Case 8:05-cv-00073-DKC Document 1-1 Filed 01/11/2005 Page 1 of 27

?" ~’r~ ~ ,
IN THE UNITED STATES DISTRICT COL~T/4 q: 1 8
FOR THE DISTRICT OF MARYLAND
SOUTHEmq DrvISION

ELIZABETH GILLESPIE, 507 Montgomery St. Laurel, MD 20707, and

DAVID IRVINE 507 Montgomery St. Laurel, MD 20707, and

ERIN WHITNEY .... 6313 Mockingbird Street Ventura, CA 93003, and

CARY BARBIN 327 Talbott Avenue Laurel, MD 20707, and
KATHRYN ELIZABETH HALE 14012 Vista Drive, Unit 16A Laurel, MD 20707, and

Civil Action No.

BRIAN LEFFLER 2606 23rd Road North
Arlington, VA 22207, and

XIOMARA PORRAS 9035 - D North Laurel Rd. Laurel, MD 20723,

Plaintiffs,
Vo

LAUREL REGIONAL HOSPITAL, 7300 Van Dusen Road Laurel, MD 20707,
Defendant.
COMPLAINT FOR INJUNCTIVE RELIEF AND FOR COMPENSATORY AND PUNITIVE DAMAGES

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NOW COME Plaintiffs Elizabeth Gillespie, David Irvine, Erin Whitney, Cart Barbin, Kathryn Elizabeth Hale, Brian Leffler, and Xiomara Porras (collectively "Plaintiffs"), by and through their undersigned counsel, and file this Complaint against Defendant Laurel Regional Hospital ("Laurel Hospital," or the "Hospital") and, in support thereof, allege as follows:
STATEMENT OF THE CASE Plaintiffs are deaf individuals that have sought and received medical treatment at Laurel F.~h has depended on Laurel Hospital for a variety of inpatient, emergency andoutpatie~t ........ medical services, due largely to the Hospital’s proximity to their respective homes. Plaintiffs will likely continue to depend upon Laurel Hospital for a variety of inpatient, emergency and outpatient medical treatment in the future. 2. To communicate effectively in medical situations - especially emergency medical situations - Plaintiffs require a live, qualified sign language interpreter. The alternative methods of communication utilized by Laurel Hospital, which may be acceptable in non-medical settings, in Plaintiffs’ cases have proven inadequate. Plaintiffs sought medical treatment at Laurel Hospital because either they or a family member were sick, injured and/or experiencing severe pain, necessitating them coming to the Hospital’s emergency room. Such medical settings, in which Plaintiffs’ health, cognizance and concentration have already been compromised, require the provision of a live and inperson, qualified sign language interpreter. Hearing patients would expect and receive nothing less than live, person-to-person medical service with oral communications between themselves and Hospital staff. Deaf patients, such as Plaintiffs, should receive nothing less than what would be provided for hearing patients. In fact, given their disability, deaf patients should receive greater communication efforts from Hospital staff, not less.

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3. On each occasion when Plaintiffs visited Laurel Hospital for treatment, they and/or others made repeated requests for the assistance of a live and in-person, qualified sign language interpreter to enable the plaintiffs to communicate with doctors, nurses and other Hospital staff, to understand and participate in their medical treatment and to receive the full benefit of the Hospital’s services. Despite specific and repeated requests for live interpreter services, however, Laurel Hospital failed and refused to provide Plaintiffs with live qualified sign language interpreters incident to the administration of medical treatment ............
4. Instead, Plaintiffs were forced to communicate through cryptic notes or lip-reading. Lipreading, the ability to understand the speech of another by watching the speaker’s lips, is an extremely speculative means of communication. Only approximately 30-40% of the spoken sounds of our language are visible, and many of those appear identical on the lips. Even the very best lip-readers, in an ideal one-to-one situation, have been found to understand only 26% of what is said.
5. In limited circumstances, Plaintiffs were able to utilized Video Remote Interpreting ("VRI"). VRI uses video conferencing technology to provide remote interpreting services. The sign language interpreter is located at a remote location and, through video conferencing, the deaf individual and the interpreter can view each other. Facing a small camera mounted on top of a computer, the deaf individual signs to the interpreter, who then voices what has been signed and interprets what is said in response by hearing participants which interpretation is displayed on a computer monitor for viewing by the deaf participant. In the specific instances facing these Plaintiffs, VRI was an insufficient mode of communication.
6. As a consequence, Plaintiffs have been denied the benefit of effective communication with physicians and health care providers at Laurel Hospital, have been unable to provide informed

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consent to treatment, have been denied the opportunity to participate in their treatment, and have been denied the full benefit of the health care services provided by Defendant Laurel Hospital as required by the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12181 et seq., and Section 504 of the Rehabilitation Act (the "Rehabilitation Act"), 29 U.S.C. § 794.
JURISDICTION AND VENUE 7. Jurisdiction in this Cot~ is proper pursuant to 28 U.S.C. § 1331 because this case involves Laurel Hospital’s multiple and repeated yiolatiov~s of b~th the ADA and the Rehabilitation Act. This Court also has jurisdiction pursuant to 28 U.S.C. § 1343(a)(4) because this case involves a violation of Plaintiffs’ civil rights. 8. Venue in this Court is proper pursuant to 28 U.S.C. § 1391 because Defendant is located in and has its principal (and exclusive) place of business in Prince George’s County, Maryland, and the events giving rise to the Complaint occurred in Prince George’s County, Maryland.
THE PARTIES 9. Plaintiff ELIZABETH GILLESPIE is a resident of Laurel, Maryland. Ms. Gillespie is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Ms. Gillespie communicates through ASL. Ms. Gillespie has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two miles from her home. 10. Plaintiff DAVID IRVINE is a resident of Laurel, Maryland. Mr. Irvine is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Mr. Irvine communicates through ASL. Mr. Irvine has sought and will likely continue to seek medical treatment from Laurel Hospital, which is

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approximately two miles from his home. Mr. Irvine has accompanied and will likely continue to accompany his wife, Elizabeth Gillespie, to Laurel Hospital for purposes of assisting her with, and participating in, her medical treatment decisions.
11. Plaintiff ERIN WHITNEY was a resident of College Park, Maryland at all times relevant to the Complaint. Ms. Whitney is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Ms. Whitney communicates through ~-amae~.can Sign Language ("ASL"). Ms. Whitney has sought ~.d received medical treatment from Laurel Hospital, which at all times relevant to the Complaint was approximately eight miles from her prior residence.
12. Plaintiff CARY BARBIN is a resident of Laurel, Maryland. Mr. Barbin is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Mr. Barbin communicates through ASL. Mr. Barbin has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two miles from his home.
13. PlaintiffKATHRYN HALE is a resident of Laurel, Maryland. Ms. Hale is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Ms. Hale communicates through ASL. Ms. Hale has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two miles from her home.
14. Plaintiff BRIAN LEFFLER was a resident of Laurel, Maryland at all times relevant to the Complaint. Mr. Leffler is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Mr. Leffier

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communicates through ASL. Mr. Leffier has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two to three miles from his home.
15. Plaintiff XIOMARA PORRAS is a resident of Laurel, Maryland. Ms. Porras is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Ms. Porras is unable to communicate effectively through reading or writing, and communicates effectively only through ASL. Ms. Porras has sought and received, and wiJLlik~ontinue to seek, medical treatment for herself and for her family from Laurd Hospital, which is approximately five miles from her home.
16. Laurel Hospital, upon information and belief, operates in Prince George’s County, Maryland at 7300 Van Dusen Road, Laurel, MD 20707. Defendant is affiliated with Dimension Healthcare Systems, a corporation located at 3001 Hospital Drive, Suite 4000, Cheverly, MD 20785. Laurel Hospital is a Maryland business and is a place of public accommodation as defined by the ADA, 42 U.S.C. § 12181 (7)(F). The Hospital receives federal financial assistance pursuant to the Rehabilitation Act and is therefore a federal recipient subject to the requirements of Section 504 of the Rehabilitation Act, 29 U.S.C. § 794.
FACTS ENTITLING PLAINTIFFS TO RELIEF 17. Paragraphs 1 through 15 are adopted and incorporated by reference as though expressly set forth. A. Laurel Hospital Failed to Provide Plaintiff Gillespie with an Appropriate Auxiliary Aid As Necessary to Ensure Effective Communication~ And Therefore Denied Her Full and Equal Medical Treatment Because of Her Disability. 18. On or about November 1, 2003, Ms. Gillespie went to the Laurel Hospital emergency room to obtain medical treatment for severe abdominal pain, nausea, and vomiting, among other

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symptoms. On numerous prior visits, Laurel Hospital failed to provide Ms. Gillespie with a sign language interpreter. Nevertheless, because Laurel Hospital is the closest hospital to her home and Ms. Gillespie needed emergency medical care, she returned to Laurel Hospital.
19. Immediately after registering at the Hospital’s front desk on November 1, 2003, Ms. Gillespie was admitted to the emergency room because of her serious condition. Ms. Gillespie’s husband, David Irvine, who is also deaf and who cannot lip-read, accompanied her to the Hospital. ~e Mr, Irvine is deaf and cannot read lips, he can speak clearly enough to be underst~d. contrast, Ms. Gillespie has limited lip reading ability but her speech is not clear. Because of her serious medical condition and severe pain, however, Ms. Gillespie’s ability to read lips was compromised during this hospital visit.
20. Upon Ms. Gillespie’s admittance, both she and her husband requested a live, in-person sign language interpreter so that they could communicate with the doctors, nurses and other Hospital staff. Laurel Hospital’s staff told them that it did not have any sign language interpreter. Ms. Gillespie and Mr. Irvine repeatedly requested an interpreter. After waiting for some time, a member of the Hospital staff finally mentioned that the Hospital has a VRI device. The staff informed Ms. Gillespie, however, that the room containing the VRI device was not available at that time because the room was being used by another patient. After waiting approximately two hours, Ms. Gillespie was finally moved to the room containing the VRI device. Due to her inability to communicate with the Hospital staff during the two-hour delay, however, Ms. Gillespie did not understand the medical advice or treatment she received during that time.
21. After moving Ms. Gillespie to the room with the video interpreting device, it took the improperly and inadequately trained Hospital staff another 20-30 minutes to set up and operate the

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equipment. The doctor communicated with Ms. Gillespie using the video interpreting device. This consultation lasted approximately 10 minutes. During this time, the doctor advised Ms. Gillespie that he did not know the cause of her severe pain, but communicated to her that he would like to perform some tests. The doctor informed Ms. Gillespie that she would undergo an x-ray and probably a CT-scan. The Hospital staffnever utilized the VRI device again during Ms. Gillespie’s visit.
22. Following the consultation, Ms. Gillespie and Mr. Irvine waited in her room before the Hospital staff returned to prepare her for her x-rays. D~ng_this procedures well as ,-luting all subsequent procedures, tests, and doctor consultations, Ms. Gillespie did not receive, and the Hospital either failed or refused to provide access to, the VRI device and denied her repeated requests for a live sign language interpreter or any other alternative mode of communication. The Hospital staff wrote notes to her only in a few select and extreme circumstances and only after Ms. Gillespie begged and continuously motioned for some sort of communication. Even then, the Hospital staff limited written communication to a few words. As a result, Ms. Gillespie and Mr. Irvine received only a partial and limited understanding of her medical condition and treatment. Rather than provide effective communication, the Hospital staff insisted on speaking to Ms. Gillespie and Mr. Irvine verbally despite the fact that he cannot read lips and Ms. Gillespie’s ability to lip-read was compromised by her medical condition.
23. After being x-rayed, Ms. Gillespie was returned to her patient room where she waited for some time before the doctor returned to consult with her and her husband. The doctor verbally informed them that Ms. Gillespie had an enlarged heart and that Ms. Gillespie would need to undergo a CT-scan. As this diagnosis was communicated only verbally, Ms. Gillespie and Mr. Irvine were forced to attempt

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to rely solely on the vagaries of lip-reading to comprehend this critical information. They did not fully

understand the doctor’s diagnosis or the medical treatment she was going to receive. 24. Ms. Gillespie and Mr. Irvine waited another few hours (almost five hours after she was

admitted to the emergency room) before a male Hospital attendant arrived to take her to the CT-scan room. Neither Ms. Gillespie nor Mr. Irvine could understand the male attendant’s instructions to them.

As a result, Ms. Gillespie repeatedly asked (by signing to Mr. Irvine who relayed her request verbally)

that the attendant communicate with the.~ inn wfi2ing~hat they could better understand the medical services he was to provide. The attendant ignored and refused the request for written communication.

Instead, the male attendant’s communication was limited to his pulling and snapping her bra’s strap when he wanted her to remove it.Ms. Gillespie was humiliated, embarrassed and violated by this

incident. 25.

The male attendant nevertheless took Ms. Gillespie to the CT-scan room. Mr. Irvine

followed. While the attendant prepared for the CT-scan, Ms. Gillespie (through Mr. Irvine) repeatedly

requested that the male attendant communicate with her in writing about the procedure. Neither Ms. Gillespie not Mr. Irvine understood the procedure. The attendant angrily and steadfastly refused to communicate with her in writing. She felt afraid and, as a result, left the CT-scan room and returned to

her patient room requesting (through Mr. Irvine) that a nurse be present during the CT-scan.

26. After undergoing the CT-scan in the presence of a female nurse, Ms. Gillespie and Mr.

Irvine returned to her patient room and waited an additional hour (almost seven and one half hours after she was first admitted to the emergency room) before a doctor returned to provide Ms. Gillespie with a

sedative for her pain. The doctor left without providing Ms. Gillespie with any diagnosis or update on

her condition or the results of any test.

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27. Because she felt exasperated with her treatment and uninformed about her medical condition arising from the Hospital’s refusal and failure to communicate with her or her husband adequately, Ms. Gillespie wanted to leave the Hospital.
28. After waiting another few hours or so, a different doctor arrived at Ms. Gillespie’s room to provide her and her husband with a summation consultation (almost ten hours after Ms. Gillespie was admitted to the emergency room). The doctor informed them that Ms. Gillespie should be admitted to the Hospital for ad~ifi0na]~sts_3_t ~exletermine the source of her pain. He communicated with them verbally and then after Mr. Irvine assisted, he sparsely used written notes. The doctor’s notes were short, confusing and cryptic. Because Ms. Gillespie had been sedated and Mr. Irvine does not read lips, they could not understanding the verbal discussion. They were also confused about the written communications since those communications were so vague. Ms. Gillespie informed the doctor through Mr. Irvine that she wanted to leave the Hospital. In response, the doctor turned, and began to leave the room. Mr. Irvine stopped him and asked about the earlier doctor’s reference to his wife’s heart being enlarged. Ms. Gillespie and Mr. Irvine believe the doctor communicated to them that the doctor who saw Ms. Gillespie earlier during her visit diagnosed her with congestive heart failure. The doctor cavalierly recommended that Ms. Gillespie go to another emergency room at a different hospital for treatment. Ms. Gillespie’s discharge papers and all other written materials she received from the Hospital failed to mention the lung problem and/or the heart condition for which she was ultimately diagnosed.
29. Ms. Gillespie’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment based on her disability. Moreover, Ms. Gillespie was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical service

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Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. B. Laurel Hospital Failed to Provide Plaintiff Irvine with an Appropriate Auxiliary. Aid
As Necessary. to Ensure Effective Communication, And Therefore Denied Him Full and Equal Medical Treatment Because of His Disability.. 30. Ms. Gillespie’s husband, David Irvine, also has suffered from Laurel Hospital’s discriminatory failure to provide effective communication. Mr. Irvine accompanied his wife to Laurel Ho~sp~t~l dur~_.’ag her November !, 2003 yisit_, Ms. Gillespie relies heavily on Mr. Irvi~e’s parti~ipaJ~n ~_ making her medical decisions. By refusing to provide a sign language interpreter or other effective communication aid during the visit, Laurel Hospital denied Mr. Irvine full and equal medical treatment because of his disability. Moreover, Mr. Irvine was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services for his wife. This denial was specifically based on Mr. Irvine’s disability, and has caused him emotional injuries. Mr. Irvine incurre damages in an amount to be proven at trial. C. Laurel Hospital Failed to Provide Plaintiff Whitne), with an Appropriate Auxiliary Aid As Necessary to Ensure Effective Communication, And Therefore Denied Her Full and Equal Medical Treatment Because of Her DisabiliW.. 31: On or about December 24, 2003, Ms. Whitney went to Laurel Hospital to obtain medical treatment. Ms. Whitney and Karl Ewan, a deaf friend of Ms. Whitney’s who had accompanied her to the Hospital, both requested a live, in-person sign language interpreter so that Ms. Whitney could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital staff informed Ms. Whitney and Mr. Ewan that an interpreter was "on the way," however, when she was admitted into a room, the Hospital staff told she and Mr. Ewan that they would have to use the VRI.

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32. The Hospital staff was inadequately trained and unable to operate the VRI device until assisted by Mr. Ewan.
33. While Mr. Ewan was assisting with the set-up of the VRI device, a doctor entered the hospital room, but left without treating Ms. Whitney because he and Ms. Whitney could not communicate.
34. Once the VRI device was connected, neither Ms. Whitney nor Mr. Ewan could understand the video interpreter due to the poor quality of the video tr~nsmissi-em. ~.~.Whitney repeated .............. her request for a live sign language interpreter, but the Hospital again refused to provide one. As a result, Ms. Whitney could not effectively communicate with the Hospital staff.
35, Ms. Whitney’s medical treatment was deficient because Laurel Hospital failed to accommodate her disability. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.
36. On or about April 25, 2004, despite Laurel Hospital’s prior failures and refusal to provide her with a qualified live sign language interpreter, Ms. Whitney returned to the Hospital for emergency medical treatment since, at the time, it was the closest hospital to her home. Upon her arrival at the Hospital, Ms. Whitney vomited several times and fainted. Prior to fainting and again upon regaining consciousness, Ms. Whitney requested a live sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. Ms. Whitney’s roommate Marie Campbell, who had accompanied her to the Hospital, requested on three separate occasions that the Hospital provide Ms. Whitney with a live, in-person sign-language interpreter. The Hospital staff told Ms. Campbell that an interpreter was "on the way."

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37. After feeling faint again, Ms. Whitney lay down on a nearby bed. A member of the Hospital staff, who did not know that Ms. Whitney was deaf, became angry with Ms. Whitney for lying on the bed, then hit Ms. Whitney in the knee, twisted her arm and dragged her off of the bed. Ms. Campbell and Ms. Whitney made repeated requests to file a complaint about the nurse’s misconduct. The Hospital staff told Ms. Campbell and Ms. whitney that they would send someone to start the complaint procedure. That person never arrived.
38. Subsequently, the Hospital staffpl~ced M_s,_Wbi~;ey in a room with a VRI device. The Hospital staff was improperly trained, was not familiar with the device and spent 30-40 minutes trying to set it up. During this period, and in a repeat of her first visit, a doctor entered the room, saw that the VRI machine was not yet ready and left without providing any medical assistance to Ms. whitney. The doctor ultimately returned once the VRI devicewas operational. Ms. whitney found communication through the VRI device difficult and ineffective due to poor picture quality on the video monitor, combined with the fact that it requires a patient to sit up to see the screen. Due to her illness, Ms. Whitney was unable to sit up in order to communicate through the VRI device. Ms. Whitney repeatedly tried to communicate with the Hospital staff to explain that she did not understand the video interpreter, and repeatedly requested a live sign language interpreter so that she could communicate effectively with the doctor and other Hospital staff. Each time the Hospital staff rebuffed and rejected Ms. Whitney’s requests for a live interpreter and told her that she would have to use the video interpreter.
39, The doctor treating Ms. whitney also insisted on using only the VRI device to communicate with her. It was through this mode of communication that the doctor advised Ms. whitney that she "might" be suffering from meningitis. At the time of this communication from the doctor, Ms. Whitney was scared, confused and light-headed from her illness. Given the severity of what she

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believed the doctor was communicating (i.e., that she had a potentially life-threatening illness), Ms. Whitney reiterated her request for a live sign language interpreter to clarify what the doctor was telling her, and to ask some follow-up questions. The doctor refused her request for an interpreter and, adding further to Ms. Whitney’s confusion, upon her discharge the next day, formally diagnosed her as suffering from the flu, with no additional mention of meningitis.
40. A short while after returning home from the Hospital, Ms. Whitney experienced continued nausea, faintness a~nd a v~r,,z high,ever. She retumed to Laurel Hospital for treatment on the afternoon of April 26, 2004, and again requested a live sign language interpreter. Ms. Campbell, who again accompanied Ms. Whitney to the Hospital, also made several requests for a live, in-person sign language interpreter. Laurel Hospital again failed and refused to provide a live sign language interpreter, insisting instead on using the VRI device.
41. The Hospital staff again struggled to set up the VRI device. Even after the video interpreting device was operational, as during her prior visit, Ms. Whitney could not see the VRI screen clearly from her position on the treatment table. In response to this situation, the doctor employed the assistance of Ms. Campbell, who is also deaf and communicates through ASL, to relay the interpreter’s messages from the VRI device to Ms. Whitney. Through this attenuated means of communication, the doctor informed Ms. Whitney that she probably suffered from meningitis and would need to undergo a spinal tap. Neither the attending physician nor any other member of the Hospital staff advised Ms. Whitney as to what the procedure would entail. Ms. Whitney again requested a live sign language interpreter from the Hospital, and the Hospital again refused her request.
42~ The Hospital staff performed the spinal tap procedure without Ms. Whitney’s written consent. Ms. Whitney never received any instructions regarding the spinal tap procedure, and no

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interpreter was provided while the procedure was conducted, despite Ms. Whitney’s repeated requests. The Hospital staff turned off the video interpreting device while conducting the spinal tap procedure. Two nurses held Ms. Whitney down as the procedure was conducted.
43. After the procedure was completed, the Hospital staff failed to convey any postprocedure instructions or restrictions to Ms. Whitney, including that she remain immobile for a period of time following the procedure, which is standard procedure following a spinal tap. Specifically, after a spinal t~ is per~fo, rrne~.d.~ d_octors typically advise patients to lay flat for a few hours ir~ order to equilibrate fluid pressure. Significant complications can arise if a patient moves too soon after undergoing a spinal tap procedure. Under such circumstances, a patient can suffer from prolonged headaches, nausea and imbalance in equilibrium. In severe cases, nerve damage and/or inner-cranial pressure can result. In Ms. Whitney’s case, shortly after her spinal tap procedure was complete, and absent any instruction to remain still, Ms. Whitney moved. She subsequently experienced, and continues to suffer from, among other problems, headaches, nausea, faintness and an imbalance in equilibrium.
44. After the spinal tap procedure was completed, another friend of Ms. Whitney’s, Heidi Holmes, came in to check on Ms. Whitney. Upon seeing there was no interpreter and listening to Ms. Whitney’s complaints for an interpreter, Ms. Holmes made a few additional requests to the Hospital staff for an interpreter. The Hospital continued to refuse to provide a live interpreter for Ms. Whitney.
45. Following the spinal tap, Ms. Whitney tested positive for viral meningitis and was readmitted to the Hospital on or about the evening of April 26, 2004. She remained in the Hospital for an additional 2-3 days, until her discharge on April 29, 2004. During that entire time, the VRI device was not available for her use. Although the equipment was brought into her room, no one from the Hospital staff set up the equipment for use, despite her repeated requests for an interpreter.

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46. Although Ms. Whitney requested on multiple occasions that the Hospital provide her with a working TTY phone and a closed caption television, the Hospital refused to accommodate her requests (as required by Department of Justice Regulations, 28 C.F.R. 36.303(d) and (e)).
47. The Hospital also failed to provide a live sign language interpreter or the VRI device for Ms. Whitney’s discharge from the Hospital, despite the fact that she requested one. The Hospital staff provided discharge instructions to Ms. Whitney’s mother instead of providing them to her directly, and r ~ea~ired Ms. Whitney’s mother to sign the discharge papers
48. Ms. Whitney’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Whitney was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. D. Laurel Hospital Failed to Provide Plaintiff Barbin with an Appropriate Auxiliary Aid
As Necessary to Ensure Effective Communications And Therefore Denied Him Full and Equal Medical Treatment Because of His Disability. 49. On or about March 19, 2004, Mr. Barbin went to Laurel Hospital to obtain medical treatment. Mr. Barbin requested a live, in-person sign language interpreter so that he could communicate with the doctors, nurses and othe~ Hospital staff treating him. The Hospital staff informed him that it did not have a sign language interpreter. Because the Hospital had no interpreter, Mr. Barbin’s hearing roommate, Michael Jacobus, who had accompanied him to the Hospital, attempted to help Mr. Barbin understand what was happening. 50. The Hospital staff insisted on using Mr. Jacobus to interpret for Mr. Barbin. Both Mr. Barbin and Mr. Jacobus informed the Hospital staff that Mr. Jacobus was not a certified sign language

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interpreter, and that neither was comfortable in having Mr. Jacobus interpret in this situation. A member of the Hospital staff responded that they "could manage" by using Mr. Jacobus to interpret. Over Mr. Barbin’s objection, the Hospital staff took Mr. Barbin’s information and commenced the examination, using Mr. Jacobus as the interpreter.
51. When the emergency room doctor arrived to treat Mr. Barbin, both Mr. Barbin and Mr. Jacobus again requested a certified sign language interpreter. The doctor told them that the Hospital did not have an interpreter, and insisted again on using Mr Jacobus to i~._temr~ Both Mr. Barbin and Mr Jacobus informed the doctor that Mr. Jacobus is not a certified sign language interpreter and is not sufficiently skilled to interpret in medical situations. Moreover, neither individual was comfortable wi the Hospital’s use of Mr. Jacobus to interpret in this type of private situation.
52. Laurel Hospital never obtained Mr. Barbin’s permission to disclose confidential medical information to Mr. Jacobus. Mr. Barbin’s medical treatment was deficient because Laurel Hospital denied him full and equal medical treatment because of his disability. Moreover, Mr. Barbin was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, he sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. E. Laurel Hospital Failed to Provide Plaintiff Hale with an Appropriate Auxiliary Aid
As Necessary to Ensure Effective Communication, And Therefore Denied Her Full and Equal Medical Treatment Because of.Her Disabili _ty. 53. On or about August 5, 2002, Ms. Hale sought medical treatment from Laurel Hospital. Upon arriving at the Hospital, Ms. Hale requested a live, in-person sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital did not provide a sign language interpreter. Instead, the Hospital insisted on Ms. Hale reading lips and passing

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written notes to communicate with the Hospital staff. While this form of communication may be appropriate in a non-medical setting, it was inappropriate in a hospital setting where Ms. Hale’s health was already compromised.
54. Ms. Hale was not afforded any communication aid during her medical treatment while at Laurel Hospital on this date. Ms. Hale’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Hale was excluded from participation in, denied the benefits of, arl.d_sub~ted to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.
55. On or about April 26, 2003, Ms. Hale again sought medical treatment from Laurel Hospital. Upon arriving at the Hospital, Ms. Hale again requested a live sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital did not provide a live sign language interpreter. Instead, the Hospital insisted on using the VRI device. The improperly and inadequately trained Hospital staff was unable to operate the video interpreting equipment. Observing the difficulty the Hospital staff encountered with the video interpreting device, Ms. Hale reiterated her request that the Hospital provide her with a live, in-person sign language interpreter. The Hospital denied her request. As a result, Ms. Hale was not afforded any communication aid during her medical treatment while at Laurel Hospital on this date. Ms. Hale’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Hale was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.

