The quality of medical care and the liability for medical malpractice on cruise ships has been problematic. The question of whether the medical staff or the cruise ship owners are held liable for malpractice often arises in situations where an ill passenger has no choice but to be treated by the medical staff provided by the cruise.
In the past, situations like these have been commonly evaluated by relying on the Barbetta Rule from the case of Barbetta v. S/S Bermuda. This resulted from an ill passenger that developed severe pneumonia and fell into a coma when a physician failed to diagnosis her with diabetes. The U.S. Court of Appeals held the doctor responsible for negligence. Essentially, this rule protected cruise owners from being held liable when negligence of the medical staff, who are considered independent contractors, caused harm to the passengers. Relying on this rule became problematic as the passengers have little choice but to seek treatment by the medical care provided the cruise ship.
However, the Barbetta Rule was recently challenged by a Florida appellate court decision in Carlisle v. Carnival Corporation, where a 14 year old female passenger became ill with abdominal pain due to appendicitis but was misdiagnosed with the flu by an onboard cruise physician. In this case, the court rejected the Barbetta Rule and held that the cruise ship held control over the doctor-patient relationship and the medical services it provided to passengers was in agreement with the cruise line's guidelines. Therefore, the cruise line can be held liable in such situations since it assumes the responsibility to treat illnesses its passengers develop.
Cruise ship immunity from malpractice was further challenged by the Franza v. Royal Caribbean Cruises decision. It involved a passenger who was injured by falling and hitting his head on the ship. He was treated by the onboard medical staff, primarily a nurse who failed to assess his injuries, neglected to perform scans and released him with no treatment. The passenger's medical care was further delayed when the credit card information could not be obtained by the staff on board. The passenger's condition worsened and he died a week later. The court rejected the Barbetta rule and held the cruise ship liable for negligence on part of its employees.
In light of recent medical malpractice claims, the issue of liability in the cruise industry has progressed to a level where the Barbetta Rule, which was once heavily relied upon, has come to be essentially erased.