Tenet Healthcare—Memorial Medical Center

Tenet Healthcare’s relationship with Memorial Medical Center during Hurricane Katrina was a strained partnership between a hospital making immediate decisions amid rising floodwaters and a corporate headquarters attempting to coordinate rescue from a distance. Tenet eventually secured private helicopters, but its role also involved delays in arranging transport for LifeCare patients housed within Memorial, gaps in communicating the hospital’s condition, and a focus on security and community evacuees alongside patients. The crisis revealed a sharp difference between corporate capacity to mobilize resources and the local staff’s need for timely, situation-specific support.

Corporate Oversight and Local Authority

Tenet’s involvement at Memorial was not confined to ordinary administration: as the emergency deepened, hospital leaders relied on corporate officials to help obtain transport and coordinate outside assistance. Yet the available account shows that operational decisions remained divided among Memorial’s incident command, clinical staff, LifeCare’s separate organization, and Tenet executives. That division mattered because patients’ evacuation depended on decisions made by people who were not all in the same place or working under a single command structure.

At Memorial, Susan Mulderick convened a hurried command meeting after staff learned that floodwaters were approaching. Karen Wynn recalled the shift in atmosphere from a hospital emergency to something resembling a military operation, with the immediate objective of acting before power failed. The group considered moving patients most dependent on life support and mechanical assistance first. At the helipad, however, the need to coordinate flights created its own authority conflicts: an Air Force captain offered her flight-line experience, and Richard Deichmann put her in charge; later, neonatal nurses successfully insisted that a pilot take their babies to the hospital prepared to receive them in Baton Rouge. These episodes show local professionals improvising within a fragmented response, rather than simply carrying out a unified corporate plan.

The relationship also existed against Memorial’s longer history as a hospital where access had been shaped by racial exclusion. Jannie Burgess, an African American nurse who had worked for decades in New Orleans hospitals and nursing homes, had been born shortly after Memorial opened in 1926, but it took more than four decades before she could be a patient there. That history is relevant to the institution entrusted with her care during the evacuation: the crisis placed patients into categories and systems that could reproduce unequal vulnerability, even when the immediate rules were presented as clinical or logistical. Memorial’s decision to send patients with do-not-resuscitate orders last was made by its doctors; the evidence does not establish it as a Tenet directive. Its consequences nevertheless became part of the wider institutional relationship between corporate coordination and care at the hospital.

LifeCare Patients and the Approval Chain

The clearest point of friction between Tenet and Memorial concerned LifeCare, which operated a patient-care unit inside the hospital. As Coast Guard helicopters began arriving, LifeCare patients had not yet been moved. Memorial’s proposed arrangement was to seek approval from Tenet’s corporate overseers to transport LifeCare patients with the Coast Guard. Why corporate permission was necessary for LifeCare to use federal rescue assets was left unexplained. From Memorial’s command center, community relations manager Sandra Cordray contacted Michael Arvin at Tenet, but her message did not convey the urgency LifeCare staff felt.

Cordray later sent Arvin the contact details for LifeCare’s Robbye Dubois and noted that no more National Guard trucks would be available that day because the water had risen too high. Meanwhile, some Memorial patients had already been transported toward Nacogdoches. Dubois waited for authorization to send ambulances and expected the process to take hours; after she finally reached Arvin, she reported that ambulances would go to a staging area, with critical patients first, but that movement might not begin until morning. LifeCare’s staff planned to proceed even if backup power failed and computer communications were lost, expecting patients to start moving between three and eight a.m. The sequence illustrates how a hospital evacuation could be slowed by a corporate approval chain even as local staff were trying to prepare for the loss of power and communications.

Tenet’s coordination also intersected with an ethical distinction that staff feared could affect outcomes. At Memorial, officials were beginning to recognize that helicopter sizes and the time required to move patients meant not everyone might get out alive. LifeCare employees likewise worried that the order in which patients left could shape their medical prospects. These concerns arose within the institutions’ evacuation process; they should not be mistaken for proof that Tenet ordered the patient-prioritization rules.

Resource Mobilization and Conflicted Messages

Tenet did eventually use its corporate reach to arrange air transport. In Dallas, Arvin made contact with a private aviation logistics company, which began lining up helicopters for Thursday morning. These were ordinary aircraft typically used for firefighting and other work, though Tenet executives began calling them air ambulances. Shortly before ten that night, the company confirmed Tenet’s signed contracts for six helicopters of different sizes, expected to converge on Memorial from around the country beginning early the next morning.

The company’s descriptions of the emergency, however, emphasized concerns beyond patient evacuation. Tenet planners told officials that they needed help moving about eight hundred community members who had taken refuge at Memorial, framing the movement of residents by boat as their real need. Corporate communications also stressed security problems and the presence of people with weapons. An update Tenet distributed for hospital communications managers stated that martial law was in place in New Orleans, a claim the narrative identifies as untrue. Such messages show how reports moving through corporate channels could shape the perceived problem, while the factual situation at the hospital remained difficult to convey.

The disconnect was especially consequential after electronic communications failed. Tenet executives had generally been out of touch with Memorial since the previous evening and did not mention in their requests for help that the hospital had lost power. They could have inferred the loss from the sudden disappearance of electronic communications and Cordray’s warnings the night before. In a later message to a Navy captain, Tenet regional senior vice president Bob Smith described Memorial as unsecured, said that gunfire prevented evacuation, and reported that people were dying in the building and that lives were in immediate danger. This was a grave account of what Tenet believed it had learned, but it came after a period in which the company’s communications had not conveyed the hospital’s power loss clearly.

Evacuation, Aftermath, and Institutional Contrast

On Thursday morning, Memorial’s chief financial officer, Curtis Dosch, used a working cell phone to speak with Smith in Dallas and confirm that Tenet was dispatching the contracted helicopters and a satellite phone. Staff gathered around the update, but still wanted specifics about when and how they would leave—answers Dosch and Mulderick could not provide. They were told that more boats and helicopters were expected and that everyone would somehow be evacuated that day. The announcement brought evidence of corporate action, but not the certainty or immediate control exhausted staff were seeking.

The book sets Memorial’s experience beside the response at Charity Hospital, where conditions were at least as severe in important respects: flooding, power loss, failed plumbing and communications, no helipad, and no corporate overseer to assist. Charity took until Friday afternoon, September 2, to transfer all its patients, a day later than Memorial, and had roughly twice as many patients across its campuses with fewer staff per patient. Yet fewer than ten patients died. Its staff had prepared for a Category Three hurricane and levee failure, used portable generators fueled with siphoned gasoline to power ventilators and monitors, sustained routine care and morale, and sent the sickest patients out first. The contrast does not reduce the difference between the institutions to a single cause, but it makes plain that corporate rescue capacity alone did not determine how care and evacuation unfolded.

A later account of preparation for Hurricane Sandy supplies a further comparison. A nonprofit hospital parent organization maintained a local command center and offered assistance to its own hospitals and others, a level of organized support described as different from what Tenet and LifeCare headquarters had provided during Katrina. Even in that better-organized setting, some staff had not planned for the failure of backup power’s backup plan. The comparison presents the Tenet–Memorial relationship as part of a broader problem of emergency preparedness: corporate coordination can mobilize resources, but it cannot substitute for shared plans, accurate situational awareness, and authority that reaches the people making decisions at the bedside.