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RICHMOND, Va. (AP) — A Virginia man who weighs more than 900 pounds (410 kilograms) pleaded guilty in a federal cocaine conspiracy case Tuesday during a hearing that was held in a courthouse loading dock as the defendant lay on a stretcher inside an ambulance.

U.S. Magistrate Judge David Novak said the court engaged in “some extraordinary procedures” Tuesday to deal with Kenneth Hicks’ health issues and to “protect his dignity.”

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Hicks, 48, stayed inside the ambulance and wasn’t visible to several of his family members and reporters who attended the hearing. He was visible to Novak and a prosecutor who sat at a table near the back of the ambulance.

The hearing was postponed last week when Hicks was brought to a hospital for an unspecified health issue after he was taken from his home.

Hicks, who lives in Emporia, was indicted along with 17 other people in a conspiracy to sell cocaine between 2013 and 2017.

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He had his initial court appearance in March via video teleconference and was allowed to remain on bond in his home pending trial.

Because of various health issues, including his morbid obesity, Hicks — through his lawyer — asked for help in being brought to the courthouse for his plea hearing. Court documents in the case described Hicks as being confined to his bed and unable to dress himself or be dressed by others.

Novak approved a plan submitted by Hicks’ defense lawyer and prosecutors to allow the U.S. Marshals Service, the FBI and first responders to remove him from his home, either by placing him on a gurney and moving him through a doorway or by cutting open a large hole in a wall of his home in order to use a device capable of lifting his weight. Officials did not disclose how he was moved.

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His plea hearing was originally scheduled for May 13. That hearing was postponed when he was taken to a Richmond hospital.

During the rescheduled hearing held on Tuesday, Hicks told Novak that he has been transferred to another hospital, is being given insulin and is being treated for several health issues.

Hicks faces a mandatory minimum sentence of five years in prison and a maximum sentence of 40 years. Novak scheduled his sentencing hearing for Sept. 4.

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