State v. Nelson

96-181




                                                                                 No. 96-181

                                                  IN THE SUPREME COURT OF THE STATE OF MONTANA

                                                                                 1997



                                                                    STATE OF MONTANA,

                                                                      Plaintiff and Respondent,

                                                                                        v.

                                                                        JAMES NELSON,

                                                                       Defendant and Appellant.




                    APPEAL FROM:                   District Court of the Seventh Judicial District,
                                                           In and for the County of Dawson,
                                                       The Honorable Dale Cox, Judge presiding.


                                                                   COUNSEL OF RECORD:

                                                                                 For Appellant:

                                               Marvin L. Howe (argued); Simonton, Howe & Schneider,
                                                                Glendive, Montana

                                                                                For Respondent:

                                       Hon. Joe Mazurek, Attorney General; John Paulson, Assistant
                                                Attorney General (argued), Helena, Montana

                                       Scott W. Herring, Deputy County Attorney, Glendive, Montana




                                                                               Submitted: May 1, 1997

                                                                               Decided:             June 24, 1997
                                                                               Filed:


                                                         __________________________________________
                                                                      Clerk

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                     Justice W. William Leaphart delivered the Opinion of the Court.



         James Nelson (Nelson) appeals from the Seventh Judicial District Court's order
   denying his motion to quash or to suppress the results of his blood alcohol test
                                           obtained
                     by means of an investigative subpoena. We affirm.
          The following facts are not in dispute. On December 7, 1994, near Glendive,
   Montana, Nelson was involved in a motor vehicle accident on Interstate 94 when he
  drifted off the highway and struck a guardrail. After Nelson received a ride from
                                               the
 accident scene to a friend's residence, Nelson's friend, Mr. Stroh, drove him to the
       Glendive Medical Center for treatment of facial injuries he sustained in the
                                          accident.
       Emergency room physician Dr. Arthur Fink treated Nelson for a broken jaw and,
concerned over Nelson's apparent lack of pain for the injury, ordered a blood test in
              order to determine his blood alcohol concentration level (BAC).
           The following morning, Nelson reported the accident to the Montana Highway
   Patrol. Highway Patrol Sergeant Jerry Mahlum (Sgt. Mahlum), a Certified Accident
 Reconstructionist, conducted the investigation of the accident. Sgt. Mahlum viewed
                                               the
 scene of the accident, determined the extent of damage to the guardrail, spoke with
                                               the
patrolman on duty the night of the accident and independently met with Nelson and Dr.
Fink. During Sgt. Mahlum's interview with Nelson, he learned that Nelson had broken
 his jaw in the accident and that it had to be wired shut as a result. Nelson told
                                              Sgt.
 Mahlum that prior to the accident he had consumed a couple of drinks at a local bar
                                               and
      that he had no recollection of the accident itself. In addition, Sgt. Mahlum
                                         determined
   that Nelson's vehicle had sustained extensive left front-end damage, the type of
                                            damage
 consistent with striking the guardrail. Sgt. Mahlum's findings led him to believe
                                          that the
    driver involved in the accident would have either fallen asleep at the wheel or
                                         would have
                       been under the influence of drugs or alcohol.
          On December 12, 1994, Sgt. Mahlum met with Dr. Fink. During the interview,
   and without divulging Nelson's BAC level, Dr. Fink told Sgt. Mahlum that Nelson's
     BAC level the night of the accident would partly explain Nelson's lack of pain
                                          normally
                           associated with his type of injuries.
          After Sgt. Mahlum compiled the findings of his investigation, Deputy County
Attorney Scott Herrin, reviewed Sgt. Mahlum's report and determined that sufficient
                                             facts
  existed to suggest an "unlawful activity had occurred" and, on December 14, 1994,
                                             filed
  a Motion for Investigative Subpoena Duces Tecum with the District Court. Setting
                                             forth


