national association of the deaf lawsuit

8/9/2019 National Association of the Deaf Lawsuit

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLUMBIA

NATIONAL ASSOCIATON OF THE DEAF, *8603 Fenton Street, Suite 820

Silver Spring, Maryland 20910 *

and *

ROBBIE CARMICHAEL, *15700 Jamies WayAccokeek, Maryland 20607 *

and *

CARRIE ST. CYR, *

594 Buckthorn WayGahanna, Ohio 43230 *

and*

ALISON McGUIGAN,1619 Gales Street N.E. *Washington, D.C. 20002

*Plaintiffs,

*

v. Civil Action No. _________*

DISTRICT HOSPITAL PARTNERS, L.P.,d/b/a THE GEORGE WASHINGTON *UNIVERSITY HOSPITAL900 23rd Street N.W. *Washington, D.C. 20037

*Serve on:CT Corporation System *1015 15

thSt., N.W.

Suite 1000 *Washington, D.C. 20005

*Defendant.

*******************************

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 1 of 27


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COMPLAINT

Plaintiffs, National Association of the Deaf, Robbie Carmichael, Carrie St. Cyr, and

Alison McGuigan, by their undersigned counsel, sue District Hospital Partners, L.P., d/b/a the

George Washington University Hospital, and state:

PRELIMINARY STATEMENT

1. The National Association of the Deaf (NAD), Robbie Carmichael, Carrie

St. Cyr and Alison McGuigan bring this action against Defendant District Hospital Partners,

L.P., d/b/a George Washington University Hospital (GWUH), for its failure to ensure effective

communication with its deaf patients. Each of the named individual plaintiffs is deaf and

communicates primarily through American Sign Language (ASL). Because GWUH insisted

on using video remote interpreting (VRI) that did not provide effective communication when

Ms. Carmichael underwent a neck operation, she was forced to provide her own qualified on-site

ASL interpreters. Ms. St. Cyr endured sixteen hours of labor struggling to communicate with her

medical staff using a defective VRI system. Ms. McGuigan spent an evening in GWUHs

emergency room very ill with vomiting and body pains not understanding the medical staff who

barely made any attempt to communicate effectively with her aside from a frustrating attempt to

use a VRI system.

2. The NAD has heard about GWUHs discriminatory treatment of deaf patients

over the years and learned about the issues involving the individuals in this case. As an

organization dedicated to achieving integration and equal rights for deaf individuals, the NAD

has had to expend its limited resources to counteract GWUHs discrimination and, therefore, has

been harmed by GWUH.

3. The NAD brings claims on behalf of its members and for itself. GWUHs failure

to provide necessary auxiliary aids and services to ensure effective communication with



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Plaintiffs Carmichael, St. Cyr, McGuigan, and members of the NAD violates Title III of the

Americans with Disabilities Act, 42 U.S.C. 1218112189; Section 504 of the Rehabilitation

Act of 1973, as amended, 29 U.S.C. 794; and the D.C. Human Rights Act, D.C. Code 2-

1402.31. Plaintiffs bring this lawsuit to compel Defendant to cease unlawful discriminatory

practices and implement policies and procedures that will ensure effective communication, full

and equal enjoyment, and a meaningful opportunity to participate in and benefit from

Defendants health care services. Further, Plaintiffs seek compensatory damages, attorneys

fees, and costs.

THE PARTIES

4. Plaintiff National Association of the Deaf (NAD) is a non-profit corporation

under the laws of the State of Maryland and has its national headquarters at 8630 Fenton Street,

Suite 820, Silver Spring, Maryland 20910.

5. Plaintiff Robbie Carmichael lives at 15700 Jamies Way, Accokeek, Maryland

20607.

6.

At the time of the events set forth in the Complaint Plaintiff Carrie St. Cyr lived at

2350 Washington Place N.E., Washington D.C. 20018. She is now temporarily living in

Germany, with her husband, and will return to the District of Columbia at the end of the summer.

7. Plaintiff Alison McGuigan lives at 1619 Gales Street N.E., Washington, D.C.

20002.

8. District Hospital Partners, L.P., d/b/a/ George Washington University Hospital

(GWUH), is a private for-profit organization that owns, operates, and/or leases a hospital in

the District of Columbia at 900 23rd Street N.W., Washington, D.C. 20037. Defendant is a

recipient of federal financial assistance.



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JURISDICTION

9. This Court has subject matter jurisdiction pursuant to 28 U.S.C. 1331 and 1343

for claims arising under Section 504 of the Rehabilitation Act, 29 U.S.C. 794, and Title III of

the ADA, 42 U.S.C. 12181, et seq., and it has supplemental jurisdiction pursuant to 28 U.S.C.

1367 for claims arising under the D.C. Human Rights Act, D.C. Code 2-1402.31.

