State v. Gideon (Slip Opinion) , 2020 Ohio 5635 ( 2020 )


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  • [Until this opinion appears in the Ohio Official Reports advance sheets, it may be cited as State
    v. Gideon, Slip Opinion No. 
    2020-Ohio-5635
    .]
    NOTICE
    This slip opinion is subject to formal revision before it is published in an
    advance sheet of the Ohio Official Reports. Readers are requested to
    promptly notify the Reporter of Decisions, Supreme Court of Ohio, 65
    South Front Street, Columbus, Ohio 43215, of any typographical or other
    formal errors in the opinion, in order that corrections may be made before
    the opinion is published.
    SLIP OPINION NO. 
    2020-OHIO-5635
    THE STATE OF OHIO, APPELLANT AND CROSS-APPELLEE, v. JAMES A. GIDEON,
    APPELLEE AND CROSS-APPELLANT.
    [Until this opinion appears in the Ohio Official Reports advance sheets, it
    may be cited as State v. Gideon, Slip Opinion No. 
    2020-Ohio-5635
    .]
    Medical license is a property right and threatened loss of the license is a form of
    coercion—R.C. 4731.22(B)—Coercion is not sufficient to warrant the
    suppression of statements made during a medical-board investigative
    interview unless defendant’s belief that he would lose his license if he failed
    to participate in the medical-board interview and answer questions
    truthfully is both subjectively believed and objectively reasonable—Court
    of appeals erred by finding that assignment of error relating to the
    sufficiency-of-the-evidence claim was moot under App.R. 12(A)(1)(c)—
    Court of appeals’ judgment reversed and cause remanded in part.
    (No. 2019-1104—Submitted August 4, 2020—Decided December 15, 2020.)
    APPEAL and CROSS-APPEAL from the Court of Appeals for Allen County,
    Nos. 1-18-27, 1-18-28, and 1-18-29, 
    2019-Ohio-2482
    .
    SUPREME COURT OF OHIO
    __________________
    STEWART, J.
    {¶ 1} In Ohio, a medical doctor has a statutory duty to answer truthfully
    questions posed by an investigator of the state medical board. The question
    presented in this appeal is whether the state may use incriminating answers given
    by a doctor during a medical-board investigation in a subsequent criminal
    prosecution of that doctor. We conclude that a medical license is a property right
    and that the threatened loss of the license is a form of coercion that can compromise
    the United States Constitution’s Fifth Amendment privilege against self-
    incrimination. That said, in order for coercion to be sufficient to warrant the
    suppression of statements made during a medical-board investigative interview, it
    must be both subjectively believed and objectively reasonable.          In this case,
    competent, credible evidence supported the trial court’s factual finding that the
    doctor did not objectively believe that a refusal to answer truthfully questions posed
    by the medical-board investigator could lead to the loss of his medical license.
    Because the court of appeals reached a contrary conclusion and held that statements
    made by the doctor were inadmissible at trial, we reverse.
    {¶ 2} We also conclude that the court of appeals erred by determining that
    its remand order mooted an assignment of error relating to the sufficiency of the
    evidence. An assignment of error challenging the sufficiency of the evidence is
    potentially dispositive of a defendant’s conviction and may not be rendered moot
    by a remand on any other assignment of error.
    Factual Background
    {¶ 3} Appellee and cross-appellant, James Gideon, was licensed as a
    physician by the State Medical Board of Ohio and maintained a practice in
    rheumatology. In 2017, three of his patients accused him of inappropriately
    touching them during office visits. Two investigations were opened: one by the
    local police and one by an investigator working for the state medical board.
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    January Term, 2020
    Although Gideon told the police that he did not inappropriately touch any patients,
    the investigator told the police that Gideon admitted to misconduct.            The
    investigator shared that information with the police as the medical board is
    authorized to do under R.C. 4731.22(F)(5).
    {¶ 4} The state charged Gideon with three third-degree misdemeanor
    counts of sexual imposition in three separate cases that were consolidated for trial.
    Gideon moved to suppress the statements that he had made to the investigator as
    having been illegally compelled in violation of the Fifth Amendment to the United
    States Constitution. He argued that because he believed he was required to submit
    to the interview by the medical board and answer the investigator’s questions or
    risk losing his medical license, the medical-board investigator coerced his
    admissions with the threat of losing his medical license. The trial judge denied the
    motion to suppress, concluding that Gideon “made voluntary statements during a
    noncustodial interview.” A jury found Gideon guilty in all three cases. The trial
    court imposed a jail term of 60 days in each case and ordered the sentences to run
    consecutively to each other.
    {¶ 5} On appeal, the Third District Court of Appeals reversed the
    convictions. The court of appeals determined that the trial court should have
    granted Gideon’s motion to suppress consistent with Garrity v. New Jersey, 
    385 U.S. 493
    , 
    87 S.Ct. 616
    , 
    17 L.Ed.2d 562
     (1967), which held that statements obtained
    from a public employee under threat of job loss are unconstitutionally coerced and
    inadmissible in subsequent criminal proceedings. The court noted that Gideon had
    a statutory duty to answer truthfully all questions posed by the medical-board
    investigator and that the investigator “created an impression that Gideon’s refusal
    to cooperate with his investigation would result in the type of penalty prohibited
    under Garrity,” 
    2019-Ohio-2482
    , 
    130 N.E.3d 357
    , ¶ 51.
