A U.S. federal appeals court has rejected a key argument that has shielded cruise lines from liability in medical malpractice cases brought against cruise ship doctors.

A three-judge panel of the 11th Circuit Court of Appeals overturned a lower court ruling that said cruise lines were not responsible for the actions of doctors onboard.

The decision came in a lawsuit filed by Patricia Franza against Royal Caribbean Cruises Ltd. in U.S. District Court for the Southern District of Florida.

Franza’s father, Pasquale Vaglio, sustained a head injury on Explorer of the Seas and later died. Franza sued alleging medical care provided on the ship was negligent.

The district court dismissed her claim against RCCL, applying a longstanding rule established in the 1988 Barbetta vs. Bermuda Star case, holding that cruise lines aren’t liable for the actions of medical staff on their ships.

The appeals court, however, rejected the reasoning in Barbetta, and sent the case back to the trial court for further action.

The court’s opinion said the rationale that cruise lines aren’t qualified or in a position to evaluate the professional judgment of physicians, and thus don’t control them as employees, is not valid.

Federal judge Stanley Marcus, who authored the opinion, wrote that the roots of Barbetta “snake back into a wholly different world. Instead of 19th century steamships, we now confront state-of-the-art cruise ships that house thousands of people and operate as floating cities complete with well-stocked modern infirmaries and urgent care centers.”

“In place of truly independent doctors and nurses we must now acknowledge that medical professionals routinely work for corporate masters,” Marcus wrote.

He added that modern communication allows much closer supervision of ships than in the past. “In short, despite its prominence, the Barbetta rule now seems to prevail more by the strength of inertia than by the strength of its reasoning,” he said.

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