It was a reasonable question given the hype and misinformation surronding the whole event and the events stemming from it.
I know, I didn't mean any negative tone. Sorry.
What would account for the 100% kill rate? Usually, there are at least some wounded(in addition to the killed) in shooting sprees.
The reports I have seen generally say that there were 2 wounded survivors.
But, I think the fatality rate was so high because he was using a rifle at across-the-room range.
What would also account for the high fraction is biological.
The following is my (given reasonable experience in studying terminal ballistics literature) thoughts on the matter.
1. The adults were probably shot multiple times at close range, and were among the first to be shot, and thus the most time to bleed out.
2. If some of the reports are to believed, he was using "green" bullets, which, if that is true, substantially increase the temporary (elastic) wound cavity relative to ball rounds, and thus cause more damage, especially in cases where significant penetration isn't "needed"
And 3, the most unfortunate, is that the bulk of the victims were small children.
(
Apologies for the detail here, I know its horrifying, and it is not my intention to dwell on that, but rather to explain, so don't read if it will bother you)The physical size of the victims in this case leads, in my opinion, directly to the high degree of lethality. As the size of the damaged region from a bullet is the same in biological material (small people have the same composition as large people), a given size damaged region can be substantially more lethal on a smaller person--there is a greater likelihood that the temporary wound cavity will intersect with major vessels and/or highly vascular organs (liver, kidney, etc). Additionally, as the damaged area is larger in proportion, and the overall blood supply volume is lower, a given loss rate will result in a much quicker fatal blood loss, even without accounting for higher blood pressure and heart rate associated with the type of victims here.
Given that, and the significant (from a biological standpoint) amount of time before medical treatment could possibly be applied (all the adults were killed, and the first responders had an active shooter to deal with, and there were far more victims than responders for the medically significant first 10-20 minutes), the resulting fatality rate is sadly, predictable.
If low penetration ammunition were in fact used, the greater rate of energy deposition per unit depth would result in even worse damage in the case of these victims, due to lower overall depth to the vital areas.
Again, I am extremely sorry for describing this horrifying event in such terms, it is not my intention to disgust or sadden.