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56. On or about August 12, 2004, Ms. Hale again sought medical treatment from Laurel Hospital. Upon arriving at the Hospital, Ms. Hale again requested a live sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital did not provide a live sign language interpreter. Instead, the Hospital again insisted on using the VRI device. Ms. Hale watched the improperly and inadequately trained Hospital staff attempt to operate the video interpreting equipment for two hours without success. Observing the continued difficulty the Hospital staff ~enco~_mtered~ w_ith t~video interpreting equipment, Ms. Hale reiterated her request that the Hospital provide her with a live, in-person sign language interpreter. The Hospital denied her request. As a result, Ms. Hale was not afforded any communication aid during her medical treatment while at Laurel Hospital on this date. Ms. Hale’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Hale was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. F. Laurel Hospital Failed to Provide Plaintiff Leffler with an Appropriate Auxiliary, Aid
As Necessary, to Ensure Effective Communication~ And Therefore Denied Him Full and Equal Medical Treatment Because of His Disability.. 57. On or about, October 27, 2003, Mr. Leffler sought emergency medical treatment at Laurel Hospital. Mr. Leffier was accompanied to the Hospital by two friends, Mr. Barbin, a co-plaintiff in this action, and a hearing friend, Michael Jacobus, who would accompany Mr. Barbin to the Hospital on a later occasion. Upon arriving at the Hospital, Mr. Jacobus requested a live, in-person sign language interpreter on Mro Leffler’s behalf so that Mr. Leffler could communicate effectively with the doctors, nurses and other Hospital staff. The Hospital registration nurse informed them that it did not have a sig

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language interpreter. Instead, the nurse offered the use of a machine that purportedly would allow Mr. Leffier to communicate with the Hospital doctors and staff. Not wanting to delay to his friends any further, and having learned that the Hospital would provide him with a communication aid, Mr. Leffier advised Mr. Barbin and Mr. Jacobus that they could leave the Hospital.
58. After waiting for approximately thirty minutes, the registration nurse advised Mr. Leffier that the machine she had referenced earlier was not available, and asked Mr. Leffier if he was able to _ read lips. M~ Leffier told the registration nurse that he did not read lips well, and expressed b~s displeasure with the prospect of undergoing a medical examination in this manner. The registration nurse nevertheless insisted on trying to communicate with Mr. Leffler through lip-reading. This method of communication proved ineffective, however, given Mr. Leffier’s general difficulty with lip-reading coupled with his then-existing medical condition which made intense concentration very difficult.
59. Despite his earlier request for a live sign language interpreter, and despite the Hospital’s original representation that a machine for interpreting would be provided, the doctor examined Mr. Leffier without the assistance of an interpreter or other communication aid. The doctor tried to communicate through written notes, but this attempt limited the depth of questions Mr. Leffier could ask in an attempt to understand fully the diagnosis and treatment. Moreover, the doctor became frustrated and impatient with having to communicate with Mr. Leffler in this fashion, and rushed through Mr. Leffler’s examination. Mr. Leffler attempted to ask the doctor questions, but the doctor cut him short, issued a prescription and ended the examination.
60. Mr. Leffler’s medical treatment was deficient because Laurel Hospital denied him full and equal medical treatment because of his disability. Moreover, Mr. Leffler was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services.

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Consequently, he sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. G. Laurel Hospital Failed to Provide Plaintiff Porras with an Appropriate Auxiliary Aid
As Necessary to Ensure Effective Communication~ And Therefore Denied Her Full and Equal Medical Treatment Because of Her Disability. ~ 61. On or about May 5, 2003, Ms. Porras’s hearing son, Rene Porras, was taken to Laurel Hospital to obtain treatment for seizures that he had been experiencing. It was later determined that Rene Porras had a potentially life-threatening condition with three abscesses op_his b~. During the visit, Rene was in and out of consciousness and, at times, unable to respond to the Hospital staff. Ms. Porras was responsible for her son’s medical care given his periodic state of unconsciousness. 62. Upon al~ving at Laurel Hospital, Ms. Porras requested a live, in-person sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her son. The Hospital informed her that it did not have a sign language interpreter. Ms. Porras’s daughter, Rebecca Porras Davis, a certified sign language interpreter who accompanied her mother to the Hospital, volunteered to provide interpreting services. The Hospital refused to allow Ms. Davis to enter her brother’s room to provide interpreting services. 63. Ms. Porras and her daughter reiterated their request that the Hospital provide a sign language interpreter. Ms. Davis attempted to give the Hospital staff phone numbers of various agencies in the area that would provide a certified sign language interpreter. The Hospital staff denied their request, and failed and refused to provide a sign language interpreter. 64. Ms. Porras and her daughter requested that the Hospital at the very least provide a video interpreting device through which Ms. Porras could communicate regarding her son’s medical treatment The Hospital staff denied that request as well.

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65. As a result, Ms. Porras was forced to make decisions affecting her son’s medical treatment without the benefit of a sign language interpreter. By refusing to provide a sign language interpreter or other effective communication aid during the visit, Laurel Hospital denied Ms. Porras full and equal medical treatment because of her disability. Moreover, Ms. Porras was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services for her son. This denial was specifically based on Ms. Porras’s disability, and has caused her emotional injuries. Ms. Porras incurred damages in an amoupt to b~ prove2_ g~t trial.
COUNT ONE (Violation of Americans with Disabilities Act) 66. Paragraphs 1 through 65 of this Complaint are incorporated by reference as though fully set forth herein. 67. At all times relevant to this action, the ADA, 42 U.S.C. §§ 12101, et seq. was in full force and effect and applied to Defendant’s conduct. 68. At all times relevant to this action, the United States Department of Justice regulations implementing Title III of the ADA, 28 C.F.R. Part 36, were in full force and effect and applied to the Defendant’s conduct. 69. At all times relevant to this action, each Plaintiff had a significant heating impairment and was a qualified individual with a disability within the meaning of Title III of the ADA, 42 U.S.C. § 12102(2). 70. At all times relevant to this action, Laurel Hospital was a place of public accommodation within the meaning of Title III of the ADA, 42 U.S.C. § 12181(7).

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71. The objective of the ADA is to eliminate discrimination against individuals with disabilities. Section 302(a) of the ADA, 42 U.S.C. § 12182(a), prohibits discrimination "on the basis of disability in the full and equal enjoyment of goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation."
72. Section 302(b)(2)(A)(iii) of the ADA, 42 U.S.C. § 12182(b)(2)(A)(iii), provides that discrimination under the AD6 furtherjnc!~@S "the failure to take such steps as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services" as defined under § 12102(1)(A) of the ADA. The term "auxiliary aids and services" under the ADA includes "qualified interpreters" who make "aurally delivered materials available to individuals with hearing impairments
73: Defendant’s failure to provide effective communication with Plaintiffs in violation of it obligations under the ADA has directly injured, and continues to injure, Plaintiffs.
74. Defendant’s violations of the ADA mentioned above directly caused Plaintiffs to sustain past and continuing physical and emotional injuries. Plaintiffs have suffered, are suffering, and will continue to suffer irreparable injury as a result of Defendant’s pattern and practice of discrimination. Defendant will not be harmed if ordered to comply with its pre-existing obligations under the ADA. The public interest supports entry of appropriate injunctive relief.
75. Plaintiffs have no plain, adequate or complete remedy at law. They are suffering and will continue to suffer irreparable injury because of the discriminatory policies, pattern, and practice of Defendant Laurel Hospital.

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COUNT TWO
(Violation of Section 504 of the Rehabilitation Act of 1973) 77: Paragraphs 1 through 75 of this Complaint are incorporated by reference as if fully set forth herein. 78. At all times relevant to this action, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794 was in full force and effect and applied to the Defendant’s conduct. 79: A[all ti~es relevant to this action, the United States Department of Health and Hnmao Services ("HHS") regulation implementing Section 504 of the Rehabilitation Act, 45 C.F.R. Part 84, were in full force and effect and applied to the Defendant’s conduct. 80. At all times relevant to this action, Plaintiffs had significant hearing impairments and were "handicapped persons" within the meaning of the Rehabilitation Act including its regulation, at 45 C.F.R. § 84.3(j), and "otherwise qualified individual[s]" within the meaning of the Rehabilitation Act including regulation, 45 C.F.R. § 84.3(k). 81. At all times relevant to this action, Defendant was a recipient of federal funds within the meaning of the Rehabilitation Act. 82. Section 504 of the Rehabilitation Act, 29 U.S.C. § 794, provides:
No otherwise qualified individual with a disability in the United States... shall, solely by reason of her or his disability, be excluded from participation in, be denied benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. 83. The United States Department of Health and Human Services regulations expressly provide that in the provision of health, welfare, or other social services, a program benefiting from federal financial assistance may not deny an individual with a disability benefits and services, or provid

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them with benefits and services not as effective as those offered to others. 45 C.F.R. § 84.52(a)-(d). Under the federal regulations, a recipient of federal assistance must provide auxiliary aids and services, including qualified sign language interpreters, to deaf individuals.
84. Defendant’s refusal to ensure effective communication with Plaintiffs discriminates against them on the basis of disability in violation of Section 504 of the Rehabilitation Act.
85. Laurel Hospital violated HHS’s regulations, 45 C.F.R. § 84.52(a) - (d) because it denied Plaintiffs from receiving benefits and services in provision of health, welfare~ and/or othero.soe;~ services and also provided disparate medical treatment compared to treatment offered non-disabled individuals. In further violation of the aforementioned HHS regulations, Laurel Hospital failed to provide Plaintiffs with auxiliary aids and services, including qualified sign language interpreters.
86. Defendant refused to provide Plaintiffs with effective communication because of Plaintiffs’. disability in violation of the Rehabilitation Act and federal regulations, which directly caus Plaintiffs to sustain past and continuing physical and emotional injuries.
87. Plaintiffs have suffered, are suffering, and will continue to suffer irreparable injury as a result of Defendant’s pattern and practice of discrimination~ Defendant will not be harmed if ordered to comply with its pre-existing obligations under the Rehabilitation Act. The public interest supports entry of appropriate injunctive relief.
88. Plaintiffs have no plain, adequate or complete remedy at law. They are suffering and will continue to suffer irreparable injury because of the discriminatory policies, pattem, and practice of Defendant Laurel Hospital.

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PRAYER FOR RELIEF WHEREFORE, Plaintiffs pray for judgrnent as follows: (A) A preliminary and permanent injunction against Laurel Hospital, its officers, directors, agents, representatives and those persons acting in association with it, enjoining them from engaging in any practice or activity that discriminates against any person solely on the basis of that person’s status as an "individual with a disability," including the practice of failing to provide qualified sign language interpreters to individuals who are deaf when they need to ~namunicate with Laurel Hospital, and ordering it to provide deaf individuals with auxiliary aids and services necessary for effective communication, including qualified sign language interpreters, TTY’s and closed captioned televisions. (B) A preliminary and permanent injunction requiring Laurel Hospital to modify existing or to adopt new, practices and policies to correct discriminatory policies. (C) An award of compensatory damages sufficient to compensate Plaintiffs for the pain, suffering, and humiliation resulting from Laurel Hospital’s discriminatory conduct against them in an amount established at trial or other appropriate date. (D) An award of punitive damages sufficient to punish Laurel Hospital for its discriminatory practices and policies in reckless disregard of Plaintiffs’ protected rights under federal law, and for willfully and maliciously causing Plaintiffs humiliation, embarrassment, and emotional p and suffering. (E) An award of attorneys’ fees and costs pursuant to the ADA, 42 U.S.C. §§ 12188(a)(1) and 12205, and the Rehabilitation Act, 29 U.S.C. § 794a, and/or common law.

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(F) Any such other and further relief as this Court may deem proper and just under the

circumstances.

DEMAND FOR JURY TRIAL

Plaintiffs demand a trial by jury. This 1 lth day of January, 2005.

Respect fully su)]mitted, ~

]~/~wis S. ~, Esq. (No. 10845) ~ast, Esq. (No. 15272) Thomas R. Bundy, III, Esq. (No. 15265) Sutherland Asbill & Brennan LLP 1275 Pennsylvania Ave, N.W. Washington, D.C. 20004 (202) 383-0100 (telephone) (202) 637-3593 (facsimile)
Elizabeth Elaine Gardner, Esq. Washington Lawyers Committee for Civil Rights and Urban Affairs 11 Dupont Circle, Suite 400 Washington, DC 20036 (202) 319-1000 (telephone) (202)319-1010 (facsimile
Counsel for Plaintiffs

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 Case 8:05-cv-00073-DKC Document 20 Filed 03/15/2005 Page 1 of 27

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND SOUTHERN DIVISION

ELIZABETH GILLESPIE, 507 Montgomery Street
Laurel, MD 20707, and

DAVID IRVINE 507 Montgomery Street Laurel, MD 20707, and

ERIN WHITNEY 6313 Mockingbird Street
Ventura, CA 93003, and

CARY BARBIN 327 Talbott Avenue Laurel, MD 20707, and
KATHRYN ELIZABETH HALE 14012 Vista Drive, Unit 16A Laurel, MD 20707, and

Civil Action No. DKC-05-CV-73

BRIAN LEFFLER 2606 23r~ Road North
Arlington, VA 22207, and

XIOMARA PORRAS 9035 - D North Laurel Rd. Laurel, MD 20723,
Plaintiffs,
Vo

DI2vlENSIONS HEALTH CORPORATION d/b/a LAUREL REGIONAL HOSPITAL, 7300 Van Dusen Road Laurel, MD 20707,

Defendant.
FIRST AMENDED COMPLAINT FOR INJUNCTIVE RELIEF AND FOR COMPENSATORY AND PUNITIVE DAMAGES

Case 8:05-cv-00073-DKC Document 20 Filed 03/15/2005 Page 2 of 27

NOW COME Plaintiffs Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn

Elizabeth Hale, Brian Leffier, and Xiomara Porras (collectively "Plaintiffs"), by and through their

undersigned counsel, and file this First Amended Complaint against Defendant Dimensions Health

Corporation d/b/a Laurel Regional Hospital ("Laurel Hospital," or the "Hospital") and, in support

thereof, allege as follows:

STATEMENT OF THE CASE

1. Plaintiffs are deaf individuals that have sought and received medical treatment at Laurel

Hospital. Each has depended on Laurel Hospital for a variety of inpatient, emergency and outpatient medical services, due largely to the Hospital’s proximity to their respective homes. Plaintiffs will likely

continue to depend upon Laurel Hospital for a variety of inpatient, emergency and outpatient medical

treatment in the future.

2. To communicate effectively in medical situations - especially emergency medical situations - Plaintiffs require a live, qualified sign language interpreter. The alternative methods of

communication utilized by Laurel Hospital, which may be acceptable in non-medical settings, in

Plaintiffs’ cases have proven inadequate. Plaintiffs sought medical treatment at Laurel Hospital because

either they or a family member were sick, injured and/or experiencing severe pain, necessitating them

coming to the Hospital’s emergency room. Such medical settings, in which Plaintiffs’ health, cognizance and concentration have already been compromised, require the provision of a live and in-

person, qualified sign language interpreter. Hearing patients would expect and receive nothing less than live, person-to-person medical service with oral communications between themselves and Hospital staff.

Deaf patients, such as Plaintiffs, should receive nothing less than what would be provided for hearing

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patients. In fact, given their disability, deaf patients should receive greater communication efforts from Hospital staff, not less.
3. On each occasion when Plaintiffs visited Laurel Hospital for treatment, they and/or others made repeated requests for the assistance of a live and in-person, qualified sign language interpreter to enable the plaintiffs to communicate with doctors, nurses and other Hospital staff, to understand and participate in their medical treatment and to receive the full benefit of the Hospital’s services. Despite specific and repeated requests for live interpreter services, however, Laurel Hospital failed and refused to provide Plaintiffs with live qualified sign language interpreters incident to the administration of medical treatment.
4. Instead, Plaintiffs were forced to communicate through cryptic notes or lip-reading. Lipreading, the ability to understand the speech of another by watching the speaker’s lips, is an extremely speculative means of communication. Only approximately 30-40% of the spoken sounds of our language are visible, and many of those appear identical on the lips. Even the very best lip-readers, in an ideal one-to-one situation, have been found to understand only 26% of what is said.
5. In limited circumstances, Plaintiffs were able to utilized Video Remote Interpreting ("VRI"). VRI uses video conferencing technology to provide remote interpreting services. The sign language interpreter is located at a remote location and, through video conferencing, the deaf individual and the interpreter can view each other. Facing a small camera mounted on top of a computer, the deaf individual signs to the interpreter, who then voices what has been signed and interprets what is said in response by hearing participants which interpretation is displayed on a computer monitor for viewing by the deaf participant. In the specific instances facing these Plaintiffs, VRI was an insufficient mode of communication.

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6. As a consequence, Plaintiffs have been denied the benefit of effective communication with physicians and health care providers at Laurel Hospital, have been unable to provide informed consent to treatment, have been denied the opportunity to participate in their treatment, and have been denied the full benefit of the health care services provided by Laurel Hospital as required by the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12181 et seq., and Section 504 of the Rehabilitation Act (the "Rehabilitation Act"), 29 U.S.C. § 794.
JURISDICTION AND VENUE 7. Jurisdiction in this Court is proper pursuant to 28 U.S.C. § 1331 because this case involves Laurel Hospital’s multiple and repeated violations of both the ADA and the Rehabilitation Act. This Court also has jurisdiction pursuant to 28 U.S.C. § 1343(a)(4) because this case involves a violation of Plaintiffs’ civil rights. 8. Venue in this Court is proper pursuant to 28 U.S.C. § 1391 because Defendant is located in and has its principal (and exclusive) place of business in Prince George’s County, Maryland, and the events giving rise to the Complaint occurred in Prince George’s County, Maryland.
THE PARTIES 9. Plaintiff ELIZABETH GILLESPIE is a resident of Laurel, Maryland. Ms. Gillespie is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Ms. Gillespie communicates through ASL. Ms. Gillespie has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two miles from her home. 10. Plaintiff DAVID IRVINE is a resident of Laurel, Maryland. Mr. Irvine is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2)

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and the Rehabilitation Act, 29 U.S.C. § 705(2)03). Mr. Irvine communicates through ASL. Mr. Irvine has sought and will likely continue to seek medical treatment from Laurel Hospital, which is approximately two miles from his home. Mr. Irvine has accompanied and will likely continue to accompany his wife, Elizabeth Gillespie, to Laurel Hospital for purposes of assisting her with, and participating in, her medical treatment decisions.
11. PlaintiffERIN WHITNEY was a resident of College Park, Maryland at all times relevant to the Complaint. Ms. Whitney is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Ms. Whitney communicates through American Sign Language ("ASL"). Ms. Whitney has sought and received medical treatment from Laurel Hospital, which at all times relevant to the Complaint was approximately eight miles from her prior residence.
12. Plaintiff CARY BARBIN is a resident of Laurel, Maryland. Mr. Barbin is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)03). Mr. Barbin communicates through ASL. Mr. Barbin has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two miles from his home.
13. PlaintiffKATHRY-N HALE is a resident of Laurel, Maryland. Ms. Hale is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)03). Ms. Hale communicates through ASL. Ms. Hale has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two miles from her home.

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14. Plaintiff BRIAN LEFFLER was a resident of Laurel, Maryland at all times relevant to the Complaint. Mr. Leffler is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Mr. Leffler communicates through ASL. Mr. Leffler has sought and received, and will likely continue to seek, medical treatment from Laurel Hospital, which is approximately two to three miles from his home.
15. Plaintiff XIOMARA PORRAS is a resident of Laurel, Maryland. Ms. Porras is deaf, and therefore qualifies as an individual with a disability as defined by both the ADA, 42 U.S.C. § 12102(2) and the Rehabilitation Act, 29 U.S.C. § 705(2)(B). Ms. Porras is unable to communicate effectively through reading or writing, and communicates effectively only through ASL. Ms. Porras has sought and received, and will likely continue to seek, medical treatment for herself and for her family from Laurel Hospital, which is approximately five miles from her home.
16. Laurel Hospital, upon information and belief, operates in Prince George’s County, Maryland at 7300 Van Dusen Road, Laurel, MD 20707, and is affiliated with Dimensions Health Corporation, which is located at 3001 Hospital Drive, Suite 4000, Cheverly, MD 20785. Dimensions Health Corporation operates several healthcare institutions in Prince Georges County, Maryland, including Laurel Hospital. Laurel Hospital is a Maryland business and is a place of public accommodation as defined by the ADA, 42 U.S.C. § 12181 (7)(F). The Hospital receives federal financial assistance pursuant to the Rehabilitation Act and is therefore a federal recipient subject to the requirements of Section 504 of the Rehabilitation Act, 29 U.S.C. § 794.
FACTS ENTITLING PLAINTIFFS TO RELIEF 17. Paragraphs 1 through 16 are adopted and incorporated by reference as though expressly set forth herein.

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A. Laurel Hospital Failed to Provide Plaintiff Gillespie with an Appropriate Auxiliary Aid As Necessary to Ensure Effective Communication~ And Therefore Denied Her Full and Equal Medical Treatment Because of Her Disability. 18. On or about November 1, 2003, Ms. Gillespie went to the Laurel Hospital emergency
room to obtain medical treatment for severe abdominal pain, nausea, and vomiting, among other symptoms. On numerous prior visits, Laurel Hospital failed to provide Ms. Gillespie with a sign language interpreter. Nevertheless, because Laurel Hospital is the closest hospital to her home and Ms. Gillespie needed emergency medical care, she returned to Laurel Hospital.
19. Immediately after registering at the Hospital’s front desk on November 1, 2003, Ms. Gillespie was admitted to the emergency room because of her serious condition. Ms. Gillespie’s husband, David Irvine, who is also deaf and who cannot lip-read, accompanied her to the Hospital. While Mr. Irvine is deaf and cannot read lips, he can speak clearly enough to be understood. By contrast, Ms. Gillespie has limited lip reading ability but her speech is not clear. Because of her serious medical condition and severe pain, however, Ms. Gillespie’s ability to read lips was compromised during this hospital visit.
20. Upon Ms. Gillespie’s admittance, both she and her husband requested a live, in-person sign language interpreter so that they could communicate with the doctors, nurses and other Hospital staff. Laurel Hospital’s staff told them that it did not have any sign language interpreter. Ms. Gillespie and Mr. Irvine repeatedly requested an interpreter. After waiting for some time, a member of the Hospital staff finally mentioned that the Hospital has a VRI device. The staff informed Ms. Gillespie, however, that the room containing the VRI device was not available at that time because the room was being used by another patient. After waiting approximately two hours, Ms. Gillespie was finally moved to the room containing the VRI device. Due to her inability to communicate with the Hospital staff

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during the two-hour delay, however, Ms. Gillespie did not understand the medical advice or treatment she received during that time.
21. After moving Ms. Gillespie to the room with the video interpreting device, it took the improperly and inadequately trained Hospital staff another 20-30 minutes to set up and operate the equipment. The doctor communicated with Ms. Gillespie using the video interpreting device. This consultation lasted approximately 10 minutes. During this time, the doctor advised Ms. Gillespie that he did not know the cause of her severe pain, but communicated to her that he would like to perform some tests. The doctor informed Ms. Gillespie that she would undergo an x-ray and probably a CT-scan. The Hospital staff never utilized the VRI device again during Ms. Gillespie’s visit.
22. Following the consultation, Ms. Gillespie and Mr. Irvine waited in her room before the Hospital staff returned to prepare her for her x-rays. During this procedure, as well as during all subsequent procedures, tests, and doctor consultations, Ms. Gillespie did not receive, and the Hospital either failed or refused to provide access to, the VRI device and denied her repeated requests for a live sign language interpreter or any other alternative mode of communication. The Hospital staff wrote notes to her only in a few select and extreme circumstances and only after Ms. Gillespie begged and continuously motioned for some sort of communication. Even then, the Hospital stafflimited written communication to a few words. As a result, Ms. Gillespie and Mr. Irvine received only a partial and limited understanding of her medical condition and treatment. Rather than provide effective communication, the Hospital staff insisted on speaking to Ms. Gillespie and Mr. Irvine verbally despite the fact that he cannot read lips and Ms. Gillespie’s ability to lip-read was compromised by her medical condition.

