The Mariner of the Seas returned to the port of Miami this evening due to an injured passenger requiring emergency medical treatment.

A passenger on the Royal Caribbean cruise ship informed me that there was an “alpha call today for the sports deck” earlier today. The ship returned to Miami and an ambulance took the injured man from the port.¬† It is unknown exactly how the passenger was injured, although there are comments on social media (above) that the man may have fractured his pelvis.

The Mariner of the Seas left Miami yesterday on a two night cruise and was scheduled to spend the day at CocoCay in the Bahamas and then return¬† to Miami tomorrow (February 9th). The ship reportedly couldn’t tender in CocoCay due to high winds.

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The Sun Sentinel recently reported on a lawsuit filed against Holland America Line arising out of a stroke suffered by a 65 year old woman while aboard the M/S Zuiderdam in March of 2018.

Lila Graciela Kohn Gale reportedly suffered a hemorrhagic stroke shortly after the HAL cruise ship left Ft. Lauderdale at the start of a seven day Caribbean cruise. Although the medical emergency occurred less than five hours after the ship left Port Everglades, when the cruise ship was likely less than 100 miles from the South Florida coast, the ship did not contact the U.S. Coast Guard in order to request an emergency medical evacuation.

Mr. and Ms. Gales reportedly enjoyed traveling together on cruises.  Mr. Gale described his wife, prior to the cruise, as a vibrant, fun loving, bilingual therapist and counselor.

Ms. Gale lost consciousness around 8:30 p.m. on the first evening of the cruise; the ship‚Äôs doctor, Socrates Lopez, assessed Ms. Gale and quickly determined that she required a CT scan of her brain and an emergency consult with a neurologist or neurosurgeon. However,¬†instead of calling the Coast Guard and requesting a medevac, the ship’s medical staff reportedly left Ms. Gales untreated despite her worsening condition. It then sent her via a tugboat to a hospital in Freeport, Bahamas, Rand Memorial Hospital, around 11:00 p.m., after giving her husband a medical bill for $3,500.¬† Ms. Gales arrived at the hospital in Freeport shortly after midnight, but the public hospital did not have a neurosurgeon, neurologist, or even a functioning CT scan.

According to the lawsuit (which you can read here), a doctor in the Bahamas made the decision to transfer Ms. Gale to Broward Health Medical Center, a comprehensive stroke center in Ft. Lauderdale, but the airport was also closed for the night.  The next morning, Ms. Gale arranged for an air ambulance (at an expenses to him of $15,000 which HAL refused to pay) to fly his wife from the Bahamas to Broward Health where she finally arrived more than 15 hours after her stroke on the cruise ship.  Ms. Gale required emergency surgery to relieve the pressure on her brain in order to try and minimize the extent of her cerebral injuries

The lawsuit alleges that the delay in treatment cause an excessive amount of Ms. Gale’s brain tissue to die, leaving her with “devastating physical, cognitive and neurological deficits which require extensive medical care and treatment around the clock.”¬† Her lawyer, Tom Scolaro of Leesfield Scolaro P.A. in Miami, (as quoted in the Sun Sentinel article) states that Ms. Gale¬†is now¬† ‚Äúseverely disabled” requiring ¬†“24-hour round-the-clock nursing care.” The Chicago Tribune, which also covered the tragic story in an article titled ‘I Want Justice’: Suburban Family Sues Cruise Ship Operator For Not Airlifting Woman Who Had Stroke On Board, further explained that Ms. Gale “cannot walk and struggles with language while her memory, perception and concentration skills have been impaired.” She now lives in pain at a nursing home and is not expected to recover enough to return home.

The irony of this sad case is is that HAL claims that it is an “industry leader in cruise medicine.” It advertises to its mostly elderly cruise customers that it can disembark them “via Coast Guard helicopter if medically appropriate and logistically possible in relation to the ship’s distance from land.”

Medically Appropriate?

