Patient at County-USC Shoots 3 Doctors, Gives Up in Standoff : Violence: One victim is reported near death and two are listed as critical. The gunman, who said he wanted pain medicine, held two staff members hostage before surrendering.

A disgruntled patient opened fire in the emergency room of Los Angeles County-USC Medical Center on Monday, critically wounding three doctors and holding two staff members hostage for nearly five hours before surrendering, authorities said.

Damacio Ybarra Torres, 40, of Los Angeles, was taken into custody at 5:10 p.m. and booked for investigation of attempted murder after bringing emergency care to a virtual standstill for most of the afternoon at the nation’s largest acute care hospital.

Police said Torres had complained about the care he had received at County-USC, and witnesses overheard him crying out for pain medication shortly before the shooting. But late Monday night, in a shouted comment to KCBS-TV cameras, Torres said he was a mental patient with nowhere left to turn.

“I feel like I’m a victim of a medical conspiracy,” he stammered as police escorted him to a squad car after questioning. “They refused me treatment for 10 years. I’m in ill health. I don’t give a damn. Where can I go? All I can do is go to jail.”

The incident--which sent scores of patients running for their lives and forced the evacuation of dozens of employees--erupted about 12:20 p.m. in the most crowded of County-USC’s three emergency rooms, the one for walk-in patients, officials said.

Witnesses said Torres--his head shaved, his camouflage jacket concealing a knife and three loaded guns--had been pacing for about 10 minutes through a crowd of more than 100 ailing people lined up in the Ambulatory Care Unit.

The unit is a port of entry at County-USC, where patients without appointments are seen by three triage doctors who interview them at partitioned desks near the door to separate those with less serious illnesses from people in need of emergency care. The patients, who are often poor and uninsured, take a number and wait for treatment--sometimes for hours.

Witnesses said Torres grew more and more agitated as his wait for care dragged on.

“Goddamn, give me something for my pain! Can’t you give me something for my pain?” patient Hope Flynn said she heard Torres cry. Then, witnesses said, he strode up to the doctors near the door and without speaking opened fire in what one called “a rain of bullets.”

“He was coming, you know, he had the look of the devil in him,” said Arturo Castaneda, whose wife had just finished having her blood pressure taken when the shooting began.

“He came in very calm,” said Celsa Chavez, who had been waiting to be treated for her pinched nerve. “He stopped in front of the desk and started shooting. I jumped to the floor and everybody started running.”

“I wanted to go at him, but it was like a stampede,” said another patient, Ralph Jimenez. He said he feared at first that the gunman would begin shooting patients, too, but it soon became clear that “he could have shot anybody he wanted, (but) he wanted to shoot those doctors.”

Hospital officials identified the wounded men as Drs. Glen Roger, 41, Paul Kazubowski, 44, and Richard May, 47. All three were listed late Monday in critical condition in the hospital’s intensive care unit. May--described by colleagues as a dedicated doctor and father of four--reportedly was near death, having been shot point-blank in the head and chest.

Hospital security guards pursued the gunman from the emergency room to a first-floor X-ray room but were too late to prevent him from taking two hostages--Lilly Bragg, 54, a receptionist, and Dr. Ann Tournay, 32, who was spending her first day on the job.

Barricading himself with the two women in the room, Torres negotiated sporadically throughout the afternoon with a Los Angeles Police Department special weapons and tactics team. LAPD Sgt. Alex Salazar said the man at one point told police he was in no hurry.

“He said normally he goes in (for treatment) and has to wait forever,” Salazar said. “So now, he says, ‘It’s your turn.’ ”

Finally, at 5:08 p.m., Torres was persuaded to release the hostages, who were visibly shaken but otherwise unharmed. Two minutes later, Torres gave himself up to police without incident.

Police recovered from Torres a .44-caliber magnum revolver, a .38-caliber automatic pistol, a sawed-off rifle and a hunting knife, said Deputy Police Chief Robert Gil.

One police source said that Torres, whose address was a downtown flophouse, told arresting officers that he suffers from AIDS. Hospital officials could not confirm the claim.

The violence did not force a evacuation of the entire hospital, but did disrupt the nation’s busiest emergency room and interrupted care for thousands of the county’s neediest patients. The 2,045-bed institution, which serves as many as 15,000 patients a day, is the largest of the county’s six public hospitals and the cornerstone of the county’s trauma care network.

Hospital officials advised patients that they will not be accepting non-emergency cases today.

Health care workers said the shootings were the most recent example of the rising tide of violence that has spilled over into the nation’s urban emergency rooms.

“We are an open front door to whatever society has to offer, and some of these patients are not the best people,” said Dr. Marshall Morgan, chief of emergency medicine at UCLA Medical Center.

“The really scary people are the ones who are angry and sober and probably a little bit crazy.”

In recent years, assailants have killed people at hospitals from San Diego to New York. A 1988 University of Louisville survey of 127 emergency rooms found that 41 reported at least one verbal threat a day, 23 received at least one armed threat a month, and 55 sustained at least one physical attack a month.