FACTUAL ALLEGATIONS

10. The NAD is the nations premier civil rights organization of, by, and for deaf and

hard of hearing individuals. The NAD membership includes individuals and associations from

all fifty states and Washington, D.C., including its affiliate, the District of Columbia Association

of the Deaf. The NAD is also the United States member of the World Federation of the Deaf,

which has over 120 national associations of deaf people as members.

11. The NAD has representational standing to sue on behalf of its deaf and hard of

hearing members, as Defendants unlawful conduct interferes with NAD members rights to

have full and equal access to society, a core goal of the NAD. First, the NAD has members

residing in and/or near D.C. who have sought and/or will seek medical care at Defendants

hospital. Those individuals have been or will be denied effective communication as long as

Defendants auxiliary aids and services policy remains in place. Such members have standing to

sue Defendant on their own. Second, advocating on behalf of its members on this issue is

germane to the NADs mission of advocating for its members rights to full and equal access to

society. Finally, none of the NADs members will be required to participate in this action

because in its representational claim the NAD is seeking declaratory and injunctive relief and not

an individualized remedy for its members.

12. The NAD also has organizational standing because of the injuries it has suffered

by GWUHs discrimination, set forth below.



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13. Robbie Carmichael is deaf. She is substantially limited in the major life activities

of hearing and speaking. Ms. Carmichaels primary language is American Sign Language

(ASL).

14.

Carrie St. Cyr is deaf. She is substantially limited in the major life activities of

hearing and speaking. Ms. St. Cyrs primary language is ASL.

15. Alison McGuigan is deaf. She is substantially limited in the major life activity of

hearing. Ms. McGuigans primary language is ASL.

16. On information and belief, the refusal to offer in-person interpreter services to

each of the individual plaintiffs as set out below is as a result of a policy or practice of Defendant

to discourage the use of on-site interpreters without regard to whether VRI services will provide

effective communication and no matter the risk to patient care.

THE NAD

17. Defendants actions have caused and continue to cause distinct, palpable, and

perceptible injury to the NAD.

18.

The NADs mission is to promote the general welfare of deaf and hard of hearing

individuals by (1) assisting deaf and hard of hearing people in their efforts to integrate

themselves into society on terms of equality and independence; and (2) removing barriers and

changing social attitudes, stereotypes, and mistaken beliefs hearing individuals have about deaf

and hard of hearing individuals concerning their deafness that result in the denial of meaningful

opportunity to deaf people in many spheres of life.

19. The NAD improves the lives of deaf people through advocacy, education,

research, technology, and programs encouraging independence and empowerment. It also

provides advocacy services and protection of civil rights for individuals who are deaf and hard of

hearing.



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20. The NADs mission includes working to ensure that deaf and hard of hearing

individuals have a full and equal opportunity to benefit from services, including medical care,

without discrimination on the basis of disability. Indeed, some of the most frequent requests for

assistance to the NAD arise from the failure of medical providers to provide effective

communication to deaf patients.

21. Ensuring a full and equal opportunity to Defendants hospital for deaf and hard of

hearing individuals is not only germane, but central, to the NADs purpose. The NAD has

strongly advocated for access to medical care by having medical providers ensure effective

communication. The NAD provides guidance about effective communication in medical settings

on its website and provides workshops for medical providers and the general community on

accessible health care for deaf and hard of hearing individuals.

22. Defendants discrimination has frustrated the NADs mission and caused it to

divert resources to identify and counteract Defendants discriminatory practices.

23. Defendants discrimination has been and continues to be a barrier to the ability of

deaf and hard of hearing individuals to fully participate in making decisions about health care.

24. Defendants discrimination has required and continues to require the NAD to

make a greater effortand to allocate scarce resourcesto educate the public and health care

providers that such discrimination is wrong and otherwise to counteract the adverse impact of

such discrimination. This impairs the NADs counseling, advocacy, educational, and training

missions.

25. Defendants discrimination sends a message that it is acceptable for medical

providers to adopt policies and procedures that deprive deaf and hard of hearing individuals of

the opportunity to be full partners in their receipt of health care. This frustrates the NADs

mission and makes it more difficult for the NAD to convince other institutions and entities with



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services, programs, or activities that the provision of auxiliary aids and services is both necessary

and required. The NAD has also devoted and continues to devote resources to identifying and

counteracting medical providers discrimination generally.

26.

These actions that the NAD has taken to identify and counteract Defendants

discrimination have diverted resources from other important programs. For example, NAD staff

members must continue to conduct outreach and counseling to inform deaf and hard of hearing

individuals that they have the right to effective communications when they are seeing health care

providers. As a non-profit, the NAD does not receive compensation for this service.

27. All of the activities undertaken to identify and counteract the effects of

Defendants discrimination have caused economic losses to the NAD in the form of staff pay,

attorney and consultant fees, and/or other funds spent on those activities.

28. The NADs injuriesincluding, without limitation, those described hereinare

traceable to the Defendants discriminatory conduct alleged in this Complaint and will be

redressed by the relief requested in it.

