Title: State v. Tomas R. Payano-Roman

State: wisconsin

Issuer: Wisconsin Supreme Court

Document:

2006 WI 47 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2004AP1029-CR 
 
 
COMPLETE TITLE: 
 
 
State of Wisconsin, 
          Plaintiff-Respondent-Petitioner, 
     v. 
Tomas R. Payano-Roman, 
          Defendant-Appellant. 
 
 
 
 
REVIEW OF A DECISION OF THE COURT OF APPEALS 
2005 WI App 118 
Reported at: 284 Wis. 2d 350, 701 N.W.2d 72 
(Ct. App. 2005 - Published) 
 
 
OPINION FILED: 
May 18, 2006   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
February 22, 2006   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Milwaukee   
 
JUDGE: 
Russell W. Stamper 
 
 
 
JUSTICES: 
 
 
CONCURRED: 
        
 
DISSENTED: 
ABRAHAMSON, C.J., dissents (opinion filed). 
BUTLER, JR., J., joins the dissent.   
 
NOT PARTICIPATING:         
 
 
 
ATTORNEYS: 
 
For 
the 
plaintiff-respondent-petitioner 
the 
cause 
was 
argued by Stephen W. Kleinmaier, assistant attorney general, 
with whom on the briefs was Peggy A. Lautenschlager, attorney 
general.  
 
For the defendant-appellant there was a brief and oral 
argument by Timothy A. Provis, Port Washington. 
 
 
2006 WI 47
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.  2004AP1029-CR  
(L.C. No. 
2002CF2054) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
State of Wisconsin, 
 
          Plaintiff-Respondent-Petitioner, 
 
     v. 
 
Tomas R. Payano-Roman, 
 
          Defendant-Appellant. 
 
 
 
FILED 
 
MAY 18, 2006 
 
Cornelia G. Clark 
Clerk of Supreme Court 
 
 
 
 
 
REVIEW of a decision of the Court of Appeals.  Reversed.   
 
¶1 
ANN WALSH BRADLEY, J.   The petitioner, State of 
Wisconsin, seeks review of a published court of appeals' 
decision that reversed a judgment convicting Tomas Payano-Roman 
of possession of heroin.1  The State asserts that the court of 
appeals erred in overturning the circuit court's determination 
that the administration of a laxative to Payano-Roman was not a 
                                                 
1 See 
State 
v. 
Payano-Roman, 
2005 
WI 
App 
118, 
284 
Wis. 2d 350, 701 N.W.2d 72 (reversing a judgment of the circuit 
court for Milwaukee County).  Judge Clare L. Fiorenza presided 
over the suppression and plea proceedings in this case.    
Reserve Judge Russell W. Stamper presided at sentencing. 
No. 
2004AP1029-CR   
 
2 
 
government search subject to the Fourth Amendment.  It further 
asserts that, even if administration of the laxative was a 
government search, the search was reasonable. 
¶2 
We determine that the administration of the laxative 
that resulted in the recovery of a baggie of heroin from Payano-
Roman's stool was a government search.  However, we conclude 
that the search was reasonable.  Therefore, Payano-Roman's 
Fourth Amendment rights were not violated.  We reverse the court 
of appeals. 
I 
¶3 
The background facts are taken from testimony offered 
at the suppression hearing.  We reference additional facts from 
the hearing as needed in the analysis portion of this opinion. 
¶4 
In April 2002, Milwaukee County Deputy Sheriff Scott 
Stiff 
and 
Special 
Agent 
Corey 
Parker 
were 
conducting 
surveillance of a residence at 1525 West Mitchell Street.  They 
had received information from an informant that a person who 
went by the name "Mingo" was trafficking cocaine and possibly 
heroin out of a Toyota Tercel station wagon, license plate 
number T19401, parked outside the residence. 
¶5 
The officers observed a man matching the informant's 
physical description of "Mingo" come from the rear of the 
residence, enter a vehicle with another individual, then access 
the driver's compartment of a Tercel with license plate number 
T19401.  The officers approached the man, who was Payano-Roman, 
and identified themselves as police. 
No. 
2004AP1029-CR   
 
3 
 
¶6 
From approximately four to six feet away, Deputy Stiff 
observed Payano-Roman look at him then put a clear plastic 
baggie containing a white powdery or chunky substance into his 
mouth.  Based upon the packaging of the substance, Stiff 
believed it was heroin.  
¶7 
Payano-Roman began swallowing large amounts of air as 
if to swallow the baggie.  The officers told him to spit out the 
baggie, and they attempted to recover it but were unsuccessful.  
They arrested Payano-Roman for possession of a controlled 
substance and placed him in handcuffs. 
¶8 
Deputy Stiff contacted his supervisor, who indicated 
he would call an ambulance.  After the ambulance and a fire 
truck arrived at the scene, the officers explained to the 
ambulance personnel and firefighters that Payano-Roman had 
possibly swallowed heroin.  Payano-Roman was conveyed to a 
hospital, and Deputy Stiff rode in the ambulance with him.  
¶9 
The hospital staff asked for information so that they 
could provide appropriate medical treatment, and the officers 
explained to the staff what they had observed Payano-Roman 
ingest.  Deputy Stiff was told by the staff that it was hospital 
policy to admit Payano-Roman for his safety because it could be 
fatal if the bag containing the suspected heroin broke.  
Similarly, Agent Parker was told that Payano-Roman was being 
admitted to the hospital for possible ingestion of a controlled 
substance that could lead to an overdose.   
No. 
2004AP1029-CR   
 
4 
 
¶10 Payano-Roman was 
eventually 
placed 
in 
a private 
hospital room, where he remained handcuffed.  At least one 
officer stayed with him at all times.  
¶11 Starting at approximately 6:00 or 7:00 p.m., Payano-
Roman was given a cup of a liquid laxative called "Go Lightly" 
to drink every twenty or thirty minutes.2  He did not speak 
English, but a Spanish-speaking nurse explained to him how much 
of the laxative he would have to drink over a specific period of 
time.  Agent Parker, who spoke some Spanish, gave Payano-Roman 
the laxative approximately six times, telling him "here you go, 
you got to take this again."   
¶12 The officers advised hospital personnel that they 
wanted to examine Payano-Roman's stool, and the hospital 
provided a portable toilet.  The officers told Payano-Roman that 
he had to use the portable toilet for defecation.  Early the 
next morning, Payano-Roman had a bowel movement in the portable 
toilet, while one or both officers observed him from just 
outside his hospital room.  Agent Parker examined Payano-Roman's 
stool and recovered the baggie.  The contents in the baggie were 
later tested and determined to be heroin. 
¶13 The State charged Payano-Roman with possession of 
heroin.  He filed a motion seeking to suppress the evidence, 
arguing that the administration of the laxative constituted an 
unreasonable search under the Fourth Amendment.  The State 
                                                 
2 The laxative is spelled "Go Lightly" in portions of the 
record.  It appears that the proper spelling is "GoLYTELY." 
No. 
2004AP1029-CR   
 
5 
 
argued that the Fourth Amendment did not apply because it was 
the private action of hospital personnel that allowed the 
officers to find and recover the heroin.  The circuit court 
ruled that Payano-Roman's Fourth Amendment rights were not 
violated 
because 
medical 
personnel 
made 
the 
decision 
to 
administer the laxative out of concern for his health.  Payano-
Roman then pled guilty but appealed the judgment of conviction. 
¶14 The court of appeals reversed the judgment.  It 
determined that the search was government action because the 
State failed to introduce testimony from qualified medical 
personnel demonstrating that the administration of the laxative 
was necessary to protect Payano-Roman's health.  Thus, the court 
reasoned, the only logical conclusion was that the laxative was 
administered to assist police in recovering evidence.  Applying 
a three-factor balancing test from Winston v. Lee, 470 U.S. 753 
(1985), the court of appeals further determined that the search 
was unreasonable.  The State petitioned for review. 
II 
¶15 This case presents two issues: (1) whether the 
administration of the laxative that resulted in the recovery of 
the baggie of heroin from Payano-Roman's stool was a government 
search or a private search, and (2) whether, if the search was a 
government search, it was reasonable under the Fourth Amendment. 
¶16 We apply a two-step standard of review when reviewing 
the mixed question of law and fact of whether a search is a 
private search or a government search.  See State v. Hajicek, 
2001 WI 3, ¶26, 240 Wis. 2d 349, 620 N.W.2d 781; State v. 
No. 
2004AP1029-CR   
 
6 
 
Martwick, 2000 WI 5, ¶16, 231 Wis. 2d 801, 604 N.W.2d 552.  We 
will not overturn the circuit court's findings of evidentiary or 
historical 
fact 
unless 
clearly 
erroneous. 
 
