An Iraq War veteran being treated for mental health issues opened fire at Fort Hood military base on Wednesday, killing three people and wounding 16 others — three critically — before turning the gun on himself. The attack took place on the same site in Killeen, Texas, where more than a dozen people were slain in 2009.
Lt. Gen. Mark Milley, commanding officer at Fort Hood, officially identified the shooter as Army Spc. Ivan Lopez during a press conference on Thursday.
Milley said that while the investigation was ongoing, there have been no indication that Lopez's actions were in any way connected to terrorism.
He added that there were “strong indications” that the shooting may have been triggered by “a verbal altercation with another soldier or soldiers” that “preceded the shooting.”
Meanwhile, many of those caught up in the gun rampage remained hospitalized Thursday.
Doctors at Scott & White Memorial Hospital in Temple, Texas, said nine patients were admitted there, three with critical injuries to the neck, spine and abdomen.
Dr. Michael Davis, the trauma director at Scott & White, indicated that he doesn't expect the death toll to rise.
"We don't expect any more fatalities at this point," he said, while cautioning: "There's a tremendous amount of work left to be done. We still have some time to go before I declare them completely out of the woods."
No extremist ties
Earlier, U.S. Army Secretary John McHugh said there was no indication the Fort Hood shooter was involved with extremist organizations and that he had no direct involvement in combat when deployed in Iraq, where he served for four months in 2011. Lopez was not physically wounded in action, but self-reported a traumatic brain injury before returning to the U.S., The Associated Press reported.
McHugh, whose comments came during a congressional hearing Thursday, also said the shooter was seen by a psychiatrist last month and showed no signs of violence or suicidal tendencies.
The gunman had been undergoing an assessment before the attack to determine if he had post-traumatic stress disorder (PTSD), according to Milley.
Wednesday's shooting once again raised questions about PTSD and if enough was being done to diagnose and treat the illness in military service members.
"The symptoms can be different in different people and also they're very subjective, so there's no test like an MRI or some other type of X-ray where you can find an answer, like with some physical problems," Dr. Devi Nampiaparampil, assistant professor at NYU Langone Medical Center, told Al Jazeera on Thursday.
"A lot of issues with mental illness are that we're relying on people to tell us things, but they may not know exactly what is important to reveal and, at the same time, they may leave out important things because they don't want to share that."
Lopez arrived at Fort Hood in February from another base in Texas. He was taking medication and receiving psychiatric help for depression and anxiety, officials said. The gunman's weapon had been recently purchased in the local area and was not registered to be on the base, Milley said.
The Department of Justice, along with the FBI, has been tasked with carrying out the investigation. Attorney General Eric Holder said the probe would work to “determine exactly what happened and why.”
"We owe it to all of our men and women in uniform — and their families — to see that justice is done; to ensure that they are safe here at home; and to do everything in our power to prevent these too-common tragedies from happening again," he said in a statement.
Security on military bases
The latest shooting at Fort Hood underscores the U.S. military's frustrated efforts to secure its bases from potential shooters, who increasingly appear to see the facilities as attractive targets.
Wednesday's shooting was the third rampage at U.S. military base in just over six months, with memories still fresh from shootings at the Washington Navy Yard in September and late last month at Naval Station Norfolk in Virginia.
"I don't think that there's any way that it's possible to guarantee that incidents like this will not happen. It's like any other aspect of our community — if someone's determined to commit this type of heinous crime, they're going to be able to do it," said Geoffrey Corn, a former military prosecutor.
"It's impossible for any organization to provide 100 percent assurance of security," Killeen Mayor Dan Corbin told Al Jazeera. "They're doing all they can reasonably do under the circumstances."
Lopez is thought to have walked into a building Wednesday afternoon and begun firing a .45-caliber semi-automatic pistol. He then got into a vehicle and continued firing before entering another building, but he was eventually confronted by military police in a parking lot, according to Milley.
As he came within 20 feet of an officer, the gunman put his hands up, but then reached under his jacket and pulled out his gun. The officer drew her own weapon, and the suspect put his gun to his head and pulled the trigger a final time, Milley said.
Those injured were taken to the base hospital and other local hospitals. At least three of the nine patients at Scott and White Hospital in Temple were listed in critical condition.
"We need everyone's prayers to comfort the families of those who have lost their loved ones and pray for those who are in recovery at the hospitals," said Corbin.
President Barack Obama vowed a complete investigation. In a hastily arranged statement while in Chicago, the president reflected on the sacrifices Fort Hood troops have made — including enduring multiple tours to Iraq and Afghanistan.
"They serve with valor. They serve with distinction, and when they're at their home base, they need to feel safe," Obama said Wednesday. "We don't yet know what happened tonight, but obviously that sense of safety has been broken once again."
Al Jazeera and wire services