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

Today, a passenger aboard the Carnival Vista notified me that there was a medevac from the cruise ship. The ship had previously left Barcelona for Gibraltar. 

The passenger who contacted me wishes to remain anonymous. He took photos and video of the medical rescue. 

There was no mention whether the passenger was ill or had been injured.

  

https://youtube.com/watch?v=bEiD-mygmBc%3Frel%3D0

 

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

http://up.anv.bz/latest/anvload.html?key=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

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.”

Please leave a comment on our Facebook page if you have information.

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

 

 

Coast Guard HelicopterI have been contacted by three cruise passengers stating that there have been medical emergencies and two evacuations during cruises,

The Oasis of the Seas had to turn around near the Cayman Islands at the beginning of the week, apparently because of a medical emergency involving a passenger.

Another person said that there was a medical emergency on the Norwegian Getaway, and that the ship was proceeding full speed ahead to Nassau. It seems strange that any U.S.-based cruise ship would speed to Nassau given the dreadful medical care in the public hospitals there.

Today, I heard from a person sailing on Royal Caribbean’s Anthem of the Seas out of Southampton on a 14 day Mediterranean voyage:

“On the evening of September 2nd, there was an “Alpha” alert (code for medical situation). On September. 3rd (Day 3), there was a medical evacuation by helicopter of the patient and his family at approximately 11am. I believe Captain Klaus Anderson indicated the patient was being flown to a hospital in Portugal. The evacuation occurred at the aft end of the ship, and all guest services areas (ie. Windjammer aft seating, Flo-Rider, iFly by RipCord, Rock climbing wall, etc.) were closed during the procedure.”

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Photo Credit U.S. Coast Guard

Cruise lines owe their crew members the absolute legal duty of providing medical treatment when the crew become sick or injured on the company’s cruise ships.

Pursuant to the “maintenance and cure” doctrine, the cruise line is required to provide “maintenance” (room and board) and “care” (medical care and treatment) to the point that the crew member reaches his or her “maximum medical improvement.”

This ancient legal doctrine of protecting seafarers can be traced back to the Medieval Sea Codes. It was introduced into United States Maritime Law by the Supreme Court in 1823. Under the doctrine, Hotel Food Greasy Salty Disgustingthe cruise lines has an affirmative obligation of taking care of their injured employees in a manner which is no different than the natural responsibility of a mother or father to a child, the courts have analogized.

But putting pleasant-sounding legal theories aside, in reality the practice of the cruise lines today is quite different. When a crew member hires a lawyer, the cruise lines put the sick crew member in dirty, low-rent hotels where they feed them disgusting food. Unfortunately, the Miami-based cruise lines act like resentful uncaring parents who neglect their responsibilities.

Royal Caribbean: When I first began representing crew members in the 1990’s, Royal Caribbean used to house their injured crew members in a hotel close to South Miami Hospital. It was a nice, safe hotel with good food where crew members could go to and from the hospital with little inconvenience. But as soon as the crew member hired a lawyer, the cruise line would retaliate against their sick employee. Royal Caribbean would immediately kick the crew member out of the hotel and send them to a dump-of-a-hotel near I-95 and 163rd Street.  The area was known as a hang-out for drug dealers and prostitutes. The hookers would use the dirty hotel rooms on an hourly basis. It was a dangerous and demoralizing location for ill crew members to try and recuperate.

More recently, Royal Caribbean uses a hotel in Miami hear 8th Street. Here are some of the descriptions on Trip Advisor:

“This hotel is absolutely horrible! Do not stay here. Management is awful. Toilet overflows constantly and cleaning crew does not help. . . Stay away from this hotel. Don’t even spend a $1 on this hotel.”

“Nothing good about this place . . . the room has no air conditioner or working fan. The bathroom was disgusting and had a terrible odor coming from the sink. Next thing, it was 11 pm and there were people just screaming for ages in the hallways . . .  Don’t stay here!!!

Crew members at this hotel complain regularly about roaches, no hot water, inedible greasy salty food (photo above by crew member), extra charges for bottled water, malfunctioning televisions, and unsanitary bathrooms.

Carnival:  We receive the same type of complaints from crew members on sick leave in the hotels which Carnival selects especially for its injured crew members who are represented by lawyers. It’s a disgraceful practice. One crew member undergoing back surgery sent us a video below of a rat that lives under the buffet in the crew member dining room.

We complained to Carnival, but it could care less.

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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

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

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