Hajicek, 
240 
Wis. 2d 349, ¶15.  However, we independently determine the 
ultimate question of whether the search was a government search 
or a private search.  See id.  Similarly, we apply the same two-
step standard to the question of the reasonableness of a search.  
State v. Trecroci, 2001 WI App 126, ¶23, 246 Wis. 2d 261, 630 
N.W.2d 555.3 
III 
¶17 We turn to address whether the administration of the 
laxative that resulted in the recovery of the baggie of heroin 
from Payano-Roman's stool constituted a government search or a 
private search.  Private searches are not subject to the Fourth 
Amendment's protections because the Fourth Amendment applies 
                                                 
3 In State v. Rogers, 148 Wis. 2d 243, 247, 435 N.W.2d 275 
(Ct. App. 1988), the court of appeals stated that the question 
of whether a search is a government search or a private search 
is a factual one, not to be disturbed unless clearly erroneous.  
The court in Rogers cited State v. Bembenek, 111 Wis. 2d 617, 
634, 331 N.W.2d 616 (Ct. App. 1983), for this standard of 
review.  Both Rogers and Bembenek, however, were decided before 
this court's decisions in State v. Hajicek, 2001 WI 3, ¶26, 240 
Wis. 2d 349, 620 N.W.2d 781, and State v. Martwick, 2000 WI 5, 
231 Wis. 2d 801, 604 N.W.2d 552.  Under the reasoning of those 
decisions which pertain, respectively, to whether a search is a 
police 
search 
or 
a 
probation 
search 
and 
to 
curtilage 
determinations, the two-part standard of review should apply to 
the question of whether a search is a private search or a 
government 
search. 
 
Thus, 
the 
Rogers 
and 
Bembenek 
characterization of the question as one only of fact, not to be 
disturbed unless clearly erroneous, is no longer a complete 
statement of the standard of review. 
No. 
2004AP1029-CR   
 
7 
 
only to government action.  State v. Rogers, 148 Wis. 2d 243, 
246, 435 N.W.2d 275 (Ct. App. 1988); see also Skinner v. Railway 
Labor Executives' Ass'n, 489 U.S. 602, 614 (1989). 
¶18 The 
court 
of 
appeals 
in 
Rogers 
stated 
three 
requirements that must be met for a search to be a private 
search: 
(1) 
the 
police 
may 
not 
initiate, 
encourage 
or 
participate in the private entity's search; (2) the 
private entity must engage in the activity to further 
its own ends or purpose; and (3) the private entity 
must not conduct the search for the purpose of 
assisting governmental efforts. 
Rogers, 148 Wis. 2d at 246.   
¶19 Similarly, a search may be deemed a government search 
when it is a "joint endeavor" between private and government 
actors:  "[C]ourts which have considered combined efforts of a 
government official and a private person in a search hold that a 
search is subject to the fourth amendment prohibition against an 
unreasonable search if the search is a joint endeavor involving 
a private person and a government official."  State v. Abdouch, 
434 N.W.2d 317, 325-26 (Neb. 1989); accord Wayne R. LaFave, 1 
Search and Seizure § 1.8(b), at 263 (4th ed. 2004) ("A search 
will also be deemed subject to Fourth Amendment restrictions if 
it is a 'joint endeavor,' involving both a private person and a 
government official . . . .") (footnote omitted). 
¶20 At the same time, however, the mere presence of a 
government official will not necessarily transform a private 
search into government action.  Rogers, 148 Wis. 2d at 246; see 
also State v. Thompson, 222 Wis. 2d 179, 193, 585 N.W.2d 905 
No. 
2004AP1029-CR   
 
8 
 
(Ct. App. 1998) ("officer's presence during [the defendant]'s 
emergency treatment and surgery did not . . . constitute a 
search under the Fourth Amendment"). 
¶21 The question of whether a search is a private search 
or a government search is one that must be answered taking into 
consideration the totality of the circumstances.  Skinner, 489 
U.S. at 614-15; United States v. Shahid, 117 F.3d 322, 325 (7th 
Cir. 1997).     
¶22 The State asserts that the court of appeals failed to 
recognize that Payano-Roman had the burden of proving government 
action.  When analyzed properly, the State argues, the circuit 
court's "finding" that the administration of the laxative was a 
private action is not clearly erroneous.   
¶23 We agree with the State that Payano-Roman had the 
burden of proof.  Once the State raises the issue, asserting 
that a search is a private search, the defendant has the burden 
of proving by a preponderance of the evidence that government 
involvement in a search or seizure brought it within the 
protections of the Fourth Amendment.  The weight of authority, 
including Wisconsin authority, holds that the burden is on a 
defendant not the State.  See Shahid, 117 F.3d at 325; United 
States v. McAllister, 18 F.3d 1412, 1417 (7th Cir. 1994); United 
States v. Reed, 15 F.3d 928, 931 (9th Cir. 1994); United States 
v. Feffer, 831 F.2d 734, 739 (7th Cir. 1987); United States v. 
Coleman, 628 F.2d 961, 965 (6th Cir. 1980); Norton v. State, 820 
S.W.2d 272, 275 (Ark. 1991); Waters v. State, 575 A.2d 1244, 
1247-48 (Md. 1990); State v. Cohen, 409 S.E.2d 383, 385 (S.C. 
No. 
2004AP1029-CR   
 
9 
 
1991); State v. Watts, 750 P.2d 1219, 1221 (Utah 1988); Rogers, 
148 Wis. 2d at 247; LaFave, 5 Search and Seizure § 11.2(b), at 
48. 
¶24 However, the circuit court's determination of whether 
the search was a private search or a government search is not a 
finding of evidentiary or historical fact.  Rather, it is 
ultimately a question of law subject to independent appellate 
review.  Thus, we must review all of the facts to determine 
whether the search was a private search or a government search, 
deferring to the circuit court's findings of historical or 
evidentiary fact and keeping in mind that Payano-Roman bore the 
burden of proof by a preponderance of the evidence. 
¶25 The circuit court focused on whether it was the 
officers or the hospital staff who made the determination that 
Payano-Roman should be administered the laxative.  It found that 
the officers did not dictate Payano-Roman's treatment and that 
it was the medical staff who made the decision to give Payano-
Roman the laxative.  These are findings of evidentiary fact 
which are supported by evidence in the record and, therefore, 
not clearly erroneous.  Although the State did not call any 
hospital personnel as witnesses at the suppression hearing, both 
officers testified that they did not direct hospital personnel 
to administer the laxative to Payano-Roman.  Deputy Stiff also 
testified that a nurse told him it was normal hospital procedure 
"to provide liquid . . . to swallow in order to defecate and 
pass . . . what [Payano-Roman] had swallowed."  Payano-Roman did 
not undercut this testimony. 
No. 
2004AP1029-CR   
 
10 
 
¶26 However, the circuit court's ultimate decision on the 
question of whether the administration of the laxative was a 
private search or a government search does not adequately 
account for the extent to which police officers participated in 
the search.  It also does not fully recognize that the police 
and medical staff were engaged in a joint endeavor with a dual 
purpose:  medical treatment and the recovery of evidence of a 
crime.  
¶27 The circuit court's findings of fact and the officers' 
testimony establish that the circumstances surrounding the 
search included the following:4 
• Payano-Roman swallowed the drugs in the course of a 
criminal drug investigation of which he was the target. 
• He had been arrested and was in police custody at the 
time of the search. 
• He remained handcuffed except when he had to defecate or 
urinate.  
• One or more officers remained with Payano-Roman at all 
times, including in the ambulance on the way to the 
hospital. 
• Although medical personnel made the determination that 
Payano-Roman should receive the laxative, Agent Parker 
directly 
participated 
in 
its 
administration. 
 