Based on the facts presented, there appears to be no dispute that it was “medically appropriate,” if not absolutely necessary, to have arranged for Ms. Gale to receive comprehensive treatment at a stroke center as soon as possible.¬† The facts alleged are that her brain was “slowly dying;” sending her via a tugboat to an ill-equipped hospital in the Bahamas without qualified and experienced specialists appears to be an undeniably ill-conceived and callous decision under the circumstances.

Logistically Possible?

And there appears to be little dispute that it was “logistically possible” (in relation to the ship’s distance from land) for the U.S. Coast Guard to dispatch a helicopter to fly 100 miles to medevac Ms. Gale from the cruise ship.

We have written about over 150 medevacs of passengers and crew members by the Coast Guard from cruise ships since 2011 (our list is admittedly not complete).  In the last four years alone, there have been at least twenty  medevacs via helicopter where the Coast Guard flew in excess of 100 miles to the cruise ships to hoist ill passengers aboard and then fly them an equal distance to a land-based hospital in the U.S. with appropriate medical facilities and experts.

The last reported medevac, just five days ago, from a cruise ship involved a Coast Guard helicopter which flew 200 miles to the Norwegian Star west of San Diego in order to medically evacuate a passenger with a heart condition.

Shorty before Christmas last year, the Coast Guard flew a distance of 402 miles to rescue a passenger suffering from kidney failure from the Anthem of the Seas in the Atlantic so that he could receive emergency medical treatment in North Carolina.

Coast Guard Helicopters Fly Thousands of Miles a Year to Rescue Sick Passengers During Cruises

The Coast Guard also conducted the following medevacs in the last four years, each in excess of 100 miles:

These distances are to the cruise ship; the Coast Guard helicopters obviously have to fly an equal distance back to land. (There may be other emergency medical rescues via helicopter; this list is not exhaustive).

In addition to these medevacs by the U.S. Coast Guard, we have written about long distance emergency medical evacuations conducted by navy and air forces in Europe involving distances of several hundred miles, such as this case in 2017 involving the P&O Aurora where a Portuguese Air Force helicopter flew nearly 600 kilometers (photo above right) from the coast of Portugal to rescue an ill cruise passenger at sea.

Strokes Require FAST Medical Treatment – Not A Slow Boat to the Bahamas

All first year medical or nursing students know the “FAST” acronym regarding a stroke:¬†¬†Facial drooping,¬†Arm weakness,¬†Speech difficulties and¬†Time to call emergency services. It is universally recognized there is a limited time period in which to treat a stroke before a patient suffers irreversible, serious neurological deficits. Failures of the type alleged in this sad case typically appear to involve incompetent shipboard medical staff.

The Delayed Care of Christina Marie Ricci

We are aware of at least one other recent instance of delayed and substandard shipboard care and a refusal to request a Coast Guard medevac involving a young woman who sustained a stroke on a Carnival cruise ship.

In 2015, 24 year-old¬†Christina Marie Ricci was a passenger aboard the Carnival Victory when she suffered a stroke¬†just eight hours after the cruise left Miami. According to her mother’s account, instead of requesting a Coast Guard medevac, the Carnival cruise ship, which was off the coast of Florida, sailed on to Key West as her medical condition worsened. Once there, about six hours after her stroke, Christina was taken to a non-trauma care facility unit, where she was assessed and then eventually flown to Miami‚Äôs trauma hospital, Jackson Memorial. Her treating doctors at Jackson informed her family that they could have managed her medical care if the cruise line had timely requested a Coast Guard medevac from the ship.

Christina died 19 days later, without regaining consciousness.

That’s why most competent ship physicians will not hesitate to contact the nearest Coast Guard station and discuss a passenger’s symptoms with a Coast Guard flight surgeon in order to request a medevac.

I have never heard of the Coast Guard refusing to dispatch a helicopter to a cruise ship involving a victim of a stroke, heart attack or other serious medical emergency, particularly where the ship was less than 100 miles from a state-of-the-art stroke center in the U.S.

