Honolulu - A man acquitted of a 1979 murder by reason of insanity escaped from a Hawaii psychiatric hospital over the weekend, took a taxi to a chartered plane in Honolulu bound for the island of Maui and then boarded another plane to San Jose, California, police said.Randall Saito, believed to be in Northern California, is considered extremely dangerous and should not be approached, Honolulu police said late on Tuesday.Saito left the state hospital outside Honolulu on Sunday at 10:00 and didn't return, police said. Hospital staff called 911 to report his disappearance shortly after 19:30 – two hours after he landed in San Jose, police said. An all-points bulletin was issued at 20:30.'A very dangerous individual'The FBI and US Marshalls Service have reviewed security footage from San Jose International Airport in connection with the manhunt, said Jon Vaden, a spokesperson for the airport.He said police have not advised him of any threats at the facility.Saito was committed to the hospital outside Honolulu in 1981, two years after he was acquitted in the killing of Sandra Yamashiro.The victim was shot and repeatedly stabbed before her body was found in her car at a mall."He is a very dangerous individual," said Wayne Tashima, a Honolulu prosecutor who argued in 2015 against Saito receiving passes to leave the hospital grounds without an escort.Tashima warned people not to approach Saito, saying there's a concern he could commit the same "very heinous and violent offence" again. Authorities asked anyone with information to call police.It was not immediately clear under what circumstances Saito left the facility in Kaneohe, a Honolulu suburb.Hawaii State Hospital Administrator William May said officials are fully cooperating with law enforcement and appropriate steps would be taken if Saito had help from someone inside the facility.Defence attorneys sought to have Saito released in 2000. But Jeff Albert, a deputy city prosecutor, objected, saying Saito "fills all the criteria of a classic serial killer."In 1993, a court denied Saito's request for conditional release, saying he continued to suffer from sexual sadism and necrophilia.The state Department of Health operates the hospital, which houses over 300 patients in Kaneohe. The department said it's investigating the escape.Public safety is a concern"There is a serious lack of information for the public," said Nicholas Iwamoto, who was stabbed 18 times on a popular Hawaii hiking trail in 2009. His attacker was found legally insane and sent to Hawaii State Hospital. He was later granted conditional release to attend community college, a decision Iwamoto wasn't notified about."Public safety has certainly been compromised," Iwamoto said. "It's extremely alarming. But nothing from the state surprises me anymore."Irving Tam, who has lived near the hospital in Kaneohe for about 30 years and was walking by the facility on Tuesday, said he worries about hospital patients getting out in his neighbourhood."When they do escape, especially someone with this kind of a record, there is a high degree of concern, he could be violent and who knows," Tam said. "That's why I have a gun, for this very reason. Hopefully I never use it."Tam said he heard about the escape from a neighbour, not the police, hospital or the media, and that patients have gotten out several times in the past."This is not totally uncommon, we have had similar incidents in the past, and fortunately nothing has ever happened," Tam said.Tam thought that someone with a violent past like Saito should closely monitored. "It is disturbing that he was given that much freedom," he said. "You would think he would be under heavier security."Similar incidentsSaito was the impetus for a rule change in 2003, when the state attorney general's office decided mental patients committed to Hawaii State Hospital have no legal right to conjugal visits.The issue came to light when the hospital administrator learned Saito had been escorted home for weekend conjugal visits over two years. The administrator blocked the visits away from the facility and on its grounds.Dangerous psychiatric patients have escaped recently from other facilities in the United States.In Washington state in 2016 a man accused of torturing a woman to death broke out of the state's largest mental hospital. Anthony Garver crawled out of a window of his ground-floor room at Western State Hospital, rode a bus about 480km to Spokane and was captured days later without incident.After the escape Washington Gov. Jay Inslee fired the hospital's CEO and brought in the Corrections Department to inspect the building for security improvements.A review of police reports by The Associated Press found 185 instances in the 3 and a half years before Garver's escape in which Western State patients escaped or walked away.