Case Title: MVA v. Dove

Citation: 413 Md. 70

Docket Number: 40/09

State: maryland

Court: Maryland Supreme Court

Date: 2010-03-17T00:00:00Z

Document:
HEADNOTE —— Administrative Law— Judicial Review— Alcohol
Concentration Testing
The Administrative Law Judge (“ALJ”) had substantial evidence to determine that the
respondent, John Edward Dove (“Dove”), should have his driver’s license suspended for
refusing a blood test to determine alcohol concentration pursuant to Md. Code (1977, 2009
Repl. Vol.), § 16-205.1(b) of the Transportation Article.  The ALJ correctly determined that
the officer properly requested a blood test to determine alcohol concentration when medical
providers removed Dove from the scene of a motor vehicle collision to a hospital emergency
room.  The ALJ had substantial evidence to conclude that Dove’s refusal was not justified
by his fear of needles, his willingness to consent to a breath test, or the later administration
of an alcohol content test by hospital staff. 
IN THE COURT OF APPEALS
OF MARYLAND
No. 40
September Term, 2009
MOTOR VEHICLE ADMINISTRATION
v.
JOHN EDWARD DOVE
 
Bell, C.J.
Harrell
Battaglia
Greene
Murphy
Adkins
Barbera, 
JJ.
Opinion by Greene, J.
Filed: March 17, 2010
1Dove testified that he “refused medical treatment on the scene and they did not 
want to let [him] go.  They took [him] to the hospital strapped to a backboard.”  It is not
clear from the record whether Dove thought better of his initial decision to refuse medical
care, given his wrist fracture and possible head injury, or whether he was taken to Calvert
(continued...)
In this case, we are asked to consider whether the Administrative Law Judge (“ALJ”)
determined correctly that the respondent, John Edward Dove (“Dove”), should have his
driver’s license suspended for refusing a blood test to determine alcohol concentration while
a hospital emergency room patient, at a time when Dove asserted that his refusal was
justified because of his fear of needles, his preference for a breath test, and the later
administration of an alcohol content test by hospital staff.  We shall hold that the record
provided substantial evidence in support of the ALJ’s decision that Dove refused an alcohol
concentration test, and that the ALJ properly suspended Dove’s license pursuant to Md.
Code (1977, 2009 Repl. Vol.), § 16-205.1(b) of the Transportation Article.
I.
At approximately 5:50 p.m., on March 3, 2008, Dove was involved in a motor vehicle
collision.  Dove was traveling southbound on Route 4 in Calvert County on a motorcycle
when he hit the rear of another vehicle that was slowing for a traffic light.
Officer Traas from the Calvert County Sheriff’s Office responded to the scene, where
he found Dove lying in the median receiving medical treatment.  Officer Traas noticed
Dove’s red, watery eyes and a “strong odor” of alcohol emanating from his person.  Upon
questioning, Dove acknowledged that he had consumed one beer earlier in the day.  Dove
was subsequently transported to Calvert Memorial Hospital for medical treatment.1
1(...continued)
Memorial against his will.
2
At Calvert Memorial Hospital, Officer Traas read to Dove his rights granted by
statute, as contained in the DR-15 Advice of Rights form (“DR-15"), and asked him to
submit to a blood test to determine alcohol concentration based on the officer’s suspicion
that Dove was driving under the influence of alcohol.  Dove indicated that he was not
willing to submit to a blood test because he does not “do needles.”  He volunteered to take
a breath test, which Officer Traas declined to administer.  Dove also offered to refuse
medical treatment and proceed to the police station, which Officer Traas rejected.  Officer
Traas asked Dove to sign the DR-15 form to acknowledge that he was advised of the
consequences of refusal, which Dove signed.  Dove asserted in his testimony that he was
strapped to a backboard when he signed the form.  Officer Traas confiscated Dove’s driver’s
license and issued him a temporary license.  After Officer Traas left the emergency room,
hospital personnel administered a preliminary breath test (“PBT”) to determine alcohol
concentration as part of Dove’s medical care, the result of which was 0.00.  The medical
staff provided routine medical care for Dove’s injuries, including administering an
intravenous morphine drip.
 
Dove requested a hearing on the pending 120-day mandatory license suspension for
refusal to take an alcohol concentration test.  After conducting an administrative hearing, the
ALJ found that Officer Traas had reasonable grounds to believe that Dove was driving his
3
vehicle while under the influence or impaired by the consumption of alcohol, based on the
odor of alcohol on Dove’s breath, his watery and red eyes, his dilated pupils, and his
acknowledgment that he consumed one beer earlier in the day.  The ALJ made the following
factual findings:  Officer Traas requested that Dove submit to an alcohol concentration test,
which Dove refused.  Officer Traas then fully advised Dove of the administrative sanctions
to be imposed should he refuse an alcohol concentration test.  Dove initially refused medical
treatment at the scene, but was subsequently transported to a hospital.  At the hospital, Dove
refused to take a blood test to determine alcohol concentration after having been advised of
his rights and of the consequences of refusal.  Dove offered to take a breath test instead of
a blood test, stating that he is afraid of needles, but refused the test as offered by Officer
Traas.  The ALJ determined that when an individual is not available to take a breath test at
the police station, Maryland law requires that a blood test be offered.  In this case, Officer
Traas offered a blood test.  
