An 80-year-old man was killed after asking a bar patron to wear a mask.

When an 80-year-old man at a bar near Buffalo, N.Y., noticed a fellow customer not wearing a face mask, he confronted him. The customer responded by swiftly pushing him to the ground, the police said. Five days later, the man was dead.

On Monday, the customer, Donald Lewinski, 65, of West Seneca, N.Y., was arrested and charged with criminally negligent homicide in the death of the 80-year-old, Rocco Sapienza. The case is believed to be one of the first of its kind in New York State.

Mr. Lewinski pleaded not guilty on Tuesday in court in Erie County. The charge carries up to four years in prison.

The encounter followed months of tension and often vitriolic confrontations across the United States over masks. Disputes have escalated to violence: Retail employees have broken up fistfights between customers, and in New York City dozens of transit workers have been attacked after trying to enforce the rules.

John J. Flynn, the Erie County district attorney, said he believed the confrontation between Mr. Sapienza and Mr. Lewinski — who apparently had exchanged terse words before the shove — was one of the first disputes over face coverings that had led to someone’s death in New York State. He said preliminary autopsy results showed that Mr. Sapienza died from blunt force trauma to the head.

“It’s beyond sad,” Mr. Flynn said. “These kinds of situations have continued to escalate, and this should cause everyone to pause and think twice now about how we as a society want to conduct ourselves during this pandemic.”

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