What happens if a passenger gets sick on a cruise ship and the treating physician, employed by the cruise line, is negligent in caring for the passenger? Is the cruise line liable?
Under the well-established "Barbetta rule" set forth by the Fifth Circuit Court of Appeals in Barbetta v. S/S Bermuda Star, 848 F.2d 1364, 1372 (5th Cir. 1988), the answer is no. General maritime law does not impute liability to carriers or ship owners, under the doctrine of respondeat superior, for the negligent acts of a ship's doctors in treating passengers. The Barbetta court found that a ship is not a floating hospital, as "[a] shipping company is not in the business of providing medical services to passengers . . . ." Id. at 1369 (quoting Amdur v. Zim Israel Navigation Co., 310 F. Supp. 1033, 1042 (S.D.N.Y. 1969)). Essentially, passengers seeking medical attention from physicians on board a cruise line do so at their own risk, leaving them with no claim against the cruise line in the event that they are negligently treated.
In reaching its conclusion, the Barbetta court focused largely on the factor of control – who controls the medical employees on board, the passenger or the shipowner? The court decided that, as far as treatment is concerned, doctors are under the control of the passengers and the doctor-patient relationship is not the business of shipowners. Id.
In a bold move, the Eleventh Circuit Court of Appeals recently found that the Barbetta rule, decided nearly twenty-seven years ago, had run its precedential course. In Franza v. Royal Caribbean Cruises, Ltd., 772 F.3d 1225, 1228 (11th Cir. 2014), the court declined to endorse the old rule, finding instead that "the rise of a complex cruise industry, and the progression of modern technology have erased whatever utility the Barbetta rule once may have had." The Franza court relied on its precedent of allowing passengers to apply general agency principles to impute liability in maritime respondeat superior cases. Id. at 1234. Thus, under general maritime law applying agency principles, shipowners have been held responsible for injuries to passengers caused by ship employees acting within the scope of their employment. However, until Franza, the Eleventh Circuit had never "examined whether the principles of vicarious liability apply to a passenger's claim for onboard medical negligence." Id. at 1233 (emphasis added).
Like the Barbetta court, the Franza court largely focused on the element of a principal's control over the actions of its agents. Id. at 1236-37. The Franza court held that the plaintiff's complaint plausibly alleged an agency relationship between the cruise line and the doctor and nurse in question, by offering "considerable 'direct evidence' of the cruise line's 'right to control' its medical staff." Id. at 1237-38. Therefore, the complaint set forth a plausible basis for imputing the alleged negligent conduct of its onboard medical personnel to the cruise line. Id. at 1238.
The Franza court found it "disingenuous for large cruise lines to disclaim any medical expertise when they routinely provide access to extensive medical care in the infirmaries they have constructed for this very purpose." Id. at 1243.
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