Are cruise lines “dumping” their sick passengers?

Fred and Connie Claussen’s honeymoon cruise on Royal Caribbean’s Serenade of the Seas ended on a tragic note. During the voyage, Fred suffered a massive heart attack. The Serenade’s medical staff treated him and then diverted the ship to St. Kitts, where he was transferred to a hospital.

The Claussens are no strangers to tragedy. Fred lost his wife of 51 years to cancer, and Connie’s husband of 48 years died of heart failure. The retired couple, who live in Macon, Ill., met and married last year but postponed their honeymoon until February.

What’s different about this latest calamity — which ended their vacation and will most likely shorten Fred’s life — is that it may have been entirely preventable.

The ship’s decision to drop the Claussens off in St. Kitts proved to be a bad one, according to Connie. Conditions at Joseph Nathaniel France General Hospital were “nothing short of deplorable,” she says. The floors were covered with dried blood and vomit, and the emergency room frequently ran out of supplies. On several occasions, Connie had to take a cab to a pharmacy to buy medication for her ailing spouse.

“Absolutely nothing was done to improve Fred’s condition while we were in St. Kitts,” she says. “The doctor would come in and look at him once a day. She would not communicate with Fred’s doctors in the States.”

Fred languished in the hospital for five days without being given a stent, which aggravated his condition and permanently damaged his heart, Connie says. And then came the final insult: The hospital demanded $1,100 for its services before it would release him to an air ambulance that transported him to an American hospital — a payment that Connie calls a “bribe.”

Patrick Martin, the chief medical officer for the Federation of St. Kitts and Nevis health ministry, says that Claussen’s allegations are under investigation as a result of my inquiry. He notes that the hospital in question has received emergency referrals from cruise ships for many years, and he says that the goal of such hospitalizations is to provide “the best available medical care locally in order to stabilize such persons and subsequently ensure their successful airlift to their next destination.”

Royal Caribbean reviewed the Claussens’ situation and says it handled it by the book. But at least one expert says that the book is wrong: If cruise lines really cared about their passengers, they’d keep them far away from any hospital near a Caribbean port of call.

“There are many horror stories like this,” says Jim Walker, a maritime attorney based in Miami who represents passengers who he says are “dumped” in the Caribbean. “The typical complaints we hear are watches, jewelry and cash being stolen by hospital personnel; unsanitary conditions; windows with no screens; flies everywhere; and nurses cleaning the toilets and then changing their IV lines. Hospitals max patients’ credit cards out. And they’re held hostage until all bills are paid.”

Walker says that cruise lines have no legal duty to an injured or ill passenger, and that they are working hard to keep it that way. “Cruise lines have spent millions of dollars lobbying against efforts to change the law,” he says.

A Royal Caribbean representative denies that the couple was “dumped” in St. Kitts, saying that the Claussens were taken to Joseph Nathaniel France because it was the closest reliable medical facility.

“The health and safety of our guests is always our foremost concern,” says Cynthia Martinez, a cruise line spokeswoman. “The guest was taken to a hospital in St. Kitts so that they could receive lifesaving medical care as soon as possible.”

I asked Royal Caribbean about its policy on dropping off passengers and whether the Claussens could have done anything differently. It declined to answer. Walker says that cruise lines keep their policies on emergency care confidential.

Patrick Deroose, a general manager for assistance operations at International SOS, a company that offers medical evacuation services, says that the Claussens’ situation is not unusual and that the cruise industry’s policies, though not disclosed, are common knowledge.

“It is usual practice for a ship to offload a passenger with medical conditions to the nearest island hospital,” he says. “But that choice is not always the best for the passenger.”

How do you avoid a similar problem? Deroose says that you need to do your homework before you leave on a trip. If you bought travel insurance, read the fine print to make sure that medical evacuation is covered, and pay close attention to information about preexisting medical problems. If you have a condition that could flare up while you’re away, you might need a different policy or a separate medical evacuation plan, the kind offered by International SOS, Medjet Assist and other companies.

Claussen says that it’s too late for her and her husband. His heart is damaged beyond repair, to the point where he can’t even answer a reporter’s questions about his ill-fated honeymoon. His doctor blames the hospital in St. Kitts, according to Connie. Now, she says she wants to warn others.

