The short version
- 46 USC 11102 excepts voyages to a Canadian port by name, and its second limb needs an Atlantic to Pacific voyage.
- A Great Lakes vessel misses both limbs, so the federal medicine chest requirement does not reach the fleet.
- 42 CFR 71.21 does reach it, because the duty attaches to a ship destined for a US port.
- 42 CFR 71.2 prices that at up to $100,000 for a person, $250,000 where a death results, and $500,000 for an organisation.
- Winter layup is the blind spot: voyage-triggered rules go quiet while riding gangs are still aboard.
The medicine chest statute has a Canada exception, and the lakes are mostly Canada
A laker clearing Duluth for Thunder Bay is on a foreign voyage. It is also, by the express words of the statute, outside the federal medicine chest requirement.
46 U.S.C. 11102(a), the operative words
A vessel of the United States “on a voyage from a port in the United States to a foreign port (except to a Canadian port)”, and a vessel of at least 75 gross tons on a voyage between a US Atlantic port and a US Pacific port, shall be provided with a medicine chest.[1]
Two limbs, and a Great Lakes vessel misses both. The foreign trade of the lakes is overwhelmingly Canadian, which the statute excepts by name. And no lake voyage runs between an Atlantic and a Pacific port, so the 75 gross ton limb never engages either.
The statute walkthrough sets out the scope and the penalty in full. The consequence for this fleet is specific: the one federal law that requires a US vessel to carry a medicine chest does not reach a Great Lakes operation.
The duty that does reach you carries a penalty a hundred times larger
That exception makes it tempting to conclude the lakes are lightly regulated on medical matters. The opposite is true, and the mismatch is severe.
42 CFR 71.21 places a reporting duty on the master of a ship destined for a US port, covering any death and any ill person aboard.[2] A vessel returning from a Canadian lake port to a US lake port is destined for a US port. The duty attaches on exactly the voyage the chest statute excepts.
| Duty | Does it reach a Duluth to Thunder Bay round trip? | Maximum exposure |
|---|---|---|
| Medicine chest 46 U.S.C. 11102 |
No. Canadian ports are excepted by name[1] | n/a |
| CDC death and illness report 42 CFR 71.21 |
Yes. Written around the destination[2] | $100,000 individual, $250,000 where the violation results in a death[3] |
| CDC penalties, organisations 42 CFR 71.2 |
Yes | $200,000 per event, $500,000 where it results in a death[3] |
Set those numbers beside the medicine chest penalty, which the inflation table puts at $1,562.[4] The duty a Great Lakes operator is exempt from carries a four figure penalty. The duty they are not exempt from carries a six figure one.
The CDC reporting walkthrough sets out the definition of an ill person, including the fever threshold and the limbs that make a person reportable. It is the single most under-briefed duty on the lakes.
The hospital space rule reaches you, and modern lakers switch it
Great Lakes cargo vessels sit under Subchapter I, where 46 CFR 92.20-35 requires a hospital space on a vessel making voyages of more than 3 days duration between ports with a crew of 12 or more.[5]
Two things make this live rather than academic for the lakes. Long ore and grain runs cross the three day line comfortably, and lake crews routinely exceed twelve. But the section also contains a switch for vessels that berth crew in single occupancy rooms, which describes most modern lakers, and it converts the obligation into a differently specified room.
The hospital space rule in full covers that exception and what the substitute room must meet. Check which side of it your tonnage falls on before assuming the requirement does not apply.
A season, not a voyage, and the layup is the blind spot
Everything above is written around voyages. The lakes run on a season, and the regulatory model does not describe the part of the year the fleet actually finds hardest.
- Winter layup with crew aboard. Riding gangs, shipyard periods and fit-out crews are on the hull with no voyage in progress. Voyage-triggered rules are dormant. The people are not.
- Ice season transits. Distance to definitive care is at its worst precisely when the weather makes evacuation hardest.
- Seasonal crewing. The population turns over, so training and briefing decay between seasons rather than accumulating.
Planning by time to definitive care is the honest way to frame a January layup in a yard hours from a trauma centre, and the medevac decision is what the master faces when the answer is bad.
The layup question worth asking
Between the last discharge and fit-out, who is medically responsible for the people aboard, and which document says so? On most lake fleets the honest answer is that the voyage-based procedures went quiet and nothing replaced them.
What runs regardless of season or border
Three regimes do not care whether the vessel is trading, laid up or crossing into Canadian water.
| Regime | Trigger | Season dependent? |
|---|---|---|
| 46 CFR part 16, chemical testing[6] | Covered crewmembers, continuously | No. The random programme runs across the calendar year |
| 46 CFR subpart 4.06, incident testing[7] | A serious marine incident on US navigable waters | No. Two hours for alcohol, 32 for drug collection |
| 46 CFR part 199, survival craft equipment[8] | Inspected US vessels, by class | No. Kits expire on their own clock |
The testing programme is the one most often mismanaged on a seasonal fleet, because the random rate in 46 CFR 16.230 is an annual percentage and a fleet that only sails eight months still owes the full year’s selections. The MIS return due 15 March falls in the middle of layup, when the office is quietest.
