[DO NOT PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT

________________________

No. 14-12771

________________________

D.C. Docket No. 6:12-cv-01268-GAP-DAB

RICHARD MARTIN, 

JOHN D'AMBROSIO, 

YOLANDA GERVARZES, 

 Plaintiffs-Appellants,

versus

HALIFAX HEALTHCARE SYSTEMS, INC., 

HALIFAX COMMUNITY HEALTH SYSTEMS, 

a Special Taxing District, 

d.b.a. Halifax Hospital Medical Center, 

 Defendants-Appellees.

________________________

Appeal from the United States District Court

for the Middle District of Florida

________________________

(July 31, 2015)

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Before JORDAN, JULIE CARNES, and LINN,* Circuit Judges. 

JULIE CARNES, Circuit Judge: 

Plaintiffs Richard Martin, John D’Ambrosio, and Yolanda Gervarzes 

(collectively, “Plaintiffs”) appeal the district court’s order granting summary 

judgment to Defendants on their disability discrimination claims arising under the 

Americans with Disabilities Act (the “ADA”) and the Rehabilitation Act of 1973 

(the “Rehab Act”).1

 The district court held that there was no evidence from which 

a reasonable jury might conclude that Plaintiffs were excluded from participating 

in, or denied the benefit of, the services Defendants provided, or otherwise 

discriminated against. After a careful review of the record, and with the benefit of 

oral argument, we affirm.

BACKGROUND

I. Factual Background

Defendants Halifax Healthcare Systems, Inc. and Halifax Community 

Health Systems own and operate Halifax Hospital Medical Center (“Halifax 

Hospital” or “the hospital”). The three plaintiffs are deaf individuals who 

communicate primarily through the use of American Sign Language (“ASL”) and 

 *

 Honorable Richard Linn, United States Circuit Judge for the Federal Circuit, sitting by 

designation. 

1

 The district court also granted summary judgment on claims asserted by Plaintiffs under 

the Florida Civil Rights Act of 1992. Plaintiffs do not specifically challenge on appeal or offer 

any arguments concerning the district court’s ruling on claims made under this statute. 

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who either were treated or were present with a family member who was treated at 

Halifax Hospital in the summer of 2011. Plaintiffs claim that they requested live 

ASL interpreting services at some point during their interaction with the hospital 

staff. And, as described in more detail below, the hospital did provide several 

hours of live interpreting services to Plaintiffs D’Ambrosio and Gervarzes, and 

communicated with all three plaintiffs via written notes. However, the hospital did 

not provide continuous live interpreting services to D’Ambrosio or Gervarzes 

throughout the duration of their stay at the hospital, nor did the hospital make a 

live interpreter available to Plaintiff Martin during his brief emergency room visit.

Because the hospital failed to do so, Plaintiffs initiated the present litigation. We 

set out, individually, the facts underlying each plaintiff’s claim. 

A. John D’Ambrosio

Accompanied by girlfriend Sandra Hill, who is also deaf, D’Ambrosio was 

rushed to the hospital on June 23, 2011, after suffering a major heart attack. Dr. 

Kirby Haws, one of D’Ambrosio’s treating physicians, testified that D’Ambrosio’s

condition upon arrival at the hospital was life threatening. Recognizing that they 

needed to act fast to save D’Ambrosio’s life, the medical staff quickly determined 

that D’Ambrosio needed an emergency cardiac catheterization, which procedure 

was soon thereafter performed by Dr. Vance Wilson. 

D’Ambrosio and his girlfriend had both requested a live ASL interpreter 

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immediately upon their arrival at the hospital. And, in fact, hospital staff contacted 

SLS Interpreting Services to request an interpreter, informing D’Ambrosio that a 

live interpreter was on the way. But once it was determined that D’Ambrosio 

needed an immediate, emergency cardiac catheterization, staff canceled the request 

for an interpreter. 

As to the time spent with D’Ambrosio before the catheterization, Dr. Haws 

and Dr. Wilson testified that they were able to communicate effectively with him, 

notwithstanding the absence of a live interpreter. Dr. Haws stated that he used the 

“LifeLinks” video remote interpreting (“LifeLinks”) system to advise D’Ambrosio 

about his condition and the catheterization procedure and that he communicated 

with D’Ambrosio’s girlfriend through a combination of lip-reading, gestures, and 

written notes.2

 Dr. Haws did not recall D’Ambrosio requesting a live interpreter 

prior to the procedure, and he did not believe that a live interpreter was necessary. 