Carmichael

29. Ms. Carmichael requires an ASL interpreter to communicate effectively in

medical settings.

30. In or about Spring of 2013, Ms. Carmichael was diagnosed with a pinched nerve

caused by three fused vertebrae. She had been having problems moving her right arm.

31. Ms. Carmichael met with Dr. Yu, a surgeon at the George Washington Spine

Center at GWUH, in June 2013.

32. An ASL interpreter was provided for the appointment with Dr. Yu.

33. Dr. Yu scheduled surgery for July 8, 2013 to separate the fused vertebrae in

Ms. Carmichaels neck.



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34. Through Dr. Yus office, Ms. Carmichael asked GWUH to provide on-site

interpreting services.

35. On July 2, Ms. Carmichael went to GWUH for pre-surgery tests.

36.

There was no on-site interpreter present. Instead, although Ms. Carmichael asked

for an on-site interpreter, GWUH provided what is referred to as a Video Remote Interpreting

(VRI) service.

37. With VRI, videoconferencing equipment provides a link between the hospital

room where a deaf patient is receiving treatment and an interpreter who is at a different site. The

interpreter, though remote, is supposed to interpret conversations between the deaf and hearing

individuals.

38. Because she was at the hospital only to have pre-surgery blood tests performed,

Ms. Carmichael said she would give VRI a try.

39. Jennifer Downs, GWUHs physician relationship manager, was present to observe

the VRI system.

40.

There were complications with the VRI machine, which was a laptop with an

approximately 13 inch screen on a moving stand.

41. The staff was unfamiliar with how to use the VRI machine.

42. Ms. Carmichael could not see the interpreter well, and the video feed of the

interpreter could not be enlarged for her to see the interpreter.

43. The VRI machine kept shutting down.

44. It took time for the VRI machine to restart and connect again.

45. What was supposed to be a quick appointment to have her blood drawn became

an ordeal lasting over an hour in which she and GWUH staff struggled unsuccessfully to

communicate through the VRI equipment.



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46. Ms. Carmichael was also supposed to use VRI to participate in a pre-surgery

class, but because the VRI equipment did not function properly, she was unable to attend the

class.

47.

Because she found her upcoming neck surgery to be distressing and because there

was a risk of paralysis, Ms. Carmichael did not want the extra anxiety she would get from having

untrustworthy auxiliary aids and services during her neck surgery.

48. On or about July 4 or 5, 2013 Ms. Carmichael asked Ms. Downs for on-site

interpreters for her surgery. Ms. Downs told Ms. Carmichael that there would be a better VRI

system by surgery day and that there would be no on-site interpreters.

49. Feeling like there were no other options, Ms. Carmichael hired ASL interpreters

to accompany her on July 8.

50. Ms. Carmichael appeared at GWUH for her surgery on July 8 at 10 a.m. for the

surgery, which was schedule for noon.

51. GWUH set up the VRI equipment for Ms. Carmichael.

52.

Ms. Carmichael was unable to clearly see what appeared on the screen.

53. Before her surgery Ms. Carmichael communicated with GWUH personnel

through the use of her privately-hired interpreters.

54. After the operation when Ms. Carmichael awakened in the recovery room,

Ms. Downs was present, with two nurses.

55. Ms. Carmichael was flat on the bed and asked for her interpreters.

56. One of the nurses gestured at a VRI monitor (which was approximately

15 inches), indicating that Ms. Carmichael should look at the device for remote interpreting.

57. Ms. Carmichael had just come out of neck surgery. She had a bandage on her

neck and a neck brace and was unable to move her head much.



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58. The VRI machine was to the side of her bed, and looking at it required her to turn

her head.

59. The nurse inclined the top half of the bed to bring Ms. Carmichael to a sitting

position and fixed the pillow in an attempt to have Ms. Carmichaels head face the VRI screen.

60.

The VRI machine was on a cart, high above Ms. Carmichaels line of sight.

Ms. Carmichael was not able to see the entire screen from her position. The screen was

approximately one to two feet away from her face.

61. The VRI machine was connected to a Video Interpreter (VI).

62. Ms. Carmichael, groggy from general anesthesia, saw a blurry face profile on the

screen, but could not distinguish facial features.

63. Ms. Carmichael became extremely upset.

64. While Ms. Carmichael was trying to look at the VRI machine, her neck began to

bleed.

65. Ms. Carmichael was not supposed to move her neck.

66.

The remote interpreter informed Ms. Downs that VRI was not effective for

Ms. Carmichael in her situation and that she needed an on-site interpreter.

67. Ms. Downs called one of Ms. Carmichaels privately hired on-site interpreters.

68. Sherri Lyster, the interpreter, came in and saw the nurse trying to reposition

Ms. Carmichael on the bed to help her see the screen. Ms. Lyster informed the nurse that

Ms. Carmichaels neck was bleeding.

