Omeed Aziz Popal, 31, of Fremont, is accused of targeting 16 pedestrians during a 15-minute span on various city streets and sidewalks of northern San Francisco on the afternoon of Aug. 29, 2006.
The victims' injuries ranged from minor scrapes to one woman who suffered major injuries and is now a quadriplegic.
Popal has already pleaded not guilty to 16 counts of attempted murder, 16 felony counts of assault with a deadly weapon, one felony count of battery on a peace officer and one felony count of reckless evasion from police, according to prosecutors.
Asked today in San Francisco Superior Court if he wished to enter a not guilty by reason of insanity plea to all the charges, Popal responded, "Yes, your honor."
Popal's attorney Sandy Feinland said outside the courtroom that Popal has a "substantial documented history of severe psychiatric disorders.
"He was insane at the time he is alleged to have committed the acts charged," Feinland said.
According to Feinland, Popal was involuntary hospitalized for his condition twice in the six-month period before the incidents, and since his arrest, has remained in the San Francisco County Jail's psychiatric ward.
About a week after being found competent to stand trial in November 2006, San Francisco sheriff's deputies thwarted a suicide attempt by Popal, who reportedly tried to hang himself in his jail cell with his jail-issued sweatshirt.
Assistant District Attorney James Thompson today said he expected the insanity plea, but called Feinland's claims "an overstatement."
Popal's insanity claim would come into play if he is found guilty of any of the charges during a trial estimated to begin in late summer.
A guilty conviction would then bring a second trial in which a jury would have to decide whether Popal was insane at the time.
Though Popal confessed to police about the crimes after his arrest, his attorney and family contend he has a history of mental illness, including schizophrenia, bipolar disorder and auditory command hallucinations.
The case is scheduled to return to court May 16 for a scheduling hearing and June 11 for the receipt of a court-ordered evaluation of Popal by a psychiatrist and a psychologist.
Popal is also awaiting trial in Alameda County on one count of murder for allegedly fatally striking 54-year-old Stephen Jay Wilson in a hit-and-run in Fremont about 45 minutes before the San Francisco attacks.
"We're hoping that if he's found not guilty by reason of insanity (in San Francisco) that the prosecutors in Alameda County would take that into strong consideration," Feinland said.