Sean "Diddy" Combs is facing mounting legal challenges ahead of his federal sex trafficking and racketeering trial, as prosecutors alleged in court Friday that Combs may have forced one of his alleged victims to undergo a medical procedure, underscoring the extent of control he allegedly exerted over her.

During a hearing in New York City, Assistant U.S. Attorney Meredith Foster told Judge Arun Subramanian that the unnamed procedure is "directly relevant" to Combs' sex trafficking charges because it goes "directly to the degree of control [Combs] had over her, consent to specific sexual acts." The victim's identity and the specifics of the procedure remain undisclosed. Prosecutors argued the evidence supports claims of coercion, a critical component of the charges against the rapper and music mogul.

Combs, who has pleaded not guilty to two counts of sex trafficking, two counts of transportation to engage in prostitution, and one count of racketeering, sat in the courtroom wearing jail-issued clothing as his attorneys attempted to limit the scope of evidence admissible at trial.

Separately, prosecutors confirmed Friday that Combs had rejected a plea offer made before his May 5 trial date. His defense team previously sought a delay, arguing that the government had been slow in producing discovery materials. Judge Subramanian denied the request, stating that with "four law firms on his side," Combs has ample resources to review the evidence before the trial begins.

One of the central witnesses for the government will be Cassie Ventura, Combs' former longtime girlfriend, who publicly accused him in a 2023 civil lawsuit of repeated rape and physical abuse. Ventura, previously referred to as "Victim-1" in court documents, has opted to testify under her real name.

Evidence presented at trial will include a 2016 hotel surveillance video showing Combs assaulting Ventura at the InterContinental Hotel in Century City, Los Angeles. Footage depicts Combs chasing Ventura, throwing her to the ground, kicking her twice, and dragging her down a hallway.

Combs' defense team unsuccessfully sought to exclude the footage, arguing it was "altered" after CNN allegedly edited and destroyed the original file. CNN denied the claims, stating, "CNN never altered the video and did not destroy the original copy of the footage, which was retained by the source." Ventura's lawyer, Douglas Wigdor, dismissed Combs' accusations as "disingenuous," asserting the video "fairly and accurately represents what happened."

Prosecutors also confirmed that the individual who recorded the video from the surveillance feed onto an iPhone will testify at trial to authenticate the footage.

Meanwhile, Judge Subramanian said he will rule later on whether to allow prosecutors to introduce audio from a 2011 911 call allegedly related to Combs breaking into a victim's home.

Combs remains detained in federal custody as the high-profile trial approaches. Jury selection is expected to begin on May 5, with sensitive materials, including the so-called "freak-off" videos, to be shown to jurors under tightly controlled conditions.