Dr. Wilson similarly indicated in his written report that he used a 

“translator” in the catheterization lab to inform D’Ambrosio that he was “having a 

heart attack and that we were going to have to open up his heart artery with a 

catheter.” Dr. Wilson did not write notes to D’Ambrosio prior to or during the 

procedure due to the need to keep the catheterization lab sterile. Nonetheless, Dr. 

Wilson did use hand gestures to let D’Ambrosio know that he was okay and to 

 

2

 LifeLinks is an interpreting service that provides access to a live ASL interpreter on a 

video screen. 

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remind him that he needed to be still during the procedure. Dr. Wilson testified 

that D’Ambrosio appeared to understand his communications. In any event, as Dr. 

Wilson explained, prior to an emergency catheterization, there is limited 

opportunity to communicate with any patient, regardless of whether or not the 

patient can hear. Indeed, due to the urgency of the procedure, a doctor’s 

communication to the patient generally consists of little more than informing the 

patient that he is having a heart attack and that a catheterization procedure needs to 

be done immediately. 

D’Ambrosio acknowledges that Dr. Wilson attempted to communicate with 

him through the LifeLinks system immediately before the catheterization 

procedure. In fact, in the summary judgment response that Plaintiffs filed in the 

district court, D’Ambrosio indicated that Dr. Wilson actually did communicate 

with him via LifeLinks prior to the procedure. Yet, in a subsequent motion to 

reconsider submitted after the entry of summary judgment, and now on appeal, 

D’Ambrosio claimed that the LifeLinks system was inoperable. As a result, 

D’Ambrosio contends that, having no understanding of his condition or what the 

catheterization would entail, he was distressed because he was in pain throughout 

the procedure. 

After the procedure, D’Ambrosio was placed in the ICU and visited there by 

Dr. Wilson, who communicated with him by writing notes. Dr. Wilson testified 

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that, through these notes, he was able to convey that the procedure was successful, 

that D’Ambrosio would be okay, and that Wilson would come back the next day to 

discuss follow-up and prognosis. The documentary evidence, which includes Dr. 

Wilson’s written notes, confirms Dr. Wilson’s testimony. Moreover, it is 

undisputed that D’Ambrosio can read and write English. D’Ambrosio nevertheless 

claims that he did not understand the information provided to him by Dr. Wilson in 

the ICU. 

D’Ambrosio was hospitalized at Halifax Hospital from June 23, 2011 

through June 28, 2011. D’Ambrosio testified that he repeatedly requested a live 

ASL interpreter during his hospitalization, but that while an interpreter was present 

some of the time, during the majority of the time there was no live interpreter. 

According to D’Ambrosio, the hospital staff tried to communicate with him 

through friends and family, written notes, and gestures, but he was unable to 

understand any of the information the staff attempted to provide. Again, however, 

written notes in the record confirm that Dr. Wilson and other staff provided 

detailed written information to D’Ambrosio concerning his condition, treatment, 

and prognosis, including a graphic depiction of the cardiac catheterization 

procedure. 

Undisputed documentary evidence also shows that the hospital provided 

webcam interpreting services to D’Ambrosio on June 24th, and a live interpreter to 

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D’Ambrosio for two hours on June 26th, four hours on June 27th, and two hours 

on June 28th. Further, D’Ambrosio, who testified that he regularly texted when 

communicating with hearing and deaf individuals in other contexts, acknowledged 

that he had his laptop during most of his hospital stay and that he could have used 

it to communicate with hospital staff by typing written notes, but he simply chose 

not to do so.3 

After his hospitalization, D’Ambrosio continued to be treated by Dr. Wilson, 

until Dr. Wilson terminated the relationship due to D’Ambrosio’s refusal to 

comply with his order that he stop smoking. An ASL interpreter was present at 

each of D’Ambrosio’s follow-up visits with Dr. Wilson. 

