In the summer of 2001, a retired New York City policeman and Korean War veteran was on a cruise with 18 of his family members when he fell and hit his head disembarking from the ship. Upon being helped by the medical team on the ship, the man was told to lay in his cabin and rest. Within days, the man was dead from a brain injury directly linked to his fall. In December, a federal appeals court overturned a ruling that exempted cruise ships from medical malpractice suits for the man's family.

What prevents a cruise ship from being sued?

There have been numerous court decisions that create exemptions for cruise lines concerning the level of medical care that they provide. One of the most recent rulings is known as the Barbetta ruling, stating that passengers on cruise ships are unable to receive the same level of medical care on a cruise ship that they would receive on land and that doctors and nurses on cruise ships are private contractors whose services are beyond the control of the ship.

According to the federal appeals court:

• Barbetta is an outdated law that may no longer apply in many instances
• Many cruise ships doctors and nurses don the ship's uniform
• Onboard medical centers are promoted in advertising materials
• Some ships have intensive care units, laboratories, and live-video conference abilities

Given this information, onboard medical negligence may no longer be exempt from medical malpractice lawsuits. This ruling directly affects the 21 million people who use cruise ships services every year.

Cruise ships are responding aggressively. They cite the existence of such a long-standing law as having merit, and passengers that take cruises are there for vacations, not medical attention. The improvement of their medical capacities does not mean that they should be held to the same standards as land-based medical treatment facilities.

As long as this ruling stands, passengers on cruise ships can sue the cruise line company for medical malpractice if it can be shown that the cruise line controls their medical staff, and they are not completely independent contractors, as these ships claim.