Ferguson v. City of Charleston

A public hospital, the Medical University of South Carolina, adopted a policy using nine criteria to identify pregnant patients suspected of cocaine use and tested their urine without probable cause or informed consent, eventually working directly with police to prosecute those who tested positive. Ten women (plaintiffs) arrested after positive tests sued the City of Charleston (defendant), claiming the policy violated the Fourth Amendment. The district court found the searches unreasonable but ruled for the city on a consent theory; the Fourth Circuit rejected consent but upheld the policy under the "special needs" doctrine, reasoning the interest in protecting maternal and fetal health outweighed the privacy intrusion.