Location: At sea; Gibraltar and Malaga, Spain; Zagreb, Croatia.


Case Summary:  Crewmember complained of severe abdominal pain at sea and the captain contacted Future Care, who provided Physician Advice at Sea telemedical treatment until the ship reached Gibraltar.  Future Care also appointed a medical case manager who prepared the crewman’s admission to the hospital, alerted the hospital treatment team, made all necessary transportation and financial arrangements and explained her role to all parties.


During the crewman’s three-day hospitalization medical case manager reviewed progress with the medical provider, reporting developments to the shipowner and family members.  The crewman did not respond to treatment as expected, and the treatment team and medical case manager agreed that he be should transferred to a facility greater medical resources in Malaga, Spain.  Future Care’s medical case manager liaised with the new treatment team beforehand and made all the necessary arrangements to smooth admission to the new hospital.


The crewmember was initially diagnosed with acute pancreatitis, which was subsequently complicated by obstructive jaundice and biliary stenosis. He was eventually stabilized and requested continued in his home country of Croatia. The medical case manager identified an appropriate medical escort for the flight from Malaga, Spain to Zagreb, Croatia and facilitated the flight arrangements with medical escort and crewmember’s wife to Croatia.


Upon repatriation the crewman was admitted to hospital in Zagreb, where he was diagnosed with pancreatic cancer and underwent five chemotherapy sessions.  During his prolonged treatment in Zagreb Future Care’s medical case manager reviewed and facilitated treatment, maintained communication with the crewman and his family, explaining treatment and evaluating options, and reported developments and costs to the shipowner.  Eventually, after much treatment, the crewman recovered, assessed as Fit For Duty and returned to sea.


Estimated Savings through Future Care Intervention:  The shipowner saved tens of thousands of dollars through Future Care’s medical case manager’s successful efforts in improving the efficiency of treatment; selecting the appropriate facility in Croatia to provide specialized treatment during the crewman’s lengthy illness; facilitating transpiration and admission to several hospitals; managing treatment through convalescence and a return to Fit For Duty.