Medical removal against passenger's wishes

[slabeaume]

On my 1st cruise, my Dad almost drowned on a ship sponsored excursion. We were on a Disney cruise at their private island. That's when I found out the medical department on board was not even part of the cruise line---they are hired in and the nurses and Dr.'s he saw were certified in the states or Canada and chose to leave their hospitals for 6 month rotations to work on the cruise ship. I suspect all the cruise lines are that way. His care on the ship was excellent, but they were very limited, in fact the portable intubation machine they had malfunctioned and they had to manually intubate him for several hours. Originally they wanted to take him to Grand Bahamas and send him to the hospital there, but after I inquired about getting him back to the states, thankfully they were able to arrange for a med jet to pick him up in Grand BAhamas and take him to Fort Lauderdale. We were actually met at sea and Dad was transported onto a tug boat for the trip to Grand Bahamas (they opened the hatch and sent him over in a basket -- still being hand intubated, and I jumped over to the tug boat). From time of accident to hospitalization was 9 hours! I can see why they would be a little leary of dismissing symptoms easily. I really doubt the captain has much choice but to do as the Dr. recommends knowing how long it would take to get to a proper medical facility if it became a real emergency.

 

I know that doesn't answer your question since in our case the evacuation was necessary, but I can see why they would make that decision seeing what all is involved in an emergency. I've been on several cruises since then and have never set foot in the medical department again and hope that I never have to. But I'm still amazed that on almost every cruise we've been there has been some kind of medical evacuation. I wonder how many more people were evacuated by tub boat?!

Edited May 30, 2014 by slabeaume

[sail7seas]

I would expect that the decision to medically remove a passenger is pretty much made by the senior medical officer on board. The Captain is certainly notified and involved, but I doubt that he would ever override the decision of the medical officer. Especially in a case where the person is removed during a normal port stop. To put is simply it would place him at considerable professional risk with little to gain to override the medical officers decision.

 

Clearly if the ship has to change course, schedule, or meet with a helicopter the Captain will be much more involved in the decision and the exact degree of urgency. There is no indication in anything that the OP stated that the removal from the ship was anything other then a normal port stop.

 

To put it another way the Medical Officer determines the what (passenger evacuation needed) the Captain determines the when and how based upon the degree of urgency from the medical officer.

 

I agree the Captain would only in the most unusual circumstance overide the doctor's recommendation the guest be medically evacuated and most assuredly if in port there would be little question.

 

However, my point is on a ship, the Captain is the final word in all circumstances. He relies upon his specialists in medicine, engineering, plumbing, security etc but the last word is Captain's.

 

That was my only point and I 'stand by it'. :)

The Captain will always be the one who will be blamed or praised thus he/she is the one who has the final word.

 

[BruceMuzz]

I agree the Captain would only in the most unusual circumstance overide the doctor's recommendation the guest be medically evacuated and most assuredly if in port there would be little question.

 

However, my point is on a ship, the Captain is the final word in all circumstances. He relies upon his specialists in medicine, engineering, plumbing, security etc but the last word is Captain's.

 

That was my only point and I 'stand by it'. :)

The Captain will always be the one who will be blamed or praised thus he/she is the one who has the final word.

 

 

Sail,

 

Under international maritime law, the Captain has the final say on every subject except one.

The Ship's doctor has final say on any medical issue.

Legally the Captain cannot over-rule him/her.

The logic behind this based on the doctor's specialized knowledge - and the fact that the medical condition could possibly affect the Captain.

[Copper10-8]

There's one more issue as it relates to a medevac by United States Coast Guard helicopter in their area(s) of responsibility; the USCG flight surgeon at the/a Coast Guard Air Station has to agree with the ship's doctor and the need to perform an aerial medevac, before a helo is dispatched on the mission

[sail7seas]

Sail,

 

Under international maritime law, the Captain has the final say on every subject except one.

The Ship's doctor has final say on any medical issue.

