Hospital probe of staff action before slaying

Less than two days before he called 911 to report that he’d killed his grandmother and cut off her head, Andrew Luke was at San Francisco General Hospital getting treated for a severe injury he gave to himself while in a delusional state, officials said.

Believing he was possessed by a demon, Luke had repeatedly slammed his head against a wall on Sept. 24, causing a gash that had to be stapled closed, prosecutors said. Despite his mental breakdown, Luke was sent home, where hours later, he allegedly killed 82-year-old ChiiChyu Horng.

On Monday, officials at San Francisco General Hospital said they are investigating whether staff followed proper protocol for people experiencing crises when they released Luke, 30, shortly after treating the wound.

The hospital would not comment on the case

due to patient privacy laws, and officials would not say whether Luke was given a psychiatric evaluation that day. But officials are “doing an investigation to make sure protocols were followed,” said Brent Andrew, a spokesman for San Francisco General.

Under the hospital’s protocol, if a patient in the emergency department meets the hospital’s criteria for a psychiatric hold – or if they are brought there on a hold — the attending physician is supposed to request a consultation from the hospital’s psychiatric emergency services department.

A physician from the psychiatric department then evaluates the patient and decides whether to hold or release the patient, according to the hospital’s policy.

Under California law people can be involuntarily hospitalized for mental health issues for up to 72 hours if they’re deemed dangerous to themselves or others.

Luke called police Wednesday shortly after midnight to report the killing inside the apartment that he shared with Horng at 801 Howard St., officials said. Officers rushed to the scene and broke down the door to find Luke covered in blood and Horng decapitated in the kitchen, prosecutors said.

Luke was taken back to San Francisco General Hospital on a psychiatric hold and later charged with murder and elder abuse after telling investigators he believed he and his grandmother were possessed by demons and that “Jesus told him to get rid of it,” prosecutors said.

Many of Luke’s relatives wanted to remain anonymous due to the violent details of the crime.

But a complicated picture of the suspect has emerged based on the family’s accounts and his social media pages — one that shows a San Francisco software engineer who went to a top university and volunteered for youth organizations, but struggled with mental illness.

Luke, who was raised by Horng after his mother died when he was a toddler, grew up in Lafayette. He attended UCLA from 2009 to 2012 and studied computer science, according to his LinkedIn page.

Luke went on to work as a software engineer in San Francisco and volunteered with several nonprofit youth organizations. But over the years, he struggled with mental illness and was institutionalized at least one time, his ex-stepmother, Eva Fok, said.

In the days leading up to the killing, Luke posted a flurry of religious-inspired messages and biblical passages on his Facebook page.

“If ultimately Jesus is the only thing that exists, how can hell exist also?” Luke wrote four days before the slaying. “They can’t both exist. Hell is not a thing if Jesus is the only thing. Maybe hell happened already on the cross. Hell ‘WAS AND IS NOT.’ ”

Amid the bizarre social media posts, Luke’s behavior also began to change. He had a fight with his father over his student loans the week before Horng died and was increasingly angry.

Fok told The Chronicle that he had suffered in the past from mental illness and was at times

“He stated that Jesus was testing him and that he was possessed by a demon and needed to get it out.” Court filing by San Francisco prosecutors

prone to violence. Things as benign as background noises or laughter could set him off, she said.

But he was always close to Horng, she said, whom “he really loved.” Luke told police that his grandmother was “the person he loves most,” prosecutors said.

No one in Luke’s family seems to know what happened in the moments leading up to Horng’s death.

On Sept. 24, Luke was in the throes of a delusional episode, prosecutors said. He believed that “God had been speaking to him and that he was possessed by a demon,” Assistant District Attorney Michael Swart wrote in a motion to detain Luke without bail.

Luke banged his head against a wall, trying to get the demon out and suffered injuries to the back of his head, prosecutors said. He was then taken to San Francisco General where doctors stapled his wound and released him.

Police and the district attorney’s office have not elaborated on the circumstances of how he got to the hospital and when he was released. Hospital officials said they will not comment on psychiatric patients.

When Luke returned home, his delusions continued. On Tuesday, “he stated that Jesus was testing him and that he was possessed by a demon and needed to get it out,” prosecutors said.

Luke then went into the bathroom and began banging his head and face on the floor, officials said. When Horng came into the room, Luke dragged her to the kitchen and stabbed her with two knives, Swart said.

He then beat her with a rolling pin and cut her head off with a knife, prosecutors said.

Luke called police a short time later, officials said. During a subsequent interview with investigators, Luke said “if Jesus told him to harm others in this fashion he would do it,” Swart wrote.

Luke is being held without bail. He remains at San Francisco General. He is due in court at 9 a.m. Tuesday.