In the November issue of Medical Care, they highlighted a recent cross-sectional study on clinical mistakes due to inaccurate language interpretation. The study found that errors in interpretation are more common when untrained interpreters are used, and that they are far rarer when professional medical interpretation services are employed. The study analyzed the interpreted transcriptions from a large number of recorded interactions comparing professional interpreters with “improvised” interpreters like friends, family and medical personnel without formal language training.

The study found that the most common type of error in interpretation are preemptive answers and omissions. 30% of the text units included wrong interpretation, a massive number especially when considering the nuance of medical diagnosis. Of the improvised, non-professional interpreters (friend, family, or nurse) 54% included inaccurate interpretation, whereas mistakes were found in just 23-25% of professional interpretations. This indicates that inaccurate interpretation occurs twice as frequently with improvised interpreters when compared to professional translators.

The analysts believed that 7% of these interpretation errors were “highly significant.” One example of a highly significant error is an interpreter telling a patient to take medicine every 6 hours as opposed to every 8 hours. Nearly 5% of the errors when using an improvised interpreter were of high significance as compared to around 1.5% with professional interpretation services.

What can we take from these findings? It is obviously better to use a professional interpreter rather than a nurse, friend or family member since it means that you will far more accurately understand the information you are getting from your physician and dramatically lower the likelihood of significant mistakes. Additionally, having a professional translator can actually reduce hospital costs. According to Harvey Castro, an emergency physician at Quest Care Partners,  “When a non-English-speaking patient comes in and you can’t understand what their chief complaint is, you are assuming the worst and tend to order more things, so your cost goes up. It makes sense to deter that cost and have services available.”

Accurate interpretation services are a critical component to effective care for healthcare companies, especially those that deal directly with patients. Investing in a strong and sustainable process for regularly obtaining professional medical interpretation services can help medical and healthcare companies reduce costs and improve patient care creating a critical win/win for everyone.

By Shanna Bergman

We previously explored the issue of who should pay for legal translation services in November of 2011, when the United States Court of Appeals for the Ninth Circuit held in Taniguchi v. Kan Pacific Saipan LTD. 633 F.3d 1218 (9^th Cir. 2011) that the district court did not abuse its discretion in awarding legal translation costs to Kan Pacific, including document translation costs (from Japanese to English) as well as interpretation costs.  The Court of Appeals interpreted 28 U.S.C. §1920(6) (which grants courts discretion to award costs for the compensation of interpreters) to include document translation as part of the costs to be awarded at the conclusion of litigation. The Court of Appeals stressed in their opinion that Rule 54 of the Federal Rules of Civil Procedure includes “decided preference for the award of costs to the prevailing party and thus, the prevailing party should be awarded costs for services required to interpret either live speech or written documents into a familiar language so long as interpretation of the items is necessary to the litigation”.  Taniguchi appealed and the Supreme Court of the United States granted certiorari to hear the case, which could have a big impact on who pays for legal translations.

The case was argued before the Court on February 21, 2012 and the decision came down on May 21, 2012.  The decision was highly anticipated in the litigation world as, amongst other things, a decision that “interpretation” is the same thing as written legal translation in the context of reimbursement for these expenses, could potentially shift the entire “cost-benefit” analysis for commencing litigation in the first place.

The Supreme Court has now held that “because the ordinary meaning of interpreter is someone who translates orally from one language to another, the category ‘compensation of interpreters’ in §1920(6) does not include the cost of document translation”.  Taniguchi v. Kan Pacific Saipan LTD, 566 U.S.____(2012)  In its opinion, the Court stated that “when a term is not defined in a statute (as is the case here) we give the term its ordinary meaning” Id.   The Court turned to several authorities to determine the ordinary meaning of “interpreter”.  They cite the following:  American Heritage Dictionary defined the term as one who translates orally from one language to another; Scribner-Bantam English Dictionary defined the word “interpret” as to “translate orally”; Random House Dictionary defined “interpret” as to translate what is said in a foreign language; Oxford Dictionary defined interpreter as one who translates languages (breaking it down into two sections)…one who’s office it is to translate the words of persons speaking different languages, esp. orally in their presence; Black’s Law Dictionary defines “interpreter” as a person sworn at trial to interpret the evidence of a foreigner to the court and “interpret” as to translate orally from one tongue to another. Id.   In addition, the Court noted that the statutory context of the Court Interpreters Act (noting that Congress enacted §1920 as part of the Court Interpreters Act) is a program to facilitate the use of qualified interpreters in judicial proceedings before the courts of the United States in any action, civil or criminal, where a witness or party speaks only or primarily a language other than the English language. The opinion goes on to state that the statute also gives very precise instructions for interpretation (i.e. simultaneous interpretation, consecutive mode etc.).  The Court stated that given these specificities, there is strong evidence that “Congress was dealing only with oral translation in the Court Interpreters Act” and nothing to do with the legal translation of documents.

With respect to Rule 54, the Court notes that “the discretion granted by Rule 54(d) is not a power to evade the specific categories of costs set forth by Congress…thus provides no sound basis for casting aside the ordinary meaning of the various items enumerated in the costs statute, including the ordinary meaning of ‘interpreter’” Id.

As an interesting final note, and one to perhaps consider as we move forward, Justice Ruth Bader Ginsberg notes in her dissent that  “Some translation tasks do not fall neatly into one category or another” (i.e. legal document translation or interpreter). She states that sometimes an interpreter “may be called upon to sight translate a written document” (i.e. convey the substance of a written document orally). Id.

So essentially, the Supreme Court has decided to maintain the status quo of reimbursement for interpretation services but not for document translation services related to litigation. Those entering into commercial or patent litigation which may require extensive legal translation of foreign-language documents need not fear paying a hefty translation bill should they lose their case, though it is still a good idea to factor in the legal translation costs they will assume, which are often far higher than originally anticipated.