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)

Cruise Ship Doctor - Cruise Line MalpracticeMost 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.

Cruise Ship Doctor - Independent Contractor? 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. 

November 11, 2014 Update: Breaking News! Cruise passengers are now permitted to sue the cruise lines for medical negligence. The Eleventh Circuit Court of Appeal ruled that cruise lines are no longer permitted to assert an "immunity defense" when their ship doctors and nurses commit medical malpractice. Read: 11th Circuit Rejects Cruise Lines’ Immunity Defense to Medical Malpractice Claims. Contact us for further information.

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



Photographs News Channel 8 (Jim Hockett) "Cruise Ship’s Doctor Puts Elderly Man Ashore"

  • linda hartwick

    Its getting pretty bad whem you think you are going on the best cruise a member of your family gets sick then dies how terrible. Carmival cruise lines will pass the buck and then blame somebody else. If you look up all the lawsuits on some web sites, I am surprised they are still in business. I cruised om 44 cruise ships with Carnival I got to know a lot of the staff. They would tell me things about Carnival and what really happens behind closed doors that you may decide you never want to cruise with this cruise line ever again

  • Carol Finkel

    My experience supports your article. In January, 2009, I was on Royal Caribbean Splendour of the Seas and suffered a sub-arachnoid hemorrhage (a deadly form of a stroke). Thankfully, there was a neurologist in our group who recognized it and told the doctor to get me off the ship immediately or I would probably be dead by morning. He listened to her and got the Coast Guard to airlift me off that evening. I recovered fully but don’t know what would have happened if it had been solely up to the ship’s medical staff.

  • Christian M

    As an MD myself and the fact I know a friend who works aboard, that I know for certain is a great doctor certainly told me there are cases of malpractice and as well cases in which the cruise medical facility wasn’t the best. In the end he ends up disembarking a lot of passengers due to this fact, lets say you come across a case of dengue onboard, there’s not much to do but to move that patient to a hospital. Is as if its almost a requisite to be completely healthy to board a cruise, unless they have better medical facilities and even more medical personnel. Also, most passengers aboard just like back home, don’t realize that for example a case of viral gastroenteritis can be similar to whole lot of things, that’s why in medicine we call it differential diagnosis, I bring this up because there are cases of patients demanding “malpractice” when a proper “most” common diagnosis is made, then turning out to be a more rare disease. That’s what is usually done in medical practice, UNLESS the symptoms scream a whole different case or disease. Besides such, cruise lines should be under examination by a medical association that could operate worldwide. That could improve health care aboard indeed.

  • Laura Warren

    I fully agree about the incompetency of the ship’s dr on Sapphire Princess, Dr Johan van der Hoff in January 2015 from a cruise from Spore. He was asked to send my diagnosis to my travel insurance. In the 5days before arriving to Spore and reminding him twice a day. On my 1st visit he confirmed I had a infection on my knee with a ESR reading of 100. The normal reading should be below 5. Prior to arriving in Spore he contacted the insurance company for me to be disembarked to a hospital, still not giving them my diagnosis. As he told me disembarkation was approved I presumed he had given them the diagnosis. When I arrived at the hospital after tests and MRI they prepared me for surgery.. Fortunately his receptionist checked with the Insurance and discovered they had not received the diagnosis and had not approved hospitalisation. Knowing the costs I aske the Dr to discharge me. He refused as he said I would get septicaemia, which my father died 60years ago. To reduce the cost he gave me a local anaesthetic, which was unbearable. Due to this fact I ended up having 4 arthroscopies within 2 months. With all the general anaesthetics and aggressive antibiotics my life has changed completely. My immunity is so low that I struggle to do any activity and am in constant pain. My dr told me the reality is I will never get back to my old self. Princess cruises and Carnival cruises have the same headquarters in Sydney, Australia