The Coast Guard Does Not Charge Cruise Passengers or Cruise Lines for Emergency Medical Care

The expenses of a Coast Guard medevac are never charged to the ill cruise passenger and are paid for 100% by the federal government. Cruise passengers do not have to have medical insurance in order to reimburse the Coast Guard. The Coast Guard also do not charge the cruise line for the medevac of their ill guests who require emergency care ashore, which makes the alleged failure of the medical staff aboard the M/S Zuiderdam even more inexplicable and troubling.

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Story credits: Sun Sentinel, Chicago Tribune, CBS 4 Miami (video).

Photo of M/S Zuiderdam –¬†Copyright ¬© 2008 K. Krallis, SV1XV – CC BY-SA 3.0, commons / wikimedia.

Photos of Ms. Gale – via Chicago Tribune, CBS 4 Miami.

Photo of Christina Marie Ricci РLisa Ricci.

Medevac Photo Top РU.S. Coast Guard via Defense Visual Information Distribution Service (DVIDS).

Medevac Photo Bottom – Esquadra 751.

The Coast Guard in Alaska medevaced a 55-year-old cruise passenger from the Seven Seas Mariner cruise ship approximately 25 miles southeast of Montague Island in the Gulf of Alaska on Wednesday.

Air Station Kodiak dispatched a MH-60 Jayhawk helicopter to the cruise ship after Air Station Anchorage received a request from the master of the Regent cruise ship indicating that the woman was suffering from internal bleeding. The Coast Guard helicopter aircrew flew to the ship and safely hoisted the woman and transported her to emergency medical services personnel in Anchorage.

Video credit: U.S. Coast Guard District 17 (Air Station Kodiak) via Defense Visual Information Distribution Service (DVIDS).

A newlywed couple from Baton Rouge, Louisiana experienced what is described as a “medical nightmare” aboard the Norwegian Pearl during a recent cruise to the Caribbean.

WWL- TV and the New Orleans Advocate¬†in Louisiana report that NCL passenger Brant Aymond was injured during a paddle board accident while the Pearl¬†stopped in Roatan. A piece of coral sliced both of his feet which required medical treatment on the cruise ship. The couple had purchased insurance which covered the shipboard medical care, but NCL still charged them $2,000 upfront. The ship doctor, Norwegian Pearlidentified as Dr. Gomez from Mexico, stiched up Mr. Aymond’s feet. The ship doctor reportedly missed that he suffered a severed tendon in the accident.

As it turned out, Dr. Gomez reportedly also left two pieces of coral sewn inside Mr. Aymond’s foot, according to emergency room physicians back in Baton Rouge who performed emergency surgery to avoid possible amputation.

Mr. Aymond’s foot became infected partially because the ship’s medical team gave him the wrong spectrum of¬†antibiotics, typically used to treat gastrointetinal problems.

In addition to the bad shipboard medical care, NCL reportedly stonewalled the couple when they tried to find out information about the qualifications of the ship doctor and nurse. It appears that NCL refused to deal transparently with their guests, something that we regularly experience with this particular cruise line.  Ms. Aymond stated during the interview:

Norwegian won’t answer my calls, won’t return my e-mails, they won’t respond to the claim, they – absolutely – have just iced us out . . .¬†

The news station interviewed the past president of the American College of Emergency Physicians who was critical of cruise ship healthcare. He indicated that hospitals in Louisiana are often required to treat returning cruise passengers who have been neglected by what is described as the “medical mess” left by the cruise lines.

Over 1,000,000 people traveled last year from the port in New Orleans.

Ms. Aymond suggested that that if you are injured during a cruise, “get off the boat . . . figure out a way to get back to the states to seek medical care if it is … serious.”

