A consultant psychiatrist warned that Valdo Calocane would "end up killing someone" after violent incidents three years before the Nottingham attacks, a public inquiry has heard.
Evidence presented to the inquiry on Wednesday included medical notes recording that Calocane showed no signs of remorse or insight in 2020, after a woman was so scared of him she jumped out of a first floor window.
The inquiry, being held in central London, was told the woman required surgery for a fractured vertebrae after an incident at student accommodation in the Radford area of Nottingham.
Calocane killed University of Nottingham students Barnaby Webber and Grace O'Malley-Kumar, both 19, and caretaker Ian Coates, 65, and attempted to kill three more people in the early hours of June 13 2023.
The inquiry has previously heard a warrant to arrest the violent schizophrenic was not executed by police for months before the attacks, in what was described as a "serious, systemic, operational failure".
In evidence to the inquiry on Wednesday, Claire Thompson, the former associate director of student wellbeing at the University of Nottingham, said Calocane studied there from September 2017 to July 2022.
The inquiry was told Calocane, who was 31 at the time of the attacks, was admitted to a mental health ward in 2020 due to a psychotic episode in May 2020.
Following a message to the university sent by Calocane's mother in June 2020, a university case summary email noted that he had been admitted under the Mental Health Act "following attempting entry to (a) neighbour's flat resulting in (an) unknown female exiting (a) first floor window in fear resulting in serious injury requiring surgery".
Mechanical engineering student Calocane had also committed criminal damage on the day of the incident, attributing his behaviour to workload and exams.
The inquiry was told he was discharged on June 17 2020 but readmitted to hospital on July 14 after another incident at his accommodation - with his medical notes on July 16 stating: "Valdo describes stopping medication two weeks after discharge from his last admission because he read that it could slow the mind."
"(There were) no signs of remorse or insight into how his actions have affected others. Dr Seedat (consultant psychiatrist Dr Faizal Seedat) observed that there seems to be no insight or remorse, and that the danger is that it will happen again, and perhaps Valdo will end up killing someone.
"Valdo simply responds by saying it will not happen again. Police are not intending to press charges."
Barrister Julian Blake, of the inquiry's team of counsel, said Calocane had to be held down by other residents during the further incident at the student accommodation on July 13 2020.
After Ms Thompson confirmed that information from the notes had not been communicated to the university, Mr Blake asked: “What do you think has gone wrong here?
“The consultant psychiatrist said he might end up killing somebody, and the university are not told that information. Prior to this inquiry, were you aware of that information?”
Ms Thompson answered: “I think I only became aware of it after the incident happened - after the (2023) attacks.
“We weren’t aware of it before then.”
The witness agreed with Mr Blake that information contained in the medical notes was “highly relevant to the university”.
She added: “I think it’s most important for the mental health team that are managing him because they are the people that are responsible for his care and treatment.
“What we would do in those situations, if that was shared with us, and we were able to work positively with the student, we would absolutely encourage them to take their medication and to engage fully with the services.
“And we always are very clear that people need to put their mental health and wellbeing first.
“I think what would have stood out to me had I seen this before, I would have been concerned very much about the lack of remorse.
“Often when your people are recovering (from psychosis) one of the things you have to work with someone about is how they feel because they will often feel very remorseful and bad about what’s happened.
A lack of remorse... is something that would have been useful for everybody to think about carefully.”