State v. Skapinok. ( 2022 )


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  • *** FOR PUBLICATION IN WEST’S HAWAI‘I REPORTS AND PACIFIC REPORTER ***
    Electronically Filed
    Supreme Court
    SCWC-XX-XXXXXXX
    03-JUN-2022
    10:22 AM
    Dkt. 19 OP
    IN THE SUPREME COURT OF THE STATE OF HAWAI‘I
    ---o0o---
    STATE OF HAWAI‘I,
    Petitioner and Respondent/Plaintiff-Appellant,
    vs.
    LEAH SKAPINOK,
    Respondent and Petitioner/Defendant-Appellee.
    SCWC-XX-XXXXXXX
    CERTIORARI TO THE INTERMEDIATE COURT OF APPEALS
    (CAAP-XX-XXXXXXX; CASE NO. 1DTA-19-01048)
    JUNE 3, 2022
    RECKTENWALD, C.J., NAKAYAMA, AND McKENNA, JJ., AND
    CIRCUIT JUDGE WONG, ASSIGNED BY REASON OF VACANCY,
    WITH WILSON, J., DISSENTING
    OPINION OF THE COURT BY RECKTENWALD, C.J.
    I.     INTRODUCTION
    This case requires us to examine the practice of
    asking so-called medical rule-out questions in the course of an
    Operating a Vehicle Under the Influence of an Intoxicant (OVUII)
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    investigation.    An officer administering a standardized field
    sobriety test (SFST) to an OVUII suspect asks the medical rule-
    out questions, which “rule out” other reasons, besides
    intoxication, for poor performance on the SFST.         Leah Skapinok
    was asked seven medical rule-out questions while in police
    custody, before she was advised of her Miranda 1 rights.       If the
    questions were interrogation, article I, section 10 of the
    Hawai‘i Constitution requires that her answers to them be
    suppressed.
    We hold that these questions are interrogation under
    the Hawai‘i Constitution.     There is no per se exception under the
    Hawai‘i Constitution for questions “necessarily ‘attendant to’
    [a] legitimate police procedure.”        Pennsylvania v. Muniz, 
    496 U.S. 582
    , 605 (1990) (citation omitted).         To avoid suppression
    for want of Miranda warnings, such questions must pass muster
    under our well-established interrogation test: “whether the
    officer should have known that his words and actions were
    reasonably likely to elicit an incriminating response from the
    defendant.”   State v. Paahana, 
    66 Haw. 499
    , 503, 
    666 P.2d 592
    ,
    595–96 (1983) (citing Rhode Island v. Innis, 
    446 U.S. 291
    , 301
    (1980)).   The medical rule-out questions asked to Skapinok in
    this case were “reasonably likely to elicit an incriminating
    1     Miranda v. Arizona, 
    384 U.S. 436
     (1966).
    2
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    response” because her answers to them aided in interpreting the
    SFSTs’ results – that is, her answers supported the inference
    that she was intoxicated because no medical cause could explain
    any aberrations in her test performance.          Skapinok’s answers to
    the medical rule-out questions must be suppressed.
    But we cannot say the same for any of the other
    challenged evidence.      Neither asking whether Skapinok would
    participate in the SFST nor asking whether she understood the
    instructions to the test would be reasonably likely to elicit an
    incriminating response.       And the evidence gathered thereafter,
    including her performance on the SFST, was not an exploitation
    of, or benefit derived from, the medical rule-out questions;
    accordingly, subsequent evidence was not the fruit of the
    poisonous tree.
    II.   BACKGROUND
    A.    Skapinok’s Arrest
    On August 18, 2019, around 11:00 p.m., Honolulu Police
    Department (HPD) Officer William Meredith observed a white
    Toyota Tacoma speeding down King Street in Honolulu. 2           He
    followed the vehicle onto Ward Avenue, where he observed it
    “weaving through traffic”; the truck then turned right onto the
    H-1 freeway onramp, merged onto the freeway, “cross[ed] over a
    2     This account of Skapinok’s arrest comes from the District Court
    of the First Circuit’s findings of fact in the order granting Skapinok’s
    motion to suppress, which are not contested on appeal.
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    solid white line,” and “crossed three lanes of the freeway to
    the left without a turn signal.”          After following the truck on
    the freeway, which appeared to be speeding, Officer Meredith
    pulled the vehicle over.       “Based on his observations, Officer
    Meredith characterized Defendant’s driving as Reckless Driving,”
    which is a petty misdemeanor under Hawai‘i Revised Statutes (HRS)
    § 291-2 (2007). 3
    When Officer Meredith approached the driver’s side and
    spoke with Skapinok, he “noticed a strong odor of alcohol coming
    from Defendant and observed Defendant’s eyes to be red, glassy
    and bloodshot.”     Officer Meredith asked if she would participate
    in an SFST; she “became argumentative” at first, but ultimately
    consented after Officer Meredith informed her that “if she did
    not participate in an SFST, that he would arrest her.”
    Officer Meredith waited for another officer, Corporal
    Ernest Chang, to arrive; 4 when Corporal Chang was informed by
    Officer Meredith, outside of Skapinok’s presence, of the reason
    for the traffic stop, he agreed that Skapinok could be arrested
    for reckless driving.      Corporal Chang then “approached
    Defendant’s vehicle and began conversing with her.            Corporal
    3     HRS § 291-2 provides: “Whoever operates any vehicle . . .
    recklessly in disregard of the safety of persons or property is guilty of
    reckless driving of [a] vehicle . . . and shall be fined not more than $1,000
    or imprisoned not more than thirty days, or both.”
    4     The record does not indicate how long Skapinok and Officer
    Meredith waited for Corporal Chang, but testimony indicated that the traffic
    stop took about thirty minutes in total.
    4
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    Chang asked Defendant if she would be willing to participate in
    an SFST.”    Skapinok asked whether she would be arrested if she
    did not participate, and “Corporal Chang told Defendant that she
    could already be arrested for reckless driving.”             Skapinok again
    consented to the SFST.
    Corporal Chang asked a series of questions known as
    the medical rule-out questions prior to administering the SFST:
    i.     Do you have any physical defects or speech
    impediments?
    ii.    Are you taking any medications?
    iii.   Are you under the care of a doctor or dentist for
    anything?
    iv.    Are you under the care of an eye doctor?
    iv.    Do you have an artificial or glass eye?
    v.     Are you epileptic or diabetic?
    vi.    Are you blind in either eye?
    According to Corporal Chang’s testimony, the
    medical rule-out questions “must be asked to administer the
    SFST safely” and when answered in the negative, it “tells
    the officer that the results he sees on the SFST are likely
    caused by an intoxicant.”        Corporal Chang “never
    administers an SFST without first asking the [medical rule-
    out] questions.”
    Skapinok responded “no” to all questions except
    that she told Corporal Chang that she was taking the
    medication Wellbutrin and that she was seeing a doctor for
    depression.       Corporal Chang knew “that ingesting Wellbutrin
    in conjunction with alcohol can cause side effects that are
    similar to that of intoxication.”
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    After performing the SFST, Skapinok was arrested
    for OVUII and reckless driving.       Neither Corporal Chang nor
    Officer Meredith administered Miranda warnings prior to her
    arrest.
