Who Pays for medical turnback expenses?

[dockman]

Just got off a very strange NCL cruise from miami to rio....the ship was being moved to MIA for use as a hotel in the Olympics so it was to be nonstop 11 days MIA to RIO...

 

about five days out off the coast of Venezuela the captain announced an on board medical emergency...eventually they were unable to get a helicopter to fly out for the evacuation so we turned around and sailed 8 hours back to Barbados where patient was taken off...and the n they had to load more fuel to cover the unexpected 16 hour out of way trip...

 

Many aboard wondered who would have to pay the likely large fuel bill for the ship to sail an extra 16 hours?...and of course to top it off the ship ultimately arrived very late in RIO meaning most people missed flights as well as the people in RIO had to wait an extra 12 hours to board...

 

Frankly I was somewhat surprised that they were apparently unable to get a helicopter to fly out as that would seem to be much less expensive than a 4000 passenger monster ship having to turn around and sail backwards..

 

Anyone know how this would all work, who would pay, and why no helicopter?

[Sir PMP]

Just got off a very strange NCL cruise from miami to rio....the ship was being moved to MIA for use as a hotel in the Olympics so it was to be nonstop 11 days MIA to RIO...

 

about five days out off the coast of Venezuela the captain announced an on board medical emergency...eventually they were unable to get a helicopter to fly out for the evacuation so we turned around and sailed 8 hours back to Barbados where patient was taken off...and the n they had to load more fuel to cover the unexpected 16 hour out of way trip...

 

Many aboard wondered who would have to pay the likely large fuel bill for the ship to sail an extra 16 hours?...and of course to top it off the ship ultimately arrived very late in RIO meaning most people missed flights as well as the people in RIO had to wait an extra 12 hours to board...

 

Frankly I was somewhat surprised that they were apparently unable to get a helicopter to fly out as that would seem to be much less expensive than a 4000 passenger monster ship having to turn around and sail backwards..

 

Anyone know how this would all work, who would pay, and why no helicopter?

 

Well, you were off the coast of Venezuela!! No money, no helicopter...

[joepeka]

Without knowing a little more about the logistics (i.e. exactly where the ship was when the emergency occurred), I would guess that there was no medical evacuation-capable helicopter within range of the ship. As to who would pay for the additional fuel, etc., I'm guessing the cruise line would just absorb that cost - or perhaps they have some sort of contingency insurance just for this type of situation.

 

I would like to hear chengkp75's opinion on this.

Edited August 8, 2016 by joepeka

[Copper10-8]

J.....................................

 

Frankly I was somewhat surprised that they were apparently unable to get a helicopter to fly out as that would seem to be much less expensive than a 4000 passenger monster ship having to turn around and sail backwards..

 

Anyone know how this would all work, who would pay, and why no helicopter?

 

No helicopter and crew available for a medevac from a ship at sea has everything to do with accessibility (organization/equipment/range/training) and, if that's in place, capability of the organization that is to fly out to, orbit the ship, and perform a successful medevac. Looking at both the Venezuelan Air Force and Navy, it doesn't appear that they have the assets, nor the capability, to perform a medevac by helicopter from a ship at sea. Guyana and Suriname don't have the assets. The French in their Guyana certainly do, as do the Brazilians, but your ship, from what it sounds like, was too far north to make use of those services, hence the return to Bridgetown

[dockman]

No helicopter and crew available for a medevac from a ship at sea has everything to do with accessibility (organization/equipment/range/training) and, if that's in place, capability of the organization that is to fly out to, orbit the ship, and perform a successful medevac. Looking at both the Venezuelan Air Force and Navy, it doesn't appear that they have the assets, nor the capability, to perform a medevac by helicopter from a ship at sea. Guyana and Suriname don't have the assets. The French in their Guyana certainly do, as do the Brazilians, but your ship, from what it sounds like, was too far north to make use of those services, hence the return to Bridgetown

 

interesting indeed....seems somewhat amazing that Venezuela would not have that capability ...originally the captain said they were hoping to get a helicopter from Trinidad but they were unable to do it at night and it was getting dark....

[sail7seas]

There have been a great many reports bout hee horrid financial conditon of Vene3auela.. they are barely feeding tyheirr perople. Not shocking they wouldn'gt have rewsources for a med-evac from a cruise ship atsty sea.

[sail7seas]

There have been a great many reports bout th horrid financial conditon of Venzauela.. they are barely feeding tyheirr perople. Not shocking they wouldn'gt have rewsources for a med-evac from a cruise ship t sea. Who knows if the ship's doctor approv edd igt and if gthere were addquate facilities to care for the patientwweretrhey left in VEvneuezla.

Edited August 8, 2016 by sail7seas

[navybankerteacher]

interesting indeed....seems somewhat amazing that Venezuela would not have that capability ...originally the captain said they were hoping to get a helicopter from Trinidad but they were unable to do it at night and it was getting dark....