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Video and photo credit: WWL

http://interactive.tegna-media.com/video/embed/embed.html?id=8003501&type=video&title=Louisiana couple's honeymoon cruise turns into medical nightmare&site=269&playerid=6918249996585&dfpid=32805352&dfpposition=embed_preroll§ion=home

Jamaica State Of EmergencyThe U.S. State Deparment issued a travel warning effective January 18, 2018 that U.S. citizens use exteme caution in traveling to certain locations in Jamaica, following a State of Emergency for St. James Parish, Jamaica which was declared by the government of Jamaica to counter the out-of-control criminal activity.

St. James Parish covers the popular travel destination of Montego Bay, which has a cruise port and is a short drive away from the cruise ports in Falmouth and Ocho Rios, Jamaica. Numerous cruise excursions take cruise passengers to and through Montego Bay and surrounding areas.

The travel warning also applies to Kingston and Spanish Town in Jamaica

The State of Emergency permits Jamaican security forces within the borders of St. James Parish to "arbitrarily detain and deport suspicious persons, enter premises, and seize property without warrant." The U.S. Embassy in Jamaica states that U.S. visitors to Jamaica should "expect to encounter increased police and military presence, checkpoints, and searches of persons and vehicles within the borders of St. James Parish."

According to an article in Newsweek, the U.S. State Department warns that "violent crime, such as home invasions, armed robberies, and homicide, is common. Sexual assaults occur frequently, even at all-inclusive resorts. Local police lack the resources to respond effectively to serious criminal incidents."

The U.K.’s  Foreign and Commonwealth Office (FCO) has warned Britons that a “major military operation” is taking place and that they should stay in their hotels. “You should follow local advice, including restrictions in selected areas. You should limit your movements outside of resorts in the area at this time, and exercise particular care if travelling at night. Travel to and from the airport or for excursions should be undertaken with organised tour operators, and transport should be arranged or provided by the resort hotels.”

Canada also warns its citizens that they need to "exercise a high degree of caution in Jamaica due to the high level of violent crime and the state of emergency in St James Parish."

Videos posted in several U.K. newspaper show military troops and extra police officers deployed in the Montego Bay area, engaged in traffic stops. The "major military operation" is underway as British tourists have been told to stay in their resorts due to the escalating crime wave. Warning residents and tourists of the deadly attacks, Prime minister Andrew Holness said "the level of criminal activity is of such a nature and so extensive in scale as to endanger public safety," according to the International Business Times.

Time writes that crimes in St. James Parish has reached a critical point, and crime in general in Jamica is a "persistent problem."

"In 2016, for example, the country of 2.9 million people saw 1,350 murders, 1,216 shootings, 449 aggravated assaults and 480 rapes, according to the U.S. Department of State Bureau of Diplomatic Security. The country is also notorious for “entrenched and widespread” corruption." The per capita murder rate in Jamaica is around 50 per 100,000, whereas the per capita rate in the U.S. is only around 4.5 per 100,000. Canada’s per capita murder rate is less than 2 per 100,000. 

In Jamaica’s resorts, beaches mask staggering bloodshed, the Toronto Sun explains that Jamaica has recently seen "unprecedented bloodshed" which has seen tourists murdered.  

Despite the upsurge in violence and the state of emergency, Jamaica’s tourism minister states that it is allegedly still safe to visit the country. Cruise lines are continuing to unload hundred of thousands of cruise passengers a month in the ports in Montego Bay, Falmouth and Ocho Rios, generating tens of millions of dollars a month in excursion fares for the U.S.-based cruise lines, as military vehicles rumble through the streets of Montego Bay (see video below).

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January 23, 2018 Update: Jamaica earns spot on the Top 10 Most Dangerous Cruise Destinations in the World.

Photo credit: loopjamaica

https://youtube.com/watch?v=nB3Wf_TosWU%3Frel%3D0

Norwegian StarSeveral passengers onboard the Norwegian Star state that the NCL cruise ship is returning to Miami a day early due to a medical emergency.

