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Using a participatory observation approach, this paper aims at exploring how public and private organizations have collaborated in response to the COVID-19 pandemic. We examine the case of MechanicalVentilator Milano (MVM), an international project with over 250 contributors and partners; this project aimed to achieve the challenging goal of designing and realizing a mechanical ventilator for mass production in about 6 weeks. The project received the Emergency Use Authorization granted by the U.S. Food and Drug Administration. The MVM ventilator is a reliable, fail-safe, and easy-to-operate mechanical ventilator that can be produced quickly at a large-scale, based on the readily available parts. The success of the MVM case is unique as it adopts open innovation practices to generate technology innovation, in addition to a lean perspective. Through the MVM project description, this study offers a framework that explains the interplay between open innovation and lean approach, highlighting the different internal and external forces and types of collaborations, and offering fine-grained insights in to the role of universities as platforms of multidisciplinary knowledge. This framework might serve as a basis for future theoretical and empirical research, providing practitioners with new best practices that are essential when facing a severe crisis like COVID-19.