Syracuse, NY -- Syracuse police, a city court judge and St. Joseph’s Hospital Health Center worked together last year to conduct a highly unusual drug search.

They collaborated to sedate a suspect and thread an 8-inch flexible tube into his rectum in a search for illegal drugs. The suspect, who police said had taunted them that he’d hidden drugs there, refused consent for the procedure.

At least two doctors resisted the police request. An X-ray already had indicated no drugs. They saw no medical need to perform an invasive procedure on someone against his will.

The notes from police and doctors suggest some tension, a standoff. At one point, eight police officers were at the hospital. A doctor remembers telling officers: “We would not be doing that.”

The hospital’s top lawyer got pulled in. He talked with the judge who signed the search warrant, which was written by police and signed at the judge’s home.

When they were done, the hospital lawyer overruled its doctors. The lawyer told his doctors that a search warrant required the doctors to use “any means” to retrieve the drugs, records show.

So St. Joe’s medical staff knocked out the suspect and performed the sigmoidoscopy, in search of evidence of a misdemeanor or low-level felony charge, records show.

The idea of a government-ordered medical procedure for such a common offense surprised defense lawyers here and national experts in medical and legal ethics.

“It’s crazy. It’s over the top, by far,” said Hermann Walz, a longtime criminal attorney and professor at John Jay College of Criminal Justice. “You’re looking for marijuana and cocaine? It’s extreme. If they wanted to cut him open and look at his stomach, that would be OK, too?”

Critics say the cops, the judge and hospital may have violated the civil rights of the suspect, subjected him to medical risk, and exposed the city and the hospital to a lawsuit.

“The whole thing is cuckoo nuts to me,” said the suspect’s defense lawyer, Charles Keller. “What country are we living in?”

So, was it worth the risk? The X-ray was right. The scope found no drugs.

And when they were done, St. Joe’s sent the suspect a bill for $4,595.12.

Charles Keller, a Syracuse defense lawyer, says the drug search of his client, Torrence Jackson, went too far. "What country are we living in?" he asked.

City Hall, judge and hospital aren’t talking

Syracuse.com | The Post-Standard pieced together what happened Oct. 16, 2017 by reviewing police reports, medical records and court documents. We interviewed more than a dozen people including the suspect, his lawyer, an emergency room doctor, and legal and medical experts.

Syracuse police, St. Joseph’s officials and Syracuse Mayor Ben Walsh’s administration refused to be interviewed for this report. Syracuse City Court Judge Rory McMahon, who issued the search warrant, said he couldn’t discuss his decision because the case was sealed.

In an email statement, the hospital said the medical procedure without consent fits its policy for complying with search warrants.

Jeff Piedmonte, president of the Syracuse Police Benevolent Association, said he’d never heard of doctors using a medical procedure and anesthesia for such a search.

“What we used to do is give them medication and wait for them to go to the bathroom,” he said.

One of the doctors who refused police told Syracuse.com | The Post-Standard that such a search violated his medical ethics.

“I told police: We would not be doing that,” Dr. William Paolo said of the requested search. “Not while I was there.”

A suspect with a bad reputation

Torrence Jackson was subjected to a forced sigmoidoscopy under general anesthesia in a search for drugs in his rectum. None were found. (Dennis Nett | dnett@syracuse.com)Dennis Nett | dnett@syracuse.com

The suspect -- Torrence Jackson, 42, of Syracuse -- had built a bad reputation with police long before they picked him up Oct. 16, 2017. He frequently defied officers, often in dangerous ways.

His criminal record started as a juvenile with a prison sentence for robbery in the mid-1990s. While on parole in 1998, he fled from police in a high-speed chase through Syracuse that included a pursuit on Interstate 81. An officer broke his ankle chasing Jackson after he ditched the car, records show.

Jackson’s 20-page rap sheet includes multiple charges of resisting arrest, fleeing officers, drug use and illegal gun possession. He led police on another chase on I-81 and I-690 in 2013. Police used a Taser twice to subdue him, records show.

In 2015, after yet another arrest, a judge admonished Jackson for his reckless behavior around police.

