11th Circuit Rules Cruise Lines Can Be Sued for Medical Malpractice


By: Laura Broome

The 11th Circuit recently ruled that cruise ships may be sued for medical malpractice, negating any reliance by cruise ship companies upon the defense of immunity in cases of medical malpractice.  In Patricia Franza v. Royal Caribbean Caribbean Cruises, Ltd., 2014 WL 580229 (11th Cir. 2014), the 11th Circuit definitively recognized the right of cruise ship passengers to assert claims against cruise lines for vicarious liability for the medical negligence of the cruise ships’ employees.  This ruling is significant because many cruise ship lines are headquartered in Miami and contractually require their passengers to sue them in the Southern District of Florida, a part of the 11th Circuit.

In Franza, the daughter of a man who died as a result of a fall on the dock of a Royal Caribbean Cruises ship sued Royal Caribbean Cruises under a theory of respondeat superior for the purported negligent medical care her father received from a ship doctor and nurse.  Royal Caribbean Cruises filed a Motion to Dismiss, relying on a 1988 5th Circuit case, Barbetta v. S/S Bermuda Star, 848 F.2d 1364 (5th Cir. 1988).  The ship doctor and nurse Franza were deemed, at least at the stage of the instant motion to dismiss, to be employed by Royal Caribbean Cruises, as opposed to being independent contractors.

In Barbetta, the cruise line was found to be immune from any claim for negligent medical care asserted under a theory of respondeat superior.  This immunity was given regardless of “how clear the ship owner’s control over its medical staff or how egregious the claimed acts of negligence.”  Id.  In Franza, U.S. District Judge Joan Lenard of the Southern District Court of Florida granted the Motion to Dismiss filed by Royal Caribbean Cruises, applying the Barbetta rule.  The 11th Circuit reversed Lenard, noting there was no binding precedent from the Supreme Court or the 11th Circuit concerning whether cruise lines can be held vicariously liable for the medical negligence of their employees.

Justice Stanley Marcus, writing for the 11th Circuit panel, rejected the Barbetta rule, noting that the “roots of the Barbetta rule snake back in to a wholly different world.  Instead of nineteenth-century steamships, we now confront state of the art cruise ships that house thousands of people and operate as floating cities, complete with well-stocked modern infirmaries and urgent care centers….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….In our view, ‘the reasons that originally led’ other courts to adopt ‘the rule have long since disappeared.’”  Id.

The Court also rejected the argument of Royal Caribbean Cruises that the doctor and nurse were independent contractors, despite the fact that the ticket sold to Mr. Franza explicitly stated the onboard medical personnel were independent contractors.  If the doctor and nurse were actually independent contractors, then Royal Caribbean Cruises would not be liable for the actions of the medical personnel under a theory of vicarious liability.  Justice Marcus noted that at the Motion to Dismiss stage, the ticket contract would not be examined, nor would the nurse and doctor be considered independent contractors simply for the reason Royal Caribbean Cruises calls them such.  Instead, Justice Marcus pointed to several allegations in the complaint, including that the doctor and nurse were paid directly by Royal Caribbean Cruises, had to wear Royal Caribbean Cruises uniforms, and were advertised as members of the ship’s crew.  Justice Marcus noted that if these allegations of the complaint, among others, are true, then the conclusion that the doctor and nurse were actual employees of Royal Caribbean Cruises, or at least controlled enough to be removed from independent contractor status, would be supported.  The 11th Circuit concluded that medical personnel who are employees of cruise lines may be sued for the purported negligence of these employees under a theory of respondeat superior, and rejected the Barbetta defense of complete immunity.

It will be interesting to see if cruise lines based out of Miami attempt to clearly define and identify medical personnel as independent contractors, by doing things such as hiring independent medical care provider groups to staff the cruise ships with medical personnel, as opposed to directly paying the doctor and nurse as employees, and further drawing a clear division between the cruise ship staff and the medical personnel (ie – not advertising the medical staff as members of the crew nor having the medical staff wear cruise ship uniforms).