On May 9, 2019, the U.S. District Court for the Western District of Virginia found that an attending physician acted legally when collecting blood and urine samples from a patient in emergency custody without the patient’s consent.

The Case

In Jane Doe v. Pamela Sutton-Wallace, the police took the plaintiff to the emergency department in keeping with Virginia’s mental health emergency custody order (ECO) statute. At the emergency department, the plaintiff alleged she was given injections meant to medically restrain her due to her strenuous objections to providing blood and urine samples.

The plaintiff further alleged that she was physically restrained against her will for her blood and urine extraction and injected with ketamine. The defendant, who was the attending physician, did not dispute that the plaintiff objected to the collection of blood and urine samples, or that drugs and physical restraints were used in order to obtain those samples.

The Ruling

After filing his answer, the defendant moved for judgment on the pleadings, and the court agreed that the plaintiff’s treatment was justified “emergency medical treatment or further medical evaluation.” Virginia law allows such treatment to be undertaken despite a patient’s objection. (Va. Code § 37.2-808(I))


Although this opinion takes a broad view of what providers can do with patients brought-in under an ECO, it is at odds with guidelines from the Virginia Department of Behavioral Health. DBHDS guidelines state, “Patients who have capacity to make informed decisions and do not consent to collections of a urine or blood specimen will not be forced, including under an emergency custody order.” Still, this case provides valuable interpretive guidance on the scope of what treatment is allowed under the ECO statute.