    B.   District Court Proceedings
    Skapinok was charged in the District Court of the
    First Circuit (district court) 5 with OVUII in violation of HRS
    §§ 291E-61(a)(1) and/or (a)(3) (2018). 6
    1.    Motion to Suppress
    Skapinok moved to suppress “[a]ny statements made by
    Defendant to [HPD] Officers or other governmental personnel” and
    “[a]ny and all evidence seized or information gained by the
    [HPD] after Defendant was placed under arrest, [and] was not
    read [their] Miranda rights.”       The motion argued that Skapinok
    was both in custody and subjected to interrogation during the
    traffic stop.    Skapinok contended she was subjected to
    interrogation when the officer asked if she would like to
    5    The Honorable Summer M. M. Kupau-Odo presided.
    6    HRS § 291E-61 provides in relevant part:
    (a) A person commits the offense of operating a vehicle
    under the influence of an intoxicant if the person operates
    or assumes actual physical control of a vehicle:
    (1) While 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; [or]
    . . . .
    (3) With .08 or more grams of alcohol per two hundred
    ten liters of breath[.]
    6
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    participate in the SFST; during the communications that occurred
    during the test itself (e.g., counting aloud during one
    component of the SFST); when she was asked the medical rule-out
    questions; and when asked if she understood the field sobriety
    test instructions or had any questions about them.
    Officer Meredith and Corporal Chang testified at the
    hearing on the Motion to Suppress.     Officer Meredith first
    testified that after pulling Skapinok over, he “observed that
    the defendant had red, glassy, bloodshot eyes and a strong odor
    of alcoholic beverage as [he] was talking to her.”       Skapinok
    stipulated to the admission of edited body-camera footage.         In
    the footage, Officer Meredith explained to Skapinok why she was
    pulled over – for speeding and swerving – and informed her that
    he could “smell a lot of alcohol coming from [her].”       Officer
    Meredith asked Skapinok if she would like to do a field sobriety
    test, to which she responded, “No. I’m – I just got off work.
    I’m in my work uniform,” and added, “I swear I haven’t been
    drinking.”
    Officer Meredith then told Skapinok that participating
    in the test was voluntary, but that if she did not, she would be
    arrested under suspicion of driving under the influence.       A
    lengthy exchange followed in which Skapinok repeated several
    times that she had not had any alcohol.     In its findings of
    fact, the district court characterized Skapinok as
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    “argumentative with Officer Meredith” during this exchange.
    Officer Meredith replied that he was not asking her if she was
    drinking, he was only conveying his observations and asking if
    she would participate in the test.
    On cross-examination, Officer Meredith testified that
    he would characterize Skapinok’s driving as reckless and that he
    had probable cause to arrest her for either OVUII or reckless
    driving even without the SFST.        Additionally, he testified that
    “very early on in [the] conversation she was not free to leave
    the scene” and that he told Skapinok three times that if she
    declined to do the SFST, she would be arrested.           Thirty minutes
    passed from the time that he stopped the vehicle to her arrest.
    Corporal Chang testified thereafter. 7        Skapinok
    stipulated to the admission of Corporal Chang’s body-camera
    footage, which showed, as relevant here, the following
    interaction:
    [CORPORAL] CHANG: (Inaudible.) Hello, ma’am. So I’m
    Officer Chang. I’m just here to offer you the standardized
    field sobriety test. Do you want to take the test, ma’am?
    THE DEFENDANT: (Inaudible.)
    [CORPORAL] CHANG: No, it’s up to you.
    THE DEFENDANT: (Inaudible.)
    [CORPORAL] CHANG: Okay. Possibly. Yeah. Possibly.
    I mean just to be honest with you, there’s already enough
    to arrest you just for the reckless driving alone.
    7     Skapinok stipulated for purposes of the hearing that Chang was
    qualified to administer and evaluate the SFST.
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    THE DEFENDANT: Just because I was speeding?
    [CORPORAL] CHANG: Yeah. ‘Cause you -- well, you
    committed multiple traffic violations.
    THE DEFENDANT: How?
    [CORPORAL] CHANG: So anyway I’m not here to -- I’m
    not here to talk about that in detail because I didn’t stop
    you. I’m just letting you know the officer apprised me of
    why he stopped you, and there’s multiple traffic
    violations. All -- I mean it’s not only the speeding.
    There’s, you know, cutting off cars. And, like I said, I’m
    just letting you know it’s reckless driving. You may be
    arrested for that as well. Just letting you know. So if
    you want to try the field test, you gotta get out of your
    car, please.
    Corporal Chang then testified that, consistent with
    his training, he asked Skapinok the seven medical rule-out
    questions before administering the SFST.         Corporal Chang
    testified that he asked the questions because “they are things
    that may affect [a suspect’s] ability to perform the test,” and
    it is “necessary to ask these questions to perform the test
    safely.”   He further testified that based on his training and
    experience, he was not permitted to administer the SFST without
    first asking the medical rule-out questions, nor had he ever
    done so.   In response, Skapinok said “no to everything” except
    that she was taking medication – Wellbutrin, which she said was
    for depression – and was under the care of a doctor for
    depression.   He then gave the instructions for each component of
    the SFST in turn, asking if Skapinok understood after each set
    of directions.
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    On cross-examination, Corporal Chang confirmed that he
    implied to Skapinok she would be arrested for reckless driving
    if she declined the test.    He further testified that he needed
    consent to do the SFST.    In addition, Corporal Chang testified
    that the medical rule-out questions help “determine if there’s
    going to be any type of medical or physical condition that might
    affect the results of the [SFST.]”     If a person answers all
    “nos” to the medical rule-out questions, “that tells [Corporal
    Chang] that a person is medically and physically fit to perform
    the test,” and “focuses [his] attention away from medical and
    physical problems and it focuses it more on a cause by an
    intoxicant.”   If a person indicates that they understand the
    instructions, but fails to follow them, that might indicate
    “that they are possibly mentally impaired by an intoxicant.”        If
    a person responds that they don’t understand the instructions to
    the SFST, that, too, might “possibly” indicate that person is
    “mentally confused or impaired by an intoxicant.”
    Corporal Chang also testified on cross-examination
    that he knew Wellbutrin “can have an effect” when it
    “interact[s] with alcohol . . . lead[ing] to certain symptoms
    that may look like impairment.”     On redirect, he testified that
    taking Wellbutrin is not a crime.
    Skapinok argued that she was in custody during the
    traffic stop and that the question of whether she would consent
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    to the SFST was interrogation because if she refused, it could
    be used against her to support consciousness of guilt per State
    v. Ferm, 94 Hawaiʻi 17, 
    7 P.3d 193
     (App. 2000).      Likewise, she
    argued the medical rule-out questions were “reasonably likely to
    elicit incriminating responses” and in fact did elicit an
    incriminating response, because Wellbutrin “can interact with
    alcohol to show symptoms of . . . impair[ment]”; Skapinok argued
    that alcohol need only be a contributing cause of impairment
    under the OVUII statute pursuant to State v. Vliet, 91 Hawaiʻi
    288, 
    983 P.2d 189
     (1999).    Asking whether she understood the
    questions would likewise be reasonably likely to elicit an
    incriminating response because a negative answer would indicate
    impairment, and a positive answer would also indicate impairment
    if she failed to follow the instructions.      Skapinok emphasized
    that Corporal Chang “is not even permitted to administer the
    [SFST] without asking” the medical rule-out questions and
    whether the suspect understands the instructions; she argued
    that the results of the SFST must therefore be suppressed as
    fruit of the poisonous tree as well.
