HONOLULU (KHON2) — The suspect in the Hawaii State Hospital stabbing that left a nurse dead has been indicted by an Oahu Grand Jury on Wednesday. But could Tommy Carvalho end up back at the Hawaii State Hospital?

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Carvalho, 25, was indicted for second-degree murder after nurse, Justin Bautista, was fatally stabbed Monday at the hospital’s transitional housing.

The Attorney General’s office will be handling the case and said…

“My heart goes out to the loved ones of Justin Bautista, a public servant who was killed doing essential work for the people of Hawaii. I commend the Honolulu Police Department personnel for their diligence and professionalism in investigating this case. The Department of the Attorney General will hold those who attack public servants accountable.”

Attorney General Anne Lopez

But could Carvalho end up back where he allegedly committed the crime?

“There’s going to have to be another hearing in the murder second case, in that hearing the court will have to decide, is he fit to proceed,” explained legal expert Megan Kau. “In other words, does he understand his defense attorney’s role? Does he understand the prosecutor’s role? Does he understand the judge’s role?”

Three factors will determine if Carvalho is sent back to the Hawaii State Hospital instead of prison.

Legal experts said it includes involuntary commitment, when the court finds the defendant poses a threat to themselves or the community and has a mental health disorder or substance abuse; If he’s unfit to stand trial or if he’s acquitted of the crime due to insanity.

“If he’s found to have this mental disease, disorder or defect and couldn’t control his behavior or conform his behavior to the requirements of the law, he will be probably acquitted and committed back to the Hawaii State Hospital again,” said Randal Lee, retired judge.

This is not Carvalho’s first time showing violence against hospital staff. According to court documents, in August 2020, the 25-year-old was found fit and sentenced to six months in prison, with credit for time served, for assaulting a state hospital employee.

Carvalho eventually returned to the state hospital for conditions under a 2017 terroristic threatening case and was granted transitional housing privileges in August following a mental exam.

The Hawaii State Department of Health is also doing a clinical review of the mental fitness exam that granted Carvalho access to transitional housing. Legal experts said another look at that exam is needed.

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HDOH said all of Carvalho’s past incidents were taken into consideration before transitional housing was granted.

Carvalho is being held at OCCC and is expected in court on Monday.