The libellant, Otto J. Murphy, recovered judgment for maintenance and cure in an action brought in admiralty in the District Court for the Western District of Pennsylvania. The respondent, Murphy’s former employer, attacks the correctness of the judgment on two grounds. One raises the question of the sufficiency of the evidence to establish the fact of the accident and injury; the second presents a question of law.
We find no difficulty with the fact question. The respondent does not seriously contest the fact that Murphy had a fall upon the deck of one of the barges being towed by it on the night of December 1, 1946. The mate who testified for the respondent said he did not see Murphy fall, but did see him get up. Respondent presses the point that the evidence is insufficient to support a finding that Murphy suffered the back injuries he claimed to have sustained. There is some conflict in the testimony, as is usual in such cases. But both the libellant’s story and the medical testimony are entirely sufficient to establish the case for the libellant and the Trial Judge found in his favor. Respondent has made an appeal to common knowledge with regard to what happens to people who suffer back injuries of the type claimed here. We do not agree with the generalization made but, in any event, we think that it would be foolish of us to substitute any notions we have on this subject for the medical testi *63 mony which is in the case. That testimony need not be recited. It is credible, it convinced the Trial Judge, and we are satisfied with the conclusion reached.
The legal point is exceedingly interesting and some phases of it are novel. Murphy was discharged from the ship’s service shortly after the accident. At the time of his discharge he was given a slip, or ticket, by the ship’s officer which entitled him to receive medical treatment at a Marine Hospital. He went to the United States Public Health Service Relief Station at Gallipolis, Ohio, four miles from his home at Henderson, West Virginia. The first visit was the day after his discharge, but no one was there to give him service. When he returned nine days later the physician in charge made an external examination, but took no X-ray pictures. He strapped Murphy’s back with adhesive tape. Murphy went back again for further consultation and on this occasion the physician advised him to go to the United States Marine Hospital at Pittsburgh, Pennsylvania, telling Murphy that he had done all that he could do for him at Gallipolis. The doctor gave to Murphy at that time a written ticket, or order, which the physician assured Murphy would entitle him to admission to this hospital. Murphy objected to the trip because he said that the pain in his back was too great. He came back at another time to the same physician at Gallipolis and was given the same advice and made the same reply. It appears that there is a Marine Ward in the hospital at Gallipolis, where the doctor’s office was situated, but it does not appear why Murphy was not offered treatment in this hospital.
The respondent says that Murphy is not entitled to any award for maintenance due to his failure to go from Gallipolis to the Marine Hospital in Pittsburgh. It says that this failure amounted to a refusal of treatment and that a seaman who refuses treatment is not entitled to an allowance for maintenance and cure.
Decisions hold that an offer of hospital services is a fulfilment of the shipowner’s obligation to furnish maintenance and cure to an injured seaman. The Bouker No. 2, 2 Cir., 1917,
For the purpose of the discussion here we accept the rule of law there announced and applied. It is a logical application of the principles controlling the claim litigated here. When we speak of maintenance and cure in the admiralty law we really mean maintenance and care because, of course, the employer is not held at his peril to effect a cure. Loverich v. Warner Co., 3 Cir., 1941,
*64
Cases have held that the patient’s disinclination and refusal for further hospital treatment is not sufficient to put the burden upon the shipowner and with this we agree. United States v. Johnson,
9
Cir., 1947,
If that is all there were to this case we would be inclined to cut off libellant’s recovery for maintenance at the point where he refused to go to Pittsburgh for hospitalization. But there was another fact involved which we think prevents the point above discussed from determining the case. This man was not told to come in to a hospital in Gallipolis for treatment; he was told to take a trip of something between 200 and 300 miles to get that treatment. There is no word in the evidence as to the means by which he was expected to get there, or who would reimburse him for the money spent to travel.
It is worthwhile reminding ourselves of the orthodox rule that seamen are wards of the admiralty. The employer also occupies a position of guardianship, at least in the instance where the injury occurred on board the ship and he was aware of it before the seaman left the ship. Cortes v. Baltimore Insular Line, Inc., 1932,
We thus agree with the conclusion reached by the learned District Judge, although the conclusion is put on a somewhat different ground.
The judgment will be affirmed.
Notes
That the obligation is to reimburse tile seaman only for money actually paid out by him is illustrated by United States v. Johnson, 9 Cir., 1947,
