Police forces nationwide have joined the hunt for a violent prisoner sprung from the clutches of prison officers as they escorted him to hospital.
Andrew Farndon made the "planned" escape as he was being escorted from Highpoint prison to West Suffolk Hospital in Bury St Edmunds, Suffolk, for treatment yesterday.
It is understood the 26-year-old, whose family live in the Coventry area, inflicted a serious knife wound on himself in prison, before being taken to the hospital's Accident & Emergency (A&E) department in a taxi accompanied by two guards.
When they arrived, a waiting gunman confronted the male and female prison officials, before fleeing with Farndon across the car park, Suffolk Police said.
Detective Chief Inspector Nick Bennett said searches were continuing in Suffolk but said it was unlikely Farndon was still in the county.
Forces across the country, including the neighbouring counties of Norfolk, Essex and Cambridgeshire, along with West Midlands Police, have issued appeals for information.
Mr Bennett added: "Along with other forces, we are pursuing various lines of inquiry, including contacting his family, friends and associates in the West Midlands.
"We are also studying CCTV and number-plate recognition records to try to identify the car which was used in the escape.
"Another line of inquiry is whether any mobile phones were used in the planning and execution of this escape.
"His prison cell has been searched and various items recovered. No blade was found in this search.
"The prison officers are still shaken and it was obviously a terrifying ordeal."
His escape is the second in just a week, after an "extremely dangerous" category A prisoner, murder suspect John Anslow, was sprung from a prison van after it left Hewell Prison in Worcestershire.
Police said they were contacted just after 6.50pm by hospital staff who witnessed Farndon's escape.
The prison officers, who had travelled from Highpoint prison in Stradishall, near Newmarket, called moments later.
Armed response officers arrived on the scene within five minutes, Mr Bennett said.
He added Farndon had been taken to hospital in a saloon from a local taxi firm, believed to be A1 Taxis based in Bury St Edmunds. The company refused to comment.
Mr Bennett said he understood it was standard practice to transport prisoners to hospital by taxi unless there was a "specific risk".
He added: "He was handcuffed to a female prison officer who removed the handcuffs when a handgun was pointed at her head. A male prison officer was also escorting him."
Farndon is described as white with a goatee beard, and was wearing a dark blue baseball cap and a light coloured jumper that was padded on the right side due to his injury.
The man with the gun is described as white, aged in his mid-40s, around 5ft 8ins and of stocky build. He possibly had a Scottish accent and was wearing a white top and blue jeans.
It is thought they may have escaped in a dark coloured car and other accomplices may be involved.
Farndon previously escaped by leaping from the dock at Coventry Crown Court in 2007, but was sentenced in his absence to an indeterminate sentence for public protection (IPP) and told he must serve at least two years before being considered for parole.
He was found guilty of grievous bodily harm after a hammer attack that left his victim with a fractured skull, but officials classed him as a category C prisoner - meaning he was deemed unlikely to make a determined escape attempt.
He was also sentenced to 18 months for dangerous driving, 18 months for aggravated vehicle taking, and banned from driving for two-and-a-half years.
Justice minister Crispin Blunt said there was no suggestion the incident was linked to the escape of Anslow from HMP Hewell earlier this week.
"Clearly, we will be examining the circumstances behind this incident," he said.
"The most important thing at the moment is to get this man back in custody and to investigate the full facts of the case."
A Prison Service spokeswoman said a full Prison Service inquiry would follow.
Former convict Mark Leech, editor of the national prisoners' newspaper Converse, called for a full inquiry into how both escapes were possible.
"Forget reform, rehabilitation or reducing reoffending, the first and primary function of the Prison Service is security," he said.
"How is it that security intelligence at these prisons missed completely both of these clearly pre-planned escapes?"
Justice Secretary Kenneth Clarke has urged MPs to scrap the indeterminate sentences, saying they had not worked properly since they were introduced under the Labour government in 2003, leaving thousands in prison beyond normal guidelines.
The IPP "experiment" left prisoners in a "Catch 22" situation, with no way of showing they were a "minimal risk to society", which they must do before they can be released, he told MPs last year.
But critics warned that scrapping IPPs would take a weapon out of a judge's armoury.
Mr Clarke has ordered an inquiry into how Anslow became the first category A prisoner to escape in more than 17 years on Monday.
A 44-year-old Tipton man arrested on Monday night on suspicion of helping Anslow to escape was released on bail pending further inquiries last night, police said.