(CNN) -- The fight started because of an alleged slight -- and ended with a crew member being accused of attempted murder.
Ketut Pujayasa, a 28-year-old room service attendant with Holland America's ms Nieuw Amsterdam, physically and sexually assaulted a female passenger while in international waters, according to a criminal complaint in which authorities say he confessed.
The 31-year-old woman, a U.S. citizen, was not identified in the complaint filed Monday in the U.S. District Court for the Southern District of Florida.
Pujayasa told authorities he delivered breakfast to the woman's room. He knocked three times before the passenger acknowledged him.
Outside the room, Pujayasa heard a female voice shout, "Wait a minute, son of a bitch!" according to the complaint. She later opened the door, and he left the food.
Pujayasa did not report the incident to a manager, but told authorities he found the woman's comment offensive. He returned to her room later. No one answered, and he left.
That same evening, he looked for the woman on a deck, "in order to punch her in the face for insulting him that morning," the complaint read. He left after realizing the location was too crowded.
That night, Pujayasa returned to the passenger's room and used his master key to enter.
He is accused of choking and punching the woman with whatever was available -- a laptop, a curling iron. She fought back with a cork screw.
At one point, the fight moved onto a balcony, where Pujayasa tried to push the woman overboard, the complaint read.
She eventually was able to break free and ran from her room. Another passenger rendered aid.
Due to the severity of her injuries, the woman was transported via air ambulance to a hospital in Florida after the ship docked the next morning. Her condition was not immediately clear.
According to the complaint, Pujayasa returned to his room after the attack and told his roommate to contact ship security because he had killed a passenger. He was placed under guard on the ship.
Pujayasa, a citizen of Indonesia, was hired in 2012 following a screening that included a clean criminal history check, the cruise line said in a statement. He had no performance issues and came with good references.
Attempts to contact his attorney Tuesday were unsuccessful.
"At Holland America Line, the safety of our guests is our highest priority, and we are shocked and deeply saddened by this incident," said Stein Kruse, president and CEO. "To our knowledge, no incident like this has occurred in our company's 140-year history."
CNN's Suzanne Presto contributed to this report.