COLUMBUS, Ohio (AP) — Police on Monday shot and killed a man in an Ohio hospital emergency room after an exchange of gunfire, authorities said.

The shooting at St. Ann’s Hospital in Westerville in suburban Columbus happened after Westerville officers responded to a report of a man passed out in a car and then followed medics to the hospital.

Westerville police said the man was inside the emergency room when gunfire was exchanged with police. Officers from Columbus and the hospital were involved in the shooting, according to Westerville police Chief Charles Chandler and Columbus Police Chief Michael Woods, The Columbus Dispatch reported. It wasn’t immediately clear who fired the fatal shots.

Police say the man had outstanding domestic violence and weapons warrants out of Franklin County. The state’s Bureau of Criminal Investigation is investigating the shooting.