OPINION BY
Judge COHN.
The Department of Transportation, Bureau of Driver Licensing (Department) appeals from the order of the Court of Common Pleas of Allegheny County, which sustained the appeal of Karen L. Malefic (Licensee) from the suspension of her.operator’s license. We reverse.
On December 18, 2000, the Department notified Licensee that her operating privileges were being suspended for one year pursuant to Section 1547 of the Vehicle Code, 75 Pa.C.S. § 1547, for refusing to submit to a chemical test on November 22, 2000. She filed a timely appeal and the matter was heard de novo before the trial court. Testifying for the Department was Officer Michael Baird. Licensee testified on her own behalf. The trial court made the following pertinent findings.
On November 22, 2000, Officer Baird was dispatched to the site of a single-vehicle accident, where he observed Licensee’s vehicle on its side with her trapped inside. When the officer offered help, Licensee responded that she was all right and that he should not call the police. An emergency medical service team extracted Licensee from the vehicle and transported her to the hospital. Prior to Licensee’s going to the hospital, however, Officer Baird questioned her about the accident. She stated that she did not know how the accident occurred, but she did admit to drinking prior to the event. The officer detected a strong odor of alcohol on Licensee’s breath, noted that she slurred her words, there was a case of beer in Licensee’s vehicle and that Licensee had a lump on her head.
After Officer Baird spent one-half hour at the accident scene investigating, he went to the hospital where he found Licensee in the emergency room on a gurney. Medical personnel were treating her when he arrived, and he noticed that they were [642]*642extracting blood from her for medical purposes. The officer told her, while she was lying on the gurney, that she was under investigation for driving while under the influence. He then read to her Form DL-26, which sets forth the warnings in accordance with Department of Transportation, Bureau of Traffic Safety v. O’Connell, 521 Pa. 242, 555 A.2d 873 (1989). Form DL-26 includes the statement: “Please be advised that you are now under arrest for driving under the influence of alcohol or a controlled substance pursuant to Section 3731 of the Vehicle Code.”
After reading the form to Licensee, Officer Baird requested several times that she consent to having blood drawn for “legal” as well as medical purposes. Licensee refused, even after being warned, once again, pursuant to O’Connell. Officer Baird then left the emergency room, deeming Licensee’s action a refusal to consent to a blood test.
Officer Baird testified both that Licensee was not under arrest at the time he read the Form DL-26 to Licensee, and that he considered his reading of the form as placing Licensee under arrest. Aside from his verbatim reading of the Form DL-26, he did not tell Licensee that she was under arrest or was not free to leave. He did not give the form to Licensee to read, and he did not know whether Licensee understood what he was reading to her. He also stated that he never physically arrested Licensee or took her into custody. He testified that, had she not been injured, he would have arrested her, but stated that he did not arrest her.
Licensee testified that she did not recall the officer reading anything to her. She further testified that it was possible that the officer did read the form to her, but there was too much going on in the emergency room for her to recall. She stated that she was never told that she was under arrest. At the hearing, her position was that the license suspension could not be sustained because (1) she was never arrested and (2) she was not able to make a knowing and conscious refusal to the request for a blood test because of the confusion taking place in the emergency room.
The trial court agreed with both of Licensee’s arguments. It noted that the only evidence suggesting that an arrest had occurred came from the officer’s reading of the Form DL-26 to Licensee. The officer’s testimony, however, indicated that he made no arrest prior to Licensee’s refusal to submit to the blood test, that he never made mention of a future arrest, and that Licensee was in no way confined or restrained so that she could not come or go at her leisure. The court determined that a statement read in a form by the officer did not vitiate the balance of his testimony establishing that an arrest did not occur. The court, therefore, found that Licensee was not under arrest prior to her refusal to submit to a blood test.1
The trial court, accordingly, sustained Licensee’s appeal, and this appeal followed. This Court’s scope of review is [643]*643limited to determining whether the trial court committed an error of law, an abuse of discretion, or whether the trial court’s findings of fact are supported by substantial evidence. Commonwealth v. Danforth, 530 Pa. 327, 608 A.2d 1044 (1992). Additionally, we must review the evidence in the light most favorable to the party that prevailed before the trial court. Department of Transportation, Bureau of Driver Licensing v. Malizio, 152 Pa.Cmwlth. 57, 618 A.2d 1091 (1992).
