December 10, 2008
By: George Coppolo, Chief Attorney
Jim Fazzalaro Principal Analyst
Connecticut's DUI law consists primarily of three statutes, CGS §§ 14-227a, -227b and -227g. The first prohibits a person from driving while under the influence of alcohol or drugs or with an “elevated” blood alcohol content (BAC). A person is “under the influence” if his ability to drive is affected to an appreciable degree. He or she has an elevated BAC if it is found to be .08% or more. CGS § 14-227g prohibits anyone under age 21 from driving with a BAC of .02% or more. The laws specify evidence admissibility criteria for alcohol and drug tests. They establish criminal penalties and driver's license suspension penalties for violations.
CGS § 14-227b provides that a person who drives a vehicle has implicitly given consent to submit to drug or alcohol testing. It establishes administrative license suspension procedures for drivers who refuse to submit to a test or whose test results indicate an elevated BAC. (These provisions are called “implied consent” and “administrative per se,” respectively.) An elevated BAC can be .08% or more or .02% or more if the driver is under age 21. A different procedure that allows for a more immediate suspension applies if the driver has a prior license suspension for a DUI conviction or has been involved in a fatal accident. The law provides for longer administrative suspension periods for someone whose BAC is .16% or more. These administrative license suspension penalties are in addition to any suspension penalties imposed for conviction of any criminal DUI charge.
Someone arrested for certain alcohol related offenses can be ordered by the court to operate only motor vehicles equipped with ignition interlock devices as a condition of release on bail or of his or her application for participation in the Pretrial Alcohol Education System. Use of an ignition interlock device (1) may also be substituted for part of the three-year license suspension penalty for certain second DUI criminal offenders, (2) must be imposed as a condition for restoration of a revoked license after a third DUI criminal conviction, and (3) beginning October 1, 2008, must be imposed following the mandatory one-year license suspension following conviction for second-degree manslaughter with a motor vehicle or second-degree assault with a motor vehicle.
Connecticut law also provides for a Pretrial Alcohol Education Program under which certain eligible offenders charged with DUI may successfully complete an alcohol intervention or substance abuse treatment program, as appropriate, and have the DUI charges dismissed.
Anyone who is convicted of DUI, or who has had two or more administrative license suspensions for BAC test failures or refusals must successfully complete a Department of Motor Vehicle (DMV)-approved substance abuse treatment program before DMV may restore the person's suspended license.
Someone who holds a commercial driver's license faces disqualification from driving a commercial motor vehicle if he is found to have: (1) a BAC of .04% or more while driving a commercial motor vehicle, (2) a BAC of .08% or more while driving any other type of vehicle, or (3) refused a BAC test whether driving a commercial or noncommercial motor vehicle.
Connecticut imposes increased criminal penalties if someone is seriously injured or killed by a driver under the influence of alcohol or drugs. In addition, people found to be “persistent felony offenders” are subject to an increased criminal penalty and the motor vehicles of certain offenders must be impounded for 48 hours.
CGS § 14-227a—Driving While Under the Influence of Alcohol or DRUGS
Driving Under the Influence or with an “Elevated” BAC.
The law prohibits driving (1) while under the influence of alcohol or drugs or (2) with an “elevated blood alcohol content” (DUI). A person is “under the influence” if his ability to drive is affected to an appreciable degree (Infield v. Sullivan, 151 Conn. 506 (1964)). This may be prosecuted with or without any direct evidence of his BAC. A person has an “elevated blood alcohol content” if his or her BAC is .08% alcohol by weight or above. The law also makes it illegal for someone under age 21 to drive with a BAC of .02% or more. While this is defined under a
different statute (CGS § 14-227g), most of the criminal drunk driving provisions apply by reference to anyone under age 21 violating the prohibition.
The DUI law applies to operating a motor vehicle anywhere not just on a road or highway, and includes the operator's property. The DUI: law also applies to the operation of snowmobiles and all-terrain vehicles.
The mere fact that a driver appears to be under age 21 does not provide reasonable and articulable suspicion that an offense has been committed that justifies a police officer's making an investigatory stop of the vehicle (CGS § 14-227g(b)).
The prosecutor cannot dismiss, nolle, or reduce a drunk driving charge without stating the reasons for it in court.
