A Hawaii man has been in a coma for about three weeks after being attacked by a cellmate at a special facility in South Carolina where the Hawaii State Hospital sent him for treatment.

Curtis Panoke, 52, is one of four State Hospital patients placed at Correct Care Recovery Solutions, Columbia Regional Care Center, a privately run mental health facility that is in a prison setting.

At about 3 a.m. June 9, Panoke was sleeping in his cell at the facility when his cellmate assaulted him with his knees, said his attorney and his sister-in-law.

Guards responded to the sounds of a commotion and had to pull Panoke’s attacker off of him, leaving him bleeding and unconscious, said Jenny Panoke, his sister-in-law. Panoke sustained a broken neck and bleeding on his brain, and was later transferred to a long-term acute care facility, InterMedical Hospital of South Carolina.

Jack Schweigert, his attorney, said he remained at the hospital last week, in a coma and connected to a ventilator.

Jenny Panoke, of Waipio Gentry, said she had concerns about whether the South Carolina facility could have done more to protect Panoke, because he had requested to be separated from his cellmate before the attack. She said Panoke previously had an argument with the cellmate and feared for his safety.

“Something failed and went wrong for him to be attacked,” she said. She said she is speaking with an attorney in South Carolina to investigate.

She also expressed concern about the delay in being notified about the attack. She said the facility never called the family and that William Sheehan, medical director of the State Hospital in Kaneohe, called her husband to tell him about the incident on June 16, a week after it happened. Then the family couldn’t get updates on Panoke’s condition for four days because they weren’t on an approved list with the hospital, she said.

State Department of Health spokeswoman Janice Okubo said in a statement that federal and state laws prohibit the department from releasing information about individual hospital patients, but said that “violence resulting in any serious injury in a facility is heartbreaking, and our thoughts and prayers would be with the victim and family.”

She said that in an incident resulting in injury or death, the state would follow the patient’s wishes, the legal representative’s instructions or court-ordered directives. The State Hospital also conducts detailed investigations and evaluations for all such events involving its patients both in Hawaii and on the mainland.

Panoke was sent to the South Carolina facility about six years ago after he assaulted a nurse at the State Hospital.

A state judge granted permission for the state to send him to the out-of-state facility in 2010, court documents show.

Panoke had been committed to the State Hospital in 2005 after being acquitted in an assault case by reason of insanity.

Schweigert, Panoke’s attorney, said the state wanted to send Panoke to the facility because he was too dangerous. He said Panoke initially supported the idea of being sent out of state because he hoped to get better treatment at the South Carolina facility and wanted to get better.

He said Panoke was showing signs of improvement and was coming up for a review by doctors to see whether he could be released to a halfway house in Hawaii.

Jenny Panoke said her brother-in-law was looking forward to returning to Hawaii, and already making plans about where he could stay. She said he had been trying to return to Hawaii for years, and she questioned why he was sent in the first place.

Okubo said patients are sent to mainland facilities in rare situations where staff, an outside expert and administration find no other acceptable alternative for patients.

She said the hospital works with the patient’s legal representative and the courts for placement out of state.

Okubo said the state currently has four State Hospital patients placed at the South Carolina facility.

The State Hospital also continues to struggle with overcrowding, Okubo said, and currently has 209 patients despite being built for 178. Another 46 overflow beds are filled at Kahi Mohala.

Housing patients out of state also saves money, costing $415 a day compared with $750 at the State Hospital, the Department of Health said.

Okubo said the department has plans to begin construction for a $160 million facility for high-risk patients in 2018.

Schweigert said he was concerned about whether Panoke will survive. He said Panoke sustained head injuries as a child when he was hit by a truck, which might explain why he has spent most of his life in prison.

“He’s got a funny side, a compassionate side,” he said. Jenny Panoke said he has a 13-year-old daughter with his girlfriend, who lives in Europe.

Schweigert said that when he spoke with the facility in South Carolina, officials were forthcoming with information about how badly Panoke was injured, and said that he might die. He said the alleged attacker was arrested for the assault.

The facility, through a spokesman, declined comment because of privacy laws and because the incident was under review.