    The State conceded that there was probable cause to
    arrest for reckless driving but argued that “no interrogation
    occurred and so therefore there was no custodial interrogation
    although the defendant was in custody.”     The State contended
    that none of the medical rule-out questions “are explicitly
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    exculpatory or inculpatory”; even Skapinok’s answer regarding
    Wellbutrin was not incriminating because “taking Wellbutrin by
    itself is not a crime.”      The State pointed to Muniz, which it
    argued held “questions . . . which were just part of the [SFST]
    were fine” but may become interrogation “when the officers
    exceeded that scope.”     The State argued that Officer Meredith’s
    repeated statements in the body-camera footage that he did not
    ask about her drinking suggested that the officers were “taking
    special precautions not to interrogate the defendant.             They’re
    just administering the standardized field sobriety test.”
    2.   District Court’s FOFs and COLs
    The court ruled in favor of Skapinok, finding that
    there was custodial interrogation.        The district court’s written
    findings of fact (FOFs) and conclusions of law (COLs) state in
    relevant part as follows:
    FINDINGS OF FACT
    . . . .
    12.   Defendant was the focus of an OVUII investigation.
    13.   Corporal Chang cannot conduct the SFST unless a
    person consents to the test.
    . . . .
    17.   Prior to administering the SFST, Corporal Chang asked
    Defendant the following questions:
    i.     Do you have any physical defects or speech
    impediments?
    ii.    Are you taking any medications?
    iii.   Are you under the care of a doctor or dentist
    for anything?
    iv.    Are you under the care of an eye doctor?
    v.     Do you have an artificial or glass eye?
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    vi.    Are you epileptic or diabetic?
    vii.   Are you blind in either eye?
    . . . .
    21.   The [medical rule-out] questions are to “rule-out”
    medical causes that might cause a person to perform
    poorly on the SFST. If a person answers “no” to all
    the [medical rule-out] questions, it tells the
    officer that the results he sees on the SFST are
    likely caused by an intoxicant[,] [a]s opposed to
    medical or physical conditions.
    22.   The [medical rule-out] questions must be asked to
    administer the SFST safely.
    23.   Based on his training, Corporal Chang never
    administers an SFST without first asking the [medical
    rule-out] questions. Corporal Chang testified that
    he is not permitted to administer an SFST without
    first asking the [medical rule-out] questions.[ 8]
    . . . .
    27.    Defendant was arrested for OVUII and Reckless
    Driving.
    28.   Defendant was never advised of her Miranda rights or
    her right to remain silent. At no point in time did
    either officer tell Defendant anything she said could
    be used against her.
    CONCLUSIONS OF LAW
    . . . .
    9.     The Hawai[ʻ]i Supreme Court has defined
    “interrogation” as “express questioning or its
    functional equivalent.” The Court has also stated
    that “to the extent that, under article I, section
    10, the ultimate question regarding “interrogation”
    is whether the questioning officer knew or reasonably
    should have known that [their] question was likely to
    elicit an incriminating response” and that
    “interrogation consists of any express question – or,
    absent an express question, any words or conduct –
    that the officer knows or reasonably should know is
    likely to elicit an incriminating response.” State
    8     We note that this sentence is   a recitation of the testimony of a
    witness, which is not a finding of fact.    See Dep’t of Env’t Servs., City &
    Cnty. of Honolulu v. Land Use Comm’n, 127   Hawai‘i 5, 15 n.12, 
    275 P.3d 809
    ,
    819 n.12 (2012) (“We encourage courts and   factfinding tribunals to properly
    state their findings . . . and not merely   recite testimony.”).
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    v. Kazanas, 138 Haw[aiʻi] 23, [38, 
    375 P.3d 1261
    ,
    1276] (2016).
    10.   Asking Defendant if she was willing to participate in
    the SFST constituted custodial interrogation because
    she was not free to leave, she was the focus of an
    OVUII investigation and officers had probable cause
    to arrest her. Asking a person if they would be
    willing to participate in a SFST is reasonably likely
    to elicit an incriminating response. For example,
    refusing to participate in the SFST can be used at
    trial to show consciousness of guilt pursuant to
    State v. Ferm, 94 Haw[aiʻi] 17, 
    7 P.3d 193
     (2000).
    . . . .
    12.   The results of the SFST and the responses to the
    [medical rule-out] questions will likely be used
    against Defendant at trial.
    13.   The [medical rule-out] questions in this case
    constituted custodial interrogation and were
    reasonably likely to elicit incriminating responses.
    In this particular case, the [medical rule-out]
    questions did elicit incriminating responses.
    Defendant stated that she was taking the medication
    Wellbutrin. Alcohol ingested in conjunction with
    medication which causes intoxication is a basis for
    OVUII . . . as alcohol only has to be a contributing
    factor in impairment.
    . . . .
    15.   Corporal Chang’s questioning during the SFST as to
    whether Defendant understood the instructions was
    reasonabl[y] likely to elicit an incriminating
    response. If Defendant answered “no,” it would be
    commentary on her mental faculties and ability to
    understand the instructions. If Defendant answered
    “yes,” and did not perform the test as instructed,
    her “yes” response could be used against her at trial
    to show her mental faculties were impaired.
    16.   Defendant’s consent to the SFST is suppressed and all
    evidence obtained after the consent i[s] fruit of the
    poisonous tree.
    17.   The [medical rule-out] questions are suppressed and
    all evidence obtained by HPD after the [medical rule-
    out] questions are suppressed as fruit of the
    poisonous tree.
    18.   Defendant’s answer that she understood the
    instructions during the SFST is suppressed and the
    SFST is suppressed as fruit of the poisonous tree.
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    19.    Defendant’s statements while she was still in the
    vehicle in response to Officer Meredith’s statement
    that he was not asking whether she was drinking is
    suppressed.
    C.   Intermediate Court of Appeals (ICA) Proceedings
    The State appealed, and the ICA affirmed in part and
    vacated in part the district court in a memorandum opinion,
    relying primarily on the ICA’s published opinion in State v.
    Sagapolutele-Silva, 147 Hawai‘i 92, 
    464 P.3d 880
     (App. 2020).
    As set forth in Sagapolutele-Silva, as applied in this
    case, the defendant’s physical performance on a field
    sobriety test was not testimonial, and the defendant’s
    responses to whether she would participate in the test and
    whether she understood the instructions were attendant to
    legitimate police procedures, and should not have been
    suppressed. We further hold, however, that the medical
    rule-out questions posed by the officer were reasonably
    likely to elicit an incriminating response, and that the
    District Court did not err in suppressing those statements.
    Finally, for the reasons stated below, we conclude that a
    statement made by the defendant in response to being asked
    whether she would participate in the test and being told
    that she was not being asked whether she was drinking, was
    not the result of custodial interrogation and should not
    have been suppressed.
    State v. Skapinok, No. CAAP-XX-XXXXXXX, 
    2020 WL 2991783
    , at *1
    (App. June 4, 2020) (mem.)
    The ICA reasoned that “the touchstone in analyzing
    whether ‘interrogation’ has taken place is whether the police
    officer ‘should have known that [their] words and actions were
    reasonably likely to elicit an incriminating response from the
    defendant.’”    Id. at *5 (quoting Kazanas, 138 Hawai‘i at 38, 375
    P.3d at 1276).    Skapinok was under investigation for OVUII at
    the time the relevant questions were asked, and Officer
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    Meredith’s observations of her driving, her eyes, and the smell
    of alcohol furnished reasonable suspicion (but not probable
    cause) for OVUII.    Id.   Because “the right against self-
    incrimination is not necessarily implicated whenever a person
    suspected of criminal activity is compelled in some way to
    cooperate in developing evidence which may be used against her,
    such as when a driver is asked to participate in a SFST,” and in
    light of Muniz’s holding that questions “necessarily ‘attendant
    to’ the police procedure” are permissible, the ICA held the
    district court “erred by suppressing Skapinok’s response to
    whether she would participate in the SFST, whether she
    understood the instructions to the SFST, and the officer's
    observations of her performance on the SFST.”      Id. at *6 (first
    citing State v. Wyatt, 
    67 Haw. 293
    , 302, 
    687 P.2d 544
    , 551
    (1984); then citing Muniz, 
    496 U.S. at 603-04
    ).
