'You make me sick': paramedic's family slams killer

On Thursday, after finding Fineanganofo not criminally responsible due to mental impairment, a court ordered he be held in custody under the supervision of a medical tribunal which will determine at what point he is to be released.

Prior to the ruling, Mr Tougher's mother Jillian unloaded on her son's killer in court, saying in her eyes he will always be a murderer and that he should "rot in hell".

"You did this to my boy and that's a fact," she said.

"All because you didn't take your medication, that's where the responsibility lies."

Ms Tougher said she is haunted by the horror of her son's terrifying final moments, during which he begged Fineanganofo to stop the attack, which lasted almost four minutes.

"His last memory is of a vicious, violent person stabbing him, who just would not stop," Ms Tougher said.

"You make me sick.

"You killed a big part of me when you killed my beautiful son Steven.

"You don't even have the guts to look at me. You don't have a knife now. I hope you rot in hell."

Steven Tougher's second child was born just weeks after his death in April 2023. (HANDOUT/NSW POLICE)

Fineanganofo barely lifted his head as he sat in court listening to around a dozen statements from family members, paramedics and others impacted by the tragedy.

At the time of the attack, Mr Tougher's wife Madison was pregnant with the couple's second child, who was born just weeks after his death.

"You murdered my husband for no reason. You did this," the widow said.

"Our beautiful daughter will never get to meet her Dad."

The court was told Fineanganofo will not be released until the Mental Health Review Tribunal is satisfied he does not pose any serious risk to himself or the community.

Regardless, Mr Tougher's father Jeff told the court he was not convinced it was the right decision.

"This decision does nothing to make society safer," Mr Tougher said.

Sister Jessica Tougher said while she understood mental illness and the effect it could have on people, she hoped her brother's killer was held in a forensic hospital for as long as possible.

"He was brutally violent that morning," she said.

"The risk posed to the community by this offender is so severe.

"I believe that if given the opportunity to be free, he could kill again."

During incidents before killing Steven Tougher, Fineanganofo confronted a man while holding a knife. (HANDOUT/NSW SUPREME COURT)

Justice David Davies expressed his condolences to the family and said he understood there were some misgivings with the outcome.

"That is the way that the court and we as a society have to deal with a tragedy such that has occurred here when mentally ill people commit these crimes," he said.

Prosecutors agreed to the special verdict being appropriate for Fineanganofo after two psychiatrists diagnosed him with schizophrenia.

Forensic psychiatrist Kerri Eagle, reported Fineanganofo had largely stopped eating and sleeping in the days leading up to the attack, and claimed to hear voices which he believed to be demons.

NSW Ambulance Commissioner Dominic Morgan delivered a statement on behalf of his organisation, which he said had been rocked to its core.

"This trauma actually happened to one of us and could happen again to any one of us," he said.

"I do not know how we can protect ourselves from that."

Fineanganofo was also cleared of acts comprising a mini-rampage leading up to the stabbing, including menacing a woman with a five-month-old baby at a Bunnings.

Prior to stabbing Mr Tougher, Fineanganofo also had several chilling encounters with other strangers, including confronting a man outside a 7-Eleven service station while holding a knife.

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