Access Now v. Ambulatory Surgery Center Group Ltd., 99109CIV.

• Decision Date: 02 May 2001
• Docket Number: No. 99109CIV.,99109CIV.
• Citation: 146 F.Supp.2d 1334
• Parties: ACCESS NOW, INC., et al., Plaintiffs, v. AMBULATORY SURGERY CENTER GROUP, LTD., et al., Defendants.
• Court: U.S. District Court — Southern District of Florida

146 F.Supp.2d 1334

ACCESS NOW, INC., et al., Plaintiffs, v. AMBULATORY SURGERY CENTER GROUP, LTD., et al., Defendants.

No. 99109CIV.

United States District Court, S.D. Florida.

May 2, 2001.

Miguel Manuel De La O, David Everett Marko, De La O & Marko, Miami, FL, for plaintiffs.

Ronald M. Rosengarden, Jennifier Gayle Demberg, Greenburg Traurig, Miami, FL, Amy Wright Littrell, Youndy Christine Cook, Ford & Harrison, Tampa, FL, Frank G. Simpson, III, Nashville, TN, for defendants.

ORDER ON DEFENDANTS' MOTION FOR DETERMINATION THAT EMERGENCY ALARM STROBE LIGHT PLACEMENT SHOULD CORRESPOND TO STANDARD MEDICAL PRACTICE

GARBER, United States Magistrate Judge.

THIS MATTER came to be heard on Defendants' Motion for Determination that Emergency Alarm Strobe Light Placement Should Correspond to Standard Medical Practice ("Defendants' Motion"). The Defendants asserted that emergency alarm devices should not, as a matter of standard healthcare practice, be placed in certain areas of hospitals, ambulatory surgery centers, and other outpatient facilities where patients may be resting or where supervised medical procedures may be performed. In support of their position, the Defendants offered evidence that standard healthcare and medical industry practice, because of concerns about the integrity of medical procedures and life safety, demands limitations on the placement of emergency alarm devices throughout medical facilities. The Court having considered the relevant portions of the file, as well as memoranda filed by the parties and indications that the parties are in agreement on many of the points raised by the Defendants' Motion, and otherwise being fully advised in the premises, the Defendant's Motion is hereby GRANTED.

I. FACTUAL AND PROCEDURAL BACKGROUND

Plaintiffs in this action are a class of similarly situated individuals with disabilities who allege that they have been denied equal access to and usability of the facilities of the Defendants, in violation of the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12101 et seq — specifically, Title III of that Act. Defendants, Ambulatory Surgery Center Group, Ltd., et al., are separately incorporated entities, affiliated but operationally and financially independent, all engaged in the provision of health care services or in operating facilities at which medical services are provided. The Defendants individually own or operate several hundred medical care facilities, including specialty hospitals, outpatient care facilities, rehabilitation hospitals, professional medical offices, surgical centers, psychiatric hospitals, medical office buildings, and general services hospitals.

Plaintiffs filed suit in this action seeking injunctive and other equitable relief against Defendants for alleged discrimination in access to places of public accommodation, in violation of Title III of the ADA. Subsequently, named Plaintiffs moved for class certification pursuant to Federal Rule of Civil Procedure 23 ("Rule 23") of a class of plaintiffs consisting of all people in the United States with disabilities who have been and who were entitled to the full and equal enjoyment of the goods, services, programs, facilities, privileges, advantages, or accommodations of any of the Defendants' Facilities, but who were denied such full and equal enjoyment due to architectural and/or communication barriers at the Defendants' Facilities. This Court granted certification pursuant to Rule 23(b)(2), as Plaintiffs seek only injunctive relief.

II. INTRODUCTION

The Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12101 et seq. mandates that places of public accommodation and commercial facilities shall be accessible to persons with disabilities. For commercial places of public accommodation, including office buildings and hospitals, this mandate is encompassed within Title III of the ADA, 42 U.S.C. § 12181 et seq. ("Title III"). Title III's provisions are implemented through regulations promulgated by the Department of Justice which include guidelines for new construction and alterations. See 28 C.F.R. Part 36 and Appendix A. These guidelines are called the Americans with Disabilities Act Access Guidelines ("ADAAG"), and they are drafted and proposed by the U.S. Architectural and Transportation Barriers Compliance Board ("Access Board").

III. RELEVANT REGULATIONS, GUIDELINES, STANDARDS AND TECHNICAL ASSISTANCE

ADAAG 4.1.3 "Accessible Buildings: New Construction" provides that:

Accessible buildings and facilities shall meet the following minimum requirements:

....

