Sometime this month or next, Cheylla Silva will be admitted to Baptist Hospital in Miami to give birth to her second child. The delivery will be high-risk: Silva suffers from high blood pressure and other complications.
Silva is hoping the delivery goes smoothly because if there are serious problems, she might be at a loss to communicate with her doctors and nurses. Silva is profoundly deaf, and, for months, Baptist administrators have refused to provide her with an American sign language interpreter, she says.
Late last week, Silva filed an emergency motion in federal court, asking U.S. District Judge Kathleen M. Williams to order Baptist to provide the interpreter, arguing the hospital’s refusal to do so violates the federal Americans With Disabilities Act, a landmark civil rights law signed by then-President George Bush in 1990.
Baptist’s obligation, the suit says, “is to ensure that deaf patients be provided an equal opportunity to participate in their care and treatment.”
“One of the essential elements of personal dignity,” the pleading adds, “is the ability to obtain the necessary information to make an adequate and informed choice about one’s own medical treatment. Medical treatment and childbirth are some of the most intense and important experiences for a person.”
Through a telephonic interpreter, Silva said her experiences at Baptist, which is near where she lives, have frequently been frustrating. “Can you imagine going to a doctor’s office and not being able to understand what they are talking about? And it’s about your care. How would you feel?”
“They write back and forth with pen and paper,” she said. “I don’t understand words in writing. I don’t understand sentence structure. English is not my first language. American sign language is.”
Representatives of Baptist Hospital declined to discuss Silva’s emergency motion with the Miami Herald.
In a statement, Assistant Vice President Christine Kotler said patient confidentiality prevented the hospital from speaking about the case. She added: “Providing a safe and positive experience for our patients and guests is a top priority, and we do our very best to provide a comfortable and supportive care environment. To that end, we provide accommodations for our patients and visitors with disabilities, including but not limited to auxiliary aids and interpretation services for the deaf.”
A federal lawsuit filed on Silva’s behalf claims that another patient, John Paul Jebian, who is profoundly deaf, also was repeatedly denied a sign language interpreter — despite a 2003 settlement to an earlier federal lawsuit Jebian filed in which Baptist administrators agreed to provide interpreters in the future to patients who were deaf or hard of hearing. Hospital staff couldn’t operate a video interpreting service in July 2012 when Jebian suffered chest pains, and refused to get him a live interpreter, the lawsuit claims.
“Instead,” said the suit, filed by Miami civil rights lawyer Matthew Dietz, “Baptist staff communicated with Jebian by writing notes.”
Silva, 31, was born completely deaf, and American sign language was her first language. The Miami woman can read and write in English, but she thinks in American sign, in the same way many bilingual Hispanics form their thoughts in Spanish, not English, she said. And sign language is different structurally from English.
A lawsuit says that Silva has been to Baptist about 20 times since 2009, and been denied an interpreter most times. When Silva is seen at Baptist — in the emergency room, or at a doctor’s appointment — she often has difficulty explaining her symptoms, or expressing what she is feeling.
Since Silva learned she was pregnant, around February, she “had to ask questions about her pregnancy via writing, and [to] try to read the answers,” her lawsuit states.
In recent months, Silva has communicated with doctors a variety of ways: Sometimes they exchange handwritten notes. Sometimes family members explain her symptoms to doctors — when Silva’s mother or brother interpreted, Silva was relying on someone whose first language was Spanish to translate English into American sign. The hospital also has provided a video translation system that is supposed to allow Silva to communicate with an interpreter remotely. The interpreter then speaks with her doctor.
But Silva said that, as often as not, the Video Remote Interpreting device, or VRI, just doesn’t work.
“When they set up the VRI screen at the hospital, it will come on and then the signal will disconnect, or it freezes,” Silva told the Miami Herald through an interpreter patched in to her phone line. “There are whole portions I don’t get. It’s lousy. I am getting only parts here and there of what the interpreter on screen is saying. The signal is so bad it does not work.”
Silva’s medical records document the difficulties in communicating, court records say. During a November 2009 appointment, for example, a doctor at Baptist wrote that Silva “was unable to describe [her] symptoms,” or to “provide her medical history.” In January and May of 2011, records said the video conferencing device was inoperable. During a May 9, 2011 visit, when Silva was suffering from acute appendicitis, a medical chart said Silva was “deaf mute [with] very little lip reading.” For two hours before family members arrived, staff communicated by passing notes.
During a June 2013 visit, court records say, the “language line phone [was] inoperable” when Silva sought treatment for chest pains. In February of this year, the VRI machine’s image “was fuzzy, making it difficult for Silva to see the remote interpreter.”
Silva, who receives federal disability payments because she is unable to work, said she does not understand why others with disabilities receive assistance, while she is asked to do without.
“It’s not fair,” she said. “They build ramps for people who have to use wheelchairs to get in. They don’t tell them they have to bring a ramp with them every time they come.”