“We’ve been through this before,” Judge John Brunetti told Jackson. “You did not cooperate with police and they had to (take) you to the ground… That does not have to happen, OK?”

Jackson’s pattern continued after last year’s search. He’s facing felony weapons and drug charges after an August arrest, accused of possessing a loaded handgun, heroin, hydrocodone and drug paraphernalia in his residence. He was interviewed for this story while in jail on the new charges. He was later released.

A ‘pretext stop’ gets violent

On the Monday that ended with his forced medical search, Jackson was stopped by police at East Beard Avenue and South State Street shortly after noon.

Members of the Syracuse Police Gang Violence Task Force said they stopped Jackson because he didn’t signal a turn in time, records show. The so-called “pretext stop” is a court-approved way for police to investigate someone they find suspicious.

Jackson had been in a confrontation with one of the officers in the past, his lawyer said. They recognized him, he said.

Jackson didn’t have a valid driver’s license. He had a baggie of marijuana in his waistband. A test of the driver’s seat came back for the presence of cocaine, police said. No cocaine was collected at the scene, his lawyer said.

While stopped, Officer Anthony Fiorini wrote in a police report, he saw Jackson raise his buttocks off the seat so far that his head was sticking out the window. That is consistent with someone hiding drugs in his rectum, Fiorini said.

At the jail, Fiorini said, Jackson quickly reached into the rear of his pants and yelled, “I got it in there!”

Jackson denies ever saying he had drugs hidden in him.

Officers forced Jackson’s hands out of his pants. They struggled as Jackson, who is 6 feet tall and 270 pounds, resisted. An officer was injured, and Jackson’s arm was broken, records show.

A county jail Special Emergency Response Team arrived to control Jackson. They took him to another room to check for illegal drugs before booking him into the jail, Fiorini wrote.

There, another commotion broke out and deputies converged again as Jackson yelled and continued resisting, Fiorini wrote.

“Jackson was observed sticking his fingers into his rectum … , ” Fiorini wrote.

Deputies used pepper spray to control him, the officer wrote.

A standoff at the hospital

St. Joseph's Hospital Health Center. Ellen Blalock | The Post-Standard

Officers put a spit mask on Jackson and took him under guard to St. Joseph’s Hospital Health Center. By that point, Jackson said in an interview, he was in a manic state. The spit mask made it hard to breathe, he said.

Hospital personnel confirmed in medical files that Jackson complained of burning from pepper spray when he arrived by ambulance shortly after 2 p.m. A nurse described him as “agitated and combative.”

Jackson’s was “threatening to kill staff members in the parking lot,” the nurse wrote in Jackson’s medical file. Jackson, considered by medical staff as a risk to himself and others, was given prescription sedatives.

Fiorini, a Syracuse police officer since 2015, said he drafted the search warrant at police headquarters, then drove to the judge’s house to get it signed. Fiorini then came to the hospital.

The medical staff noted the warrant’s arrival at 6:36 p.m. Doctors weren’t budging.

“Police requesting for retrieval of foreign object per rectum, with warrant present. Pt (patient) is refusing all interventions. Given strong pt refusal, no further actions taken,” resident doctor Kavitha Muruganantham wrote in the medical notes.

Around that time, the medical staff X-rayed Jackson’s abdomen. It showed “no radiopaque foreign body in the rectum.”

That’s where Keller, Jackson’s lawyer, says the search should have ended.

Typically, in these cases, police use less aggressive methods to get the drugs. State courts have approved searches in which a doctor uses a gloved hand to pull out drugs. Federal courts have encouraged enemas – gas or water injected into the rectum.

Mostly, they help nature to run its inevitable course, lawyers said.

“It’s coming out,” Keller said. “You can’t hold onto it forever.”

About an hour later, Dr. Kishani Heller wrote in the notes that Jackson continued to refuse any intervention. He refused to drink a medicine designed to speed up a bowel movement. He refused a rectal exam. He refused to answer questions, Heller wrote.

