The Article below was taken from a deaf news service and is reprinted here by permission.

From the newsroom of the American Lawyer Media (ALM), San Francisco,
California, Tuesday, February 15, 2005 .....

New Hospital Technology Is Target of Lawsuit

Bethany Broida
Legal Times

Elizabeth Gillespie had been suffering from intense stomach pain, nausea and
vomiting for days. Finally, the 46-year-old former Gallaudet University
professor, at the urging of her doctor and her husband, went to the
emergency room.

She was admitted immediately. But that turned out to be the simplest part of
the evening.

Gillespie, who is deaf, couldn't tell anyone her symptoms. No one at the
emergency room at Laurel Regional Hospital, she says, could communicate with
her. She tried lip reading with hospital staff members for hours before
giving up. Her husband, who accompanied her to the hospital, is also deaf.

"We weren't able to communicate for the first four hours in the ER," she
says in an e-mail interview. "We didn't know what was going on. Not only was
I in severe pain, I was scared and frustrated. Nobody would write [anything]
down to tell us what was going on."

The hospital, she says, had no sign language interpreter available. Instead,
she says, the hospital relied on a video conferencing system to eventually
put Gillespie in touch with an interpreter at a remote location. But
ultimately, she says, she ended up confused about her condition.

"I was treated like an animal devoid of intelligence," she says. "All
because I couldn't hear."

With health care costs soaring, hospitals across the country are turning to
new technologies, such as video remote interpreting technology, which
connect deaf patients with off-site interpreters. But some say deaf
patients' rights to fully participate in and be informed about their medical
treatment are being compromised in the name of cost-cutting.

Gillespie and her husband, David Irvine, are two of seven deaf people suing
Laurel Regional Hospital. In what the suit's lawyers say is potentially a
test case with national implications, the plaintiffs claim that use of the
new video remote interpreting technology is an inadequate alternative to
hospitals providing live on-site interpreters for critical medical
situations.

The use of this new technology, they claim in a suit to be heard by Judge
Deborah Chasanow in the U.S. District Court in Greenbelt, Md., violates
provisions of the Americans With Disabilities Act. The plaintiffs seek an
unspecified amount of damages and an injunction requiring the hospital to
provide deaf patients with auxiliary aids and services for more effective
communication.

Disability experts say it's unclear under the law when hospitals must use
on-site interpreters.

VRI works in a similar way to video conferencing. The hospitals are equipped
with video cameras, monitors and microphones, which allow the patient, the
doctor and the off-site interpreter to see and communicate with each other.

For Gillespie, being given access to the VRI machine didn't end her woes
that day in November 2003. While she says the conferencing helped
tremendously -- finally, she was able to understand what the doctors were
telling her -- the session lasted only 15 minutes.

Hours later, without use of the machine or an interpreter, doctors
unsuccessfully tried to communicate with Gillespie about her condition. The
diagnosis, she says, wasn't written down, and after 10 hours in the ER, she
grew frustrated and left. Two days later, a physician at another emergency
room told her she had congestive heart failure.

"All I kept thinking," she says, "[is] what if I had died after I got home
because we didn't understand the severity of the medical condition? What if
I had remained clueless and didn't seek further treatment?"

INDIVIDUAL NEEDS

There are an estimated 28 million deaf people across the country and the
Washington region attracts large numbers of the deaf because of the presence
of Gallaudet University and the government printing industry, which often
employs deaf workers.

The ADA mandates equal access to health care for the disabled, and requires
that hospitals provide "effective means of communication for patients,
family members, and hospital visitors who are deaf or hard of hearing."

But disability experts say the act doesn't necessarily require hospitals to
fully accommodate the needs of deaf patients by offering interpreters on
site.

"You have to make a reasonable accommodation," says John Banzhaf III, a
professor at George Washington University Law School, "but that includes
balancing of costs and other factors. It doesn't mean you necessarily have
to use the best way."

Banzhaf says an in-person interpreter is probably ideal, but, he says, it's
expensive and time-consuming. "Anyone would be happier and more comfortable
having someone in the room with them," he says, "but it does seem to me you
can get through reasonably well with a video device."

Robert Dinerstein, associate dean and professor of ADA law at American
University Washington College of Law, agrees that the ADA does not require
that hospitals provide the best possible solution.

"You are not entitled to the best modification or the one you prefer, but
one that is adequate," he says.

However, Dinerstein says that required accommodations under the act are
tailored to the individual. What will work for one person, he says, may not
be legally adequate for someone else.

Pamela White, a partner at Ober, Kaler, Grimes & Shriver in Baltimore, who
represents Laurel Regional Hospital, declines to comment on the suit or the
allegations directly. But she says, "The unique personal and medical
circumstances will drive what interpreter services are available to
individual patients."

"The needs of each patient are addressed on an individual basis," White
says, adding, "hospital policies and procedures are absolutely in compliance
with the ADA."

Steven Smith, an Ober Kaler partner in D.C. also involved in the suit, says
the hospital expects to file its answer this week.

MIXED MESSAGES

The lawsuit charges that the methods employed by Laurel to serve its deaf
patients, however, are inadequate. "In specific instances facing these
plaintiffs," the suit says, "VRI was an insufficient mode of communication."

Lewis Weiner, a partner at D.C.'s Sutherland Asbill & Brennan who is
handling the case pro bono for the plaintiffs, says the suit "is not an
indictment of this type of communication. ... We understand its value in
certain situations."

But Weiner says his clients visited the emergency room at Laurel with
serious ailments, ranging from heart and lung problems to meningitis, and
they required the assistance of a live on-site interpreter in order to fully
participate in and make informed decisions about their treatment.