B. Yolanda Gervarzes

Gervarzes accompanied her seventeen-year old daughter, Angelique Martin, 

to the hospital on August 2, 2011 when Martin manifested pre-term labor

symptoms. Upon arrival at 9:00 p.m., Gervarzes requested a live ASL interpreter. 

Gervarzes was not a newcomer to the hospital, having been there many times 

before and having received live interpreting services on at least 48 prior occasions 

when she had been seen as a patient. This time, though, the staff first attempted to 

use the LifeLinks system to communicate with her, instead of obtaining a live 

 

3

 D’Ambrosio also had access to an ASL translating service on his laptop, but, crediting 

D’Ambrosio’s testimony, we assume that he was prohibited by his service agreement from using 

the translating service to converse with people in the same room as him, and so he could not use 

the service to communicate with hospital staff. 

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interpreter. 

Nurse Laperriere, who spoke with Gervarzes upon her daughter’s admission 

to the hospital, testified that she had used LifeLinks without any problems in the 

past, but Gervarzes nonetheless refused to use the service. Laperriere then

contacted Nurse Pollock, the supervising nurse on duty at the time, about obtaining 

a live interpreter for Gervarzes. Pollock testified that when he encountered 

Gervarzes, she was angry and shaking an ADA flyer in an “animated” manner. 

Even though the LifeLinks system had been set up and was ready for use by 

Gervarzes, Pollock acceded to Gervarzes’ demand and immediately arranged for a 

live interpreter to come to the hospital instead. Pollock placed no restrictions on 

the time the interpreter could remain there. 

Gervarzes’ daughter gave birth to a healthy baby boy at 5:40 p.m. on August 

4, and was discharged on August 6. During her stay, the hospital provided live 

interpreting services to her mother, Plaintiff Gervarzes, from 11:30 p.m. until 1:30 

a.m. on August 2-3, and from 9:30 a.m. until 12:30 p.m. on August 3. When no 

interpreter was present, hospital staff was able to communicate with Gervarzes via 

her daughter, who was not deaf, and by writing notes. 

C. Richard Martin

Martin was treated in the hospital’s emergency room for a minor head injury 

that he suffered when he fell out of his motorized scooter while shopping on 

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August 17, 2011. While he was in the ER, Martin was examined and his vital 

signs were taken. Martin had a CT scan of his brain and x-rays of his cervical 

spine and shoulder, the results of which were normal. 

Dr. Kocisko, who attended to Martin during his ER visit, testified that 

Martin never requested a live interpreter,4 and Kocisko did not believe a live 

interpreter was necessary. Dr. Kocisko wrote notes to communicate with Martin, 

who appeared to understand all the information that was conveyed to him. Martin 

received typed instructions upon discharge, and it is undisputed that he could read 

and write English. As Martin was only in the emergency room for about two hours 

before he was discharged, the above constitutes the extent of his interaction with 

hospital staff on this particular occasion. Further, it is undisputed that the hospital 

had provided live interpreting services to Martin on at least 42 prior occasions. 

II. Procedural History

Plaintiffs filed their complaint in August, 2012, asserting claims against 

Defendants under Title II and Title III of the ADA, § 504 of the Rehab Act, and the 

 

4

 Plaintiffs claimed in their brief in opposition to summary judgment, as they claim in 

their appellate brief, that Martin requested an interpreter upon his arrival at the hospital and 

numerous times thereafter, but no interpreter was provided. Yet, Plaintiffs cited no evidence in 

support of that claim in any of the materials they filed in the district court. Likewise, Plaintiffs 

cite no supporting evidence for this assertion on appeal. See Mann v. Taser Int’l, Inc., 588 F.3d 

1291, 1303 (11th Cir. 2009) (“For factual issues to be considered genuine, they must have a real 

basis in the record.”) (citation and quotation marks omitted); Gargiulo v. G.M. Sales, Inc., 131 

F.3d 995, 999 (11th Cir. 1997) (“to oppose [a] properly supported motion for summary 

judgment, [the plaintiff] must come forward with specific factual evidence, presenting more than 

mere allegations”). 

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Florida Civil Rights Act. In their complaint, Plaintiffs alleged that the above 

statutes require that deaf individuals have an equal opportunity to participate in and 

enjoy the benefits of the hospital’s services, and that Defendants failed to meet the 

obligations imposed on them by these laws. Plaintiffs sought both compensatory 

damages and injunctive relief. 

