State v. Deases

Decision Date22 June 1994
Docket NumberNo. 92-2045,92-2045
Citation518 N.W.2d 784
PartiesSTATE of Iowa, Appellee, v. Edward Cassimiro DEASES, Appellant.
CourtIowa Supreme Court

Linda Del Gallo, State Appellate Defender, and B. John Burns, Asst. State Appellate Defender, for appellant.

Bonnie J. Campbell, Atty. Gen. and Thomas S. Tauber and Robert Glaser, Asst. Attys. Gen., for appellee.

Considered by McGIVERIN, C.J., and LARSON, CARTER, SNELL, and TERNUS, JJ.

TERNUS, Justice.

Defendant Edward Cassimiro Deases was convicted after a jury trial of first-degree murder in violation of Iowa Code section 707.2 (1993). Deases now appeals, arguing that the district court erred in admitting the testimony of three of the State's witnesses. First, Deases argues the court erred in admitting the testimony of a nurse because this evidence was protected by the professional communications privilege. Second, he contends the testimony of a correctional officer should not have been admitted because the statements of Deases to which the officer testified were obtained in violation of Deases' Fifth Amendment rights. Third, Deases asserts the court erred in admitting the testimony of a rebuttal witness because the testimony was hearsay. Deases' last assignment of error is the trial court's failure to give Deases' requested instruction on impeachment. We agree that the testimony challenged by Deases was improperly admitted. Consequently, we reverse.

I. Background Facts and Proceedings.

At the time of the offense involved in this case, Deases was an inmate of the Fort Madison Penitentiary. He and another inmate, Joseph Perea, fought in the penitentiary cafeteria. The fight ended when Deases fatally stabbed Perea with a shank (a knife-like instrument).

Deases was charged with first-degree murder. He claimed self-defense. There was conflicting evidence about who initiated the fight. There was also conflicting evidence concerning whether it was Deases or Perea who brought the shank into the cafeteria. The jury found Deases guilty and the court sentenced him to life imprisonment. We will discuss additional facts as necessary.

II. Professional Communications Privilege.

During the fight with Perea, Deases was cut on the palm of his hand. He was taken to the prison health care unit for treatment. Nurse Adella Hull asked Deases where he got the shank. Deases told her he made it in the welding shop. Three correctional officers and the treating physician were present during Nurse Hull's conversation with Deases.

The trial court overruled Deases' motion to suppress the nurse's testimony. Deases had contended that this testimony should not be admitted because his statements to the nurse were protected by the professional communications privilege. See Iowa Code § 622.10 (1993). The district court concluded that Deases' statements were not privileged because they were made in the presence of prison guards. We review the trial court's interpretation of section 622.10 for errors of law. State v. Jones, 490 N.W.2d 787, 789 (Iowa 1992).

Iowa Code section 622.10 prohibits a physician's assistant from disclosing, in testimony, any confidential communication obtained because of the person's employment and necessary to enable the person to discharge the functions of the person's office. The physician-patient privilege is intended to promote free and full communication between a patient and his doctor so that the doctor will have the information necessary to competently diagnose and treat the patient. State v. Bedel, 193 N.W.2d 121, 124 (Iowa 1971). We construe this statute liberally to carry out its manifest purpose. State v. Tornquist, 254 Iowa 1135, 1154, 120 N.W.2d 483, 494 (1963).

The essential elements of the professional communications privilege in this case are: (1) the existence of a professional relationship between the physician's assistant and the patient; (2) the information is acquired during this relationship; and (3) the information is necessary to enable the assistant to treat the patient skillfully. Snethen v. State, 308 N.W.2d 11, 14 (Iowa 1981). However, even when these elements are present, the privilege may be lost if the patient makes statements in the presence of a third person. Tornquist, 254 Iowa at 1155, 120 N.W.2d at 495.

The State concedes that a professional relationship existed between Deases and Nurse Hull and that any information she learned from him was acquired during this relationship. However, the State argues that Deases' statement regarding where the shank came from was not privileged because it was not information necessary for Deases' treatment. We disagree.