    {¶ 6} Both the state and Gideon appealed the appellate court’s judgment.
    The state offers this proposition of law:
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    SUPREME COURT OF OHIO
    When a non-government employee gives a statement to an
    administrative board/licensing agency governed by the state, and
    when there is no threat of loss of employment or removal from
    office, that statement is not subject to Garrity v. New Jersey, 
    385 U.S. 493
     (1967).
    {¶ 7} Gideon offers two cross-propositions of law:
    (1) A licensing board investigator’s intent to assist law
    enforcement in obtaining a criminal conviction for the purpose of
    influencing the outcome of an administrative-sanction proceeding
    against a licensee is a factor strongly weighing in favor of a finding
    that the licensee had an objectively reasonable belief that assertion
    of his Fifth Amendment Privilege Against Self-Incrimination would
    expose him to revocation of his license and loss of his livelihood.
    (2) Under App.R. 12(A)(C), a court of appeals has a duty to
    adjudicate any assignment of error that raises a claim of
    insufficiency of the evidence to support a criminal conviction or that
    involves a claim of error that is likely to again become an issue
    during proceedings upon remand.
    The Privilege Against Self-Incrimination
    {¶ 8} We will first address the state’s proposition of law together with
    Gideon’s first cross-proposition of law. The Fifth Amendment to the United States
    Constitution provides that no person “shall be compelled in any criminal case to be
    a witness against himself.” Article I, Section 10 of the Ohio Constitution provides
    the same protection: “No person shall be compelled, in any criminal case, to be a
    4
    January Term, 2020
    witness against himself * * *.” “The Amendment not only protects the individual
    against being involuntarily called as a witness against himself in a criminal
    prosecution but also privileges him not to answer official questions put to him in
    any other proceeding, civil or criminal, formal or informal, where the answers
    might incriminate him in future criminal proceedings.” Lefkowitz v. Turley, 
    414 U.S. 70
    , 77, 
    94 S.Ct. 316
    , 
    38 L.Ed.2d 274
     (1973).
    {¶ 9} Because a witness may voluntarily testify to matters which may be
    incriminating, the privilege against self-incrimination is not self-executing. The
    witness seeking the privilege must “claim it.” United States v. Monia, 
    317 U.S. 424
    , 427, 
    63 S.Ct. 409
    , 
    87 L.Ed. 376
     (1943). If the witness answers a question, the
    answer will be considered voluntary. See Minnesota v. Murphy, 
    465 U.S. 420
    , 427,
    
    104 S.Ct. 1136
    , 
    79 L.Ed.2d 409
     (1984). Gideon did not assert the privilege against
    self-incrimination during his interview with the medical-board investigator.
    {¶ 10} At times, when it is necessary to “safeguard the core constitutional
    right protected by the Self-incrimination Clause,” an assertion of the privilege
    against self-incrimination is not required. Chavez v. Martinez, 
    538 U.S. 760
    , 770,
    
    123 S.Ct. 1994
    , 
    155 L.Ed.2d 984
     (2003) (plurality opinion). An exception to
    asserting the privilege exists for statements made during custodial interrogations in
    which the state undermines the privilege by physically or psychologically coercing
    a suspect. See Miranda v. Arizona, 
    384 U.S. 436
    , 448-450, 
    86 S.Ct. 1602
    , 
    16 L.Ed.2d 694
     (1966).
    {¶ 11} The right to remain silent can also be infringed by coercion when
    there is a penalty for asserting the right.        In Garrity, the attorney general
    investigated police officers for fixing traffic tickets. Although advised of their right
    to remain silent, the officers also were told that refusing to answer questions would
    lead to the termination of their employment. The officers answered questions and
    the state used some of their answers against them in a subsequent criminal case.
    The U.S. Supreme Court observed that “[t]he option to lose their means of
    5
    SUPREME COURT OF OHIO
    livelihood or to pay the penalty of self-incrimination is the antithesis of free choice
    to speak out or to remain silent.” Garrity, 
    385 U.S. at 497
    , 
    87 S.Ct. 616
    , 
    17 L.Ed.2d 562
    . The court thus held that the confessions were not voluntary but coerced and
    that the Fourteenth Amendment prohibited the use of the statements in subsequent
    criminal proceedings. 
    Id. at 497-498, 500
    .
    {¶ 12} Unlike the officers in Garrity, Gideon is not a public employee. He
    was a medical doctor in private practice. As a practicing physician, he was subject
    to licensure by the state medical board. See R.C. 4731.17(B) (state medical board
    shall issue licenses to practice medicine). Gideon’s medical license constitutes a
    liberty and property interest subject to due-process protections. Watts v. Burkhart,
    
    854 F.2d 839
    , 842 (6th Cir.1988) (“the freedom to pursue a career is a protected
    liberty interest, and * * * state regulation of occupations through a licensing process
    gives rise to protected property interests”); see also Flynn v. State Med. Bd., 2016-
    Ohio-5903, 
    62 N.E.3d 212
    , ¶ 45 (10th Dist.).
