The University of Texas Medical Branch (UTMB) has grown from 1 building in 1891 to an important and modern health science center with more than 70 major buildings, 2,500 plus students and 1,000 faculty. As a result of Hurricane Ike in September of 2008, the Universities’ 132 elevators were damaged from minor to full and complete destruction. Lerch Bates was asked to execute an assessment condition damage report and compare those findings with FEMA official’s results. Temporary repairs were agreed upon to get the priority elevators back into operation while complying with jurisdictional authority mandates. The real work began with scores of renovation and modernization specifications as well as construction administration, code inspections, etc. Also damaged during the storm was the Universities’ pneumatic tube system in their main hospital core. Our 3MH group performed on-site reviews, formulated mitigation tasks, and renovations are underway on their pneumatic trash and linen chute system and the pneumatic tube system.