69. The nurse abandoned her efforts to reposition Ms. Carmichael.

70. Ms. Carmichaels interpreter stayed until approximately 8 p.m. that night.

71. The day after her surgery Ms. Carmichael woke up and discovered that neither an

on-site interpreter nor VRI was available.



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72. Ms. Downs came and told Ms. Carmichaels sister that the hospital would try

using the VRI machine again. Ms. Carmichaels sister objected, without avail.

73. The VRI monitor was placed at the foot of Ms. Carmichaels bed. Because of her

immobile neck and her inability to see a small screen from where it was placed, the remote

interpreter told others in the room with Ms. Carmichael that the patient was not responding to her

and that an on-site interpreter was needed.

74. Ms. Carmichael was not able to communicate with her doctors during their

morning rounds.

75. Later in her hospitalization GWUH finally provided on-site interpreters on July 8

from approximately 1 p.m. to 8 p.m. and on July 9 from approximately 8 a.m. to 5 p.m. and on

July 10 from 8 a.m. until she was discharged.

76. There were no interpreters provided when Ms. Carmichaels doctor came to

examine her at the 6 a.m. morning rounds.

77. Ms. Carmichael paid the on-site interpreters $1,616.00.

St. Cyr

78. Ms. St. Cyr is unable to communicate effectively in a medical setting through lip-

reading or writing.

79. Ms. St. Cyr requires a qualified ASL interpreter to communicate with those who

do not know ASL.

80. In February 2013, Ms. St. Cyr discovered she was pregnant with her first child.

Her husband, Martin Dietrich, worked in Germany at that time.

81. Ms. St. Cyr was always provided with an ASL interpreter at her prenatal

appointments at Capital Womens Care Center and The George Washington University Medical

Faculty Associates.



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82. In April and May of 2013, Ms. St. Cyr visited GWUH for pregnancy

complications. An ASL interpreter was provided for each visit.

83. In May Ms. St. Cyr was diagnosed with a short cervix and ordered to remain on

modified bed rest. Later that month, she was ordered to be on complete bed rest.

84.

On July 17, 2013 Ms. St. Cyr went to GWUH at 9:30 p.m. because although she

was only 30 weeks pregnant, she had been experiencing labor pains and contractions for the past

few days.

85. Ms. St. Cyr was accompanied by her mother, Denise St. Cyr; her brother,

Andrew St. Cyr; and her friend, Lore Ameloot. All of them are deaf. Ms. St. Cyrs husband was

on his way home from Germany.

86. Upon arrival at GWUH, Ms. St. Cyr requested an on-site ASL interpreter. The

staff informed her that an interpreter would be present in one to two hours. They informed her

that they would provide interpreting services with VRI in the interim.

87. The VRI machine consisted of a Dell laptop computer with a screen of

approximately thirteen inches. The computer was on a rolling stand approximately three to four

feet tall. There was a camera fixed inside the computer.

88. The medical staff kept telling Ms. St. Cyr that an on-site interpreter would be

arriving soon. Later, however, the hospital staff told Ms. St. Cyr that they cancelled the request

for an on-site interpreter pursuant to GWUHs policy of providing only VRI services.

89. While in labor Ms. St. Cyr was in considerable pain and was unable to remain in a

position necessary to view the small screen displaying the interpreter. Andrew St. Cyr had to

relay information from the VRI machine to his sister as she struggled through her labor.

90. There were several other problems with the VRI system other than the inability to

adjust to Ms. St. Cyrs line of sight.



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91. The video quality was choppy and poor. The machine lost connection numerous

times throughout the night. At several points, the connection would be lost after five minutes. It

would take another five minutes to re-connect to the interpreting service provider, who would

then take time to connect to the next available VI. Adding all delays altogether, Ms. St. Cyr lost

a significant amount of time of access to information. In fact, for quick information exchanges,

the nurse would communicate with family members instead of turning on the VRI machine

because the machine took too long to connect.

92. The remote interpreter who Ms. St. Cyr encountered most often did not behave

impartially and did not interpret accurately. Ms. St. Cyrs deaf family members were able to

catch some of the interpreters many mistakes and they attempted to remedy incorrect

information by informing the nurses that the information shared was inaccurate. Mr. St. Cyr

attempted to explain to the nurses that VRI was ineffective and that an on-site interpreter was

necessary. The remote interpreter argued that she was capable of interpreting and that VRI was

effective. The nurses chose to believe the remote interpreter over Ms. St. Cyr and her family

members.

93. It is unknown if the remote interpreter made additional mistakes that the St. Cyrs

missed.

94. The remote interpreter was angry that Andrew St. Cyr was relaying information to

Ms. St. Cyr and repeatedly told him to stop. Mr. St. Cyr refused to stop, because his efforts

provided the only way his sister could understand any of what the medical staff was saying.

95. Some of the nurses who worked with Ms. St. Cyr did not know how to operate

the VRI device - or even how to turn it on.

