case, we consider whether a crime victim's statements to
his medical providers were testimonial and, if so, whether
their admission at trial violated the defendant's right
of confrontation under the Sixth Amendment to the United
States Constitution. We hold that the victim's statements
in this case were nontestimonial because they were not made
with the primary purpose of creating an out-of-court
substitute for trial testimony. We separately hold that there
was sufficient evidence to support the petitioner's
unlawful imprisonment conviction. We affirm the Court of
FACTS AND PROCEDURAL HISTORY
a decade after his wife of over 50 years died, 82 year old
Leroy Bagnell met a woman in a bar. He initially introduced
57 year old Theresa Gail Scanlan to his children as a friend,
and within a month or two she moved into his house. At some
point, he began referring to her as his girlfriend.
year later on October 16, 2014, the police responded to a 911
hangup call made from Bagnell's house. Scanlan answered
the door and told the police she had been having an argument
with her roommate. Bagnell then appeared at the top of the
stairs wearing a T-shirt and underwear. His head and forearm
were bleeding, and he had a big, bloody, and bruised lump on
his leg. When the police asked Bagnell how he had been
injured, Scanlan replied that Bagnell had fallen out of his
car. As a result of this incident, the Federal Way Municipal
Court issued a domestic violence no contact order prohibiting
Scanlan from coming within 1, 000 feet of Bagnell's
house. Bagnell did not seek medical care for his injuries.
November 6, 2014, Bagnell's children became concerned
when they were unable to reach him all day on either his cell
phone or landline. All four children went to the house,
arriving around 5:30 p.m. They found the lights out and the
shades drawn, and they got no answer when they knocked and
rang the bell. They let themselves in with a key. There was
blood on the entryway carpet, on the stairs, and throughout
the upstairs bedrooms. The stairway wall had been dented and
gouged, and the kitchen floor was littered with shattered
glass and broken ceramic figurines.
was more blood in the family room, along with a large trash
can containing a broken, bloodstained broom handle and a
broken golf club. There was a hammer on the coffee table and
a crowbar on the dining table. Bagnell was also in the family
room, sitting in a chair in the dark with his eyes closed.
Bagnell was severely bruised from head to toe. His children
called 911. All four children and the responding police
officer testified that Bagnell was initially nonresponsive,
then dazed and in a state of shock and confusion. Three of
his children thought that he was dead or possibly
was found in the garage underneath a blanket in her car with
the doors locked. When the police arrived and removed Scanlan
from the car, Bagnell's daughter shouted at her that she
could have killed him. Scanlan replied that it was "not
that bad." 6 Transcript of Proceedings (TP) (Nov. 18,
2015) at 769; 8 TP (Nov. 23, 2015) at 1071.
was taken to the emergency room, where he was treated by
Nurse Catherine Gay, Dr. Robert Britt, and social worker
Jemima Skjonsby. In addition to extensive bruising, he also
had two broken fingers and several skin tears on his legs and
arms. The police subsequently arrived around midnight, spoke
to Bagnell, and had him sign a medical release form
authorizing St. Francis Hospital and its staff to release his
medical records to police and prosecutors.
November 12, 2014, the police met with Bagnell at his house
and obtained a second medical release form for Virginia Mason
Medical Center. The next day, Bagnell met with Dr. Curtis
Endow, his primary care physician, at Virginia Mason. Dr.
Endow referred Bagnell to a wound care clinic at Virginia
Mason, where he subsequently received care from physician
assistant Stacy Friel and Dr. Jessica Pierce.
was charged with second degree assault, felony violation of a
no contact order, unlawful imprisonment, and fourth degree
assault. Neither Bagnell nor Scanlan testified at trial, but
the court admitted several statements that Bagnell made to
his medical providers.