BAC can be measured by testing the driver's blood, breath, or urine, with the police officer having the discretion to determine which test to use. This law establishes a rebuttable presumption that a driver's BAC at the time it is tested is the same as the BAC at the time he or she was stopped. But if the result of the second test is .12% or less and higher than the first test, the prosecution must demonstrate that the BAC at the time of the test accurately reflects the BAC at the time of the offense.
Admissibility of Evidence
In order for the test results to be admissible:
1. the driver must be given a reasonable chance to call an attorney before starting the test;
2. a copy of the test results must be mailed or personally delivered to the driver within 24 hours or at the end of the next business day after the results are known;
3. the test must be administered by a police officer or at his or her direction;
4. the test must be administered using methods and equipment approved by the Department of Public Safety (DPS) and in accordance with DPS regulations;
5. the test equipment must be checked for accuracy in accordance with the DPS regulations;
6. a second test of the same type must be administered at least 30 minutes after the first test is conducted (unless the second test is to detect the presence of drugs in which case it can be of a different type and does not have to be administered within that time frame); and
7. the test must begin within two hours of operation (presumably the time of the alleged offense).
The DPS commissioner must determine the reliability of each method and type of device offered for chemical testing of blood, breath, and urine, and certify those suitable for use in Connecticut. He must adopt regulations governing the conduct of tests, the operation and use of test devices, the training and certification of test operators, and the drawing or obtaining of blood, breath, and urine samples (CGS § 14-227a(c)).
Evidence that a driver refused to submit to a test is admissible if the procedural requirements of CGS § 14-227b (described below) are followed. At trial, the court must instruct the jury as to what inferences can and cannot be drawn from the refusal.
Samples Taken from Apparently Injured Drivers Requiring Medical Treatment.
A different set of admissibility standards applies to blood or urine samples taken from an injured driver in the course of his or her medical treatment. Results of a chemical analysis of the sample are competent evidence to establish probable cause for the person's arrest by warrant and are admissible in a subsequent prosecution if (1) the sample was taken for the diagnosis and treatment of the injury, (2) if a blood sample, it was taken in accordance with DPS regulations, (3) a police officer satisfies a Superior Court judge that he or she has reason to believe the person was driving under the influence of alcohol or drugs and the blood or urine sample constitutes evidence of this offense, and (4) the judge issues a search warrant authorizing seizure of the test results. The warrant may also authorize seizure of hospital medical records prepared in connection with the diagnosis and treatment of the injury.
A person convicted of DUI is subject to the penalties listed in Table 1.
Either (a) up to six months with a mandatory minimum of two days or (b) up to six months suspended with probation requiring 100 hours of community service
Up to two years, with a mandatory minimum of 120 consecutive days and probation with 100 hours community service
Three years (or until age 21 if longer)
Third and Subsequent
Up to three years, with mandatory minimum of one year and probation with 100 hours community service
In addition, if the court sentences someone to a period of probation, it may require as a condition of probation that he or she participate in a victim impact panel program approved by the Court Support Services Division. The panel must provide a non-confrontational forum for victims of alcohol or drug related offenses and offenders to share experiences on the impact of alcohol or drug related incidents in their lives. The nonprofit organization that conducts the panel may charge a participation fee of up to $25 for any offender ordered to participate.
In assessing these penalties, the law considers as a subsequent conviction one that occurs within 10 years of a prior conviction for the same offense. Also, any conviction that occurs in another state for an offense that the court determines has “substantially the same” essential elements as Connecticut's criminal drunk driving offenses, manslaughter in the 2nd degree with a motor vehicle, or assault in the 2nd degree with a motor vehicle will constitute a prior conviction of the same offense for purposes of determining someone's prior criminal history. (2nd degree manslaughter or assault with a motor vehicle involves driving while under the influence of liquor or drugs.)
The law allows someone whose driver's license has been revoked following a third conviction for driving under the influence of alcohol or drugs to seek restoration of driving privileges after six years, provided the commissioner determines it does not endanger public safety, certain requirements are met, and the person submits to installation and use of a vehicle ignition interlock device (PA 07-167).
The license suspension under this law is stayed while a conviction is being appealed. For a driver under age 18, the suspension period is until he or she turns 18 or the period listed above, whichever is longer. For drivers driving under a work-only driving permit (described below) suspension periods are doubled. In addition to these penalties, the court can order a driver to participate in an alcohol education and treatment program.
