A NEO-NAZI gunman killed a girl of 14, her mother, and a teacher in a horror shooting rampage at a house and hospital in Rotterdam.
Dutch student Fouad L, 32, was arrested over the twin shootings and arson attacks on Thursday at both the Erasmus Medical Center and a nearby house on Thursday.
Cops confirmed three people - a 39-year-old woman, her 14-year-old daughter, and a 43-year-old male teacher from the hospital - were killed by the lone gunman, who wore combat gear.
During a search of the suspect's phone, investigators uncovered disturbing material including "Nazi-related and right-wing extremist images" and pictures of people being stabbed to death.
The Public Prosecution Service had warned the Erasmus MC about his "worrying behaviour" in an email earlier this year, reports NOS.
He is claimed to have been found "half naked in the garden on a pile of leaves", shouting and laughing loudly in a display of "psychotic behaviour".
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Police Chief Fred Westerbeke said that the suspect wore a bulletproof vest as he shot and killed the female victim and wounded her teenage daughter at their home in the first shooting.
The girl later died from her injuries.
The attack took place at a house in the west of the port city on Heiman Dullaertplein - close to the home of the suspect.
Then the shooter, armed with a handgun, travelled by motorbike to the nearby Erasmus Medical Center where he shot and killed a male teacher in a classroom.
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Rotterdam's chief prosecutor, Hugo Hillenaar, said that the gunman was known to police after being convicted of animal abuse in 2021.
He was accused of shooting an arrow at a pigeon and abusing a rabbit by kicking or punching it into a bush.
The suspect had also shared disturbing posts on online forum 4Chan and was a self-professed alcoholic, saying he had "deep trauma".
He had previously feuded with university professors, accusing them of "sabotaging" him.
In a post on the dark web, the suspect claimed he was suspended from his classes repeatedly and made an anti-Semitic comment about the professor, according to Dutch media.
He claimed a former Erasmus professor felt he was "arrogant for not apologising for being late to his useless... class".
Fouad L complained he was picked on by staff at the university and took his frustrations out on a rabbit after being suspended.
He said he had "mortal levels of alcohol in my blood and deep trauma" at the time.
In a police interview, he admitted he suffered from depression and alcohol addiction, which is did not take medication for, and that he often forgot what he did while drunk.
The suspect was student at Erasmus MC and was set to be made a doctor.
Erasmus was informed of his conviction by the Public Prosecution Service.
Two major fires were also started at both locations by the attacker.
Cops are still investigating the suspect's motive behind the twin shootings and arson attacks.
An investigation is underway as to whether he was a student of the teacher shot dead.
Authorities believe that the woman and her daughter were close neighbours of the suspect, leading police chief Westerbeke to suggest they were "targeted attacks".
Rotterdam mayor Ahmed Aboutaleb said "I am angry and sad" as he spoke of the "black day" for his city.
The mayor told reporters: "We have been shocked by a horrific incident... the emotion in the city is running high."
The shootings sparked mass panic as hospital staff, students and patients were forced to run for their lives or be wheeled out still in their beds to escape from the gunman and the blaze he started.
Footage from the scene showed heavily armed police units wearing body armour as they stormed the hospital, while helicopters buzzed overhead.
A medical student told RTL Nieuws: "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."
An unnamed witness told broadcaster NOS: "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."
One patient, Angeliek Vleesenbeek, said she was standing just outside the hospital having coffee when pandemonium broke out.
"It was drama. It really was drama," the 54-year-old said, still hooked up to her intravenous drip.
The sole suspect is now in police custody after an urgent manhunt ended when he was apprehended on the teaching hospital's helipad.
The gunman was taken into custody and chief prosecutor Hillenaar told reporters he was cooperating with police following his arrest.
Hillenaar said: "We cannot say anything about the motive of this terrible act at this time. The probe is still ongoing."
The entrance to the Erasmus MC remains cordoned off as students were seen walking around in tears with doctors standing by patients in wheelchairs.
The investigation into the double shooting is ongoing, police said.
The Erasmus Medical Center has now re-opened its doors for visitors and will begin re-admitting patients on Friday.
Erasmus University cancelled all Friday's classes and will be offering counselling to students.
This year, Rotterdam has been the scene of a spate of shootings and small explosions that have been blamed on score settling by rival drug gangs.
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In July, two people and a gunman were injured during a shooting at a summer festival in the city.
And in 2019, three people were shot dead on a tram in Utrecht, sparking a huge manhunt.