On March 8, 2019, a federal medical malpractice jury rendered its verdict against a cruise line, Royal Caribbean, in the amount of $3.38 million for the medical negligence of the onboard cruise line doctor that led to the death of a passenger. The federal medical malpractice jury awarded $34,390.32 in medical expenses and $4.8 million in loss of companionship, pain, and suffering. Royal Caribbean was determined by the jury to be 70 percent at fault and therefore is responsible for $3,384,073.22 of the verdict. Royal Caribbean has stated through a spokesperson that it plans to file an appeal.
The passenger was on a Royal Caribbean Alaskan cruise with his family in 2016, celebrating his 70th birthday. While on the cruise ship, he went to the onboard infirmary when he experienced shortness of breath. The onboard doctor allegedly diagnosed that he had a septal infarction of undetermined age for which she provided the man with medications and allowed him to return to his cabin. The man collapsed in his cabin about a half hour later, according to the family’s cruise line medical malpractice lawsuit.
The family alleged that the cruise line was negligent in failing to contact the man’s family after the initial visit to the on-board infirmary and that the man should have remained in the infirmary for further medical testing or he should have been transported to an appropriate onshore medical facility. The man’s family faulted the onboard doctor for failing to timely have the passenger transported to a medical facility in Juneau, Alaska until late in the afternoon. The man died four days later.
Under the general maritime law, a shipowner traditionally has owed no duty to practice medicine or to carry a physician on board. Therefore, the shipowner is only liable to its passengers for medical negligence if its conduct breaches the carrier’s more general duty to exercise “reasonable care under the circumstances.”
Courts have generally applied agency principles to impute liability in maritime tort cases. In a 2014 federal case involving allegations of onboard medical malpractice against Royal Caribbean, the United States Court of Appeals for the Eleventh Circuit (“Federal Appellate Court”) stated, “[w]e can see nothing inherent in onboard medical negligence, when committed by full-time employees acting within the course and scope of their employment, that justifies suspending the accepted principles of agency … absent any statutory mandate to the contrary, the existence of an agency relationship is a question of fact under the general maritime law.”
The Federal Appellate Court stated that at the pleading stage, a passenger must allege sufficient facts to render it facially plausible that an agency relationship is present. In cases of medical malpractice, as in other maritime respondeat superior cases, the essential element of the relationship is the principal’s control over its agents. An agency relationship requires: (1) the principal to acknowledge that the agent will act for it; (2) the agent to manifest an acceptance of the undertaking; and (3) control by the principal over the actions of the agent.
The Federal Appellate Court stated, “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.”
The Federal Appellate Court held: “As a matter of law, we are hard-pressed to see why the principal-agent relationship between a shipowner and a medical professional should be treated any differently — particularly where the shipowner employs a large medical staff, wholly outfits the clinics where its medical employees work, and exercises sufficient control over those personnel.”
Source Franza v. Royal Caribbean Cruises, Ltd.,, Case No. 13-13067.
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