German Court Sentences Bogus Doctor to Three Years in Jail

AIDAvitaToday, a German Court sentenced a nurse, who had worked aboard a cruise ship as a doctor, to three years in jail.

News agency dpa reported that the Berlin state court convicted the nurse of "bodily harm, fraud, abuse of titles and deprivation of liberty." The latter charge referred to the fact that he put 41 patients under anesthetic, apparently before he began fraudulently working aboard a cruise ship. 

ABC News said that the court found that the 41-year-old nurse claimed to be a doctor for five years starting in 2010, using a forged medical license, to enhance his status and because doctors earn more money. At one point, he worked for 10 months on a cruise ship. 

We first mentioned the nurse's arrest last year.  A number of readers said that the man worked aboard the Aidavita, although the U.S. newspapers did not mention the name of the cruise line or cruise ship.

The cruise line obviously did not conduct a thorough pre-employment background check. Carnival-owned Aida Cruises offered no explanation why it hired someone with no medical school education or experience. 

This raises the issue whether adequate background checks were performed on other cruise employees.

Photo Credit: CC BY-SA 2.5

Update: A reader sent an article from a German newspaper titled: Falscher Arzt behandelte unzählige Aida-Gäste ("Wrong doctor treated countless on Aida guests"). The article says that the imposter doctor (identified as "Denny H.") obtained a position at the German Organ Transplantation Foundation. Later, he worked as a ship doctor for AIDA for ten months and was involved in about 1300 treatments; in 21 of the cases he performed injections or infusions.  

Cruise Ship Passengers Beware: Don't Go to Princess Margaret Hospital in Nassau

Hospitals NassauA U.S. citizen was reportedly the victim of medical malpractice at a large public hospital (Princess Margaret) in Nassau, Bahamas and is now telling the world about his ordeal.

As explained in a local Fox News station and in a gofundme page, Jake Tyler (Beiersdorf), a young man from Minnesota, traveled to Nassau in January of this year to work at an annual poker tournament. After he experienced severe pain in his right lower flank, he was taken to Princess Margaret Hospital where he reportedly faced a medical nightmare. Here is what the online information contends happened:

Jake "waited 14 hours until they finally decided that he had a ruptured appendix and needed surgery. They opened him up down the center of his abdomen from his breastbone to the top of his groin. Following the surgery they thought it was best to leave him unstitched . . . for the next 4 (yes, FOUR) days. That Monday they finally gave him just 13 loosely sewn, superficial epidermal stitches (with several open gaps remaining and where at least 35-45 staples were required), and zero inner stitches reattaching the fascia (muscle and fat layer) within- which helps keep ones 'insides" from basically falling out."  

After this ill-conceived surgery, Jake was reportedly sent to a "(filthy) communal room" with many other patients where his friend reportedly came to see him and witnessed "unbelievable unsanitary surroundings. It was just plain gross . . ."

His friend obtained his eventual discharge but had to return him to Princess Margaret for a final checkup and determination whether he was fit to fly back to the U.S. His checkup was held in what is described as an "unsanitary storage closet with random items strewn everywhere."

Once back in the U.S., he underwent emergency surgery where it was discovered that the surgeons in the Bahamas did not stitch the muscle layer beneath his skin and did not even remove his appendix (which had not ruptured as they claimed).

If you are an ill or injured cruise passenger (like in a moped accident or taken from a cruise ship) in Nassau, you do not want anyone to take you to the Princess Margaret hospital!  We have heard complaints from many cruise passengers over the years who have ended up there. There is a saying in the Bahamas that Princess Margaret hospital is "the reason local Bahamians pray not to get sick."   

It is better to use travel insurance and get back to the U.S. As a last resort, be prepared to pull out your credit card and be admitted to a private hospital (like Doctors Hospital) in Nassau which may be inferior to U.S. standards but is a definite step above what you will experience at Princess Margaret.  

March 9, 2016 Update: The Nassau Guardian published an article today about this story, stating that the Public Hospitals Authority and the Princess Margaret Hospital will be investigating the allegations. 

March 10, 2016 Upgrade: The public hospital denied everything today, except admitting that Mr. Beiersdorf was not seen for an extraordinary period of time according to the Nassau Guardian. A well known local Bahamian surgeon not involved in the medical case claims: " . . .  very scurious allegations defame the professional integrity of an entire institution, a number of medical professionals and a country as a whole." My thoughts?  Denial and misplaced patriotism.  

 

Video: Article and video Fox9  

Map credit:  Google

Witnesses to Gem Drowning: "NCL Screwed Up"

Earlier this week, a 10 year old child drowned in a crowded swimming pool on NCL's Norwegian Gem

It's the seventh time that a child has drowned, or nearly-downed, on a cruise ship in just two years. The incidents occurred on cruise ships operated by all of the major cruise lines' ships: Carnival, Disney, Norwegian Cruise Line and Royal Caribbean. None of the cruise lines employed life guards at the time. (Disney subsequently changed its policy after a child sustained catastrophic and permanent injuries requiring lifetime medical care.) 