Sixteen and Seventeen Year-Old Drivers
The law requires the court to report DUI convictions to the DMV commissioner following established statutory procedures. The commissioner must suspend the license or nonresident operating privilege of anyone reported as convicted for the period the law requires. The commissioner must determine the period of the suspension required based on the number of convictions the person has had within the specified time period according to his or her driver history record maintained by DMV, notwithstanding the sentence imposed by the court for the conviction. Suspension for conviction of a criminal DUI charge is in addition to any previously imposed administrative license suspension under the implied consent law (see below).
PA 08-32 establishes a 48-hour summary suspension of a 16- or 17-year-olds driver's license if the teenage driver is cited for driving under the influence of alcohol or drugs or with an elevated blood-alcohol level (which is 02% or more for anyone under age 21). If the 16- or 17-year-old is cited for either of these violations, the police officer must seize the driver's license for 48 hours on behalf of the DMV commissioner and may have the vehicle removed. The license seizure begins on the date and time the arrest is made or the summons or infraction complaint is issued. The driver's license is considered suspended for 48 hours.
To regain the license, the 16- or 17-year-old and his or her parent or legal guardian must appear in person at the police department, state police barracks, or other designated location and sign a written acknowledgement of its return. (A subsequent act, PA 08-150, amends this provision to exempt an emancipated minor from the requirement for accompaniment by a parent or guardian when retrieving the license.) No restoration fee may be charged for return of the license. The police officer who seized the license must make a written report of the violation and the suspension action to the commissioner on a form, and in a time and manner, that the commissioner prescribes.
PA 08-32, which took effect August 1, 2008, prohibits someone under age 18 who is arrested for DUI from being considered a youthful offender.
PERSISTENT DUI OFFENDERS
A person is considered a “persistent operating under the influence felony offender” if he or she (1) is convicted of manslaughter or assault in the second degree with a motor vehicle and (2) within the prior 10 years has been convicted of either of these offenses or of driving under the influence of alcohol or drugs, or of substantially similar offenses in other states (CGS § 53a-40f).
The court may impose the prison sentence for the next higher degree of felony for a persistent operating under the influence felony offender. Thus, it increases, from 10 to 20 years, the maximum possible prison term for a persistent offender convicted of manslaughter in the second degree with a motor vehicle and, from five to 10 years, the maximum possible sentence for a persistent offender convicted of assault in the second degree with a motor vehicle (CGS § 53a-49f as amended by PA 08-1, Jan. Spec. Sess.).
IGNITION INTERLOCK DEVICES
Ignition interlock devices are special types of equipment installed in motor vehicles that require the vehicle operator to exhale into the device prior to starting the vehicle. If the device detects a BAC above a certain threshold level, it prevents the vehicle from being started. Interlock devices also require periodic breath samples while the vehicle is operating. The threshold BAC level can vary according to the requirements of the law (which in Connecticut is .025% BAC).
Under Connecticut law, anyone who has been arrested for DUI, 2nd degree manslaughter with a motor vehicle, or 2nd degree assault with a motor vehicle may be ordered by the court not to operate any motor vehicle unless it is equipped with an ignition interlock device. This order may be made as a condition of his or her release on bail or application to participate in the Pretrial Alcohol Education System.
Also, an ignition interlock requirement may be applied to someone convicted of DUI for a second time when the conviction was based solely on alcohol use. Second DUI offenders are subject to a three-year license suspension. When the court reports a second conviction to DMV and the conviction is based solely on alcohol use, the offender may apply, when appropriate, and, if he or she qualifies, DMV must permit use of an ignition interlock device on any vehicle he or she has or will operate. The interlock requirement substitutes for two of the three years of the license suspension (CGS §14-227a).
Someone is ineligible for the interlock option if he has not enrolled in a Substance Abuse Treatment Program as required by law following a DUI conviction or has not received a waiver from that requirement as provided by the law, or if his license has been suspended by the commissioner for any other reason except for a DUI conviction based solely on alcohol use.
