BETHLEHEM, Pa. — A witness says a patient who returned to a Pennsylvania hospital and stabbed a nurse who had treated him weeks earlier went outside after the attack, walked in circles and howled at the moon.

Brigid McNamara testified Tuesday at a preliminary hearing for 19-year-old Joshua Santos, who is accused of stabbing Leo Bermudez in the neck with a 5-inch (13-centimeter) knife on June 30 at Lehigh Valley Health Network-Muhlenberg. Bermudez has since recovered.

Santos’ attorney says his client is mentally ill. He didn’t contest a judge’s decision Wednesday that Santos should stand trial on attempted homicide and other charges in the stabbing.

Santos had apparently been upset that Bermudez inserted a catheter while treating him four weeks earlier.

Defense attorney Gavin Holihan says, “This is really a mental health issue.”

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