Recently, a 51- and 48-year-old newlywed couple went on Royal Caribbean’s Serenade of the Seas for their honeymoon and suffered what most passengers fear – a medical emergency onboard. Their experience shows why most passengers have that fear. In the paragraphs below, our cruise accident lawyers explain maritime law as it relates to the cruise lines’ duty to provide medical assistance to their sick and injured passengers. Based on our extensive practice in preparing and trying our own cases, we know how cruise lines have been trying to avoid liability in this area for years. This incident demonstrates just one of the ways they attempt to do so.
During the Claussen’s cruise, Fred Claussen suffered a massive heart attack. The Serenade’s medical staff treated him and then diverted the ship to St. Kitts, where he was transferred to the Joseph Nathaniel France General Hospital (pictured to the right). According to Connie Claussen, the hospital’s condition was “nothing short of deplorable.” The floors were reportedly covered with dried blood and vomit, and the emergency room frequently ran out of supplies. On several occasions, Connie had to take a cab to a pharmacy to buy medication for her ailing spouse.
“Absolutely nothing was done to improve Fred’s condition while we were in St. Kitts,” she said. “The doctor would come in and look at him once a day. She would not communicate with Fred’s doctors in the States.” Fred languished in the hospital for five days without being given a stent, which Connie said aggravated his condition and permanently damaged his heart.
Consumer advocate, Christopher Elliott, reported this incident in an article titled, “Are cruise lines ‘dumping’ their sick passengers?” Comments to the article, however, demonstrate just how contentious this topic becomes, with some commentators believing that there was nothing else the cruise line could have done and others wondering why the cruise line is even blamed for this. Knowing the cruise lines’ duty under maritime law, however, may clarify some of these issues.
Under maritime law, cruise lines owe its sick and injured passengers a duty to exercise reasonable care to furnish aid and assistance as ordinarily prudent persons would render under similar circumstances. If a ship’s medical facilities are incapable of dealing with a passenger’s illness (as was the case with Fred Claussen), then there is a duty of reasonable care to secure medical help. According to the Southern District Court of Florida, this duty can be discharged by putting the passenger into port or summoning air rescue/evacuation.
While some may argue that the cruise line is meeting their burden by simply dropping the passenger off in the nearest port, that is not always the case. When the cruise is passing through poor, isolated countries (again, as was the case with Fred Claussen), then the passenger might not be better off at all and their condition may actually be aggravated. So what are the alternatives?
Technology such as “Face-to-Face Telemedicine” allows a cruise line to exercise supervision and control of its medical facility by putting the shipboard doctors and nurses in real time contact with any land-based hospital of the cruise line’s choosing or the cruise line’s own Shoreside Medical Department. Such modern means of communication make the location of the cruise ship effectively irrelevant and allows the cruise line to directly control the medical care on their ships. At the very least, it gives them an opportunity to stabilize the passenger in order to evacuate them. In addition, cruise lines have set itineraries that their ships travel through repeatedly. It should not be difficult for them to predetermine and have available a list of five to ten qualified hospitals in their route that sick and injured passengers could be evacuated to in cases of emergency.
It is important to note that cruise lines do not have a medical facility onboard for the mere convenience of its passengers. Rather, they have it because 1) it is cheaper than evacuating and/or diverting for every sick or injured passenger (which, as noted above, they have a duty to do); and 2) they profit from the medical services. In addition, they promote the fact that there is a “qualified” physician on board with a well-equipped and well-staffed infirmary. They use it as an enticement to purchase the ticket.
Despite the economic benefit that they receive from having such facility, they have been avoiding liability for years by clinging to the antiquated and outdated argument that they lack the expertise to supervise a physician carried onboard a ship and, as seen here, by simply dropping off their sick/injured passengers to any random island.
Unlike resorts and airlines, cruises are floating cities. They are no longer just a means of transportation. Unfortunately though, the Claussens’ experience highlights how dangerous it is to be on these ships during a medical emergency. Until the cruise lines start facing their responsibility, the only viable option for passengers seems to be travel insurance. Until the cruise lines start facing their responsibility, the only viable option for passengers seems to be travel insurance, or to contact a skilled admiralty attorney.
Photo credits: Royal Caribbean, St. Kitts’ Ministry of Health