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     the facts recited above, the motion requested that the District Court issue an
                                          investigative
 subpoena to the records keeper at the Glendive Medical Center to require disclosure
                                                   of
  all medical records pertaining to Nelson's BAC taken December 7, 1994. On December
16, 1994, the District Court found that sufficient facts were present and granted the
    motion to issue the Investigative Subpoena Duces Tecum. On January 3, 1995, the
  medical reports on Nelson's blood test from December 7, 1994, were provided to the
 deputy county attorney showing that, shortly after his accident, Nelson's BAC level
                                                  was
                                                .233.
         Nelson was charged by Complaint with the offense of driving under the influence
of alcohol, a misdemeanor, in violation of            61-8-401, MCA. Nelson entered a plea of
 not guilty in Justice Court. Nelson then filed a motion to suppress evidence which
                                                  was
    denied by the Justice Court. Nelson then entered a plea of guilty reserving his
                                              right to
              appeal the denial of the motion to suppress to the District Court.
           Nelson then appealed to District Court where he filed a Motion to Quash the
   Investigative Subpoena or, in the alternative, Motion to Suppress Evidence. After
 entertaining oral argument on the motion, the District Court denied the motion with
                                                   no
   findings of fact or conclusions of law. Thereafter, Nelson entered a plea of not
                                               guilty
  and judgment was entered sentencing him to ten days in the Dawson County jail and a
  fine of $500. The sentence was stayed pending appeal to the Montana Supreme Court.
     Nelson appealed to this Court and we remanded to the District Court for further
  proceedings on the question of whether the State had established a compelling state
   interest justifying the discovery of the BAC test, as required under Article II,
                                            Section 10
     of the Montana Constitution. Pursuant to this remand order, the District Court
                                             conducted
          a hearing and filed Findings of Fact and Conclusions of Law and Judgment.
           The District Court concluded that: (1) a health care provider may disclose
                                               health
information about a patient without the patientþs authorization if the disclosure is
                                                 made
      pursuant to      50-16-530, MCA, which allows for disclosure þto a law enforcement
 officer about the general physical condition of a patient being treated in a health
                                                 care
       facility if the patient was injured on a public roadway or was injured by the
                                              possible
     criminal act of another . . . . þ Section 50-16-530(4), MCA. Further, the court
   recognized that health care information may be disclosed by a health care provider
   pursuant to       50-16-535(1)(j), MCA, when "the health care information is requested
                 pursuant to an investigative subpoena issued under 46-4-301."
         Section 46-4-301, MCA, provides the authority for the issuance of investigative
                                     subpoenas, as follows:
            Whenever a prosecutor has a duty to investigate alleged unlawful activity,
            any justice of the supreme court or district court judge of this state may
                cause subpoenas to be issued commanding the persons to whom they are
              directed to appear before the prosecutor and give testimony and produce

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              books, records, papers, documents, and other objects as may be necessary
               and proper to the investigation. A subpoena may be issued only when it
          appears upon the affidavit of the prosecutor that the administration of justice
                                      requires it to be issued.

         In the instant case, the Dawson County Attorney, relying on Sgt. Mahlumþs
investigation, filed a motion for an investigative subpoena to the Glendive Medical
                                        Center
 for release of reports of Nelson's blood alcohol level relative to the time of the
                                      accident.
The District Court found that the "administration of justice" required the subpoena
                                          be
   issued. Pursuant to the subpoena, the County Attorney received Nelsonþs blood
                                       alcohol
                      results from the Glendive Medical Center.

                                                       Questions Presented
                                   We phrase the issues on appeal as follows:
            1.         Did the taking of a blood sample from Nelson violate his constitutional
                               rights to be free from unreasonable searches?

                 2.         Did the information provided to Sgt. Mahlum by Dr. Fink exceed the
                                       provisions of   50-16-530(4), MCA?

       3.   Did release of the blood alcohol information pursuant to an investigative
    subpoena violate Nelsonþs right of privacy under Article II, Section 10 of the
                                        Montana
                                     Constitution?

                                                    Discussion
     We review a district courtþs denial of a motion to suppress to ascertain whether
  the courtþs factual findings are clearly erroneous and whether the findings were
                                      correctly
   applied as a matter of law. State v. Arthun (1995), 274 Mont. 82, 906 P.2d 216.
        1. Did the taking of a blood sample from Nelson violate his constitutional
                                        rights
                        to be free from unreasonable searches?