The interlock device option applies only when the second DUI conviction based solely on alcohol use occurs and is prosecuted in Connecticut. By law, DUI and other alcohol related criminal offenses that occur out-of-state and the essential elements of which are determined by the court to be substantially the same as Connecticut offenses constitute a prior offense for purposes of determining imposition of penalties for second or subsequent offenses. By federal and state law, states must record convictions for certain highway related offenses, including DUI, committed by nonresidents and report these convictions to the offender's state of residence for imposition of penalties. Thus if someone has a prior DUI conviction and is subsequently convicted for DUI in another state, DMV is informed of the out-of-state conviction and imposes the three-year license suspension required under Connecticut law for a second DUI offense. However, since the conviction did not occur for a violation of CGS §14-227a, the offender may not apply for the interlock option to substitute for two of the suspension years and must serve the full three-year suspension.
The law also provides an interlock option following a third DUI conviction. After a third conviction, the offender's license must be revoked by DMV. After six years, the offender may apply to the DMV commissioner for a hearing to consider reversal or reduction of the revocation. After consideration of certain evidence the law specifies and determining that such an action would not endanger the public safety or welfare, the commissioner may grant a reversal or reduction in the
revocation. The commissioner must impose a requirement that the offender operate ignition interlock-equipped vehicles as a condition for reinstatement. The interlock must be used from the date of the reversal or reduction until 10 years have passed since the original revocation.
Beginning October, 1, 2008, the law requires anyone convicted of (1) second-degree manslaughter with a motor vehicle or (2) second-degree assault with a motor vehicle to operate ignition interlock-equipped motor vehicles for two years following the mandatory one-year license suspension. The law also makes anyone whose license has been suspended and subsequently restricted to use of only ignition-interlock equipped motor vehicles subject to a re-imposition of suspension for failing to install and use the device as required. The re-suspension must be for a period not to exceed the period of the original suspension (PA 08-150).
CGS § 14-227B—IMPLIED CONSENT TO TEST AND ADMINISTRATIVE PER SE LICENSE SUSPENSION
Under this section, anyone who drives has implicitly consented to permit the testing of his blood, breath, or urine. If the driver is a minor, his or her parents or guardians are considered to have given their consent.
Before administering the test, the police officer must:
1. inform the driver of his or her constitutional rights,
2. give the driver a chance to call an attorney,
3. inform him that his license will be suspended if he refuses to take the test or if his test results indicate an elevated BAC, and
4. inform him that evidence of a refusal may be used against him in a criminal prosecution.
Administrative Per Se
This law requires an administrative license suspension process for drivers who refuse to submit to the test or whose test results indicate an elevated BAC (.08% or more or .02% or more if under age 21). In such cases, the police officer, acting on behalf of the motor vehicle commissioner, must revoke the driver's license for 24 hours and submit a report to the DMV, which among other things must contain any test results and the grounds the officer had for arresting the person. In cases of test refusals, a third party who witnessed the refusal must sign the report.
A different procedure applies when someone gives a blood or urine sample at a police officer's request and this requires a laboratory analysis to determine the results. In this case, the officer can not immediately take possession of the person's license or follow the other procedural requirements of the per se law. Instead, immediately upon receiving test results showing an elevated BAC, the officer must notify the DMV commissioner and submit the required written report.
The process followed once the commissioner receives the police report depends on the driver's circumstances. As long as the driver either (1) has not previously been suspended for a DUI conviction within the 10 years preceding the present arrest or (2) been involved in an accident that resulted in a fatality, the commissioner may suspend his or her license or nonresident operating privilege as of a date certain, but not more than 30 days after the person receives notice of his arrest by the police officer. In the case of someone with a prior DUI license suspension or who has been involved in a fatal accident, the commissioner may suspend his or her license or operating privilege on any date specified in the suspension notice. This can be immediate.
In either case, the driver is entitled to a hearing before DMV to contest the suspension. In the first case (no prior DUI suspension or fatal accident involvement), this must occur prior to the effective date of the suspension provided the person contacts DMV no later than seven days after DMV mails the suspension notice. In the latter case (prior DUI suspension or fatal accident involvement), the hearing can occur after the suspension occurs, but not more than 30 days after the person contacts the DMV to schedule a hearing (CGS Sec. 14-227b).
In either case, the hearing is limited to whether: (1) the police officer had probable cause to arrest the person, (2) he or she was arrested, (3) he or she was driving, and (4) he or she refused the test or had an elevated BAC. In the case of test results obtained from a blood sample taken from an apparently injured driver, the hearing must include an additional determination of whether the blood sample was obtained according to the statutory conditions for admissibility and competence as evidence. If the answer to any of these questions is no, the driver gets his or her license back.
