This story has been updated.
Two assailants attacked a San Bernardino County, California, public health department holiday party Wednesday morning, killing 14 and wounding 21 others. After a manhunt, police killed both suspects, one of whom authorities say was a department employee.
The holiday party was held at a conference space at Inland Regional Center, a not-for-profit that provides services to people with developmental disabilities.
The attack is the deadliest shooting in the United States since the massacre at Sandy Hook Elementary School in 2012 when 20-year-old Adam Lanza killed 20 children and six adults.
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According to San Bernardino Police Department Chief Jarrod Burguan, one suspect, Syed Rizwan Farook—an environmental inspector with the health department—attended the holiday party Wednesday morning. He then left the party "angry" and returned with his wife, Tashfeen Malik.
The couple carried long guns, handguns, and wore "tactical clothes," Burguan said, adding authorities were unsure of the motive, but had not ruled out terrorism. Officials also discovered explosives at the scene of the attack. "There had to be some degree of planning that went into this," Burguan noted.
After Farook and Malik had fled, the facility was put on lockdown and swarmed by police. Hours later, police found the suspects, who were killed in a shootout.
Most victims of the shooting were taken to nearby Arrowhead Regional Medical Center (ARMC) and Loma Linda University Medical Center (LLUMC), Adam Rubenfire reports for Modern Healthcare.
As of Wednesday evening, ARMC had accepted five patients into its Level 2 trauma center. The hospital and other county buildings later went on lockdown. Ben Scaglione, director of health care security services for G4S, a British security company, noted that hospitals typically go on lockdown when a shooter may be nearby.
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The Press Enterprise reports that some family members of patients wounded in the shooting could not enter the hospital while it was locked down. "Any situation with shooters running around, you want to make sure they don't decide to hide or go into your hospital for cover," Scaglione told Modern Healthcare.
Five patients were taken to LLUMC's Level 1 trauma center. As of late Wednesday, two were in critical but stable condition, two were in fair condition, and one was still being assessed. Around 3 p.m. PT, a bomb threat was called into LLUMC, but authorities later determined it was not credible.
Hospital spokesperson Briana Pastorino said LLUMC was "always prepared to handle the worst of the worst injuries—like today."
Humberto Ochoa, a physician in the ED at Riverside University Health System-Medical Center, said two victims with gunshot wounds were taken to Riverside by helicopter. "They had multiple gunshot wounds and were critical, but they've been stabilized," he told The Press Enterprise (Southhall et al., New York Times, 12/3; Dauber et al., Washington Post, 12/3; Turkewitz/Mueller, New York Times, 12/3; Nagourney et al., New York Times, 12/2; Dolan et al., Los Angeles Times, 12/2; Rubenfire, AP/Modern Healthcare, 12/2; The Press Enterprise, 12/3; Zimmerman, et al., The Press Enterprise, 12/3; AP/SF Gate, 12/3).
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