It was still dark out the morning Edwin Duffus says Maine Medical Center staff put him in a wheelchair and told him he had to leave.

Duffus, an uninsured Jamaican farm worker, had been at the Portland hospital for 12 days in the summer of 2022 after suffering a stroke in Warren, according to a lawsuit he filed against MaineHealth last week in federal court. 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,” the complaint alleges.

Duffus was sent back with his medications and a blank signup form for a treatment center in Kingston, Jamaica, “approximately two hours by taxi from Mr. Duffus’ residence,” according to the lawsuit.

Duffus is suing MaineHealth, which operates the Portland hospital, for violating the Emergency Medical Treatment and Active Labor Act by not ensuring he was “stabilized” before discharging him.

According to his attorneys at Pine Tree Legal Assistance, MaineHealth did not inform Duffus that he could have applied for insurance under the Affordable Care Act, nor did they make arrangements for further treatment in Jamaica. He went 18 days without medical treatment upon his return and is no longer able to work, according to his attorneys. The father of four had been coming to the United States for more than 30 years under the H-2A visa program for seasonal, agricultural workers, and he had always served as his family’s primary wage earner before his stroke.

In his lawsuit, he also accused MaineHealth of discrimination and denying him equal rights, on the basis of race and national origin. Duffus is seeking a jury trial and has asked the court to declare his rights have been violated and to award him damages.

“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,” a MaineHealth spokesperson wrote in an email Tuesday.

The lawsuit states that EMTALA prohibits “patient-dumping” by hospitals that receive Medicare payments from the federal government.

In court filings, MaineHealth has denied allegations that it violated federal laws around discharging and stabilizing patients since Duffus first filed a complaint in 2024. A federal judge denied a motion by MaineHealth to dismiss an earlier version of Duffus’ lawsuit in 2025, rejecting the health system’s arguments that it had automatically met its obligations under federal law by admitting Duffus to inpatient care.

Maine Medical Center agreed to admit Duffus after he was initially treated at Pen Bay Medical Center in Rockland on July 17, 2022, according to court records. He was flown to the Portland hospital by LifeFlight and spent time in its Neurocritical Care Unit, where he was overseen by several specialists who monitored his condition, including his blood pressure.

Judge Stacy Neumann also rejected the hospital’s arguments that the lawsuit belonged in state court as a medical malpractice claim.

Duffus amended his complaint on Sept. 22 to add the discrimination and equal rights claims. He alleged the hospital denied him equal treatment under its health program because he’s Black and Jamaican. His attorneys said MaineHealth failed to provide an interpreter or let Duffus appoint a family member to help communicate with hospital staff about his care. They also argued that MaineHealth violated patient privacy laws by sharing his health information with a Jamaican government agency that supports its farm workers in the United States.

“I think it potentially explains why it is that the hospital did what it did,” Lisa Butler, an attorney from Pine Tree Legal Assistance representing Duffus, said of the new discrimination claims.

Attorneys for MaineHealth have until later in October to file an answer to the amended complaint.

The complaint alleges several times that MaineHealth “medically repatriated” Duffus to Jamaica, referring to a practice by which hospitals return noncitizen patients to their countries of origin for long-term care.

Only the federal government is allowed to deport someone, so hospitals rely on a patient’s consent.

According to the complaint, Duffus only agreed to go back to Jamaica under coercion. His attorneys said that his brother and his wife told the doctor who signed off on his discharge that Duffus did not want to return to Jamaica.

The medical director of the Maine Mobile Health Program, which primarily serves rural farm workers, attempted several times to reach MaineHealth staff about Duffus’ discharge and eligibility for insurance under the ACA, according to the complaint, which alleges MaineHealth employees “laughed at” him” and/or hung up on him.”

“And when it came to the point of discharge, at 2 a.m. in the morning, Edwin didn’t know where he was going,” Butler said. “So, he definitely did not have informed consent to the transfer out of the hospital.”

The issue has emerged in several court cases nationally, including a lawsuit in Florida where a jury determined in 2009 that a hospital had not acted irresponsibly when it chartered a plane to send a severely brain-injured patient back to Guatemala. Before that verdict, an appeals court in the same case issued a verdict that discouraged hospitals from discharging patients to other countries without consent, finding that only the government can deport a person, according to reporting by the New York Times.

There’s little data on how often this occurs, according to a Harvard International Law Journal article on the issue.

Butler said she and other attorneys at Pine Tree Legal Assistance haven’t worked on a medical repatriation case before, but that generally Maine’s migrant farm workers are isolated and struggle with access to healthcare services.