Nfld. & Labrador

Regal Princess mishandled medical emergency, says couple left stranded in St. John's 46 days

A retired couple from Toronto says cruise ship staff mishandled a serious medical emergency at sea that left the two in St. John's for 46 days and delayed care for the man, who had suffered a brain aneurysm.

Cruise ship didn't call 911 or rush disembarking process, company sends letter of apology

Ana Elisa Avelino discusses traumatic incident that saw her husband hospitalized 1:42

A retired couple from Toronto says cruise ship staff mishandled a serious medical emergency at sea that left the two in St. John's for 46 days and delayed care for the man, who had suffered a brain aneurysm.

"The nightmare that I never imagined became reality," wept Ana Elisa Avelino about the ordeal, which began in September.

Somebody from the port helped me to carry him to a taxi. To my surprise, four more people were put in the same taxi.- Ana Elisa Avelino 

Avelino and her husband, Cayetano Avelino, were on a long European cruise aboard the Regal Princess, which departed from Copenhagen. It was due to dock at St. John's — its only Canadian stop — the next day when Cayetano Avelino collapsed in the shower.

"He said, 'Please help me, something is wrong,'" said Avelino. "I didn't know how to ask for help. I started screaming."

Ship paramedics rushed her husband to the medical centre on board, suspecting bleeding in his brain. He was kept overnight.

Avelino, meanwhile, was told to pack the couple's bags in advance of disembarking. She thought she and her husband would be whisked off the ship to a local hospital, but that rush never happened.

Ana Elisa Avelino and her husband, Cayetano Avelino, says she was worried that at one point, she thought her husband was dying. (CBC)

'We lost precious time'

The largest cruise ship to ever visit St. John's, the Regal Princess had more than 3,600 passengers on board on Sept. 22.

The ship docked in the St. John's harbour around 8 a.m. Avelino said that instead of getting off first, she and her husband had to wait until other passengers disembarked first.

Princess cruise line mishandled medical emergency, didn't call 911 or rush disembarking process, company sends letter of apology 3:08

"Around 10 a.m., we were allowed to exit when everybody else had left the ship already," she said. "Why were we not allowed to leave as soon as we touch the port, if they suspect my husband had bleeding?"

There was no wheelchair to help or any ambulance waiting.

"We had to carry him. Somebody from the port helped me to carry him to a taxi. To my surprise, four more people were put in the same taxi," said Avelino.

The packed cab then sped off — not to the province's largest hospital, the Health Sciences Centre, which is equipped to handle major traumas. 

Instead, the Avelinos wound up at St. Clare's Mercy Hospital, a smaller facility closer to the harbour. 

Cayetano Avelino's diagnosis while aboard the cruise ship cited possible brain hemorrhaging. (CBC)

"My husband was at that point almost unconscious," said Avelino, who said she and the cab driver then dragged him out of the taxi and into the hospital's patient lineup.

"I wait 10, 15 minutes, and then I scream, 'My husband is really sick,'" said Avelino. "I didn't know what to do. I actually screamed. I thought my husband was dying at that point."

After that, Avelino said doctors swung into action. A diagnosis swiftly followed — a serious aneurysm. An ambulance rushed him to the Health Sciences Centre where he could be treated.

"They told me it's very serious, it's extremely complicated," wept Avelino, who said the medical team told her that if cruise staff had called 911 from aboard the ship, an ambulance would have taken her husband directly to the Health Sciences Centre for treatment. 

"We lost precious time." 

16-day coma, 46-day wait

Cayetano Avelino spent 16 days in an induced coma at the Health Sciences Centre with his wife never far away.

"In those days, we didn't know if he was going to make it or not," said Avelino, who said she spent much of that time in shock.

"I can't describe where the days went. I couldn't sleep."

I was thinking, at one point, to mortgage my condominium.- Ana Lisa  Avelino

When her husband woke up, doctors gave the green light to return to Toronto, but with one expensive catch: Cayetano could only travel by air ambulance at a cost of about $23,000.

The couple had travel insurance through Green Shield Canada, which covered air ambulances, but only to bring a patient back to Canada if they were outside the country.

The Avelinos' cruise was entirely international, except for the one stop in St. John's.

"I feel lost and abandoned. Abandoned because I was sure that the insurance was going to help me to get home sooner," said Avelino, who spent much of the ordeal on her own in St. John's, staying at the hostel attached to the hospital, racking up expenses.

The Regal Princess carried more than 3,600 passengers into dock in St. John's on Sept. 22. (Sobhana V)

"I was thinking, at one point, to mortgage my condominium." 

Green Shield Canada told CBC the Avelinos have an industry-standard policy meant to repatriate Canadians who get sick or injured abroad back into the Canadian health-care system.

Avelino said even re-reading the fine print of her policy didn't make that point clear.

"I want people to be aware that even when you buy insurance, you think you are protected and you are covered, but you are not."

The medical team at the Health Sciences Centre — Avelino called them "her angels" — eventually recommended the Avelinos fly commercial once her husband recovered.

The two flew home to Toronto on Nov. 7.

The cruise ship's company, Princess Cruises, has not responded to CBC's request for comment. But the company sent the Avelinos a letter apologizing for the ordeal. (Cecil Haire/CBC)

Cruise ship response

Still, Avelino is dogged by questions, as to why the staff aboard Regal Princess didn't call 911 immediately for her husband.

"I feel I am pretty sure that if prompt, faster help and better care had been given to my husband, we wouldn't have been here for so long," said Avelino who wonders had that emergency call been made from international waters, it may have helped with the insurance problem.

The CBC contacted the Regal Princess's parent company, Princess Cruises, for a response, but has not yet had a reply.

Avelino remains unsure if her husband will make a full recovery, and says he lost weeks of rehabilitation by remaining in St. John's. (CBC)

Princess Cruises sent the Avelinos a letter apologizing for the ordeal, and admitting that Cayetano Avelino should have been taken to hospital in an ambulance.

The company wrote that a taxi had already been arranged for other passengers who needed to visit the hospital, and the ship's doctor felt it would be faster than calling an ambulance.

Avelino said it still isn't clear whether her husband will make a full recovery.

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