A Tip, Subterfuge And Lots Of Money: A Mass. Hospital Executive On The 'Pursuit Of PPE'

As chief physician executive at Baystate Health in Springfield, Dr. Andrew Artenstein says he rarely gets involved in the purchase of protective equipment like masks. But that was before the coronavirus pandemic.

In a New England Journal of Medicine article published on Friday, Artenstein describes the lengths he and other hospital staff went to recently in order to secure a shipment of masks.

They found out about the supplies through "an acquaintance of a friend of a team member." They paid five times the amount the hospital would normally pay for such a shipment. Artenstein himself drove to a small mid-Atlantic airport to review the order when it arrived. Then, he says, the FBI showed up.

Artenstein says the hospital system had to take these unprecedented measures as supplies dwindled and patients kept being admitted.

"These patients were coming fast and furious," Artenstein tells WBUR. "Sick patients were filling our hospital and other hospitals. And you need to be able to protect the staff. We didn't feel like the cavalry was coming to rescue us."

Artenstein spoke to WBUR Morning Edition host Bob Oakes about the struggle to get protective equipment, and his worries about getting future supplies. The following transcript has been lightly edited for clarity.

Bob Oakes: I have to say that your story sounds something like a movie script. Set the scene for us: what were you looking to buy and from who? 

Dr. Artenstein: Our supply chain people have been sourcing various avenues, uncovering every rock, lifting every stone to try to find these supplies. We came across a lead that they vetted appropriately, both for the fact that these [suppliers] had a track record of being in the business and that they could actually — potentially— get their hands on a fairly large quantity of the N95 type respirators as well as normal three-ply face masks that would supply us for a number of weeks.

So several members of your team flew down to a small airport in the mid-Atlantic region and you drove down. And in addition to you, you [brought] two tractor-trailers that were disguised, so to speak, as food service vehicles to put this equipment in. Why?

We were concerned that perhaps crossing different state lines, we could run into some trouble with medical supplies, especially with PPE, if trucks were so marked. We just wanted to take every possible precaution once we obtained this equipment, that we actually got it back to our health system where it was so desperately needed.

After you got there, you opened some of the boxes to make sure that you were getting what you were paying for. And then you proceeded to load the trucks and were approached by two FBI agents. What happened? 

The FBI agents— after they identified themselves appropriately — told me that their job was to ensure that all personal protective equipment got to either health systems, hospitals or first responders. In other words, they were there to ensure that it wasn't going to funny places or to resellers or to some kind of black market. I had all my appropriate identification. They seemed to be satisfied with that.

But even then, after they released the equipment and it was loaded onto the trucks, you were worried about the federal Department of Homeland Security. You learned that they were considering seizing the shipment and redirecting it somewhere else — probably to the federal stockpile?

What we were told was that after the agents said we were good to go and my understanding was the trucks would be loaded and they'd be off, several hours went by and nothing was going on. Then our team learned that it was being determined by Homeland Security whether they would exercise an option they apparently have, and that is the option to redirect or take such equipment.

"Our team learned that it was being determined by Homeland Security whether they would exercise an option they apparently have, and that is the option to redirect or take such equipment."

Dr. Andrew Artenstein

And it took a member of the [Massachusetts] congressional delegation to intervene to make sure that you would get the equipment and that it wouldn't be seized by homeland security. 

It took a number of calls, correct. And a lot of work.

So I have to ask: do you have enough equipment now or are you still struggling to maintain the supply?

Well, it's a good question. It is not resolved. This is not over. This very basic need is still not addressed. For instance, we've had a lot of difficulty and we're running out of disposable gowns. These are basic tools to care for patients. Same thing with the N95 small size masks. A lot of our caregivers wear small size masks and those are very difficult to get.

Are you getting any help from the state? Do you feel as if Gov. Charlie Baker and the state are doing all they can to help you out? Or is the state falling short in that regard?

First of all, I feel that the state government has acted in the best way possible. I think Gov. Baker and his team and the whole Department of Public Health, they've been good partners in this. But I think that they, judging from his comments I hear at the press conferences, they have the same concerns and the same limitation.

You write toward the conclusion of your story in The New England Journal of Medicine that the experience might be an entertaining tale for a cocktail party if it weren't such darn serious business.

I really do feel that way.  I've been doing this for a long time. I've had a lot of interesting experiences. I was an Army physician for 10 years in the 80s and 90s. So I saw a lot of interesting things. But I never had these kind of experiences or felt that this would ever happen.

And it doesn't sound like you think this situation is going to change much at any time in the near future?

What's accurate is: I don't feel it's been resolved. I do think as time goes by, my guess is, there'll be more [production]. Domestic production will be enhanced and these supply chains perhaps will be more solidified.

"We didn't feel like the cavalry was coming to rescue us."

Dr. Andrew Artenstein

Why did you feel like you had to act on your own? Were you just not getting the help you needed from state and federal officials in procuring this equipment?

Yes, we were not getting adequately supplied. And then to be honest with you, we had multiple lines in the water in parallel. This is a situation where we can't — and no health system can — afford to come even close to running short on these things because they burn at a high rate on a daily basis. These are disposable items, even though now we're reusing and sterilizing some of them. That's a relatively new phenomenon that's been born out of innovation necessary from shortages. These patients were coming fast and furious. Sick patients were filling our hospital and other hospitals. And you need to be able to protect the staff. We didn't feel like the cavalry was coming to rescue us.