Where anything in the chest is scheduled, 21 CFR 1301.25 attaches to whoever holds it, ashore or afloat, and disposal does not pause for winter. Our controlled substances service covers that layer year round.
Building a standard where the statute leaves you out
Being outside 46 U.S.C. 11102 is a legal fact, not a clinical one. The crew is the same distance from care whether or not a statute names them.
Because no federal contents list applies, the specification has to be authored and cited. Chest stocking works through the sources, and the flag state comparison shows how far apart registers are. Our ship medical chest management service writes and dates it.
Ashore, the owner and DPA split decides who owns the season, and the crew medical record has to survive a full turnover of seasonal personnel.
Six checks for a Great Lakes fleet
- Stop assuming the chest statute applies. Canadian ports are excepted by name, so your standard is voluntary and therefore yours to write.[1]
- Brief the CDC duty properly, because it attaches on the same voyage and carries penalties up to $250,000 for an individual.[2][3]
- Check the hospital space trigger and the single occupancy switch for each hull.[5]
- Write a layup medical annex. Voyage-based procedures go quiet in December.
- Run the random testing rate against the full calendar year, not the sailing season.[6]
- Diary 15 March for the MIS return, which lands mid-layup.[6]
Discovery Health MD is led by Ann Jarris MD, MBA, FACEP, a board certified emergency physician. Writing a medical standard for a fleet a federal statute expressly excepts, and testing it the way an audit would, is exactly the work our maritime medical consulting line does. Programme frame in the six decisions. Speak to the team.
Common questions
Does the US medicine chest law apply to Great Lakes vessels?
Generally no, and the exception is express. 46 U.S.C. 11102(a) requires a medicine chest on a vessel of the United States on a voyage from a US port to a foreign port, but it excepts a voyage to a Canadian port by name, and its second limb covers only a vessel of at least 75 gross tons on a voyage between a US Atlantic port and a US Pacific port[1]. Great Lakes foreign trade is overwhelmingly Canadian and no lake voyage runs between the Atlantic and the Pacific, so the fleet misses both limbs.
Does the CDC reporting duty apply on a Great Lakes voyage to Canada?
Yes, and it attaches on exactly the voyage the chest statute excepts. 42 CFR 71.21 places the duty on the master of a ship destined for a US port, covering any death and any ill person aboard[2]. A vessel returning from a Canadian lake port to a US lake port is destined for a US port. The exemption from one federal duty says nothing about the other.
What are the penalties under 42 CFR part 71?
Substantially larger than most operators expect. 42 CFR 71.2 provides for a fine of no more than $100,000 for a person where the violation does not result in a death, or no more than $250,000 where it does, and for organisations no more than $200,000 per event, or $500,000 where the violation results in a death[3]. By comparison the medicine chest penalty under 46 U.S.C. 11102 is listed in the Coast Guard inflation table at $1,562[4].
Do Great Lakes vessels need a hospital space?
Many do. 46 CFR 92.20-35 requires a hospital space on a vessel which in the ordinary course of its trade makes voyages of more than 3 days duration between ports and which carries a crew of 12 or more[5]. Long ore and grain runs cross the three day line and lake crews routinely exceed twelve. The section also contains a switch for vessels berthing crew in single occupancy rooms, which describes most modern lakers and converts the obligation into a differently specified room.
What medical rules apply during winter layup?
The voyage-based ones go quiet, and that is the blind spot. Riding gangs, shipyard periods and fit-out crews are aboard with no voyage in progress, so duties written around voyages are dormant while the people are not. The continuing regimes do not pause: the random testing programme under 46 CFR part 16 runs across the calendar year[6], serious marine incident testing under 46 CFR subpart 4.06 attaches to a casualty on US navigable waters whatever the season[7], and survival craft kits expire on their own clock[8].
Does a seasonal fleet owe a full year of random drug testing?
Yes. The minimum annual percentage rate in 46 CFR 16.230 is an annual figure applied to covered crewmembers, not a rate pro-rated to the sailing season[6]. A fleet that trades eight months still owes the full calendar year’s selections, spread reasonably through the year. The MIS return is due 15 March, which falls in the middle of layup when the office is quietest.
If the statute exempts us, why carry a medicine chest at all?
Because being outside a statute is a legal fact, not a clinical one. The crew is the same distance from definitive care whether or not a federal law names them, and ice season transits put that distance at its worst exactly when evacuation is hardest. No federal contents list applies to the fleet, so the specification has to be authored from the available sources and cited, which is the same discipline any flag state inspection would expect.
