Cruise ship passengers who have suffered medical neglect now have a far easier time filing a medical malpractice suit against medical staff, according to a new a United States Court of Appeals ruling.

Prior to the ruling, cruise lines were given immunity even when their medical staff employees were negligent in treating passenger-patients. Immunity was based on a 1988 base, Barbetta versus Bermuda Star, which basically held that the only way passengers on a cruise line who were treated negligently by medical personnel could sue was to personally sue the provider who had treated the patient. The cruise line itself was immune from a lawsuit.

This made suing for medical malpractice that occurred on a cruise ship almost impossible for practical reasons. A recent case, Franza versus Royal Caribbean Cruises, changed all of this.


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An elderly passenger, Pasquale Vaglio, fell asleep when the ship was docked in Bermuda. Vaglio was carried back onto the ship where he sought treatment from the medical staff in the ship’s designated medical center.

According to the court documents, over the next few hours, Vaglio allegedly received such negligent medical attention that his life could not be saved. The court decision states that “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.

After his death, Vaglio’s daughter, Patricia Franza, sued Royal Caribbean Cruise Lines. The case was initially dismissed based on the so called “Barbetta doctrine,” but on appeal, the U.S. Court of Appeals declined to adopt the Barbetta rule and instead found that Franza had plausibly established a claim against Royal Caribbean as the employers of the negligent medical staff.

The court’s decision has opened the door for passengers injured as a result of medical malpractice on board a cruise ship to now sue. In its decision, the court stated that “much has changed in the quarter-century since Barbetta… the evolution of legal norms, the rise of a complex cruise industry, and the progression of modern technology have erased whatever utility the Barbetta rule once may have had.”

Ann W. Latner, JD, a former criminal defense attorney, is a freelance medical writer in Port Washington, N.Y.