He 
testified that he gave the laxative to Payano-Roman 
                                                 
4 Payano-Roman was also a witness at the suppression 
hearing.  The circuit court found that his testimony was not 
credible, and we do not rely on it. 
No. 
2004AP1029-CR   
 
11 
 
approximately six times, telling Payano-Roman "here you 
go, you got to take this again."  
• The officers were concerned with Payano-Roman's well-
being, but also intent on recovering the heroin as 
evidence of a crime.   
• In light of the officers' goal to recover evidence, they 
requested that they be allowed to examine Payano-Roman's 
stool.  The hospital staff then provided a portable 
toilet for Payano-Roman's hospital room. 
• The officers told Payano-Roman he had to use the portable 
toilet for defecation, observed his bowel movement, then 
examined his stool and recovered the baggie of heroin.5   
¶28 Taking all of these circumstances into account, we 
determine that Payano-Roman established by a preponderance of 
the evidence that the search meets the test for a government 
search.  The totality of the facts shows that the officers and 
medical personnel were engaged in a joint endeavor to speed the 
passage of the baggie of drugs through Payano-Roman's system.  
The administration of the laxative had a dual purpose, medical 
                                                 
5 This fact suggests 
that, by the time 
Payano-Roman 
defecated in the portable toilet if not before, the focus of the 
laxative's administration had become recovery of the evidence, 
not concern for his health.  We note that the State points to no 
evidence in the record showing whether (and, if so, when) 
medical personnel examined the baggie to determine whether it 
had ruptured and whether any additional course of action may 
have been medically indicated. 
No. 
2004AP1029-CR   
 
12 
 
treatment and the recovery of evidence of a crime.6  Moreover, 
Agent Parker directly participated in the administration of the 
laxative to Payano-Roman.  This is not a case involving the 
"mere presence" of a police officer. 
¶29 There can be no question on this record that one 
purpose of the laxative procedure was medical treatment.  
However, when we consider all the circumstances of this case, we 
conclude that the medical purpose of the procedure cannot 
insulate the simultaneous evidence-gathering purpose from Fourth 
Amendment scrutiny. 
IV 
¶30 Because we have determined that the search was a 
government search, we must address the question of whether it 
was reasonable under the Fourth Amendment.  The officers made no 
attempt to obtain a warrant to search Payano-Roman.  Warrantless 
searches are per se unreasonable under the Fourth Amendment 
subject to certain exceptions that are "jealously and carefully 
drawn."  State v. Boggess, 115 Wis. 2d 443, 449, 340 N.W.2d 516 
(1983) (quoting Jones v. United States, 357 U.S. 493, 499 
(1958)).  The government bears the burden of proving that a 
warrantless search falls within one of the narrowly drawn 
exceptions.  State v. Rome, 2000 WI App 243, ¶11, 239 
Wis. 2d 491, 620 N.W.2d 225. 
                                                 
6 Cf. 
State v. Jenkins, 
80 
Wis. 2d 426, 
433-34, 259 
N.W.2d 109 (1977) (holding that where a blood test is taken at 
the request of a physician "solely" for diagnostic purposes, 
there is no search and seizure within the meaning of the Fourth 
Amendment). 
No. 
2004AP1029-CR   
 
13 
 
¶31 One of the exceptions to the warrant requirement is a 
search incident to a lawful arrest.  Leroux v. State  58 
Wis. 2d 671, 688, 207 N.W.2d 589 (1973); Rome, 239 Wis. 2d 491, 
¶11; see also Wis. Stat. § 968.11 (2003-04).7  A lawful arrest 
gives rise to heightened concerns that may justify a warrantless 
search, including the need to discover and preserve evidence.  
State v. Pallone, 2000 WI 77, ¶32, 236 Wis. 2d 162, 180, 613 
N.W.2d 568. 
¶32 Another exception 
to 
the 
warrant 
requirement is 
exigent circumstances.  This exception requires an inquiry into 
whether officers might reasonably have believed that they were 
confronted with an emergency, in which the delay necessary to 
obtain a warrant, under the circumstances, threatened the 
destruction of evidence.  State v. Faust, 2004 WI 99, ¶12, 274 
Wis. 2d 183, 682 N.W.2d 371. 
                                                 
7 Wisconsin Stat. § 968.11 provides as follows: 
Scope of search incident to lawful arrest.  When 
a lawful arrest is made, a law enforcement officer may 
reasonably search the person arrested and an area 
within such person's 
immediate 
presence 
for the 
purpose of: 
. . . . 
(3) Discovering and seizing the fruits of the 
crime; or 
(4) Discovering and seizing any instruments, 
articles or things which may have been used in the 
commission of, or which may constitute evidence of, 
the offense. 
No. 
2004AP1029-CR   
 
14 
 
¶33 The record is unclear as to whether the officers 
reasonably believed that they were confronted with an emergency, 
in which the delay necessary to obtain a warrant threatened the 
destruction of evidence.  However, the parties no longer dispute 
whether Payano-Roman was under lawful arrest at the time of the 
search.  Thus, at least one exception to the warrant requirement 
is present.8 
¶34 Still, this does not end our inquiry.  The scope and 
nature of a warrantless search fitting one of the warrant 
exceptions must meet the reasonableness requirements of the 
Fourth Amendment.  See Leroux, 58 Wis. 2d at 688. 
¶35 Relying primarily on a case involving a border search,9 
the State asserts that the use of the laxative was reasonable 
because the State was entitled to detain Payano-Roman until he 
had a bowel movement.  However, border search jurisprudence is 
not dispositive because "the Fourth Amendment's balance of 
reasonableness is qualitatively different at the international 
border than in the interior."  United States v. Montoya de 
Hernandez, 473 U.S. 531, 538 (1985); see also, e.g., Torres v. 
Puerto Rico, 442 U.S. 465, 473 (1979); United States v. Ramsey, 
                                                 
8 Because one exception to the warrant requirement is 
sufficient, we need not rely on the exigent circumstances 
exception.  The dissent concedes that a search incident to 
arrest is excepted from the warrant requirement if the search 
was reasonable under the circumstances.  Dissent, ¶78.   
9 United States v. Adekunle, 980 F.2d 985 (5th Cir. 1992), 
vacated in part, revised and reinstated as revised, 2 F.3d 559 
(5th Cir. 1993). 
No. 
2004AP1029-CR   
 
15 
 
431 U.S. 606, 620 (1977).  Moreover, the officers here did not 
simply detain Payano-Roman until he had a bowel movement.  
Rather, he was given a laxative that resulted in the recovery of 
the baggie of heroin from his stool. 
¶36 More helpful than border search jurisprudence is 
Winston v. Lee, 470 U.S. 753 (1985), the case under which the 
State makes its backup argument.  The court of appeals analyzed 
the reasonableness of the search under Winston, as does Payano-
Roman. 
¶37 In Winston, the United States Supreme Court applied a 
three-factor balancing test to determine the reasonableness of a 
search involving a medical procedure that intruded on a criminal 
suspect's bodily integrity.  Under that test, courts examine (1) 
the extent to which the procedure may threaten the safety or 
health of the individual and (2) the extent of the intrusion 
upon the individual's dignitary interests in personal privacy 
and bodily integrity.  Winston, 470 U.S. at 761-62.  They then 
weigh these two factors against (3) the community's interest in 
fairly and accurately determining guilt or innocence.  Id. at 
762.10  The balance "is a delicate one admitting of few 
categorical answers."  Id. at 760. 
                                                 