Nurse Hull testified that she asked Deases where he got the shank so that she could decide whether to give him a tetanus shot. Hull stated it was important in treating Deases to find out whether there were shavings in his hand. She believed that the source of the shank had a bearing on whether shavings were likely to be found in Deases' cut. Based on this evidence, we conclude Deases' communications to the nurse regarding the shank were necessary to enable her to treat him skillfully.

The State also argues that Deases lost any privilege he might otherwise have had because his statements were made in the presence of third persons, the three correctional officers. Deases argues that the correctional officers were assistants to the doctor and nurse because they were there to protect the medical personnel. We have not previously considered this precise argument.

In the Tornquist case, we held that the testimony of a hospital employee concerning statements she heard the defendant make to his treating physician was admissible. Our decision was based on the lack of evidence that the hospital employee was present to assist the doctor. Tornquist, 254 Iowa at 1155, 120 N.W.2d at 495.

In State v. Flaucher, 223 N.W.2d 239, 241 (Iowa 1974), we stated in dicta that statements made by a defendant to his doctor in the presence of police officers were not privileged. However, the defendant in that case apparently did not argue that the officers' presence was necessary for the defendant to obtain treatment.

Finally, in State v. Craney, 347 N.W.2d 668 (Iowa 1984), we considered the admissibility of a police officer's testimony concerning a statement he heard the defendant make to the defendant's attorney. We held that the admission of this testimony did not violate the attorney-client privilege because the communication made by the defendant to his attorney was not intended to be confidential. Craney, 347 N.W.2d at 679.

The New York Court of Appeals confronted a situation similar to that presented here in People v. Decina, 2 N.Y.2d 133, 157 N.Y.S.2d 558, 138 N.E.2d 799 (App.1956). In Decina, a police guard was present, pursuant to the district attorney's orders, during defendant's examination by a doctor. In determining whether the privilege should apply in this situation the court said that the "true test appears to be whether in the light of all the surrounding circumstances, and particularly the occasion for the presence of the third person, the communication was intended to be confidential." Decina, 157 N.Y.S.2d at 569, 138 N.E.2d at 807. Applying this test the court found that the communication was privileged and improperly admitted into evidence at trial. Id.; see also State v. Gibson, 3 Wash.App. 596, 476 P.2d 727, 730 (1970) (court applied test set forth in Decina and held that communication between defendant and doctor in presence of police guard was privileged).

Similarly, in State v. George, 223 Kan. 507, 575 P.2d 511, 517 (1978), the Kansas Supreme Court concluded that the information obtained by the defendant's physician during his examination of the defendant was privileged even though police officers were present during the examination. The court observed, "[a] patient who is in custody can hardly be expected to ask the arresting officers to leave the jail so that he may be alone with his physician." George, 575 P.2d at 517.

We hold that the presence of a third person during an otherwise confidential communication does not automatically destroy the privilege. If the third person is present to assist the physician in some way or the third person's presence is necessary to enable the defendant to obtain treatment, then the privilege protects confidential communications made in the presence of the third person.

We find that the presence of the correctional officers here was necessary for Deases to be treated. They were not casual observers. The State acknowledges the guards were there for security. The need to protect the doctor and nurse from Deases is understandable since Deases had just stabbed and killed another inmate and had previously been convicted of the brutal killing of a young woman. See State v. Deases, 479 N.W.2d 597 (Iowa App.1991). Any attempt by Deases to ask the guards to step outside would have been futile. Under these circumstances, the presence of the correctional officers did not destroy the doctor-patient privilege.

We believe this interpretation of the statute promotes its intended purpose of allowing free and full communication between the doctor and patient as needed for adequate treatment. Any other interpretation would unfairly require a prisoner to risk inadequate treatment or surrender his doctor-patient privilege.

In summary, we find that the essential elements for existence of the professional communications privilege were present. Further, we conclude that the communications Deases made to the nurse were privileged despite the presence of the correctional officers. Consequently, the district court erred in admitting the testimony of Nurse Hull into evidence.

III. Fifth Amendment Claim.

While Deases was at the health care unit, a Fort Madison police sergeant advised Deases of his Miranda rights. Deases told the police officer that he did not want to talk. After Deases had been treated, the officers took him to a small office down the hall...

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