    However, the ICA concluded that the medical rule-out
    questions were “reasonably likely to elicit an incriminating
    response.”    
    Id.
     (quoting Kazanas, 138 Hawai‘i at 38, 375 P.3d at
    1276).    “An incriminating response is any response, either
    inculpatory or exculpatory.”     Id. (citing Innis, 
    446 U.S. at
    301
    n.5).    But the ICA noted that a physical response – like the
    “inability to articulate words in a clear manner” – is not a
    testimonial response requiring Miranda warnings.      
    Id.
     (citing
    Muniz, 
    496 U.S. at 590-91
    ).     The ICA held: “Based on, inter
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    alia, our analysis in Sagapolutele-Silva, we conclude that the
    medical rule-out questions posed to Skapinok were reasonably
    likely to elicit an incriminating response and, therefore,
    constituted interrogation.”     
    Id.
    The ICA finally addressed the district court’s
    suppression of Skapinok’s statements in response to Officer
    Meredith’s statements that he wasn’t asking her if she was
    drinking, concluding that this was error.      Id. at *8.   The ICA
    reasoned that “informing a defendant of the reason for being
    stopped or arrested does not constitute custodial interrogation
    likely to elicit an incriminating response,” and that Officer
    Meredith’s statements were otherwise “attendant to a permissible
    OVUII investigation.”    Id.   “We cannot conclude that Officer
    Meredith informing Skapinok that he was not asking her if she
    was drinking was reasonably likely to elicit an incriminating
    response and therefore, it did not constitute interrogation.”
    Id.
    D.    Supreme Court Proceedings
    Both the State and Skapinok sought review in this
    court.   The State’s application for writ of certiorari presents
    two questions: (1) “[w]hether the ICA gravely erred in holding
    that the medical rule-out questions asked as part of the [SFST]
    are interrogation” and (2) “[w]hether the ICA gravely erred in
    affirming the suppression of [Skapinok’s] answers to the medical
    17
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    rule-out questions.”
    In Skapinok’s application for writ of certiorari, she
    first contends that the ICA correctly held that the medical
    rule-out questions were interrogation, but failed to address the
    district court’s conclusion of law that “all evidence obtained
    by HPD after the [medical rule-out] questions are suppressed as
    fruit of the poisonous tree.”        Skapinok next challenges the
    ICA’s conclusion that the district court’s COL 7 9 was erroneous,
    arguing that “[t]he ICA gravely erred in holding that Skapinok
    was not in ‘custody’ for the ‘separate and distinct[]
    investigation’ for OVUII.” 10     Finally, Skapinok asks us to
    correct the ICA’s “gravely erroneous holding” that “Skapinok’s
    9     The district court’s COL 7 held that the officers had probable
    cause prior to the administration of the SFST, and that custody had attached:
    At the time that Defendant was sitting in her vehicle,
    prior to the administration of the SFST, she was not free
    to leave, she was the focus of an OVUII investigation and
    officers had probable cause to arrest her for OVUII and/or
    Reckless Driving. Officer Meredith and Corporal Chang did
    not need the results of the SFST to arrest Defendant for
    OVUII and/or Reckless Driving. Legal custody had attached.
    10    Skapinok contends the ICA erred because she “was in ‘custody’ as
    the district court correctly concluded[.]” But the ICA affirmed the custody
    determination, holding only that the district court erred insofar as “red and
    glassy eyes alone and imperfect driving are insufficient to establish
    probable cause to arrest a person for OVUII,” a correct statement of Hawai‘i
    law. State v. Skapinok, No. CAAP-XX-XXXXXXX, 
    2020 WL 2991783
    , at *5
    (emphasis added) (citing to State v. Kaleohano, 99 Hawai‘i 370, 377–78, 
    56 P.3d 138
    , 145–46 (2002) (“We conclude that red and glassy eyes, a criminal
    record, and imperfect driving, standing alone, are insufficient to establish
    probable cause to arrest a person for driving under the influence of
    drugs.”)).
    Since the ICA affirmed that Skapinok was in custody, an issue we
    do not address, see infra note 11, and nothing else about this conclusion of
    law is germane to the question of what evidence should have been suppressed,
    we do not further address Skapinok’s argument as to this conclusion of law.
    18
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    right against self-incrimination was not implicated when she was
    asked to participate in the SFST,” as well as when she was asked
    whether she understood the instructions.
    III. STANDARD OF REVIEW
    “We review the [trial] court’s ruling on a motion to
    suppress de novo and must look to the entire record on appeal to
    determine whether the ruling was right or wrong.”            State v.
    Joseph, 109 Hawai‘i 482, 493, 
    128 P.3d 795
    , 806 (2006) (citation
    omitted).
    IV.   DISCUSSION
    A.   The Medical Rule-Out Questions Were Interrogation
    Article I, section 10 of the Hawai‘i Constitution provides
    that “[n]o person shall . . . be compelled in any criminal
    case to be a witness against himself.” State v. Pau‘u, 
    72 Haw. 505
    , 509, 
    824 P.2d 833
    , 835 (1992) (quoting article
    [I], section 10). It is established that “[w]hen 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.” 
    Id.
    (citing State v. Russo, 
    67 Haw. 126
    , 
    681 P.2d 553
     (1984)).
    State v. Eli, 126 Hawai‘i 510, 519–20, 
    273 P.3d 1196
    , 1205–06
    (2012) (alterations in original).
    Miranda warnings safeguard the right against self-
    incrimination contained in article I, section 10 of the Hawai‘i
    Constitution, and a defendant’s statements adduced in violation
    of Miranda cannot be used against them at trial.            Kazanas, 138
    Hawai‘i at 34, 375 P.3d at 1272.          But not all police questioning
    must be preceded by Miranda warnings.          “A defendant seeking to
    19
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    suppress [their] statement [for want of Miranda warnings] ‘must
    establish that [their] statement was the result of (1)
    “interrogation” that occurred while [they were] (2) “in
    custody.”’”    Id. at 35, 375 P.3d at 1273 (quoting State v.
    Ketchum, 97 Hawai‘i 107, 118, 
    34 P.3d 1006
    , 1017 (2001)).            The
    ICA held, and the State does not now challenge, that Skapinok
    was in custody at all relevant times. 11       Therefore, the State’s
    application presents only the question of whether the medical
    rule-out questions were interrogation.
    1.    The ICA misapplied Pennsylvania v. Muniz
    This court adopted under the Hawai‘i Constitution the
    definition of interrogation set forth in Innis: “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.”       State v. Paahana, 66 Haw. at 503,
    
    666 P.2d at
    595–96 (citing Innis, 
    446 U.S. at 301
    ); State v.
    Trinque, 140 Hawaiʻi 269, 277, 
    400 P.3d 470
    , 478 (2017) (“There
    are several important considerations in this court’s definition:
    ‘interrogation’ under Miranda refers to (1) any words, actions,
    or practice on the part of the police, not only express
    11   The State’s application admits that it “conceded at the hearing
    in this case that Skapinok was in custody.” This opinion therefore does not
    address custody and assumes that Skapinok was in custody at all relevant
    times.