10 Winston v. Lee, 470 U.S. 753 (1985), involved the 
question of whether a state could compel a suspect to undergo 
surgery to remove a bullet believed to be evidence of a crime.  
Winston, 470 U.S. at 756, 758.  Removal of the bullet was 
neither something the suspect wanted nor, apparently, medically 
prescribed.   
No. 
2004AP1029-CR   
 
16 
 
¶38 We agree with the court of appeals, Payano-Roman, and 
the State in its backup argument that Winston provides a useful 
framework for the case at bar.  The Winston test recognizes that 
"[t]he overriding function of the Fourth Amendment is to protect 
personal privacy and dignity against unwarranted intrusion by 
the State."  Winston, 470 U.S. at 760 (quoting Schmerber v. 
California, 384 U.S. 757, 767 (1966)).  The Fourth Amendment 
neither forbids nor permits all bodily intrusions.  Winston, 470 
U.S. at 760.  Rather, the Amendment's function is to constrain 
against 
intrusions 
"which 
are 
not 
justified 
in 
the 
circumstances, or which are made in an improper manner."  Id. 
(quoting Schmerber, 384 U.S. at 768). 
¶39 Other courts have applied Winston to determine the 
reasonableness of a search involving a medical procedure that 
intrudes on an individual's bodily integrity.11  One useful 
example is the Iowa Supreme Court's decision in State v. Strong, 
493 N.W.2d 834 (Iowa 1992). 
¶40 In Strong, police observed the defendant place some 
small objects in his mouth as they approached him to investigate 
a fight.  Strong, 493 N.W.2d at 835.  The defendant eventually 
                                                 
11 United States v. Husband, 226 F.3d 626, 630-33 (7th Cir. 
2000); State v. Strong, 493 N.W.2d 834 (Iowa 1992); Hendrix v. 
State, 843 So. 2d 1003, 1005-06, 1008-10 (Fla. Dist. Ct. App. 
2003). 
 
For 
additional 
cases 
involving 
Fourth 
Amendment 
challenges to the admissibility of evidence under related 
factual scenarios, see United States v. Nelson, 36 F.3d 758 (8th 
Cir. 1994), United States v. Borchardt, 809 F.2d 1115 (5th Cir. 
1987), People v. Bracamonte, 540 P.2d 624 (Cal. 1975), and State 
v. Brockman, 439 N.W.2d 84 (Neb. 1989). 
No. 
2004AP1029-CR   
 
17 
 
swallowed the objects but the officers were able to see several 
small pieces of a rock-like substance that appeared to be crack 
cocaine.  Id.  The defendant then admitted that he had swallowed 
crack cocaine.  Id.  The officers took him to the hospital and, 
without obtaining a warrant, requested that medical personnel 
pump his stomach.  Id.  The crack cocaine was recovered as a 
result of the stomach pumping.  Id. 
¶41 The court determined that the case implicated both the 
exigent-circumstances and search-incident-to-arrest exceptions 
to the warrant requirement.12  Id. at 836-37.  However, the court 
explained, that determination did not end its analysis:  "When 
the warrantless search involves an intrusion into the body, a 
more demanding test must be met."  Id. at 837.  "We must be 
satisfied that the method chosen to search [the defendant]'s 
stomach contents was reasonable."  Id.  Accordingly, the court 
applied the Winston factors.  See id. at 837-38.  It concluded 
there was no Fourth Amendment violation after considering all 
the circumstances.  Id. at 838. 
¶42 Like the Iowa Supreme Court, we conclude that even 
when one or more of the warrant exceptions is present, an 
intrusion into the body demands something more:  The scope and 
nature of the intrusion must be reasonable.  The reasonableness 
of a search depends upon all of the circumstances, see, e.g., 
State v. Rewolinski, 159 Wis. 2d 1, 13, 464 N.W.2d 401 (1990), 
                                                 
12 One difference between Strong and the case at bar is that 
in Strong the drugs that the defendant swallowed were not in a 
container. 
No. 
2004AP1029-CR   
 
18 
 
and the Winston factors help inform the reasonableness inquiry.  
The State bears the burden of proof as to the reasonableness of 
the search.13 
¶43 Applying 
the 
factors 
of 
Winston, 
we 
begin 
by 
considering the extent to which the administration of the 
laxative threatened Payano-Roman's safety or health.  Important 
to our determination in this case is that the evidence before 
the circuit court relevant to this factor showed that the 
laxative procedure was medically indicated for Payano-Roman's 
safety and health.  There was no evidence before the court that 
the administration of the laxative posed a threat to his safety 
or health.   
¶44 As already explained, the circuit court made well-
supported findings that the officers did not dictate Payano-
Roman's treatment and that it was the medical staff who made the 
decision to give Payano-Roman the laxative.  Deputy Stiff 
testified that a nurse told him it was normal hospital procedure 
"to provide liquid . . . to swallow in order to defecate and 
pass . . . what [Payano-Roman] had swallowed."  In addition, 
                                                 
13 Although Winston does not expressly address whether the 
State or defendant bears the burden of proof, it suggests that 
the burden is on the State.  See Winston, 470 U.S. at 766.  In 
any 
event, 
placing 
the 
burden 
on 
the 
State 
to 
show 
reasonableness 
is 
required 
by 
other 
Fourth 
Amendment 
jurisprudence.  See, e.g., State v. Rome, 2000 WI App 243, ¶11, 
239 Wis. 2d 491, 620 N.W.2d 225 ("The State bears the burden of 
proving that the warrantless search falls within one of these 
narrowly drawn exceptions."); see also Strong, 493 N.W.2d at 836 
("The State must prove the legality of the search and seizure by 
a preponderance of the evidence.").   
No. 
2004AP1029-CR   
 
19 
 
Agent Parker testified there were "several conversations" among 
hospital personnel regarding the laxative.  He further testified 
that the initial discussion about the laxative involved an 
emergency room physician and one or two nurses. 
¶45 Payano-Roman did not undercut the State's evidence.  
He introduced no evidence that the laxative presented any 
particular risk to his safety or health.  Similarly, he brought 
forth no evidence that the laxative was administered in a manner 
or under circumstances that may have put his health at risk. 
¶46 The State's evidence also showed that the laxative was 
administered in a hospital environment with supervision by 
medical personnel.  Payano-Roman presented no evidence that the 
administration of the laxative involved an unusual or untested 
procedure, or that the laxative was given in a manner that 
deviated from accepted medical practices.  We recognize, of 
course, that the administration of virtually any drug, or the 
performance of virtually any medical procedure, presents at 
least some amount of minimal risk.  However, we have no reason 
on this record to determine that the laxative presented anything 
beyond a negligible risk to Payano-Roman. 
¶47 We stress that courts should generally not assume, 
without evidence, that a particular procedure is medically 
indicated in a given case.  A review of the case law suggests 
that what is medically indicated may, as one might expect, vary 
under the circumstances.  See, e.g., Hendrix v. State, 843 
So. 2d 1003, 1006 (Fla. Dist. Ct. App. 2003) (physicians 
testified that administration of laxative to individual who had 
No. 
2004AP1029-CR   
 
