Cartel gunmen in the once peaceful state of Guanajuato stormed a local hospital and executed a male who survived a shooting from the night before that left five of his associates dead.

The execution happened on January 17 in Salvatierra, which is located in the southeastern section of the state approximately 90 miles from the capital of Guanajuato. The gunmen also executed a municipal police officer who was providing security for the wounded victim.

According to the state attorney general’s office for Guanajuato, witnesses described seeing five, heavily-armed men arrive outside the hospital at approximately 9 am. Three of the gunmen located the victim in the emergency room and immediately opened fire, killing him and the police officer who was providing security according to local media reports.

The state attorney general’s office further revealed that the male victim was the lone survivor from an attack the night before when he and five associates were shot by cartel gunmen who stormed a residence in the municipality of Salvatierra. They were pronounced dead at the scene. The attorney general indicated that several of the victims killed in the residence had been under investigation for possible illegal drug activity.

In a hospital surveillance video released by authorities, three gunmen can be observed hurriedly entering with rifles drawn, accompanied by a male who has a rifle pointed at his back. The male, who is presumably an employee, quickly points to a room on his left, where the wounded man is recovering. A gunman quickly enters the room while two others remain in the hallway providing cover. After the gunman kills the wounded male and police officer, he reappears in the hallway, and the gunmen quickly exit the hospital through the same entrance. Everything happens in a span of 13 seconds. A nurse and a family member visiting the victim were also wounded, according to the attorney general.

For years, Guanajuato enjoyed the reputation for being peaceful and spared from the cartel violence. In 2006, the state registered 242 murders and in 2015, the number climbed to 879. In 2017, at least 1,800 murders were counted.

Drug cartels battling over control of the state has accounted for the steady climb in hostilities in addition to challenges against the Cartel Jalisco Nueva Generacion (CJNG), which currently controls the state. In October, a group who identified as Cártel Santa Rosa de Lima Guanajuato released a video on social media declaring war against the CJNG.

Robert Arce is a retired Phoenix Police detective with extensive experience working Mexican organized crime and street gangs. Arce has worked in the Balkans, Iraq, Haiti, and recently completed a three-year assignment in Monterrey, Mexico, working out of the Consulate for the United States Department of State, International Narcotics and Law Enforcement Program, where he was the Regional Program Manager for Northeast Mexico (Coahuila, Tamaulipas, Nuevo Leon, Durango, San Luis Potosi, Zacatecas.)