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Language barriers increase risk of failure to diagnose

Ann Arbor residents today are a more diverse population than perhaps any other point in our history. We may hear any number of languages besides English spoken on the streets, in shopping malls and schools, in restaurants and on public transportation. Unfortunately, one place where languages other than English are not spoken nearly enough -- or nearly well enough -- is our hospitals and clinics.

The problem exists all over the United States. In one case, a Spanish-speaking teen was feeling nauseous. His relatives tried to tell health care workers this, but were misunderstood due to a language barrier. Thinking they meant he was intoxicated, providers proceeded to diagnose and treat the patient for a drug overdose, when in fact he was suffering a brain aneurysm.

The young man was left with permanent paralysis of his arms and legs. The failure to diagnose his brain aneurysm rendered him a quadriplegic.

The Journal of the American Medical Association recently published a study on this concerning problem. It also noted the problem of hospital staff with some non-English language skills trying to freelance as interpreters when a trained interpreter is not available. Emphasizing that medical interpretation is a skilled profession not just anyone can attempt, the study called out the significantly increased risk of misdiagnosis and medical errors experienced by patients with limited English proficiency.

Given the widespread vulnerabilities to which this population is subject on a daily basis, there may be a mindset among victims to blame themselves when this occurs, or a reluctance to try accessing the legal system. It should be noted, in response, that the young man above misdiagnosed with a drug overdose went on to pursue a medical malpractice lawsuit. The final settlement value: $71 million.

Source:, "Patient was not 'intoxicated': The issue of language barriers in our health-care system," Bushra Hossain, April 10, 2015

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Goethel Engelhardt, PLLC
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