A gunman has opened fire with an assault rifle inside a hospital in the Bronx borough of New York, killing one doctor and injuring six other people, five of them seriously.
The gunman, a former doctor at the hospital, killed himself in the attack.
The shooting began at about 14:55 local time (18:55 GMT) at the 1,000-bed Bronx-Lebanon Hospital.
Mayor Bill de Blasio said the shooting was not an act of terrorism, but rather workplace-related.
He said the attack had been a “horrific situation in the middle of a place that people associate with care and comfort”.
Several of the injured are “fighting for their lives,” he added.
Police Commissioner James O’Neill said the attack began on the 16th floor and all the victims were shot on the 16th and 17th floors.
The gunman has not been officially named but police sources told US media he was Henry Bello, 45, a former family-medicine doctor at the hospital.
Sources quoted by NBC said he had resigned in 2015 in lieu of termination.
Mr O’Neill said the gunman had tried to set himself on fire and died of a self-inflicted wound.
Messages on social media spoke of doctors and nurses barricading themselves inside the building in the Mount Hope district.
Police said the suspect was wearing a white medical coat when found.
An assault rifle was also discovered nearby, which a local politician separately said appeared to be a military-grade M16 rifle.