When orthopedic surgeon David B. Cohen, MD, delivered the bad news to Paul Warren Pardus, that his 84-year-old mother's surgery did not go well and she probably would never walk again, the distraught son pulled out a gun, shot the doctor and barricaded himself in his mother's room. Johns Hopkins Hospital in Baltimore halted to a standstill for 3 hours before police discovered that Mr. Pardus had shot and killed himself and his mother.

Dr. Cohen, who was shot in the abdomen yesterday and rushed into surgery, is expected to recover. News reports suggest that Mr. Pardus blamed the surgeon for leaving his mother paralyzed, with one eyewitness telling police he shouted, "You ruined my mother," after receiving the prognosis.

"He thought it was [the doctor's] fault, but it wasn't," a nurse told the Baltimore Sun on condition of anonymity. Mr. Pardus was reportedly the sole caregiver of his mother, Jean Davis, who suffered from arthritis and rheumatism. The surgery Dr. Cohen performed was related to her cancer treatment.

Mr. Pardus had a permit to carry a concealed weapon in Virginia, where he lived, and was carrying a semiautomatic handgun in his waistband on the day of the shooting. He shot his mother in the back of the head in what one police officer characterized as a "mercy killing" before turning the gun on himself.

Located in a high-crime area of Baltimore, Johns Hopkins "has long focused on safety" but, like most hospitals, doesn't require all visitors to pass through metal detectors, the Sun reports.

"To put in magnetometers at 80 doors, and the requisite armed force needed to staff them, would be impossible," Harry Koffenberger, vice president for corporate security at Hopkins, told reporters after the incident. "Not in a health care setting." The hospital does conduct searches and use metal detection wands in "high-risk situations" in the emergency department.

The shooting comes just a few months after the Joint Commission issued a Sentinel Event Alert warning of an uptick in violent crime in healthcare facilities over the past 3 years. The alert offers guidance on how facilities can identify and secure high-risk areas and prevent situations from escalating into violence.

Irene Tsikitas

More breaking news