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23. After being x-rayed, Ms. Gillespie was returned to her patient room where she waited for some time before the doctor returned to consult with her and her husband. The doctor verbally informed them that Ms. Gillespie had an enlarged heart and that Ms. Gillespie would need to undergo a CT-scan. As this diagnosis was communicated only verbally, Ms. Gillespie and Mr. Irvine were forced to attempt to rely solely on the vagaries of lip-reading to comprehend this critical information. They did not fully understand the doctor’s diagnosis or the medical treatment she was going to receive.
24. Ms. Gillespie and Mr. Irvine waited another few hours (almost five hours after she was admitted to the emergency room) before a male Hospital attendant arrived to take her to the CT-scan room. Neither Ms. Gillespie nor Mr. Irvine could understand the male attendant’s instructions to them. As a result, Ms. Gillespie repeatedly asked (by signing to Mr. Irvine who relayed her request verbally) that the attendant communicate with them in writing so that they could better understand the medical services he was to provide. The attendant ignored and refused the request for written communication. Instead, the male attendant’s communication was limited to his pulling and snapping her bra’s strap when he wanted her to remove it. Ms. Gillespie was humiliated, embarrassed and violated by this incident.
25. The male attendant nevertheless took Ms. Gillespie to the CT-scan room. Mr. Irvine followed. While the attendant prepared for the CT-scan, Ms. Gillespie (through Mr. Irvine) repeatedly requested that the male attendant communicate with her in writing about the procedure. Neither Ms. Gillespie not Mr. Irvine understood the procedure. The attendant angrily and steadfastly refused to communicate with her in writing. She felt afraid and, as a result, left the CT-scan room and returned to her patient room requesting (through Mr. Irvine) that a nurse be present during the CT-scan.
9

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26. After undergoing the CT-scan in the presence of a female nurse, Ms. Gillespie and Mr. Irvine returned to her patient room and waited an additional hour (almost seven and one half hours after she was first admitted to the emergency room) before a doctor returned to provide Ms. Gillespie with a sedative for her pain. The doctor left without providing Ms. Gillespie with any diagnosis or update on her condition or the results of any test.
27. Because she felt exasperated with her treatment and uninformed about her medical condition arising from the Hospital’s refusal and failure to communicate with her or her husband adequately, Ms. Gillespie wanted to leave the Hospital.
28. After waiting another few hours or so, a different doctor arrived at Ms. Gillespie’s room to provide her and her husband with a summation consultation (almost ten hours after Ms. Gillespie was admitted to the emergency room). The doctor informed them that Ms. Gillespie should be admitted to the Hospital for additional tests to determine the source of her pain. He communicated with them verbally and then after Mr. Irvine assisted, he sparsely used written notes. The doctor’s notes were short, confusing and cryptic. Because Ms. Gillespie had been sedated and Mr. Irvine does not read lips, they could not understanding the verbal discussion. They were also confused about the written communications since those communications were so vague. Ms. Gillespie informed the doctor through Mr. Irvine that she wanted to leave the Hospital. In response, the doctor turned, and began to leave the room. Mr. Irvine stopped him and asked about the earlier doctor’s reference to his wife’s heart being enlarged. Ms. Gillespie and Mr. Irvine believe the doctor communicated to them that the doctor who saw Ms. Gillespie earlier during her visit diagnosed her with congestive heart failure. The doctor cavalierly recommended that Ms. Gillespie go to another emergency room at a different hospital for treatment. Ms. Gillespie’s discharge papers and all other written materials she received from the
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Case 8:05-cv-00073-DKC Document 20 Filed 03/15/2005 Page 11 of 27
Hospital failed to mention the lung problem and/or the heart condition for which she was ultimately diagnosed.
29. Ms. Gillespie’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment based on her disability. Moreover, Ms. Gillespie was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. B. Laurel Hospital Failed to Provide Plaintiff Irvine with an Appropriate Auxiliary Aid
As Necessary to Ensure Effective Communication~ And Therefore Denied Him Full and Equal Medical Treatment Because of His Disability. 30. Ms. Gillespie’s husband, David Irvine, also has suffered from Laurel Hospital’s discriminatory failure to provide effective communication. Mr. Irvine accompanied his wife to Laurel Hospital during her November 1, 2003 visit. Ms. Gillespie relies heavily on Mr. Irvine’s participation in making her medical decisions. By refusing to provide a sign language interpreter or other effective communication aid during the visit, Laurel Hospital denied Mr. Irvine full and equal medical treatment because of his disability. Moreover, Mr. Irvine was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services for his wife. This denial was specifically based on Mr. Irvine’s disability, and has caused him emotional injuries. Mr. Irvine incurred damages in an amount to be proven at trial. C. Laurel Hospital Failed to Provide Plaintiff Whitney with an Appropriate Auxiliary Aid As Necessary to Ensure Effective Communication~ And Therefore Denied Her Full and Equal Medical Treatment Because of Her Disability. 31. On or about December 24, 2003, Ms. Whitney went to Laurel Hospital to obtain medical treatment. Ms. Whitney and Karl Ewan, a deaf friend of Ms. Whitney’s who had accompanied her to
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Case 8:05-cv-00073-DKC Document 20 Filed 03/15/2005 Page 12 of 27
the Hospital, both requested a live, in-person sign language interpreter so that Ms. Whitney could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital staff informed Ms. Whitney and Mr. Ewan that an interpreter was "on the way," however, when she was admitted into a room, the Hospital staff told she and Mr. Ewan that they would have to use the VRI.
32. The Hospital staff was inadequately trained and unable to operate the VRI device until assisted by Mr. Ewan.
33. While Mr. Ewan was assisting with the set-up of the VRI device, a doctor entered the hospital room, but left without treating Ms. Whitney because he and Ms. Whitney could not communicate.
34. Once the VRI device was connected, neither Ms. Whitney nor Mr. Ewan could understand the video interpreter due to the poor quality of the video transmission. Ms. Whitney repeated her request for a live sign language interpreter, but the Hospital again refused to provide one. As a result, Ms. Whitney could not effectively communicate with the Hospital staff.
35. Ms. Whitney’s medical treatment was deficient because Laurel Hospital failed to accommodate her disability. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.
36. On or about April 25, 2004, despite Laurel Hospital’s prior failures and refusal to provide her with a qualified live sign language interpreter, Ms. Whitney returned to the Hospital for emergency medical treatment since, at the time, it was the closest hospital to her home. Upon her arrival at the Hospital, Ms. Whitney vomited several times and fainted. Prior to fainting and again upon regaining consciousness, Ms. Whitney requested a live sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. Ms. Whitney’s roommate Marie
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Campbell, who had accompanied her to the Hospital, requested on three separate occasions that the Hospital provide Ms. Whitney with a live, in-person sign-language interpreter. The Hospital staff told Ms. Campbell that an interpreter was "on the way."
37. After feeling faint again, Ms. Whitney lay down on a nearby bed. A member of the Hospital staff, who did not know that Ms. Whitney was deaf, became angry with Ms. Whitney for lying on the bed, then hit Ms. Whitney in the knee, twisted her arm and dragged her off of the bed. Ms. Campbell and Ms. Whitney made repeated requests to file a complaint about the nurse’s misconduct. The Hospital staff told Ms. Campbell and Ms. Whitney that they would send someone to start the complaint procedure. That person never arrived.
38. Subsequently, the Hospital staff placed Ms. Whitney in a room with a VRI device. The Hospital staff was improperly trained, was not familiar with the device and spent 30-40 minutes trying to set it up. During this period, and in a repeat of her first visit, a doctor entered the room, saw that the VRI machine was not yet ready and left without providing any medical assistance to Ms. Whitney. The doctor ultimately returned once the VRI device was operational. Ms. Whitney found communication through the VRI device difficult and ineffective due to poor picture quality on the video monitor, combined with the fact that it requires a patient to sit up to see the screen. Due to her illness, Ms. Whitney was unable to sit up in order to communicate through the VRI device. Ms. Whitney repeatedly tried to communicate with the Hospital staff to explain that she did not understand the video interpreter, and repeatedly requested a live sign language interpreter so that she could communicate effectively with the doctor and other Hospital staff. Each time the Hospital staff rebuffed and rejected Ms. Whitney’s requests for a live interpreter and told her that she would have to use the video interpreter.
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39. The doctor treating Ms. Whitney also insisted on using only the VRI device to communicate with her. It was through this mode of communication that the doctor advised Ms. Whitney that she "might" be suffering from meningitis. At the time of this communication from the doctor, Ms. Whitney was scared, confused and light-headed from her illness. Given the severity of what she believed the doctor was communicating (i.e., that she had a potentially life-threatening illness), Ms. Whitney reiterated her request for a live sign language interpreter to clarify what the doctor was telling her, and to ask some follow-up questions. The doctor refused her request for an interpreter and, adding further to Ms. Whitney’s confusion, upon her discharge the next day, formally diagnosed her as suffering from the flu, with no additional mention of meningitis.
40. A short while after returning home from the Hospital, Ms. Whitney experienced continued nausea, faintness and a very high fever. She returned to Laurel Hospital for treatment on the afternoon of April 26, 2004, and again requested a live sign language interpreter. Ms. Campbell, who again accompanied Ms. Whitney to the Hospital, also made several requests for a live, in-person sign language interpreter. Laurel Hospital again failed and refused to provide a live sign language interpreter, insisting instead on using the VRI device.
41. The Hospital staff again struggled to set up the VRI device. Even after the video interpreting device was operational, as during her prior visit, Ms. Whitney could not see the VRI screen clearly from her position on the treatment table. In response to this situation, the doctor employed the assistance of Ms. Campbell, who is also deaf and communicates through ASL, to relay the interpreter’s messages from the VRI device to Ms. Whitney. Through this attenuated means of communication, the doctor informed Ms. Whitney that she probably suffered from meningitis and would need to undergo a spinal tap. Neither the attending physician nor any other member of the Hospital staff advised Ms.
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Whitney as to what the procedure would entail. Ms. Whitney again requested a live sign language interpreter from the Hospital, and the Hospital again refused her request.
42. The Hospital staffperformed the spinal tap procedure without Ms. Whitney’s written consent. Ms. Whitney never received any instructions regarding the spinal tap procedure, and no interpreter was provided while the procedure was conducted, despite Ms. Whitney’s repeated requests. The Hospital staff turned offthe video interpreting device while conducting the spinal tap procedure. Two nurses held Ms. whitney down as the procedure was conducted.
43. After the procedure was completed, the Hospital staff failed to convey any postprocedure instructions or restrictions to Ms. Whitney, including that she remain immobile for a period of time following the procedure, which is standard procedure following a spinal tap. Specifically, after a spinal tap is performed, doctors typically advise patients to lay flat for a few hours in order to equilibrate fluid pressure. Significant complications can arise if a patient moves too soon after undergoing a spinal tap procedure. Under such circumstances, a patient can suffer from prolonged headaches, nausea and imbalance in equilibrium. In severe cases, nerve damage and/or inner-cranial pressure can result. In Ms. Whitney’s case, shortly after her spinal tap procedure was complete, and absent any instruction to remain still, Ms. Whitney moved. She subsequently experienced, and continues to suffer from, among other problems, headaches, nausea, faintness and an imbalance in equilibrium.
44. After the spinal tap procedure was completed, another friend of Ms. Whitney’s, Heidi Holmes, came in to check on Ms. Whitney. Upon seeing there was no interpreter and listening to Ms. Whitney’s complaints for an interpreter, Ms. Holmes made a few additional requests to the Hospital staff for an interpreter. The Hospital continued to refuse to provide a live interpreter for Ms. Whitney.
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45. Following the spinal tap, Ms. Whitney tested positive for viral meningitis and was readmitted to the Hospital on or about the evening of April 26, 2004. She remained in the Hospital for an additional 2-3 days, until her discharge on April 29, 2004. During that entire time, the VRI device was not available for her use. Although the equipment was brought into her room, no one from the Hospital staff set up the equipment for use, despite her repeated requests for an interpreter.
46. Although Ms. Whitney requested on multiple occasions that the Hospital provide her with a working TTY phone and a closed caption television, the Hospital refused to accommodate her requests (as required by Department of Justice Regulations, 28 C.F.R. 36.303(d) and (e)).
47. The Hospital also failed to provide a live sign language interpreter or the VRI device for Ms. Whitney’s discharge from the Hospital, despite the fact that she requested one. The Hospital staff provided discharge instructions to Ms. Whitney’s mother instead of providing them to her directly, and required Ms. whitney’s mother to sign the discharge papers.
48. Ms. Whitney’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Whitney was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. D. Laurel Hospital Failed to Provide Plaintiff Barbin with an Appropriate Auxiliary Aid
As Necessary, to Ensure Effective Communication~ And Therefore Denied Him Full and Equal Medical Treatment Because of His Disability. 49. On or about March 19, 2004, Mr. Barbin went to Laurel Hospital to obtain medical treatment. Mr. Barbin requested a live, in-person sign language interpreter so that he could communicate with the doctors, nurses and other Hospital staff treating him. The Hospital staff informed
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him that it did not have a sign language interpreter. Because the Hospital had no interpreter, Mr. Barbin’s hearing roommate, Michael Jacobus, who had accompanied him to the Hospital, attempted to help Mr. Barbin understand what was happening.
50. The Hospital staff insisted on using Mr. Jacobus to interpret for Mr. Barbin. Both Mr. Barbin and Mr. Jacobus informed the Hospital staff that Mr. Jacobus was not a certified sign language interpreter, and that neither was comfortable in having Mr. Jacobus interpret in this situation. A member of the Hospital staff responded that they "could manage" by using Mr. Jacobus to interpret. Over Mr. Barbin’s objection, the Hospital staff took Mr. Barbin’s information and commenced the examination, ¯ using Mr. Jacobus as the interpreter.
51. When the emergency room doctor arrived to treat Mr. Barbin, both Mr. B arbin and Mr. Jacobus again requested a certified sign language interpreter. The doctor told them that the Hospital did not have an interpreter, and insisted again on using Mr. Jacobus to interpret. Both Mr. Barbin and Mr. Jacobus informed the doctor that Mr. Jacobus is not a certified sign language interpreter and is not sufficiently skilled to interpret in medical situations. Moreover, neither individual was comfortable with the Hospital’s use of Mr. Jacobus to interpret in this type of private situation.
52. Laurel Hospital never obtained Mr. Barbin’s permission to disclose confidential medical information to Mr. Jacobus. Mr. Barbin’s medical treatment was deficient because Laurel Hospital denied him full and equal medical treatment because of his disability. Moreover, Mr. Barbin was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, he sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.
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E. Laurel Hospital Failed to Provide PiaintiffHale with an Appropriate Auxiliary Aid As Necessary to Ensure Effective Communication~ And Therefore Denied Her Full and ..E...quai Medical Treatment Because of Her Disability. 53. On or about August 5, 2002, Ms. Hale sought medical treatment from Laurel Hospital.
Upon arriving at the Hospital, Ms. Hale requested a live, in-person sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital did not provide a sign language interpreter. Instead, the Hospital insisted on Ms. Hale reading lips and passing written notes to communicate with the Hospital staff. While this form of communication may be appropriate in a non-medical setting, it was inappropriate in a hospital setting where Ms. Hale’s health was already compromised.
54. Ms. Hale was not afforded any communication aid during her medical treatment while at Laurel Hospital on this date. Ms. Hale’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Hale was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.
55. On or about April 26, 2003, Ms. Hale again sought medical treatment from Laurel Hospital. Upon arriving at the Hospital, Ms. Hale again requested a live sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital did not provide a live sign language interpreter. Instead, the Hospital insisted on using the VRI device. The improperly and inadequately trained Hospital staffwas unable to operate the video interpreting equipment. Observing the difficulty the Hospital staff encountered with the video interpreting device, Ms. Hale reiterated her request that the Hospital provide her with a live, in-person sign language
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interpreter. The Hospital denied her request. As a result, Ms. Hale was not afforded any communication aid during her medical treatment while at Laurel Hospital on this date. Ms. Hale’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Hale was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.
56. On or about August 12, 2004, Ms. Hale again sought medical treatment from Laurel Hospital. Upon arriving at the Hospital, Ms. Hale again requested a live sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her. The Hospital did not provide a live sign language interpreter. Instead, the Hospital again insisted on using the VRI device. Ms. Hale watched the improperly and inadequately trained Hospital staff attempt to operate the video interpreting equipment for two hours without success. Observing the continued difficulty the Hospital staff encountered with the video interpreting equipment, Ms. Hale reiterated her request that the Hospital provide her with a live, in-person sign language interpreter. The Hospital denied her request. As a result, Ms. Hale was not afforded any communication aid during her medical treatment while at Laurel Hospital on this date. Ms. Hale’s medical treatment was deficient because Laurel Hospital denied her full and equal medical treatment because of her disability. Moreover, Ms. Hale was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, she sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial.
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F. Laurel Hospital Failed to Provide Plaintiff Leffler with an Appropriate Auxiliary Aid As Necessary to Ensure Effective Communication~ And Therefore Denied Him Full and Equal Medical Treatment Because of His Disability. 57. On or about, October 27, 2003, Mr. Leffler sought emergency medical treatment at
Laurel Hospital. Mr. Leffler was accompanied to the Hospital by two friends, Mr. Barbin, a co-plaintiff in this action, and a hearing friend, Michael Jacobus, who would accompany Mr. Barbin to the Hospital on a later occasion. Upon arriving at the Hospital, Mr. Jacobus requested a live, in-person sign language interpreter on Mr. Leffler’s behalf so that Mr. Leffler could communicate effectively with the doctors, nurses and other Hospital staff. The Hospital registration nurse informed them that it did not have a sign language interpreter. Instead, the nurse offered the use of a machine that purportedly would allow Mr. Leffler to communicate with the Hospital doctors and staff. Not wanting to delay to his friends any further, and having learned that the Hospital would provide him with a communication aid, Mr. Leffler advised Mr. Barbin and Mr. Jacobus that they could leave the Hospital.
58. After waiting for approximately thirty minutes, the registration nurse advised Mr. Leffler that the machine she had referenced earlier was not available, and asked Mr. Leffler if he was able to read lips. Mr. Leffler told the registration nurse that he did not read lips well, and expressed his displeasure with the prospect of undergoing a medical examination in this manner. The registration nurse nevertheless insisted on trying to communicate with Mr. Leffler through lip-reading. This method of communication proved ineffective, however, given Mr. Leffler’s general difficulty with lip-reading coupled with his then-existing medical condition which made intense concentration very difficult.
59. Despite his earlier request for a live sign language interpreter, and despite the Hospital’s original representation that a machine for interpreting would be provided, the doctor examined Mr. Leffler without the assistance of an interpreter or other communication aid. The doctor tried to
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communicate through written notes, but this attempt limited the depth of questions Mr. Leffier could ask in an attempt to understand fully the diagnosis and treatment. Moreover, the doctor became frustrated and impatient with having to communicate with Mr. Leffier in this fashion, and rushed through Mr. Leffier’s examination. Mr. Leffier attempted to ask the doctor questions, but the doctor cut him short, issued a prescription and ended the examination.
60. Mr. Leffier’s medical treatment was deficient because Laurel Hospital denied him full and equal medical treatment because of his disability. Moreover, Mr. Leffier was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services. Consequently, he sustained physical and emotional injuries, and incurred damages in an amount to be proven at trial. G. Laurel Hospital Failed to Provide Plaintiff Porras with an Appropriate Auxiliary Aid
As Necessary, to Ensure Effective Communication~ And Therefore Denied Her Full and Equal Medical Treatment Because of Her Disability. 61. On or about May 5, 2003, Ms. Porras’s hearing son, Rene Porras, was taken to Laurel Hospital to obtain treatment for seizures that he had been experiencing. It was later determined that Rene Porras had a potentially life-threatening condition with three abscesses on his brain. During the visit, Rene was in and out of consciousness and, at times, unable to respond to the Hospital staff. Ms. Porras was responsible for her son’s medical care given his periodic state of unconsciousness. 62. Upon arriving at Laurel Hospital, Ms. Porras requested a live, in-person sign language interpreter so that she could communicate with the doctors, nurses and other Hospital staff treating her son. The Hospital informed her that it did not have a sign language interpreter. Ms. Porras’s daughter, Rebecca Porras Davis, a certified sign language interpreter who accompanied her mother to the Hospital,
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volunteered to provide interpreting services. The Hospital refused to allow Ms. Davis to enter her brother’s room to provide interpreting services.
63. Ms. Porras and her daughter reiterated their request that the Hospital provide a sign language interpreter. Ms. Davis attempted to give the Hospital staff phone numbers of various agencies in the area that would provide a certified sign language interpreter. The Hospital staff denied their request, and failed and refused to provide a sign language interpreter.
64. Ms. Porras and her daughter requested that the Hospital at the very least provide a video interpreting device through which Ms. Porras could communicate regarding her son’s medical treatment. The Hospital staff denied that request as well.
65. As a result, Ms. Porras was forced to make decisions affecting her son’s medical treatment without the benefit of a sign language interpreter. By refusing to provide a sign language interpreter or other effective communication aid during the visit, Laurel Hospital denied Ms. Porras full and equal medical treatment because of her disability. Moreover, Ms. Porras was excluded from participation in, denied the benefits of, and subjected to discrimination in the receipt of medical services for her son. This denial was specifically based on Ms. Porras’s disability, and has caused her emotional injuries. Ms. Porras incurred damages in an amount to be proven at trial.
COUNT ONE (Violation of Americans with Disabilities Act) 66. Paragraphs 1 through 65 of this First Amended Complaint are incorporated by reference as though fully set forth herein. 67. At all times relevant to this action, the ADA, 42 U.S.C. §§ 12101, et seq. was in full force and effect and applied to Defendant’s conduct.
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68. At all times relevant to this action, the United States Department of Justice regulations implementing Title III of the ADA, 28 C.F.R. Part 36, were in full force and effect and applied to the Defendant’s conduct.
69. At all times relevant to this action, each Plaintiff had a significant heating impairment and was a qualified individual with a disability within the meaning of Title III of the ADA, 42 U.S.C. § 12102(2).
70. At all times relevant to this action, Laurel Hospital was a place of public accommodation within the meaning of Title III of the ADA, 42 U.S.C. § 12181(7).
71. The objective of the ADA is to eliminate discrimination against individuals with disabilities. Section 302(a) of the ADA, 42 U.S.C. § 12182(a), prohibits discrimination "on the basis of disability in the full and equal enjoyment of goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation."
72. Section 302(b)(2)(A)(iii) of the ADA, 42 U.S.C. § 12182(b)(2)(A)(iii), provides that discrimination under the ADA further includes "the failure to take such steps as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services" as defined under § 12102(1)(A) of the ADA. The term "auxiliary aids and services" under the ADA includes "qualified interpreters" who make "aurally delivered materials available to individuals with hearing impairments."
73. Defendant’s failure to provide effective communication with Plaintiffs in violation of its obligations under the ADA has directly injured, and continues to injure, Plaintiffs.
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74. Defendant’s violations of the ADA mentioned above directly caused Plaintiffs to sustain past and continuing physical and emotional injuries. Plaintiffs have suffered, are suffering, and will continue to suffer irreparable injury as a result of Defendant’s pattern and practice of discrimination. Defendant will not be harmed if ordered to comply with its pre-existing obligations under the ADA. The public interest supports entry of appropriate injunctive relief.
75. Plaintiffs have no plain, adequate or complete remedy at law. They are suffering and will continue to suffer irreparable injury because of the discriminatory policies, pattern, and practice of Laurel Hospital.
COUNT TWO (Violation of Section 504 of the Rehabilitation Act of 1973) 76. Paragraphs 1 through 75 of this First Amended Complaint arc incorporated by reference as if fully set forth herein. 77. At all times relevant to this action, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794 was in full force and effect and applied to the Defendant’s conduct. 78. At all times relevant to this action, the United States Department of Health and Human Services ("HHS") regulation implementing Section 504 of the Rehabilitation Act, 45 C.F.R. Part 84, were in full force and effect and applied to the Defendant’s conduct. 79. At all times relevant to this action, Plaintiffs had significant hearing impairments and were "handicapped persons" within the meaning of the Rehabilitation Act including its regulation, at 45 C.F.R. § 84.3(j), and "otherwise qualified individual[s]" within the meaning of the Rehabilitation Act including regulation, 45 C.F.R. § 84.3(k).
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80. At all times relevant to this action, Defendant was a recipient of federal funds within the meaning of the Rehabilitation Act.
81. Section 504 of the Rehabilitation Act, 29 U.S.C. § 794, provides: No otherwise qualified individual with a disability in the United States... shall, solely by reason of her or his disability, be excluded from participation in, be denied benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.
82. The United States Department of Health and Human Services regulations expressly provide that in the provision of health, welfare, or other social services, a program benefiting from federal financial assistance may not deny an individual with a disability benefits and services, or provide them with benefits and services not as effective as those offered to others. 45 C.F.R. § 84.52(a)-(d). Under the federal regulations, a recipient of federal assistance must provide auxiliary aids and services, including qualified sign language interpreters, to deaf individuals.
83. Defendant’s refusal to ensure effective communication with Plaintiffs discriminates against them on the basis of disability in violation of Section 504 of the Rehabilitation Act.
84. Laurel Hospital violated HHS’s regulations, 45 C.F.R. § 84.52(a) - (d) because it denied Plaintiffs from receiving benefits and services in provision of health, welfare, and/or other social services and also provided disparate medical treatment compared to treatment offered non-disabled individuals. In further violation of the aforementioned HHS regulations, Laurel Hospital failed to provide Plaintiffs with auxiliary aids and services, including qualified sign language interpreters.
85. Defendant refused to provide Plaintiffs with effective communication because of Plaintiffs’ disability in violation of the Rehabilitation Act and federal regulations, which directly caused Plaintiffs to sustain past and continuing physical and emotional injuries.
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86. Plaintiffs have suffered, are suffering, and will continue to suffer irreparable injury as a result of Defendant’s pattern and practice of discrimination. Defendant will not be harmed if ordered to comply with its pre-existing obligations under the Rehabilitation Act. The public interest supports entry of appropriate injunctive relief.
87. Plaintiffs have no plain, adequate or complete remedy at law. They are suffering and will continue to suffer irreparable injury because of the discriminatory policies, pattern, and practice of Laurel Hospital.
PRAYER FOR RELIEF WHEREFORE, Plaintiffs pray for judgment as follows: (A) A preliminary and permanent injunction against Defendant, its officers, directors, agents, representatives and those persons acting in association with it, enjoining them from engaging in any practice or activity that discriminates against any person solely on the basis of that person’s status as an "individual with a disability," including the practice of failing to provide qualified sign language interpreters to individuals who are deaf when they need to communicate with Laurel Hospital, and ordering it to provide deaf individuals with auxiliary aids and services necessary for effective communication, including qualified sign language interpreters, TTY’s and closed captioned televisions. (B) A preliminary and permanent injunction requiring Defendant to modify existing, or to adopt new, practices and policies to correct discriminatory policies at Laurel Hospital. (C) An award of compensatory damages sufficient to compensate Plaintiffs for the pain, suffering, and humiliation resulting from Defendant’s discriminatory conduct against them in an amount established at trial or other appropriate date.
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(D) An award of punitive damages sufficient to punish Defendant for its discriminatory practices and policies in reckless disregard of Plaintiffs’ protected rights under federal law, and for

willfully and maliciously causing Plaintiffs humiliation, embarrassment, and emotional pain and suffering.

(E) An award of attorneys’ fees and costs pursuant to the ADA, 42 U.S.C. §§ 12188(a)(1) and 12205, and the Rehabilitation Act, 29 U.S.C. § 794a, and/or common law.
(F) Any such other and further relief as this Court may deem proper and just under the circumstances.

DEMAND FOR JURY TRIAL

Plaintiffs demand a trial by jury. This 14th day of March, 2005.

Respectfully submitted,

..... ’
Lewis S. Wiener, Es_ _~N0. 10845) David A. Last, Esq. (No. 15272) Thomas R. Bundy, III, Esq. (No. 15265) Sutherland Asbill & Brennan LLP 1275 Pennsylvania Ave, N.W. Washington, D.C. 20004 (202) 383-0100 (telephone) (202) 637-3593 (facsimile)
Elizabeth Elaine Gardner, Esq. Washington Lawyers Committee for Civil Rights and Urban Affairs 11 Dupont Circle, Suite 400 Washington, DC 20036 (202) 319-1000 (telephone) (202) 319-1010 (facsimile
Counsel for Plaintiffs

27

 
 Case 8:05-cv-00073-DKC Document 79-1 Filed 07/17/2006 Page 1 of 25

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MARYLAND SOUTHERN DIVISION

)

ELIZABETH GILLESPIE,

)

507 Montgomery St.

)

Laurel, MD 20707, and

)

)

DAVID IRVINE

)

507 Montgomery St.

)

Laurel, MD 20707, and

)

)

ER_IN WHITNEY

)

5019 Odessa Road

)

College Park, MD20740, and

)

)

CARY BARBIN

)

327 Talbott Avenue

)

Laurel, MD 20707, and

)

)

KATHKYN ELIZABETH VADAKIN )

14012 Vista Drive, Unit 16A

)

Laurel, Maryland 20707-5883, and

)

)

BRIAN LEFFLER

)

i03 Bellevue Avenue East #409

)

Seattle, WA 89102, and

)

)

XIOMARA PORRAS

)

9035 - D North Laurel Rd.

Laurel, MD 20723, and

)

)

Plaintiffs,

)

)

and

)

)

THE UNITED STATES OF AMERICA, )

)

Plaintiff-Intervenor, )

)

)

Vo

)

Civil File No.: DKC-05-CV-73 JURY TRIAL DEMANDED

Case 8:05-cv-00073-DKC Document 79-1 Filed 07/17/2006 Page 2 of 25
DIMENSIONS HEALTH CORPORATION, d/b/a LAUREL REGIONAL HOSPITAL 7300 Van Dusen Road Laurel, MD 20707,
Defendant.
COMPLAINT IN INTERVENTION FOR INJUNCTIVE RELIEF AND FOR COMPENSATORY DAMAGES AND CIVIL PENALTIES Plaintiff-Intervenor, the United States of America ("United States"), alleges as follows: 1. This is a civil action brought to redress discrimination on the basis of.disability in violation of title KI of the Americans with Disabilities Act ("ADA"), 42 U.S.C. § § 12181-12188, and the Department of Justice’s implementing regulation, 28 C.F.R. Part 36. The United States alleges, inter alia, that Defendant Dimensions Health Corporation, d/b/a Laurel Regional Hospital, ("Defendant" or "Hospital") discriminated on the basis of disability against individuals who are deaf by repeatedly failing or refusing to provide appropriate auxiliary aids and services to ensure effective communication with them, thus denying them opportunities to participate in or benefit from the Hospital’s services or facilities that are equal to those afforded to others without disabilities. 21 The Attorney General has instituted this action because it involves a pattern or practice of discrimination under title KI of the ADA, 42 U.S.C. § 12188(b)(1)(B)(i), and it raises issues of general public importance, 42 U.S.C. § 12188(b)(1)(B)(ii).
JURISDICTION AND VENUE o This court has jurisdiction over this action under 42 U.S.C. § 12188(b)(1)(B) and (b)(2); and 28 U.S.C. §8 1331 and 1345. The Court may grant declaratory and other relief
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pursuant to 28 U.S.C. §§ 2201 and 2202.

