A 21-year-old man accused of fatally stabbing his grandparents at their Panaewa home Jan. 16 was arraigned Friday in Hilo Circuit Court.

Joshua Ho appeared before Judge Henry Nakamoto in a red-and-white striped prison uniform and handcuffs following his indictment Thursday by a Hilo grand jury on charges of first-degree murder and two counts of second-degree murder in the deaths of well-known community members Jeffrey and Carla Takamine, both 68, founders of the popular Big Island Delights cookie and confections company.

Ho was also charged with second-degree attempted murder for allegedly injuring his brother during a struggle.

The first-degree murder charge, applied in cases involving multiple deaths, carries a mandatory sentence of life imprisonment without the possibility of parole. Hawaii County prosecutors also indicated in the indictment that they plan to seek an extended term of imprisonment of life without parole for the two second- degree murder charges since the victims were seniors.

Deputy Public Defender Kenji Akamu entered not-guilty pleas to all charges on Ho’s behalf during Friday’s hearing. Nakamoto granted Akamu’s request to place Ho at the Hawaii State Hospital in Kaneohe on Oahu. The defendant is expected to undergo a mental health examination by a panel of experts.

The case was reassigned to Kona Circuit Court after Nakamoto and fellow Hilo Judge Peter Kubota recused themselves from presiding over the case for unstated reasons.

Ho’s arraignment will continue April 6. His bail remains at $2.75 million.

Hawaii island police responded to a call about a disturbance at a Makalika Street residence shortly before 7 a.m. Jan. 16. Cheryl Ho, the defendant’s mother and the Takamines’ daughter, told police he has schizophrenia and was having an episode and holding a knife, police said in court documents. When officers arrived, they saw Joshua Ho being restrained by his brother and father.

Police found the Takamines dead in their bedroom with multiple stab wounds. Items were also seen scattered in the room as if a struggle had occurred.

Court documents said a 17-year-old girl who was sleeping in the home woke up after she heard noises that sounded like things getting knocked over and thrown around. She then heard screams. Frightened, the teen ran toward the front door of the residence and saw Ho standing naked and holding a knife in a hallway that leads to Jeffrey and Carla Takamine’s bedroom.

Ho’s brother, Kaulana Ho, 28, also woke up when he heard a female screaming, and when he came out of his bedroom, he saw the defendant standing unclothed in the living room while holding a kitchen knife. Kaulana Ho said he also saw blood on his brother’s chest.

Police said the two struggled as Kaulana Ho managed to get the knife away from him and threw it out of the house. Police later recovered the weapon.

The 17-year-old girl ran to another residence on the property where she woke up Ho’s father, Guy Ho, and told him Joshua Ho was “running around with a knife,” court documents said. The elder Ho ran across the courtyard toward the main residence and saw his son through a window holding a butcher knife in the kitchen.

Police said Ho’s father confronted the defendant and told him to put down the knife, and he complied.

Kaulana Ho 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 in Hilo in 1996. Relatives and community members described the couple as humble, giving and supportive of their ohana and nonprofit organizations and other businesses.