(14) If emergency warning systems are provided, then they shall include both audible alarms and visual alarms complying with 4.28. Sleeping accommodations required to comply with 9.3 shall have an alarm system complying with 4.28. Emergency warning systems in medical care facilities may be modified to suit standard health care alarm design practice.

ADAAG 4.1.3 (emphasis in italics added).

ADAAG 4.28 "Alarms" provides the following general requirement: At a minimum, visual signal appliances shall be provided in buildings and facilities in each of the following areas: restrooms and any other general usage areas (e.g., meeting rooms), hallways, lobbies, and any other area for common use. ADAAG 4.28.1 (italics in original). See also ADAAG Manual, § 4.28.3 which provides:

In general, it is not sufficient to install visual signals only at audible alarm locations. Audible alarms installed in corridors and lobbies can be heard in adjacent rooms but a visual signal can be observed only within the space it occupies. Visual alarms are required in hallways, lobbies, restrooms, and any other general usage and common use areas, such as meeting and conference rooms, classrooms, cafeterias, employee break rooms, dressing rooms, examination rooms and similar spaces. Visual alarms are not required in areas used solely as employee work areas or in mechanical, electrical, or telephone closets, janitor's closets, or similar non-occupiable spaces.

As stated explicitly in ADAAG 4.1.3(14), however, these general requirements may be modified in medical care settings. The ADAAG Manual explains the scoping requirements for Medical Care Facilities as follows:

Requirements for alarms may be modified in medical care settings according to standard industry practice. In many health care facilities, personnel responsible for ensuring the safety of patients respond to intercom messages or other signals not intended to alert or alarm patients incapable of independent evacuation. Under industry practices, a supervised emergency response plan is essential and generally does not include installation of alarms in patient rooms and wards.

ADAAG Manual, § 4.28, discussing ADAAG 4.1.3(14) "Scoping" (emphasis added).

The Access Board has also issued a technical assistance bulletin on Visual Alarms. See Bulletin # 2: Visual Alarms (Access Board 1994) ("Bulletin # 2").¹ In Bulletin # 2, the Access Board explains why there is an exception in the scoping requirements of ADAAG 4.1.3(14) for "standard health care alarm design practice":

In medical care settings where a supervised emergency evacuation plan is in place, it is usually not desirable to install alarms in patient rooms or wards. In such occupancies, personnel responsible for ensuring the safe egress of patients will respond to an intercom message or other signal that is not intended to alert or alarm patients incapable of independent evacuation. Additionally, visual alarms may not be appropriate for use in some specialized medical facilities, such as operating rooms, where lighting levels are high and the sudden discharge of a strobe flash might adversely affect a surgical procedure. For such facilities, the requirements for visual and audible alarms may be modified to suit industry-accepted practices.

See Bulletin # 2 (emphasis in italics added).

Accordingly, ADAAG recognizes an exception in the general rules regarding the placement of emergency alarm notification devices to accommodate standard healthcare alarm practice, and specifically approves the public policy underlying this exception. Defendants assert that standard alarm design practice in the healthcare industry limits the placement of emergency alarm notification devices to general common areas, and does not place such devices in those areas of medical facilities where patients will be resting (i.e., patient rooms or wards) or where medical procedures will be performed.

IV. DISCUSSION

A. Standard Health Care Alarm Design Practice Dictates Limitations in Placement of Emergency Warning Systems Based on Concerns for Medical, Safety, Life Safety, and Liabilities.

Defendants agree that the general rule under operative guidelines and codes is that emergency warning devices should be placed in all common areas of all facilities. Defendants point to the recognized exception for medical care facilities in support of their argument that their facilities — all of which are medical care facilities — should be subject to more limited placement guidelines. For example, Section 4.1.3(14) of 28 CFR Part 36 Appendix A (ADAAG 4.1.3(14)) specifically anticipates that "Emergency warning systems in medical care facilities may be modified to suit standard health care alarm design practice." While Defendants do not point to any written standard contained in any industry-wide publication or mandated by any national fire alarm consensus standard for where not to place audible and visual emergency alarms, a standard clearly emerges from the design criteria used by healthcare facilities and their designers in planning, installing, and modifying emergency alarm systems in a healthcare setting. The single underlying theme is that visual alarms are not recommended for use in patient rooms (or the restrooms in those patient rooms), surgical or medical procedure rooms, recovery or surgical preparation areas, or in other areas where patients are under the...