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    questioning, (2) other than those normally attendant to arrest
    and custody, and (3) that the police should know is reasonably
    likely to invoke an incriminating response.”); Kazanas, 138
    Hawaiʻi at 38, 375 P.3d at 1276 (“We agree and reaffirm that the
    touchstone in analyzing whether ‘interrogation’ has taken place
    is whether the police officer ‘should have known that [their]
    words and actions were reasonably likely to elicit an
    incriminating response from the defendant.’” (citation
    omitted)).     “‘[I]ncriminating response’ . . . refer[s] to any
    response – whether inculpatory or exculpatory – that the
    prosecution may seek to introduce at trial.”           Innis, 
    446 U.S. at
    301 n.5.
    In Sagapolutele-Silva, upon which the ICA relied in
    the instant case, the ICA concluded that “the medical rule-out
    questions posed to [the defendant]” – which were largely
    identical to those administered to Skapinok 12 – “were reasonably
    likely to elicit an incriminating response and, therefore,
    constituted interrogation.”       147 Hawaiʻi at 102, 464 P.3d at
    890. 13    There, the ICA based this conclusion on Muniz:
    12    In addition to the seven questions asked to Skapinok in this
    case, the officer in Sagapolutele-Silva also asked the defendant if she wore
    corrective lenses. 147 Hawaiʻi at 102, 464 P.3d at 890.
    13    The ICA’s memorandum opinion in the instant case relied on this
    reasoning and did not opine any further:
    (continued . . .)
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    In Muniz, an officer asked a defendant if he knew the date
    of his sixth birthday to which the defendant responded:
    “No, I don't.” [Muniz, 
    496 U.S. at 586
    .] The Muniz court
    held the question constituted interrogation because it
    required a testimonial response. 
    Id. at 600
    [.]
    . . . .
    Here, although [the officer] stated that the purpose
    of the medical rule-out questions was to assist him in
    evaluating [the defendant]’s physical performance on the
    SFST, which is non-testimonial evidence, his subjective
    intent is not relevant. Kazanas, 138 Hawaiʻi at 40, 375
    P.3d at 1278 . . . . The medical rule-out questions
    required a testimonial response that disclosed facts
    relating to the offense of OVUII and that was reasonably
    likely to assist the police in determining whether [the
    defendant] was under the influence of an intoxicant by
    either admitting or denying there were other causes that
    could explain her actions. A negative response to all of
    the questions is testimonial, and combined with physical
    characteristics of impairment, supports an incriminating
    inference of impairment. Similarly, a positive response to
    whether a defendant is taking any medicines, in some
    instances, may constitute an incriminating statement.
    Sagapolutele-Silva, 147 Hawaiʻi at 102, 464 P.3d at 890.
    Respectfully, the ICA incorrectly analyzed Muniz in
    Sagapolutele-Silva.      Muniz addressed a number of questions asked
    in connection with a drunk-driving arrest, one of which was the
    sixth birthday question described above.          But the Supreme Court
    (continued . . .)
    Based on, inter alia, our analysis in Sagapolutele-
    Silva, we conclude that the medical rule-out questions
    posed to Skapinok were reasonably likely to elicit an
    incriminating response and, therefore, constituted
    interrogation. See Sagapolutele-Silva, No. CAAP-19-
    0000491, 
    2020 WL 1699907
    , slip op. at 17-20 (Haw. App.
    April 8, 2020).
    Skapinok was in custody. She had not been given
    Miranda warnings. The medical rule-out questions
    constituted interrogation. Thus, we conclude that her
    responses to those questions should have been suppressed
    and the District Court did not err in so concluding in COLs
    13 and 17.
    Skapinok, mem. op. at *6-7.
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    held as it did because it determined the response to that
    question was testimonial – in other words, the “communication
    . . . itself, explicitly or implicitly, relate[d] a factual
    assertion or disclose[d] information.”       Muniz, 
    496 U.S. at 594
    (quoting Doe v. United States, 
    487 U.S. 201
    , 210 (1988)).
    Pennsylvania had argued that the question did not require a
    testimonial response because “the inference [from the answer]
    concerns ‘the physiological functioning of Muniz’s brain,’” not
    any particular fact related to the crime.       Id. at 593 (brackets
    omitted).    The Court disagreed because the content of the answer
    would have supported the conclusion he was impaired – “the
    incriminating inference of impaired mental faculties stemmed,
    not just from the fact that Muniz slurred his response, but also
    from a testimonial aspect of that response.”         Id. at 599.   In
    this way, the sixth birthday question differed from non-
    testimonial observations that can be compelled, such as a voice
    sample or blood alcohol content.       Id. at 593.
    In this case and in Sagapolutele-Silva, there is no
    dispute that the responses to the medical rule-out questions are
    testimonial.    The contents of the answer, as opposed to the
    manner in which the answer is given, communicate the information
    that may or may not be used to support the incriminating
    inference of impairment.    Indeed, Muniz took as given that the
    question was incriminating.    
    496 U.S. at 592
    .       The “birthday
    23
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    question” analysis in Muniz therefore provides little assistance
    to answering the determinative question: whether the medical
    rule-out questions would be “reasonably likely to elicit an
    incriminating response.”     
    Id. at 601
    .
    2.   Under article I, section 10 of the Hawai‘i
    Constitution, evaluating whether questions are
    “attendant to” a police procedure still requires an
    inquiry into whether the officer knew or should have
    known the questions were reasonably likely to elicit
    an incriminating response
    The Muniz court did, however, consider whether certain
    questions asked in advance of an SFST when defendant Muniz was
    in custody were interrogation.      The Court held that the “limited
    and carefully worded inquiries as to whether Muniz understood
    th[e] instructions” to each component of the SFST were not
    interrogation.   Muniz, 
    496 U.S. at 603
    .       Rather, “these focused
    inquiries were necessarily ‘attendant to’ the police procedure,”
    and therefore Muniz’s answers “were not elicited in response to
    custodial interrogation.”     
    Id.
     at 603–04.     The Court cited to
    South Dakota v. Neville, 
    459 U.S. 553
     (1983), which “h[eld] that
    police inquiry [into] whether [the] suspect would submit to
    blood-alcohol test was not ‘interrogation within the meaning of
    Miranda.’”   Muniz, 
    496 U.S. at 604
     (quoting Neville, 
    459 U.S. at
    564 n.15).   Neville explained:
    [P]olice words or actions “normally attendant to arrest and
    custody” do not constitute interrogation. The police
    inquiry here is highly regulated by state law, and is
    presented in virtually the same words to all suspects. It
    is similar to a police request to submit to fingerprinting
    24
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    or photography. Respondent’s choice of refusal thus enjoys
    no prophylactic Miranda protection outside the basic Fifth
    Amendment protection.
    
    459 U.S. at
    564 n.15 (quoting Innis, 
    446 U.S. at 301
    ).
    In Gibson v. Commonwealth, 
    706 S.E.2d 541
     (Va. Ct.
    App. 2011) – a decision that the ICA in Sagapolutele-Silva
    explicitly rejected, 147 Hawaiʻi at 101, 464 P.3d at 889, but
    that the State now urges us to adopt – the Court of Appeals of
    Virginia relied on Muniz when it held that asking “whether [an
    OVUII suspect] had any physical problems” prior to administering
    the SFST was not interrogation.      
