In Franza v. Royal Caribbean (No. 13-13067) the US Court of Appeals for the Eleventh Circuit reversed the summary judgment of the US District Court in Southern Florida and found the plaintiff adequately pled all the elements of both actual and apparent agency and may press her claims under either or both theories. Her complaint named the cruise line, not its shipboard medical team.
The district court had dismissed the actual agency count by applying the 'Barbetta rule' (derived from an older decision by the US Court of Appeals for the Fifth Circuit), which has immunized shipowners from agency liability for medical malpractice resting on the assumption that cruise ships are not in the business of providing medical services and the doctors and nurses working on board are independent professionals and not employees or agents of the cruise line.
But times have changed, and the appeals court stated it could imagine cases other than Franza v. Royal Caribbean in which additional evidence might demonstrate a cruise line’s medical expertise—particularly since lines 'routinely claim to possess such knowledge.' Major operators tout their modern medical facilities, equipped with computerized radiology and sophisticated laboratories, and have achieved accreditation to international health care standards and ISO 9001 certification.
The decision is 'definitely precedent-setting,' according to Robert Kritzman of Fowler White Burnett in Miami, a maritime attorney who was not involved in the case. 'It is a change and not preferential to the cruise lines but it's not a complete reversal. It does not say cruise lines are responsible for the cruise ship doctor. The decision provides that each case will depend on the facts.'
In Franza v. Royal Caribbean, the plaintiff alleges an Explorer of the Seas passenger fell and hit his head while boarding a trolley at the dock in Bermuda. He was taken by wheelchair to the ship's infirmary where a nurse observed a lump and abrasion on the man's head but released him to return to his cabin without any diagnostic scans.
When the man's condition worsened, he was seen by the ship's doctor, allegedly following several delays, then was transferred to a hospital ashore. The man died a week later.
His daughter sued Royal Caribbean, not the ship's nurse and doctor. The complaint alleged her father was 'required' to go to the ship's infirmary to be seen for his injuries and that, relying on the advice of the nurse, he was released to return to his cabin without being properly assessed or monitored, and deviating from the standard of care for patients who suffer a blow to the head.
The suit invoked the doctrine of actual agency, alleging that Royal Caribbean was negligent 'by and through the acts of its employees or agents' and, under the theory of apparent agency 'because the cruise line purportedly 'manifested to [plaintiff's father] ... that its medical staff ... were acting as its employees and/or actual agents' and her father 'relied to his detriment on his belief that the physician and nurse were direct employees or actual agents' of the line.
Royal Caribbean noted the ticket contract makes clear that on-board medical personnel are independent contractors, not employees or agents. But the appeals court declined to consider the ticket contract at this point, for several reasons. Plaintiff did not attach the contract to the complaint or mention it. 'Finally, even if we were to look to the contract at this stage, we would not consider the nurse and doctor to be independent contractors simply because that is what the cruise line calls them,' the court said.
The decision indicates the recognition there have been a lot of changes over time since the Barbetta rule and the court has a different view of the law based on current circumstances and practices, attorney Kritzman told Seatrade Insider.
'It's generally assumed this will result in more lawsuits unless there's further resolution,' he added, 'because it gives plaintiffs and plaintiffs' attorneys more hope that a malpractice claim will be heard by the court.'