 

Helicopters are short range aircraft to begin with. If Trinidad (about 200 miles south-southwest of Barbados) was concidered as an option - and you had been that far away from Barbados, you must have been well off-shore of the mainland. Venezuela is an almost-failed state and might simply not had a medevac capability. Looking at a map you are hard put to identify many likely alternatives to Barbados.

[Copper10-8]

interesting indeed....seems somewhat amazing that Venezuela would not have that capability ...originally the captain said they were hoping to get a helicopter from Trinidad but they were unable to do it at night and it was getting dark....

 

The Trinidad and Tobago Air Guard certainly has the capability, having had four Agusta-Westland AW-139 multi-mission helos in operation since 2011 plus one Bell 412EPI helo configured for Search And Rescue (SAR) since 2015. The TTAG crews have been training constantly under the guidance of foreign ex-military helo crew members working for manufacturer Agusta-Westland. That training has included hoisting operations to and from ships at sea, a prerequisite for successfully performing the 'real thing'

 

Check out this article and the training with the Cape Dawson, a passing commercial tanker, about 2/3 down

 

http://www.verticalmag.com/features/startingfromscratch/

 

Edited August 9, 2016 by Copper10-8

[take us away]

So Copper - does HAL cover the medevac costs or recharge the passenger?

[chengkp75]

As for the fuel cost, port cost, etc, of any evacuation, the cruise line will absorb that cost, though mostly through their P&I insurance, and to make it short and sweet, P&I is really self-insurance. The fuel bill for the diversion would be around $40k.

 

National agencies will not charge for their services in SAR or medical evac. But a cash strapped country like Venezuela can just say that assets are not available.

 

As for the Venezuela part of it, just because you are along the coast of a country doesn't mean that there is an airport or hospital close by. A lot of that coast is pretty undeveloped, so the helicopter would have to travel a long way.

 

John seems to have a handle on the assets in the area, so I'll leave that discussion to him. The flight surgeon of the SAR service will also have a lot to say about whether a helicopter evacuation is warranted. They need to weigh the risk to the patient (winching accident, aircraft failure, time out of the care of a facility, etc) to the reward of getting the patient to a hospital sooner. In most cases, the ship's medical facility can provide better care than the helicopter, so if the patient is stable and not in a life threatening condition, moving the ship trumps the helicopter.

[dockman]

As for the fuel cost, port cost, etc, of any evacuation, the cruise line will absorb that cost, though mostly through their P&I insurance, and to make it short and sweet, P&I is really self-insurance. The fuel bill for the diversion would be around $40k.

 

National agencies will not charge for their services in SAR or medical evac. But a cash strapped country like Venezuela can just say that assets are not available.

 

As for the Venezuela part of it, just because you are along the coast of a country doesn't mean that there is an airport or hospital close by. A lot of that coast is pretty undeveloped, so the helicopter would have to travel a long way.

 

John seems to have a handle on the assets in the area, so I'll leave that discussion to him. The flight surgeon of the SAR service will also have a lot to say about whether a helicopter evacuation is warranted. They need to weigh the risk to the patient (winching accident, aircraft failure, time out of the care of a facility, etc) to the reward of getting the patient to a hospital sooner. In most cases, the ship's medical facility can provide better care than the helicopter, so if the patient is stable and not in a life threatening condition, moving the ship trumps the helicopter.

 

thanks for the info....glad to hear that at least the guy wouldn't have to pay the fuel bill...word was that he broke his back but nobody seemed sure of that....

[CruiserBruce]

thanks for the info....glad to hear that at least the guy wouldn't have to pay the fuel bill...word was that he broke his back but nobody seemed sure of that....

 

Yep....make someone else pay...or was it a crew member?

[sail7seas]

Yep....make someone else pay...or was it a crew member?

 

 

Perhaps the broken back was the result of an accdent where the ship may have been careless to clean up a spill. and HAL is in line for 'some liabiltity for the accicdent? Merely speculation.

Edited August 9, 2016 by sail7seas

[chengkp75]

Yep....make someone else pay...or was it a crew member?

 

Perhaps the broken back was the result of an accdent where the ship may have been careless to clean up a spill. and HAL is in line for 'some liabiltity for the accicdent? Merely speculation.

 

Doesn't really matter who it was, or whether the company has any liability or not, the cost of the diversion is eaten by the P&I insurance.

[sail7seas]

Doesn't really matter who it was, or whether the company has any liability or not, the cost of the diversion is eaten by the P&I insurance.

Thanks. :) Makes sense.

