ECMC staffers were prepared to save lives Saturday. In most cases, they didn't get the chance

At the tail end of his 7 a.m. to 3 p.m. shift last Saturday at Erie County Medical Center, Dr. Michael Manka Jr. received word that a shooting victim was on the way to the hospital's Emergency Department.

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Multiple victims, Manka heard moments later. 

As Manka, nurses and staff in the Emergency Department made their way to the trauma resuscitation area to get ready, more information flowed in: This was an active shooter situation with mass casualties. Horrified, but prepared to help, he and his team of providers still weren't sure how many victims would be arriving. 

Until the first ambulance pulled in.

One of the paramedics who brought in Zaire Goodman, 20, a Tops employee who was wounded in the shooting, shared the grim news with Manka. 

"She was able to tell me that the majority of the victims were deceased at the scene and wouldn't be coming to the hospital," said Manka, ECMC's chief of emergency medicine. "That was hard information, obviously, to hear. Just hearing that there were multiple victims who had died at the scene was kind of shocking for us."

It got more shocking as more details emerged and national attention focused on the Tops Markets on Jefferson Avenue, where police say a white supremacist from the Southern Tier shot and killed 10 people – all Black.

After his conversation with the paramedic, Manka said the two other wounded victims arrived in quick succession. All three, he said, were in stable condition without life-threatening injuries.

Goodman, the first to arrive, had a gunshot wound to his upper back and neck – "literally millimeters away from him having a fatal injury," Manka said. Typically, with that kind of gunshot wound to that area of the body, Manka said patients will frequently have significant injuries, whether it's to the spinal cord or a major blood vessel in the neck or to their airway.

"There's a lot of critical structures pretty tight in that area and the neck," he said. "And especially to have a gunshot wound with a high-velocity rifle like this through that area ... It's hard for me to say he's lucky – he's very unlucky that this happened to him – but he's fortunate that he didn't have more severe injuries."

Goodman was discharged from the hospital that night. 

So, too, was Jennifer L. Warrington, 50, a pharmacist at the supermarket. Warrington, Manka said, had a wound to her scalp, possibly from shrapnel that had hit her in the head. 

"That's something where it could have very easily been something that actually penetrated her skull and maybe caused a brain injury, but, fortunately, did not," he said.

Christopher Braden, 55, remains at ECMC, but he's stable. Braden was shot in the leg, sustaining an open fracture to his tibia and fibula that required surgery.

"Unfortunately, he's going to have probably some persistent disability related to that injury," Manka said.

Dozens of health care providers have been involved in the care of the three survivors, he said. That includes physicians, nurses, technicians and support staff, among others.

Manka said ECMC has a protocol to handle mass casualty situations. If victims were arriving over a period of hours or days, Manka said that would have involved setting up an external triage area to receive patients who aren't seriously injured to save space in the hospital's trauma rooms for those who are critically injured. 

Last Saturday, however, all three gunshot victims arrived within 15 minutes with non-life-threatening injuries. That made the Emergency Department busy, Manka said, but hospital staff was able to manage the situation without having to call in additional resources. It was the type of response that the region's only Level 1 adult trauma center is accustomed to providing.

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But Manka wishes ECMC would have had the opportunity to save more of the victims.

"When we heard there were multiple people who were shot, I think all of us, because of what we do every day, we wanted to have the opportunity to help those people," he said. "And I don't want to make it sound like we were hoping for more victims to come to us, but we certainly were hoping that all of the people who were shot were going to be able to come to our hospital to receive care.

"And it was somewhat deflating to us, and to everybody, really, when we heard that there were so many people who had been pronounced deceased at the scene because of how horrific that is, number one, but secondly, that we didn't even have a chance to really help those people."