do things and put them in jail (at least for a little while) if they don’t, I’m wondering what one’s obligations are if placed in this situation. Must you do what the warrant provides? If you assist in executing the warrant by eg performing a colonoscopy or giving an anesthetic, are you acting as an agent of the court? If there is a complication (anesthetic mishap, colon perforation, etc), does any of the responsibility lie with the issuer of the warrant or is it all yours and your hospitals? I’d appreciate your thoughts.

    • SkepticalScalpel says:

      Excellent questions. Regarding whether one must do what the warrant asks–I am aware of a few cases in which the ED MD refused to perform such a search. I mentioned one of them in the beginning of this post. I do not believe that physician suffered any consequences for his refusal.
      ****
      I cannot answer your second question because I have not read anything specific to the subject of who would be responsible for any complications of say, a court-ordered colonoscopy. I would hope a lawyer or a judge could comment.

      • KAC RN says:

        If someone has drugs in gi tract, because he/she swallowed balloons of drugs or inserted balloons into the rectum nature says they have to pass sometime. I fail to see how time is of the essence in these situations. If there was evidence the individuals had drugs in their gi tracts, reasonable people would say let nature take its course. It seems to me there were no reasonable people in the mix here. After the initial exams, the situation escalated into a frenzy and any possibility of sanity prevailing was lost. As you say S.S. these are just the cases we have heard of. As an RN, I have had encounters with law enforcement in the ICU. Some officers were professional, cool, collected and controlled. Some struck me as being on the edge of TFN. I don’t think my experiences were unique; I think the people who were abused in the situations you write of had those same experiences.

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