4. Venue lies in this District pursuant to 28 U.S.C. § 1391 as the claims arose in, and

the defendant does business in, the District of Maryland.

THE PARTIES 5. Plaintiff-I_ntervenor is the United States of America.

6. Defendant Dimensions Health Corporation, d/b/a Laurel Regional Hospital is a

private entity that owns and operates a general acute care hospital. The defendant is, therefore, a

public accommodation within the meaning Of title IK of the ADA, 42 U.S.C. § 12181 (7)(F).

Dimensions Health Corporation is located at 3001 Hospital Drive, Suite 4000, Cheverly, MD

20785. Laurel Regional Hospital is located at 7300 Van Dusen Road, Laurel, MD 20702.

FACTS

The United States alleges the following upon information and belief:

7. Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Vadakin, Brian Leffler, Xiomara Porras and Janette Pokorski1 (collectively "Victims"’) are deaf

and use sign language for communication.

8. For effective communication with the victims in an emergency department setting

or during a hospitalization, the provision of appropriate auxiliary aids or services is necessary.

Ms. Gillespie and Mr. Irvine

9.

On November 1, 2003, Ms. Gillespie, accompanied by her husband, Mr. Irvine,

went to the emergency department at the Hospital. She was experiencing severe abdominal pain,

1Ms. Pokorski is not one of the named plaintiffs in Gillespie v. Dimensions Health Corp., d/b/a Laurel Regional Hospital, Case. No. DKC-05-CV-73 (D. Md.). Paper 20.

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nausea, and vomiting. 10. Ms. Gillespie and Mr. I_rvine informed emergency department personnel that they
were deaf and requested sign language interpreters. 11. Hospital personnel told Ms. Gillespie and Mr. Irvine that the Hospital did not
have interpreters. ¯ 12. Ms. Gillespie and Mr. Irvine repeatedly asked for a sign language interpreter. 13. Hospital personnel attempted to communicate orally with Ms. Gillespie. Hospital
personnel also often refused tocommunicate in writing with Ms. Gillespie, despite the fact that she repeatedly asked the personnel to transcribe their oral communications.
14. Approximately two hours after Ms. Gillespie’s arrival at the Hospital, Hospital personnel told Ms. Gillespie and Mr. Irvine that the Hospital had a videophone to provide video interpreting services.2
15. Hospital personnel told Ms. Gillespie and Mr. Irvine that they would have to wait to use the videophone because the room housing the videophone was occupied by another patient. After waiting an additional period of time, Hospital personnel transferred Ms. Gillespie to the room with the videophone.
16.. Initially, Hospital personnel did not know how to set up or use the videophone. Ms. Gillespie had to wait approximately 20 minutes before Hospital personnel connected the
2A videophone connected to a television monitor allows people in separate locations to have live face-to-face communications. The videophone includes a camera and transmits images via a high-speed Lntemet connection. When the videophone is connected to a remotely located interpreter ("video interpreter"), the TV shows a split screen of two live images: the interpreter on one side and a patient on the other side. The patient and the video interpreter see and sign to each other while the attending physician or other personnel communicate by voice.
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videophone to a video interpreter. Ms. Gillespie and Mr. Irvine communicated with a physician and staff through video interpreting services for approximately 10-15 minutes. The physician and staff said that they needed to take X-rays and run certain tests because they were concerned about Ms. Gillespie’s enlarged hem-t. Hospital persormel then terminated the use of the video interpreting service.
17. After that time, Hospital persormel did not provide Ms. Gillespie and Mr. Lrvine with video interpreting services again.
18. At a later point, in preparation for a CT scan, a Hospital staff member attempted to communicate with Ms. Gillespie by rudimentary gestures. Twice Ms. Gillespie gestured for him to write his instructions, but he refused.
19. Hospital persormel did not provide an interpreter or any other form of communication before or during the CT scan.
20. After another lengthy wait, a different doctor appeared and orally stated to Ms; Gillespie and Mr. Lrvine that she should be admitted to the Hospital for additional tests to determine the source of her pain. After Mr. Lrvine requested that the doctor use paper and pen to communicate with them, the doctor provided them with sparse written notes.
21. Ms. Gillespie and Mr. Irvine were confused about what the doctor said both orally and in writing. Ms. Gillespie informed the doctor through Mr. Lrvine that she wanted to leave the Hospital. In response, the doctor turned and began to leave the room.
22. Mr. Lrvine then asked about the earlier doctor’s reference to his wife’s heart being enlarged.
23. The doctor told Mr. Lrvine that Ms. Gillespie might want to return to a hospital for

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treatment in two to three days. 24. Mr. Irvine was confused and reluctant to have Ms. Gillespie discharged because of
his concerns about her health. However, Ms. Gillespie was so frustrated with the Hospital and her inability to communicate with the Hospital or understand what was happening that she and Mr. Irvine left the Hospital.
25. The next day, Ms. Gillespie was rushed to another hospital, admitted for several days, and treated for congestive heart failure.
26. During Ms. Gillespie’s November 1, 2003, hospital Visit, the Hospital did not provide effective communication with Ms. Gillespie and Mr. I_rvine.
", 27. Ms. Gillespie suffered physical and emotional injuries resulting from the Hospital’s conduct.
28. Mr. I_rvine suffered emotional injuries resulting from the Hospital’s conduct. Ms. Whitney
29. On December 24, 2003, Ms. Whitney sought emergency medical treatment at the Hospital for a dog bite.
30. Ms. Whitney and a deaf companion who accompanied her asked Hospital personnel for sign language interpreting services.
31. Hospital personnel attempted to use its videophone. After Hospital persofinei could not set up the videophone, Ms. WNtney’s deaf companion intervened, set up the videophone, and connected it to a video interpreter. The picture was blurry and Ms. WNtney could not clearly distinguish the arms and hands of the video interpreter and so did not understand the interpreter.
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32. The Hospital provided no other auxiliary aids to Ms. Whitney on December 24, 2003.
33. During Ms. Whitney’s December 24, 2003, hospital visit, the Hospital did not provide effective communication with her.
34. Ms. Whitney suffered emotional injuries resulting from the Hospital’s conduct during her December 24, 2003, hospital visit.
35. On April 25, 2004, Ms. Whitney sought emergency medical treatment at the Hospital when she experienced a high fever and vomiting.
36. Ms. Whitney was accompanied to the Hospital by another deaf companion. Ms. Whitney and this companion repeatedly requested on-site sign language interpreters.
..37. Ms. Whitney was so ill she lay down on a nearby bed in the emergency department. Unable to communicate effectively that they did not want her on the bed, Hospital personnel treated her roughly, dragging her off the bed and forcing her to lie on the floor of the emergency department.
38. Ms. Whitney was required to wait quite some time before the room with the videophone was made available to her. After Ms. Whitney was transferred to the room, she waited approximately an additional 30-40 minutes while Hospital personnel struggled to set up the videophone.
39. Due to her illness, Ms. Whitney was unable to sit up. 40. Hospital personnel connected the videophone to a video interpreter but did not adjust the videophone for a prone patient. Ms. Whitney, who was in a prone position, was unable to see clearly the screen displaying the video interpreter, and the interpreter could not see
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her.
41. Without asking either Ms. Whitney or her deaf companion whether Ms. Whimey’s companion could be used.as a relay interpreter, Hospital personnel used the companion to relay communication between Ms. Whimey and the video interpreter.
42. After receiving an anti-nausea medication and sleeping overnight, Ms. Whitney was discharged in the morning of April 26, 2004.
43. Hospital personnel did not provide nor request an on-site interpreter during Ms. Whitney’s April 25-26, 2004, visit.
44. During Ms. Whitney’s April 25-26, 2004, hospital visit, the Hospital did not provide effective communication with her.
45. Ms. Whitney suffered physical and emotional injuries resulting fi:om the Hospital’s conduct during her April 25-26, 2004, hospital visit.
46. On April 26, 2004, the day of Ms. Whitney’s discharge, Ms. Whitney’s symptoms worsened and she returned to the Hospital. She requested on-site sign language interpreters. Instead, Hospital personnel chose alternatives such as video interpreting services, lipreading, and handwritten notes. These alternatives did not ensure effective communication with Ms. Whitney.
47. ’ After Hospital personnel examined Ms. Whitney, they told her they suspected meningitis and ordered a spinal tap.
48. Ms. Whitney underwent a spinal tap. Neither prior to, nor during, Ms. Whitney’s spinal tap, did the Hospital provide her with any on-site interpreter, despite her repeated requests for one.
49. Neither the physician nor any other Hospital personnel ensured effective

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communication with Ms. Whitney regarding what the spinal tap entailed, nor did they effectively communicate any post-procedure instructions. Because she was not aware that she should remain immobile for a period of time following the procedure in order for her fluid pressure to equilibrate, Ms. Whitney did move and so experienced, and continues to suffer from, headaches, nausea, faintness, and an imbalance in equilibrium.
501 Ms. Whitney tested positive for meningitis and was admittedto the Hospital as an inpatient in the early morning of April 27, 2004, and was discharged in the evening of April 29, 2004.
51. On April 27, 2004, Ms. Whitney repeatedly requested a sign language interpreter for communications with the treating doctor and other Hospital personnel regarding her condition and treatment.
52. In the morning 0fApril 27, 2004, the Hospital attempted tO use video interpreting services in Ms. Whitney’s room, but the video interpreting service vendor was unable to provide an interpreter during that time.
53. During the daytime hours of April 27, 2004, the Hospital provided medical services to Ms. Whitney, but did not provide effective communication.
54. The Hospital obtained on-site interpreting services for Ms. Whitney for fewer than three hours in the evening of April 27, 2004, and for approximately ten hours on April 28, 2004.
55. Beginning in the evening of April 27, 2004, Ms. Whitngy’s hearing mother stayed with Ms. Whitney sporadically throughout the remainder of Ms. Whitney’s hospitalization.
56. On April 29, 2004, the Hospital did not secure interpreting services. 57. On April 29, 2004, without asking Ms. Whitney if her mother was an interpreter
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or if the Hospital could use her mother to facilitate communication between the Hospital and Ms. Whitney, Hospital personnel relied on Ms. Whitney’s mother to provide communication between Ms. Whitney’and the Hospital.
58. Ms. Whitney’s mother was not fluent in sign language and interpreting. Ms. Whitney’s mother was unable to interpret effectively, accurately, and impartially both receptively and expressively, nor could she interpret any specialized medical vocabulary.
59. On April 29, 2004, when Ms. Whitney was being discharged, the Hospital provided discharge instructions to Ms. Whitney’s mother instead of providing them to Ms. Whitney directly, and requested that her mother sign the discharge papers..
60. At no time on April 26-28, 2004, did the Hospital, despite Ms. Whitney’s requests, provide Ms. Whitney with a working telecommunication device for deaf persons ("TTY")3, so she was unable to use a telephone.
61. During most of Ms. Whitney’s April 26, 2004, emergency department visit, and April 27-29, 2004, hospitalization, the Hospital did not provide effective commttnication with her.
62. Ms. Whitney suffered physical and emotional injuries resulting from the Hospital’s conduct during her April 26, 2004, emergency department visit, and April 27-29, 2004, hospitalization.
Mr. Barbin 63. On March 19, 2004, Mr. Barbin sought medical treatment at the Hospital after
3A TTY is a special device that let~ people who are deaf, hard of hearing, or speech-impaired use the telephone to communicate, by allowing them to type messages back and forth to one another instead of talking and listening.
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being bitten on the face by a dog. He was accompanied by a companion who is hearing. Both men asked for sign language interpreting services several times.
64. Hospital personnel did not provide Mr. Barbin with either on-site or video interpreting services.
65. Without asking Mr. Barbin or his companion if his companion could be used as his interpreter, the Hospital used Mr. Barbin’s companion as a communication facilitator between Mr. Barbin and the Hospital.
66.. Mr. Barbin’s companion was not fluent in sign language and interpreting. The companion was unable to interpret effectively, accurately, and impartially both receptively and expressively, using any specialized medical vocabulary. In addition, the companion could not understand some of the medical terms used by Hospital personnel and would have to stop signing to ask what certain medical terms or phrases meant.
67. Mr. Barbin’s companion repeatedly asked that the Hospital provide an interpreter for Mr. Barbin, but his requests were ignored. When, on Mr. Barbin’s betialf, his companion again asked Hospital personnel for a sign language interpreter, Hospital personnel said, don’t have interpreters."
68. When Mr. Barbin and his companion requested that the triage nurse obtain an interpreter, the nurse said that the Hospital did not have an interpreter. Despite repeated protests, Hospital personnel used Mr. Barbin’s companion as a communication facilitator between Mr. Barbin and the personnel. The companion could not simultaneously interpret, but rather consecutively relayed to Mr. Barbin and Hospital personnel what was said or signed by the various personnel. Mr. Barbin’s communication with the Hospital was compromised because of
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the companion’s limited signing skills, expressive and receptive, compounded by his being very nauseated by the sight of Mr.. Barbin’s blood.
69. Mr. Barbin was fi-ustrated both by his companion’s limited ability as an interpreter and because Mr. Barbin had to bring his own language level down so that his companion could convey Mr. Barbin’s communication in simple terms more suited to the companion’s limited interpreting skills. The companion did not understand some of the medical terms and phrases being used and often would have to stop interpreting to ask Hospital personnel what a phrase or term meant.
70. During Mr. Barbin’s emergency department visit, the Hospital had a video interpreting service available but the Hospital did not offer to use it.
71. During Mr. Barbin’s hospital visit, the Hospital did not provide effective communication with him.
72. Mr. Barbin suffered emotional injuries resulting from the Hospital’s conduct during his March 19, 2004, emergency department visit.
Ms. Vadakin 73. On August 5, 2002, Ms. Vadakin drove herself to the Hospital’s emergency department during the night. She was in a severe state of depression, and was feeling tired and ill. She had not slept well for days. 74. Upon her arrival, Ms. Vadakin asked for an interpreter. The Hospital chose to use video interpreting services. 75. Ms. Vadakin was then called into an emergency treatment room but the room did not have a videophone. She asked the treating doctor about the videophone, but the doctor
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ignored her request. Instead, the doctor used lipreading and handwritten notes to communicate with Ms. Vadakin. The doctor often asked Ms. Vadakin to repeat what the doctor had said in order to ensure that she understood him. Ms. Vadaldn was in poor condition, physically and mentally, which made it difficult for her to concentrate and attempt to understand, or to guess, what the doctor was saying.
76. Ms. Vadakin was still fi-ustrated by her experience with the Hospital and she decided to leave the Hospital on the morning of August 6, 2002. She went home without either a prescription or a diagnosis.
77. Ms. Vadaldn was not provided with either on-site or video interpreting services during her hospital visit of August 5-6, 2002.
78. During Ms. Vadakin’s August 5-6, 2002, emergency department visit, the Hospital did not provide effective communication with her.
79. Ms. Vadakin suffered emotional injuries resulting from the Hospital’s conduct during her August 5-6, 2002, emergency department visit.
80. On April 26, 2003, Ms. Vadakin drove to the Hospital because she needed medication for her depression and anxiety. She had been unable to sleep for several days.
81. Upon her arrival at the Hospital on April 26, 2003, Ms. Vadakin asked for an interpreter.
82. The Hospital elected to use video interpreting services. 83. Hospital personnel were unable to operate the videophone. Observing the difficulty the personnel faced with the videophone, Ms. Vadakin requested that the Hospital provide her with an on-site interpreting service. The Hospital denied her .request. The attending
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doctor used written notes to communicate with Ms. Vadakin but because of her medical condition and fatigue, as well as the difficult-to-read handwriting of the doctor, she was unable to understand fully the communication.
84. During Ms. Vadakin’s April 26, 2003, emergency department visit, the Hospital did not provide effective communication with her.
85. Ms. Vadakin suffered emotional injuries resulting fi:om the Hospital’s conduct during her April 26, 2003, emergency department visit.
86. On August 12, 2004, Ms. Vadakin was transported by ambulance to the Hospital. She had asked the ambulance crew to take her to a different hospital because of her negative experiences with the Hospital but the crew insisted that she be taken to the Hospital.
87. Upon her arrival in the emergency department at the Hospital on August 12, 2004, Ms. Vadakin asked for an on-site interpreter.
88. The Hospital insisted on using video interpreting services. 89. Hospital personnel were unable to operate the videophone, though the personnel did attempt for approximately two hours to operate the videophone. 90. Observing the difficulty the Hospital personnel faced with the videophone, Ms. Vadakin then reiterated her request for an on-site interpreter. The Hospital denied her request. 91. After failing to operate the videophone, Hospital personnel used paper an.d pen to communicate with Ms. Vadakin, but the communication was limited to only basic and sparse information. 92. Ms. Vadakin became so fi-ustrated with the ineffective communication, especially
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given her medical condition, and the Hospital’s failure to obtain an interpreter, that she informed the Hospital she was fine simply so that she could be discharged.
93. During Ms. Vadakin’s August 12, 2004, emergency department visit, the Hospital did not provide effective communication with her.
94. Ms. Vadakin suffered emotional injuries resulting from the Hospital’s conduct during her August 12, 2004, emergency department visit.
Mr. Leffler 95. On October 27; 2003, Mr. Leffler sought emergency medical treatment at the Hospital for his sore throat. He was accompanied by his two companions, one hearing, and one deaf. Both Mr. Leffler and his hearing companion asked Hospital personnel for an interpreter. 96. Hospital personnel said that they were not sure if the Hospital had an interpreter. Instead, the personnel offered the use of the videophone. 97. Despite Mr. Leffler’s and the hearing companion’s protests claiming that the hearing companion was not qualified as an interpreter, Hospital personnel used the hearing companion to interpret consecutively between the personnel and Mr. Leffler during triage. 98. After triage, because Mr. Leffler understood that the Hospital would be providing him with video interpreting services, he told his two companions to leave the Hospital. Mr. Leffler’s companions left the Hospital at that time. 99. After Mr. Leffler had been sitting in the waiting room for approximately 30 minutes, Hospital personnel advised him that the videophone was not available and asked him if he was able to read lips. Mr. Leffler told the personnel that he did not read lips well and that writing would be better. Hospital personnel nevertheless insisted on trying to communicate with
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Mr. Leffler through lipreading. 100. Hospital personnel wrote on the triage form that Mr. Leffler "needs interpreter";
however, the personnel made no attempt to secure interpreting services for Mr. Leffler. 101. When the attending doctor arrived to examine Mr. Leffler, the doctor first asked
Mr. Leffler if he could read lips. Mr. Leffler indicated that his lipreading skills were "not great" and he wrote a note to the doctor requesting an interpreter. The doctor ignored this request.
102. The doctor examined Mr. Leffler without an interpreter. The doctor tried to communicate with Mr. Leffler though written notes, but this method of communication was ineffective.
103. The doctor became frustrated and impatient having to communicate with Mr. Leffler in this fashion, and rushed through his examination.
104. When Mr. Leffler tried to ask the doctor questions, the doctor cut him short. Instead, the doctor simply wrote him a prescription and abruptly ended the examination.
105. Because the communication provided to Mr. Leffler by the Hospital was so ineffective, he left the Hospital unsure of his diagnosis and whether he had strep throat, which generally requires follow-up care, or simply a sore throat.
106. During Mr. Leffler’s October 27, 2003, emergency department visit, the Hospital did not provide effective communication with him.
107. Mr. Leffler suffered emotional injuries resulting from the Hospital’s conduct during his October 27, 2003, emergency department visit.
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Ms. Porras 108. On May 5, 2003, Ms. Porras’ adult hearing son was taken to the emergency department at the Hospital because of recurrent seizures. During Ms. Porras’ visit to the emergency department, her son was in and out of consciousness and, at times, unable to respond to Hospital personnel. 109. Upon arriving at the Hospital, Ms. Porras, through her hearing daughter, requested an interpreter in order to communicate with Hospital personnel regarding Ms. Porras’s son’s condition and care. Hospital personnel denied this request, and explained that sign language interpreting services were available only for deaf patients and that since Ms. Porras was not a patient, the personnel would not provide Ms. Porras with an interpreter. Ms. Porras’s daughter, who is a certified sign language interpreter, volunteered to provide interpreting services to facilitate communication between Ms. Porras and Hospital personnel. The personnel refused the daughter’s offer for interpreting services. 110. Ms. Porras’ daughter again asked Hospital personnel to allow her to accompany Ms. Porras into her son’s room in order to provide interpreting services for Ms. Porras and Hospital personnel. Hospital personnel, apparently enforcing a one-person-at-a-time visitation policy, refused this request. 111. Ms. Porras’ daughter informed Hospital personnel that Ms. Porras would not be able to understand written commnnication because her English skills were so basic. 112. Ms. Porras’ daughter asked the Hospital to utilize video interpreting services, but the Hospital refused this request. 113. Ms. Porras entered her son’s room alone, but she was completely unable to
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communicate with Hospital personnel. 114. Ms. Porras was fi-ustrated and angry that Hospital personnel did not communicate
with her. 115. Because the Hospital did not provide any auxiliary aids or services for effective
communication with Ms. Porras, Ms. Porras was excluded fi:om any discussions regarding her son’s medical history, medical tests, diagnosis and follow-up care.
116. At the time of Ms. Porras’ son’s discharge, the Hospital chose Ms. Porras’ daughter, who was not allowed in the room with her brother most of the time, instead of Ms. Porras, to sign the son’s discharge papers.
117. Ms. Porras left the Hospital confused about what tests and procedures had been administeredto her son, as well as his diagnosis and requisite follow-up care. Ms. Porras was very concerned that her son was being discharged, given his poor condition..
118. Ms. Porras’ son subsequently was hospitalized at a different hospital for ’, approximately one week with brain abscesses.
119. During Ms. Porras’ May 5, 2003, emergency departmentvisit, the Hospital did not provide effective communications with her.
120. Ms. Porras suffered emotional injuries resulting fi:om the Hospital’s conduct during her May 5, 2003, emergency department visit.
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Ms. Pokorski 121. In preparation for inpatient surgery on March 2, 2004, Ms. Pokorski called the Hospital during the second week of February 2004, using an interpreter in her office, to arrange for interpreting services for her surgery and subsequent recovery in the Hospital. Ms. Pokorski asked the Hospital if the Hospital would cover the costs of Ms. Pokorski’s own interpreter. 122. The Hospital refused to cover the costs of Ms. Pokorski’s own interpreter and stated that it had its own contract interpreting service. The Hospital gave Ms. Pokorski the wrong name of the contracting service; Ms. Pokorski was not familiar with any service by that name, nor the reputation of its interpreters. When Ms. Pokorski asked for additional information about the contractor and its interpreting service, the Hospital refused to provide her with that information. The Hospital also offered to use video interpreting services, butMs. Pokorski had heard negative things about these services and, not understanding how to use them, declined.. The Hospital ’informed Msi Pokorski that she should contact the Hospital if she wanted it to provide an interpreter from its contracting service. 123. After that date and prior to the day of her surgery on March 2, 2004, Ms. Pokorski did not again request that she be provided with an interpreter by the Hospital because she thought it would be futile to make such a request, nor did the Hospital raise it with her. 124. On March 2-4, 2004, Ms. Pokorski was operated on and recuperated in the Hospital without the provision of any interpreting services or other auxiliary aids and services by the Hospital. 125. At no time while she was in the Hospital did any Hospital personnel or physicians ask her whether she wanted or needed an interpreter.
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126. Without asking Ms. Pokorski if her mother was an interpreter, or whether she could serve as an interpreter, the Hospital used Ms. Pokorski’s mother as a communication facilitator between the Hospital and Ms. Pokorski.
127. Ms. Pokorski’s mother is hearing and was not fluent in sign language and interpreting. Ms. Pok0rski’s mother was unable to interpret effectively, accurately, and impartially both receptively and expressively, nor could she use any specialized medical vocabulary.
128. Ms. Pokorski’s mother had difficulty comprehending Hospital personnel’s communication regarding her daughter’s condition and treatment.
129. Hospital personnel did not attempt to communicate with Ms. Pokorski in any way, instead communicating solely with her mother regarding Ms. Pokorski’s condition and treatment.
130. Ms. Pokorski felt frustrated, angry, and ignored by the Hospital. 131.. During Ms. Pokorski’s hospitalization, the Hospital did not provide effective communications with her. 132. Ms. Pokorski suffered emotional injuries resulting from the Hospital’s conduct during her March 2-4, 2004, hospitalization. 133. On information and belief, the Hospital has discriminated against others who are deaf and use sign language for communication by failing to provide effective communication with them; and, as a result, they suffered similar injuries.
CAUSE OF ACTION 134. As described above, the defendant discriminated against the victims and other individuals who are deaf, by excluding them from participation in and denying them the benefits
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of its services,programs, or activities, and by subjecting them to discrimination on the basis of disability, in violation of section 302 of title l~I of the ADA, 42 U.S.C. § 12182, and its implementing regulations at 28 C.F.R. Part 36.
135. The defendant has discriminated against the victims and other individuals who are deaf by, inter alia:
(A) Failing to provide the victims and other individuals who are deaf appropriate auxiliary aids and services, including qualified interpreters and exchange of written notes, when necessary to afford the individuals an equal opportunity to enjoy the benefits of the services, programs, or activities of the Hospital, in violation of section 302(b)(2)(A)(iii) of title Ill of the ADA, 42 U.S.C. § 12182(b)(2)(A)(iii), and its implementing regulation at 28 C.F.R. § 36.303(c);
(B) Providing a service that is not as effective in affording equal opportunity to obtain the same result as that afforded to others by failing to provide appropriate auxiliary aids and services to the victims and other individuals who are deaf and who seek hospital services at the Hospital, in violation of section 302(b)(1)(A)(ii) of title [[I of the ADA, 42 U.S.C. § 12182(b)(1)(A)(ii), and its implementing regulation at 28 C.F.R. § 36.202;
(C) Failing to provide TTYs upon request by plaintiffs in violation of section 302(b)(1)(A)(ii) of title Ill of the ADA, 42 U.S.C. § 12182(b)(1)(A)(ii), and its implementing regulation at 28 C.F.R. § 36.202; and
(D) Failing to make reasonable modifications in policies, practices, and procedures that restrict the availability of appropriate auxiliary aids and services, including the policies of one-person-at-a-time visitations and of interpreters-only-for-patients, as necessary to ensure effective communication with individuals who are deaf, in violation of section 302(b)(2)(A)(ii)
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of title III of the ADA, 42 U.S.C. § 12182(b)(2)(A)(ii), and its implementing regulation at

28 C.F.R. § 36.302.

136. The victims and other individuals who are deaf and use sign language for

’ communication have been and will continue to be harmed if they returnto this Hospital for

hospital services if the Hospital does not comply with the requirements of title II[ of the ADA, 42

U.S.C. §§ 12181-12188, and 28 C.F.R. Part 36.