20 
 
swallowed a large baggie of cocaine was "absolutely necessary"); 
but see Blefare v. United States, 362 F.2d 870, 873 (9th Cir. 
1966) (physician testified that reliance on laxatives "would be 
dangerous," apparently because relatively large packets of drugs 
might not pass from the stomach to the small intestine); cf. 
People v. Bracamonte, 540 P.2d 624, 631 (Cal. 1975) (suggesting 
that rubber containers of drugs "may pass completely through the 
digestive tract, by the ordinary process of nature, without 
causing any ill effects" and that such containers "would 
effectively prevent the contents from being absorbed into the 
system").  
¶48 Thus, in many cases, it may be necessary for the State 
to call one or more appropriate medically qualified witnesses.  
The court of appeals' concern with the absence of qualified 
medical evidence in this case is understandable.  However, we 
are satisfied that the record in this case demonstrates that 
administration of the laxative was medically appropriate and 
presented no appreciable risk to Payano-Roman's safety or 
health.  Rather, the evidence showed that the procedure was 
medically indicated to preserve his safety and health. 
¶49 Next, we apply the second Winston factor, inquiring 
into the extent of the intrusion upon Payano-Roman's dignitary 
interests in personal privacy and bodily integrity.  "The Fourth 
Amendment protects against damage to 'the individual's sense of 
personal privacy and security,' regardless of whether the 
intrusion 'injure[s] the physical person of the individual.'"  
No. 
2004AP1029-CR   
 
21 
 
United States v. Husband, 226 F.3d 626, 632 (7th Cir. 2000) 
(quoting Winston, 470 U.S. at 761-62). 
¶50 The administration of the laxative to Payano-Roman was 
more than a negligible intrusion into his dignitary interests in 
personal privacy and bodily integrity.  According to Agent 
Parker's testimony, Payano-Roman was required every 20 or 30 
minutes to drink either 12 or 20 ounces of the laxative over the 
course of several overnight hours.  As part of the laxative 
procedure, Payano-Roman was then made to defecate while police 
observed.  Parker testified that, after Payano-Roman said he 
would have a bowel movement more easily if people were not in 
the room, Parker and Deputy Stiff would step into the hallway, 
partially shut the door, and watch Payano-Roman through a window 
in the door.  The officers then examined his stool in order to 
recover the baggie of heroin. 
¶51 The Supreme Court has recognized that "[t]here are few 
activities in our society more personal or private than the 
passing of urine."  Skinner, 489 U.S. at 617 (quoting National 
Treasury Employees Union v. Von Raab, 816 F.2d 170, 175 (5th 
Cir. 1987)).   The same must be said for the human body's other 
primary excretory function. 
¶52 Thus, the laxative procedure resulting in the recovery 
of the baggie of heroin from Payano-Roman's stool was a 
significant intrusion on his dignitary interests.  However, we 
note that Payano-Roman's bodily integrity would have been 
compromised if the baggie containing heroin had ruptured while 
inside him.  Waiting until he passed the baggie, without the 
No. 
2004AP1029-CR   
 
22 
 
administration of the laxative, would have apparently lengthened 
the time that he was exposed to this danger. 
¶53 We turn to the third Winston factor, the community's 
interest 
in 
fairly 
and 
accurately 
determining 
guilt 
or 
innocence.  Considerations relevant to this factor include 
whether there is a clear indication that the procedure will 
produce evidence of a crime; whether the procedure is an 
effective means of obtaining the expected evidence; the risk, 
absent the procedure, that the evidence will be destroyed; and 
the difficulty the government would have in proving its case 
without using the procedure to obtain the expected evidence.  
See Winston, 470 U.S. at 762-63; Husband, 226 F.3d at 633; 
Hendrix, 843 So. 2d at 1009; Strong, 493 N.W.2d at 838.   
¶54 On the record before us, it cannot be disputed that 
there was a clear indication that administration of the laxative 
would produce evidence of a crime.  We highlight some of the 
relevant facts:  the officers had information from an informant 
that the man who turned out to be Payano-Roman was trafficking 
in cocaine and possibly heroin; the officers' observations 
confirmed information the informant provided, including Payano-
Roman's physical description, his location at a particular 
address, and his association with a Toyota Tercel with license 
plate T19401; and Deputy Stiff, who had experience and training 
as part of a drug enforcement unit, saw Payano-Roman swallow a 
clear plastic baggie containing a white powdery or chunky 
substance that he believed to be heroin in light of its 
packaging.  There also can be no real dispute on this record 
No. 
2004AP1029-CR   
 
23 
 
that the procedure was an effective means of obtaining the 
expected evidence. 
¶55 The record is not conclusive as to the likelihood that 
the heroin in the baggie would have been destroyed, absent the 
administration of the laxative to Payano-Roman.  What evidence 
the record does contain suggests that without the laxative, 
there was increased risk that the baggie would rupture, 
resulting in the absorption of some or all of the heroin into 
Payano-Roman's system.  This is suggested both by the circuit 
court's finding that medical personnel made the determination to 
administer the laxative and by the testimony that it was 
hospital procedure. 
¶56 This same evidence suggests that there may have been 
an increased risk that the government would have had more 
difficulty in proving its case without use of the laxative.  Had 
the officers been unable to recover the heroin, the government's 
case against Payano-Roman would not have been as strong. 
¶57 At the same time, it cannot be ignored that Payano-
Roman's situation was self-created insofar as he swallowed the 
baggie of heroin in an apparent attempt to conceal or dispose of 
evidence.  In our view, this should be a consideration in the 
balancing of the Winston factors. 
¶58 We also recognize that the officers acted, at least in 
part, out of concern for Payano-Roman's well-being.  Indeed, had 
the officers not initially sought at least some form of medical 
attention for Payano-Roman, they may have been derelict in their 
No. 
2004AP1029-CR   
 
24 
 
duties.  These circumstances tend to support a determination 
that the search in this case was reasonable. 
¶59 Taking into consideration all of the facts, and 
considering the three Winston factors, we conclude that the 
State met its burden to show that the administration of the 
laxative that resulted in the recovery of the baggie of heroin 
from Payano-Roman's stool was reasonable.  In weighing (1) the 
extent to which the laxative procedure threatened Payano-Roman's 
safety or health and (2) the extent of the intrusion upon his 
dignitary interests against (3) the community's interest in 
fairly and accurately determining guilt or innocence, we 
determine that the balance tips in favor of the State. 
¶60 Weighing heavily in our determination is that the 
State's evidence showed that the administration of the laxative 
was medically indicated and likely reduced the health risks to 
Payano-Roman.  He presented no evidence suggesting otherwise.  
Thus, in this case, the first Winston factor actually favors the 
State.  
¶61 Although the laxative procedure resulting in the 
recovery of the baggie of heroin from Payano-Roman's stool was a 
significant intrusion on his dignitary interests, that intrusion 
was justified under the circumstances here.  Not only does the 
record suggest that the procedure was medically appropriate, but 
also it shows that the officers had a clear indication that 
Payano-Roman's stool would contain evidence of a crime.  They 
were justified in seeking to preserve the evidence to facilitate 
the community's interest in determining guilt, which would have 
No. 
2004AP1029-CR   
 
25 
 
been more difficult in Payano-Roman's case had the police not 
recovered the baggie of heroin.  In short, balancing the Winston 
factors as applied to the circumstances here leads us to the 
conclusion that the search was reasonable.   
¶62 Although we conclude that the search in this case was 
reasonable, this is not to say that the administration of a 
laxative in all future cases will be reasonable.  It bears 
repeating that we arrive at our conclusion based on the totality 
of circumstances presented.  As the United States Supreme Court 
said in Schmerber, "[t]hat we today hold that the Constitution 
does not forbid . . . minor intrusions into an individual's body 
under stringently limited conditions in no way indicates that it 
permits more substantial intrusions, or intrusions under other 
conditions."  Schmerber, 384 U.S. at 772.   
V 
¶63 In sum, we determine that the administration of the 
laxative that resulted in the recovery of a baggie of heroin 
from Payano-Roman's stool was a government search.  However, we 
also determine that the search was reasonable and therefore not 
in 
violation 
of 
Payano-Roman's 
Fourth 
Amendment 
rights.14  
Accordingly, we reverse the court of appeals. 
By the Court.—The decision of the court of appeals is 
reversed. 
 
