(KHON/KRON) — A patient missing from Hawaii State Hospital has a violent past, and his escape is once again raising concerns about public safety.

Police say Randall Saito, 59, left Hawaii State Hospital in Kaneohe at around 9 a.m. on Sunday, Nov. 12, and never returned.

According to the Maui Police Department, shortly after his escape, Saito boarded a plane to Kahului, then caught another flight off the island.

Authorities say he is heading to Bay Area, and he has been referred to as a “psychopath.”

The U.S. Marshals Service is assisting with the search.

Saito was accused of murdering Sandra Yamashiro in 1979 at Ala Moana Center.

Police discovered her body sprawled in the front seat with multiple stab wounds to her chest and back.

Two years later, Saito was acquitted by reason of insanity.

We had several questions for the Department of Health, which oversees the hospital, but officials had little to say, citing patient privacy laws.

The department issued the following statement:

“The Hawaii State Hospital staff takes all escapes seriously and has safeguards in place to minimize the chances of these from occurring.

A thorough investigation is now underway to gather more details to identify areas for improvement.

“To comply with federal and state privacy laws, the Hawaii Department of Health (DOH) may not disclose information on Hawaii State Hospital patients.

“We are also aware of the need to support the safety of the public and per protocol, any escape is reported to law enforcement to expedite searches for patients, including the patient who escaped from the Hawaii State Hospital on Sunday.”

It’s still not clear how Saito was able to leave hospital grounds on his own.

Prosecutors tell us that in 2015, Saito filed a motion requesting permission to leave the hospital and go unescorted to Koolau Clubhouse, a rehabilitation facility that helps patients reintegrate to society.

Prosecutors argued against it and the judge agreed, but Saito was allowed to go the facility regularly with an escort.

“We opposed any kind of release to the community, not that he wasn’t fit, but because of the risk of danger he posed. We weren’t comfortable with him being out there, even with an escort going to the clubhouse,” said deputy prosecutor Wayne Tashima.

“Why do you feel he’s still a danger?” KHON2 asked.

“Well once he committed a crime, we feel that he always has it in him to commit the crime or another crime similar to that,” Tashima replied. “It never leaves a person as far as we’re concerned, so that’s why he maintains that high risk or moderate risk of danger to the community if he’s not escorted, if he’s not being watched by someone.”

Saito is 6 feet tall and 220 pounds with black hair and brown eyes.

Anyone who sees Saito is asked to call 911, Honolulu CrimeStoppers at (808) 955-8300, or the Honolulu Police Department’s Criminal Investigation Division at (808) 723-3609.

Officials advise people to exercise caution and not approach him.

Here is the full statement from Honolulu police:

Randall Saito, who was committed to the Hawaii State Hospital by the State of Hawaii, First Circuit Court, after being acquitted for first-degree murder in 1981, escaped from the hospital on Oahu, Hawaii, and is believed to be in Northern California. Saito is considered extremely dangerous and should not be approached. Anyone who sees him or has information on his whereabouts should call the Honolulu Police Department’s Criminal Investigation Division, (808)723-3609, or Honolulu Crime Stoppers, (808)955-8300. The public may also contact their local law enforcement agency.

On Sunday, November 12, 2017, at 10:00 a.m. (Hawaii time) Saito left the State Hospital and did not return. It has been determined that he took a taxi from Kaneohe to Honolulu, where he chartered a plane to Maui. From Maui, Saito boarded a plane to San Jose, California. Saito arrived in San Jose around 5:30 p.m. (Hawaii time) on Sunday. Staff from the State Hospital called 911 to report Saito’s disappearance shortly after 7:30 p.m. (Hawaii time). A second-degree escape case was initiated, and an all-points bulletin was issued at 8:30 p.m. (Hawaii time).

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