PRAYER FOR RELIEF

WHEREFORE, the United States prays that the Court grant the following relief-

(A) Declare that the practices, policies, and procedures of the defendant, as set forth

above, violate title I~ of the Americans with Disabilities Act, 42 U.S.C. §§ 12181-12188, and the

Department of Justice’s implementing regulation, 28 C.F.R. Part 36;

03) Enjoin the defendant, its officers, agents, and employees, and all other persons in

active concert or participation with any of them, from violating the requirements of title I~ of the

ADA;
(c)

Order the defendant to provide individuals who are deaf with appropriate auxiliary

aids and services, including qualified sign language and oral interpreters, TTY’s, writing

materials, and written colrmaunications, when necessary for effective communication;

(D) Order the defendant to ensure that video interpreting services deliver high quality,,.

clear, delay-free full-motion video and audio over a dedicated high-speed Internet connection;

provide clear and sharply delineated pictures of the heads, arms, hands, and fingers of the deaf

individual, regardless of body position, and the video interpreter; and ensure that voices being

transmitted are clear and easily understood;

22

Case 8:05-cv-00073-DKC Document 79-1 Filed 07/17/2006 Page 23 of 25
(E) Order the defendant to ensure that Hospital personnel are trained and able to operate and cormect the videophone quickly and efficiently and are available at the Hospital at all times; and that Hospital personnel are trained regarding the limitations of the videophone;
(F) Order the defendant to develop and implement a plan to~ provide all appropriate auxiliary aids and services when required for effective communication with individuals who are deaf;
(G) Order the defendant to design and implement appropriate staff training programs to ensure that all Hospital personnel who have contact with members of the public are knowledgeable about the policies related to the provision of services to persons who are deaf, including that each such person knows how to secure appropriate auxiliary aids and services for persons who are deaf;
(H) " -Enjoin the defendant, its officers, agents, and employees, and all other persons in active concert or participation with any of them, from discriminating against any individual because that individual has opposed any act or practice which is unlawful under the ADA, or because that individual made a charge, testified, assisted, or participated in this action;
(I) Enjoin the defendant, its officers, agents, and employees, and all other persons in active concert or participation with any of them, from coercing, intimidating, threatening, or interfering with any individual in the exercise or enjoyment of the civil rights at issue in this action;
(J) Award monetary damages to the victims, and all other persons who where harmed by the defendant, to compensate them for injuries resulting from such discrimination, including damages for pain and suffering.
23

Case 8:05-cv-00073-DKC Document 79-1 Filed 07/17/2006 Page 24 of 25 (K) ¯ Assess a civil penalty against the defendant as authorized by 42 U.S.C.
§ 12188(b)(2)(C), to vindicate the public interest; and (L) Order such other appropriate relief as the interests of justice may require.
24

Case 8:05-cv-00073-DKC Document 79-1 Filed 07/17/2006 Page 25 of 25
DEMAND FOR JURY TRIAL The United States demands a trial by jury. Dated this/_~ay of "--] ~ , ZOO ~,
ALBERTO R. GONZALES Attorney General of the United States

ROD J. ROSENSTEIN United States Attorney

ASSISTANT AT--,TORNEY GENERAL Civil Rights Division

JO~I~ L. WODATCH, Chief
L. ~/~ENE BOW-EN, Deputy Chief PI-I~IP L. BREEN, Special Legal Counsel Disability Rights Section Civil Rights Division

JAMIE M. BENNETT Assistant United States Attorney
Office of the U.S. Attorney District of Maryland 36 South Charles Street Fourth Floor Baltimore, Maryland 21201 Tele: 410-209-4800

ROBERT J. MATHER KATHLEEN S. DEVINE Trial Attorneys Disability Rights Section Civil Rights Division U.S. Department of Justice 950 Pelmsylvania Avenue NW Washington, D.C. 20530 Telephone: (202) 307:2236 (Mather) Telephone: (202) 307-0480 (Devine)

25

 
 369 F.Supp.2d 636 (2005)
Elizabeth GILLESPIE, et al. v.
DIMENSIONS HEALTH CORPORATION d/b/a Laurel Regional Hospital.
No. CIV.A. DKC 2005-0073.
United States District Court, D. Maryland.
May 16, 2005.
637 *637 David A. Last, Elizabeth Elaine Gardner, Lewis S. Wiener, Thomas Robinson Bundy, III, Washington, DC, for Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler and Ziomara Porras.
Pamela J. White, Baltimore, MD, for Dimensions Health Corporation d/b/a Laurel Regional Hospital.
MEMORANDUM OPINION
CHASANOW, District Judge.
Presently pending and ready for resolution in this disability discrimination action is the motion by Defendant Dimensions Health Corporation d/b/a Laurel Regional Hospital to dismiss count I of Plaintiffs' complaint[1] (Paper 10) pursuant to Fed.R.Civ.P. 12(b)(6). The issues have been fully briefed and the court now rules, no hearing being deemed necessary. Local Rule 105.6. For the following reasons, Defendant's motion will be granted in part and denied in part.
I. Background
A. Factual Background
The following facts have been alleged by Plaintiffs Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Hale, Brian Leffler, and Xiomara Porras. Plaintiffs are deaf individuals who have sought and received medical treatment at Defendant Laurel Regional Hospital ("Laurel Regional") either for themselves, or, in one instance, for a child. To communicate effectively in medical situations, Plaintiffs require a live, qualified sign language interpreter. On multiple occasions when Plaintiffs visited Laurel Regional independent from one another, they made repeated requests for the assistance of a live and in-person, qualified sign language interpreter to enable them to communicate effectively with hospital personnel in order to participate in their medical treatment. On each occasion, despite specific and repeated requests for live interpreter services, the hospital refused to comply with Plaintiffs' requests. Rather, on several occasions, Plaintiffs were forced "to 638 communicate through cryptic notes or lip-reading,... an extremely speculative means of *638 communication." Paper 20, ¶ 4. Additionally, in some instances, rather than communicating with an in-person interpreter, Plaintiffs were able to utilize a Video Remote Interpreting ("VRI") device, which proved to be an insufficient mode of communication.[2]
For example, on November 1, 2003, Plaintiff Elizabeth Gillespie, accompanied by her hearing impaired husband, Plaintiff David Irvine, sought medical treatment at Laurel Regional's emergency room for, among other things, severe abdominal pain, nausea, and vomiting. After being admitted due to her serious medical condition, both she and her husband requested a live, in-person interpreter in order to communicate with the doctors, nurses, and hospital staff. Plaintiffs were told the hospital did not have any sign language interpreters. After some time had passed, and repeated requests for an interpreter went unanswered, Gillespie and Irvine were informed that the hospital had a VRI device they could utilize. However, the device was unavailable at that time because it was being used by another patient. Approximately two hours later, Gillespie was moved to the room containing the

VRI device, but, in the interim, she alleges she was unable to communicate with the hospital staff and did not understand the medical advice or treatment she received during that time period. Moreover, after moving her to the room with the VRI, it took the hospital staff approximately twenty to thirty minutes to set up the device due to "improper[] and inadequate[] train[ing.]" Paper 20, ¶ 21. Once the VRI device was operational, Gillespie and Irvine engaged in an approximate ten minute consultation with the doctor, during which time he informed her that he did not know what was causing her pain, and that he was ordering an x-ray and, possibly, a CT-scan.
Following this consultation, and during all subsequent tests, procedures, and doctor consultations, Laurel Regional failed and/or refused to provide access to the VRI device, and denied Gillespie and Irvine's repeated requests for a live sign language interpreter or an effective alternative mode of communication. Rather, the hospital staff insisted on speaking verbally to Gillespie and Irvine despite the fact that Irvine cannot read lips and Gillespie's ability to read lips was compromised by her medical condition. Occasionally, the hospital staff would write notes to communicate with Gillespie and Irvine, but only "in a few select and extreme circumstances and only after Ms. Gillespie begged and continuously motioned for some sort of communication." Id., ¶ 22. Even then, the hospital staff limited its writing to a "few words." Id.
After the initial x-ray, a doctor returned and verbally informed them that Gillespie had an enlarged heart and that she would need to undergo a CT-scan. Because this information was communicated only verbally, Plaintiffs "did not fully understand the doctor's diagnosis or the medical treatment [Gillespie] was going to receive." Id., ¶ 23. After a few hours had elapsed, a male hospital attendant arrived to take Gillespie to the CT-scan room. Neither 639 Gillespie nor Irvine could understand the attendant's instructions to them, nor the *639 procedure which she was about to undergo. Further, despite repeatedly indicating to the attendant their desire to communicate in writing, he refused to comply. Rather, apparently to indicate that Gillespie was to remove some of her clothing for the procedure, the attendant pulled on and snapped her bra strap. Id., ¶ 25. As a result, Gillespie refused to undergo the CT-scan unless a female nurse was present. Eventually, however, Gillespie underwent the procedure.
After a few more hours elapsed, a doctor appeared to inform Gillespie that additional tests were needed to determine the source of the pain. During this consultation, the doctor primarily communicated with Gillespie and Irvine verbally, but, per Irvine's request, sparsely used written notes. However, these notes were "short, confusing and cryptic." Id., ¶ 28. At this time, feeling exasperated with her treatment and uninformed about her medical condition due to the hospital's failure to communicate with Plaintiffs adequately, Gillespie informed the doctor that she wanted to leave. Plaintiffs allege that the doctor "cavalierly recommended that Ms. Gillespie go to another emergency room at a different hospital for treatment." Moreover, the discharge papers and written materials given to Gillespie upon their departure failed to mention the heart condition which the hospital had earlier detected.
The other Plaintiffs in this action allege similar experiences during their visits to Laurel Regional. All of them requested a live, in-person sign language interpreter in order to communicate effectively with the hospital staff; all of their requests went unfulfilled. In those situations where the VRI device was utilized as an alternative method of communication, it was wholly ineffective, either because the staff was inadequately trained and unable to operate the VRI device, because Plaintiffs were unable to understand the video interpreter due to the poor quality of the video transmission, or both.[3] As a consequence, Plaintiffs content that they have been denied the benefit of effective communication with physicians and other health care providers, denied the opportunity to participate in their treatment, and denied the full benefit of the health care services provided by Laurel Regional.
B. Procedural Background
On January 11, 2005, Plaintiffs filed suit, alleging that Laurel Regional violated the Americans with Disabilities Act ("ADA"), 42 U.S.C. §§ 12101 et seq., and § 504 of the Rehabilitation Act, 29 U.S.C. § 794, by failing to provide Plaintiffs with an appropriate auxiliary aid necessary to ensure effective communication, thereby denying them full and equal medical treatment because of their disability. Plaintiffs allege that Laurel Regional's unlawful conduct has directly caused Plaintiffs to sustain past and continuing physical and emotional injuries. They further allege 640 that Plaintiffs "have suffered, are suffering, and will continue to suffer irreparable injury as a *640 result of [Laurel Regional's] pattern and practice of discrimination." Id., ¶ 74.
On February 10, 2005, Defendant filed a motion to dismiss, pursuant to Fed.R.Civ.P. 12(b)(6), Plaintiffs' ADA claim (count I). Defendant contends that because injunctive relief is the only remedy available to Plaintiffs under

count I, Plaintiffs lack standing to assert this claim, and, accordingly, count I must be dismissed. For the following reasons, Defendant's motion will be granted as to Plaintiffs Whitney and Leffler, but denied as to the remaining Plaintiffs.
II. Standard of Review
The purpose of a motion to dismiss pursuant to Fed.R.Civ.P. 12(b)(6) is to test the sufficiency of the plaintiff's complaint. See Edwards v. City of Goldsboro, 178 F.3d 231, 243 (4th Cir.1999). Accordingly, a 12(b)(6) motion ought not be granted unless "it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief." Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957). Except in certain specified cases, a plaintiff's complaint need only satisfy the "simplified pleading standard" of Rule 8(a), Swierkiewicz v. Sorema N.A., 534 U.S. 506, 513, 122 S.Ct. 992, 152 L.Ed.2d 1 (2002), which requires a "short and plain statement of the claim showing that the pleader is entitled to relief." Fed.R.Civ.P. 8(a)(2).
In its determination, the court must consider all well-pled allegations in a complaint as true, see Albright v. Oliver, 510 U.S. 266, 268, 114 S.Ct. 807, 127 L.Ed.2d 114 (1994), and must construe all factual allegations in the light most favorable to the plaintiff. See Harrison v. Westinghouse Savannah River Co., 176 F.3d 776, 783 (4th Cir.1999) (citing Mylan Laboratories, Inc. v. Matkari, 7 F.3d 1130, 1134 (4th Cir.1993)). The court must disregard the contrary allegations of the opposing party. See A.S. Abell Co. v. Chell, 412 F.2d 712, 715 (4th Cir.1969). The court need not, however, accept unsupported legal allegations, Revene v. Charles County Comm'rs, 882 F.2d 870, 873 (4th Cir.1989), legal conclusions couched as factual allegations, Papasan v. Allain, 478 U.S. 265, 286, 106 S.Ct. 2932, 92 L.Ed.2d 209 (1986), or conclusory factual allegations devoid of any reference to actual events, United Black Firefighters v. Hirst, 604 F.2d 844, 847 (4th Cir.1979).
III. Analysis
Title III of the ADA applies to privately operated public accommodations, including hospitals, and prohibits discrimination "on the basis of disability in the full and equal enjoyment of goods, services, facilities, privileges, advantages, or accommodations." 42 U.S.C. ¶ 12182(a). Although Title III does not allow a private party to seek damages, it does provide for injunctive relief. Dudley v. Hannaford Bros. Co., 333 F.3d 299, 304 (1st Cir.2003); Pickern v. Holiday Quality Foods, Inc., 293 F.3d 1133, 1136 (9th Cir.2002); Proctor v. Prince George's Hosp. Ctr., 32 F.Supp.2d 820, 824 (D.Md.1998). To establish standing for injunctive relief, a plaintiff must first demonstrate that he will suffer an injury in fact which is (a) concrete and particularized and (b) actual or imminent, not conjectural or hypothetical. See Lujan v. Defenders of Wildlife, 504 U.S. 555, 560-61, 112 S.Ct. 2130, 119 641 L.Ed.2d 351 (1992).[4] Regarding an "injury *641 in fact," the Supreme Court has explained that "[p]ast exposure to illegal conduct does not in itself show a present case or controversy regarding injunctive relief ... if unaccompanied by any continuing, present adverse effects." City of Los Angeles v. Lyons, 461 U.S. 95, 102, 103 S.Ct. 1660, 75 L.Ed.2d 675 (1983) (quoting O'Shea v. Littleton, 414 U.S. 488, 495-96, 94 S.Ct. 669, 38 L.Ed.2d 674 (1974)). In Lyons, the Court held that a plaintiff who had been subjected to a "chokehold" by the Los Angeles police would have had to allege not only that he would have another encounter with the police, but that he was likely to suffer similar injury during that encounter in order to obtain injunctive relief. Lyons, 461 U.S. at 105-06, 103 S.Ct. 1660. "Absent a sufficient likelihood that he will again be wronged in a similar way," the Court stated, "Lyons is no more entitled to an injunction than any other citizen of Los Angeles." Id. at 111, 103 S.Ct. 1660.
In support of its argument, Defendant cites to several ADA opinions, including two from this court, which have held that the plaintiffs lacked standing to pursue injunctive relief. It asserts that the "plain and inescapable conclusion given the [cited] body of law is that Plaintiffs simply lack standing to pursue injunctive relief under Title III of the ADA because they face no real and immediate threat of harm." Paper 18 at 16. A careful reading of these cases, however, demonstrates that Defendant's reliance is misplaced.
In Proctor, a hearing-impaired plaintiff sued the medical center ("PGHC") that treated him for severe injuries arising from a motorcycle accident, alleging that he was denied live interpretive services during the course of his treatment, in violation of Title III of the ADA. 32 F.Supp.2d at 821. Raising the issue of standing sua sponte, this court dismissed his Title III claim on the basis that he had failed to "demonstrate the requisite predicate for seeking" injunctive relief. Id. at 824. Citing some of the same cases on which Defendant now relies, the court

concluded that Proctor had failed to show an injury in fact, i.e., a real and immediate threat of future injury at the hands of the defendant. The court stated:
By now, several months have passed since Plaintiff was discharged from PGHC. Thus, even if Plaintiff correctly alleges that he was the victim of discrimination, the present record does not reflect any on-going discrimination against him or that he is likely to return to PGHC in the near future. While the [Office for Civil Rights of the United States Department of Health and Human Services'] findings do not have binding effect in this court, the complaints and order evidence that issues have arisen regarding whether PGHC is in compliance with the ADA. However, the relevance of the past complaints is limited by the fact that the hospital subsequently amended its policy designed to prevent violations. Plaintiff has not challenged the policy's adequacy. Instead, Mr. Proctor contends that PGHC failed to follow it when treating him. Additionally, Plaintiff must demonstrate that any violation resulted from conditions that make repeated violations likely if Mr. Proctor should return to PGHC.
642 Id. at 825.[5] Accordingly, the court concluded that on the record it had before it, *642 it was "unlikely an injunction would be appropriate." Id.
Similarly, in Falls v. Prince George's Hospital Center, 1999 WL 33485550, at *1 (D.Md. Mar.16, 1999), this court entered judgment in favor of the defendant, PGHC, on the plaintiff's ADA claim because "there was [no] `actual and imminent' threat" to the plaintiff's hearing-impaired daughter's rights, and, thus, "she [did] not have standing to seek injunctive relief." 1999 WL 33485550, at *6. Critical to this court's conclusion was that the record neither reflected any on-going discrimination by PGHC against the plaintiff's daughter, nor that she was likely to return to PGHC in the near future. Indeed, the plaintiff stated in her deposition that she did not want to use the services of PGHC again, even if her daughter was "near death." Id. Accordingly, the plaintiff was unable to establish that her daughter faced "a real and immediate threat of future harm from Defendant, and not merely a conjectural or hypothetical threat." Id.
Those cases are significantly different than this one. First, both Proctor and Falls involved plaintiffs alleging violations of the ADA based on one visit to PGHC, as opposed to multiple plaintiffs, some of whom are alleging multiple violations on multiple occasions. See Paper 20, ¶¶ 18, 31, 36, 53, 55, 56. Second, in both Proctor and Falls, the hospital provided, or made arrangements to provide, an interpreter for part of the plaintiffs' respective visits, although for the bulk of their stay, interpreters were not provided. Proctor, 32 F.Supp.2d at 824; Falls, 1999 WL 33485550, at *4. In stark contrast, Plaintiffs allege in this case that despite their repeated requests for a live and in-person interpreter, none was ever provided, and that the VRI device the hospital sparingly attempted to utilize was utterly ineffective. Moreover, in both Proctor and Falls, the records reflected that neither plaintiff was likely to return to PGHC in the near future. Proctor, 32 F.Supp.2d at 825; Falls, 1999 WL 33485550, at *6. As mentioned above, Ms. Falls testified in her deposition that she would not take her daughter back to PGHC, even if she was "near death." In contrast, Plaintiffs Gillespie, Irvine, Barbin, Hale, and Porras have alleged that they have "sought and received, and will likely continue to seek, medical treatment" from Laurel Regional for themselves and their family members. Paper 20, ¶¶ 9, 10, 12, 13, 15. This allegation is buttressed by the proximity of Laurel Regional to their homes. Each of these five allege that they live between two and five miles from the hospital, making it the closest and most convenient medical center to their homes. See id. Far from alleging that they will never visit Laurel Regional again, these Plaintiffs allege that they will likely continue to seek medical treatment there. This is further supported by the fact that Gillespie and Hale both made repeated visits to Laurel Regional even after being denied the services of a sign language interpreter on previous visits. Id., ¶¶ 18 (Gillespie), 55-56 (Hale).
Finally, Plaintiffs are alleging that they have been injured, and will likely continue to be injured, by Defendant's "policies, pattern, and practice." Id., ¶¶ 74, 75. In contrast, in Proctor, prior to the plaintiff's encounter with PGHC, 643 it had amended its policy in order to prevent ADA violations. Thus, this court made clear that Proctor *643 was not "challeng[ing] the policy's adequacy," but rather "that PGHC failed to follow it when treating him." Proctor, 32 F.Supp.2d at 825. Similarly, in Falls, the plaintiff was not challenging the policy of PGHC, which, according to the then-existing PGHC Guide to Services, was that "sign language interpreters [were] available upon request." 1999 WL 33485550, at *4. Indeed, on a previous visit to PGHC, Ms. Falls had utilized an interpreter for her daughter. Id., at *3. Rather, Ms. Falls brought suit on the basis that during her last, and according to her, final visit to PGHC,

it failed to provide interpreters despite repeated requests. Id., at **3-4. Thus, she was not challenging PGHC's policy, but rather its failure to observe it.
This critical difference makes it less likely that the plaintiffs in Proctor and Falls would be aggrieved in the event of a future visit to PGHC than Plaintiffs here would be during future visits to Laurel Regional. Given that Plaintiffs have alleged that it is the policy, pattern, and practice of Laurel Regional to not provide live, in-person, qualified sign interpreters, but rather to resort to occasional and sporadic note-taking, and to a VRI device that its staff is allegedly improperly and inadequately trained on, and which on numerous occasions proved ineffective due to the quality of the picture, it is likely that Plaintiffs will be harmed again if and when, as they allege, they return to Laurel Regional. See Proctor, 32 F.Supp.2d at 825 ("Additionally, Plaintiff must demonstrate that any violation resulted from conditions that make repeated violations likely if Mr. Proctor should return to PGHC.") (emphasis added). Accordingly, reliance on this court's previous rulings in Proctor and Falls is misplaced.
Neither do the cases Defendant cites from outside this district support its position. First, in Aikins v. St. Helena Hosp., 843 F.Supp. 1329 (N.D.Cal.1994), the court dismissed the plaintiff's claim for injunctive relief under Title III because the plaintiff "ha[d] not shown that defendants' alleged discrimination [was] on-going and that she [was] likely to be served by defendants in the near future." Id. at 1334. Indeed, this latter point would have been difficult for the plaintiff to demonstrate given that she merely owned a mobile home near the defendant hospital and only stayed there "several days each year." Id. at 1333.[6]
In Schroedel v. New York Univ. Med. Ctr., 885 F.Supp. 594 (S.D.N.Y.1995), the court dismissed the plaintiff's claim for injunctive relief on standing grounds because the defendant hospital was "not the nearest medical center to either [the plaintiff's] residence or place of employment," the plaintiff had not alleged that "she regularly utilizes the services of the Hospital for any specific medical condition," and, on two prior occasions before the events giving rise to the cause of action, the plaintiff had visited a different hospital. Id. at 599.
Finally, in Freydel v. New York Hosp., 2000 WL 10264 (S.D.N.Y. Jan.4, 2000), the court dismissed the plaintiff's 644 claim for injunctive relief on standing grounds because there were "eleven [health] care centers *644 closer to
[the plaintiff's] home" than the defendant hospital. Id., at *3. Additionally, her primary care physician no longer worked at the defendant hospital, "thus severing [the plaintiff's] previous link with the institution." Id. Perhaps most important, however, was the fact that the hospital "ha[d] amended its policy of providing translation services in ways which [made] a recurrence of [the] alleged violation of her rights even more unlikely." Id. Thus, even if the plaintiff were to return to that particular hospital, its new policy made it unlikely that she would experience the same treatment.
All three of these cases present critically different factual situations from the one set forth by Plaintiffs, who assert that the alleged discrimination is an ongoing manifestation of Laurel Regional's policy and practice, and where five of the Plaintiffs continue to reside within two to five miles of the hospital, supporting their assertions that they likely will seek treatment there in the future.[7] Accordingly, these cases provide little or no support for Defendant's position.
The main cases to which Defendant cites, arguably beginning with Aikins, 843 F.Supp. 1329, all hold that injunctive relief is not available for isolated instances of medical personnel refusing to provide auxiliary aids to patients who have not alleged or demonstrated a likelihood of seeking and being denied treatment without the necessary aids in the future. "However, where a public accommodation in the health care field adheres to its policies of refusing to provide the requested auxiliary aid or has denied treatment altogether to an individual who seeks to receive treatment at the facility, injunctive relief may be available." Majocha v. Turner, 166 F.Supp.2d 316, 325 (W.D.Pa.2001). In Majocha, the plaintiffs filed suit under the ADA and Rehabilitation Act against a doctor and his partners for the doctor's refusal to supply a qualified interpreter during a medical consultation for their fifteen month old son. The plaintiffs averred that they would still like their son to be evaluated and treated by the defendants, but "that they [were] prevented from doing so because defendants steadfastly refuse[d] to alter their procedures for dealing with hearing impaired parents." Id. at 325. The evidence suggested that the doctor who the plaintiffs initially saw, and to whom they would like to take their son in the future, always used written 645 communications by notes in such cases and intended *645 to continue that practice despite plaintiffs' exertion of rights claimed under the ADA. Id. Accordingly, the court concluded that the plaintiffs did have standing to seek

injunctive relief, and that "they [would] have the opportunity to prove their case for such relief at trial." Id.; see also Mayberry v. Von Valtier, 843 F.Supp. 1160, 1166 (E.D.Mich.1994) (holding plaintiff may seek injunctive relief under Title III of the ADA where doctor refused to treat deaf patient because she did not want to provide a sign interpreter and where evidence suggested she would not revise her policy and "intended to refuse to hire an interpreter in the future"); cf. Dudley v. Hannaford Bros. Co., 146 F.Supp.2d 82 (D.Me.2001) (where defendant declines to revise its policies which resulted in discrimination against plaintiff on the basis of his alleged disability, plaintiff is not required to perform a futile act of seeking the services again; injunctive relief is available), aff'd, 333 F.3d 299 (1st Cir.2003) (Dudley II) (stating that "while there is no absolute certainty that Dudley would be denied the right to purchase alcoholic beverages during a future visit to [defendant's store], the likelihood of a denial seems substantial. No more is exigible to support a Title III right of action.").
Similarly, Plaintiffs allege that they have been harmed, and will likely continue to be harmed, by the policy, pattern, and practice of Defendant. Their claim is not that Defendant acted contrary to an ADA compliant policy, but rather that the existing and on-going policy and practice itself violates their rights under the ADA. This claim is supported by the allegations that on multiple occasions, Laurel Regional has denied requests to provide live, inperson interpreters, and instead, has attempted to utilize alternative, and allegedly, ineffective methods of communication. Moreover, Plaintiffs allege that they have sought, and will likely continue to seek, medical treatment from Laurel Regional. This allegation is supported by the fact that Plaintiffs Gillespie, Irvine, Barbin, Hale, and Porras reside within two to five miles of Laurel Regional, thus, making it highly likely that Laurel Regional, rather than some other medical facility, will be where they go in an emergency. Additionally, Plaintiffs Gillespie and Hale have alleged multiple visits to Laurel Regional, despite what they allege was unlawful treatment in the past. This fact only bolsters the allegation that they will likely return there in the future. Given the proximity of their residences to Laurel Regional, their strikingly common past experiences with the hospital, and the fact that they seek to enjoin what they allege is an unlawful policy, pattern, and practice, the court concludes that Plaintiffs Gillespie, Irvine, Barbin, Hale, and Porras have sufficiently alleged a real and immediate threat of future injury at the hands of Defendant in order to have standing to seek injunctive relief. Cf. Dudley II, 333 F.2d at 306 ("To sum up, the question before us is whether Dudley has proffered enough evidence to establish a real and immediate threat that Hannaford's policy will again result in a Title III violation. Given the remedial purpose underlying the ADA, courts should resolve doubts about such questions in favor of disabled individuals."). Whether Defendant's actions violate Plaintiffs' rights under Title III of the ADA, entitling them to injunctive relief, is not the question to be decided today. Rather, it is whether these Plaintiffs, or some of them, have standing to seek such relief. The court concludes that some do. Accordingly, Defendant's motion to dismiss count I as to Plaintiffs Gillespie, Irvine, Barbin, Hale, and Porras will be denied.
646 However, because Plaintiffs Whitney and Leffler now reside outside of the state of Maryland, it is much less likely *646 that they will seek medical treatment at Laurel Regional in the future. Thus, the likelihood that these two Plaintiffs will ever be harmed again by Defendant is minimal at best. Hoepfl, 906 F.Supp. at 320 (finding plaintiff lacked standing because at the time of the suit, she resided in a different state, making it "highly unlikely that she will ever again be in a position where any discrimination by [the defendant] against disabled individuals will affect her personally"). "Absent a sufficient likelihood that [they] will again be wronged in a similar way," Lyons, 461 U.S. at 111, 103 S.Ct. 1660, they lack standing to seek injunctive relief. Accordingly, Defendant's motion to dismiss count I for lack of standing as to Plaintiffs Whitney and Leffler will be granted.
IV. Conclusion
For the foregoing reasons, Defendant's motion to dismiss count I for lack of standing is denied in part and granted in part. The motion is denied as to Plaintiffs Gillespie, Irvine, Barbin, Hale, and Porras, and granted as to Plaintiffs Whitney and Leffler. A separate Order will follow.
[1] After Defendant filed its motion to dismiss, Plaintiffs moved for leave to file an amended complaint merely to correct the name and related information of the previously misidentified Defendant. Defendant did not object, and the court granted the motion on March 15, 2005. Accordingly, Defendant's motion will be analyzed vis-a-vis Plaintiffs' amended complaint.

