The Texas Court of Criminal Appeals (CCA) has convoluted history with blood and privacy.


In a 1991 opinion, State v. Comeaux, the CCA dealt with a situation where a defendant involved in a traffic accident was taken to a hospital where his blood was drawn by hospital personnel for medical purposes. A state trooper investigating the accident secured a sample of the defendant’s blood even though the trooper had no reason to believe that alcohol was the cause of the accident or that the defendant was intoxicated at the time of the accident. The State tested the blood sample at a DPS laboratory.  It revealed the defendant had been intoxicated at the time of the accident. The defendant was indicted and convicted of driving while intoxication. The CCA reversed the conviction, finding that the securing and testing of the blood sample violated the defendant’s Fourth Amendment privacy rights.


Six years later in State v. Hardy, the CCA in an en banc opinion in a misdemeanor driving while intoxicated conviction dealt with a situation in which blood was not only drawn from a defendant but tested for alcohol as well. The Hardy court essentially held that the State’s acquisition of the test results of the blood draw did not implicate any Fourth Amendment privacy interests. Hardy, a pre-HIPPA case, held that whatever privacy rights a patient may have in his or her medical records, it did not include the results of blood-alcohol testing by hospital personnel.


Three years ago in State v. Huse the CCA in yet another misdemeanor driving case held that when law enforcement personnel extracts a defendant’s blood and subsequently conduct blood-alcohol testing on the blood, two searches have occurred. The CCA once again held that HIPPA notwithstanding, a defendant does not enjoy a reasonable expectation of privacy in his or her medical records related to blood-alcohol test results.


Difference Between Blood and Medical Records


Essentially, the CCA settled case law through Hardy and Huse that the State need not secure a warrant to obtain the results of blood-alcohol testing by hospital personnel performed for medical purposes following a traffic accident.


In 2014, Juan Martinez was transported to a hospital in an ambulance following a traffic accident in Beeville, Texas. Medical personnel informed him that they had drawn his blood as part of its “trauma procedures.” Martinez told the medical personnel that he did not have the money to pay for the procedures. He removed the IV from his arm and left the hospital. A state trooper arrived at the hospital after Martinez had left the facility. Hospital personnel informed the trooper that they had Martinez’s blood. He instructed them not to destroy the blood.


The trooper thereafter secured a Grand Jury Subpoena which he subsequently showed to hospital personnel. The hospital released four vials of Martinez’s blood to the trooper. A DPS laboratory test confirmed that Martinez had been intoxicated at the time of the accident which resulted in a fatality.


Martinez was indicted for intoxication manslaughter. Upon a motion to suppress the DPS test results, the state trial court held that while the initial seizure of Martinez’s blood from the hospital was a valid seizure, the search of the blood itself violated the Fourth Amendment because the state did not secure a requisite search warrant. The Thirteenth Court of Appeals upheld the trial court ruling.


The state sought, and secured, discretionary review before the CCA.


In a March 20, 2019 decision, State v. Martinez, the CCA held that:


“ …  we believe the Comeaux plurality reached the correct result twenty eight years ago when it considered the question we are faced with today. There are private facts contained in a sample of a person’s blood beyond simple confirmation of a suspicion that a person is intoxicated. These private facts are those that a person does not voluntarily share with the world by the mere drawing of blood and may be subject to Fourth Amendment protection. We hold that there is an expectation of privacy in blood that is drawn for medical purposes. The expectation is not as great as an individual has in the sanctity of his own body against the initial draw of blood …”


Warrantless Blood Test Incident to Arrest Unconstitutional


Relying strongly on the U.S. Supreme Court decision in Birchfield v. North Dakota in which that court held that warrantless blood testing incident to an arrest violates the Fourth Amendment, the CCA concluded:


“In this case, medical staff at the hospital performed a private search by beginning trauma procedures and drawing Appellee’s blood for medical purposes. The government’s actions consisted of subjecting Appellee’s blood to testing at the DPS laboratory. As discussed above, testing itself constitutes a search, and this search was not done by the hospital. Appellee’s privacy interest vis-a-vis the contents of the blood—the blood’s ‘informational dimension’ —had not been frustrated by 4 the actions of the hospital. The State, and only the State, tested and therefore searched the blood, and, ipso facto, the government search went beyond the scope of the private search.


“We hold that there is a Fourth Amendment privacy interest in blood that has already been drawn for medical purposes. In this case, Appellee had a subjective expectation of such a privacy interest in his blood, and the State’s subsequent testing of the blood was a Fourth Amendment search separate and apart from the seizure of the blood by the State. Because no exception to the warrant requirement applied, the State was required to obtain a warrant before testing Appellee’s blood. The trial court properly granted Appellee’s motion to suppress, and the court of appeals correctly affirmed. We therefore affirm the judgment of the court of appeals.”


The Martinez decision reinforces society’s reasonable expectation that their health care information is private under HIPPA; that health care providers cannot disclose their private medical information to law enforcement absent a court order, warrant, or subpoena.