While Dove was at the hospital, staff administered a PBT.  The breath test
administered as part of hospital protocol was not an alcohol concentration test pursuant to
§ 16-205.1(a)(2) of the Transportation Article, which mandates that “[a]ny person who
drives . . . on a highway . . . in this State is deemed to have consented . . . to take a test” for
alcohol concentration.  Accordingly, the ALJ concluded that Dove refused an alcohol
concentration test in violation of § 16-205.1(b) of the Transportation Article, which
penalizes refusal of the test described in § 16-205.1(a)(2) of the Transportation Article, and
2Md. Code (1973, 2006 Repl. Vol.), § 12-305 of the Courts and Judicial
Proceedings Article states that:
(continued...)
4
suspended Dove’s driving privilege for 120 days.
On judicial review, the Circuit Court for Calvert County reversed the ALJ’s decision
and held that it is improper to request a blood test rather than a breath test when a suspect
states a preference for a breath test due to a fear of needles.  Also, the court opined that a
blood test was not required pursuant to Md. Code (1973, 2006 Repl. Vol.), § 10-
305(a)(1)(ii) of the Courts and Judicial Proceedings Article because it was “debatable”
whether Dove’s injures “required” removal to a hospital, given that Dove was conscious,
aware, and refusing medical treatment at the scene.  Because this Court noted the
Legislature’s preference for breath tests rather than blood tests in Hyle v. MVA, 348 Md.
143, 156, 702 A.2d 760, 764 (1997), the Circuit Court strictly construed the exceptions
warranting a blood test enumerated in § 10-305(a)(1) of the Courts and Judicial Proceedings
Article.  The Circuit Court also held that Dove did not make a knowing and voluntary
refusal of the alcohol concentration test because he believed that signing an
acknowledgment of refusal was a prerequisite to receiving medical treatment.  Finally, the
Circuit Court held that the ALJ erred in refusing to accept evidence of the preliminary breath
test administered by the hospital staff.  
This Court granted the State’s petition for certiorari, pursuant to Md. Code (1973,
2006 Repl. Vol.), § 12-305(2) of the Courts and Judicial Proceedings Article,2 to determine
2(...continued)
The Court of Appeals shall require by writ of certiorari that a
decision be certified to it for review and determination in any
case in which a circuit court . . . has rendered a final judgment
on appeal from an administrative decision under Title 16 of the
Transportation Article if it appears to the Court of Appeals,
upon petition of a party that: . . . (2) There are other special
circumstances rendering it desirable and in the public interest
that the decision be reviewed.
5
1) whether an officer may rely on the judgment of medical personnel regarding a driver’s
removal to a hospital when evaluating whether a blood test for alcohol concentration is
required pursuant to § 10-305(a)(1)(ii) of the Courts and Judicial Proceedings Article; and
2) whether a driver’s offer to consent to a method of alcohol concentration testing other than
the method required by § 10-305(a) of the Courts and Judicial Proceedings Article, or the
driver’s consent to an alternative method of alcohol concentration testing for purposes of
medical treatment, constitutes a refusal of an alcohol concentration test as required by § 16-
205.1(a)(2) of the Transportation Article.
II.
Pursuant to the Maryland Administrative Procedure Act, Md. Code (1984, 2009 Repl.
Vol.), § 10-201 et seq. of the State Government Article, “Maryland courts play a limited role
when reviewing adjudicatory decisions of administrative agencies.”  MVA v. Shepard, 399
Md. 241, 251, 923 A.2d 100, 106 (2007).  Md. Code (1984, 2009 Repl. Vol.), § 10-222(h)
of the State Government Article governs the scope of judicial review of agency decisions:
Decision. — In a [judicial review] proceeding under this section,
6
the court may:
(1) remand the case for further proceedings;
(2) affirm the final decision; or
(3) reverse or modify the decision if any substantial right of the
petitioner may have been prejudiced because a finding,
conclusion, or decision:
(i) is unconstitutional;
(ii) exceeds the statutory authority or jurisdiction of the
final decision maker;
(iii) results from an unlawful procedure;
(iv) is affected by any other error of law;
(v) is unsupported by competent, material, and substantial
evidence in light of the entire record as submitted; or
(vi) is arbitrary or capricious.
A reviewing court’s role is “limited to determining if there is substantial evidence in
the record as a whole to support the agency’s findings and conclusions . . . .  In applying the
substantial evidence test, a reviewing court decides whether a reasoning mind reasonably
could have reached the factual conclusion the agency reached.”  Shepard, 399 Md. at 252,
923 A.2d at 106 (quoting Board of Physicians v. Banks, 354 Md. 59, 67-68, 729 A.2d 376,
380-81 (1999)); see also MVA v. Weller, 390 Md. 115, 141, 887 A.2d 1042, 1057 (2005);
MVA v. Atterbeary, 368 Md. 480, 490-91, 796 A.2d 75, 81-82 (2002).  “[A] court’s task on
review is not to ‘substitute its judgment for the expertise of those persons who constitute the
administrative agency’” when there is substantial evidence supporting the ALJ’s decision.