96. Following her friend Ms. Ameloots suggestion, Ms. St. Cyr contacted Gloria

Mills, a friend who is an ASL interpreter who often works in hospitals. Ms. St. Cyr told



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Ms. Mills about her frustration with VRI at GWUH. Ms. Mills then tried to explain, in spoken

English, to the nurse why VRI was not effective for Ms. Cyr.

97. The remote interpreter heard Ms. Mills and told the nurse not to listen to

Ms. St. Cyr. The nurse then hung up on Ms. Mills.

98.

After Ms. Mills phone call was disconnected Ms. Mills contacted Mia Heisley, a

deaf medical access advocate, and asked her to go to GWUH to help Ms. St. Cyr advocate for an

on-site interpreter.

99. At approximately 10:30 p.m., Ms. St. Cyrs water broke in the triage room. At

that time Ms. St. Cyr and her family and friend were moved to a labor and delivery room. At

approximately 2 a.m., Ms. St. Cyr was asked if she wanted an epidural. The remote interpreter

encouraged Ms. St. Cyr to say yes, despite a requirement that interpreters remain impartial and

strictly relay information between parties. Ms. St. Cyr then said she would like to receive an

epidural.

100. The staff instructed everyone to leave, citing policy. This instruction included

Mr. St. Cyr, who had been relaying information to Ms. St. Cyr because she could not see the

interpreter on the VRI machine.

101. Prior to the procedure, Ms. St. Cyr had wanted to learn more about the

advantages, disadvantages, and risks of having the epidural. Ms. St. Cyr asked about these

issues. Instead of relaying her questions to the healthcare professionals, the interpreter

responded: Do you want your pain to go away? Take it. Ms. St. Cyr attempted to

communicate directly with the nurse, to no avail. Feeling trapped, Ms. St. Cyr signed the release

forms for the epidural.

102. Prior to the insertion of the needle for the epidural, Ms. St. Cyr was instructed not

to move her head or arms and to remain in the curled position throughout the procedure.



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103. When the needle was inserted in her spine, the nurse wanted to communicate with

Ms. St. Cyr via the VRI machine. When Ms. St. Cyr did not move - as she believed she was

instructed to and out of fear of risk of moving with a needle in her spine - the nurse grabbed

Ms. St. Cyrs face and moved it so Ms. St. Cyr could see the VRI machine. This terrified

Ms. St. Cyr and caused her to worry about possible injury to her spine.

104. The first attempt to put the epidural in failed. The second attempt worked.

105. In the middle of the night, deaf advocate, Mia Heisley arrived and again explained

to the nurses that the VRI machine was not effective. Despite this information, the nurses did

not get an on-site interpreter.

106. At approximately 4 or 5 a.m. on July 18, 2013, Ms. Downs went to Ms. St. Cyrs

room and witnessed the technical difficulties of the VRI machine. Ms. Heisley explained to

Ms. Downs the ineffectiveness of the VRI in this situation. Ms. Heisley left at 6 a.m.

107. After Ms. Heisley left Ms. St. Cyr began to vomit and worried that something was

wrong. The nurse said the vomiting could be a side effect of the epidural and that this

information was shared earlier prior to the epidural insertion. Ms. St. Cyr did not get that

warning. Ms. St. Cyr also wanted to eat, not knowing that she could not with the epidural.

Again, she did not receive this information prior to the epidural.

108. Approximately 16 hours after arriving at GWUH, an on-site interpreter arrived.

The interpreter arrived twenty minutes before the birth of Ms. St. Cyrs son, Nitram Hy St. Cyr,

at 1:44 p.m. on July 18, 2018. Because Nitrams umbilical cord was wrapped around his neck he

faced a serious risk of injury during birth, which made the absence of an on-site interpreter all

the more upsetting to Ms. St. Cyr.

109. Upon the arrival of the on-site interpreter, Ms. St. Cyr felt better because of the

availability of effective communication.



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110. The interpreter was scheduled to leave at 7 p.m. Ms. St. Cyrs husband arrived

from Germany at approximately 6:30 p.m. He is unable to lip read or speak English. Because he

had questions about the birth and his premature sons health, he asked the interpreter if she could

stay another hour. The head nurse said no and GWUH resumed using VRI at 7 p.m.

111.

Ms. St. Cyr remained in the hospital until July 20th. Nitram was in the neonatal

intensive care unit (NICU). Every time Ms. St. Cyr wanted to visit her son prior to her

discharge, she had to wheel the VRI machine herself from her recovery bed to her sons cradle.

112. For the five weeks that Nitram remained in the NICU, Ms. St. Cyr and her

husband were forced to communicate with GWUH personnel strictly through the VRI machine.

113. The only other time they had an on-site interpreter was when Nitram was

discharged.

McGuigan

114. Alison McGuigan has limited ability to communicate in spoken English. Only in

a one-on-one setting with someone she is very familiar with and when she is healthy and alert

can she communicate with individuals using spoken English.

