Dorothy McCullum v. Orlando Regional Healthcare System, Inc., 2014 U.S. App. LEXIS 18911

Background

D.F., a deaf and mute 14-year-old, was hospitalized at Parrish Medical Center (20 days) and Arnold Palmer Hospital for Children (11 days) in 2009 for ulcerative colitis and surgery; family members regularly interpreted for him using home signs/limited ASL.
Neither hospital provided a professional ASL interpreter nor directly offered one; staff relied on written notes, visual aids, a nurse with some signing, and family interpretation.
Plaintiffs (D.F.’s parents individually and on behalf of D.F. and his sister) sued under the ADA and the Rehabilitation Act seeking damages and injunctive/declaratory relief.
District court dismissed the parents’ and sister’s individual/associational claims for lack of statutory standing, granted summary judgment to defendants on D.F.’s claims for damages (no deliberate indifference) and injunctive relief (no likelihood of future injury).
Eleventh Circuit affirmed: (1) non-disabled family members lacked associational standing because they did not allege they were personally excluded/denied benefits/discriminated against; (2) D.F. lacked Article III standing for injunctive relief (no real/immediate threat of future harm); (3) no genuine dispute that hospitals were deliberately indifferent (no evidence staff knew accommodations were substantially likely ineffective and deliberately refused an interpreter).

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Do non-disabled family members have statutory/associational standing under ADA/RA?	Parents argue RA/ADA allow non-disabled persons to sue for any independent injury caused by association (relying on Loeffler).	Hospitals argue associational standing is limited: non-disabled must allege they were personally excluded, denied benefits, or discriminated against because of the association.	Held: Affirmed dismissal — associational standing limited to persons personally excluded/denied benefits/ discriminated against.
Is D.F entitled to injunctive relief (Article III standing)?	D.F. argues chronic condition makes future hospitalization likely, so injunction is warranted.	Hospitals point to successful surgery, current stability, hospital policies, and fact D.F. has not been rehospitalized.	Held: No Article III standing for injunction — no real and immediate threat of future injury.
Did hospitals act with deliberate indifference (necessary for compensatory damages under ADA/RA)?	D.F. contends need for interpreter was obvious and hospitals had authority to provide one but failed to do so.	Hospitals assert they provided reasonable accommodations (written aids, family interpreters, staff efforts) and lacked notice that those aids were ineffective; plaintiffs never requested an interpreter.	Held: No genuine issue of material fact on deliberate indifference — summary judgment for defendants on damages.
Is Loeffler’s broader RA associational-standing rule controlling?	Plaintiffs rely on Loeffler to expand RA standing to independent injuries caused by denial of services to disabled associates.	Hospitals/court argue Loeffler is inconsistent with RA text/context and ADA associational provision; associational standing must be coextensive with ADA’s limiting language.	Held: Court rejects Loeffler’s broader approach and construes RA associational standing in line with ADA’s narrower scope.

Key Cases Cited

Lujan v. Defenders of Wildlife, 504 U.S. 555 (standing requires concrete, particularized, actual/imminent injury)
Farmer v. Brennan, 511 U.S. 825 (obviousness of risk can support an inference of knowledge)
Loeffler v. Staten Island Univ. Hosp., 582 F.3d 268 (2d Cir. 2009) (associational standing under RA interpreted broadly)
Liese v. Indian River Cnty. Hosp. Dist., 701 F.3d 334 (11th Cir. 2012) (deliberate indifference standard for damages under RA/ADA)
Shotz v. Cates, 256 F.3d 1077 (11th Cir. 2001) (injunctive-relief standing requires real and immediate threat)