LITTLE ROCK — In 2007, a couple brought their 2-month old daughter Luzdeestrella (Spanish for starlight) to a Colorado Springs hospital for surgery to remove a cystic kidney.
The parents, neither of whom spoke English very well, were nervous but trusted their doctor, with whom they communicated through their other daughter, who was learning English in school. The mother and father were relieved when Luzdeestrella came through the surgery, but the next day, the baby suffered kidney failure and had to go on a transplant waiting list.
Luzdeestrella’s mom and dad did not clearly understand the risks of the surgery because there was not a qualified interpreter present, and they had not been given consent forms in Spanish. They successfully sued the hospital to recover some of the huge costs of the care and surgery their daughter would now require.
Luzdeestrella’s case is just one of many in which courts have upheld patients’ rights to communicate clearly with care providers.
There are many cases like this, the most famous involving a Florida teenager, Willie Ramirez, whose emergency-room doctors were told that he was “intoxicado,” which in Spanish could mean he was suffering from food poisoning or nausea. The ER team thought intoxicado sounded like the English word intoxicated and treated him accordingly.
Actually, Willie had suffered a brain hemorrhage and because he did not receive proper care quickly, he was left a quadriplegic for life. Willie and his family received a huge settlement because of an error that could have been avoided if a qualified medical interpreter had been present.
Title VI of the Civil Rights Act of 1964 states that hospitals receiving federal funds cannot discriminate based on race, color or national origin, and this includes patients who are not proficient in English. The Rehabilitation Act of 1973 requires effective communication for patients who are deaf or hard of hearing, and by extension, those with limited English proficiency.
The lack of qualified interpreters not only increases the chance for serious errors, it also results in higher costs for hospitals. A study by the University of Massachusetts Medical School found that the length of hospital stays for patients with limited English was significantly shortened when professional interpreters were used, and patients who had access to interpreters were less likely to be readmitted within 30 days. This is because patients can only follow their doctor’s instructions when they can understand them.
Although clear communication between doctor and patient is essential for good medical care, not many hospitals or clinics in Arkansas have professional interpreters, so they have to come up with other ways of communicating with patients who don’t speak English well. Some of these ways include using children as interpreters for their parents (as happened with Luzdeestrella), relying on the patient’s or the caregiver’s limited knowledge of the other’s language, or even using hand signals to play a risky game of charades.
The main reason hospitals take the risk of relying on ad hoc interpreters is because of the cost of hiring qualified professionals. Under the 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA), however, Arkansas could get an increased matching rate from the federal government for language access services, such as written translation of healthcare materials and spoken translation services in a health-care setting.
Arkansas should join the states that do take advantage of CHIPRA matching funds allowing them to use qualified medical interpreters. If our state did this, patients and their parents could communicate better with their doctors and nurses and thereby receive better care, and unfortunate incidents like those of Luzdeestrella and Willie could be avoided.
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Christopher T. Williams is a certified medical interpreter and Arkansas state chairman for the International Medical Interpreters Association.
Editorial, Pages 11 on 02/25/2013