      Nelson contends that, since his blood was drawn at the hospital at a time when
                                          law
 enforcement was not involved, the implied consent law,    61-8-402(1), MCA, does not
apply. He contends, nonetheless, that since the blood was taken by a doctor without
                                         first
  seeking Nelsonþs consent, that the taking constitutes an illegal search and the
                                     results must
be suppressed. He cites State v. Kirkaldie (1978), 179 Mont. 283, 587 P.2d 1298, in
                              support of his contention.
         In Kirkaldie, the investigating officer and the deputy coroner asked the
                                       defendant
   to submit to a blood alcohol test and the defendant refused. The coroner then
                                       requested
 the assistance of the attending physician who testified that he advised Kirkaldie

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                                       that he
  did not have to give blood but that it was in his best interest that he do so.
                                     Kirkaldie,
587 P.2d at 1302. Kirkaldie eventually agreed to the drawing of his blood. He then
   argued on appeal that his consent was the involuntary product of psychological
                                      coercion
  by the State. Kirkaldie, 587 P.2d at 1302. We reviewed the voluntariness issue
                                        under
 the þtotality of circumstancesþ test and found substantial evidence to support the
                                        trial
 courtþs conclusion that the defendant was not coerced into consenting to the test.
                            Kirkaldie, 587 P.2d at 1303.
     The instant case is clearly distinguishable from Kirkaldie. Here, in contrast
                                          to
 Kirkaldie, there was no State involvement in the taking of the blood sample. The
                                        blood
 was drawn by a doctor at the Glendive Medical Center. The exclusionary rule, which
  Nelson seeks to invoke, does not apply to evidence resulting from the actions of
                                       private
  individuals unless they are acting as agents of the State. State v. Christensen
                                     (1990), 244
Mont. 312, 797 P.2d 893; see also State v. Baker (1995), 272 Mont. 273, 283, 901 P.2d
 54, 60. Here, there is no suggestion or argument that Dr. Fink, in drawing blood
                                         from
Nelson, was acting at the direction or request of the State. In the absence of any
                                        State
 action or involvement, Nelsonþs contention that he did not voluntarily consent and
                                         that
the drawing of his blood constituted an illegal search under the Fourth Amendment to
                                          the
 United States Constitution or Article II, Section 11 of the Montana Constitution,
                                         must
                                        fail.



                 2.
               Did the information provided to Sgt. Mahlum by Dr. Fink exceed the
                         provisions of    50-16-530(4), MCA ?
        Nelson contends that Dr. Finkþs comments to Sgt. Mahlum about Nelsonþs BAC
 were in excess of the parameters of    50-16-530(4), MCA, which allows a health care
    provider to disclose the þgeneral physical conditionþ of a patient to a law
                                     enforcement
   officer if the patient were injured on a public roadway. Although there is no
                                      definition
    of þgeneral physical condition,þ þgeneral health conditionþ is defined as the
                                      patientþs
 health status described in terms of critical, poor, fair, good, excellent or terms
                                       denoting
     similar conditions. Section 50-16-504(3), MCA. Given this narrow scope of
                                      authority,
 Nelson contends that þthe only information that Officer Mahlum should have obtained
   from Dr. Fink was Nelsonþs health status." He argues that any information which

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  exceeded the parameters of the general descriptors of critical, poor, fair, good,
                                       excellent,
                                etc. must be suppressed.
       Nelsonþs argument ignores the fact that the restrictions imposed by   50-16-530
                                           (4),
    MCA, are directed not at law enforcement but at health care providers. If, as
                                         Nelsonþs
    posits, Dr. Finkþs gratuitous comments to Sgt. Mahlum about Nelson lack of pain
 exceeded the scope of    50-16-530(4), MCA, then Nelsonþs remedy lies with the health
    care provider, not through a motion to suppress. A motion to suppress must be
                                         premised
     upon illegal conduct by state officials. Section 50-16-530(4), MCA, does not
                                        provide a
basis for suppressing evidence and, thus, the District Court did not error in denying
                            Nelsonþs motion in that regard.

       3.   Did release of the blood alcohol information pursuant to an investigative
    subpoena violate Nelsonþs right of privacy under Article II, Section 10 of the
                                        Montana
                                     Constitution?

