In re: the PEOPLE of the State of Colorado, Plaintiff, v. Noelle Dawn KELLEY, Defendant.In re: the PEOPLE of the State of Colorado, Plaintiff, v. Noelle Dawn KELLEY, Defendant.
Attorneys for Defendant: Megan A. Ring, Public Defender, Anna Schamberg, Deputy Public Defender, Centennial, Colorado
Attorneys for Respondent Arapahoe County District Court: Philip J. Weiser, Attorney General, Emily Buckley, Senior Assistant Attorney General, Denver, Colorado
En Banc
JUSTICE BERKENKOTTER delivered the Opinion of the Court, in which CHIEF JUSTICE BOATRIGHT, JUSTICE MARQUEZ, JUSTICE HOOD, JUSTICE GABRIEL, JUSTICE HART, and JUSTICE SAMOUR joined.
JUSTICE BERKENKOTTER delivered the Opinion of the Court.
¶1 Noelle Dawn Kelley was taken by ambulance to the hospital after she was involved in a car accident in which another person was injured. At the hospital, an officer investigating the accident asked Kelley if she would release her medical records to the police. She refused. After Kelley was charged with vehicular assault, careless driving, and driving under the influence, she pled not guilty and endorsed the affirmative defense of involuntary intoxication.
¶3 Kelley’s petition raises two issues. First, Kelley contends that when she endorsed the affirmative defense of involuntary intoxication, she did not impliedly waive her physician-patient privilege. She further asserts that even if she did waive the privilege, the trial court’s order requiring the release of her medical records was too broad. We conclude that (1) a party impliedly waives the physician-patient privilege when they assert the affirmative defense of involuntary intoxication, (2) the scope of the implied waiver is limited to those medical records related to the affirmative defense, and (3) the trial court’s disclosure order here was not overbroad because it was carefully limited to those medical records that related to Kelley’s endorsement of the affirmative defense of involuntary intoxication.
¶4 Second, Kelley argues that her refusal to release her medical records is inadmissible because she cannot be penalized for exercising her
¶5 For these reasons, we discharge the rule to show cause.
I. Facts and Procedural History
¶6 The People allege that on September 7, 2021, Kelley caused a car accident in Aurora, injuring another person. When Officer Lloyd Johnson arrived at the scene, Kelley was in an ambulance. Before Kelley was transported to the hospital, Officer Johnson talked with her and inquired about her registration and insurance. At that time, Officer Johnson did not notice any indicia of intoxication or find any intoxicants in Kelley’s vehicle, which she gave Officer Johnson consent to search.
¶7 After the search, the ambulance transported Kelley to the hospital to treat her injuries, and Officer Johnson followed. There, he spoke to Kelley again and noticed that her speech was slurred, her eyes were closing, she had trouble forming sentences, and she seemed confused. During their interaction, Kelley claimed she was not driving that day but had instead been a passenger on a motorcycle. Kelley’s account, however, was inconsistent with what Officer Johnson observed at the scene because the accident involved two cars. Ultimately, Kelley asked to have an attorney present. But before terminating their communication, Officer Johnson asked whether Kelley was willing to sign a release to allow the police to obtain her medical records. Kelley refused.
¶8 The People charged Kelley with vehicular assault,
¶9 The trial court subsequently held a motions hearing at which Officer Johnson testified. Applying the factors from People v. Matheny, 46 P.3d 453, 465–66 (Colo. 2002),
¶10 After the court explained its ruling, Kelley raised a separate
¶11 The People then filed a motion to reconsider and raised two issues. First, the People asked the trial court to revisit its decision to suppress Kelley’s refusal to release her medical records, citing People v. Beaver, 725 P.2d 96, 99 (Colo. App. 1986) (concluding that the refusal to consent to a search is not testimonial in nature and therefore is not entitled to Miranda protection). Second, the People argued that they were entitled to disclosure of Kelley’s relevant medical records because, in their view, she impliedly waivеd her physician-patient privilege by endorsing the affirmative defense of involuntary intoxication.
¶12 In response, the court issued an order, explaining that (1) it recognized that Beaver appeared to directly contradict its initial ruling suppressing Kelley’s refusal to consent to the release of her medical records and (2) it “perceive[d] the Defendant’s endorsement of the defense of Involuntary Intoxication ... as a potential implied waiver of her physician-patient privilege for medical records from her hospitalizаtion beginning on September 7, 2021.” However, the court did not rule on the People’s motion; instead, it ordered Kelley to file a response.
¶13 The following day, the People served a subpoena on the hospital:
YOU ARE ... COMMANDED TO PRODUCE for Noelle Dawn Kelley ... relating to a vehicular assault for the day of September 7, 2021: Any and all records, documents or notes relating to any toxicology evaluation, screen, or analysis, including breath, blood, and urine. Any and all records, evaluations, screens or testing for or detecting alcohol, controllеd substances, or any other drug. Any and all records, documents, or notes reflecting the verbal history given by Noelle Dawn Kelley.
