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William Bos, Isaiah Johnson, Mateo Maya

Weapons and Tactics, EUCOM

Brantley Williams, Mia Sadler, Alya Fathia Fitri, Editor; Cameron Munoz, Evan Beachler, Senior Editor

September 28, 2023

Erasmus Medical Center, Rotterdam[1]

The Counterterrorism Group (CTG) is issuing a FLASH ALERT for residents in downtown Rotterdam and major cities in the Netherlands. Suspect Fouad L. was arrested around 1600 local time in connection with two shootings that took place earlier in the afternoon. The first shooting occurred at a private residence located in Heiman Dullaertplein, where the suspect killed his neighbor, a 39-year-old woman, and wounded a 14-year-old girl who later died from her injuries. The suspect started a fire in the residence and fled to Erasmus Medical Center on his motorcycle. The second shooting occurred when the suspect entered a classroom and killed a teacher. The suspect then proceeded to the entrance lobby and set it ablaze. Despite strict gun control laws, mentally ill individuals can still obtain semi-automatic firearms and body armor to commit violence.

CTG is on HIGH alert for the increase of illicit firearms circulating through the Netherlands and the HIGH risk of undetected radicalized individuals at various stages in the Pathway to Violence. The suspect ALMOST CERTAINLY illegally obtained the illicit firearm and body armor used in the attacks. The suspect VERY LIKELY had outside assistance obtaining the equipment necessary to attack because of his anti-social nature and background as a medical student. Illicit social and smuggling networks will LIKELY increase in low-crime areas like the Netherlands.


Dutch Police received a call at 1430 hours about a shooting at a private residence located West of downtown Rotterdam. The caller reported hearing gunshots from a nearby house, where Fouad L. killed his 39-year-old neighbor and injured her 14-year-old daughter. Fouad then set the house ablaze and fled to Erasmus Medical Center, located 900 mts from the residence. Fouad shot and killed his teacher, a 46-year-old general practitioner.[2] Fouad moved to the entrance lobby, which he also burned. Fouad was detained at around 1600 local time and taken into custody. Local police suspect that Fouad had a grudge against the medical center and his former teacher based on his internet chat history and documents found on his phone.


Using the Pathway to Violence matrix, a comprehensive guide to the stages leading to an attack based on reports from the Department of Homeland Security, CTG has identified several stages explaining how these shootings occurred.[3] Fouad showed clear signs of Grievance and Violent Ideation before carrying out the shootings. His outsider status within his study and hostile behavior confirm the passing of this stage. Fouad has a history of anti-social behavior and was sentenced to 40 hours of community service for having abused and killed a rabbit in 2021.[4] These behaviors were warning signs that required closer monitoring. There was likely little time between the stages of research and planning, preparation, probing, and breaching. Fouad expressed his misanthropic views and frustration through 4chan, calling for the death of “normies” (people who follow social norms).[5] Platforms like 4chan critically affect the attacker’s motivation, likely reinforcing thoughts based on user reciprocity. Fouad’s quick navigation through the hospital was very likely a direct result of his familiarity with the building.

Although hospitals in the Netherlands legally require unarmed security personnel to act as access control officers,[6] these facilities are very likely to be considered a soft target for attackers because of hospital security regulations. Hospitals and medical centers will likely develop active shooter training programs for patients and healthcare workers to respond to active shooter incidents properly. Soft target facilities will likely increase the presence of private security operators and tighten the security access control. There is a roughly even chance that the public and private security companies will request a policy change in Dutch law allowing armed security guards in public facilities.

Given that the individual could maneuver his way into the classroom without security or staff detecting their firearm, the lack of metal detectors and other countermeasures will very likely continue to be a vulnerability. Security measures in hospitals are a crucial part of the normal function of these establishments. Law enforcement and the administrative bodies of these establishments must reconsider their approaches toward enhancing security. Metal detectors in patient access points and the student wing are crucial countermeasures to respond to active shooters and similar threats.

The private security staff's capabilities onsite should allow the guard to subdue or at least incapacitate an aggressor. Using non-lethal weapons such as Tasers will likely allow guards/operators to de-escalate and control the situation. The shooter's ability to acquire the weapon is of concern. Rotterdam is the biggest port in Europe and transports many goods. The shooter likely acquired the weapon this way illegally. Port entry cities like Rotterdam are a target for illicit goods smuggling.


  • CTG recommends that the Rotterdam Police Department conduct a security assessment over the access control and security perimeter of educational centers in universities and schools. Entry points and social areas at the Rotterdam Medical Centre University were vulnerable to any attack.

  • CTG recommends that universities adopt AI-assisted firearm detection software with their security cameras and combine this technology with an alarm system that communicates directly with law enforcement.

  • CTG recommends deploying fire doors to block off sections of the building to restrict access to potential attackers.

  • CTG recommends Dutch private security companies add active shooter training courses to the basic training of their personnel, based on the specific client's requirements, and conduct regular drills to detect possible weak points.

  • CTG recommends the implementation of security alerts to hospital staff cell phones to facilitate communication.

  • CTG recommends using sound detection technology to identify gunshots like Shotspotter™ when responding to security incidents.

  • CTG recommends that the administrative bodies of health and education institutions consider warnings about an individual’s psychotic behavior with a higher degree of severity and monitor the suspected individual’s online activity.

  • CTG recommends monitoring online traffic on platforms such as 4chan, specifically targeting violent and extremist rhetoric.

The recommendations and analysis indicate that hospitals are LIKELY to continue being targeted with their current security measures. There is a HIGH PROBABILITY that weapons will continue to be acquired illegally through the black market. Unregulated platforms will VERY LIKELY continue to foment extremist rhetoric. There will LIKELY be a reevaluation of the monitoring procedures for individuals with psychotic behaviors.


[2] “Three dead in Erasmus MC shooting and fire, including 39-year-old woman, 14-year-old girl and 43-year-old teacher”, Rijnmond, September 2023,

[4] At least two killed in Rotterdam shootings - police, BBC, September 2023

[5] 14-year-old girl also killed in Rotterdam shootings, AD News, September 2023,

[6] Create safety in healthcare with security, Dutch Crowd Security, September 2023,


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