The Florida Supreme Court has refused to modernize maritime law by allowing a cruise line to be held vicariously liable for the injuries of a passenger who became sterile after the ship's physician failed to diagnose her appendicitis.

Elizabeth Carlisle, then 14, fell ill while traveling with her family on a Carnival Corp. ship in 1997. Her parents' case against the company was an opportunity to throw overboard the immunity from claims for negligent medical care of passengers that cruise lines have traditionally enjoyed.

While cases dating back to the 19th century have upheld that immunity, Nietes v. American President Lines, 188 F.Supp. 219 (1959), said liability could be imposed vicariously on a ship owner for the malpractice of its onboard physician.

The Florida 3rd District Court of Appeal found Nietes to be “the most persuasive precedent” when it reinstated the Carlisles' claims in 2003. But the Supreme Court did not reach the merits in ruling last week that the case should be summarily dismissed for the sake of the “federal principles of harmony and uniformity.”

“The position espoused by the Third District has some appeal because much has changed in the world in the one hundred years since the earlier courts held ship owners immune from such [negligence] claims,” the opinion said. Nevertheless,

At the time the instant case was decided by the Third District, with the exception of Nietes, the federal maritime law uniformly held that a ship owner is not vicariously liable for the medical negligence of the shipboard physician.

Carlisle suffered a ruptured appendix after the doctor on board the ship Ecstasy who treated her for stomach pains diagnosed her with flu and prescribed antibiotics. The rupture and a related infection left her sterile.

The case was potentially very significant since most of the major cruise lines are based in Florida and their ticket contracts say suits should be filed there. The Supreme Court's decision means passengers are limited to suing doctors for malpractice –- which isn't much of a remedy since most ship's physicians are foreigners beyond the jurisdiction of U.S. courts.

"It's a perfect decision to be taken to the U.S. Supreme Court and I think it will be," a maritime attorney told the South Florida Sun-Sentinel.

If things get that far, Carlisle could certainly argue that the case law is no longer uniform. As the Illinois Court of Appeals noted in Mack v. Royal Caribbean Cruises, 838 N.E.2d 80 (2005),

Nietes and the federal cases that have followed its reasoning and holding indicate that the question of whether a vicarious liability claim against a shipowner for the negligent treatment by its on-board doctor will stand under maritime law is not settled [italics added] at this time.

The 3rd District, reversing a Miami-Dade County trial judge, recognized the “practical realities” of today's competitive cruise industry and that by having a doctor on board, a cruise line avoids the expense of evacuating an ailing passenger.

“The cruise line's duty of reasonable care under the circumstances includes the duty of the ship's doctor to adhere to the standard of care of a reasonable ship's doctor under the circumstances,” the court concluded.

By Matthew Heller
2/22/07