# Vega-Ruiz v. Northwell Health

> District Court, E.D. New York · March 20, 2023

URL: https://www.frixlaw.com/law-library/cases/10309384

## Case

- **Court:** District Court, E.D. New York
- **Decided:** March 20, 2023
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/10309384

## How later opinions describe it (automated extraction)

- noting that it is not “dispositive that the patient got the same ultimate treatment that would have been obtained even if the patient were not deaf”
- finding that nominal damages are “concrete” for a completed past injury and can satisfy the redressability element of Article III standing

## Opinion text

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF NEW YORK
X

LISSETTE VEGA-RUIZ,
MEMORANDUM OF

DECISION & ORDER
Plaintiff,
19-CV-537(GRB)(AYS)
-against-

NORTHWELL HEALTH SYSTEMS (formerly
NORTH SHORE-LONG ISLAND JEWISH
HEALTH SYSTEM), LONG ISLAND JEWISH
VALLEY STREAM (formerly FRANKLIN
HOSPITAL IN VALLEY STREAM), LONG
ISLAND JEWISH MEDICAL CENTER,

Defendants.
X

GARY R. BROWN, United States District Judge:

Appearances:
Andrew Rozynski
Eisenberg & Baum, LLP
Attorneys for Plaintiff
24 Union Square East
Fourth Floor
New York, NY 10003

David John Hommel, Jr.
Eisenberg & Baum, LLP
Attorneys for Plaintiff
24 Union Square East
Fourth Floor
New York, NY 10003

John P. Keil
Collazo & Keil LLP
Attorneys for Defendants
747 Third Avenue
New York, NY 10017

Daniel J. LaRose
Collazo & Keil LLP
Attorneys for Defendants
747 Third Avenue
New York, NY 10017

In this action, plaintiff Lissette Vega-Ruiz (“plaintiff”) seeks damages Rehabilitation Act
and the Affordable Care Act for the purported failure of defendants to provide her with sufficient
ASL translation services during her brother’s stay at a medical facility operated by defendants.
Both parties have moved for summary judgment. For the following reasons, plaintiff’s motion is
DENIED and defendants’ motion is GRANTED in part and DENIED in part. The result of that
motion practice is significant: as described herein, plaintiff is left solely with a claim for nominal
damages.
BACKGROUND
The following facts are undisputed, except as otherwise noted, and are taken from the
parties Statements of Undisputed Facts filed pursuant to Rule 56.1.1
Plaintiff Lissette Vega-Ruiz (“plaintiff”) is a deaf individual whose primary method of
communication is American Sign Language (“ASL”). Def. Reply R. 56.1 Statement, DE 53 at ¶
1. On October 14, 2015, plaintiff accompanied her brother, Jose Vega, to Long Island Jewish
Valley Stream Hospital (“the hospital”) where he would be undergoing spinal surgery. Id. at ¶¶
40, 42. The parties dispute whether plaintiff was Mr. Vega’s legal healthcare proxy,2 see Pltf.
Reply R. 56.1 Statement, DE 60 at ¶ 157, and whether the provision of an ASL interpreter was
requested before the hospitalization, id. at ¶¶ 122-23, 125, Mr. Vega’s medical records

nonetheless reflect that Ms. Vega-Ruiz was identified as his “Patient Representative” and contain

1 All citations to the parties’ respective 56.1 Statements, unless otherwise noted, omit internal citations.
2 In fact, plaintiff’s brother testified that he did not have a health care proxy. See Pltf. Reply R. 56.1 Statement, DE
60 at ¶ 157.
an entry stating, “Lissette Vega sister in waiting room sister deaf [sic].” Def. Reply R. 56.1
Statement, DE 53 at ¶ 47.
ASL interpreters were provided during only some portions of Mr. Vega’s stay in the
hospital.3 Particularly, plaintiff was provided three different interpreters between her arrival on
the 14th and approximately 6 o’clock P.M. on the 15th, id. at ¶¶ 150, 154, but there is conflicting

evidence as to whether plaintiff was nonetheless able to effectively communicate and understand
what was being explained to her during the conversations where an interpreter was not present.
See, e.g., id. at ¶¶ 81, 82, 95; see also Pltf. Reply R. 56.1 Statement, DE 60 at ¶ 164. There is
also inconsistent testimony as to whether plaintiff and/or her brother requested additional
interpretive services throughout Mr. Vega’s hospitalization. See, e.g., Def. Reply R. 56.1
Statement, DE 53 at ¶¶ 48-51, 54, 56; Pltf. Reply R. 56.1 Statement, DE 60 at ¶¶ 129, 161.
On October 18, 2015, plaintiff returned to the hospital to visit her brother and was
informed that he had been moved to the Intensive Care Unit (“ICU”) because he was
experiencing hypoxia and had developed a pulmonary embolism. See Def. Reply R. 56.1

