KATHLEEN M. WILLIAMS, UNITED STATES DISTRICT JUDGE.
This is a disability discrimination case. Defendants are two Miami-area non-profit hospitals and their non-profit parent company. Plaintiffs Cheylla Silva and John Paul Jebian are unrelated deaf individuals who allege that, during their many visits to Defendants' facilities, Defendants ineffectively communicated with them and were deliberately indifferent to their federally-protected rights. Consequently, Plaintiffs filed this lawsuit seeking injunctive relief and compensatory damages pursuant to the Americans with Disabilities Act ("ADA") and Rehabilitation Act of 1973 (the "RA"). The Eleventh Circuit determined that Plaintiffs' injunctive relief claims may proceed to trial because genuine issues of material fact exist as to whether Defendants provided Plaintiffs with effective communication as required by the ADA and RA. (DE 149); see also Silva v. Baptist Health S. Florida, Inc., 856 F.3d 824 (11th Cir. 2017). The sole question now before the Court is whether Plaintiffs' damages claim may also proceed to trial, the answer to which depends on whether triable issues exist regarding
By their count, Silva and Jebian visited Defendants' facilities a combined 59 times between March 2009 and April 2016. (DE 158-1; DE 158-2; DE 158-3).
Plaintiffs' argument rests entirely on their generalized and identical affidavit statements that during each visit, they "repeatedly requested that hospital staff provide a live ASL interpreter to help ... communicate with nurses and doctors regarding... condition and care. On most occasions, no interpreter was present. On some occasions, an interpreter was provided." (DE 61-13 ¶ 7; DE 61-14 ¶ 7). They state, without identifying specific instances, that "[o]n some occasions, hospital staff would attempt to use a video relay interpreting (`VRI') machine to communicate with [them] ... [h]owever, the machine was inoperable or unusable. Sometimes, it appeared that hospital staff could not figure out how to operate the machine. Other times, the picture would be blocked, frozen, or degraded." (DE 61-13 ¶ 10; DE 61-14 ¶ 10).
Defendants respond that they have promulgated and diligently adhered to policies for the provision of interpreter services for the deaf. (DE 59 ¶ 3). Those policies provide for a range of services to assist deaf patients and their family members. (DE 59 ¶ 7). One of those services is an in-person interpreter. (DE 59 ¶ 7). Another is VRI, although VRI is not available at Baptist Health's outpatient facilities. (DE 59 ¶¶ 7, 9).
Summary judgment is appropriate "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a). The movant "bears the initial responsibility of informing the district court of the basis for its motion, and identifying those portions of [the record] which it believes demonstrate the absence of a genuine issue of material fact." Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). "An issue of fact is `material' if, under the applicable substantive law, it might affect the outcome of the case. An issue of fact is `genuine' if the record taken as a whole could lead a rational trier of fact to find for the nonmoving party." U.S. ex rel. Urquilla-Diaz v. Kaplan Univ., 780 F.3d 1039, 1050 (11th Cir. 2015) (quoting Harrison v. Culliver, 746 F.3d 1288, 1298 (11th Cir. 2014)). Rule 56(c)(3) provides that "[t]he court need consider only the cited materials, but it may consider other materials in the record."
After the movant has met its burden under Rule 56(c), the burden shifts to the nonmoving party who "must do more than simply show that there is some metaphysical doubt as to the material facts." Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986). The non-moving party "may not rely merely on allegations or denials in its own pleading," but instead must come forward with "specific facts showing a genuine issue for trial." FED. R. CIV. P. 56(e); Matsushita, 475 U.S. at 587, 106 S.Ct. 1348. "Thus, to survive summary judgment, the nonmoving party must offer more than a mere scintilla of evidence for its position; indeed, the nonmoving party must make a showing sufficient to permit the jury to reasonably find on its behalf." Urquilla-Diaz, 780 F.3d at 1050 (citing Brooks v. Cty. Comm'n of Jefferson Cty., Ala., 446 F.3d 1160, 1162 (11th Cir. 2006)).
In evaluating a defendant's motion for summary judgment, the Court views all the evidence in the light most favorable to the plaintiff and resolves all reasonable doubts about the facts in favor of the plaintiff. See Liese v. Indian River Cty. Hosp. Dist., 701 F.3d 334, 337 (11th Cir. 2012). However an "inference based on speculation and conjecture is not reasonable." Chapman v. Am. Cyanamid Co., 861 F.2d 1515, 1518 (11th Cir. 1988). Accordingly, "[w]here the record taken as a whole could not lead a rational trier of fact to find for the non-moving party, there is no genuine issue for trial." Allen v. Tyson Foods, Inc., 121 F.3d 642, 646 (11th Cir. 1997) (quoting Matsushita, 475 U.S. at 587, 106 S.Ct. 1348).
