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Often at Center of Mayhem, Emergency Rooms Tend to Be Gunfire-Free Zones

James A. Romagnoli, left, of North Shore-Long Island Jewish Health System, which has had no shootings on its 16 campuses.Credit...Uli Seit for The New York Times

It would seem almost inevitable, yet still hard to fathom: rival gang members, angered and perhaps aggrieved over some recent disagreement, seek to continue or end the dispute the next time they meet — even if that encounter occurs at a hospital.

This happened on Wednesday, in a waiting area at Bronx-Lebanon Hospital Center’s emergency room. A man being treated for facial injuries bumped into a rival gang member who had also shown up at the hospital, and both of them called for backup crews who came to the hospital that evening.

One of those who came to the hospital brought a gun and fired it, wounding a hospital nurse and a security guard. The police identified the gunman as Michael Wayman, 19; he was arrested on Thursday.

But even though hospital emergency rooms often sit at the intersection of mayhem and medicine, they tend to be fire-free zones to New York’s criminal class.

A reason might lie in the tradition of the medical arena as noncombatant territory — a custom borrowed from past wartime battlefields, where medics with white-and-red crosses emblazoned on their backs were not targets.

Or perhaps simple street code dictates that carrying the gunfire into the brightly lit, densely populated spaces of public hospitals has an unacceptable risk-to-reward ratio: the chance of success is outweighed by the likelihood of being caught.

Nonetheless, administrators and staff members in New York hospitals are very aware that they could be vulnerable to an episode of violence at any time.

“Every member of the job, regardless of whether they are on the job, will speak almost all the time of being aware of your surroundings and that you can be in an area with a cycle of violence, a drug war or whatever,” said Patrick Bahnken, a past president of Local 2507 of District Council 37, which represents 3,000 emergency medical technicians and paramedics in the Fire Department.

“We will, wherever possible, attempt to separate the parties involved, when it is a violence issue, a running fight or a domestic issue,” Mr. Bahnken said. “In the hospital, they try to separate each side out; you don’t want combatants sitting next to each other.”

However, he added, “We don’t always have that luxury.”

Ana Marengo, a spokeswoman for the city’s Health and Hospitals Corporation, said that there had been no shootings in the system’s 11 hospitals in recent history, and that “gun violence has not been a problem inside our hospitals.” She referred questions about crime statistics to the Police Department, and police officials could not immediately provide such figures.

And in the few instances in the last 20 years or so where shots were fired inside a hospital, the gunmen tended to target hospital workers. In a case in 2004, a man shot a desk clerk at Elmhurst Hospital Center in Queens and abducted his wife; the man, Miguel Carrasquillo, was later arrested but died in custody while awaiting trial.

On Dec. 31, 1997, a former patient took a security guard hostage at Jamaica Hospital Medical Center; he fired two shots during a standoff but surrendered without injuring anyone.

Hospital officials said that most violent episodes were caused by patients with behavior or mental health problems, and that if they were armed, it was usually not with a firearm, but some odd object they managed to grab, like a piece of furniture.

“We have 16 campuses, and we’ve never had a shooting,” said James A. Romagnoli, vice president for protective services of North Shore-Long Island Jewish Health System. “Anything can happen, but historically, the campus is safer than the area it serves. Hospitals have been viewed, generally, by the public, as a sanctuary, much like a church, but some of the violence that is on the street does make its way to us.”

Mr. Romagnoli said the system’s 700 uniformed officers were trained to spot the kinds of stressful situations that could lead to assaults on health-care workers, and how to defuse them before they erupt violently, sometimes with “verbal judo” techniques.

Dr. Alicia Salzer, a founder of Medhattan Immediate Medical Care, an urgent-care center in downtown Manhattan that is staffed by 15 emergency room doctors from around the city, said that threats were common when she worked in a psychiatric emergency room, but that most came from patients.

“We took quite a few knives off patients,” she said.

Once, a nurse was badly bitten by a patient. Another time, Dr. Salzer had urine thrown at her. And one time, she and others had to weather a tirade by a patient who tore a metal paper-towel holder off the wall and managed to cause damage before security workers responded.

Security personnel at hospitals are trained to mitigate all types of violence, whether by irate relatives of patients, people with psychiatric disorders or criminals bent on real-time revenge, said Gregory E. Floyd, the president of Local 237, a union that represents 850 hospital police officers employed by the city’s Health and Hospital Corporation.

Mr. Floyd said his members were adept at quelling combustible situations and defusing threats. Hospital police officers are not armed. They do not carry pepper spray, but they do carry batons; some wear bullet-resistant vests, he said. Their mere presence and skill, he said, is one reason episodes of hospital violence are so rare.

Mr. Floyd has abandoned for now efforts to get his police officers armed; a bill that would have done so passed the State Legislature in 1999 but was vetoed. But he still believes his members should be armed, citing a trial program a few years ago that allowed security officers at two city hospitals, including Kings County Hospital Center, to carry guns. It proved worthwhile after a man entered the Kings County hospital with a machete.

“They made the man drop his weapon,” Mr. Floyd said of the security staff in that episode. “He came in. He was irate, and he was chasing someone. It was a fight that spilled from the street into the hospital.”

In the State Capitol, Assemblyman Richard N. Gottfried said he heard more from patients and hospital personnel about theft than violence.

“You might think that violent crime in hospitals would be more common,” said Mr. Gottfried, a Democrat from Manhattan who is chairman of the Assembly’s Health Committee. “For whatever reason, that, so far, does not seem to be the reality.”

He said he supported the position of the city’s public hospitals that having its officers carry guns would probably do more harm than good.

But Mr. Floyd cautioned that criminals — specifically gang members — seem increasingly disrespectful of traditionally hallowed social areas, like hospitals and schools. He said he envisioned the need for arming security officers at least on the perimeters of hospital properties.

“They have outside posts and patrol posts,” he said. “There should be firearms there.”

A version of this article appears in print on  , Section A, Page 17 of the New York edition with the headline: Often at Center of Mayhem, Emergency Rooms Tend to Be Gunfire-Free Zones. Order Reprints | Today’s Paper | Subscribe

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