[Viesczy]

So I guess after all this discussion the real meaning is, that unless the bone is sticking out and you're unable to stop the bleeding, don't alert medical! :D

[chengkp75]

So I guess after all this discussion the real meaning is, that unless the bone is sticking out and you're unable to stop the bleeding, don't alert medical! :D

 

Huh? There are risks and rewards to a helicopter evacuation, if it is possible, and both the ship's doctor and the flight surgeon will determine if it is in the patient's best interest to risk an evacuation. But, if the patient is stable, then the risk of an evacuation outweighs any benefit of getting from one clinical setting (ship) to another (hospital).

[jtl513]

... and HAL is in line for 'some liabiltity for the accicdent?

 

Doesn't really matter who it was, or whether the company has any liability or not, the cost of the diversion is eaten by the P&I insurance.

Especially since it was an NCL ship. ;)

[dockman]

Yep....make someone else pay...or was it a crew member?

 

 

No idea as captain didn't share that kind of info and the info about

"broken back" was a rumour going around the ship but not sure if that was the case or not.

 

I do know it created chaos for a lot of the pax who were due to fly out of rio that night aug 4 as very few if any hotels were available so a LOT of pax who missed flights and had to sleep in the airport...the late ship was made even worse by total screw up by Brazilian immigration folks who took FOUR HOURS to clear the ship and return 700 passports to the pax.....It was truly total CHAOS...We were supposed to arrive aug 4 at 8 am...ship arrived at 6 pm but coudn't get passport and get off til approx 10 pm....

[Nanobot]

I have worked in Maritime SAR (Search and Rescue) on ships and ashore for many years before retirement, and would add the following. Rescue of a person in distress, such as this broken back case, can take many avenues to be resolved. The ship would have called a Maritime Rescue Co-ordination Centre and in consultation with the ship, the Centre would develop a plan on how to remove the person and transport them to a place to be treated. In the considerations of what to do would be the capabilities of the cruise ship, location of other ships in the area and the capabilities of air transport along the route to the treatment centre. Execution of plan would then be monitored until the patient is received at a treatment centre. In this case it was most expedient to have the ship steam back and rendezvous with the helicopter.

 

In my past the Canadian Coast Guard has used the Westbound Queen Elizabeth and more recently Queen Mary2 to transfer patients from distant fishing vessels and bring them closer to shore so that the patient could be flown by SAR helicopter to shore. This was more expedient than trying to get a slow fishing vessel to come back to rendezvous with a helicopter, plus there is a Doctor on the Cunard ships.

 

Background: The International Convention on the Rescue of Persons at Sea (the SAR Convention) and the United Nations Convention on the Law of the Sea both cover the requirements nations must abide to as part of their contribution to the world-wide Search and Rescue network. These services are provided without charge to the victims. This is based on an axiom 'the comity of mariners' where it is known over the last 2,000 years of maritime trade that it 'could be me being rescued' and I would want to be treated the same.

[easyboy]

As for the fuel cost, port cost, etc, of any evacuation, the cruise line will absorb that cost, though mostly through their P&I insurance, and to make it short and sweet, P&I is really self-insurance. The fuel bill for the diversion would be around $40k.

 

National agencies will not charge for their services in SAR or medical evac. But a cash strapped country like Venezuela can just say that assets are not available.

 

As for the Venezuela part of it, just because you are along the coast of a country doesn't mean that there is an airport or hospital close by. A lot of that coast is pretty undeveloped, so the helicopter would have to travel a long way.

 

John seems to have a handle on the assets in the area, so I'll leave that discussion to him. The flight surgeon of the SAR service will also have a lot to say about whether a helicopter evacuation is warranted. They need to weigh the risk to the patient (winching accident, aircraft failure, time out of the care of a facility, etc) to the reward of getting the patient to a hospital sooner. In most cases, the ship's medical facility can provide better care than the helicopter, so if the patient is stable and not in a life threatening condition, moving the ship trumps the helicopter.

Thanks for your insight.

[Sequim88]

Nanobot - thanks for the insights.

 

Searched for "the Comity of Mariners" and got half a dozen results for the Seattle Mariners. Google must figure that was my interest. :rolleyes:

 

Searching just Comity and got definitions. Never too old to learn me a new word. ;)

Edited August 9, 2016 by Sequim88

[Hlitner]

There are multiple issues in this thread. Regarding being off the coast of Venezuela, this is currently a country in huge political turmoil (many would now call it a "failed state") where it is inadvisable for many citizens of other countries (especially the USA) to enter. Helicopter operations with cruise ships are a risky venture (at best) and the cruise lines must use lots of discretion when considering if a helicopter operation meets the safety requirements of the cruise line.

 

As to the additional cost of a ship diverting to disembark a medical emergency....the additional cost (both fuel and otherwise) is not passed onto the passenger in distress. To quote a recently retired cruise ship Captain (a personal friend) "the health and safety of both my crew and passengers always take precedence, regardless of cost."

 

Hank

[Sonora5]

Very interesting discussion. Thanks to all.