What were the extent of his injuries - how much blood loss, any shock, any injury to liver or kidneys?  Any massive injuries to muscles?  How soon after the injuries was the blood drawn? 

Was the blood draw for the alcohol done before or after other treatments were initiated?  If other treatments had been initiated, what were they? 

As for the laboratory test, check to see what procedure was used at the hospital to measure alcohol. Some hospital laboratories have gone to versions of alcohol measurement based upon spectral analysis.  However, many still use the old enzymatic method.  The enzymatic method is quick, but not as specific as other methods because it relies upon using the enzyme alcohol dehydrogenase to convert the blood ethanol to acetaldehyde.  The problem is that other chemicals in the blood may also be metabolized by this enzyme.  The assay procedure does not measure the disappearance of ethanol or the appearance of acetaldehyde.  Instead, the assay measures the conversion of the cofactor NAD to NADH.  Therefore, any chemical that is metabolized by alcohol dehydrogenase will give a false reading with respect to alcohol concentration, because the metabolism of that chemical will also result in the conversion of NAD to NADH. 

I have always been curious about another possible complication in cases such as yours.  Tissue injury may result in the release of enzymes from cells into the blood.  Some of these enzymes may also convert NAD to NADH by pathways other than alcohol dehydrogenase.   The bottom line is that unless a control blank is measured in which the conversion of NAD to NADH is measured without adding any alcohol dehydrogenase, then it would be unclear whether the NAD to NADH conversion is caused by the presence of alcohol in the blood or due to the presence of enzymes in the blood that have been released from damaged tissues.

Fanney says: contact Joe Citron, md @

My best recommendation to you is that you contact Joe Citron in Atlanta.  Joe is a medical doctor who does extensive expert testimony in DWI cases.  His medical background enables him to give opinions on a wide range of topics.  I consulted with Joe on a DWI/Involuntary case where the State's evidence was going to be the hospital blood test.  He can give you a great amount of information and may be interested in consulting for you for a reasonable fee.  Please see his email address above. 

Joe is a great witness and a great guy.

1)      Whether the hospital drew blood and tested it depends on the severity of the injury.  Not everyone taken to the hospital needs an emergency blood draw and the subsequent plasma testing.  Officers usually don' t get to make the call on whether the hospital draws and tests blood.

 2)      You should move to suppress the results of the search warrant (i.e. the medical records) the warrant itself may not be enough to waive HIPPA requirements.  HIPPA normally requires a court order more explicit than a search warrant.  You should further move to suppress the blood test results pre-trial.  Additionally, there are scientific issues that are critical to examine when using a hospital blood test result to then convert into a whole blood result.  Plasma tests (i.e. hospital blood tests) are commonly known as "dirty tests", they are not done to forensic standards such as a regular blood test for alcohol.  Additionally, the alcohol reading can be inflated severely by the administration of lactated ringers which is generally administered in any trauma situation. 

3)      The results are simply unreliable, so fight at every stage to keep them out.  Not to mention, I bet the State will have a severe chain of custody issue not that the U.S. Supreme Court continues to strengthen the confrontation clause in areas of forensic testing.  See Melendez-Diaz and the latest Bullcoming opinions.