    {¶ 13} The medical board has disciplinary authority over medical doctors
    and may “limit, revoke, or suspend a license or certificate to practice or certificate
    to recommend, refuse to issue a license or certificate, refuse to renew a license or
    certificate, refuse to reinstate a license or certificate, or reprimand or place on
    probation the holder of a license or certificate * * *.” R.C. 4731.22(B). Among
    the reasons listed for exercising the authority to impose such sanctions is the
    “[f]ailure to cooperate in an investigation” and the “failure to answer truthfully a
    question presented by the board in an investigative interview * * *.”             R.C.
    4731.22(B)(34).
    {¶ 14} The state’s threat to impose a legal penalty for the failure to give
    truthful responses in a state-medical-board investigation is coercive. This threat
    puts a medical doctor in the position of having to choose between two rights: the
    property right in the medical license or the privilege against self-incrimination. See
    Spevack v. Klein, 
    385 U.S. 511
    , 512, 
    87 S.Ct. 625
    , 
    17 L.Ed.2d 574
     (1967) (private-
    6
    January Term, 2020
    practice lawyer could not be disbarred for refusing to testify at a judicial inquiry
    into professional misconduct).
    {¶ 15} A different approach is required when, as here, the person under
    investigation has not been “expressly confronted * * * with the inescapable choice
    of either making an incriminatory statement or being fired,” State v. Graham, 
    136 Ohio St.3d 125
    , 
    2013-Ohio-2114
    , 
    991 N.E.2d 1116
    , ¶ 23. When incriminating
    statements are not coerced by the direct threat of job termination, we apply an
    “objectively reasonable” “subjective belief” test. 
    Id.
     Under that test, statements
    are compelled by threat of discharge if (1) a person subjectively believed that
    asserting the privilege would lead to discharge and (2) that belief was objectively
    reasonable under the circumstances. 
    Id.
    {¶ 16} Applying the Graham test, the trial court found that while Gideon
    testified that he subjectively believed that he would “be penalized” with the loss of
    his medical license if he did not answer questions posed by the medical-board
    investigator, his belief was not objectively reasonable.
    {¶ 17} In Graham, we explained that the objective reasonableness of a
    defendant’s belief that disciplinary action will result unless the defendant
    cooperates requires a showing of “some demonstrable coercive action by the state
    beyond ‘[t]he general directive to cooperate.’ ” (Brackets sic.) Graham at ¶ 23,
    quoting United States v. Vangates, 
    287 F.3d 1315
    , 1324 (11th Cir.2002). We
    further explained that “ ‘ordinary job pressures, such as the possibility of discipline
    or discharge for insubordination, are not sufficient to support an objectively
    reasonable expectation of discharge.’ ” 
    Id.,
     quoting People v. Sapp, 
    934 P.2d 1367
    ,
    1372 (Colo.1997).
    {¶ 18} Gideon did not establish through evidence that coercive action by
    the medical-board investigator had occurred. The trial court found no evidence that
    the medical-board investigator informed Gideon that “he must waive his rights
    against self-incrimination or subject himself to discharge or revocation of his
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    SUPREME COURT OF OHIO
    license.” And neither Gideon nor the investigator mentioned during the interview
    anything that suggested Gideon could lose his medical license if he refused to
    comply with the investigator’s questioning.
    {¶ 19} Besides the lack of evidence showing that Gideon had an objectively
    reasonable basis for believing that he could lose his medical license, the trial court
    correctly found that R.C. 4731.22(B), which requires a doctor’s cooperation in an
    investigation, does not subject that doctor “to an automatic suspension or
    revocation” of a license should the doctor exercise the right to remain silent.
    Although that section speaks in mandatory terms about discipline for certain
    violations (the board “shall” impose one of the listed sanctions), discipline is not
    automatic. It requires the affirmative vote of “not fewer than six” medical-board
    members to impose discipline for one of the reasons listed in R.C. 4731.22(B). And
    even when the medical board determines that a doctor has committed a violation,
    revocation of a medical license is not a required sanction—it is one of several
    sanctions available to the board. See R.C. 4731.22(B). In Gideon’s case, there was
    no direct threat of discipline for failure to cooperate; he faced only the possibility
    of discipline.
    {¶ 20} The Third District disagreed: “the trial court did not capture the
    concept of [R.C. 4731.22] and, more importantly, failed to consider the totality of
    the circumstances surrounding Gideon’s interview * * *.” (Emphasis sic.) 2019-
    Ohio-2482, 
    130 N.E.3d 357
    , at ¶ 31.
    {¶ 21} Yet the trial court did consider the circumstances surrounding the
    interview. In its findings of fact, the trial court observed that Gideon sounded
    “eager to speak” with the investigator despite having no notice of the investigator’s
    visit. Gideon declined the investigator’s offer to reschedule the interview. Because
    the interview occurred in Gideon’s office, the investigator told Gideon that he
    would pause the interview so that Gideon could see waiting patients. The trial court
    found that Gideon “took the lead initially in the interview and described his
    8
    January Term, 2020
    techniques with his patients prior to any substantive questions being posed by the
    investigator.” Although Gideon testified during the suppression hearing that the
    surprise nature of the interview denied him the ability to refresh his memory of the
    specific patients, the trial court determined that Gideon “was able to give a very
    detailed account of the treatments provided” and that only 18 minutes into the
    interview, Gideon “admitted to touching certain areas on the patients and
    succumbing to temptation.”
