On May 8, 2017, the U.S. Court of Appeals for the Eleventh Circuit issued a decision holding that, under the Americans with Disability Act (“ADA”) and Rehabilitation Act, deaf patients have the right to sue a hospital for not providing adequate interpretation services for hearing-impaired patients.
The plaintiffs, Cheylla Silva and John Paul Jebian, are both deaf and rely on American Sign Language (“ASL”) for communication. The plaintiffs separately made numerous visits to Baptist Hospital of Miami, Inc. and South Miami Hospital, Inc., which both belong to the same parent organization, Baptist Health South Florida, Inc. The plaintiffs alleged that for their numerous visits to the defendant hospitals, they requested live ASL interpreters, but the hospitals primarily used Video Remote Interpreting (“VRI”) technology whereby a remotely located ASL interpreter would provide the service through real-time audio-video conferencing. The plaintiffs further alleged that the VRI equipment malfunctioned on many occasions such that hospital staff would rely on written notes or interpretation assistance from the plaintiffs’ family members instead of providing direct services from an ASL interpreter.
The plaintiffs sued the defendants for violating the ADA and Rehab Act, and sought both injunctive relief and monetary damages. The District Court for the Southern District of Florida granted summary judgment in favor of the defendants, finding that the plaintiffs lacked standing and failed to show a genuine dispute as to any material fact because they did not allege any adverse medical consequence or any inhibited ability to communicate their chief medical complaints when seeking treatment. On appeal, a three-judge panel of the Eleventh Circuit reversed and remanded the case back to the district court for further proceedings.
In its decision, the Eleventh Circuit held that the plaintiffs did have standing to seek injunctive relief under the ADA and Rehab Act because they satisfied the injury-in-fact requirement by showing a “real and immediate” likelihood that they will return to the defendant hospitals and that they “will likely experience a denial of benefits or discrimination” when their return.
The opinion then addressed the standard for effective communication and held that, under the alleged circumstances, the plaintiffs did not need to show instances of adverse medical consequences. The court explained that “[t]he ADA and RA focus not on quality of medical care or the ultimate treatment outcomes, but on the equal opportunity to participate in obtaining and utilizing services.” The court further explained, “regardless of whether a patient ultimately receives the correct diagnosis or medically acceptable treatment, that patient has been denied the equal opportunity to participate in healthcare services whenever he or she cannot communicate medically relevant information effectively with medical staff.”
The court noted that the federal rules requiring healthcare providers to offer appropriate auxiliary aids to ensure effective communication do not mean that “deaf patients are entitled to an on-site interpreter every time they ask for it.” According to the court, effective communication under the ADA and Rehab Act may include many alternatives to live on-site interpreters, and determining any violation of the standard is “inherently fact-intensive.” The court concluded, however, that the facts presented by the plaintiffs were sufficient to survive summary judgment.
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