LifeCare's Effort to Include Its Patients in the Evacuation

LifeCare's effort to include its patients in the evacuation from Memorial Medical Center became a test of whether a hospital within a hospital could be seen, counted, and moved as part of the same emergency. Diane Robichaux and Robbye Dubois sought transport for fifty-three LifeCare patients, including people dependent on ventilators, assisted breathing, or dialysis. Their attempts unfolded amid restricted communications and conflicting understandings of which agencies had responsibility. A brief offer of Coast Guard transport gave way to the discovery that LifeCare had not been included in Memorial's request, while assurances about a separate federal plan left the timing and arrangements uncertain.

A hospital unit outside the evacuation picture

Diane Robichaux was seven months pregnant and serving as incident commander for LifeCare's New Orleans hospitals. She had taken on the role so the senior administrator could leave the city before the storm with his family, including a child with special needs. At Memorial Medical Center, Robichaux was working on backup power with limited telephone and internet access, while also trying to manage patients at LifeCare's other campus near the New Orleans airport. Her responsibilities thus crossed both an institutional boundary inside Memorial and a geographic one across the city.

Memorial's leaders told her that the helipad was operational and LifeCare patients could use it. Robichaux relayed the information through a chat connection to Shreveport, where Robbye Dubois, LifeCare's senior vice president for clinical services, was coordinating from the corporate side. Robichaux sent a list of fifty-three patients who still needed evacuation. The list had begun with fifty-five; two patients had died. Seven of those remaining depended on ventilators, one on an assisted-breathing device, and five needed dialysis. The figures made plain that this was not simply a request to move a group of people: some patients depended on specialized support, and delays or transport arrangements mattered to their care.

An expected federal plan without a confirmed timetable

LifeCare's Shreveport staff had been in contact with Knox Andress, whom they believed worked with the Federal Emergency Management Agency. The staff understood that the agency and the Louisiana Department of Health and Hospitals knew LifeCare's situation and planned to evacuate patients on ventilators first. But Andress could not say when help would arrive. The message offered a broad assurance of awareness without a schedule or a definite route from the hospital to safety.

The distinction between apparent authority and actual authority later proved central to the confusion. Andress was a nurse at a Catholic hospital in Shreveport who had volunteered as a disaster-preparedness coordinator for northwest Louisiana after September 11. His title, HRSA District Regional Coordinator, came from a federal hospital bioterrorism-preparedness grant to the state. He took the volunteer role seriously and participated in training as both a student and a speaker, but he did not work for the Federal Emergency Management Agency. LifeCare's belief that it had a federal contact therefore rested on a mistaken identification, even though the contact himself was engaged in disaster-preparedness work.

The offer that disappeared

In midafternoon, Memorial made an urgent offer: LifeCare patients could leave on Coast Guard helicopters heading for Baton Rouge, and the unit had twenty minutes to decide. Before Robichaux and her colleagues could answer, the offer was withdrawn. The Memorial representative had assumed LifeCare patients were part of the patient count already sent to the Coast Guard. They were not.

Earlier that afternoon, Memorial incident commander Susan Mulderick had called an air-evacuation coordinator at the Coast Guard's emergency command center in Alexandria, Louisiana. She requested transport for two hundred people, a figure slightly larger than the number of Memorial patients. LifeCare's patients were absent from that request. Robichaux's message to colleagues in Shreveport made the omission explicit and emphatic. What had appeared to be a shared evacuation opportunity was instead a mistaken assumption about who had been counted.

That omission also exposed a mismatch in evacuation priorities. Memorial had been understood to be moving its critical patients first and then its other patients. From LifeCare's perspective, this meant that Memorial's less-sick patients might leave before LifeCare's generally much sicker patients. Dubois believed the helicopters were coming for both groups and that the hospitals were supposed to be included in a federal plan. She questioned how federal agencies could be coordinating without including LifeCare, and why patients with more urgent medical needs would wait behind less critical patients elsewhere in the building.

Calls, clarifications, and unresolved responsibility

A LifeCare staff member in Shreveport called Andress again, asking whether the unit would be included with Memorial. His reported response remained nonspecific: he had LifeCare's information and would get back to them; hospitals would be evacuated, but the order was unclear. Dubois continued calling people who might help and urged Robichaux to go to the helipad to explain directly to the Coast Guard that LifeCare was a hospital operating within Memorial and also needed evacuation.

Robichaux returned to Memorial's command center and came back with what seemed to her to be clarification. Memorial, she was told, was not using the Federal Emergency Management Agency to evacuate its patients. It was using the Coast Guard to take them to Baton Rouge, en route to other Tenet facilities. That explanation separated Memorial's arrangement from the federal plan LifeCare believed it was on. Yet the distinction did not establish when LifeCare would be moved. Robichaux relayed the clarification while still relying on the belief that the federal agency had LifeCare on its list and had a plan to reach it.

The episode occurred in a city where evacuation itself was already constrained. Residents without cars depended on public transport plans with acknowledged gaps, including too few drivers; traffic had trapped some people trying to leave, and dispatchers at the region's largest ambulance company, Acadian, faced a surge of calls. Some ambulances took patients to the Superdome rather than attempting to carry them out of town. Against that wider backdrop, LifeCare's problem was not a lack of awareness that evacuation was needed, but the absence of a dependable connection between separate plans and institutions.

What the effort reveals

LifeCare's exchanges show how a patient group could be physically located inside a hospital yet remain administratively outside its evacuation count. Information traveled through limited channels, across Memorial and LifeCare management, from New Orleans to Shreveport, and between people whose roles were understood differently from what they were. A list of fifty-three patients and specific medical dependencies could be transmitted, but the existence of the list did not guarantee inclusion in a transport request.

The effort also makes the stakes of fragmented coordination concrete. The larger disaster involved inadequate transport, poor communications, and uncoordinated rescue efforts; at Memorial, those systemic failures appeared in the gap between a twenty-minute offer and its withdrawal, and in repeated reassurances that did not provide a definite time or order. The available account establishes Robichaux and Dubois's attempts, the mistaken assumptions, and the competing understandings of who would evacuate LifeCare. It does not establish the eventual transport arrangements for the fifty-three patients, so the episode ends with responsibility and timing still unresolved.