Weller, 390 Md. at 142, 887 A.2d at 1058 (quoting Banks, 354 Md. at 67-69, 729 A.2d at
380-81 (quoting United Parcel v. People’s Counsel, 336 Md. 569, 576-77, 650 A.2d 226,
230 (1994) (internal citations omitted) (emphasis in original))).  The reviewing court “may
set aside an agency’s factual finding only when the finding is ‘unsupported by competent,
7
material, and substantial evidence in light of the entire record as submitted.’”  Shepard, 399
Md. at 252, 923 A.2d at 106 (quoting Spencer v. State Board of Pharmacy, 380 Md. 515,
529, 846 A.2d 341, 349 (2004)).
This Court reviews the agency’s decision, not the decision of the Circuit Court,
applying the same statutory standards used by the Circuit Court.  Weller, 390 Md. at 140,
887 A.2d at 1057; Spencer, 380 Md. 515, 524, 846 A.2d 341 (2004); Atterbeary, 368 Md.
at 491, 796 A.2d at 81-82.  The “agency’s decision is prima facie correct and presumed
valid,” and viewed in the light most favorable to the agency.  Shepard, 399 Md. at 252, 923
A.2d at 106 (quoting Banks, 354 Md. at 67-68, 729 A.2d at 380-81), Aviation
Administration v. Noland, 386 Md. 556, 571, 873 A.2d 1145, 1154 (2005) (reaffirming the
principle that the agency’s decision is “‘prima facie correct and presumed valid, and . . . it
is the agency’s province to resolve conflicting evidence’ and to draw inferences from that
evidence” (quoting Banks, 354 Md. at 67-69, 729 A.2d at 380-81 (internal citations
omitted)).
III.
Section 16-205.1(a)(2) of the Transportation Article, sometimes called the “Implied
Consent Statute,” states that “[a]ny person who drives or attempts to drive a motor vehicle”
on a Maryland roadway “is deemed to have consented” to an alcohol concentration test if
a police officer reasonably suspects that the driver is under the influence of alcohol or
3Md. Code (1977, 2009 Repl. Vol), § 16-205.1(a) of the Transportation Article
states:
Suspension or disqualification for refusal to submit to
chemical tests for intoxication.
(a) Definitions; implied consent to chemical test.  —
(1)(i)  In this section the following words have the
meanings indicated. . . . 
(iv)  “Test” means, unless the context requires
otherwise:
1.  A test of the person’s breath or of 1
specimen of a person’s blood to determine alcohol
concentration;
2.  A test or tests of 1 specimen of a
person’s blood to determine the drug or controlled dangerous
substance content of the person’s blood; or
3.  Both . . . .
(2)  Any person who drives or attempts to drive a motor
vehicle on a highway or on any private property that is used by
the public in general in this State is deemed to have consented,
subject to the provisions of §§ 10-302 through 10-309,
inclusive, of the Courts and Judicial Proceedings Article, to take
a test if the person should be detained on suspicion of driving or
attempting to drive while under the influence of alcohol, while
impaired by alcohol, while so far impaired by any drug, any
combination of drugs, or a combination of one or more drugs
and alcohol that the person could not drive a vehicle safely,
while impaired by a controlled dangerous substance, in violation
of an alcohol restriction, or in violation of § 16-813 of this title.
4Md. Code (1973, 2006 Repl. Vol.), §§ 10-302 through 10-309 of the Courts and
Judicial Proceedings Article, establish the protocols that police officers must follow when
obtaining a test of a driver’s “breath or blood . . . for the purpose of determining alcohol
concentration” or “drug or controlled dangerous substance content of the person’s blood.”
(continued...)
8
drugs.3  Section 16-205.1 of the Transportation Article is read in pari materia with Md. Code
(1973, 2006 Repl. Vol.), §§ 10-302 through 10-309 of the Courts and Judicial Proceedings
Article,4 which establish the parameters of alcohol concentration testing.  Lowry v. State,
4(...continued)
§ 10-302 of the Courts and Judicial Proceedings Article.  “A specimen of breath or 1
specimen of blood may be taken for the purpose of a test for determining alcohol
concentration . . . within 2 hours after the person is apprehended.”  § 10-303(a) of the Courts
and Judicial Proceedings Article.  The person administering the test must be a “qualified
medical person” or a “qualified person” as defined by §§ 10-304(a)(2) and (3) of the Courts
and Judicial Proceedings Article, and the test must be administered using “equipment
approved by the toxicologist under the Postmortem Examiners Commission” at the request
of a police officer.  §§ 10-304(b) and (c) of the Courts and Judicial Proceedings Article.  If
the officer and the personnel who perform the test follow the statutory protocols, the results
of the test are “admissible as substantive evidence without the presence or testimony of the
technician or analyst who performed the test,” § 10-306(a)(1) of the Courts and Judicial
Proceedings Article, and the state is entitled to presumptions about intoxication pursuant to
§ 10-307 of the Courts and Judicial Proceedings Article.
9
363 Md. 357, 368-69, 768 A.2d 688, 694 (2001).  The alcohol concentration test shall be
a breath test, unless a blood test is required pursuant to § 10-305(a)(1) of the Courts and
Judicial Proceedings Article.  Section 10-305(a)(1) states: 
Chemical test for alcohol, drug or controlled dangerous
substance content — Type of test administered.
