*656 Opinion
This is an appeal by the Department of Motor Vehicles (DMV post) from a judgment that mandated DMV to set aside its decision suspending respondent McDonnell’s driving license for six months pursuant to California Vehicle Code section 13353. The section creates an implied consent to a chemical test—blood, breath or urine—on the part of a driver suspected of driving under the influence of intoxicating liquor. The driver may choose which he prefers. He must be informed that his failure to submit to such test or to complete it will result in a six-month suspension of his driving privilege. He must also be advised that he does not have the right to have an attorney present before stating whether he will submit to a test or deciding which to take or during administration of the test. In the event of refhsal, upon the officer’s sworn statement that there was reasonable cause to believe that such person had been driving under the influence and had refused or failed to complete the test, DMV is required to suspend the driver’s license, effective 10 days after written notice to the driver who may demand a hearing which must be held within 15 days after receipt of request therefor.
Respondent had attended a fund raising dinner for a pharmaceutical association. Before that he had taken two Actifed tablets to allay allergic symptoms he was suffering. At a cocktail hour, he had consumed “about” four scotches. A dinner of beef or steak, pasta and dessert was served at 10:30 p.m., during the course of which he drank “about” two glasses of wine. He then played cards. He testified that when he started to leave he felt funny, disoriented and confused. At 1:05 a.m. he was stopped en route home. Officer Pina had observed that his driving had been jerky and he was going across the center line of the highway. The officer could smell alcohol on his breath and noted slurred speech and bloodshot eyes. These observations and respondent’s responses to routine field tests fully justified Pina’s arrest of respondent and the invocation of the procedures of said section 13353. Pina had reasonable cause to believe respondent had been driving while drunk.
The officer read the standard form of admonition. 1 Respondent said *657 he wanted an attorney. Pina read the form again and explained it. Respondent said he understood and agreed to take the breath test. The officers took him to the police station and on the way the standard Miranda warning was read to him. It was read only once. At the station when another officer had set up the breathalizer he refused to take the test unless an attorney was present. Explanation was again made and he was offered the other two tests but he persisted—no attorney—no test.
Some two years before his arrest, respondent, after jogging, became concerned that he may have had a small stroke or other vascular accident. He had a “little knowledge” of medical matters which, with a nód to Shakespeare, he said could be a dangerous thing. He consulted a physician and had a three-hour glucose tolerance test. He was told that he had a tendency to low blood sugar and should eat protein before exertion. He did not remember being told that attacks of hypoglycemia symptoms could be brought about by consumption of carbohydrates. The record contains no mention of hypoglycemia at that time. About a month before his arrest, there was an episode of distress after he had consumed numerous cups of coffee with sugar in each during a two-hour session with a colleague. He felt nervous, was trembling and his speech was affected. He stopped his car, went into a restaurant, had a light steak lunch and the episode passed. He decided he would no longer use sugar with coffee. He testified that he was not aware that the Actifed, drinks and dinner he’d had on the night in question could precipitate the attack he suffered.
A few days after his arrest he consulted a physician who gave him a five-hour glucose tolerance test. The doctor’s diagnosis, confirmed by a consulting internist, was that respondent suffers from reactive hypoglycemia, i.e., an abnormally small concentration of glucose in the blood stream that, if triggered by the ingestion of carbohydrates—sugar or alcohol—produces flushing, sweating, dizziness, tremulousness, confusion, disorientation and, sometimes, stupor. The doctor said these symptoms closely parallel those of intoxication. To differentiate their cause would require a blood sugar test. The doctor also testified that the condition is extremely aggravated by the consumption of alcohol; that antihistamines (which Actifed contains) exacerbate the alcohol effect; that an attack could be triggered by an amount of alcohol insufficient to cause drunkenness; that a severe attack could be expected to occur in *658 two and one-half to three hours after the ingestion of the drinks and dinner described by respondent and that judgment would be impaired during an attack.
The appeal presents the following issues:
1. Is there evidence to support the finding that respondent refused to take any test because of officer-induced confusion?
The trial court found that respondent initially agreed “to take a breath test and changed his mind because of confusion resulting from the officer’s later advice that he had a right to have a lawyer present.” DMV contends this finding has no support in the evidence. It is recognized that juxtaposition of the implied consent warnings (no right to refuse a test and no right to consult with or to have an attorney present during its administration) with the
Miranda
admonition (right to refuse interrogation and to have an attorney present at all stages of a police interrogation, etc.), is apt to induce confusion. If a driver who has been given
Miranda
insists on the presence of an attorney before choosing a test the courts have recognized that he may have been confused by the two warnings and the officer’s failure to clarify and explain the difference. In such a case the refusal to take a test has been held not to be a refusal within the meaning of said section 13353.
(Rust
v.
Department of Motor Vehicles
(1968)
Pepin
v.
Department of Motor Vehicles
(1969)
In the instant case,
Miranda
was read only once. There was no embellishment such as occurred in
Rust
v.
Department of Motor Vehicles, supra,
2. Where a refusal is the result of confusion arising from a combination of a driver’s physical condition and his use of alcohol, should the driver be exempted from the application of Vehicle Code section 13353?
