Regal Princess Medical Emergency in St. John's, Newfoundland

[Minne Wonka Girl]

September 22, 2015: http://www.cbc.ca/beta/news/canada/newfoundland-labrador/cruise-ship-mishandled-medical-emergency-for-canadian-couple-1.3310921

[WISH84]

September 22, 2015: http://www.cbc.ca/beta/news/canada/newfoundland-labrador/cruise-ship-mishandled-medical-emergency-for-canadian-couple-1.3310921

 

There are always two sides to every story and I bet this one has a 3rd called "attorney spin"

 

Just say'n

[moki'smommy]

Media reports tell a very one sided version of any story....and hindsight is always 20/20.

[GOLDENBONNY]

September 22, 2015: http://www.cbc.ca/beta/news/canada/newfoundland-labrador/cruise-ship-mishandled-medical-emergency-for-canadian-couple-1.3310921

 

I don't believe it at all. Wheel chairs available even for those fake needed ,who dance all night but then use wheel chair to be first get out of ship. There is more to this story.

[newcruzer2]

WOW, I'm stunned. Not only at Regal princess' mishandling of his EVac, but the letter the wife received from princess was a TRUE slap in the face. Citing all that stuff about .."well you agreed to ____". WHAT the heck, princess is trying to cover their, you know what, SHAME SHAME princess.

I sure hope this thread and story gets the attention it deserves and princess does right by them...

[Shogun]

Hi All

 

Do a search under I hate Princess, and you will get some interesting results.

 

yours Shogun

[fishywood]

Clearly not a news article but a press release from their attorney submitted to the paper. Why else would the paper have a copy of the letter from Princess to the client? Princess possibly now has grounds to void any settlement through arbitration due to violation of the confidentiality of the process. Which is fine with me.

Edited November 11, 2015 by fishywood

[Coral]

I hope the gentleman is doing better.

 

This is sad and it does sounds like somethings could have been handled better.

 

I thought the letter was quite rude as most spouses would be distraught if they were going through similar situations.

[cruisequeen4ever]

How sad! Though I have read so many examples of Princess's medical services saving pax's lives, this couple's experience was not up to snuff. I know the media runs with this stuff, but truly he should have been disembarked into an ambulance right when the ship docked and taken straight to the trauma hospital. I'm glad Princess apologized, and I hope they learned their lesson.

[kenorus]

Why defend princess, they apologized which means they screwed up! Really when we were on the ship in october stafv were absolutely horrible. Yes horrible! We are not picky people either, but staff were not great! Feel for this couple, hope he gets better!

[broberts]

Reading the letter from Princess leaves me disgusted.

 

I still don't understand how any competent medical authority would not take a cautious path and have an ambulance waiting.

 

The letter is quite clear, Princess knew the patient had bleeding in the brain. "The hellivac would have worsened the brain bleed . . ."

 

If the port agent could have a taxi waiting, why was it beyond their means to organize an ambulance?

 

My main takeaway is that unlike other cruise lines, Princess is incapable of having an ambulance waiting when a ship docks. So do not have a medical emergency aboard one of their ships.

[CZEE]

There are always two sides to every story and I bet this one has a 3rd called "attorney spin"

 

Just say'n

 

I agree,

 

Those of us with medical issues do take chances traveling. We should not expect the same level of care that we would get in our home countries. We can all second guess the doctor and Princess ad infinitem. If Princess is found to have done something wrong, they will get the "opportunity" to make amends.

[Coral]

 

My main takeaway is that unlike other cruise lines, Princess is incapable of having an ambulance waiting when a ship docks. So do not have a medical emergency aboard one of their ships.

 

The odd thing is that I have been on ships that have raced to port to disembark a passenger and an ambulance was waiting for the ship. This was just wrong.

[Cruzin-K]

Um. Wow! There is no excuse for not having an ambulance waiting at the ship, and disembarking the sick passenger first thing. No excuse at all. None.

[iceleven]

I've been on Princess when an ambulance was summoned. I think it was a Mexican port. It didn't appear to be a critical situation but the guest obviously needed a safe transport.

[satxdiver]

If you are sick on a ship, the ship will dock and then it is up to the local authorities to handle the emergency. The ship has no control over emergency services in a port foreign or domestic. St Johns, NL is a city of 100,000 in a metro area of just under 200,000 and is located quite a distance from Canada's largest cities. This is not the medical mecca so it is not a good place to have a very serious medical emergency unlike Toronto in this story.

 

That being said, the big question is if the ship did summons emergency assistance from the local authorities and they did not respond. The alternative at that point would have been to seek other transportation such as a taxi. The taxi driver not being a medical professional and seeing the problem would head for the nearest hospital which he did. The ship medical staff would naturally hold the patient until emergency aid was available which sounds like they may have done and then seek other avenues if that aid was not forthcoming. We have a lot of missing information.

 

Having a serious medical emergency while onboard a ship is not the best place to have it happen. But then we don't get to choose when and where. This though is not that much difference from say a medical emergency in the remote areas of the US west where a hospital of any kind can be 100's of miles away.