One passenger on the ship writes:

"The Norwegian Star is speeding to Miami, to arrive 10 hours early due to a passenger medical emergency onboard. The Star will now arrive at 6 PM on Sunday instead of 4 AM Monday. Passengers other than the medical evacuee must remain on board until the regular disembarkation date . . . "

If this information is in fact accurate, it seems odd that the Star has not contacted the U.S. Coast Guard to request a helicopter medevac.

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Photo credit: Pjotr Mahhonin – CC BY-SA 3.0, commons / wikimedia.

Anthem of the SeasA passenger aboard the Royal Caribbean Anthem of the Seas contacted me yesterday evening stating that:

“On the Anthem of the seas. The ship had to come back a night early . . . ¬†there are 4 critically ill passengers on board . . . Captain not saying anymore then 4 critically ill and pleaded we understand because if this was our family we would want the same.” ¬†The captain specifically stated that ¬†the passengers were in “critical” medical condition.

The passenger subsequently stated that two and possibly three of the passengers had died. There was no information whether the passengers had been injured or were sick.

@PTZtv indicated that the cruise ship returned to the harbor in New York early last night for “medical emergencies.”

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It’s surprising how little insight we have received on this story, as one other blogger notes.

Photo Credit: Dickelbers Creative Commons 3.0 via Wikipedia

 

 

This afternoon an online webcam and marine tracking websites showed the Regal Princess cruise ship entering the Port of Miami for what people on social media were describing as unspecified medical emergencies involving two passengers. Local TV stations covered the story with helicopters. I covered the incident on my Facebook page involving the gay "30th Anniversary Caribbean Cruise."

This is the first time that the Regal Princess, which calls on Fort Lauderdale, has come to Miami. 

There is a great deal of chatter on Facebook and Twitter that the medical emergencies involved drug overdoses. The South Florida Gay News says that "speculation swirls around drug activity." It quotes a Regal Princess passenger saying that “It’s an all gay cruise and they’re all drunk. There’s three thousand gay men on this boat. You know what that means. There’s a lot of high risk activity associated with that.”

Perhaps an over-generalization.  But there’s reason why the image may be appropriate. 

Six years ago we wrote: GLAAD Board Member Dies Aboard Royal Caribbean’s Mariner of the Seas due to a drug over-dose. 

Five years ago, we wrote: Another Death on a Royal Caribbean – Atlantis Cruise again due to drugs.

Four years ago: Passenger Busted for Selling Drugs on Royal Caribbean’s Allure of the Seas which had a half-dozen drug overdoses aboard the ship.

Does the organizer (RSVP Vacations) discuss the use of drugs and the foreseeable risk of a drug overdose with the cruise line to make certain that there are properly trained medical personnel to respond to emergencies?

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Photo Credit: PTZtv

The U.S. Coast Guard announced today that it rescued a 51-year-old cruise passenger who was suffering from undisclosed medical issues while aboard a Carnival cruise ship approximately 130 miles southwest of Key West, Florida. ‚Ä®

Shortly after noon yesterday, the Coast Guard in Key West received a report from the Carnival Liberty indicating that a cruise passenger suffered an illness while crossing the Gulf of Mexico.

‚Ä®The coast Guard launched a MH-60 Jayhawk helicopter from Clearwater. ‚Ä®When the helicopter arrived, the aircrew hoisted the passenger transported him to Lower Keys Medical Center in Key West. 

 

Carnival Paradise MedevacThe U.S. Coast Guard reports that it medevaced a 66-year-old passenger from a Carnival cruise ship yesterday when the ship was approximately 180 miles southwest of Marco Island, Florida. 

The Carnival Paradise contacted the Coast Guard around 2:00 PM yesterday regarding a male passenger who was suffering from an undisclosed medical illness while the cruise ship was sailing to Tampa.

A MH-60 Jayhawk helicopter was dispatched from the Coast Guard’s station in Clearwater.

FOX News reports that when the Coast Guard helicopter crew arrived at the cruise ship, the aircrew lowered their rescue swimmer, hoisted the ill cruise passenger and transported him to Tampa General Hospital for medical care. 

Photo Credit: FOX 4