Refusals to take tests have never been excused in California on any ground other than officer-induced confusion reviewed above. Refusals contingent upon the presence of a private physician or attorney are no defense to license suspension.
(Beales
v.
Dept. of Motor Vehicles
(1969)
*660 The trial court found that respondent was suffering from an involuntary and severe attack of reactive hypoglycemia which rendered him incapable of understanding the nature, purpose or effects of his acts or forming a rational response to the officer’s requests that he submit to chemical testing pursuant to the code section in question. The medical testimony contains substantial evidence to support the finding except, however, the attack was involuntary only in the sense that respondent testified he did not know or have reason to expect that the alcohol he consumed, exacerbated by Actifed and a carbohydrate rich dinner, would bring about the attack.
Although we must reject respondent’s stated contention that “confusion caused by the officer’s instructions was enhanced by (respondent’s) physical condition” because the officer’s actions and statements had nothing to do with the refusal, the appeal has been briefed, by both parties upon the basic issue as we have stated it. The crucial question becomes whether or not there is an impaired judgment defense to a license suspension under said section 13353.
The only authority advanced by respondent is the concurring opinion in
Hulshizer
v.
Department of Motor Vehicles
(1969)
Subsequent history of the
Hulshizer
concurring dictum is of interest. It did not destroy the authority of
Bush
v.
Bright, supra, 264
Cal.App.2d 788, which has since been cited with approval in
Goodman
v.
Orr, supra,
Goodman
v.
Orr, supra,
In
Fankhauser
v.
Orr, supra,
This case is one of first impression in California -as to whether or not the fact that a driver did not know he was abnormally susceptible to the effects of alcohol should excuse a refusal made when his judgment has *662 been impaired because of the unexpected results of the use of alcohol. For the following reasons we are of the opinion that an illness that is triggered by alcohol consumption and produces the symptoms of intoxication is not a defense to suspension where the arresting officer has reasonable cause to believe that a driver is intoxicated.
The legislative history of the implied consent statute and cases heretofore discussed indicate that the statute is remedial in nature and aimed at reducing the hazards of drunken driving on the highways of California. It was designed to secure the
civil
cooperation of all persons privileged to drive in providing objective scientific evidence of intoxication (or sobriety) when the privilege is being exercised. The sanction of suspension when such cooperation is refused is not a criminal penalty and does not depend upon a subsequent conviction of driving while under the influence. Hearings under the statute are civil and not criminal in nature.
(Funke
v.
Department of Motor Vehicles
(1969)
In other jurisdictions having similar statutes it has been held that there is no requirement to prove specific intent as to such refusal.
(Garcia
v.
Department of Motor Vehicles
(1969)
The conduct that triggers suspension of a license is the refusal of any person to submit to a chemical test upon the request of an officer who has reasonable cause to believe that the subject has been driving while drunk. Reasonable cause existed on the night in question. Alcohol was present on respondent’s breath. His manner of driving made him as much a menace on the highway as if he had been drunk. His drinking was entirely voluntary. He réfused any test. Nothing the police did (except their lawful request) contributed to his refusal or to any confusion that existed in his mind which may have impaired his judgment. Because alcohol was a factor, the officers had a right and were under a duty to invoke the procedures of section 13353.
In these circumstances, impaired judgment should not be a defense. An impossible burden would be placed upon law enforcement if an officer had to eliminate medical or physiological conditions of a suspect driver with alcohol on his breath as a cause for erratic driving before proceeding with the case. Our ruling makes it unnecessary to decide if an unexpected seizure unrelated to alcohol would excuse a refusal. There is merit to appellant’s argument that an abandonment of the objective standards tests would seriously impair attainment of the objectives of said section 13353. The circumstances of the case do not involve considerations that might arise if an unexpected seizure of hypoglycemia or other illness entirely unrelated to alcohol occurs when a person is already driving.
The judgment is reversed with direction to enter judgment denying the petition for writ of mandate.
Draper, P. J., and Brown (H. C.), J., concurred.
A petition for a rehearing was denied April 2, 1975, and respondent’s petition for a hearing by the Supreme Court was denied May 22, 1975. Tobriner, J., was of the opinion that the petition should be granted.
Notes
Retired judge of the superior court sitting under assignment by the Chairman of the Judicial Council.
‘Yo.u are required by State law to submit to a chemical test to determine the alcoholic content of your blood. You have a choice of whether the test is to be of your blood, breath or urine. If you refuse to submit to a test, or fail to complete a test, your driving privilege will be suspended for a period of six months. You do not have the right to talk *657 to an attorney, or have an attorney present, before stating whether you will submit to a test, before deciding which test to take, or during the administration of the test chosen.”
The last paragraph of subdivision (a) of said section 13353 is, “Any person who is dead, unconscious, or otherwise in a condition rendering him incapable of refusal shall be deemed not to have withdrawn his consent and such tests may be administered whether or not such person is told that his failure to submit to or complete the test will result in the suspension of his privilege to operate a motor vehicle."
Campbell
v.
Superior Court
(1971)
In addition to the risk that excessive force might render involuntary test results inadmissible (cf.
People
v.
Kraft
(1970)
