A federal appeals court has reinstated charges of vicarious liability against Royal Caribbean Cruises Ltd. in connection with the death of an elderly passenger who was allegedly incompetently treated by ship medical personnel after a fall.

Pasquale Vaglio was a passenger aboard Miami-based Royal Caribbean’s cruise ship “Explorer of the Seas” on July 23, 2011, when he fell boarding a trolley at a port-of-call in Bermuda and suffered a severe blow to his head, according to Monday’s ruling by the 11th U.S. Circuit Court of Appeals in Miami in Patricia Franza, as personal representative of the estate of Pasquale F. Vaglio v. Royal Caribbean Cruises Ltd., a Liberian corporation.

When he was taken to the ship’s infirmary, he was told by a nurse, who did not administer or recommend any diagnostic scans, that he was fine to return to his cabin.

After his condition deteriorated, he was seen four hours later for the first time by a shipboard doctor, who ordered Mr. Vaglio transferred to a local hospital, where he arrived another 2½ hours later.

“By that time, Vaglio’s life was beyond saving,” said the ruling. Although he was transferred to a hospital in Mineola, New York, the day after his fall, he remained in intensive care until he died a week later.

Mr. Vaglio’s daughter, Ms. Franza, filed suit in January 2013 against Royal Caribbean charging it with negligence in connection with her father’s death. The U.S. District Court in Miami dismissed the case in May 2013, citing a 1988 rule stemming from the decision by the 5th U.S. Circuit Court of Appeals in New Orleans in Barbetta v. S/S Bermuda Star.

The Barbetta rule immunizes a shipowner from liability whenever a ship’s employees render negligent medical care to its passengers, and “confers this broad immunity no matter how clear the ship owner’s control over its medical staff or how egregious the claimed acts of negligence,” according to the 11th Circuit.

A three-judge panel of the appellate court reinstated the charges against the cruise line in a unanimous ruling.

“Much has changed in the quarter-century since Barbetta,” said the decision. “As we see it, the evolution of legal norms, the rise of a complex cruise industry, and the progression of medical technology have erased whatever utility the Barbetta rule may once have had.”

“We thus decline to adopt the Barbetta rule, and find that the complaint in this case plausibly establishes a claim against Royal Caribbean,” said the ruling, in remanding the case for further proceedings.

In 2013, the parents of a child who had to undergo emergency brain surgery because of an injury he sustained while playing a ball game during a Royal Caribbean cruise filed suit against the cruise line, charging it with negligence. The case was settled in February 2014 for an undisclosed amount, according to court records.