Statement, DE 53 at ¶ 91. Northwell staff attempted to explain the situation to plaintiff by
writing her a note informing her that her brother would have an additional procedure done to
insert a filter into a vein in his leg to prevent a blood clot from reaching his lungs. Id. at ¶ 96.
Additionally, her brother’s physician, Dr. Lisa Chen, discussed Mr. Vega’s condition and the
plan to implant the filter in his leg with plaintiff and did not record any difficulty communicating
with plaintiff in her notes. Id. at ¶¶ 147-49. Plaintiff testified that she was having difficulty
communicating with staff at this time, but there is at least some evidence that she understood that

3 While plaintiff’s complaint stated that she was provided with a Spanish interpreter instead and of an ASL
interpreter, plaintiff testified under oath that she was provided with three different ASL interpreters. See Pltf. Reply
R. 56.1 Statement, DE 60 at ¶¶ 161-63. 173. The allegation of the erroneous provision of a Spanish interpreter
appears to be untrue, and may be an artifact from another similar action brought by plaintiff.
the staff members were professing a lack of awareness of certain details of the situation. Id. at ¶¶
95, 97-99.
Based on the foregoing, plaintiff now brings a claim for violation of the Patient
Protection and Affordable Care Act, 42 U.S.C. § 18116, premised on defendants' failure to
provide an ASL interpreter throughout Mr. Vega’s stay in the hospital. See Amended Compl.,

DE 32.
DISCUSSION
Currently before the Court are motions for summary judgment by both parties. These
motions are decided under the oft-repeated and well-understood standard of review for motions
made under Rule 56, as discussed in Bartels v. Inc. Vill. of Lloyd Harbor, 97 F. Supp. 3d 198,
211 (E.D.N.Y. 2015), aff'd, 643 F. App'x 54 (2d Cir. 2016), incorporated by reference herein. In
sum and substance, the Court must determine whether, drawing inferences in favor of the non-
movant, based upon the undisputed material facts, judgment should be entered in favor of the
movant upon the claim or issue under examination.

Plaintiff’s Motion Regarding Liability
Plaintiff claims entitlement to summary judgment on liability for disability
discrimination under the ACA, which requires showing three elements: “1) [plaintiff] is a
qualified individual with a disability; 2) [defendant] is an entity subject to the acts; and 3)
[plaintiff] was denied the opportunity to participate in or benefit from defendant's services,
programs, or activities or [defendant] otherwise discriminated against [her] by reason of [her]
disability.” Wright v. New York State Dep't of Corr., 831 F.3d 64, 72 (2d Cir. 2016). The third
element proves problematic.
There are numerous issues as to whether plaintiff was “denied the opportunity to
participate in or benefit” from Northwell’s services. As demonstrated by the factual summary
above, there are disputes as to whether Northwell’s provision of ASL interpreters for two days
along with other accommodations for the balance of her brother’s stay in the hospital permitted
her sufficient access to the services, whether effective communication took place, and whether

any purported failure was material given her role as a companion and health care proxy.
Additional factual issues going to plaintiff’s credibility, including assertions that she provided
inconsistent statements and false sworn statements in this action, that could well further bear on
these issues.
Counsel argues that plaintiff “is entitled to interpreter services for all critical encounters
under the ACA,” an assertion which, under these facts, raises more questions than it answers.
DE 51 at 17. At which points during her brother’s 10-day hospital stay did such “critical
encounters” occur? Part of the answer may turn on when or whether the plaintiff was the
healthcare proxy. Remarkably, in support of its argument, plaintiff’s counsel cites to factors that