If the answer to all of the questions is yes, the driver's license is suspended for the period specified in Table 2. Longer suspensions apply if the person's BAC was measured at .16% or more.
Per Se Offense
Third or Subsequent Offense
.08% or more
BAC of .16% or more
The penalties also apply to someone who takes the initial test but refuses to take the second test. These provisions do not apply to someone whose condition makes such tests medically inadvisable. These administrative license suspension penalties are in addition to any suspension penalties imposed as a result of conviction on any criminal DUI charge (see Table 1 above).
Enhanced Administrative Penalties for Drivers under Age 21
Anyone under age 21 who does not contact DMV for a hearing, fails to show up for a scheduled hearing, or who receives an adverse hearing decision is subject to a license suspension that is twice as long as the period imposed on someone age 21 or older for a similar type of violation.
PA 08-32 makes this enhanced administrative license suspension even longer for a 16- or 17-year-old for a first per se offense. Specifically, the suspension for a first per se violation by a 16- or 17-year-old is increased from: (1) one year to 18 months for a test refusal, (2) 180 days to one year for a test result of 02% but under .16%, and (3) from 240 days to one year for a test result of 16% or more.
SUBSTANCE ABUSE TREATMENT PROGRAM PARTICIPATION
The law requires anyone whose license or nonresident operating privilege has been suspended for any DUI conviction, or for two or more administrative per se suspensions for test failures or refusals, to successfully complete a DMV-approved substance abuse treatment program that includes an assessment of the degree of alcohol abuse and treatment deemed appropriate for the person. The program must be
successfully completed before DMV may restore the offender's driver's license or nonresident operating privilege. The program must provide intensive treatment and continuing individual aftercare supervision and monitoring.
The commissioner can approve one or more private organizations that meet his qualifications to provide the program, but the entire cost of the program must be paid from user fees. The fees are subject to the commissioner's approval.
The person may petition the commissioner for waiver of the program participation requirement on the grounds that (1) the defendant is presently undergoing or has already completed an equivalent program subsequent to his or her most recent arrest either as a result of a Superior Court order or on a voluntary basis or (2) a Connecticut licensed physician attests that the defendant does not have a current addiction problem that affects his ability to operate a vehicle safely (CGS § 14-227f).
PRETRIAL ALCOHOL EDUCATION SYSTEM
Someone charged with DUI, operating a vehicle with a BAC of .02% or more if under age 21, operating a vessel or waterskiing while under the influence of alcohol or drugs, or reckless operation of a vessel while under the influence of alcohol or drugs, may apply to the court for admission to the Pretrial Alcohol Education System. The applicant must pay a $50 application fee and a $100 nonrefundable evaluation fee. The applicant also must make certain affirmations under oath before the court, one being that the defendant has not had the program previously invoked on his or her behalf within the preceding 10 years, or, if under age 21 and charged with operating a vehicle with a BAC of .02% or more, that he or she has never had the program invoked on his behalf before.
The court can grant the application after considering the recommendations of the state's attorney and assessment and confirmation of the person's eligibility by the Court Support Services Division (CSSD). If the court grants the application, it must refer him or her to CSSD for assessment and confirmation of the eligibility of the applicant and to the Department of Mental Health and Addiction Services (DMHAS) for evaluation.
Upon confirmation of eligibility, the person is referred to DMHAS for placement in either an appropriate alcohol intervention program or a state-licensed substance abuse treatment program.
Any person who enters the system must agree to:
1. the tolling of the statute of limitations with respect to such crime,
2. a waiver of such person's right to a speedy trial,
3. complete 10 to 15 counseling sessions in an alcohol intervention program or successfully complete a substance abuse treatment program of at least 12 sessions dependent upon the evaluation report and the court order,
4. upon completion of participation in the alcohol intervention program, accept placement in a treatment program upon recommendation of a provider under contract with DMHAS or placement in a state-licensed treatment program, which meets DMHAS standards if CCSD deems it appropriate, and
5. if ordered by the court, participate in at least one victim impact panel.
If the court makes a determination of ineligibility or if the program provider certifies to the court that the defendant did not successfully complete the assigned program or is no longer amenable to treatment, the court must order the court file to be unsealed, enter a plea of not guilty for the defendant and immediately place the case on the trial list.