(a) Alcohol content. — The type of test administered to
the defendant to determine alcohol concentration shall be the
test of breath except that the type of test administered shall be:
(1) A test of blood if:
(i) The defendant is unconscious or
otherwise incapable of refusing to take a test to determine
alcohol concentration; 
(ii) Injuries to the defendant require
removal of the defendant to a medical facility;
(iii) The equipment for administering the
test of breath is not available; or
(iv) The defendant is required to submit to
a test of one specimen of blood under 16-205.1(c)(1)(ii) of the
Transportation Article; or
(2) Both a test of the person’s breath and a test of
one specimen of the person’s blood if the defendant is required
10
to submit to both a test of the person’s breath and a test of one
specimen of the person’s blood under § 16-205.1(c)(1)(iii) of the
Transportation Article. . . . 
Section 10-305(a) of the Courts and Judicial Proceedings Article demonstrates the General
Assembly’s clear preference for a breath test, unless an enumerated exception applies, which
justifies the invasiveness of a blood test.  Hyle, 348 Md. at 153, 702 A.2d at 764.  The blood
test must be administered by “a qualified medical person using equipment approved by the
toxicologist under the Postmortem Examiners Commission acting at the request of a police
officer,” Md. Code (1973, 2006 Repl. Vol.), § 10-304(c)(1)(i) of the Courts and Judicial
Proceedings Article, and “shall be taken within 2 hours after the person accused is
apprehended,” Md. Code (1973, 2006 Repl. Vol.), § 10-303(a)(2) of the State Government
Article.
Although § 16-205.1(a)(2) of the Transportation Article mandates that drivers on
Maryland roads consent to an alcohol concentration test by default, § 16-205.1(b) of the
Transportation Article grants drivers the right to refuse the test.  Refusing an alcohol
concentration test, however, is not without consequences.  Section 16-205.1(b) enumerates
the consequences of refusal:
(b)  No compulsion to take chemical test; consequences of
refusal. — 
(1) Except as provided in subsection (c) of this section,
a person may not be compelled to take a test.  However, the
detaining officer shall advise the person that, on receipt of a
sworn statement from the officer that the person was so charged
and refused to take a test, or was tested and the result indicated
an alcohol concentration of 0.08 or more, the Administration
11
shall:
(i) In the case of a person licensed under this title:
. . . 
3.  For a test refusal:
A.  For a first offense, suspend the driver’s
license for 120 days; or
B.  For a second or subsequent offense,
suspend the driver’s license for 1 year . . . . 
As the statute indicates, the officer must advise the driver of consequences of refusing the
alcohol concentration test, thus affording the driver the opportunity to make an informed
choice.  Forman v. Motor Vehicle Admin., 332 Md. 201, 206, 630 A.2d 753, 762 (1993). 
To assist police officers in providing the required notice of the administrative penalty
for refusal of an alcohol concentration test, “[t]he MVA has developed an Advice of Rights
form, the DR-15, which accurately and adequately conveys to the driver the rights granted
by the statute.”  Forman, 332 Md. at 218, 630 A.2d at 762.  The officer presents the DR-15
Advice of Rights form to the driver to explain the administrative procedures and
consequences of refusal.  The officer then asks the driver to sign the form so that the driver’s
“consent or refusal to submit to the [alcohol concentration test is] . . . reduced to writing for
the purpose of providing evidentiary proof.”  Atterbeary, 368 Md. at 498, 796 A.2d at 86.
The signed statement is “strong evidence of the drunk driving suspect’s willingness or
unwillingness to submit to the test.”  Id.  
Although a signed DR-15 is evidence of a driver’s refusal to submit to an alcohol
concentration test, the ALJ or court may find that the driver refused a test even if the driver
also refused to sign the DR-15 form.  “A test for alcohol concentration is refused when the
12
driver, after having been advised pursuant to section 16-205.1(b), declines the officer’s
request to submit to the test.”  Motor Vehicle Admin. v. Vermeersch, 331 Md. 188, 193, 626
A.2d 972, 975 (1993).  “A refusal of [an alcohol concentration test] ‘is complete at the
moment it is communicated to the officer.’”  Atterbeary, 368 Md. at 497, 796 A.2d at 85
(quoting Motor Vehicle Admin. v. Gaddy, 335 Md. 342, 348, 643 A.2d 442, 445 (1994));
see also Vermeersch, 331 Md. at 193, 626 A.2d at 975.  Refusal must be voluntary and with
knowledge of the rights contained in the DR-15 form.  See Forman, 332 Md. at 218, 630
A.2d at 762-63.
The facts of the present case raise three issues:  1) whether the circumstances,
particularly Dove’s removal to the hospital for medical treatment, warranted a blood test
rather than a breath test pursuant to § 10-305 of the Courts and Judicial Proceedings Article;
2) whether Dove refused the alcohol concentration test, when he offered to take a breath test
instead of a blood test; and 3) if Dove refused the alcohol concentration test, whether the
breath test performed by hospital personnel negated Dove’s refusal.