The hospital lawyer steps in

Syracuse City Court Judge Rory McMahon and St. Joseph's General Counsel Lowell Seifter. (Syracuse.com/provided photo)

At 7:45 p.m., doctors consulted with St. Joe’s top lawyer.

“Spoke with hospital attorney Mr. Lowell Seifter who has reviewed court order and has spoken with judge who issued the court order, and states that pt does not have the right to refuse,” Heller wrote at 9:14 p.m.

Seifter, the hospital’s general counsel, has been a prominent lawyer for decades in Syracuse. Before coming to St. Joe’s in 2012, he was a partner in the Green and Seifter law firm, which later became Bousquet Holstein. His expertise is in business, real estate and health care, according to the hospital’s website. His office declined to comment for this story.

The doctor who performed the search, Hui Hing Tin, also checked with Seifter. He got the same answer, his notes show.

“… it's a valid warrant and we are obligated to help the police under any means to retrieve the object,” Tin wrote.

At 10 p.m., the doctors approached Jackson with their plan.

“Pt continues to refuse any interventions,” Heller noted. “He became violent and hospital police called.”

By 10:30 p.m., eight police officers surrounded Jackson, according to Tin’s notes. Fiorini indicated he was there.

At 11:38 p.m., Tin inserted the colonoscope into Jackson, who was unconscious.

It confirmed the X-ray: No drugs.

Keller, the lawyer, defended his client’s resistance to the procedure.

“Good for him,” he said. “If somebody was going to do surgery on me without any evidence, I would be upset, too.”

Jackson said he woke up, not sure what had happened. “I felt tampered with,” he said.

Jackson was released from jail the following day. There was blood in his underwear, he said. He went to the emergency room at Community General Hospital.

There, he said, an emergency room examined him and told him what happened: Someone had probed his colon.

Jackson didn’t pay his bill for the unwanted procedure, and St. Joe’s threatened to send it to a collection agency before forgiving the cost.

Jackson’s drug charges were thrown out and he pleaded guilty to traffic tickets.

This bill for the forced sigmoidoscopy was sent to Torrence Jackson. He refused to pay it. Provided photo.

Did doctors act properly?

St. Joe’s has maintained that it was just following a court order – and would do so again.

“We comply with court orders whenever they are issued for detainees who come to our hospital in police custody,” the hospital said in its statement to Syracuse.com | The Post-Standard.

The mayor’s office also declined to say whether police have ever requested such a search in the past – or if they’d do so again.

In defense of the warrant, Mayor Walsh’s corporation counsel noted the marijuana and cocaine residue found in the vehicle Jackson was driving, the officer’s description of Jackson’s admissions and behavior, as well as Jackson’s drug history.

The city’s statement also expressed concern for Jackson’s well-being. “Of particular concern was the risk to Mr. Jackson in the event the suspected narcotic’s packaging was ruptured while in his rectum,” Corporation Counsel Kristen Smith wrote.

The hospital, in its statement, also referred to its concern for Jackson’s safety. “Regardless of the circumstance, the safety and well-being of all people in our care is always our top priority,” the hospital said.

But police and medical notes in Jackson’s case show doctors, who are charged with deciding the patient’s best care, were willing to wait it out. And they don’t need a search warrant to order necessary emergency care. It’s the police, hospital lawyer and judge who made the call.

Paolo, the ER doc who refused to do the search, said nothing he knew about the situation posed a serious risk to Jackson.

“The physician’s role is merely to aid the patient,” said Paolo, a professor at Upstate Medical University who covers emergency room ethics in the classroom. “If an individual doesn’t have any medical complaint and is purely there for evidentiary collection, and is not an imminent threat to themselves, then the doctor is not there to do anything against the patient’s wishes.”

Another doctor warned Jackson about the risk.

“I have explained to the pt that the packets may rupture and cause cardia arrest (sic),” wrote Heller, one of Jackson’s doctors. “The pt stated that he is fine w/ dying and understands the risk. I did not conduct a rectal exam – pt refused.”

The search warrant makes no mention of acting to help the patient.

Paolo said he doesn’t agree with what happened.

