uddled in a backyard shed in Sulphur Springs, the four boys examined their prize: a .380-caliber pistol so smooth it looked like a futuristic toy.
One of the boys had stolen it from his uncle. They thought it was unloaded, so they passed it around, pointing it at each other like in the movies, until it fired, its bullet tearing a hole in Ikeim Boswell’s neck.
Ikeim died that night, March 14, 2015, at Tampa General Hospital. He was 16.
Gun injuries are a growing problem for Florida’s children, rising along with the increasing availability of firearms across the state, the Tampa Bay Times has found.
To determine how many kids are shot each year — accidentally, intentionally or during the commission of a crime — the Times looked at millions of hospital discharge records for patients across Florida, as well as data collected by the state’s 24 medical examiners.
The analysis found that, between 2010 and 2015, nearly 3,200 kids 17 and younger were killed or injured by firearms. Put another way, a child in Florida was shot, on average, every 17 hours.
From 2010 through 2015, the number of kids killed in gun-related incidents rose nearly 20 percent. Injuries from guns jumped 26 percent from 2014 to 2015 alone.
“That’s a very rapid increase,” said Dr. Garen J. Wintemute, who runs the Violence Prevention Research Program at the University of California Davis School of Medicine.
Firearms killed 475 kids during that six-year span — slightly less than cancer, but more than cardiovascular, infectious or respiratory diseases.
Meanwhile, hospitals statewide billed more than $100 million for pediatric gun injuries. More than $75 million of that was billed to a publicly subsidized insurance provider such as Medicaid or Florida KidCare.
“This is a major problem for our children,” said Dr. Judy Schaechter, chair of the pediatrics department at the University of Miami Health System. “I call it America’s most preventable disease.”
Yet ask state law enforcement officials how many kids are shot each year, and they don’t know. The Florida Department of Health has a statewide campaign to reduce drownings, but nothing aimed at reducing the number of child gun incidents, which kill roughly as many children 17 and under.
“We have an epidemic,” said Dr. Leopoldo Malvezzi, trauma director at Nicklaus Children’s Hospital in Miami. “And nobody is doing anything about it.”
Here are the top 10 ways children in Florida died in 2015. Guns deaths, including homicides, suicides and accidents, are No. 6.
But many deaths are stillbirths and children who die shortly after birth from complications. After the first few weeks of life, the picture changes dramatically. By the time a child is 1, the list looks like this.
By the time a child is 5, guns are the second-leading cause of death.
By the time a child is 14, he or she is nearly as likely to die from a gunshot wound than in a car crash.
Source: Florida Department of Health
t happens in big cities like Miami and small ones like Marianna, across all races and income groups. Children arrive in emergency rooms with gunshot wounds to the head, chest, stomach. Others never make it to the hospital. They die where they were hit.
About 80 percent of the youths shot between 2010 and 2015 were teenagers, the Times analysis found. But some were far younger. Nearly 30 children under age 5 went to the hospital for gun injuries each year.
Most of the injured or dead were boys. A disproportionate share — roughly two-thirds — were black. Black boys were two times more likely to be shot than white boys in 2015, the analysis found.
In the hospital data, most cases were categorized as accidents, assaults or self-injury.
Accidents accounted for about 45 percent of all incidents — and were by far the fastest-growing category. The uptick: nearly 50 percent between 2010 and 2015.
The hospital data did not provide details about the circumstances of each shooting. But research by the advocacy group Everytown for Gun Safety shows unintentional shootings involving children often take place at the home or the home of a friend or family member. Younger children tend to shoot themselves. Older children are often shot by someone else.
That’s what happened to Lavardo Denashe Fisher II.
The 13-year-old, who went by El’jay, was playing video games at a relative’s house in Orlando in February 2016 when he was shot in the back of his head. His cousin had been handling a gun on a hoverboard and fired the weapon by mistake.
Assaults made up another 45 percent of incidents, the Times analysis found. Those incidents were more likely to be fatal than accidents.
