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Local hospitals accused of discrimination, making patients feel 'completely powerless'

Entrance to a local hospital. (WJLA photo)

WASHINGTON (WJLA) – You trust medical facilities with your life. The way they communicate your symptoms and potential solutions is key to your health. But the 7 On Your Side I-Team found medical facilities that end up on the radar of the Department of Justice (DOJ) for problems with their communication to a specific community: the deaf and hard of hearing. And it’s not a small problem; the DOJ considers it a matter of discrimination, which is illegal.

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Federal settlement records show the DOJ has pursued civil cases against more than a dozen medical facilities across the country under the department’s Barrier-Free Health Initiative, which was launched in 2012. Those cases include hospitals, doctors’ offices and clinics in the D.C. area. (See a complete, interactive list at the bottom of this article.)

“We were continuing to see a lot of medical care providers refusing to provide sign language interpreters or communicate effectively with their patients or their prospective patients,” said Deputy Assistant Attorney General Eve Hill, who works in the Civil Rights Division.

Court records show that in the deaf and hard of hearing discrimination cases, patients weren’t always given access to auxiliary aids and services, including sign language interpreters. The 20 settlements obtained by ABC7 show the medical facilities had to take corrective actions to ensure access to effective communication, as well as compensation for patients who claimed harm. Seven of those cases involved facilities in the D.C. area, including Dominion Hospital in Falls Church, Va. and Commonwealth Health & Rehab Center in Fairfax, Va.

“The settlements in these cases range from about $3,000 to $70,000, depending on the egregiousness of the violation and the harm to the person,” Hill said. “We do try to make sure the person is really compensated for the damage that happened to them, but it's not intended to be punitive.”

The compensation mentioned by Hill includes payments made directly to victims in the federal cases. But there are also civil penalties. For example, an October 2014 case involving the Associated Foot & Ankle Center of Northern Virginia, PC shows the podiatry practice with offices in Stafford and Lake Ridge, Va., agreed to pay $14,000 to the female patient involved in the case, as well as a $1,000 civil penalty. In that case, the victim, who is deaf, claimed the practice did not provide sign language interpretive services during multiple medical appointments and provided someone who is not a qualified interpreter during other medical appointments.

In its settlement, Dominion Hospital agreed to pay $50,000 to victims, according to court records. The case involving Commonwealth Health & Rehab included $160,000 in payments to victims in its settlement.

But discrimination cases involving health care don’t always have to be handled by the Justice Department. Often, they’re handled through private lawsuits, according to Howard Rosenblum, executive director of the National Association of the Deaf (NAD).

He says, “Sometimes you have to do something dramatic to change something for the better.”

The NAD filed suit in 2014 against a D.C. hospital it believes needs to make changes. The lawsuit filed against George Washington University Hospital names three former patients as plaintiffs, including Carrie St. Cyr, of Hyattsville, Md. She was a patient in 2013, when she gave birth to a baby boy 10 weeks before her due date.Court filings obtained by the 7 On Your Side I-Team claim St. Cyr endured 16 hours of labor at the hospital with no on-site interpreter, despite repeated requests to staff.

“I knew that was a violation of my human rights,” St. Cyr said. “There was no effective communication access during labor.”

George Washington University Hospital told ABC7 it couldn’t comment in detail because of the ongoing lawsuit and privacy laws, but said, “The Hospital complies with Federal and State requirements requiring accommodation to its deaf and hard of hearing patients. Such compliance is consistent with The Hospital’s primary goal of providing the highest quality healthcare services to its patients. The Hospital believes it has met its legal obligation to provide accommodations to the patients at issue in this lawsuit, and is confident that its practices will be vindicated at the conclusion of the case.”

The case against the facility says it supplied a video remote interpreter, or VRI, during St. Cyr’s stay, something court filings say was pursuant to its policy. But the video quality was choppy and poor according to the suit, with a connection that was lost numerous times during the night. In addition, during St. Cyr’s labor, she claims she often couldn’t see the monitor, like during her epidural.

“That was really the moment where I felt completely powerless,” St. Cyr said.

Robbie Carmichael, of Accokeek, Md., is also a named plaintiff in the lawsuit against George Washington University Hospital. She was a patient at the hospital in 2013, undergoing neck surgery. Court records show VRI was also used during her time at the facility, with Carmichael claiming she was told to look at the computer monitor in the recovery room following surgery. Forced to turn her head to see the screen, the suit claims Carmichael’s neck wound began to bleed.

“The surgeon's assistant came in and they had an odd expression on their face and they said, ‘Why is your neck bleeding?’” Carmichael told ABC7.

Carmichael said the situation was scarring and has vowed not to return to the hospital. Her experience is one reason the National Association of the Deaf decided to file suit against the hospital.

Rosenblum says, “They do not see the issue of providing interpreters as civil rights.”

The organization claims the hospital discriminated against St. Cyr, Carmichael and a third woman treated at the facility, violating the Americans with Disabilities Act. The lawsuit seeks compensatory damages and also asks that the hospital develop and comply with specific policies and procedures to prevent future discrimination.

