Hawaii
Suspect in fatal Hawaii nurse stabbing pleaded guilty last year to assaulting mental health worker
A former Hawaii psychiatric hospital patient indicted Wednesday on a murder charge in the stabbing death of a nurse at the facility had pleaded guilty to a 2020 assault of a state mental health worker, court records show.
A grand jury indicted Tommy Kekoa Carvalho on a second-degree murder charge and a judge ordered him held without bail, the state attorney general’s office said.
Carvalho, 25, is accused of stabbing Justin Bautista, 29, a nurse working at a transitional group home at the Hawaii State Hospital in Kaneohe, a Honolulu suburb.
There were no details available on what prompted Monday’s incident and what was used in the stabbing. Hospital Administrator Dr. Kenneth Luke called it an “unanticipated and unprovoked incident.”
Carvalho pleaded guilty last year to assaulting an employee “at a state-operated or -contracted mental health facility” in May 2020.
According to the Hawaii Department of Health, Carvalho was discharged from the hospital in August and was participating in a community transition program.
That made him no longer a hospital patient, even though he was still on the campus, Luke said Tuesday.
Carvalho was allowed to leave the site briefly during the day, which he had done Monday before the stabbing, Luke said.
In response to questions about whether there were any concerns about Carvalho in light of the 2020 assault, the department said that information would have been considered when the decision was made to discharge him.
“It is public record that the patient pled guilty to assault in the third degree that was reported to have occurred on May 29, 2020, during a State Hospital admission,” department spokesperson Claudette Springer said in an email Wednesday.
She added that such information, along with the patient’s hospitalization record, are “carefully reviewed and considered” when making a clinical assessment over whether to discharge a patient.
The hospital primarily houses patients with significant mental health issues who have committed crimes and have subsequently been ordered there by the courts. Courts may also order people to stay at the facility while they wait to be evaluated for their mental fitness to stand trial.
Carvalho was committed to the state hospital after he was acquitted by reason of mental disease, disorder or defect in a 2016 terroristic threatening case on Kauai, where he’s from.
State Public Defender James Tabe said Wednesday that his office is expected to represent Carvalho at his initial appearance on the murder charge. Tabe declined to comment on the case. Carvalho is scheduled to be arraigned Monday.
Attorney Benjamin Ignacio represented Carvalho in the 2020 assault case. “Tommy was a mental health defendant and that always presents very difficult problems for both prosecuting and defending … so it’s very unfortunate,” he said Wednesday. “Mental health is a very difficult kind of legal problem.”
The facility has been under scrutiny in the past, including in 2017 when Randall Saito, who spent decades in the hospital for killing a woman, walked off the campus, called a taxi, and boarded a chartered flight to Maui. He then took a commercial flight to California and was arrested in Stockton three days after his escape.
A 2021 lawsuit in federal court says a case of mistaken identity led to a man being locked up in the hospital for more than two years.
Luke said the stabbing has prompted a safety review.

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Is This What Passes for a Hawaii Flight Now?

Has something shifted on flights to Hawaii—and not in a good way? We just flew five and a half hours across the Pacific, and we got one poured beverage, no refills, and no meal purchase option.
We were in economy—if you think that was bad, wait to hear what happened in first class.
There are no trays, promised improved snacks, or new drink options—just the bare minimum on a route United once treated like something special—a route BOH editors have been flying for over 30 years.
One beverage, poured only, and a 3/4 ounce snack.
Service began early and ended fast. Economy passengers received a single poured beverage in a plastic cup. Flight attendants made clear there would be no second beverage service and no full cans offered. If you wanted more, water would be available—and it was offered once. It didn’t even feel like a Hawaii flight. It felt like an afterthought.
Pretzels, quinoa crisp, or stroopwafel followed. With little for the flight attendants to do, they became obsessed with the State of Hawaii Agriculture forms. They tried to collect ours early in the flight, and when it wasn’t ready, we were told we might be arrested if it wasn’t completed before landing. This was a first.
We’ve come to expect minimal service in economy, which is fine. However, this United Airlines flight from San Francisco to Kauai was different. After all, it was marketed and priced as a premium leisure route. Five plus hours in the air with one tiny drink and a small snack only questionably meets reasonable standards.
