Deaf Fresno mother says Valley Children’s shut her out of child’s care. ‘It was horrible’

A deaf Fresno mother who accompanied her teen daughter at Valley Children’s Hospital in Madera for emergency surgery said what should have been a two-day stay stretched more than a week because staff left her out of important conversations.

Rosemary Wanis said the frustrating nine-day hospital stay left her daughter, Rashelle Diaz, “traumatized by this experience.”

“It was a horrible experience for me. For her, she’s not ever going to trust another doctor and be willing to go to the hospital for another checkup, ever,” Wanis, 50, said through an American Sign Language interpreter.

The case highlights the difficulty the deaf and hard of hearing community in Fresno and the San Joaquin Valley face in securing interpreter services during hospital visits — even when a care facility has more than one option at its disposal.

Wanis, a professor at Fresno State and Ohlone College in Fremont, said her requests for communication from Valley Children’s were ignored and met with hostility by some staffers while her 16-year-old daughter was rushed in for two surgeries in 2022.

Wanis said the hospital was willing to meet with her to discuss a settlement after she complained, but she rejected that offer. Instead, the mother wants the hospital to improve access to interpreter services and train employees on interacting with deaf patients and their relatives.

Two years later, Wanis and Diaz say their frustration has only grown.

Valley Children’s Hospital and communication for the deaf

Diaz, who is fluent in American Sign Language but not hard of hearing, was taken by ambulance to Valley Children’s Hospital on Sept. 4, 2022, with intense stomach pain, Wanis said.

The mother and daughter had already visited Kaiser Permanente Fresno Medical Center that day when the pain first struck, thinking it might be food poisoning. Their stay at Kaiser was relatively short but Wanis said she was satisfied with the interpretation there.

Doctors there referred the pair to Valley Children’s for an appendectomy, and Wanis said she believed Kaiser notified the Madera hospital of her interpretation needs.

Wanis said the ambulance crew told Valley Children’s of her interpretation needs when they arrived at the hospital. But, she said, the hospital didn’t provide the services until after she herself asked for it several times.

The hospital used video remote interpreting, commonly called VRI, which is essentially a tablet computer hung at about eye level that connects to a remote interpreter. The service can interpret many languages, but American Sign Language (ASL) requires additional accommodations.

While many languages need to be relayed only audibly, ASL requires the interpreter and the deaf person to be able to see each other over the video screen. That was difficult, Wanis said, because the tablet computer’s spotty connection couldn’t keep it working consistently.

Wanis said the nurse in the room was also standing between her and the screen, making communication difficult.

“She pushed me. Actually, she pushed me when I tried to get access to the equipment,” Wanis said. “So I gestured, like, I pointed to my eyes, and I pointed to the VRI screen, and gestured, please. I didn’t touch her, but I gestured if you could move over so I could see the screen, and she very purposefully put her back up against the machine and pushed me away.”

The staffers repeatedly skipped over speaking to the mother, Wanis said, and spoke directly to Diaz as she ached in pain.

Diaz, who is now 18, said she was in extreme agony, and repeatedly told the nurses her pain was a 10 on a scale of one to 10. The nurses gave Diaz medication and ignored her mother’s questions about dosages.

Diaz said she tried to fill in Wanis, who was left out of the chain of communication.

“I’m in excruciating pain, you know?” Diaz said. “She doesn’t have any of the reassurance that she needs. She doesn’t have any confirmation about what’s happening.”

Nurses would wake up Diaz, who was still recovering from surgery, and have her interpret for her mother, the mother and daughter both said.

On the third day into their nine-day stay, an ASL interpreter walked into Diaz’s room, they said. The hospital had an interpreter in the building but hadn’t called them to the room. The interpreter arrived only after learning from another deaf patient on another floor of the hospital that a deaf family member needed help, Wanis said.

Diaz had a second surgery on the eighth day of her visit to clear a blockage. Wanis later learned some of the information nurses gathered from her daughter was incorrect, which she said may have been why the hospital stay extended to nine days.

Valley Children’s Hospital’s response

Valley Children’s declined The Fresno Bee’s request for an interview, noting the Health Insurance Portability and Accountability Act protects the privacy of patients.

Hospital spokesperson Zara Arboleda said in a statement the hospital values and respects the deaf and hard of hearing community and is “dedicated to providing exceptional care and support to these patients.”

“For nearly 45 years, our Interpreter Services Department has been committed to meeting the needs of our diverse region with bilingual and bi-cultural qualified health interpreters,” Arboleda said in a statement. “We offer assistance in more than 100 languages and represent 37 distinct cultures, providing language support 24/7 through face-to-face, phone and video interpreting services.”

The hospital also works with families to address areas that need improvement, Arboleda said.

Limits of remote interpreters

Many people who are deaf or heard of hearing will avoid hospitals to their detriment because the lack of communication is a roadblock, according to Michelle Bronson, the executive director of the Deaf and Hard of Hearing Service Center in Fresno.

Bronson, who described Wanis as a friend and mentor, said deaf people want to be able to understand the care a hospital is providing to them or their loved ones like anyone else.

But video interpretation can only go so far, advocates say.

“The hospital needs to ask each patient, ‘What do we need to communicate effectively?’ They don’t decide for the patient,” Bronson said. “They need to ask the patient. Each of us is different.”

Federal law requires that hospitals have a means of communication that is accessible, according to the National Deaf Association, a national nonprofit that advocates for deaf rights.

While VRI can be helpful, it needs to stream without interruption and hospital staffers should be trained on using it, the association’s interim Executive Director Bobbie Beth Scoggins told The Bee in an email.

“VRI should not replace in-person interpreters when the nature of the medical interaction requires physical presence for effective communication,” she wrote.

Hospital negotiations

Wanis said after she complained about her experience, representatives of the hospital began negotiating with her and an attorney. She said the hospital offered her money, but she was only interested in changes.

Wanis sent a formal complaint to the hospital in late 2022, and negotiations started in summer 2023 but fell apart by the start of this year, she said.

Zeenat Hassan, an attorney with the Disability Rights California advocacy group who represented Wanis, said the hospital “wants to throw money at Dr. Wanis to make this all go away, but she is not interested in money.”

“She wants them to change the way they serve deaf patients and visitors,” Hassan said. “They are not willing to do that.”

Wanis said the hospital should better train employees to work with deaf patients and their family members, connect all VRI to the internet using a wired Ethernet connection rather than Wi-Fi, and work with a consultant from the Deaf community who will conduct routine reviews and make recommendations on the hospital’s policies and training for interpretation for the Deaf.

“I don’t want our story to become someone else’s story. If we don’t have communication, we cannot have good quality health care. The two go hand in hand,” Wanis said. “There’s a relationship directly between communication needs, between me as a mom advocating for my daughter and what she needs so that we can get the best quality health care possible for her.”