Cruise Law News : Maritime Lawyer & Attorney : James M. Walker : Walker & O'Neill Law Firm : Admiralty Law, Cruise Ship Accidents & Injuries

Here's another great guest bog by one of our attorneys here at Cruise Law, Charles Gourlis, who takes a look at cruise line medical care for ship employees: 

Not all cruise lines are made equal. Some provide adequate medical treatment to their injured crew members, but there are several cruise lines that just won’t get “on board” (pun intended).

I try to live up to the saying, “Don’t Just Complain, Do Something About It!” So, in that spirit, I have a few recommendations for our friends at the cruise lines. My recommendations:

1. Invest in Quality Shipboard Physicians

Most shipboard doctors either were not qualified to attend medical school in the U.S. and are not licensed in the U.S. Most cruise lines hire non-U.S. doctors because it’s cheaper than hiring U.S. doctors. If shipowners paid their doctors salaries that were competitive with U.S. salaries, they would attract better-trained physicians. The quality of care would improve, diagnoses would become more accurate, and more serious injuries & illnesses would be prevented.

2. Bring Your Crew Members to Miami for Treatment

Most injured crew members are repatriated to their home country to receive medical treatment from doctors in their home country. This presents the same problem as problem number one. By bringing ill or injured crew to Miami for immediate treatment, all examinations, tests, and doctor’s visits are conducted by U.S. physicians here in Miami. Again, the quality of care would improve, the amount of care needed would decrease as American physicians more precisely diagnose conditions and deliver timely treatment, the need for drawn-out care would decrease.

3. Pay Your Crew Members, Not Your Defense Lawyers

As I outlined in my first guest bog post, most crew members sue only after the cruise line stops paying maintenance & cure and the crew member becomes destitute. The cruise line could prevent problems by coordinating with its local agents to ensure that all injured crew members receive maintenance payments on a timely basis every month and are promptly scheduled for medical appointments. As a result, thousands of crew members don’t languish at home while the defense lawyers for the cruise line earn their holiday bonus defending the cruise line.

Following these recommendations, the cruise lines could actually save the cruise line millions of dollars a year in needless medical and legal expenses. If the human factor wan’t a compelling enough reason to change the business practices, dozen’t saving money make a strong business case for pro-active medical treatment?

Photo credit: Pullmantur.es

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CBC News in Canada published a story this week about cruise passenger Bernie Hamilton, age 66, who died following a Holland America Line ("HAL") cruise due to what sounds like a series of errors by the ship's medical personnel.  The article is entitled "Cruise Death Prompts Warning on Ships' Medical Care."  

I have heard these stories time after time over the years.   A couple excited about a dream vacation.  The husband experiences medical issues during the cruise which a competent doctor ashore would easily handle.  But due to blunders by the cruise ship medical team, the wife returns home alone to face the cruise line's denials of responsibility for the suffering and death.

In Bernie Hamilton's case, you can read about the ship doctor's misdiagnosis by concluding that Mr. Hamilton had just a common cold or perhaps asthma which led to a prescription of Ventolin which accelerates a patient's heart rate.  You can read that after Mr. Hamilton collapsed on the floor of the cabin, his wife Heather had to witness the spectacle of the medical personnel trying to decipher the instructions for the automatic defibrillator as precious minutes ticked away on her husband's life.  

After the ship medical team struggled to insert an intravenous line and intubation tube and finally "stabilized" Mr. Hamilton, the ship put Mr. Hamilton ashore in Spain where the shore-side doctors declared him brain dead.

Ms. Hamilton received no apologies from HAL.  The cruise line is quoted in the article saying that they "believe the care provided to Mr. Hamilton was appropriate."  All that Ms. Hamilton received from HAL was a bill for $2,000.

The article mentions other similar stories by members of the non-profit International Cruise Victims organization.   Also quoted is Miami lawyer, and my friend, Phil Gerson who is quoted saying: "They advertise that they do have a medical clinic on board . . . and they actually sell those services to their passengers.  But they don't tell them … that they have no legal responsibility for the carelessness of the medical personnel."