The Motor Vehicle Administration (“MVA”) argues that, pursuant to this Court’s
opinion in Hyle, 348 Md. 143, 702 A.2d at 764-65, the driver does not have the option to
choose the method of alcohol concentration testing.  Rather, in the MVA’s view, the test
must be administered in the method proscribed by § 10-305 of the Courts and Judicial
Proceedings Article.  In this case, Deputy Traas arrived on the scene after medical personnel
determined that Dove’s injuries required removal to a hospital for treatment.  According to
13
the MVA, when he detected evidence of alcohol, Deputy Traas properly requested a blood
test to determine blood alcohol concentration under § 10-305(a)(1)(ii) of the Courts and
Judicial Proceedings Article.  The MVA argues that the Circuit Court erroneously concluded
that § 10-305(a) of the Courts and Judicial Proceedings Article did not apply in hindsight,
infringing on the ALJ’s role in determining whether the facts of the case met the
requirements of the statute.  The MVA further contends that the ALJ correctly ignored the
PBT performed by hospital personnel because the test was performed for purposes of
providing medical treatment and does not constitute a withdrawal of refusal under § 16-
205.1(g) of the Transportation Article.  The MVA points out that the PBT performed by the
hospital did not meet the requirements outlined in §§ 10-302 through 10-309 of the Courts
and Judicial Proceedings Article because the sampling equipment was not approved by the
State Toxicologist and the test was performed outside of the required two hour time limit.
Thus, according to the MVA, Dove refused the alcohol concentration test required by § 16-
205.1(a)(2) of the Transportation Article and § 10-305(a)(1)(ii) of the Courts and Judicial
Proceedings Article, and substantial evidence in the record supported the sanction imposed
by the ALJ.
Dove counters, arguing that he did not refuse an alcohol concentration test because
he indicated to Officer Traas that he was willing to consent to a breath test.  In Dove’s
opinion, his circumstances did not warrant a blood test under § 10-305(a) of the Courts and
Judicial Proceedings Article because his injuries did not “require” removal to the hospital.
14
Dove defines “required” medical treatment as “[n]ot, simply, was the motorist injured such
that medical treatment was appropriate, advisable or standard,” but rather “that the injuries
mandate removal to a hospital” because the injuries require immediate urgent medical care.
In this case, according to Dove, medical personnel should have given him a Refusal of Care
form, released him to law enforcement, and allowed Officer Traas to take him to the
Sheriff’s station or the Maryland State Police Barracks for a breath test.  Dove also argues
that his alleged fear of needles warranted his refusal, relying on the Supreme Court’s
decision in Schmerber v. California, 384 U.S. 757, 86 S.Ct. 1826, 16 L.Ed.2d 908 (1966).
Even if a blood test was required, Dove argues that he did not knowingly and voluntarily
refuse the blood test because he was under duress and subjectively believed that he would
not be released from the backboard until he signed the DR-15 form.  Finally, Dove argues
that even if he refused the alcohol concentration test, the PBT administered by Calvert
Memorial Hospital negated his refusal, even though “the Calvert Memorial Hospital
breathalzyer test for alcohol concentration was probably not performed by a person qualified
nor performed on approved equipment.”  Further, Dove asserts that the PBT result, showing
a reading of 0.00, should have been admitted for the purpose of “determining if probable
cause did exist.”
In the present case, there is substantial evidence in the record to support the ALJ’s
finding that Dove’s circumstances warranted a blood test for alcohol concentration pursuant
to § 10-305(a)(1)(ii) of the Courts and Judicial Proceedings Article because Dove’s injuries
15
required his removal to a medical facility.  Medical personnel who responded to the scene
of the collision determined that Dove’s injuries, including a displaced wrist fracture and a
possible head injury, required his removal to Calvert Memorial Hospital.  The independent
judgment of trained medical professionals about the need for medical care, made at the time
of the motor vehicle collision with the available information, is substantial evidence to
support a finding that removal for medical care was required.  We decline the invitation to
review the medical judgments of trained medical personnel “in hindsight.”  Even if we were
to take into account that Dove ultimately had not sustained a head injury, the emergency
room physician noted on Dove’s medical chart that he or she, upon discharging Dove,
“[e]mphasized [the] necessity of [followup care], [because of the] possible loss of hand
[function] or perm[anent] deformity if he doesn’t.” (Emphasis in original.)  Clearly, an
injury that, if left untreated, could lead to a permanent loss of function or deformity is of the
type that requires urgent medical care.  Further, Dove acknowledged in his testimony that,
after the collision, he had a “knot . . . on [his] head [sustained] when [his] head hit the street
at 60 miles per hour.”  If trained medical personnel determine that the contact of one’s head
with the pavement at 60 miles per hour warrants immediate transport to a hospital, this
determination appears reasonable, considering the need to evaluate and treat the patient’s
medical condition.
Because Dove’s injuries required removal to Calvert Memorial Hospital, Officer
Traas properly offered a blood test to determine alcohol concentration pursuant to § 10-
16
305(a)(1)(ii) of the Courts and Judicial Proceedings Article, which states that “the type of
test administered to the defendant to determine alcohol concentration shall be . . . [a] test of
blood if . . . [i]njuries to the defendant require removal of the defendant to a medical
facility.”  (Emphasis added).  “[T]he use of the word ‘shall’ in this statute imposes a
mandatory duty upon police officers.  As we have stated repeatedly: ‘Under settled
principles of statutory construction, the word ‘shall’ is ordinarily presumed to have a
mandatory meaning.’” State v. Werkheiser, 299 Md. 529, 533, 474 A.2d 898, 900 (1984)
(internal citations omitted) (interpreting whether § 10-305 required that an officer direct
medical personnel to draw blood while a driver was unconscious and unable to refuse
consent).  Thus, because the Legislature established the circumstances under which the
officer “shall” offer a blood test pursuant to § 10-305(a) of the Courts and Judicial
Proceedings Article, neither the officer nor the driver has the discretion to choose whether
the alcohol concentration test may be a breath test or a blood test.  Rather, the Legislature
exercised its discretion and determined that a blood test would be the appropriate test.  