Gay testified that when she asked what had happened to him,
Bagnell told her "that his girlfriend had beaten him up,
and that he'd had a no contact order on this
individual." 8 TP at 1108-09. When she asked him about a
ring mark that she noticed on the back of his neck,
"[h]e told me that his girlfriend . . . had tried to
strangle him with his sweatshirt and had pulled the
sweatshirt so hard, it had left this permanent ring around
the back of his neck." Id. at 1110. She
clarified on cross- examination that she could not recall
whether he had used the word "strangled," but that
"she, you know, did whatever with the sweatshirt and had
it really tight." Id. at 1118. Gay testified
that knowing how a patient's injury occurred and the
identity of his assailant is important for monitoring
hospital security and patient safety, determining whether to
refer him to a social worker, and ensuring that he has the
follow-up care he needs, including having a safe place to go
Britt testified that Bagnell stated "that he had been in
his home for two days, that he had been imprisoned, or at
least held in his home, against his will," that "he
hadn't really eaten in a  couple of days," and
that "[h]e wasn't allowed to talk to his
family." 7 TP (Nov. 19, 2015) at 925. Dr. Britt also
testified that Bagnell "said that he was hit with fists,
that he had been bitten in a couple of places[, ] and that he
had been hit with a broom." Id. at 925-26. Dr.
Britt stated that it was important to determine how
patients' injuries occur because the mechanism of the
injury determines how serious it is and affects which tests
he runs, and it impacts discharge planning.
worker Skjonsby testified that when she asked Bagnell whether
he felt safe to go home, he responded "[t]hat he was
relieved that this person had been removed from the home by
police and that he wouldn't have to worry about it
again." Id. at 883-84. Skjonsby stated that
knowing about a patient's relationship with his assailant
and knowing whether the assailant is in police custody helps
her assess for safe discharge and connect the patient with
appropriate social work services.
Endow testified that when he asked how Bagnell had been
injured, Bagnell "stated that he received the injuries
during an assault" by "[h]is girlfriend."
Id. at 818. Dr. Endow stated that to effectively
treat patients he needs to know how an injury
occurred-whether the injury is related to underlying medical
conditions, is due to accidents, occurred from fainting or in
the course of medical care, and so on. Dr. Endow further
stated that it is important to know the identity of a
patient's assailant to know whether the patient is still
in potential danger and to know whether to refer the patient
to Virginia Mason's social services department.
assistant Friel testified that when she asked Bagnell how his
injuries occurred, he told her that "[h]e was living
with a girlfriend at the time who had locked him in a room
and had beat him with a candlestick, a broom, and a hammer
over multiple areas." 8 TP at 1181. Friel explained that
it was important to know for treatment purposes whether an
injury had been caused by an object (versus, say, a hand) to
make sure that no foreign bodies remain in the wound. Friel
stated that knowing the identity of an assailant influences
treatment because she wants to ensure that the patient has a
safe place to go and is not returning to an environment that
could result in more wounds.
Pierce testified that when she asked Bagnell how his injuries
occurred, "[h]e said that it was as a result of domestic
violence.... He told me he was hit with a candlestick, a
broom. He was punched or hit-I want to say a hammer,
something hard." 7 TP at 909. Dr. Pierce stated that it
was important to know the mechanism of injury because there
is a high recidivism rate for wound patients. Accordingly,
her practice involves not only treatment of existing wounds
but also prevention of new wounds by, for example, having
patients install grab bars in their homes. In addition, Dr.
Pierce testified that knowing whether patients are returning
to a safe environment is important from a treatment
standpoint because more wounds result in more surface area to
bandage and treat, which results in longer healing time, more
potential for infection, and other complications.
jury convicted Scanlan of second degree assault, felony
violation of a no contact order, and unlawful imprisonment.
On appeal, Scanlan argued that admitting Bagnell's
hearsay statements to his medical providers violated her
confrontation clause rights and that there was insufficient
evidence to support her unlawful imprisonment conviction. The
Court of Appeals held that Bagnell's statements to
medical personnel were nontestimonial and therefore not subject to
the confrontation clause, and it sustained her unlawful
imprisonment conviction. We granted Scanlan's petition for
review and now affirm the Court of Appeals. State v.
Scanlan, 191 Wn.2d 1026 (2018).
Bagnell's statements to his medical providers were not
testimonial because they were not made with the primary
purpose of creating an out-of-court substitute for trial
first contends that Bagnell's statements to his medical
providers were testimonial and that admitting them therefore
violated the confrontation clause of the United States
Constitution. We review confrontation clause challenges de
novo. State v. Price, 158 Wn.2d 630, 638-39, 146
P.3d 1183 (2006).
The primary purpose test ...