    {¶ 22} Appellate review of a suppression ruling involves a mixed question
    of law and fact. State v. Burnside, 
    100 Ohio St.3d 152
    , 
    2003-Ohio-5372
    , 
    797 N.E.2d 71
    , ¶ 8. “An appellate court must accept the trial court’s findings of fact if
    they are supported by competent, credible evidence.” State v. Hawkins, 
    158 Ohio St.3d 94
    , 
    2019-Ohio-4210
    , 
    140 N.E.3d 577
    , ¶ 16. “[T]he appellate court must then
    independently determine, without deference to the conclusion of the trial court,
    whether the facts satisfy the applicable legal standard.” Burnside at ¶ 8, citing State
    v. McNamara, 
    124 Ohio App.3d 706
    , 
    707 N.E.2d 539
     (4th Dist.1997).
    {¶ 23} The court of appeals did not dispute the trial court’s factual findings.
    It believed, however, that the investigator acted as a “straw man” for the state.
    
    2019-Ohio-2482
    , 
    130 N.E.3d 357
    , at ¶ 42. While the board may share with law-
    enforcement agencies any information it receives in an investigation, see R.C.
    4731.22(F)(5), cooperation with law-enforcement officials does not necessarily
    convert a medical-board investigation into a law-enforcement mission. See State
    v. Jackson, 
    154 Ohio St. 3d 542
    , 
    2018-Ohio-2169
    , 
    116 N.E.3d 1240
    , ¶ 21, citing
    Ohio v. Clark, 
    576 U.S. 237
    , 249, 
    135 S.Ct. 2173
    , 
    192 L.Ed.2d 306
     (2015). The
    investigator admitted that he agreed to share information with the police, but that
    does not mean that he acted for the primary purpose of furthering a criminal
    prosecution by the state. The investigator interviewed Gideon for the primary
    purpose of determining whether Gideon was subject to disciplinary action by the
    medical board for engaging in the misconduct alleged by his patients.
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    SUPREME COURT OF OHIO
    {¶ 24} We conclude that Gideon’s medical license is a property right and
    that the threatened loss of the license is a form of coercion that can compromise the
    United States Constitution’s Fifth Amendment privilege against self-incrimination.
    That said, in order for coercion to be sufficient to warrant the suppression of
    statements Gideon made during a medical-board investigative interview, his belief
    that he would lose his license if he failed to participate in the medical-board
    interview and answer questions truthfully must be both subjectively believed and
    objectively reasonable. In this case, competent, credible evidence supported the
    trial court’s factual finding that Gideon’s belief that a refusal to answer truthfully
    questions posed by the medical-board investigator could lead to the loss of his
    medical license was not objectively reasonable.
    Duty to Adjudicate Assignments of Error
    {¶ 25} In his second cross-proposition of law, Gideon claims that the court
    of appeals erred by finding that his assignment of error relating to the sufficiency
    of the evidence on one count of sexual imposition was moot. He argues that the
    appellate court’s remand on the suppression issue did not moot this assignment of
    error. We agree.
    {¶ 26} App.R. 12(A)(1)(c) states that “[u]nless an assignment of error is
    made moot by a ruling on another assignment of error,” a court of appeals shall
    “decide each assignment of error and give reasons in writing for its decision.” An
    assignment of error is moot when it cannot have “ ‘any practical legal effect upon
    a then-existing controversy.’ ” Culver v. Warren, 
    84 Ohio App. 373
    , 393, 
    83 N.E.2d 82
     (7th Dist.1948), quoting Ex parte Steele, 
    162 F. 694
    , 701
    (N.D.Ala.1908). Put differently, an assignment of error is moot when an appellant
    presents issues that are no longer live as a result of some other decision rendered
    by the appellate court.
    {¶ 27} An assignment of error going to the sufficiency of the evidence
    supporting a criminal count is always potentially dispositive of that count. While
    10
    January Term, 2020
    a reversal based on weight of the evidence does not preclude a retrial, a reversal
    based on insufficient evidence leads to an acquittal that bars a retrial. See State v.
    Thompkins, 
    78 Ohio St.3d 380
    , 387, 
    678 N.E.2d 541
     (1997), citing Tibbs v. Florida,
    
    457 U.S. 31
    , 47, 
    102 S.Ct. 2211
    , 
    72 L.Ed.2d 652
     (1982). “Because ‘the state is not
    entitled to retry a criminal defendant after reversal for trial court error if the state
    failed in the first instance to present sufficient evidence * * * a defendant’s assigned
    error that the conviction is based on insufficient evidence is not moot under these
    circumstances.’ ” (Ellipsis added in Mathis.) State v. Mathis, 6th Dist. Lucas No.
    L-18-1192, 
    2020-Ohio-3068
    , ¶ 78, quoting State v. Vanni, 
    182 Ohio App.3d 505
    ,
    
    2009-Ohio-2295
    , 
    913 N.E.2d 985
    , ¶ 15 (9th Dist.); see also State v. Croskey, 8th
    Dist. Cuyahoga No. 107772, 
    2019-Ohio-2444
    , ¶ 9 (errors which could result in an
    acquittal must be separately addressed).
