What can you do when tragedy aboard a cruise ship is compounded by being handed a bill for substandard healthcare and ending in the death of your loved one? This question was brought home forcefully to one family, left unnamed here, who left the United States on February 27, 2011 on a Royal Caribbean cruise to the Caribbean. 

The day after departure, a family member -- a 75-year-old man -- suddenly became ill with cellulitis. At that time, the Explorer of the Seas was still within U.S. coastal waters. An airlift to a hospital onshore could and should have been arranged. Instead, the ship's doctor decided that the case was within his competency, and kept the patient on board for treatment. The patient's wife, of course, remained as well. 

As the doctor did not express any urgency about the patient's condition, the man and his wife fell into a false sense of security. Two days later, the man's condition had deteriorated significantly with sepsis setting in. The ship's doctor belatedly decided that hospitalization was necessary after all. By then, the nearest port of call was in the Dominican Republic, and so the critically ill patient and his wife were brought to shore to a waiting ambulance - not, however, without a last-minute impost from the cruise line. 

The nearest hospital was two and a half hours away in the town of Santo Domingo, and as the couple was getting into the ambulance, the wife had papers thrust at her. These turned out to be bills in the amount of $3,404.88 which represented the medical services provided on board. The patient was later airlifted from the Dominican Republic to Florida for further treatment -- something that would have been unnecessary if the evacuation had been done when he first fell ill -- but this effort proved unavailing. 

He died two hours later on March 5, 2011. The widow was shocked to see the $3,404.88 appear on her next credit card statement since she had never pre-signed for or approved any of the charges. This imposed charge seemed to add insult to injury, as she suspects that the actions and inactions of the ship's doctor was the causal factor that led to her husband's death.