[broberts]

If you are sick on a ship, the ship will dock and then it is up to the local authorities to handle the emergency. The ship has no control over emergency services in a port foreign or domestic. St Johns, NL is a city of 100,000 in a metro area of just under 200,000 and is located quite a distance from Canada's largest cities. This is not the medical mecca so it is not a good place to have a very serious medical emergency unlike Toronto in this story.

 

That being said, the big question is if the ship did summons emergency assistance from the local authorities and they did not respond. The alternative at that point would have been to seek other transportation such as a taxi. The taxi driver not being a medical professional and seeing the problem would head for the nearest hospital which he did. The ship medical staff would naturally hold the patient until emergency aid was available which sounds like they may have done and then seek other avenues if that aid was not forthcoming. We have a lot of missing information.

 

Having a serious medical emergency while onboard a ship is not the best place to have it happen. But then we don't get to choose when and where. This though is not that much difference from say a medical emergency in the remote areas of the US west where a hospital of any kind can be 100's of miles away.

 

Just WOW! The patient lived. Despite a serious and complicated medical condition that through the actions of Princess did not receive the most prompt attention. And you wish to suggest that part of the problem is down to the fact that you do not think St John's has excellent medical facilities. Personally I think any North American city hosting a faculty of medicine and two adult hospitals with emergency care facilities is likely to offer excellent care.

 

Local authorities cannot handle a situation of which they are unaware. Based on the information provided by Princess it appears that they did not feel it necessary to tell anyone ashore of the medical emergency aboard.

 

The letter from Princess also makes clear that their port agent summoned a taxi for other passengers and the doctor on-board decided there was no reason to summon an ambulance. This despite knowing the patient had a brain bleed.

 

Princess erred. The port authority was not at fault and shares no responsibility for the situation. The fact an ambulance was not waiting for the ship is entirely down to the fact that for one reason or another Princess employees and its contractors did not treat the situation with the seriousness it deserved.

[moki'smommy]

We don't know the full situation, but it does appear that Princess dropped the ball in not having appropriate transportation available for this patient as soon as the ship docked. The personnel on the ship may not have the necessary information to choose a hospital for transfer (closest facility vs. one better able to handle a complex situation), but there is no excuse that I can see for not having an ambulance ready as soon as the ship is tied up..and the patient should have been evacuated as soon as that ambulance was ready to receive him.

 

On the other hand, there are plenty of issues in the published story that cause one to wonder--the wife who didn't know how to get help so she "just screamed," for instance. Every cruise ship I've been on has a button on the phone labeled "medical emergency" yet this individual couldn't think that far when an emergency occurred in her cabin. And she is upset with the insurance coverage they purchased, but obviously didn't read the fine print before the purchase. And the comment that the gentleman missed several weeks of rehab because he wasn't in Toronto...so one is left to guess that the hospital in St. Johns is not able to provide appropriate rehab. But if he is so ill that he'd need a medical evac flight, how is he stable enough for rehab?

 

Sorry, I think that errors were made, but also that this is an emotional ploy probably put forth by an attorney.

[newcruzer2]

 

local authorities cannot handle a situation of which they are unaware. Based on the information provided by princess it appears that they did not feel it necessary to tell anyone ashore of the medical emergency aboard.

 

The letter from princess also makes clear that their port agent summoned a taxi for other passengers and the doctor on-board decided there was no reason to summon an ambulance. This despite knowing the patient had a brain bleed.

 

Princess erred. The port authority was not at fault and shares no responsibility for the situation. The fact an ambulance was not waiting for the ship is entirely down to the fact that for one reason or another princess employees and its contractors did not treat the situation with the seriousness it deserved.

well said :)

[TracieABD]

I hope he is on the mend...

[Hlitner]

WOW! What an awful tale. But lets look at it step by step. The apparent decision not to call an ambulance was made by the ship's Physician. If it is the same physician we had on the Regal last week, the doctor is from Namibia! One could speculate as to the knowledge of this physician regarding the Canadian Health Care System. And that brings up the next issue which is how the patient was treated by the initial Canadian health care facility. It sounds like there was no effective triage when the group arrived at the facility....and we have even seen this happen at hospitals (I have worked in emergency rooms) in the USA. But finally the patient gets transferred to a facility capable of providing the necessary care. As to the insurance situation, that has nothing to do with the cruise line and is totally on the passenger buying the insurance. If the policy specifies only international transfers (a common clause in many travel policies) then the patient and family simply got what they paid for....even if that sucks.

 

But I cannot help but go back to ship physician. This has been a major issue for cruise lines for as long as there have been cruise lines. Many lines employ physicians from countries where the cost is simply cheaper. And they also like to use countries that can minimize future malpractice issues (try suing a physician from Namibia). But some other cruise lines have adopted a different attitude and tries to put their passengers first. For example, HAL only employees US or Canadian physicians who specialize in trauma. We have heard (but cannot verify) that all are now Board Certified or Eligible Traumatologists which is a good thing to have on any ship.

