Fairview to pay fine over deaf services

From: Minneapolis Star Tribune, MN - Dec9, 2004

Glenn Howatt
Star Tribune
Published December 9, 2004

When Linda White donated a kidney to her husband, Michael, at Fairview-University Medical Center in 2002, the hospital provided qualified doctors and nurses to care for them from beginning to end. However, the Minneapolis hospital did not provide qualified sign-language interpreters to the Whites, who are deaf.

As a result, the Whites said, they weren't fully informed of the surgery's risks. They had to share one interpreter between them. Linda, who reads lips, spotted an interpreter making mistakes. At one point, Michael was given the wrong medication when there wasn't an interpreter to mediate.

The Whites complained to the government, which on Wednesday announced a settlement in their favor.

In that settlement, Fairview Health Services has agreed to pay $208,000 in federal and state penalties and in compensation to the Whites and three other deaf people.

Fairview also agreed to ensure that qualified sign-language interpreters are available at five of its hospitals. A judge will monitor its compliance for three years.

"This agreement will significantly improve the quality of health care for Minnesota's hearing impaired patients," said U.S. Attorney Tom Heffelfinger, whose office investigated the complaints as violations of the Americans with Disabilities Act.

Officials hope the settlement will spur broad change in the health care industry. A state official said discussions are in progress with other Minnesota hospitals to get them to voluntarily comply with the standards. The other hospitals were not identified.

"We know that Fairview is not the only health care system or hospital failing in this regard," said Steve Lipinksy, an official with the Minnesota Human Rights Department, which assisted in the Fairview investigation.

Fairview issued a written statement apologizing to the Whites and two other families, who also had complained about insufficient services for deaf patients.

"Fairview takes these concerns seriously," the statement said, adding that the hospital had taken steps to improve sign-language services before the settlement was signed.

Under federal law, hospitals must provide "effective communication" with their patients. Under state law, hospitals must make reasonable accommodations to serve the disabled.

The Whites, speaking through an interpreter at a news conference announcing the settlement, said they took action because they didn't want other deaf people to experience the same problems.

Michael White asked the hearing public to consider what it would be like to be the only English-speaking patient in a Japanese hospital. He said he was extremely disappointed to discover that one interpreter was assigned to both of them.

"There were two patients in this case," he said. "The situation really required two interpreters, two qualified interpreters."

Patient-advocate

Problems arose as Linda White was undergoing surgery.

"I had to change from being a patient to being an advocate, to asserting myself to finding how we could get those services," despite her own physical and emotional stress, she said.

"I may have looked OK on the outside, but it was very difficult for me on the inside," she added.

When the state Human Rights Department investigated, it found a pattern of discrimination against deaf and hard-of-hearing patients.

"It became apparent in the investigation of these individual cases that these were not the only individuals affected by Fairview's practices," Lipinksy said.

The federal-state complaint, filed Wednesday with the settlement, describes ongoing problems that the Whites and the other families had in obtaining interpreter services at Fairview-University.

The Whites had their surgery at the Riverside campus of the hospital. The complaint doesn't make clear whether the same problems existed at the University of Minnesota campus.

The documents reveal how deaf patients can become captive to the circumstances of their interpreters.

When Michael White had been readmitted to the hospital because of complications from the transplant, a meeting with his physician had to be put on hold while his interpreter, Kari Kramer, breast-fed and changed the diaper of her infant, according to court documents.

Kramer earlier that year had been assigned to Robert Oberly, a deaf surgical patient at Fairview-University.

While Oberly was undergoing emergency surgery, Kramer's husband entered the waiting room and told Oberly's spouse that he had a "healing facility" where the ailing Oberly could go and a "group would lay hands on him to heal him," according to the documents.

The Kramers could not be reached for comment. Oberly's wife, Julie, declined to comment on the encounter.

According to the complaint, Julie Oberly had to interpret for her husband because no interpreter was made available or because Robert Oberly was concerned about Kramer's skills.

Despite repeated requests for a qualified interpreter from the Oberlys, he was often without one as his medical condition deteriorated. One doctor refused a nurse's request to write a note to Oberly, saying "he did not have time to write notes to patients," according to the documents.

Another surgeon told the Oberlys that it wasn't necessary to have an interpreter present while Oberly was recovering from a tracheotomy. According to the legal documents, Oberly developed complications from the surgery. Julie Oberly had to interpret as her husband's condition worsened.

After nearly a month at Fairview-University, Oberly transferred to another hospital in April 2002. He died three months later.

"Can you imagine how hard it is for someone who can't speak?" said Julie Oberly. Without interpreters, she said, a deaf person doesn't even have the comfort of knowing what is being done to him.

A matter of good care

Rick Macpherson of the Minnesota Disability Law Center, who represented the Whites and the Oberlys, said that interpreters are needed to help the deaf and to ensure that doctors provide good medical care.

"This is not simply a matter of something nice that the hospital is doing for deaf people," Macpherson said. "If the doctor is misunderstanding information that the patient is giving, that could compromise care."

Heffelfinger said the agreement is the first in the country to require that hospitals provide qualified interpreters. Sign-language interpreters are certified according to national standards. In the White and Oberly cases, Fairview was using an interpreter who lacked the required qualifications.

The settlement covers Fairview-University in Minneapolis, Fairview Southdale in Edina, Fairview Ridges in Burnsville, Fairview Northland in Princeton and Fairview Lakes in Wyoming.

For the next three years, Fairview must submit compliance reports to the court, which will monitor its progress.

Last year, the state reached a settlement with Abbott Northwestern Hospital in Minneapolis after it failed to provide adequate interpreter services to a deaf patient in the emergency room.

Macpherson, who represented the patient in that case, said the hospital has tried to improve its services but has had problems.

He said there are not enough interpreters on staff to respond to requests. He also said the hospital had problems providing general information in American Sign Language format.

Hospital spokeswoman Jennifer Syltie Johnson said the hospital now has enough interpreters available and is committed to meeting the terms of the settlement.

Glenn Howatt is at howatt@startribune.com.

© Copyright 2004 Star Tribune. All rights reserved.