      Nelson's next prong of attack is aimed at the fact that the State obtained the
                                         results
of his BAC test through the use of an investigative subpoena. Since an investigative
   subpoena involves state action, this presents a different issue than Dr. Fink's
                                       gratuitous
                 statement to Sgt. Mahlum about Nelson's lack of pain.
       In the context of this case, the investigative subpoena finds its roots in a
                                        series of
   statutes starting with    50-16-530(6), MCA, which provides that the health care
                                        provider
 may disclose information pursuant to compulsory process in accordance with     50-16-
      535, MCA.    Section 50-16-535, MCA provides, in relevant part, as follows:
           Health care information may not be disclosed by a health care provider
             pursuant to compulsory legal process or discovery in any judicial,
                      legislative, or administrative proceeding unless:

                                                                                            . . .

                              (c)       the patient is a party to the proceeding and has placed his
                                             physical or mental condition in issue;

                                                                                            . . .

                   (i) a court has determined that particular health care information is
              subject to compulsory legal process or discovery because the party seeking
              the information has demonstrated that there is a compelling state interest
                           that outweighs the patient's privacy interest; or

                                  (j)        the health care information is requested pursuant to an
                                             investigative subpoena issued under 46-4-301.



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            In the present case, the County Attorney filed a motion for investigative
                                           subpoena
thereby invoking subsection (j) of       50-16-535(1), MCA, which provides for release of
    health care information pursuant to such a subpoena. The motion recited that the
    "administration of justice" required the issuance of the subpoena. Further, in
                                         issuing the
   order for the subpoena, the court specifically stated that the "administration of
                                           justice"
 requires that the subpoena be issued. Thus, it is clear that the court employed the
   "administration of justice" standard of         46-4-301, MCA, under subsection (j) and
                                               that
           the compelling state interest test of subsection (i) was not at issue.
         Nelson contends that the investigative subpoena for release of his health care
information violated his right of privacy under Article II, Section 10 of the Montana
  Constitution. He points out that       50-16-535(2), MCA, provides that "[n]othing in
                                               this
      part authorizes the disclosure of health care information by compulsory legal
                                         process or
       discovery in any judicial, legislative, or administrative proceeding where
                                        disclosure is
otherwise prohibited by law." The question presented is whether Nelson's health care
 information is protected under the constitutional right of privacy and, if so, what
                                             effect
       does this protected status have on the issuance of investigative subpoenas?
        We begin our discussion by reviewing our holdings in State v. Burns (1992), 253
     Mont. 37, 830 P.2d 1318 and in State v. Henning (1993), 258 Mont. 488, 853 P.2d
                                              1223.
             In Burns, the defendant was charged with deviate sexual conduct. He had
  provided a list of some fifteen character witnesses. The State, in order to rebut
                                               and
  cross-examine these character witnesses, sought an investigative subpoena to obtain
   Burns' personnel files from the Catholic Diocese. After conducting an in camera
                                             review
of the records, the district court barred discovery of the records. Burns, 830 P.2d
                                                at
   1319. On appeal, we reiterated the two-part test from State ex rel. Great Falls
                                            Tribune
 Co. v. Eighth Judicial District Court (1989), 238 Mont. 310, 318, 777 P.2d 345, 350,
for determining whether privacy interests are protected under Article II, Section 10
                                             of the
 Montana Constitution. Burns, 830 P.2d at 1321. The two prongs of that test are as
                                          follows:
            1) Whether the person involved had a subjective or actual expectation of
                                          privacy; and,

             2)       Whether society is willing to recognize that expectation as reasonable.

      We held in Burns that it was apparent that the above test had been satisfied.

                 When discovery of documents such as personnel records are at issue,
               privacy rights are undoubtedly at stake. Montana adheres to one of the
             most stringent protection of its citizens' right to privacy in the country.

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              Mont. Const. Art. II, Sec. 10. Montana's treatment of privacy rights is
             more strict than that offered by the Federal Constitution. Montana Human
              Rights Division v. City of Billings (1982), 199 Mont. 434, 439, 649 P.2d
           1283, 1286. It is against this constitutional backdrop that we view the case
                                              at bar.

