## Facts

- York Obstetrics & Gynecology, P.A. operated an obstetrics/gynecology medical practice open to the public.
- Raymond McLaren and his wife, both deaf and primarily using American Sign Language, received care from the practice during a high-risk pregnancy.
- McLaren repeatedly requested a sign-language interpreter for prenatal visits at which he accompanied his wife.
- The practice refused to provide an interpreter on multiple occasions, resulting in McLaren’s asserted inability to understand important medical information.
- A jury found that the practice failed to ensure effective communication with McLaren in violation of Title III of the Americans with Disabilities Act (ADA) and awarded him $60,000 in damages.
- After the verdict, the United States sought prospective injunctive relief and civil money penalties based on the proven violation and asserted broader compliance concerns.

## Issues

1. Whether the court should enter injunctive relief requiring the practice to implement policies, training, notices, and auxiliary-aid procedures to ensure effective communication with deaf and hard-of-hearing patients and companions.
2. Whether the court should impose Title III civil money penalties in addition to the jury’s $60,000 damages award.

## Decision

- The court granted injunctive relief requiring the practice to comply prospectively with Title III’s effective-communication requirements.
- The injunction required, among other measures, no-cost provision of appropriate auxiliary aids and services (including sign-language interpreters when needed), adoption and distribution of a written policy, staff training, and visible waiting-room notices about the availability of interpreters and other aids.
- The court set a compliance timeline (including implementation within 60 days for specified measures).
- The court denied the United States’ request for civil penalties, concluding additional monetary sanctions were not warranted on this record given the existing damages award and the limited scope of the violations proven at trial.

## Legal Principles

- Title III of the ADA requires public accommodations, including medical practices, to furnish appropriate auxiliary aids and services when necessary to ensure effective communication with individuals with disabilities, absent a showing of undue burden or fundamental alteration.
- After a proven Title III violation, a court may order forward-looking equitable relief tailored to prevent recurrence, including policies, training, and notice requirements designed to ensure effective communication.
- Civil money penalties under Title III, when sought by the United States, are discretionary; a court may decline penalties where deterrence and redress are adequately served by compensatory damages and injunctive relief.
- Civil penalties are not a substitute mechanism to reimburse the government’s ordinary litigation expenses.

## Conclusion

The court responded to a jury finding that a medical practice denied effective communication to a deaf patient-companion by entering a detailed ADA compliance injunction, but it refused to add civil penalties because the $60,000 damages award and prospective remedial order were sufficient to address deterrence and future compliance under the circumstances.


United States v. York Obstetrics & Gynecology, P.A., No. 00-8-P-DMC, 2001 WL 80082 (D. Me. Jan. 30, 2001)