As we discussed in Hyle, 348 Md. at 151-52, 702 A.2d at 764, the legislative history
of § 10-305 supports our interpretation.  We stated in Hyle:
Prior to a 1983 amendment, § 10-305 permitted the defendant to
choose whether to take a blood test or a breath test.  Chapter 289
of the Acts of 1983.  Concern arose regarding the increasing
number of defendants choosing blood tests over breath tests
because of:  (1) the difficulty of accomplishing the blood test in
certain situations; (2) the delay in processing caused by
administering blood tests instead of breath tests; and (3) the
problems caused by the necessity to have medical personnel
17
attend hearings where a blood test was used. . . . When 10-305
was being amended, it originally called for the police officer to
select the type of test.  Ch. 238 of the Acts of 1983. . . . This
version, however, did not pass.  In fact, “[t]he bill failed 28-17
after a number of senators complained that it would give too
much discretion to law enforcement officers and harm
motorists’ rights.”  The version that ultimately passed eliminated
officer discretion with respect to the type of test to be
administered, and instead statutorily determined which type of
test would be administered.
Id.  (quoting Tom Linthicum, Bill to tighten intoxication tests given new life, BALTIMORE
SUN, March 16, 1983, at F14) (emphasis added).  Dove notes correctly that the Legislature
stated a general preference for breath tests in § 10-305(a) of the Courts and Judicial
Proceedings Article, absent the special circumstances stated in § 10-305(a)(1).  The
Legislature’s general preference for breath tests, however, does not override the plain
language of the statute, mandating a blood test when the driver’s injuries require removal
to a hospital.  Clearly, the Legislature expressed a specific preference for blood tests where
the driver was unconscious, unable to refuse the test, or removed to a medical facility
because of injury, or where the equipment for administering a breath test is unavailable.
The record also contains substantial evidence supporting the ALJ’s conclusion that
Dove knowingly and voluntarily refused the alcohol concentration test as offered by Officer
Traas.  The strongest evidence supporting a knowing, voluntary refusal is Dove’s own
testimony.  In his testimony, Dove acknowledges that Officer Traas asked him to take a
blood test, that he refused, and that Officer Traas advised him of his rights.
Administrative Law Judge Zell (“ALJ”):  All right.  Well the
18
officer’s report indicates that he read you the advice of rights.
Is that correct?
Defendant Dove (“Dove”):  The advice of rights, meaning . . .
?
ALJ:  Your rights . . .
Dove:  . . . what’s on that paper that states I’m refusing?
ALJ:  Well that would be the [DR-15] advice of rights form.
Dove:  Yeah, he did read it to me.
ALJ:  He explained to you what the sanctions were for refusing
an alcohol test?
Dove:  Yes.
ALJ:  Okay.  He requested you take the test?
Dove:  He requested that he stick me with a needle, yes.
ALJ:  So he requested that you [take] the test.  Did you agree to
the test at the hospital which would have been a blood test?
Dove: No.
Dove acknowledged that Officer Traas read to him from the DR-15 Advice of Rights form,
providing substantial evidence that Officer Traas advised him of the administrative penalties
of refusing an alcohol concentration test, as required by § 16-205.1(b) of the Transportation
Article.  Dove also acknowledged that he refused a blood test to determine alcohol
concentration, offered by Officer Traas as required by § 10-305(a)(1)(ii) of the Courts and
Judicial Proceedings Article.  Dove’s offer to submit to a breath test fails to mitigate his
19
refusal to take a blood test as required by § 10-305(a)(1)(ii) because, as discussed supra, the
only alcohol concentration testing option available to him under § 10-305(a) of the Courts
and Judicial Proceedings Article was a blood test.
Dove’s assertion that his refusal was not voluntary because he felt compelled to sign
the DR-15 form is not persuasive.  As discussed supra, a refusal to submit to an alcohol
concentration test is complete when it is communicated to the officer, regardless of whether
the driver signed the DR-15 form.  In the present case, Dove’s refusal to submit to the
alcohol concentration test was complete the moment he communicated it to Officer Traas.
Even if Dove were persuaded to sign the DR-15 form because he was on the backboard,
Dove clearly testified that the fact that he was strapped to the backboard had no effect on his
decision to refuse the blood test for alcohol concentration.
Dove: I get to the hospital.  He [Officer Traas] comes in, he
says, “Mr. Dove, I need to do an alcohol test on you.”  I said not
a problem.  Get the breathalyzer; I’ll be more than happy to take
one.  “No, Sir.  We’re going to do it by needle.”  I said, “No.
We’re not doing it by needle because I don’t do needles.”
(Emphasis added).  Dove testified that he offered to submit to various other tests, including
a horizontal nystagmus test (“the eye tests”) or a breath test.  At no point, however, did he
agree to a blood test.  Even if the signed DR-15 were excluded from the record, Dove’s own
testimony provides substantial evidence that Dove made a knowing and voluntary refusal
to submit to a blood test to measure alcohol concentration.
