"The shooter placed the pistol under his chin and pulled the trigger. He died immediately."

A prisoner escaped after shooting a warder in Port Elizabeth's Livingstone Hospital on Monday morning, the Eastern Cape health department said.

Spokesman Sizwe Kupelo said the warder brought the prisoner to the hospital for an x-ray.

The prisoner apparently asked to use the toilet, then asked again only minutes later.

The second time, he asked the warder to unlock his handcuffs.

“It's alleged that at that point he then shot the warder using a gun that was apparently smuggled into the hospital and into the toilets,” Kupelo said.

The prisoner escaped, reportedly with the aid of accomplices who had brought a getaway car into the hospital grounds.

Kupelo said the warder was wounded in the pelvis, abdomen and back, and was in a stable condition at Livingstone.

He said this was the third shooting at the hospital in a year, and the department, concerned for the safety of patients and staff, planned to install closed-circuit cameras and metal detectors.

He said the hospital was supposed to be a gun-free zone, which meant that the private guards responsible for its security did not carry guns either.

This made things difficult when they had to deal with incidents such as shootings. - Sapa