This might be why the pilot came out to extensively greet everyone before departure, trying to put everyone in a good mood before the flight, and the issues not of their making were revealed.
First class, minus the class.
Up front, things weren’t much better. Maybe they were worse. We were seated in the first row behind first class, where it was very clear: no meals were offered, and no alcohol was served. Instead, passengers received an apologetic explanation, one poured beverage, and a mileage credit as compensation.
It was a striking downgrade for a premium cabin on a long-haul Hawaii flight. There was no sense that this was a one-time issue; It felt routine. And if this is what first class looks like during peak summer travel, it raises the question: What exactly are travelers paying for?
The real issue: a meltdown at SFO.
The flight attendants didn’t sugarcoat it—and neither will we. United’s catering operation out of San Francisco is still a mess. Things haven’t stabilized after switching from Gate Gourmet to LSG Sky Chefs, which leaves flights in disarray. Many flights are going with minimal or missing onboard service, with service items sometimes stuffed into trash bags and boarded, and nobody at United seems surprised anymore.
Before departure, United sent a text admitting the problem: “Due to a catering transition, some of our outbound flights from San Francisco may not have our typical onboard selection.” Translation: Don’t expect much at all. According to the crew, the situation won’t improve until sometime after July.
What triggered this? United replaced longtime SFO caterer, Gate Gourmet, with LSG Sky Chefs. That shift came with a fallout: hundreds of Gate Gourmet employees were reportedly laid off, and LSG rehired many of the same people under different terms. It’s unclear what that means for quality, continuity, or morale, but passengers pay the price for how United handled the transition.
What triggered problems at United?
How could a company the size of United allow this to unfold, at its largest hub west of Denver and on key longer-haul domestic routes to Hawaii, among others? It’s a mystery even the crew couldn’t explain. We were told that some crew members have refused to work routes from San Francisco until this is resolved, and given the circumstances, we can see why.
It is abundantly clear that the transition was poorly timed and badly communicated, and paying passengers have been feeling it for a long time.
Travelers across routes have reported dry flights with no food, downgraded premium meals, and mystery substitutions. On this Hawaii flight, there was technically food. But that’s about as generous as we can be.
Navigating SFO was its own ordeal.
San Francisco International is also in the middle of a major construction project. Rob received a text from United warning: “San Francisco Airport (SFO) is currently undergoing renovations, which may require additional time to reach your gate.”
It meant the usual main entrance was closed, forcing a circuitous detour up and down and through the garage parking lot after getting off the AirTrain. Signage was limited, help was hard to find, and the layout felt more improvised than planned. Staff did their best, but the entire setup frustrated many travelers before the flight began.
This isn’t about any perks. It’s about the basics.
Most travelers flying to Hawaii from the mainland know they’re no longer getting free checked bags or a hot meal. But what’s happening now on United SFO routes is different. When five-plus-hour flights can’t offer passengers two beverages, that’s not even economy service. That’s a failure of planning.
Some others on social media said that United had warned them there would be no catering and that they should bring their food before boarding. Some reported a $15 credit from United, which at SFO wouldn’t go far for any meal.
It’s not the crew’s fault. They were efficient and apologetic. But they’re working within severe operational limits given to them. One good thing is that United flight attendants recently secured a tentative contract that includes raises of up to 45% over five years. It doesn’t fix the catering mess, but at least their patience in the cabin might finally pay off.
We’ll be watching this all summer.
Bring your food if you’re flying from San Francisco to Hawaii this season. That includes water. Don’t count on anything onboard. And don’t assume your United Hawaii flight will feel like anything special.
The only thing that stood out on this flight was high-quality Wi-Fi across the Pacific for $8, which we shared between the two of us with a Mobile Hotspot. The Viasat Wi-Fi on the route previously didn’t work most of the time. This article was written at 30k feet.
Have you flown on any routes from United San Francisco to Hawaii recently? Was your experience the same, or better? Let us know what you saw, and we’ll keep tracking what’s going on aboard Hawaii flights from the mainland.
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