¶14 The hospital filed the subpoenaed documents under seal with the court two weeks later.
¶15 In her response, Kelley argued that Beaver did not apply. In the alternative, she asserted—for the first time—that the trial court should deny the People’s motion for reconsideration under the
¶16 The trial court ultimately granted the People’s motion. First, it concluded that Kelley’s endorsement of involuntary intoxication constituted an implied waiver of the physician-patient privilege. The court then turned to the scope of the waiver and considered Kelley’s burden at trial to present some evidence of involuntary intoxication. Next, the court determined that the scope of the waiver was limited to the elements of her involuntary intoxication defense and included:
records from her hospitalization of September 7, 2021 as involve basic identification information for herself and her medical providers; toxicology testing results; medications prescribed to the Defendant and/or being used by the Defendant at the time of the accident; the Defendant and her medical providers’ observations of her mental and physical capacities and interactions; statements made by the Defendant related to her physical condition and mental capacities; and any observations or statements by the Defendant or her medical
providers as to her capacity to conform her conduct to the law.
¶17 Then the trial court described its in camera review of the subpoenaed documents and ordered the disclosure, with certain redactions, of twenty-seven pages of Kelley’s records from her hospitalization the night of the accident.
¶18 Finally, the court concluded that Officer Johnson’s request for Kelley’s consent to release her medical records was not an interrogation and that Kelley’s response was therefore not protected by Miranda. The court did not reach the argument Kelley raised for the first time in her response—the assertion that she could not be penalized for refusing to consent to a warrantless search under the
¶19 Kelley petitioned this court for a rule to show cause, which we issued.1
II. Analysis
¶20 Kellеy first contends that her endorsement of the affirmative defense of involuntary intoxication did not constitute an implied waiver of the physician-patient privilege, and, in the alternative, that the court’s order requiring disclosure of her records was overbroad. Second, Kelley argues that her refusal to release her medical records is inadmissible under the
A. Waiver of Physician-Patient Privilege
¶21 We begin our analysis by explaining why we choose to exercise our original jurisdiction as to this issue. Next, we provide the legal background related to the physician-patiеnt privilege. We then explain why we conclude that (1) Kelley waived her physician-patient privilege by endorsing the affirmative defense of involuntary intoxication, (2) the scope of her implied waiver was limited to those medical records related to that affirmative defense, and (3) the trial court’s order requiring disclosure of those twenty-seven pages of redacted medical records was not overbroad.
1. Original Jurisdiction and Standard of Review
¶22 “The exercise of our original jurisdiction under
2. Legal Background
¶23
¶25 Waiver “can [also] be implied through a patient’s conduct.” Alcon, 113 P.3d at 739. For instance, a party impliedly waives the physician-patient privilege when they “inject[] [their] physical or mental condition into the case as the basis of a claim or an affirmative defense.” Clark, 668 P.2d at 10. As we explained in Clark, “[w]hen the privilege holder pleads a physical or mentаl condition as the basis of a claim or as an affirmative defense, the only reasonable conclusion is that he thereby impliedly waives any claim of confidentiality respecting that same condition.” Id. Under those circumstances, the privilege holder “has utilized his physical or mental condition as the predicate for some form of judicial relief, and his legal position as to that condition is irreconcilable with a claim of confidentiality.” Id.
¶26 Although Clark was a civil case, we are not without guidance in analyzing this type of privilegе in criminal cases.2 Specifically, we have applied the same standard in criminal cases, albeit under different procedural circumstances. For instance, in People v. Sisneros, we addressed whether a trial court has the discretion to review a victim’s psychotherapy records to determine which of those records are privileged. 55 P.3d at 801. In concluding that the trial court did not have this discretion, we explained that “the proper inquiry is whether the victim has injected her physical or mental condition into the case as the basis of a сlaim or an affirmative defense.” Id.
¶27 Later, in People v. Johnson, we considered whether a juvenile impliedly waived her psychotherapist-patient privilege by requesting a reverse-transfer hearing. ¶ 13, 381 P.3d at 319. There, the trial court concluded that the reverse-transfer statute,
¶28 Most recently, we applied the Clark standard in People v. Brown, 2019 CO 50, ¶ 20, 442 P.3d 428, 433. There, the People charged Brown, who was a minor when the alleged crimes occurred, as an adult. Brown sought a reverse transfer to remove his case to juvenile court. Id. at ¶ 3, 442 P.3d at 430–31. Unlike the defendant in Johnson, Brown planned to use his medical records at the reverse-transfer hearing but sought a protective order prohibiting the prosecution from using those records against him at trial. Brown, ¶ 4, 442 P.3d at 431.