But Rosenblum is also hoping for other action. While the Department of Justice has laid out guidelines that say VRI is effective communication, specifics about the appropriateness of its use in medical settings have not been clearly spelled out, according to Rosenblum. It’s a problem the NAD has made a priority. The organization believes VRI is appropriate in some situations, but it wants clarifications on the federal guidelines to ensure deaf and hard of hearing patients are not put at risk.

“The message needs to be that hospitals cannot just rely on technology for all communication needs,” Rosenblum said. “That is not the answer.”

The deaf and hard of hearing population is not the only one with the Department of Justice on its side. People dealing with HIV and AIDS who have dealt with claims of patient discrimination have also been a priority for the DOJ as part of its initiative. Six of the cases settled by the agency since 2011 included patients who felt they had been discriminated against by a healthcare provider, something that goes against the Americans with Disabilities Act. Those cases include settlements with a Rite Aid pharmacy the feds say refused to provide a flu shot to a man with HIV and an eating disorder clinic a woman claimed wouldn't treat her because she had the disease.

A Virginia dental clinic, Woodlawn Family Dentistry, also settled a case with the Department of Justice. The Alexandria facility paid $3,000 in civil penalties after a male patient with HIV claimed he was treated unequally when scheduling his appointments, which he claims he was told had to be the last ones of the day.

National Association of the Deaf Lawsuit

Below is a clickable list of settlements from Department of Justice records to learn more about what the ABC 7 News I-Team found went wrong with facilities here in the D.C. area and across the country.

Genesis Healthcare System -- Re: Primary care physician's discriminatory denial of care due to HIV and improper referral of patients with HIV in violation of title III of the ADA (Jan. 15, 2015).

Franciscan St. James Health -- Re: Provision of auxiliary aids and services to ensure effective communication for patients at two hospitals (Dec. 3, 2014).

Swedish Edmonds Hospital -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf or hard of hearing to ensure effective communication at a hospital (Oct. 14, 2014).

Associated Foot & Ankle Centers of Northern Virginia, PC -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication in specialty medical care offices (Oct. 9, 2014).

Dr. Hal W. Brown and Primary Care of the Treasure Coast -- Re: Adoption of effective communication and non-retaliation policies in family medical practice (Aug. 29, 2014).

Dr. Peter Chang-Sing, M.D., F.A.C.C. -- Re: Provision of sign language interpreters and other auxiliary aids in a specialist medical practice (July 22, 2014).

Wade W. Han, M. D. and Florida Ear Nose Throat and Facial Plastic Surgery Center -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication in specialty medical care offices (April 18, 2014).

Commonwealth Health & Rehab Center -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a skilled nursing facility (March 24, 2014).

Rite Aid of Michigan, Inc. -- Re: Pharmacist’s denial of flu shot to customer because of his HIV status (Feb. 4, 2014).

Virginia Psychiatric Company, Inc. d/b/a Dominion Hospital -- Re: Provision of auxiliary aids and services, including sign language interpreters, to patients and companions who are deaf to ensure effective communication in a psychiatric hospital (Sept. 6, 2013).

The Heart Center of Memphis -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication in specialty medical care offices (June 27, 2013).

Midtown Neurology, P.C. -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a doctor's office (June 26, 2013).

Burke Health and Rehabilitation Center -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a skilled nursing facility (May 3, 2013).

Monadnock Community Hospital -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a hospital (April 5, 2013).

Manassas Health and Rehab Center -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a skilled nursing facility (April 5, 2013).

Gainesville Health and Rehab Center -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a skilled nursing facility (April 5, 2013).

Center for Orthopaedic and Sports Medicine, Inc. -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a rehabilitation center (April 5, 2013).

Northern Ohio Medical Specialists -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a doctor's office (April 5, 2013).

Glenbeigh -- Re: Settlement regarding exclusion of an individual from an alcohol treatment program because of the side effects of his HIV medication (March 13, 2013).

Woodlawn Family Dentistry -- Re: Dentist office's unequal treatment of people with HIV in the scheduling of future dental appointments (Feb. 12, 2013).

Castlewood Treatment Center -- Re: Eating disorder clinic's refusal to treat a woman for a serious eating disorder because she has HIV (Feb, 6, 2013).

Fayetteville Pain Center -- Re: Unlawful exclusion of a person with HIV from treatment (Jan. 31, 2013).

Northshore University Healthsystems -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a hospital (June 28, 2012).

Steven Senica, M.D., and Senica Bruneau, Ltd. -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a doctor's office (June 11, 2012).

Richard Noren, M.D., Henry Kurzydlowski, M.D., and Pain Care Consultant, Inc. -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a doctor's office (April 3, 2012).

Trinity Regional Medical Center and Trinity Health Systems -- Re: Provision of auxiliary aids and services, including sign language interpreters, to persons who are deaf to ensure effective communication at a hospital (March 29, 2012).

Henry Ford Health System -- Re: Providing appropriate auxiliary aids and services, including sign language interpreters, to persons who are deaf or hard of hearing throughout the hospitals and medical facilities of a regional health care system (Feb. 1, 2012).

Cheshire Medical Center, Keene Health Alliance, and Dartmouth-Hitchcock Clinic D/B/A Dartmouth-Hitchcock Keene -- Re: Consent decree to provide appropriate auxiliary aids and services, including sign language interpreters, to persons who are deaf or hard of hearing at a hospital (Oct. 31, 2011).

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