"Basically, it doesn't work well for people who are really sick, can't focus
well enough, or can't get positioned correctly," says Elaine Gardner,
director of the disability rights project at the Washington Lawyers'
Committee for Civil Rights and Urban Affairs and co-counsel on the suit. "We
don't want to paint this as a bad thing. The technology is great for less
serious ailments, but it has problems."

The other plaintiffs in the suit list a litany of complaints with the VRI
equipment at Laurel, citing problems with its mobility, with seeing the
monitor, and with the hospital staff, which, the suit charges, repeatedly
had trouble making the equipment work.

One of the most serious complaints involves plaintiff Erin Whitney. When
Whitney, who was a College Park, Md., resident at the time, arrived at the
Laurel ER, the suit alleges, she was vomiting and fainting. Eventually, she
was placed in a room that contained VRI equipment, but because she was
unable to sit up and the video transmission was of such poor quality, she
was unable to fully communicate with the interpreter, the suit says. Whitney
claims in the suit that she didn't fully appreciate it when the doctor said
she could have meningitis, a potentially life-threatening illness.

Whitney left the hospital the next day. Her discharge papers made no mention
of the meningitis, instead diagnosing her with the flu, the suit says, but
her condition worsened and she returned to the emergency room later the same
day.

This time the pain was so severe that she could not see the VRI monitor at
all, the suit says, and so the hospital asked Whitney's friend, who was also
deaf, to relay the interpreter's messages. Again, the doctor told her she
may have meningitis and this time recommended a spinal tap.

The hospital performed the spinal tap without Whitney's written consent, the
suit charges, and provided no information about the procedure or the
follow-up care.

Whitney's spinal tap revealed that she did indeed have meningitis and she
was admitted to the hospital. For the rest of her stay, a VRI device was not
available, the suit claims.

Tracie Veihmeyer, a hospital spokeswoman, also declines to discuss any
specifics of the suit, but disputes the assertion that the hospital staff
was poorly trained on the equipment, saying staff members receive VRI
instruction on multiple occasions.

IMMEDIATE ACCESS

Veihmeyer says the hospital turned to VRI because it provides immediate
communication for patients. The hospital, she says, had problems finding
in-person interpreters.

The company that provides Laurel Regional with its VRI device says that with
the technology, patients are able to get immediate care, usually waiting
less than 15 minutes for a remote interpreter instead of one to three hours
for a live interpreter.

"We are the patient's voice in the doctors ear and the voice of the doctor
or nurse in the patient's ear," says Robert Fisher, president of Deaf-Talk,
which provides the video interpreting service to hospitals nationwide.

Fisher says his company began installing VRI units in hospitals in 2000. By
2002, Deaf-Talk had 30 hospital clients, and today it has more than 200,
including many hospitals in the D.C. metropolitan area, such as Washington
Hospital Center, Howard University Hospital, Shady Grove Adventist Hospital,
and Frederick Memorial Hospital.

And hospitals save money. According to statistics provided by Deaf-Talk,
hospitals on average spend over $30,000 a year to use on-site sign language
interpreters, while video remote interpreting can cost half that amount.
Typically, hospitals must pay a two-hour minimum and travel time for an
on-site interpreter service, while average consultations usually last only
15 minutes. In addition, hospitals incur another fee for unscheduled
sessions with on-site interpreters -- which would include all emergency room
visits.

In contrast, VRI customers usually pay a monthly fee for the equipment and
pay for the translation service by the minute.

However, even Fisher concedes that VRI is best when used as part of a
package of interpretation services offered by a hospital.

"We provide immediate communication to get people started," he says. "VRI is
meant to be used as a supplement to other types of interpretation."

That's the right approach, says plaintiff Gillespie.

"In some situations, VRI may be good enough," she says. "But it is not a
cookie-cutter answer to the interpreting dilemma."

On Feb. 10, Laurel Regional Hospital filed its answer to the plaintiffs'
complaint. In the answer, the hospital admits the plaintiffs sought and
received medical treatment at the hospital, but denies that it violated any
of the patients' rights or federal law in treating the patients.

The hospital also denies allegations in the complaint that a live sign
language interpreter "is the sole means of effective communication in an
emergency room setting."

The answer was signed by White and Neil Duke, also of Ober Kaler.

Copyright 2005 ALM Properties, Inc. All rights reserved.

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Proposed for Deaf in American Hospitals
(Video Interpreters Presciption for Disaster?)

DeafTalk Video Remote Interpreting that is being installed in hospitals in
MD and slowly throughout the nation. We feel this is a very dangerous thing
to be happening. They are "sold" this product by DeafTalk as a way to meet
the requirements of the ADA and to save money. Where in fact, they are
ignoring the request of a deaf person to have an interpreter present in the
room. Someone will die and have to sue DeafTalk before they realize it is
not safe to use this service for all instances. It may be fine to use as a
temporary accommodation in the ER until an interpreter arrives. But,
unfortunatlely it is being misused and is being used INSTEAD of getting an
interpreter.

What I am writing to tell you is that there will be a meeting at the Christ
United Methodist Church for the Deaf in Pasadena on Saturday, December 4th
from 9:30 until 12:30 p.m. (3703 Mountain Road) to discuss the pros and cons
of DeafTalk. We need Deaf people to come and hear what is going on and voice
their concerns. We are asking interpreters to come to act as scribes to help
write letters that will be sent to the hospital administrations, Joint
Commission on Accreditation of Hospitals Organization (FYI-If hospitals are
not accredited they don't get reimbursed by Medicare and Medicaid) and DOJ
and ODHH.

Please help to spread the word to all the Deaf in So. MD - all are welcome
and invited. Also, if you know any interpreters who would be willing to come
and volunteer their time to help write down the "stories", please give their
names to Carol Stevens via e-mail (carolstevens100@hotmail.com).