Volume 39, Number 1, 2023

Before and after the 2021 Allina Clinic Active Shooter
by Caroline Ramsey-Hamilton, CHS-3

This article details the special circumstances and specific events leading up to the deadly
shooting. The attack highlights the continuing workplace violence problem in healthcare

(Caroline Ramsey-Hamilton, CHS-3, is President of Risk & Security LLC, based in Park-
land, Florida. She can be reached at

On February 9, 2021, a quiet Tuesday, a 67-year-old man left a motel in Minnesota with a
suitcase containing a 9mm hand-gun, 50 rounds of ammunition, and five homemade bombs.

He boarded a city bus for the Allina Health Clinic, in Buffalo. There, within about 6 minutes, he planted and detonated three bombs—two in the lobby and a third in an adjacent workstation—before shooting five staff members. He killed a 37-year-old medical assistant and wounded four others. One man was shot six times. The gunman then called 911 on himself and laid down on the floor with his arms spread out at his sides.

According to the police report, the gunman, Gregory Paul Ulrich, had threatened several
times before to carry out a mass shooting at the clinic, where he had undergone back surgery in
2016. Following treatment, Ulrich experienced a great deal of pain, for which his doctor prescribed opioids. He was reportedly unhappy with the medical care he had received at the facility. He had repeatedly come back to the clinic to complain, and his behavior was so disruptive that the doctor had asked for, and received, a restraining order against Ulrich in 2018.

Healthcare workers face the constant challenge of violence against them from the patients
they treat. On the day of the shooting, the Minnesota Nurses Association issued a news release spotlighting this issue, citing its own 2019 survey showing that 95% of its nurses say they do not feel safe from violence at work.

The full story of what happened at the Allina Clinic reinforces the importance of having strong plans in place for preventing and handling violence from patients who blame the healthcare staff for their problems.

As Rick Fuentes, a spokesman for the Minnesota Nursing Association, noted after the incident, a lot went wrong leading up to the shooting, including Ulrich’s repeated violations of the restraining order. Complicating the situation, doctors had initially prescribed strong medication for Ulrich’s pain, but he also bought illegal narcotics, which were found in his motel room. In the past, he had taken too much medication, which resulted in an overdose. Because he had overdosed, the doctors were no longer allowed to prescribe pain medication. Ulrich continued to go to the clinic and complain about his
medical treatment. He referred to the medical staff as the people who “tortured” him. Accord-
ing to a police report, the 2018 restraining order was issued after a physician, Andrew Burgdorf, told investigators that Ulrich had talked about “shooting people, blowing things up, and practicing different scenarios of how to get his revenge.” The doctor reported that Ulrich told him he dreamed about exacting
revenge on the people who “tortured” him, referring to issues he had after surgery and the handling of his pain medication.

Ulrich claimed to the police that he had just been telling the doctor about his dreams and that he would not actually do anything. The police took him for a mental health evaluation, the report says. But even after the restraining order had been granted, Ulrich continued to visit the clinic and terrorize employees,
sometimes being escorted out of the clinic by a worker or being arrested by police. The shooting incident underscores a grim reality for clinics—“restraining orders work best on the people least likely to violate them.” Opioid use after the surgery played a major role in the shooting. Ulrich had quickly developed a dependence on pain medications. The restraining order stated that, shortly after leaving the hospital following a surgery, Ulrich overdosed on the opioids he had been prescribed, which, as mentioned above, led to him being cut off from opioid medication.

In the application for a search warrant enabling a search of Ulrich’s motel room, Wright County Sherriff Deputy Patrick Bailey said he believed “the driving force” behind the shooting at the Allina Clinic was the suspect’s dependence on opioid medication and distress that his legal supply had been stopped. Richard Ulrich, the suspect’s brother, seems to agree. He has been quoted as saying that Gregory Ulrich “seemed to be upset with the doctors and frustrated that they wouldn’t give him any medication. That’s probably
what set him off.” Although the exact motive was not immediately known, the Buffalo police chief, Pat Budke, said Ulrich had a long history of conflict with healthcare clinics in the area, dating back more than 10 years.

In light of Ulrich’s drug problems, how did he manage to obtain the gun he used? According to news reports, the Buffalo Police Department granted him a permit to buy a gun even though the restraining order had been is sued, Ulrich had already violated that order, and a court services agent had highly recommended against allowing him to have a weapon.


On September 27, 2021, seven and a half months after the shooting, Allina Health reopened its newly renovated clinic in Buffalo. David Simonson, whose wife works at the clinic and was inside during the deadly shooting, said, “It’s a pretty emotional day for her and everyone involved.”

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