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Hawai’i Supreme Court Announces Medical ‘Rule-Out Questions’ Prior to Field Sobriety Test Are Interrogation Triggering Miranda Requirements

by Anthony W. Accurso

The Supreme Court of Hawai’i held that a defendant’s right not to incriminate herself under article I, section 10 of the Hawai’i Constitution was violated when an officer asked her “medical rule-out” questions prior to performing a field sobriety test without first providing the required Miranda warnings to her.

Late in the evening of August 18th, 2019, Honolulu Police Department Officer William Meredith observed a truck being driven by Leah Skapinok that was “weaving through traffic … [and] cross[ed] over a solid white line” while merging onto the freeway and “crossed three lanes of the freeway to the left without a turn signal.”

Officer Meredith found this conduct sufficient to arrest the driver for reckless driving, a petty misdemeanor, and initiated a traffic stop. When he spoke with Skapinok, he “noticed a strong odor of alcohol coming from [her] and observed [her] eyes to be red, glassy, and bloodshot.” He asked if she would be willing to participate in a standardized field sobriety test (“SFST”) to determine if she was operating a vehicle under the influence of an intoxicant (“OVUII”). He also informed her that regardless of her participation, he already had sufficient cause to arrest her for reckless driving. Skapinok was advised that she was not free to leave.

Officer Meredith was joined by Corporal Ernest Chang, who also sought Skapinok’s consent to perform an SFST. Prior to administering the test and without first Mirandizing her, Chang asked her the standard medical rule-out questions as follows: “do you have any physical defects or speech impediments? Are you taking any medications? Are you under the care of a doctor or dentist for anything? Are you under the care of an eye doctor? Do you have an artificial or glass eye? Are you epileptic or diabetic? Are you blind in either eye?”

Later during a suppression hearing, Chang stated that these questions “must be asked to administer the SFST safely,” and when they are answered in the negative, that “tells the officer that the results he sees on the SFST are likely caused by an intoxicant.”

Skapinok advised that she was taking Wellbutrin for depression, which Chang acknowledged knowing that “in conjunction with alcohol can cause side effects that are similar to that of intoxication.” After performing the SFST, Skapinok was arrested for reckless driving and OVUII.

Prior to trial, Skapinok filed to suppress her statements made to the officers on the ground that the administration of the medical rule-out questions constitute an interrogation and were asked without the proper Miranda warnings, because the officers should have known such questions are “reasonably likely to elicit incriminating responses.” State v. Paahana, 666 P.2d 592 (Haw. 1983) (citing Rhode Island v. Innis, 446 U.S. 291 (1980)). In support of her position, she noted her response indicating her prescription for Wellbutrin, in addition to any alcohol consumption, is sufficient for an OVUII conviction under State v. Vliet, 983 P.2d 189 (Haw. 1999) (ruling that alcohol need only be a contributing cause of impairment under the state’s OVUII statute).

The State conceded that, at all times relevant to the inquiry, Skapinok was “in custody,” but that the officers’ questions were routine questions incident to standard police procedures and, as such, exempt from classification as interrogation. See Pennsylvania v. Muniz, 496 U.S. 582 (1990). The trial court rejected that argument and granted the suppression motion; the State appealed.

The Intermediate Court of Appeals (“ICA”) ruled that the medical rule-out questions are reasonably likely to elicit an incriminating response and thus constitute interrogation. The State appealed that decision.

The Supreme Court’s analysis began with article I, section 10 of the state Constitution, which provides, “[n]o person shall … be compelled in any criminal case to be a witness against himself.”

“When a confession or other evidence is obtained in violation of [this right], the prosecution will not be permitted to use it to secure a defendant’s criminal conviction.” State v. Pau’u, 824 P.2d 833 (Haw. 1992). The Court stated that Miranda warnings preserve the right against compelled self-incrimination, and statements obtained in violation of Miranda can’t be used at trial against the defendant. State v. Kazanas, 375 P.3d 1261 (Haw. 2016). In order to have statements suppressed, a defendant must show that the statements were the result of (1) interrogation that occurred (2) while in custody. Id.

The State conceded that Skapinok was in custody during the relevant time period, so the issue to be resolved was whether the medical rule-out questions constitute interrogation, according to the Court. “In determining whether an officer’s questions constitute interrogation, the test is whether the officer should have known that [their] words and actions were reasonably likely to elicit an incriminating response from the defendant.” Paahana. The Court determined that the rule-out questions do, in fact, constitute interrogation for two reasons.

First, the question about medications a defendant is taking can directly lead to self-incrimination, as was the case when Skapinok admitted to taking Wellbutrin. The Court explained that, “[e]ven if Skapinok did not consume enough alcohol to exceed the breath or blood alcohol content thresholds, she may still be guilty of OVUII if she operate[d] or assum[ed] actual physical control of a vehicle … [w]hile under the influence of alcohol in an amount sufficient to impair the person’s normal mental faculties or ability to care for the person and guard against casualty.” Citing HRS § 291E-61(a)(1). It added that while it is undetermined what amount of alcohol ingested together with Wellbutrin will cause impairment, any amount may be sufficient under the OVUII statute.

Second the Court stated that, “[a]lthough the incriminating inference may be indirect, [all] the questions [together] nevertheless adduce evidence to establish that intoxication caused any poor performance on the SFST.” It stated that the questions posed to Skapinok were designed “to gather evidence against the defendant rather than simply determining whether evidence can viably be gathered.” Since the officers could have reasonably been expected to understand their questions could produce incriminating responses and because Skapinok was in custody at the time, the medical rule-out questions were an interrogation, the Court concluded.

The Court declined to adopt a blanket exception to the interrogation test that would eliminate the need to determine whether particular questions are reasonably likely to elicit incriminating statements when the questions are necessarily attendant to a legitimate police procedure. See Muniz. It held that under the state Constitution’s self-incrimination clause, questioning by police that’s attendant to a legitimate police procedure must still be analyzed to determine whether police “knew or should have known that the questions were reasonably likely to elicit an incriminating response.” If the questions are likely to elicit incriminating statements, the questions “must be preceded by Miranda warnings in order to be admissible,” the Court instructed. 

Thus, because the medical rule-out questions constitute an interrogation and Skapinok wasn’t properly Mirandized beforehand, the answers to those questions must be suppressed, the Court ruled. 

Accordingly, the Court affirmed the ICA’s judgment suppressing Skapinok’s responses to the medical rule-out questions but for different reasons than the ICA. See: State v. Skapinok, 510 P.3d 599 (Haw. 2022). 

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