[2] According to Plaintiffs' amended complaint, VRI uses video conferencing technology to provide remote interpreting services. Paper 20, ¶ 5. When utilizing VRI, a sign language interpreter is located at a remote location and, through video conferencing, the deaf individual and the interpreter can view each other. Facing a small camera mounted on top of a computer monitor, the deaf individual signs to the interpreter, who then voices what has been signed to hearing participants. The interpreter then signs the hearing participants' response so that the deaf individual can view the response in the monitor. Id.
[3] Plaintiff Whitney alleges that on multiple visits to Laurel Regional when the VRI device was utilized, she could not understand the video interpreter due to the poor quality of the video transmission, and because she was unable to sit up in order to see the monitor. See Paper 20, ¶¶ 34, 38, 41. Plaintiff Hale alleges that on multiple visits to Laurel Regional, the VRI device proved utterly ineffective because the improperly and inadequately trained hospital staff was unable to operate the equipment. See id., ¶¶ 55, 56. Plaintiff Leffler alleges that he was informed by hospital staff that the VRI device, for reasons unknown to him, was simply "not available" during his emergency visit to the hospital. Id., ¶ 58.
[4] In addition to "injury in fact," a plaintiff must also demonstrate that the conduct complained of will cause the injury alleged, and that it is likely, not speculative, that the injury will be redressed by a favorable decision. Id. These elements are not at issue here.
[5] In July of 1991 and January of 1992, deaf former PGHC patients filed complaints with the Office for Civil Rights of the United States Department of Health and Human Services ("OCR"), alleging that the PGHC failed to provide them with effective communication during their treatment. In December of 1993, the OCR found that PGHC was in violation of § 504 of the Rehabilitation Act. Shortly before the OCR released its finding, and apparently as a result of the OCR's investigation, PGHC revised its policy on accommodations for hearing impaired patients. Id. at 822. Thus, well before Proctor's visit to PGHC, it had revised its policy in an attempt to comply with federal anti-discrimination laws.
[6] The Aikins court dismissed the ADA count with leave to amend "to show that Mrs. Aikins faces a real and immediate threat of future injury at the hands of defendants." After amending her complaint to add additional allegations that she considered it "reasonably possible that she might need to seek services from the hospital, and that defendants ... engaged in `a pattern and practice of violating' pertinent anti-discrimination statutes," the court, in an unpublished opinion, denied the defendants' motion to dismiss, notwithstanding the plaintiff's relatively infrequent visits to her mobile home. See Aikins v. St. Helena Hosp., 1994 WL 794759, at *3 (N.D.Cal. Apr.4, 1994).
[7] Similar analysis of the remaining cases Defendant cites reveals that critical and important differences exist between those cases and Plaintiffs' which made dismissal appropriate in the former, but inappropriate here. See, e.g., Constance v. State Univ. of New York Health Science Ctr. at Syracuse, 166 F.Supp.2d 663 (N.D.N.Y.2001) (finding plaintiffs lacked standing because they only traveled to the Syracuse area, where the hospital was located, a few times a year, they had not been to the hospital prior to or after the incident giving rise to the action, and one plaintiff sought cancer treatment from her oncologist at another hospital in another city); Hoepfl v. Barlow, 906 F.Supp. 317, 320 (E.D.Va.1995) (finding plaintiff lacked standing because at the time of the suit, she "reside[d] in a different state," making it "highly unlikely that she will ever again be in a position where any discrimination by [the defendant] against disabled individuals will affect her personally"). Moreover, in Naiman v. New York Univ., 1997 WL 249970 (S.D.N.Y. May 13, 1997), the court dismissed for lack of standing the plaintiff's claim for injunctive relief but granted him leave to amend to allege facts sufficient to demonstrate standing. Id., at *5. Interestingly, and of some relevance here, is that the court noted that "[a]lthough not exhaustive nor necessarily dispositive, such allegations (if they can be made on the facts) might include whether [the plaintiff] suffers from a recurring medical condition and the reasons why [the defendant hospital,] as opposed to some other hospital, is the facility which [the plaintiff] would go to in an emergency." Id. (emphasis added).
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 District of Maryland (CM/ECF Live 3.0) - Docket Report

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CASREF, CLOSED, MAG-D, MAG-S
U.S. District Court District of Maryland (Greenbelt) CIVIL DOCKET FOR CASE #: 8:05-cv-00073-DKC

Gillespie et al v. Dimensions Health Corporation Assigned to: Judge Deborah K. Chasanow Referred to: Magistrate Judge William Connelly Cause: 28:1331 Federal Question: Other Civil Rights

Date Filed: 01/11/2005 Date Terminated: 08/09/2006 Jury Demand: Plaintiff Nature of Suit: 446 Civil Rights: Americans with Disabilities - Other Jurisdiction: Federal Question

Plaintiff Elizabeth Gillespie

represented by Elizabeth Elaine Gardner Washington Lawyers Committee for Civil Rights and Urban Aff 11 Dupont Circle NW Ste 400 Washington, DC 20036 12023191000 ext 131 Fax: 12023191010 LEAD ATTORNEY ATTORNEY TO BE NOTICED

Lewis S Wiener Sutherland Asbill and Brennan LLP 1275 Pennsylvania Ave NW Washington, DC 20004 12023830140 Fax: 12026373593 Email: lewis.wiener@sablaw.com LEAD ATTORNEY ATTORNEY TO BE NOTICED

Thomas Robinson Bundy, III Sutherland Asbill and Brennan LLP 1275 Pennsylvania Ave NW Washington, DC 20004 12023830100 Fax: 12026373593 Email: thomas.bundy@sablaw.com LEAD ATTORNEY ATTORNEY TO BE NOTICED

David Adam Last Office of the U S Attorney for the District of Columbia 555 Fourth St NW Washington, DC 20530

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Plaintiff David Irvine
Plaintiff Erin Whitney
Plaintiff Cary Barbin
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12025147566 Email: david.last@usdoj.gov TERMINATED: 01/03/2006
represented by Elizabeth Elaine Gardner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Lewis S Wiener (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Thomas Robinson Bundy, III (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
David Adam Last (See above for address) TERMINATED: 01/03/2006
represented by Elizabeth Elaine Gardner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Lewis S Wiener (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Thomas Robinson Bundy, III (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
David Adam Last (See above for address) TERMINATED: 01/03/2006
represented by Elizabeth Elaine Gardner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
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Plaintiff Kathryn Elizabeth Hale TERMINATED: 06/16/2005
Plaintiff Brian Leffler
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Lewis S Wiener (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Thomas Robinson Bundy, III (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
David Adam Last (See above for address) TERMINATED: 01/03/2006
represented by Elizabeth Elaine Gardner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Lewis S Wiener (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Thomas Robinson Bundy, III (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
David Adam Last (See above for address) TERMINATED: 01/03/2006
represented by Elizabeth Elaine Gardner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Lewis S Wiener (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Thomas Robinson Bundy, III (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
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Plaintiff Ziomara Porras
Plaintiff Kathryn Elizabeth Vadakin formerly known as Kathryn Elizabeth Hale
Intervenor Plaintiff United States of America
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David Adam Last (See above for address) TERMINATED: 01/03/2006
represented by Elizabeth Elaine Gardner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Lewis S Wiener (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Thomas Robinson Bundy, III (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
David Adam Last (See above for address) TERMINATED: 01/03/2006
represented by Elizabeth Elaine Gardner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Lewis S Wiener (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Thomas Robinson Bundy, III (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
David Adam Last (See above for address) TERMINATED: 01/03/2006
represented by Jamie M Bennett Office of the United States Attorney 36 S Charles St Fourth Fl Baltimore, MD 21201 14102094838
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V. Defendant Laurel Regional Hospital TERMINATED: 03/15/2005
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Fax: 14109629947 Email: jamie.bennett@usdoj.gov LEAD ATTORNEY ATTORNEY TO BE NOTICED
Kathleen Susan Devine United States Department of Justice Disability Rights Section Civil Rights Division 950 Pennsylvania Ave NW Washington, DC 20530 12023070480 Fax: 12023059775 Email: kathleen.s.devine@usdoj.gov LEAD ATTORNEY ATTORNEY TO BE NOTICED
Robert John Mather United States Department of Justice Civil Rights Division Disability Rights Section 950 Pennsylvania Ave NW Washington, DC 20530 12023072236 Fax: 12026166862 Email: robert.mather@usdoj.gov LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Neil E Duke Ober Kaler Grimes and Shriver 120 E Baltimore St Baltimore, MD 21202 14103477398 Fax: 14105470699 Email: neduke@ober.com LEAD ATTORNEY ATTORNEY TO BE NOTICED
Pamela J White Ober Kaler Grimes and Shriver 120 E Baltimore St Baltimore, MD 21202-1643 14106851120 Fax: 14105470699 Email: pjwhite@ober.com TERMINATED: 01/25/2007
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Defendant
Dimensions Health Corporation doing business as Laurel Regional Hospital

represented by Pamela J White (See above for address) TERMINATED: 01/25/2007

Date Filed 01/11/2005
01/11/2005 01/11/2005 01/11/2005
01/11/2005
01/13/2005 01/13/2005 02/10/2005 02/10/2005 02/10/2005
02/10/2005
02/24/2005 02/25/2005

#

Docket Text

1 COMPLAINT against Laurel Regional Hospital ( Filing fee $ 150 receipt number 2299771.), filed by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. (Attachments: # 1 Civil Cover Sheet)(rank, Deputy Clerk) (Entered: 01/11/2005)
2 Summons Issued 20 days as to Laurel Regional Hospital. (rank, Deputy Clerk) (Entered: 01/11/2005)
3 Correspondence from the Clerk re: Electronic filing of documents. (c/m 1/11/05 rk) (rank, Deputy Clerk) (Entered: 01/11/2005)
4 MOTION of Elizabeth Gardner to Appear Pro Hac Vice by David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. (rank, Deputy Clerk) (Entered: 01/12/2005)
5 ORDER granting 4 Motion of Elizabeth Elaine Gardner to Appear Pro Hac Vice. Signed by the Clerk on 1/11/05. (c/m 1/12/05 rk) (rank, Deputy Clerk) (Entered: 01/12/2005)
6 NOTICE of Appearance by Lewis S Wiener on behalf of all plaintiffs (Attachments: # 1)(Wiener, Lewis) (Entered: 01/13/2005)
7 NOTICE of Appearance by David A Last on behalf of all plaintiffs (Attachments: # 1)(Last, David) (Entered: 01/13/2005)
8 ANSWER to Complaint by Laurel Regional Hospital.(White, Pamela) (Entered: 02/10/2005)
9 Local Rule 103.3 - Corporate Disclosure Statement. (White, Pamela) (Entered: 02/10/2005)
10 MOTION to Dismiss by Laurel Regional Hospital. Responses due by 2/27/2005 (Attachments: # 1 Memorandum in Support of Motion to Dismiss# 2 Appendix # 3 Text of Proposed Order)(White, Pamela) (Entered: 02/10/2005)
11 SCHEDULING ORDER: Discovery / Status Report due by 6/27/2005. Motions due by 7/25/2005. Signed by Judge Deborah K. Chasanow on 02/10/2005. (Chasanow, Deborah) (Entered: 02/10/2005)
12 Settlement Conference - requesting (Wiener, Lewis) (Entered: 02/24/2005)
13 MOTION for Extension of Time or For Modification of Schedule by Laurel Regional Hospital. Responses due by 3/14/2005 (Attachments: # 1 Exhibit)(White, Pamela) (Entered: 02/25/2005)

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02/25/2005 02/28/2005 03/07/2005 03/14/2005
03/14/2005 03/15/2005 03/15/2005 03/15/2005 04/08/2005 04/08/2005
05/06/2005

14 PAPERLESS ORDER "GRANTING" 13 Motion of the Defendant for Extension of Time within which to confer with Plaintiffs' counsel and submit a report regarding deposition hours until 03/07/2005. Signed by Judge Deborah K. Chasanow on 02/25/2005. (Chasanow, Deborah) (Entered: 02/25/2005)
15 RESPONSE in Opposition re 10 MOTION to Dismiss filed by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Replies due by 3/14/2005. (Attachments: # 1 Appendix)(Wiener, Lewis) (Entered: 02/28/2005)
16 STATUS REPORT in Response to Court's Scheduling Order by Laurel Regional Hospital. (White, Pamela) (Entered: 03/07/2005)
17 MOTION for Leave to File First Amended Complaint for Injunctive Relief and for Compensatory and Punitive Damages by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Responses due by 3/31/2005 (Attachments: # 1 Exhibit (Proposed Amended Complaint)# 2 Exhibit (Blackline of Proposed Amended Complaint))(Last, David) (Entered: 03/14/2005)
18 REPLY to Response in Opposition to re 10 Motion to Dismiss filed by Laurel Regional Hospital. (White, Pamela) (Entered: 03/14/2005)
19 PAPERLESS ORDER granting 17 Motion for Leave to File First Amended Complaint. Signed by Judge Deborah K. Chasanow on 03/15/05. (Chasanow, Deborah) (Entered: 03/15/2005)
20 AMENDED COMPLAINT against Dimensions Health Corporation, filed by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras.(rank, Deputy Clerk) (Entered: 03/15/2005)
Jury Trial Demand by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. (rank, Deputy Clerk) (Entered: 03/15/2005)
21 Consent MOTION for Extension of Time For the Filing of Expert Disclosures by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Responses due by 4/25/2005 (Last, David) (Entered: 04/08/2005)
22 PAPERLESS ORDER "GRANTING" 21 Consent Motion of Plaintiffs to Enlarge the Deadline for the Filing of Expert Disclosures as follows: Plaintiffs' Rule 26(a)(2) Disclosures regarding Experts will be due 30 days following the Court's ruling on Defendant's pending Motion to Dismiss; Defendant's Rule 26(a)(2) Disclosures regarding Experts will be due 30 days thereafter; and Plaintiffs' Rebuttal Rule 26(a)(2) Disclosures regarding Experts will be due 14 days thereafter. Signed by Judge Deborah K. Chasanow on 4/8/2005. (Chasanow, Deborah) (Entered: 04/08/2005)
23 MOTION for Protective Order ; Points and Authorities by Dimensions Health Corporation. Responses due by 5/23/2005 (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E)(White, Pamela) (Entered: 05/06/2005)

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05/07/2005
05/09/2005 05/09/2005 05/10/2005 05/16/2005 05/16/2005
05/16/2005 05/20/2005 05/20/2005
05/24/2005 05/27/2005

24 RESPONSE to Motion re 23 MOTION for Protective Order ; Points and Authorities and Motion to Compel Defendant's Identification of Rule 30(B)(6) Deponents filed by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Replies due by 5/23/2005. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F# 7 Exhibit G)(Wiener, Lewis) (Entered: 05/07/2005)
Telephone Conference held before Judge Deborah K. Chasanow. (td, Deputy Clerk) (Entered: 05/09/2005)
25 LETTER/ORDER "GRANTING" 23 Motion of the Defendant for Protective Order. Signed by Judge Deborah K. Chasanow on 5/9/2005. (Chasanow, Deborah) (Entered: 05/09/2005)
26 MOTION to Compel by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Responses due by 5/27/2005 (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F)(Wiener, Lewis) (Entered: 05/10/2005)
27 MEMORANDUM OPINION. Signed by Judge Deborah K. Chasanow on 5/16/2005. (Chasanow, Deborah) (Entered: 05/16/2005)
28 ORDER "GRANTING" in part and "DENYING" in part 10 Motion of the Defendant to Dismiss Count I of Plaintiffs' Complaint - "GRANTED" as to Plaintiffs Erin Whitney and Brian Leffler and "DENIED" as to Plaintiffs Elizabeth Gillespie, David Irvine, Cary Barbin, Kathryn Hale and Xiomara Porras; and "DISMISSING" the claims of Plaintiffs Whitney and Leffler for injunctive relief under the ADA (Count I). Signed by Judge Deborah K. Chasanow on 5/16/2005. (Chasanow, Deborah) (Entered: 05/16/2005)
29 ORDER REFERRING CASE to Magistrate Judge Charles B. Day for settlement. Signed by Judge Deborah K. Chasanow on 5/16/05. (jmw, Chambers) (Entered: 05/16/2005)
30 MOTION for Extension of Time to Complete Discovery and to Modify the Joint Report in Response to the Court's Scheduling Order by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Responses due by 6/6/2005 (Attachments: # 1 Exhibit A# 2 Exhibit B)(Last, David) (Entered: 05/20/2005)
31 PAPERLESS ORDER "GRANTING" 30 Unopposed Motion of the Plaintiffs to Extend the Discovery Deadline from 6/27/2005 to 9/27/2005; "EXTENDING" the Dispositive Motions Deadline from 7/25/2005 to 10/27/2005; and "STATING" that the Court will consider Plaintiffs' Request concerning the number of hours for depositions once Defendant has had an opportunity to file a Response. Signed by Judge Deborah K. Chasanow on 5/20/2005. (Chasanow, Deborah) (Entered: 05/20/2005)
32 Correspondence re: scheduling settlement conference. Reply required. (bab, Chambers) (Entered: 05/24/2005)
33 RESPONSE in Opposition re 26 MOTION to Compel filed by Dimensions Health Corporation. Replies due by 6/10/2005. (Attachments: # 1 Exhibit A# 2 Exhibit B)(White, Pamela) (Entered: 05/27/2005)

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06/01/2005 06/01/2005
06/02/2005 06/10/2005 06/10/2005 06/13/2005 06/16/2005 06/16/2005 06/27/2005 07/05/2005

34 STIPULATION to Enlarge Time to File Plaintiffs' Responses to Defendant's Discovery Requests by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Dimensions Health Corporation, Ziomara Porras, Laurel Regional Hospital. (Wiener, Lewis) (Entered: 06/01/2005)
35 PAPERLESS ORDER "APPROVING" 34 Stipulation of the Parties to Enlarge Time for Plaintiffs to Respond to Defendant's First Set of Interrogatories and First Request for Production of Documents to 6/9/2005; and "STATING" that Counsel need not request the Court to rule on such stipulations in the future, pursuant to Local Rule 104.8.a. Signed by Judge Deborah K. Chasanow on 6/1/2005. (Chasanow, Deborah) (Entered: 06/01/2005)
36 ORDER "Scheduling" Settlement Conference Signed by Judge Charles B. Day on 6/2/05 (c/m)(ajh, Deputy Clerk) (Entered: 06/02/2005)
37 RESPONSE in Support re 26 MOTION to Compel filed by Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Replies due by 6/24/2005. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F)(Wiener, Lewis) (Entered: 06/10/2005)
38 MOTION to Compel to Permit Non-Parties (DOJ Attorneys) to Attend Depositions and Have Access to Documents by Elizabeth Gillespie, David Irvine, Cary Barbin, Kathryn Elizabeth Hale, Brian Leffler, Ziomara Porras. Responses due by 6/27/2005 (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E)(Wiener, Lewis) (Entered: 06/10/2005)
39 NOTICE by Kathryn Elizabeth Hale of Change in Name of a Party (Last, David) (Entered: 06/13/2005)
40 PAPERLESS ORDER "GRANTING" 30 Request of the Plaintiffs to Modify the number of Deposition Hours from 50 to 100, as no opposition was filed; and "APPROVING" 39 Notice of Change in Name of Plaintiff Kathryn Elizabeth Hale to Kathryn Elizabeth Valadkin. Signed by Judge Deborah K. Chasanow on 6/16/2005. (Chasanow, Deborah) (Entered: 06/16/2005)
41 PAPERLESS ORDER "AMENDING" [40] Paperless Order which approved the Notice of Change in Name of Plaintiff Kathryn Elizabeth Hale to Kathryn Elizabeth VADAKIN (not Valadkin). Signed by Judge Deborah K. Chasanow on 6/16/2005. (Chasanow, Deborah) (Entered: 06/16/2005)
42 RESPONSE in Opposition re 38 MOTION to Compel to Permit Non-Parties (DOJ Attorneys) to Attend Depositions and Have Access to Documents filed by Laurel Regional Hospital. Replies due by 7/11/2005. (Attachments: # 1 Memorandum in Support of Opposition# 2 Text of Proposed Order)(White, Pamela) (Entered: 06/27/2005)
43 MOTION to Compel Defendant's Responses to Plaintiffs' Discovery Requests by Kathryn Elizabeth Vadakin, Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Brian Leffler, Ziomara Porras. Responses due by 7/22/2005 (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F# 7 Exhibit G# 8 Exhibit H# 9 Exhibit I# 10 Exhibit J# 11 Exhibit K# 12 Exhibit L# 13 Exhibit M# 14 Exhibit N# 15 Exhibit O# 16 Exhibit P# 17

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07/06/2005 07/06/2005
07/11/2005
07/11/2005 07/14/2005 07/14/2005 07/14/2005 07/15/2005 07/18/2005 07/19/2005

Errata Q# 18 Exhibit R# 19 Exhibit S# 20 Exhibit T)(Last, David) (Entered: 07/05/2005)
44 Return pleading letter 43 Motion to Compel as it does not conform to Local Rule 104.8. (Chasanow, Deborah) (Entered: 07/06/2005)
45 NOTICE of service of motion to compel discovery by Kathryn Elizabeth Vadakin, Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Brian Leffler, Ziomara Porras (Attachments: # 1 Appendix Motion to Compel Discovery# 2 Exhibit A# 3 Exhibit B# 4 Exhibit C# 5 Exhibit D# 6 Exhibit E# 7 Exhibit F# 8 Exhibit G# 9 Exhibit H# 10 Exhibit I# 11 Exhibit J# 12 Exhibit K# 13 Exhibit L# 14 Exhibit M# 15 Exhibit N# 16 Exhibit O# 17 Exhibit P# 18 Exhibit Q# 19 Exhibit R# 20 Exhibit S# 21 Exhibit T)(Last, David) (Entered: 07/06/2005)
46 Consent MOTION for Extension of Time to File Response/Reply as to 42 Response in Opposition to Motion, to Permit Non-Parties (DOJ Attorneys) to Attend Depositions and Have Access to Documents by Kathryn Elizabeth Vadakin, Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Brian Leffler, Ziomara Porras. Responses due by 7/28/2005 (Last, David) (Entered: 07/11/2005)
47 PAPERLESS ORDER "GRANTING" 46 Consent Motion of the Plaintiffs to Enlarge the Deadline for Filing a Reply in support of their Motion to Permit Non-parties (DOJ Attorneys) to Attend Depositions and Have Access to Documents from 7/11/2005 to 7/19/2005. Signed by Judge Deborah K. Chasanow on 7/11/2005. (Chasanow, Deborah) (Entered: 07/11/2005)
48 AFFIDAVIT of Service for Subpoena for Deposition on July 19, 2005 served on Mike Jacobus on 7/6/05, filed by Laurel Regional Hospital. (Duke, Neil) Modified on 7/15/2005 (rank, Deputy Clerk).Discovery material not filed with the Court (Entered: 07/14/2005)
49 AFFIDAVIT of Service for Subpoena for Deposition July 18, 2005 served on Rebecca Davis on 7/6/05, filed by Laurel Regional Hospital. (Duke, Neil) Modified on 7/15/2005 (rank, Deputy Clerk).(Discovery material not to be filed with the Court (Entered: 07/14/2005)
50 AFFIDAVIT of Service for Subpoena for Deposition July 15, 2005 served on Rene Porras on 7/6/05, filed by Laurel Regional Hospital. (Duke, Neil) Modified on 7/15/2005 (rank, Deputy Clerk).(Discovery material not to be filed with the Court) (Entered: 07/14/2005)
51 Correspondence from the Clerk re: Notice of Service of Discovery. (rank, Deputy Clerk) (Entered: 07/15/2005)
52 NOTICE by Kathryn Elizabeth Vadakin, Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Brian Leffler, Ziomara Porras Withdrawing Motion to Permit DOJ to Attend Depositions (filed June 10, 2005) (Wiener, Lewis) (Entered: 07/18/2005)
53 ORDER REFERRING CASE to Magistrate Judge William Connelly for discovery. Signed by Judge Deborah K. Chasanow on 7/19/05. (jmw, Chambers) (Entered: 07/19/2005)

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07/25/2005 07/25/2005
08/03/2005 08/05/2005 08/08/2005 08/31/2005 09/09/2005 09/09/2005 09/09/2005 09/09/2005 10/11/2005 10/12/2005 11/04/2005

54 PAPERLESS ORDER SCHEDULING telephone conference on Tuesday, July 26, 2005 at 4:00 p.m. regarding 26 Motion to Compel. Chambers will initiate the conference call. Signed by Judge William Connelly on 07/25/05. (Connelly, William) (Entered: 07/25/2005)
55 Notice of serice of RESPONSE in Opposition re 45 MOTION to Compel Defendant's Responses to Plaintiffs' Discovery Requests filed by Dimensions Health Corporation. Replies due by 8/8/2005. (Duke, Neil) Modified on 7/27/2005 (rank, Deputy Clerk). Modified on 7/27/2005 (rank, Deputy Clerk). (Entered: 07/25/2005)
Settlement Conference held before Judge Charles B. Day. (bab, Chambers) (Entered: 08/03/2005)
56 STIPULATION to Suspend Discovery for 30 Days and Request to Enlarge the Discovery Period by Laurel Regional Hospital. (Duke, Neil) (Entered: 08/05/2005)
57 PAPERLESS ORDER "GRANTING" 56 Joint Stipulation to Suspend and Enlarge Discovery 30 days. Discovery closes and a status report is due 10/27/05, dispositive motions due 11/28/05. Signed by Judge Deborah K. Chasanow on 8/8/05. (Chasanow, Deborah) (Entered: 08/08/2005)
58 PAPERLESS ORDER DENYING WITHOUT PREJUDICE 26 Motion to Compel. The Motion To Compel may be reinstated if settlement negotiations are not successful. Signed by Judge William Connelly on 08/31/05. (Connelly, William) (Entered: 08/31/2005)
59 Correspondence re: Additional Period of Time to Suspend Discovery (Duke, Neil) (Entered: 09/09/2005)
60 PAPERLESS ORDER "APPROVING" 59 Counsel's request to further suspend and enlarge discovery 30 days. Discovery closes and status report due 10/11/05, dispositive motions due 11/14/05. Signed by Judge Deborah K. Chasanow on 9/9/05. (Chasanow, Deborah) (Entered: 09/09/2005)
61 Correspondence re: the Court's Order of 9/9/05 (Last, David) (Entered: 09/09/2005)
62 PAPERLESS ORDER "APPROVING" 61 Clarification of Schedule. Discovery will be suspended until 10/11/05, discovery closes and status report due 11/30/05, dispositive motions due 12/30/05. Signed by Judge Deborah K. Chasanow on 9/9/05. (Chasanow, Deborah) (Entered: 09/09/2005)
63 Correspondence re: Modification of Scheduling Order (Duke, Neil) (Entered: 10/11/2005)
64 PAPERLESS ORDER "APPROVING" 63 Correspondence requesting modification of schedule. Discovery will be suspended until 11/1/05, all remaining deadlines are unchanged. Signed by Judge Deborah K. Chasanow on 10/12/05. (Chasanow, Deborah) (Entered: 10/12/2005)
65 Correspondence re: Proposed Modification of the Scheduling Order (Last, David) (Entered: 11/04/2005)