115. All other times, especially when she is ill, she requires an ASL interpreter to

communicate effectively with those who do not sign ASL.

116. A car accident in 2007 led to stomach removal surgery at GWUH in 2008 for

Ms. McGuigan. She had on-site interpreters for this surgery. Since her surgery she has

experienced intermittent gastrointestinal issues.

117. On May 7, 2014, Ms. McGuigan became very ill. She began to vomit and

experience body pain. After two days of feeling sick and weak, Ms. McGuigan contacted the

surgeon who operated on her stomach, Dr. Pau Lin. Dr. Lin is a surgeon with the George

Washington Medical Faculty Associates.



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118. Because it was not during business hours, Ms. McGuigan spoke with Dr. Lucas,

who was on call, and who instructed her to go to the emergency room (ER). Dr. Lucas also

instructed Ms. McGuigan to have the ER contact Dr. Lucas once she arrived.

119.

James McGuigan, Ms. McGuigans husband, dropped her off at the ER and went

to park their car at approximately 5 p.m.

120. Mr. McGuigan also is deaf and unable to communicate via spoken English.

121. Ms. McGuigan went to the triage nurse and asked her to call Dr. Lucas at the

number she provided. She told the nurse that Dr. Lucas was expecting the ER to call.

122. The nurse nodded and took Ms. McGuigans vital signs.

123. The nurse entered information on an online intake form on her computer, which

was visible to Ms. McGuigan.

124. Ms. McGuigan saw a checkbox indicating that a patient needed an ASL

interpreter on the online form. She pointed to that box, and the nurse checked it.

125. Mr. McGuigan arrived at the ER.

126.

Ms. McGuigan was not able to move much, so the nurse put her in a wheelchair

and wheeled her past many vacant bays to a small room with four beds close together.

127. A medical student came to question Ms. McGuigan.

128. Ms. McGuigan asked for an interpreter. The student nodded.

129. Ms. McGuigan was able to respond verbally to simple questions. She was not

able to understand complicated questions, instructions, or anything more than a sentence, and

was not able to respond to those.

130. Ms. McGuigan told the student that she could not understand him whenever he

spoke more than a sentence.



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131. Other medical students came and observed Ms. McGuigan. Ms. McGuigan asked

each student to get an interpreter and received a nod from each.

132. There was a nurse who came in and out of the room to take care of

Ms. McGuigan. Ms. McGuigan asked her for pain and nausea medicine.

133.

Although Ms. McGuigan had an IV placed in her arm, she did not receive

medicine upon request.

134. Mr. McGuigan told his wife that the nurse wanted her to give a urine sample.

135. At approximately 6 or 7 p.m. the nurse gave Ms. McGuigan a large bottle of

barium.

136. Not understanding what it was for and thinking she had to drink the entire bottle,

Ms. McGuigan did not drink it. She told the nurse that if she had tried to drink it, she would

vomit immediately.

137. Ms. McGuigan still did not receive any medicine.

138. Although the nurse was visibly angry that Ms. McGuigan would not drink the

barium, she made no effort to explain what it was for.

139. After several frustrating attempts to communicate with the medical staff,

Ms. McGuigan was upset and loudly said that she could not understand them. She also said she

could not understand why she needed to drink the barium. She said she could not understand

why she was so sick.

140. Only at this point, and after Ms. McGuigans several requests for an interpreter

made to several people, did GWUH personnel bring in a VRI machine.

141. When the VRI machine was brought in, the nurse commented that this was what

they had and this was what Ms. McGuigan would get.



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142. The VRI machine was a laptop with an approximately thirteen-inch screen on a

stand.

143. The room was so small that the VRI machine could not be positioned where

Ms. McGuigan could see the screen. At that time, Ms. McGuigan was curled up in a fetal

position due to extreme pain, and could not move very much.

144. No member of the staff present knew how to set up the VRI machine.

145. Another woman came in to help set up the VRI machine. Together, the staff

spent an hour attempting to set up the VRI machine.

146. Even after the staff set up the VRI machine, Ms. McGuigan could not see the

screen. Therefore, her husband had to relay information between her and the remote interpreter.

147. Hours after giving Ms. McGuigan the barium, a nurse finally explained to

Ms. McGuigan what the drink was for: it was for a CAT scan and she only needed to drink a

little.

148. The VRI machine was shut off after 5 minutes of use.

149.

A medical student brought breathing tubes to help Ms. McGuigan breathe better.

When she informed him that her nose was blocked, the student threw the breathing tube at her.

150. McGuigan became very upset and cried out that she could not understand

anything and that nobody would attempt to tell her anything. When Ms. McGuigan was taken to

a radiologist she had no interpreter, was in pain from an injection she received and unable to

discuss her symptoms with anybody. Ms. McGuigan was terrified, afraid of dying and felt left

alone.

151. After the CAT Scan, Ms. McGuigan was vomiting, even though her stomach was

already empty. Then, the nurses finally provided IV fluids, which made Ms. McGuigan feel

somewhat better.



