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A federal appeals court has refused to reconsider a decision that opens the door for cruise ship passengers to sue for medical malpractice.

The 11th U.S. Circuit Court of Appeals rejected a bid by Royal Caribbean Cruise Lines to revisit the ruling. The court noted that none of the 11th Circuit judges voted in support of reconsideration.

Royal Caribbean could still appeal to the U.S. Supreme Court. A company spokesman said legal options are under review.

The ruling last year reversed 100 years of court precedent that effectively protected cruise companies from being sued for medical negligence aboard ships.

The decision came in the case of retired New York City policeman Pasquale Vaglio, who died after hitting his head on an excursion in Bermuda.