                                                 
14 We need not reach the State's alternative argument that 
the baggie of heroin should be admissible under the inevitable 
discovery doctrine. 
No.  2004AP1029-CR.ssa 
 
1 
 
 
¶64 SHIRLEY S. ABRAHAMSON, C.J.   (dissenting).  I agree 
with the court of appeals that the evidence obtained as a result 
of administering the laxative to the defendant, Tomas Payano-
Roman, should have been suppressed.  Six hours elapsed between 
the arrest and the administration of the laxative——more than 
enough time for the officers to get a search warrant.  The 
officers did not try to get a search warrant.  The evidence must 
be suppressed. 
¶65 I 
agree 
with 
the 
majority 
opinion 
that 
the 
administration of the laxative was state action for the purposes 
of Fourth Amendment search and seizure analysis.  I disagree, 
however, that the administration of laxatives constituted a 
reasonable search. 
¶66 The purpose of a warrant is to allow a neutral 
decision-maker to make an informed, deliberative decision about 
whether the search is reasonable under the circumstances.1  A 
warrantless search is per se unreasonable under the Fourth 
Amendment unless it falls within an exception to the warrant 
requirement.2  The State has the burden of proof that an 
exception to the warrant requirement exists.3   
                                                 
1 2 Wayne R. LaFave, Search and Seizure § 4.1(a), at 441-42 
(4th ed. 2004). 
2 State v. Boggess, 115 Wis. 2d 443, 449, 340 N.W.2d 516 
(1983) (citing Cady v. Dombrowski, 413 U.S. 433, 439 (1973)). 
3 State v. Pallone, 2000 WI 77, ¶29, 236 Wis. 2d 162, 613 
N.W.2d 568 ("The State bears the burden of proving that a 
warrantless 
search 
falls 
under 
one 
of 
the 
established 
exceptions.").  
No.  2004AP1029-CR.ssa 
 
2 
 
¶67 The 
State 
argues 
that the 
exigent 
circumstances 
exception applies.  The majority opinion does not address this 
exception; it concludes that the administration of the laxative 
to the defendant was reasonable because the circumstances meet 
the 
search 
incident 
to 
arrest 
exception 
to 
the 
warrant 
requirement.   
¶68 To prove exigent circumstances, the State must show 
that the delay in obtaining a warrant would jeopardize seizure 
of the evidence sought.  This exception applies if reasonable 
officers would have believed that they were confronted with an 
emergency that threatened to destroy the evidence.4 
¶69 The second exception to the warrant requirement, upon 
which the majority relies, is that police may conduct a search 
incident to arrest without a warrant so long as that search is 
reasonable considering all the attending circumstances.5 
¶70 I 
conclude 
neither 
exception 
to 
the 
warrant 
requirement applies in the present case.  I address each of 
these exceptions in turn.   
¶71 Finally, I discuss the Winston and Schmerber cases 
upon which the majority opinion relies.  Those cases do not 
support the majority's conclusion. 
I 
¶72 The 
State 
proffers 
two 
exigent circumstances to 
justify the warrantless administration of the laxative: (1) to 
                                                 
4 State v. Faust, 2004 WI 99, ¶12, 274 Wis. 2d 183, 682 
N.W.2d 371; see majority op., ¶32. 
5 Ker v. California, 374 U.S. 23, 32-33 (1963). 
No.  2004AP1029-CR.ssa 
 
3 
 
recover the heroin in the plastic bag for use as evidence; and 
(2) to provide medical care to the defendant, in the belief that 
his health was in danger if the plastic bag ruptured inside his 
body.6  Though either of these situations may produce exigent 
circumstances in the proper case, the State has not proven 
either exigency in the instant case.  Although the majority 
opinion does not address exigent circumstances, I do because the 
existence 
of 
exigent 
circumstances 
(or 
lack 
thereof) 
is 
important to evaluate the reasonableness of the search incident 
to arrest.   
¶73 The argument that the evidence might be lost unless an 
expedited 
search 
occurred 
does 
not 
constitute 
exigent 
circumstances 
under 
the 
facts 
of 
the 
instant 
case.  
Approximately six hours passed between the time of the arrest 
and the time the laxative was administered.  If the officers 
were concerned about the defendant's health why did it take them 
so long to act?  Furthermore, six hours was more than enough 
time to get a warrant.7  Yet the officers failed to secure a 
warrant during this six-hour period.   
¶74 The second putative justification for applying the 
exigent circumstances exception is medical necessity.  The 
argument is made that the plastic bag might have ruptured, 
endangering the defendant's life.  This putative necessity is 
                                                 
6 See majority op., ¶¶54-55, 59. 
7 Approximately sixteen hours elapsed between the arrest and 
the time the defendant defecated the plastic bag containing 
heroin.   
No.  2004AP1029-CR.ssa 
 
4 
 
not applicable in the instant case.  The record indicates that 
it took between 45 minutes and two hours to transfer the 
defendant to the hospital after he was arrested.  A total of six 
hours passed before the laxative was administered.  If the 
defendant was at such great risk, why did it take six hours to 
administer the laxative?  As I explain fully later, the State 
did not prove that the administration of the laxative was 
necessary to protect the defendant's health.8  No exigent 
circumstances exist here excusing the need for a search warrant.  
¶75 Furthermore, an individual may choose not to accept 
medical treatment.  Individuals have a constitutional right to 
refuse medical treatment.  This right is often analyzed under 
general privacy principles, but more properly is analyzed under 
the Fourteenth Amendment liberty guarantee.9  Had the defendant 
                                                 
8 See ¶¶85-90, infra. 
9 Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 
261, 279 & n.7 (1990) ("Although many state courts have held 
that a right to refuse treatment is encompassed by a generalized 
constitutional right of privacy, we have never so held.  We 
believe this issue is more properly analyzed in terms of a 
Fourteenth Amendment liberty interest."; whether a person's 
constitutional interests have been violated is determined by 
balancing the liberty interests against the relevant state 
interests); Lenz v. L.E. Phillips Career Ctr., 167 Wis. 2d 53, 
67, 482 N.W.2d 60 (1992) ("[A]n individual's right to refuse 
unwanted medical treatment emanates from the common law right of 
self-determination and informed consent, the personal liberties 
protected by the Fourteenth Amendment, and from the guarantee of 
liberty in Article I, section 1 of the Wisconsin Constitution"). 
The right to refuse medical treatment also comes from the 
common law torts of assault and battery.  Mills v. Rogers, 457 
U.S. 291, 294 n.4 (1982) ("Under the common law of torts, the 
right to refuse any medical treatment emerged from the doctrines 
of trespass and battery, which were applied to unauthorized 
touchings by a physician.").   
No.  2004AP1029-CR.ssa 
 
5 
 
not been under arrest, he surely would have been permitted to 
refuse a laxative if he had ingested a dangerous material.  No 
authority is cited for the proposition that an arrest negates 
the need for a person's consent for medical treatment or for a 
showing of medical necessity.     
¶76 In the instant case, the medical excuse for the search 
fails to establish the reasonableness of the search.  The State 
has failed to meet its burden of proof on this exception to the 
warrant requirement. 
¶77 In sum, the record is such that the State failed to 
meet its burden that the search was reasonable. 
II 
 