Defendants moved for summary judgment. Plaintiffs filed a timely 

response. Yet, while Gervarzes, D’Ambrosio, and D’Ambrosio’s girlfriend

submitted declarations, and Martin submitted a set of interrogatory responses, in 

opposition to summary judgment, Plaintiffs neither submitted nor referenced any 

of their own deposition testimony. Thereafter, Defendants filed their reply. It was 

only then, about a month after filing their response, that Plaintiffs sought leave to 

supplement the record by designating additional evidence, primarily the complete

transcript of each Plaintiff’s deposition. 

The district court denied Plaintiff’s motion to supplement, and granted 

summary judgment to Defendants. Plaintiffs moved for reconsideration of the 

summary judgment order, but attached only D’Ambrosio’s deposition transcript as 

an exhibit, and not the deposition transcripts of Martin and Gervarzes. Defendants 

filed a motion to strike the deposition transcript, which the district court granted in 

conjunction with its order denying reconsideration. 

On appeal, Plaintiffs contend that there is sufficient evidence in the record to 

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withstand Defendants’ motion for summary judgment. According to Plaintiffs, the 

hospital’s failure to provide live interpreters during the entirety of their stay creates 

a triable issue as to whether the hospital failed to provide appropriate auxiliary aids 

necessary to ensure effective communication, as required by the ADA and the 

Rehab Act. Related to this contention, Plaintiffs also argue that the district court 

erred in denying their motion to reconsider, meaning that the court should have 

considered D’Ambrosio’s deposition testimony in ruling on the summary judgment 

motion. 

DISCUSSION

I. Motions to Supplement and Reconsider

In support of their motion for summary judgment, Defendants cited 

documentary evidence and testimony, including excerpts from the depositions of 

D’Ambrosio and Martin. In their response, however, Plaintiffs cited to no 

deposition testimony. Instead, the only evidence Plaintiffs submitted in response 

to Defendants’ motion was a set of interrogatory responses from Martin

establishing that he is deaf and primarily uses ASL to communicate, and 

declarations from Gervarzes, D’Ambrosio, and D’Ambrosio’s girlfriend summarily 

stating that (1) they requested an interpreter during their interactions with the 

hospital and “on many occasions [an interpreter] was not provided” and (2) they 

did not understand the information the hospital staff tried to convey through other 

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means, such as written notes.5 Gervarzes and D’Ambrosio never specified what 

information they did not understand.

Nearly a month after they filed their initial response, and after Defendants 

had already filed their reply, Plaintiffs sought leave to supplement the summary 

judgment record by designating additional deposition testimony. Even had it been 

timely, this tardy submission still failed to comply with the Federal Rules of Civil 

Procedure because Plaintiffs never offered any specific cites in their belated 

offering. See Fed. R. Civ. P. 56(c)(1)(A) (requiring a party who asserts that a fact 

is genuinely disputed to support the assertion by “citing to particular parts of 

materials in the record”). The district court denied the motion. In their subsequent 

motion to reconsider, Plaintiffs attached D’Ambrosio’s complete deposition as an 

exhibit and, only then, did they finally cite to specific portions of the testimony on 

which they relied. The district court granted Defendants’ motion to strike this 

untimely proffer of evidence, and it denied reconsideration. 

We review the district court’s rulings on the motion to supplement and the 

motion to reconsider for an abuse of discretion. See Fed. R. Civ. P. 56(e)

(permitting but not requiring the district court to “give an opportunity to properly 

support or address” a fact); Sanderlin v. Seminole Tribe of Florida, 243 F.3d 1282, 

 

5

 They also attached to the declarations some hospital records, including D’Ambrosio’s 

discharge summary and selected handwritten notes that D’Ambrosio and Gervarzes had 

exchanged with hospital staff. 

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1285 (11th Cir. 2001) (“The denial of a motion for reconsideration . . . is reviewed 

only for abuse of discretion.”). We find no abuse of discretion. See Fils v. City of 

Aventura, 647 F.3d 1272, 1283 (11th Cir. 2011) (“the district court does not abuse 

its discretion simply because the appellate court would have handled the issue 

differently”). 

