A convicted killer dubbed the Black Dog Strangler has escaped from a secure hospital, police have said.
Phillip Westwater, 44, fled St Nicholas Hospital in Gosforth, Newcastle, at 10am on Wednesday after asking to go to the toilet.
He was detained indefinitely under the Mental Health Act following a pub fight in 1989, then strangled fellow patient Derek Williams at Ashworth Hospital, Liverpool, with his dressing gown cord.
He admitted manslaughter on the grounds of diminished responsibility, having become convinced his victim had turned into a black dog.
Northumbria Police said the public should not approach Westwater.
A spokesman for the force said: "Officers are making inquiries into this individual and any risks he may or may not pose.
"In the meantime people are asked to contact police on the 999 emergency number if they see him and not to approach him."
The police spokesman added: "At 10am on January 2, Mr Westwater was being escorted in the hospital when he asked to go to the toilets, from where he escaped."
Westwater is described as white, 6ft and of slim build, with brown/grey hair.
He left his clothes in the toilet so police have no description of what he is wearing.