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152. Ms. McGuigan had asked someone why Dr. Lucas had not yet arrived. She could

not understand the persons response.

153. At 3 a.m. medical staff went to Ms. McGuigan to have a discussion about her

condition. The medical staff made no effort to set up the VRI machine and Ms. McGuigan was

not able to understand most of what was said.

154. Ms. McGuigan left GWUH at approximately 3:00 a.m.

155. Throughout the visit, Ms. McGuigan felt that everything she said became an

argument. The staff was able to understand her, but she could not understand them. The staff

could not understand this fact.

156. The experience of being very ill and unable to communicate, without any help

from the staff, was very distressing for Ms. McGuigan.

COUNT I

TITLE III OF THE AMERICANS WITH DISABILITIES ACT

(NAD v. District Hospital Partners, L.P.)

157. Plaintiff NAD repeats and re-alleges paragraphs 1 to 156 in support of this claim.

158.

The NADs members are substantially limited in the major life activities of

hearing. Accordingly, they are considered individuals with a disability as defined under the

Americans with Disabilities Act (ADA), 42 U.S.C. 12102(2).

159. Defendant owns, leases, and/or operates a place of public accommodation as

defined under Title III of the ADA, 42 U.S.C. 12181(7)(F).

160. Title III of the ADA prohibits discrimination on the basis of disability in the full

and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations

of any place of public accommodations . . . 42 U.S.C. 12182(a).



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161. Pursuant to Title III of the ADA and its implementing regulations, a public

accommodation cannot deny participation or offer unequal or separate benefit to individuals with

disabilities. 42 U.S.C. 12182(b)(1)(A); 28 C.F.R. 36.202.

162.

Pursuant to Title III of the ADA and its implementing regulations, a public

accommodation shall furnish appropriate auxiliary aids and services to ensure effective

communication with individual with disabilities. 42 U.S.C. 12182(b)(2)(A)(iii); 28 C.F.R.

36.303(b)(1).

163. Pursuant to Title III of the ADA and its implementing regulations, a public

accommodation, in choosing the type of auxiliary aid or service to ensure effective

communication, must consider the method of communication used by the individual; the nature,

length, and complexity of the communication involved; and the context in which the

communication is taking place. 28 C.F.R. 36.303(c)(1)(ii).

164. Pursuant to Title III of the ADA and its implementing regulations, in order to be

effective, the type of auxiliary aid or service provided by the public accommodations must be

provided in accessible formats, in a timely manner, and in such a way as to protect the privacy

and independence of the individual with a disability. 28 C.F.R. 36.303(c)(1)(ii).

165. Pursuant to Title III of the ADA and its implementing regulations, when a public

accommodation provides VRI service, it must ensure that the service includes all the following

criteria: (1) [r]eal-time, full-motion video and audio over a dedicated high-speed, wide-

bandwidth video connection or wireless connection that delivers high-quality video images that

do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication; (2)

[a] sharply delineated image that is large enough to display the interpreters face, arms, hands,

and fingers, and the participating individuals face, arms, hands, and fingers, regardless of his or

her body position; (3) [a] clear, audible transmission of voices; and (4) [a]dequate training to



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users of the technology and other involved individuals so that they may quickly and efficiently

set up and operate the VRI. 28 C.F.R. 36.303(f).

166. Pursuant to Title III of the ADA and its implementing regulations, A public

accommodation may not impose a surcharge on a particular individual with a disability or any

group of individuals with disabilities to cover the costs of measures, such as the provision of

auxiliary aids . . . 28 C.F.R. 36.301(c).

167. Defendant discriminated against the individual Plaintiffs on the basis of their

disabilities by denying access to full and equal enjoyment of the goods, services, facilities,

privileges, advantages, and/or accommodations of their place of public accommodation and

equal opportunity to participate in and benefit from Defendants health care services in violation

of 42 U.S.C. 12181, et seq.

168. Defendant discriminated against the individual Plaintiffs by failing to ensure

effective communication through the provision of qualified in-person interpreters.

169. Defendant discriminated against Plaintiff Carmichael by having her pay for

auxiliary aids and services necessary for effective communication.

170. As set out above, absent injunctive relief there is a clear risk that Defendants

actions will recur with additional patients.

171. On information and belief, the refusal to offer in-person interpreter services is as a

result of a policy or practice of Defendant to discourage the use of in-person interpreters without

regard to whether VRI services will provide effective communication and no matter the risk to

patient care.

COUNT II

SECTION 504 OF THE REHABILITATION ACT

(NAD v. District Hospital Partners, L.P.)

172.

Plaintiffs repeat and re-allege paragraphs 1 to 171 in support of this claim.



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173. Plaintiffs Carmichael, St. Cyr, McGuigan, and members of the NAD are

substantially limited in the major life activities of hearing. Accordingly, they are individuals

with a disability as defined under Section 504, as amended, 29 U.S.C. 708(20)(B).