The Department argues that the trial court erred by (1) finding that Licensee was not under arrest at the time Officer Baird requested that she submit to a blood test, and (2) concluding that Licensee was incapable of making a knowing and conscious refusal in the absence of supporting medical evidence.
To establish that a suspension of operating privileges was proper, the Department must prove at a statutory appeal hearing that the licensee (1) was arrested for driving while under the influence by a police officer who had reasonable grounds to believe that the licensee was operating a vehicle while under the influence of alcohol or a controlled substance, (2) was asked to submit to a chemical test, (3) refused to do so, and (4) was warned that a refusal would result in a license suspension. Banner v. Department of Transportation, Bureau of Driver Licensing, 558 Pa. 439, 737 A.2d 1203 (1999). Moreover, the issue of whether a licensee has been placed under arrest for purposes of Section 1547 is one of fact. Pappas v. Department of Transportation, Bureau of Driver Licensing, 669 A.2d 504 (Pa.Cmwlth.1996). The relevant inquiry is whether the licensee, at the time the testing request is made, would have inferred from the totality of the circumstances that he or she was under the custody and control of the police officer. Id.
The Department asserts that the officer’s reading of the DL-26 form contradicts his immediately preceding statement that she was simply under “investigation” and, in fact, he did not leave the hospital until she had refused to submit to the chemical testing. It further points to Officer Baird’s later testimony that he would have “physically” arrested Licensee had she not been indisposed with medical treatment.
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OPINION BY
Judge COHN.
The Department of Transportation, Bureau of Driver Licensing (Department) appeals from the order of the Court of Common Pleas of Allegheny County, which sustained the appeal of Karen L. Malefic (Licensee) from the suspension of her.operator’s license. We reverse.
On December 18, 2000, the Department notified Licensee that her operating privileges were being suspended for one year pursuant to Section 1547 of the Vehicle Code, 75 Pa.C.S. § 1547, for refusing to submit to a chemical test on November 22, 2000. She filed a timely appeal and the matter was heard de novo before the trial court. Testifying for the Department was Officer Michael Baird. Licensee testified on her own behalf. The trial court made the following pertinent findings.
On November 22, 2000, Officer Baird was dispatched to the site of a single-vehicle accident, where he observed Licensee’s vehicle on its side with her trapped inside. When the officer offered help, Licensee responded that she was all right and that he should not call the police. An emergency medical service team extracted Licensee from the vehicle and transported her to the hospital. Prior to Licensee’s going to the hospital, however, Officer Baird questioned her about the accident. She stated that she did not know how the accident occurred, but she did admit to drinking prior to the event. The officer detected a strong odor of alcohol on Licensee’s breath, noted that she slurred her words, there was a case of beer in Licensee’s vehicle and that Licensee had a lump on her head.
After Officer Baird spent one-half hour at the accident scene investigating, he went to the hospital where he found Licensee in the emergency room on a gurney. Medical personnel were treating her when he arrived, and he noticed that they were [642]*642extracting blood from her for medical purposes. The officer told her, while she was lying on the gurney, that she was under investigation for driving while under the influence. He then read to her Form DL-26, which sets forth the warnings in accordance with Department of Transportation, Bureau of Traffic Safety v. O’Connell, 521 Pa. 242, 555 A.2d 873 (1989). Form DL-26 includes the statement: “Please be advised that you are now under arrest for driving under the influence of alcohol or a controlled substance pursuant to Section 3731 of the Vehicle Code.”
After reading the form to Licensee, Officer Baird requested several times that she consent to having blood drawn for “legal” as well as medical purposes. Licensee refused, even after being warned, once again, pursuant to O’Connell. Officer Baird then left the emergency room, deeming Licensee’s action a refusal to consent to a blood test.