“If the cruise line and insurance company looked into these hospitals and the kind of care available there, hopefully they could prevent this from happening to someone else,” she says.

Christopher Elliott

Christopher Elliott is an author, journalist and consumer advocate. You can read more about him on his personal website or contact him at . Got a question or comment? You can post it on the new forum.

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  • Michael__K

    Is the captain of a ship responsible for anything?  Or is it every passenger for him/herself?

  • ngbmd

    We were on Princess cruising to Hawaii when a passenger started having massive bleeding from the stomach ..there was a 2 am ship wide call for blood donors with Red Cross ID..2days later we arrived at the first Hawaiian island–he was transferred..

    The doctors (South African) and medical facility are state of the art! 
    The patient survived to be transferred under very difficult conditions (required many blood transufsions )- only surgery could have corrected the bleeding)

    Afte the event, the ship doctor gave us a tour of the facility (my husband & I are MD’s)–amazing what they are capable of doing short of invasive interventions like PTCA/surgeries…

    One other item that was mentioned, altho I am sure this rarely impacts on care on board:  It is thought that Americans are medical malpractice suit prone…the ship doctor mentioned that Princess has been sued many times for malpracice…mostly by Americans…the suit is dropped when the medical bills are “forgiven”.  In her experience, only a very small minority of passengers ( all nationalities) carry trip insurance.

  • Michael__K

    Even if you have medical evacuation coverage, if either:

    (a) you aren’t aware that the nearest hospital isn’t qualified to treat your condition

    or

    (b) your are travelling alone or you and your travel companion both have incapacitating medical emergencies and your tour operator doesn’t capture passenger insurance information

    … then you can’t take advantage of that coverage.

  • jerryatric

    I say it again. Coming to port, confirm people have the coverage, & call in Air Ambulance. Even if they are not covered the Cruise line could probably make arrangements. It’s true re entitlement, but as an old geezer I’m also FED UP with the lack of service, rudeness & just plain stupidity of some people in the service industry. Not to mention thieves ! I can regale you with personal horror stories.

  • Fit_to_be_tied

    What would you want that boat to do if the sick person were you or your father? At least having an understanding of where the better hospitals are is better than dropping someone off at an island where maybe they have horrible care. There should be a plan in place for emergencies in areas where care is bad. You don’t just drop a sick person off and leave them with no recourse. Sorry, but if you’re going to be in the cruise business you need to have this stuff mapped out.

  • Daves

    Feel better?

    DavidZ

  • Daves
  • Rosered7033

    Thank you for your knowledgeable information, Lindabator, here and in answer to other posts. You do a service for everyone who reads them!

  • Don Spilky

    74% would have kept the patient onboard? Any policy that doesn’t quickly get an emergent patient to a HIGHER LEVEL of care would be the irresponsible course.

    Don’t agree? Consider the case of any patient who is kept onboard, then crashes while 3 hours out at sea. These cruise line “sick bays” are simply not set up to do anything more than triage, bandage, medicate and release.

    Yes, I am an EMT.

    Interestingly enough, while the poll seems lopsided the only comments are from the minority vote. Chris – Is the poll reporting correctly?

  • Sting D’Ding

    While I do feel for the couple involved, travel – especially to what are considered less developed countries – involve inherent risks. Medical care is one of them. I do think we also need to consider the hospital in St. Kitts. As far as they are concerned, they received a patient and treated him to the best of their abilities and charged him a mere (compared with US medical rates) $1,100 for that. I think it is a little culturally insensitive to be hesitant to pay that bill when they received a service just because it wasn’t what you would expect in the US.

  • Pingback: Cruise Lines Avoid Liability to Sick and Injured Passengers — Cruise Ship Law Blog()

  • boboadobo

    TAKING A CRUISE IS JUST NOT WORTH IT! you are on a big nice ship, but they really can not do anything to help you! and just because you are on vacation does not make you immune to LIFE. if you survive long enough you will get dumped in a third world backwards joke of a “hospital” you want fun in the sun? go to fort lauderdale ,marco island or palm beach for a week ! nobody ever thinks they will be the one wishing they had not gone on the cruise. stay out of the third world. travelers diarrhea, mosquito born illness and other goodies aside.