174.

During all relevant times, Defendant was and continues to be a recipient of federal

financial assistance, including but not limited to its acceptance of Medicare and Medicaid.

175. Pursuant to section 504, No otherwise qualified individual with a disability . . .

shall, solely by reason of her or his disability, be exclude from the participation in, be denied the

benefits of, or be subjected to discrimination under any program or activity receiving Federal

financial assistance . . . 29 U.S.C. 794.

176. Defendant has discriminated and continues to discriminate against Plaintiffs

solely on the basis of their disability by denying them meaningful access to the services,

programs, and benefits the Defendant offers to other individuals by refusing to provide auxiliary

aids and services necessary to ensure effective communication in violation of Section 504 of the

Rehabilitation Act. 29 U.S.C. 794.

177.

Defendant discriminated against the individual Plaintiffs by failing to ensure

effective communication through the provision of qualified in-person interpreters.

178. Defendant discriminated against Plaintiff Carmichael by having her pay for

auxiliary aids and services necessary for effective communication.

179. As set out above, absent injunctive relief there is a clear risk that Defendants

actions will recur with additional patients.

180. On information and belief, the refusal to offer in-person interpreter services is as a

result of a policy or practice of Defendant to discourage the use of in-person interpreters without

regard to whether VRI services will provide effective communication and no matter the risk to

patient care.



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COUNT IV

VIOLATION OF D.C. HUMAN RIGHTS LAW

(All Plaintiffs v. District Hospital Partners, L.P.)

189. Plaintiffs repeat and re-allege paragraphs 1 to 188 in support of this claim.

190.

Plaintiffs Carmichael, St. Cyr, McGuigan, and members of the NAD are persons

with a disability as defined by Section 2-1401.02(5A) of the Code of the District of Columbia.

191. Defendant owns, leases, or operates a place of public accommodation as defined

under Section 2-1401.02(24) of the Code of the District of Columbia.

192. The Code provides that It shall be an unlawful discriminatory practice [t]o

deny, directly or indirectly, any person the full and equal enjoyment of the goods, services,

facilities, privileges, advantages, and accommodations of any place of public accommodations.

D.C. Code 2-1402.31(a)(1).

193. Defendant discriminated against the individual Plaintiffs as set out above by

denying them equal access to the services, programs, and benefits by refusing to provide

auxiliary aids and services necessary to ensure effective communication in violation of 2-

1402.31(a) of the Code of the District of Columbia. It is likely that the discrimination will recur.

RELIEF

Plaintiffs respectfully request that this Court provide the following relief:

(a) Issue a declaratory judgment that Defendants policies, procedures, and practices

subjected Plaintiffs to discrimination in violation of Title III of the Americans with Disabilities

Act, Section 504 of the Rehabilitation Act, and Section 2-1402.31(a) of the Code of the District

of Columbia;

(b) Enjoin Defendant from implementing or enforcing any policy, procedure, or

practice that denies individuals who are deaf or hard of hearing, such as Plaintiffs, meaningful

access to and full and equal enjoyment in Defendants services or programs;



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(c) Order Defendant to develop and comply with written policies, procedures, and

practices to ensure that Defendant does not discriminate in the future against Plaintiffs and other

similarly situated individuals who are deaf or hard of hearing, by failing to provide effective

communication;

(d) Affirmatively enjoin Defendant to implement a policy that when a patient or other

deaf individual determines that an on-site interpreter is required for effective communication,

one will be provided either at the time of a scheduled appointment or within two hours of the

request if the appointment is unscheduled;

(e) Order Defendant to train all representatives and employees about Plaintiffs rights

and the rights of individuals who are deaf, hard of hearing, , as well as provide training on

Defendants policies and procedures on the use of VRI in emergency situations and in-person

interpreters in non-emergency situations;

(f) Award Plaintiffs Carmichael, St. Cyr, McGuigan and NAD compensatory

damages;

(g) Award Plaintiffs attorneys costs and fees; and

(h) Award any and all other relief that this Court finds necessary and appropriate.

Respectfully submitted,

/s/ Joseph B. EspoJoseph B. Espo, D.C. Bar No. 429699BROWN GOLDSTEIN LEVY LLP

120 East Baltimore Street, Suite 1700Baltimore, Maryland 21202T: (410) 962-1030F: (410) [email protected]



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Debra Patkin (pro hac motion to be filed)Caroline Jackson

(pro hac motion to be filed)

National Association of the DeafLaw and Advocacy Center8630 Fenton Street, Suite 820Silver Spring, MD 20910

T: (301) 587-7732F: (301) [email protected]@nad.org

Attorneys for Plaintiffs

Dated: July 1, 2014

JURY DEMAND

Plaintiffs hereby demand a trial by jury on all issues so triable.

/s/ Joseph B. EspoJoseph B. Espo


national association of the deaf lawsuit

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