¶78 I also conclude that the search incident to arrest 
exception to the warrant requirement was not met in the instant 
case.  A search incident to arrest is excepted from the warrant 
requirement 
if 
the 
search 
was 
reasonable 
under 
the 
circumstances.10  The warrantless search was not reasonable under 
the circumstances of the present case.   
¶79 A search incident to arrest is reasonable under the 
circumstances if the search is necessary either to seize 
evidence or prevent dangerous materials from circulating in a 
secure environment such as a jail.11  An essential element of 
                                                                                                                                                             
For statutes protecting the rights to medical care of 
certain patients whose liberty has been restricted, see Wis. 
Stat. §§ 50.09, 51.61.   
10 Ker v. California, 374 U.S. 23, 32-33 (1963). 
11 Chimel v. California, 395 U.S. 752, 755-63 (1969). 
No.  2004AP1029-CR.ssa 
 
6 
 
this determination is whether the officers had sufficient time 
to 
obtain 
a 
search 
warrant.12 
 
Here 
the 
search 
(the 
administration of the laxative) was not necessary; the natural 
course of human events would have delivered the plastic bag and 
its contents to the police.  In the instant case, the search was 
not needed to prevent the drugs from circulating to others.  The 
                                                 
12 Chimel, 395 U.S. at 755-63.   
The Chimel Court observed: 
When an arrest is made, it is reasonable for the 
arresting officer to search the person arrested in 
order to remove any weapons that the latter might seek 
to use in order to resist arrest or effect his escape.  
Otherwise, 
the 
officer's 
safety 
might 
well 
be 
endangered, and the arrest itself frustrated.  In 
addition, it is entirely reasonable for the arresting 
officer to search for and seize any evidence on the 
arrestee's person in order to prevent its concealment 
or destruction.  And the area into which an arrestee 
might reach in order to grab a weapon or evidentiary 
items must, of course, be governed by a like rule.  A 
gun on a table or in a drawer in front of one who is 
arrested can be as dangerous to the arresting officer 
as one concealed in the clothing of the person 
arrested.  There is ample justification, therefore, 
for a search of the arrestee's person and the area 
"within his immediate control"——construing that phrase 
to mean the area from within which he might gain 
possession of a weapon or destructible evidence. 
There is no comparable justification, however, for 
routinely searching any room other than that in which 
an arrest occurs——or, for that matter, for searching 
through all the desk drawers or other closed or 
concealed areas in that room itself.  Such searches, 
in the absence of well-recognized exceptions, may be 
made only under the authority of a search warrant.  
The "adherence to judicial processes" mandated by the 
Fourth Amendment requires no less. 
Id. at 762-63 (footnote omitted). 
No.  2004AP1029-CR.ssa 
 
7 
 
evidentiary and security purposes of the search incident to 
arrest exception did not require the administration of the 
laxative without a search warrant.  The State has failed to meet 
its 
burden 
of 
proof 
on 
this 
exception 
to 
the 
warrant 
requirement. 
¶80 In sum, the record is such that the State failed to 
meet its burden that the search was reasonable. 
III 
¶81 The two United States Supreme Court cases upon which 
the majority opinion relies do not support the majority's 
conclusion in the present case. 
¶82 In Winston v. Lee, 470 U.S. 753 (1985), the United 
States Supreme Court addressed a fact pattern similar to that of 
the instant case.  In Winston, the perpetrator of an armed 
robbery was shot by the victim in self-defense.  Approximately 
20 minutes after the incident, the defendant was arrested with a 
bullet wound.  Although there was no medical reason to remove 
the bullet, the State petitioned the state courts to order the 
bullet removed so that it might be used as evidence against the 
defendant.  The Virginia courts granted the petition.  Upon 
petition for habeas corpus, the federal district court and the 
federal Fourth Circuit Court of Appeals enjoined the surgery.   
¶83 On 
certiorari, 
the 
United 
States 
Supreme 
Court 
affirmed the denial of the State's request for surgery.13  In 
reaching this conclusion, the Supreme Court stated a three-part 
balancing test for evaluating whether exigent circumstances 
                                                 
13 Winston v. Lee, 470 U.S. 753, 760-63 (1985). 
No.  2004AP1029-CR.ssa 
 
8 
 
justify a search involving bodily invasion.  The Supreme Court 
balanced (1) the extent to which the procedure may threaten the 
health and safety of the defendant; (2) the extent of the 
intrusion upon the defendant's dignitary interests in personal 
privacy and bodily integrity; and (3) the community's interest 
in fairly and accurately determining guilt or innocence.14 
¶84 In Winston, removal of the bullet was not medically 
necessary and the evidence was not critical for a conviction.15  
The Winston Court placed great emphasis on the bodily integrity 
of the individual in reaching its decision.16   
¶85 As to the first Winston factor, the record in the 
instant case fails to establish whether the procedure would 
endanger the defendant's health.  In the present case, an 
analogous consideration is whether the procedure was necessary 
to protect his health.  The burden is on the State to justify a 
warrantless intrusion on the basis of the defendant's health.  
In the absence of evidence on the record, this first element 
under Winston weighs against the State. 
¶86 The only evidence in the record demonstrating that the 
laxative was medically indicated is the hearsay testimony of the 
officers that a nurse said that the typical procedure in the 
hospital for such cases was to administer a laxative.  Even if 
this hearsay testimony is accurate and reliable, it does nothing 
                                                 
14 Winston, 470 U.S. at 764-66; majority op., ¶37. 
15 See Winston, 470 U.S. at 765. 
16 See id. at 764-65. 
No.  2004AP1029-CR.ssa 
 
9 
 
to establish that the laxative was medically indicated for this 
defendant.     
¶87 Medical treatment requires an individual approach.  
Nothing on the record indicates that the defendant was asked 
about any medical condition he might have that might be affected 
by a laxative, about any allergy to laxatives, about the nature 
of the plastic bag, or about its contents.  In sum, the record 
is silent about whether the laxative administered was medically 
indicated or was medically appropriate for the defendant. 
¶88 Furthermore, the record does not demonstrate that the 
laxative was administered under the supervision of qualified 
medical personnel.  The record is extremely limited regarding 
the involvement of a doctor in the decision-making regarding the 
defendant's care.17  The only clear testimony is that a doctor 
was present during the initial consultation with the police 
officers in the emergency room.  The record is unclear whether a 
doctor ever met with or examined the defendant.  No doctor is 
named.  Moreover, no testimony exists that the administration of 
the laxative was at a doctor's behest.  The closest the record 
comes to establishing a doctor's involvement is the following 
statement by Special Agent Parker at the suppression hearing: 
I don't recall if——if he [the doctor]——I believe he 
also had told——said the same thing, but it was 
consistent, if both said something to that effect to 
me, it was definitely consistent, that the fluids that 
Mr. Payano would drink would allow for things to pass 
through him much more rapidly than otherwise.     
                                                 
17 See majority op., ¶44 (discussing the record upon which 
the majority relies). 
No.  2004AP1029-CR.ssa 
 
10 
 
¶89 As is clear, Special Agent Parker never testified that 
the doctor recommended the laxative.  Rather, he testified only 
that, if the doctor said anything to him about that subject, it 
was not inconsistent with what a nurse told him.   
¶90 The record is thus weak in demonstrating that the 
laxative did not threaten the health and safety of the defendant 
or that the procedure was needed to protect his health. 
¶91 As to Winston's second factor: The administration of a 
laxative was far less intrusive upon the defendant's dignitary 
interests in personal privacy and bodily integrity than the 
medical procedure contemplated in Winston.  Nevertheless, the 
defendant's bodily integrity in the present case is entitled to 
great weight, as the majority opinion properly explains.  The 
defendant has a substantial interest in determining his own 
medical care and determining the medical procedures to be 
performed. 
¶92 In 
sum, 
the 
record 
shows 
that 
the 
defendant's 
dignitary and privacy interests are substantial in the present 
case. 
¶93 As to Winston's third factor, a defendant's bodily 
integrity should not be breached absent a showing by the State 
of a compelling need for the evidence sought.18  The State's 
interest in recovering the drugs is not very strong in the 
present case.  Although in the instant case the criminal case 
may 
be 
weaker 
without 
the 
recovered 
heroin, 
the 
State 
nonetheless could have charged and prosecuted the defendant 
                                                 