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11/04/2005
12/15/2005 12/16/2005
01/03/2006
01/03/2006 01/20/2006 01/20/2006
02/24/2006 02/27/2006
03/09/2006 03/15/2006 04/19/2006 04/27/2006 04/28/2006

66 PAPERLESS ORDER APPROVING 65 correspondence requesting modification of schedule. Discovery will be suspended until 12/15/05, discovery closes and status report due 2/15/06, dispositive mtions due 3/15/06. Signed by Judge Deborah K. Chasanow on 11/4/05. (Chasanow, Deborah) (Entered: 11/04/2005)
67 Correspondence re: Proposed Modification of the Scheduling Order (Last, David) (Entered: 12/15/2005)
68 PAPERLESS ORDER APPROVING 67 correspondence requesting modification of schedule. Discovery will be suspended until 1/20/06, discovery closes and status report due 3/22/06, dispositive mtions due 4/26/06. Signed by Judge Deborah K. Chasanow on 12/16/05. (Chasanow, Deborah) (Entered: 12/16/2005)
69 MOTION to Withdraw Appearance of David A. Last as Counsel of Record for Plaintiffs by Kathryn Elizabeth Vadakin, Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Brian Leffler, Ziomara Porras. Responses due by 1/20/2006 (Last, David) (Entered: 01/03/2006)
70 PAPERLESS ORDER GRANTING 69 Unopposed Motion to Withdraw the Appearance of David A. Last as counsel of record for plaintiffs. Signed by Judge Deborah K. Chasanow on 1/3/06. (Chasanow, Deborah) (Entered: 01/03/2006)
71 STATUS REPORT re Settlement to Court by Elizabeth Gillespie. (Wiener, Lewis) (Entered: 01/20/2006)
72 PAPERLESS ORDER APPROVING 71 Status Report requesting modification of schedule. Discovery will be suspended until 2/27/06, discovery closes and status report due 4/28/06, dispositive motions due 5/26/06. Signed by Judge Deborah K. Chasanow on 1/20/06. (Chasanow, Deborah) (Entered: 01/20/2006)
73 Status Report Submitted requesting modification of schedule by Elizabeth Gillespie (Wiener, Lewis) (Entered: 02/24/2006)
74 PAPERLESS ORDER APPROVING 73 Status Report requesting modification of schedule. Discovery will be suspended until 4/28/06, discovery closes and status report due 6/28/06, dispositive motions due 7/26/06. Signed by Judge Deborah K. Chasanow on 2/27/06. (Chasanow, Deborah) (Entered: 02/27/2006)
75 Correspondence re: scheduling settlement conference. Reply required. (bab, Chambers) (Entered: 03/09/2006)
76 ORDER "Advising" counsel that a settlement conference has been scheduled. Signed by Judge Charles B. Day on 3/15/06. (rank, Deputy Clerk) (Entered: 03/15/2006)
Settlement Conference held on 4/18/2006 before Judge Charles B. Day. (bab, Chambers) (Entered: 04/19/2006)
77 Status Report Submitted Requesting Modification of Scheduling Order by Elizabeth Gillespie (Wiener, Lewis) (Entered: 04/27/2006)
78 PAPERLESS ORDER APPROVING 77 Status Report requesting modification of schedule. Discovery will be suspended until 6/26/06, discovery closes and status report due 8/28/06, dispositive motions due 9/26/06. Signed by Judge Deborah K. Chasanow on 4/28/06. (Chasanow, Deborah) (Entered: 04/28/2006)

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05/24/2006 07/17/2006 07/17/2006 07/17/2006 07/17/2006 07/20/2006 07/24/2006
07/28/2006 07/31/2006 07/31/2006 07/31/2006 07/31/2006 08/08/2006 08/09/2006 08/10/2006

Settlement Conference held on 5/24/2006 before Judge Charles B. Day. (bab, Chambers) (Entered: 05/24/2006)
79 Intervenor COMPLAINT , filed by United States of America. (Attachments: # 1 Notice# 2 Wavier of Service of Summons# 3 Text of Proposed Order # 4 Civil Cover Sheet)(elt, Deputy Clerk) (Entered: 07/17/2006)
80 Consent MOTION to Intervene as of Right or, Alternatively, to Intervene by Permission by United States of America. (Attachments: # 1 Memorandum in Support)(elt, Deputy Clerk) (Entered: 07/17/2006)
81 Consent Decree by United States of America (Attachments: # 1 Exhibit 1# 2 Exhibit 2)(elt, Deputy Clerk) (Entered: 07/17/2006)
82 CERTIFICATE OF SERVICE by United States of America (elt, Deputy Clerk) (Entered: 07/17/2006)
83 PAPERLESS ORDER GRANTING 80 Consent Motion to Intervene. Signed by Judge Deborah K. Chasanow on 7/20/06. (Chasanow, Deborah) (Entered: 07/20/2006)
84 PAPERLESS ORDER CONFIRMING that a telephone conference with counsel is scheduled Monday, July 31, 2006, at 5:00 p.m. Chambers will initiate the conference call. Signed by Judge Deborah K. Chasanow on 7/24/06. (Chasanow, Deborah) (Entered: 07/24/2006)
85 REQUEST and ORDER "ENTERING" the appearance of Robert J. Mather on behalf of a Federal Government Agency. Signed by the Clerk on 7/28/06. (c/m 7/31/06 rk) (rank, Deputy Clerk) (Entered: 07/31/2006)
86 Intervenor COMPLAINT, filed by United States of America. (Attachments: # 1 # 2)(Mather, Robert) (Entered: 07/31/2006)
87 WAIVER OF SERVICE Returned Executed by United States of America. Dimensions Health Corporation waiver sent on 7/31/2006, answer due 9/29/2006. (Attachments: # 1 # 2)(Mather, Robert) (Entered: 07/31/2006)
Telephone Conference held on 7/31/2006 before Judge Deborah K. Chasanow. (td, Deputy Clerk) (Entered: 07/31/2006)
88 REQUEST and ORDER "ENTERING" the appearance of Kathleen S. Devine on behalf of a Federal Government Agency. Signed by the Clerk on 7/31/06. (c/m 8/1/06 rk) (rank, Deputy Clerk) (Entered: 08/01/2006)
89 ORDER APPROVING 81 Consent Decree. Signed by Judge Deborah K. Chasanow on 8/8/06. (Chasanow, Deborah) (Entered: 08/08/2006)
90 Consent MOTION to Dismiss W/ PREJUDICE by Elizabeth Gillespie. Responses due by 8/28/2006 (Wiener, Lewis) (Entered: 08/09/2006)
91 PAPERLESS ORDER GRANTING 90 Consent Motion to Dismiss, DISMISSING this case with prejudice, and DIRECTING the Clerk of Court to CLOSE this case. Signed by Judge Deborah K. Chasanow on 8/10/06. (Chasanow, Deborah) (Entered: 08/10/2006)

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08/21/2006 01/25/2007

92 REQUEST and ORDER "ENTERING" the appearance of Robert J. Mather on behalf of a FEderal Government Agency. Signed by the Clerk on 7/28/06. (c/m 8/21/06 rk) (rank, Deputy Clerk) (Entered: 08/21/2006)
93 NOTICE by Dimensions Health Corporation of Withdrawal of Appearance (White, Pamela) (Entered: 01/25/2007)

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 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND SOUTHERN DIVISION

ELIZABETH GILLESPIE, et aI.,
Plaintiffs and THE UNITED STATES OF AMERICA·
Plaintiff-Intervenor,
v.
DIMENSIONS HEALTH CORPORATION d/b/a Laurel Regional Hospital,
Defendant.

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Civil Action No.: DKC-05-CV-73

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CONSENT DECREE Plaintiffs Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Vadakin, Brian Leffler, and Xiomara Porras (collectively referred to as "private plaintiffs"), Defendant Dimensions Health Corporation d/b/a Laurel Regional Hospital ("Laurel" or the "Hospital"), and the :United States Department of Justice (the "United States") have consented to entry of the following Order:
I. BACKGROUND A. On January 11,2005, private plaintiffs filed a lawsuit pursuant to title III of the Americans with Disabilities Act of 1990 ("ADA"), 42 U.S.C. §§ 12181-12189; the United States' implementing regulation, 28 C.F.R. Part 36; section 504 of the Rehabilitation Act ("the

Rehabilitation Act"), 29 U.S.C. § 794; and the United States Department of Health and Human Services' implementing regulation, 45 C.F.R. Part 84. Private plaintiffs, all deaf, alleged that the Hospital violated title III of the ADA and the Rehabilitation Act by discriminating on the basis of disability against persons who are deaf. Gillespie v. Dimensions Health Corporation, No. DKC05-73 (D. Maryland). The complaint alleged, inter alia, that the Hospital did not provide qualified sign language interpreters and/or other appropriate. aids and services to the private plaintiffs either in the Emergency Department or during their hospitalization. Two of the plaintiffs, David Irvine and Xiomara Porras, allegedly did not seek treatment at the Hospital but accompanied family members treated in the Emergency Department. The Hospital has denied the allegations.
B. The United States Department of' Justice ("the United States") received a complaint from the Gillespie plaintiffs mirroring the allegations in that case and initiated its own investigation, pursuant to its authority under the ADA, see 42 U.S.C. § 12188(b), in March 2005. The United States also received a complaint from Janette Pokorski, another deaf patient who allegedly was not provided interpreting services and other auxiliary aids and services during her surgery, hospitalization, and recovery from surgery. According to the allegations in the private plaintiffs' Amended Complaint filed in this action an:d/or the facts elicited during the United States' investigation,. the plaintiffs and Ms. Pokorski were unable to understand the purpose of certain tests, were unclear and confused about their diagnoses, were unable to ask sufficient questions concerning their medical conditions, did not understand their discharge instructions and, in certain instances, allegedly were discharged without realizing that they had life-
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threatening illnesses or conditions. In addition, Hospital personnel and physicians allegedly refused multiple requests for qualified sign language interpreters, and instead elected to use paper and pen, gestures, and lipreading to communicate or used family members/companions to act as· communication conduits, despite the various individuals' inability to effectively communicate
with Hospital personnel and physicians. See M., Amended Complaint, ~~ 3-4, 22, 28. Also,
only two of the private plaintiffs, Elizabeth Gillespie and Erin Whitney, allegedly were provided
any access to either an on-site interpreter or video interp---reting services (where a ~ign language
interpreter appears via video on a videophone) during the delivery of medical treatment at the Hospital. Ms. Pokorski, a complainant in the United States' investigation, was offered the use of video interpreting services but declined. Ms. Vadakin (formerly Hale) also was offered the use of video interpreting services but the Hospital was unable to operate its video interpreting equipment. Those plaintiffs who used or attempted to use the Hospital's video interpreting service allege that it was generally ineffective. For example, plaintiffs alleged, and the United States observed during its site visit, that Hospital personnel were, at times, unable to set up and/or operate the videophone; the image on the monitor was t60 blurry for the patient to clearly distinguish the arms and hands ofthe video interpreter; and the camera on the videophone could not be adjusted for a prone patient so that the patient and the video interpreter could clearly see each other's hands, arms and head. In addition, in one instance, a plaintiff was offered the use of video interpreting services by the Hospital but when the video interpreter vendor was unable to provide a video interpreter, no on-site interpreter was offered in its stead. Hospital personnel allegedly informed certain other plaintiffs that no interpreters were available, or otherwise
3

refused to respond to repeated requests for interpreters and declined to offer access to video interpreting services. Some Hospital personnel and Emergency Department physicians allegedly refused to communicate in writing with the plaintiffs and Ms. Pokorski, insisting that these plaintiffs attempt to communicate by lipreading.
C. The United States is authorized to investigate alleged violations of title III of the ADA and to bring a civil action in federal court if it is unable to secure voluntary compliance in any case that involves a pattern or practice of discrimination or that raises issues of general public importance, 42 U.S.C. § 12188(b).
D. The United States, which was not an original party to the Gillespie litigation, has filed a Complaint in Intervention against the Hospital alleging that the Hospital has engaged in a pattern or practice of discrimination and discriminated against persons who are deaf by excluding them from or denying them the benefit of the Hospital's services by failing to take appropriate steps whenever necessary to ensure effective communication.
E. The Hospital is a place of public accommodation covered by title III of the ADA, 42 U.S.C. § 12181(7)(F), and its implementing regulation, 28 C.F.R. § 36.104. The Hospital is committed to satisfy its statutory requirements and fulfill its responsibilities to provide medical services to members of the community without discrimination on the basis of disability.
F. It is the position of the private plaintiffs and the United States that the facts show that the Hospital has engaged in a pattern or practice of discrimination and has discriminated against persons who ate deaf or hard of hearing by excluding them from or" denying them the benefit of the Hospital's services by failing to provide qualified interpreters and/or other
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appropriate aids and services necessary for effective communication. Such failure constitutes

discrimination on the basis of disability within the meaning of section 302 of the ADA, 42

U.S.C. § 12182. The private plaintiffs and the United States also allege that the Hospital

discriminated against David Irvine by imposing communication responsibilities on him and

against Xiomara Porras for refusing to communicate with her, in violation of the ADA. In

addition, it is the position of the private plaintiffs that the facts show a violation of section 504 of

the Rehabilitation Act, 29 U.S.C. § 794. The Hospital denies these allegations.

G. The private plaintiffs, the United States, and the Hospital (collectively "the

Parties"), after good-faith negotiations, have determined that the Gillespie litigation and the

United States' investigation and litigation should be resolved through this Consent Decree. In

addition, the private plaintiffs and defendant have entered into a confidential settlement

agreement to resolve all remaining issues between them.

H. The United States, having participated in the negotiations among the Parties in the

Gillespie litigation, and having conducted its own investigation of the matters addressed by this

Consent Decree, asserts that the public interest will be served by entering this Consent Decree.

I.

Therefore, the parties and the United States have consented to this Consent

Decree, as indicated by the signatures appearing below. Although the Hospital disputes the

allegations, the Parties agree to resolve this matter as set forth below.

J.

In consideration ofthe terms of this Consent Decree, and in particular the

provisions in Sections III-XI, the Attorney General of the United States agrees to refrain from

undertaking further action in this case, except as provided in Section X (B) and Section XI (A).

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In order to secure compliance by voluntary means and avoid the costs of litigation, the Parties hereby agree as follows:
II. JURISDICTION AND VENUE This Court has jurisdiction over this action pursuant to 42 U.S.C. § 12188(b)(1)(B) and 28 U.S.C. §§ 1331 and 1345. Venue is proper in this District pursuant to 28 U.S.C. § 1?91 in that all claims alleged herein arose within this District. Declaratory relief is appropriate pursuant to 28 U.S.C. §§ 2201 and 2202.
III. DEFINITIONS A. The term "appropriate auxiliary aids and services" includes, for example, qualified sign language, oral, or relay interpreters (either appearing in person or through video interpreting services), note takers, computer-assisted real time transcription services, written materials, the exchange of handwritten notes, telephone handset amplifiers, assistive listening devices, assistive listening systems, telephones compatible with hearing aids, closed caption decoders, open and closed captioning, TTY's (see definition infra), acquisition or modification of equipment or devices, video interpreting services, and other methods of delivering effective communication to individuals with hearing impairments. B. The term "Companion" means a person who is (1) deaf or hard of hearing and who accompanies a deaf or hard of hearing Patient, or (2) deaf or hard of hearing and who accompanies a hearing Patient, or (3) hearing and who accompanies a deaf or hard of hearing . Patient; and who is (i) legally authorized to make health care decisions on behalf of the Patient, or (ii) designated by the Patient to communicate, or circumstances otherwise indicate should
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communicate, with Hospital personnel about the Patient, the Patient's needs, condition, history, or symptoms, or (iii) authorized to help the Patient act on information or instructions by Hospital personnel, or (iv) the Patient's next of kin or health care surrogate or such person with whom the Hospital personnel ordinarily and regularly communicate concerning the Patient's medical condition and medical advice.
C. The term "date of this [Consent] Decree" means the date on which this Consent Decree is entered by the Court.
D. . The term "Hospital Personnel" means all employees and independent contractors with contracts to work on a substantially full-time basis for Laurel (or on a part-time basis exclusively for Laurel), including, without limitation, nurses, physicians, social workers, technicians, admitting personnel, billing staff, security staff, therapists, and volunteers, who have or are likely to have direct contact with "Patients" or "Companions," as defined herein.
E. The term "Patient" means a person who is seeking and/or receiving medical services at Laurel.
F. The term "Qualified Interpreter" shall include "sign language interpreters," "oral interpreter," or other "interpreters" who are able to interpret competently, accurately, and impartially, both receptively and expressively, using any specialized terminology necessary for effective communication in a Hospital setting to a Patient or a Companion. Not all interpreters are qualified for all situations. For example, an interpreter who is qualified to interpret using American Sign Language is not necessarily qualified to interpret orally. Also, someone who has only a rudimentary familiarity with sign language or finger spelling is not a "qualified sign
.7

language interpreter." Likewise, someone who is fluent in sign language but who does not possess the ability to process spoken communication into the proper signs or to observe someone signing and translate their signed or finger-spelled communication into spoken words is not a qualified sign language interpreter. A "Qualified Interpreter" may include a "relay interpreter" who has special skill and training in acting as an intermediary between a Patient or Companion and a sign language interpreter in instances when the interpreter cannot otherwise independently understand the consumer's primary mode of communication.
G. The term "TTY's" means devices that are used with a telephone to communicate with persons who are deaf or hard of hearing by typing and reading communications.
H. The term "VIS" means video interpreting services usirig video conference techriology over high speed Internet lines.
IV. INJUNCTIVE RELIEF A. General Obligations
1. Program to Provide Appropriate Auxiliary Aids and Services. Within sixty days of the date of this Consent Decree, the Hospital shall modify, publish, and describe its program for providing auxiliary aids and serVices ("Program") to implement effectively the provisions of this Consent Decree, including, without limitation: a. Developing and/or revising and coordinating specific procedures to implement fully this Consent Decree, including the revised policies attached as Exhibit 1 to this Consent Decree;
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b. Scheduling, announcing and promoting all training required by this

Consent Decree;

c. Developing a plan for drafting, maintaining and providing all

reports required by this Consent Decree;

d. Within sixty (60) to ninety (90) days, modifying or adapting

medical and intake forms as necessary to ensure that once a deaf or

hard of hearing Patient or Companion enters the Hospital, the

Hospital makes the communication assessment cqnsistent with this
/
Consent Decree. The Hospital will use Exhibit 2 or a form

substantively similar to Exhibit 2 attached to this Consent Decree;

e. Designating an individual or office at the Hospital that will

maintain full information about access to, and the operation of, the

Program ("Information Office");

f.

Designating (i) a Communications Director(s) on call and

responsible twenty-four hours a day, seven days a week, for

assuring access to, and locating, auxiliary aids throughout the

Hospital, to answer questions and provide assistance for proper use

of the auxiliary aids,and to maintain, repair, replace, and distribute

auxiliary aids; and (ii) a Nurse Supervisor(s) (by position or title)

present twenty-four hours a day, seven days a week, within the

Emergency Department who will be responsible for securing

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appropriate auxiliary aids throughout the Hospital.

2. Provision of Appropriate Auxiliary Aids and Services.

a. During the term of this Decree, the Hospital shall continue to

provide on-site interpreters and shall comply with Section IV (B),

Section V, and

1.

Provide to Patients and Companions any appropriate

auxiliary aids and services that may be necessary for

effective communication after making the assessment

described below, including, but not limited to, access to

Qualified Interpreters appearing either in person at the

Hospital or through video interpreting services, assistive

listening devices, assistive listening systems, pictograph

forms and flash cards, and computer-assisted real time

transcription;

11. .Ensure that televisions with built-in captioning capability

are available to deaf or hard or hearing Patients and

Companions at no additional cost; and that the directions

for use of the closed caption capability are clearly stated in

the Patient Handbook (or equivalent publication) or

otherwise available in each Patient room and public area

containing a television with captioning capability.

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b. Within ninety (90) days after the date of this Consent Decree, the Hospital shall ensure that all videos or DVDs purchased, obtained, . or created by the Hospital and all pre-recorded programs produced by the Hospital for the purpose of providing educational or training information to Patients are closed captioned, whenever closed captioning is available as an option with such product. Ifclosed captioning is not available with such product, the Hospital will provide written program material that conveys the same information as contained on the video or DVD product for which closed captioning is not available.
B. Communication Assessment. The Hospital will consult with individual Patients who are deaf or hard of hearing and Companions wherever possible to determine what type of auxiliary aid or interpretive service is needed to ensure effective communication. While consultation is strongly encouraged, the ultimate decision as to what measures to take to ensure effective communication rests in the hands of the Hospital, provided that the method chosen· results in effective communication.
1. General Assessment Criteria. The assessment shall take into account all relevant facts and circumstances, including without limitation the following: a. The nature, length and importance of the communication at issue; b. The individual's communication skills and knowledge;
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c. The Patient's health status or changes thereto; d. The Patient's and/or Companion's request for or statement of need
for an interpreter, including the Patient's or Companion's request for the provision of interpreting services through a video
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interpreting service or through an on-site interpreter; and e. The reasonably foreseeable health care activities of the Patient
(~, group therapy sessions, medical tests or procedures, rehabilitation services, meetings with health care professionals or social workers or discussions concerning billing, insurance, selfcare, prognoses, diagnoses, history and dIscharge). 2. Time for Assessment. The determination of which appropriate auxiliary aids and services are necessary for effective communication, and the timing, duration and frequency with which they shall be provided, will begin at the time an appointment is scheduled or on the arrival of the Patient or Companion at the Hospital, whichever is earlier. Hospital Personnel will perform communication assessments and reassessments and will detail such information in the Patient's medical chart, including the use of forms designed for that purpose. Hospital personnel will reassess the effectiveness of communication as necessary throughout the course of the Patient or Companion's visit. In the event that communication is not effective, Hospital Personnel will reassess which appropriate auxiliary aids
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and interpretive services are necessary, in consultation with the Patient or Companion where possible. C. Successive Patient Visits. The Hospital will implement policies and procedures to expedite arrangements for the provision of auxiliary aids and interpretive services when a Patient or Companion requests appropriate auxiliary aids or services for successive visits to the Hospital. Hospital Personnel will keep appropriate records that reflect the provision of auxiliary aids and services to Patients and Companions, such as notations in Patients' medical charts. During a Patient or Companion's successive visit, Hospital Personnel will reference the individual's prior medical records, where available, as part of the Communication Assessment required by Section IV (B). D. Medical Equipment. Nothing in this Consent Decree shall require that an electronic device or equipment constituting an appropriate auxiliary aid be used when or where its use may interfere with medical or monitoring equipment or may otherwise constitute a threat to a Patient's medical condition. In such an event, the Hospital will continue to comply with Sections IV.A.2 and IV.B. E. Determination Not to Provide Auxiliary Aid or Service. If, after conducting a Communication Assessment required by Section IV (B), Hospital Personnel determine (i) that the circumstances do not warrant provision of an auxiliary aid or service; (ii) to provide a different auxiliary aid OJ; service from that preferred by the Patient or Companion; or (iii) to provide an auxiliary aid or service at a time, or for a duration or frequency, different from that preferred by the Patient or Companion, then Hospital Personnel will so advise the person
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requesting the auxiliary aid or service and shall document (a) the date and time of the denial; (b) the name and title ofthe Hospital Personnel who made the determination; and (c) the basis for the determination. A copy of this documentation will be made available to the Patient or Companion when the circumstances allow or upon request, will.be maintained with the log described in Section IV (F), infra, and contained in the Patient's medical chart.
F. Maintenance of Log. The Hospital will maintain a log of (i) each request for an
auxiliary aid or service; (ii) the type of auxiliary aid requested by the Patient or Companion; (iii) the type of auxiliary aid provided by the Hospital; (iv) the time and date the request is made; (v) the identity of the Patient and Companion in a manner that appropriately protects the confidentiality of the Patient; (vi) the name of the Hospital Personnel who performed any communication assessment or reassessment under Section IV (B); (vii) the name of the Hospital Personnel responsible for the determinatibn of the auxiliary aides) or service(s) to be provided; (viii) the time and date ofthe scheduled appointment (if a scheduled appointment was made); (ix) the time and date the auxiliary aid and service was provided, or a statement that the auxiliary . aid and service was not provided and the basis for such deterniination.
G. Telephones. 1. Public Telephones. As soon as practicable but no later than 90 days after the date of this Consent Decree, the Hospital will provide the following: a. TTY's in public areas. The Hospital will make a TTY device available wherever a telephone is made available to the public. There will be at least one TTY available for each bank of four
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public telephones, but never less than one. To satisfy this provision:, the Hospital may permanently install the required TTY's or make available a sufficient number of portable TTY's. b. TTY's required in specific locations. The Hospital will provide a. TTY at each public telephone location in or adjacent to the emergency department, recovery room, or waiting room. To satisfy this provision, the Hospital can permanently install the required TTY's or make available a sufficient number of portable TTY's. c. Shelves and outlets. Wherever portable TTY's are made available as an alternative to installed TTY's, and wherever there is a bank of three or more public telephones,the Hospital will provide ADAcompliant shelves and electrical outlets. d. Signs indicating the location of TTY's. Wherever public telephones are available but TTY's are not permanently installed, the Hospital will post ADA-compliant signs indicating the location of the nearest portable or permanently installed TTY's; and wherever TTY's are permanently installed, the Hospital will post ADA-compliant signs identifying them to indicate their location. e. Volume control telephones. The Hospital will ensure that no less than 25 percent of all of its public telephones are equipped with volume control mechanisms, plus at least one public telephone at
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each of the following locations: in or adjacent to the emergency department, recovery rooms, or waiting rooms.. The Hospital will ' ensure that volume control phones are dispersed among all public telephones throughout the Hospital and that ADA-compliant signs are displayed at each volume control telephone. f. Hearing aid compatible telephones. The Hospital will ensure that no less than 25 percent of all ofits public telephones' are hearing aid compatible, plus at least one public telephone at each of the following locations: in or adjacent to the emergency department, recovery rooms, or waiting rooms. The Hospital will ensure that hearing aid compatible telephones are dispersed among all public telephones throughout the Hospital. g. Storage and availability of equipment. Portable equipment for use .by persons with hearing impairments in public areas shall be stored in places that are readily accessible to all Hospital Personnel who have clie~t contact at all timesofthe day and night. All Hospital Personnel will be notified of the storage location that is closest to their work area(s). The equipment is to be stored at the appropriate supervised location (~., nurses' station, admission desk, etc.) closest to the public phone for which the equipment is to be made available. Such equipment will be made available to Patients or
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Companions generally within 10 minutes from the time of the Patient's or Companion's request, or as soon as practicable thereafter. 2. Telephones in Patient Rooms. Within 90 days of the date ofthis Consent Decree: a. Timeliness. The Hospital will make the equipment required by this section available within 30 to 60 minutes of a Patient's arrival in a Patient room, or as expeditiously as possible thereafter. The Hospital will notify all relevant Hospital Personnel of the availability and location of this equipment. b. Portable access technology - General Obligations. The Hospital will make available portable access technology! for use in rooms of Patients who are deaf or hard of hearing in a manner that is equivalent to telephones provided to hearing Patients. In units of the Hospital where Patients normally do not have telephones in their rooms, if hearing Patients are given access to common area telephones other than the public phones identified in this Consent Decree, the Hospital will maintain in each such unit appropriate
!Portable access technology includes TTY's with printout capability, visual notification devices for incoming telephone calls, volume control telephones, and telephones that are hearing aid compatible.
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portable access technology that can be used by deaf or hard of hearing Patients and Companions so that such persons have equal access to outgoing calls and incoming calls as that of hearing persons. The Hospital shall ensure that each volume control telephone and each visual notification device for incoming telephone calls complies with the ADA. H. Complaint Resolution/Grievance Procedure. The Hospital shall maintain a written complaint resolution/grievance procedure regarding the provision, or lack thereof, of auxiliary aids and services to Patients and Companions. The Hospital shall maintain records of all complaints/grievances, whether oral or written, made to the Hospital and actions taken with respect thereto. The Hospital will post and continue to post at appropriate places, including but not limited to,"the Emergency Department waitirig room, the Emerge11cy Department triage center, and the Registration room, its Patient Bill of Rights and Responsibilities, which notifies persons who are deaf or hard of hearing of the Hospital's complaint resolution/grievance procedure mechanism, to whom complaints should be made, and the right to receive a written response to the complaint if requested. Copies of all complaints/grievances or notes reflecting oral complaints/grievances and the responses thereto shall be maintained by the Hospital. Within four weeks of receipt of the complaint/grievance the Hospital shall provide a written response to the complaint/grievance, and shall provide a copy of both the complaint/grievance and the response to the United States.
18