Legally the Captain cannot over-rule him/her.

The logic behind this based on the doctor's specialized knowledge - and the fact that the medical condition could possibly affect the Captain.

 

 

Thanks for the clarification, BruceMuzz.

 

Makes sense.

[sail7seas]

There's one more issue as it relates to a medevac by United States Coast Guard helicopter in their area(s) of responsibility; the USCG flight surgeon at the/a Coast Guard Air Station has to agree with the ship's doctor and the need to perform an aerial medevac, before a helo is dispatched on the mission

 

 

Thanks, Copper.

That, too, makes sense. :)

 

[POA1]

There's one more issue as it relates to a medevac by United States Coast Guard helicopter in their area(s) of responsibility; the USCG flight surgeon at the/a Coast Guard Air Station has to agree with the ship's doctor and the need to perform an aerial medevac, before a helo is dispatched on the mission

 

Welcome back!

[treasure4two]

Has anyone been medevacked from a HAL cruise against their wishes? While on a cruise last year my mom went into a coughing fit due to her throat being sore, which made her cough and have difficulty breathing. She called 911 and had oxygen administered and then felt much better. She told the doctor that she felt better, but when the medical staff found out her medical history included heart problems they insisted she be removed from the cruise and sent to the hospital. She repeated several times that she felt fine, but they had made their decision.

 

Upon arrival at the hospital she had to wait a week until they would release her pending the outcome of tests they insisted on doing, even though the entire time she insisted she felt fine. The tests came back clear and she was released less than 24 hours later, but not before being presented with a bill for several thousand dollars which This troubles me greatly, because I think these types of cases will make people think twice about making that call to the ship's medical department for fear of being removed from the ship. Just because someone has a less than ideal medical history, does that mean HAL doesn't want the responsibility of having them as a guest? Is anyone familiar with their policies and guidelines for medical evacuation, or is the decision strictly up to the discretion of the attending physician?

 

her insurance company is refusing to pay because of the “pre-existing condition” clause.

 

My question, did your mother buy the insurance within 14 days or whatever the insurance company required to cover pre-existing conditions? Thank you.

[serendipity1499]

her insurance company is refusing to pay because of the “pre-existing condition” clause.

 

My question, did your mother buy the insurance within 14 days or whatever the insurance company required to cover pre-existing conditions? Thank you.

 

Umm..

 

This thread was started by the OP almost three months ago & brought back up again this week..

 

Therefore, you probably will not get an answer from the OP & as she mentioned in subsequent posts that was not why she posted about the insurance company..

 

However, I for one am glad it was brought up again as we got to hear both Bruce Muzz's & Coppers answers about the Medical Officers & the Coast Guards decision's on this subject.

Edited May 31, 2014 by serendipity1499

[sail7seas]

Umm..

 

 

<snip>

 

However, I for one am glad it was brought up again as we got to hear both Bruce Muzz's & Coppers answers about the Medical Officers & the Coast Guards decision's on this subject.

 

 

I agree.

Those were both very interesting posts.

 

[slabeaume]

In my Dad's case, he wasn't transported by the Coast Guard. A private company with jet ambulances was sent for him. I was told a helicopter couldn't go that far. How far can they go?

[Copper10-8]

In my Dad's case, he wasn't transported by the Coast Guard. A private company with jet ambulances was sent for him. I was told a helicopter couldn't go that far. How far can they go?

 

Depends on the branch of service involved/where the ship is at, and the helo type; USCG uses two different types of aircraft. Depending on the air station and area of responsibility, you'll either see the HH-65 Dolphin (range 345 nm) or the larger Sikorsky HH-60 Jayhawk (range 700 nm)

 

There have been rescues /medevacs performed off cruise ships beyond the helos operational range but there are only a few services that can perform those type of missions and they will involve an aerial refueling from an accompanying flying tanker. A California Air National Guard unit from Moffett Field in the Silicon Valley performed such a mission off HAL's Westerdam in the Pacific last year