A Hilo grand jury returned an indictment against a 21-year-old man, charging him in connection with the stabbing deaths of his grandparents in Panaewa.

Joshua Ho appeared in a striped prison uniform with his hands cuffed at his arraignment today before Judge Henry Nakamoto at Hilo Circuit Court on charges of first-degree murder and two counts of second-degree murder in the deaths of Jeffrey and Carla Takamine, both 68.

Ho was also charged with second-degree attempted murder.

He pleaded not guilty to all of the charges.

Nakamoto continued the arraignment to April 6 at Kona Circuit Court and granted a request by Deputy Public Defender Kenji Akamu to place Ho at the Hawaii State Hospital in Kaneohe, Oahu.

His bail remains at $2.75 million.

Hawaii island police responded to a call of a disturbance at a Makalika Street home shortly before 7 a.m. on Jan. 16.

Police in court documents said Ho’s mother told police Ho has schizophrenia and was having an episode and holding a knife.

When officers arrived, they saw Ho being restrained by his brother and father.

Police found the Takamines in their bedroom, dead with multiple stab wounds.

Court documents said Ho’s brother woke up that morning when he heard a female screaming. He then observed Ho standing unclothed in the living room while holding a kitchen knife. The brother also saw blood on Ho’s chest.

Police said a struggle ensued after Ho’s brother tried to get the knife away from him.. The brother managed to get the knife and threw it out of the house. Police later recovered it.

The brother sustained multiple lacerations to his head and was taken to Hilo Medical Center where he received 19 stitches.

Jeffrey and Carla Takamine opened Big Island Delights, a popular cookie and confections company in Hilo in 1996.