Israeli forces fired into the main hospital in southern Gaza early on Thursday, killing a patient and wounding six others, according to reports.
Nasser Hospital, in the southern city of Khan Younis, has been the latest focus of operations that have gutted Gaza’s health sector as it struggles to treat scores of patients wounded in daily bombardments.
Israel accuses Hamas of using hospitals and other civilian structures to shield its fighters.
Video of the aftermath of the strike showed doctors scrambling to wheel patients on stretchers through a corridor filled with smoke or dust.
A doctor used a phone flashlight to illuminate a darkened room where a wounded man screamed out in pain as gunfire echoed outside.
The Associated Press could not authenticate the videos but they were consistent with its reporting.
Dr Khaled Alserr, one of the remaining surgeons at Nasser Hospital, told AP that the seven patients struck early on Thursday were already being treated for past wounds.
On Wednesday, a doctor was lightly wounded when a drone opened fire on the upper stories of the hospital, he said.
“The situation is escalating every hour and every minute,” he said.
The Israeli military said on Wednesday that it had opened a secure corridor for displaced people to leave the hospital but would allow doctors and patients to remain there.
Videos circulating online showed scores of people walking out of the facility on foot carrying their belongings on their shoulders.
The military had ordered the evacuation of Nasser Hospital and surrounding areas last month.
But as with other health facilities, doctors said patients were unable to safely leave or be relocated, and thousands of people displaced by fighting elsewhere remained there.
Palestinians say nowhere is safe in the besieged territory, as Israel continues to carry out strikes in all parts of it.
The Gaza health ministry said last week that Israeli snipers on surrounding buildings were preventing people from entering or leaving the hospital.
Prior to Thursday’s strike, it said 10 people had been killed inside the complex over the past week, including three shot and killed on Tuesday.
The war began when Hamas militants burst through Israel’s defences on October 7 and rampaged through several communities, killing some 1,200 people and taking another 250 hostage.
More than 100 of the captives were freed during a cease-fire last year in exchange for 240 Palestinian prisoners.
About 130 captives remain in Gaza, a fourth of whom are believed to be dead.
Israel responded to the October 7 attack by launching one of the deadliest and most destructive military campaigns in recent history.
More than 28,000 Palestinians have been killed, 80% of the population have fled their homes and a quarter are starving amid a worsening humanitarian catastrophe.
Large areas in northern Gaza, the first target of the offensive, have been completely destroyed
Hamas has continued to attack Israeli forces in all parts of Gaza, and says it will not release all the remaining captives until Israel ends its offensive and withdraws.
Negotiations over a cease-fire in Gaza appear to have stalled, and Israeli prime minister Benjamin Netanyahu has vowed to continue the offensive until Hamas is destroyed and the hostages are returned.