Fearful that New Orleans would run out of ventilators by early April as the number of COVID-19 patients rose by the hundreds, even thousands, per day, Louisiana officials set out to get every device they could find. At the time, that meant securing an additional 14,000.
Within days of President Donald Trump's urging states to get their own supplies because it would "be faster if they can get them directly," Louisiana sought only a fraction of them from the federal government and turned to private companies for the rest, having little confidence one supplier would give the state all it needed.
"If I knew for a fact that I could get all that I wanted from one vendor, I wouldn't be ordering from another," Gov. John Bel Edwards said March 31.
Louisiana set out to buy 9,000 from the private sector, where each device can cost tens of thousands of dollars.
"Medtronic Ventilators _ $88,000,000 for 2,000 ($43,500 a piece)!" Christina Dayries, a senior state official for homeland security and emergency preparedness, wrote March 27 to two colleagues about one type of high-acuity ventilator from medical device behemoth Medtronic, according to emails between Louisiana and Federal Emergency Management Agency officials on the state's pandemic response that KHN obtained through a public records request. The total order for the ventilators and related accessories amounted to $88.2 million.
The ventilator price is 23% higher than the $35,383 average price Medtronic was offering for the same model last year, according to market analysis from ECRI Institute, a nonprofit research firm.
Laws prohibit price gouging on precious resources during times of emergency _ such as gas prices during an oil shortage or water during a drought. But no such rules or laws applied as states like Louisiana _ which got an $88.2 million quote while bracing for a deadly pandemic _ scrambled to find essential medical equipment according to the laws of supply and demand.
One state health official said they didn't think there was "egregious price gouging" from manufacturers, but officials nonetheless had little choice but to pay what was asked. Louisiana also overshot orders out of fear that ventilators wouldn't arrive or that they would be sent elsewhere to a higher bidder.
Louisiana's hunt for thousands of ventilators underscores the crisis triggered by the federal government's lack of a coordinated response to the pandemic. It speaks to the "every man for himself" mentality promoted by the White House.
As Jared Kushner, Trump's son-in-law and a senior adviser, said in a daily press briefing April 3: "The notion of the federal stockpile was, it's supposed to be our stockpile. It's not supposed to be states' stockpiles that they then use."
Officials from other states, including Washington, Michigan and Minnesota, said in interviews that they have also ordered millions of dollars' worth of ventilators from private companies even as the Trump administration snapped up thousands of its own to replenish the Strategic National Stockpile.
Against that backdrop, Dr. Rebekah Gee, CEO of Louisiana State University's Health Care Services Division and the state's former health secretary, said she spent weeks "chasing every rabbit hole" to secure ventilators at the peak of Louisiana's outbreak.
"The most important thing in a disaster is clear communication," she said.
"We found ourselves competing against not only other states but hospital systems and even the federal government," said Dr. Joseph Kanter, an emergency physician and assistant state health officer for the Louisiana Department of Health.
"The private sector can be a dizzying place," he added. "When it's life and death, there needs to be some measure of additional coordination."
In a statement, Medtronic said the Louisiana price was given before the company in April moved to single, flat prices under which every U.S. customer pays the same cost for a particular ventilator model and configuration. The company would not provide the figure, but said the prices are lower than before the pandemic.