Following the death of the little girl, NCL issued a press release, which avoided the issue of lifeguards, but touted its allegedly "quick" and "full" NCL Norwegian Gemresponse by its ship's medical team.

"On Sunday afternoon, the ship's medical team responded to an emergency call from the pool deck, as a ten year-old female guest was reported unresponsive. The team quickly administered CPR and full emergency care. After extensive efforts, the guest could not be revived."

But witnesses on the ship dispute NCL's PR statement.  

Several cruise passengers left messages regarding what they witnessed:

One passengers said: 

"I'm still on the Gem now. And i was right there. On this incident I can blame NCL for their lack of effort. Passengers who were nurses and doctors did all the work while NCL workers watched and looked panicked. They did not know what to do. They kept telling the real nurses and doctors to stay away. I talked to one of the ICU nurses and she said they are handling it all wrong. They told her to move away meanwhile shes yelling at them on what to do. The girl had a pulse. . . . Bottom line, NCL dropped the ball on this on big time. If you weren't there then don't say a thing backing NCL. Cause they did absolutely nothing. The passengers came to the rescue. Applaud them. They were fighting for the kid while NCL looked DAZED."

Another passenger remarked:

"My wife and I witnessed this tragic event right before our eyes while on board the Gem this past week. My wife is a registered nurse and tried to help, but was told 'they were handling it and to stay away' . . . she was completely upset with the lack of treatment she witnessed by the staff personnel. That poor girl was being worked on by inexperienced people, pool side for more than 15 minutes before being rushed down to the medical center.

As a parent traveling with 3 kids, I agree it is our responsibility to "watch our children." However the pool deck was really crowded at that time, and with those crowds it was very easy to lose sight of your kids. The family pool is 5' - 6' deep, which is very dangerous IMO for children and inexperienced swimmers. I'm amazed that NCL wouldn't employ trained lifeguards with that setup.

The bottom line is an innocent child died, and my heart goes out to the family."

The Cruise Line International Association (CLIA) argues that cruise lines "manage pools with the safety of passengers" by providing "signs that a lifeguard is not present."

This, of course, is double-talk. Four and six year old kids like the ones who drowned on lifeguard-less cruise ships can't read or comprehend warning signs. A no-lifeguard sign recommended by the cruise lines' defense lawyers is an acknowledgment that the cruise industry is committed to a policy of not providing reasonable safety to children. 

Medical Malpractice on the High Seas: Cruise Passengers Have Rights!

Three years ago, i wrote an article lamenting the sad state of affairs surrounding cruise ship medical care entitled: Medical Malpractice on the High Seas: Do Cruise Passengers Have Any Rights? 

The answer, in short, was no.  I wrote that a cruise ship is about the only place on earth where a doctor can negligently kill your loved one and there is no accountability.

In "If the Ship Doctor Kills You, Too Bad," I explained that passengers were plagued not only by the limited nature of cruise ship medical care but by the cruise industry's immunity from legal responsibility. Cruise cruise lines were able to avoid all liability even when the ship doctor or nurses negligently Royal Caribbean Cruise Medical Careharmed the passenger.  Cruise lines had immunity for medical malpractice lawsuits under the antiquated "Barbetta doctrine."

Passengers were left to seek accountability by trying to sue the doctor. This was problematic for several reasons. The doctor inevitably does not live in the U.S. and it was difficult to serve a ship doctor with a lawsuit or obtain personal jurisdiction over him in a U.S. court. Also, many ship doctors do not have liability insurance and have few assets.

You can read this case to see the extraordinary steps that the ship doctors and cruise lines went to to avoid liability even in clear cut cases where the doctor acted irresponsibly. Over the years, cruise lines fought tooth and nail to maintain their immunity from medical negligence on cruise ships even though they collect tens of billions of dollars a year and pay no U.S. taxes. 

With the recent 11th Circuit decision in Franza v. Royal Caribbean, the law has now changed. Cruise lines are finally responsible when passengers receive bad medical care on cruise ships. 

The landmark decision reflects the reality of the cruise industry today. Cruise lines are extremely wealthy, pay no U.S. taxes, and operate state-of-the-art medical facilities in what are essentially floating cities. Royal Caribbean's newest ship, Quantum of the Seas, cost over $1,000,000,000 and is touted as the most sophisticated ship in the world.  Plus, it offers some of the most dangerous attractions in the cruise industry, with the iFly simulated sky-diving and FlowRider simulated surfing attractions. Why shouldn't this cruise line be responsible when cruise passengers are seriously injured and then the cruise ship doctor commits malpractice?