                                        Burns, 830 P.2d at 1320 (citations omitted).

        We affirmed the district court's holding that, under the circumstances of the
                                            case,
   the State could not show a compelling interest to gain access to Burns' personnel
                                           files.
 Burns, 830 P.2d at 1322. But see Montana Human Rights Div., 649 P.2d 1283 (granting
      Commission access to employment records to investigate possible violations of
  discrimination) and Great Falls Tribune v. Sheriff (1989), 238 Mont. 103, 775 P.2d
                                             1267
  (holding that the privacy interests of the employee police officers did not exceed
                                              the
                                 public's right to know).
        In Henning, the defendant was arrested for DUI and refused a breathalyser test.
 Instead of submitting to the breathalyser test, he asked the officer to take him to
                                              the
 hospital so that a blood test could be administered at his expense. Accordingly, a
                                            blood
sample was taken by a registered nurse. The results of the test were obtained by the
State pursuant to an investigative subpoena. Henning, 853 P.2d at 1226 (Trieweiler,
                                              J.,
 concurring). Henning was convicted in justice court and appealed to district court
                                            where
   he filed a motion in limine asking the court to suppress the results of the blood
                                          test as
  being inadmissible. The district court determined that, pursuant to         50-16-535(1)
                                            (i),
    MCA, the State had demonstrated a compelling interest which outweighed Henning's
privacy interests and therefore the test results were admissible under         50-16-535(1)
                                            (i),
     MCA. Henning, 853 P.2d at 1224. Henning, relying on         50-16-535, MCA, and not
   on Article II, Section 10 of the Montana Constitution (Right of Privacy), argued
                                         that his
  medical records were privileged and that the State had not satisfied the statutory
 "compelling state interest" burden under        50-16-535(1)(i), MCA. On appeal, we held
that     50-16-535, MCA, pertains to the discovery of health care information but does
                                             not
  control the admissibility of that information as evidence at trial. Henning, 853
                                          P.2d at
     1225. Since Henning had not challenged the discovery of the test results, we
                                        focused on
   the question of admissibility. We determined that since the blood was drawn with
    Henning's consent, the result of the blood sample was admissible in evidence.
                                        Kirkaldie,
   587 P.2d at 1302. "Once the evidence was discovered, it was no longer privileged
      information and the State was entitled to move for its admission at trial."

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                                       Henning, 853
                                      P.2d at 1225.
        Nelson's appeal differs from Henningþs in that Nelson does contend that the
medical information was not constitutionally discoverable under Article II, Section
                                           10 of
    the Montana Constitution which provides: þThe right of individual privacy is
                                      essential to
the well-being of a free society and shall not be infringed without the showing of a
                              compelling state interest.þ
       Nelson's claim of privacy in medical records satisfies the two-part test set
                                           forth
   above in our discussion of Burns. That is, Nelson had a subjective or actual
                                        expectation
     of privacy in his medical records and, society is willing to recognize that
                                     expectation as
                                        reasonable.
            As the California Supreme Court stated in interpreting that state's
                                     constitutional
      guarantee of privacy, Article I, Section 1 of the California Constitution:
           Legally recognized privacy interests are generally of two classes: (1)
            interests in precluding the dissemination or misuse of sensitive and
          confidential information ("informational privacy"); and (2) interests in
        making intimate personal decisions or conducting personal activities without
                observation, intrusion, or interference ("autonomy privacy").

     Hill v. National Collegiate Athletic Ass'n (Cal. 1994), 865 P.2d 633, 654.
      We agree with the California court that informational privacy is a core value
furthered by state constitutional guarantees of privacy and that the zone of privacy
                                         created
 by those provisions extends to the details of a patient's medical and psychiatric
                                        history.
  Cutter v. Brownbridge (1986), 228 Cal.Rptr. 545, 549. In Cutter, the California
                                          court
                                       explained:
         [T]he right to control circulation of personal information is fundamental.
          This right reaches beyond the interests protected by the common law right
          of privacy, and may be protected from infringement by either the state or
        by any individual. The "zones of privacy" created by article 1, section 1,
       extend to the details of one's medical history. And, an "individual's right
       to privacy encompasses not only the state of his mind, but also his viscera,
            detailed complaints of physical ills, and their emotional overtones."

