772 F.3d 1225 (11th Cir. 2014)
In July 2011, Pasquale Vaglio was a passenger on the Explorer of the Seas, a cruise ship owned and operated by Royal Caribbean Cruises, Ltd.1 On July 23, after the ship docked in Bermuda, Vaglio fell while boarding a trolley at or near the dock and suffered a severe blow to the head.2 He was taken in a wheelchair to the ship's infirmary around 10:00 a.m.3
There, nurse Racquel Y. Garcia, allegedly employed full-time by Royal Caribbean, examined him and observed a lump and an abrasion on his head but did not administer any diagnostic scans.4 Vaglio was advised he was fine to return to his cabin and might have a concussion, and he returned around 10:45 a.m. with no further care.5
About ninety minutes later, at 12:15 p.m., Vaglio's condition deteriorated, leading his daughter-in-law to call 911.6 After delays in obtaining a wheelchair and credit card information, Dr. Rogelio Gonzales, also allegedly an employee of Royal Caribbean, examined Vaglio at about 1:45 p.m., started a Mannitol drip, and ordered transfer to King Edward Memorial Hospital in Bermuda, where Vaglio arrived at approximately 4:22 p.m.7
Vaglio was airlifted to Winthrop-University Hospital in Mineola, New York, the next day and remained in intensive care until he died one week later.8 On January 10, 2013, Patricia Franza, Vaglio's daughter and personal representative of his estate, filed a three-count complaint against Royal Caribbean in the United States District Court for the Southern District of Florida under 28 U.S.C. § 1333 and the general maritime laws, alleging negligence by the onboard medical staff under actual and apparent agency theories.9 The district court dismissed the complaint on May 30, 2013, and Franza appealed to the United States Court of Appeals for the Eleventh Circuit.10
Whether a passenger may invoke the principles of actual agency to impute to a cruise line liability for the medical negligence of its onboard nurse and doctor?11
Under the general maritime law, a shipowner may be held vicariously liable for the medical negligence of its onboard employees under the doctrine of respondeat superior.12 To establish such liability, the plaintiff must show three elements: (1) the principal acknowledged that the agent would act on its behalf; (2) the agent accepted the undertaking; and (3) the principal exercised control over the actions of the agent.13
Yes. Franza's complaint plausibly alleged each element of actual agency under the general maritime law.14 Royal Caribbean acknowledged that Nurse Garcia and Dr. Gonzales would act on its behalf by employing them full-time, paying their salaries directly, owning and operating the medical center, and holding them out as crew members to passengers and immigration authorities.15 Both medical professionals accepted the undertaking by performing their duties as the ship's nurse and doctor within the scope of employment.16
Royal Caribbean exercised control by paying salaries directly, owning the medical center, requiring uniforms with its logo, placing staff under superior officers' command, and billing through its Sign and Sail Card system.17 The alleged negligent acts occurred within the scope of employment.18
The district court's dismissal of the actual agency claim is reversed because the complaint states a plausible claim for vicarious liability under actual agency principles.19
Whether a passenger may invoke the principles of apparent agency to impute to a cruise line liability for the medical negligence of its onboard nurse and doctor?20
Under the general maritime law, a shipowner may be held vicariously liable for the medical negligence of its onboard medical staff under the doctrine of apparent agency.21 The plaintiff must establish that the principal made representations to the plaintiff that the alleged agent was authorized to act for the principal's benefit.22 The plaintiff must also show that he reasonably believed the alleged agent was so authorized.23 Finally, the plaintiff must show that he detrimentally and justifiably relied on the appearance of agency.24
Yes. Franza's complaint plausibly alleged each element of apparent agency.25 Royal Caribbean made representations to Vaglio by promoting its medical staff as employees through brochures and advertising, describing medical centers in proprietary language, billing passengers directly, requiring logo uniforms, holding staff out as crew members, and introducing the doctor as an officer.26 These representations caused Vaglio reasonably to believe the staff were authorized to act for Royal Caribbean's benefit, as the cruise line encouraged the perception as a marketing tool.27
Vaglio relied to his detriment on this belief by following the advice without further testing while in Bermuda and by not following up after being told he had no serious injury.28 This reliance was justifiable given the ship's control over care and lack of alternatives at sea.29 The district court's conclusion that the apparent agency claim was inadequately pled is therefore incorrect.30
The district court's dismissal of the apparent agency claim is reversed because the complaint states a plausible claim for vicarious liability under apparent agency principles.31