The death of a tourist visiting Bermuda on a cruise ship more than a decade ago has created a legal precedent in the United States.

The ruling by a US appeals court would allow those injured on cruise ships to sue cruise lines for medical negligence by ship staff.

Pasquale Vaglio, an 82-year-old retired New York City policeman, was visiting the Island on board the Explorer of the Seas in August 2001, when he fell and struck his head shortly after leaving the vessel for a sightseeing trip.

He was wheeled back to the ship’s medical unit, where a nurse told him that he should rest in his cabin. Mr Vaglio and his family returned to their cabin but his condition steadily worsened, leading his daughter to contact ship personnel about 90 minutes later.

Mr Vaglio was seen by the ship’s doctor, who sent him to King Edward VII Memorial Hospital. He was subsequently airlifted off the Island but died a week later.

His family subsequently launched a legal action against Royal Caribbean, the cruise line that operates the ship, alleging that the ship’s medical staff had acted negligently by failing to diagnose his condition and failing to carry out or recommend any diagnostic tests.

Lawyers for the cruise line, however, argued that the “Barbetta Rule” protects the owners of a ship from allegations of medical negligence by its medical staff, who they argued in this case were independent contractors.

The District Court for the Southern District of Florida dismissed the case, but the Eleventh Circuit Court of Appeals recently found that the existing rules were outdated, and noted that the doctor and nurse wore cruise ship uniforms and were presented as ship employees.

In a decision, Circuit Judge Stanley Marcus wrote: “Much has changed in the quarter-century since Barbetta. As we see it, the evolution of legal norms, the rise of a complex cruise industry and the progression of modern technology have erased whatever utility the Barbetta rule once may have had.”

The ruling is not the end of the legal matter but, if not overturned, it will give the Vaglio family an opportunity to argue their case before the courts.