If the defendant satisfactorily completes the assigned program, he or she may apply for dismissal of the charges. Upon a finding of satisfactory completion, the court must dismiss the charges (CGS § 54-56g).
Anyone whose employment or residence makes it unreasonable to attend a program in Connecticut may attend, with the court's approval, a similar program in another state that has standards substantially similar to or higher than Connecticut's.
An officer must impound for 48 hours the motor vehicle of anyone he or she arrests for operating under the influence whose right to drive in Connecticut is under suspension or revocation. The owner may reclaim the vehicle after paying all towing and storage costs (CGS § 14-227h).
OPERATING WHILE LICENSE SUSPENDED FOR DUI
Anyone who operates a motor vehicle during the period his or her license is under suspension or revocation for driving under the influence or for refusing to submit to a BAC test is subject to a fine of up to $1,000 and imprisonment of up to one year. The offense also carries a 30-day mandatory prison sentence unless the court specifies mitigating circumstances in writing (CGS § 14-215(c)).
TESTING AFTER ACCIDENTS
The chief medical examiner and other specified officials must include in any investigation of a fatal motor vehicle accident a blood sample from any driver or pedestrian who dies in the accident. These samples must be examined for the presence and concentration of alcohol and drugs by the chief medical examiner or the DPS Division of Scientific Services. A blood or breath sample must be obtained from any surviving driver whose vehicle is involved in an accident resulting in the death or serious physical injury to another person if a police officer has probable cause to believe that the driver operated the vehicle while under the influence of alcohol, drugs, or both (CGS § 14-227c). Since the law requires the sample to be tested for drugs as well as alcohol, and breath samples cannot provide reliable evidence of the presence of drugs, the law, in effect, appears to require blood samples from surviving operators.
The testing of any such samples must be performed at the direction of a police officer and according to methods and with equipment approved by DPS. The person performing the test must be certified or recertified for this purpose by DPS or recertified by someone certified as an instructor by DPS.
Test equipment must be checked immediately before and after the test by someone who is DPS-certified. If a blood test is performed, the sample must be taken by someone licensed to practice medicine and surgery, a qualified laboratory technician, an emergency medical technician II, a registered nurse, a physician assistant, or a phlebotomist. These requirements differ slightly from those that apply to tests in connection with drunk driving arrests.
WORK-ONLY DRIVERS' PERMITS
By law, anyone who has had a driver's license suspended, except a person (1) with a previous suspension, (2) who operated a vehicle while under suspension, (3) who failed to appear for trial, or (4) under suspension for refusing to submit to a DUI blood, breath, or urine test until at least 90 days of his mandatory six-month suspension has run, may apply for a special driving permit that allows certain work-related driving (CGS § 14-37a).
COMMERCIAL DRIVERS' LICENSE (CDL) HOLDERS
CGS § 14-44a et seq., imposes a .04% BAC limit for drivers operating buses, large trucks, and vehicles carrying hazardous material under a commercial driver's license. If someone holding a CDL is found to have either refused to submit to a BAC test or has taken a test that resulted in a BAC of .04% or more, he or she is disqualified from driving a commercial motor vehicle for one year. If an offense involves driving a vehicle transporting hazardous materials requiring placards under federal law, the disqualification is for three years, instead of one year.
The disqualification applies (1) for any BAC test refusal, whether the violator was driving a commercial motor vehicle or any other type of motor vehicle. or (2) for a BAC result of .04% or more while driving either a commercial motor vehicle or .08% or more while driving any other motor vehicle.
CGS § 53a-56b establishes the crime of manslaughter in the second degree with a motor vehicle. A person commits this offense when, while operating a motor vehicle under the influence of alcohol or any drug, he causes the death of another person as a consequence of the effect of the alcohol or drugs. The penalty is a prison term of up to 10 years, or a fine of up to $10,000, or both. CGS § 53a-60d establishes the crime of assault in the second degree with a motor vehicle. A person commits the offense when, while operating a motor vehicle under the influence of alcohol or drugs, he causes serious physical injury to another person as a consequence of the effect of the alcohol or drugs. The penalty is a prison term of up to five years, or a fine of up to $5,000, or both. The law defines a “serious physical injury” as one that creates a substantial risk of death, or causes serious disfigurement, serious impairment of health or serious loss or impairment of the function of any bodily organ