I. Prohibition of Surcharges. All appropriate auxiliary aids and services required by this Consent Decree shall be provided free of charge to the Patient or Companion.
J. Individual Notice In Absence of Request. If a Patient or a Companion does not request appropriate auxiliary aids or services but Hospital Personnel, following the communication assessment required by Section IV (B), have reason to believe or conclude that such person would benefit from appropriate auxiliary aids or services for effective communication, the Hospital shall inform the person that appropriate auxiliary aids and services are available free of charge.
K. Communication with Inpatients and Companions. The Hospital shall take appropriate steps to ensure that all Hospital Personnel having contact with a Patient or Companion are made aware of such person's disability so that effective communication with such person is achieved. The Hospital shall take appropriate steps to ensure that all Hospital Personnel having contact with a Patient or Companion are aware of the Hospital's Program and policies.
V. QUALIFIED INTERPRETERS A. Circumstances Under Which Interpreters Shall Be Provided. The Hospital shall provide Qualified Interpreters to Patients and Companions as necessary for effective communicationfor its programs, services, and activities. The determination ofwhen such interpreters shall be provided to Patients or Companions shall be made as set forth in Section IV (B) (Communication Assessment) above. Examples of circumstances when it may be necessary to provide interpreters include, but are not limited to, the following:
19

1. Determination of a Patient's medical history or description of ailment or Injury;
2. Provision of Patients' rights, informed consent, or permission for treatment;
3. Diagnosis or prognosis of ailments or injuries; 4. Explanation of procedures, tests, treatment, treatment options, or surgery; 5. Explanation of medications prescribed (such as dosage, instructions for
how and when the medication is to be taken and side effects or food or drug interactions); 6. Explanation regarding follow-up treatments, therapies, test results, or recovery; 7. Blood donations or apheresis (removal of blood components); 8. Discharge planning and discharge instructions;' 9. Provision of mental health evaluations, group and individual therapy, counseling and oth~r therapeutic activities, including grief counseling and crisis intervention; 10. Explanation of complex billing or insurance issues; 11. Educatiomil presentations, such as classes concerning birthing, nutrition, CPR, and weight management; 12. Explanation of living wills or powers of attorney (or their availability); 13. Filing of administrative complaints or grievances against the Hospital or
20

Hospital Personnel; and 14. Any other circumstance in which a qualified interpreter is necessary to
ensure a Patient's privacy, confidentiality, or other rights provided by Federal, state, or local law. The foregoing list does not imply that an interpreter must always be provided in these circumstances. Nor does it suggest that there are not other circumstances when it may be appropriate to provide interpreters for effective communication. B. . Method for Obtaining Qualified Interpreters. 1. The Hospital shall continue to maintain one or more contracts with· an interpreter service provider(s) ("the IS Provider") to provide Qualified Interpreters at the request of the Hospital. 2. The Hospital shall ensure that its IS Provider(s) will (i) provide Qualified Interpreters when requested by authorized personnel at the Hospital for a variety of situations, including but not limited to, Emergency Department visits, Patient/doctor consultations, admissions, outpatient visits, surgeries, Patient education programs, staff meetings and conferences; (ii) maintain a staff of nationally certified "on-call" interpreters who will be ready and . able to respond to emergency and non-emergency requests 24 hours a day; (iii) maintain detailed records regarding each assignment placed against the contract; (iv) provide one general contract orientation meeting for Hospital personnel in order that they may learn about the contract with the
21

IS Provider and become more familiar with how to ensure communication access with dea£Patients and employees; (v) work with Hospital representatives on procedures and periodic reviews of the system and its effectiveness; (vi) ensure an adequate level of staffing for each assignment, considering type and duration of interpreting services needed, as determined by the Hospital and the IS Provider; and (vii) ensure that interpreters adhere to strict professional standards of confidentiality with respect to Patient, facility and assignment related information, as required by the Hospital, HIPAA, the IS Provider and the Code of Ethics of the Registry of Interpreters for the Deaf, Inc. (RID). 3. The Hospital will provide on-site interpreter services in those situations where the use of video interpreting services is otherwise not feasible or does not result in effective communication. 4. In lieu of contracting with an IS provider, the Hospital may hire one or more Qualified Interpreters to be available 24 hours per day. 5. The Hospital may also provide VIS, asset forth in Section V (C) below, as a means of providing a Qualified Interpreter. C. Video Interpreting Services. 1. Video interpreting services can provide immediate, effective access to interpreting services seven days per week, twenty-four hours a day in a variety of situations including emergencies and unplanned incidents. The
22

Hospital will maintain a contract with a VIS provider with the capability

of providing VIS and technical assistance 24 hours a day, s~ven days a

week, 365 days a year, with interpreters promptly available on this basis

who are qualified to interpret in medical situations, and who are familiar

with medical terminology.

2. The Hospital's VIS shall meet the following performance standards:

a. high qUality, clear, delay-free full-motion video and audio over a

dedicated high-speed Internet connection;

b. a clear, sufficiently large, and sharply delineated picture of the

interpreter's and the Patient/Companion's heads, arms, hands, aJ}d

fingers, regardless ofthe body position ofthe Patient/Companion;

c. clear and easily understood transmission of voices; and

d. non-technicians will be trained to accomplish efficient set-up and

operation.

3.

The Hospital shall ensure that appropriate Hospital Personnel shall be trained,

available, and able to operate and connect the VIS system quickly and

efficiently at the Hospital at all times. Training shall include attention to the

limitations of VIS technology, such as with respect to (i) Patients who have

limited ability to move their heads, hands, or arms; vision problems; cognitive

or consciousness issues; or pain issues; (ii) Patients who may be moved to

areas of the Hospital that do not have a designated high speed Internet line;

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and (iii) Patients who will be treated in rooms where space considerations mitigate against using the service. In circumstances where the limitations of VIS technology mitigate against its use, Hospital Personnel shall conduct another Communication Assessment as required by Section N (B), in order to reassess the need for an alternative auxiliary aid or interpretive service to ensure effective communication. D. Provision of Interpreters in a Timely Manner 1. Scheduled Appointments. For scheduled appointments (appointments scheduled two or more hours in advance, or four or more hours in advance if a request is made between the hours of 8 p.m. and 8 a.m. or a weekend or holiday), the Hospital shall make an interpreter available at the time of the scheduled appointment, if necessary for effective communication. 2. Non-scheduled incidents. ''Non-scheduled incidents" refer to all situations not covered by the definition of "scheduled appointment." For "nonscheduled incidents," the Hospital shall make an interpreter available as soon as practicable. However, the time within which the interpreter is provided shall be no more than (a) two hours from the time the request is made if the service is provided through a contract interpreting service or a staff interpreter (see subparagraph G, infra) who is located off-site at the time the need arises or (b) 30 minutes from the time the Patient's or Companion's request is made if the service is provided through VIS or a staff interpreter who is on-site at
24

the time of the request or need for an interpreter. E. Force Majeure Events. Any response time that is delayed from the times set forth above because of a force majeure event, is excluded from the determination of whether the prescribed response criteria have been met. Force majeure events are events outside the reasonable control of the Hospital, the IS Provider, or the interpreter called to respond, such as severe weather problems and other Acts of God, unanticipated illness or injury of the interpreter while en route to the Hospital, and unanticipated transportation problems (including, without limitation, mechanical failure of the interpreter's automobile, automobile accidents and roadway obstructions, other than routine traffic or congestion).
F. Modification of Performance Standards. In the event that the response time
performance standards set forth above cannot be maintained despite the Hospital's good faith efforts, the Hospital may propose to the United States such modifications as may be reasonable under the circumstances. The United States will consider any such request reasonably and in good faith, and any such modification that is agreed to shall be presented to the Court for approval and, once approved, deemed an amendment to this Consent Decree.
G. Staff Interpreters. The Hospital may, but has no obligation to, satisfy its obligations under this Consent Decree by hiring qualified staff and/or contract interpreters. Staff interpreters and contract interpreters must meet the definition of Qualified Interpreters. Patients and Companions who are provided with staffJcontract interpreters must have the same level of coverage (for both duration and frequency) as the Hospital is otherwise obligated to provide under this Consent Decree. The Hospital may assign other duties to staff interpreters, but the staff interpreters'
25

perfonnance of those other duties shall not interfere with interpreter coverage responsibilities under this Consent Decree.
H. Notice to Patients and Companions. As soon as Hospital Personnel have determined that an inteI1?reter is necessary for effective communication with a Patient or a Companion, the Hospital shall infonn such a person (or a family member or friend, if such Patient/Companion is not available) of the current status of efforts being taken to secure a qualified interpreter on his or her behalf. Additional updates shall be provided periodically thereafter until an interpreter is secured. Notification of efforts to secure a qualified interpreter does not lessen the Hospital's obligation to provide qualified interpreters in a timely manner as required by this Consent Decree.
I. Other Means of Communication. Between the time when an interpreter is requested and when an interpreter is made available, Hospital Personnel shall continue to try to communicate with the Patient or Companion for such purposes and to the same extent as they would have communicated with the person but for the disability, using the most effective means of communication, particularly written notes, or sign language pictographs. This provision in no way lessens the Hospital's obligation to provide qualified interpreters in a timely manner as required by this Consent Decree.
J. Restricted Use of Certain Persons to Facilitate Communication. Due to· considerations of confidentiality, potential emotional involvement, and other factors that may adversely affect the ability to facilitate communication, the Hospital will not require, coerce, or rely upon a family member, companion, caregiver, case manager, advocate, or friend of a deaf or hard of
26

hearing Patient or Companion to interpret or facilitate communications between Hospital Personnel and such Patient or Companion, except that such person may provide such assistance if (i) he or she wishes to do so and (ii) if the Patient or Companion provides written agreement to the use of such person to interpret or facilitate communication, and (iii) if such use is necessary or appropriate under the circumstances, giving appropriate consideration to any privacy issues that may arise; provided, however, that in time-sensitive life-threatening situations, the Hospital may rely upon communications through a Companion until a Qualified Interpreter is obtained.
VI. NOTICE TO COMMUNITY A. Policy Statement. The Hospital will continue to post and maintain signs of conspicuous size and print at all Hospital admitting stations, the Emergency Department, and wherever a Patient's Bill of Rights and Responsibilities is required by law to be posted. Such signs shall be to the following effect:
Qualified Interpreters, TTY's, and other auxiliary aids and services are available free of charge to people who are deaf or hard of hearing. For assistance, please contact any Hospital Personnel or the Information Office at _ _ _ __ (voice/TTY), room _ _ _ __
These signs shall include the international symbols for "interpreters" and "TTY's." B. Patient Handbook. The Hospital shall include in all future printings of its Patient
Handbook (or equivalent) and all similar publications a statement to the following effect: To ensure effective communication with patients and their companions who are deaf or hard of hearing, we provide appropriate auxiliary aids and services free of charge, such as: sign language and oral interpreters, TTY's, note takers, written materials, telephone handset amplifiers, assistive listening devices and systems, telephones compatible with hearing aids, closed caption decoders, and open and closed captioning of most Hospital programs.
27

Please ask your nurse or other Hospital personnel for assistance, or contact the

Information Office at

(voice or TTY), room _.

The Hospital shall also include in the Patient Handbook a description of the

Hospital's complaint resolution mechanism. The Hospital shall provide all

Patients who seek treatment at the Hospital's Emergency Department and all

Companions a copy of the Patient Handbook when they are evaluated in triage or

when they register, whichever occurs first.

C. Website. The Hospital shall include in its website the statement referenced in

Section VI (B), supra.

. VII. NOTICE TO HOSPITAL PERSONNEL AND PHYSICIANS

A. Within thirty (30) days of entry of this Consent Decree, the Hospital shall publish its

revised policies, attached as Exhibit 1 to this Consent Decree. The Hospital will print and

maintain copies of these policies in a central location, in written form, provide these policies

to any interested entity or individual requesting them, and incorporate the policies into its standard

operating procedures.

B. The Hospital shall publish, in appropriate form, the following notice regarding the

Hospital's provision for providing effective communication with persons who are deaf or hard of

hearing. The notice should include, but is not limited to, language to the following effect:

If you recognize or have any reason to believe that a patient or companion of a patient is deaf or hard of hearing, you must advise the person that appropriate auxiliary aids and services such as sign language and oral interpreters, video interpreting services, TTY's, note takers, written materials, telephone handset amplifiers, assistive listening devices and systems, telephones compatible with hearing aids, closed caption decoders, and open and closed captioning of most

28

Hospital programs shall be provided free of charge. If you are the responsible

health care provider, you must ensure that such aids and services are provided

when appropriate. All other personnel should direct that person to the

[responsible] Administrator, located at

, and available at telephone

extension

. This offer and advice must likewise be made in response to

any overt request for appropriate auxiliary aids or services.

C. The Hospital will distribute the notice in subsection B and its revised policies,

attached as Exhibit 1 to this Consent Decree, within forty-five days after entry of this Consent

Decree, to all Hospital Personnel and affiliated physicians (physicians with practicing or admitting

privileges), to all new Hospital Personnel and newly affiliated physicians upon their affiliation or

employment with the Hospital, and to all Hospital Personnel on an annual basis.
vm. TRAINING OF HOSPITAL PERSONNEL

A. Emergency Department Personnel. The Hospital shall ensure that mandatory in-

service trainini is provided to all Hospital Personnel with Patient responsibility who work or

volunteer in the Emergency Department that addresses the special needs of deaf or hard of hearing

Patients and Companions utilizing that department. This training will include the following

objectives: to promptly identify communication needs and preferences of persons who are deaf or

hard of hearing; to secure qualified interpreter services as quickly as possible when necessary,

including how to operate any video interpreting services equipment; to use, when appropriate, flash

cards and pictographs (in conjunction with any other available means of communication that shall

2 "In-service training" for purposes ofthis Consent Decree includes, without limitation, such means of training or familiarization used by the Hospital to inform Hospital Personnel of policies, procedures, expectations, etc. Examples ofin-service training could include, without limitation, written policies and procedures, videotapes, training materials, training sessions, seminars, conferences and the like.
29

augment the effectiveness of the communication); and an explanation of all policies described andlor modified pursuant to this Consent Decree. The Hospital shall ensure that such training is provided to all Hospital Personnel with Patient responsibility who work or volunteer in the Emergency Department or, if already provided, updated, prior to the date on which the Hospital is scheduled to implement the modified Program and annually thereafter.
B. Psychiatric Personnel and Social Workers. The Hospital shall provide specialized mandatory in-service training to Hospital Personnel with Patient responsibility who work in the Department of Psychiatry (or its equivalent, if any) or are members of the Social Work Department (or its equivalent). This training shall include the following objectives: to promptly identify communication needs and preferences of deaf or hard of hearing Patients and Companions; to secure qualified interpreter services as quickly as possible when necessary, including training regarding how to operate any video interpreting services equipment; to facilitate appropriate interaction between deaf or hard of hearing Patients and other Patients, when appropriate (~, group therapy sessions and other times when interaction with persons other than Hospital Personnel is encouraged); and an explanation of all policies modified pursuant to this Consent Decree. The Hospital shall ensure that such training is provided, or if already provided, updated, prior to the date on which the Hospital is scheduled to implement the modified Program and annually thereafter.
C. Other Key PersonneL The Hospital shall provide training to other Hospital Personnel not otherwise trained as provided above who have direct contact with deaf or hard of hearing Patients, families of deaf or hard of hearing Patients, and Companions, to include all clinical directors and nursing supervisors; all senior-level administrators; personnel who staff the
30

AdmissioniRegistration desk (or its equivalent for in-patient registration); all triage J;lurses and other triage professionals; and heads of each department in which communication with Patients occurs. The Hospital shall provide to personnel responsible for billing and insurance issues who routinely interact with Patients and Companions training on the availability of auxiliary aids and services and the existence in the Hospital of an Information Office and Administrator(s). The Hospital shall ensure that such training is provided, or if already provided, updated prior to the date on which the Hospital is scheduled to implement the modified Program and annually thereafter.
D. Operators. The Hospital shall provide to Hospital Personnel who receive telephone calls from the public, special instructions on using telecommunication relay services, including, but not limited to, TTY's and the Maryland Tele-Video Relay Service to make and receive telephone- calls and training generally on the existence in the Hospital of an fuformation Office and Administrator(s) and complaint resolution processes. The Hospital shall ensure that such training is provided, or if already provided, updated prior to the date on which the Hospital is scheduled to implement the modified Program and annually thereafter.
E. Affiliated Physicians. 1. Training Sessions. The Hospital shall annually conduct one or more training sessions on the communication and psychological needs of persons who are deaf or hard of hearing, and shall invite all physicians who are affiliated in any way with the Hospital (admitting or surgical privileges, etc.) to attend. In addition, the Hospital shall provide training videotapes that contain substantially similar information to any affiliated physician upon request.
31

2. Written Materials. Within sixty (60) days of the entry of this Consent Decree, the Hospital shall distribute a set of materials to all affiliated physicians. These materials shall contain at least the following: the Hospital's policies revised pursuant to this Consent Decree; any relevant forms; a description of the Hospital's Program and a request that physicians' staff members notify the Hospital about deafor hard of hearing Patients and Companions as soon as they schedule admissions, tests, surgeries or other health care services at the Hospital. In addition, if Hospital policies are further modified pursuant to this Consent Decree, the Hospital shall distribute the modified policies to all . affiliated physicians within 21 days of such modification.
F. Other PersonneL The Hospital shall develop and implement an internal program that shall provide appropriate training to all Hospital Personnel not trained under the preceding sections who should be trained in order to meet the obligations under this Consent Decree. This training shall take place at such times as may be necessary to permit the Hospital to meet all of its obligations under this Consent Decree.
G. General Provisions. The Hospital will provide the training specified above to new Hospital Personnel (including without limitation Emergency Department, Psychiatric and Social Work personnel) as part of any Orientation. Such training will be comparable to training provided to specific departments as necessary. Watching the entire video of the original training shall suffice to meet this obligation. The Hospital shall maintain attendance sheets of all training conducted pursuant to Section VIII of this Consent Decree, which shall include the names and respective job
32

titles of the attendees, as well as the date, time, duration, and location of the training session. IX. MISCELLANEOUS INJUNCTIVE RELIEF
A. Discrimination by Association. The Hospital shall not deny equal services, accommodations, or other opportunities to any individual because of the known relationship of the person with someone who is deaf or hard of hearing.
B. Retaliation and Coercion. The Hospital shall not retaliate against or coerce in any way any person who made or is making a complaint according to the provisions of this Consent Decree or exercised or is exercising his or her rights under this Decree or the ADA.
X. REPORTING, MONITORING AND VIOLATIONS A. Reports
1. Compliance Reports. Three, nine, fifteen, twenty-one, and thirty-three months following the entry of this Consent Decree, the Hospital shall provide a written report ("Report") to the United States regarding its efforts to comply with this Consent Decree. Each Report must state the identity of each deaf or hard of hearing Patient or Companion in a manner that appropriately protects their confidentiality and the auxiliary aides) or service(s).provided to the individual(s), and whether VIS or on-site interpreters were used. In the event that the Hospital does not provide the particular auxiliary aides) or service(s) requested by a Patient or Companion, or provides no auxiliary aides) or service(s), the Report must state (a) the procedure followed by the Hospital in determining whether to provide auxiliary aids and services to the Patient or
33

Companion and (b) the Hospital's reasons for not providing the particular

auxiliary aides) or service(s) requested by the Patient or Companion, including

an explanation regarding which aid or service was requested and what, if any,

aid or service was provided. The Hospital shall maintain appropriate records,

including, but not limited to, those described in this Consent Decree, to

document the information contained in the Report.

2.

Complaints. During the term of this Consent Decree, the Hospital shall notify

the undersigned counsel for the United States if any individual brings any

lawsuit, complaint, charge, or grievance alleging that the Hospital failed to

provide auxiliary aids and services to deaf or hard of hearing Patients or

Companions. Such notification shall be provided in writing via certified mail

within fifteen days of when the Hospital has received notice of the allegation

and shall include, at a minimum, the nature ofthe allegation, the name of the

individual bringing the allegation and any documentation possessed by the

Hospital relevant to the allegation.

B. Violation of Consent Decree.

1. If the Hospital violates this Consent Decree, the United States will have such

remedies as are allowed by law, provided that the first such violation by the

Hospital shall be deemed a violation of the ADA for the purpose of assessing

civil penalties.

2. Notwithstanding the provisions of Section X (B)(1), in the event that the

34

l

United States believes that the Hospital has violated any provision of this Consent Decree, the United States will give written notice (including reasonable particulars) of such violation to the Hospital's chief executive officer, and the Hospital shall then respond to such notice andlor cure such non-compliance as soon as practicable but no later than thirty days thereafter. Any event of non-compliance that prevents or restricts a Patient from receiving urgent health care services shall be cured without delay. The United States and the Hospital shall negotiate in good faith in an attempt to resolve any dispute relating thereto before the United States seeks relief under Section X (B)(l) above.
XI. NITSCELLANEOUS
A. Duration of the Consent Decree. This Consent Decree shall remain in effect for three years from the date of this Consent Decree. Three years after the date of this Consent Decree, this Consent Decree shall terminate unless (i) the United States moves for cause for an . extension, and (ii) the Court grants such motion. This Court retains jurisdiction over this case for the purpose of deciding any issue that may arise under this Consent Decree, and for purposes of enforcement of this Consent Decree. Any party may bring such issues before the Court by filing an appropriate motion.
B. Entire Consent Decree. This Consent Decree constitutes the entire agreement by the United States and the parties and no other statement, promise, or agreement, either written or oral, made by any party or agents of any party, that is not contained in this written Consent Decree,
35

including its attachments, shall be enforceable. C. Changing Circumstances. During the term of this Consent Decree, there may be a
change in circumstances such as, for example and without limitation, an increased or decreased availability of qualified sign language, relay, or oral interpreters or developments in technology to assist or improve communications with persons who are deaf or hard of hearing. If the Hospital determines that such changes create opportunities for communicating with such persons more efficiently or effectively than is required under this Consent Decree, or create difficulties not presently contemplated in the provision of appropriate auxiliary aids and services, it may propose changes to this Consent Decree by presenting written notice to the United States. Such changes shall then only be presented to the Court for incorporation in this Consent Decree if the United States, upon review, grants its approval, which approval shall not be unreasonably withheld. The Hospital and the United States will negotiate in good faith prior to proposing any changes to the Court.
D. Binding Effect. This Consent Decree is final.and has binding effect on the parties and the United States, including all 'principals, agents, executors, administrators, representatives, employees, successors in interest, beneficiaries, assigns, heirs and legal representatives thereof. The Hospital has a duty to so inform any successor in interest and to timely notify all Parties and the United States of all such successors in writing. In the event the Hospital seeks to transfer or assign all
,
or part of its interests in any facility covered by this Consent Decree, and the successors or assign intends on carrying on the same or similar use of the facility, as a condition of sale the Hospital shall obtain the written accession of the successor or assign to any obligations remaining under this Consent Decree for the remaining term of this Consent Decree. -II
36

E. Non-Waiver. Failure by the United States to seek enforcement of this Consent Decree pursuant to its terms with respect to any instance or provision shall not be construed as a waiver to such enforcement with regard to other instances or provisions.
F. Severability. In the event that the Court determines that any provision of this Consent Decree is unenforceable, such provision shall be severed from this Consent Decree and all other provisions shall remain valid and enforceable, provided, however, that if the severance of any such provision materially alters the rights or obligations of the Parties and the United States hereunder, they shall, through reasonable, good faith negotiations, agree upon such other amendments hereto as may be necessary to restore the Parties and the United States as closely as possible to the relative rights and obligations initially intended by them hereunder.
G. Compliance with Applicable Laws. Any modification or amendment of this Consent Decree does not affect the Hospital's independent responsibilities under any applicable Federal, state or local laws or regulations.
37

For the United States:
ROD l ROSENSTEIN . United States Attorney District of Maryland
JAMIE BENNETT Assistant United States Attorney United States Attorney's Office District of Maryland 36 Charles Street Fourth Floor Baltimore, MD 21201 Telephone: (410) 209-4800
Of COlll1sel

WAN lKIM ASSISTANT ATTORNEY GENERAL Civil Rights Division
JOHN L. WODATCH, Chief PHILIP L. BREEN, Special Legal
Counsel L. IRENE BOWEN, Deputy Chief Disability Rights Section Civil Rights Division
~~
ROBERT l MATHER Trial Attorneys Disability Rights Section Civil Rights Division U.S. Department of Justice 950 Pennsylvania Avenue NW NYA
Bldg. Washington, DC 20530 Telephone: (202) 307-0480 (Devine) Telephone: (202) 307-2236 (Mather) Fax: (202) 305-9775 (Devine) kathleen.s.devine@usdoj.gov Fax: (202) 616-6862 (Mather) robert.mather@usdoj.gov

38

For Elizabeth Gillespie, David Irvine, Erin Whitney, Cary Barbin, Kathryn Vadakin, Brian Leffler, and Xiomara Porras:
WASHINGTON LAWYERS COMMITTEE FOR CIVIL RlGHTS AND URBAN AFFAIRS
Elizabeth Elaine Gardne, sq. 11 Dupont Circle, Suite 0 Washington, DC 20036 (202) 319-1000 (telephone) (202) 319-1010 (facsimile) and Counsel for Plaintiffs SUTHERLAND ASBILL & BRENNAN LLP
~~ wi S. ne sq. (No. 10845) Thomas R. undy, ill, Esq. (No. 15265) 1275 Pennsylvania Ave, N.W. Washington, D.C. 20004 (202) 383-0100 (telephone) (202) 637-3593 (facsimile)
39

For Dim~ion Health Corporation: "
C?~~~ .. -
PamelaJ.Whl~~.~ \~ .VJ."OP
Neil E. Duke, Esq." fflf'-<-\" )
OBER, KALER, GRTh1ES & SHRIVER 120 East Baltimore Street Baltimore, MD 21202-1643 (410) 685-1120 (telephone) (410) 547-0699 (facsimile) Counsel for Dimension Health Corporation Attachments" (Exhibits 1 and 2)
40