Officer Baird testified both that Licensee was not under arrest at the time he read the Form DL-26 to Licensee, and that he considered his reading of the form as placing Licensee under arrest. Aside from his verbatim reading of the Form DL-26, he did not tell Licensee that she was under arrest or was not free to leave. He did not give the form to Licensee to read, and he did not know whether Licensee understood what he was reading to her. He also stated that he never physically arrested Licensee or took her into custody. He testified that, had she not been injured, he would have arrested her, but stated that he did not arrest her.
Licensee testified that she did not recall the officer reading anything to her. She further testified that it was possible that the officer did read the form to her, but there was too much going on in the emergency room for her to recall. She stated that she was never told that she was under arrest. At the hearing, her position was that the license suspension could not be sustained because (1) she was never arrested and (2) she was not able to make a knowing and conscious refusal to the request for a blood test because of the confusion taking place in the emergency room.
The trial court agreed with both of Licensee’s arguments. It noted that the only evidence suggesting that an arrest had occurred came from the officer’s reading of the Form DL-26 to Licensee. The officer’s testimony, however, indicated that he made no arrest prior to Licensee’s refusal to submit to the blood test, that he never made mention of a future arrest, and that Licensee was in no way confined or restrained so that she could not come or go at her leisure. The court determined that a statement read in a form by the officer did not vitiate the balance of his testimony establishing that an arrest did not occur. The court, therefore, found that Licensee was not under arrest prior to her refusal to submit to a blood test.1
The trial court, accordingly, sustained Licensee’s appeal, and this appeal followed. This Court’s scope of review is [643]*643limited to determining whether the trial court committed an error of law, an abuse of discretion, or whether the trial court’s findings of fact are supported by substantial evidence. Commonwealth v. Danforth, 530 Pa. 327, 608 A.2d 1044 (1992). Additionally, we must review the evidence in the light most favorable to the party that prevailed before the trial court. Department of Transportation, Bureau of Driver Licensing v. Malizio, 152 Pa.Cmwlth. 57, 618 A.2d 1091 (1992).
The Department argues that the trial court erred by (1) finding that Licensee was not under arrest at the time Officer Baird requested that she submit to a blood test, and (2) concluding that Licensee was incapable of making a knowing and conscious refusal in the absence of supporting medical evidence.
To establish that a suspension of operating privileges was proper, the Department must prove at a statutory appeal hearing that the licensee (1) was arrested for driving while under the influence by a police officer who had reasonable grounds to believe that the licensee was operating a vehicle while under the influence of alcohol or a controlled substance, (2) was asked to submit to a chemical test, (3) refused to do so, and (4) was warned that a refusal would result in a license suspension. Banner v. Department of Transportation, Bureau of Driver Licensing, 558 Pa. 439, 737 A.2d 1203 (1999). Moreover, the issue of whether a licensee has been placed under arrest for purposes of Section 1547 is one of fact. Pappas v. Department of Transportation, Bureau of Driver Licensing, 669 A.2d 504 (Pa.Cmwlth.1996). The relevant inquiry is whether the licensee, at the time the testing request is made, would have inferred from the totality of the circumstances that he or she was under the custody and control of the police officer. Id.
The Department asserts that the officer’s reading of the DL-26 form contradicts his immediately preceding statement that she was simply under “investigation” and, in fact, he did not leave the hospital until she had refused to submit to the chemical testing. It further points to Officer Baird’s later testimony that he would have “physically” arrested Licensee had she not been indisposed with medical treatment. It asserts that, under the totality of the circumstances test, this evidence is sufficient to meet its burden that Licensee was placed under arrest, relying upon several cases that we shall now examine.