County-USC has been no exception. During the first six months of 1991, security guards at the hospital responded to 1,400 reports of threats or attacks, six of which led to arrests. Among the assailants was a panhandler who approached four nurses in the cafeteria and plunged a pair of suture-removal scissors deep into a nurse’s neck.

Officials at County-USC said it was unclear how an armed man could have made it into the emergency room, which is monitored by security guards. Ted Holland, who heads security at the hospital, said one officer was posted inside the emergency room and two others were just outside.

But Holland added that the officer assigned to the emergency room was far from the site of the shooting. Moreover, other hospital workers said, the emergency room never has been equipped with metal detectors.

Hospital spokesman Harvey Kern said such precautions have never been proposed because the emergency room “never had anything like this happen.”

“I don’t know if you could have prevented something like this,” said LAPD spokesman Lt. John Dunkin.

But patients and hospital employees disagreed.

Bob McCloskey, an official of the county nurses union, said inadequate security at County-USC was a major issue in strikes by nurses in 1989 and 1991. The county has since beefed up security budgets at all of its hospitals by $1.1 million a year, but the union, Local 660 of Service Employees International Union, considers the measures inadequate. At County-USC there are many unguarded doors and routes to the emergency area, McCloskey said.

“They have a lot of unruly patients in those emergency rooms,” he said. “They cuss, they spit. Some are high on drugs or drunk, and they are hard to control.”

He said nurses have been shoved, hit and verbally abused by patients and family members upset by long waits for care at County-USC, which has suffered in recent years from chronic overcrowding.

“People get mad when they wait 16 hours and are still not seen,” McCloskey said.

Witnesses to the shooting also said they could understand the gunman’s frustration.

“They treated him with no respect,” said one man who was in the emergency room with his wife and baby when the shooting occurred.

“They should have addressed him a little bit better. Everybody’s human, and he was sick. They should have spoke to him with a little more respect.”

Times staff writers Andrea Ford, Melissa McCoy, Douglas P. Shuit, Edward J. Boyer, Scott Harris, Claire Spiegel, Irene Wielawski, Hector Tobar and Nieson Himmel contributed to this story.

Hospital Violence

In recent years, violent incidents have shattered the calm in hospitals across the country. They included: 1991

Los Angeles: While four nurses ate breakfast in the cafeteria at County-USC, a panhandler plunged a pair of scissors deep into one nurse’s neck.

Salt Lake City: A 39-year-old Utah man, angry because doctors had performed sterilization surgery on his wife, stormed a suburban hospital, armed with dynamite and two guns. He killed a nurse and held eight people hostage before surrendering.

Costa Mesa: A painter at Fairview Developmental Center, who was angry with administrators for ignoring tensions in his division, shot and killed a facilities supervisor and injured two others.

Los Angeles: Gang gunfire ripped through the windows of White Memorial Hospital in Boyle Heights, and shotgun pellets struck a pregnant woman in the face. 1990

San Diego: A man distraught over the death of his father walked into Mission Bay Memorial Hospital in San Diego and fired a barrage of bullets that killed a nurse and a hospital trainee and wounded a doctor and a visitor.

Los Angeles: A gun-wielding assailant killed one woman and shot another several times at UCLA Medical Center.

Los Angeles: An 18-year-old gang member was shot in the face during an altercation involving about 20 youths who were visiting patients at County-USC. 1989

New York: At Bellevue Hospital Center, a 23-year-old homeless man with a history of psychiatric problems who had been living for weeks in a closet and roaming the hallways in a stolen lab coat, was charged with the rape and strangulation murder of a woman doctor. 1988

Los Angeles: Five carloads of gang members put Martin Luther King Jr./Drew Medical Center in Watts under virtual siege, converging on the lobby of the emergency room and terrorizing people in the waiting room. 1985

Chicago: A 32-year-old food service supervisor at Rush-Presbyterian-St. Luke’s Medical Center was assaulted and left bound and gagged on a hospital stairwell. 1984

Los Angeles: A patient at County-USC Medical Center was shot to death by a security guard in the emergency room after he allegedly reached up from his gurney, grabbed another guard’s gun and opened fire. 1982

Chicago: A woman being treated at the University of Chicago Medical Center in Hyde Park was raped in her hospital room.

Chicago: A security guard was found beaten to death in a hallway of the Loyola University Medical Center near Maywood.

SOURCE: Los Angeles Times files

Compiled by Times researcher Cecilia Rasmussen

Hospital Terrorized

A gunman, reportedly yelling for pain medication, shot three doctors in the Los Angeles County-USC Medical Center emergency room on Monday. Here is a rundown of the afternoon’s events according to witnesses and authorities.

Gunman enters emergency room on first floor.

He opens fire about 12:20 p.m. on doctors sitting at desk near door. Security guards chase gunman.

He takes two hostages.

Suspect barricades himself with hostages in X-ray room on hospital’s first floor.

Area is cordoned off; SWAT team members are called in.

Emergency surgery performed on the three critically wounded doctors.

Negotiations with gunman begin; about 5:10 p.m., he surrenders. Hostages are unharmed.

Source: Staff and wire reports