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(TULSA, Okla.) — A patient gunned down his surgeon and three other people in a mass shooting at a Tulsa, Oklahoma, medical building on Wednesday after blaming the doctor for his pain, according to police.

On May 19, the suspected gunman underwent back surgery. Dr. Preston Phillips — one of the four people killed in the shooting at the Natalie Building, a five-story medical complex at Saint Francis Hospital — was the suspect’s doctor in that surgery, Tulsa Police Chief Wendell Franklin said at a news conference Thursday.

A letter recovered on the suspect, Michael Louis, made it clear “that he came with the intent to kill Dr. Phillips and anyone who got in his way,” Franklin said. “He blamed Dr. Phillips for the ongoing pain following the surgery.”

Louis bought an AR-style semi-automatic rifle just hours before the shooting, Franklin said. He bought a 40-caliber pistol from a pawn shop on May 29, police said.

The shooter died at the site from an apparent self-inflicted gunshot wound, police said.

The three others killed were Dr. Stephanie Husen, receptionist Amanda Green and patient William Love, Franklin said.

“They stood in the way” so the suspect “gunned them down,” Franklin said.

The suspect was released from the hospital on May 24, five days after his surgery, Franklin said. After his release, the suspect called several times over several days complaining of pain and wanting additional treatment, the chief said.

On Tuesday, Phillips saw the suspect again for additional treatment, the chief said. On Wednesday, the suspect called the doctor complaining of back pain and wanting additional help, the chief said.

At 4:52 p.m. local time Wednesday, a patient on a video chat with a doctor called 911 after the doctor told her there was shooting, police said. The first 911 call came in at 4:53 p.m. and police arrived at 4:56 p.m., the chief said.

A gunshot heard at 4:58 p.m. was believed to be the suspect’s self-inflicted gunshot wound, police said.

Phillips was found dead in an exam room, police said.

The chief called it a “senseless tragedy.”

“This is yet another act of violence upon an American city,” Franklin said. “We train for instances such as this. And I’m overwhelmed and proud of the men and women, all those that responded.”

“Our training led us to take immediate action without hesitation. … That’s what they did in this instance,” Franklin said.

ABC News’ Jenna Harrison Esseling contributed to this report.

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(NEW YORK) — Michael Avenatti was sentenced Thursday to four years in prison for defrauding Stormy Daniels, the client who made him a fixture on cable and a speculative candidate for public office for a brief time during the Trump administration.

“It has been three years since she discovered what Mr. Avenatti has done and she was devastated,” Clark Brewster, Daniels’ current lawyer, said.

“The regularly accepted theme was this guy was a great lawyer but … his legal scholarship based on the cases we took over is in doubt. This was a deceitful scheme. It wasn’t a mistake. It was calculated,” he added.

Avenatti, in beige prison garb over a long-sleeved white T-shirt, entered court shackled at the ankles. The judge denied Avenatti’s request to wear a suit to his sentencing hearing.

Avenatti was convicted of wire fraud and aggravated identity theft for stealing from Daniels, his former client, about $300,000 she was supposed to receive in connection with a book contract.

“Avenatti stole from his client. He did so to support his own business and fund his own lifestyle. He did so despite presenting himself to the world as his client’s champion and defender and despite using that feigned credibility to secure fame and pursue political influence. And he did so by exploiting his position of trust and authority as an attorney, by forging his client’s signature, and by lying to his client and others repeatedly and callously for months,” prosecutors said in a sentencing memorandum.

The judge allowed Avenatti to serve about half of his sentence at the same time he serves prison time for extorting Nike. He will spend an extra 2 1/2 years in prison for stealing from Daniels.

The judge said the sentence reflected the “abuse of trust” Avenatti demonstrated and a belief he could get away with it because people would believe him over Daniels due to her “unorthodox” career as an adult film actress.

Daniels was not present in court.

Avenatti briefly wept as he told the judge he will forever be known as a “disgraced lawyer.”

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(UVALDE, Texas) — The first search warrant returned in the Uvalde, Texas, school shooting sought access to the suspect’s iPhone as authorities search for clues that could point to the motive for last week’s fatal shooting of 19 children and two teachers.

A black iPhone 13 Pro Max was found next to the body of Salvador Ramos after he was shot and killed by a Customs and Border Protection tactical team, according to the search warrant affidavit.

Investigators from the Texas Department of Public Safety sought permission from a judge to analyze the text messages, photos, videos and other “stored communications” on the phone, according to the affidavit, which was first obtained by Houston television station KHOU.

The Texas Rangers, a division of the Texas DPS, is conducting an investigation into the shooting, one of the deadliest in modern U.S. history.

