Memorial Medical Center—LifeCare

Memorial Medical Center and LifeCare Hospitals of New Orleans shared a building during the Katrina disaster but remained distinct institutions, with separate patients, command structures, and corporate interests. Their relationship shifted from practical coordination to conflict over who would be evacuated, when, and under whose authority. LifeCare staff worked to get critically ill patients out, while Memorial’s decisions and the requirement to seek corporate approval slowed access to rescue resources; the resulting delays left vulnerable patients exposed and later shaped investigations and legal disputes.

Shared Building, Separate Responsibilities

LifeCare operated a hospital unit inside Memorial, so its patients depended on Memorial’s physical infrastructure and evacuation routes while remaining under LifeCare’s care. As the crisis deepened, the elevators stopped working, complicating the movement of patients who needed dialysis or could not descend stairs without help. LifeCare’s director, Diane Robichaux, pressed for Memorial to accept some of the most critical patients if possible. Her colleagues planned to meet patients wherever helicopters deposited them and arrange onward transport by ambulance or Angel Flight. Their immediate priority was patients dependent on ventilators and dialysis.

That shared space did not produce a unified evacuation plan. Memorial wanted a list of ambulatory LifeCare patients first, a reversal of the earlier focus on getting the sickest and most dependent patients out. By then, a patient Anna Pou had tried to resuscitate had died, and only seven of LifeCare’s fifty-two surviving patients were on the list. Robichaux regarded transport by boat as a way to get at least some patients moving, even if they were not the most critical. The change in priority exposed the gap between the urgent needs of LifeCare’s patients and the categories Memorial was using to manage evacuation.

Rescue Assets and Delayed Coordination

As United States Coast Guard helicopters began landing at Memorial, LifeCare’s patients still had not been moved. Memorial proposed asking Tenet Healthcare for permission to transport LifeCare patients using the federal rescue helicopters. The need for corporate approval to use those assets was unclear to LifeCare staff. From Memorial’s command center, community relations manager Sandra Cordray contacted Tenet about the request, but the message was framed around prioritizing Memorial’s own patients rather than conveying LifeCare’s urgency. The proposed arrangement was that Memorial would bring LifeCare patients to a staging area outside New Orleans, where LifeCare could meet them with ambulances and take them to Baton Rouge.

Around eleven at night, a Coast Guard Jayhawk helicopter arrived with a mission to begin evacuating all remaining patients. Someone at the helipad told its crew that no patients still needed to leave and that the helicopter should return after daylight. The crew instead flew to Tulane Hospital with an Acadian coordinator and medical equipment, leaving Memorial without any patients aboard. At that point Memorial had reduced its census from 187 to about 130, but all fifty-two LifeCare patients remained on the seventh floor, including seven who depended on ventilators.

The delay continued overnight. Coast Guard personnel wanted to resume rescues, particularly after learning about the ventilator-dependent patients, rising water, and the possibility that power would fail within hours. A doctor asked Richard Deichmann what to tell a Coast Guard officer seeking to send more helicopters; Deichmann said to send them in the morning, judging it too dangerous to reopen the helipad and believing staff needed rest. Memorial incident commander Susan Mulderick discussed the issue with Robichaux. With the elevators out, Robichaux said her team needed extra hands to carry the most critical patients downstairs. Mulderick said the men available to help had gone to bed, and Robichaux agreed to wait until daybreak. Morning would also allow LifeCare to send its own ambulances and move patients to other LifeCare hospitals, a plan that could ease the handoff while keeping patients within the company’s system.

Evacuation Categories and Patients at Risk

By Wednesday morning, staff at Memorial and LifeCare had more than one hundred patients to move. Unable to locate enough official color-coded triage armbands, doctors and nurses adopted a paper-based system. Patients who could sit up or walk were labeled 1 and prioritized first; those needing more assistance were 2; and the very ill, along with patients who had DNR orders, were categorized 3 and assigned last priority. Pou helped coordinate the movement, while staff and family members searched for cots and stretchers and carried patients to the second-floor lobby.

The improvised categories shaped where patients waited. Roughly three dozen 1s from the two institutions were brought to the emergency-room ramp, where the initial plan was to send them out by airboat. Gina Isbell of LifeCare and Karen Wynn of Memorial oversaw their care there. Around seventy 2s were placed along a corridor leading toward a passage to the parking garage and helipad. Approximately eighteen 3s waited in a corner of the lobby near a Hibernia Bank ATM and a planter of striped dieffenbachia. Staff continued basic care: changing diapers, fanning patients, and giving sips of water when patients could drink. But once patients left their rooms on Wednesday, most other medical interventions were limited. A DNR order meant that a patient whose heartbeat or breathing stopped should not be resuscitated; it did not mean that the patient should not be rescued. In practice, however, the evacuation system placed DNR patients last.

That distinction became painfully concrete on both floors. A bed-bound Memorial patient with a DNR order was repeatedly passed over as other patients were moved around her, and staff were told not to tell her daughter that the order was the reason. When the daughter learned what was happening, she said she had not understood DNR to mean that her mother would be left behind. She asked for the order to be canceled, and the patient was moved downstairs and toward the helipad. On LifeCare’s seventh floor, Angela McManus likewise tried to rescind her mother Wilda’s DNR order after learning it was delaying evacuation; staff told her there was no doctor available to do so.

Four LifeCare patients were eventually taken by Coast Guard helicopters and successfully transferred to other hospitals. Five other ventilator-dependent patients did not make it out. One died while being carried down a staircase; another, a woman in a deep coma with a DNR order, never left the seventh floor. Memorial staff came to LifeCare to say that patients with DNR orders could not go. These outcomes show how an institution’s evacuation categories could turn a clinical instruction about resuscitation into a practical barrier to rescue.

Investigation and Unequal Aftermath

After the disaster, the distinction between the two institutions became part of the dispute over responsibility. During the investigation, prosecutors’ concerns included the possibility that the grand jury would hear Memorial nurses’ accounts without hearing LifeCare witnesses. A draft letter from the attorney general’s team argued that jurors appeared to believe LifeCare staff had failed to care for their patients and had not tried to evacuate them. The letter said jurors had not been shown messages documenting LifeCare’s efforts to arrange an evacuation or the confusing directions it received from Memorial, and that LifeCare employees and administrators had offered to testify voluntarily. A Memorial operating-room nurse manager also criticized LifeCare, suggesting its nurses had been sleeping on the job. The competing accounts made the hospital’s internal boundary consequential well beyond the evacuation itself: it affected which actions the public and investigators understood as effort, delay, or abandonment.

The nurses who had worked for LifeCare experienced lasting consequences. Gina Isbell continued to have nightmares about her patients and felt that she had been permanently changed by the storm and its ending, though she remained convinced that she and her colleagues had done the best they could. Cheri Landry, meanwhile, described losing her job as worse than losing her home and questioned whether she and Lori Budo would ever be able to work as nurses again. Their uncertainty and distress belonged to the aftermath of a disaster in which responsibility was divided among staff, hospital leadership, corporate offices, and rescuers, while patients in the same building waited under different institutional arrangements.

The legal consequences also followed separate tracks. LifeCare had settled years earlier with families who sued. Claims against Memorial Medical Center and Tenet Healthcare over deaths and injuries connected to electrical-system deficiencies, preparedness, and evacuation plans proceeded as a class action and were settled before trial for $25 million, without an admission of wrongdoing. Checks were not distributed until 2013, and families objected in court to what they considered inadequate compensation. The settlement did not resolve the deeper question raised by the shared building: when two healthcare institutions relied on the same endangered facility, who had the authority—and the responsibility—to get each patient out?