Marion Hammer, the National Rifle Association’s top lobbyist in Florida, believes the number of assaults is larger than what is reflected in the hospital data — and thus more attributable to criminal behavior.
“A lot of them are gangbangers who are shooting each other,” she said.
But many cases are not that cut and dried.
Noricia Talabert, 17, was driving home from dinner at an Applebee’s in Miami-Dade County with two friends when a bullet pierced the windshield of her red Nissan Sentra and struck her forehead.
Her death on Oct. 17, 2015, stunned her family, friends and teachers. She made top grades in high school, worked weekend shifts at McDonald’s, squirreled her paychecks away into a college savings account. She hoped to study biology at the University of Central Florida.
A 16-year-old has been charged in the case and is awaiting trial. Police won’t say who he was targeting or why. Regina Talabert believes her daughter was caught in gang crossfire.
“I never thought I’d lose her to guns,” the mother said.
ne possible reason for the soaring number of gun accidents among children is that the number of guns is increasing.
Legal firearm sales are on the rise. Background checks, which are required to buy firearms from licensed gun dealers, jumped 66 percent between 2010 and 2015, according to the Florida Department of Law Enforcement. The number of concealed weapon permit holders over that period nearly doubled from 739,222 to 1.4 million, far outpacing population growth.
That doesn’t account for a possible increase in guns bought from private sellers or in illegal gun sales, which aren’t easily tracked.
Research has found a statistically significant association between gun availability and rates of unintentional gun deaths, gun homicides and gun suicides among children. In simple terms, the more guns, the more kids will shoot themselves or others.
The number of concealed carry permits and background checks indicate Floridians are buying more guns.
Beyond that, some experts believe societal changes are pushing more people to store firearms within easy reach — making them even more available to children.
Twenty years ago, hunting was the primary reason people purchased a firearm, according to the Pew Research Center. But in 2013, nearly half of gun owners in a Pew national survey said they bought their gun for protection.
“People have been convinced of two things,” said Daniel Webster, who runs the Center for Gun Policy and Research at Johns Hopkins University. “That you are at risk at all times, which is not true, and that you will be able to handle that risk so long as you have your loaded handgun at the ready.”
That changes how people store their weapons, he said. People who have guns for self-defense often don’t keep them locked or separate from the ammunition. They want them to be accessible in an emergency.
The result, however, is that kids in the home are at greater risk.
Take RJ Gaines. The 3-year-old Tallahassee boy found a semiautomatic gun underneath his uncle’s bed a few days after Christmas in 2014. He wrapped his fingers around the trigger and squeezed, the barrel pointed inward.
RJ died from his injuries. His uncle, Jaleel Taylor, is serving a three-year sentence for having a firearm with the serial number removed and failing to secure a firearm from a minor, among other crimes. His mother, Shantel Taylor, no longer decorates her home for Christmas.
“My heart fell out,” she said.
Not all experts agree the indicators prove kids in Florida have greater access to guns. Gary Kleck, a retired Florida State University criminologist, said an increase in background checks doesn’t necessarily mean a larger share of households have guns.
The sales figures, he said, reflect the number of “additional guns people who already had guns are getting.”
But Tom Gabor, the Florida-based author of the book Confronting Gun Violence in America, said children in homes with more than one gun face an increased threat.
“A lot of these households that have multiple guns aren’t doing as good of a job at keeping tabs on where the guns are,” Gabor said. “That’s a real concern.”
Ikeim Boswell, 16
Jamylin Turner, 16
Richard Newton, 14
Richard Hallman, 16
Marlon Eason, 10
Trevor Pimentel, 16
Brady Pimentel, 6
Kevin Pimentel, 12
keim Boswell’s fatal shooting in Tampa in March 2015 marked the start of an especially deadly two weeks for children in Florida.
Four hours later, on a basketball court about five miles away, someone opened fire onto a group of friends, killing Jamylin Turner, also 16. He wasn’t believed to be the intended target.
The shooting continued.
March 21: Richard Newton, 14, was shot dead when a fight escalated at a Tampa birthday party.
