An Indian-origin paediatrician suffering from terminal cancer took another doctor as hostage and, after several hours of a stand-off with police,  killed her and then himself, according to police.

Bharat Narumanchi took several people hostage at a children's clinic in Austin, Texas, on Tuesday evening but except for a doctor the others escaped or were let go, local police said in a statement on Wednesday.

Hostage negotiators tried to contact him and when that failed, a police SWAT team entered the building and found him and the doctor held as hostage, Katherine Lindley Dodson, dead from “apparent gunshot wounds,” according to police. Dodson, 43, was a mother of three children. 

“It appeared that Dr Narumanchi shot himself after shooting Dr Dodson,” police said.

According to the hostages, Narumanchi had visited the clinic a week ago seeking a volunteer position.

Mystery surrounds the incident as there did not appear to be any relationship or other contacts between him and the victim, according to police.

Police Lt. Jeff Greenwalt was quoted by TV station KXAN as saying, “We feel like his terminal cancer probably played a large part in whatever it was that occurred in his life and what was happening yesterday.”

When Narumanchi went to the clinic on Tuesday he was armed with a pistol and what appeared to be a shotgun, according to the hostages interviewed by police.

Healthgrades.com reported that Narumanchi, 43, studied medicine at medical college on the island of Grenada and had worked at an army medical centre in Hawaii. He was also on the list of doctors at two hospitals in Santa Ana but the details about him were removed.

According to news reports, Narumanchi had a chequered background. KXAN said that his services had been terminated by a New York hospital after a year and a half and he had filed a case against the hospital.

The Austin American-Statesman newspaper reported that he had been charged with domestic abuse in Hawaii, but the case was dropped. He had divorced his wife and they had a custody battle in court over their child, according to the newspaper.

There are an estimated 80,000 doctors of Indian origin in the US.