Biondo v. Kaleida Health
935 F.3d 68
| 2d Cir. | 2019Background
- Kathleen Biondo, a profoundly deaf patient who primarily uses ASL and reads at a low grade level, was hospitalized at Buffalo General Medical Center (BGMC) for six days in 2014 for fainting episodes and related testing.
- Biondo and her husband repeatedly requested an ASL interpreter from multiple BGMC staff; no interpreter was ever provided and no waiver of interpreter services was signed.
- During the stay Biondo underwent procedures (including a tilt-table test), signed a generic consent form, and exchanged medically important information primarily via writing and her husband acting as an ad hoc interpreter.
- BGMC had an internal Interpreter/Translation/Teletypewriter policy requiring interpreter services for history taking, explanation of procedures/treatment, and discharge instructions, and listing vendor contact numbers for arranging interpreters.
- Biondo sued under Section 504 of the Rehabilitation Act, the ADA, and state/local anti-discrimination laws; the district court granted summary judgment to BGMC on federal claims (dismissing RA damages claim for lack of deliberate indifference proof) and declined supplemental jurisdiction over state claims.
- The Second Circuit vacated and remanded, holding that material factual disputes exist about whether hospital staff knew of the communications deprivation, had authority to secure an interpreter, and failed to act — precluding summary judgment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether failure to provide an interpreter violated the Rehabilitation Act | Biondo: her limited written English, procedures performed, and six-day stay meant absence of interpreter denied equal access to care | BGMC: disputes sufficiency of evidence that lack of interpreter deprived equal opportunity to benefit | Court: RA violation is a triable issue; reasonable jury could find denial of equal opportunity to benefit from services |
| Whether hospital is liable for damages (deliberate indifference) — attribution to an "official/policymaker" | Biondo: nurses/doctors who knew of requests had authority to obtain interpreters and their failure was deliberate indifference attributable to BGMC | BGMC: plaintiff waived argument and no staff member was an "official"/policymaker whose indifference binds the hospital | Court: not waived; factual disputes exist whether staff had authority and actual knowledge — cannot decide as matter of law; remand for factfinding |
| Standard for who qualifies as an "official/policymaker" for RA damages | Biondo: front-line staff who can secure interpreters can be officials for attribution | BGMC: an official must have substantial supervisory authority/complete discretion at key decision point | Court: adopts Loeffler test — an official must have authority to address discrimination and institute corrective measures; declines to require blanket supervisory-title test used by Eleventh Circuit |
| Standing for injunctive relief | Biondo: reluctance to return because of inadequate services shows risk of future injury | BGMC: argued lack of likelihood of future injury | Court: discussed Friends of the Earth principle; standing issue not central to this appeal and district court's ruling on injunctive relief not reviewed here |
Key Cases Cited
- Loeffler v. Staten Island Univ. Hosp., 582 F.3d 268 (2d Cir. 2009) (sets deliberate-indifference/official requirement for RA damages in hospital context)
- Gebser v. Lago Vista Indep. School Dist., 524 U.S. 274 (Sup. Ct. 1998) (requires official with authority and actual knowledge who fails to act for damages under similar doctrine)
- Bartlett v. New York State Bd. of Law Examiners, 156 F.3d 321 (2d Cir. 1998) (discusses policymaker liability)
- Reynolds v. Giuliani, 506 F.3d 183 (2d Cir. 2007) (deliberate-indifference cannot be mere negligence or bureaucratic inaction)
- Friends of the Earth, Inc. v. Laidlaw Envtl. Servs., 528 U.S. 167 (Sup. Ct. 2000) (standing where ongoing violation deters plaintiff's use of defendant's services)
- Liese v. Indian River County Hosp. Dist., 701 F.3d 334 (11th Cir. 2012) (alternative narrower test for who is an "official" — substantial supervisory authority)
- Nick's Garage, Inc. v. Progressive Cas. Ins. Co., 875 F.3d 107 (2d Cir. 2017) (summary judgment standard; draw inferences for nonmoving party)