March 24: Richard Hallman, 16, was gunned down in Miami, after a dispute that may have involved drugs. His friends tried to retaliate that day, but inadvertently killed 10-year-old Marlon Eason as he retrieved a basketball from the street.
March 25: Kevin Pimentel, 12, opened fire on his brothers while they prepared fish sticks in their Pasco County home, and then fatally shot himself. Trevor, 16, survived. Brady, 6, died.
The deaths left parents across Florida in a unique state of grief.
Luis Pimentel, the father of the three Pasco boys, was furious his ex-wife had a loaded firearm in her home.
“I just feel like the reason why my children aren’t alive today is because that gun wasn’t secured,” he told the Times before the funeral.
Months passed before Patricia Davis was able to put her son Ikeim’s photographs, trophies and urn on display in the living room. She still struggles to make sense of his death. She wonders if he understood the risk guns pose, thinking back to the video games he played with his friends.
“In the game, you can shoot someone, and you are going to hit reset and you are going to get another life,” she said. “I don’t think they understood that a gun can kill.”
he National Rifle Association, a powerful force in state and national politics, says the best way to keep children from getting hurt by guns is to teach them what to do if they find a firearm.
At the heart of that effort is the Eddie Eagle GunSafe program, developed by a team of psychologists and educators in 1988. Eddie, a fictional character, teaches kids four gun safety steps: Stop! Don’t touch. Run away. Tell a grown-up.
The NRA launched the program in 63 Florida counties in 1989, winning praise from police departments and gun owners. The lesson continues to be used in parts of the state, including Pasco and Duval counties.
The nonprofit More Health provides a similar four-step firearm safety lesson to children in the Hillsborough and Pinellas schools. Unlike Eddie Eagle, however, it does not include a cartoon.
“We take firearm safety education very seriously,” executive director Karen Pesce Buckenheimer said. “We empower kids with the knowledge to make better decisions if they are ever faced with a firearm.”
But research has shown kids are drawn to guns — and teaching them to stay away doesn’t necessarily mean they’ll heed the warning.
In a ground-breaking 1996 study, psychologist Marjorie Sanfilippo — now an associate dean at Eckerd College in St. Petersburg — showed most young children will touch a gun, even after participating in a safety lesson.
Sanfilippo recreated her experiment with hidden cameras for the ABC news magazine 20/20 in 1999, and again in 2014. The results were similar.
“Younger children cannot distinguish between a real gun and a fake gun,” she recently told the Times. “The only way they can tell is if they pick it up. And in that case, the gun is already in their hands.”
Even adolescents feel the pull. They are more impulsive than adults. A young brain doesn’t fully mature until the early 20s, according to the National Institute of Mental Health.
The takeaway, Sanfilippo said: “Education alone isn’t enough.”
Damasa Dreier, who owns Suncoast Weapons and Tactical in Venice, advises her clients to lock up their firearms when children are home. Anyone who needs quick access to a gun should wear it in a holster, she said.
For Dreier, safety is paramount. She has a 15-year-old son.
“I’m not so sure that the general populous follows this,” she said.
xperts say public health strategies — teaching gun owners about safe storage and distributing free locks, for example — could reduce the number of child gun injuries and deaths, and cut taxpayer costs.
They point to successful public health campaigns, such as efforts to improve safety in automobiles.
“That has been a fantastic public health approach,” said Malvezzi, the trauma director at Nicklaus Children’s Hospital. “Car deaths have plummeted. ... Nobody said you can’t have cars.”
Some municipalities and nonprofits have stepped up when it comes to gun safety. St. Petersburg, for example, offers free gun locks to residents, as well as advice for keeping firearms away from children and criminals. More Health also has given away free locks.
Yet the state does little to address gun safety. The state health department has an injury prevention section, which publishes occasional fact sheets on firearm injuries and deaths. But its most recent strategic plan makes no mention of firearms.
Instead, the section focuses on preventing child drownings and motor-vehicle deaths, neither of which increased as fast as child gun deaths between 2010 and 2015.
