Stanwood Elkus (Daily Pilot / May 28, 2014)

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An accused murderer told a nurse, "Call the police, I'm insane, call the police," moments after he shot a Newport Beach doctor multiple times in the chest early last year, a police detective testified Wednesday.

Stanwood Elkus, 76, used a fake name to make an appointment with prominent urologist Ronald Gilbert, of Huntington Beach, at his Hoag Hospital-affiliated office and shot the doctor to death on Jan. 28, 2013, the detective told Orange County Superior Court Judge Margaret R. Anderson, who determined during a preliminary hearing that there was enough evidence to send the case to trial.

Based on interviews with witnesses, Newport Beach police Det. Kyle Cammack explained how the shooting unfolded, starting with a nurse leading Elkus to an examination room in a medical building off Superior Avenue in Newport Beach.

Once in the exam room, Elkus removed three coats and a satchel so the nurse could take his blood pressure, Cammack said.

The nurse reported hearing loud bangs a short time later, prompting her to return to the room.

That's when Elkus opened the door holding a .45-caliber handgun and told her to call police, Cammack said.

Inside, the nurse and another doctor saw Gilbert's bloodied body and shell casings littering the floor, according to Cammack and Newport Beach police Sgt. Brad Miller.

Elkus then handed over the pistol and waited for authorities to arrive, the officials said.

The retired barber from Lake Elsinore is facing a special-circumstances murder charge with a sentencing enhancement for the use of a firearm.

Listening to the evidence against him Wednesday, Elkus leaned forward and cupped his hands behind his ears.

"I've got a 60% hearing loss," he explained before the court produced a hearing aid for him.

After hearing the testimony, Anderson ruled that the case could proceed and denied a request from Elkus' lawyer to reduce the charge to second-degree murder.

The killing was not planned, argued Elkus' lawyer, Colleen O'Hara.

O'Hara produced documentation showing that Elkus had scheduled an appointment with his psychiatrist for Jan. 30. He scheduled that visit on Jan. 23, one day after he set up his Jan. 28 appointment with Gilbert, O'Hara said.

Elkus brought a folder of medical records with him to Gilbert's office the day of the shooting.

"Presumably he had some intention of going over them with Dr. Gilbert," she said.

Anderson said that fact could become relevant during the trial but, "It's not really important at this point."

Elkus' psychiatric appointment also did not convince the judge that it negated premeditation.

"It could be a ploy," Anderson said. "It could be any reason."

In a jailhouse interview last year with the Daily Pilot, Elkus said he was angry about the aftereffects of prostate surgery that he claimed Gilbert performed on him at an unspecified Veterans Affairs hospital two decades ago.

At the time, a lawyer for the Gilbert family said the urologist did work at the VA during that time period but it was another doctor who performed the surgery.

During Wednesday's hearing, Cammack said the nurse working in Gilbert's office referred to Elkus — at that time going by the name Adam Gold — as a "new old patient," meaning he'd seen Gilbert in the past but hadn't returned for a long stretch of time.

When the nurse tried to take a urine sample from Elkus before the shooting, he declined to give one, saying he had a condition that caused him to urinate multiple times while he was waiting, according to Cammack.

Elkus is scheduled to be arraigned next month and may have to find a new lawyer.

O'Hara told Anderson that she may have to withdraw as Elkus' retained attorney because he no longer has the means to pay for his defense.

In a wrongful-death lawsuit filed by Gilbert's wife and two sons, a civil court judge essentially stripped Elkus of all assets to compensate the family.