The document also said the two witnesses to the car wreck that preceded the massacre saw Ramos “dressed completely in black with long shoulder length black hair.” The witnesses also told police they saw “the male subject was holding a long rifle and proceeded to load the rifle with a magazine” before he “began to fire multiple gunshots in their direction.”

The judge authorized investigators to download the contents of the device.

Ramos’ grandfather, Rolando Reyes, whose home he was living in at the time of the shooting, told ABC News the suspect had argued with his grandmother over paying a cellphone bill on the morning of the shooting. However, Reyes said he did not believe it was significant. Ramos allegedly shot his grandmother before driving to the school and opening fire.

ABC News has previously reported that authorities have yet to find a specific piece of evidence that explains why the attack occurred May 24 or why Robb Elementary School was the target.

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(TULSA, Okla) — At least four people are dead and multiple people are injured following a shooting at the Natalie Building at Saint Francis Hospital in Tulsa, Oklahoma, on Wednesday evening, according to police.

Dispatchers received a 911 call shortly before 5 p.m. local time about a man walking with a rifle at the Natalie Building, a physicians’ office building on the Saint Francis Hospital campus. When police responded, they said it turned into an active shooter situation, according to Tulsa Police Capt. Richard Meulenberg.

When police entered the building, they found multiple people shot in one area on the second floor, including in an orthopedic office, authorities said. The victims could be a combination both of employees and visitors, authorities initially said.

“Officers immediately rushed to the second floor where the shooting was taking place, when they got there they found a few people had been shot, a couple were dead at that time,” Meulenberg told ABC News. “We also found at that time who [we] believe and still believe to [be] the shooter because he had a long rifle and a pistol with him.”

The Tulsa shooting comes amid a spate of shootings in the U.S., including the Uvalde shooting in Texas where 21 people — including 19 children — were killed, and a mass shooting at a Buffalo, New York, supermarket that saw 10 Black people shot dead.

One of the Tulsa victims died after leaving the scene trying to seek medical aid, according to Meulenberg. It is unclear at this time how many others were wounded in the shooting, though Meulenberg believed it to be under 10.

The shooter died from an apparent self-inflicted gunshot wound, according to Tulsa Police Deputy Chief Eric Dalgleish. Police were still working to confirm the identity of the suspected shooter, a man believed to be between the ages of 35 and 40, Dalgleish said during a briefing.

It appears both weapons were fired, according to Dalgleish. It is unclear if the suspect was targeting anyone specifically, he said.

Police said they went through the five-story medical complex room by room to secure the building.

“We are doing a meticulous floor-by-floor, room-by-room search,” Meulenberg said. “It’s calmed down. We’re trying to connect people and we’re hoping not to find any victims.”

Police said they are also investigating a possible bomb threat that may be connected to the suspected shooter.

Authorities evacuated a home in Muskogee, Oklahoma, about 50 miles southeast of Tulsa, after receiving a tip that the suspect “may have left a bomb at this residence,” Muskogee Chief of Police Johnny Teehee said Wednesday night.

A bomb squad was on scene and police were working to obtain a warrant to search the residence, he said.

Muskogee Mayor Marlon Coleman later said the bomb squad cleared the location of a potential threat, and that the scene had been “turned over to the necessary authorities.”

The Tulsa Police Department said to stay away from the area of the shooting and that reunification for families will be at Memorial High School on the west side of LaFortune Park.

Saint Francis Health System said in a statement late Wednesday that, “out of respect for the families,” it is “not commenting on or releasing names of those lost or injured at this time.”

“Saint Francis Health System is grieving the loss of four members of our family. As a faith based organization, the only recourse we have at this moment is to pray while we navigate this tragedy,” Saint Francis Health System said. “We are sincerely thankful for the quick response by the Tulsa Police Department, first responders and EMS agencies. And, our deepest gratitude extends to the members of our own Saint Francis family who cared for their own during this incident.”

“To allow our staff and caregivers the opportunity to process today’s tragedy, all Warren Clinic appointments in Tulsa and Broken Arrow scheduled before noon tomorrow have been cancelled. Additionally, the Warren Clinic Orthopedic offices in the Natalie Building will be closed until further notice,” the statement continued. “We ask that you please pray for the employees and physicians of the Saint Francis Health System.”

Tulsa Mayor G. T. Bynum expressed “profound gratitude” for the “broad range of first responders who did not hesitate today to respond to this act of violence.”

Oklahoma Gov. Kevin Stitt also praised the first responders who “did their best to contain a terrible situation” and offered to provide the city with any state resources needed.

“What happened today in Tulsa is a senseless act of violence and hatred,” he said on Twitter.

President Joe Biden and Vice President Kamala Harris have been briefed on the shooting, White House officials said.

“The White House is closely monitoring the situation and has reached out to state and local officials to offer support,” the White House said in a statement.

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