A medical student who shot dead his neighbour and her daughter before killing one of his teachers in a classroom has diminished responsibility as a result of an autism spectrum disorder, prosecutors told a court on Monday.

Fouad L., 33 is believed to have targeted his neighbour, Marlous, after she reported him to the housing association for abusing his pets, which resulted in a conviction for animal cruelty in 2021.

L. shot the 39-year-old woman in her Rotterdam home along with her 14-year-old daughter, who opened the door to him, on September 28 last year. He then went to the Erasmus Medical Centre teaching hospital and killed Jurgen Damen, 43, in front of his students.

L. was studying medicine at Erasmus university, but had been declined a degree because of concerns about his mental health. The university had asked him to undergo a psychiatric examination after being warned about him by the public prosecution department, but L failed to comply.

He wrote long posts on the networking site 4Chan in which he claimed that the staff at Erasmus teaching hospital were conspiring to prevent him from qualifying as a doctor.

Behavioural experts at the Pieter Baan Centrum, which assesses the mental health of criminal suspects, said L’s autistic condition was likely to have contributed to his actions and the court should rule his responsibility was impaired.

The centre recommended detaining L. in a secure hospital under a compulsory psychiatric treatment order.

L, who is also charged with arson, threatening behaviour and possession of a firearm, was not present at the hearing. Neighbours gathered at several locations in Rotterdam last week to commemorate the victims on the anniversary of the tragedy.