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Photo Credit: Jim Walker

11th Circuit Rejects Cruise Lines' Immunity Defense to Medical Malpractice Claims

Today the Eleventh Circuit Court of Appeal published an opinion which recognizes the right of cruise ship passengers who become victims of medical malpractice to hold cruise lines vicariously liable for the negligence of the shipboard doctors and nurses.

The case is PATRICIA FRANZA, as Personal Representative of the Estate of Pasquale F. Vaglio versus ROYAL CARIBBEAN CRUISES, LTD., a Liberian corporation.  You can read the opinion (63 pages) here.    

Previously, cruise lines were able to hide behind the immunity defense set forth in Barbetta v. S/S Bermuda Star, 848 F.2d 1364 (5th Cir. 1988). The so-called “Barbetta rule” immunizes a shipowner Quatum of the Seas from respondeat superior liability whenever a cruise ship employee renders negligent medical care to its passengers. Cruise lines enjoyed broad immunity "no matter how clear the shipowner’s control over its medical staff or how egregious the claimed acts of negligence."

The Franza v. Royal Caribbean decision involved an "elderly cruise ship passenger (who) fell and bashed his head while the vessel, the Explorer of the Seas, was docked at port in Bermuda. The injured traveler, Pasquale Vaglio, was wheeled back onto the ship, where he sought treatment from the onboard medical staff in the ship’s designated medical center. Over the next few hours, Vaglio allegedly received such negligent medical attention that his life could not be saved. In particular, the ship’s nurse purportedly failed to assess his cranial trauma, neglected to conduct any diagnostic scans, and released him with no treatment to speak of. The onboard doctor, for his part, failed even to meet with Vaglio for nearly four hours."

The Vaglios then encountered another delay when "the onboard medical staff would not examine Vaglio until the ship’s personnel obtained credit card information." Tragically, Mr. Vaglio died a week later.

Mr. Vaglio's daughter, Patricia, filed suit to hold Royal Caribbean vicariously liable for the shipboard medical team's negligence under two theories: actual agency (also termed respondeat superior) and apparent agency. 

After the trial court dismissed Ms. Vaglio's lawsuit under the "Barbetta rule," she appealed the dismissal of her case to the Eleventh Circuit Court of Appeal.  

In a decision authored by Justice Stanley Marcus, the Eleventh Circuit rejected the "Barbetta rule" and recognized that maritime employers have long been vicariously liable for the negligence of their ship employees. The Barbetta rule was fashioned at a time when ships had sparse, if any medical facilities, and often no ship doctor or nurses. But now the cruise industry boasts state-of-the-art medical facilities and touts that its cruise ship doctors and infirmaries comply with the the American College of Emergency Physicians guidelines. 

Justice Marcus pointed out that in a Royal Caribbean press release authored by Royal Caribbean cruise executive Adam Goldstein, he boasted about the cruise line's "onboard laboratory equipment, x-ray units, and clot-busting thrombolytics" which were important to the public's "tranquility and peace of mind." The court stated that it was "disingenuous for large cruise lines to disclaim any medical expertise when they routinely provide access to extensive medical care in the infirmaries they have constructed for this very purpose."

Justice Marcus stated: 

“Here, the roots of the Barbetta rule snake back in to a wholly different world. Instead of nineteenth-century steamships, we now confront state of the art cruise ships that house thousands of people and operate as floating cities, complete with well-stocked modern infirmaries and urgent care centers. In place of truly independent doctors and nurses, we must now acknowledge that medical professionals routinely work for corporate masters. And whereas ships historically went ‘off the grid’ when they set sail, modern technology enables distant ships to communicate instantaneously with the mainland in meaningful ways. In short, despite its prominence, the Barbetta rule now seems to prevail more by Philip D. Parrish Lawyer Miamithe strength of inertia than by the strength of its reasoning. In our view, ‘the reasons that originally led’ other courts to adopt ‘the rule have long since disappeared.’”

The decision is an important one because cruise lines will no longer entice cruise passengers aboard their cruise ships by representing the excellence of the medical care and then assert immunity when the shipboard doctors and nurses maim the passengers. 

The case was handled by trial lawyers Andy Waks and Joel Barnett at the trial level and appellate specialist Philip D. Parrish at the appellate level (photo right).  Mr. Parrish has handled other important maritime cases on behalf of cruise ship passengers.  Mr. Parrish successfully handled several high profile decisions for our firm's clients: Chaparro v. Carnival (cruise lines have duty to warn of crimes in ports of call), Johnson v. Royal Caribbean (flowrider liability waiver is illegal), and Doe v. Princess (addressing scope of crew member arbitration agreement).    

 

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Photo Credit: Wikipedia / Wedel 04 CC BY-SA 4.0 Frank Schwichtenberg