353 F. Supp. 3d 772
E.D. Wis.2018Background
- Plaintiff Alissa Juech, deaf and primarily an ASL user, visited Children's Hospital ED with her infants in 2015 and 2017 and requested interpreters; hospital policy provides in-person interpreters when available and otherwise uses video remote interpreting (VRI).
- During the visits hospital staff initially used VRI; Juech reported delays, freezing/pixilation, and difficulty using VRI (including while breastfeeding); in-person interpreters were provided at later points and at both discharges.
- Juech sued under Title III of the ADA, §504 of the Rehabilitation Act, the ACA, and Wisconsin law, alleging defendants failed to provide auxiliary aids necessary for effective communication.
- Defendants moved for summary judgment; they conceded Juech is a qualified person with a disability but argued VRI and written notes were adequate and the claims were duplicative.
- The court evaluated effectiveness of auxiliary aids, deliberate-indifference standard for damages, and Article III standing for injunctive relief.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Are the auxiliary aids provided (VRI/written notes) adequate under ADA/§504? | Juech: VRI repeatedly malfunctioned and written notes were inadequate, so she lacked effective communication. | Children’s: VRI and notes were appropriate alternatives to in-person interpreters and hospital obtained needed history. | Genuine dispute of material fact exists; reasonable juror could find discrimination based on ineffective VRI/notes. |
| Must plaintiff elect among overlapping federal claims (ADA, §504, ACA)? | Juech: may pursue multiple claims. | Children’s: claims are duplicative and plaintiff should choose one. | Court declined to force election at summary judgment; allowed multiple federal claims to proceed. |
| Are compensatory damages under §504/Title II available — what standard applies? | Juech: repeated VRI failures support deliberate indifference and thus damages. | Children’s: no evidence of deliberate indifference by administrators; staff attempted remedies. | Deliberate indifference is required for damages; court found insufficient evidence of deliberate indifference, so §504 damages claim dismissed. |
| Does Juech have standing to seek injunctive relief under Title III? | Juech: lives in area, has children, uses Children’s in past and likely will return. | Children’s: plaintiff lives closer to other hospitals; visits to ED/admissions are unpredictable and speculative. | No standing for injunctive relief: risk of future harm is speculative and not sufficiently imminent. |
Key Cases Cited
- Liese v. Indian River Cty. Hosp. Dist., 701 F.3d 334 (11th Cir. 2012) (effectiveness of auxiliary aids is fact-intensive)
- Silva v. Baptist Health S. Fla., Inc., 856 F.3d 824 (11th Cir. 2017) (VRI acceptable but inquiry focuses on exchange of medically relevant information and effectiveness)
- Lacy v. Cook Cty., 897 F.3d 847 (7th Cir. 2018) (discussing deliberate-indifference standard)
- Jaros v. Ill. Dep't of Corr., 684 F.3d 667 (7th Cir. 2012) (ADA and Rehabilitation Act claims largely coextensive)
- McCullum v. Orlando Reg'l Healthcare Sys., 768 F.3d 1135 (11th Cir. 2014) (standing for injunctive relief requires realistic threat of future harm)
- Sunderland v. Bethesda Hosp., Inc., [citation="686 F. App'x 807"] (11th Cir. 2017) (repeated VRI failures can support discrimination; distinct facts about deliberate indifference)
- Scherr v. Marriott Int'l, 703 F.3d 1069 (7th Cir. 2013) (standing for injunctive relief requires concrete, imminent plans to return)
- Lujan v. Defenders of Wildlife, 504 U.S. 555 (1992) (Article III standing requirements)
- Farrar v. Hobby, 506 U.S. 103 (1992) (nominal damages and prevailing-party considerations)