18 Winston, 470 U.S. at 766; 2 LaFave, supra note 1, 
§ 3.2(a), at 29-30. 
No.  2004AP1029-CR.ssa 
 
11 
 
based on testimony of the police officers and other witnesses 
regarding the defendant's conduct.   
¶94 Furthermore, absent any evidence on the record to the 
contrary, there is no reason to think that the defendant would 
not have eventually passed the plastic bags, at which point the 
police officers present would have been able to recover the 
heroin for use against the defendant at a trial.  Because the 
record fails to establish that no less intrusive means of 
recovering the evidence was available, administration of the 
laxative was unreasonable.19 
¶95 I therefore conclude that the defendant's health and 
dignitary interests were significant and the State's interests 
in protecting the defendant's health and welfare and securing 
the evidence through this means were not strong. 
¶96 The instant case does not meet Winston's stringent 
standards for invasion of the body.  If the Supreme Court 
refused to authorize an invasion of the body in Winston, clearly 
law enforcement officers cannot, without a warrant, authorize 
the administration of laxatives in the present case.   
                                                 
19 See United States v. Cameron, 538 F.2d 254, 258 (9th Cir. 
1976) ("[L]ess intrusive means of obtaining the evidence may 
properly have been considered. In time, the contraband in the 
rectal cavity might have been eliminated naturally."); Colorado 
v. Thompson, 820 P.2d 1160, 1165 (Colo. Ct. App. 1991) (citing 
Cameron, 
538 
F.2d 
254) 
("[D]efendant 
was 
constitutionally 
entitled to a court ruling whether a less intrusive means of 
securing the evidence was available."). 
See United States v. Husband, 226 F.3d 626, 631 (7th Cir. 
2000) (record 
insufficient 
to 
determine reasonableness of  
police's use of  general anesthesia to recover evidence in 
accused's mouth). 
No.  2004AP1029-CR.ssa 
 
12 
 
¶97 In Schmerber v. California, 384 U.S. 757 (1966), the 
U.S. 
Supreme 
Court 
addressed 
the 
admissibility 
of 
blood 
withdrawn 
from 
an 
individual 
suspected 
of 
driving 
while 
intoxicated.  The blood was withdrawn in a hospital by a 
physician while the suspect was unconscious.20 
¶98 Applying the same balancing test that was later 
applied in Winston, the United States Supreme Court affirmed the 
admissibility of the blood.21  The Court concluded that it would 
have taken too long to obtain a warrant and evidence of blood 
alcohol content, an essential aspect of the State's case against 
the defendant, would have dissipated in the interim.22 
¶99 The facts of Schmerber are distinguishable from the 
facts of the instant case.  The blood test was the only certain 
way to establish that the defendant was under the influence of 
alcohol.  In Schmerber, the drawing of blood was a minor 
invasion of the body.  The bodily invasion was undertaken at a 
hospital under a doctor's direct supervision.  There was no time 
to get a warrant because the evidence of alcohol would have 
dissipated by the time a warrant would have issued.  The 
suspect's interest in bodily integrity was high but the invasion 
was limited.  The State's interest in obtaining the evidence in 
Schmerber was very high. 
                                                 
20 Schmerber v. California, 384 U.S. 757, 758-59 (1966). 
21 Schmerber, 384 U.S. at 766-72. 
22 Schmerber, 384 U.S. at 770. 
No.  2004AP1029-CR.ssa 
 
13 
 
¶100 Even in these circumstances, the United States Supreme 
Court was very hesitant in admitting the blood evidence and 
carefully limited the application of Schmerber, stating: 
[W]e reach this judgment only on the facts of the 
present record. The integrity of an individual's 
person is a cherished value of our society. That we 
today hold that the Constitution does not forbid the 
States minor intrusions into an individual's body 
under 
stringently 
limited 
conditions 
in 
no 
way 
indicates that it permits more substantial intrusions, 
or intrusions under other conditions.23 
¶101 And, indeed, a number of courts have found bodily 
intrusions similar to the intrusion in the instant case to be 
unreasonable.24   
¶102 For the reasons stated, and on the basis of Winston 
and Schmerber, I conclude that without a warrant the evidence 
should have been suppressed.25 
                                                 
23 Schmerber, 384 U.S. at 772.  
24 See, e.g., Rochin v. California, 342 U.S. 165, 172-174 
(1952)(forcible extraction of contents of accused's stomach 
violates due process); United States v. Cameron, 538 F.2d 254, 
258 (9th Cir. 1976) (administration of laxative unreasonable 
when record fails to establish that less intrusive means are 
available); Colorado v. Thompson, 820 P.2d 1160, 1165 (Colo. Ct. 
App. 1991) (same). 
25 I conclude that a warrant (an ex parte proceeding) was 
necessary under the facts of the instant case.  Some cases and 
commentators have suggested that under some circumstances an 
adversarial proceeding, with the opportunity for an accused to 
present evidence, may be necessary to invade the accused's body.   
See, e.g., United States v. Crowder, in which Judge McGowan 
observed in his concurring opinion:  
Had [the Government] declined to invoke the authority 
of the judiciary in advance, relying instead upon 
after the fact justifications, we would have been 
presented with quite a different——and palpably more 
No.  2004AP1029-CR.ssa 
 
14 
 
                                                                                                                                                             
difficult——case.  But because it proceeded as it did, 
appellant was, prior to the removal of the bullet and 
at 
the 
Government's 
insistence, 
afforded 
an 
evidentiary hearing before a United States District 
Judge in which he was represented by counsel, asserted 
his 
objections, 
and 
had 
the 
benefit 
of 
cross-
examination 
of 
the 
Government's 
medical 
witness. 
Opportunity was further provided appellant, before the 
operation, to seek appellate scrutiny of the District 
Court's findings and authorizations. 
No.  2004AP1029-CR.ssa 
 
15 
 
¶103 The inevitable discovery doctrine does not save the 
search.  The police were not actively pursuing an alternative 
line of investigation at the time the discovery was made.26  
                                                                                                                                                             
543 F.2d 312, 318 (D.C. Cir. 1976) (McGowan, J., concurring).  
See also State v. Overstreet, 551 S.W.2d 621, 627-28 (Mo. 1977) 
(warrant for removal of bullet not valid when there was no 
adversarial hearing, no opportunity to cross-examine, no finding 
by a court of degree of medical intrusion, and no opportunity 
for pre-surgery appellate review). 
 
For a discussion of cases before and after Winston and 
Schmerber, see 2 LaFave, supra note 1, § 4.1(e), at 455-71. 
26 I agree with the court of appeals' analysis of inevitable 
discovery in the instant case.  The court of appeals stated: 
We 
conclude 
that 
inevitable 
discovery 
is 
not 
applicable here because of the invasion of the body.  
If we were to rule as the State suggests, there would 
be no incentive for the police to respect the bodily 
integrity of persons in custody because they could 
always argue inevitable discovery. 
No.  2004AP1029-CR.ssa 
 
16 
 
¶104 For the reasons stated, I dissent. 
¶105 I am authorized to state that Justice LOUIS B. BUTLER, 
JR. joins this dissent. 
 
                                                                                                                                                             
State v. Payano-Roman, 2005 WI App 118, ¶16 n.3, 284 
Wis. 2d 350, 701 N.W.2d 72. 
No.  2004AP1029-CR.ssa 
 
 
 
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