  Cutter, 228 Cal.Rptr. at 549 (citations omitted). See also Dr. K v. State Bd. of
                                      Physician
   Quality Assur. (Md. Ct. Spec. App. 1993), 632 A.2d 453, 457 (holding that every
                                       citizen
        has a constitutional right of privacy in his or her medical records).
        Although medical records have not been historically protected by the Fourth
Amendment's prohibition against unreasonable searches and seizures, see Whalen v. Roe
   (1977), 429 U.S. 589, 604 n.32, 97 S.Ct. 869, 878 n.32, 51 L.Ed.2d 64, 76 n.32,
Montana's separate constitutional guarantee of privacy expands the breadth of privacy
 beyond traditional search and seizure principles derived from the Fourth Amendment

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                                              and
    Article II, Section 11 of the Montana Constitution. See State v. Siegal (Mont.
                                          1997), 934
  P.2d 176, 191, 54 St.Rep. 158, 163-64, and State v. Bullock (1995), 272 Mont. 361,
 384, 901 P.2d 61, 72 (both decisions holding that Montana's constitutional right of
privacy is broader than the right of privacy under the Federal Constitution). We now
      hold that Article II, Section 10's guarantee of privacy encompasses not only
                                          "autonomy
                 privacy" but confidential "informational privacy" as well.
          We hold further that, if the right of informational privacy is to have any
                                           meaning
it must, at a minimum, encompass the sanctity of oneþs medical records. In contrast
                                              to
  telephone company billing records, for which there is no reasonable expectation of
  privacy, Hastetter v. Behan (1982), 196 Mont. 280, 283, 639 P.2d 510, 511, medical
 records fall within the zone of privacy protected by Article II, Section 10 of the
                                           Montana
Constitution. As the Montana Legislature has recognized, "health care information is
     personal and sensitive information that if improperly used or released may do
                                         significant
    harm to a patient's interests in privacy and health care or other interests."
                                       Section 50-16-
 502(1), MCA. Medical records are quintessentially þprivateþ and deserve the utmost
                                constitutional protection.
          Nelsonþs medical records were discovered via an investigative subpoena under
   46-4-301, MCA. This statute allows an investigative subpoena to be issued if the
    administration of justice so requires. Although the administration of justice
                                        threshold had
 not been defined, it is safe to conclude that it is considerably less exacting than
                                              the
  þcompelling state interestþ test demanded by Article II, Section 10's guarantee of
                                           privacy.
 State v. Baldwin (1990), 242 Mont. 176, 182, 789 P.2d 1215, 1220 (the prerequisites
                                              for
        obtaining a search warrant are more stringent than those for acquiring an
                                        investigative
  subpoena). We hold that, as applied to the discovery of constitutionally protected
     materials such as medical records, the þadministration of justiceþ standard is
     unconstitutional. Medical records may be discovered through an investigative
                                           subpoena
  only upon a showing of a compelling state interest under Article II, Section 10 of
                                              the
Montana Constitution. Since this is an issue of first impression in Montana, we must
         define a test for determining whether a compelling state interest exists.
            We note that under similar circumstances, a Pennsylvania court employed a
   probable cause standard. In Commonwealth of Pennsylvania v. Moore (Pa. Super Ct.
  1993), 635 A.2d 625, the police sought a subpoena for defendant's medical records.
  Based upon observations and information given by witnesses to the fatal accident,
                                            police
  were aware that the defendant had been involved in a serious accident in which his
   vehicle had crossed into the lane for oncoming traffic and that alcohol had been
                                           detected

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on his breath.       "This constituted probable cause to believe that a criminal offense
                                              had
                been committed." Moore, 635 A.2d at 627. The court concluded:
              Under these circumstances, we conclude, as did the trial court, that the
              police use of a subpoena to compel the production of appellant's medical
              records for the preliminary hearing did not violate any constitutionally
            protected right of privacy which appellant possessed in his medical records.

