Supplement for case 712480. On the evening of March 11, 2011, Mayama Fumihiro, the Managing Director of Ishinomaki Kouwan Hospital knew that it would be a long, cold night. The 103 staff members and 162 patients and families were huddled on the top two floors of the four-story hospital, where they had gone to escape three tsunami waves that had destroyed the first floor and part of the second floor.