On 19 September 2010 in the small town of Lörrach, Germany, 41-year-old Sabine Radmacher killed her five-year-old son and the boy's father, her ex-partner, in her flat.

After setting part of the building on fire, she crossed the street to St. Elisabethen Hospital where she shot and stabbed one nurse, killing him, and injured three people with gunshots, including a police officer.

On 16 September 2010 – only three days before the Lörrach rampage – the boy's father had to appear in court on a charge of failure to securely store his gun.

Radmacher then covered the rooms of her apartment with 70 liters of a mixture of nitro thinner, gasoline, and ethanol before setting a fire, causing an explosion, due to which 15 people, all residents of the same building, suffered the effects of smoke inhalation.

After taking the stairs up to the first floor to the gynaecology ward, Radmacher killed a 56-year-old surgical nurse with three shots in the head and numerous stab wounds.

Neighbours variously described Radmacher as a confident, friendly and ambitious woman who dressed sharply and drove a Mercedes she bought with her own money, while others noted that she was surly and erratic with "strange priorities", having clashed with her old employer who threatened to sue her, over which she contacted a journalist to publish an account, which was described as "incoherent".

Due to her targeting of the St. Elisabethen Hospital, investigators also considered possible trauma stemming from pregnancy loss, as Radmacher experienced the miscarriage of a previous child in the 16th week at the clinic in 2004.