• Health-Care Industry: Heal Thyself
• Trireme In New York City
• International Medical Case Management
• Travel Health: The Doctor Is In (Another Country)
• Dare to Care for your Crew!
• Advisory to Mariners
• WISTA
• Pushing Back When Insurers Deny Coverage for Treatment
• Panel Says New Jersey Won't Save All Hospitals
• New Services Help Unsnarl Medical Bills
• Just What the Doctor Did Not Order: Pre-Employment Examinations and ADA Liability
• What does a health crisis look like? See Houston
• U.S. stays vigilant against TB
• Lessons of Heart Disease, Learned and Ignored
• Food for thought, Healthier eats means healthier Crew!!
• Preventing the Tragedy of Misdiagnosis
• Who'll Treat Us as We Get Older?
• Caring for the Crew
• Seasickness—Coping with Mal de Mer
• Errors in healthcare: scope of the
  problem
• Suffering

Advisory to Mariners

Treating injuries or illnesses carries risks for both the crewmember and the Master or Chief Officer.  Failure to notify a doctor and delay of treatment endangers both the officers and the patient.

A recent case demonstrates how serious this may be.

Future Care was notified that a crewmember had been subject to high fevers, jaundice, incontinence of stool and urine, loss of consciousness and pain for several days.  By the time we were notified, the vessel was 3 days from closest port, and 5 days from destination.

The vessel had been in a port with a high incidence of Malaria.

Once we were notified, we determined that the likely diagnosis was Malaria and what medication should be taken.  There was a favorable response to the medication but unfortunately we could not be certain of the diagnosis and that that the favorable response would persist, and had to advise continued vessel diversion.  Had we been apprised of the situation initially, treatment would have been started earlier, and probably the diversion of the vessel and possible death of the crew member averted.

But why do we state this is a risk for the Master and Chief Officer as well?

The Master and Chief Officer are responsible by law to offer medical assistance to the crew when needed.  If they do not do so, they may be prosecuted for this failure.

The law firm of Goylos and Nassikas in Piraeus, Greece writes of a case in “Currents” the American Club magazine of November 2007 where even if the seamen were admitted to a hospital, their symptoms could have fooled the doctors. Yet the Master and Chief Officer were criminally prosecuted for failure to offer appropriate medical attendance.  In the case they describe, the local district attorney decided that even though the doctors could not immediately diagnose the situation (malaria) the Master and Chief Officer should stand trial on charges that they caused damage by negligence since they failed to timely notify a doctor.  These guidelines apply as directives from the U.S. Coast Guard for vessels traveling in U.S. waters.

Mistakes in diagnosis are made with the doctor at the bedside, so it is certainly understandable how an officer at sea can miss a diagnosis and harm somebody.  In this age of rapid communication there is no excuse for a Master not to request supportive medical professional advice in a timely manner.