 

One can also find some interesting stories about medical care and related liability on cruise ships. Until recent years the cruise lines would hide behind International Maritime Law which worked to shield the line from any responsibility or liability. But there has been some cases in the US that have shifted some of the legal responsibility to the cruise lines.

 

Hank

[moki'smommy]

The cruise lines get the physicians they are willing to pay for. Many cruise lines do not hire medical center personnel directly, but work thru various companies that supply physicians and nurses to the cruise industry (Vantner Medical is one). However, the individual cruise lines still specify the qualifications for the personnel. On the positive side, the days of taking a year off between med school and residency and working for a cruise line are gone (fortunately!)

 

One can debate all day whether it is better to have a trauma specialist, an ER doc, or an internist. It all depends on what the issue that might happen on any given cruise could be. Most companies provide extensive shoreside consultation services to the on board physicians, but again, the physician must recognize the need and choose to take advantage of those services.

 

Many lines have chosen to employ only US, Canadian, or European trained physicians and to insist that they have excellent skills in English. That does not assure that they have an understanding of the medical system in the country where the ship might port, but again, communication between the doc, the captain, and the "ship's agent" at the port should quickly result in the appropriate transportation to a hospital as well as a proper decision as to whether a helicopter evacuation, speeding up the ship to arrive at port ASAP, or a diversion to another port is the most appropriate management for a patient.

 

There are far too many possibilities to cover all of them in a short article or post. However, I would not be comfortable with a doc trained in a third world country. And if this is the level of care that Princess provides, it could become a concern in choices of cruise lines.

[fishywood]

But I cannot help but go back to ship physician. This has been a major issue for cruise lines for as long as there have been cruise lines. Many lines employ physicians from countries where the cost is simply cheaper. And they also like to use countries that can minimize future malpractice issues (try suing a physician from Namibia). But some other cruise lines have adopted a different attitude and tries to put their passengers first. For example, HAL only employees US or Canadian physicians who specialize in trauma. We have heard (but cannot verify) that all are now Board Certified or Eligible Traumatologists which is a good thing to have on any ship.

 

When I took the UST on Star Princess the chief doctor told us that Princess (along with Cunard and P&O) still hearken back to their British management and only hire chief doctors and chief nurses who were trained and licensed in trauma in the UK or another Commonwealth nation (including Canada but not the USA). So the doctor you unfairly judge by his country of origin likely is licensed in South Africa or at the very least did his training in a 'first world' university hospital casualty department. The presumption that Princess or even their third-party recruiter would hire a doctor not fully qualified in emergency medicine for a long term contract that includes a trans-Atlantic voyage strictly as a cost savings measure is misplaced.

 

And good luck to any cruise line that thinks they can hire Board Certified trauma surgeons (or even board certified trauma nurses) from the USA to spend half a year or so away from their families working seven days a week for a small fraction of what they earn at home. It is astoundingly difficult, time consuming and costly for a surgeon to become Board Certified--they certainly have better things to do than work on a cruise ship once they make such an achievement. My mother was the office manager for a surgical practice and can vouch for that--as well as for knowing doctors and nurses who did work on US based cruise ships, none of whom had any trauma experience since their long-ago residencies and only took their short gigs on board for the free cabins for their family and friends. So permit me to be a little judgmental in that I would be worried if the ship's doctor was from the USA.

[PurpleHays]

In my cruise experience, I've only been to the medical center once (food poisoning from my last land-based meal). The doc that trip was from South Africa. He seemed quite competent from my nurse self opinion.

 

In this instance, not knowing all the details, I tend to lean more toward blaming the physician for not calling emergency services. If the patient was that sick, and no emergency services were available, at the very least he should have accompanied the patient to the hospital.

[moki'smommy]

 

In this instance, not knowing all the details, I tend to lean more toward blaming the physician for not calling emergency services. If the patient was that sick, and no emergency services were available, at the very least he should have accompanied the patient to the hospital.

 

I agree that the doc should have arranged transportation and communicated with a specific doc at the receiving hospital. As to riding with the patient to the hospital--that creates a whole other set of problems if he does ANYTHING after the patient leaves the ship. Unfortunately, this could be construed as practicing medicine without a license in the jurisdiction where the ship docked and is a criminal act.

 

I have personally dealt with this situation when I was called upon to assist a patient during an international flight. I insisted that the airline make arrangements to have a doc meet the plane on landing and that my services would end when the plane touched down as I was not licensed in the state where we would be landing.

 

I do understand that the authorities are unlikely to pursue a case when the doc is assisting in an emergency, but I am not willing to put myself and my family's future at risk. Sorry if that makes me a jerk. Arranging a smooth transfer of care is what is required.

 

As to US docs on cruise ships...I've never encountered any who weren't doing it basically as a short term "vacation" job, and these were not fully trained specialists. It is my belief that most cruise lines do not hire docs in these situations any longer.

Edited November 13, 2015 by moki'smommy