                        Moore, 635 A.2d at 627 (citation omitted).
          As we set forth above, Article II, Section 10 of the Montana Constitution
                                           expands
  the breadth of privacy beyond that recognized under Article II, Section 11 of the
                                           Montana
    Constitution. In requiring a "compelling state interest" it does not, however,
                                         establish
   a new or heightened level of protection for any particular privacy interest. The
                                             home,
 for example, has always been afforded protection under Article II, Section 11 of the
    Montana Constitution and the Fourth Amendment to the United States Constitution.
Although the home likewise comes under the privacy protection of Article II, Section
                                              10,
 it does not, by virtue of Article II, Section 10 have any "more" protection than it
                                              had
    under Article II, Section 11. Rather, Article II, Section 10 is broader in the
                                        sense that
     it encompasses information and activities in addition to places and persons.
                                       Nonetheless,
 privacy rights, whether under Article II, Section 11 of the Montana Constitution or
                                             under
Article II, Section 10 of the Montana Constitution are not absolute. State v. Pastos
(1994), 269 Mont. 43, 47, 887 P.2d 199, 202. They must yield to the State's interest
                                               in
             conducting reasonable searches upon a showing of probable cause.
        When an investigative subpoena seeks discovery of protected medical records or
  information, the subpoena can be likened to a search warrant which must satisfy the
      strictures of the Fourth Amendment and Article II, Section 11 of the Montana
 Constitution. A search warrant can only issue upon a showing of þprobable cause.þ
                                               In
      the context of search and seizure law, probable cause exists when facts and
                                      circumstances
presented to a magistrate would warrant an honest belief in the mind of a reasonable
                                              and
prudent person that an offense has been, or is being, committed and that property (or
 information) sought exists at the place designated. Section 46-5-221, MCA; Siegal,
                                              934
   P.2d at 193. We hold that in order to establish that there is a compelling state
                                          interest
 for the issuance of an investigative subpoena for the discovery of medical records,
                                              the
    State must show probable cause to believe that an offense has been committed and
 medical information relative to the commission of that offense is in the possession
                                            of the

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                 person or institution to whom the subpoena is directed.
      We turn then to the question of whether, under the facts in this case, there was
    probable cause to believe that an offense had been committed and that Nelsonþs
                                          medical
records contained evidence of the offense. The motion for investigative subpoena was
 based upon Sgt. Mahlumþs report that Nelson was involved in an unreported automobile
   accident in which Nelsonþs vehicle was traveling west, drifted left and struck a
                                         guardrail
  and Nelson received injuries; that a Mr. Stroh transported Nelson to the Glendive
      Medical Center where Nelson received emergency room treatment; and that when
 interviewed by Sgt. Mahlum, Nelson indicated that he had consumed a couple of drinks
prior to the accident. Even if we disregard Dr. Fink's thinly veiled comment to Sgt.
  Mahlum as to the reason for Nelson's lack of pain, the balance of the information
                                           known
to law enforcement was sufficient to establish probable cause. That is, that Nelson
                                            had
   consumed a couple of drinks before the accident; that the road was bare and dry;
                                          that he
ran into a guardrail; that he suffered a broken jaw; and that he had received medical
                         treatment at the Glendive Medical Center.
       We reiterate our holding as follows: Medical records and medical information are
protected under Article II, Section 10's guarantee of privacy. When an investigative
    subpoena seeks discovery of medical records, the subpoena can issue only upon a
  showing of a compelling state interest. In order to establish the existence of a
                                        compelling
  state interest to justify the issuance of an investigative subpoena, the State must
demonstrate þprobable causeþ just as it would if it were seeking issuance of a search
    warrant under Article II, Section 11 of the Montana Constitution and the Fourth
                       Amendment to the United States Constitution.
          The order denying the motion to quash the investigative subpoena, or in the
                     alternative to suppress the evidence is affirmed.

                                                                                                  /S/       W. WILLIAM LEAPHART

                                                                            We concur:

                                                               /S/ J. A. TURNAGE
                                                               /S/ KARLA M. GRAY
                                                            /S/ TERRY N. TRIEWEILER
                                                                /S/ JIM REGNIER
                                                              /S/ JAMES C. NELSON
                                                            /S/ WILLIAM E. HUNT, SR.




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