Language barriers in health care can be a catalyst to providing health care that fails to meet the accepted standard for that specialty, which Bangor injury attorneys know is how we measure medical malpractice. Maine is not known for being especially diverse, but gains over the last 50 years have been steady, including more than 700 refugees from African countries like Ethiopia and Somalia, as well as migrant workers (primarily from Latin America) and France/Canada. As noted by researchers with Bowdoin College, Portland historically has had the most concentrated population of immigrants, though rising housing rates have meant many new immigrants are settling in newer areas in southern Maine. Although many hospitals are striving to become more culturally and medically competent in order to care for new immigrant patients, the reality is English proficiency and literacy has a big impact on a person’s ability to access health care – from setting up appointments to using public transportation to understanding preventative care.
A study published a few years ago by the University of California, Berkley School of Public Health and the National Health Law Program, reported at least 2.5 percent of medical malpractice claims involved a language barrier that was partially or substantially related to failure to provide appropriate language services. The cases identified involved patients who either died or suffered irreparable harm. Of those who died, two were children and three were adults.
In 32 of the 35 total cases wherein a language barrier was causal in a medical malpractice case, it was alleged the health care providers did not use competent interpreters. Several used family or friends as interpreters, including minor children. In one instance, it was the decedent child who served as an interpreter before suffering respiratory arrest. In another case, it was the 16-year-old sibling of the child who died who served as an interpreter. At least a dozen of the medical malpractice claims involved alleged failure to help translate important documents. Another child suffered major organ damage, an adult underwent an unnecessary leg amputation and another was rendered permanently comatose.
In some cases, health care providers made the mistake of assuming an apparent concordance with race and/or ethnicity between a patient and physician, this meant that there was effective communication. This seemed to happen most often in this instance with Asian patients-physicians, where there is a large and diverse group of cultures and languages, and providers failed to account for distinctions between languages and geographical dialects (i.e., Cantonese, Mandarin and other Chinese dialects). In none of those cases did providers reportedly ask patients for clarification on their primary language.
Researchers noted in several cases that ineffective oral and written communication might have resulted in patient’s lack of understanding and urgency for follow-up.
Our Portland medical malpractice attorneys note any health care providers that receive federal funds (primarily through Medicaid and Medicare) have a legal obligation to provide patients with interpretation and translation services. This is expressly outlined in Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act and the Affordable Care Act. The ACA in particular requires not just interpreters but “qualified medical interpreters.” These can be certified through the Commission for Healthcare Interpreters, the National Board of Certification for Medical Interpreters and the Registry of Interpreters for the Deaf.
Patients with limited English proficiency who receive inadequate interpretation and translation services may have a case for damages.
If you are injured, contact Peter Thompson & Associates at 1-800-490-5218 for a confidential consultation to discuss your rights.
Language Barriers and the Patient Encounter, Aug. 2007, AMA Journal of Ethics
More Blog Entries:
Understaffed Hospitals in Maine Can Result in Negligent Medical Errors, Jan. 11, 2019, Portland Maine Medical Malpractice Attorney Blog