National Association of The Deaf Lawsuit

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 1 of 27
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 Way
Accokeek, Maryland 20607
*
*
and
CARRIE ST. CYR,

594 Buckthorn Way
Gahanna, 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 HOSPITAL
900 23rd Street N.W.
*
*
*
Serve on:
CT Corporation System
1015 15th St., N.W.
Suite 1000
*
*
*
Defendant.
*******************************
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
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 21402.31. 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
6.
At the time of the events set forth in the Complaint Plaintiff Carrie St. Cyr lived at
20607.
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.
8.
District Hospital Partners, L.P., d/b/a/ George Washington University Hospital
20002.
(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.
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.
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.
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
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.
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.
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.
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
65.
Ms. Carmichael was not supposed to move her neck.
66.
The remote interpreter informed Ms. Downs that VRI was not effective for
bleed.
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.
10
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.
11
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.
12
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
13
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.
14
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.
15
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.
16
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.
17
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.
18
142.
The VRI machine was a laptop with an approximately thirteen-inch screen on a
143.
The room was so small that the VRI machine could not be positioned where
stand.
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.
19
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).
20
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.
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.
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, widebandwidth 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
21
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.
22
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.
23
COUNT III
SECTION 504 OF THE REHABILITATION ACT
(All Plaintiffs v. District Hospital Partners, LP)
181.
182.
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).
183.
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.
184.
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.
185.
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.
186.
As a result of Defendants failure to ensure effective communication, the
individual Plaintiffs have suffered and will continue to suffer mental anguish, fear, isolation,
suffering, embarrassment, and humiliation.
187.
As a result of Defendants actions Ms. Carmichael incurred the cost of paying for
her own interpreter.

188.
As a result of Defendants actions, the NAD has suffered harm as set out above.
24
COUNT IV
VIOLATION OF D.C. HUMAN RIGHTS LAW
(All Plaintiffs v. District Hospital Partners, L.P.)
189.
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 21402.31(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;
25
(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. Espo

Joseph B. Espo, D.C. Bar No. 429699
BROWN GOLDSTEIN LEVY LLP
120 East Baltimore Street, Suite 1700
Baltimore, Maryland 21202
T: (410) 962-1030
F: (410) 385-0869
jbe@browngold.com
26
Debra Patkin (pro hac motion to be filed)

Caroline Jackson (pro hac motion to be filed)
National Association of the Deaf
Law and Advocacy Center
8630 Fenton Street, Suite 820
Silver Spring, MD 20910
T: (301) 587-7732
F: (301) 587-1791
debra.patkin@nad.org
caroline.jackson@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. Espo

Joseph B. Espo
27

National Association of The Deaf Lawsuit

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

IN THE UNITED STATES DISTRICT COURT

NATIONAL ASSOCIATON OF THE DEAF, *

CARRIE ST. CYR,

Civil Action No. _________

DISTRICT HOSPITAL PARTNERS, L.P.,

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 2 of 27

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

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 3 of 27

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

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

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

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 4 of 27

by GWUHs discrimination, set forth below.

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 5 of 27

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

hearing. Ms. McGuigans primary language is ASL.

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

perceptible injury to the NAD.

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

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 6 of 27

Defendants discrimination has frustrated the NADs mission and caused it to

divert resources to identify and counteract Defendants discriminatory practices.

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

Defendants discrimination has required and continues to require the NAD to

Defendants discrimination sends a message that it is acceptable for medical

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 7 of 27

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

The NADs injuriesincluding, without limitation, those described hereinare

Ms. Carmichael requires an ASL interpreter to communicate effectively in

Center at GWUH, in June 2013.

Ms. Carmichaels neck.

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 8 of 27

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

With VRI, videoconferencing equipment provides a link between the hospital

Ms. Carmichael said she would give VRI a try.

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

the VRI system.

approximately 13 inch screen on a moving stand.

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

The VRI machine kept shutting down.

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 9 of 27

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

to accompany her on July 8.

surgery, which was schedule for noon.

GWUH set up the VRI equipment for Ms. Carmichael.

Before her surgery Ms. Carmichael communicated with GWUH personnel

through the use of her privately-hired interpreters.

Ms. Downs was present, with two nurses.

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

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 10 of 27

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

screen, but could not distinguish facial features.

Ms. Carmichael became extremely upset.

Ms. Carmichael was not supposed to move her neck.

The nurse abandoned her efforts to reposition Ms. Carmichael.

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

on-site interpreter nor VRI was available.

Case 1:14-cv-01122-RC Document 1 Filed 07/01/14 Page 11 of 27

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

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

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

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