Additionally, Officer Traas did not restrain Dove or strap him to the backboard.
20
Dove was placed on the backboard as part of his medical care.  Dove testified that he was
“[taken] to the hospital strapped to the backboard” by the paramedics.  The emergency room
records reflect that when upon his admission to Calvert Memorial Hospital, Dove’s room
assignment was the “hallway outside Room 2.”  Thus, we surmise that Dove’s location in
the hallway on the backboard was the result of the decisions of his medical providers, not
the will of Officer Traas.  Further, pursuant to § 10-303(a)(2) of the Courts and Judicial
Proceedings Article, Officer Traas had a duty to approach Dove and request that he submit
to the required alcohol concentration test within two hours of Dove’s apprehension.  Under
the circumstances, the ALJ had substantial evidence to reasonably conclude that Dove was
not improperly coerced by the constraints imposed by his medical providers.  
Dove’s fear of needles does not excuse his knowing, voluntary refusal of the alcohol
concentration test offered to him.  Dove’s reliance on Schmerber v. California, 384 U.S.
757, 86 S.Ct. 1826, 16 L.Ed.2d 908, is unconvincing.  In Schmerber, the Supreme Court of
the United States considered the admissibility of a blood sample that was taken despite the
defendant’s refusal, on the advice of counsel, to consent to the test.  Schmerber, 384 U.S.
at 759, 86 S.Ct. at 1829, 16 L.Ed 2d at 913.  The Court held that the blood sample, taken
despite the defendant’s express refusal, was not taken in violation of the defendant’s Fourth
and Fourteenth Amendment right to be free of unreasonable searches.  384 U.S. at 772, 86
S.Ct. at 1836, 16 L.Ed.2d at 920.  The Court noted in dicta that the fear of needles might be
a legitimate reason for refusing an involuntary blood test that “would have to be respected.”
21
384 U.S. at 771, 86 S.Ct. at 1836, 16 L.Ed.2d at 920.  
Schmerber is distinguishable from the present case because in  Schmerber, the blood
sample used to measure alcohol concentration was taken over the suspect’s express
objection.  The Court speculated that a blood sample taken by force over an express
objection might be an unreasonable intrusion into the suspect’s person if the suspect were
afraid of needles.  Unlike in Schmerber, in the present case, Dove had the express statutory
right to refuse the blood test, as enumerated in § 16-205.1(b)(1) of the Transportation
Article.  The blood test was not performed over Dove’s objection.  Rather, Officer Traas
presented Dove with a choice: submit to the blood test as required by § 16-205.1(a)(2) of
the Transportation Article and § 10-305(a)(1)(ii) of the Courts and Judicial Proceedings
Article, or face the administrative penalty mandated by § 16-205.1(b) of the Transportation
Article.  Dove was informed of the consequences of refusal and free to decide whether his
fear of needles outweighed his desire to maintain his driving privilege in the state of
Maryland. 
In the present case, the ALJ had before him for consideration Dove’s testimony that
he was afraid of needles, and Dove’s medical records relating to his treatment at Calvert
Memorial Hospital.  Dove’s medical records revealed that he was administered pain
medication by a intravenous morphine drip.  The admission of Dove’s medical records into
evidence was substantial evidence from which the ALJ could have reasonably inferred that
Dove’s fear of needles was relative.
5Md. Code (1977, 2009 Repl. Vol.), § 16-205.1(g) of the Transportation Article
permits withdrawal of a refusal to submit to an alcohol concentration test, and states the
factors the ALJ shall consider when determining whether the refusal was withdrawn.
Section 16-205.1(g) states:
(g) Withdrawal of initial refusal to take test; subsequent
consent. — 
(1) An initial refusal to take a test that is withdrawn as
provided in this subsection is not a refusal to take a test.
(2) A person who initially refuses to take a test may
withdraw the initial refusal and subsequently consent to take the
test if the subsequent consent:
(i) Is unequivocal;
(ii) Does not substantially interfere with the timely
and efficacious administration of the test; and 
(iii) is given by the person:
1. Before the delay in testing would
materially affect the outcome of the test; and
2.A. For the purpose of a test for
determining alcohol concentration, within 2 hours of the
person’s apprehension . . .
(3) In determining whether a person has withdrawn an
initial refusal for the purposes of paragraph (1) of this
subsection, among the factors that he Administration shall
consider are the following:
(i) Whether the test would have been administered
properly:
1. For the purpose of a test for determining
alcohol concentration, within 2 hours of the person’s
(continued...)
22
Finally, the ALJ correctly determined that the breath test administered by Calvert
Memorial Hospital staff did not nullify Dove’s refusal of the alcohol concentration test.
Section 16-205.1(g) of the Transportation Article permits withdrawal of a driver’s refusal
to take a blood alcohol concentration test if the withdrawal is unequivocal and made in a
timely fashion.5  In this case, Dove’s expression of consent to an alcohol concentration
5(...continued)
apprehension . . . 
