Other medical incidents

Potential passengers should know that cruise lines exist outside the bounds of U.S. regulations. Almost all cruise ships are incorporated in foreign countries such as Panama and Liberia, allowing them to avoid U.S. taxes as well as labor and safety laws. The fine print on the back of the ticket spells out the company's limited (or lack of) liability for nearly anything that might go wrong, including a medical error.

If you book a cruise with Carnival, for instance, you're agreeing to a legally binding contract that describes the ship's physician as an independent contractor, and adds, "Guests use the services of all independent contractors at the Guest's sole risk." That means you can't sue the cruise line if something goes wrong.

There is adequate medical care onboard most cruises, and in the case of an emergency like a heart attack the guest will be airlifted off and taken to the closest hospital for treatment.

Of course, that hospital might be in a small Caribbean island country with different standards for medical care than you'd find back home, says James Walker, a maritime lawyer in Miami.

And, Walker adds, "for every story of someone getting medevaced, there are five stories of someone who was misdiagnosed with heartburn when they were suffering the precursors of cardiac arrest."

What you can do: Keep your own doctor's number handy, says Klein. If you start to feel worrisome symptoms, or the ship's doctor wants to administer a new medication, ask your doctor back home what he or she thinks. And always be sure to let the ship's doctor know medications you might already be taking to avoid dangerous drug interactions.

Be prepared

Bring an extra week's supply of your prescription medications. Make up a basic first aid kit with some gut-grief meds, headache relief and antacids. Maybe pack a flashlight. It can't hurt.

Just think about what might go wrong, Klein suggests, "and ask yourself, 'What can I do if it does happen so that I'm in control as opposed to somebody else being in control?' " Then, he says, "have a blast."

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