    {¶ 28} In State v. Brewer, 
    113 Ohio St.3d 375
    , 
    2007-Ohio-2079
    , 
    865 N.E.2d 900
    , we determined that the court of appeals erred by refusing to consider
    an assignment of error challenging the sufficiency of the evidence after it had
    determined trial error warranted reversal of the defendant’s conviction. A jury had
    found Brewer guilty of gross sexual imposition. On direct appeal, he raised nine
    assignments of error, including that hearsay testimony was improperly allowed by
    the court and that the state failed to offer sufficient evidence. State v. Brewer, 8th
    Dist. Cuyahoga No. 87701, 
    2006-Ohio-6029
    , ¶ 1. The court of appeals determined
    that the trial court erred by allowing hearsay testimony into evidence and ordered a
    new trial. Id. at ¶ 13. That finding led it to conclude that the remaining assignments
    of error were moot. Id. We summarily reversed that decision: “[t]he judgment of
    the court of appeals holding that the assignment of error in which appellant
    challenged the sufficiency of the evidence was moot is reversed, and the cause is
    remanded to the court of appeals for consideration of that assignment of error.”
    Brewer, 
    113 Ohio St.3d 375
    , 
    2007-Ohio-2079
    , 
    865 N.E.2d 900
    , at ¶ 2.
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    SUPREME COURT OF OHIO
    {¶ 29} When a conviction is based on evidence that does not establish a
    defendant’s guilt beyond a reasonable doubt, the court of appeals must vacate the
    conviction and double-jeopardy protection bars the defendant’s retrial for the same
    offense. An assignment of error raising the sufficiency of the evidence is thus
    potentially dispositive of a particular count and cannot be moot. When evaluating
    an assignment of error challenging the sufficiency of the evidence, a reviewing
    court must consider all evidence admitted at trial, including the improperly
    admitted evidence that was the source of the reversal for trial error. See State v.
    Brewer, 
    121 Ohio St.3d 202
    , 
    2009-Ohio-593
    , 
    903 N.E.2d 284
    , ¶ 24-26. The court
    of appeals erred by finding that Gideon’s assignment of error relating to the
    sufficiency-of-the-evidence claim was moot under App.R. 12(A)(1)(c).
    Conclusion
    {¶ 30} For the reasons stated above, we reverse the judgment of the Third
    District Court of Appeals. We also remand to that court to consider Gideon’s
    assignment of error relating to the sufficiency of the evidence.
    Judgment reversed
    and cause remanded in part.
    O’CONNOR, C.J., and KENNEDY, FRENCH, FISCHER, and DEWINE, JJ.,
    concur.
    DONNELLY, J., dissents, with an opinion.
    _________________
    DONNELLY, J., dissenting.
    {¶ 31} The majority opinion states that the medical board can “ ‘limit,
    revoke, or suspend’ ” a license to practice medicine if the licensee fails to
    “ ‘cooperate in an investigation’ ” or “ ‘answer truthfully a question presented by
    the board in an investigative interview.’ ” Majority opinion at ¶ 13, quoting R.C.
    4731.22(B). The majority opinion concludes that appellee and cross-appellant,
    James Gideon, subjectively believed that he could lose his license if he failed to
    12
    January Term, 2020
    cooperate or to answer questions truthfully. I agree. See R.C. 4731.22(B)(34).
    Based on the language of R.C. 4731.22(B), Gideon’s subjective belief that he could
    lose his license was well-founded. But the majority opinion further concludes that
    Gideon’s subjective belief was not objectively reasonable because he did not
    demonstrate “ ‘coercive action by the state beyond “[t]he general directive to
    cooperate.” ’ (Brackets sic.) [State v. Graham, 
    136 Ohio St.3d 125
    , 2013-Ohio-
    2114, 
    991 N.E.2d 1116
    ,] ¶ 23, quoting United States v. Vangates, 
    287 F.3d 1315
    ,
    1324 (11th Cir.2002).” Majority opinion at ¶ 17. I disagree.
    {¶ 32} The majority concludes that the “investigator interviewed Gideon
    for the primary purpose of determining whether Gideon was subject to disciplinary
    action by the medical board for engaging in the misconduct alleged by his patients,”
    majority opinion at ¶ 23. The well-written and unanimous opinion of the court of
    appeals thoroughly explicates why the majority’s characterization of the
    investigator’s interview of Gideon is untenable:
    The evidence in the record reflects that the circumstances
    surrounding the administrative investigation at issue in this case
    show some demonstrable, coercive action by the state beyond the
    general directive to cooperate. Indeed, the combination of Gideon’s
    duty to cooperate under R.C. 4731.22(B)(34) and Investigator
    Yoakam’s process in this case exceeded an ordinary job pressure to
    cooperate.      As we have noted, R.C. 4731.22(B)(34) requires
    licensees to cooperate with investigations of the board.[1 (originally fn.8)]
    1. The following language appears as footnote 8 in the court of appeals’ opinion:
    It appears that the State contends that R.C. 4731.22(B)(34)’s duty to
    cooperate requires only that a subject answer truthfully questions posed by an
    investigator of the board during an interview. Compare United States v.
    Goodpaster, 
    65 F.Supp.3d 1016
    , 1029 (D.Or.2014) (noting that “[a]n order to
    ‘cooperate’ demands more of the reasonable employee than an order merely to be
    13
    SUPREME COURT OF OHIO
    Compare [United States v. Goodpaster, 
    65 F.Supp.3d 1016
    , 1029
    (D.Or.2014)] (noting that “Goodpaster was subject to a regulation
    * * * requiring that he ‘cooperate with all audits, reviews, and
    investigations conducted by the Office of Inspector General’ ”),
    quoting 39 C.F.R. 230.3(a). R.C. 4731.22(B) puts licensees on
    notice that their failure to cooperate, amongst other reasons, will
    penalize their license (by a vote of no fewer than six members of the
    board). Compare 
    id.
