OBJECTIVES This study intends to analyze management and decision-making procedures of a public organization during moments of crisis. We studied the case of the Public Hospitals in Buenos Aires City, Argentina, before and after an emergency situation due to a macro-economic shock in 2002, as a result of the devaluation of the Argentine currency, that raised prices in health care inputs, as pharmaceuticals. During the health crisis, the public policy on drugs purchases was threaten due to the impossibility of formal rules to provide solutions to emerging problems. The lack of a specific national or local program supporting the purchase of drugs for in-patient care treatments, and the increasing demand of care at public facilities, placed hospitals into a financially vulnerable situation. METHODS This research carried out with a flexible and descriptive design that combined qualitative and quantitative data obtained from several information sources. The former was analysed in a qualitative way. We performed our research throughout semi structured interviews, applied to government officials and staff members of the Buenos Aires City public hospitals, and the analysis of official statistics, public documents and normative. RESULTS We reveal how some informal practices raised within these organizations, acting as buffers, absorbing the shock, and decreasing the impact over the Public Hospitals users. CONCLUSIONS We conclude that the formal structure of the hospital organization became an institutional risk, which is transmitted to the more vulnerable sectors of the population reducing their access to drugs.