In Department of Transportation, Bureau of Traffic Safety v. Uebelacker, 98 Pa.Cmwlth. 436, 511 A.2d 929 (1986), the police officer arrived at the accident scene, radioed for an ambulance, followed it to the hospital and, waited while the licensee was confined to a bed. The officer then told the licensee that “he was going to be arrested” for driving under the influence and the officer stated that he would like the licensee to submit to a blood test. We held in Uebelacker that the totality of the circumstances established that a reasonable person would have inferred that he was under the custody and control of the police officer. In Department of Transportation, Bureau of Driver Licensing v. Shine, 114 Pa.Cmwlth. 523, 539 A.2d 42 (1988), the officer who investigated the accident then went to the hospital and advised the licensee that he was going to be arrested for several charges, including driving under the influence. We determined, there, that the evidence showed that the totality of the circumstances was sufficient for the licensee to infer that he was under the control or custody of the officer, even though the officer did not move the licensee from the hospital to the police station to process the arrest. In [644]*644Department of Transportation, Bureau of Driver Licensing v. Jones, 120 Pa.Cmwlth. 88, 547 A.2d 877 (1988), petition for allowance of appeal denied, 522 Pa. 579, 559 A.2d 40 (1989), we determined that an arrest had occurred when the police officer investigating the accident then went to the hospital and gave the licensee his Miranda rights, with the explanation that he was going to be placed under arrest for drunk driving. Again, we said that, under the totality of the circumstances, the reasonable impression of the licensee should have been that he was subject to the officer’s custody and control.
The trial court, however, found the case of Welcome v. Department of Transportation, Bureau of Driver Licensing, 167 Pa.Cmwlth. 245, 647 A.2d 971 (1994), to be persuasive. There, we determined that a licensee being treated at a hospital following an accident was not under arrest when the investigating officer informed the licensee that he had the right to remain silent, “informed [him] of the implied consent law,” and requested that he submit to a blood test. Id. at 973. We found significant in Welcome the fact that the officer never restricted the licensee’s freedom at the hospital or indicated that he could not leave or would be placed under arrest for drunk driving. Also, we noted that the fact that the licensee would not leave the hospital because of his concern for his children, who were also in the accident and being treated, had no bearing on the fact that he could have left the hospital had he chosen to do so. Finally, we found it significant that when the licensee refused to consent to a chemical test, the officer simply left the hospital without “formally” arresting or charging him. Importantly, however, our decision in that case does not state that the officer’s explanation of the “implied consent law” included the paragraph read by Officer Baird in the present case stating that the licensee was “now under arrest for driving under the influence.” In addition, in our case it is clear from the record that Licensee was not going to be leaving the hospital anytime soon because she was undergoing emergency medical treatment. (N.T. 17, 20, 23.) We, therefore, conclude that Welcome is distinguishable and that, in line with the cases cited by the Department, the totality of the circumstances indicate that there was an arrest.
Turning to the second issue, the Department asserts that the trial court erred in concluding that Licensee did not need to present medical evidence that she was incapable of making a knowing and conscious refusal. Licensee has the burden to show that her refusal to submit to a chemical test was not knowing and conscious. Pappas. Unless there are severe, obvious and incapacitating injuries, expert testimony is required to meet this burden. Ostermeyer v. Department of Transportation, Bureau of Driver Licensing, 703 A.2d 1075 (Pa.Cmwlth.1997).
In Department of Transportation, Bureau of Driver Licensing v. Garlan, 121 Pa.Cmwlth. 400, 550 A.2d 873 (1988), petition for allowance of appeal denied, 522 Pa. 614, 563 A.2d 499 (1989), a driver who presented only lay testimony that he had suffered a concussion, a corneal abrasion, bruises and a loss of memory was held not to have met his burden. His situation can be contrasted with that of the licensee in Department of Transportation, Bureau of Traffic Safety v. Day, 93 Pa.Cmwlth. 49, 500 A.2d 214 (1985), where we held that a broken jaw, severe facial lacerations, a broken arm, an injured leg and blows to the head were sufficiently severe and obvious to obviate the need for expert medical testimony. In the case sub judice, however, the only evidence regarding the injury was that Licensee bumped her head and [645]*645had a lump on her forehead that was black and blue and swelling and that she had two black eyes. Nonetheless, she was able to converse with Officer Baird at the accident scene and later with medical personnel. Contrary to the circumstances in Day, this evidence does not support the notion that Licensee’s injuries were so obviously severe and incapacitating that she did not need to present expert medical evidence. Indeed, they were far less severe than those in Garlan. Accordingly, since she failed to present any expert testimony that she could not make a knowing and conscious refusal, we agree with the Department that Licensee has not met her burden on this issue.
Based on the foregoing discussion, the trial court’s order is reversed.
ORDER
NOW, March 26, 2003, the order of the Court of Common Pleas of Allegheny County in the above-captioned matter is hereby reversed.