     (“The same regulation provides that ‘failing to
    cooperate [* * *] may be grounds for disciplinary or other legal
    action.’ ”), quoting 39 C.F.R. 230.3(a).
    Further, in addition to R.C. 4731.22(B)(34)‘s directive to
    cooperate with the board’s investigation, the record reflects “some
    demonstrable action of the state” supporting Gideon’s subjective
    belief. See [People v. ]Sapp[, 
    934 P.2d 1367
    , 1372 (Colo.1997)];
    [United States v. ]Camacho[, 739 F.Supp 1504, 1518 (S.D.Fla.)]. In
    this case, the demonstrable action of the State lies with Investigator
    Yoakam’s conduct and his intent underlying that conduct. Compare
    Camacho, 739 F.Supp. at 1518-1519 (construing the evidence in the
    ‘truthful’ ”), citing Minnesota v. Murphy, 
    465 U.S. 420
    , 434, 
    104 S.Ct. 1136
    , 
    79 L.Ed.2d 409
     (1984) (observing that “Murphy’s probation condition [to be
    truthful] proscribed only false statements”). That is, the State argues that “[t]elling
    falsehoods * * * is different than remaining silent, and the Fifth Amendment is
    not implicated.” (Appellee’s Brief at 6). However, the text of that subsection of
    the statute states that a subject must cooperate in investigations of the board. R.C.
    4731.22(B)(34) proceeds to provide a non-exhaustive list of ways in which a
    subject must cooperate with an investigation of the board—only one of which is
    to provide truthful answers to questions presented by the board in an investigative
    interview. See In re Hartman, 
    2 Ohio St.3d 154
    , 155-156, 
    443 N.E.2d 516
     (1983)
    (noting that the word “ ‘including’ implies that that which follows is a partial, not
    an exhaustive listing of all that is subsumed within the stated category.
    ‘Including’ is a word of expansion rather than one of limitation or restriction.”).
    (Emphases, brackets, and ellipses sic.)
    14
    January Term, 2020
    record reflecting the “actions of the investigators” to determine
    whether there was “demonstrable state conduct” and, thus, whether
    the defendants’ beliefs that they would penalized for asserting their
    Fifth Amendment rights were objectively reasonable).
    At the suppression hearing, Investigator Yoakam testified to
    the extent that he collaborated with law enforcement as part of his
    investigation—that is, he specifically stated that the investigation of
    Gideon “turned into a joint investigation.” (Aug. 22, 2017 Tr. at 4);
    (Oct. 13, 2017 Tr. at 7, 20-21).       Indeed, Sergeant Hochstetler
    concurred that he and Investigator Yoakam agreed “to cooperate
    with each other” during the course of their investigations. (Oct. 13,
    2017 Tr. at 51-52). By cooperating, Sergeant Hochstetler clarified
    that meant that he and Investigator Yoakam would share
    information. Investigator Yoakam elaborated that the Revised Code
    permits him to share information obtained as part of his
    investigations with law enforcement and that he will share such
    information if there is “a shared interest.”          (Id. at 19-20).
    Investigator Yoakam further testified that he shared the information
    he collected (regarding Gideon) with the Bluffton Police
    Department.
    Undeniably, R.C. 4731.22(F) provides, in relevant part, the
    following:
    “(3) In investigating a possible violation of this chapter or
    any rule adopted under this chapter, * * * the board may question
    witnesses, conduct interviews, administer oaths, order the taking of
    depositions, inspect and copy any books, accounts, papers, records,
    or documents, issue subpoenas, and compel the attendance of
    witnesses and production of books, accounts, papers, records,
    15
    SUPREME COURT OF OHIO
    documents, and testimony, except that a subpoena for patient record
    information shall not be issued without consultation with the
    attorney general’s office and approval of the secretary and
    supervising member of the board.
    “* * *
    “(4) All * * * investigations * * * of the board shall be
    considered civil actions for the purposes of section 2305.252 of the
    Revised Code.
    “(5) * * *
    The board may share any information it receives pursuant to
    an investigation * * * with law enforcement agencies, other
    licensing boards, and other governmental agencies that are
    prosecuting, adjudicating, or investigating alleged violations of
    statutes or administrative rules.”
    R.C. 4731.22(F)(3)-(5) (Apr. 6, 2017) (current version at R.C.
    4731.22(F)(3)-(5) (Mar. 20, 2019)).[2 (originally fn.9)]
    Thus, while there is nothing inherently wrong with
    Investigator Yoakam and law enforcement’s agreement to share
    2. The following language appears as footnote 9 in the court of appeals’ opinion:
    R.C. 2305.252 applies to peer-review privilege. See, e.g., Cousino v.
    Mercy St. Vincent Med. Ctr., 6th Dist. Lucas, 
    2018-Ohio-1550
    , 
    111 N.E.3d 529
    ,
    ¶ 15 (“The purpose of this statute is to protect the integrity and confidentiality of
    the peer review process so that health care entities have the freedom to
    meaningfully review and critique—and thereby improve—the overall quality of
    the healthcare services they provide.”). The statute also applies the peer-review
    privilege to only the Bureau of Workers’ Compensation (“BWC”); however, the
    statute excepts the BWC to “share proceedings and records within the scope of
    the peer review committee * * * with law enforcement agencies, licensing boards,
    and other governmental agencies that are prosecuting, adjudicating, or
    investigating alleged violations of applicable statutes or administrative rules.”
