Hospital fined $16,000 in hard-of-hearing suit

Cleveland Clinic did not comply with court agreement to provide resources for hearing impaired patients

South Florida’s deaf community will benefit from a federal court victory over a “recalcitrant” hospital giant in more ways than one.

Deaf patients can be assured that, going forward, Cleveland Clinic Florida will have training and resources required by the Americans with Disabilities Act to communicate with them. And a $16,000 fine paid by the Cleveland Clinic Florida for failing to provide those resources over 15 months will enable hearing-impaired South Florida residents to hire sign language interpreters for social events and job interviews.

The win for the disabled community was secured after a federal judge in Fort Lauderdale labeled Cleveland Clinic Florida as “especially recalcitrant and dilatory” for “refusing to comply” with terms of a settlement the company had agreed to more than a year earlier.

The saga began in December 2018 when Rose Adams, a Palm Beach County high school teacher who is “profoundly deaf,” visited her physician with symptoms of jaundiced skin and fatigue stemming from a blood-related disorder, according to a February 2020 federal lawsuit filed on Adams’ behalf by Matthew Dietz, of the Miami-based law firm Disability Independence Group Inc., on behalf of Rose Adams.

The physician sent her to Cleveland Clinic in Palm Beach County for a blood transfusion. There, Adams asked for an interpreter so she could understand what doctors and nurses were saying, but none was provided, the suit states.

When she was handed a gown to change into, she didn’t understand she was being admitted to the intensive care unit because of decreased levels of hemoglobin and other diagnostic test results.

“She did not have her hearing aid, glasses or contact lenses and thus could neither lip-read or read documents reliably,” the suit states. She could not adequately communicate her medical history, including her past adverse reaction to steroids and Benadryl. She was given steroids and Benedryl.

Communication efforts failed again when a staff member attempted to discuss a proposed “painful procedure that involves a biopsy needle being inserted into a bone” while the patient is fully awake. A video relay interpreting machine was brought into the room “but it did not function,” Adams’ complaint states.

Adams asked for a sign language interpreter at least every day during her six-day stay, and the request was recorded in her medical chart at least five times, the suit states.

“I felt like a dog — more like a rat — a dog,” Adams told WTVJ-TV in January. “You don’t talk to a dog. That’s what I felt like. I was told to be quiet. You’re bothering the other patients.”

Only once was a sign language interpreter provided, after the biopsy, but “this was a simple round check” by one of the doctors “and Adams could only voice her frustration that she wanted to go home.”

In its response, Cleveland Clinic Florida denied most of Adams’ allegations but acknowledged it did not employ a full-time sign language interpreter.

In a mediation settlement in November 2020, the hospital system agreed to “make its best efforts” to obtain interpreters when requested. It also agreed to provide training for all of its staff members on how to implement a policies spelling out when and how to provide interpretive services for deaf patients.

More than a year elapsed without the Cleveland Clinic Florida providing training as spelled out by the settlement, according to documents Adams filed with the court. Training conducted by the hospital system was not completed by an individual knowledgeable about effective communication with the deaf, and not provided in a mutually agreed-upon format as agreed upon. Adams’ attorney was never informed as to whether the training was completed or who performed it.

Adams filed four motions asking a federal judge to force Cleveland Clinic Florida to live up to its November 2020 agreement. In another agreement filed in July 2021, the company said it would produce a 15-minute closed-captioned video and submit it to Adams’ attorney, Matthew Dietz, for review. Within 90 days of the order, Cleveland Clinic Florida will submit an affidavit to the court affirming that all staff members had watched the video, the agreement said.

Over the next five months, Cleveland Clinic Florida’s attorney asked three times for extensions of the deadline.

Finally in January, U.S. District Judge Rodolfo Ruiz II decided enough was enough. On Jan. 31, Ruiz held Cleveland Clinic Florida in civil contempt and imposed a fine of $1,000 a day until evidence of compliance was presented.

Ruiz’ contempt order called Cleveland Clinic Florida “an especially recalcitrant and dilatory party refusing to comply with their settlement obligations.”

The court, Ruiz wrote, “will no longer tolerate [the clinic’s] contumacious disregard for this Court’s directives.”

He wrote, “The Court finds it impossible that a health system entrusted with the care of millions of patients on an annual basis, and with revenues exceeding $15 billion a year, is incapable of showing a 15-minute video to help ensure that deaf patients are treated equitably.”

By the time Cleveland Clinic Florida submitted proof that it produced and showed the training video, 16 days had elapsed since the order, and the clinic’s fine totaled $16,000.

Cleveland Clinic Florida’s certificate of compliance asserted that the company revised its annual training for caring for deaf and hard of hearing patients in November 2020 “in contemplation of the settlement” ands made the training requirement for all “caregivers” in 2020 and 2021.

The hospital system’s attorneys worked with Dietz beginning in February 2021 “to incorporate [Dietz’] comments and edits” into the video.

The hospital system, the statement said. “is, and has always been, committed to providing the highest quality of care to all patients, irrespective of complexity of disease of condition, This commitment is reflected in comprehensive policies, procedures and training designed to benefit all of our patients, including persons with disabilities.”

After the compliance was established, Ruiz “purged” the contempt order against the Cleveland Clinic Florida. Unlike in criminal cases, civil contempt is not a crime.

In his March 14 order, Ruiz, at Adams’ suggestion, ordered that the $16,000 fine be given to the Center for Independent Living of Broward, based in Lauderdale Lakes.

The money will be made available for members of the deaf community to hire translators for occasions in which they are not required by the Americans with Disabilities Act. Those include weddings, funerals, and birthday parties, Dietz said.

“This fund will be available for a hearing family who would like to invite a deaf child to a birthday party, or a deaf family that will have both hearing and deaf people at a funeral,” he said.

It will also be available so deaf people can bring a sign language interpreter to a first job interview, Dietz said. “Many times when a deaf person applies for a job, and then asks for an interpreter for an interview, the application goes to the bottom of the pile of applicants.”

More than 270 hours of interpreter time will be funded by the fine, he said.

KIMBERLI DIMARE/FPG Cleveland Clinic Florida was ordered to pay a $16,000 fine after a judge found it was in civil contempt for taking more than a year to provide services to the deaf.