A farm worker from Jamaica had a stroke. He says MaineHealth sent him back without a plan.
Edwin Duffus, a Jamaican farm worker who suffered a stroke in Warren last summer, alleges in a federal lawsuit that MaineHealth violated federal law by discharging him from its Portland hospital without ensuring he was medically stable. Duffus, who was uninsured, spent 12 days at Maine Medical Center after being transferred from Pen Bay Medical Center in Rockland on July 17, 2022. He was flown to Portland by LifeFlight and treated in the Neurocritical Care Unit.
According to the complaint, four MaineHealth physical therapists recommended that Duffus be discharged to an inpatient rehabilitation facility, and one questioned whether he could safely fly back to Jamaica. Instead, the hospital sent him home with his medications and a blank enrollment form for a treatment center in Kingston, roughly two hours by taxi from his residence.
Duffus’s lawsuit claims that MaineHealth violated the Emergency Medical Treatment and Active Labor Act (EMTALA) by failing to stabilize him before discharge. The complaint also states that the hospital did not inform him that he could have applied for insurance under the Affordable Care Act, nor did it arrange for follow‑up care in Jamaica. As a result, Duffus went 18 days without medical treatment and is now unable to work. He is the father of four and has been coming to the United States for more than 30 years under the H‑2A visa program for seasonal agricultural workers, serving as his family’s primary wage earner before his stroke.
In addition to the EMTALA claim, Duffus amended his complaint on Sept. 22 to add allegations of discrimination and denial of equal rights based on race and national origin. He asserts that the hospital refused to provide an interpreter or allow a family member to help communicate with staff, and that it improperly shared his health information with a Jamaican government agency that supports farm workers in the United States.
“I think it potentially explains why it is that the hospital did what it did,” said Lisa Butler, an attorney with Pine Tree Legal Assistance representing Duffus. She noted that at the time of discharge, around 2 a.m., “Edwin didn’t know where he was going,” and therefore could not give informed consent.
The lawsuit describes the practice as “medical repatriation,” a term used when hospitals return non‑citizen patients to their home countries for long‑term care. Because only the federal government can deport someone, hospitals typically rely on the patient’s consent. Duffus’s attorneys say he agreed to return only under coercion; his brother and his wife told the physician signing the discharge that he did not want to go back to Jamaica.
The complaint also alleges that the medical director of the Maine Mobile Health Program, which serves rural farm workers, repeatedly tried to contact MaineHealth staff about Duffus’s discharge and his eligibility for ACA coverage, but was “laughed at” or had calls hung up on him.
MaineHealth, which operates Maine Medical Center, has denied the allegations. In a statement, a spokesperson said, “While MaineHealth cannot comment on individual patient cases, we follow all applicable federal and state laws when it comes to the Emergency Medical Treatment and Labor Act (EMTALA) and we assure that all patients in our care receive a safe discharge plan.”
In court filings, MaineHealth has argued that it automatically met its obligations by admitting Duffus to inpatient care. A federal judge denied the health system’s motion to dismiss an earlier version of the lawsuit in 2025, rejecting that argument and also refusing to transfer the case to state court as a medical malpractice claim. Judge Stacy Neumann ruled that the case belongs in federal court.
The issue of medical repatriation has surfaced in other cases nationwide. In 2009, a Florida jury found that a hospital had not acted irresponsibly when it chartered a plane to send a severely brain‑injured patient back to Guatemala. Earlier, an appeals court in the same case had discouraged hospitals from discharging patients to other countries without consent, noting that only the government can deport a person. A Harvard International Law Journal article has observed that there is little data on how often such discharges occur.
Butler said her office has not handled a medical repatriation case before, but noted that Maine’s migrant farm workers are often isolated and struggle to access healthcare. Attorneys for MaineHealth have until later in October to file an answer to the amended complaint.
