A medical student accused of shooting dead three people at a house and a hospital in Rotterdam is appearing in court for the second time on Monday.

Fouad L., 32, is charged with killing 43-year-old lecturer Jurgen Damen and setting fire to a classroom at the Erasmus Medical Centre in October.

L. is also alleged to have shot dead his 39-year-old neighbour and her daughter at their home on Herman Dullaertplein and set fire to his own home shortly beforehand.

The public prosecution service had written to the university hospital warning them about L.’s “concerning” and potentially psychotic behaviour in the weeks before the shooting. L. was ordered to undergo a psychiatric examination, but failed to comply.

He is believed to have targeted his neighbour after she reported him to the housing association for mistreating his pets, which resulted in a conviction for animal cruelty in 2021.

At the hearing today prosecutors are expected to apply for L. to be kept in custody while the investigation into the shooting continues. Under Dutch law prisoners held on remand must be brought back to court within 90 days.

L. has also been sent for examination at the Pieter Baan Centrum, where criminal suspects are assessed for psychiatric treatment.