The state Department of Health cites overcrowding at an aging facility not built for high-security in answer to an escape from the Hawaii State Hospital by a man who led police on a chase while driving a stolen dump truck through Waikiki in 2013 and allegedly struck a police officer earlier this year.

Allen Pitts, 47, remained on the loose Monday after escaping Saturday night from the Hawaii State Hospital, where he was committed by court order for two separate incidents.

Police said Pitts escaped sometime between 9 p.m. and 10 p.m. Saturday from the Kaneohe facility by breaking a window and fleeing. But the hospital staff only discovered him missing during a bed check at 8 a.m. Sunday. He is now wanted for second-degree escape.

“The staff does take this very, very seriously,” said Janice Okubo, spokeswoman for the Department of Health, adding that the hospital is doing well compared with other mainland facilities. “We’re trying to have zero incidents.”

She could not comment on any specific patient due to privacy concerns, but the department is working with the police department, which is searching for and seeking the public’s help for the patient’s return.

The hospital contracted in May with a security company for four additional security guards stationed 24/7 with funding from the Legislature, she said. Higher-risk patient units each have one security guard posted 24/7, and the lower security units share a guard, she said.

She said the hospital is conducting a thorough evaluation of the escape to determine what corrective actions or measures are needed to prevent future events, which is done anytime an elopement occurs.

“Each time there is an elopment, it points to the need for less overcrowded patient conditions and facilities designed for higher security,” she said in a written release. The hospital is overcrowded with 205 patients, over the 202 licensed capacity, and also has 40 patients at Kahi Mohala.

The hospital was originally designed to house 178 severely mentally ill patients, not court-ordered patients, Okubo said.

The state will begin demolishing one of the hospital buildings in November to make way for a new $160 million facility, which will provide a more space.

In 2013, Pitts stole a dump truck with an attached trailer, led police on a chase up and down Kalakaua Avenue along Kapiolani Park, damaging police cars. He struck a coconut tree, jumped out of the truck and into the ocean.

Police arrested him 90 minutes or so later off Sans Souci Beach.

Pitts was charged with unauthorized control of a propelled vehicle, reckless endagering and three counts of criminal property damage.

In 2014, Pitts stood trial and a judge found him not guilty by reason of physical or mental disease, disorder or defect, and committed him to the State Hospital.

His attorney, Neal Kugiya, said Pitts was doing well, so he applied for and was given conditional release July 2015, and was living in a halfway house.

But while there, Pitts was “out and about” for roughly two to three weeks, he said.

On Jan. 19, the court issued a bench warrant for his arrest.

Kugiya said Pitts intended to turn himself in to police at the Waikiki substation, but got into an altercation, and was indicted April 19 with assaulting a police officer and harassment, Kugiya said.

A three-doctor panel found him Aug. 22 unfit to proceed to trial, and was sent back to the State Hospital.

He is scheduled Nov. 22 for a fitness review hearing.

Pitts is Caucasian, 6 feet tall, weighs 222 pounds, with brown hair, blue eyes, a mustache and full beard.

Anyone who sees him is urged to call CrimeStoppers at 955-8300 or *CRIME on a cell phone. Text CS808 and your message to 274637 or CRIMES.