Pursuant to Rule 56, Plaintiffs were required to cite in their initial response 

the “particular parts” of any depositions relied upon in opposition to summary 

judgment. Fed. R. Civ. P. 56(c)(1)(A). The depositions at issue had been available 

to Plaintiffs for more than six months when they filed their response, and Plaintiffs 

were aware that Defendants had cited portions of these same depositions in support 

of their motion for summary judgment. Yet, Plaintiffs did not offer, and still do 

not offer, any reason for neglecting to provide the required citations or to respond 

specifically to the evidence cited by Defendants. Even when they filed their 

subsequent motion to supplement, Plaintiffs still failed to cite to “particular parts” 

of the depositions, as required by Rule 56. 

Plaintiffs finally provided citations to D’Ambrosio’s deposition in their 

motion to reconsider. However, given the unexplained delay and the previous 

failure to provide any specific citations, our precedent and the governing federal 

rules did not require the district court to consider D’Ambrosio’s deposition 

transcript. See Fed. R. Civ. P. 56(c)(3) (“The court need consider only the cited 

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materials, but it may consider other materials in the record.”); Young v. City of 

Palm Bay, Florida, 358 F.3d 859, 864 (11th Cir. 2004) (“the district court had a 

range of options which included refusing to consider untimely filings”). 

Accordingly, we find no abuse of discretion by the district court in denying 

Plaintiff’s motions to supplement and to reconsider. 

II. Summary Judgment Motion

A. Standard of Review

We review the district court’s order granting summary judgment de novo. 

McCullum v. Orlando Reg’l Healthcare Sys., Inc., 768 F.3d 1135, 1141 (11th Cir. 

2014). We apply the same standard as the district court, viewing the facts and 

drawing all reasonable inferences in the light most favorable to Plaintiffs. Liese v. 

Indian River Cnty. Hosp. Dist., 701 F.3d 334, 337 (11th Cir. 2012). 

B. Applicable Law

Plaintiffs’ ADA and Rehab Act claims are governed by the same legal 

standard. See Cash v. Smith, 231 F.3d 1301, 1305 (11th Cir. 2000). To prevail, 

Plaintiffs must prove (1) that they are qualified individuals with a disability, (2) 

who were excluded from participation in or denied the benefits of the hospital’s 

services, programs, or activities, or otherwise discriminated against, (3) on account 

of their disability. See Shotz v. Cates, 256 F.3d 1077, 1079 (11th Cir. 2001). 

Further, to recover compensatory damages, Plaintiffs must also show that the 

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exclusion or denial was the result of intentional discrimination. Liese, 701 F.3d at 

344 (citing Wood v. President & Trs. of Spring Hill Coll., 978 F.2d 1214, 1219 

(11th Cir. 1992)). Here, Plaintiffs sought both compensatory damages and 

injunctive relief in their complaint. There is no dispute that Plaintiffs are qualified 

individuals with a disability. The question is whether the hospital excluded 

Plaintiffs from, or denied them the benefits of, the hospital’s services or programs 

by failing to provide a live ASL interpreter every time an interpreter was 

requested. 

The governing regulations provide that such an exclusion or denial occurs 

when a hospital fails to provide “appropriate auxiliary aids” to a deaf individual, 

including a deaf companion, “where necessary to ensure effective 

communication.” 28 C.F.R. § 36.303(c)(1). See also 28 C.F.R. § 36.202(b) 

(requiring public accommodations to provide an “equal” opportunity for the 

hearing impaired to participate in and benefit from services). “Companion” 

includes a family member of an individual seeking access to a hospital’s services. 

28 C.F.R. § 36.303(c)(1)(i). Appropriate auxiliary aids include live interpreters or

video remote interpreting systems, among other aids such as computer-aided 

transcription services, written materials, and exchange of written notes. See 28 

C.F.R. § 36.303(b). The type of aid that is necessary varies depending on the 

individual’s communication method, the “nature, length, and complexity” of the 

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involved communication, and the context in which the communication occurs. 28 

C.F.R. § 36.303(c)(1)(ii). 

