Police and deputy sheriffs are looking for a Hawaii State Hospital patient with a violent history who escaped Sunday.

Police said Randall Saito, 59, left the Kaneohe hospital at about 9 a.m. and did not return.

He was acquitted by reason of insanity for the murder of a 29-year-old woman in July 1979.

In the unprovoked attack, Saito shot Sandra Yamashiro with a pellet rifle as she was returning to her car at the Ala Moana Center parking lot, then repeatedly stabbed her with a knife, court records said.

Diagnosed with sexual sadism and necrophilia, Saito has been committed to the State Hospital since 1981.

He is described as 6 feet tall with a heavy build, and he has black hair and eyes.

He is the second patient to be reported missing from the State Hospital this year.

Rhegan Kinoshita was reported missing the morning of Sept. 26. Police found him in Kaneohe that day. Court records said Kinoshita was acquitted of third-degree assault and committed to the State Hospital in June in lieu of prosecution.

In an emailed statement, state Health Director Dr. Virginia Pressler said, “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 of improvement.”

Saito is considered dangerous and should not be approached. Anyone with information about his whereabouts is urged to call 911, state sheriffs at 586-1352 or CrimeStoppers at 955-8300. Anonymous web tips can also be sent here.