Five people were killed, including a gunman, in a shooting on a hospital campus in Tulsa, Oklahoma, police said.
Police officers' quick response to the incident helped ensure more people were not harmed, police said.
Police arrived at the St Francis Hospital three minutes after receiving a call about the shooting and followed the sound of gunfire up to the Natalie Building's second floor, Tulsa deputy police chief Jonathan Brooks told reporters.
Police were through every room in the building checking for additional threats, police said, according to CNN.
The Bureau of Alcohol, Tobacco, Firearms and Explosives was assisting on the scene of the shooting, the ATF Dallas Field Division said on Twitter.
Police responses have come under increased scrutiny after a gunman killed 19 children and two teachers in a Texas school classroom last week while officers waited outside for nearly an hour.
The previous week 10 people were killed in a supermarket in Buffalo, New York.
The teenage gunman accused of the killings in Buffalo has been charged with domestic terrorism. Prosecutors allege 18-year-old Payton Gendron, who earlier pleaded not guilty, was motivated by racial hatred.
Asked by reporters whether police had refreshed training or thinking about active shooters after the Uvalde, Texas school shooting, Eric Dalgleish, another Tulsa deputy police chief said: "I think that's probably fresh on everyone's minds."
"I will say Tulsa revisits that topic regularly. I was very happy with what we know so far regarding the response of our officers," Dalgleish said.
Brooks said police were trying to determine the suspect's identity and estimated he was aged between 35 and 40.
The Natalie Building contains doctors' offices including an orthopedic centre, he said, adding he believed the victims included employees and patients.
The White House said President Joe Biden had been briefed on the shooting and offered support to state and local officials in Tulsa, a city of some 411,000 people that sits around 160km northeast of the capital, Oklahoma City.
- Reuters / CNN / BBC