    706 S.E.2d at 545
    .     The
    Virginia court opined that Muniz “recognized two exceptions to
    this definition of interrogation”: (1) the “‘routine booking
    question’ exception which exempts from Miranda’s coverage
    questions to secure the ‘biographical data necessary to complete
    booking or pretrial services,’” and (2) the exception for
    “inquiries ‘necessarily “attendant to” [a legitimate] police
    procedure.’”   
    Id.
     (brackets in original) (quoting Muniz, 
    496 U.S. at 601, 603-04
    ).    Applied to the question at issue, “[t]he
    ‘physical problems’ question is sufficiently analogous to asking
    whether [the suspect] understood [the officer’s] instructions as
    to how each test is to be performed.       Both questions are clearly
    meant to assure the validity of the test and not to elicit an
    incriminatory response.”    
    Id.
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    In turn, Gibson relied on the analysis of the Supreme
    Court of Vermont, which had also “recognized that inquiries
    intended to assure the validity of a legitimate police procedure
    fall under the ‘necessarily attendant to a legitimate police
    procedure’ exception.”    
    Id.
       In State v. Blouin, 
    716 A.2d 826
    (Vt. 1998), the Supreme Court of Vermont held that asking an
    OVUII suspect prior to administering a breath test whether he
    “burped, belched or vomited within the last fifteen minutes” –
    the purpose of which “is to ensure that trace amounts of alcohol
    are not in the mouth which could render an inaccurate test
    result,” 
    id.
     at 827 – did not require Miranda warnings.           
    Id. at 830
    .   The Blouin court determined that the “burp question” was
    not likely to elicit an incriminating response because:
    The burp question is designed to help assure the accuracy
    of the test – an objective as significant to the suspect as
    to the State. In and of itself, there is nothing
    incriminating about defendant’s response: if defendant had
    answered yes to the question, the officer would have merely
    waited another fifteen minutes to obtain accurate test
    results. In short, the burp question is not interrogation.
    
    Id.
    We decline to adopt an exception to the interrogation
    test that obviates the need to inquire into whether the question
    would elicit an incriminating response when the question is
    attendant to the SFST or otherwise “necessarily ‘attendant to’
    the legitimate police procedure.”       Muniz, 
    496 U.S. at
    605
    (citing Neville, 
    459 U.S. at
    564 n.15).        While we have
    26
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    explicitly recognized the “attendant to arrest and custody”
    carve-out to the definition of “interrogation,” Trinque, 140
    Hawaiʻi at 277, 400 P.3d at 478, Hawaiʻi law points against
    eliminating the “incriminating response” inquiry even when the
    police ask questions “attendant to” a routine, legitimate
    procedure.
    Application of the “routine booking question
    exception” is instructive: Muniz recognized that “questions to
    secure the biographical data necessary to complete booking or
    pretrial services” that are “requested for record-keeping
    purposes only” and “reasonably related to the police’s
    administrative concerns” do not require Miranda warnings despite
    being direct questioning of an in-custody suspect.          
    496 U.S. at 601-02
     (quotation marks omitted).       Nonetheless, “the police may
    not ask questions, even during booking, that are designed to
    elicit incriminatory admissions.”       
    Id.
     at 602 n.14.     The same is
    true under the Hawai‘i Constitution:
    [I]f the “booking” officer knows or reasonably should know
    that a “routine booking question” is likely to elicit an
    incriminating response, [they] must administer the
    requisite warnings and obtain a valid waiver of the
    arrestee’s relevant constitutional rights before posing the
    question if the prosecution, in a subsequent criminal
    prosecution of the arrestee, is to be permitted to adduce
    evidence of the arrestee’s response without running afoul
    of article I, section 10 of the Hawai‘i Constitution.
    Ketchum, 97 Hawai‘i at 128, 
    34 P.3d at 1027
    .
    27
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    Ketchum rejected the existence of a so-called “booking
    exception” under Hawaiʻi law, but our analysis in that case
    comports with that of many other courts, which permit booking
    questions without Miranda warnings, but not if the officer knew
    or should have known that the question would be reasonably
    likely to elicit incriminating information.      Compare id. at 119,
    120–21, 
    34 P.3d at 1018
    , 1019–20 (“[T]he ‘exception’ is, when
    scrutinized, no real exception at all. . . .      In other words,
    the ‘routine booking question exception’ does no more than
    recognize that not every ‘express question’ constitutes
    ‘interrogation.’”) with United States v. Zapien, 
    861 F.3d 971
    ,
    975 (9th Cir. 2017) (“Once the import of the booking exception
    is properly understood as part and parcel of the question
    whether there has been ‘interrogation,’ it becomes clear that
    the determinative issue is whether the officer ‘should have
    known that his questions were reasonably likely to elicit an
    incriminating response.’” (citation omitted)); see also United
    States v. Williams, 
    842 F.3d 1143
    , 1147 (9th Cir. 2016) (“The
    booking questions exception, however, is subject to an important
    qualification: ‘When a police officer has reason to know that a
    suspect’s answer may incriminate him, however, even routine
    questioning may amount to interrogation.’” (quoting United
    States v. Henley, 
    984 F.2d 1040
    , 1042 (9th Cir. 1993)).
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    In Ketchum, we held that asking the suspect his
    address – to be sure, information that is usually not
    incriminating – constituted interrogation when asked after a
    drug raid of a residence; the officer knew or should have known
    that the information was relevant to establishing constructive
    possession of the contraband recovered from the home.       97 Hawai‘i
    at 126-27, 
    34 P.3d at 1025-26
    .     Thus, even usually mundane
    biographical information can constitute interrogation if the
    officer should know that the question is reasonably likely to
    elicit an incriminating response.      Other jurisdictions have
    similarly held that, for example, asking where a suspect was
    born may require Miranda warnings when asked by a federal
    immigration agent and where the suspect faces charges related to
    illegal entry.   United States v. Gonzalez-Sandoval, 
    894 F.2d 1043
    , 1046-47 (9th Cir. 1990).     Likewise, asking a suspect
    during booking whether they are a gang member may be reasonably
    likely to elicit an incriminating response depending on the
    circumstances and thus require Miranda warnings, despite the
    question’s legitimate relationship to “police’s administrative
    concerns” of prison security and inmate placement.       People v.
    Elizalde, 
    351 P.3d 1010
    , 1017 (Cal. 2015); Williams, 842 F.3d at
    1148-49.
    The so-called booking exception is analogous to the
    “‘attendant to’ the legitimate police procedure” carve-out that
    29
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    the State urges us to adopt.    Muniz, 
    496 U.S. at 605
    .     While the
    booking exception independently developed in the federal courts
    before Innis and Muniz, it provides a useful touchpoint to
    understanding the validity of a purported “attendant to a
    legitimate police procedure” exception because they both relate
    to the definitional exclusion from interrogation for express
    questioning “normally attendant to arrest and custody.”
    Trinque, 140 Hawai‘i at 277, 400 P.3d at 478; United States v.
    Gotchis, 
    803 F.2d 74
    , 79 (2d Cir. 1986) (“Routine questions
    about a suspect’s identity and marital status, ordinarily
    innocent of any investigative purpose, do not pose the dangers
    Miranda was designed to check; they are rather the sort of
    questions ‘normally attendant to arrest and custody[.]’”