In accordance with the above regulations, this Court has recognized that the 

question whether a hospital has provided appropriate auxiliary aids to a deaf 

patient is generally a “fact-intensive” inquiry that depends on context, especially 

the nature, significance, and complexity of the involved treatment. Liese, 701 F.3d 

at 342. We have thus held that a live ASL interpreter might be necessary for a 

patient to understand a complex procedure such as gallbladder surgery. Id. at 343-

44 (finding a question of fact as to whether a hospital violated the ADA and the 

Rehab Act where a deaf patient asked for an interpreter but did not receive one, 

and thus did not understand much of what was conveyed to her, via lip-reading, 

notes, and pantomiming, about her proposed gallbladder removal surgery). Yet we 

have also warned that not every denial of a request for an auxiliary aid precludes 

summary judgment or creates liability under the ADA or the Rehab Act. Id. at 

343. Otherwise, a requested service would automatically be transformed into a 

“necessary” service merely by the fact that it was requested. Id. (“[C]onstruing the 

regulations in this manner would effectively substitute ‘demanded’ auxiliary aid 

for ‘necessary’ auxiliary aid.”).

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C. Exclusion or Denial of Benefits 

1. John D’Ambrosio

The record here indicates that the hospital provided the appropriate auxiliary 

aids necessary to ensure that D’Ambrosio could effectively communicate with 

hospital staff. It is undisputed that the staff immediately requested a live ASL 

interpreter for D’Ambrosio as soon as he arrived at the hospital. The request was 

cancelled only when it was determined that D’Ambrosio needed an emergency 

catheterization procedure. The reason for the cancellation is obvious: time was of 

the essence in performing the catheterization and waiting for a live interpreter 

would have been severely detrimental to D’Ambrosio’s health. Indeed, had the 

doctors not gotten D’Ambrosio into the catheterization lab as quickly as possible, 

but instead waited for an interpreter to arrive, they might well have been unable to 

save his life. In short, the biggest barrier to the staff’s ability to converse with 

D’Ambrosio at that time was not the absence of a live ASL interpreter, but the fact 

that the doctors had to immediately begin the procedure necessary to save his life. 

The undisputed evidence further shows that during D’Ambrosio’s 

hospitalization following the catheterization, Dr. Wilson and other staff used a 

variety of appropriate auxiliary aids to ensure effective communication with him, 

including simple but detailed written notes and graphics. It is undisputed that 

D’Ambrosio can read and write English and that he regularly uses writing, 

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including texting, to communicate with hearing and deaf individuals in other 

contexts. In fact, in his declaration, D’Ambrosio never specifies what, exactly, he 

failed to understand in these written notes and graphics.6

 In addition, it is 

undisputed that the hospital provided D’Ambrosio with bedside webcam 

interpreting services on June 24th, and with eight hours of live ASL interpreting 

services between June 26th and his discharge from the hospital on June 28th. 

In light of the above evidence, the declarations D’Ambrosio and his 

girlfriend provided to the district court were insufficient to show that the hospital 

failed to provide aids necessary to ensure effective communication, in violation of 

the ADA or the Rehab Act. Nor could a jury have reasonably inferred a violation 

based on the cited portions of D’Ambrosio’s deposition testimony. In fact, 

D’Ambrosio’s deposition testimony clarifies that the basis of his discrimination 

claim is that he did not receive round-the-clock live ASL interpreting services 

during his hospitalization.7

 As we explained in Liese, a hospital is not required by 

the ADA or the Rehab Act to provide every auxiliary aid that is demanded. Liese, 

701 F.3d at 343. See also McCullum, 768 F.3d at 1147 (the applicable regulations 

 

6 In his brief, D’Ambrosio asserts that certain written exchanges reveal the existence of 

“communication barriers.” Leaving aside the fact that D’Ambrosio did not include this assertion 

in his declaration, the cited written notes, when read in context, do not demonstrate any lapse in 

comprehension.

7

 D’Ambrosio testified at his deposition that he believed a live ASL interpreter should 

have been present at all times during his hospitalization, even when he was asleep or 

unconscious.

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“do not require healthcare providers to supply any and all auxiliary aids even if 

they are desired and demanded”). Because there is no evidence that the hospital 

failed to provide auxiliary aids that were necessary to ensure effective 

communication with D’Ambrosio, Defendants are entitled to summary judgment 

on his claims. 

