A 32-year-old gunman dressed in combat gear opened fire in a hospital in the Dutch city of Rotterdam on Thursday, killing and wounding an unknown number of people and setting the facility ablaze.
Elite police stormed the Erasmus MC hospital in the Dutch port city, as panicked medics in white coats flooded out of the building pushing patients in wheelchairs and on stretchers.
"First there was a shooting on the fourth floor. Four or five shots were fired. Then a Molotov cocktail was thrown into the education centre," said a medical student cited by RTL Nieuws, who did not give his name.
"There was a lot of panic and screaming... I didn't hear any shots, just the panic and that's what I started to act on," public broadcaster NOS cited another eyewitness as saying.
Pictures showed helicopters buzzing overhead and police snipers taking up positions on the hospital roof.
Police said there were an "unknown" number of dead, adding that the families were being informed before more details could be made available.
They were still hunting for victims or people who had barricaded themselves in, they said in a statement.
The drama started just after 2pm local time (1200 GMT) when shots were fired at a house near the hospital, with a fire later breaking out there. At least one person was thought to be injured in this attack.
Next the gunman moved to the hospital, where shots were heard and a large fire erupted that was later brought under control.
Police had earlier said the suspect was wearing "combat-style" clothes, was tall, with black hair and carrying a backpack. His motive is not yet known.
He is suspected of carrying out both shootings and there is not believed to be a second shooter, police said.
"It's unbelievable," said Rotterdam GP Matthijs van der Poel, cited on the Algemeen Dagblad website.
"Everyone is totally shocked by the events and is watching the news with horror. I'm afraid such things cannot be prevented," he said.
Rotterdam is often the scene of shootings, usually attributed to score-settling by rival drug gangs.
Authorities were expected to hold a news conference shortly to give more details.
In 2019, three people were shot dead on a tram in Utrecht, sparking a huge manhunt.
And in 2011, the country was left shocked when 24-year-old Tristan van der Vlis killed six people and wounded 10 others in a rampage at a packed shopping mall.