    (quoting Innis, 
    446 U.S. at 301
    )).     The pragmatic basis for
    booking questions and procedural questions is the same: both are
    “highly regulated . . . and . . . presented in virtually the
    same words to all suspects,” Neville, 
    459 U.S. at
    564 n.15,
    posing less risk that the questioning would “subjugate the
    individual to the will of [their] examiner and thereby undermine
    the privilege against compulsory self-incrimination.”       Paahana,
    66 Haw. at 502, 
    666 P.2d at 595
     (quotation marks omitted)
    (quoting Innis, 
    446 U.S. at 299
    ).      But that is not to say there
    is no risk, and we see no reason to treat questions “attendant
    to” police procedures differently than “booking questions” under
    30
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    the Hawai‘i Constitution – the inquiry in both circumstances is
    whether the question is reasonably likely to elicit an
    incriminating response.
    We therefore hold that under the self-incrimination
    clause of the Hawai‘i Constitution, police questioning that is
    “‘attendant to’ [a] legitimate police procedure,” Muniz, 
    496 U.S. at 605
    , is interrogation if the officer “knows or
    reasonably should know that [the question] is likely to elicit
    an incriminating response,” Ketchum, 97 Hawai‘i at 128, 
    34 P.3d at 1027
    .   In other words, being attendant to a police procedure,
    standing alone, does not obviate the need to examine whether the
    officer knew or should have known that the questions were
    reasonably likely to elicit an incriminating response.                If such
    questions are reasonably likely to elicit an incriminating
    response, they must be preceded by Miranda warnings in order to
    be admissible.
    3.    The medical rule-out questions were reasonably likely
    to elicit an incriminating response
    We must then apply this principle to the seven medical
    rule-out questions asked to Skapinok in this case:
    i.     Do you have any physical defects or speech
    impediments?
    ii.    Are you taking any medications?
    ii.    Are you under the care of a doctor or dentist for
    anything?
    iv.    Are you under the care of an eye doctor?
    v.     Do you have an artificial or glass eye?
    vi.    Are you epileptic or diabetic?
    vii.   Are you blind in either eye?
    31
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    Corporal Chang knew or should have known that “are you
    taking any medications” is reasonably likely to elicit an
    incriminating response.    A person may be guilty of OVUII if they
    “operate[] or assume[] actual physical control of a vehicle
    . . . [w]hile under the influence of any drug that impairs the
    person’s ability to operate the vehicle in a careful and prudent
    manner.”   HRS § 291E-61(a)(2).    “Drug” is defined as “any
    controlled substance, as defined and enumerated in schedules I
    through IV of chapter 329, or its metabolites.”      HRS § 291E-1
    (2007).    In turn, Chapter 329, the Uniform Controlled Substances
    Act, classifies numerous legal prescription medications as
    controlled substances in schedules I through IV, including, for
    example: Marijuana (HRS § 329-14(d)(20) (2010)), Xanax (HRS
    § 329-20(b)(1) (2010)) (identified by its generic name
    Alprazolam), and Ambien (HRS § 329-20(b)(54) (2015)) (identified
    by its generic name Zolpidem).     Someone who is lawfully
    prescribed and taking a medication that is a controlled
    substance confronts the “cruel trilemma of self-accusation,
    perjury or contempt,” Muniz, 
    496 U.S. at 596
     (quoting Doe, 
    487 U.S. at 212
    ), when faced with this question: lie, incriminate
    themselves with the truth, or say nothing and face arrest.
    Even answering the question with a medication that is
    not a controlled substance may be incriminating, as Skapinok’s
    32
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    answer demonstrates.    Corporal Chang testified that he knew
    Wellbutrin can interact with alcohol to create side effects that
    look like impairment.    Even 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 assume[d] 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.”     HRS § 291E-61(a)(1).    As
    Skapinok has pointed out, “[n]othing in the statute requires
    that alcohol be the sole or exclusive cause of a defendant’s
    impairment.   Rather, what is required is proof beyond a
    reasonable doubt that liquor contributed to the diminishment of
    the defendant’s capacity to drive safely.”      Vliet, 91 Hawaiʻi at
    293, 
    983 P.2d at 194
    ; see also 
    id. at 294
    , 
    983 P.2d at
    195
    (citing favorably to, inter alia, State v. Daniels, 
    379 N.W.2d 97
    , 99 (Minn. Ct. App. 1986), in which a defendant was convicted
    for consuming alcohol and an anti-depressant).      Skapinok, too,
    faced the “cruel trilemma”: admit to the incriminating fact that
    she was taking Wellbutrin, lie, or face certain arrest by
    remaining silent.   Thus, given that many answers to “[a]re you
    taking any medications” would incriminate an OVUII suspect, the
    officers knew or should have known that asking a person under
    investigation for OVUII if they are taking any medication is
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    reasonably likely to elicit an incriminating response.            Even
    though the question relates to the administration of the SFST,
    if the suspect is in custody, this question must be preceded by
    Miranda warnings for the answer to be admissible.
    The remaining medical rule-out questions at issue here
    do not present the same direct link to the crime being
    investigated.    “Do you have any physical defects or speech
    impediments?”; “[a]re you under the care of a doctor or dentist
    for anything?”; “[a]re you under the care of an eye doctor?”;
    “[d]o you have an artificial or glass eye?”; “[a]re you
    epileptic or diabetic?”; and “[a]re you blind in either eye?”;
    elicit information that, standing alone, neither inculpates nor
    exculpates the defendant of OVUII. 14       But Skapinok argues these
    questions, as a battery, are incriminating because they serve to
    rule out other possibilities for poor performance on the SFST.
    In other words, the incriminating inference to be drawn from all
    “no” responses is that only drugs or alcohol could have caused
    the defendant to exhibit signs of intoxication on the test.              The
    lone dissenter in Blouin agreed with this argument as to the
    14    Both Gibson and Blouin reasoned that “assuring the accuracy of
    the [test] is just as significant to [the defendant] as it is to the
    [government].” Gibson, 
    706 S.E.2d at 546
    ; Blouin, 
    716 A.2d at 830
    . Whether
    or not the question is “significant” to the defendant is of no matter.
    Indeed, an incriminating response is “any response – whether inculpatory or
    exculpatory – that the prosecution may seek to introduce at trial.” Innis,
    
    446 U.S. at
    301 n.5 (1980) (first emphasis added); Miranda v. Arizona, 
    384 U.S. at 477
     (“[N]o distinction may be drawn between inculpatory statements
    and statements alleged to be merely ‘exculpatory.’”).
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    “burp” question: “the interrogatory is designed to bolster the
    quality of evidence against the suspect and, thus, calls for an
    incriminating response.”    
    716 A.2d at 831
     (Skoglund, J.,
    dissenting).   Likewise, in State v. Forsyth, 
    859 A.2d 163
     (Me.
    2004), the Supreme Judicial Court of Maine rejected the State’s
    argument that asking whether the defendant “had any physical
    impairments” in advance of a component of the SFST was “a mere
    preliminary question for the officer to determine whether or not
    a test would be fair” akin to “general health and other similar
    booking questions”: “[w]e do not agree that such a question does
    not seek to elicit incriminating statements.      The question asks
    a suspect to provide information to assist the officer in ruling
    out anything other than intoxication as an explanation for
    [their] performance on a field sobriety test.”      
    Id. at 165
    .
    We conclude that all of the medical rule-out questions
    are interrogation.   Although the “incriminating inference” may
    be indirect, the questions nevertheless adduce evidence to
    establish that intoxication caused any poor performance on the
    SFST.   Sagapolutele-Silva, 147 Hawaiʻi at 102, 464 P.3d at 890.
    Indeed, Corporal Chang testified that the medical rule-out
    questions “focuse[d] [his] attention away from medical and
    physical problems and . . . more on a cause by an intoxicant[.]”
