A hospital worker views police activity around the scene of a shooting on July 24, 2014, at Mercy Fitzgerald Hospital in Darby, Pa. (AP Photo)

A worker heard yelling and swung open the door.

Richard Plotts, 49, was pointing a gun at his psychiatrist in the psychiatric crisis center at Mercy Fitzgerald Hospital in a Philadelphia suburb Thursday afternoon. The worker and another employee quietly shut the door, sneaked away and called 911, Delaware District Attorney Jack Whelan told reporters. A short time later, they heard gunshots.

“I heard the cop shouting, ‘Come on, come on, get out!'” said Millicent Russell, who was snoozing in the lobby, waiting for a 3 p.m. appointment. She told the AP: “There were people with walkers and canes and stuff. All these cops were outside running here and there with these guns.”

Three floors up, Plotts had allegedly opened fire, killing a caseworker who had accompanied him to his appointment. Late Thursday, Whelan identified the woman as 53-year-old Theresa Hunt.

Plotts’s psychiatrist, Lee Silverman, crouched down behind his desk and grabbed his gun.

“[Silverman] was able to reach for his weapon, and realizing it was a life or death situation, was able to engage the defendant in the exchange of gunfire,” Whelan said.

Silverman was grazed in the temple but returned fire. Plotts was shot twice in the torso and once in the arm.

The struggle spilled into the hallway where another doctor and caseworker secured Plotts’s gun.

Late Thursday, police were attempting to determine what motivated Plotts to kill a caseworker and whether his psychiatrist had concerns about him, the Associated Press reported early Friday morning.

“We do believe that there were some issues between the doctor and the patient, but whether or not he actually feared him is unclear,” Whelan said, speculating that Plotts may have had issues with his doctor over his treatment plan. Still, it’s not clear why Silverman was armed, which is reportedly against the hospital’s policy.


A gunman opened fire inside a Pennsylvania psychiatric facility on Thursday, killing a woman and wounding a doctor before he was shot and critically wounded, authorities said. (REUTERS/Charles Mostoller)

The hospital policy bars anyone except on-duty law enforcement officers from carrying weapons on the premises, a spokesman for the Mercy Health System told the AP.

Still, Yeadon Police Chief Donald Molineux said, “Without that firearm, this guy [the patient] could have went out in the hallway and just walked down the offices until he ran out of ammunition.”

On Thursday evening, Silverman had been treated and released, but Plotts was still in surgery. Whelan told the Delaware County Daily Times complications arose during surgery, but he did not elaborate.

Plotts has a history of psychiatric problems, including two suicide attempts, according to news reports. He also has a criminal record.

“His criminal record goes back to the early 1990s for three arrests for illegal possession of firearms and arrests for narcotics violations and assaults in Philadelphia,” Upper Darby Police Superintendent Michael Chitwood told the Daily Times. “In Upper Darby, he has been [committed to a hospital for psychiatric evaluation] on at least three occasions. The last one of the three was in January 2013.”

Plotts also served time in prison for a bank robbery, NBC Philadelphia reported.

Thursday evening, local reporters went to Hunt’s neighborhood and spoke to her neighbors.

Some said Hunt would sit with them on the stoop outside when she got home from work, though, they said she was often tired and drained from the job.

“She was a sweet woman. She was funny. She loved bingo,” her neighbor, Lorraine Moore, told CBS Philadelphia. “She used to sit with us, tell us about her days.”

The Daily Times reported Plotts was in custody Thursday at the Hospital of the University of Pennsylvania.