On March 26, 2019, OCR’s Eastern and Caribbean Region received a call from an advocate for the deaf community, alleging that the Caribbean Medical Center (CMC), a 36-bed, short term, acute care and surgical facility in Fajardo, Puerto Rico, failed to provide appropriate sign language interpretive services to a deaf individual who sought an evaluation for surgical care, which resulted in amputation surgery.  The advocate reported that during the patient’s encounter with CMC staff, CMC staff relied on his family member to relay complex medical information and recommendations to him. CMC then sought a staff social worker who had some knowledge of sign language to attempt to communicate with the patient.  The advocate expressed concern about CMC’s failure to provide the patient with a qualified sign language interpreter.

OCR contacted CMC to provide technical assistance regarding its obligation to ensure effective communication with deaf individuals and the requirement to conduct an individualized assessment of patients’ needs by providing a qualified, independent interpreter.  As a result of OCR’s intervention, CMC provided the patient with a qualified sign language interpreter throughout the duration of the patient’s hospital admission and during the patient’s consultation with CMC’s surgical team.

CMC further committed to ensure that qualified sign language interpreters and other appropriate auxiliary aids and services are available for deaf patients when they meet with hospital personnel.   CMC also agreed to review its policies and procedures for providing sign language interpreters and auxiliary aids and services to ensure effective communication.

“Our system of informed consent breaks down when medical facilities fail to communicate effectively with patients,” said Roger Severino, OCR Director. “Persons who are deaf or hard of hearing are entitled to qualified interpreters when making serious and life-altering decisions regarding their medical care.  We commend CMC for taking prompt action to ensure that effective communication was provided for its patient in this critical situation.”

To learn more about laws and regulations enforced by OCR, visit us at https://www.hhs.gov/civil-rights/for-providers/laws-regulations-guidance/laws/index.html.

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