    And the State, in its application, admitted that the questions
    do not just “ensure the accuracy” of the SFST, but “assist the
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    trier-of-fact in evaluating the OVUII suspect’s physical
    performance on the SFST.”    That they are used to assist the
    trier-of-fact shows that the medical rule-out questions elicit a
    “response — whether inculpatory or exculpatory — that the
    prosecution may seek to introduce at trial.”      Ketchum, 97 Hawai‘i
    at 130, 
    34 P.3d at 1029
     (quoting Innis, 
    446 U.S. at
    301 n.5).
    Here, the questions do not merely ensure that the SFST
    can be safely performed, they affect the officer’s
    interpretation of the test’s output – in other words, the
    questions gather evidence against the defendant rather than
    simply determining whether evidence can viably be gathered.       The
    questions’ breadth demonstrates that their scope exceeds what is
    needed to assess whether the test can in fact be administered
    and crosses into investigatory: it is difficult to understand
    how being under the care of a dentist or having a speech
    impediment, for instance, would affect whether not the defendant
    could safely perform the test.     Compared to Muniz, these are not
    the “limited and carefully worded inquiries” that case
    sanctioned, nor do they reflect that the officers “carefully
    limit[] [their] role to providing [the suspect] with relevant
    information.”   
    496 U.S. at 603, 605
    .    Rather, the sweep of the
    seven medical rule-out questions asked to Skapinok ensured not
    only that the officer could administer the test, but that all
    other possible explanations were systemically ruled-out as
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    causes of the test’s results.        They were interrogation under
    article I, section 10 of the Hawai‘i Constitution.           Because
    Skapinok was in custody at the time the officer asked them,
    Miranda warnings were required, and her answers to them must be
    suppressed.
    B.    Neither Asking if Skapinok Would Participate in the SFST
    nor Asking if She Understood the Instructions Constituted
    Interrogation
    Although not squarely raised as a point of error, 15 the
    ICA did not err by holding that neither asking Skapinok if she
    would participate in an SFST nor asking if she understood the
    instructions were interrogation.          We recently considered the
    same questions in State v. Uchima, 147 Hawai‘i 64, 
    464 P.3d 852
    (2020):
    Here, [the officer administering the SFST] asked [the
    defendant] whether he would participate in an [S]FST,
    whether he understood the instructions of the individual
    tests, and whether he had any questions. These preliminary
    questions were not reasonably likely to lead to
    incriminating responses because neither an affirmative or
    negative response to these questions is incriminating.
    Rather, the questions allow the officer to determine
    whether [the defendant] was willing to undergo the [S]FST
    and whether he understood the officer’s instructions prior
    to performing the three tests comprising the [S]FST. Thus,
    these questions were not of such nature that [the officer]
    should have known that they were likely to elicit an
    incriminating response.
    Id. at 84, 464 P.3d at 872.
    15    The only point of error in Skapinok’s application relates to
    fruit of the poisonous tree, but the application nonetheless discusses the
    ICA’s treatment of these other questions.
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    We reach the same conclusion here.         Asking whether
    Skapinok would participate in and understood the tests
    constituted “limited and focused inquiries” that were not
    reasonably likely to elicit an incriminating response.             Muniz,
    
    496 U.S. at 605
    .     The ICA did not err by concluding that these
    questions are not interrogation.
    C.    The Evidence Gathered After the Miranda Violation Was Not
    “Fruit of the Poisonous Tree”
    We must next consider whether the evidence obtained
    after the illegality – including questions asked subsequent to
    the medical rule-out questions as part of the SFST and
    Skapinok’s performance on the SFST (to which we will refer
    collectively as “the SFST”) – was tainted by the Miranda
    violation as fruit of the poisonous tree. 16        “[T]he ‘fruit of the
    poisonous tree’ doctrine ‘prohibits the use of evidence at trial
    which comes to light as a result of the exploitation of a
    previous illegal act of the police.’”         Trinque, 140 Hawaiʻi at
    281, 400 P.3d at 482 (quoting State v. Fukusaku, 85 Hawai‘i 462,
    16    The record suggests that Skapinok was asked whether she
    understood the instructions to the SFST after being asked the medical rule-
    out questions. As explained above, this question is not itself
    interrogation. The fruit of the poisonous tree doctrine would furnish an
    independent ground to suppress this question, but as we explain in this
    section, this argument is also unavailing.
    We also note that Skapinok squarely raised the fruits doctrine in
    her answering brief to the ICA, but the ICA’s memorandum opinion did not
    address it. We ultimately agree with the result the ICA reached. But
    because fruit of the poisonous tree, if applicable, would require suppression
    of evidence acquired after the Miranda violation irrespective of whether that
    evidence was the product of interrogation, the ICA erred by failing to
    evaluate whether the fruits doctrine applied.
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    475, 
    946 P.2d 32
    , 45 (1997)).     We hold that the SFST was not an
    exploitation of the illegality in this case.
    We addressed the fruits doctrine under virtually
    identical circumstances in State v. Manion, SCWC-XX-XXXXXXX
    (Haw. 2022).   In that case, during an OVUII investigation, the
    defendant was asked the medical rule-out questions while in
    custody, in violation of Miranda; Manion argued that his
    performance on the SFST must therefore be suppressed as fruit of
    the poisonous tree.    Id. at *10.     But we explained, “Although
    they immediately preceded the SFST in time, the medical rule-out
    questions did not give the officers information that ‘le[d]
    [them] to search for’ evidence of intoxication, nor did the
    medical rule-out questions pique their suspicions such that
    their investigation was ‘direct[ed]’ towards discovering
    evidence of intoxication.”    Id. at *12 (brackets in original)
    (quoting State v. Lee, 149 Hawai‘i 45, 50, 
    481 P.3d 52
    , 57
    (2020)).
    The same is true here.      The officers had already set
    out to administer the SFST before asking the medical rule-out
    questions – indeed, they had already asked for, and received,
    Skapinok’s consent for the tests.       “The officers did not exploit
    the illegality by continuing to gather evidence that they had
    already set out to gather.”    
    Id.
         And “that the illegally-
    obtained evidence is relevant to interpreting subsequently-
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    obtained evidence does not mean that discovery of the latter
    ‘exploit[s]’ the former.” 17       Id. at *14 (quoting State v.
    Poaipuni, 98 Hawai‘i 387, 392, 
    49 P.3d 353
    , 358 (2002)).
    Accordingly, the SFST was not the fruit of the poisonous tree in
    this case.
    V.    CONCLUSION
    For the foregoing reasons, although we disagree in
    part with its reasoning, the ICA was correct to conclude that
    Skapinok’s answers to the medical rule-out questions must be
    suppressed but that the other challenged evidence is admissible.
    The ICA’s June 30, 2020 judgment on appeal is accordingly
    affirmed.
    Brian R. Vincent                           /s/ Mark E. Recktenwald
    for Petitioner and Respondent
    State of Hawai‘i                           /s/ Paula A. Nakayama
    Alen M. Kaneshiro                          /s/ Sabrina S. McKenna
    for Respondent and Petitioner
    Leah Skapinok                              /s/ Paul B.K. Wong
    17    For this reason, respectfully, the dissent incorrectly frames the
    inquiry when it considers only whether the questions “[had] an effect on” the
    administration of the SFST or “allow[ed] officers to interpret” its results.
    Dissent at 14, 16. That the medical rule-out questions are incriminating
    because they assist in the interpretation of the test’s results is distinct
    from whether the questions lead the officers’ investigation towards the
    tests.
    40