Medical Malpractice on Cruise Ships: Negligent Doctors on the High Seas

Maritime Law is slowly beginning to adapt to the modernization of the massive cruise line industry. Cruise companies are able to bypass many laws and regulations that consumers are accustomed to on the mainland. One such regulation is providing medical care while at sea. Although cruise liners now have medical staffs and facilities, there are no regulations as to what these facilities must contain or what the qualifications of the medical staff must be. Cruise ships have usually not been held liable for medical malpractice that occurs on their ships.

Troubled Waters

The rule that has been commonly followed for nearly thirty years is the Barbetta rule which arose from the case of Barbetta v. S/S Bermuda Star under the U.S. Court of Appeals of the Fifth Circuit which has jurisdiction over Louisiana, Texas, and Mississippi. [848 F.2d 1364 (5th Cir. 1988).] Florence Barbetta suffered a coma due to a doctor not being able to identify that she had diabetes over a five day period. The Barbetta rule states that a cruise company is liable to hire a competent and effective medical staff. If a carrier fails to provide a qualified staff, then it is negligent. Any negligence on the doctor’s part does not reflect on the carrier. Thus, cruise ships are not responsible for their doctors’ negligence according to this rule. Doctors are not treated as employees, rather as independent contractors, and operate beyond the jurisdiction of most courts. This leaves consumers in an incredibly vulnerable position if they are harmed by the ship’s medical staff.

Shifting Tides

In November 2014, a new legal precedent was set in the Franza v. Royal Caribbean Cruises, Ltd. case under the U.S. Court of Appeals of the Eleventh Circuit which has jurisdiction over Alabama, Florida, and Georgia. [772 F.3d 1225 (11th Cir. 2014).] Pasquale Vaglio, the father of Patricia Franza, who sustained a severe blow to the head while docked at port in Bermuda, was brought back on to the ship where he was not properly tended to until four hours after the injury at which point it was too late. Vaglio passed away a week later at Winthrop-University Hospital in Mineola, N.Y. as a result of the injury. Franza used the doctrine of actual agency, concluding that Royal Caribbean was negligent “by and through the acts of its employees or agents.” Franza also cited the doctrine of apparent agency because the ship had Mr. Vaglio believe that the doctor and nurse were acting as employees, or agents, of the cruise company.

The Voyage Ahead

Cruise companies must now be held to different standards than they were during centuries prior. As the ships have become incredibly high-tech and their capacities for passengers continue to increase, it is imperative to hold these companies to higher medical standards. It is especially necessary considering a dangerous medical condition at sea could quickly become much more severe or fatal. Not only are laws governing the conduct of these ships somewhat ancient, but laws to deal with the fallout are too. The same way that these ships are to carry safety boats and life-jackets, they should be required to have a certain number of qualified doctors on staff as well as certain necessary medical supplies in case of emergency. Although holding doctors liable can be a complicated matter, it is a pragmatic first step to hold the companies liable to encourage them to raise the level of their medical staff and facilities as well as providing compensation for those who have been harmed.