Plaintiffs request compensatory damages under § 504 of the Rehabilitation Act, 29 U.S.C. § 794(a). This statute provides that "[n]o 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 the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance...." 29 U.S.C. § 794(a). Under the RA's implementing regulations, hospitals that receive federal funding must "afford handicapped persons equal opportunity to obtain the same result, to gain the same benefit, or to reach the same level of
To establish a right to compensatory damages pursuant to § 504 of the RA, Plaintiffs must prove: (1) that they are qualified individuals with a disability, (2) who were excluded from participation in or denied the benefits of Defendants' services, programs, or activities, or otherwise discriminated against, (3) on account of their disability, and (4) that the exclusion or denial was the result of intentional discrimination. Martin v. Halifax Healthcare Sys., 621 Fed.Appx. 594, 601 (11th Cir. 2015) (citing Shotz v. Cates, 256 F.3d 1077, 1079 (11th Cir. 2001); Liese, 701 F.3d at 344). As to the fourth element, the Eleventh Circuit in Liese v. Indian River County Hospital District established that a plaintiff may demonstrate discriminatory intent through a showing of deliberate indifference, which occurs when a defendant knows that a rights violation is substantially likely and fails to act on that likelihood. 701 F.3d at 344-45. Importantly, deliberate indifference "plainly requires more than gross negligence" and "requires that the indifference be a `deliberate choice,' which is an `exacting standard.'" Id. at 344 (citations omitted). Moreover, the defendant's deliberate indifference must have been through "an official who at a minimum has authority to address the alleged discrimination and to institute corrective measures on the [hospital's] behalf [and who] has actual knowledge of discrimination in the [hospital's] programs and fails to adequately respond." Id. at 349 (emphasis in original) (quoting Gebser v. Lago Vista Indep. Sch. Dist., 524 U.S. 274, 290, 118 S.Ct. 1989, 141 L.Ed.2d 277 (1998)).
Four Eleventh Circuit decisions guide the Court's analysis of whether genuine disputes of material fact remain as to deliberate indifference. First, in Liese, the plaintiffs repeatedly asked orally and in writing for interpreters, but were not given ASL interpreters either in-person or through an available video interpreter service. Id. at 337-39. Instead, they were "laughed at" by an emergency room doctor. Id. at 351. Moreover, Liese, the deaf patient plaintiff, clearly informed hospital staff she could not read lips and that she did not understand the majority of her interactions with a specific doctor, Dr. Perry, who ignored her when she could not read his lips or understand his pantomime. Id. at 339-40. Liese did not understand why tests performed on her were necessary; she did not understand the results from those tests; she did not understand the reason for her gall bladder surgery when she had presented with chest pains; and she could not understand the doctor's post-operative instructions. Id. at 339-41. On these facts, the Eleventh Circuit reversed the district court's grant of summary judgment for the hospital and held that the plaintiffs could present the jury with the issue of whether the defendants were deliberately indifferent to the plaintiffs' federal rights. Id. at 356.
Then, on the other end of the spectrum, there are two cases where the Eleventh Circuit affirmed summary judgment for defendant hospitals. In McCullum v. Orlando Regional Healthcare System, Inc., 768 F.3d 1135 (11th Cir. 2014) "the staff at
Similarly, in Martin, the Eleventh Circuit affirmed summary judgment for the defendant hospital system where three deaf patient plaintiffs sued the defendant hospitals for failing to provide "continuous live interpreting services" during their hospital stays. Martin, 621 Fed.Appx. at 594. Two of the three plaintiffs submitted declarations stating that they asked for ASL interpreters but were denied their requests and subsequently did not understand what was said to them. Id. at 600. However, they never specified what they did not understand or how their lack of comprehension impacted their treatment. See Id. at 602-03 (finding no evidence that the hospital failed to provide proper auxiliary aids, because, among other things, plaintiff "never specifies what, exactly, he failed to understand" in his declaration). The third plaintiff never asked for an in-person interpreter and indicated that he understood typed notes that the hospital provided to him. Id. at 603. Crucially, the hospital system did, in fact, offer and provide patients with auxiliary aids such as written or typed notes, detailed graphics, some in-person live interpreting, and a video interpreting service. Id. at 596-600. Consequently, the Eleventh Circuit found that "when a plaintiff cannot show that a defendant failed to provide appropriate communication aids, that plaintiff has also necessarily failed to show that the defendant acted with deliberate indifference." Id. at 604.