are not dispositive of the question of liability. DE 51 at 12-13 (citing Silva v. Baptist Health S.
Fla., Inc., 856 F.3d 824, 829 (11th Cir. 2017) (noting that it is not “dispositive that the patient
got the same ultimate treatment that would have been obtained even if the patient were not deaf”)
and Giterman v. Pocono Med. Ctr., 361 F. Supp. 3d 392, 410 (M.D. Pa. 2019) (supporting the
proposition that “subjective beliefs” of Northwell’s staff that Ms. Vega-Ruiz understood them or
her brother’s treatment are not “determinative as to whether she truly understood”)). Such
arguments reflect a misapprehension of the standard applicable on a Rule 56 motion: as to
plaintiff’s motion, the Court is required to draw inferences in favor of the non-movant. Thus,
factors identified as inconclusive cannot support summary judgment in plaintiff’s favor.
Plaintiff’s motion for summary judgment on liability is therefore DENIED.
Defendant’s Motion as to Available Damages
In the wake of the Supreme Court’s decision in Cummings v. Premier Rehab Keller,
P.L.L.C., 142 S. Ct. 1562, reh'g denied, 142 S. Ct. 2853 (2022), defendant seeks summary
judgment on most categories of damages sought by plaintiff. Importantly, Cummings involved a

plaintiff who sought recovery under the Rehabilitation Act and the Affordable Care Act for the
failure of a federally-funded medical facility to provide ASL translators. In Cummings, the
Supreme Court ruled that in actions based on Congressional enactments predicated upon the
Spending Clause of the Constitution, damages are limited to “the usual contract remedies in
private suits.” Id. at 1571. Thus, for example, the Court concluded that “emotional distress
damages are not recoverable under the Spending Clause statutes we consider here.” Id. at 1572.
Thus, plaintiff’s claim for emotional distress damages is no longer viable.
Analysis of the effect of Cummings on plaintiff’s remaining damages claims is greatly
simplified by Judge Briccetti’s thoughtful decision in Fantasia v. Montefiore New Rochelle,

2022 U.S. Dist. LEXIS 107935 (S.D.N.Y. June 16, 2022), which is not only factually
indistinguishable from this case, but was litigated by the same plaintiff’s counsel, who raised
identical arguments.4 Thus, the Court adopts the reasoning of Fantasia and, for the reasons set
forth in that case, similarly finds that plaintiff’s claims for “dignitary harm” and “expectation
damages” are no longer viable. At the same time, based on the reasoning in Fantasia, applying
the Supreme Court’s determination in Uzuegbunam v. Preczewski, 141 S. Ct. 792, 801 (2021)
(finding that nominal damages are “concrete” for a completed past injury and can satisfy the
redressability element of Article III standing), the Court finds that plaintiff still has a claim for

4 Indeed, as in Fantasia, counsel argues to this Court that Cummings was wrongly decided, reflecting a
fundamental misconception of the judicial process.
nominal damages. Thus, defendant’s motion for summary judgment is DENIED as to nominal
damages and GRANTED with respect to the remaining categories of damages sought by
plaintiff.
The Road Forward
This leaves the matter in an unusual posture. To resolve the question of liability requires

a trial at which plaintiff may only pursue nominal damages. While the question may not yet be
ripe, defendant has, on this motion, provided authority suggesting that, absent a “ground-
breaking conclusion of law,” attorney’s fees may not be available should plaintiff prevail only on
an award of nominal damages. Pino v. Locascio, 101 F.3d 235, 238 (2d Cir. 1996) (“[F]ee
awards are not appropriate where, having failed to capture compensatory or punitive damages, a
plaintiff wins only ‘the moral satisfaction of knowing that a federal court concluded that [their]
rights had been violated.’”). Thus, we may be in a situation in which, as posited by the Chief
Justice, “a plaintiff asks only for a dollar [and] the defendant should be able to end the case by
giving him a dollar, without the court needing to pass on the merits of the plaintiff ’s claims.”

Uzuegbunam v. Preczewski, 141 S. Ct. at 808 (Roberts, C.J., dissenting) (further noting that
“defendant can even file an offer of judgment for one dollar, rendering the plaintiff liable for any
subsequent costs if he receives only nominal damages.”)
As such, counsel is directed to meet and confer forthwith, and file a status report within
two weeks of the date of this Order.
SO ORDERED.

Dated: Central Islip, New York
March 20, 2023

/s/ Gary R. Brown
GARY R. BROWN
United States District Judge

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10309384. Public record. Not legal advice.