BUFFALO — A Minnesota man accused of walking into a medical clinic and opening fire, killing one staff member and wounding four others, was indicted on a more serious charge of premeditated murder, and remained detained after a court appearance Monday.

A grand jury indicted Gregory Ulrich, 68, with one count of first-degree premeditated murder in the Feb. 9 shooting at the Allina Health Clinic in Buffalo, a small city about 40 miles (65 kilometers) northwest of Minneapolis. He also faces four counts of first-degree attempted murder in the attack.

He is also accused of setting off several pipe bombs at the clinic before eventually surrendering to law enforcement, and has been charged with discharging an explosive device.

Lindsay Overbay, a 37-year-old medical assistant, was killed in the shooting.

Ulrich appeared in a Wright County District Court on Monday and remains detained. Bail has been set at $5 million with conditions, or $10 million without conditions. His attorney, Gregory Davis, had no comment on the upgraded charge.

In Minnesota, the count of premeditated first-degree murder must be charged by a grand jury; Ulrich will face a mandatory life sentence if convicted. Prosecutor Brian Lutes said he convened the grand jury after a judge ruled in August that Ulrich was competent to stand trial.

Court records allege Ulrich has mental health and substance abuse problems, and that he frequently reported unfounded thefts or minor quarrels involving his neighbors and others. Police have said Ulrich was no stranger to them and was known to have been angry over his medical treatment.

Ulrich’s next court hearing is set for Oct. 18.