Finally, in Sunderland v. Bethesda Hospital Inc., 686 Fed.Appx. 807 (11th Cir. 2017), the Eleventh Circuit affirmed summary judgment with respect to some plaintiffs and reversed with respect to others. There, the Court found a genuine issue of material fact on deliberate indifference, where the medical records and the plaintiffs' testimony identified specific instances in which the hospital officials knowingly failed to correct denials of effective communication. Id. For example, the Court found a genuine dispute of fact where a plaintiff had to communicate through gesturing, before and after an invasive procedure, even though plaintiff had requested an in-person interpreter and her son had complained that VRI was not working. Id. at 817. The Court also found a genuine dispute of fact where plaintiffs indicated they did not understand the VRI interpreter's signing and the hospital failed to provide an alternative aid. Id. at 817-818. In each case, the evidence showed that defendants were aware of these deficiencies at the time of treatment and failed to provide alternative aids. Id. at 816. By contrast, the Court found no issue of material fact in circumstances where the VRI malfunctioned but defendants were not aware of the malfunction, or where VRI malfunctioned and defendants provided alternative
Based on the framework provided by these four cases, the Court finds that, in this case, there is no genuine dispute of material fact as to whether Defendants acted with deliberate indifference towards Plaintiffs. As noted, "deliberate indifference plainly requires more than gross negligence. Rather, deliberate indifference requires that the indifference be a `deliberate choice,' which is an `exacting standard.'" Liese, 701 F.3d at 344 (citations omitted). For example, "bad faith or gross misjudgment ... may satisfy the standard." L.M.P. ex rel. E.P. v. Sch. Bd. of Broward Cty., Fla., No. 05-60845-CIV, 2014 WL 4771750, at *13 (S.D. Fla. Sept. 24, 2014) (citations omitted). The record, here, contains no indication — other than Plaintiffs unsupported, conclusory allegations — that Defendants were actually aware of any instance in which they communicated ineffectively with Plaintiffs. Aside from these allegations, there is no evidence that Plaintiffs ever complained to or informed Defendants that they were not receiving proper assistance.
Plaintiffs also incorrectly assert that prior settlements, on their own, put Defendants on notice that harm to a federally protected right is likely. Indeed, the case relied upon by Plaintiffs acknowledges that "the relevance of the past complaints is limited by the fact that the hospital subsequently amended its policy designed to prevent violations." Proctor v. Prince George's Hosp. Ctr., 32 F.Supp.2d 820, 825 (D. Md. 1998). Here, the record demonstrates that Defendants have promulgated policies to ensure the provision of interpreter services for the deaf (DE 59 ¶ 3) — such as VRI, which did not exist when Mr. Jebian and Defendants settled their prior dispute — and that they continually train their staff to identify need for interpretation and to provide appropriate auxiliary aids. (59 ¶ 5, 6, 21-27, 30, 44, 51). Plaintiffs have provided no evidence that Defendants have failed to adhere to those policies.
Finally, in support of their claims, Plaintiffs submitted three charts, with supporting medical records, summarizing their visits to Defendants' facilities over the years (DE 158-1; DE 158-2; DE 158-3). But these charts, which were submitted in violation of this Court's Order of July 5, 2017 (DE 154), do not establish that Defendants acted with deliberate indifference. Indeed, of the forty-five
In fact, there is no evidence in the record that Plaintiffs ever complained about the accommodations received in any of the visits. Plaintiff Silva admits that she had no issues with Defendants except for her first visit back in 2009 (DE 59-1 at 83). And even for that visit, Plaintiff Silva admits that she "allowed" her brother to interpret, because her brother "knew what was going on," "knows [her] health" and "already knew what was wrong with [her]." (DE 59-1 at 85). Similarly, there is no evidence in the record that Plaintiff Jebian ever complained about the accommodations provided. Although Plaintiffs generally claim that the communication between Plaintiffs and Defendants was ineffective, Plaintiffs failed to raise any complaints to the hospital at the time of their visits and now fail to specify what information they did not understand during these encounters. There is also no evidence that Silva, Jebian or any of the family members that assisted with ASL interpretation told Defendants' staff at that time that the family members were unqualified to interpret for Plaintiffs. See McCullum, 768 F.3d at 1148.
The Court finds that Defendants' failure to obtain a live interpreter or VRI — in light of their efforts to provide alternative aids and in light of Plaintiffs' failure to contemporaneously complain about the accommodations provided — at most constituted negligence, and was not a "deliberate choice" to deny Plaintiffs rights as the law requires. See Liese, 701 F.3d at 344. Certainly, the facts of this case are not comparable to the circumstances of Liese, where a doctor mocked a deaf patient before refusing to provide available accommodations. They are also not comparable to the circumstances of the winning plaintiffs in Sunderland, who were able to show, for specific visits involving complex medical procedures, that defendants' doctors refused to provide live-interpretation or alternative aids even though they knew they were not communicating with plaintiffs effectively. Sunderland, 686 Fed.Appx. at 816-818 (finding, based on deposition testimony and hospital medical records, that the doctors and nurses were aware that VRI was malfunctioning and no alternative aid was provided). Instead, this record contains no evidence showing that Defendants knew that Plaintiffs' rights were likely being violated. Thus, a reasonable jury could not find that Defendants' personnel acted with deliberate indifference. See McCullum, 768 F.3d at 1139, 1146-47 (affirming summary judgment for defendant on deliberate indifference where attending physician believed he was effectively communicating and medical records did not contradict this belief); Martin, 621 Fed.Appx. at 604 ("As the name implies, deliberate indifference involves a `deliberate choice.' Mere negligence is insufficient.") (citations omitted); Wood v. President & Trustees of Spring Hill Coll. in City of Mobile, 978 F.2d 1214, 1219 (11th Cir. 1992) ("As a general matter, good faith attempts to pursue legitimate ends are not sufficient to support an award of compensatory damages under section 504."). Accordingly, the Court grants Defendants' motion as to Plaintiffs' compensatory damages claims.
For the reasons above, it is