Last year, I wrote an article "If the Ship Doctor Kills You, Too Bad" which explains the dangers provided by the limited nature of cruise ship medical care and the difficulty seeking compensation when malpractice of the ship doctor or nurses harms your family. 

Yes, doctors and nurses make mistakes, but a cruise ship is about the only place where a doctor can negligently kill your loved one and there is no accountability. 

As I mentioned last year, as long as cruise lines are not liable for bad medical care, there is no financial incentive for the ships to invest in training and hiring more qualified and experienced doctors and nurses.

There is no economic or moral justification for such an inequitable situation. The cruise industry collects over $35 billion dollars a year and pays no Federal income taxes by registering their cruise ships in foreign countries.  As long as travel agents, cruise fans and the public are indifferent to these type of stories, in the future other families will experience the horror of dream vacations going terribly wrong.

Photo credit:   CBC News / Heather Hamilton

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This is reason no. 6 in the series: Top 10 Reasons Not To Cruise

The last place you want to become ill or injured is on a cruise ship far away from a U.S. port.

Cruise ship medical care is limited.  Ship doctors are usually from foreign medical schools.  The shipboard facilities are often inadequate and the medical care is sub-standard.  Consider reading "Cruise Ship Medical Care Spotty" (Consumer Affairs) and "Ocean Liners' Medical Care May Not Be Shipshape." (CNN)

Most disturbing is the fact that cruise lines are not legally responsible when their ship doctors commit malpractice.

In Carnival v. Carlisle, a family took a vacation cruise aboard Carnival's Ecstasy.  During the cruise, the family's 14 year old daughter developed abdominal pain and was seen several times by the cruise ship doctor.  The doctor assured the concerned family that it was not a case of appendicitis, but was just the flu.  When the family returned home to Michigan, a U.S. doctor correctly diagnosed a ruptured appendix.  Due to the rupture, infection and delay in treatment, the daughter was rendered sterile.

The family sued Carnival for damages caused by the Carnival ship doctor's negligence.  The Florida Supreme Court ruled, however, that cruise lines like Carnival are not legally responsible when the ship doctor commits malpractice.  The Court held that because the ship doctors are "independent contractors," cruise lines cannot be held vicariously liable for the doctor's wrongdoing.

If a passenger is injured or killed due to malpractice by the ship doctor, the passenger is forced to try and sue the doctor.  This is problematic for several reasons.   The doctor inevitably does not live in the U.S.  It is very difficult to serve a ship doctor with a lawsuit or obtain personal jurisdiction.  Also, many doctors do not have liability insurance and have few assets.   

This presents a "double whammy" to passengers.  The chance of receiving bad medical care is greater on a foreign flagged cruise ship than in a passenger's home town.  And if there is malpractice, the cruise line can avoid responsibility because of the "independent contractor" defense.  

This leaves an injured passenger, or the family's surviving family members, forced to try and chase the foreign ship doctors around the world to obtain accountability.

Over one-half of the passengers who seek medical treatment during cruises are over age 65.  Many passengers have pre-existing medical conditions including heart conditions.  Elderly passengers are at risk for complications on cruise ships with noro-virus and are then at the mercy of incompetent or inattentive ship doctors.  For an example of cruise ship medical negligence, consider reading:

Cruise Ship Doctors: Roll The Dice With Your Life

As long as cruise lines are not liable for bad medical care, there is no financial incentive for the ships to hire more qualified and experienced doctors and nurses. 

There is no economic or moral justification for such an inequitable situation.  The cruise industry collects over $35 billion dollars a year and pays no Federal income taxes by registering their cruise ships in foreign countries.       

Most passengers do not understand that the "Carnival" ship doctor, wearing a uniform with a "Carnival" badge, is not considered by the cruise line to be a "Carnival" employee. 

If the ship doctor's negligence kills your parent or maims your child, what are you going to do?

This lack of accountability by the cruise industry is another reason why Americans should think twice about taking a family cruise. 

Tomorrow, we will discuss Reason No. 7 Not to Cruise: Cruise Lines Exploit Foreign Crew Members, Like You'd Never Believe.

Credits:

Photographs       TBO.com News Channel 8 (Jim Hockett) "Cruise Ship's Doctor Puts Elderly Man Ashore"

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