Brown, 442 P.3d at 431. 3 The trial court denied the protective order, and Brown appealed. Id. at ¶ 5–6, 442 P.3d at 431. On appeal, both parties agreed that our holding in Clark, that a party waives their privilege when they inject their “physical or mental condition into the case as the basis of a claim or an affirmative defense,” applied. Brown, ¶ 20, 442 P.3d at 433 (quoting Alcon, 113 P.3d at 739). But Brown contended that “‘as the basis of a claim or an affirmative defense’ mean[t] that he [was] only putting his physical and mental condition at issue with respect to the jurisdictional issue in the reverse-transfer hearing[,]... [not] as to the underlying alleged crimes.” Id. (quoting Alcon, 113 P.3d at 739). Rejecting Brown‘s argument, we recognized “that Brown face[d] a difficult choice regarding whether to disclose privileged information during his reverse-transfer hearing,” but concluded “that difficulty d[id]n‘t grant him the right to limit any resulting waiver to that hearing.” Id. at ¶ 31, 442 P.3d at 435.
¶29 Finally, once an implied waiver has been established, the court must also determine the scope of the waiver. “[A]n implied waiver does not grant adverse parties access to the entirety of оne‘s medical history: ‘[I]mplied waivers have always been limited by the circumstances of the case, rather than amounting to consent to general disclosure of all the patient‘s communications with his or her physician.‘” Hartmann v. Nordin, 147 P.3d 43, 50 (Colo. 2006) (alteration in original) (quoting Alcon, 113 P.3d at 739). We have explained that “[t]he scope of any implied waiver necessarily depends on the nature of the claim asserted by the patient.” Samms v. Dist. Ct., 908 P.2d 520, 529 (Colo. 1995).
3. Application
¶30 We first consider Kelley‘s assertion that she did not waive her physician-patient privilege. Then, we address Kelley‘s argument that the trial court‘s disclosure order was overbroad.
¶31 To begin, Kelley broadly argues that the plain language of the involuntary intoxication statute supports her interpretation. See
¶32 In a similar vein, Kelley contends that the absence of an express statutory waiver provision in the involuntary intoxication statute demonstrates that the General Assembly did not intend for a defendant‘s assertion of the affirmative defense to constitute a waiver. In support of this argument, Kelley points to
¶34 Separate from title 18, the General Assembly has crafted a detailed scheme that governs the affirmative defenses of insanity and impaired mental condition. See §§ 16-8-101 to - 122, C.R.S. (2022). The explicit waiver provision is contained there, in title 16, not in title 18.
¶35 Second, Kelley contends that her endorsement of the affirmative defense of involuntary intoxication merely constitutes a response to the People‘s allegation that she was voluntarily intoxicated and that she has thus not injected her physical condition into the case. But Kelley conflates pleading not guilty with endorsing an affirmative defense. Endorsing an affirmative defense is legally distinct from pleading not guilty or from denying the prosecution‘s allegations: “Affirmative defenses, including involuntary intoxication, do not simply challenge the existence of an element of the offense, but seek to justify or mitigate thе entire crime.” People v. Miller, 113 P.3d 743, 750 (Colo. 2005); accord People v. Pickering, 276 P.3d 553, 555 (Colo. 2011) (explaining that affirmative defenses “admit the defendant‘s commission of the elements of the charged act, but seek to justify, excuse, or mitigate the commission of the act“).
¶36 For these reasons, we reject Kelley‘s contentions and conclude that her endorsement of the affirmative defense of involuntary intoxication impliedly waived her physician-patient privilege. We emphasize that the scope of her waiver is limited to her medical records related to her endorsement of the affirmativе defense of involuntary intoxication. That affirmative defense, by definition, plainly implicates Kelley‘s physical or mental condition:
¶37 Finally, we conclude that the trial court‘s order requiring disclosure of Kelley‘s records was not overbroad. Contrary to Kelley‘s contention, the required disclosure is “limited by the circumstances of the case,” and does not amount to a “general disclosure of all [Kelley]‘s communications with ... her physician.” Hartmann, 147 P.3d at 50 (quoting Alcon, 113 P.3d at 739). Recall, the trial court issued a detailed order that requires only the disclosure of records from Kelley‘s September 7, 2021 hospitalization that “contain information related to involuntary intoxication.” Moreover, the trial court further narrowed the scope of the disclosure by enumerating the precise types of documents for which Kelley impliedly waived the physician-patient privilege. Then the court redacted the documents to exclude information that was not subject to the waiver. Because the court here carefully tailored the disclosure to Kelley‘s involuntary intoxication affirmative defense, the order was not overbroad. Id.
B. Admissibility of Kelley‘s Refusal to Release Her Medical Records
¶38 Kеlley also contends that her refusal to consent to releasing her medical records is inadmissible because she has the right to refuse a warrantless search under the
III. Conclusion
¶39 For the foregoing reasons, we discharge the rule as to the trial court‘s order concluding that Kelley impliedly waived her physician-patient privilege by asserting the affirmative defense of involuntary intoxicаtion and further directing the disclosure of twenty-seven redacted pages of Kelley‘s hospital records that fell within the limited scope of that waiver. We decline to address Kelley‘s