    R.C. 2305.252(B).
    (Emphasis and ellipsis sic.)
    16
    January Term, 2020
    information, the evidence in the record reveals that Investigator
    Yoakam exceeded statutorily permissible collaboration by taking
    demonstrable steps to coerce Gideon to provide him an
    incriminating, oral and written statement in reliance on Gideon’s
    duty to cooperate. In other words, Investigator Yoakam was posing
    as a “straw man” to effectuate law enforcement’s criminal
    investigation. See State v. Gradisher, 9th Dist. Summit No. 24716,
    
    2009-Ohio-6433
    , 
    2009 WL 4647378
    , ¶ 23 (Belfance, J., dissenting)
    (approving the “concern that government agents should not pose as
    ‘straw men’ in order to effectuate police investigations”).
    Specifically, Investigator Yoakam contacted Sergeant Hochstetler
    prior to interviewing Gideon, and “discussed that [he] was going to
    hold off on the administrative investigation until [law enforcement
    determined] that [Investigator Yoakam] could interview [Gideon].”
    (Oct. 13, 2017 Tr. at 7-8). Investigator Yoakam’s intention for
    sharing his investigative plan with law enforcement was to
    “determine how [law enforcement] was going to proceed with the
    criminal case” because proving an administrative-sanction case is
    easier “from a criminal conviction” as opposed to “through witness
    testimony.” (Id. at 15-16). That is, he elaborated that his method is
    “what they call a bootstrap on a criminal case that’s where a
    physician * * * is criminally charged, and the Board takes action on
    that criminal disposition, and the other [is] based on information
    gathered in the course of an investigation. Action that’s taken based
    on that.” (Id. at 15).
    Prior to Investigator Yoakam’s interview of Gideon,
    Sergeant Hochstetler told Investigator Yoakam that Gideon “denied
    any improprieties during [law enforcement’s] interview” of Gideon.
    17
    SUPREME COURT OF OHIO
    (Oct. 13, 2017 Tr. at 21, 55). And, after discussing Gideon’s denials
    to law enforcement with Sergeant Hochstetler, Investigator Yoakam
    informed Sergeant Hochstetler that it would not be “appropriate” for
    law enforcement to jointly interview Gideon with Investigator
    Yoakam. (Id. at 28, 55-56). Specifically, Investigator Yoakam
    testified that
    “doctor’s [sic] are obligated to cooperate in our investigation. So
    [he] did not want that to * * * impede in * * * any of the criminal
    proceedings...And [he] didn’t want * * * there to be an issue that the
    doctor provided a statement with law enforcement present because
    the provider is obligated to cooperate in our investigations.”
    (Emphasis added.) (Id. at 29). (See also Oct. 13, 2017 Tr. at 55);
    (Defendant’s Ex. 4). In other words, Investigator Yoakam’s method
    was to avoid a scenario in which his interview (of Gideon) could not
    be used as part of the criminal case because (as indicated by
    Investigator Yoakam) the lack of a criminal conviction would make
    his administrative-sanction case more cumbersome.             Compare
    Gradisher at ¶ 23 (Belfance, J., dissenting) (expressing concern that
    “government overreaching could easily occur by pushing off
    criminal investigations to state agents so as to bypass protection
    against the abridgement of an individual’s Fifth Amendment
    rights”); Camacho, 739 F.Supp. at 1519 (noting that the
    investigator’s action in purposely omitting “his preamble regarding
    voluntariness and compulsion * * * in order to avoid flagging the
    issue of voluntariness” “speaks louder” than any belief that the
    statements were voluntary and concluding that “the investigators’
    central aim was to take a statement first and litigate its admissibility
    later”).
    18
    January Term, 2020
    Moreover, based on our review of the record, Investigator
    Yoakam’s intent for the investigation reflects the demonstrable state
    action necessary to support Gideon’s subjective belief that his
    medical license would be penalized if he failed to cooperate with
    Investigator Yoakam’s investigation.      Specifically, Investigator
    Yoakam’s interview of Gideon reflects his intent to assist law
    enforcement in obtaining a criminal conviction of Gideon for
    purposes of influencing the outcome the administrative-sanction
    case against Gideon.
    Even though he is not a law enforcement officer, Investigator
    Yoakam testified that he had law enforcement training and is
    familiar with the elements of offenses under the Revised Code,
    including sexual imposition.      Keeping his training in mind,
    Investigator Yoakam arrived unannounced to Gideon’s medical
    office to conduct his interview to catch him “off guard” “to get the
    truth out of [him].” (Oct. 13, 2017 Tr. at 5, 32-33). Despite Gideon
    having patient appointments at the time of the visit, Investigator
    Yoakam did not advise Gideon that he did not have to speak with
    him that day or otherwise offer to reschedule—he merely asked
    Gideon “if he would have a few minutes to chat with” him. (Id. at
    5). (See also State’s Ex. A). In other words, Investigator Yoakam
    did nothing to dissuade Gideon’s belief that he was statutorily
    obligated to cooperate with his investigation, which included
    consenting to Investigator Yoakam’s request to “chat.” Compare
    Camacho at 1511 (“At no time during the interview or after did
    either Sergeant Green or Assistant State Attorney DiGregory make
    any effort to dissuade Sinclair of his view that he was compelled to
    give a statement or answer his question.”).