(ii) Whether a qualified person, as defined in 10-
304 of the Courts Article, to administer the test and testing
equipment were readily available;
(iii) Whether the delay in testing would have
interfered with the administration of a test to another person; 
(iv) Whether the delay in testing would have
interfered with the attention to other duties of the arresting
officer or qualified person, as defined in § 10-304 of the Courts
Article; 
(v) Whether the person’s subsequent consent to
take the test was made in good faith; and 
(vi) Whether the consent after the initial refusal
was while the person was still in police custody.
(4) In determining whether a person has withdrawn an
initial refusal for the purposes of paragraph (1) of this
subsection, the burden of proof rests with the person to establish
by a preponderance of the evidence the requirements of
paragraph (2) of this subsection. 
(Emphasis added).
23
breath test administered by hospital staff for purposes of medical treatment was not an
unequivocal withdrawal of the refusal communicated to Officer Traas.  Dove consented to
a PBT by hospital staff, not a blood test as requested by Officer Traas pursuant to § 10-
305(a)(1)(ii) of the Courts and Judicial Proceedings Article.  As discussed supra, § 10-
305(a)(1)(ii) mandated a blood test in this case, not a breath test.  Dove’s consent to an
alternative method of testing fails to satisfy the requirements of § 16-205.1(a)(2) of the
Transportation Article and § 10-305(a)(1)(ii) of the Courts and Judicial Proceedings Article
because the statute does not grant the driver discretion to choose the method of testing.
Additionally, the PBT performed by staff at Calvert Memorial Hospital did not meet
24
the procedural requirements of § 10-304 of the Courts and Judicial Proceedings Article.
Pursuant to § 10-304(b)(1) of the Courts and Judicial Proceedings Article, even if a breath
test were appropriate in this case, the person administering the test must be “a qualified
person [using] equipment approved by the toxicologist under the Postmortem Examiners
Commission.”  Id., see also Vermeersch, 331 Md. at 192, 626 A.2d at 974.  Dove admitted
in his brief that neither the person conducting the test nor the equipment used to administer
the test met the requirements of § 10-304(b)(1) of the Courts and Judicial Proceedings
Article.  Further, pursuant to § 10-304(b)(1), the breath test must also be performed “at the
request of a police officer,” not by the hospital staff for purposes of medical treatment.
Section 16-205.1(a)(2) of the Transportation Article states that the driver consents to an
alcohol concentration test “subject to the provisions of §§ 10-302 through 10-309 of the
Judicial Proceedings Article.” 
As this Court noted in Vermeersch, 331 Md. at 193, 626 A.2d at 975, a driver may
not refuse the alcohol concentration test requested by the officer, then obtain an independent
test that fails to meet the requirements of §§ 10-304 and 10-305 of the Courts and Judicial
Proceedings Article and argue that his refusal is vitiated by “substantial compliance.”  In this
case, even assuming arguendo that the hospital performed a test within two hours of Dove’s
apprehension, the breath test performed by Calvert Memorial Hospital did not comply with
the statutory requirements of §§ 10-304 and 10-305.  The test was performed for the purpose
of providing medical care and not at the request of Officer Traas, the test was not performed
25
using equipment approved by the Postmortem Examiner’s Commission, and the test was not
a blood test.  Accordingly, Dove did not withdraw his refusal to consent to an alcohol
concentration test pursuant to § 16-205.1 of the Transportation Article when he consented
to a breath test at Calvert Memorial.
The fact that the preliminary breath test performed at Calvert Memorial Hospital
showed a reading of 0.00 is irrelevant to the analysis of whether Dove refused the required
blood test.  The purpose of the sanction for refusal is not to punish driving under the
influence directly, but rather “to provide an incentive for drivers detained under suspicion
of drunk driving to take, rather than refuse, a test for alcohol concentration.”  Vermeersch,
331 Md. at 194, 626 A.2d at 975; see also Shepard, 399 Md. at 255, 923 A.2d at 108 (“The
purpose of the statute was to reduce the incidence of drunk driving and to protect public
safety by encouraging drivers to take alcohol concentration tests.”); Forman, 332 Md. at
206, 630 A.2d at 756 (holding that the statute is a “strict penalty . . . designed to encourage
licensees to take, rather than to refuse, such alcohol tests”).  Dove argues that the preliminary
breath test result, 0.00, should have been applied to a “probable cause” analysis.  Dove,
however, ignores the fact that a probable cause analysis has no place in this case.  Section
16-205.1(a)(2) of the Transportation Article does not require probable cause when an officer
requests an alcohol concentration test, but rather permits a test “if the person should be
detained on suspicion of driving or attempting to drive while under the influence of
alcohol.”  Suspicion based on reasonable grounds is a lower standard than a preponderance
26
of the evidence or probable cause.  Shepard, 399 Md. at 254, 923 A.2d at 107.  In this case,
the record provided the ALJ with substantial evidence that Officer Traas had reasonable
suspicion that Dove was driving his vehicle while under the influence of alcohol, based on
the odor of alcohol detected on Dove’s person at the scene, his watery eyes, and his
involvement in a motor vehicle collision.
JUDGMENT 
OF 
THE 
CIRCUIT
COURT FOR CALVERT COUNTY IS
REVERSED.  CASE REMANDED TO
THAT COURT WITH DIRECTIONS
TO AFFIRM THE DECISION OF THE
ADMINISTRATIVE LAW JUDGE.
RESPONDENT TO PAY THE COSTS.