2. Yolanda Gervarzes

Like D’Ambrosio, Gervarzes submitted a declaration in response to 

Defendants’ summary judgment motion stating that she requested live ASL 

interpreting services, that the services were not provided, and that, as a result, she 

was unable to participate in her daughter’s care. Gervarzes did not specify how her 

participation was limited. Moreover, there is undisputed evidence that Gervarzes 

was offered interpreting services over the LifeLinks system upon her arrival to the 

hospital, but she rejected those services. She then was provided at least five hours 

of live ASL interpreting services during her daughter’s hospitalization. When a 

live interpreter was not there, the staff was able to communicate with Gervarzes 

via her daughter and by writing notes. Given this evidence, a reasonable jury 

could not conclude that the hospital failed to provide the auxiliary aids necessary 

for effective communication with Gervarzes. Thus, the district court properly 

granted summary judgment to Defendants on her claims. 

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3. Richard Martin

Finally, as to Richard Martin, he failed, both in the district court and on 

appeal, to cite to any evidence showing that he ever asked for a live interpreter 

during his brief emergency room visit. Martin’s treating physician Dr. Kocisko 

testified that Martin did not ask for a live interpreter and further that, given how 

minor Martin’s injury was—essentially a “bump on the head,”—an interpreter was 

not necessary. Martin received typed instructions upon his discharge, which he 

indicated he understood, and it is undisputed that Martin was able to read and write 

English. Given this evidence, the hospital did not violate the ADA or the Rehab 

Act by failing to provide a live interpreter to Martin on this particular occasion. 

Cf. Liese, 701 F.3d at 343-44 (finding that a live interpreter might be required to 

explain the plaintiff’s emergency gallbladder surgery).

D. Compensatory Damages

Assuming Defendants did fail to provide appropriate and necessary auxiliary 

aids, such a failure by itself does not sustain a claim for compensatory damages. 

Id. at 344. Plaintiffs must also show by a preponderance of evidence that the 

failure was the result of intentional discrimination. Id. (citing Wood, 978 F. 2d at 

1219). Plaintiffs can meet this requirement with evidence that Defendants were 

“deliberately indifferent” to their rights under the ADA and the Rehab Act. Id. at 

345.

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Deliberate indifference occurs when a defendant knows that a rights 

violation is substantially likely and fails to act on that likelihood. Id. at 344; see 

also Doe v. Sch. Bd. of Broward Cnty., Florida, 604 F.3d 1248, 1259 (11th Cir. 

2010) (describing deliberate indifference as “an exacting standard”). As the name 

implies, deliberate indifference involves a “deliberate choice.” Liese, 701 F.3d at 

344. Mere negligence is insufficient. See Kelley v. Hicks, 400 F.3d 1282, 1285 

(11th Cir. 2005) (applying the deliberate indifference standard in an Eighth 

Amendment case). As such, a hospital’s failure to provide an interpreter on 

demand is not sufficient to support a finding of deliberate indifference. McCullum, 

768 F.3d at 1147. Rather, a plaintiff must show that hospital staff knew there was 

a substantial likelihood that they would be unable to communicate effectively 

absent an interpreter, but still made a “deliberate choice” not to provide one. Id. at 

1147-48. 

Here, the district court, having based its grant of summary judgment on 

Plaintiffs’ failure to offer evidence that Defendants failed to provide appropriate 

aids necessary to effective communication, did not need to reach the question 

whether Defendants had acted with deliberate indifference to Plaintiffs’ rights 

under the pertinent statutes. We likewise do not need to explore Defendants’ state 

of mind except to note the obvious: when a plaintiff cannot show that a defendant 

failed to provide appropriate communication aids, that plaintiff has also necessarily 

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failed to show that the defendant acted with deliberate indifference to the 

plaintiff’s rights under the relevant statutes. Cf. Loeffler v. Staten Island Univ. 

Hosp., 582 F.3d 268, 276 (2d Cir. 2009) (finding an issue of fact as to deliberate 

indifference where the defendant hospital failed to provide any interpretive 

services whatsoever during the twelve-day period following a heart patient’s 

surgery and subsequent stroke and convalescence).

CONCLUSION

For the reasons stated above, we AFFIRM the judgment of the district 

court.

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