On 14 February 1942, seeking reprisal for losses sustained during the Battle of Pasir Panjang, Japanese soldiers entered the hospital from its western end, bayoneting staff and patients. They were allegedly chasing Indian troops who had fled their pursuit through the hospital building. Among the casualties was a British officer, Lieutenant Weston, who was carrying a white flag, to signify the hospital's surrender.
Other victims wounded included 2 patients lying on the operating tables at the ground floor of the surgical block, as well as doctors and other patients. No female nurses were known to have been killed, as most had already been evacuated from Singapore on 13 February. A number of nurses were lost at sea though on the fourteenth while being evacuated.
A group of over 200 walking wounded and staff were taken to what was later described as a shed, an extension of the Sisters'' quarters, and kept overnight. Numerous victims died due to exhaustion and dehydration.
On 15 February, the Japanese troops systematically took prisoners out and bayoneted them, before pushing their bodies into a mass grave. This mass grave was purportedly at the rear of the hospital, and was discovered by an Army Chaplain, who conveyed his discovery to Brigadier Charles Stringer. Shells hit the shed, and some prisoners managed to escape. Only five individuals were known to have given their statements regarding this incident - Bryer, Hoskins, Waller, Johnson, and Gurd.
Affidavits claim that around 250 people were massacred.
On 16 February, Lieutenant-General Renya Mutaguchi, Commander of the Japanese 18th Division, allegedly apologised for the crimes of his soldiers, although this was later denied by Mutaguchi himself. Some variations of the Alexandra Hospital massacre epic claim that General Tomoyuki Yamashita visited the hospital, however, this was not true. A handwritten letter from survivor Lieutenant Walter Salmon, who was in the dining room on the ground floor of the main building, claims that the Japanese soldiers responsible for the massacre were executed right outside the hospital.
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