A man on trial over a fatal knife rampage at a care home for people with mental disabilities near Tokyo in 2016 reappeared in court Friday, two days after he was removed from the courtroom for trying to bite off his finger.

Satoshi Uematsu, 29, who on Wednesday admitted to killing 19 residents and injuring dozens more at the facility, wore mittens on the second day of his trial at the Yokohama District Court.

The high-profile case involving an attack targeting socially vulnerable individuals, combined with discriminatory remarks Uematsu has made against people with mental disabilities, has shocked Japanese society.