    19
    SUPREME COURT OF OHIO
    (Emphases and ellipses sic; brackets added in citations and footnote numbers;
    remaining brackets sic.) 
    2019-Ohio-2482
    , 
    130 N.E.3d 357
    , at ¶ 38-45.
    {¶ 33} This analysis amply supports a conclusion that Yoakam’s
    investigation was improperly coercive under Garrity v. New Jersey, 
    385 U.S. 493
    ,
    
    87 S.Ct. 616
    , 
    17 L.Ed.2d 562
     (1967). Although there is nothing wrong with
    Yoakam and the Bluffton Police Department sharing information, their approach
    suggests that Yoakam was strategically attempting to elicit information to benefit
    the Bluffton Police Department investigation.              This is tantamount to
    collaborating—not merely sharing information that was collected independently.
    If Yoakam had appeared at Gideon’s office with an officer from the Bluffton Police
    Department, the coercive nature of the investigation would have been manifest. It
    is no less so here. Yoakam was all but deputized to act for the benefit of the
    Bluffton Police Department. Moreover, the court of appeals examined another way
    in which the interview demonstrates that Gideon had an objectively reasonable
    belief that his medical license was at risk if he did not cooperate:
    Investigator Yoakam advised Gideon at multiple points to “to go
    back to [law enforcement] and change his statement” to avoid facing
    possible falsification charges. (Oct. 13, 2017 Tr. at 22). Investigator
    Yoakam’s insistence that Gideon return to law enforcement to
    change his statement is also evidence supporting Gideon’s belief
    that a refusal to give a statement will be met with a licensure penalty.
    That is, Investigator Yoakam’s insistence that Gideon provide law
    enforcement with a statement reflects an intent to coerce Gideon to
    cooperate with the investigation. Indeed, (as raised during cross-
    examination) if Investigator Yoakam was “just concerned about
    [the] medical investigation there would be no need to tell [Gideon]
    20
    January Term, 2020
    to go back to the police department and change his statement * * *.”
    (Id. at 22).
    (Brackets and ellipsis sic.) 
    2019-Ohio-2482
    , 
    130 N.E.3d 357
    , at ¶ 48.
    {¶ 34} The court of appeals also had appropriate concern that Yoakam’s
    conduct after the interview reflects his understanding that he and the Bluffton
    Police were engaged in a joint investigation, not a mere sharing of information:
    At the conclusion of the interview, instead of reporting back
    to the board, Investigator Yoakam immediately went to the Bluffton
    Police Department to report Gideon’s confessions to law
    enforcement. (See Defendant’s Ex. 2). Despite his employment
    responsibilities with the State Medical Board, Investigator Yoakam
    chose to immediately share Gideon’s confessions with law
    enforcement “because the doctor had [ ] an interview with [law
    enforcement] where he denied any impropriety so [he] wanted to tell
    [law enforcement] what happened during [his] interview.” (Oct. 13,
    2017 Tr. at 26-27). Moreover, Investigator Yoakam agreed that he
    “wanted to assist [law enforcement] in that criminal investigation by
    providing [law enforcement] with statements made by Dr. Gideon
    during an interview that same day * * *[.]” (Id. at 27).
    (Emphasis, brackets, and ellipsis sic.) 
    2019-Ohio-2482
    , 
    130 N.E.3d 357
    , at ¶ 50.
    {¶ 35} I agree with the court of appeals’ conclusion that
    based on the facts and circumstances presented by this case,
    Investigator Yoakam’s actions created an impression that Gideon’s
    refusal to cooperate with his investigation would result in the type
    21
    SUPREME COURT OF OHIO
    of penalty prohibited under Garrity.        See Camacho at 1520
    (concluding “that the actions of the State were directly implicated in
    creating [the] belief” that the defendants’ subjective belief “that
    failure to answer would result in termination”). Therefore, Gideon’s
    belief that his medical license would be penalized if he did not
    cooperate with Investigator Yoakam’s investigation was objectively
    reasonable. See 
    id.
     Thus, Gideon’s statements were not voluntary
    within the meaning of Garrity. Accord Graham, 
    136 Ohio St.3d 125
    , 
    2013-Ohio-2114
    , 
    991 N.E.2d 1116
    , at ¶ 30 (“Statements
    extracted under these circumstances cannot be considered voluntary
    within the meaning of Garrity.”)
    
    2019-Ohio-2482
    , 
    130 N.E.3d 357
    , at ¶ 51.
    {¶ 36} The circumstances of Yoakum’s interview demonstrate that it was
    coercive and therefore that Gideon’s subjective belief that he could lose his medical
    license if he did not answer was objectively reasonable. Accordingly, I conclude
    that the trial court erred when it denied Gideon’s motion to suppress statements he
    made to Yoakam. I would affirm the well-reasoned decision of the court of appeals.
    I dissent.
    _________________
    Nicole M. Smith, Lima Assistant City Prosecuting Attorney, and Anthony
    M. DiPietro, Deputy Law Director, for appellant and cross-appellee.
    Dennis C. Belli, for appellee and cross-appellant.
    _________________
    22