“I don’t believe anybody should have any procedure that is not deemed necessary,” he said. “If a particular foreign body is not a threat to the patient, then there’s no medical necessity. Doctors are not an agent of the state and not obligated to become an agent of the state.”

Torrence Jackson looks out a window at the Onondaga County Justice Center jail during an interview with Syracuse.com | The Post-Standard. (Dennis Nett | dnett@syracuse.com)

Similar case at St. Joe’s but no search

Since the Jackson search, the hospital handled a similar situation differently in May 2018.

A man was brought in by police who suspected he had hidden cocaine in his rectum. X-rays were also negative. The suspect refused consent.

But here, doctors -- who consulted with hospital lawyers -- wrote in their notes: “Policy states that no cavity search to be performed unless medically indicated.”

Doctors noted that any drugs would come out in time. “The patient will need to move his bowels at some point with expected expulsion of the foreign body,” they wrote. We “will follow in case an urgent procedure is needed.”

St. Joseph’s said in its statement the two cases were different, citing the two warrants and subsequent conversations with the two judges who signed them.

The hospital lawyer told doctors that McMahon’s search warrant compelled Jackson’s procedure. In the more recent case, City Court Judge Ross Andrews told the hospital that his warrant wasn’t compulsory, according to doctor’s notes provided to Syracuse.com | The Post-Standard.

Doctors are not detectives

An emergency room doctor who has researched body-cavity warrants warned that doctors are not agents of police. Doctors don’t have to do something unethical simply because police order it.

“Police can’t have a private citizen break into a car for them,” Dr. Charles Pilcher, a Washington-based emergency room doctor who has researched the topic, told Syracuse.com | The Post-Standard. The same logic holds true for cavity searches: “It’s a fine line between compliance and assault.”

What if doctors had punctured Jackson’s bowel during the search? Pilcher wondered. “Who’s at fault? Who’s paying the bills for that?” he said.

Pilcher summed up his position in a 2016 article for the American College of Emergency Physicians newsletter.

“A physician … cannot be made an agent of the state for the purposes of law enforcement; if an activity being performed isn’t advancing the health care of a patient, then the physician has no business performing that activity,” Pilcher wrote.

Still, Pilcher said, some situations call for doctors to promote public safety over patient privacy.

A blood draw against the will of a suspected drunken driver, for example, is generally permissible.

Judge’s broad search warrant

Keller said the warrant, drafted by Fiorini and signed by McMahon, led to his client’s ordeal.

“I was shocked that a judge would sign off on the warrant based on what was presented,” Keller said. “There’s no medical necessity to anything that was done. Even worse, there was an X-ray that showed no foreign bodies.”

The warrant allowed:

“…St. Joseph’s Hospital to utilize any/all medicines and/or medical/surgical procedures to assist in said removal to include, but not limited to, anesthesia, IV, X-ray/sonogram and/or physical manipulation, and any and all other medical procedures determined by said medical staff to be necessary and prudent to assist in the retrieval/removal of said illicit/illegal substances (evidence) located within the anal cavity of Torrence L. Jackson.”

Walz, the NYC lawyer, said the warrant gives cops too much power.

“They’re basically saying to police: Do whatever you want to this guy. Could you put him into a medically induced coma and take out his colon?” he said.

How far can a search warrant go?

In a widely publicized 2013 case, a New Mexico man won $1.6 million from authorities after being subjected to a colonoscopy during a drug search.

The U.S. Supreme Court has set standards for how far medical warrants can go. They range from the permissible blood draw in the case of a DWI suspect to the impermissible removal of a bullet from a murder suspect under general anesthesia.

In a 2012 case, a federal appeals court in Texas shares some facts with Jackson’s case. There, a drug suspect was subjected to a proctoscope inserted into his rectum while sedated. However, the suspect there was conscious; in the Syracuse case, Jackson was knocked out.

The Texas court ruled that search was illegal, and that it should raise concern for more than just the victim.

“In our society, the thought of medical technicians, under the direction of police officers, involuntarily sedating and anally probing a conscious person is jarring,” the court ruled. “Such a procedure is degrading to the person being probed -- both from his perspective and society’s.”