When asked why the focus was not on gun injuries and deaths, spokeswoman Mara Gambineri pointed out that the federal Centers for Disease Control and Prevention have funded much of the state’s injury prevention efforts. Since 1996, Congressional Republicans have pressured the agency not to fund gun research and safety measures.
Karen Liller, a University of South Florida public health professor who serves on the health department’s injury prevention advisory council, said child gun injury prevention should be “high on the agenda” in Florida.
“But you are battling so many political forces with this one,” she said.
he one step Florida has taken troubles most public health officials. In 2011, state lawmakers passed a first-of-its-kind law that outlawed the practice of physicians discussing guns with patients unless the information is “relevant to the patient’s medical care.” It made doctors who violate the law subject to disciplinary action.
Supporters of the ban — including the NRA — said physicians had no place questioning their patients’ constitutional right to own a gun. Physicians, however, claimed the law’s passage had an immediate chilling effect on lifesaving conversations.
Last week, after a long court battle, the law was struck down by a federal appeals court on the grounds it violated free speech. But the decision could still be appealed to the U.S. Supreme Court.
Pediatricians in particular say they need to discuss guns with patients, just as they discuss other household hazards like swimming pools and electric outlets. The American Academy of Pediatrics publishes detailed guidelines for such conversations and recommends they happen at each routine visit.
“My job is to say, if you choose to have a gun in the home, here’s how we can keep little Johnny safe,” said Dr. Toni Richards-Rowley, a Lithia pediatrician.
Research suggests counseling can make a difference. A 2003 study in the Journal of the American Board of Family Practice found patients who received verbal counseling by family physicians about firearm storage habits were three times more likely than other patients to make safe changes.
Regina Talabert, the Miami woman whose daughter was shot on the way home from Applebee’s, believes the state should focus its energy on preventing child gun injuries and deaths.
“If they had control in Florida over guns, my daughter would be here,” she said. “We’ve got to make changes.”
Times researcher Caryn Baird contributed to this report. Designed by Lyra Solochek and Lauren Flannery. Graphics by Lauren Flannery. Contact Kathleen McGrory at firstname.lastname@example.org or (727) 893-8330. Follow @kmcgrory.
For those who know of the dangers of guns but still keep a gun in the home:
To determine how many kids are injured by guns, the Tampa Bay Times analyzed a database of Florida hospital records kept by the Agency for Health Care Administration. The Times searched through more than 60 million emergency-room and inpatient discharge records from 2010 through 2015, looking for incidents involving children and firearms.
The newspaper identified 2,859 children who had gone to the hospital and grouped them by age, county, ZIP code and circumstance to determine how and where firearms were endangering kids. Reporters then looked for trends by age, race, type of weapon, circumstance, location, injury and death.
To get a better picture of child gun deaths, the Times requested records from all the regional medical examiner’s offices in the state to see the kids who died and may have not gone to the hospital. The newspaper used death rates from the state Bureau of Vital Statistics to determine the total number of firearm-related deaths. Those numbers, plus the number of children who went to the hospital but didn’t die, amount to a total of 3,168 kids injured or killed by guns.
Responding to an inquiry from the Times, the Florida Department of Health ran its own analysis to determine the number of child gun injuries. The department omitted one CDC firearm injury code and two others the Times chose to include. The department also declined to provide data from 2015, citing changes to the international system that classifies injury and disease.
Presented with detailed questions about its analysis — which the Times was unable to exactly replicate using the same data — and its priorities for addressing child gun deaths and injuries, the department declined to provide further explanation.
The Times analysis using only the state’s codes found 100 more injured kids, and the newspaper’s increase from 2010 to 2014 was 1.3 percent lower than the state’s.
Even the CDC was unable to shed light on the system for classifying firearm injuries, saying its protocol had been developed years ago and that many of the employees responsible had since retired.
This article was written while Times health and medicine writer Kathleen McGrory was participating in the National Health Journalism Fellowship, a program of the University of Southern California’s Annenberg School of Journalism.