A man who became distraught as he was being briefed on his mother's condition by a surgeon at a Baltimore Hospital pulled a gun and shot and wounded the doctor, then killed his mother and himself in her room.
The gunman, 50-year-old Paul Warren Pardus, had been listening to the surgeon on Thursday when he "became emotionally distraught and reacted ... and was overwhelmed by the news of his mother's condition," said Police Commissioner Frederick Bealefeld.
Pardus pulled a semi-automatic gun from his waistband and shot the doctor once in the abdomen, the commissioner said. The doctor is expected to survive.
Pardus then holed up in the room at the world-renowned Johns Hopkins hospital in a stand-off lasting more than two hours.
When officers made their way in, they found Pardus and his mother, 84-year-old Jean Davis, shot dead, he on the floor, she in her bed.
"I guess he just couldn't bear to see her the way she was," said Pardus' brother, 59-year-old Alvin Gibson of Virginia. He said their mother suffered from arthritis and rheumatism and had surgery last week, but it didn't help her.
"I guess because he thought my mom was suffering because the surgery wasn't successful and she probably wouldn't be able to walk again," he said about a possible reason for Pardus' actions. "She was a dear, sweet lady."
The doctor, named by colleagues as orthopaedic surgeon David Cohen, collapsed outside the eighth-floor room where Pardus' mother was being treated.
Hopkins is widely known for its cancer research and treatment. It is part of Johns Hopkins University, which has one of the foremost medical schools in the world.
Harry Koffenberger, vice president of security, said the hospital uses handheld metal detectors to screen patients and visitors known to be high-risk. However, with 80 entrances and 80,000 visitors a week, it is not realistic to place metal detectors and guards everywhere.